Patent Publication Number: US-2018046768-A1

Title: System for tracking patient wait times at a healthcare clinic

Description:
BACKGROUND 
     Field of the Invention 
     The present invention is directed generally to systems for tracking waiting times at healthcare clinics. 
     Description of the Related Art 
     Modern delivery of healthcare has become a technology driven field. For example, a healthcare facility may have one or more complex computer systems that control the facility. Such systems track patients, patient records, tests, and the like. Further, computer systems are used to help manage and monitor medical staff. Unfortunately, technology has not been used effectively to determine patient wait times or to use that information to plan staffing. Therefore, a need exists for systems and methods of tracking wait times and demand at a healthcare clinic. The present application provides these and other advantages as will be apparent from the following detailed description and accompanying figures. 
    
    
     
       BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS 
         FIG. 1  is a block diagram of a plurality of healthcare organizations connected to a wait time system. 
         FIG. 2  is a block diagram illustrating a healthcare clinic of one of the healthcare organizations of  FIG. 1 . 
         FIG. 3  is a block diagram of the wait time system connected to a plurality of computing and display devices of the healthcare clinic of  FIG. 2 . 
         FIG. 4  is a block diagram illustrating a patient receiving care at the healthcare clinic of  FIG. 2 . 
         FIG. 5  is a flow diagram of a method performed by the wait time system of  FIG. 1 . 
         FIG. 6  is an illustration of a screen showing patient wait times displayed by a display device provided in a waiting area of the healthcare clinic of  FIG. 2 . 
         FIG. 7  is an illustration of a screen showing medical staff member status displayed by the display device provided in the waiting area of the healthcare clinic of  FIG. 2 . 
         FIG. 8  is an illustration of a screen displayed by an external display device of the healthcare clinic of  FIG. 2 . 
         FIG. 9  is an illustration of a screen displayed by a display device of a flow area computing device of the healthcare clinic of  FIG. 2 . 
         FIG. 10  is an illustration of an encounter area management screen of an administrative portal displayed by a display device of a patient services computing device of the healthcare clinic of  FIG. 2 . 
         FIG. 11  is an illustration of a patient visit management screen of the administrative portal displayed by the display device of the patient services computing device of the healthcare clinic of  FIG. 2 . 
         FIG. 12  is an illustration of a first screen displayed by a display device of an encounter area computing device of the healthcare clinic of  FIG. 2 . 
         FIG. 13  is an illustration of a second screen displayed by the display device of the encounter area computing device of the healthcare clinic of  FIG. 2 . 
         FIG. 14  is an illustration of a third screen displayed by the display device of the encounter area computing device of the healthcare clinic of  FIG. 2 . 
         FIG. 15  is a diagram of a hardware environment and an operating environment in which the computing devices of  FIGS. 1-4  may be implemented. 
     
    
    
     Like reference numerals have been used in the figures to identify like components. 
     DETAILED DESCRIPTION 
       FIG. 1  is a block diagram of a plurality of healthcare organizations  100  and  102  connected to a wait time system  106 . Each of the organizations  100  and  102  has one or more physical locations (referred to as sites). For ease of illustration, the organization  100  has been illustrated as including sites  120  and  122 , and the organization  102  has been illustrated as including sites  124  and  126 . 
     Within each site, each of the organizations  100  and  102  may include one or more groups. For ease of illustration, the site  120  has been illustrated as including three groups  131 - 133 . However, each of the sites  120 - 126 , may include any number of groups. Some of the patients  150  may “walk-in” to one of the groups  131 - 133  (e.g., the group  131 ) and others of the patients  150  may have appointments. By way of non-limiting examples, a group may be a separate practice or department. For example, the group  131  may be an urgent care clinic, a walk-in clinic, an express care facility, and the like. For ease of illustration, the group  131  will be described as being a healthcare clinic  131 . 
     Each of the groups  131 - 133  includes medical staff  140  that provide healthcare services to patients  150  (e.g., a patient  152  depicted in  FIG. 4 ). Referring to  FIGS. 4 and 7 , non-limiting examples of members of the medical staff  140  include physicians or doctors  142  and  146 , a nurse  144 , a medical assistant  148 , a nurse practitioner, a pharmacist, a behavioral health specialist, and the like. 
     Each of the groups  131 - 133  has one or more encounter areas where the patients  150  are examined and/or treated by at least one member of the medical staff  140 . For ease of illustration, the group  131  has been illustrated as including three encounter areas  161 - 163 , the group  132  has been illustrated as including two encounter areas  164  and  165 , and the group  133  has been illustrated as including two encounter areas  166  and  167 . However, each of the groups  131 - 133 , may include any number of encounter areas. As will be explained in more detail below, each group (e.g., the groups  131 - 133 ) within an organization (e.g., the organization  100 ) is connected to the wait time system  106 . 
     The wait time system  106  assigns at least some of the members of the medical staff  140  to one of the groups. Each of the encounter areas may also be assigned to a group. Optionally, at least some of the members of the medical staff  140  may be assigned to an encounter area. A staff member may temporary change the membership (e.g., the medical staff and/or the encounter areas) assigned to a group. 
