title: Follow-Up Consultation Through a Healthcare Kiosk for Patients with Stable Chronic Disease in a Primary Care Setting: A Prospective Study.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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.
authors.affiliation: SingHealth Polyclinics, 167 Jalan Bukit Merah, Tower 5, #15-10, Singapore, 150167, Singapore. juliana.bahadin@singhealth.com.sg.
authors.forename: Juliana
authors.initials: J
authors.lastname: Bahadin
authors.affiliation: Eastern Health Alliance, Centre for Innovation, 5 Tampines Central 1, Tampines Plaza, #08-01/05, Singapore, 529541, Singapore.
authors.forename: Eugene
authors.initials: E
authors.lastname: Shum
authors.affiliation: SingHealth Polyclinics, 167 Jalan Bukit Merah, Tower 5, #15-10, Singapore, 150167, Singapore.|Agency for Science, Technology and Research (A*STAR), 1 Fusionopolis Way, Connexis North Tower, #20-10, Singapore, 138632, Singapore.
authors.forename: Grace
authors.initials: G
authors.lastname: Ng
authors.affiliation: Eastern Health Alliance, Centre for Innovation, 5 Tampines Central 1, Tampines Plaza, #08-01/05, Singapore, 529541, Singapore.
authors.forename: Nicolette
authors.initials: N
authors.lastname: Tan
authors.affiliation: SingHealth Polyclinics, 167 Jalan Bukit Merah, Tower 5, #15-10, Singapore, 150167, Singapore.
authors.forename: Pushpavalli
authors.initials: P
authors.lastname: Sellayah
authors.affiliation: Agency for Science, Technology and Research (A*STAR), 1 Fusionopolis Way, Connexis North Tower, #20-10, Singapore, 138632, Singapore.
authors.forename: Sze Wee
authors.initials: SW
authors.lastname: Tan
mesh_terms: D000368:Aged; D000554:Ambulatory Care Facilities / Q000639:trends; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011320:Primary Health Care / Q000379:methods* / Q000639:trends; D011446:Prospective Studies; D012017:Referral and Consultation / Q000639:trends; D012846:Singapore / Q000453:epidemiology
keywords: alternative care delivery; healthcare kiosk; stable chronic disease