The Doctor Kiosk

An automated health-care interface aims to streamline preventative screening.

A computerized kiosk under development at Massachusetts General Hospital (MGH) can take a patient's medical history, weight, pulse, blood pressure, and other vital signs, and even perform simple blood tests for glucose and cholesterol. Physicians hope that the device, slated to begin field testing in the United Kingdom in June, will one day bring relief to the overburdened healthcare system, and allow doctors to intervene earlier in chronic disease.

Credit: Massachusetts General Hospital

Doctors' appointments in the United States often feel like more of an inconvenience than a help, both for patients, who can spend hours in waiting rooms, and doctors, who spend hours filling in charts and organizing patient information. Ronald Dixon, director of the Virtual Practice Project, imagines that his kiosk--a small, Windows-based desktop computer with just a few peripherals--could one day revolutionize doctors' visits just as ATMs transformed banking. By removing the tellers from the interactions that could be easily automated, banks saved face-to-face contact for more complex transactions. Dixon, who's also a primary-care physician at MGH, believes that the same could be done for doctors.

The kiosk consists of a tabletop computer and a number of peripherals--a blood-pressure cuff, a scale, a pulse oximeter to measure blood oxygen levels, and a peak-flow meter to determine whether someone's airways are constricted--as well as a blood-testing device commonly used in emergency rooms that can measure cholesterol and glucose levels. (The current version requires a trained assistant to do the finger stick for blood collection, although future versions will be automated.)

Ideally, Dixon envisions his kiosks placed in supermarkets and big-box stores: customers could step up, key in their password-protected information, answer questions related to their personal health history, and then get their checkup. "The results would then go to your provider, and that provider sends a message back to you the way you want it--either through e-mail or texting--about what to do with that result," he says. It could determine whether current medications are doing their job, whether a particular strategy is working or changes need to be made, and whether a more in-depth exam is necessary.

In June, the kiosk will get its first glimpse at prime time. A pilot version will be tested in stores and other public spaces in Britain as part of a newly established vascular screening program to prevent cardiovascular disease, stroke, and heart attack. The United Kingdom is an ideal testing ground because it has a nationalized health-care system: everyone has an assigned primary-care physician and electronic health records, so the infrastructure for sharing and responding to the results is already in place.

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"They're trying to catch people who typically don't get screened, since a lot of the population doesn't go to the doctor unless they're sick," Dixon says. "But everyone goes to the drugstore or grocery store once in a while." A 10-minute interaction will include a blood-pressure check, combined with blood glucose and cholesterol screens. The information can then be sent off to a central database. Those residents at highest risk for disease will receive a phone call from their physician.

While some might worry that the kiosk will perform medical care best left in the hands of a doctor, Dixon notes that it's not geared to diagnosis: the machine is designed to collect and relay test information in a much more streamlined fashion than that used today. And it is targeted, at least in part, to patients who might not otherwise visit a doctor's office.