     Optionally, each site may include one or more auxiliary departments (e.g., an auxiliary department  170 ) that is responsible for providing services (upon request) to the groups (e.g., the groups  131 - 133 ) within the site (e.g., the site  120 ). When present, each auxiliary department is connected to the wait time system  106 . In the example illustrated, the site  120  includes the auxiliary department  170 , which provides services to the groups  131 - 133  and is connected to the wait time system  106 . By way of non-limiting examples, the auxiliary department  170  may be laboratory or radiology department. 
     Optionally, each site (e.g., the site  120 ) may have one or more roving workers  180  (e.g., auxiliary staff members). Each of the roving workers  180  is an employee responsible for clinical or ancillary care in more than one group (e.g., the groups  131 - 133 ). Non-limiting examples of the roving workers  180  include a phlebotomist who draws blood in multiple groups, a janitorial worker who cleans the encounter areas of multiple groups throughout a site. The site  120  may include any number of roving workers. 
     One or more of the sites (e.g., the site  120 ) may include one or more devices  182  (e.g., a device  350  illustrated in  FIG. 4 ) that may be used (as appropriate) to provide healthcare services to one or more of the patients  150 . One or more of the devices  182  may be mobile (e.g., movable to one of the encounter areas  161 - 167 ) or fixed (e.g., installed in the auxiliary department  170 ). By way of non-limiting examples, the device(s)  182  may include medical imaging devices, and the like. 
     The wait time system  106  may be connected to a practice management and/or an electronic medical record (“PM/EMR”) computing system  190  that stores patient medical records  192 . Each of the patient medical records  192  stores a medical record number (“MRN”) that uniquely identifies one of the patients  150  who is associated with the record. 
     The wait time system  106  may have a system administrator (not shown). Further, each of the organizations  100  and  102  may have an organizational system administrator (not shown). Additionally, each of the sites  120 - 126  may have a site system administrator (not shown). Each of the groups  131 - 133  may have a group system administrator (not shown). 
     The wait time system  106  is configured to provide the patients  150  with real-time information regarding wait times within one of the groups  131 - 133 . Wait time refers to an amount of time that one of the patients  150  is estimated to wait before being checked into one of the encounter areas (e.g., one of the encounter areas  161 - 163 ) of one of the groups (e.g., the group  131 ). In other words, the wait time system  106  provides an estimate of an amount of time that one of the patients  150  will have to wait before being served. The wait time system  106  maintains and updates a patient queue  202 . The patient queue  202  indicates an order in which the patients  150  will be served and is used to calculate wait times. The wait time system  106  may also improve workflow with respect to the medical staff  140  to improve efficiency. Further, the wait time system  106  may improve workflow with respect to the patients  150  to better serve them. 
       FIG. 2  is a block diagram of the healthcare clinic  131  connected to the wait time system  106 . Each of the groups  132  and  133  may be configured similarly to the healthcare clinic  131 . As mentioned above, the clinic  131  includes the encounter areas  161 - 163 . The clinic  131  may also include an optional back office area  204 , a waiting area  206 , and a reception area  208 . 
     By way of non-limiting examples, the back office area  204  may include a group or auxiliary department display device  214  coupled to a computing device  216 . The display device  214  provides overall situational information (e.g., in a graphical format) to the medical staff  140  (see  FIG. 1 ) and/or staff of the auxiliary department  170  (see  FIG. 1 ). By way of a non-limiting example, the display device  214  may be implemented as a display portion of a tablet (e.g., an iPad) computing device. The display device  214  and the computing device  216  may be used to change a group message (e.g., selected from a predefined list of messages). By way of another non-limiting example, the display device  214  and the computing device  216  together may be implemented as a tablet computing device (e.g., an iPad, and the like). 
     Each of the encounter areas  161 - 163  includes an EA display device  220  coupled to an EA computing device  222 . Within each of the encounter areas  161 - 163 , the EA computing device  222  and the EA display device  220  may be implemented using a small, programmable, interactive display device (e.g., a tablet computing device such as an iPad). The EA computing device  222  and the EA display device  220  may be mounted next to a door of one of the encounter areas  161 - 163 . Optionally, each of the encounter areas  161 - 163  may include a second EA computing device and a second EA display device (like the EA computing device  222  and the EA display device  220 , respectively) positioned (e.g., mounted) inside of the encounter area. Each of the encounter areas  161 - 163  includes a token reader  224 . The token reader  224  may be implemented using a camera of the EA computing device  222  or the EA display device  220 . Alternatively, the token reader  224  may be a separate device connected to the wait time system  106  via the EA computing device  222  or a separate connection. As will be described below,  FIGS. 12-14  depict a screen  500  that is displayable by the EA computing device  222  and the EA display device  220 . 
     Referring to  FIG. 2 , the reception area  208  may include a display device  230  connected to a patient services computing device  232 . The display device  230  and the patient services computing device  232  may be implemented as a medium-sized mounted interactive display device. For example, the display device  230  and the patient services computing device  232  may be implemented using a tablet computing device (e.g., an iPad). Alternatively, the display device  230  may be implemented as an additional computer monitor separate from a monitor (not shown) connected to the PM/EMR computing system  190  (see  FIG. 1 ). As will be described below,  FIGS. 10 and 11  depict an administration or admin portal  310  that is displayable by the display device  230  and the patient services computing device  232 . 
