title: An emergency department registration kiosk can increase HIV screening in high risk patients.
abstract: We evaluated the feasibility and the patient acceptability of integrating a kiosk into routine emergency department (ED) practice for offering HIV testing. The work was conducted in four phases: phase 1 was a baseline, in which external testing staff offered testing at the bedside; phase 2 was a pilot assessment of a prototype kiosk; phase 3 was a pilot implementation and phase 4 was the full implementation with automated login. Feasibility was assessed by the proportion of offering HIV tests, acceptance, completion and result reporting. During the study period, the number of ED patients and eligible patients for screening were similar in the three main phases. However, the number and proportion of patients offered testing of those eligible for screening increased significantly from phase 1 (32%) to phase 3 (37%) and phase 4 (40%). There were slightly higher prevalences of newly diagnosed HIV with kiosk versus bedside testing (phase 1, 0%; phase 3, 0.2%; phase 4, 0.5%). Compared to patients tested at the bedside, patients tested via the kiosk were significantly younger, more likely to be female, to be black, and to report high risk behaviours. ED-based HIV screening via a registration-based kiosk was feasible, yielded similar proportions of testing, and increased the proportion of engagement of higher-risk patients in testing.
authors.affiliation: Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA yhsieh1@jhmi.edu.
authors.forename: Yu-Hsiang
authors.initials: YH
authors.lastname: Hsieh
authors.affiliation: Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Megan
authors.initials: M
authors.lastname: Gauvey-Kern
authors.affiliation: Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Peterson
authors.affiliation: Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Alonzo
authors.initials: A
authors.lastname: Woodfield
authors.affiliation: Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Deruggiero
authors.affiliation: Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Charlotte A
authors.initials: CA
authors.lastname: Gaydos
authors.affiliation: Department of Emergency Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Rothman
mesh_terms: D000328:Adult; D000367:Age Factors; D004636:Emergency Service, Hospital; D005240:Feasibility Studies; D005260:Female; D015658:HIV Infections / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D012307:Risk Factors; D012737:Sex Factors; D014584:User-Computer Interface; D055815:Young Adult