Follow-Up Consultation Through a Healthcare Kiosk for Patients with Stable Chronic Disease in a Primary Care Setting: A Prospective Study

J Gen Intern Med. 2017 May;32(5):534-539. doi: 10.1007/s11606-016-3931-8. Epub 2016 Dec 9.

Abstract

Introduction: The global healthcare kiosk market is growing, and kiosks are projected to be a larger part of healthcare delivery in the coming decades. We developed an unmanned healthcare kiosk that automates the management of stable patients with chronic conditions to complement face-to-face primary care physician (PCP) visits.

Aim: The aim of our study was to show that the kiosk could be a feasible means of delivering care for stable patients with chronic conditions and could generate cost savings for the management of patients with stable chronic disease.

Methods: We conducted a prospective single-arm study of 95 participants with well-controlled chronic cardiovascular diseases who visited our clinic in Singapore every 3 months for review and medication refill. During their subsequent appointments for chronic disease management at 3 and 6 months, participants used the kiosk instead of consulting a physician. All participants who used the kiosk were also evaluated by a nurse clinician (NC). The kiosk assessment of whether the patient was well controlled was then compared to the NC's assessment to determine rates of agreement. Patient satisfaction was evaluated through a questionnaire, and any adverse outcomes were documented.

Results: Cohen's κ for agreement between the kiosk and the NC assessment of patients' chronic care control was 0.575 (95% CI, 0.437-0.713). The modest agreement was due to differences in systolic blood pressure measurements between the kiosk and the NC. The 96% of participants who completed two kiosk visits were all satisfied with the kiosk as a care delivery alternative. None of the participants managed through the kiosk suffered any adverse outcomes. Use of the kiosk resulted in a reduction of 128 face-to-face PCP visits.

Conclusions: Healthcare kiosks can potentially be used to complement primary care clinician visits for managing patients with stable chronic diseases and can generate cost savings.

Keywords: alternative care delivery; healthcare kiosk; stable chronic disease.

MeSH terms

  • Aged
  • Ambulatory Care Facilities* / trends
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / psychology
  • Cardiovascular Diseases / therapy*
  • Chronic Disease
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Patient Satisfaction*
  • Primary Health Care / methods*
  • Primary Health Care / trends
  • Prospective Studies
  • Referral and Consultation* / trends
  • Singapore / epidemiology