ADA Kiosks – Healthcare Kiosk Accessibility

Read full article at Paciello Group March 2020

Healthcare kiosks are, now more than ever, a valuable tool for serving more patients without the need for up close staff interaction. They can be used for checking in patients and gathering symptom information for efficient triage purposes. They can also be used to measure patient blood pressure or heart rate, temperature, and other diagnostic information. Moreover, healthcare kiosks are also helpful for educating patients, collecting health insurance information, and scheduling future services.

Making a healthcare kiosk accessible not only improves patient care, but is required by the Americans with Disabilities Act (ADA). The ADA prohibits discrimination against individuals with disabilities regarding public accommodations and the court has defined public accommodation to include (in title III) service establishments including healthcare facilities.

Creating an accessible healthcare kiosk

Disabilities, according to the ADA, can be physical (motor skills), cognitive (intellectual), low to no vision, low to no hearing, and more. But before addressing software accessibility, the first step to creating an accessible healthcare kiosk should be to make the kiosk physically accessible. The ability to access the kiosk by users in a wheelchair is required by the ADA.  It outlines specific compliance guidelines like the height of operable parts, the viewing angle, and the approach area for accessing the kiosk — which must also be accessible via a wheelchair. The approach area requires a clear path without stairs, uneven flooring, or objects to obstruct access.

Once physical accessibility has been established, turn your attention to another an equally important component: software. The kiosk application must also be accessible for use by someone who is blind or has low vision. The kiosk needs to have a screen reader, such as JAWS® for kiosk to turn text to speech. Some examples of accessible kiosks can be found in this video.

Touchscreens may be difficult for people with disabilities, so an external input/navigation device is also useful to allow users to engage with a kiosk without using a touchscreen.  The kiosk application must be developed to ensure it can be easily navigated and understood when read through a screen reader. WCAG 2.1 AA standards are application and website guidelines for accessibility. Following those guidelines with a healthcare check-in app, for instance, will make it easier for a blind or low vision user to understand and navigate the kiosk app. Learn more about selecting the right input device for your accessible kiosk.

Some things to consider when planning your accessible healthcare kiosk

  1. What application will you be using? Is it already accessible? If yes, can you improve usability for kiosk users?
  2. Is the kiosk hardware ADA compliant for height and reach specifications?
  3. Does the kiosk include an input device that has an audio jack? Oftentimes, there is no effect on audio jacks built in audio jacks when headphones are inserted. Using an input device that includes an audio jack will allow JAWS to turn off and on based on the presence of the headphones.
  4. Are you providing all information in a way that is accessible to all users, including those who are deaf or hard of hearing, and those who are blind or who have low vision? That includes any PDFs that are being read on the screen, videos in need of captioning, and document signing for HIPAA compliance.
  5. Are you protecting user privacy at every turn?

Read full article at Paciello Group March 2020

Another Cerner Hospital Decides to Switch to Epic

Hospitals Switching To Epic

From Becker Hospital Review Feb 2020 — Seems to be a contagion going around as far as Cerner EHR implementations go.  We saw week before AdventHealth switching horses and this last week we see Atrium Health deciding to “transition” to Epic EHR.

Epic and Cerner dominate the EHR marketplace, with both companies combined accounting for more than 50 percent of the acute care hospital market share, according to KLAS.

In 2018, Epic had 28 percent of the market while Cerner had 26 percent. However, over the years Epic has gained ground as hospitals and health systems decide to switch over from Cerner or other EHR providers. In some cases, hospitals or small health systems make the switch to match larger health systems with Epic after they’re acquired. In other cases, the health systems make a change to improve efficiencies.

Here are 11 instances in the past five years where hospitals or health systems left Cerner for Epic.

https://www.bizjournals.com/kansascity/news/2020/02/20/cerner-epic-systems-ehr-atrium-health.html

https://www.healthcareitnews.com/news/atrium-health-drop-cerner-move-epic-ehr-system

Cerner Replaced with Epic in the past 5 years

Epic EHR Replaced Cerner

From Beckers Hospital Review Feb 2020

VA EHR KiosksEpic and Cerner dominate the EHR marketplace, with both companies combined accounting for more than 50 percent of the acute care hospital market share, according to KLAS.

In 2018, Epic had 28 percent of the market while Cerner had 26 percent. It appears though that Epic has increased its percentage since then notwithstanding some large contracts wins by Cerner which include the DoD and the Veterans Adminstration. The VA is currently specing out its next generation patient check-in and it appears to be hybrid between VistA and the new Cerner. The VA leadership has stumbled some recently so whether they are on schedule or not remains to be seen.

Becker has a list of 11 hospitals which switched from Cerner to Epic in the last 5 years including AdventHealth.

See full list at Beckers Hospital Review

Patient check-in for Veterans

From Vantage Point the VA blog Feb 2020

Using surveys and feedback to improve patient experience

patient check-in veterans

Since 2017, more than 4 million Veterans have given VA feedback on their customer experience. These surveys are usually sent to VA customers within a few days of their appointment. Recently, 88.5% of Veterans have responded that they agree or strongly agree with the statement, “I trust VA for my health care needs.” That trust question is what VA’s trust rating is based on, but the other questions in the Veterans Signals program survey helps VA pin point opportunities for improvement.

