Kiosks as tools for health information sharing: exploratory analysis of a novel ED program.


It is widely recognized that the demand for emergency services is rising. Emergency department (ED) utilization increased from 36.9 visits per 100 persons per year in 1995 to 42.8 in 2010 [1,2]. With increasingly timeand personnel-constrained EDs, self-service kiosks have emerged as one potential solution to perform simple tasks such as registration and information distribution. This process-oriented solution may free up health care providers for more complex duties and is particularly relevant to EDs, whose core mission is to provide emergency care for potentially life-threatening conditions. A non-targeted opt-in rapid oral fluid HIV testing program has been part of standard of care in this ED since 2005 [3,4]. Recently, we evaluated the feasibility and outcomes of a kiosk approach to testing in order to improve efficiency and reach a greater proportion of patients [5]. As part of that quality insurance program evaluation, we included a structured questionnaire on the kiosk to determine patient comfort level with using kiosks to share and update personal health information with ED staff. This report presents a secondary analysis of data [5]. Kiosk-facilitated screening involved two stages, a front-end registration kiosk to engage those interested in HIV testing, and a back-end testing kiosk that collected demographic data and provided a single location for testing [5]. The front-end kiosk surveyed patients about comfort level with using kiosk technology, measured via a 5-point Likert scale (Figure). Level 1 Emergency Severity Index patients who were sent directly to treatment rooms and non-ambulatory patients were excluded from the program evaluation, due to inability to use the free-standing kiosks [6]. The study was approved by the Johns Hopkins University School of Medicine Institutional Review Board. Between December 2011 and April 2012, 4351 patients completed the kiosk module. Table 1 summarizes patient demographic and clinical information collected from the electronic medical record. The majority of patients (57%) responded positively to using the kiosk, indicating that they felt either “very comfortable” (32%) or “somewhat comfortable” (25%) with using it to update their information; 15% rated “neutral”, while 6% answered “not very comfortable” and 16%, “not at all comfortable” (Table 2). We performed a multivariate regression analysis to determine whether patient characteristics were associatedwith kiosk comfort level (Table 3). Menwere less confident than women with using kiosks to enter information (OR, 0.8) and patients age 65 and older were less likely to express comfort utilizing kiosks for this purpose relative to those 18–24 years old (OR, 0.6). To the best of our knowledge, our analysis is one of the first to examine patient preferences surrounding kiosk utilization for personal data entry. Porter et al (2004) reported the use of a kiosk in ED

DOI: 10.1016/j.ajem.2014.04.025

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@article{Orlando2014KiosksAT, title={Kiosks as tools for health information sharing: exploratory analysis of a novel ED program.}, author={M . H . S . Lori A . Orlando and Richard E Rothman and Alonzo S. Woodfield and Megan Gauvey-Kern and Stephen C. Peterson and Peter Michael Hill and Charlotte A. Gaydos and Y - H Hsieh}, journal={The American journal of emergency medicine}, year={2014}, volume={32 7}, pages={797-9} }