Original Article

Check-in Kiosks in the Outpatient Clinical Setting: Fad or the Future?

Authors: Zachary A. Mosher, MD, Parke W. Hudson, MD, Sung R. Lee, MD, Jorge L. Perez, MD, Alexandra M. Arguello, BS, Gerald McGwin, MS, PhD, Steven M. Theiss, MD, Brent A. Ponce, MD


Objectives: Check-in kiosks are increasingly used in health care. This project aims to assess the effects of kiosk use upon check-in duration, point of service (POS) financial returns, and patient satisfaction.

Methods: Six kiosks were implemented in a large academic orthopedic clinic, and check-in duration for 8.5 months following implementation and POS returns for 10.5 months before and after implementation were analyzed. Consumer Assessment of Healthcare Providers and Systems Clinician and Group survey and self-devised surveys recorded patient satisfaction.

Results: Cumulatively, 28,636 kiosk-based patient encounters were analyzed. Compared with historical norms, check-in duration decreased 2 minutes, 47 seconds (P < 0.001). Daily gross and individual POS returns increased $532.13 and $1.89, respectively (P < 0.001). Satisfaction surveys were completed by 719 of 1376 consecutive patients (52% response rate), revealing 12% improvement (P < 0.001), but Consumer Assessment of Healthcare Providers and Systems Clinician and Group survey responses demonstrated no change (P = 0.146, 0.928, and 0.336).

Conclusions: Kiosks offer to reduce check-in duration and increase POS revenue without negatively affecting patient satisfaction.
Posted in: Quality Health Care, Patient Safety, & Best Practices1

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1. Centers for Medicare and Medicaid Services. National Health Expenditures Fact Sheet. https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/nhe-fact-sheet.html. Accessed February 10, 2017.
2. Dieleman JL, Baral R, Birger M, et al. US spending on personal health care and public health, 1996-2013. JAMA 2016;316:2627-2646.
3. Belatti DA, Pugely AJ, Phisitkul P, et al. Total joint arthroplasty: trends in medicare reimbursement and implant prices. J Arthroplasty 2014;29:1539-1544.
4. Belatti DA, Phisitkul P. Trends in orthopedics: an analysis of Medicare claims, 2000-2010. Orthopedics 2013;36:e366-e372.
5. Claxton G, Rae M, Panchal N, et al. Health benefits in 2015: stable trends in the employer market. Health Affairs (Millwood) 2015;34:1779-1788.
6. Scotti DJ, Harmon J, Behson SJ. Links among high-performance work environment, service quality, and customer satisfaction: an extension to the healthcare sector. J Healthc Manag 2007;52:109-125.
7. Cook KE, Ludens GM, Ghosh AK, et al. Improving efficiency and reducing administrative burden through electronic communication. Perm J 2013;17:26-30.
8. Brown DF, Sullivan AF, Espinola JA, et al. Continued rise in the use of mid-level providers in US emergency departments, 1993-2009. Int J Emerg Med 2012;5:21.
9. Hing E, Burt CW. Characteristics of office-based physicians and their medical practices: United States, 2005-2006. Vital Health Stat 13 2008;( 166 ):1-34.
10. Brys S. Kiosk-based “office” extends reach of health services providers. Behavioral Healthc Exec 2013;33:42.
11. Belt K. How self-service check-in works in the real world. Baptist Health CFO Katrina Belt gives the insider scoop on kiosk adoption and use by staff and patients. Health Manag Technol 2015;36:18-19.
12. Orlando MS, Rothman RE, Woodfield A, et al. Public health information delivery in the emergency department: analysis of a kiosk-based program. J Emerg Med 2016;50:223-227.
13. Ng G, Tan N, Bahadin J, et al. Development of an automated healthcare kiosk for the management of chronic disease patients in the primary care setting. J Med Syst 2016;40:169.
14. Padwal RS, Townsend RR, Trudeau L, et al. Comparison of an in-pharmacy automated blood pressure kiosk to daytime ambulatory blood pressure in hypertensive subjects. J Am Soc Hypertens 2015;9:123-129.
15. Joshi A, Trout K. The role of health information kiosks in diverse settings: a systematic review. Health Info Libr J 2014;31:254-273.
16. Kreuter MW, Black WJ, Friend L, et al. Use of computer kiosks for breast cancer education in five community settings. Health Educ Behav 2006;33:625-642.
17. Stein JC, Navab B, Frazee B, et al. A randomized trial of computer kiosk-expedited management of cystitis in the emergency department. Acad Emerg Med 2011;18:1053-1059.
18. Lawrence D. Cashing in on check-in. As hospitals face steeper challenges in collecting fees for service, bringing the revenue cycle to the kiosk may be an answer. Healthc Inform 2010;27:18.
19. Woolhandler S, Campbell T, Himmelstein DU. Costs of health care administration in the United States and Canada. N Engl J Med 2003;349:768-775.
20. Centers for Medicare and Medicaid Services. National Health Expenditures 2014 Highlights. https://www.cms.gov/research-statistics-data-and-systems/statistics-trends-and-reports/nationalhealthexpenddata/downloads/highlights.pdf. Published 2015. Accessed June 16, 2016.
21. Himmelstein DU, Jun M, Busse R, et al. A comparison of hospital administrative costs in eight nations: US costs exceed all others by far. Health Aff (Millwood) 2014;33:1586-1594.
22. Raosoft Inc. Sample Size Calculator. http://www.raosoft.com/samplesize.html. Accessed January 29, 2017.
23. Hagland M. Enhancing the patient experience at Sharp Rees-Stealy Medical Group in San Diego. https://www.hcinnovationgroup.com/finance-revenue-cycle/article/13025173/enhancing-the-patient-experience-at-sharp-reesstealy-medical-group-in-san-diego. Published June 1, 2015. Accessed January 11, 2020.
24. Rohleder TR, Lewkonia P, Bischak DP, et al. Using simulation modeling to improve patient flow at an outpatient orthopedic clinic. Health Care Manag Sci 2011;14:135-145.
25. Manley M. 5 ways to improve patient flow. Med Econ 2014;91:40-42.
26. Backer LA. Strategies for better patient flow and cycle time. Fam Pract Manag 2002;9:45-50.
27. Bureau of Labor Statistics. May 2015 national occupational employment and wage estimates in the United States. https://www.bls.gov/oes/current/oes_nat.htm#31-0000. Accessed February 18, 2017.
29. Centers for Medicare and Medicaid Services. Consumer Assessment of Healthcare Providers and Systems (CAHPS). https://www.cms.gov/Research-Statistics-Data-and-Systems/Research/CAHPS. Accessed January 29, 2017.
30. Levinson W, Gorawara-Bhat R, Lamb J. A study of patient clues and physician responses in primary care and surgical settings. JAMA 2000;284:1021-1027.