Use of Indoor Location Technologies in Healthcare Contexts: A Scoping Review
Source abstract
Abstract
The adoption of healthcare technologies has grown significantly, with real-time location systems (RTLSs) gaining particular attention. Despite decades of research, gaps persist in understanding the current state of the field and its future directions. This scoping review, conducted by PRISMA guidelines, identified 1718 articles retrieved from six databases, from which 83 were included. The findings reveal a dominance of U.S.-based case studies and a lack of systematic literature reviews. While RFID is the most commonly used technology, alternative solutions are emerging, though few studies explore their combined use. The emergency department is the most studied setting, focusing on patient flow. However, case study quality varies, which affects replicability, and literature reviews often fail to justify technological choices adequately. RTLS benefits include improved efficiency, enhanced patient safety, and cost reduction, but challenges such as precision issues and signal interference persist. RTLS also serves as a foundation for digital twins, integrating AI and Industry 4.0 technologies for more sustainable healthcare operations. Technological advancements may shift perceptions of RTLS challenges and benefits, highlighting the need for analysis by technology type and release date. Additionally, current MeSH terms fail to adequately cover healthcare technologies, resulting in the exclusion of relevant studies.
Source: crossref · Quality: baseline
Research context
OpenAlex topics: Indoor and Outdoor Localization Technologies · Context-Aware Activity Recognition Systems
SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.
Affiliations
Algoritmi Research Centre/LASI, Department of Production and Systems, School of Engineering, University of Minho, 4800-058 Guimarães, Portugal
Superior School of Health Sciences, Brasília 70710-907, Brazil
Department of Economics, Management, Industrial Engineering and Tourism, University of Aveiro, 3810-193 Aveiro, Portugal
Fundação de Ensino e Pesquisa em Ciências da Saúde, Brasília 70710-907, Brazil
Funding
Fundação para a Ciência e Tecnologia · Scientific Initiation Program of the School of Health Sciences—PIC/ESCS through the funds of the Foundation for Teaching and Research in Health Sciences—FEPECS
References (100+)
Show source-provided references
1. Figueroa, C.A., Harrison, R., Chauhan, A., and Meyer, L. (2019). Priorities and challenges for health leadership and workforce management globally: A rapid review. BMC Health Serv. Res., 19.10.1186/s12913-019-4080-7 ↗
2. Project Management in Hospital Environments: A 5-Year Systematic Literature Review
3. Measuring the current state-of-the-art in lean healthcare literature from the lenses of bibliometric indicators10.1108/BIJ-10-2021-0580 ↗
4. Exploring the Trend of Technology Use and Innovation in Health Care Service in Hospitals through a Bibliometric Analysis10.38029/babcockuniv.med.j..v7i1.379 ↗
5. Operational excellence in hospitals10.1108/IJLSS-07-2024-257 ↗
6. Industry 4.0 triggered by Lean Thinking: Insights from a systematic literature review10.1080/00207543.2020.1832274 ↗
7. Business process analysis in healthcare environments: A methodology based on process mining10.1016/j.is.2011.01.003 ↗
8. Hospital operations management—Characterising patients’ process flows in emergency departments10.1108/BPMJ-08-2023-0632 ↗
9. The adoption and implementation of RFID technologies in healthcare: A literature review10.1007/s10916-011-9789-8 ↗
10. A Survey About Real-Time Location Systems in Healthcare Environments10.1007/s10916-021-01710-1 ↗
11. Mans, R.S., Van Der Aalst, W.M.P., and Vanwersch, R.J.B. (2015). Process Mining in Healthcare Evaluating and Exploiting Operational Healthcare Processes, Springer. [1st ed.].10.1007/978-3-319-16071-9 ↗
