Development of an Automated Healthcare Kiosk for the Management of Chronic Disease Patients in the Primary Care Setting

An increase in the prevalence of chronic disease has led to a rise in the demand for primary healthcare services in many developed countries. Healthcare technology tools may provide the leverage to alleviate the shortage of primary care providers. Here we describe the development and usage of an automated healthcare kiosk for the management of patients with stable chronic disease in the primary care setting. One-hundred patients with stable chronic disease were recruited from a primary care clinic. They used a kiosk in place of doctors’ consultations for two subsequent follow-up visits. Patient and physician satisfaction with kiosk usage were measured on a Likert scale. Kiosk blood pressure measurements and triage decisions were validated and optimized. Patients were assessed if they could use the kiosk independently. Patients and physicians were satisfied with all areas of kiosk usage. Kiosk triage decisions were accurate by the 2nd month of the study. Blood pressure measurements by the kiosk were equivalent to that taken by a nurse (p = 0.30, 0.14). Independent kiosk usage depended on patients’ language skills and educational levels. Healthcare kiosks represent an alternative way to manage patients with stable chronic disease. They have the potential to replace physician visits and improve access to primary healthcare. Patients welcome the use of healthcare technology tools, including those with limited literacy and education. Optimization of environmental and patient factors may be required prior to the implementation of kiosk-based technology in the healthcare setting.

[1]  Katrina M. Krause,et al.  Family Physicians as Team Leaders: “Time” to Share the Care , 2009, Preventing chronic disease.

[2]  Yongqiang Lyu,et al.  Designing and optimizing a healthcare kiosk for the community. , 2015, Applied ergonomics.

[3]  D. Blumenthal,et al.  Information technology comes to medicine. , 2007, The New England journal of medicine.

[4]  James E Stahl,et al.  A randomized trial of virtual visits in a general medicine practice , 2009, Journal of telemedicine and telecare.

[5]  Nir Menachemi,et al.  Factors Affecting the Adoption of Telemedicine—A Multiple Adopter Perspective , 2004, Journal of Medical Systems.

[6]  P. Shekelle,et al.  Systematic Review: Impact of Health Information Technology on Quality, Efficiency, and Costs of Medical Care , 2006, Annals of Internal Medicine.

[7]  Asynchronous virtual visits for the follow-up of chronic conditions. , 2014 .

[8]  Elliott S Fisher,et al.  Physician workforce crisis? Wrong diagnosis, wrong prescription. , 2008, The New England journal of medicine.

[9]  J. Barlow,et al.  A systematic review of the benefits of home telecare for frail elderly people and those with long-term conditions , 2007, Journal of telemedicine and telecare.

[10]  F. Whittaker,et al.  The costs and benefits of technology-enabled, home-based cardiac rehabilitation measured in a randomised controlled trial , 2014, Journal of telemedicine and telecare.

[11]  Hwa Sun Kim,et al.  Development of a Multi-Agent m-Health Application Based on Various Protocols for Chronic Disease Self-Management , 2015, Journal of Medical Systems.

[12]  J. Laragh,et al.  How common is white coat hypertension? , 1988, JAMA.

[13]  Gareth Furber,et al.  Telephone-based low intensity therapy after crisis presentations to the emergency department is associated with improved outcomes , 2015, Journal of telemedicine and telecare.

[14]  Pierre Frémont,et al.  Systematic Review of Factors Influencing the Adoption of Information and Communication Technologies by Healthcare Professionals , 2012, Journal of Medical Systems.

[15]  T. Bodenheimer,et al.  Can health care teams improve primary care practice? , 2004, JAMA.

[16]  Ashish Joshi,et al.  The role of health information kiosks in diverse settings: a systematic review. , 2014, Health information and libraries journal.

[17]  Charles M Kilo Transforming care: medical practice design and information technology. , 2005, Health affairs.

[18]  T. Bodenheimer,et al.  Transforming primary care: from past practice to the practice of the future. , 2010, Health affairs.

[19]  Piya Hanvoravongchai,et al.  Human resources for health in southeast Asia: shortages, distributional challenges, and international trade in health services , 2011, The Lancet.

[20]  MenachemiNir,et al.  Factors Affecting the Adoption of TelemedicineA Multiple Adopter Perspective , 2004 .

[21]  James E Stahl,et al.  Virtual visits in a general medicine practice: a pilot study. , 2008, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[22]  H. S. Khoo,et al.  Primary healthcare system and practice characteristics in Singapore , 2014, Asia Pacific family medicine.

[23]  Sakib Jalil,et al.  A Meta-Synthesis of Behavioral Outcomes from Telemedicine Clinical Trials for Type 2 Diabetes and the Clinical User-Experience Evaluation (CUE) , 2015, Journal of Medical Systems.

[24]  Da Tao,et al.  A 3-Month Randomized Controlled Pilot Trial of a Patient-Centered, Computer-Based Self-Monitoring System for the Care of Type 2 Diabetes Mellitus and Hypertension , 2016, Journal of Medical Systems.