Practices offer auto check-in

In the spirit of gas station pay-at-the-pump technology, airline kiosks and grocery store self-checkout lanes, some physician practices have adopted automated systems that allow patients to register themselves for appointments.

The new technology, which comes in the form of kiosks or portable tablets, can direct the patient through every step of the check-in process, from verifying insurance eligibility to completing forms and collecting a co-pay. It has been praised by doctors who use them as a way to streamline the registration process and free up time for front-office staff to perform other tasks.

"The major reasons for us going to the tablets was to avoid transcription errors and cut down on front-office staff time and effort," said Richard L. Wasserman, MD, PhD, an allergy/immunology specialist and managing partner of Dallas Allergy/Immunology, a four-physician group that implemented the technology three months ago. "We've seen intangible benefits as well. Patients express to us that they think we're on the cutting edge."

With only a few companies offering registration products to health care organizations, the practices that have adopted the technology truly are pioneers. While the self-serve kiosk concept is prevalent in many other service and retail industries, it has yet to surface on many doctors' radars.

One consultant says that's because most physician practices have more pressing technology issues.

"The biggest issue facing medical practices from an [information technology] standpoint is the EMR," said Reuben Allen, president of Allen Consulting in Wilmington, N.C. The kiosk "really isn't much of an issue today."

But as practices strive for low-cost ways to be more efficient, they may entertain the idea of automated registration. One company, Marietta, Ga.-based Clearwave Corp., charges a $1,500 installation fee for its kiosk product and between $100 and $150 per month for the device.

The company usually suggests a practice acquires two kiosks, which Clearwave integrates with the existing practice management and electronic medical record technology, company CEO Gerard White said.

Dr. Wasserman said his group, which purchased the technology from a different company, has invested about $30,000 in the system, including eight portable tablets split between two offices. There are "modest" ongoing support costs as well, he said. While the group estimates it has not yet recouped its full costs in the three months since it implemented the technology, it won't be long before that happens, Dr. Wasserman said.

The Westchester Medical Group, an 85-physician multispecialty practice based in White Plains, N.Y., uses six kiosks at a pilot site. The registration system can save the practice an estimated $75,000 per year, and it has decreased the office's need for front-desk staff by one-third, said Simeon Schwartz, MD, a hematologist/oncologist and president of the group.

"We estimate the [return on investment] in a large practice can be as soon as 90 days," Dr. Schwartz said.

Both practices said they have not laid off workers as a result of the technology. Instead, workers were reassigned, and some positions were not filled during normal office turnover.

With the registration system linked to the other office software, a practice can retrieve real-time information on patients and cut down on both transcription costs and errors.

Using the registration system without having other technology in the office, however, might not offer the financial benefits a practice is seeking. A practice that is not very advanced electronically but looking for a quick efficiency fix can probably find other ways to streamline operations, Dr. Schwartz said. "This is not technology for the IT novice."

The systems start by asking the patient to swipe a credit card or another card with a magnetic stripe, or enter information and a personal identification number to verify identity. The system then asks the patient to update personal and insurance information, if necessary. It verifies insurance eligibility and offers to charge the patient's co-pay to the previously swiped credit card.

There are clinical possibilities for the system as well. In addition to filling out medical history, patients also can complete questionnaires related to the reason for their visit.

The Westchester Medical Group will soon start asking patients who have scheduled a mammogram to complete a questionnaire, which will help automate and document the breast screening process, Dr. Schwartz said.