July 2011
In the right direction - Wayfinding just isn't about signage any longer
According to Craig Knowles, three out of four people visiting a hospital are heading toward a destination they've never been to before. Not surprisingly then, he says, one of the biggest complaints hospital visitors have is getting lost.
"Most people who are coming to your hospital have never been there before and are very stressed," says Knowles, general manager of LogicJunction, a Beachwood, Ohio-based software company specializing in hospital way-finding tools. "Hospital buildings get placed wherever they find real estate, and then a campus can just grow and grow. Everyone is always building and tearing down or moving."
LogicJunction started in Atlanta and then moved to the Cleveland area and got into the hospital way-finding business around 2009 with a custom-built touch-screen kiosk at Lake Health's West Medical Center in Willoughby, Ohio. "At Lake West, they had to shut down the main elevator in the hospital," Knowles recalls, so the information was inputted into the way-finding kiosk and visitors were given alternate routes. Instructions are given via text or audio spoken by an onscreen avatar that has multiple language options.
LogicJunction then recreated that application in triplicate with three kiosks installed at Lake Health's TriPoint Medical Center in Concord Township before tackling its first mega-project: Cleveland Clinic.
"The Cleveland Clinic has many, many buildings and is always in a state of flux," Knowles says, explaining that the way-finding system there keeps track of the ever-changing landscape and has become a popular tool for new staff orientation.
The company is now doing the same at 615-bed Sarasota (Fla.) Memorial Hospital, which is in the middle of a $250 million, 220-bed replacement renovation project that includes a new $186 million patient tower.
"They're building a huge addition right in the middle of everything," Knowles says, explaining the need for a sophisticated way-finding tool.
Although LogicJunction's technology can send travel instructions as a phone text message or as an e-mail, Knowles says iPhone applications may not be worth the cost (about an additional $150,000 to $170,000) just because of the demographics of the target audience.
Not all way-finding elements are high-tech. They can include your standard directional signs and, for campuses that evolved in a somewhat haphazard fashion, they can incorporate new architectural features that help tie together disparate sections and create a sense of unity.
"With new construction, I find it to be a much easier project than a renovation," says Chris Bauer, managing principal of focusEGD, a Dallas-based environmental graphics design firm, who describes how landscape features, artwork or atriums, major building entrances, cafes or other constructed features can be used as landmarks that help orient first-time visitors.
Bauer also recommends breaking down large buildings into "zones," such as what was done with the 250-bed, 2 million-square-foot Seattle Children's Hospital, a seven-story structure built into a hillside that allows it to have entrances on its first, fourth, fifth and sixth floors.
"Wherever you're coming in from, you feel like you're on the first floor," she says, adding that the size of the 1953-vintage building (retrofitted in 1978) also increased the need for way-finding. "Two million square feet," she says. "The general public can't get their arms around that, so it's broken into smaller zones."
Often, these can be simply labeled Zone A, Zone B and so on, but at Seattle Children's there is the balloon zone, giraffe zone, rocket zone and whale zone. Similarly, in the process where the National Naval Medical Center in Bethesda, Md., is merging with the Walter Reed Army Medical Center in Washington to become in September the Walter Reed National Military Medical Center, Bauer says her team adapted by "learning the language" and culture of the military healthcare system-even though they may have thought it wouldn't be understood by a majority of the general public.
They also had to be subtle and sensitive in changing a Navy hospital into an institution serving all military branches. She says military-themed icons were created to guide visitors through the seven new zones of the hospital such as the Hero Zone, which includes tributes to decorated medical personnel from each branch.
Bauer says they were asked to do the same for the new $394 million Naval Hospital Camp Pendleton (Calif.) replacement facility that is set to open in 2014, but she says zoning would not work there. So, instead, an "anchoring" technique is being employed using the main north and south elevator banks. "Not every technique is appropriate for every building," she says.
At the Veteran Affairs Department Long Beach (Calif.) Healthcare System's new Blind Rehabilitation Center, Outpatient Clinic and Educational Resource Center, a design featuring roofs with extended canopies designed to mimic undulating waves was incorporated into the new buildings that quickly establishes where the entrances are while adding a unifying element to the campus.
