Related Experiment Video
Updated: May 27, 2026
Methodology for Establishing a Community-Wide Life Laboratory for Capturing Unobtrusive and Continuous Remote Activity and Health Data
Published on: July 27, 2018
Measuring process change in primary care using real-time location systems: feasibility and the results of a natural
James E Stahl1, Mark A Drew, Donna Leone
1Massachusetts General Hospital - Institute for Technology Assessment, Boston, MA 02114, USA. jstahl@partners.org
Introduction:
Objectively measuring the effect of primary care process interventions is very challenging. Real time location systems (RTLS) hold the potential to solve this problem.
Methods:
An outpatient clinic was outfitted with a RTLS based on active-RFID (radiofrequency identification). Staff and patients volunteered to wear RFID transponders which unobtrusively recorded time and location. Wearers were identified only by their role: Patient, MA, RN, MD. The clinical process intervention consisted of reorganizing how medical assistants were utilized from a ad hoc common pool of medical assistants to dedicated assignment of medical assistants. Process measures were recorded before, during and after the intervention.
Results:
230 unique patient encounters were recorded from October 2009-January 2010. Eight MDs, 7 MA and 6 RNs participated. Total flow time was significantly decreased while waiting room time was increased. Variance was significantly reduced for both total flow time and face time. In-room wait time and patient face time were decreased, though this did not reach statistical significance.
Conclusion:
Objectively measuring process change in primary care is feasible using RTLS. In this case the intervention resulted in the waiting room being used more effectively as a process buffer smoothing flow and potentially increasing clinic capacity.
