Cashing in on Check-in

December 31, 2009
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As hospitals face steeper challenges in collecting fees for service, bringing the revenue cycle to the kiosk may be an answer

In addition to kiosks, tablets are another touch-screen device that patients can use independently. At Adventist, Snyder is using them as a kiosk alternative that can also take credit card swipes and can be used anywhere in the hospital. “You can push the same content to the tablet or the kiosk,” says Snyder. At Adventist, patients waiting for morning surgeries are handed tablets in the waiting room. “If there is a co-pay due, we process that, and it allows one registration clerk to handle four or five patients at a time,” he says. “We've been an early adopter as to how much we've leveraged this in our revenue cycle.”

Tablets are also in use in the emergency room at Adventist, both for registration and collection. “We have this myth about EMTALA,” says Hallowell, referring to the Emergency Medical Treatment and Active Labor Act (see sidebar on the lower half of this page). “All EMTALA says is that you have to be medically screened - and once the patient has seen a nurse, that means the medical screen is done.” He believes tablets are a good choice for emergency room collections and registration. “The truth is,” Hallowell says, “it's not an emergency 90 percent of the time. They're sitting there for hours.”

Another use for kiosks or tablets in the ED is initial triage, something Snyder is planning. “They can, in a simple manner, identify their medical condition and make that immediately available to the triage nurse,” he says. “That's a function we have on our roadmap.”

In the end, for kiosks to continue to be relevant, says Hallowell, better functionality on the revenue side - including autocorrect for patient identity - will be key. “We all like flashy things, and the problem is people buy them but they don't fix the process,” he says. “If I was a CIO, I'd be looking at ROI and business direction to fix a problem, not bright lights.”

At Adventist, it wasn't bright lights Snyder was looking at - it was the ROI he gained using kiosks and tablets for electronic consents. As Snyder continues to roll out functionality, he says a best practice is utilizing the tablets as part of his kiosk strategy. “Tablets allow us to migrate into the additional features and determine how well they're accepted and refine workflow without having to make a larger investment in the kiosk,” he says. “Some populations may be more accepting of kiosks depending on the hospital's clientele, so I think taking it in smaller steps and gauging it has proved a prudent approach.”

Healthcare Informatics 2010 January;27(1):18-20
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