2014/10/11
How one health care kiosk is changing provider-patient dynamics
KioskMarketplace recently highlighted several self-service healthcare trends in a comprehensive feature about the industry. However, with some of this technology, there's a lot more to it than meets the eye. For example, patient check-in kiosks can do a lot more than register patients when they arrive at their healthcare provider's office. They can also maintain an entire file of the patient's information in one cloud-based location.
Kiosks can distinguish between patients of the same name, prompt the patient to enter information not on file, direct patients where to go when they don't have an appointment, and in some cases, validate insurance benefits and prompt patients to pay outstanding balances, all in real time.
KioskMarketplace spoke with Eric Anderson, COO of Clearwave, about his company's Clearwave Kiosk designed for the healthcare industry, to find out more about its technology for patient self-service.
KioskMarketplace: Tell us about the Clearwave patient check-in kiosk – why did your company feel there was a need for this technology in healthcare?
Eric Anderson: At Clearwave, we saw a gap in the healthcare market. It's about the only place where you never interact with any technology, and it’s inefficient. For example, if you walk into a doctor's office, you could be late for your appointment if people are in line in front of you. And people at the front desk don't know what they have on file when a patient arrives, so they always ask the same questions.
Our healthcare kiosk customizes patient registration to why a patient is there that day. It covers the basic facts – demographics for government use, payments due and insurance – and offers a registration time of two to three minutes, about the same time it takes to withdraw money from an ATM. The kiosks aren't asking questions out of ignorance; everything a patient sees on the screen is what they need to see. And because so many people use smartphones and tablets, the check-in process is understandable and comfortable.
KioskMarketplace: Can you explain how the check-in process works? What are the steps a patient goes through using the kiosk?
Eric Anderson: The first thing the kiosk does is to identify who the patient is. A patient can do this by scanning a healthcare card or I.D. or touching the screen. In our software development kit, we have templates for IDs that have to be updated. If there are two patients with the same name, it looks at the address using an algorithm.
If the machine doesn't know who you are, you will have to enter your first and last name, and if there's no match, it asks for the address. If the kiosk doesn't have a cell phone number, it specifically asks.
This information will cross-reference benefits providers and any outstanding balance, and patients get access to the information on file. We've found that when patients see their information electronically, they take a lot more ownership for it because it's accessible and right in front of them when they check-in.
Secondly, the kiosk will ask if the patient has an appointment. Then he can check-in through the practice management system, book future appointments, input insurance and pay a bill. The kiosks are connected to that in real-time.
But the software is where the magic happens. With an appointment, a patient goes along a very specific path. If he doesn't have an appointment, he will go to the kiosk, and it will send him to the front desk. In the case of urgent care centers, it will register the patient, ask why he is there, send him down the registration path and tell him where to go. And when an appointment is made, Clearwave knows about it.
KioskMarketplace: As you know, privacy is a critical issue these days. How can patients and staff be assured the kiosks are protecting patient privacy?
Eric Anderson: Every kiosk has embedded privacy filters [somewhat similar to] venetian blinds. If you stand a little bit to left or right, you can’t see anything.
Somebody could take a picture of the screen, but they could also take a picture of a clipboard in your lap. We have an obligation to protect patient privacy, but we can’t stop people from stealing. We do comply with all government regulations for privacy and have the highest level of security.
Patients and customers sometimes ask for privacy wings. Privacy wings are perceived as security, but those can be worthless because someone can still see your information. The perception of privacy is there, but it isn't the best way to protect customers. We'll put the privacy wings on if they want, but sometimes it just takes training of staff to help patients understand the privacy the kiosks offer.
The kiosks also have a scanner, the same kind of technology used for passports. They use optical character recognition to read info off the driver's license, which allows us to know where the data is.
KioskMarketplace: Are there particular demographic groups of patients that are likely to use a kiosk?
Eric Anderson: We discovered that 55 percent of people who use the kiosks are on Medicare. Most healthcare consumers are older people, not younger. The average patient using our kiosks in many places is 65 to 68.