     Referring to  FIG. 2 , the waiting area  206  may include one or more display devices  240 . The display device(s)  240  may each be implemented as a large non-interactive monitor that displays information to the patients  150  (see  FIG. 1 ) regarding their current status and wait time. The display devices  240  may include an express care or walk-in display  242  and an appointment display  244 . The walk-in display  242  may display wait time information with respect to each walk-in patient in the patient queue  202  and the appointment display  244  may display wait time information with respect to each patient in the patient queue  202  who scheduled an appointment. If the appointment display  244  is shared by more than one group, one group&#39;s information may be displayed at a time. Referring to  FIG. 6 , the displays  242  and  244  (see  FIG. 2 ) may each display a screen  238  for each group that includes, for each patient waiting for services by the group, a unique patient identifier  241 , a promised wait time (“PWT”)  243 , a remaining wait time  246 , a visit state value  247 , a queue position  248 , a name of the group  249 , and one or more messages  251  (e.g., a group status message, a message from a member of the medical staff  140 , and the like). 
     Referring to  FIG. 2 , the message(s)  251  (see  FIG. 6 ) displayed by the screen  238  (see  FIG. 6 ) may include a message for the group (e.g., the group  131 ) and/or a message to the patients of a particular member of the medical staff  140  (see  FIG. 1 ). On the other hand, the message(s)  251  (see  FIG. 6 ) displayed by the walk-in display  242  may include a message for the group (e.g., the group  131 ). A care team of each of the groups  131 - 133  (a medical assistant, a nurse, another care provider, and the like) may change the published group message. 
     The wait time system  106  may also be connected to an external display device  250  visible to passersby outside the clinic  131 . By way of non-limiting examples, the external display device  250  may be implemented as a “Watchfire” sign, an outdoor LCD display, and the like. Referring to  FIG. 8 , the external display device  250  is used to display an advertised wait time (AWT)  252  to passersby outside the clinic  131  (see  FIGS. 1, 2, and 4 ). The AWT  252  is a projected amount of time that a prospective walk-in patient may wait before the prospective patient is taken to an encounter area for an examination and/or treatment. A separate AWT  252  is calculated for each group (e.g., the groups  131 - 133 ). 
     The AWT  252  is calculated for each of the groups  131 - 133  (see  FIG. 1 ) based on (1) the number of patients in the patient queue  202  of the group, (2) the number of encounter areas available to the group and (3) the number of members of the medical staff  140  available to the group. By way of a non-limiting example, the AWT  252  may be calculated for a particular group based on the following parameters: 
     Average Turn Time (“ATT”), which is an estimated turn over time for each encounter area for the current time of day and day of the week; 
     Minimum Wait Time (“MWT”), which is an estimated minimum wait time for the current time of day and day of the week; 
     Available Encounter Areas (“AEA”), which is a total number of encounter areas that are available (or open) in the group; 
     Patients Waiting (“PatW”), which is a total number of patients currently waiting (e.g., in the waiting area  206 ); and 
     Patients in Exam (“PatE”), which is a total number of patients currently in the encounter areas of the group. 
     For example, if the PatW/AEA is less than AEA, there are more encounter areas than there are patients waiting for an encounter area. In this case, the AWT  252  may be determined to be the MWT. On the other hand, if PatW/AEA is equal to AEA, there are an equal number of encounter areas and patients waiting for an encounter area. In this case, the AWT  252  may be determined to be a sum of ATT and MWT. Finally, if the PatW/AEA is greater than AEA, there are fewer encounter areas than there are patients waiting for an encounter area. In this case, the AWT  252  may be determined using the following formula: 
       (PatW/AEA*ATT)+(SumRET/AER)+MWT. 
     In the above formula, SumRET is a summation of a RET value calculated for each patient. RET is equal to (((ATT/60)−(Current_Time−Checkin_Time))*60) when the patient has been checked in but has not yet checked out. Otherwise, Ret is equal to zero. Current_Time is the current time and Checkin_Time is the time the wait time system  106  recorded for checking the patient in to the encounter area  161 . 
     The AWT  252  may be recalculated every time there is a change in the number of patients in the patient queue  202 , the number of available encounter areas, and/or the number of available members of the medical staff  140 . The AWT  252  may also be recalculated occasionally (e.g., at one minute intervals). 
     The wait time system  106  is connected to a flow area computing device  260  coupled to a display device  262 . The flow area computing device  260  is located in a flow area  264  accessible by the medical staff  140  (see  FIG. 1 ). In particular, the flow area computing device  260  may be accessed by the nurse  144  and/or the medical assistant  148 . The display device  262  shows information related to the encounter areas  161 - 163  of the clinic  131 , the doctors,  142  and  146 , the nurse  144 , and the medical assistant  148 . At least one of the doctors  142  and  146 , the nurse  144 , and/or the medical assistant  148  may be assigned (or appointed) to one of the encounter areas  161 - 163 . The display device  262  allows an appointed member of the medical staff  140  (see  FIG. 1 ) to select a message to display on the displays  242  and  244  (see  FIG. 2 ) in the waiting area  206 . For non-appointed members of the medical staff  140  (see  FIG. 1 ), the display device  262  may display the current wait time. 
