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Self-service technology doctors up health care, pt. I

Self-service technology, kiosks especially, may be changing the way we access health care and the privacy issues we encounter from the pharmacy desk to the doctor's diagnosis.

Self-service technology doctors up health care, pt. I


| by Nicole Troxell — Associate Editor, Networld Media Group

This is the first in a two-part look at kiosk and self-service technologies across the spectrum of health care and how self-service is altering the patient-provider landscape.

Despite HIPAA laws in health care, many patients find themselves in less-than-private moments with health care providers where they are forced to divulge information in front of others about the state of their health, simply due to everyday tasks required for care: ordering prescriptions at a pharmacy, disclosing the reason for a doctor's visit with a lobby receptionist, asking for directions to a specialist's office. These are common situations that can inadvertently reveal information about the state of our health or the health of a loved one.

Self-service technology, kiosks especially, may be changing the way we access health care and the privacy issues we encounter from the pharmacy desk to the doctor's diagnosis.

"One of the primary uses for patient kiosks in health care is to provide access to information/education about health conditions, treatments, medications or preventative care. Patients can also use kiosks to check in upon arrival, fill out forms, submit information, read HIPAA documentation and more. Ordering prescriptions, scheduling consultations or reviewing diagnoses can also be patient-facing tasks completed with kiosk usage," said Laura Miller, director of marketing for kiosk software company Kioware, in an email.

"Health care kiosks can be a great asset for securing data at doctors' offices and/or health care facilities. They can be used by patients and their loved ones or by health care professionals that need to access sensitive health care data while protecting patient privacy," she said.

Here's a look at how self-service is changing the health care landscape:

Pharmacy self-service

In an August report on pharmacy automation published by MarketsandMarkets.com, the industry was valued at $4.7 billion globally for 2011 and is expected to reach $7.8 billion by 2018, Pharmacy Times reported. 

The largest share of that value comes from automated medicine dispensing systems — kiosks that track and supply medication and are designed to eliminate human error in the workplace. Valued currently at $2.3 billion, the segment holds 48.9 percent of the pharmacy automation market and is forecasted to bring in $3.6 billion by 2018, with a compounded growth of 6.7 percent. 

The shift to decentralized automation from centralized hospital pharmacies is driving the market, according to Pharmacy Times, as self-service becomes more of a demand and organizations look to technology for efficiency, accuracy and cost savings. And with the Millennial generation's preference for self-service, we're likely to see a greater push in numerous industries toward this initiative.

Among the latest medication-dispensing products are the marijuana dispensary kiosks gaining traction across the country as laws change in favor of medicinal or recreational use of marijuana.

One such kiosk solution comes from Medbox, a provider of technology to marijuana dispensaries, which have been cropping up in states that have legalized the drug medicinally and recreationally. Medbox is a "partner of the cannabis industry," the company said, though the company also has pharmaceutical kiosks in prisons, urgent care centers and assisted living facilities, according to the company website.

"Medbox's kiosks are installed behind the counter and are operated by the staff," former Medbox CEO Dr. Bruce Bedrick said in a March 2014 company announcement. "The kiosks are integrated with the dispensary's POS system and dispense medical marijuana after the patient has been authenticated through a fingerprint scan. They store information about each transaction in compliance with state medical marijuana regulations."  

Checking in

One of the more recent tech evolutions in the health care field, self check-in, is already utilized in airports around the world.

Hospital or doctor's office self-service check-in solutions use custom-designed kiosks to streamline the check-in process and alleviate the stress of overburdened health care workers, particularly when facilities are short on nursing staff.

"They are extremely useful in improving patient service and providing relief for overburdened health care workers," said Jeff Goldstein, vice president of sales for kiosk provider SeePoint LLC, in an email. "Patient check-in kiosks can quickly and efficiently compile patient information that is more accurate than old-style clipboards, while also alleviating the need for additional work by clinic staff."

SeePoint installed kiosks at University of California, San Diego Health System to provide patients a private way of checking in themselves. The kiosks also serve UCSD vendors as an interface with its vendor-management system. Vendors will use VantagePoint Print kiosks for verifying information, identification and credentials. The print kiosks will deliver unique UCSD Health System identification tags via thermal printing.

Cincinnati-area hospitals have expressed an interest in implementing self-service solutions as well, according to TriHealth's manager of facilities and construction, Jann Doering-Woodson, in a bizjournals.com article.

"They're going to check themselves in. Then they are going to go to their exam on their own; they're going to push a little button and then the nurse is going to come see them," she said.

Among the incentives to switch to self-service solutions is the desire for many industries to attract Millennials, who grew up accustomed to such technology, as Doering-Woodson indicated: "Some of us older folks may not take too kindly to that, but it's the future — it's what's coming."

Doering-Woodson likened the change to a time when filling stations switched from attendants to self-serve, then self-pay options.

