Knowledge Expansion RTLS: Keeping electronic tabs on patients (and staff) can offer major insights into efficiency in care Insight Article Patient Flow Patient Care Technology Practice Efficiency Sign in to save Andy Stonehouse MA Using electronic tools to keep track of patients could be the key to enhanced efficiencies in healthcare, although the stigma of having someone looking over your shoulder still needs to be addressed with patients and staff alike. Kevin Hoover, MD, PhD, Director of Musculoskeletal Imaging and Intervention at Virginia Commonwealth University, recently spoke to MGMA senior editor Daniel Williams on the MGMA Insider podcast to discuss advances in real-time location systems (RTLS) – tech tools designed to provide pinpoint monitoring of both patients and staff. Real-time location tools (RTLS) Hoover said the largely non-intrusive RTLS tools, contained in something as simple as a clip-on ID badge, allow instantaneous updates on patient whereabouts, and can yield data invaluable to integrating specialist services or even monitoring patient drug interactions. “It’s a neat tool,” he said. “What RTLS allows us to do is to know where someone is, and when they’re there. These are all really key pieces of information that allow us to optimize the time patients spend in one place. For example, if you’ve got a patient receiving infusion for a rheumatoid condition, which might take two hours, we want to know how long that patient is sitting there. Or you may just want to know how long that patient spent in a waiting room.” Using data to optimize care While the location technology may also conjure images of Big Brother, Hoover said most patients appreciate the opportunity to allow providers to use the data to optimize their care. “I think I have three or four examples of patients in the last three years that have refused to wear it. So education piece is critical for everyone, across the institution. We talk about what RTLS is for, and what we’re trying to do with it, and where it needs to be so that it’s detectable – and when you’re done to deposit it in the box, to tell us that you’re done with your day or your care.” Decreasing wait time Hoover said the RTLS systems can be especially useful in making sure that patients are not neglected and that care does not overlap. “We don’t want patients to wait too long. We have a goal that no one’s by themselves without a staff person for more than 10 minutes. Anyone can see that information on the board, so it’s our job to go and touch base with that patient and the staff, and say, ‘what’s going on? Why are they waiting so long?’” Monitoring technology sometimes results in pushback from the frontline healthcare staff being observed, but Hoover said education is again the key to building a level of comfort with rollout of the tracking systems. “We express to our staff that it’s not a tracking device and we’re not watching how long they’re on YouTube,” he said. This kind of technology is “really here to make sure that staff are properly allocated, and help to improve the patient experience, and hopefully the staff experience, too.” Practice efficiency Beyond simply keeping tabs on patient locations, Hoover said the range of data generated by RTLS tech can offer a model for healthcare administrators to optimize workflow and process management. “We’re still early on, but as we get the technological tools to really learn from this data, it’s going to be very valuable. One place we visited, the Dana Farber Cancer Institute in Boston, was using the information to determine how many rooms a physician should have at a given time. You can, in real time, tell how many patients are waiting – if one physician is very busy, they may have three rooms, whereas if things are going more slowly for another physician, they may have just one room.” Ultimately, Hoover believes the data may also help push better amalgamation of overall care, as the continued sub-specialization of healthcare often means a sometimes bewildering revolving door of doctors and nurses, and little centralized tracking. “I’m a radiologist, so one of my big pushes is the delivery of radiology care in a way that’s integrated and streamlined with the other care. At our center, we integrated the radiology into the patient care area in the clinic, and we also integrated myself into the clinic. As a result, we’ve seen really dramatic differences and overall time spent with patients. It’s also been a useful tool to justify what we’re doing and to have some of it done at other places.” You can listen to Kevin Hoover talk about the impact of RTLS in health systems and medical practices at 13:35 in this episode of MGMA Insights podcast. Additional Resources: "Core tenets of effective patient engagement in medical practices" (MGMA Insight Article) "7 key ways healthcare can be impacted by artificial intelligence" (MGMA Insight Article) "Will you offer telehealth services in 2019?" (MGMA Stat) To hear Kevin Hoover speak live, join us at MGMA19 | The Annual Conference, Oct. 13-16 in New Orleans. For more information about MGMA19, check out our Annual Conference blog at mgma.com/fuse. To register, visit MGMA.com/bigeasy19.