JMIR Publications

ABSTRACT

Background:

Emergency departments (EDs) globally face unprecedented pressures due to ageing populations, multimorbidity, and staff shortages. Technological solutions such as digital check-in and triage kiosks could reduce wait times, improve patient flow, and alleviate overcrowding. However, further research is needed to evaluate the efficacy and safety of these interventions.

Objective:

This systematic review aims to summarise the impacts of digital check-in and triage kiosks in safety and efficacy compared to traditional nurse-led triage methods in EDs.

Methods:

Comprehensive searches were conducted in MEDLINE, Web of Science, and EMBASE. A narrative synthesis was carried out to evaluate the impact on patient safety (e.g., agreement rate, accuracy, sensitivity, specificity) and efficacy (e.g., operational efficiency, patient flow). The quality of the studies was assessed using NHLBI quality assessment tools.

Results:

Five studies, comprising 47,778 patients and 310,249 ED visits, were included. Three studies focused on self-check-in kiosks, one on self-triage kiosks, and another on technology combining both. Two studies evaluated safety, reporting high sensitivity for predicting high-acuity outcomes and low under-triage rates but poor agreement with nurse-assigned triage scores. Four studies examined the efficacy, reporting high over-triage rates and mixed impacts on waiting times.

Conclusions:

Evidence on the safety and efficacy of digital check-in and triage kiosks remains sparse. While effective at accurately identifying high-acuity patients, the impact of digital kiosks on operational efficiency measures is unclear. Further research is required to understand how digital kiosks can safely and effectively address the growing issue of ED workload. Clinical Trial: PROSPERO registration number: CRD42024481506