# Use of Indoor Location Technologies in Healthcare Contexts: A Scoping Review
## 4 Discussion
However, some of these benefits and challenges are contradictory across different studies, making it essential to analyse them within the context of the technology used and the publication date, as advancements in the field are ongoing. For example, accuracy is sometimes cited as a limitation [31; 55; 68], while, in other instances, it is regarded as a benefit [67]. These differing perspectives often depend on the specific implementation of the technology and the period in which the study was conducted, highlighting the need for a nuanced approach when interpreting the results. While costs have been highlighted, there is a lack of comparative studies on implementation, maintenance, and long-term savings, leaving the real advantage and feasibility of RTLS use open to debate. One point of concern is that a significant portion of the studies do not present the initial workflows or propose modelling improvements or process enhancements. This may indicate an opportunity for further research, suggesting that these activities could be enhanced following the implementation of RTLS, potentially combined with other approaches such as process mining. Finally, a critical issue identified in the research is the limited scope of existing studies on indoor positioning systems in hospital settings, which primarily focus on applying a single pre-selected technology without a deeper analysis or justification for this choice. This compromises the replicability and usefulness of these studies for future similar applications and limits the overall results, which is especially significant as few articles address the challenges of maintaining RTLS systems and integrating them with other approaches. This review intends to address this gap by systematically mapping the key technologies employed, their application contexts, and the factors influencing their adoption. This provides insights into technological trends and supports more informed decision making in future research and implementation. Real-Time Location Systems (RTLSs) are among the key technologies enabling the development of digital twins (DTs), models that integrate with reality and exchange data in real time [17; 19; 84; 85]. Although this research primarily focuses on location systems, many publications related to DTs do not explicitly use the term, instead referring to concepts such as the Internet of Things (IoT) or Cyber-Physical Systems [17]. In this context, overcoming the challenges associated with RTLS can drive the advancement of DTs, unlocking benefits such as improved workflows, data-driven decision making, and enhanced patient experiences, all of which contribute to more sustainable systems [17, 86]. Addressing these challenges to facilitate data collection is a key enabler of digital twins and a fundamental step toward integrating advanced technologies in hospital operations management, such as artificial intelligence and big data analytics, ultimately driving the development of smart hospitals [18, 19, 86, 87]. This study has some limitations. The results are constrained by the search strategy and the databases selected, which may have excluded relevant studies. Industry research was not included, as it is often excluded from academic publications due to patent-related secrecy. Additionally, a formal bibliometric analysis to identify potential biases from recurring groups of researchers was not conducted; this will be explored in a future publication. MeSH (Medical Subject Headings) terms are an important tool for finding specific information in databases. The absence of MeSH terms related to these technologies, especially newer ones, appears to be a limitation, as relevant articles may be excluded, thereby narrowing the scope of searches. This limitation was likely overlooked, given that few of the analysed articles were reviews, and only one explicitly mentioned the lack of MeSH terms as a restriction [88]. Of all the articles used in the research, 12 were review articles; of these, only 3 posed well-defined research questions.