Self-Service Healthcare Kiosk Accessibility

Posted on Monday, 30 March 2020 by Laura Miller

Modern healthcare facility front desk/check in area.

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?

Ensuring privacy with an accessible kiosk

Kiosks in a healthcare setting must provide an accessible and private user experience for all patients.  This means including accessibility features to allow a blind or low vision user to use the kiosk without assistance, and not broadcasting personal information out to the entire room. In order to protect patient privacy, all patients with disabilities should be able to use kiosks without the need of third-party assistance.

Methods for how healthcare providers can use kiosks while also protecting patient privacy include:

  • Privacy screens that protect from others viewing the screen
  • Proximity switches that reset the kiosk when a user leaves the kiosk
  • Kiosk software that clears user data in between each user.

Kiosks help make safety a priority….

One of the major issues that healthcare providers face in the 2020 COVID-19 pandemic is the issue of exposure. Healthcare kiosks can be used to gather patient information without exposing providers to the immediate risk that occurs when interacting with patients directly.  Using kiosks to collect information from patients can allow for distancing and proper triage processes to minimize the number of providers and employees with whom a patient interacts during the admission process or the doctor’s office visit.

Kiosks can also save time and resources, allowing healthcare providers to obtain more information from patients while requiring fewer human resources. This is particularly relevant given the high demands placed on healthcare providers, the above average illness rate, and the additional need to socially distance whenever possible.

COVID-19 has a particularly potent impact on the blind community. People who are blind are more susceptible to the virus due to many of the illnesses and chronic conditions that cause blindness in the first place and offices and medical facilities are not always accessible.  In an article on ABC.com, Clark Rachfal, director of advocacy and governmental affairs for the American Council for the Blind, indicated that he is concerned that some medical offices and healthcare systems aren’t well equipped to handle blind patients who may have flu-like symptoms. Furthermore, some offices may not have patient portals with accessibility options, he said.

But can they also mitigate hygiene efforts?

In light of these concerns about COVID-19 and the need to protect patients and healthcare workers from exposure and relieve healthcare workers from unnecessary tasks, experts are questioning if kiosks are safe for patients.

The question of kiosk cleanliness is particularly relevant in a healthcare setting but should be considered important in all kiosk use cases. Anti-microbial touchscreen films and surfaces are available through some kiosk manufacturers. It is also important to discuss cleaning procedures and appropriate cleaning supplies for washing kiosks and kiosk accessories such as input devices. It is typically easy to clean a kiosk using appropriate materials, but to be sure, kiosks are easily overlooked on cleaning schedules and are only cleaned if they are considered a priority by janitors and staff.

Here are some resources about cleaning kiosks and peripheral devices.

Patients should take the same precautions when using a kiosk as when they handle a shopping cart.  If facilities provide appropriate cleaning supplies for patients to use prior to utilizing the kiosk or upon completion of usage (like at a gym), then the kiosks will preserve both user safety and that of healthcare staff.

Benefits of accessible kiosks in healthcare

There are many advantages to using kiosks in a healthcare capacity. Shorter wait times and a streamlined check-in process is one.  Another is consistency. Kiosks provide patients with the same experience each time, which improves efficiency. Kiosks can be used to schedule follow-up appointments, pay bills, collect insurance information, and request contact or demographic details. Kiosks serve a wide range of purposes and help to alleviate the demands on healthcare attendants.

Innovations in the self-service medical space are not new: this 2013 article in Forbes shows diagnostic kiosks placed in pharmacies and grocery stores. Kiosks can also serve patients across language barriers or literacy barriers. Making these kiosks accessible is critical to preserving the quality of patient care for all patients regardless of ability.

Kiosk Accessibility Settlements and Agreements

Kiosk accessibility has been at the root of numerous public settlements. In a July 2016 settlement, Massachusetts Attorney General Maura Healy (with the National Federation of the Blind), announced a settlement with Pursuant Health.  In the agreement, Pursuant health agreed to make their self-service healthcare kiosks accessible to blind consumers. The services available on the kiosks included vision assessments, blood pressure screening, weight assessments, BMI evaluations, and advice on pain management. Pursuant also agreed to pay $95,000 in the settlement, in addition to the cost of retrofitting their kiosks for accessibility.  Post settlement, Mark A. Riccobono, President of the NFB stated “Health information has the potential to be more accessible than ever to the blind with twenty-first-century technology, but only if the manufacturers of technology keep accessibility in mind.”

Next steps for healthcare facilities with kiosks

Retrofitting kiosks is one option for kiosks that are already deployed into a healthcare setting. Kiosk input devices and screen reader software, such as JAWS for Windows, can be added and applications can be updated in order to provide an accessible experience.  If new kiosks are still being deployed, it is more cost effective to consider an accessible design earlier in the design phase and/or before new kiosks are manufactured. Costs to build an accessible kiosk are marginally higher than those of an inaccessible kiosk.  Learn more about how TPG can help with building an accessible kiosk.

 


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