Beyond the desk: digital self-registration as a redesign of the emergency department front door

Emergency departments are increasingly adopting digital self-registration, allowing patients to enter their own details rather than having them recorded at a staffed desk. Evaluations have largely focused on the speed and accuracy of this administrative task. Registration, however, forms part of a wider front-door system in which staff answer questions, assist patients and pass concerns to clinical colleagues. Some of this work is informal and absent from process maps or job descriptions. Introducing self-registration changes who performs the work, how patients remain visible and where responsibility lies, even when staff remain present. Safe implementation should begin with understanding how the existing pathway functions in practice and assigning responsibility within the redesigned pathway. Evaluation should examine whether patients can use the process safely and whether deterioration is recognised and escalated without delay. Digital self-registration should therefore be approached as a redesign of the emergency department front door.