Self-Check-In Kiosks Utilization and Their Association With Wait Times in Emergency Departments in the United States

Mahmood, Asos; Wyant, David K.; Kedia, Satish; Ahn, SangNam; Powell, M. Paige; Yu, Jun; Bhuyan, Soumitra S.

doi:10.1016/j.jemermed.2019.11.019

Cited by 14 publications

(29 citation statements)

References 41 publications

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“…Kiosks aided in the provision of acute care in the ED by performing patient triage, reliably collecting patient data, and significantly improving the time to identify new arrivals [ 72 , 73 ]. Other uses in the acute care pathway in the ED included patient registration [ 74 ] and medication adherence [ 75 ].…”

Section: Resultsmentioning

confidence: 99%

“…We found only a few studies in our literature search that evaluated patient self–check-in kiosks. These studies showed statistically significant reductions in waiting times for patients who checked in using the kiosks compared with those who did not [ 65 , 74 ]. What was surprising was the small number of studies in the published academic literature, given the growing adoption of patient self–check-in screens over the past 10 years.…”

Section: Resultsmentioning

confidence: 99%

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The Role of Health Kiosks: Scoping Review

Maramba¹,

Jones²,

Austin³

et al. 2022

JMIR Med Inform

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Background Health kiosks are publicly accessible computing devices that provide access to services, including health information provision, clinical measurement collection, patient self–check-in, telemonitoring, and teleconsultation. Although the increase in internet access and ownership of smart personal devices could make kiosks redundant, recent reports have predicted that the market will continue to grow. Objective We seek to clarify the current and future roles of health kiosks by investigating the settings, roles, and clinical domains in which kiosks are used; whether usability evaluations of health kiosks are being reported, and if so, what methods are being used; and what the barriers and facilitators are for the deployment of kiosks. Methods We conducted a scoping review using a bibliographic search of Google Scholar, PubMed, and Web of Science databases for studies and other publications between January 2009 and June 2020. Eligible papers described the implementation as primary studies, systematic reviews, or news and feature articles. Additional reports were obtained by manual searching and querying the key informants. For each article, we abstracted settings, purposes, health domains, whether the kiosk was opportunistic or integrated with a clinical pathway, and whether the kiosk included usability testing. We then summarized the data in frequency tables. Results A total of 141 articles were included, of which 134 (95%) were primary studies, and 7 (5%) were reviews. Approximately 47% (63/134) of the primary studies described kiosks in secondary care settings. Other settings included community (32/134, 23.9%), primary care (24/134, 17.9%), and pharmacies (8/134, 6%). The most common roles of the health kiosks were providing health information (47/134, 35.1%), taking clinical measurements (28/134, 20.9%), screening (17/134, 12.7%), telehealth (11/134, 8.2%), and patient registration (8/134, 6.0%). The 5 most frequent health domains were multiple conditions (33/134, 24.6%), HIV (10/134, 7.5%), hypertension (10/134, 7.5%), pediatric injuries (7/134, 5.2%), health and well-being (6/134, 4.5%), and drug monitoring (6/134, 4.5%). Kiosks were integrated into the clinical pathway in 70.1% (94/134) of studies, opportunistic kiosks accounted for 23.9% (32/134) of studies, and in 6% (8/134) of studies, kiosks were used in both. Usability evaluations of kiosks were reported in 20.1% (27/134) of papers. Barriers (e.g., use of expensive proprietary software) and enablers (e.g., handling of on-demand consultations) of deploying health kiosks were identified. Conclusions Health kiosks still play a vital role in the health care system, including collecting clinical measurements and providing access to web-based health services and information to those with little or no digital literacy skills and others without personal internet access. We identified research gaps, such as training needs for teleconsultations and scant reporting on usability evaluation methods.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The Role of Health Kiosks: Scoping Review

Maramba¹,

Jones²,

Austin³

et al. 2022

JMIR Med Inform

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show abstract

“…Previous studies are limited to self-check-in kiosks in the USA which are designed primarily to collect basic demographic and clinical information for registration. An estimated 9% of US EDs use self-check-in kiosks and waiting times in departments with kiosks were 56.8% shorter when compared with those without [15].…”

Section: Discussionmentioning

confidence: 99%

“…All triage scales currently in use have a tendency to undertriage, with a substantial proportion of ED patients who die or are critically ill not designated high acuity at triage [13]. There is evidence that self-triage potentially could result in decreased waiting times and reduced amount of face-to-face contact [14,15]. There has been successful use of self-triaging in other departments within hospitals including ophthalmic EDs [16][17][18] and sexual health clinics [19].…”

Section: Introductionmentioning

confidence: 99%

Agreement and validity of electronic patient self-triage (eTriage) with nurse triage in two UK emergency departments: a retrospective study

Dickson

Dewar

Richardson

et al. 2021

European Journal of Emergency Medicine

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Background Triage and redirection of patients to alternative care providers is one tool used to overcome the growing issue of crowding in emergency departments (EDs). Electronic patient self-triage (eTriage) may reduce waiting times and required face-to-face contact. There are limited studies into its efficacy, accuracy and validity in an ED setting.Objectives The aim of this study was to assess the agreement and validity of eTriage with a reference standard of nurse face-to-face triage. A secondary aim was to assess the ability of both systems to predict high and low acuity outcomes.Design This was a retrospective study conducted over 8 months in two UK hospitals. Inclusion criteria were all ambulatory patients aged ≥18. All patients completed an eTriage and nurse-led triage using the Manchester Triage System (MTS). Main ResultsDuring the study period, 43 788 adult patients attended one of the two ED sites and 26 757 used eTriage. A total of 1424 patient episodes had no recorded MTS and were excluded from the study leaving 25 333 paired triages for the final cohort. Agreement between eTriage and nurse triage was low with a weighted Kappa coefficient of 0.14 (95% CI, 0.14-0.15) with an associated weak positive correlation (r s 0.321). Level of undertriage by eTriage compared with nurse triage was 10.1%, and overtriage was 59.2%. The sensitivity for prediction of high acuity outcomes was 88.5% (95% CI, 77.9-95.3%) for eTriage and 53.8% (95% CI 41.1-66.0%) for nurse MTS. The specificity for predicting low risk patients was 88.5% (95% CI, 87.4-89.5%) for eTriage and 80.6% (95% CI, 79.3-81.8%) for nurse MTS. ConclusionAgreement and correlation of eTriage with the reference standard of nurse MTS was low; patients using eTriage tended to over triage when compared to the triage nurse. eTriage had a higher sensitivity for high acuity presentations and demonstrated similar specificity for low acuity presentations when compared to triage nurse MTS. Further work is necessary to validate eTriage as a potential tool for safe redirection of ED attenders to alternative care providers.

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“…14 Automated tools have also been shown to reduce the waiting time before seeing a healthcare professional in the emergency department. 15 A group in Sweden is currently investigating the use of a self-reported history taking for patients with acute chest pain collecting data to assess chest pain according to the HEART score. 16 Self-reported history taking tools could aid a shift in the relationships between healthcare professionals and patients and an increase in the time for direct patient contact, thoughtful communication and subsequently improved patient care.…”

Section: An Audible and Readable Patient Voicementioning

confidence: 99%