Patent Publication Number: US-2011050411-A1

Title: Integrated healthcare communication and locating system

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application claims priority to U.S. Provisional Application Ser. No. 61/238,980, filed Sep. 1, 2009, which is incorporated by reference herein in its entirety. 
    
    
     TECHNICAL FIELD 
     The present disclosure relates generally to healthcare communication systems such as patient-nurse communication systems, and more particularly to an integrated nurse call and locating and tracking system. 
     BACKGROUND 
     Hospital staff, including doctors, nurses, physician assistants, orderlies, etc., provide patient care while the patient is undergoing treatment and/or therapy during a hospital visit. A number of systems have been developed to facilitate providing patient care. Healthcare communication systems, including nurse call systems, are one such type of system. Exemplary healthcare communication systems are disclosed in U.S. Pat. No. 5,561,412, U.S. Pat. No. 5,838,223, and U.S. Patent Application Publication No. 2009/0212956. The disclosures of these patents and patent applications are incorporated herein by this reference in their entirety. 
     Nurse call systems enable communication among members of a nursing staff and other persons dispersed throughout a healthcare facility. Such systems generally provide information about the current status or condition of patients in the facility, and enable voice communication between patients and staff members through a telecommunications infrastructure. 
     One example of a known nurse call system is Hill-Rom&#39;s COMLINX® system. In the COMLINX® system, a “master station” is provided, which is configured to oversee the operation of the system for a specific territory within a facility, such as a nursing unit or units or the entire facility. The master station communicates call information to audio stations that are positioned at various locations throughout the monitored territory. 
     Locating and tracking systems may interface with a nurse call system to, for instance, determine the location of a caregiver and route a call to the caregiver at that location. For example, U.S. Pat. No. 6,876,303 to Reeder et al. discloses a hospital monitoring system that tracks the location of caregivers on duty, and issues calls to caregivers through a locating and tracking system that is connected to a nurse call system. In Reeder et al., the locating and tracking system and the nurse call system are independent systems that are interconnected by computer network technology. Other exemplary locating systems are described in U.S. Pat. No. 6,539,393 to Kabala, U.S. Pat. No. 5,515,426 to Yacenda, and U.S. Pat. No. 5,455,851 to Chaco. The disclosures of all of these patents are incorporated herein by this reference in their entirety. 
     SUMMARY 
     Disclosed is a integrated healthcare and locating and tracking system incorporating infrared and RFID technology. The disclosed features are directed to reducing the implementation costs of such a system while improving locating accuracy. 
     According to one aspect, transition zones are defined, incorporating hysteresis to identify transition lines for entering a specific room or location in a facility. The computer may be configured to operate a nurse call system. The system may include a first I/O board coupled to the computer, where the first I/O board includes a first locating and tracking subsystem configured to locate persons or assets, incorporated therein. The plurality of receivers may include a first receiver incorporated into the first I/O board. The first receiver may be an RF receiver. 
     A second I/O board spaced from the first I/O board, wherein the second I/O board includes a second locating and tracking subsystem configured to locate persons or assets, incorporated therein. The plurality of receivers may include a first receiver incorporated into the first I/O board and a second receiver incorporated into the second I/O board. The first receiver may be an RF receiver and the second receiver may be an IR receiver. 
     According to another aspect, a decision engine or similar apparatus or mechanism associates capabilities of located assets with patient information, such as treatment plans and/or care alerts, based on proximity. The locating and tracking subsystem may include a plurality of receivers, where each receiver is configured to monitor a defined zone, and at least two receivers monitor each transition zone. Each transition zone may include a physical area that is located in between two zones. At least one of the transition zones may include an area located adjacent an entryway to a room of a healthcare facility. A transition zone may include a portion of a common area located adjacent a door to a patient&#39;s room, and/or a portion of the patient&#39;s room located adjacent to the door. 
