Licking Memorial Webinar Q&A

Licking Memorial, a 227-bed hospital in Central Ohio is truly leading the way in the adoption of electronic medical records and CPOE. Named as a “Top 100” hospital by Thomson Reuters for 10 years in a row, Licking Memorial has also achieved Stage 6 on the HIMSS Analytics EMR Adoption Model (EMRAM), has attested for Stage 1 Meaningful Use and has just received an “A” rating for patient safety from the Leapfrog Group.

While the promise and benefits of EMR systems are enormous, moving an entire population from paper-based to electronic medical records is no simple task. Clinician workflows, productivity and security can be significantly impacted. Repetitive logins and multiple passwords slow clinician productivity and EMR/CPOE adoption.

Last week Sallie Arnett, VP of Information Systems at Licking Memorial Hospital spoke about these issues and more, during her presentation on How SSO and Strong Authentication Helped Speed EMR Adoption at Licking Memorial. Among the many topics covered during this presentation, Sallie discussed how authentication management and single sign-on allowed Licking Memorial to:

• Achieve Stage 6 HIMSS EMRAM
• Attest for Stage 1 Meaningful Use
• Meet the State of Ohio Board of Pharmacy requirements from Positive ID at the point of ePrescribing
• Eliminate 40-50 logins per clinician per day
• Increase PHI security for better compliance with HIPAA regulations

At the conclusion of Sallie’s presentation, we held a live Q&A with the audience. Below is the transcript of the Q&A session.

Q: What type of hardware do you have at your nursing workstations? Windows desktop or thin clients?

Sallie Arnett: It’s all Windows desktops. We’ve got XP deployments as well as Windows 7.

Q: Did you use outside consultants with this project?

Sallie Arnett: No, we did not. It really is so simple. There was no need for an outside consultant; the Imprivata resources were outstanding for us.

Q: Where can I get a copy of the Virtualization Study that Imprivata talked about?

James Millington, Imprivata: If you go the resources page the Imprivata website, you can download the CPOE study, and the Virtualization Study as well as gain access to the Gartner Marketscope on SSO and other papers there.

Q: Do you have any specific data around ROI for the project?

Sallie Arnett: We really didn’t focus on ROI for this project as much as we focused on clinician satisfaction; that was far more important to us than ROI. The time savings that we were seeing was 3 minutes per log on time, which is about 150 minutes saved per day. That is a bit on the longer side, but that was not uncommon when we started this process.

We are also using shared workstations on the clinical floors. So, the clinicians do not have to go through a process where they log into Windows and then log into the application. All they have to do is go up to the shared workstation, which is at the desktop level with no applications logged in. They put their finger down and they’re logged into their applications.

James Millington: How Sallie tracked ROI is also what we hear from a lot of our other customers. They look at ROI in terms of clinician satisfaction and time savings. We regularly hear the message that the doctors and nurses “count the clicks” that it takes them to log in. We describe our solution as “No Click Access” because we take away the clicks. In Sallie’s case, she has implemented fingerprint readers to replace usernames as well as the passwords. If you think about when you first got a fingerprint reader on your laptop, you still typed in your username and you used the fingerprint as the password. With what we have, we are able to eliminate that typing altogether and use it to recognize, identify, and authenticate the user.

We have a very interesting case study with Mahaska Health, where they applied a LEAN principle study to what they called authentication waste; they took a very holistic view around everything to do with passwords—the number of passwords that had to be remembered, the number of resets, the number of password calls to the helpdesk, the number of logins every day, and the number of different applications.

They came out with a time savings of 45 minutes per day per clinician. We have heard anecdotally from our customers that there is a times savings from 15 minutes up to an hour a day. There are also real benefits around the physician satisfaction.

Q: How is this product used with EPCS? What two factors are used? If biometrics are used, what is the other factor?

Sallie Arnett: Licking Memorial is not doing EPCS (e-prescribing of controlled substances) yet. I don’t think that there are many EMR vendors who are ready for that. Our opinion is that, at least for us in the state of Ohio, biometrics is viewed as two-step authentication. They are authenticating to the PC with their fingerprint, the equivalent of their user ID and password; they are also doing that in the application itself.

Q: How does OneSign work on an iPad?

James Millington: Part of the solution is a product called OneSign Anywhere. This enables an iPad to log into a portal and get the full single sign-on experience to web-based and hosted applications. If you have users moving around the hospitals or if you have a BYOD program in place, then they can log into the portal and get full single sign-on whether they are moving around the hospital or whether they are sitting at home. At the end of the day, they can get access into the systems and are able to check on their patients from the comfort of their own home.

Q: What kind of ID badges do you support?

James Millington: We support a very broad set of proximity badges and smart cards. The likelihood is that if you already have a card that you are using for building access, for example, we are able to support that.

Q: Do you have any web-based applications enabled? Does this work in that scenario?

Sallie Arnett:  We have quite a few web-based applications enabled. Building the SSO is really predicated upon the Imprivata application being able to recognize that window. As long as they recognize that window, we can build an SSO to make that work. We recognize web-based applications, win32 applications, and even terminal emulators. There are very few applications that we can’t actually provide single sign-on to. Single sign-on enabling the applications is very simple; it’s a drag and drop user interface that you can build the enablement in 5 to 10 minutes, with no scripting involved. You don’t need consultants; it is something you can do in-house. Licking Memorial has 115 applications managed all internally.