"We took the opportunity at Long Beach to give them a whole new image and a whole new unifying look to the front of their facility," says Scott Mackey, associate principal at Lee, Burkhart, Liu architects. "Signs are OK, but it's a whole lot easier to orient yourself with a major architectural form-when you see those wave forms, it draws you to them aesthetically."
He calls the waves "a grand gesture" and notes how, originally, the new facilities were to be built on vacant sites independent of each other and with a hodge podge of building facades, but now there is "a structural visual identity."
Andis Robeznieks - Modern Healthcare Magazine
http://www.modernhealthcare.com/article/20110725/MAGAZINE/110729966
June 2011
Vendors roll out the next generation of health care signage
New technologies are advancing rapidly in the world of digital wayfinding. From electronic kiosks and lighted message boards to high-definition screens and wireless handheld devices, vendors are coming up with new ways to help patients and visitors navigate hospitals.
More hospitals are using high-tech digital signage, such as information kiosks, light-emitting diode (LED) message boards and handheld devices, to provide wayfinding help to patients and visitors.
This signage provides quick-changing, on-demand information that traditional, static formats cannot. Moreover, the growth of digital health care signage is riding the wave of new instant-communications technologies and may open up a new world to hospitals characterized by smart phones and other interactive tools.
However, digital signage always must be considered part of the overall signage program and be designed carefully into each facility.
Digital advances
"Digital signage has been used with success by hospitals all over the United States for the past five years, primarily as a communications tool," says Craig Knowles, general manager of LogicJunction's Wayfinding Division (www.logicjunction.com), Cleveland. "We're just now seeing the emergence of the next generation of advanced interactive wayfinding, which includes handheld devices, wireless, large-format systems and dynamic mapping technologies."
At its most basic, digital signage improves the hospital experience for patients and visitors. Along with providing much-needed directions within complex facilities, it increases the efficiency of the admissions process.
"A health care campus can be an intimidating and stressful environment," says Dave Rathbun, vice president of national accounts, health care, Four Winds Interactive (www.fourwindsinteractive.com), Denver. "Digital signage can provide a platform for communicating hospital amenities, encouraging the utilization of cafeterias, gift shops and educational classes."
Chuck Kuczynski, sales manager for the digital group, Clarke Systems (www.clarkesystems.com), Allentown, Pa., agrees, noting that digital signage provides hospitals with an opportunity to enhance their connection with employees, customers and the general public.
"Digital signage can help a hospital differentiate its message from other facilities by promoting healthy lifestyle suggestions, upcoming hospital events and specialty services," he notes. "It also can alleviate the typical help questions that can be repetitive and cumbersome to busy hospital staff."
As hospitals expand their campuses and the patient, staff and visitor populations become more ethnically diverse, it is getting harder to communicate consistently and clearly within these large facilities, says Andrea Hyde, AAHID, MDCID, a health care consultant based in Baltimore. Traditional fixed signs and bulletin boards are not designed to display information in real time.
"By using kiosks and digital signage, health care providers can communicate key information to various stakeholders, reduce waiting times and stimulate sales of additional services," she says.
Digital signage is a great wayfinding tool for hospitals with multiple buildings, says Patty Hudson, vice president, project design, APCO Sign Systems (www.apcosigns.com), Atlanta. However, she cautions, it is not a good fit for all facilities.
"Electronic directories are not the right choice for smaller hospitals," she says. "In addition to the initial expense, only one visitor at a time can access the wayfinding information." Also, facility professionals at some hospitals may install high-tech systems for the wrong reason: to look technologically progressive.
Integrating digital
Most experts agree that integrating digital and conventional signage requires careful planning. Mark VanderKlipp, president, Corbin Design (www.corbindesign.com), Traverse City, Mich., offers the following suggestions to facilitate the design process:
Use consistent terminology. Make sure that every tool used for wayfinding consistently speaks to the visitor regardless of its format.
