Healthcare - Building Kiosks From Scratch

In an era of consumerism, physician group practices are looking for ways to improve customer service and gain loyalty. So when surveys of patients at Springfield (Ill.) Clinic revealed dissatisfaction with the time-consuming, inefficient check-in process, CIO James Hewitt decided to take action.

Hewitt determined that installing self-service kiosks could help resolve the problem. But when he shopped for devices, he was disappointed with what he found. The hardware was too costly and took too long to implement, he says. And, more important, the kiosks did not integrate well with practice management and electronic health record software.

So he took the extraordinary step of working with two vendors as a co-developer of new kiosk technology. In this way, he was able to build into the kiosk every feature he desired and roll out the devices at a deep discount. Special features include new technology that uses palm scanning for patient identification.

The 195-physician multi-specialty practice, which has two dozen locations in Central Illinois, expects to install as many as 50 kiosks this year after recently testing the hardware at one location. "At our test site, we're seeing, on average, three pieces of registration information changed by patients," Hewitt says. For example, patients are entering new information about their employer, insurer, mailing address or emergency contact.

In addition to the development and testing efforts at Springfield Clinic, George Washington University Medical Faculty Associates, Washington, D.C., is serving as a beta site for the kiosks.

Springfield Clinic collaborated on the project with Tokyo-based Fujtisu Ltd., which manufactures the hardware, and Allscripts-Misys Healthcare Solutions Inc., Chicago, which markets the devices.

Hewitt and several members of his I.T. team did much of the software development work. The CIO has expertise in this arena, having formerly served as CIO at Allscripts.

"I wanted it to look like an airport check-in kiosk with big buttons," Hewitt says. The kiosks have 19-inch touch-screen monitors that patients use to make selections or type in information.

EHR Interface

The kiosks link to both Springfield Clinic's EHR system from Allscripts and its practice management software from GE Healthcare, Waukesha, Wis. When patients initially register to use the kiosks, they can use the Fujitsu palm scanner technology or just scan their credit card or other identification card.

The biometric technology uses near-infrared light to capture a patient's palm vein pattern, generating a template that is then matched against a database of enrolled users' palm-vein patterns.

The palm scanners "give the patient a sense of added security for their records," Hewitt says. "And they have that coolness factor."

The kiosks also have a camera to capture a photo that's displayed every time a patient signs in. The photo is included in the patient's electronic record.

In addition to confirming all scheduled appointments for the day, the kiosks, by linking to electronic records, show reminders, such as the need to slate an eye exam or schedule attendance at a prevention program. Users can update demographic information and make co-payments using a credit card. "The kiosk will even tell you if you are in the wrong location and print out directions to the right one," Hewitt says

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