The ability to efficiently screen for and monitor chronic diseases, such as diabetes and hypertension, whose rates are predicted to rise over the next 10 to 20 years, will be especially important. “Treatment for these should be very streamlined to make sure that people are on the medicines they need to be,” says Kristian Olson, a pediatrician at MGH involved in global-health initiatives. “And all of that should be routinized as much as possible, or else you’re reinventing the wheel for each patient.”
Other physicians familiar with the project have created their own visions for how the kiosk might be used. “A trip to the doctor’s office is a fairly clunky process,” says David Howes, president, chief medical officer, and CEO of Martin’s Point Health Care, based in Maine and New Hampshire. “It takes a lot of effort, it takes a lot of time, and it doesn’t really use the time of high-paid specialized professionals in the best possible way.”
Howes believes that just placing versions of Dixon’s kiosk in doctors’ offices could streamline the process and completely change primary care for both patients and their physicians. “Think about your process of going to the doctor: you go in, the nurse sits down with you, takes a lot of history, takes vitals, and might even order some lab studies. And then the physician comes in and replicates a lot of that work,” he says.
But a kiosk would allow for much of that to be accomplished before a patient ever sits down in an exam room. “By the time you get in to see the physician, the information has been gathered and organized,” Howes says. A clinician can look at the information and determine what conversations she and the patient need to have. “We’ve daydreamed that a tool like this, in the intake process, would be very useful.”
An automated system like the health kiosk could also be used to extend health-care access to the poorest nations. “It’s clear that there’s a human-resource limitation overseas that’s far larger than what we have in this country,” says MGH’s Olson. The kiosks, in combination with just a single physician or nurse practitioner, “could provide common care to a huge percentage of people,” he says.
In developing nations, Olson views the kiosk as less of a preventative screening tool than one that could be used for vital follow-ups. “I could see it being incredibly useful for routine follow-up for patients with issues such as tuberculosis or HIV,” he says. “It’s a way to follow up with physicians, demonstrate side effects, talk about whether [patients are] taking their meds.”