Use materials that match other wayfinding information in the hospital. By doing that, facility professionals create a pattern of elements that people learn to access for information. Use of color, typography and accents such as wood or aluminum should keep the wayfinding system visually consistent.
Update content on a regular basis. A team should meet regularly to keep electronic signage updated, by creating content based on patient needs and projecting a positive message as part of the hospital's brand.
"Interactive elements provide almost limitless opportunities to put information in the public realm," VanderKlipp says. "This information can become visual noise if not managed properly."
Kelly David, director of marketing and product management for ASI Sign Systems (www.asisignage.com), Dallas, agrees, noting that digital signage should integrate within the facility and complement the building's architecture.
"In any project, the goal should be to work with the facility's natural wayfinding elements and incorporate signage as needed," she says. "Best practices have been derived from studies on the proper use of signage; those practices apply to any sign, digital or static."
The Americans with Disabilities Act compliance is another consideration. For example, facility professionals should ask such questions as: Should signage include Braille and tactile letters?
"Such considerations carry over to content displayed on the screen," David notes. "Make sure good color contrast and font selection is used to ensure legibility. This ties into the demographics of the facility."
Another key issue is the use of technologies for limited English proficiency (LEP), according to Randy Cooper, president, Cooper Signage & Graphics (www.signsystems.org), Atlanta. LEP encompasses hospital patients and visitors who do not speak English as a first language; it also extends to people with low reading levels.
"When a person with a second-grade reading level is faced with medical terms such as 'otolaryngology,' technology can help bring communication to the lowest common denominator," Cooper notes. "Icons/pictograms and language targeted at low reading levels help provide clarity."
Screens and kiosks
Larger, thinner and multilayered screens are becoming more prevalent in hospitals, experts agree.
"As the price of large [liquid crystal display] and LED screens falls, we are seeing larger screens being installed in hospitals," says Will Pymm, president, RedyRef (www.redyref.com), Long Island City, N.Y. Where 15-inch and 17-inch monitors used to be the norm, 22-inch to 32-inch monitors (and even 65-inch monitors) are becoming common.
High-definition (HD) technology has progressed to the point where these displays can offer multilayered information - providing policy information, upcoming events, service line promotion and patient education along with live television in a split-screen format, according to Cooper.
"The software that drives HD displays allows for flexible content scheduling, ensuring that information displayed is up-to-date," he notes.
David predicts that screen sizes will continue to evolve into thinner formats. "Over the next few years, we will see paper-thin screens that can be utilized in digital signage applications at an affordable price," she notes. "This will open up opportunities for additional implementation of digital signage. A slimmer, lighter profile will allow installation in new areas."
With renewed emphasis on improving the patient experience, interactive kiosks are being used as registration centers in hospitals, just as they are at airports worldwide.
"Along with wayfinding information, interactive kiosks have started to serve other roles including patient registration, medical-treatment updates and limited Internet and e-mail access in waiting rooms," says Chip Floyd, vice president of marketing, Innerface Architectural Signage (www.innerfacesign.com), Atlanta.
Natalie Bobila, vice president, marketing and sales, Interactive Touchscreen Solutions (www.itouchinc.com), Crofton, Md., agrees. "Self-check-in and registration kiosks are the latest hospital applications," she says. "We're seeing a huge wave of self-service applications such as ATMs, grocery store check-outs and airport check-ins. Allowing patients to self-register at hospitals is part of that trend."
Infrastructure needs
As for the installation of digital signage systems, experts say there are no special infrastructure requirements beyond typical power and network connections for PCs and displays already installed in facilities.
According to Cooper, however, installation requirements can vary dramatically, with some requiring no additional support and others requiring extensive cabling to achieve full functionality.
"Most need to be mapped out as part of the overall facility wayfinding plan," he says. "Care also must be taken to provide for updates and harmony in the terminology, look and integration of components of the wayfinding system."
VanderKlipp adds that the weight of current hardware often requires that additional blocking be added to walls. Increasingly, electronic signage can be wireless; however, all maps must be oriented properly, depending on the point of view of the user. Also, wireless technology is not always allowed within health care environments, so installation must be carefully mapped out with facilities staff.