     Referring to  FIG. 8 , the flow area computing device  260  may display a screen  266  configured for one of the groups  131 - 133  and one of the members of the medical staff  140  (see  FIG. 1 ). In  FIG. 8 , the screen  266  has been illustrated displaying information for the clinic  131  and the nurse  144 . In the embodiment illustrated, the screen  266  displays indicia “EXAM 1,” “EXAM 2,” and “EXAM 3” corresponding to the encounter areas  161 - 163  (see  FIG. 1 ), respectively, and shows a picture of the nurse  144  next to the indicia “EXAM 1,” “EXAM 2,” and “EXAM 3,” which indicates that the nurse  144  is currently appointed to the encounter areas  161 - 163  (see  FIG. 1 ). The screen  266  also shows a picture  268  of another member of the medical staff  140  (see  FIG. 1 ) next to the indicia “EXAM 1” indicating that member is appointed to the encounter area  161 . 
     In some embodiments, the wait time system  106  is also connected to an optional kiosk  270 . The kiosk  270  includes or is connected to a display device  272 . The kiosk  270  may be implemented by a medium-sized, touch-screen, interactive display device. For example, the kiosk  270  may be implemented using a tablet computing device (e.g., an iPad). 
     Optionally, the wait time system  106  may be connected to one or more mobile devices  280 . One or more of the medical staff  140  (see  FIG. 1 ) and/or the roving workers  180  (see  FIG. 1 ) may be assigned to a different mobile device  280 . In the embodiment illustrated, the mobile device  280  has been implemented as a mobile computing device  282  connected to a mobile display device  284 . By way of a non-limiting example, referring to  FIG. 4 , the mobile device  280  may be implemented as a CP computing device  286  connected to a CP display device  287 . By way of another non-limiting example, the mobile device  280  may be implemented as a roving computing device (not shown) connected to a roving display device (not shown). The mobile device  280  may be implemented using a tablet computing device (e.g., an iPod Touch, an iPad, and the like). 
       FIG. 3  is a block diagram of the wait time system  106 . In the embodiment illustrated, the wait time system  106  includes a web server  302 , a mobile server  304 , an application/services server  306 , and a database server  308 . The database server  308  stores data and communicates with the web mobile server  304 , the mobile server  304 , and the application/services server  306 . 
     The web server  302  updates the AWT  252  (see  FIG. 8 ) displayed by the external display device  250 . The web server  302  also communicates with the admin portal  310  (see  FIGS. 10 and 11 ) displayed by the display device  230  (see  FIG. 2 ) of the patient services computing device  232 . For example, the web server  302  receives data from the admin portal  310  and sends that data to the database server  308 . Conversely, the web server  302  receives data from the database server  308  and sends that data to the admin portal  310 .  FIG. 10  depicts an embodiment of an encounter area management screen and  FIG. 11  depicts an embodiment of a patient visit management screen. 
     The servers  304  and  306  each communicate with one or more token reader  314  (e.g., the readers  224  and  234  illustrated in  FIG. 2 ), the flow area computing device  260 , and the AE computing device  222 . Optionally, the servers  304  and  306  may communicate with the mobile device(s)  280  (e.g., see  FIG. 2 ), the group or auxiliary department computing device  216 , and the kiosk  270 , when present. 
     Referring to  FIG. 4 , as mentioned above, the clinic  131  is operated the medical staff  140  (see  FIG. 1 ). In the example illustrated, the medical staff  140  includes a patient services representative  330 , the nurse  144 , the doctors  142  and  146 , and the medical assistant  148 . Optionally, the medical staff  140  (see  FIG. 1 ) may also include the roving worker(s)  180  (see  FIG. 1 ), one or more auxiliary staff members, and the like. 
     Each of the medical staff  140  (see  FIG. 1 ) operating the clinic  131  signs into the wait time system  106  using a login and a password. Further, each of these people may be assigned a unique token that is associated with the person and that uniquely identifies that person. The token is machine-readable by the readers  314 . As used herein, the term “token” refers to a physical object, such as a printed  3 D barcode (e.g., on a badge), a radio-frequency identification (“RFID”) tag, a smart card (e.g., HID® encoded card), a proximity card, and the like. In the example illustrated in FIG.  4 , the patient services representative  330 , the doctor  142 , the nurse  144 , and the medical assistant  148  are assigned tokens  340 - 346 , respectively. Additionally, each of the device(s)  182  (see  FIG. 1 ) may be assigned a unique token that is associated with the device and that uniquely identifies that device. For example, in  FIG. 4 , a device  350  is assigned a token  352 . 
     As illustrated in  FIGS. 1-4 , the wait time system  106  is connected to the PM/EMR computing system  190 , each of the computing devices  216 ,  222 ,  232 ,  260 ,  270 , and  282 , and the display devices  240  and  250 . Each of the computing systems and devices  190 ,  216 ,  222 ,  232 ,  260 ,  270 , and  282  may be implemented as a computing device  12  (see  FIG. 15 ) described below. Additionally, each of the servers  302 - 308  may be implemented using the computing device  12  (see  FIG. 15 ). 
