American are taking a shine to self-service healthcare.
They may not be snatching the scalpel out of their doctor's hands and doing their own surgery, but they are registering on their own - in doctors' offices, clinics and hospitals - thanks to the advent of healthcare kiosks. Taking their cue from airlines, retail stores and banks, healthcare providers are using kiosks to speed up the registration process, enter valuable data into the electronic health record and push revenue cycle management capabilities to the front end - all while advancing the concept of consumer-directed healthcare.
"The uniqueness of this application is that the patient is involved - this is the first application to focus on the patient," said Josh Napua, vice president of the healthcare group at Fujitsu, which has teamed with Allscripts-Misys Healthcare Solutions to launch a kiosk. "This creates a portal for the patient into two key areas: billing and the EMR."
Jeffery M. Kendall, director of business development for NCR, said kiosks are popular with healthcare providers seeking to clean up their front-office efficiencies. Tying the kiosk into a Web-based portal, providers are able to push appropriate clinical content to the patient prior to the appointment, as well as establish payment plans and set up billing procedures.
NCR recently teamed up with Passport Health Communications of Franklin, Tenn., to integrate revenue cycle management solutions into NCRs MediKiosk. Increasing the efficacy and efficiency of front office activities can have a direct impact on improving revenue cycle. Integrating with Passport increases the benefit NCR solutions can have in this critical area, said Raj Toleti, general manager of NCR Healthcare.
The list of kiosk vendors in the healthcare market is large and growing larger by the day. It includes GE Healthcare, Siemens, the NCR Corp., Healthcare Kiosk Management, DynaTouch, Gokis, Medfusion, McKesson and D2 Sales, to name just a few. Another new entry to the market is Navicure, which partnered with Clearwave to unveil the Navicure Check-In solution in March. And The CBORD Group, based in Ithaca, N.Y., markets a series of kiosks designed specifically for food service in hospitals.
According to a study undertaken by the Pittsburgh VA Medical Center, the healthcare kiosk market is expected to top $800 million by 2013.
Kiosks are popping up in hospitals and clinics from one end of the country to the other. The Carle Clinic Association in Illinois, one of the nation's largest private physician groups, implemented D2's My Patient Passport Express kiosks earlier this year at 11 offices in central Illinois. Following the rollout of 90 self-service kiosks in 60 medical clinics in southern California, Kaiser Permanente conducted a patient satisfaction survey. The survey indicated 75 percent of those using the kiosks found it to be faster than checking in with a receptionist.
According to Lynn Dunbrack of Health Industry Insights, kiosks will work in the healthcare setting if they improve the patient experience - and that means reduce the time spent waiting, making the technology easy to use and linking patients to billing services. With so many hospitals operating in the red, she pointed out, a technology that improves revenue cycle management is a good sell.
"There is the concern that you're removing the clinician from the encounter, but you're actually freeing up time for the clinician to talk to the patient," she added.
Merge Healthcare is in the "proof of concept" phase for its own kiosk, which will feature registration, billing and management applications. Company officials were impressed by how kiosks had caught on in airports, but understand the airline and healthcare industries are vastly different.
"The variations on a theme are pretty spectacular," said Tim Kulbago, Merge Healthcare's chief strategy officer. "Unlike airplanes, healthcare is still very much a person and a patient."
Kulbago said a kiosk by itself won't work in a hospital setting. Merge is working with avatars, he said, to make the experience more personal for healthcare consumers.
"It comes down to a comfort factor," he said. "It's a little impersonal, and sometimes you just want to talk to somebody."
"The worst thing you can do is walk up to a kiosk and it tells you to go talk to somebody at the front desk," he added.
As for concerns that kiosks would put nurses on the unemployment line or be too impersonal, Fujitsu's Napua said kiosks will actually free up nurses to make better use of their time.
"The human interface doesn't go away," he said. "It actually enhances their jobs."
Not everyone is enamored with kiosks. Kelvin Buncum, of Atlanta-based International Medical Solutions, says providers and patients need something more mobile - something that can be carried with the patient or doctor and be used by different people. To that end, IMS is marketing the Mobile Patient Communicator, which looks like a tablet PC and has all the functions of the kiosk.
"It's a better alternative than the standard kiosk," said Buncum. "Kiosks have been out there for a bit and they haven't really penetrated well."
Buncum said the MPC can be customized for each patient, capturing data and providing access to a portal that can provide educational material as well as directions and messaging.
"We think this is the missing piece of the puzzle for healthcare," he said.