"We've seen applications that are hosted remotely, on servers or in the 'cloud,' and provide information via streaming media or downloading to each sign element," he explains. "Information technology departments often want this information to be housed on their own servers; this is a key design constraint when programmers are building the software to run the signage. So it must be addressed early."
RedyRef recently helped UH Case Hospital in Cleveland solve its wayfinding challenge by implementing an innovative system hookup.
"Most facilities of this size have database security restrictions in place," explains Pymm. "One of the issues at UH was how to keep the directory database/content updated with constantly changing staff and relocation to different offices."
The solution was to import essential data from the existing database by building a program that imports it from a secure location on a daily basis. "Instead of connecting to the hospital's existing backbone, we connected to the guest wireless network and had all the wayfinding systems access the secure location on a subdirectory (not the primary network)," he explains. This solved the problem of managing two databases. Now one person updates the hospital database, and the wayfinding system automatically imports that data.
Peeking into the future
Experts agree that the future of digital signage offers some intriguing scenarios.
Knowles predicts that interactive wayfinding will become an integral part of hospitals. "As screens become cheaper and more powerful, the sky is the limit," he says. "In addition to wireless integrated screens, we will see integration with handheld devices, visitor recognition and personal greeting via radio-frequency identification, and automated check-in and registration via near-field tagging."
Bobila envisions individual global positioning system (GPS) devices for patients and visitors preloaded with their entire itinerary mapped out - from their first appointment to their last, and then finally back to the parking lot.
"This information will be downloaded to their smart phone, or a handheld GPS could be loaned to them while on campus," she notes.
Rathbun predicts that technology will enable enhanced access to back-end hospital data, allowing quick retrieval of critical patient health information. "New technology will allow more advanced interactivity with displays throughout the facility, such as screens mounted in patient rooms where the caregiver can pull up information such as vitals as well as instructions for patients," he says.
VanderKlipp sees clunky interfaces, such as quick response codes, being replaced by near-field communication tools that will be integrated into smart phones. As a result, users will be able to access information by merely holding a phone close to a physical signage element.
He also believes that expectations for privacy and access to information will be redefined by these new technologies. "Just as developers focus on capability, they also will need to focus on security so that users are confident their records are protected."
Health Facilities Management Magazine - Neal Lorenzi
http://www.hfmmagazine.com/hfmmagazine_app/jsp/articledisplay.jsp?dcrpath=HFMMAGAZINE/Article/data/06JUN2011/0611HFM_FEA_Marketplace&domain=HFMMAGAZINE
June 2011
LogicJunction finds its niche with wayfinding avatars at hospitals
Meet Marie. She's welcoming - a little stiff and a bit of a know-it-all, perhaps - but she'll help you navigate the winding pathways of the Cleveland Clinic's sprawling main campus. Marie isn't a real person, but rather an animated Clinic employee displayed on an electronic kiosk. She dons the same red jacket as the health system's human greeters, though, and she's helped hundreds of Clinic visitors reach their destinations by offering step-by-step directions that can be printed or sent to someone's phone. Marie also has provided a much-needed boost to her developer, LogicJunction, a software company in Beachwood that, according to its leaders, was struggling to gain momentum until it delved into the health care field over the last year.
The 10-year-old company, which moved to Northeast Ohio from Atlanta about six years ago, focuses on developing customized avatars, or computer-generated characters. By coupling the avatars with navigation software, LogicJunction officials said, they've found a segment of the market with an illustrated need, according to Mark Jowell, the company's CEO. "We've really focused on way-finding in health care," Mr. Jowell said.
The company previously worked primarily as a custom shop creating an array of avatars for a number of specific uses - an arrangement that requires a hefty amount of resources and manpower. For one, LogicJunction designed an avatar for use at the Western Reserve Historical Society's complex in University Circle to act as a museum curator to educate visitors. Likewise, the company designed a "virtual tour guide" for General Electric's education center in Schenectady, N.Y., to inform visitors about the company's role in developing power systems.
