Apr 05, 2013Joint Implant Surgeons of Florida (JISF), an orthopedic clinic that provides diagnostic, reconstructive and therapeutic services, prides itself on managing high volumes of patients efficiently. In fact, says Renee Humbert, JISF's practice administrator, the facility has five physicians on staff, two of whom are usually onsite on any given day, and typically receives between 165 and 185 patients daily who require joint or osteoarthritis-orthopedic care, and who may then also schedule surgical appointments.
In an effort to boost efficiency, the clinic adopted a real-time location system (RTLS) provided by Solstice Medical and Ekahau to time, track and locate all patients and clinical staff members. The system collects data regarding where delays may occur, so that they can be resolved, and also provides alerts if an individual may have been waiting for a long time (longer than the clinic's benchmarked time limit) within one area.
Last year, Humbert says, JISF completed a manual time survey of how long patients remained in each area of the clinic, in an effort to improve scheduling processes and determine ways in which to better serve patients. "We found it very hard to evaluate" the exact amount of time that each patient spent at each location, she says, and what variables might influence that waiting period, such as a patient's needs and state of mind, as well as the particular staff member providing assistance. For example, it might take longer to schedule surgery for a very worried patient than it would for someone who considered it a routine procedure.
Therefore, says Dan Sands, Solstice Medical's CEO and president, the clinic approached his firm in early 2012, and installed Ekahau's RTLS technology by last summer, in order to accomplish two goals: tracking the locations of staff members and patients for analytics (to improve efficiency), and gaining real-time updates when delays occur. Solstice provided a solution featuring Ekahau B4 Wi-Fi badge tags worn or carried by personnel and patients, and including the installation of approximately 65 Ekahau LB1 infrared (IR) location beacons throughout the 15,000-square-foot facility. The clinic's existing Aerohive wireless local area network (LAN) receives the 2.4 GHz signals transmitted by the B4 badge, and that data is forwarded to Ekahau's Vision software, which calculates each tag's location based on that data, according to Mark Norris, Ekahau's president and CEO. Solstice Medical's own Real-Time Patient Flow (RTPF) software then provides analytic data based on that location information, to help the clinic optimize appointment scheduling, as well as boost patient satisfaction and operational efficiencies.
Each clinical staff member's B4 badge transmits an ID number linked to that individual in the Ekahau software. The software comes with a floor map on which an icon representing that worker can be seen moving around, according to his or her location.
Upon checking in, patients are provided with a badge that they can clip onto a belt or jacket. As a patient receives the tag, a staff member uses a computer to access the Solstice software and click on a drop-down menu to initiate a timer indicating how long that individual has been waiting to be seen. Unlike staff badges, the patient badge is anonymous—the unique ID number encoded to that tag is not linked to any patient data.
Once initiated, the patient tag is also tracked in the Ekahau software, and computers running that software can display an icon representing that individual as he or she moves from a main waiting room to the imaging area, or to the clinic's waiting room, examining room, injection area or surgery-scheduling station. In the event that a patient has been waiting longer than the predetermined acceptable time for that location, the icon will flash to indicate a problem.
In the clinic's injection area, a staff member presses the button on the patient's badge upon injecting that person with medication. The Solstice software collects that data to determine the number of injections completed daily—in this way providing information necessary to predict the amount of medication that needs to be prepared for a typical day.
The Solstice software also tracks how long a physician or physician's assistant spends with a patient, thereby enabling the clinic to track the amount of time that patients wait for a health-care provider, as well as how long that provider spends with each patient, and how long specific procedures take to complete. By tracking such information, Humbert says, she is able to determine, for example, which staff members may be more efficient at a specific procedure, and thus would be the best person to train other newly hired personnel.
"It also helps us revise and optimize the order of our clinical schedule," Humbert says, "which is made up of different types of appointments, such as new patient, existing patient, MRI results consultation, injection or post-op—which all have different average cycle times," since the data helps determine how long each type of appointment takes.
Humbert says she can also use data collected by the RTLS solution to determine the number of rooms to assign to a specific doctor, based on the amount of time that patients wait in those rooms. For example, she notes, the facility could reduce the number of rooms per physician in order to decrease the time patients spend at the facility. In addition, the clinic can utilize the RTLS data to keep patients better informed. If it becomes evident that a delay is occurring, for example, the staff can announce this status to those still waiting, enabling them to step away for a cup of coffee.
"We've always been extremely good at providing high-volume [service]," Humbert states. However, she says, the RTLS solution has helped the clinic improve on that efficiency.
In some cases, to create greater granularity, several IR location beacons were installed within a single room to help the clinic pinpoint a patient's location—identifying even in which chair an individual may be sitting, thereby allowing the staff to know what stage of the visit he or she has reached.
"Of the installation," Sands reports, "I would say, personally, the startup and implementation phase was pretty seamless. This is unique application, and the potential is pretty significant."
