A hospital emergency room can be a chaotic place.
Patients arrive with injuries ranging from minor cuts to gunshot wounds, and doctors and nurses with myriad specialties scramble to get patients to the right place and schedule the proper tests with a limited number of resources.
It’s a challenge to keep track of it all.
Akron City Hospital has installed infrared-based tracking technology to help emergency department personnel keep track of patients, doctors, charts and the equipment needed to handle the more than 70,000 visits to the ER each year.
"One of the things that was a problem for us was we have a geographical structure that is not open," says Linda Breedlove, administrative director of emergency/trauma services for Summa Health System. "We have several pods, or departments, within departments. Knowing what was going on from pod to pod or zone to zone was almost impossible. We have certain people in charge of the flow of patients, but they had no idea what was going on. Was a patient in a room or had they been moved?"
The solution was EDTracker, a tracking system that uses infrared badges to identify the location of doctors, nurses, patients, patient charts and even equipment. All tracking is done automatically and is time-stamped so records show when a particular doctor visited a particular patient and how long he or she spent with the person.
If a chart is missing, a few clicks on the computer immediately locates its position within the ER.
"It used to be a major task to determine who is in the waiting room, how long they have been there and who we need to get back first," says Brian Keaton, attending physician and EM informatics director for Summa.
All of that can now be determined by looking at a computer screen. Doctors know in real time whether a patient has been relocated to another bed.
When patients enter the ER, they are assigned a tracking badge that links to their registration information. The system monitors where the patient goes, enters a time stamp each time the location changes and notes when a doctor or nurse enters and how much time they spend there.
With badges on portable EKG and X-ray machines, a doctor can know that a patient has had a particular test done by checking the tracking board on the computer. Receivers have also been placed in other key areas. If the computer shows the patient has been to the MRI area and back, the physician knows the MRI has been completed.
"None of this requires any interaction from the doctors or nurses," says Keaton. "Sending a patient home or admitting a patient is the only time that requires a manual act.
"When we were looking at systems, I knew I wasn’t going to get the doctors and nurses to do one more thing than what they are doing now. The technology had to improve their life in either the process or the care of patients and had to piggyback off of what they are normally doing. If you are asking them to make a bunch of mouse clicks and move information around, that would be additional jobs, and it would be the first thing they would quit doing when things got hectic, and that’s when you want the tracking the most."
The system also helps better plan for patients arriving by ambulance. Before they arrive, they are assigned a tracking badge with the corresponding information. The system is linked to sister hospital St. Thomas, so a supervisor can check to see where the best place to send a patient would be.
Supervisors in charge of moving people from the ER to available hospital beds know how many people are waiting and how long they have been waiting without talking to anyone.
"It’s something before that’s always been done by a phone call," says Breedlove. How to reach: Summa Health System, (800) 237-8662
Only the beginning
Technology in health care is advancing at an unprecedented pace. The infrared tracking system Akron City Hospital uses to better manage its ER department is just the first step in a journey toward doing electronic physician order entry at the enterprise level, and that’s one of the changes we’re likely to see.
Systems working off of radio frequencies that use badges that can be accurately located to within four to 12 inches, and can not only tell where a patient is but whether he or she fell out of bed based on the patient’s badge height.
"These badges will be capable of two-way communication," says Brian Keaton, EM informatics director for Summa. "You could put one in every IV pump in the enterprise. You would know where every piece of inventory is located at any given time, you could query to find out which ones needed the batteries replaced, and the pharmacy could be automatically contacted when the IV was running low and needed to be replaced.
"Instead of a sign-in and logon at a computer, a doctor could walk up and touch an ID spot. The same thing could happen when you drive up to the parking lot — the gate would automatically open without having to wait. You can really track all your assets. We’ve just now touched on the beginnings of what is possible to do."
