{ "abstract": "Real-time location systems track assets and individuals, and in high-income clinical settings, they have improved patient flow. However, their use in low- and middle-income countries remains limited. Smart Spot, a low-cost Bluetooth low-energy real-time location system was integrated within the Smart Triage quality improvement platform in the outpatient department of Uganda Martyrs’ Hospital Ibanda. The primary objective was to evaluate whether Smart Spot data could be used to detect differences in time spent across clinical locations associated with Smart Triage implementation. The secondary objective was to assess the accuracy of Smart Spot data. At triage, children (or their caregivers) received a beacon attached to a lanyard. The beacons tracked patients’ locations throughout their time in the outpatient department. Smart Spot data were collected during a 4‑month baseline phase (pre-Smart Triage) and a 12‑month Smart Triage intervention phase. An algorithm was developed to reduce noise and generate more accurate records of each patient’s journey. The resulting pathways were compared to expected paths to evaluate Smart Spot’s accuracy. The median durations of patient time spent in specific areas were compared between phases using quantile regression. Data cleaning improved the matching to the expected patient flow from 13.0% to 73.1%. Compared with baseline, the median time patients spent in the assessment area decreased by 51.7% (-81.9 min; CI: -95.1 to -68.8), in the emergency room by 69.1% (-44.3 min; CI: -67.7 to -20.8), and total visit duration by 58.2% (-122.9 min; CI: -138.4 to -107.3), all with p-value < 0.001. Real-time location data supported the demonstration of the Smart Triage platform’s benefits. In the cleaned dataset, the intervention phase had shorter total visit time and time reductions within specific areas. Our evaluation demonstrates Smart Spot’s feasibility as an effective data-collection platform for quality improvement and its utility for retrospective analyses in low-resource settings. Author summary: Healthcare infrastructure in low- and middle-income countries often falls behind that of high-income countries. Significant resource constraints in these settings contribute to this difference, ultimately resulting in patients lacking the optimal care they need. Additionally, without digital health infrastructure tools, low-resource healthcare settings do not have the resources to record any data to track their progress on quality improvement goals. To address this issue, we developed Smart Triage, a triage platform for children in the outpatient department of hospitals in Uganda. The platform provides data-driven triage and can also be used to track quality improvement. Our study focused on Smart Spot (a wireless tag), which is part of Smart Triage and offers live tracking of patients’ locations. We found that the data collected through Smart Spot was noisy, so we developed a method to clean this data to provide a more accurate measurement of the children’s movement. While the system can benefit from further accuracy improvements, it showed us where improvements were made during the Smart Triage implementation. Our study shows that an affordable tracking approach can be used to monitor the process of care, guide local improvements, and enhance patient outcomes.", "abstract_shown": true, "affiliations": [ "Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, Vancouver, British Columbia, Canada", "Institute for Global Health, BC Children’s Hospital and BC Women’s Hospital + Health Centre, Vancouver, British Columbia, Canada", "Uganda Martyrs’ Ibanda Hospital, Ibanda, Uganda", "World Alliance for Lung and Intensive Care Medicine in Uganda, Kampala, Uganda", "Uganda Catholic Medical Bureau, Kampala, Uganda" ], "article_type": "Research Article", "arxiv": null, "author_total": 12, "authors": [ { "affs": [ 0, 1 ], "name": "Daniel Choi", "orcid": "0009-0002-2200-6983" }, { "affs": [ 2 ], "name": "Ediketh Tugume" }, { "affs": [ 