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The Use of a Kiosk-Model Bilingual Self-Triage System in the Pediatric Emergency Department

Sinha, Madhumita MD, MHSM*; Khor, Kai-Ning MPH*; Amresh, Ashish PhD; Drachman, David PhD; Frechette, Alan MD*

doi: 10.1097/PEC.0000000000000037
IT in the ED

Background Streamlining the triage process is the key in improving emergency department (ED) workflow. Our objective was to determine if parents of pediatric ED patients in, low-literacy, inner-city hospital, who used the audio-assisted bilingual (English/Spanish) self-triage kiosk, were able to enter their child’s medical history data using a touch screen panel with greater speed and accuracy than routine nurse-initiated triage.

Methods Parent/child dyads visiting the pediatric ED for nonurgent conditions (February to April 2012) were randomized prospectively to self-triage kiosk group (n = 200) and standard nurse triage group (n = 200). Both groups underwent routine nurse-initiated triage that included verbal elicitation of basic medical history and manual entry into patients’ electronic medical records.

Results The kiosk user was a parent in 88.5% of the cases, a patient (range, 11–17 years) in 9.5% of the cases, and a proxy user (sibling or friend) in 2% of the cases. Language choice for kiosk use was equally distributed (English vs Spanish, 50.5% vs 49.5%). The mean (SD) time to enter medical history data by the kiosk group was significantly shorter than the standard nurse triage group (94.38 [38.61] vs 126.72 [62.61] seconds; P < 0.001). Significant inverse relationship was observed between parent education level and kiosk usage time (r = −0.26; P < 0.001). The mean inaccuracies were significantly lower for kiosk group (P < 0.05) in areas of medical, medication and immunization histories, and total discrepancy score.

Conclusions Kiosk triage enabled users to enter basic medical triage history data quickly and accurately in an ED setting with future potential for its wider use in improving ED workflow efficiency.

Supplemental digital content is available in the text.

From the *Department of Pediatrics, Arizona Children’s Center, Maricopa Integrated Health Systems, Phoenix; †College of Technology and Innovation, Arizona State University, Tempe; and ‡Department of Research, Maricopa Integrated Health Systems, Phoenix, AZ.

Disclosure: The authors declare no conflict of interest.

Reprints: Madhumita Sinha, MD, MHSM, Pediatric Emergency Medicine, Arizona Children’s Center, Maricopa Integrated Health Systems, 2601 E Roosevelt St, Phoenix, AZ (e-mail:

Grant Funding: This study was funded by the Agency for Healthcare Research and Quality under the Innovations and Emerging Issues Portfolio (grant ID: R03HS020235-01A1) registered with (identifier: NCT01515488). This study has been presented at the Pediatric Academic Societies Annual Meeting at Washington, DC, last May 2013.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (

© 2014 Lippincott Williams & Wilkins, Inc.