       FIG. 5  is flow diagram of a method  400  performed by the wait time system  106 . Before the method  400  begins, referring to  FIG. 4 , the patient  152  enters the clinic  131  and decides whether to check in using the optional kiosk  270  or the patient services representative  330 . Returning to  FIG. 5 , in first block  402 , the wait time system  106  (see  FIGS. 1-4 ) checks in the patient  152  (see  FIG. 4 ). By way of non-limiting examples, checking in the patient  152  may involve verifying the patient&#39;s identity, confirming identity and contact information, and obtaining a valid and correct medical record number (“MRN”) from the PM/EMR computing system  190  (see  FIG. 1 ). Further, additional steps may be necessary to register the patient  152  for the appointment in the PM/EMR computing system  190 . In block  402 , referring to  FIG. 4 , the wait time system  106  receives check in information from either the optional kiosk  270  or the patient services representative  330  (via the admin portal  310 ). If the patient  152  used the optional kiosk  270 , the patient  152  enters information into the optional kiosk  270  in response to questions displayed on the display device  272 . The entered information is transmitted by the kiosk  270  to the wait time system  106 . The kiosk  270  may display the AWT  252  (see  FIG. 8 ) to the patient  152 . On the other hand, if the patient  152  went directly to the patient services representative  330 , the patient services representative  330  enters information into the admin portal  310 , which is transmitted thereby to the wait time system  106 . 
     After the patient  152  has been checked in, referring to  FIG. 5 , a patient visit is initiated. In block  404 , the wait time system  106  adds the patient  152  to the patient queue  202  (see  FIGS. 1, 2, and 4 ). In block  404 , the wait time system  106  assigns a Patient Arrival Time (“PAT”) to the patient  152 . The wait time system  106  may also validate queue information and calculate both the PWT  243  (see  FIG. 6 ) and the AWT  252  (see  FIG. 8 ). The PWT  243  is specific to the patient  152 . Optionally, the wait time system  106  may provide the PWT  243  to the patient  152  (e.g., via the patient services representative  330  or the kiosk  270  illustrated in  FIG. 4 ). In block  404 , referring to  FIG. 2 , the wait time system  106  may also update the display device(s)  240  in the waiting area  206 , the CP display device  287  (see  FIG. 4 ), and/or the external display device  250 . Referring to  FIG. 4 , after the patient  152  is added to the patient queue  202 , the patient  152  may go to the waiting area  206 . The patient  152  may monitor the walk-in display  242  or the appointment display  244 , whichever is appropriate, to view current wait times. 
     In block  408 , referring to  FIG. 4 , the wait time system  106  associates a patient token  409  with the patient  152 . For example, the wait time system  106  may prompt the patient services representative  330  to scan (via the reader  234 ) the patient token  409  and associate the patient token  409  with the patient  152  during the visit. The patient services representative  330  may keep the patient token  409  (e.g., behind a reception desk in the reception area  208 ) or give the patient token  409  to the patient  152 . 
     The patient  152  waits until it is the patient&#39;s turn. Then, referring to  FIGS. 4 and 5 , in block  410 , the wait time system  106  indicates (e.g., to the medical assistant  148 ) that the patient  152  is next in the patient queue  202 . This indication may be displayed on one of the mobile devices  280  operated by the medical assistant  148 . The medical assistant  148  escorts the patient  152  from the waiting area  206  into one of the encounter areas  161 - 163  (see  FIG. 1 . For ease of illustration, the patient  152  will be described as having been escorted to the encounter area  161 . The medical assistant  148  may collect the patient token  409  (e.g., from behind the reception desk). Alternatively, the medical assistant  148  may obtain the patient token  409  from the patient  152 . 
     In block  412 , the wait time system  106  checks the patient  152  (and optionally, the medical assistant  148 ) into the encounter area  161 . Checking the patient  152  into the encounter area  161  also removes the patient  152  from the waiting list displayed on the walk-in display  242  or the appointment display  244 , whichever is appropriate, in the waiting area  206 . 
     In block  412 , the wait time system  106  receives an indication that both the medical assistant  148  and the patient  152  have arrived at the encounter area  161 . For example, the medical assistant  148  may use the EA reader  224  to read token information from both the MA token  346  and the patient token  409 . The EA reader  224  provides the token information to the wait time system  106 . The EA display device  220  displays options from which the medical assistant  148  may select. Non-limiting examples of such options include assigning the patient  152  to the encounter area  161 , checking a current patient out (presented if there is another patient currently checked into the encounter area  161 ), canceling the current action, and accepting the current action. The medical assistant  148  may enter or exit the encounter area  161 . Optionally, the medical assistant  148  may store the patient token  409  outside the encounter area  161 . 
     In block  412 , the wait time system  106  records the current time as an end time for the current state (e.g., “waiting for encounter area”), changes current state (e.g., to “in encounter area”), and uses the current timestamp as a begin time for the new state. The wait time system  106  also updates the state of the encounter area  161  to “in use” and updates queue positions. The wait time system  106  may also update the walk-in display  242  or the appointment display  244 , whichever is appropriate, in the waiting area  206 , the CP display device  287 , and/or the EA display device  220  in the encounter area  161 . 
     In optional block  414 , the wait time system  106  receives an indication that the medical assistant  148  has left the encounter area  161 . The medical assistant  148  may use the EA reader  224  to read the MA token  346  upon exiting the encounter area  161 . The EA reader  224  provides this information to the wait time system  106 . 
     In block  416 , the wait time system  106  receives an indication that the doctor  142  has arrived at the encounter area  161 . The doctor  142  may use the EA reader  224  to read the CP token  342  upon arriving at the encounter area  161 . The EA reader  224  provides this information to the wait time system  106 , which acknowledges this information. Then, the doctor  142  enters the encounter area  161  and examines the patient  152 . 
     At any time, other medical staff may enter the encounter area  161 . 
