Using patient-facing kiosks to support quality improvement at mental health clinics

Evidence-based services improve outcomes in schizophrenia, but most patients at mental health clinics do not receive such services. This gap in care has been perpetuated by a lack of routinely collected data on patients' clinical status and the treatments they receive. However, routine data collection can be completed by patients themselves, especially when aided by health information technology. It is not known whether these data can be used to improve care quality.

In a controlled trial, 8 medical centers of the Veterans Health Administration were assigned to implementation or usual care. A total of 571 patients with schizophrenia were overweight and had not used evidence-based weight services. The implementation strategy included data from patient-facing kiosks, continuous data feedback, clinical champions, education, social marketing, and evidence-based quality improvement teams. Mixed methods evaluated the impact of the kiosks on utilization of and retention in weight services.

Compared with usual care, implementation resulted in individuals being more likely to use weight services, availing services >5 weeks sooner, and continuing to use the services 3 times more. When compared with the year before implementation, patients at implementation sites saw a 3-fold increase in treatment visits. Usual care resulted in no change.

Mental health clinics have been slow to adopt health information technology. This study is among the first to implement and evaluate automated collection of data from patients at these clinics. Patient-facing kiosks are feasible in routine care and provide data that can be used to substantially improve the quality of care.