What kiosks offer that online telehealth cannot

From the mHealthNews archive
By Eric Wicklund
09:11 am

Ohio-based HealthSpot says its kiosk model is more effective than online telehealth platforms – and it's pointing to a recent pilot in San Diego as proof.

For nine months, a kiosk sitting in the front lobby of the San Diego County office building offered the roughly 6,000 employees within a mile or two easy access to their Kaiser Health doctors. In that time period, 436 people used the kiosk for a medical appointment, and HealthSpot officials said every one rated that experience as the same or better than what they would have gotten at a doctor's office, giving it high marks for convenience, access and service, and saying they'd recommend it to friends.

"This is the bar. This is what we expect with HealthSpot," company CEO Steve Cashman said of the pilot, which will soon be expanded to five employer locations. "This offers the same standard of care as an in-person visit."

The kiosk, which was unveiled at CES two years ago and has been on display at several conferences, including those organized by HIMSS and the American Telemedicine Association, is a self-contained booth equipped with several mobile-enabled medical devices and a videoconference feed with local physicians (in the San Diego pilot, the connection is with Kaiser Permanente, the county's health insurer). A nurse is on hand at the kiosk to help orient visitors and collect some vitals at the beginning of the 20-minute session, which then shifts to a videoconference with a doctor.

Ciara Webb, a county employee, visited the kiosk twice – once because she was battling a chest cold and didn't want to take two hours out of her day to travel to a doctor's office. She made use of a stethoscope in the kiosk, was diagnosed with bronchitis and given a prescription. All in 20 minutes.

"I actually found it to be a little more enjoyable because I didn't feel rushed," she said, "and it was a more personable experience."

Webb also noted that she tends to wait too long before seeing a doctor about a health issue. That's a common issue, and one that telehealth advocates say can be greatly eased by such resources as kiosks and online telehealth visits. To wit: If someone can get an appointment with a doctor within an hour or two, he or she won't procrastinate, any health issues will be identified sooner, and healthcare costs and clinical outcomes will improve.

Elaine Pitpit, a services manager for the San Diego County Human Resources Department, said the kiosk was never crowded – there were seven or eight appointments per day – and those using the kiosk "really like how much time they had with a doctor." She said there were some initial concerns with sanitation, but those were addressed through a video that explains how the kiosk is thoroughly cleaned.

More concerning, Pitpit said, was that employees felt they could use the kiosk only if they didn't feel well.

"We need to remind them that it's not just for when you’re feeling sick," she said, noting the kiosk can be used for flu shot clinics and other programs. "We would like it to be used as more of a wellness station."

Paul Bernstein, MD, medical director for Kaiser Permanente's San Diego region, says the kiosk not only proved convenient for consumers, but was "very satisfying" for the physicians as well (Kaiser currently has 10 physicians trained to use the kiosk).

The combination of a video feed and associated biometric devices "means you're not just looking at somebody," he said. "This is virtual care. It's efficient, it (provides) quality care, and it is personal for physicians."

He called it an ideal solution for locations with a large number of potential users, such as office buildings and retail locations. That's a slightly different business case than that trumpeted by the online telehealth providers, who see their service as ideal for the parent at home who has a sick child or the consumer wanting to check in with a doctor at home after work (or one who's home sick).

HealthSpot officials said their kiosks are finding traction in many locations across the country, from hospitals and health clinics to pharmacies and office buildings, and are garnering near-perfect patient satisfaction rates. In recent months the company has forged partnerships with Rite Aid, Xerox and CareSource. An estimated 20 kiosks were in use as of November 2014, with both the Mayo Clinic and Cleveland Clinic poised to launch pilots.

Cashman sees growth in the retail market for HealthSpot, with kiosks potentially in more than 60,000 pharmacies and tens of thousands of other high-traffic areas around the country. He even envisions them in nursing homes, clinics and hospital emergency rooms, where they can handle the less-serious cases and enable clinicians to focus on where they're needed most.

"This is becoming an extension of the medical community," he said. "Doctors love it, and the only question we're getting from consumers is, 'Why aren't there more?"


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