How Passive Tracking Works in the ED

When installing standard tracking systems in an ED, the problem that most frequently arises is who is going to enter information. The fast-paced, high-volume EDs do not have sufficient personnel to make manual entries.

That problem is what brought about Amelior EDTracker's greatest distinguishing feature: the ability to track patients passively.

Active versus Passive Tracking Systems

Most emergency department tracking systems on the market are active systems: somebody has to (or multiple somebodies have to) enter almost all of the data the system displays. Some data (e.g., patient demographics or lab/imaging results) may flow in from other computer systems via interfaces, but the vast majority of information used to track patients and department resources is manually entered by a person sitting in front of a computer screen. Ironically, a system that's supposed to simplify the emergency department's operations and improve patient flow actually ends up doing the opposite because people have to constantly stop caring for patients to enter data. Also, to compound the problem, when the department is busy, people stop making entries to the system and the data becomes useless. Yet it is when the department is busy that the data is most needed.

Amelior EDTracker still requires some manual entry, and the system can operate in fully active mode as well. However, most of the system takes advantage of passive tracking via infrared (IR) locating technology, thereby eliminating about 95 percent of the data entry that would be required if the system were operating in active mode.

How does it all work?

Infrared Locating in a Nutshell

All ED patients and staff wear small badges, which emit an infrared signal (similar to that of a TV remote control) roughly every three seconds. The badge signal uniquely identifies the badge.

The infrared signals that badges emit are received by sensors located in the ceilings throughout the emergency department and ancillary areas (radiology, ultrasound, nuclear medicine, etc.) that patients frequently visit. These sensors collect the infrared light from badges and, with the help of some other hardware, convert the infrared signatures into badge location data that software can understand.

Through Amelior EDTracker, users associate badge numbers with individual patients, staff, or equipment. Likewise, the Amelior EDTracker database links individual sensors to specific locations. For example, badge 12345 might be associated with John Doe. Similarly, sensor ABC is associated with ED exam room 14. Thus, if sensor ABC receives a signal from badge 12345, Amelior EDTracker can check the associations and determine that John Doe is in exam room 14.

As a result, ED personnel can use the system's infrared capabilities to find the current location of patients, charts, equipment, and even staff (if desired).

Although valuable, simple locating is just the most basic application of the infrared technology. By applying business rules to location, movement, and interaction data, we can track the progression of visits and determine both what has been done and what still needs to be done. For example,

• When a patient's badge is first tracked at any sensor back in the main department (i.e., not in the waiting room), we can assume that the patient has entered the ED—one of the primary "milestones" in the visit.
• If a patient's badge is tracked at a sensor representing a treatment room and the system shows that room as available, we can automatically assign the patient to the room. With this information, we can add the patient's name to several work queues. The work queue of patients waiting to be seen by a nurse is updated to include this patient, as is the queue of patients waiting to be seen by a doctor. If bedside registration is done, the registration queue is also updated. All of these people are informed of a new patient without any manual data entry.
• If a patient badge and a nurse badge show up together at a sensor representing the patient's assigned room for more than 30 seconds, we can mark the "Nurse at Bed" milestone and remove the patient from the Waiting for a Nurse queue. (Essentially, the same logic applies to doctor assignment and registration as well.)
• If a patient badge is tracked at a sensor representing a CT room, we can indicate that a CT is in progress. When the patient is tracked in the department again, we can indicate that the CT is complete.
• If a badge attached to a portable X-ray or EKG machine shows up at a sensor representing a treatment room while a patient is also there, we can indicate that a portable X-ray or EKG is in progress. When the machine leaves the room, we can show it as complete.

These are just a few (somewhat simplified) sample rules for translating location, movement, and interaction data into useful information about the visit. We also keep a log of all interactions between patients and staff members. As a result, department managers can accurately measure time spent with patients, identify potential bottlenecks, and assess how efficiently patients flow through the department. In addition, if a patient complains that nobody checked on him even though he pressed the nurse call button, you have data on whether the claim is true or not. With the infrared interaction log, it's easy to counter such claims.

Put simply, with the infrared technology—which can keep an eye on everyone in the whole department at once—we can gather the kind of comprehensive data people would be hard-pressed to keep track of themselves. But more importantly, we can do so with very little human-computer interaction. In the end, caregivers get the information they need, but they don't have to interrupt care for annoying data entry.

For additional information on the benefits of using infrared light for passive tracking, see Benefits of Amelior EDTracker