Hey Reader,

The healthcare industry might finally take indoor navigation seriously? At Open@Epic last week, Epic announced its partnership with Cartogram, which brings patient wayfinding directly into MyChart. This move represents the convergence of appointment scheduling, patient engagement, and location intelligence.
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But this isn't just about helping patients find their appointments—it's about building the geospatial foundation that unlocks Care Traffic Control and transforms hospital operations. Let's explore why patient wayfinding is the strategic starting point for location-based services.

🏥 The Hidden Cost of Getting Lost

• 30% of patients report getting lost in large healthcare facilities, contributing to missed or delayed appointments.
• Navigation stress is a top contributor to poor patient experience, especially among elderly, disabled, or first-time visitors.
• Hospitals with wayfinding systems report improved patient satisfaction scores, reduced staff interruptions, and better appointment adherence.
• Interactive wayfinding systems reduce time spent navigating by up to 50%, improving operational flow and resource allocation.

🎯 Beyond Blue Dots: The Strategic Foundation

Smart hospitals recognize that patient wayfinding implications stretch far beyond helping people find their appointments. While I'll explore the broader operational impacts in a future post, today we're focusing specifically on patient wayfinding—because the components of a patient wayfinding system create the foundation for a broad array of location-based services.

This is the geospatial starting point that enables Care Traffic Control fundamentals to take shape. The indoor positioning infrastructure required for blue-dot navigation can be deployed on any mobile device, and forward-thinking hospitals are already considering what this means for overall operations.

⚠️ Why Every Hospital Doesn't Already Have This

Patient wayfinding has existed for over a decade and has consistently topped patient experience technology priority lists. Yet adoption remains limited. The reason? The cost of getting it wrong is disastrous.

No hospital should implement wayfinding without developing internal LBS domain knowledge and dedicating resources to own the platform. This is your digital front door—poorly executed wayfinding will drive patients away from your PHR and damage trust. The bar for indoor navigation is unforgiving; patients expect the same seamless, error-free experience they get from outdoor GPS. Anything less creates frustration and abandonment.

Epic's partnership with Cartogram offers significant advantages, along with some important architectural considerations worth examining.

📱 The Patient Experience: From Reminder to Reception

1. Before the Visit

The patient receives an appointment reminder via MyChart with an embedded "Navigate to Appointment" button. Tapping it launches Cartogram's indoor positioning layer within MyChart—no separate app required.

2. Arrival at the Facility

As the patient approaches the hospital, Cartogram bridges Google Maps outdoor navigation with indoor positioning, transitioning seamlessly from street-level directions to indoor mapping.

3. Entering the Building

The patient sees a blue dot representing their live location on the hospital's floor plan. The dot updates every half-second using BLE beacon triangulation combined with phone sensors (gyroscope and accelerometer).

4. Navigating Indoors

The app provides turn-by-turn guidance to destinations—radiology, lab, clinic, or specialty departments. It accounts for floor changes, elevators, and restricted areas. If the patient deviates from the route, the app reroutes automatically.

5. Contextual Awareness

The map highlights check-in desks, restrooms, waiting areas, and amenities. For patients with multiple appointments, the app guides them sequentially through each location.

6. Post-Visit

The app guides patients back to the exit or parking garage, with optional prompts for satisfaction surveys, follow-up scheduling, or directions to pharmacy pickup.

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⚙️ Technical Requirements

Users need the updated Epic MyChart app with location services, Bluetooth Low Energy (BLE), and notifications enabled. GPS handles outdoor location; indoor positioning (via BLE) takes over inside the facility. Appointment-triggered notifications include routing all the way to the receiving department's reception desk.

The outdoor experience leverages proven technology. Because the base layer uses Google Maps, reliability is high and failure points are minimal. Patients receive familiar turn-by-turn routing to the building entrance.

🅿️ The Critical Parking Transition

Parking represents a key user experience transition point. Hospitals often have complex parking arrangements relative to entrances, and ADA compliance is paramount. The system should identify patients with handicapped status and route them to appropriate accessible parking locations.

Parking garages are treated as indoor spaces, requiring indoor positioning technology to ensure smooth transitions. Cartogram handles the geocoding to make this work, but hospitals must provide comprehensive parking details, accessibility maps, and entrance relationships.

🗺️ The Map Data Architecture Challenge

Here's where using Cartogram presents a drawback for your hospital's enterprise location-based services architecture: Cartogram uses proprietary maps. This is common among wayfinding vendors who understand the value of controlling map access.

However, hospitals need more than patient-facing maps. Cartogram maps should be mirrored using a standard format like Indoor Mapping Data Format (IMDF) so your hospital maintains "master data" control. Patient-facing maps are lower fidelity than operational maps, so even IMDF versions need more robust counterparts for hospital operations.

The best RTLS (Real-Time Location Systems) and RFID software use GIS (Geographic Information Systems)-grade maps. Ensuring your hospital has full control over that data is essential for future expansion of location-based services.

📍 Indoor Positioning: The Foundation of Care Traffic Control

Indoor positioning systems (IPS) function like GPS for indoor spaces and represent a critical component of Care Traffic Control. Cartogram uses BLE beacons managed through a console interface (beacons require battery maintenance).

Apple offers highly accurate indoor positioning using existing WiFi infrastructure, requiring no additional hardware. However, because it's Apple-only, many vendors don't support it for patient-facing wayfinding. Still, it's good practice to augment beacon-based IPS with Apple Indoor positioning—the high-fidelity IMDF maps are valuable for troubleshooting, and every iPhone can access the location without third-party software. This represents an important step toward enterprise LBS architecture.

✅ Implementation Best Practices

Testing and Documentation

Document and test every step in the patient journey across multiple mobile devices. Ensure you have the ability to disable features if critical problems emerge after going live.

Routing Topology

Navigation relies on routing topology that requires special consideration for floor changes and off-route scenarios. Like the maps themselves, your hospital should develop intimate familiarity with the routing topology—even if initial implementations serve only as a starting point for a mature maps program.

Contextual Awareness

Contextual awareness drives user experience and represents the first opportunity to leverage operational context for efficiency. While auto-check-in won't be available initially, the underlying technology exists. Once privacy and security considerations are addressed, these features become viable.

🚀 The Gateway to Location Intelligence

Moving forward with patient wayfinding opens the door to a world of location-based services that are extremely valuable to your hospital's digital strategy. While the initial implementation may seem basic, the implications—once privacy and security considerations are addressed—represent a goldmine of operational intelligence.

The infrastructure and maps you build for patient wayfinding will drive new features that cascade into operations, safety, and quality improvements. This isn't just about helping patients find their appointments; it's about building the geospatial foundation for Care Traffic Control.

Next week: We'll explore how patient wayfinding becomes the catalyst for Care Traffic Control and why this might be the spark that accelerates your hospital's location intelligence strategy.

​What's your hospital doing about patient wayfinding? Reply and let me know—I'd love to hear about your challenges and successes.​

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Why Where Matters explores how location intelligence transforms healthcare operations. Subscribe for weekly insights on location-based services, digital twins, and Care Traffic Control.

Until next week,

Paul E. Zieske ​Location, Digital Twins and Agentic Design Consulting ​​​