     According to yet another aspect, confidence levels are determined based on information from multiple tracking systems. The confidence levels may be incorporated into the location determination, and/or may be used in decision making by caregivers or other healthcare facility staff. The system may determine the confidence level by evaluating data from a plurality of locating and tracking mechanisms including an IR locating and tracking mechanism and an RF locating and tracking mechanism. The system may be configured to monitor a plurality of transition zones, where each transition zone includes an area located between zones monitored by different receivers, and the system determines the confidence level of the located person or asset if the located person or asset is in a transition zone. 
     Patentable subject matter may include one or more features or combinations of features shown or described anywhere in this disclosure including the written description, drawings, and claims. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The detailed description refers to the following figures in which: 
         FIG. 1  is a simplified schematic showing a logical architecture for a patient-nurse communication system in communication with other components of the system; 
         FIG. 2  is a simplified schematic showing physical components of a patient-nurse communication system and showing connectivity to other services and systems; 
         FIG. 3  is a simplified diagrammatic view of an exemplary implementation of a patient-nurse communication system in a patient care facility; 
         FIG. 4  is a block diagram of a locating and tracking system of the patient-nurse communication system; and 
         FIG. 5  is a flow diagram of a locating and tracking method of the patient-nurse communication system. 
     
    
    
     DETAILED DESCRIPTION 
     Aspects of the present invention are described with reference to certain illustrative embodiments shown in the accompanying drawings and described herein. 
     The location of caregivers and other hospital staff may be monitored using badges or tags (or other type of wireless signal transmitter) carried by the person. Various wireless technologies may be employed for this purpose, including infrared (IR) and radio frequency (RF) technologies. Infrared signals cannot pass through walls or other solid structures. Thus, if infrared transmitters are used, many IR receivers are required, as an IR receiver must be located in each room in which a monitored person may travel. However, as a result, such configurations are able to determine the location of a person by determining the room in which the person&#39;s IR signal is detected. 
     RF signals can pass through walls or other solid structures. Thus, a monitored person&#39;s RF signal may be detected by an RF receiver that is not located in the same room as the person. For example, an RF receiver located in a patient&#39;s room may detect an RF signal from a staff member walking down the hallway outside the room. Among other things, this disclosure describes methods and systems for resolving the location of origin of RF signals on a room by room or location by location basis, for use in a healthcare communication system of a healthcare facility. 
     In general, a healthcare communication system includes one or more staff or nursing computers or computing devices, which may be referred to as stations or consoles. The stations or consoles, in cooperation with various computers, networks, and supporting equipment and services, enable nurses and other staff to receive, view, manage, and route, output or respond to electrical and wireless signals from a variety of communication, call, monitoring, detecting and/or signaling devices. Some communication, call, monitoring, detecting and/or signaling devices are operated by patients, staff, or visitors. Others are activated by the occurrence of an event or condition detected by signal receivers, patient monitoring equipment or hospital beds located throughout a healthcare facility. When the system receives a signal from a communication, call, monitoring, detecting and/or signaling device, one or more indicator assemblies may be activated to alert hospital staff of the condition or event being signaled by the communication, call, monitoring, detecting and/or signaling device. 
     One embodiment of a patient-nurse communication system  10  is diagrammatically illustrated in  FIG. 1 . System  10  includes a primary user console or station  12 , and one or more secondary user consoles or stations  14 ,  24 ,  26 ,  36 ,  38  which are configured to be operated by nurses or other staff. Primary station  12  enables nurses or staff to monitor activity and communicate with patients and other staff within the facility or portion of the facility monitored by the system. Primary station  12  is a computer or computing device that has a display screen, voice communication capabilities, and one or more input devices (such as a keyboard, touch screen, mouse, switch, button, knob, or the like) configured to control the operation of the patient-nurse communication system. Voice communication capabilities are provided by an integrated microphone and speaker and/or a telephone handset. 
     Primary console or station  12 , 14  is configured to enable a nurse or other staff to place calls, cancel calls, monitor the location of other staff members, process calls and alerts and route or relay calls or alerts to and from other consoles or other components of the system. Primary console  12  may further be configured to enable an authorized user to update the status of calls, alerts, monitored persons and/or monitored devices or equipment, and enable or disable calls or alerts. Primary station  14  is configured to be desk-mounted but could also be wall-mounted. 
