Designing and validating a low-cost real time locating system to continuously assess patient wait times.

Objective: Outpatient clinics lack infrastructure to easily measure and understand patient wait times. Our objective was to design a low-cost, portable passive real time locating system within an outpatient clinic setting to measure patient wait times and patient-provider interactions.Materials and...

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Publicado en:Journal of Biomedical Informatics Vol. 106
Autores principales: Newman-Casey, Paula Anne, Musser, John, Niziol, Leslie M., Shedden, Kerby, Burke, David, Cohn, Amy
Formato: research Journal Article
Publicado: Academic Press Inc. Jun2020
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2020
      vid: 106
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      pub: Academic Press Inc.
      place: Burlington, Massachusetts
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        10.1016/j.jbi.2020.103428
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        atl: Designing and validating a low-cost real time locating system to continuously assess patient wait times.
      aug:
        au:
          Newman-Casey, Paula Anne
          Musser, John
          Niziol, Leslie M.
          Shedden, Kerby
          Burke, David
          Cohn, Amy
        affil: Department of Ophthalmology & Visual Sciences, University of Michigan Medical School, MI, United States
      sug:
        subj:
          Radio Frequency Identification
          Waiting Lists
          Systems Analysis
          Human
          Computer Systems
          Comparative Studies
          Multicenter Studies
          Evaluation Research
          Validation Studies
          Scales
          Ferrans and Powers Quality of Life Index
      ab: Objective: Outpatient clinics lack infrastructure to easily measure and understand patient wait times. Our objective was to design a low-cost, portable passive real time locating system within an outpatient clinic setting to measure patient wait times and patient-provider interactions.Materials and Methods: Direct observation was used to determine workflow in an outpatient glaucoma clinic at the University of Michigan. We used off-the shelf, antenna-integrated ultra-high frequency (UHF) RFID readers (ThingMagic, Astra-Ex, Woburn, MA) and UHF re-useable passive RFID tags (Zebra Impinj Monza 4QT, Seattle, WA). We designed a custom RFID management application in the Java programming language that was equipped with 'live' device administration to collect time and location data from patients and providers. These hardware choices enabled low cost system installation. Hidden Markov Modeling (HMM) was used to smooth patient and provider location data. Location data were validated against direct observations and EHR evaluation.Results: The HMM smoothed RFID system data accurately predicted patient location 80.6% of the time and provider location 79.1% of the time, compared to direct observation locations, an improvement over the raw RFID location data (65.0% and 77.9% accurate, respectively). Patient process time was on average 42.8 min (SD = 27.5) and wait time was 47.9 min (SD = 33.1). The installation and recurring capital costs of the system are approximately 10% of available commercially-supplied patient/provider tracking systems.Discussion: Passive RFID time study systems can enable real-time localization of people in clinic, facilitating continuous capture of patient wait times and patient-provider interactions. The system must be tailored to the clinic to accurately reflect patient and provider movement.Conclusions: Capturing wait time data continuously and passively can empower continuous clinical quality improvement initiatives to enhance the patient experience.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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