Lessons Learned from Implementing Kiosks for Patient Self Registration at a Walk-in Sexually Transmitted Disease (STD) Clinic, New York City (NYC), 2010-2011

Background: The NYC Department of Health and Mental Hygiene’s (DOHMH) Bureau of STD Control (BSTDC) operates nine clinics providing free and confidential STD services to patients on a walk-in basis. Patient visits increased 11% from 2006-2009. Time and motion studies revealed substantial delays at registration.  In July 2010, we implemented two patient self-registration kiosks at a busy clinic in the Bronx.  Patients were directed to kiosks after triage, entered their demographic and risk information, and signed consent for care. Kiosks interface with our electronic medical record (EMR).

Objectives:  Evaluate impact of self-registration on clinic flow and patient data completeness.

Methods:  Using EMR data, we compared cycle times, data completeness and total patient census among self-registered and staff-registered patients since kiosk implementation; evening and weekend sessions were excluded, as were visits with invalid data.

Results:  A total of 16,981 visits were registered at this clinic between August 1, 2010 to September 30, 2011. Kiosks were used on 185 (64%) clinic days; 11,333 (67%) completed registration on kiosk-days; 2,513 (22%) of those were self-registered. On average 61 patients were registered on kiosk-days versus 53 on non-kiosk days. The interval from arrival to completed registration differed by no more than 5 minutes. Patients younger than 30 years old: kiosk-registered (76%), staff-registered (64%), p<0.0001. Gave an email address (August - September 2010): kiosk-registered (42%), staff-registered (8%). Said they had receptive anal sex in the last 3 months: kiosk-registered (10%), staff-registered, reported to a physician (8%), p< 0.05.

Conclusions: Although kiosk use did not substantially change patient cycle time, it did permit more patients to be registered per day and for more complete email and sexual risk information to be collected than during staff registration.

Implications for Programs, Policy, and Research: The additional information given during self-registration could be helpful in providing targeted STD services and for timelier follow-up.