Understanding performance and behavior of tightly coupled outpatient systems using RFID: initial experience

Area of Science:

• Health Services Research
• Clinical Informatics
• Operations Research

Background:

• Efficient clinical system operation is crucial, especially with limited medical resources.
• Understanding actual outpatient clinic behavior is vital for optimizing healthcare delivery.
• Objective and unobtrusive methods are needed to capture real-world clinical dynamics.

Purpose of the Study:

• To evaluate if an indoor positioning system (IPS) using radiofrequency identification (RFID) can objectively and unobtrusively measure outpatient clinic behavior.
• To compare key process metrics between a primary care clinic and an urgent care clinic using IPS data.

Main Methods:

• An RFID-based IPS was implemented in two outpatient clinics: a primary care (PC) clinic with templated scheduling and an urgent care (UC) clinic with unconstrained scheduling.
• Patients and staff wore RFID transponders; participation was voluntary.
• Primary outcomes measured included flowtime, wait time, and patient/clinician face time.

Main Results:

• A total of 526 patients and 38 clinicians participated.
• While total flowtime was similar, the PC clinic had significantly shorter wait times (7.6 min vs. 19.7 min) and longer face times (29.9 min vs. 9.8 min) compared to the UC clinic.
• Face time distributions differed, with PC reflecting template scheduling and UC showing a log-normal distribution.

Conclusions:

• An RFID-based IPS can effectively measure critical process metrics in live outpatient settings.
• The IPS successfully captured behavioral differences between distinct outpatient clinic organizational structures.
• This technology offers a valuable tool for objective assessment and improvement of clinical operations.