     Secondary user consoles or stations  24 ,  26 ,  36 ,  38  have similar components and provide similar but often more limited capabilities than the primary console  12 ,  14 . For example, primary console  12  may include a larger display screen, a graphical user interface configured for data entry, monitoring, and analysis, a network interface (e.g., for TCP/IP connectivity), and/or a telephone handset. However, different configurations of secondary consoles  24 ,  26 ,  36 ,  38  exist that may or may not have a graphical display or telephone handset, or may have limited network connectivity. 
     For example, console  24  has structural components that are similar to console  14  but generally does not have all the same functional capabilities as console  14  because console  24  is a secondary console. Console  24  may be configured to display only a subset of the information that is available at console  14  (i.e., console  24  may be configured to display only calls pertaining to a particular grouping of patient rooms assigned to a specific nurse, while console  14  is configured to display all call information for all rooms in a nursing unit, group of units or entire facility). Consoles  26 ,  36  have similar structural components and functional capabilities as console  24  but do not have a telephone handset. Console  38  is a scaled-down and potentially lower cost version of console  24 , and as such has more limited graphic capabilities and restricted network connectivity. 
     Notwithstanding the above description, secondary consoles  24 ,  26 ,  36 ,  38  may have all of the components and functional capabilities as primary console. For example, a console or station may be a primary console for one nursing unit, zone or portion of a facility and also be configured as a secondary console for another unit, zone or portion of the facility. In this way, information for multiple units, zones or portions of a facility may be monitored from one station or console. 
     Consoles  12 ,  14 ,  24 ,  36 ,  38  are connected either directly or indirectly (i.e., through an electrical assembly, such as an input-output board) to a switch  18 . In the illustrated embodiment, switch  18  is a Power over Ethernet (POE) switch, however, other suitable types of switches may be used, as will be understood by those skilled in the art. Switch  18  and electrical assemblies or input-output boards  32 ,  34  provide connectivity to a variety of call, communication, monitoring, detecting and/or signaling devices  40 ,  42 ,  44 ,  46 ,  48 ,  50 ,  52 ,  54 ,  56 ,  58 ,  60 ,  62 ,  64 ,  66 ,  68  to receive call and/or alert signals therefrom. Switch  18  may also be configured to provide electrical power to remote devices, as is the case with POE switches. 
     In general, “console” or “station” is used herein to refer to a computer or computing device configured to provide an interface to the system for a user, such as a nurse, staff member, patient, or visitor. As such, these equipment generally include at least one output device, such as a visual display or speaker, to notify or communicate calls and/or other information to the user. Stations or consoles may also include at least one input device, such as a touchscreen, keypad or keyboard, microphone, telephone handset, push button, switch, dial, lever, or the like, to enable the user to place and/or respond to the calls or other information. Stations or consoles also include circuitry to connect them to the system  10 . Stations or consoles include embodiments that may be desk- or table-mounted, as well as embodiments that may be mounted to a wall, headwall, column, bed, siderail, or other structure. 
     Input/output boards  32 ,  34  are circuit board assemblies that provide computing processing and wiring for a patient location in the healthcare facility, such as a patient room. Among other things, the electrical assemblies or I/O boards operate to convert device-specific protocols from a variety of devices, which may be installed in patient rooms, to a single network protocol suitable for communication over a network. For example, I/O boards  32 ,  34  convert serial links to primary and secondary consoles, remote locating receiver or bed interface unit room bus protocols, and serial to dome light protocols, on the one side, to XML-over-TCP/IP on the other side. In the illustrated embodiments, each I/O board  32 ,  34  includes a multimedia microprocessor with built-in multimedia capability, such as the Freescale IMX 27. Input-output boards  32 ,  34  may also include one or more POE ports to enable devices to connect directly to the board instead of connecting to the system through a switch. 