12. Implementation of lean in health care environments: An update of systematic reviews10.1108/IJLSS-07-2019-0074 ↗
13. Contextual Computing : A Bluetooth based approach for tracking healthcare providers in the emergency room10.1016/j.jbi.2016.11.008 ↗
14. Real-time locating systems (RTLS) in healthcare: A condensed primer10.1186/1476-072X-11-25 ↗
15. Sivadevuni, S.S., and Ravichandran, S.K. (2023). Systematic Literature Review—IoT-Based Supply Chain Management in Industry 4.0. Intelligent Cyber Physical Systems and Internet of Things: ICoICI 2022, Springer.10.1007/978-3-031-18497-0_22 ↗
16. Indoor positioning systems provide insight into emergency department systems enabling proposal of designs to improve workflow10.1038/s43856-025-00793-y ↗
17. Digital twinning for smart hospital operations: Framework and proof of concept10.1016/j.techsoc.2023.102317 ↗
18. Sun, T., He, X., Song, X., Shu, L., and Li, Z. (2022). The Digital Twin in Medicine: A Key to the Future of Healthcare?. Front. Med., 9.10.3389/fmed.2022.907066 ↗
19. Machine intelligence and medical cyber-physical system architectures for smart healthcare: Taxonomy, challenges, opportunities, and possible solutions10.1016/j.artmed.2023.102692 ↗
20. Nowotarski, P., Pasławski, J., Skrzypczak, M., and Krygier, R. (July, January 28). RTLS systems as a Lean Management tool for productivity improvement. Proceedings of the 34th International Symposium on Automation and Robotics in Construction (ISARC 2017), Taipei, Taiwan.10.22260/ISARC2017/0143 ↗
21. Musser, J.A., Cho, J., Cohn, A., Niziol, L.M., Ballouz, D., Burke, D.T., and Newman-Casey, P.A. (2022). Measuring impact of a quality improvement initiative on glaucoma clinic flow using an automated real-time locating system. BMC Ophthalmol., 22.10.1186/s12886-022-02495-8 ↗
22. PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation10.7326/M18-0850 ↗
23. Use of indoor location technologies in healthcare contexts: A scoping review protocol
24. PRESS Peer Review of Electronic Search Strategies: 2015 Guideline Statement10.1016/j.jclinepi.2016.01.021 ↗
25. Gray literature: An important resource in systematic reviews10.1111/jebm.12266 ↗
26. Improving logistics processes of surgical instruments: Case of RFID technology10.1108/BPMJ-06-2016-0127 ↗
27. Yoo, S., Kim, S., Kim, E., Jung, E., Lee, K.-H., and Hwang, H. (2018). Real-time location system-based asset tracking in the healthcare field: Lessons learned from a feasibility study. BMC Med. Inform. Decis. Mak., 18.10.1186/s12911-018-0656-0 ↗
28. Using Location Tracking Data to Assess Efficiency in Established Clinical Workflows
29. Visualization and Analysis of Activities in Critical Care Environments
30. Real-time locating systems to improve healthcare delivery: A systematic review10.1093/jamia/ocab026 ↗
31. Challenges and issues of geolocation in clinical environment
32. Liu, J., and Rao, R. (2011, January 4–6). A coordinator loss-tolerant zigbee mesh network with region detection using RFID for the real-time indoor positioning system. Proceedings of the 2011 3rd International Conference on Multimedia Information Networking and Security (MINES), Shanghai, China.10.1109/MINES.2011.55 ↗
33. A new specimen management system using RFID technology10.1007/s10916-009-9417-z ↗
34. Gao, T., and White, D. (September, January 30). A next generation electronic triage to aid mass casualty emergency medical response. Proceedings of the Annual International Conference of the IEEE Engineering in Medicine and Biology Society, New York, NY, USA.
35. Muhammad, S.U.-R., Rabie, T., and Suleiman, S. (2016, January 6–8). A Novel Wireless Mesh Network for Indoor Robotic Navigation. Proceedings of the 5th International Conference on Electronic Devices, Systems and Applications (ICEDSA), Ras Al Khaimah, United Arab Emirates.
