title: Coupling direct collection of health risk information from patients through kiosks with decision support for proactive care management.
abstract: Data collection from patients for use in clinical decision making is foundational for medical practice. Increasingly, kiosks are being used to facilitate direct data collection from patients. However, kiosk-collected data are generally not integrated into the care process. In this project, 4,014 people initiated a kiosk-administered health risk assessment questionnaire using a free-standing public-access kiosk. For 201 of these initiated sessions, kiosk users supplied a Medicaid identification number which allowed their data to be integrated into a regional health information exchange and reviewed by a standards-based clinical decision support system. This system identified 479 survey responses which had been predetermined to warrant follow-up. Notices about these sentinel responses were emailed to care managers and sent to clinical sites. While this study demonstrates the feasibility of collecting and acting on patient-entered health data, it also identifies key challenges to providing proactive care management in this manner.
authors.affiliation: Department of Community and Family Medicine, Duke University Medical Center, Durham, NC, USA.
authors.forename: David F
authors.initials: DF
authors.lastname: Lobach
authors.forename: Garry M
authors.initials: GM
authors.lastname: Silvey
authors.forename: Janese M
authors.initials: JM
authors.lastname: Willis
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Kooy
authors.forename: Kensaku
authors.initials: K
authors.lastname: Kawamoto
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Anstrom
authors.forename: Eric L
authors.initials: EL
authors.lastname: Eisenstein
authors.forename: Fredrick
authors.initials: F
authors.lastname: Johnson
mesh_terms: D020000:Decision Support Systems, Clinical; D005240:Feasibility Studies; D005568:Forms and Records Control; D006305:Health Status Indicators; D016247:Information Storage and Retrieval; D008487:Medical History Taking / Q000379:methods*; D009657:North Carolina; D011795:Surveys and Questionnaires; D018511:Systems Integration; D017216:Telemedicine / Q000379:methods*; D014584:User-Computer Interface