Finding Health Care In A Kiosk

On an early summer evening at a public housing project in central Cleveland, Tanisha Perry stands at her open front door as two of her children play nearby.

Perry has five children who range in age from 6 months to 10 years old. In the past, she's been a frequent visitor to the emergency department for the children's healthcare. Now, she just walks them across the street to a kiosk.

"It was a great experience for me. Some people are skeptical with using it, but I've used it like two or three times already," Perry says.

The kiosk is a type of remote medical care that's not completely self-serve. A technician helps her dial up a doctor on a screen.

"When you go over here, they take your vitals, you sit there, you don't have to wait as long. It's better. But you know for a lot of people that likes to see the doctors actually up close and personal face-to-face … you still get to see them. They still face to face. They're just on a screen," Perry says.

A space-age looking module

The kiosk is a space-age looking module about the size of two photo booths put together. The patient walks in and stands on a scale built into the floor. The technician checks the patient's weight and height and then asks the patient to sit down in a chair in front of a screen.

Once a high-speed connection is made, the technician operates tools that allow the doctor on the other end to conduct a virtual visit.

"We've seen some allergies, urinary tract infections, vomiting, flu, I mean you... rashes, cold sores," says Heather Roberts, a medical technician for University Hospitals central Cleveland kiosk.

Ohio-based HealthSpot develops the kiosk. The company contracts with health systems in Ohio as well as California and Florida. Pilot projects have gone so well, a company spokeswoman says, that plans are underway to place kiosks in retail drug chains and on university campuses.

Dr. Allan Khoury, a senior consultant with Towers Watson who follows the telemedicine industry, says there is enormous potential for kiosks and other forms of virtual medicine.

Even with a price of up to $60,000, the kiosks remain less expensive than building a doctor's office, Khoury says. They can be used to expand medical access to underserved rural and urban areas across the U.S.
In addition, kiosks can provide convenient and low-cost after-hours or emergency care.

They could even even replace office visits for a lot of routine care, he says.

"So the great thing about the kiosk is you can have your blood pressure taken. There's an automated cuff there. The doctor can see you, which is crucial. Can obviously hear you and you can see the doctor so it's a more life-like interaction. There's an otoscope so you can look in the ears. There's a stethoscope so you can listen to the heart and lungs," Khoury says.

One thing the doctor can't do is touch the patient.

Promoting caution

Seeing a doctor on a screen is no replacement for face-to-face medicine with a family doctor, according to the nation's largest physician organization.

American Medical Association President Dr. Robert Wah warns that mistakes could be made if the doctor on the other end of the line does not know the patient's history.

"It is a possible concern and a challenge that inadequate or partial information would be available and that would lead to decisions being made that were, you know, not optimal," Wah says.

For parents like Tanisha Perry, University Hospital's kiosk is a good addition to the neighborhood. Trips to the doctor's office on public transportation can be difficult and taxing with children in tow.

Perry's only complaint is that the health kiosk in her neighborhood is just for kids: "I wish they had one for the adults but I'm hoping and praying that they will get there for the adults."

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