The health paradigm has changed from cure-based to care-based services [1]. Since the advent of new technologies such as near-field communication (NFC) and iBeacon, healthcare services have been combined with Internet of Things (IoT) technologies. In the healthcare sector, Brigham and Women's Hospital in the Unites States and the Client Home Healthcare system of the National Statistical Office of the Netherlands are good illustrations of system buildup based on IoT. As a case of convergence of NFC and healthcare services, the NFC system developed at Brigham and Women's Hospital allows nurses to keep track of medications safely for patients [2]. Statistics Netherlands announced that the population of persons aged 65 years and older in the Netherlands will increase from 15.6% in the latter half of 2010 to 25.6% in 2040. Accordingly, the government launched the NFC Home Healthcare Service as part of a wider effort to address the needs of the elderly [3]. It focused on enabling the elderly aged 65 years and above to live independently. This service automates information, such as patients' arrival time, retention time, and healthcare services provided at home, which used to be written by hand.

The Home Healthcare System differs from other healthcare systems by enabling healthcare service providers to register information on their patients' health and healthcare services, and making it easy to identify the location of the healthcare service provider, which is helpful in planning manpower allocation and adjusting patient management schedules. By applying new information technology (IT), hospitals are able to enhance healthcare quality, work flow, and patient safety [4,5,6].

In designing healthcare systems to simplify and automate the work process of hospitals, generally NFC has been applied [2,3]. Recently, beacon technology has been emerging as a novel approach for many types of businesses that provide contextual information based on the proximity of users and the prevalence of smartphones [7]. It is a low-cost hardware that transmits a short burst of data over a near distance using the Bluetooth low energy (BLE) protocol. This data contains basic text information that could include a URL and other relevant information.

IoT refers to appliances, objects, and other things that are enabled by access to the Internet [7]. iBeacon and NFC are considered as technologies for IoT [7,8]. Services based on IoT technologies have emerged in various business environments. These services link offline and online shops to maximize customers' offline shopping experience and satisfy the needs of consumers in their purchase routes [9,10,11,12,13,14,15].

Based on these technologies, this research applied NFC and iBeacon to provide patient care as an omni-channel service for hospitals. Explicitly, this study attempted to answer the following two questions to build various healthcare service models and develops a new system: (1) How hospitals apply new information technologies such as NFC and iBeacon to patient care services and (2) What are the benefits and disadvantages of the NFC and iBeacon-based service model adopted in hospitals.

An application of an IoT technology based on NFC and iBeacon was conducted in a general hospital in Seoul, Korea during August 2015 through June 2016, and the development and evaluation results were aligned to action research framework. Action research is directly involved in planned organizational change. The action researcher intervenes by creating organizational change and simultaneously studies the impact of this change [16]. Baskerville and Wood-Harper [17] suggested that action research was ideal as a systems development methodology for information systems research. We adopted a five-phase, cyclical process, which can be described as an ideal exemplar of the original formulation of action research [18] to development of a patient care service using beacon and smart tag system supported by a government grant for IoT business.

Figure 1 shows the five phases of the research process. During the diagnosis phase, we identified the primary problems that are the underlying causes of the hospital's desire for change. Current problems in the hospital were identified after regular meetings with eight departments: Psychiatry, the Cancer Center, Surgery, the Nutrition Team, Physical Medicine and Rehabilitation, the General Affairs Team, the Facility Management Team, and Nursing. During the action planning phase, we specified actions that the hospital could take to relieve or improve the primary problems identified in the diagnosis phase. Then, our research team conducted interviews with the hospital healthcare practitioners and observed the practitioner's situation.

At the action taking phase, we collaborated in active intervention with stakeholders. With reference to the “patient care service based on beacons and smart tags,” a new form of patient care service can be carried out when a patient confirms a signal sent from a BLE beacon to his/her portable terminal (hereinafter the confirmation process of the BLE beacon signal is referred to as ‘catch’), or NFC tags distributed in the hospital are read by the patient's portable terminal (hereinafter the NFC tag reading process is referred to as ‘touch’). This smart service enables the hospital to have continued relationships with patients even after they leave a certain area of the hospital.

