Something different is happening in hospitals across the United States. Patients who once selected health centers based primarily on location have morphed into discerning customers who aren't afraid to take their out-of-pocket payments elsewhere. As a result, facilities are going above and beyond to find ways to keep patients — or as they are now called, consumers — satisfied, whether it means installing flat-screen TVs, offering free wireless, or implementing self-service check-in kiosks.
Patients' expectations are changing, and health systems are taking notice. According to Erica Drazen, a partner at Falls Church, Va.-based CSC Healthcare, and Jared Rhoads, a senior research analyst, it is a trend whose time has come. In a recently published report, Drazen and Rhoads state that the focus previously placed on the provider and payer now includes the patient “as an equally important constituent.”
What this means, says Drazen, is that healthcare, an industry that has traditionally lagged behind in putting the “customer” at the center of the experience, is now trying to capitalize on the success that airlines and hotels have achieved by automating tasks like check-in. For CIOs, who often have to contend with implementations like CPOE that can be both time-consuming and costly, kiosks are a breath of fresh air. The technology isn't perfect, but it's uncomplicated and, as Drazen says, any time a hospital can more effectively compete for market share by leveraging a solution that is relatively easy to install, it's a no-brainer.
“Hospitals have a new set of customers that they need to worry about, and new priorities they need to think about,” she says. “And while you really do have to get the basics down first — we're not saying you should put in kiosks before you put in closed-loop medication management or anything like that — but once you get beyond that, you really have a choice about where you're going to make strategic investments. This is a perfect example of a good place to start.”
Self-service kiosks enable patients to check in, update their medical history, make payments using a credit card, sign documents, and schedule future appointments. Some models even incorporate wayfinding functionalities to help patients and visitors navigate a facility. Through these features, kiosks offer several potential benefits for organizations, including a streamlined patient registration process, shortened wait times, reduced administrative costs and improvements in revenue cycle management.
“There's a lot of interest in kiosks, partly because they're easy to implement — they're a proven technology in other industries. You can pilot them in one unit and you don't have to have a lot of infrastructure,” says Drazen, adding that kiosk use can result in time savings for staff members. Anything you do to speed up registration makes the flow of the practice more efficient,” she says. “So it's a win-win situation.”
Cutting down the ‘wait’ in the ER
Patient flow was a concept that seemed out of reach for the emergency room staff at Parkland Health and Hospital System in Dallas, a facility that hosts an average of 150,000 patients per year. Because of the consistently high volumes, the staff faced significant challenges, not just in helping patients get treated in a reasonable amount of time, but checking them in and prioritizing who needed treatment first.
Before the MediKiosk (from Dayton, Ohio-based NCR Corporation) was piloted last summer, patients often stood in line for as long as an hour and a half waiting to be triaged. “We had no idea who in the line should be seen first, unless someone fell over,” says CIO Jack Kowitt.
When the kiost was first installed in Parkland's ER, the staff was thrilled. It meant triage nurses could scan the list and prioritize patients based on complaint. That way, those who had chest pains or other urgent conditions could be seen first. “It really accomplished a couple of terrific things — one, it got patients out of line and let them sit down, and two, it identified the emergent patients so the staff could start care as quickly as possible,” says Kowitt.
In a high-pressure ED, anything that can ease the staff's burden is critical, says Kowitt. “The staff is happy because they can get to the cases that they should get to quickly, and now there's less of a chance of a patient crashing waiting for service. We have a very busy ER; the average dwell time is more than any of us would tolerate. This has been a step in fixing some of the problems, and everybody involved is very happy.”
Parkland's biggest motivators for implementing kiosks were to improve workflow and shorten patient wait times. At Scottsdale Healthcare, a three-hospital network in Scottsdale, Ariz., the objectives were similar; the difference between the two facilities is the environment in which kiosks were piloted. Instead of the ER, Scottsdale chose to place the Horizon Patient Kiosk from McKesson (San Francisco) in its outpatient surgery center to facilitate the registration process for patients who were already scheduled to undergo procedures, according to Vice President and CIO Jim Cramer.