Check-in process problems

In 2018, the Lexington, Ky., VA Medical Center (VAMC) noticed a key customer experience falling short of expectations. When Veterans were asked “After I checked in for my appointment, I knew what to expect,” the satisfaction score was 82%. This alerted the Lexington VA’s Veterans Experience Officer that their patients did not understand what to expect next when checking in to appointments.

After a deep dive look at the check-in process and using a few secret shoppers (sending a few Veterans or VA employees through the process who would document their experience), the Lexington VA saw the problem. The check-in process was not the same in every office and that was confusing patients.

Creating a solution

The Lexington VA then developed standard scripts and other communication aid materials to help VA employees standardize the check-in process and expectation. Also, employing a Lean Six Sigma technique called GEMBA (Japanese term meaning “the real place”) identified some key meeting places such as clinic lobbies or hallways. It then placed display boards and signs in these high traffic spots between the check-in and provider appointment locations to help patients navigate.

The results

The results pointed to an 8-point increase from 82% to 90% from the end of fiscal 2018 to the end of fiscal 2019 for the same patient satisfaction question, “After I checked in for my appointment, I knew what to expect.”

These results aren’t isolated to the Lexington VA. Improvements based on customer experience feedback are underway across the country. Customer feedback data and patient experience programs pair perfectly to improve VA’s effectiveness, ease, and empathy for Veterans, their families, caregivers and survivors.

This story is part of the Secretary’s Priorities series, which was outlined to the House Committee on Appropriations, Subcommittee on Military Constructions, Veterans Affairs, and Related Agencies on Feb. 26, 2019, by VA Secretary Wilkie. The Secretary’s Priorities are Customer Service, MISSION Act, Electronic Health Record, Transforming Business Systems, and Suicide Prevention. These stories are designed to give a closer look at the improvements VA is making in how we relate to, interact with, and ultimately serve our Veterans, their families, caregivers and survivors.

Amanda Clark is a Veteran Experience Officer at the Lexington VA Health Care System.

Phreesia Patient Check-In – Stock Climbed

Phreesia Stock Rise

From Motley Fool Feb 2020

What happened

Shares of Phreesia (NYSE:PHR) gained 16.4% in January, according to data from S&P Global Market Intelligence . The healthcare software stock gained ground following an announcement that a health services network is integrating the company’s service.

So what

Lee’s Summit Physicians Group announced last month that it had implemented Phreesia’s patient check-in and optional payment services. In a press release, the Missouri-based healthcare services network touted the benefits and convenience offered by Phreesia’s software.

The company provides software-as-a-service (SaaS) applications for healthcare providers that help manage patient intake and payments. It generates roughly 80% of its sales from recurring revenue streams, and customers tend to stick with the company’s services once integrating them.

Read full story From Motley Fool Feb 2020

Kaiser income nearly triples

KP Logo ImageFrom Healthcare Dive News

Kaiser Permanente Dive Brief:

  • Kaiser Permanente nearly tripled its net income in 2019 to $7.4 billion due in large part to its investment portfolio, the nonprofit integrated health system reported on Monday. That’s up from $2.5 billion in net income in 2018.
  • Oakland, California-based Kaiser reported operating income of $2.7 billion and other income of $4.7 billion. Nearly two-thirds of Kaiser’s net income came from investment performance rather than its core operations.
  • Kaiser said the performance allows the organization to continue to make key capital investments back into the company and community. But the financials come as nonprofit healthcare operators across the country face rising scrutiny from regulators and lawmakers for mounting profits and their tax-exempt status.

Read Insight – From Healthcare Dive News

More Kaiser News

https://patientkiosk.io/kaiser-news-unexpected-passing-of-kaiser-permanente-ceo-bernard-tyson/

https://patientkiosk.io/chf-case-study-patient-check-in-kaiser-permanente/

VA – Wilkie on Byrne Departure

From FedScoop

VA EHR KiosksThe removal of Deputy Secretary James Byrne “will not impact at all” the massive migration project at the VA, according to Department of Veterans Affairs Secretary Robert Wilkie

The project is a massive migration of the electronic health records of millions of veterans from the outdated Veterans Information Systems and Technology Architecture (VistA) platform to a cloud-based commercial Cerner system. The department is working in partnership with the DOD to ensure seamless interoperability between the two as active service members retire and depend on VA health services.

While Wilkie didn’t directly address if the launch of the modernized EHR is still scheduled for late March, he said “I expect us to be able to launch this. The mission goes on.”

Meanwhile various entities and groups are preparing to directly confront the VA should the new check-in kiosks do not meet Section 508 guidelines, ACAA and ADA 2010.  Currently over 4000 units in the field are NOT accessible to blind veterans, and that is not including all other types of disabilities.

