OSLI Retina

December 2020

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684 Ophthalmic Surgery, Lasers & Imaging Retina | Healio.com/OSLIRetina ■ C L I N I C A L S C I E N C E ■ Characterization of Kiosk Usage for Ophthalmic Outpatient Visits Weilin Song, BS; Andrew X. Chen, BSE; Thais F. Conti, MD; Tyler E. Greenlee, DO; Grant L. Hom, BA; Aleksandra V. Rachitskaya, MD; Rishi P. Singh, MD BACKGROUND AND OBJECTIVES: This study aims to characterize check-in kiosk usage within a multi- disciplinary ophthalmic clinic. PATIENTS AND METHODS: Chart review of patients aged 18 or older seen at Cole Eye Institute, Cleve- land Clinic, from August 1, 2019, to October 31, 2019. Primary endpoint was percentage of patients who used a check-in kiosk. Secondary endpoints were demographic characteristics and visual acuity (VA) of the two groups. RESULTS: Of 13,752 patients, 3,542 (26%) used a check-in kiosk. Kiosk users were significantly younger than kiosk non-users (median [interquar- tile range (IQR)]: 63.6 [49.4-72.6] vs. 66.6 [55.0- 75.4]; P < .0001), had a lower proportion of Med- icaid patients (282 [8%] vs. 930 [10%]; P < .0001), and lived in areas with a greater median income (mean [± standard error]: $58,421 [± 399) vs. $54,992 [±236]; P < .0001). On average, they also had better VA (mean ETDRS [95% confidence in- terval]: 80.5 [80-80.9] vs. 78.3 [78-78.6]; P < .0001). CONCLUSIONS: Significant demographic and VA differences were observed between kiosk users and non-users and may influence kiosk usage. [Ophthalmic Surg Lasers Imaging Retina. 2020;51:684-690.] INTRODUCTION Advanced technologies have altered long-stand- ing processes within customer-based industries, resulting in greater efficiency, productivity, and quality of service. 1,2 Self-service technology (SST), a technological interface that allows business oper- ators to produce a service without the involvement of a service employee, is a proven business model that generates favorable impact in industries such as airports, hotels, and retail. 3,4 In settings with long lines and wait times, self-service kiosks have been shown to be a valuable tool in enhancing op- erational efficiencies and have been implemented across virtually all service industries, 5 including health care. Recent studies have evaluated the utilization of check-in kiosks within emergency departments (EDs), where overcrowding has been shown to have a significant detrimental impact on various clini- cal outcomes. 6,7 In one clinical trial by Sinha et al., of 400 participants visiting a pediatric ED, pa- tients randomized to the self-triage kiosk group had a shorter mean time to enter medical history data and lower mean inaccuracies in areas of medical, medication, and immunization histories compared to the group randomized to standard nurse triage. 8 Another prospective trial by Coyle et. al. demon- strated that ambulatory patients who used self- check-in kiosks had shorter time to first identifica- tion, which was defined as the interval between ED arrival and identification in the hospital system. 9 From Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio (WS); Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic Foun- dation, Cleveland, Ohio (AXC, TFC, TEG, GLH, AVR, RPS); and Case Western Reserve University School of Medicine, Cleveland, Ohio (AXC, GLH, RPS). Originally submitted May 28, 2020. Revision received May 28, 2020. Accepted for publication October 7, 2020. Accepted for presentation at the 2020 Association for Research in Vision and Ophthalmology Annual Meeting, Baltimore, Maryland. Mr. Chen reports grants from the NIH Institutional Training T32 Award and RPB Medical Student Eye Research Fellowship during the conduct of the study. Dr. Rachitskaya reports personal fees from Alcon, Novartis, Zeiss, and Allergan outside the submitted work. Dr. Singh reports personal fees from Alcon, Novartis, Zeiss, Genentech/Roche, Bausch + Lomb, Ophthea, and Regeneron Pharmaceuticals, as well as grants from Apellis and Graybug, outside the submitted work. The remaining authors report no relevant financial disclosures. Dr. Singh did not participate in the editorial review of this manuscript. Address correspondence to Rishi P. Singh, MD, Cole Eye Institute, Cleveland Clinic Foundation, 9500 Euclid Ave., Mail Code i-32, Cleveland, OH 44195; email: singhr@ccf.org. doi: 10.3928/23258160-20201202-02

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