     In optional block  418 , the wait time system  106  may receive identifications of one or more actions entered (e.g., via the CP computing device  286 ) by the doctor  142  (e.g., a physician) and/or the medical assistant  148  (e.g., via one of the mobile devices  280  illustrated in  FIG. 2  or the EA display device  220 ). For example, the doctor  142  and/or the medical assistant  148  may use a screen  500  displayed by the EA display device  220  to enter action(s). Referring to  FIGS. 12-14 , the screen  500  includes action buttons  419  that each correspond to a particular action. An action is any activity that needs to be performed for the patient  152  or the encounter area  161 . Each action may be represented by an associated icon on various displays. A solid (or non-flashing) icon may be used to indicate information and a flashing icon may be used to indicate an action needs to be taken. 
     By way of non-limiting examples,  FIG. 12  illustrates an action button  502  indicating an examination by a doctor is required and an action button  504  indicating the encounter area  161  needs cleaning.  FIG. 12  also includes an indication  506  that the action button  504  has been selected. By way of other non-limiting examples,  FIG. 13  illustrates an action button  512  indicating a note should be entered, an action button  514  indicating the nurse  144  is needed, an action button  516  indicating a test is needed, an action button  518  indicating the medical assistant  148  is needed, an action button  520  indicating the patient&#39;s blood pressure needs to be taken, and an action button  522  indicating medication is needed. By way of other non-limiting examples,  FIG. 14  illustrates an action button  532  indicating the patient&#39;s chart needs to be completed, an action button  534  indicating the (doctor) doctor  142  is needed, an action button  536  indicating a follow up appointment is needed, an action button  538  indicating a test is needed, an action button  540  indicating a shot or vaccination is needed, and an action button  542  indicating an imaging scan is needed. 
     The action(s) entered may direct other medical staff (e.g., the medical assistant  148 , the nurse  144 , one or more of the roving workers  180  (see  FIG. 1 ), and/or the auxiliary department  170 ) with respect to one or more actions that are to be taken with respect to the patient  152 . Optionally, the doctor  142  and/or the medical assistant  148  may enter a priority for one or more of the action(s) or, when more than one action has been entered, change the order of the actions. 
     In block  420 , the wait time system  106  receives an indication that the doctor  142  has left the encounter area  161 . The doctor  142  may use the EA reader  224  to read the CP token  342  upon leaving the encounter area  161 . The EA reader  224  provides this information to the wait time system  106 , which acknowledges this information. 
     If one or more actions were received in block  418 , in block  422 , the wait time system  106  notifies (e.g., sends an action alert to) any of the medical staff  140  (see  FIG. 1 ) who will be performing the action(s). At this point, the medical staff  140  (e.g., the roving worker  180 , the employee of the auxiliary department  170 , and the like) may receive a specific monitored action alert (e.g., on mobile devices  280  operated thereby). Any such medical staff moves to the encounter area  161 . 
     In optional block  424 , the wait time system  106  receives an indication that the medical staff need to perform the action(s) has arrived at the encounter area  161 . This medical staff may use the EA reader  224  to read the token(s) associated with the medical staff. The EA reader  224  provides this information to the wait time system  106 , which acknowledges this information. Then, the medical staff enters the encounter area  161  and completes indicated action(s) with respect to the patient  152  or the encounter area  161 . 
     In optional block  426 , the wait time system  106  may receive indications that the action(s) have been completed and closes out the action(s). The medical staff may indicate a particular action has been completed by selecting the action and pressing an appropriate one or more of the action button(s)  419  (see  FIGS. 12-14 ) on EA display device  220 . The mobile device(s)  280  used by the medical staff will indicate that the action has been completed (e.g., a notification will disappear) after the medical staff as entered such information in to the EA computing device  222 . 
     The action(s) may indicate that the patient  152  is to be transferred to another area (e.g., a different encounter area). For example, the patient  152  may be transferred to a lab, radiology, and the like. Alternatively, the patient  152  may be ready to leave the clinic  131 . 
     In optional block  428 , the wait time system  106  receives an indication that the medical staff has left the encounter area  161 . The medical staff may use the EA reader  224  to read the token(s) associated with the medical staff. The EA reader  224  provides this information to the wait time system  106 , which acknowledges this information. Then, the medical staff leaves the encounter area  161 . The wait time system  106  updates the status of the doctor  142  and the CP display device  287  displays information regarding a next patient visit, the status of a different encounter area status, and the location of the different encounter area. 
     In optional block  430 , the wait time system  106  receives an indication that the patient  152  has left the encounter area  161 . The medical assistant  148  may use the EA reader  224  to read the patient token  409  and the EA display device  220  to enter a change in the status (e.g., “transferred,” “end visit,” and the like) of the patient  152 . The EA reader  224  and the EA display device  220  provide this information to the wait time system  106 , which acknowledges this information. Then, the patient  152  exits the encounter area  161 . As mentioned above, the medical assistant  148  may transfer the patient  152  to another encounter area. When this occurs, the medical assistant  148  may indicate that the encounter area  161  is to be held until the patient  152  returns. 
     In optional block  432 , the wait time system  106  changes the status of the patient  152  and the encounter area  161 . If the patient  152  is being discharged, the patient&#39;s status may be changed to indicate the patient&#39;s visit has terminated. The status of the encounter area  161  may be changed to indicate that it needs to be cleaned or available for another patient. 
     Then, the method  400  terminates. 
