Rheumatology Advance Access originally published online on May 22, 2006
Rheumatology 2006 45(8):1050-1051; doi:10.1093/rheumatology/kel167
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LETTER TO THE EDITOR |
Re: Touch screen computer systems in the rheumatology clinic offer a reliable and user-friendly means of collecting quality-of-life and outcome data from patients with rheumatoid arthritis
Department of Rheumatology, Leiden University Medical Center (LUMC), Leiden, The Netherlands
Correspondence to: I. G. de Boer, Leiden University Medical Center, Department of Rheumatology (C1-R), P.O. box 9600, 2300 RC Leiden, The Netherlands. E-mail: i.g.de_boer{at}lumc.nl
SIR, With great interest we read the article by Greenwood et al. [1] on the use of touch screen computer systems in the rheumatology clinic. They demonstrated that the use of touch screen questionnaires is a feasible way of data collection in a rheumatology clinic. Another application of interactive computer systems in rheumatology clinics may be the provision of health information [2]. It was found earlier that patients with chronic rheumatic diseases use the Internet primarily to search for information about the disease and its treatment [3]. We would like to share our experience with an interactive patient-information kiosk.
In July 2005, an interactive patient-information kiosk was placed in the waiting area of the rheumatology out-patient clinic. The kiosk had a user-friendly design and provided access to one specific website via a high-speed Internet connection. This website (www.reumanet.nl) contained general information and address/telephone/e-mail directories regarding various regional healthcare services [4] and organizations for patient with rheumatic diseases. Moreover, links to 65 selected other related websites were included. An instruction chart on how to use the kiosk and an information leaflet about the website were present at the kiosk. Directly after putting up the kiosk, consecutive patients attending the out-patient clinic were invited by a nurse specialist in rheumatology to try out the kiosk and to fill in an evaluation form afterwards. The evaluation form included demographic and disease variables (age, gender, availability of Internet access and type of rheumatic disease), reason for using the kiosk, satisfaction with the kiosk (eight statements with a 5-point scale ranging from 1 ‘totally agree’ to 5 ‘totally disagree’) and room for suggestions for improvement. Seventy-seven patients filled in an evaluation form.
The mean age of the respondents was 47.8 yrs (S.D. 16.6), and 52 (68%) were female. About half of the respondents (37, i.e. 48%) had rheumatoid arthritis, 68 (88%) patients had an Internet connection at home, and the main reasons for using the kiosk were: curiosity (57; 74%) and to search for information (16; 21%), whereas ‘because I was invited to’ was mentioned by 4 (5%) patients. Table 1 shows that, in general, respondents were satisfied with all aspects of using the kiosk. Suggestions for improvement most frequently listed were related to the ergonomics of the trackball, keyboard and elbow-rest (n = 8). Moreover, seven patients advised us to extend the information available on the kiosk with medical information on rheumatic diseases.
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This study demonstrates that patients' satisfaction with an interactive patient-information kiosk was high, and most of the patients stated that they were likely to use the kiosk again. These results are comparable with the positive findings of an earlier study [2] among 2878 users of an interactive patient-education touch screen kiosk in a hospital waiting room, which provided easy-to-access and validated information on the diabetic eye and foot examinations, vaccinations and mental health appointments.
Since the information provided by the kiosk was web-based and not specially designed for a touch-screen computer system, the kiosk had a regular computer interface (keyboard and trackball) instead of touch-screen, which may be more suitable for patients unfamiliar with the use of a mouse or having hand function problems. Despite this design, the majority of patients were satisfied with the current interface.
In this study, the possession of Internet access was relatively high among respondents, given the fact that in cross-sectional studies about 50% of the patients with rheumatic diseases have access to the Internet [5, 6]. For 12% of the users, the interactive kiosk might have been their first experience with the Internet. In the future, additional strategies should be applied to especially encourage this group to use the kiosk.
Information about healthcare services is a major need among patients with rheumatic conditions. For those who do have access to the Internet, finding relevant sites of sufficient quality may prove to be difficult. Apart from the use of the kiosk, healthcare providers, for example nurses in rheumatology specialists, should add the use of Internet to their standard patient education programme. Web-based portals, developed for specific patient groups, may facilitate this form of patient education. Recently, Taylor et al. [7] developed a web-based portal system for patients with juvenile rheumatoid arthritis. With respect to the website used in the present study, usage and patients' satisfaction will be evaluated on a larger scale in a separate study.
In conclusion, patients' satisfaction with an interactive patient-information kiosk in the waiting room of a rheumatology out-patient clinic was high, and most patients stated that they were likely to use the kiosk again. Apart from data collection and information seeking, other potential applications of interactive computer systems in rheumatology clinics, such as contacts with healthcare providers and the provision of feedback or overviews regarding the data entered, should be further evaluated.
Acknowledgments
This study was financially supported by the Netherlands Organisation for Health Research and Development (ZonMw; grant 3206.0125) and the board of directors of the Leiden University Medical Center.
The authors have declared no conflicts of interest.
References
- Greenwood MC, Hakim AJ, Carson E, Doyle DV. Touch-screen computer systems in the rheumatology clinic offer a reliable and user-friendly means of collecting quality-of-life and outcome data from patients with rheumatoid arthritis. Rheumatology 2006;45:66–71.
[Abstract/Free Full Text] - Goldschmidt L, Goodrich GL. Development and evaluation of a point-of-care interactive patient education kiosk. J Telemed Telecare 2004;10(Suppl. 1):30–2.[CrossRef]
- Lankveld WG, Derks AM, van den Hoogen FH. Disease related use of the internet in chronically ill adults: current and expected use. Ann Rheum Dis 2006;65:121–3.
[Abstract/Free Full Text] - Verhoef J, Oosterveld FGJ, Hoekman R et al. A system of networks and continuing education for physical therapists in rheumatology: a feasibility study. Int J Integrated Care 2004;4:1–16.
- Gordon MM, Capell HA, Madhok R. The use of the Internet as a resource for health information among patients attending a rheumatology clinic. Rheumatology 2002;41:1402–5.
[Abstract/Free Full Text] - Richter JG, Becker A, Specker C, Monser R, Schneider M. Disease-oriented Internet use in outpatients with inflammatory rheumatic diseases. Z Rheumatol 2004;63:216–22.[Web of Science][Medline]
- Taylor J, Lovell D, Theile D et al. Development of patient portal to improve quality of care for patients with juvenile rheumatoid arthritis. Arthritis Rheum 2005;52 (Suppl. S):S666
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