Understanding Performance and Behavior of Tightly Coupled Outpatient Systems Using RFID: Initial Experience

  • Authors:

  • James E. Stahl;Julie K. Holt;Nancy J. Gagliano

  • Affiliations:

  • MGH-Institute for Technology Assessment, Boston, USA 02114;MGH-Institute for Technology Assessment, Boston, USA 02114;Massachusetts General Hospital, Massachusetts General Physician Organization, Boston, USA 02114

  • Venue:
  • Journal of Medical Systems
  • Year:
  • 2011

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Abstract

Understanding how clinical systems actually behave in an era of limited medical resources is critical. The purpose of this study was to determine if a radiofrequency-identification-based indoor positioning system (IPS) could objectively and unobtrusively capture outpatient clinic behavior. Primary outcomes were flowtime, wait time and patient/clinician face time. Two contrasting clinics were evaluated: a primary care clinic (PC) with templated scheduling and an urgent care clinic (UC) with unconstrained visit time and first-in, first-out scheduling. All staff wore transponders throughout the study period. Patients carried transponders from check in to check out. All patients and staff were allowed to opt out. The study was approved by hospital IRB. Standard descriptive and analytic statistical methods were used. Five hundred twenty-six patients (309 patients (PC), 217 patients (UC)) and 38 clinicians (eight (PC) and 30 (UC)) volunteered between April 30 and July 1, 2008. Total FT was not significantly different across clinics. PC wait time was significantly shorter (7.6 min [SD 15.8]) vs. UC (19.7 min [SD 25.3], p驴p驴