     During the method  400 , the EA display device  220  may display a “touch time” that shows how long it has been since the last interaction with the patient  152  (see  FIG. 4 ). The touch time may be reset every time an action is taken or one of the medical staff  140  (see  FIG. 1 ) enters (and checks into) the encounter area  161 . 
     Referring to  FIG. 4 , whenever the doctor  142 , the nurse  144 , or the medical assistant  148  is checked into the encounter area  161 , the wait time system  106  records the current timestamp, and closes any open service events involving that party that checked in. In other words, the party is checked out of any other rooms/locations in which they may have been. Further, the EA display device  220  shows the medical staff member(s) as being inside the encounter area  161 . 
     Whenever, the doctor  142 , the nurse  144 , the medical assistant  148 , or the device  350  is checked into the encounter area  161 , the wait time system  106  creates a service event for the patient  152  on the visit. 
     Computing Device 
       FIG. 15  is a diagram of hardware and an operating environment in conjunction with which implementations of the one or more computing devices of  FIGS. 1-4  may be practiced. The description of  FIG. 15  is intended to provide a brief, general description of suitable computer hardware and a suitable computing environment in which implementations may be practiced. Although not required, implementations are described in the general context of computer-executable instructions, such as program modules, being executed by a computer, such as a personal computer. Generally, program modules include routines, programs, objects, components, data structures, etc., that perform particular tasks or implement particular abstract data types. 
     Moreover, those skilled in the art will appreciate that implementations may be practiced with other computer system configurations, including hand-held devices, multiprocessor systems, microprocessor-based or programmable consumer electronics, network PCs, minicomputers, mainframe computers, and the like. Implementations may also be practiced in distributed computing environments where tasks are performed by remote processing devices that are linked through a communications network. In a distributed computing environment, program modules may be located in both local and remote memory storage devices. 
     The exemplary hardware and operating environment of  FIG. 15  includes a general-purpose computing device in the form of the computing device  12 . Each of the computing devices of  FIGS. 1-4  (including the computing systems, devices, and servers  190 ,  216 ,  222 ,  232 ,  260 ,  270 ,  282 , and  302 - 308 ) may be substantially identical to the computing device  12 . By way of non-limiting examples, the computing device  12  may be implemented as a laptop computer, a tablet computer, a web enabled television, a personal digital assistant, a game console, a smartphone, a mobile computing device, a cellular telephone, a desktop personal computer, and the like. 
     The computing device  12  includes a system memory  22 , the processing unit  21 , and a system bus  23  that operatively couples various system components, including the system memory  22 , to the processing unit  21 . There may be only one or there may be more than one processing unit  21 , such that the processor of computing device  12  includes a single central-processing unit (“CPU”), or a plurality of processing units, commonly referred to as a parallel processing environment. When multiple processing units are used, the processing units may be heterogeneous. By way of a non-limiting example, such a heterogeneous processing environment may include a conventional CPU, a conventional graphics processing unit (“GPU”), a floating-point unit (“FPU”), combinations thereof, and the like. 
     The computing device  12  may be a conventional computer, a distributed computer, or any other type of computer. 
     The system bus  23  may be any of several types of bus structures including a memory bus or memory controller, a peripheral bus, and a local bus using any of a variety of bus architectures. The system memory  22  may also be referred to as simply the memory, and includes read only memory (ROM)  24  and random access memory (RAM)  25 . A basic input/output system (BIOS)  26 , containing the basic routines that help to transfer information between elements within the computing device  12 , such as during start-up, is stored in ROM  24 . The computing device  12  further includes a hard disk drive  27  for reading from and writing to a hard disk, not shown, a magnetic disk drive  28  for reading from or writing to a removable magnetic disk  29 , and an optical disk drive  30  for reading from or writing to a removable optical disk  31  such as a CD ROM, DVD, or other optical media. 
     The hard disk drive  27 , magnetic disk drive  28 , and optical disk drive  30  are connected to the system bus  23  by a hard disk drive interface  32 , a magnetic disk drive interface  33 , and an optical disk drive interface  34 , respectively. The drives and their associated computer-readable media provide nonvolatile storage of computer-readable instructions, data structures, program modules, and other data for the computing device  12 . It should be appreciated by those skilled in the art that any type of computer-readable media which can store data that is accessible by a computer, such as magnetic cassettes, flash memory cards, solid state memory devices (“SSD”), USB drives, digital video disks, Bernoulli cartridges, random access memories (RAMs), read only memories (ROMs), and the like, may be used in the exemplary operating environment. As is apparent to those of ordinary skill in the art, the hard disk drive  27  and other forms of computer-readable media (e.g., the removable magnetic disk  29 , the removable optical disk  31 , flash memory cards, SSD, USB drives, and the like) accessible by the processing unit  21  may be considered components of the system memory  22 . 
     A number of program modules may be stored on the hard disk drive  27 , magnetic disk  29 , optical disk  31 , ROM  24 , or RAM  25 , including the operating system  35 , one or more application programs  36 , other program modules  37 , and program data  38 . A user may enter commands and information into the computing device  12  through input devices such as a keyboard  40  and pointing device  42 . Other input devices (not shown) may include a microphone, joystick, game pad, satellite dish, scanner, touch sensitive devices (e.g., a stylus or touch pad), video camera, depth camera, or the like. These and other input devices are often connected to the processing unit  21  through a serial port interface  46  that is coupled to the system bus  23 , but may be connected by other interfaces, such as a parallel port, game port, a universal serial bus (USB), or a wireless interface (e.g., a Bluetooth interface). A monitor  47  or other type of display device is also connected to the system bus  23  via an interface, such as a video adapter  48 . In addition to the monitor, computers typically include other peripheral output devices (not shown), such as speakers, printers, and haptic devices that provide tactile and/or other types of physical feedback (e.g., a force feedback game controller). 