     Indicator assemblies  28 ,  30  are coupled to electrical assemblies or input-output boards  32 ,  34  and receive control signals therefrom to activate a visual or audible notification, or a combination of visual and audible notifications, at the indicator assembly. 
     In general, primary console  12  is in communication with electrical assemblies or input-output boards  32 ,  34  through a computer network  8  and switch  18 . Secondary consoles  14 ,  24 ,  26 ,  36 ,  38  are in communication with primary console  12  over network  8  through a switch  18  and may thereby receive information and commands from primary console  12 . In the illustrated embodiment, network  8  is a TCP/IP network running an XML data protocol configured to enable communication among a number of devices and/or systems usable by the healthcare facility. 
     Call, communication, monitoring, detecting and/or signaling devices include, for example: beds  40 ,  42 ,  44 ,  46  (such as Hill-Rom TotalCare® or VersaCare® beds), which are linked to system  10  via bed interface units  48 ,  50 , audio bed station connectors (ASBCs)  52 ,  54 , or similar bed connector devices; patient monitors and other medical or clinical devices or equipment (such as therapy equipment, heart rate or respiration monitoring devices, and the like), which are linked to system  10  via connectors  56 ,  58 ; call cords  60 ,  62 ; wireless (i.e. infrared or radio frequency) location tracking receivers or “remote location receivers”  64  and related location tracking badges or tags  66 , and smoke alarm  68 . Some call, communication, monitoring, detecting and/or signaling devices, such as remote receiver  64 , cords  60 ,  62 , smoke alarm  68  and bed interface units  48 ,  50 , are coupled directly to I/O boards  32 ,  34  by communication links  6 . Other devices are coupled to I/O boards  32 ,  34  indirectly through consoles or stations, such as ASBCs  52 ,  54 , which connect beds  44 ,  46  to station  38 . In the illustrated embodiment, links  6  are RS485 connections. 
     For ease of description, this disclosure may use “incoming call” or “call” to refer to one or more calls, messages, communications or signals sent from a call, communication, detecting, monitoring, and/or signaling device to system  10 , and may use “outgoing notification”, or “notification” to refer to one or more calls, messages, communications, alarm signals, alert signals or other indications or annunciations that are configured to notify or otherwise direct the attention of a nurse or other staff member of or associated with the facility to an incoming call. Further, this disclosure may use “call device” to refer individually or collectively to such call, communication, detecting, monitoring, and/or signaling devices. 
     As shown in  FIG. 1 , switch  18  links various components of system  10  to a primary station  12 ,  14 . Primary station  12 ,  14 , alone or in combination with one or more other server computers and/or computing devices, hosts and executes software and services needed to operate system  10 . Primary station computer  14  is configured to process control messages generated by system  10  and send them to the appropriate destination or endpoint, such as a secondary console, I/O board, or other electrical assembly. As such, server  14  includes a soft telephony switch and related componentry. 
     Server  14  is configured to operate and manage many of the primary nurse call functions of system  10 , such as receiving and managing messages from various connected devices, synchronizing devices that come online, controlling placement and canceling of calls, answering of calls, generating of notifications or alerts, acknowledging and canceling of notifications and alerts, managing location information for staff and devices, activating and deactivating staff, managing staff-patient assignments, assigning and managing roles and responsibilities to staff and devices, and managing patient information and patient discharges and transfers. 
     Switch  18  may also link system  10  to an “enterprise” server  16 . Enterprise server  16  may be configured to enable system  10  to interface with systems or services that are considered “external” or “optional” to system  10 . For example, server  16  may be coupled to a telecommunications server  20 , which acts as a gateway to a facility&#39;s telecommunications infrastructure  22 . Infrastructure  22  generally includes a network that is configured to facilitate communication among a variety of telecommunication devices, including analog and digital devices, fixed telephones and mobile or cellular devices, personal data assistants (PDAs), pagers and the like. For example, infrastructure  22  may include a public switched telephone network (PSTN) or private branch exchange (PBX) or the like. 
