At Saint Luke’s Health System, a 10-hospital network providing primary, acute, tertiary and chronic care throughout the Kansas City, Mo. area, excellent healthcare services to our patients is our number one priority. As the IT technology integration manager for the system, I’m always looking for new technologies that will save our medical staff time and help them care for their patients. My goal is to deliver technology solutions that enable our medical staff to care for their patients without having to think about how to use the technology.
One challenge we have faced to meet that goal has been strengthened security measures under HIPAA regulations, which made it slower and more cumbersome for our clinicians to access computerized patient information. We also wanted to meet meaningful use criteria necessary to qualify for stimulus funding as well as meet our long-term goal to eliminate paper records.
First Solutions Weren’t the Right Fit
We previously implemented single sign-on (SSO) to limit the number of usernames and passwords clinicians needed to remember, and then added session roaming to streamline user workflow. However, these solutions proved inadequate for clinicians to willingly adopt the thin-client devices we wished to deploy.
We also tried biometrics, facial recognition, active proximity cards, and other combinations of access and security technologies to optimize security and speed of access, but they fell into the 80/20 rule: they only worked 80 percent of the time. Then we tried an enhanced secure sign-in solution that sits in front of our currently deployed SSO system. It leverages standard passive proximity badges, which were already used for identification and building access, to securely simplify and speed up logins and logoffs.
Before deciding whether or not to deploy this, we took it on a “road show” to most of our system hospitals to get feedback from the chief medical officers and chief nursing officers and to enable selected physicians to try the solution for themselves. The immediate feedback was very positive.
Clinicians immediately understood how to use the new solution by tapping their badge and letting the software automate their workflow. Our physician board, which votes on proposed IT capital expenditures, voted to purchase HealthCast QwickACCESS (supplied by HealthCast Inc., Boise, Idaho), giving it one of the largest margins of votes for a product we have ever seen.
Physicians Need to Support New Technology
After deploying the new system, clinicians are saving time each day; for example, we have had physicians say they are able to see two to three more patients a day with the additional time it saves them. At the beginning of each day, clinicians walk up to any PC or thin client and “tap” their proximity badge on the attached USB proximity reader; their Microsoft Active Directory username is automatically populated and they then enter their Active Directory password, which is configured to be temporarily saved for two hours.
Each user’s unique Citrix session is then automatically launched. The users select the applications they want to access without having to enter a password, because the passwords and sign-on to applications are managed by Citrix. When users are finished with their work or wish to move to another location, they simply “tap-out” with their badge to securely disconnect their session and applications.
Before Saint Luke’s deployed the new system, we had challenges with smooth roaming; now, the entire process is automated. Our physicians and nurses need only tap their badges and they can start caring for their patient with no additional clicks or manual interaction. At each tap-in or tap-out event, the two-hour password-save time is automatically refreshed, which typically results in them not having to enter their Active Directory password again for the rest of the day.
Now that our clinicians are happy with the speed and security of their access to patient data, we were able to move forward with our plans to replace more expensive PCs with Hewlett-Packard thin clients. These devices have allowed Saint Luke’s to increase security and achieve cost savings simultaneously.
Because thin clients store data remotely on a server, we eliminate any concerns about private medical data being compromised if devices are stolen—as soon as thin clients are physically disconnected from the server, the data can no longer be accessed.
The HealthCast-HP thin client solution requires fewer IT resources and less time to manage. The thin clients have only required two Microsoft patches in two years. Proximity badges are self-enrolling, eliminating the need for IT staff to enroll each user. Clinicians were quickly trained, using a 30-second video that we produced in-house.
Virtualized Solution is a Hit
The demand for this combined solution has grown faster than we anticipated when we introduced it two years ago. Today we have more than 4,000 clinicians accessing information through this solution, and we have deployed over 2,000 thin clients.
Our plan is to replace more expensive PCs wherever and whenever possible with less expensive and more secure thin clients, and to strategically locate the single sign-on solution so our clinicians can quickly and securely access their patients’ information wherever they need it.
This solution met my goal to deliver improved but unobtrusive security that allowed our clinicians to devote more time to patient care.
Michael Kamer is technology integration and IT manager at Saint Luke’s Health System, Kansas City, Mo.
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