Digital tools help patients find their way

Hospitals offer wayfinding apps for patients and staff.

Negotiating Mayo Clinic's sprawling headquarters in Rochester, Minn., can be an intimidating experience for first-time visitors. The medical campus encompasses 59 buildings spanning 15 million square feet, connected by a maze of pedestrian skyways and underground walkways.

Soon, however, visitors will be able to type any location into their phone and receive turn-by-turn instructions to their destination.

Five years ago, Mayo introduced a smartphone application that connected patients to their electronic health records (EHRs) and appointment schedules, as well as maps of the campus and points of interest in the surrounding community. Visitors could use the app to view the campus and their current location, but many still had trouble navigating from their cars to points inside the hospital.

Photo by Thinkstock
Photo by Thinkstock.

“Next-generation indoor mapping is allowing us to implement a much higher level of turn-by-turn directions to route patients through the campus,” said Mark Henderson, Mayo's chair of information technology (IT). “Patients will now have an experience similar to Google Maps, where they will see their real-time location represented by a blue dot moving on a map.”

Like Mayo, many medical centers are taking advantage of advances in technology to update their wayfinding systems and make it easier for visitors and staff to find their way around. While initially developed as navigation aids, the apps have a variety of other potential uses, including equipment tracking and quality improvement.

“Wayfinding apps are going through a digital revolution as hospitals invest in indoor positioning systems that are extremely accurate and capable of locating and tracking movements in real time,” said David Sawin, vice president of product and marketing for MobileSmith, a platform for creating hospital mobile apps based in Raleigh, N.C. “They started with basic point-to-point directions but are becoming more and more sophisticated and enabling interesting new uses.”

Harnessing GPS technology

The latest wayfinding apps use Bluetooth low-energy beacons to power indoor GPS navigation. These small, wireless devices are placed throughout a facility and emit signals to nearby smartphones. Many retailers already use them to communicate with customers about discounts or special offers while they're in their stores.

The battery-powered beacons enable location accuracy within a few feet, said Geoff Halstead, chief product officer for New York-based Connexient, developer of Medinav, a wayfinding app designed specifically for the health care market. They allow apps to be continuously refreshed so that users are quickly prompted to turn around if they take a wrong turn.

The Medinav app integrates with Google Maps and includes custom layers to fill in gaps, such as names of buildings or location entrances, said Mr. Halstead. The idea is to have a seamless transition from outside to inside so that visitors don't get stuck in the parking garage.

“One of the biggest problems patients encounter is not knowing how to get from their parking spot to their appointment,” he said. A new version of the app includes a feature called “find my car” that prompts visitors to save their parking location so they can be guided back to it later.

Stamford Hospital, in Stamford, Conn., began using Medinav last year after it opened a new 640,000-square-foot building attached to its main hospital, said John Rossi, Stamford's executive director of information services and security.

“We were looking for a way to improve the patient experience navigating across a larger campus,” he said. “Patients tell us that they love the pulsating dot because they can actually see where they are and feel oriented turn by turn.”

Stamford integrated the app with information about the surrounding community and hospital features as well as access to the patient portal and bill paying, he added.

“We're trying to simplify patient access and their experience on campus,” he said. “The app helps take the frustration and mystery out of getting around.”

Not just for patients

The latest wayfinding apps are just as useful to hospital staff as they are to visitors, noted Mr. Halstead. Physicians and other clinicians are often early adopters of the technology and often use it for responding to problems as well as getting around, he said. For example, Connexient customized its wayfinding app for the National Institutes of Health's 3.5 million-square-foot Clinical Center Complex in Bethesda, Md., which houses 40,000 employees. Rapid response teams use the app to quickly pinpoint the location of emergency calls around the complex.

Stamford Hospital's wayfinding app, dubbed “Find My Way,” is especially popular among residents and new employees, said Mr. Rossi. Physicians use it to find their way between the ambulatory clinics and acute care hospitals, for example.

“The campus can seem like a maze, and new employees love having an app that gives them turn-by-turn directions,” he said. “It especially helps out residents who have to travel throughout the campus on a daily basis.”

Similarly, Mayo Clinic is hoping to add capabilities that will allow physicians to use the wayfinding app to locate conference rooms in far-flung areas of the campus, helping them get where they're going on time and with less frustration, said Mr. Henderson.

Hospitals are also using wayfinding apps to improve the orientation experience for new employees, said Mr. Sawin. Apps can be customized to include information about workplace policies, procedures, and community services, allowing employees to quickly find answers to administrative questions instead of placing a call to human resources.

Beyond mapping

Many hospitals are continuing to improve and customize their wayfinding apps to improve the patient experience, said Mr. Henderson. Mayo is working on several enhancements aimed at streamlining the check-in and registration process and increasing patient engagement.

Similar to how the apps are used by retailers, hospitals could begin to send messages and alerts to patients and visitors based on their location in the hospital, he said.

For example—with patient permission—the app could trigger an alert when a patient is en route to an appointment or arrives in the lobby so that the registration and check-in process could begin before she arrives. It could also generate a message about what's on the menu that day as a visitor passes through the cafeteria or an alert that flu shots are available in the clinic.

“We hope to use the app to trigger certain events when a patient walks through a zone,” said Mr. Henderson. “When someone walks through the front door, for example, a welcome message would pop up on their phone with a link to view activities happening that day.”

The apps also have potential uses for quality improvement based on the information they collect, said Mr. Halstead. For example, apps can be customized to collect data on patient wait times by setting up zones—called “geofences”—around certain areas and tracking entrances and exits.

“It's possible to get real-time data every day on how long patients are waiting in specific areas or how long they spend in transit to their destinations,” he said. “In the future, patients might sign in to the app so that staff could check in with them and provide updates if someone has been waiting a long time.”

MobileSmith is working on an app aimed at improving antimicrobial stewardship, said Mr. Sawin. The app creates a virtual boundary around a hospital room and sends reminders about hand washing to anyone with an app-enabled smartphone who leaves or enters the room.

“Staff members inside the room would get an alert reminding them to wash their hands and confirm that they did it,” he said. “Hospitals could then measure outcomes by department or collect data on correlations between hand-washing adherence and rates of infection in specific locations.”

The more patients use an app, the richer it becomes as a data source, noted Mr. Henderson. For example, maps can be enhanced to show traffic flow at different places and times of day.

“The data is giving us valuable information about where we might need to rethink the design of our facilities,” he said. “Knowing peak traffic times in key areas, such as the cafeteria, and where people congregate also helps us with staffing appropriately and locating additional services, like wheelchairs or parking attendants.”

Until now, wayfinding apps have been mostly focused on the patient experience, but they are evolving into a more comprehensive navigation platform, said Mr. Halstead.

“Over time we can see many uses for wayfinding apps to help hospitals better manage patient flow and give better service,” he said. “They'll be used to remind patients about their appointment, tell them where to park, let the staff know they've arrived, and alert patients to delays. The goal is to solve real-world problems by providing much more than an indoor map.”