Implementation of a Web-based Diabetic Retinopathy Training Module for Medical Students

Purpose The use of kiosk technology in the healthcare setting has become increasingly common, although its use has not been formally evaluated in ophthalmology. The purpose of this study was to assess patient satisfaction and specific barriers to successful usage after the implementation of self check-in kiosks in an academic ophthalmology department. Methods We performed a cross-sectional study comparing patients who were kiosk users to those who utilized in-person check-in. We also enrolled patients to participate in a voluntary, IRB-approved electronic survey administered by two interviewers in a comprehensive ophthalmology clinic at an urban academic medical center. To identify patient satisfaction and barriers to usage, we surveyed randomly selected participants, including kiosk and non-kiosk users. The survey consisted of questions with a fivepoint Likert scale derived from a previously established framework based on the World Health Organization (WHO) conceptual model on patient satisfaction. Aggregate demographic and socioeconomic data were obtained from electronic health records. Results Records of 9,824 patients were reviewed. There were 137 kiosk users (1.4%). We received 100 survey responses among kiosk and non-kiosk users. Kiosk users were younger compared to non-kiosk users (median age 46 vs. 58, respectively, p < 0.01). The proportion of primarily Spanish-speaking patients was lower in the kiosk cohort (12.1% vs. 19.1%, respectively, p < 0.001). Among the 16 kiosk users who participated in the survey, 10 (63%) patients strongly agreed with the statement that they were satisfied with their check-in experience, as compared to 71 of 84 (84%) non-kiosk users (p < 0.05). Sixty-three percent of all survey respondents (n = 63), regardless of check-in method, were initially unaware of the intended purpose of the kiosks. While 55% of all survey respondents (n = 55) had used a kiosk in a different setting previously, only 16% (n = 16) felt comfortable successfully using a kiosk in this setting. Conclusions Implementing kiosks in ophthalmology may pose distinct logistical challenges. In this study, kiosks were less likely to be used among patients over 50, non-English speaking patients, and those without insurance. There are unique barriers to kiosk usage reported by visually impaired patients.