# Use of Indoor Location Technologies in Healthcare Contexts: A Scoping Review
## 4 Discussion  
The use of digital technologies in healthcare has emerged as a prominent area of practice, utilising routine and innovative technologies to meet health-related needs [79]. Specifically, indoor positioning technologies have the potential to provide real-time, accurate data collection, thereby improving operational efficiency [39, 41, 61, 80]. However, despite publications dating back to 2005, notable gaps remain in the scientific development of this topic. Most of the identified reviews were non-systematic, focusing on presenting technologies and discussing their benefits rather than answering a specific question. This highlights a gap in comparative studies, making it challenging for healthcare organisations to select the most suitable technology for implementation. This is evident from the large number of case studies, many of which lack a robust literature review to justify their decisions. Many studies are driven by the feasibility of the technology itself, aiming to validate a preselected tool rather than conducting a thorough comparative analysis [33, 78, 80]. Additionally, there appears to be significant variability in the quality of the articles, with structures that are often dissimilar and do not adhere to the case report or literature review guidelines commonly adopted in health studies [81]. In this regard, it would be beneficial for the authors of future publications to consider adapting quality checklists when structuring their work. RFID has been the dominant choice regarding the technologies themselves, primarily due to its low cost and ease of implementation, with numerous solutions already available on the market. However, industrial advancements seem to have driven a shift in recent years, with the rise of BLE starting in 2015. One point of concern is the limited number of publications exploring the combined use of different technologies, a strategy employed in other contexts to address precision and cost issues, for example. Although some manufacturers have started incorporating this approach into their offerings, the studies do not yet reflect this trend, possibly due to the time required for scientific publications. Precision has become a significant challenge [27; 31; 55; 62; 66; 68], which can be mitigated by applying multiple positioning technologies in conjunction with probabilistically mapped movement models. Given the specificities of each workflow and the implementation environment, no generic solution fits all cases, making tailored implementations essential. Costs appear to be decreasing, driven by the increasing popularity and emergence of new technologies. The diversity of possible applications for indoor positioning is evident from the various hospital areas studied and the different types of workflows analysed (Supplementary Table S2). The emergency department and surgery stand out, aligning with the lean healthcare literature [12]. However, there is a noticeable gap in studies examining different hospital areas and their interactions, which could be an area for future research, as this is one of the potential improvements proposed by RTLS. In terms of workflows, patient flows are given priority, likely reflecting value-based healthcare concepts [82]. Staff flows are also frequently considered, but material flows receive less attention, presenting opportunities for further research. This gap represents a significant operational disadvantage, as the efficiency of hospital care depends on several factors and characteristics [83]. The lack of comprehensive studies encompassing all logistical aspects of the hospital environment limits the implementation of more integrated and effective hospital management solutions  
As presented in the results, the main benefits identified were improved efficiency (measured by LOS and waiting time), enhanced patient safety, and cost reduction [13; 39; 40; 41; 42; 43; 44; 45]. Challenges include data accuracy, user acceptance, and signal interference.