36. A comparison of commercial and custom-made electronic tracking systems to measure patient flow through an ambulatory clinic10.1186/s12942-015-0023-7 ↗
37. Enhancing Workflow Analysis in Acute Stroke Patients Using Radiofrequency Identification and Infrared-based Real-Time Location Systems10.1016/j.jacr.2016.07.004 ↗
38. Rosen, M.A., Dietz, A.S., Lee, N., Wang, I.-J., Markowitz, J., Wyskiel, R.M., Yang, T., Priebe, C.E., Sapirstein, A., and Gurses, A.P. (2018). Sensor-based measurement of critical care nursing workload: Unobtrusive measures of nursing activity complement traditional task and patient level indicators of workload to predict perceived exertion. PLoS ONE, 13.10.1371/journal.pone.0204819 ↗
39. Yan, Y., Tang, G., Chamber, E., Gillespie, J., Wallace, C., Chiu, T., Pompos, A., Godley, A., Timmerman, R., and Jiang, S. (2021, January 25–29). An Indoor Real-Time Location System (RTLS) to Improve Patient Safety and Clinical Workflow of Radiation Therapy. Proceedings of the AAPM 63rd Annual Meeting & Exhibition, Online. Available online: https://w4.aapm.org/meetings/2021AM/programInfo/programAbs.php?sid=9374&aid=58497.
40. An Investigation of an RFID-based Patient-tracking and Mobile Alert System10.5772/45672 ↗
41. Application of Radio-frequency Identification in Perioperative Care10.1016/j.aorn.2009.12.034 ↗
42. Cost Savings Generated by a Radio Frequency Identification (RFID) Search System10.1016/j.annemergmed.2016.08.122 ↗
43. Effects of a WLAN-based real time location system on outpatient contentment in a Level I trauma center10.1016/j.ijmedinf.2013.10.001 ↗
44. Kim, D.-S., Kim, J., Kim, S.-H., and Yoo, S.K. (2008, January 20–25). Design of RFID based the Patient Management and Tracking System in Hospital. Proceedings of the 2008 30th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, Vancouver, BC, Canada.10.1109/IEMBS.2008.4649442 ↗
45. Development and impact of radio-frequency identification-based workflow management in health promotion center: Using interrupted time-series analysis10.1109/TITB.2009.2026167 ↗
46. Improvement in the workflow efficiency of treating non-emergency outpatients by using a WLAN-based real-time location system in a level I trauma center10.1136/amiajnl-2012-001307 ↗
47. Browning, L., White, K., Siiankoski, D., Colling, R., Roskell, D., Fryer, E., Hemsworth, H., Roberts-Gant, S., Roelofsen, R., and Rittscher, J. (2022). RFID analysis of the complexity of cellular pathology workflow—An opportunity for digital pathology. Front. Med., 9.10.3389/fmed.2022.933933 ↗
48. Smart medical environment at the point of care: Auto-tracking clinical interventions at the bed side using RFID technology10.1016/j.compbiomed.2010.03.007 ↗
49. Experiences With a Prototype Tracking and Verification System Implemented Within an Imaging Center10.1016/j.acra.2006.12.002 ↗
50. Radiofrequency identification specimen tracking in anatomical pathology: Pilot study of 1067 consecutive prostate biopsies10.1016/j.anndiagpath.2013.04.007 ↗
51. Weng, S.-J., Tsai, M.-C., Tsai, Y.-T., Gotcher, D.F., Chen, C.-H., Liu, S.-C., Xu, Y.-Y., and Kim, S.-H. (2019). Improving the efficiency of an emergency department based on activity-relationship diagram and radio frequency identification technology. Int. J. Environ. Res. Public Health, 16.10.3390/ijerph16224478 ↗
52. Automatic Time-Motion Study of a Multistep Preoperative Process10.1097/ALN.0b013e31817302ca ↗
53. Tanaka, K., and Maeda, H. (2022, January 12–15). Robust Indoor Positioning Method using BLE and Wireless Mesh Network. Proceedings of the 2022 IEEE International Conference on Dependable, Autonomic and Secure Computing, Falerna, Italy.10.1109/DASC/PiCom/CBDCom/Cy55231.2022.9927764 ↗
54. Using technology to improve and support communication and workflow processes10.1016/S0001-2092(06)60301-3 ↗
55. Measuring process change in primary care using real-time location systems: Feasibility and the results of a natural experiment10.3233/THC-2011-0638 ↗
56. Ward, D.R., Ghali, W.A., Graham, A., and Lemaire, J.B. (2014). A real-time locating system observes physician time-motion patterns during walk-rounds: A pilot study. BMC Med. Educ., 14.10.1186/1472-6920-14-37 ↗
57. Using smart RFID solutions to improve RBC units stock management, transfusion safety and blood unit traceability with clear benefits to the patient
