The Kiosk Will See You Now: Lessons from an ED Experiment

Sara Ackerman
Ralph Gonzales


This is archived content, for historical reference only.

Moving patients more efficiently through the emergency department (ED) was the goal of a three-year computer kiosk experiment in several California hospitals. A previous pilot test in a clinic demonstrated that many women presenting with uncomplicated urinary tract infections (UTIs) could get much faster care by using the kiosk. However, the ED implementation yielded disappointing results, which are discussed in this case study of the interaction between the technical and human aspects of an innovation.

Among the lessons learned from this experiment:

  • Think broadly about the users. Use close observation and open-ended interviews to understand the social and institutional systems of those who will interact with the technology. Involve them in every phase of the project.
  • Approach technology implementation as an institutional, social, and behavioral change process, not just a technical project. Attend to how technology affects clinical work and how workers attempt to change or work around the technology.
  • Understand that “success” and “failure” are in flux and subject to opinion. Researchers, staff, and patients may have different opinions about a technology.
  • Balance the needs of research with those of implementation. It is crucial to be flexible and responsive to local needs and circumstances.

The authors concluded that the success or failure of a technology cannot be attributed only to how it performs in a particular place, but for whom it works, and how its value is negotiated among groups with a stake in its use or non-use.

The complete case study is available as a Document Download.