Use of a Kiosk-Model Self-Triage System for COVID-19 Triage

Asli Gorek Dilektasli,1 Vahide Aslihan Durak,2 Erol Armagan,2 Engin Korkmaz,3 Gorsel Kiras,3 Aykut Sen,3 Emel Bulbul Baskan,4,5,* Sehime G Temel4,6,7,* 1Bursa Uludag University, Faculty of Medicine, Department of Pulmonary Medicine, Bursa, Turkey; 2Bursa Uludag University, Faculty of Medicine, Department of Emergency Medicine, Bursa, Turkey; 3CITS, Bursa, CITS IT R&D Center, Coskunoz Holding, Bursa, Turkey; 4Bursa Uludag University, Health Sciences Institute, Department of Translational Medicine, Bursa, Turkey; 5Bursa Uludag University, Faculty of Medicine, Department of Dermatology, Bursa, Turkey; 6Bursa Uludag University, Faculty of Medicine, Department of Medical Genetics, Bursa, Turkey; 7Bursa Uludag University, Faculty of Medicine, Department of Histology & Embryology, Bursa, Turkey*These authors contributed equally to this workCorrespondence: Emel Bulbul Baskan; Sehime G Temel, Bursa Uludag University, Health Sciences Institute, Department of Translational Medicine, 16059 Nilüfer, Bursa, Turkey, Email [email protected]; [email protected]: Pandemics put healthcare workers (HCWs) at risk of infections, making emergency department (ED) triage critical. This study aims to compare smart innovative self-kiosk triage (SKT) with routine triage (RT).Patients and Methods: COVID-19-suspected ED patients enrolled. Volunteers received RT after completing SKT. The key outcomes were HCW exposure and total exposure time (TET). Secondary outcomes included participants’ satisfaction with SKT.Results: The study included 115 patients with a mean age of 32.54± 10.84 years old. SKT significantly reduced HCW exposures (median 0 [IQR 0– 1] vs 2 [IQR 2– 3], p< 0.0001) and triage time (median 3 [IQR 2– 3] vs 8 [IQR 5– 10] minutes, p< 0.0001), compared to RT. Elevated body temperature increased RT time (p=0.003), while higher education levels reduced SKT time (p=0.019). Oxygen saturation influenced HCW exposure in both methods, with higher saturation decreasing HCW exposure during RT (p=0.008) and increasing it during SKT (p=0.017). A PCR-positive status was associated with increased RT time but fewer HCW exposures. 80.0% of participants completed SKT independently. The majority of participants (72.8– 82.9%) agreed or strongly agreed, based on a 4-point Likert scale, that the SKT procedure was user-friendly (mean score: 3.40± 1.08), with clear instructions (3.35± 1.16), easy-to-use oximetry and thermometer (3.12± 1.29 and 3.31± 1.16, respectively), and a reasonable time requirement (3.37± 1.23).Conclusion: Our findings suggest that emergency department self-kiosk triage can minimize medical staff exposure and time spent with COVID-19-risk patients, without compromising patient satisfaction.Plain Language Summary: The COVID-19 pandemic created significant challenges for healthcare systems worldwide, particularly in reducing contact between patients and healthcare workers to prevent virus transmission. To address this, we developed a self-triage medical kiosk, designed to minimize face-to-face interactions and enhance safety in emergency departments (EDs). In our study, 115 patients (mean age 32.54± 10.84 years, 52.2% female) used the kiosk for initial health assessments and COVID-19 risk scoring before seeing a healthcare professional. The results showed that the self-kiosk triage (SKT) significantly reduced triage time (median 3 minutes vs 8 minutes for routine triage, p< 0.0001) and healthcare worker exposure (median 0 vs 2 hCWs exposed, p< 0.0001). Multivariable analysis revealed that patient education level, body temperature, and oxygen saturation influenced triage times and HCW exposure. Notably, the kiosk maintained high patient satisfaction, with more than 80% of participants completing self-triage independently and reporting the system as user-friendly, with clear instructions and easy-to-use devices. In conclusion, our research suggests that self-triage kiosks can improve safety and efficiency in emergency department operations during pandemics by minimizing direct contact while maintaining high-quality patient care.Keywords: telehealth, self-kiosk triage, emergency department, COVID-19