Clearwave – Healthcare Tablet for Patients & Staff

Excerpt from Digital Journal

Patient Kiosk Check-In Tablet

Click for full size image

Clearwave, a self service check-in solution company, announces Clearware Connect. The system enables patients to be booked in and, applicable to the U.S, for-profit healthcare system, for payments from patients to be made.

From the site — In addition to our in-practice kiosks, Clearwave offers tablets for your patients to use, expanding the number of check-in options for your patients. Clearwave Connect is our flexible tablet solution that fit practices of any size, specialty, and budget.

Key Benefits Tablet Kiosk Check-in

Flexible Form Factor
The tablet can fit any size office and any specialization. Whether handed out to reduce Kiosk lines or placed on the front desk, the tablet can go anywhere the practice needs it

Better Patient Interaction
Patients can now go back and review their responses and make form edits during the check-in process

Great User Experience
The Clearwave Connect tablet offers the same intuitive and seamless check-in experience as the kiosk offering a familiar experience independent of the hardware

Secure Payments
The integrated payment collection allows patients to pay co-pays and outstanding balances directly from the tablet

The advantages of the new patient tablet check-in system include:

  • Multiple options for patient check in, including the use of tablets, kiosks or Mobile Pre-Check™. Each allows for patient self-service registration.
  • Insurance eligibility verification, with the system providing real-time, accurate responses to insurance checks.
  • Secure payment collection, enabling patients can swipe their credit card at the tablet or kiosk.
  • Co-pays and outstanding balances can be automatically collected.
  • Data collection and integration.
  • Clearwave offers thirteen different languages and customizeable forms.

VA Patient Check-In Kiosk News – RFI Issued

Background on VA RFP

Connected Health (CH) is about extending the reach of the health care system beyond the traditional brick and mortar walls and empowering patients to assume a greater role for managing their own health. Access to care and an exceptional Veteran experience are listed as the Department of Veterans Affairs (VA) Veterans Health Administration’s (VHA) top priorities. VA CH initiative is aligning virtual care technologies to create a seamless, unified experience for Veterans by:

• Identifying patient needs to drive the next generation of tools.
• Translating Veteran needs to information and services.
• Developing Health Information Technology (IT) solutions to meet Veteran needs (e.g. reminders, secure email, and video visits)
• Tailoring across platforms to optimize reach (e.g. smart phone, feature phone, web and Veterans Point of Service Kiosk Tablets)

The Veterans Point of Service (VPS) program office is responsible for managing the current VA Point of Service Initiative, known as VetLink, and the future replacement patient kiosk Commercial-off-the-shelf (COTS) solution. VPS under the Office of Veterans Access to Care completed national deployment of ≈ 6,300 vKiosk devices to approximately 161 VA Medical Centers (VAMC) and their Community Based Outpatient Clinics (CBOC) nationwide in 2014. The legacy vKiosk devices have met the end of their device life-cycle. This effort is not a 1:1 refresh of all the currently deployed vKiosk devices, only 4,200 patient tablet kiosk units tablets will be purchased. Currently branded vKiosks and the Government- off-the-shelf (GOTS) VetLink proprietary software are provided by Vecna Technologies, Inc.

VA strives to provide high quality, effective, and efficient clinical and business capabilities, along with IT services to those persons who are responsible for providing care to the Veterans at the point-of-care. In addition, VA strives to provide high quality health care to Veterans throughout all points of their experience in an effective, timely, and compassionate manner. VA depends on a strong business backing, information management and IT systems to meet mission goals

In 2020 VA is seeking a Contractor to demonstrate feasibility of a replacement self- service tablet patient check-in solution designed especially for the healthcare industry. VHA is seeking a viable solution that can be easily transferred from one commercial vendor to another.

Subsequent, national roll-out to all VA health care facilities will only occur following the acceptable completion of Pilot 1 at Spokane, Washington (henceforth referred to as Spokane) and Pilot 2 at Columbus, Ohio (henceforth referred to as Columbus) followed by the completion of two acceptable small phased approach deployments in VISN 20 and in VISN 10. While the national deployment schedule isn’t defined, it is expected that national deployments will move through a phased roll-out, VISN by VISN over an estimated 12 to 18-month period.

VHA envisions an advanced level of interoperability with tablets and/or mobile apps that will allow Veterans to conveniently transact with the Federal Government.

Editor Notes: stimated units is 4,200

EHR Epic News – Epic No Longer supporting Google Cloud

From CNBC

Account representatives from Epic Systems, one of the largest providers of medical record systems, have started calling customers with a clear message: We will not be pursuing further integrations with Google Cloud.

Epic’s reps told customers the company would instead focus its energies on Amazon Web Services and Microsoft Azure. They said the company decided to halt development with Google Cloud because it wasn’t seeing sufficient interest among its health system customers to warrant the investment.

The calls have come in the past few weeks, said three people with knowledge of the matter, and were directed to Epic’s hospital customers that use Google’s cloud-based technology either for medical research, data storage or for their basic IT operations, including file-sharing. These people declined to be named because they were not authorized to speak for their organizations on the matter.
Read full article From CNBC