58. Process visibility analysis in ambulatory care: A simulation study with RFID data
59. Practical Considerations in Implementing RFID for the Blood Supply
60. Face Time Versus Test Ordering: Is There a trade off?
61. RFID Applications in Hospitals-A Case Study for Emergency Department
62. Passive tracking of linac clinical flow using radiofrequency identification technology10.1016/j.prro.2013.03.005 ↗
63. RFID-initiated workflow control to facilitate patient safety and utilization efficiency in operation theater10.1016/j.cmpb.2010.08.017 ↗
64. Tracking technology: Lessons learned in two health care sites10.3233/THC-130738 ↗
65. Development of a WLAN-based real time localization system for patient tracking in a Level I Trauma center
66. Ariffin, F.N.H., Wan, A.T., and Suhaili, W.S.H. (2015, January 10–11). Psychiatric Patients Monitoring Using RFID: An Affordable Approach. Proceedings of the 2015 IEEE International Conference on Computer and Communications (ICCC), Chengdu, China.10.1109/CompComm.2015.7387564 ↗
67. Radiofrequency identification: Exploiting an old technology for measuring nurse time and motion10.1097/NXN.0b013e3182545418 ↗
68. Multidimensional evaluation of a radio frequency identification wi-fi location tracking system in an acute-care hospital setting10.1136/amiajnl-2011-000560 ↗
69. A novel method for inferring RFID tag reader recordings into clinical events10.1016/j.ijmedinf.2011.09.006 ↗
70. Comparison of RFID Systems for Tracking Clinical Interventions at the Bedside
71. Surian, D., Kim, V., Menon, R., Dunn, A.G., Sintchenko, V., and Coiera, E. (2019). Tracking a moving user in indoor environments using Bluetooth low energy beacons. J. Biomed. Inform., 98.10.1016/j.jbi.2019.103288 ↗
72. Newman-Casey, P.A., Musser, J., Niziol, L.M., Shedden, K., Burke, D., and Cohn, A. (2020). Designing and validating a low-cost real time locating system to continuously assess patient wait times. J. Biomed. Inform., 106.10.1016/j.jbi.2020.103428 ↗
73. The advantages and disadvantages of Radio Frequency Identification (RFID) in Health-care Centers; approach in Emergency Room (ER)10.12669/pjms.291(Suppl).3552 ↗
74. Patient-clinician concordance, face-time and access10.1108/IJHCQA-04-2013-0048 ↗
75. Emergency Department Crowding and Time at the Bedside: A Wearable Technology Feasibility Study10.1016/j.jen.2018.03.005 ↗
76. RFID in US hospitals: An exploratory investigation of technology adoption10.1108/MRR-09-2014-0222 ↗
77. A method for the analysis and visualization of clinical workflow in dynamic environments10.1016/j.jbi.2018.01.007 ↗
78. Accuracy of Patient’s Turnover Time Prediction Using RFID Technology in an Academic Ambulatory Surgery Center10.1007/s10916-015-0192-8 ↗
79. World Health Organization (2024, August 15). WHO Guideline: Recommendations on Digital Interventions for Health System Strengthening. Available online: https://www.who.int/publications/i/item/9789241550505.
80. A RFID Specific Participatory Design Approach to Support Design and Implementation of Real-Time Location Systems in the Operating Room10.1007/s10916-014-0168-0 ↗
81. UK Equator Centre (2024). Enhancing the QUAlity and Transparency of Health Research, UK Equator Centre. Equator Network.
