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Self-service BP kiosks provide benefits to clinicians, patients

Automated systems set up to measure blood pressure in a family medicine clinic offered engagement and education opportunities and was generally well accepted by both clinicians and their staff, and were well-received by patients, according to data recently published in the Journal of the American Board of Family Medicine.

 “From the clinic perspective, the kiosk not only saved [medical assistant] time but also increased provider engagement and provided opportunities for better BP monitoring and patient education,” Chia-Fang Chung, MBA, of the department of human centered design and engineering, University of Washington, Seattle, and colleagues wrote. “While some patients felt kiosks were impersonal, the clinic identified opportunities to provide a more personal experience, such as allowing [medical assistants] to spend more time taking patient histories and placing the navigator in the waiting room. Provider and [medical assistant] endorsement of the kiosk also increased patient acceptance.”

The clinic participating in the study had five front desk employees, eight medical assistants, a physician assistant and six physicians. The clinic was part of a larger health system with four other primary care clinics and a hospital.

Chung and colleagues observed staff workflow and patient interactions with the kiosk the first 9 months the device was in the clinic. Staff member focus groups and patient questionnaires were conducted 2 and 8 months after its’ installation.

Researchers found increasing time with patients, gaining a better understanding of a patients’ BP history and having more time to return other patients’ phone calls were benefits to using the kiosk.

Some staff members initially expressed concerns regarding the device’s accuracy, and concerns about job security or work responsibility. According to Chung and colleagues, staff members compared BP readings provided by the kiosk with those taken manually and found in most instances the results were similar. In addition, clinic leaders told staff members the device was intended to enhance patient care, not eliminate jobs or change work responsibilities.

Patients also liked using the kiosks, with 82.2% of 103 respondents saying they felt “comfortable” or “very comfortable” using them at the 2-month mark, as did 88.8% of 125 patients at the 8-month mark. Researchers wrote patients also seemed to pay more attention to their BP readings, used the kiosk to record their BPs between office visits and were more likely to notice when their BP was high. However, the increased awareness also brought anxiety to some patients, and they also expressed concerns regarding the device’s accuracy and confusion regarding some of the data provided. To ensure accuracy and clear up confusion, clinic staff members provided tips on best times to measure BP and offered other assistance. At the study’s end, the clinic kept the kiosk; 86% of the patients had indicated they wanted the clinic to do so.

“Although patients were the primary users of this self-service technology, our study highlights that the kiosks influenced both provider and staff workflow,” Chung and colleagues wrote. – by Janel Miller