2 ], "name": "Isaac Mwesigye" }, { "affs": [ 3 ], "name": "Aine Ivan Aye Ishebukara" }, { "affs": [ 0, 1 ], "name": "Charly Huxford", "orcid": "0000-0002-0836-0647" }, { "affs": [ 0, 1 ], "name": "Yashodani Pillay" }, { "affs": [ 2 ], "name": "Gotharido Tumubugane" }, { "affs": [ 3 ], "name": "Nathan Kenya-Mugisha" }, { "affs": [ 4 ], "name": "Ronald Kasyaba" }, { "affs": [ 0, 1 ], "name": "J. Mark Ansermino", "orcid": "0000-0001-8427-2035" }, { "affs": [ 0, 1 ], "name": "Dustin Dunsmuir", "orcid": "0000-0001-9717-3685" }, { "affs": [ 0 ], "name": "Pediatric Sepsis CoLab" } ], "bibtex": "https://research.draconitic.com/paper/4w6tktprahzfz.bib", "cited_by": 0, "doi": "10.1371/journal.pdig.0001790", "fulltext_url": "https://journals.plos.org/digitalhealth/article?id=10.1371/journal.pdig.0001790", "id": "4w6tktprahzfz", "issns": [ "2767-3170" ], "landing_url": "https://journals.plos.org/digitalhealth/article?id=10.1371/journal.pdig.0001790", "language": "eng", "licence": "CC-BY", "licence_label": "CC BY", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "heading", "Africa" ], [ "heading", "Clinical Medicine" ], [ "heading", "Computer Software" ], [ "heading", "Computer and Information Sciences" ], [ "heading", "Critical Care and Emergency Medicine" ], [ "heading", "Engineering and Technology" ], [ "heading", "Epidemiology" ], [ "heading", "Geographical Locations" ], [ "heading", "Health Care" ], [ "heading", "Medical Risk Factors" ], [ "heading", "Medicine and Health Sciences" ], [ "heading", "Outpatients" ], [ "heading", "Patients" ], [ "heading", "Pediatrics" ], [ "heading", "People and Places" ], [ "heading", "Research Article" ], [ "heading", "Sepsis" ], [ "heading", "Signs and Symptoms" ], [ "heading", "Software Engineering" ], [ "heading", "Triage" ], [ "heading", "Uganda" ], [ "plos", "/Computer and information sciences/Software engineering/Computer software" ], [ "plos", "/Engineering and technology/Software engineering/Computer software" ], [ "plos", "/Medicine and health sciences/Clinical medicine/Signs and symptoms/Sepsis" ], [ "plos", "/Medicine and health sciences/Critical care and emergency medicine" ], [ "plos", "/Medicine and health sciences/Critical care and emergency medicine/Triage" ], [ "plos", "/Medicine and health sciences/Epidemiology/Medical risk factors" ], [ "plos", "/Medicine and health sciences/Health care/Patients/Outpatients" ], [ "plos", "/Medicine and health sciences/Pediatrics" ], [ "plos", "/People and places/Geographical locations/Africa/Uganda" ] ], "openalex": null, "pdf_url": "https://journals.plos.org/digitalhealth/article/file?id=10.1371/journal.pdig.0001790&type=printable", "pmcid": "PMC13730383", "pmid": "42976193", "published": "2026-11-01", "publisher": "Public Library of Science", "ris": "https://research.draconitic.com/paper/4w6tktprahzfz.ris", "sources": [ { "first_seen": "2026-11-04T12:20:43Z", "native_id": "10.1371/journal.pdig.0001790", "source": "plos", "url": "https://journals.plos.org/digitalhealth/article?id=10.1371/journal.pdig.0001790" }, { "first_seen": "2026-11-04T15:20:46Z", "native_id": "PMC:PMC13730383", "source": "europepmc", "url": "https://europepmc.org/article/PMC/PMC13730383" }, { "first_seen": "2026-11-07T12:22:57Z", "native_id": "PMC13730383", "source": "pmc", "url": "https://doi.org/10.1371/journal.pdig.0001790" } ], "subjects": [ { "field": "medicine", "origin": "plos:epidemiology", "subfield": "epidemiology-public-health" }, { "field": "medicine", "origin": "plos:pediatrics", "subfield": "reproductive-child" } ], "title": "A retrospective study of smart spot, a Bluetooth low‑energy real‑time location system supporting quality improvement efforts in Uganda", "title_text": "A retrospective study of smart spot, a Bluetooth low‑energy real‑time location system supporting quality improvement efforts in Uganda", "type": "peer-reviewed", "updated_at": "2026-11-07T12:22:57Z", "url": "https://research.draconitic.com/paper/4w6tktprahzfz", "venue": "PLOS Digital Health", "versions": [] }