Though he wouldn't provide figures, Mr. Jowell said LogicJunction has experienced revenue growth over the last three years and is "poised to grow significantly over the next year" given its success with the wayfinding software. In addition to the Clinic, Logic-Junction's clients include the Lake Health system in Lake County and Sarasota Memorial Health Care System in Florida. LogicJunction still provides avatars for a number of other non-health care clients as well, including a "virtual insurance agent" for the Cleveland-based Council of Smaller Enterprises. Recent exposure at a few health care industry conferences, including the Clinic's Patient Experience Summit held last month, have sparked interest in the company's products, which Mr. Jowell said is a sign LogicJunction is moving in the right direction. "We've got a lot of confirmation in what we're doing," he said.
All about the patient
In the ever-competitive health care business in Northeast Ohio, care providers always are looking for ways to improve patient experiences, according to Mary Curran, senior director for special projects at the Clinic. The avatars help achieve that goal, as the kiosks also display activities around the Clinic campus, such as yoga classes, concerts or massages - events she said the hospital has had difficulty promoting in the past.
"We try to take the health care experience to a whole other level," Ms. Curran said. "It's not just about sickness and health, but we want to give you something to do while you wait." The Clinic, which has two kiosks and others on the way, isn't looking to replace its army of 38 "red coats," or Clinic employees donning red jackets who help patients and their families navigate its main campus. Rather, Ms. Curran said installing the kiosks is about giving patients "tools at their fingertips."
Last fall, Lake Health installed kiosks in the lobbies at Lake West Medical Center in Willoughby and TriPoint Medical Center in Concord Township as a method to ease anxiety and confusion when patients and their families enter the hospitals.
"From people who are using digital technology, we've had very positive feedback," said Diane Weber, director of radiology at Lake Health. "In some ways, it's clearer than the volunteer or somebody at desk giving directions."
Crain's Cleveland - Timothy Magaw
http://crainscleveland.com/article/20110613/SUB1/306139986&template=printart
April 2011
LogicJunction aims to make hospital navigation easy
Software developer LogicJunction hopes its Wayfinder touch-screen kiosk makes getting lost at hospitals a thing of the past.
The Cleveland-area company's interactive kiosks employ a talking avatar to help patients and visitors navigate the sometimes-confusing and sprawling layouts of hospitals, and features maps and step-by-step instructions that can be printed or sent to phones via text message. (Another Cleveland-area company, Intelligent Mobile Support, provided the text-messaging functionality.) "We're basically doing a Google Maps for interior spaces," said Ed Wagner, LogicJunction's director of sales.
Three hospitals, including Cleveland Clinic and Lake Health in Northeast Ohio, have installed Wayfinders so far, but Wagner sees a potential U.S. market of about 2,500. That is, roughly half the nation's 5,000 hospitals are large and complex enough that their visitors would benefit from navigation systems.
With more hospitals focusing on improving patient experience - and new technology becoming readily available - helping patients navigate layouts figures to become a higher priority for hospital administrators. And data suggests that hospital design and layout plays a key role in patient safety and satisfaction.
One study of a major tertiary care hospital calculated the annual cost of "wayfinding" at $220,000 - mainly due to the time spent direction-giving (more than 4,500 staff hours) by people other than information staff, according to a report from the Robert Wood Johnson Foundation.
Cleveland Clinic's use of LogicJunction's Wayfinder is an example of its increased emphasis on patient experience. "We are very focused on enhancing the patient experience and making our healthcare environment easy to navigate," said Mary Curran, senior director of special projects at Cleveland Clinic. "We are continuously exploring new ways of improving this for our patients." (As a nonprofit, the Clinic can't endorse products, so Curran declined to answer specific questions about LogicJunction's Wayfinder, a spokeswoman said.)
Certainly, LogicJunction isn't alone in seeking to help hospitals solve the wayfinding problem. Competitors in the interactive kiosk field include Four Winds Interactive, Navigo and Ready Ref. Navigo, in particular, boasts an impressive client list for its wayfinding software, with customers including Kaiser Permanente, Inova Heart & Vascular Institute and Mercy Hospital of Miami. Nonetheless, with the wayfinding market still in relative infancy, early entrants like LogicJunction stand as good a chance of coming out on top as anyone.