       FIG. 2  illustrates connectivity among components of an embodiment of a healthcare communication system  80  including a nurse call system  82  and a plurality of other services and/or systems  84 . Nurse call system  82  includes a primary console  86  operably coupled to a switch  90 , and a secondary console or station  88  logically coupled to primary console  86  and physically coupled to switch  90 . Secondary console  88  is configured to display information about a nursing unit or unit(s) for which it is not the primary console. 
     Switch  90  is operably coupled to I/O board  92  and server  116 . I/O board  92  is configured to receive incoming calls from a variety of devices connected thereto, including but not limited to indicator assemblies  94 ,  96 , secondary console  98 , call cord or switch  100 , secondary console  102 , bed  104 , bed interface unit  106 , remote locating receiver  108 , and pillow speaker  110 . In general, these devices are connected to I/O board  92  by an RS 485 link. Additional devices, such as bed connector  112  and call cord  114 , may be coupled to or integrated with a secondary console such as console  102  and thereby connected to system  80 . One embodiment of an electrical assembly or I/O board is IBM Part No. 43T2063. 
     An interface  105  is operable to connect bed  104  to I/O board  92 . In the illustrated embodiment, interface  105  is a  37  pin connector facing outward that a bed plugs into. On the other side of the plate  105 , inside the back box, wires are connected to each pin of the  37  pin connector that could be run to other devices that the bed controls, such as lighting controller, TV, radio, and nurse call patient stations. It may be used in place of a bed interface unit or ASBC. 
     Server  116  is a VoIP server configured to translate system operations and communications to the corresponding messages that then control endpoint devices, such as nurse or staff stations, consoles or room input/output boards. As such, server  116  includes a soft telephony switch and other associated componentry. Server  116  may also provide integration with the hospital telecommunications structure (e.g., PBX or other voice communication system). In the illustrated embodiment, server  116  is a Windows server running 3CX. 
     Primary console  86  may optionally be coupled to a second server  118  by a network  115 , such as a TCP/IP network. Server  118  may also be coupled to switch  90 . Server  118  is similar to enterprise server  16  described above. 
     According to this disclosure, a wireless communications server  126  for handling communications to and from wireless badges for locating and tracking of staff members is an integral part of the patient-nurse communication system. Other services and systems of system  84  are in communication with network  115  through server  118 . Such other services or systems may include a database server  120 , one or more third party servers  122 , a wireless communications server  124  for managing communications to and from wireless telecommunications devices, a user authentication server  128  for managing user accounts, passwords, and user authorization; a third party product integration server  130 , which facilitates integration with third party or legacy products or services; a hospital administrative client  132  for conducting administrative tasks relating to patients and staff, such as adding patients and assigning staff to patients; and a status or reports server  134  for managing displays and reports of calls and notifications for one or more locations in the facility. 
     While the term “server” is used herein, it will be understood by those skilled in the art that the functionality represented or performed by these elements may comprise software programs or services that may be resident and/or executable by any computer, device or equipment in the system or more than one computer, device or equipment in the network. 
     In the illustrated embodiment, server  124  is configured to provide communication and configuration for wireless devices using Emergin Wireless Office; server  126  is configured to provide communication and configuration for wireless Vocera devices; server  130  is configured to interface with a Hill-Rom NaviCare system to receive and process alerts therefrom; and server  134  is configured to operate an “electronic status board,” which displays locations within the facility and current information about them, such as active calls, bed status information, staff located in the location, and staff assigned to the location. 
       FIG. 3  diagrammatically shows an illustrative implementation in a facility of a healthcare communication system  150  including many of the components described above. The illustrated facility has a plurality of nursing units or zones  152 ,  154 ,  156 , each of which has one or more patient rooms or locations  158 , hallways or common areas  138 , and staff locations  160 ,  164 . Each patient room  158  has a bathroom or washroom  159 . 
