They’ve been touted as the next wave in operational efficiency in health facilities and a major advance in increasing patient satisfaction by reducing waiting times at check-ins, sort of like automated baggage checkers at airports.
Proponents argue that interactive self-registration kiosks that are now surfacing at health facilities across Canada offer greater convenience and privacy to clients, while liberating staff to do more meaningful work. The bean counters, meanwhile, salivate over the prospect of reduced staff salaries that might accrue from having computers, rather than real people, collect basic triage information and direct patients down the correct corridor.
From a physician’s perspective, patient kiosks also have the benefit of protecting health care providers from costly privacy complaints, says the doctor who developed the first interactive computer station for self-registration to be used in Canada. Many physicians are unaware that the Canadian Medical Protective Association doesn’t provide protection from privacy complaints, says Dr. Thom Tyson, founder and CEO of the Appletree Medical Group based in Ottawa, Ontario, which operates 28 multidisciplinary medical clinics in Ontario.
“Kiosks allow you to provide the patient the option to register silently, privately, and on their terms. They don’t have to give their email, and no one is making choices for them,” Tyson says.
Typically, while self-registering, patients are asked to swipe their health card, confirm their appointment and personal information, such as demographics, telephone numbers, address and family contact, before being directed by the kiosk to the appropriate office in the clinic.
It frees up staff to do more “higher-value activities,” Tyson says. “It helps with those activities that aren’t the staff’s core administrative duties, allowing them to take better care of the patient. In that way, the kiosk benefits the staff as well as the patient and the doctor.”
Kiosks seem very efficient, notes Ashwin Kutty, manager of electronic health programs at the Capital District Health Authority in Halifax, Nova Scotia, which recently introduced self-registration systems in 13 clinics. “Doctors are very impressed with the service. They find that patients are reporting to them their satisfaction with how quick the process has been and how quickly they are receiving care from the physicians themselves.”
Over 90% of patients report that they prefer kiosks to traditional registration procedures because of reduced wait times, Kutty notes. “We have seen traditional wait times of an hour in some of our clinics, which has changed to being able to see the care provider almost immediately, or at a maximum of 5 to 10 minutes.”
No job losses have resulted as registration workers have been reassigned to different positions, Kutty stresses. “The registration people are satisfied because they find that the stress and aggravation that patients traditionally have with the wait has decreased.”
The introduction of kiosks can result in the need for training of staff to “do work of greater value,” Tyson says. “In that way, the kiosks benefit the staff as well as the patient and the doctor. If you don’t make that plan, the kiosks disintermediate the staff. Improvement in one area of work flow doesn’t benefit everybody equally.”
In the United States, though, kiosks are touted as a cost saver to facilities. Although they are intended to “supplement” rather than replace staff, facilities have found they resulted in reduced costs, notes a report, Touchscreen Check-In: Kiosks Speed Hospital Registration, prepared for the California Healthcare Foundation. In one case study, at a facility in Texas, “a basic cost-benefit analysis estimated that the average cost of a check-in with a kiosk is estimated between [US]$0.74 and [US]$1.12, compared to [US]$8.12 per check-in through an office clerk,” states the study (www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/T/PDF%20TouchscreenCheckInKiosks.pdf).
Capital Health budgeted $95 000 to implement the kiosks through a provider, McKesson Canada, but actual costs ended up being less, Kutty says.
But before kiosks are widely adopted in hospitals across Canada, there will have to be clear evidence that they are cost-efficient and result in improved health care, says Pamela Fralick, president and CEO of the Canadian Healthcare Association. “Assuming we get positive answers to that, I would hope that other hospitals pick this up. And from what I’ve been told, people do love it, and they even have staff on hand to help people who aren’t as comfortable with technology.”
Tyson predicts that day isn’t far off and notes that 1.4 million Ontarians have already used a kiosk. The next-generation of kiosks, he adds, will likely involve robotics. “Most people think of the technology as something simple, but the way we use the kiosk now is so dynamic. We’re just beginning to scratch the surface of what we can do.”