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Saving Clinicians Precious Time


By Joseph Goedert, News Editor August 2007
Clinicians at Eisenhower Memorial Hospital routinely access six modules from San Francisco-based McKesson Corp., two applications from Kansas City, Mo.-based Cerner Corp. and several other ancillary and homegrown information systems.

And the 289-bed hospital in Rancho Mirage, Calif., part of the Eisenhower Medical Center delivery system, soon will install three to five more modules from McKesson. So the time has come, says CIO David Perez, to make clinicians' lives a little easier. Consequently, the hospital this spring implemented single-sign-on software on nursing floors. This summer, it will add the technology to applications in ancillary departments.

"Our initial focus was on nurses who were required to log in to eight or nine applications multiple times during their shifts," he adds.

While some organizations have installed single-sign-on software with little or no outside help, others, particularly larger organizations, can find the job challenging, says Mark Anderson, CEO of AC Group, a Montgomery, Texas-based consulting firm. "It's a great product if you do your due diligence ahead of time."

Anderson estimates that 80% of organizations use single-sign-on as a stand-alone product. But some facilities install the technology in conjunction with biometrics authentication software that replaces a password. And some use it in combination with context management software that enables access to patient data from multiple information systems during a single workstation session.

Dramatic improvement

The improvement in clinician acceptance of information systems when context management is used with single-sign-on is dramatic, contends Steve Hight, director of strategic technology projects in the Phoenix division of Catholic Healthcare West, a multi-state provider network based in San Francisco. "They're mildly appreciative of single-sign-on," he notes. "But with context management, they're practically thanking us and asking us to lunch."

One early-adopter physician told Hight he is saving two to three hours a day in retrieving patient data. Further, physicians can access the information systems remotely using a Web portal that supports single-sign-on and context management. Several major applications previously were not remotely accessible.

Organizations implementing single-sign-on should spend time conducting load tests, says Celwyn Evans, a senior partner at Greencastle Consulting, Malvern, Pa. The tests ensure the technology is responsive and works with the desired information systems.

Some information systems automatically log out users after a certain period of inactivity. Others do not log out until the user manually does it. Consequently, 500 users might be signed on to information systems at a given time, but only 50 are actually using them. That's a problem because many systems limit how many users can be signed in at the same time. As a result, access by those actually using the system could be restricted. Further, Evans says, some software vendors certify single-sign-on to work on only specific versions of their information systems.

To get around that problem, an organization should build tables during the design phase that lay out user limits, log-out requirements of each application and the overall suitability of applications, says Mark Stabile, another senior partner at Greencastle. These tables are helpful when determining which applications will get single-sign-on and developing appropriate log-in/log-out procedures.

"Learn this before you buy the tool," Evans counsels.

Customized desktop

Eisenhower Memorial Hospital's single-sign-on initiative, called FastPass, uses technology from Sentillion Corp., Andover, Mass. Eventually about two dozen applications will be accessible via single-sign-on.

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