While it may appear almost natural to the technically savvy younger generation, the challenge lies in working with those who are older, according to Doering-Woodson.

"How do we continue to serve folks that are 60-65 years old, but still be ready for the 18-20 year olds that are coming out of college?" she said in the article. 

Patti Meszaros, director of facility planning for Cincinatti's Mercy Health, said an important factor in self-service technology is flexibility, "We're building for the future. We understand we are going to be dealing with more acuity levels."

Being user-friendly, regardless of the user's physical or mental abilities is important in kiosk design. For example, Olea Kiosks' Cambridge Self Check-in Kiosk doesn't require an adjustable height mechanism, but instead can "extend forward to provide full-front access by wheelchair," the company said in a press release. It's important that the end-user's access to the kiosk's abilities not be limited. 

But check-in solutions, just like staff, have to be HIPAA compliant too. 

Austin (Texas) Regional Clinic's kiosks come equipped with screen filters, which ARC kiosk program manager Katherine Noble said is more private than checking in the traditional way, according to KVUE.

The clinic still intends to provide old-fashioned counter services, but said the kiosks reduce time waiting to see a doctor.

"Because we have multiple check-in options, patients are actually checked in faster, and that means they get to see the doctor faster," Noble said in the article.

The ARC's self-service option confirms why a patient is visiting, which physician he or she will see, the appointment time and location, Noble said.

Check-in technology at the University of the Pacific Arthur A. Dugoni School of Dentistry provides a different kind of service. The San Francisco school deployed Advanced Kiosks to install a "wall" of its iKiosks to greet customers at the school's entrance. 

After patients check in at iKiosks, the machines issue individualized security passes with appointment information and a barcode that provides entrance to the clinic when scanned at a turnstile. The pass must also be scanned when leaving. 

"We are the first dental school to have this kind of controlled-entry system that uses kiosks, turnstiles and seamless integration into our clinic-management system in order to ensure the privacy and safety of everyone in the building," said Raybel Ramos, the school’s director of information technology and telecommunications, in the article.

"Our kiosks are actually making another piece of equipment work," Advanced Kiosk project manager Nathan Morse said in the article. "Yes, they are integrated with the patient database, but they are also physically opening and closing turnstiles."

Check-in kiosks are often multipurpose solutions, too, providing advertisements, customer-engagement opportunities, alerts, information and directions. 

A knowledge gateway

Kiosks are used for quality control at Womack Army Medical Center at Fort Bragg, N.C. The hospital installed four interactive kiosks at each of their main entrances to survey patients and visitors on the quality of services and expects to implement more at area army clinics. 

At U.K.-based health care chain Lloyd's Pharmacy, nine kiosks are providing customers an outlet to browse pharmacy products, place orders, and pay online using interactive touchscreens and printers. 

Riverdale, N.J.-based kiosk supplier Redyref said in an email that kiosks can "provide [patients] information in multiple languages, including printed text directions." They can get out information about wellness activities and other hospital services, the company said. Redyref supplies wayfinding kiosks designed to reduce patient anxiety.

"Blinking path arrows display the directional route on the map(s) while text directions offer additional assistance for those who prefer written directions. Print functionality is included on Redyref wayfinding systems, allowing maps to be printed right from the system's location," the company said in an email. Kiosk software can deliver forms about issues, advanced directives and tell a patient "what a procedure will entail, time required and other information that serves to lower patient anxiety," according to RedyRef.

The company's products have been used to display physician information, events and meetings.

At Stanford University's Stanford Cancer Institute in Palo Alto, California, SeePoint LLC installed its VantagePoint kiosk to alert patients to cancer clinical trials. The Institute was concerned that the word wasn't successfully getting out about clinical-trial opportunities. After installation, enrollment has gone up, SeePoint said. The kiosks provide a filtered screen for privacy so that only the person standing directly in front of it can see the information. It displays hundreds of trial opportunities as well as qualifying information.

Health care facilities have even gone as far as installing touchscreen vending kiosks that contain healthier choices for patients and employees, to help promote healthier habits. Healthy vending has recently become one of the fastest growing industries in the nation.

Roanoke, Virginia's Carilion Clinic is the first health care provider in the state to offer this kind of option, according to a WDBJ7 article.

User can swipe their fingers across the screen to view each product. Nutritional information is displayed when customers choose the appropriate button for each selection. The machine also has cashless payment options.

(Check back here Wednesday for part two. Next up, a look at health assessment technologies and potential risks of the latest self-service health care solutions.)

Kiosk screenshot photos courtesy of Redyref.


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We Build Everything Kiosk. REDYREF designs and manufactures self service interactive kiosks. With 325+ staff and (4) manufacturing facilities, we can support small roll outs and full scale deployments.

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Nicole Troxell

Nicole’s work has appeared in business, education, technical, and travel publications. She is currently the editor of QSRweb.com and PizzaMarketplace.com.

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