Implementation of a New Kiosk Technology for Blood Pressure Management in a Family Medicine Clinic: from the WWAMI Region Practice and Research Network

Background: Using a self-service kiosk to measure blood pressure (BP) has the potential to increase patients' awareness of their BP control and free up medical assistant (MA) time. The objective of this study was to evaluate BP kiosk acceptability and usability, as well as its effects on the workflow of patient BP self-measurement in a primary care clinic. Methods: We used qualitative and quantitative assessments of kiosk implementation via meetings with clinic leaders, focus groups with clinic providers and staff, observations of kiosk users, and surveys of kiosk users at 2 and 8 months. Results: Most patients were comfortable using the kiosk (82% at 2 months, 87% at 8 months). Initial provider concerns included accuracy, but most gained confidence after comparing it with other monitors and reviewing the literature supporting its accuracy. Patients and providers saw many benefits: easier BP checks, increased patient engagement, and saved MA time for other tasks. The clinic addressed early concerns (eg, infection control, confusing instructions, perceived loss of personal touch). Most patients (86%) supported the clinic continuing to use the kiosks. Conclusions Providers, staff, and patients adapted to the use of BP kiosks, providing value by engaging patients in their own care and saving MA time. The clinic decided to keep the self-service kiosk after the pilot period.

[1]  M. Kaylor,et al.  The use of ambulatory blood pressure monitoring to confirm a diagnosis of high blood pressure by primary-care physicians in Oregon , 2016, Blood pressure monitoring.

[2]  P. Nilsson,et al.  World Hypertension League Position on Public Use of Blood Pressure Kiosks , 2015, Journal of clinical hypertension.

[3]  A. Siu Screening for high blood pressure in adults: U.S. Preventive Services Task Force recommendation statement. , 2015, Annals of internal medicine.

[4]  S. Fleming,et al.  Self-Screening and Non-Physician Screening for Hypertension in Communities: A Systematic Review , 2015, American journal of hypertension.

[5]  Timothy P. Hogan,et al.  VA OpenNotes: exploring the experiences of early patient adopters with access to clinical notes , 2015, J. Am. Medical Informatics Assoc..

[6]  Evelyn P Whitlock,et al.  Diagnostic and Predictive Accuracy of Blood Pressure Screening Methods With Consideration of Rescreening Intervals: A Systematic Review for the U.S. Preventive Services Task Force , 2015, Annals of Internal Medicine.

[7]  R. Townsend,et al.  Comparison of an in-pharmacy automated blood pressure kiosk to daytime ambulatory blood pressure in hypertensive subjects. , 2015, Journal of the American Society of Hypertension : JASH.

[8]  Yu-Feng Yvonne Chan,et al.  Medical utilization of kiosks in the delivery of patient education: a systematic review. , 2014, Health promotion perspectives.

[9]  Tom Delbanco,et al.  OpenNotes: hospitalists' challenge and opportunity. , 2013, Journal of hospital medicine.

[10]  Blake J. Lesselroth,et al.  Primary care provider perceptions and use of a novel medication reconciliation technology. , 2011, Informatics in primary care.

[11]  C. Lowe,et al.  The use of kiosk technology in general practice , 2010, Journal of telemedicine and telecare.

[12]  Teemu J Niiranen,et al.  Home-Measured Blood Pressure Is a Stronger Predictor of Cardiovascular Risk Than Office Blood Pressure: The Finn-Home Study , 2009, Hypertension.

[13]  J. Lowery,et al.  Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science , 2009, Implementation science : IS.

[14]  B. Alpert Validation of the Pharma-Smart PS-2000 public use blood pressure monitor , 2004, Blood pressure monitoring.

[15]  Daniel W. Jones,et al.  The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. , 2003, JAMA.

[16]  Susan Leigh Star,et al.  Institutional Ecology, `Translations' and Boundary Objects: Amateurs and Professionals in Berkeley's Museum of Vertebrate Zoology, 1907-39 , 1989 .

[17]  A D Mickalide,et al.  U.S. Preventive Services Task Force. , 1986, Pediatric clinics of North America.