Mar 27, 2012Two years after installing a real-time location system (RTLS) to track patient flow, as well as staff members and some assets, Pacific Medical Centers' Canyon Park Clinic, located in Bothell, Wash., has doubled its number of patient visits each month—from 3,000 to 6,000—and achieved an average patient visit time of approximately 46 minutes. In fact, says Brett Daniel, Pacific Medical Centers' chief of primary care, the biggest problem now may be that the waiting room is too large for the very few people occupying it.
The RTLS solution, provided by Versus Technology, has reportedly enabled the clinic to reduce average wait times, and to improve patients' satisfaction by ensuring that they spend less idle time alone, and more time meeting with caregivers.. When Pacific Medical Centers was planning the Canyon Park Clinic, its goal was to create a facility that would serve as a model for its next generation of clinics, by creating greater efficiency in regard to patient treatment. The hospital wanted the new clinic to employ technology that could reduce the amount of time staff members might otherwise waste searching for patients, fellow workers and equipment. Pacific Medical operates 10 clinics, all within the state of Washington, and it has determined that a primary-care visit to one of its clinics averages about 70 minutes, though 46 minutes is considered best-practice. More than half of this time consists of waiting for an examining room, a medical assistant (MA) or a physician.
When Virginia Mason Medical Center opened a new facility in Kirkland, in spring 2009, it installed Versus' RTLS solution (see At Virginia Mason Clinic, RFID Eliminates the Need to Wait). Pacific Medical visited Virginia Mason's clinic to view the Versus system in action before deciding whether or not to deploy it. "We liked the Versus product," Daniel says. "They were willing to work with us on our timeline."
Versus' RTLS solution employs battery-powered badges and asset tags using both RFID and infrared technologies. Every three seconds, the tag simultaneously transmits a 433 MHz RF signal, using a proprietary air-interface protocol, and an infrared signal, both encoded with the same unique ID number. The Canyon Park Clinic's 30,000-square-foot facility has 35 standard examination rooms, four enlarged specialty exam rooms, procedure rooms, and areas for testing and infusions. The system was designed so that individuals and assets could be located within any of those areas, explains Tom Ott, Versus' national sales director. To accomplish that goal, he says, Versus installed 139 IR sensors (to receive the tags' IR signals) throughout the facility, at least one in each room, thereby enabling the system to pinpoint a particular badge's location within a room, or within a few feet (in the event that multiple IR sensors are used in the same room); for example, an IR sensor is deployed at each of five infusion chairs. Versus also installed RFID readers every 100 feet throughout hallways, in order to receive RFID transmissions as a redundancy to the IR system. What's more, the clinic attached Versus IR-RFID tags to approximately 130 pieces of equipment, such as electrocardiography (EKG) machines, pumps, defibrillators and DVD players.
The Versus software utilizes location data to help the clinic's staff identify each room's status (either empty or in use), track caregiver visits, automate the nurse-calling system, track EKG procedures (based on the presence of an EKG machine near a specific patient) and determine which additional tests were run on a patient (based on the specific rooms visited).
Upon arriving at the clinic, a patient checks in at the desk, and a staff member inputs that person's name, reason for visiting, time of appointment and physician's name. The patient is then provided with a Versus IR-RFID badge, the number of which is entered into the Versus software, which links to the facility's Centricity clinic-management system. A desk employee can then view a map of the clinic in the Versus software, and identify which examining rooms are available. The system color-codes each room, based on whether or not it is occupied by a patient.
When a medical assistant enters the room, the system captures that person's ID number, updating the software to indicate which worker is with the patient at that time. Upon leaving, the MA presses a button on her own badge, indicating that she is finished, and the system displays the room in yellow, indicating to the appropriate physician that the patient is now ready to be examined. If a piece of equipment, such as an EKG machine, is brought into the room, the system is also updated to indicate which procedure the patient is receiving.
Once a physician has completed examining the patient, he presses a button on his own badge, signifying that the visit is over, and a message is displayed for the MA staff that the patient is ready for discharge. Employees then know when the patient leaves the room, and that it is thus ready to be cleaned and prepared for another occupant.
The software provides a list indicating in which room equipment is located, as well as how long it has remained at that spot, thereby enabling the clinic to reduce the amount of time that employees spend walking throughout the facility searching for required equipment. Additionally, the system provides historical data, such as how long each patient has spent in which area, the length of time that each physician or medical assistant spends with patients, and where delays may occur. For instance, if a patient appears to have had an especially long visit, management can look through the records and determine at which point the patient was delayed. Analysis can also be broken down by department—for example, determining an average visit's duration at the infusion area, or within the ophthalmology department.
Since the system's 2010 installation at Canyon Park Clinic, the facility reports that it has received the highest patient-satisfaction scores among all of Pacific Medical's 10 clinics: an 85 percent "excellent" rating for the overall visit during the first year, and 91 percent during the second year (the scores are based on questionnaires that the patients completed in regard to their visits, with 85 and 91 ratings signifying the percentage of patients who rated their visits as "excellent"). Because the MA staff spends less time looking for equipment, fellow employees or patients, as well as less time filling out paperwork regarding visits (recording data that is now automated thanks to the RTLS), they have more time to answer phone calls from patients, Pacific Medical Centers reports. Of the patients responding to a questionnaire about their satisfaction with regard to receiving timely assistance by phone, 73 percent rated their experience as "excellent."
Pacific Medical Centers is currently in the process of deploying the same solution at its Totem Lake location, with the expectation of going live with the technology in mid-May 2012. In the future, Pacific Medical also hopes to use data from the RTLS to provide physicians with automatic access to its Epic medical records software. When a doctor and a patient are in an examining room together, for example, the system could use the physician's badge ID to provide him or her with automatic access to a PC within the room, without requiring the doctor to sign in via a password, and (using the patient's badge ID) immediately pull up the medical records for that patient as well. This function, however, is not yet in use.
