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Development of an Automated Healthcare Kiosk for the Management of Chronic Disease Patients in the Primary Care Setting

  • Grace NgEmail author
  • Nicolette Tan
  • Juliana Bahadin
  • Eugene Shum
  • Sze Wee Tan
Patient Facing Systems
Part of the following topical collections:
  1. Patient Facing Systems

Abstract

An increase in the prevalence of chronic disease has led to a rise in the demand for primary healthcare services in many developed countries. Healthcare technology tools may provide the leverage to alleviate the shortage of primary care providers. Here we describe the development and usage of an automated healthcare kiosk for the management of patients with stable chronic disease in the primary care setting. One-hundred patients with stable chronic disease were recruited from a primary care clinic. They used a kiosk in place of doctors’ consultations for two subsequent follow-up visits. Patient and physician satisfaction with kiosk usage were measured on a Likert scale. Kiosk blood pressure measurements and triage decisions were validated and optimized. Patients were assessed if they could use the kiosk independently. Patients and physicians were satisfied with all areas of kiosk usage. Kiosk triage decisions were accurate by the 2nd month of the study. Blood pressure measurements by the kiosk were equivalent to that taken by a nurse (p = 0.30, 0.14). Independent kiosk usage depended on patients’ language skills and educational levels. Healthcare kiosks represent an alternative way to manage patients with stable chronic disease. They have the potential to replace physician visits and improve access to primary healthcare. Patients welcome the use of healthcare technology tools, including those with limited literacy and education. Optimization of environmental and patient factors may be required prior to the implementation of kiosk-based technology in the healthcare setting.

Keywords

Tele-health Telemedicine Technology Kiosk Primary care Chronic disease 

Notes

Acknowledgments

The authors thank our collaborators Ronald Dixon from Massachusetts General Hospital Department of Medicine, and Marc Filerman from Center for the Integration of Medicine and Technology (CIMIT), Boston, for their invaluable inputs and guidance with the study. We thank Tan Ngiap Chuan for helpful discussions; our study coordinators Susan Toh and Cheah Seng Lian; and our nurses Lee Yuet Lai, Woo Yuen Kau, Teo Sok Hoon, Munahwarah Bte Mokhtar and Pushpavalli Selayah from SingHealth Polyclinics for their immense support and contributions, without which this study would not have been possible. The kiosk was designed and fabricated by AIT Technologies Private Limited. This work was supported by an A*STAR-CIMIT commercialization project grant.