82. What Is Value in Health Care?10.1056/NEJMp1011024 ↗
83. Strategies for utilisation management of hospital services: A systematic review of interventions10.1186/s12992-022-00835-3 ↗
84. Digital twins for health: A scoping review10.1038/s41746-024-01073-0 ↗
85. Armeni, P., Polat, I., De Rossi, L.M., Diaferia, L., Meregalli, S., and Gatti, A. (2022). Digital Twins in Healthcare: Is It the Beginning of a New Era of Evidence-Based Medicine? A Critical Review. J. Pers. Med., 12.10.3390/jpm12081255 ↗
86. Digital Twins for Managing Health Care Systems: Rapid Literature Review10.2196/37641 ↗
87. Cellina, M., Cè, M., Alì, M., Irmici, G., Ibba, S., Caloro, E., Fazzini, D., Oliva, G., and Papa, S. (2023). Digital Twins: The New Frontier for Personalized Medicine?. Appl. Sci., 13.10.3390/app13137940 ↗
88. A framework for performance and data quality assessment of Radio Frequency IDentification (RFID) systems in health care settings10.1016/j.jbi.2010.12.004 ↗
89. Iqbal, Z., Luo, D., Henry, P., Kazemifar, S., Rozario, T., Yan, Y., Westover, K., Lu, W., Nguyen, D., and Long, T. (2018). Accurate real time localization tracking in a clinical environment using Bluetooth Low Energy and deep learning. PLoS ONE, 13.10.1371/journal.pone.0205392 ↗
90. Ghori, M., Wan, T.-C., and Sodhy, G. (August, January 30). Bluetooth Low Energy 5 Mesh Based Hospital Communication Network (B5MBHCN). Proceedings of the International Conference on Advances in Cyber Security 2019, Penang, Malaysia.10.1007/978-981-15-2693-0_18 ↗
91. Tu, Y., Chi, H., Zhou, W., Kapoor, G., Eryarsoy, E., and Piramuthu, S. (2019, January 27–29). Critical evaluation of RFID applications in healthcare. Proceedings of the 2019 International Conference on Future Network Systems and Security, Melbourne, Australia.10.1007/978-3-030-34353-8_18 ↗
92. Lee, C.K.M., and Palaniappan, S. (2014, January 12-15). Effective Asset Management For Hospitals with RFID. Proceedings of the 2014 IEEE International Technology Management Conference, Chicago, IL, USA.10.1109/ITMC.2014.6918596 ↗
93. Handling the demands of a population boom. Using RTLS to improve patient care and workflows
94. Investigation of RFID-based Workflow Analysis10.1016/j.ijrobp.2012.07.1448 ↗
95. Mapping Hospital Environments: Doctors and Architects Working Together to Design Better Emergency Departments
96. Fry, E.A., and Lenert, L.A. (2015, January 14–18). MASCAL: RFID Tracking of Patients, Staff and Equipment to Enhance Hospital Response to Mass Casualty Events. Proceedings of the American Medical Informatics Association Annual Symposium 2015 (AMIA 2015), San Francisco, CA, USA.
97. Measuring Sensitivity and Precision of Real-Time Location Systems (RTLS): Definition, Protocol and Demonstration for Clinical Relevance10.1007/s10916-020-01606-6 ↗
98. Musa, A., and Yusuf, Y. (2012, January 22–24). MEWARE: Enhanced workflow automation, reliability and efficiency in medical establishments. Proceedings of the 2012 Colloquium in Information Science and Technology, Fez, Morocco.10.1109/CIST.2012.6388073 ↗
99. Vankipuram, A., Patel, V.L., Traub, S., and Shortliffe, E.H. (2019). Overlaying multiple sources of data to identify bottlenecks in clinical workflow. J. Biomed. Inform.10.1016/j.yjbinx.2019.100004 ↗
100. Arunachalam, S.P., Albertson, S.M., Sir, M.Y., Nestler, D.M., Heaton, H.A., Marisamy, G., and Pasupathy, K.S. (2020, January 6–9). Patient satisfaction in the emergency department is influenced by total length of stay: A RFID based feasibility study. Proceedings of the 2020 Design of Medical Devices Conference, Minneapolis, MN, USA.