In the early 80s I was in the Army Infantry, and I loved land nav. You had a topographic map, a compass and flashlight, because yes, sometimes you will have to do this at night. Navigating was a matter of life and death as an Infantryman, so I wanted to be good at it, and I was. This is not hiking because you are busting brush to get to a very specific spot on the map. A good “point man” can read the contour lines on a topo map and picture the terrain around them. The compass is sometimes not even necessary in hilly our mountainous terrain. When it is flat terrain, you need a good compass and a perfect “pace count” for distance. The Army used to hold competitions for day and night land nav that were something like what is now called geocaching. Being good at this in peacetime is fine, in war you are walking point, so maybe, not so good. I became a map junky, and I had stacks of topo maps. I would go to the post exchange when I traveled and get maps, just in case I got the chance to go out and use them. I never touched a GPS in the Army.

I spent the entire 90s in Air Traffic Control as a systems engineer, and that entire decade was when everything changed regarding how airplanes were going to navigate. GPS was still restricted to military aircraft under the “selective availability” program. The accuracy for civilian devices was a 10th of what it could be. I was a radar guy and there was talk that GPS would even obsolete radar. I had used the devices that were available, and they were still amazing, even with the reduced accuracy, but in 2000 the government ended selective availability. Game on!! The market exploded and now we see GPS on everything including watches.

My interest in GIS (geographic information services) was piqued in 2005 when I started to use Mapmyrun for fitness. It amazed me that I could draw a route on a map and measure the distance. I used to have to drive a new course to make sure they were safe and to measure them. Mapmyrun was revolutionary to me. This was still two years before the iPhone was released. Pretty soon you could even track your ride and eventually it was on the iWatch. I started to pay attention to the technology and one day, in 2014, I saw the indoor floor plan of an airport on an Apple map and I decided this was something I need to learn more about.

Now the 2010’s and I am the manager of Location Services for major health system. The Army and the FAA are far behind me. I was a customer for several solutions that had indoor maps. There were also some that had named locations but no maps. In 2015 we had the several people from the company that we used for asset management in to talk about expanding the use of the product. They wanted some feedback, and I brought up the maps. I asked the product person why they don’t use GIS maps. I was told that maps don’t matter to an asset management solution. Privately, he said also, “because they are f’in hard”. He said, “all the customer cares about are tables and named locations” for things they are trying to find. If you tell them where to find it in a couple words they can get to the asset. I tucked that that away knowing there was something wrong with that thinking.

As a customer of several of these products I could see that they all had different maps, and they were either cartoonish or pixelated images of a CAD file. They were broken up into images for each department and you couldn’t see where they fit together. They were so hard to use no wonder no one used them. Even the named locations were often inaccurate and outdated. Trying to find something with them was a challenge and almost impossible if it left your department. As someone who was used to an outdoor GIS map, I could envision that whole user experience being brought indoors.

Location is Coming Indoors

Locating things was something I had done my entire career, so I was always looking at new tech. A product that intrigued me was the Tile. It was a crowdfunded product that came out in 2013. It would allow you to see the location of a small tag called a Tile, with your iPhone. I had to have one and signed up for the presales release and waited. When I got it, I put it through its paces. That same year Apple announced iBeacon, which was the kind of technology the tile was built upon. Still being the fitness guy, I was into this new iOT toy that Apple released. I built an app to track my laps around the indoor track and then moved on to building my own home baked version of the Tile with my iBeacons. The vision for where this might be going was starting to come into focus. 

In 2015 our CTO got me connected with our Apple account manager to talk about iBeacons. We had a good conversation and he asked me if I was at WWDC that spring. I was flattered that he thought I might be, and I said, “no, why?”. He said I am going to connect you to someone, and he told me about Apple indoors. He gave me a link and got to see an indoor GPS work and wanted to learn everything I could about it. I was connected to Yuval Kossovsky who was THE guy from Apple when it comes to indoors. He knew what I wanted to do for healthcare with indoor maps and he was willing to talk to me. Everything changed from there. All of this was in Beta, and we were able to participate only because we were healthcare, and we were hungry to learn and use it. The Apple stalkers even found the indoors app on the app store while it was still in Beta.

I got heads down and I built our first indoors app in late 2016.  The first week in January 2017 we did the indoor survey of our 3M sq/ft hospital building. On Saturday the 17th of January I was on my way to the Detroit Autoshow. I drove the family to hospital and parked out front and said just give me 5 mins. I ran into the building with my phone and stood in the Atrium and within 5 seconds the blue dot shrunk to my exact location. I walked down the hall, and it followed me like a shadow. Jumped in the elevator and when I came out, I saw the floor switch on my map. I walked down the hall, back down the stairs and out to the car and it tracked me so close I could see which side of the hall I was on. I told my wife “We have freaking indoor GPS”. I looked back at everyone in the car and their blank stares that were like, “here he goes again”. All I could think of at the Autoshow was how amazing would this be at the Autoshow, but even more so, every hospital should have this. I did this with nothing but my time and the WiFi team to help me with the survey. I could see the current approach to location-based services was turned inside out. Why is RTLS where so many health systems start? It is so expensive, and most health systems need to learn location services before they take on RTLS. I could see Indoor positioning (IPS) is where it should start, and the focus should be on mobile. RTLS can come later and here is the great part. You can use the same maps.

The more I learned about GIS, IPS and RTLS, the more I could see that they all should be playing on the same platform. That platform should have GIS rendering its maps. The years of knowledge that has been accumulated in geospatial science has produced tons of tools that can do amazing things without reinventing the wheel. There are geofences, routing and 3d features that are useful for tracking things as much as they are tracking people. The FindMy user experience does some of this now, but it only works outdoors, and it doesn’t work for enterprise.

I have experience first-hand several revolutions in navigation in my live and know one when I see it. Indoors is the next revolution in navigation and location in general. In the 90s we had GPS but that was a single technology with no competition. With indoors there are several options. Some good, some bad. It is important to pay attention to it because it is the key to a strong mobility strategy in healthcare.

Care Traffic Control Roadmap

Pardon the irony, but the roadmap to our care traffic control system really does start with maps. Those maps should be the source of truth for everything that uses location in the health system. In 2021 a standard was created by the Open Geospatial Consortium (OGC) called Indoor Mapping Data Format (IMDF). This means maps can be repeatable and consistent. Because hospitals have a requirement to have accurate CAD files, the data to create good maps is close at hand. That JCHAO requirement is for Life Safety, and it could even be satisfied with those same maps.

Equally important, is the indoor positioning that goes with the maps. Apple has made this easy but there are ways to do Android, as well. The ability to locate the devices in the building is revolutionary.

Maps do matter to care traffic control, and they are much more than a visual reference. They are the main component of the digital twin we will talk more about in other posts. They are the main ingredient in any location-based user experience. The tools to manage them are open source and mature. Everything listed below requires little investment and gets you off to a good start. As always, I am happy to answer any of your questions about maps.

Map and Indoors Basics

• Get the IMDF created for all your hospitals.
• Assign someone to learn the basics of GIS and manage them.
• Do the Apple indoor survey for all the hospitals in your system.
• Compel any vendor you work with that has maps to use those maps.
• Use a location platform, like NavvTrack, for tracking people and property.