Skip to main content
Top
Published in: Journal of General Internal Medicine 5/2017

01-05-2017 | Original Research

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

Authors: Juliana Bahadin, MBBS, Mmed (Fam Med), FCFP, FAMS, Eugene Shum, MBBS, MPH, FAMS, Grace Ng, BEng, MEng, Phd, MBBS, GDFM, Nicolette Tan, BA, Pushpavalli Sellayah, BSc, Sze Wee Tan, MBBS, MBA

Published in: Journal of General Internal Medicine | Issue 5/2017

Login to get access

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.
Literature
4.
go back to reference Jesmin S, Thind A, Sarma S. Does team-based primary health care improve patients’ perception of outcomes? Evidence from the 2007–08 Canadian Survey of Experiences with Primary Health. Health Policy. 2012;105(1):71–83.CrossRefPubMed Jesmin S, Thind A, Sarma S. Does team-based primary health care improve patients’ perception of outcomes? Evidence from the 2007–08 Canadian Survey of Experiences with Primary Health. Health Policy. 2012;105(1):71–83.CrossRefPubMed
5.
go back to reference Taylor E, Rachel M, Meyers D, et al. Enhancing the primary care team to provide redesigned care: The roles of practice facilitators and care managers. Ann Fam Med. 2013;11(1):80–83. Taylor E, Rachel M, Meyers D, et al. Enhancing the primary care team to provide redesigned care: The roles of practice facilitators and care managers. Ann Fam Med. 2013;11(1):80–83.
6.
go back to reference Borrill C, West M, Shapiro D, et al. Team working and effectiveness in health care. Br J Healthc Manag. 2000;6(8):364–371. Borrill C, West M, Shapiro D, et al. Team working and effectiveness in health care. Br J Healthc Manag. 2000;6(8):364–371.
7.
go back to reference Hoffmann A. Minute medicine: examining retail clinic legal issue and legislative challenges health matrix. J Law Med. 2010;20(2):467–497. Hoffmann A. Minute medicine: examining retail clinic legal issue and legislative challenges health matrix. J Law Med. 2010;20(2):467–497.
8.
go back to reference Rosati R. Evaluation of remote monitoring in home health care. 2009 International Conference on eHealth, Telemedicine, and Social Medicine 2009:25–27 Rosati R. Evaluation of remote monitoring in home health care. 2009 International Conference on eHealth, Telemedicine, and Social Medicine 2009:25–27
9.
go back to reference Bayer S, Barlow J, Curry R. Assessing the impact of a care innovation: telecare. Syst Dyn Rev. 2007;23(1):61–80.CrossRef Bayer S, Barlow J, Curry R. Assessing the impact of a care innovation: telecare. Syst Dyn Rev. 2007;23(1):61–80.CrossRef
12.
go back to reference Ng G, Tan N, Bahadin J, et al. Development of an automated healthcare kiosk for the management of chronic disease patients in the primary care setting. J Med Syst. 2016;40(7):1–11. doi:10.1007/s10916-016-0529-y. Ng G, Tan N, Bahadin J, et al. Development of an automated healthcare kiosk for the management of chronic disease patients in the primary care setting. J Med Syst. 2016;40(7):1–11. doi:10.​1007/​s10916-016-0529-y.
14.
go back to reference O’Brien E, Asmar R, Beilin L, et al. European Society of Hypertension Working Group on Blood Pressure Monitoring. European Society of Hypertension recommendations for conventional, ambulatory and home blood pressure measurement. J Hypertens. 2003;21:821–848. O’Brien E, Asmar R, Beilin L, et al. European Society of Hypertension Working Group on Blood Pressure Monitoring. European Society of Hypertension recommendations for conventional, ambulatory and home blood pressure measurement. J Hypertens. 2003;21:821–848.
15.
go back to reference Pickering TG, Hall JE, Appel LJ, et al. Recommendations for blood pressure measurement in humans and experimental animals: Part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Hypertension. 2005;45:142–161.CrossRefPubMed Pickering TG, Hall JE, Appel LJ, et al. Recommendations for blood pressure measurement in humans and experimental animals: Part 1: blood pressure measurement in humans: a statement for professionals from the Subcommittee of Professional and Public Education of the American Heart Association Council on High Blood Pressure Research. Hypertension. 2005;45:142–161.CrossRefPubMed
16.
go back to reference Mancia G, Parati G, Casadei R, et al. Effect of stress on diagnosis of hypertension. Hypertension. 1991;17(supplIII):III-56–III-62. Mancia G, Parati G, Casadei R, et al. Effect of stress on diagnosis of hypertension. Hypertension. 1991;17(supplIII):III-56–III-62.
17.
go back to reference Mancia G, Bertinieri G, Grassi G, et al. Effects of blood pressure measurements by the doctor on patient’s blood pressure and heart rate. Lancet. 1983;2:695–698. Mancia G, Bertinieri G, Grassi G, et al. Effects of blood pressure measurements by the doctor on patient’s blood pressure and heart rate. Lancet. 1983;2:695–698.
18.
go back to reference Mancia G, Parati G. Reactivity to physical and behavioural stress and blood pressure variability in hypertension. In: Julius S, Bassett DR, eds. Handbook of hypertension: volume 9, behavioural factors in hypertension. Amsterdam: Elsevier; 1987:104–122. Mancia G, Parati G. Reactivity to physical and behavioural stress and blood pressure variability in hypertension. In: Julius S, Bassett DR, eds. Handbook of hypertension: volume 9, behavioural factors in hypertension. Amsterdam: Elsevier; 1987:104–122.
19.
go back to reference Luo N, Koh WP, Ng WY, et al. Acceptance of information and communication technologies for healthcare delivery: a SingHealth Polyclinics study. Ann Acad Med Singapore. 2009;38(6):529–8. Luo N, Koh WP, Ng WY, et al. Acceptance of information and communication technologies for healthcare delivery: a SingHealth Polyclinics study. Ann Acad Med Singapore. 2009;38(6):529–8.
23.
go back to reference Huang Z, Tao H, Meng Q, et al. Management of endocrine disease. Effects of telecare intervention on glycemic control in type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials. Eur J Endocrinol. 2015;172(3):R93–101. doi:10.1530/EJE-14-0441. Huang Z, Tao H, Meng Q, et al. Management of endocrine disease. Effects of telecare intervention on glycemic control in type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials. Eur J Endocrinol. 2015;172(3):R93–101. doi:10.​1530/​EJE-14-0441.
24.
go back to reference Neville RG, Marsden W, McCowan C, et al. Email consultations in general practice. Inform Prim Care. 2004;12(4):207–14. Neville RG, Marsden W, McCowan C, et al. Email consultations in general practice. Inform Prim Care. 2004;12(4):207–14.
26.
Metadata
Title
Follow-Up Consultation Through a Healthcare Kiosk for Patients with Stable Chronic Disease in a Primary Care Setting: A Prospective Study
Authors
Juliana Bahadin, MBBS, Mmed (Fam Med), FCFP, FAMS
Eugene Shum, MBBS, MPH, FAMS
Grace Ng, BEng, MEng, Phd, MBBS, GDFM
Nicolette Tan, BA
Pushpavalli Sellayah, BSc
Sze Wee Tan, MBBS, MBA
Publication date
01-05-2017
Publisher
Springer US
Published in
Journal of General Internal Medicine / Issue 5/2017
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-016-3931-8

Other articles of this Issue 5/2017

Journal of General Internal Medicine 5/2017 Go to the issue

Original Research

Faces of Lyme

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.