References

  1. 1.
    Kanchanachitra, C., Lindelow, M., Johnston, T., Hanvoravongchai, P., Lorenzo, F.M., Huong, N.L., Wilopo, S.A., and dela Rosa, J.F., Human resources for health in Southeast Asia: shortages, distributional challenges, and international trade in health services. Lancet. 377(9767):769–781, 2011. doi: 10.1016/S0140-6736(10)62035-1.CrossRefPubMedGoogle Scholar
  2. 2.
    Margolius, D., and Bodenheimer, T., Transforming primary care: from past practice to the practice of the future. Health Aff (Millwood). 29(5):779–784, 2010. doi: 10.1377/hlthaff.2010.0045.CrossRefGoogle Scholar
  3. 3.
    Goodman, D.C., and Fisher, E.S., Physician workforce crisis? Wrong diagnosis, wrong prescription. N Engl J Med. 358(16):1658–1661, 2008. doi: 10.1056/NEJMp0800319.CrossRefPubMedGoogle Scholar
  4. 4.
    Blumenthal, D., and Glaser, J.P., Information technology comes to medicine. N Engl J Med. 356(24):2527–2534, 2007.CrossRefPubMedGoogle Scholar
  5. 5.
    Chaudhry, B., Wang, J., Wu, S., Maglione, M., Mojica, W., Roth, E., Morton, S.C., and Shekelle, P.G., Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Ann Intern Med. 144(10):742–752, 2006.CrossRefPubMedGoogle Scholar
  6. 6.
    Barlow, J., Singh, D., Bayer, S., and Curry, R., A systematic review of the benefits of home telecare for frail elderly people and those with long-term conditions. J Telemed Telecare. 13(4):172–179, 2007.CrossRefPubMedGoogle Scholar
  7. 7.
    Whittaker, F., and Wade, V., The costs and benefits of technology-enabled, home-based cardiac rehabilitation measured in a randomised controlled trial. J Telemed Telecare. 20(7):419–422, 2014. doi: 10.1177/1357633X14552376.CrossRefPubMedGoogle Scholar
  8. 8.
    Bidargaddi, N., Bastiampillai, T., Allison, S., Jones, G.M., Furber, G., Battersby, M., and Richards, D., Telephone-based low intensity therapy after crisis presentations to the emergency department is associated with improved outcomes. J Telemed Telecare. 21(7):385–391, 2015. doi: 10.1177/1357633X15579785.CrossRefPubMedGoogle Scholar
  9. 9.
    Or, C., and Tao, D., A 3-month randomized controlled pilot trial of a patient-centered, computer-based self-monitoring system for the care of type 2 diabetes mellitus and hypertension. J Med Syst. 40(4):81, 2016. doi: 10.1007/s10916-016-0437-1.CrossRefPubMedGoogle Scholar
  10. 10.
    Dixon, R.F., and Stahl, J.E., Virtual visits in a general medicine practice: a pilot study. Telemed J E Health. 14(6):525–530, 2008. doi: 10.1089/tmj.2007.0101.CrossRefPubMedGoogle Scholar
  11. 11.
    Dixon, R.F., and Stahl, J.E., A randomized trial of virtual visits in a general medicine practice. J Telemed Telecare. 15(3):115–117, 2009. doi: 10.1258/jtt.2009.003003.CrossRefPubMedGoogle Scholar
  12. 12.
    Dixon, R.F., and Rao, L., Asynchronous virtual visits for the follow-up of chronic conditions. Telemed J E Health. 20(7):669–672, 2014. doi: 10.1089/tmj.2013.0211.CrossRefPubMedGoogle Scholar
  13. 13.
    Yarnall, K.S., Ostbye, T., Krause, K.M., Pollak, K.I., Gradison, M., and Michener, J.L., Family physicians as team leaders: “time” to share the care. Prev Chronic Dis. 6(2):A59, 2009.PubMedPubMedCentralGoogle Scholar
  14. 14.
    Grumbach, K., and Bodenheimer, T., Can health care teams improve primary care practice? JAMA. 291(10):1246–1251, 2004.CrossRefPubMedGoogle Scholar
  15. 15.
    Kilo, C.M., Transforming care: medical practice design and information technology. Health Aff (Millwood). 24(5):1296–1301, 2005.CrossRefGoogle Scholar
  16. 16.
    Park, H.S., Cho, H., and Kim, H.S., Development of a multi-agent m-health application based on various protocols for chronic disease self-management. J Med Syst. 40(1):36, 2016. doi: 10.1007/s10916-015-0401-5.CrossRefPubMedGoogle Scholar
  17. 17.
    Jalil, S., Myers, T., and Atkinson, I., A meta-synthesis of behavioral outcomes from telemedicine clinical trials for type 2 diabetes and the clinical user-experience evaluation (CUE). J Med Syst. 39(3):28, 2015. doi: 10.1007/s10916-015-0191-9.CrossRefPubMedGoogle Scholar
  18. 18.
    Khoo, H.S., Lim, Y.W., and Vrijhoef, H.J., Primary healthcare system and practice characteristics in Singapore. Asia Pac Fam Med. 13(1):8, 2014. doi: 10.1186/s12930-014-0008-x.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Sng QS (2010) Ministry of Health Singapore: primary care survey 2010-profile of primary care patients. https://www.moh.gov.sg/content/moh_web/home/Publications/information_papers/2011/primary_care_survey2010profileofprimarycarepatients.html Accessed 18 May 2016
  20. 20.
    Joshi, A., and Trout, K., The role of health information kiosks in diverse settings: a systematic review. Health Info Libr J. 31(4):254–273, 2014. doi: 10.1111/hir.12081.CrossRefPubMedGoogle Scholar
  21. 21.
    Pickering, T.G., James, G.D., Boddie, C., Harshfield, G.A., Blank, S., and Laragh, J.H., How common is white coat hypertension? JAMA. 259(2):225–228, 1998.CrossRefGoogle Scholar
  22. 22.
    Lyu, Y., Vincent, C.J., Chen, Y., Shi, Y., Tang, Y., Wang, W., Liu, W., Zhang, S., Fang, K., and Ding, J., Designing and optimizing a healthcare kiosk for the community. Appl Ergon. 47:157–169, 2015. doi: 10.1016/j.apergo.2014.08.018.CrossRefPubMedGoogle Scholar
  23. 23.
    Menachemi, N., Burke, D.E., and Ayers, D.J., Factors affecting the adoption of telemedicine–a multiple adopter perspective. J Med Syst. 28(6):617–632, 2004.CrossRefPubMedGoogle Scholar
  24. 24.
    Gagnon, M.P., Desmartis, M., Labrecque, M., Car, J., Pagliari, C., Pluye, P., Frémont, P., Gagnon, J., Tremblay, N., and Légaré, F., Systematic review of factors influencing the adoption of information and communication technologies by healthcare professionals. J Med Syst. 36(1):241–277, 2012. doi: 10.1007/s10916-010-9473-4.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Grace Ng
    • 1
    • 2
    Email author
  • Nicolette Tan
    • 3
  • Juliana Bahadin
    • 1
  • Eugene Shum
    • 3
  • Sze Wee Tan
    • 2
  1. 1.Singapore Health Services (SingHealth) PolyclinicsSingaporeSingapore
  2. 2.Agency for Science, Technology and Research (A*STAR)SingaporeSingapore
  3. 3.Centre for InnovationEastern Health AllianceSingaporeSingapore

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