Below is a demonstration of LogicJunction's Wayfinder in action at Cleveland Clinic.
MedCity News
http://www.medcitynews.com/2011/04/logicjunction-aims-to-make-hospital-navigation-easy/
March 2011
Lake Health addressing visitors' critical need to navigate facilities during difficult times
When people come to the hospital - either as a visitor or as a patient - they often are not at their best. They could be preoccupied if they are there to see someone who has just completed a scary surgery or been admitted with injuries from an auto accident. Or maybe they have their head in the clouds and are walking on air after welcoming a new baby to the family.The hospital is probably not a place they visit often, and even if they've recently been in the emergency room with a friend or relative, the patient floors and other areas may be a mystery to them.
To help them negotiate to where they want to be, Lake Health has made its hospitals more user friendly. It's installed touch-screen kiosks in the lobbies of Lake West Medical Center in Willoughby and TriPoint Medical Center in Concord Township. Two kiosks are found at Lake West and three are at TriPoint. When it opened in October 2009, TriPoint became Northeast Ohio's first digital hospital. Now it's taken that one step further by becoming the first in the country to deploy a digital wayfinding system to help both patients and visitors navigate to their destinations. A special feature even allows users to have directions sent to their cell phones via text messaging.
Intuitive and easy to use, the system displays interactive maps and delivers consistent directions around the clock - whether the user is seeking a patient room or is in search of the cafeteria.rnrn"Navigating medical facilities can cause frustration and anxiety for both patients and their families," said Steve Karns, vice president of Administrative Services for Lake Health. "This technology ensures that everyone feels comfortable with basic navigation from the moment they enter our hospitals." Studies have shown that putting patients and their families at ease yields other benefits. They are more likely to arrive for appointments on time and bring with them a trusting and open attitude toward staff members.
"An effective wayfinding system can help lower stress levels and improve the patient experience," said Ed Wagner, spokesman for LogicJunction, the Cleveland-based developer of the technology. "That boosts the health system's image and leads to improved patient outcomes, safety and profitability." He said kiosks designed for Lake Health fit in well with the modern, high-tech facilities. "They also provide rich content to health care consumers who are accustomed to getting information on demand," he said.
Wagner and his team worked with Lake Health for nearly two years to customize the technology and make sure it works in concert with the more traditional sign-based interior and exterior systems in place at the two hospitals. Although the technology is not intended to replace the volunteers who staff the hospital reception desks, it provides a way for patients and visitors to access information privately and on their terms. User feedback has already resulted in some modifications - for instance, the avatar's name was changed from Sarah to Eve - and the system will continue to evolve.
Beyond providing directions within both hospitals, the kiosks will be able to serve as a virtual concierge, allowing users to search for nearby restaurants, hotels and even check the weather forecast. Those options are being developed now and should be available at the kiosks by summer. Future enhancements will include multilingual capabilities along with other expanded content.
Interactive technology is nothing new to Lake Health, which has been using it in its Diagnostic Imaging departments since fall of 2009. Patients can answer questions and register themselves at a kiosk instead of waiting to be called up to a desk. Janie Racer, Lake Health's director of clinical services, said the technology has streamlined patient check-in and improved the delivery of car. "From electronically capturing consent documents to gathering vital medical history, our self-service technology facilitates a more effective registration process, ensures accurate patient identification and minimizes the potential for errors," Racer explained.
Patient privacy is another important component. "By eliminating the need for patients to give private information verbally, the kiosks help safeguard patient privacy," she noted. The kiosks also help reduce the workload for registration personnel, freeing them to assist patients with more complicated needs. "Patient satisfaction has improved," she said. "We also are seeing operational benefits such as improved accuracy of demographic data in patient records."
Janet Podolak
http://news-herald.com/articles/2011/03/04/news/nh3661869.txt
LogicJunction Inc.
23950 Commerce Park Road
Beachwood, OH 44122
Phone: (877) 286-2631
Fax: (216) 292-6661