     A number of call monitoring and/or communication or signaling devices are located throughout the facility, including primary consoles  140 , secondary consoles  142 ,  144 ,  146 ,  170 ,  176 , bed interface units  148  and beds  166 ,  168 , toilet, bath and/or shower switches  172 , wireless locating receivers  174 ,  180 , and wireless locating transmitter badges  182 . In the illustrated configuration, each nursing unit  152 ,  154 ,  156  includes a primary console  140 , and each patient room includes at least one secondary console  146  and at least one switch  172  located in the bath/washroom  148 . 
     An indicator assembly  190  is mounted in the hallway  138  outside of each patient room  158 . Indicator assemblies  190  may be mounted either to a wall or ceiling, above the door to the room or in another suitable location indicative of the patient room with which the indicator assembly is associated. An electrical assembly or I/O board  178  is also associated with each patient room and may be mounted adjacent to each indicator assembly. 
     Secondary consoles  142 ,  144  may also be located in hallways  138  and staff locations  160 ,  164 . Locating and tracking receivers  174 ,  180  are provided in the patient rooms  158 , hallways  138  and other locations. 
     A POE switch  184 ,  186 ,  188  is associated with each unit  152 ,  154 ,  156  and operably coupled to the devices of its respective unit. System server  192  is coupled to switch  184 , which is in turn coupled to switches  186 ,  188  in the illustrated embodiment. System server  192  is similar to server  118  described above. VOIP server  194  is operably coupled to server  192  and to telecommunications devices  196 ,  198 , substantially as described above. 
     In operation, when a call or signal is initiated by one of the call initiating devices, executable computer logic processes the call or signal, determines which nurse or staff member to notify of the call, if a notification is necessary, locates the nurse or staff member, and routes an appropriate notification or notifications to one or more output devices associated with the assigned nurse or staff member or within the closest proximity to the assigned nurse or staff member. At the same time, a notification is routed to the output device nearest the location where the call originated. Such computer logic may be located in memory at a primary console, I/O board or at the application server  192 . 
     For example, if a nurse is assigned to units  152  and  156 , is currently attending to a patient in room  157  of unit  156 , and a patient or piece of monitoring equipment in room  158  issues a call, then system  150  locates the nurse using room receivers  174  and hall receivers  180  and the nurse&#39;s badge  182 . System  150  then activates the appropriate visual and/or audible notifications at the indicator assembly  178  assigned to the patient room where the call originated. System  150  may activate a visual and/or audible notification at the console  170 , nearest the nurse&#39;s location, as well. System  150  may cancel or disable one or more of the notifications when the locating receivers detect that the nurse has departed the area or when the nurse enters the room  158  where the call originated. 
     Each locating and tracking badge or tag  182  includes an active-RFID transmitter. In certain embodiments, tags  182  may be custom developed or supplied by Radianse, Inc. of Andover, Mass. Tags  182  typically transmit signals at a radio frequency in the range of about 433 MHz. Tags  182  are normally made of a durable material such as impact-resistant plastic or the like, are tamper-resistant and programmable. Tags  182  may have one or more buttons or similar controls, which may be programmable by the hospital or health care facility to issue customized alert notifications or other signals to the system  10  or a component thereof. Each tag  182  is programmable for use in locating and tracking a caregiver or other staff member of the healthcare facility, a patient, or a physical asset, such as a hospital bed, medical device or other equipment. 
     One or more of the locating and tracking receivers  180  receive the RF signals from the tags  182  and communicate electronically with the locating and tracking server  126 . The locating and tracking server  126  includes executable programs  300  that track the location of persons and assets carrying the tags  182  in real time. Executable program or programs  300 , or portions thereof, may be distributed among the receivers  180  such that each receiver  180  constitutes a locating and tracking subsystem  400  of system  126 , as shown schematically in  FIG. 4 . 
     In the illustrated embodiment, the RF receivers and subsystems  400  are incorporated into the I/O boards  32 ,  34 , such that the locating and tracking system is completely integrated into the nurse call system. In this way, the need for duplicate wiring, hardware and the like (as is typically required by prior art systems) is eliminated. 