     The input devices described above are operable to receive user input and selections. Together the input and display devices may be described as providing a user interface. 
     The computing device  12  may operate in a networked environment using logical connections to one or more remote computers, such as remote computer  49 . These logical connections are achieved by a communication device coupled to or a part of the computing device  12  (as the local computer). Implementations are not limited to a particular type of communications device. The remote computer  49  may be another computer, a server, a router, a network PC, a client, a memory storage device, a peer device or other common network node, and typically includes many or all of the elements described above relative to the computing device  12 . The remote computer  49  may be connected to a memory storage device  50 . The logical connections depicted in  FIG. 15  include a local-area network (LAN)  51  and a wide-area network (WAN)  52  (e.g., the Internet). Such networking environments are commonplace in offices, enterprise-wide computer networks, intranets, and the Internet. 
     Those of ordinary skill in the art will appreciate that a LAN may be connected to a WAN via a modem using a carrier signal over a telephone network, cable network, cellular network, or power lines. Such a modem may be connected to the computing device  12  by a network interface (e.g., a serial or other type of port). Further, many laptop computers may connect to a network via a cellular data modem. 
     When used in a LAN-networking environment, the computing device  12  is connected to the local area network  51  through a network interface or adapter  53 , which is one type of communications device. When used in a WAN-networking environment, the computing device  12  typically includes a modem  54 , a type of communications device, or any other type of communications device for establishing communications over the wide area network  52 , such as the Internet. The modem  54 , which may be internal or external, is connected to the system bus  23  via the serial port interface  46 . In a networked environment, program modules depicted relative to the personal computing device  12 , or portions thereof, may be stored in the remote computer  49  and/or the remote memory storage device  50 . It is appreciated that the network connections shown are exemplary and other means of and communications devices for establishing a communications link between the computers may be used. 
     The computing device  12  and related components have been presented herein by way of particular example and also by abstraction in order to facilitate a high-level view of the concepts disclosed. The actual technical design and implementation may vary based on particular implementation while maintaining the overall nature of the concepts disclosed. 
     In some embodiments, the system memory  22  stores computer executable instructions that when executed by one or more processors cause the one or more processors to perform all or portions of one or more of the methods (including the method  400  illustrated in  FIG. 5 ) described above. Such instructions may be stored on one or more non-transitory computer-readable media. 
     In some embodiments, the system memory  22  stores computer executable instructions that when executed by one or more processors cause the one or more processors to generate the screens  238 ,  266 , and  500  illustrated in  FIGS. 6, 9, and 12-14  and the admin portal  310  illustrated in  FIGS. 10 and 11  described above. Such instructions may be stored on one or more non-transitory computer-readable media. 
     The foregoing described embodiments depict different components contained within, or connected with, different other components. It is to be understood that such depicted architectures are merely exemplary, and that in fact many other architectures can be implemented which achieve the same functionality. In a conceptual sense, any arrangement of components to achieve the same functionality is effectively “associated” such that the desired functionality is achieved. Hence, any two components herein combined to achieve a particular functionality can be seen as “associated with” each other such that the desired functionality is achieved, irrespective of architectures or intermedial components. Likewise, any two components so associated can also be viewed as being “operably connected,” or “operably coupled,” to each other to achieve the desired functionality. 
     While particular embodiments of the present invention have been shown and described, it will be obvious to those skilled in the art that, based upon the teachings herein, changes and modifications may be made without departing from this invention and its broader aspects and, therefore, the appended claims are to encompass within their scope all such changes and modifications as are within the true spirit and scope of this invention. Furthermore, it is to be understood that the invention is solely defined by the appended claims. It will be understood by those within the art that, in general, terms used herein, and especially in the appended claims (e.g., bodies of the appended claims) are generally intended as “open” terms (e.g., the term “including” should be interpreted as “including but not limited to,” the term “having” should be interpreted as “having at least,” the term “includes” should be interpreted as “includes but is not limited to,” etc.). It will be further understood by those within the art that if a specific number of an introduced claim recitation is intended, such an intent will be explicitly recited in the claim, and in the absence of such recitation no such intent is present. For example, as an aid to understanding, the following appended claims may contain usage of the introductory phrases “at least one” and “one or more” to introduce claim recitations. However, the use of such phrases should not be construed to imply that the introduction of a claim recitation by the indefinite articles “a” or “an” limits any particular claim containing such introduced claim recitation to inventions containing only one such recitation, even when the same claim includes the introductory phrases “one or more” or “at least one” and indefinite articles such as “a” or “an” (e.g., “a” and/or “an” should typically be interpreted to mean “at least one” or “one or more”); the same holds true for the use of definite articles used to introduce claim recitations. In addition, even if a specific number of an introduced claim recitation is explicitly recited, those skilled in the art will recognize that such recitation should typically be interpreted to mean at least the recited number (e.g., the bare recitation of “two recitations,” without other modifiers, typically means at least two recitations, or two or more recitations). 
     Accordingly, the invention is not limited except as by the appended claims.