Eliminate Login Nightmares With Single Sign-On Technology

Administrative tasks have always been a burden to health providers. In fact, according to a study by Health Affairs, administrative costs accounted for 25.3 percent of all hospital spending in the U.S. in 2014. However, until recently, physicians were able to delegate many of their administrative responsibilities to other staff members in order to focus on patient care. This is beginning to change. Criteria outlined in the Meaningful Use program and aspects of the ACA are placing added administrative and documentation responsibilities on physicians — responsibilities they can no longer entrust to other employees.

Dale Atkins, technical architect at Munson Medical Center (MMC), a 391-bed nonprofit hospital serving as northern Michigan’s regional referral center, sees the effect these new requirements are having on his organization’s 3,700 clinical employees, including the 845 physicians affiliated with Munson Healthcare.

“Our providers expressed how HITECH and the ACA placed added demands on their time from a documentation perspective,” says Atkins. “They could no longer afford to waste precious minutes continually logging in and out of multiple applications across multiple sites throughout the day. From an IT perspective, we knew we needed to identify and implement a solution that would enable us to address this issue.”

Care providers at MMC regularly need to remember eight or more application passwords because clinicians employ a multitude of applications and solutions, from Cerner and STAR McKesson to eClinicalWorks and NextGen –– all of which require their own sign-ons and logins. Manual logins at each location increasingly disrupted workflows and hindered efficiency. Although each may take only a few seconds to enter, the user had to wait for the login to be processed and accepted.

“For example, every time a clinician logs in and out of Cerner, it takes 10 seconds,” Atkins calculated. “Logging in to a PC running Windows might add another 1 to 3 minutes in wait time. Add in ancillary applications and multiply that by the employed physicians and additional clinical staff, and the time spent entering and processing user credentials can quickly add up.”

Two years ago, Atkins and his team began to research new applications, hardware solutions, and products that could solve the slow process clinicians faced when accessing applications as part of their daily patient rounds/ activities. That’s when MMC began exploring a virtual desktop infrastructure. According to Atkins, this initiative fit the health system’s vision for anytime, anywhere system access.

Virtualization, SSO, Facilitate Anytime, Anywhere Access

After a thorough product evaluation, MMC implemented a combination of Citrix- and VMware-based virtual desktops throughout its enterprise. However, through the user discovery process, Atkins and the IT staff found that SSO (single sign-on) technology was also necessary to streamline login processes and provide clinicians with quick and easy access to hospital systems.

Atkins’ team had researched and implemented other SSO solutions in the past and had even implemented two or three of them, but none worked the way providers and other clinical staff needed them to. Earlier solutions operated well in terms of handling SSO, but they provided a substandard user experience or were difficult to install.

“Our previous solutions typically failed to couple SSO with a desktop experience that provided a standard and secure connection while reducing login time,” says Atkins. “We needed the flexibility to limit the SSO to specific business applications, while allowing our clinicians to roam anywhere throughout our facilities. Because previous products didn’t allow us to do this, we could never get SSO rolled out into general use.”

With these requirements in mind, MMC began to reevaluate SSO solutions on the market. It soon found a solution that met its needs in Imprivata OneSign.

SSO Provides Two-Year Payback

Imprivata OneSign enables clinicians to get the right information, in the right place, at the right time, with secure access. By replacing repetitive, manual logins with automated processes, this single sign-on solution helps MMC’s providers obtain information via fast access to virtual desktops that “follow” care providers as they move around a facility. The application also maintains the state of a user’s system and applications as they change locations and devices.

The solution’s tap-and-go functionality enables clinicians to use a single username and password to gain access to several key applications on clinical workstations. They use the authentication tool by waving a badge over a reader, which automatically logs them in to their virtual desktops, presented to the user on a zero client through a VMware-hosted session. With the tap-and-go nature of these proximity cards, care providers gain rapid, No Click access to medical records as they change locations. They can then quickly log in and view files such as patient charts in an EMR, X-ray images, and echocardiograms.

“Today when an employee uses a badge to log in to a PC and sign in to an application, that’s it — they are finished logging in for the day,” says Atkins. “No matter where they move within the hospital, using the badge to tap in and out enables them to pick up where they left off, a feature that offers tremendous time savings.”

MMC’s new SSO solution is also secure. Users tap their badge on the reader when they walk away from the workstation, which instantly closes the session and brings up a refreshed login screen.

Atkins estimates that with all 3,700 clinical staff members enabled in MMC’s VDI (virtual desktop infrastructure)/Imprivata environment, his organization has achieved a $500,000 soft-cost savings and a complete payback on the technology investment in a little more than two years.

“We broke out our clinical groups into major categories such as nurses, physicians, and RT/OT/PT and determined an average hourly rate for each,” explained Atkins. “Using data we had for login times, reconnect times, and number of logins and reconnects per day, both prior to using Imprivata and then after, we were able to calculate just how much money this implementation ultimately saved MMC.”

MMC also has benefitted from additional cost savings since implementing its single sign-on/virtual desktop solution. With virtualization, hospitals like MMC save money on replacing expensive data center hardware. In fact, Atkins and his team converted 1,200 PCs, initially due for replacement, from a standard Windows 7 Desktop to a Windows 7 thin client. This enabled the IT team to leverage its existing hardware investments to meet the hospital’s plans to access virtual desktops using VDI or sessions.

The Value Of Combining VDI And SSO

Hospitals and healthcare facilities in general have adopted the notion of using thinner clients. This model puts all of the applications back on a centralized server and leverages the network to deliver the desktop experience to smaller endpoints.

“Our clinicians feel our new thin-client/SSO environment has allowed them to be much more productive,” says Atkins. “We’ve heard numerous accounts of how single sign-on makes their jobs easier. I can’t imagine going back to the way we used to handle credentialing.”

MMC is not alone in its plans to combine VDI and SSO efforts. Within the next two years, 84 percent of organizations adopting VDI plan to implement SSO, according to 2014 research from Imprivata.

“Care providers are highly mobile and extremely pressed for time, so there is tremendous value in giving them roaming access to the information and systems they need at the point of care,” says Atkins. By keeping clinicians, providers, nursing staff, and managers involved in the process from research to design to implementation, Atkins and his team ensured they were always on the right path to positive results.