Our Thomas Eye Group customer has patients with an average age of 46 using the kiosks, and Baptist Health an average age of 47. However, this average fluctuates according to the type of facility. For example, the Baptist Health Cancer Center has an average patient age of 62.
KioskMarketplace: Perhaps this is a good time to discuss some of your company's facility customers. You just mentioned Thomas Eye Group, for instance?
Eric Anderson: The total number of kiosks deployed throughout Thomas Eye Group’s eight clinic locations is 23. The average percent of patients using the kiosks to check-in is 91 percent. Every month, over 12,500 patients check in at Thomas Eye Group Kiosks. They have 144,000 patients checking in at the kiosk every calendar year. The average patient check-in time at the kiosk is two minutes and 10 seconds. Staff doesn't have to enter anything and that saves time.
Kiosk Marketplace: And Baptist Health?
Eric Anderson: Baptist Health has 54 kiosks deployed through the Baptist Health Hospital System. Patients check in at the kiosks at a rate of 95 percent. Our average across all customers is 85 percent, which makes Baptist Health one of our best practice locations. Every month, over 38,000 patients check in at Baptist Health kiosks. They have 460,000 patients checking in at the kiosk every calendar year.
KioskMarketplace: How do the venues themselves benefit from installing and utilizing a kiosk?
Eric Anderson: Most patients, in fact 80 percent, think it's easier to check-in on their own. The font size is much larger for those who need it. It's easier for those with arthritis too, because it can be painful to use a pen. The buttons are bigger and easier to read.
The kiosk also helps the front desk know when a patient arrives. Before implementing the kiosk, charts would be ready for nurses on average 10 minutes after the patient arrived for some of our customers. Now, it's about nine minutes before they get there. The inefficiency is gone.
And because it validates insurance benefits, collects copayments and outstanding balances, providers reap financial benefits too.
KioskMarketplace: How do you see kiosks fitting into the future of healthcare? And how do tablets enter into the equation – or do they?
Eric Anderson: Imagine a world where a patient walks up to a kiosk, enters his name, posts a payment, insurance information is collected, and he is checked in and no staff has lifted a finger.
Tablets aren't going to be as successful with this process as kiosks because you have to wait in line for the tablet, then hand the tablet back so you wait in line twice. Kiosks are so prevalent and working so well because you don’t have to wait and you can do it on your own.
View from the Healthcare Floor
As indicated in the main text, Atlanta-based eyecare provider Thomas Eye Group has now installed 23 Clearwave patient check-in kiosks in its eight clinic locations, and more than 90 percent of patients are now using the kiosks at check in.
CEO Rodney W. Roeser had these comments on how his facility has successfully integrated the kiosk technology:
On reaction from the staff toward the kiosks and how it's changed workflow: "Like any other type of change, there's an adjustment period for the staff. Within a few months, though, the staff readily saw the benefit of the check-in kiosks."
On patients' reaction to the kiosks: "Just like the staff, there was some resistance in the beginning -- but now that the patients see the benefits from an efficiency standpoint, the comments we receive are overwhelmingly positive. The integration with our practice management system and paperless check-in makes a big difference in the patient’s initial view of our organization. We do have patients who experience frustration with the kiosk from time to time. This is for a variety of reasons. When this occurs we just check the patient in manually.
On privacy issues: "We’ve not really had any privacy concerns mainly because the kiosks have a special screen that only allows viewing if you are directly in front of the unit."
On the benefits to Thomas Eye Group from a business standpoint: "The benefits are both operational and financial. Our check-in process is very smooth, high tech, and paper free. The ROI comes from a decrease in paper and filing, eligibility savings, cash collections at time of service (deductible, co-insurance, etc.), which decreases bad debt, and a reduction in claim denials, which cost about $20 each to process."
Topics: Check-in/Check-out kiosks , Health Care , Healthcare / Hospitals , Patient Self-Service
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