     The locating and tracking server  126  includes executable program or programs  500  that associate the capabilities of located persons or assets with patient treatment plans, care alerts or the like. In this regard, executable program(s)  500  may include decision support software. 
       FIG. 5  illustrates steps of a method according to this disclosure. At block  600 , one or more receivers  180  receive an RFID signal from an active RFID tag  182 . Program(s)  300  determine from the RFID signal whether the tag  182  is in a transition zone (e.g., one of zones  200 ,  202 ,  204 ,  206 ,  208 ,  210  shown in  FIG. 3 ). A transition zone refers to an area in between two defined zones, where more than one receiver  180  may detect the signal from the tag  182 . As shown in  FIG. 3 , the transition zones  200 ,  202 ,  204 ,  206 ,  208 ,  210  are areas near the entryway from a hallway into a patient room. For example, a transition zone may be defined as the 3 square foot area on either side of the door to a patient room. Hysteresis is incorporated into the location determination in that software  300  incorporates data relating to the previous location of the tag  182  into the location determination. 
     In one embodiment, if the tag  182  is in a transition zone, then information from other sub-systems  400  that received signals from the tag  182  is evaluated at block  604  and a determination is made at block  606  as to a confidence level associated with the location of the tag  182 . For example, referring to  FIG. 3 , if a tag  182  is in transition zone  200 , software  300  will determine a confidence level that the tag  182  is actually located in room  158  and/or a confidence level that the tag  182  is actually located in hallway  138 . At block  608 , software  300  will determine the location of the tag  182  based on the confidence level or levels previously generated. In each case, the confidence level is determined based on one or more characteristics of the signal received from tag  182  (e.g. the signal strength) and the last known location of the tag  182 . The previous location data for each tag is stored in one or more databases or similar computerized data structures of the system  10 . 
     In some embodiments, the confidence level may be determined by evaluating data received from multiple locating and tracking mechanisms. For example, the system  10  includes an infrared locating and tracking mechanism in addition to the active RFID tracking mechanism. Software  300  may evaluate the location information determined by each of these mechanisms to determine the confidence level. 
     In another embodiment, the confidence level is always determined, regardless of whether the tag  182  is in a transition zone. In this case, the confidence level is determined based on one or more characteristics of the signal received from tag  182  (e.g. the signal strength) by a receiver  180 , and the last known location of the tag  182 . The previous location data for each tag  182  is stored in one or more databases or similar computerized data structures of the system  10 . Each tag is assigned a unique identifier, and an association between the tag identifier and the person or asset being tracked by the tag is made in the database. For example, the database may store both a unique identifier for each tag and for each person or item being tracked by the system  10 . When a tag is assigned to a person or asset, the database is updated to associate the tag with the assigned person or asset. A location table or database, or similar data structure, stores location information associated with each RF receiver. As the tag changes location, the database is updated to store the most recent location. The tag&#39;s location is determined using a process such as outlined in  FIG. 5  and described above. 
     Once the location of the person or asset being tracked has been determined, software  500  can associate the location information with other information available to it (e.g. using the Navicare® system CareAlerts data or otherwise), to proactively generate care-related suggestions or recommendations related to the tracked person or asset. For example, if a patient has returned to the patient&#39;s room, an alert may be issued to the patient&#39;s assigned caregiver to activate a feature of the patient&#39;s hospital bed, mattress, or other medical device or equipment. For instance, a reminder may be issued to activate a pressure relief or pulmonary therapy (e.g. percussion, vibration, rotation) feature of the patient&#39;s bed. 
     The present disclosure describes patentable subject matter with reference to certain illustrative embodiments. The drawings are provided to facilitate understanding of the disclosure, and may depict a limited number of elements for ease of explanation. Except as may be otherwise noted in this disclosure, no limits on the scope of patentable subject matter are intended to be implied by the drawings. Variations, alternatives, and modifications to the illustrated embodiments may be included in the scope of protection available for the patentable subject matter.