At the evaluating phase, the collaborative researchers and practitioners determined whether the theoretical effects of the action were realized, and whether these effects relieved the problems. Timmers [19] explained that a business model is architecture for the product, service, and information flow, including a description of the various business actors and their roles; a description of the potential benefits for the various business actors; and a description of the sources of revenues. According to a definition by Timmers [19], we evaluated the business model of the hospital that focused on the IoT (NFC and iBeacon)-based medical service areas. At the last phase, specifying learning phase, we gained a better understanding of the issues and knowledge through interviews with healthcare practitioners [20].

The current challenges faced in the healthcare sector that often lead to healthcare operation failures include medical mistakes, increasing costs, theft loss, drug counterfeiting, and inefficient workflow. To deal with automated care, improved work procedures, guided indoor pathways, automatic data capturing, and collaboration, these problems can be overcome by appropriate IT supports such as radio-frequency identification (RFID). In particular, RFID technologies have been applied to tracking and tracing patients, integrated data management systems, efficient data capturing mechanisms, and human error prevention processes [22,23,24,25,26].

In our action research, we applied and verified the IoT technology (NFC and iBeacon)-based service models for the healthcare sector. In contrast to previous studies, which mainly applied NFC, we applied not only NFC but also iBeacon technology. The proposed services with emerging IoT technology, such as iBeacon and NFC, are effective to solve the aforementioned problems. Each service model produced good results, but there are some issues that arise with the adoption of iBeacon and NFC in various application areas. Previous studies have reported similar service models for vulnerable patients that can improve care [27,28,29,30].

The former six service models adopted beacon technology to automate the current work process, which is time consuming and error prone. It increases work efficiency and helps fast recovery of inpatients. The latter two service models provide patient information, such as name, date of birth, allergy, surgical site, etc., to the medical team, increase patient safety, and shorten the time required to check patient information in case of an emergency. In summary, our findings extend the exising knowledge of previous studies.

In addition, new services using beacon technology, such as indoor navigation, exercise volume checking, monitoring of high-risk patients, and real-time information delivery of emergency patients, can improve the competitiveness of hospitals. NFC and beacon-based services, which are near-field wireless communication technologies, were developed and applied during four months, which is a relatively short period of time in comparison to existing information systems.

Another feature is the mobile-based healthcare system, in which most of the patients and medical staff have smartphones and are skillful at using them. Therefore, it is cost saving because patients and medical staff do not need expensive equipment (e.g., beacon reader). Currently, changes in healthcare services in the near future are being discussed. A new medical approach, called ‘precision medicine’, is being developed for the prevention and treatment of diseases, considering differences among people's genes, environment, and lifestyle. IoT-based services enable a hospital to acquire lifelog data for precision medicine and ultimately be able to move one step closer to precision medical care.

The present study has several theoretical and practical implications. From an action research perspective, IoT-based healthcare services were developed and verified. We applied the concept of omni-channel service to the medical field, which has been mainly implemented in other fields to maximize customer experience, increase satisfaction and increase offline sales. The new type of omni-channel medical service proposed in this study is provided to outpatients even after the patient leaves the hospital, and the information is managed in real time by sharing it with the medical staff. In addition, it is possible for patients to experience unprecedented medical services in the hospital space and to share such experience online in real time; thus, the satisfaction of medical service is improved by providing seamless medical service by extending the space.

From a practical perspective, the NFC and beacon-based IoT system generates additional patient-related data that the hospital could not obtain in the past, such as the location of the patient (from monitoring service for high-risk inpatients, patient exercise volume check service), frequency of service usage per spot or contents (from healing tour service, indoor navigation service, cancer information/education service), and service channel preference (number of shares per social media channel). By analyzing the location data, it is possible to identify blind spots of the hospital and minimize patients' movement between hospital rooms. Also, by analyzing lifelog data, such as patient exercise data, personalized treatment can be performed. In conclusion, it is expected that hospital optimization will be possible by improving work processes and services through data analysis.

However, this study is limited to a service period and service adoption in one specific and tertiary hospital. Thus, the benefits of the IoT-based service model in other hospitals, such as secondary and primary hospitals, need to be examined to verify the findings of this study. Thus, the result findings should be interpreted with caution. Additionally, considering the time it takes for relevant hospital employees to form a habit of using a new service, we expect an increase in productivity and sales from 2017. Therefore, further research also needs to be conducted on service satisfaction and economic evaluation.