Kiosks win patient kudos and speed registration

$140 million effort enhances patient-centered care

A series of MediKiosks designed by Maitland, FL-based Galvanon Inc. have cut patient check-in time at the Baylor Sammons Breast Imaging Center in Dallas from seven or eight minutes down to three, while winning broad approval from patients. The pilot program, which ultimately may spread to the entire Baylor Health Care System, is part of a $140 million clinical transformation effort at Baylor.

“One of our overriding goals is to consolidate several [electronic] systems into one, to allow a single patient record across all of Baylor,” explains Randy Fusco, corporate director of Internet development services for the Baylor Health Care System. “Within this initiative is a specific opportunity to create what we call the ‘ideal patient experience.’ This entails making the entire patient experience faster, better, and safer,” he points out. “Self-service technology is one way to achieve this.”

The pilot program for the kiosks was launched Oct. 15, 2004, but it had its origins in earlier work Fusco had done with Galvanon. “We were working with this vendor on another software development project inside Baylor,” he recalls, “and it turns out, they had some work going on with this device that, with the swipe of a driver’s license or a credit card like at some airports, allows a patient to check in. I was intrigued, and since they use similar technology to us, it made it a nice fit both for technology and the ideal patient experience.”

Fusco set up a meeting for product demonstration in the summer of 2004. “We got rockin’ and rollin’ fast, because when we demonstrated it to executive management, they were blown away by it, and said, ‘Let’s do a pilot,’” he reports.

Although Galvanon does make freestanding kiosks, this pilot program started off with handheld versions of the technology. “The hand-held model is a wireless display device with a touch-screen,” explains Jason Whiteside, manager, business management, Internet development services, who managed the pilot project and interfaced with the staff. The devices work like this: When patients come to the desk, staff hand them an e-clipboard, on which they fill out the required forms. (A soft keyboard at the bottom of the device allows patients to spell out words when required.)

“There are a total of 14 in the clinic right now,” Whiteside says. “We are in the process of determining where the best fit is to do this; our goal is to include the freestanding floor model as well, so we will have experience with that technology, too. This way, as we continue to move forward, we will be in a position to see which of the two models fits specific problems best.”

Getting the project up and running required little if any staff training. “The workflow basically emulates the same forms, the same activities,” he explains. “All we really had to cover was what to do if the device freezes, and so on.”

In introducing the kiosks, Baylor had three major goals: streamline the patient check-in process, reduce administrative costs, and enhance the total patient experience. All three seem to have been achieved.

“Our No. 1 patient complaint had been the cumbersome paperwork,” Whiteside notes. “This process is not only faster, but it allows the patient to do it only once; when they come back, we can present them with the information they gave the last time, and they only have to update it.”

There were some fears the technology would meet with patient resistance, as many of the patients are 50 or older, but that resistance never materialized. “When we first launched, we expected a high percentage of the ladies would just decline to use it,” Fusco adds. “But to our surprise, they didn’t. The response has been tremendous.”

As for administrative costs, Whiteside sees many advantages. “This practice spends $20,000 a year on paper,” he says. “We have taken a 12- to 14-page paper process down to one piece of paper, so we’ve seen maybe an 80% to 90% reduction in costs per year, and those savings will be ongoing.”

In addition, Whiteside says, a tremendous amount of staff time has been freed up. “They spent a vast majority of their day doing forms, shuffling paper,” he observes. “Since the pilot began, they have gotten about 50% of that time back — that’s over three hours per day per staff member, so that’s a total of 18 hours per day back. We want to focus that [regained time] on day-to-day customer support,” Whiteside explains.

Budget constraints should not prevent smaller facilities from using such a system, he continues, because it will pay for itself. “I would say absolutely [it would work at a smaller facility],” he insists. “With the old registration process, appointments were scheduled a month or so out. What we see is that date getting closer, and we’re seeing more patients in a day.

“That means a pretty nice increment of patients we’ve not seen before. If we can do that, the incremental revenue alone will pay for the project,” Whiteside adds.

Baylor is now looking at starting pilot programs at its new Plano Regional Medical Center, as well as other facilities. “The interesting thing is, everyone gets it — they see the potential, and they’re scrambling to see how to best fit the technology into their work flow,” Fusco explains. “But, I’d caution against introducing a new technology with old processes. You’ve got to make sure your forms and so on are in good shape, too,” he adds.

“The main thing I want to emphasize,” Fusco continues, “is this is not so much an exercise in trying to find technology, but an effort in looking to improve the patient experience. We have come across a lot of technology, but this is the first time we have had patients come unsolicited to administration and say, ‘This is the best.’ Those things are golden.”