Wednesday, September 19, 2007

The kiosk approach to health care

I recently read in an article that, in an attempt to cut down on lines by patients waiting to be checked into ER's, some hospitals are trying out an automated kiosk system, where patients put in their own information - and are then seen in turn according to information they provide. Of course the wait to see a doctor is still the same - and long - in many places, but nurses report that it cuts down on staff's work and some patients seem pleased with it.

Last night as I watched the movie Idiocracy, the hospital scene reminded me of this article. I don't know if you're familiar with this movie, but it's about an average guy from the Army who is put into hibernation (supposedly for a year) as an experiment but winds up waking up in the year 2500 or so. As he brushes himself off and emerges into this new world, he realizes that it's a "dumbed down" version of our society. The movie's premise is that the folks who had kids had, well, the lower IQ's and over time this produces a generation of subverbal people.

As Joe goes looking for help, he sees the front of a hospital called St. God;s Memorial Hospital and the lettering kind of falls off at the end because it just didn't fit - or someone couldn't figure out how to make it fit. Inside the receptionist has a board in front of her - with pictures - showing possible patient complaints. She never says a word to Joe - simply hits a picture on the board showing a stick figure holding its arms up with two question marks next to its head in response to his explanation that he woke up from an experiment and doesn't know where he is. I suppose that picture was the best fit. And that reminded me of the kiosk, for some reason.

I must admit, as a person with quadriplegia, that I cringe whenever I see things set up in our health care system that create more access problems rather than alleviate them. I'd hate to try to get the attention of a busy staff member if I can't use a kiosk system due to my disability simply to get information put down. And I wouldn't be too keen on asking another patient to help me enter this kind of information.

And what about the questions it inevitably leaves out because suddenly we're reduced to a preprogrammed set of questions? Oh ,I know, one could debate this issue and say that the computer would do a much better job than some humans would, but shouldn't hospitals be providing a knowledgeable employee to take this information down? Having paid my share of ER bills, I would be delighted if I thought it would bring the price of care down, but there was no hint of that in this article. So unless it cuts down the wait to see a doctor and improves services, as long as I'm sitting around for the inevitable wait for a doctor, I'd rather be checked in by a human being. Otherwise it appears to only save the hospital staff's time, not mine.

After watching Idiocracy and seeing how they relied even more on these kinds of techniques in their care, I found myself disliking the kiosk idea even more. Because the next thing Joe had to undergo was sticking probes into his mouth, ears and rectum so that a machine could diagnose him. Well, it would save the staff's time....

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