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Self-service Kiosks Fail Me

January 4, 2011
by anonymous
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The need for kiosk usability, functionality optimization

I'm all for self-service, especially when it adds efficiency. That's one reason I've always thought self-check-ins at doctors' offices and clinics would be a great time saver.

I'm sick up to my eyeballs of writing in basic information for the umpteenth time. If I have to do it (and I question whether all of it is really necessary), let me enter it on a keyboard, which should be faster than the ubiquitous brown clipboard with pen.

Now I'm a kiosk fan. Kiosks at train stations, airports, and banks are speedy and efficient. I use them. But self-service kiosks in healthcare settings are another story. Every one I've experienced so far has left me less than impressed.

I go to a pharmacy-based clinic for my annual flu shot. Check-in via kiosk there is downright painful on a hunt-and-peck touch screen at a height that has been optimized for a midget. (I'm short, but not short enough.)

Another recent check-in experience had a family member type in his name. The system was finicky--no caps, please; watch the spacing--so finicky that after two failed attempts, the desk person finally did data entry. Needless to say, I was mightily unimpressed with the technology improvement.

Neither system accepted anything more than name and demographic information to ensure that I was who I said I was. No request for my insurance information or scanner for my insurance card. No way to pay my co-pay.

The concept of self-service for check-ins clearly offers promise, but if execution is no better than my recent experiences, we're still in a technology zone stuck on potential.



Unfortunately there are inconsistencies with self-service kiosks, how they are engineered and what interface is used. There are many that adher to the ADA guidelines and the touch interface is very graphical and easy. Devices such as card readers, medical scan scanners with OCR, pin pads, privacy screens, signature pads and more are becoming more available. Guidelines such as PCI, ADA, and HIPAA all come into play and are designed for in the better stations.

You bring up some excellent points. Thank you for sharing your wealth of expertise and experience.

The use of personal devices, such as iPads and smartphones, to streamline data input processes makes sense. Now we just need the apps to make it happen.

Hi Charlene, I understand how self-service kiosks can be more hassle than help when they don't function properly. However, it seems like the problems you've experienced and seen are problems caused mainly by the health care offices you were dealing with, and not an inherent issue with the kiosks themselves.

Most manufacturers that I know design and build kiosks to a client's specs. That includes the software that allows you to check-in for appointments. So if the kiosk doesn't allow caps, that's because whoever requested to have these kiosks created didn't want to allow caps. If the touch screen is slow or unresponsive, it could be because it wasn't calibrated properly (or at all) when first set up, or because there is no regular maintenance done to keep the kiosk in working order. If the check-in process didn't require any other info to prove your identity because that particular medical office didn't plan for this info to be entered and therefore didn't make it a part of the software's capabilities.

So it's not the technology that's the problem. It seems more so like a lack of education on the part of the clinic using the kiosk. Either their kiosk manufacturer didn't make them aware of the types of functions kiosks can handle, the manufacturer didn't offer information on basic maintenance and touch screen calibration, or perhaps the clinic didn't have the kiosk software custom-made to handle additional functions. If nothing else, I think we as kiosk manufacturers can take steps to educate our clients on what is possible with their kiosks as well as how to handle basic maintenance. Although kiosks are not new technology, they are still not very mainstream in most industries (aside from banks and airports), so I see these issues improving with better education and planning.

Also, to build on what Craig Keefner stated yesterday...there are many factors that determine how a kiosk operates. These factors are generally chosen by the office which owns the kiosk, and not by the manufacturer. Again, the main problem is that some clients don't seem to know what options are available to them or the best way to make their kiosks functional for their customers and patients.

The best remedy for this is for offices who are interested in integrating kiosks to sit down and have consultations with their potential kiosk providers to get the necessary facts and suggestions before ordering. It's also not a bad idea for businesses to ask their customers directly what kind of functionality would be most helpful for checking in, purchasing etc. That way, you cover both bases and customers get to experience a kiosk that they helped to design.

I think it would be most helpful to poll customers about what they need before a business even embarks on a kiosk purchase. Then they could take the poll results into consideration during the planning and design stages of their kiosk project. This has inspired me to create a blog post on the topic of how and why kiosks can be a turn off to customers in the health care industry. Hopefully it can shed some light for clinics and other medical facilities that have adopted self-service kiosk technology.

Charlene, you raise valid concerns and that is why we urge our hospital partners to conduct regular patient satisfaction surveys through their self-service technology so that we can all address potential problems to better the technology and processes. This is also why it is paramount that all healthcare self-service vendors leverage lessons learned from other industries like the airlines, banking and retail. These industries have been able to survive and flourish in large part because of self-service, which has enabled them to operate more efficiently with less people, while also maintaining a high level of consumer satisfaction.

With health reform, providers will experience an estimated 32 million new patients. Self-service technology is a proven strategy that can help providers take on this new patient population without having to add numerous FTEs to their staff. It is one of the only technologies that will help improve efficiency, while also enhancing the patient experience. No one technology is going to solve this challenge, but a multi-channel strategy that includes self-service is surely an important part of the answer.

When done correctly, self-service in healthcare—which includes free-standing check-in kiosks, tablets, online patient portals and mobile applications—can offer a range of benefits to patients and healthcare organizations alike. This white paper from the Center for Health Transformation is a good resource that shows the impact self-service can have in healthcare.

Hi Charlene,

When considering "kiosks", hospitals have to concern themselves with a number of issues, including:

1. ROI (Return on investment) - the kiosk is only the tip of the iceberg in terms of installation, maintenance, updates, etc.
2. Fomite surfaces and disease transfer - a major issue and frequently a show stopper
3. Security of patient information and unit - more headaches for IT, to physical theft of anything not bolted down
4. Privacy of patient information - "shoulder surfing", etc.
5. Resiliency of unit in a variety of potential scenarios - spilled liquids, vomit, mass casualty/disaster, physical abuse, etc.
6. Scalability and maintenance - and is it just another thing to break??
7. Language, Handicap, equal access, etc. - which becomes much more complex in a hospital setting
7. Alternatives (apps, etc.) - potentially technology is improving to the point to overcome many of the shortcomings - including things like gaze directed cursor control, focused privacy displays, and at least addressing services for "registered" customers to start with (which reduces the need for re-entry of personal information)

Unfortunately, much of the "Kiosk" industry has remained fixated on unreliable operating systems/programming, and vendors have often confused (interactive) digital signage, web kiosk, application front-ends, etc.

The good news is, we are seeing iPad/iTouch/Android and similar devices being used to overcome many of the issues the "Kiosk" industry continues to grapple with, but a myriad of other challenges remain. But, it is likely that the whole trend of "Apps" on intelligent personal devices may usher in a whole new future in health care.

Hopefully for all of us, successful business&technology blended solutions are just around the corner.

As patient check-in kiosk take off you have more organizations throwing a 'kiosk' at the fire hoping to get some business. I hope the bad experience doesn't turn you away to all patient check-in kiosk. We work with a few different EHRs, Epic being one of them and their patient check-in application is really a step above what i've seen in the industry.

As for the kiosk itself, it should provide equal access, meeting and exceeding all ADA guidelines, it should also be as intuitive to use as the software running on the screen. In order to achieve this, kiosk manufacturers need to spend time and money purpose building a kiosk and not simply re-using past designs and sticking new pieces of equipment on the surface.

There is also a 3rd element, the hospitals, if their workflow is such that a kiosk will be capable of no more than single demographic update then the kiosk will in all likelihood, not impress.

Here is a link to a Forbes video that covers the topic and shows some different kiosk designs.