# Health Pods for Automated Triage Improve Efficiency and Satisfaction in Nurses and Patients
## 2 Materials and Methods  
The CAPSULA system is an IoMT system integrating some medical devices for the self-measurement of heart rate (HR), respiratory rate (RR), body temperature (BT), oxygen saturation (SpO\({}_{2}\)), and arterial blood pressure (BP) with diastolic and systolic values. This setup enables continuous monitoring with minimal staff intervention, reflecting the feasibility of automated systems in high-volume environments. Health pods are new systems that include small spaces equipped with medical devices where users can measure several biomedical parameters related to their health status and receive other medical services [8]. The presence (or not) of a healthcare operator to support or lead the procedure is one important variable. In the proposed case study, where the reduction in effort of the nurses is one of the main targets, the preferred solution of not having the operator is mandatory. In case of absence, the subject has to carry out the procedure in self-mode. In this case, a very efficient, intuitive, and engaging user experience/user interface (UX/UI) is needed to avoid procedural errors and obtain reliable measurements. For this reason, after a deep task analysis and co-design workshop with users (patients and nurses), the CAPSULA Triage system uses an engaging UI that guides step-by-step the patient in the process: images and animations of devices, measuring procedures, status of the systems with confirmation of having properly completed each measure, meaning of values, and sequences of actions to be carried out are proposed to the patient so that the efficiency and reliability of operation are achieved. This will be further analyzed and discussed in the experimental outcomes. The consent was obtained by the participant in anonymous form at the beginning of the process: entering the CAPSULA Pod each user was asked to sanitize the hands to start the process and by tapping the START button the user confirmed the agreement to participate to the protocol of automated ED triage analysis, including the collection of data in anonymous form and their possible publication only in aggregated and anonymous form. The CAPSULA triage system was installed for three months (April-July 2024) in the ED of a reference city hospital. In particular, the CAPSULA pod was placed in a low-intensity zone for low-risk patients identified during initial triage that was carried out by the nurse (Figure 1). This setup assessed the system's capacity to streamline patient management without requiring continuous nurse intervention, providing real-world data on CAPSULA's efficiency and care quality. Immediately after the triage conducted by the nurse, the low-risk patient is asked to repeat the vital sign measurement to verify the reliability of the measures with the self-assessment procedure. Then, they were asked to repeat the CAPSULA assessment every 30 min. All data were stored in the system's cloud platform: each record is anonymous and contains all vital signal values, the parameters of the subject, and the ECG track, which HR  
Figure 1: The CAPSULA “Triage express” health pod in the waiting room of the emergency room. and RR are computed from. This initiative aims to enhance the management of low-risk and low-intensity (the so-called \"blue code\") patients by continuously monitoring vital signs: SpO\({}_{2}\), BT, HR, RR, and BP. While these patients are stable, they present symptoms that may lead to relapses, requiring further evaluation. In case one or more of the vital signs fall outside the normalcy range, or they differ more than 10% from the previously measured value, the health pod provides a warning to the nurse so that a complete re-evaluation and eventual decision can be performed. This involves a sentence (\"please contact immediately the triage nurse\") printed onto the paper ticket released to the patient. In this first experiment, we asked the patient to self-check this possible deviation and to refer to the nurse.