Implementation of a New Kiosk Technology for Blood Pressure Management in a Community-Based Primary Care Clinic
technology adoption and diffusion, primary care, qualitative research, technology assessment
Background: Asking patients to measure their own vital signs using a self-service validated blood pressure (BP) kiosk in clinic has the potential to increase patient awareness of their BP control, and free up medical assistant time for other activities. We sought to evaluate BP kiosk acceptability, usability and impact on workflow of patient BP self-measurement in a primary care clinic waiting room.
Methods: A primary care clinic in eastern Washington placed two validated BP kiosks in the waiting room. Patients were asked to take their own BP and print out the results at the start of their clinic visit. Mixed-method assessments included early (2-month) and later (8-month) qualitative and quantitative descriptive assessments of kiosk implementation via meetings with clinic leaders, focus groups with clinic staff and providers, observations of kiosk users and in-clinic surveys of adult kiosk users.
Results: Of the roughly 400 BPs/week on the kiosk, 34% were stage 1 hypertension and 13% stage 2 or higher. Patient surveys revealed that most patients were comfortable using the BP kiosk (82% at 2 months and 87% at 8 months), and most thought it was accurate or more accurate than medical assistant measurements (81% at both time points). Initial provider concerns included accuracy, but most were confident after a discussion with the study team and use. Patients and providers saw many benefits: easier BP rechecks at the same and follow-up visits, increased patient engagement and savings of medical assistant time (1 minute 30 seconds per visit) allowing them to do other tasks. The clinic addressed early concerns such as infection (sanitary wipes), instructions (simplification) and lack of personal touch (stationing a receptionist in the waiting room). Most patients (86%) were in favor of the clinic continuing to use the BP kiosks. Remaining challenges include kiosk privacy (possibly moving one kiosk to the examination room area) and accommodating differently sized and able patients.
Conclusion: Providers, staff and patients adapted to use of a self-service kiosk, providing opportunities for deploying saved medical assistant time for other patient-care activities. The clinic decided to keep the self-service BP kiosk after the pilot period.
Green B, Chung CF, Munson SA, Thompson MJ, Baldwin LM, Kaplan J, Cline R. Implementation of a new kiosk technology for blood pressure management in a community-based primary care clinic. J Patient Cent Res Rev. 2017;4:185.