January 13, 2011

Self-service Kiosks Fail Me

Blog entry on drawbacks in medical patient check-in. Off Medical Informatics.

Self-service Kiosks Fail Me | Blog | Healthcare Informatics

Self-service Kiosks Fail Me
Posted on: 1.4.2011 2:23:52 PM Posted by Charlene Marietti

I'm all for self-service, especially when it adds efficiency. That's one reason I've always thought self-check-ins at doctors' offices and clinics would be a great time saver.

I'm sick up to my eyeballs of writing in basic information for the umpteenth time. If I have to do it (and I question whether all of it is really necessary), let me enter it on a keyboard, which should be faster than the ubiquitous brown clipboard with pen.

Now I'm a kiosk fan. Kiosks at train stations, airports, and banks are speedy and efficient. I use them. But self-service kiosks in healthcare settings are another story. Every one I've experienced so far has left me less than impressed.

I go to a pharmacy-based clinic for my annual flu shot. Check-in via kiosk there is downright painful on a hunt-and-peck touch screen at a height that has been optimized for a midget. (I'm short, but not short enough.)

Another recent check-in experience had a family member type in his name. The system was finicky--no caps, please; watch the spacing--so finicky that after two failed attempts, the desk person finally did data entry. Needless to say, I was mightily unimpressed with the technology improvement.

Neither system accepted anything more than name and demographic information to ensure that I was who I said I was. No request for my insurance information or scanner for my insurance card. No way to pay my co-pay.

The concept of self-service for check-ins clearly offers promise, but if execution is no better than my recent experiences, we're still in a technology zone stuck on potential.

Monday, January 10, 2011 12:49:25 PM by Fraumann

Hi Charlene,

When considering "kiosks", hospitals have to concern themselves with a number of issues, including:

1. ROI (Return on investment) - the kiosk is only the tip of the iceberg in terms of installation, maintenance, updates, etc.
2. Fomite surfaces and disease transfer - a major issue and frequently a show stopper
3. Security of patient information and unit - more headaches for IT, to physical theft of anything not bolted down
4. Privacy of patient information - "shoulder surfing", etc.
5. Resiliency of unit in a variety of potential scenarios - spilled liquids, vomit, mass casualty/disaster, physical abuse, etc.
6. Scalability and maintenance - and is it just another thing to break??
7. Language, Handicap, equal access, etc. - which becomes much more complex in a hospital setting
7. Alternatives (apps, etc.) - potentially technology is improving to the point to overcome many of the shortcomings - including things like gaze directed cursor control, focused privacy displays, and at least addressing services for "registered" customers to start with (which reduces the need for re-entry of personal information)

Unfortunately, much of the "Kiosk" industry has remained fixated on unreliable operating systems/programming, and vendors have often confused (interactive) digital signage, web kiosk, application front-ends, etc.

The good news is, we are seeing iPad/iTouch/Android and similar devices being used to overcome many of the issues the "Kiosk" industry continues to grapple with, but a myriad of other challenges remain. But, it is likely that the whole trend of "Apps" on intelligent personal devices may usher in a whole new future in health care.

Hopefully for all of us, successful business&technology blended solutions are just around the corner.

Tuesday, January 11, 2011 12:49:27 PM by Charlene

You bring up some excellent points. Thank you for sharing your wealth of expertise and experience.

The use of personal devices, such as iPads and smartphones, to streamline data input processes makes sense. Now we just need the apps to make it happen.

Thursday, January 13, 2011 12:39:25 PM by Craig Keefner

Unfortunately there are inconsistencies with self-service kiosks, how they are engineered and what interface is used. There are many that adher to the ADA guidelines and the touch interface is very graphical and easy. Devices such as card readers, medical scan scanners with OCR, pin pads, privacy screens, signature pads and more are becoming more available. Guidelines such as PCI, ADA, and HIPAA all come into play and are designed for in the better stations.

Self-service Kiosks Fail Me | Blog | Healthcare Informatics

Posted by staff at January 13, 2011 12:26 PM