United Regional Health Care System (Wichita Falls, Texas) and Lake Forest Hospital (Lake Forest, Illinois) faced the same issues confronting most hospitals in today’s digital environment. HIPAA regulations mandating patient information privacy required adoption of a complex web of passwords and user authentication technologies to preserve and protect sensitive data, as well as assure greater accountability.

Remembering as many as eight or nine different passwords was becoming a time-consuming nightmare for physicians, nurses and other clinical staff, presenting an obstacle to timely treatment and decision-making — especially in critical care situations. In addition, calls from users who needed their passwords reset devoured a significant portion of the hospitals’ help desk time and budget.

After assessing their needs, CDW Healthcare introduced United Regional and Lake Forest to Imprivata’s OneSign solution. The hospitals quickly decided on OneSign because it was appliance-based with built-in redundancy, and integrated seamlessly with their existing infrastructure—in addition to being easy to deploy and expand, intuitive to use and extremely cost-competitive. Plus, implementation took less than a week, compared to the month required for competitors’ software-based systems.

United Regional purchased 1000 SSO user licenses, and 400 users have been deployed within the past year. Fourteen workstations were set up initially, along with a terminal server application, and at least a dozen applications are accessible via OneSign using OTP tokens and proximity badges. Lake Forest purchased 2500 SSO user licenses and is in the process of rolling out OneSign to the fi rst 1000 users within three months—at half the cost of a software-based system the hospital had considered previously. Lake Forest Hospital clinicians will utilize either biometrics or proximity cards to access applications with OneSign, both onsite and remotely.

Password Explosion

When Lanny Evans joined United Regional as Information Services Manager a little more than a year ago, his overriding goal was to provide top-notch service to his “customers” — the healthcare system’s physicians and nurses. The I.S. department decided quickly that implementing SSO would help make that objective a reality by radically improving ease of access to critical patient data.

United Regional’s diverse applications all had different password policies. Some required eight-character, alphanumeric ones, some assigned passwords and others allowed users to create their own. Bottom line: Remembering multiple passwords was an annoying burden for the clinicians, increasing the temptation to write passwords down or share them.

Even more important, it prevented doctors and nurses from quickly accessing the patient information they needed to make timely treatment decisions.

Lake Forest Hospital faced similar issues, with the average user being required to remember between seven and nine different passwords. “SSO was the next step we needed to take to make sure physicians had access to all the applications they needed without multiple sign-ons,” Security Administrator Josh Rosales explains.

He also wanted remote users to have the capability of logging on through the hospital’s VPN and authenticating only once, rather than repeatedly for every system and application they needed to access.

Help for the Help Desk

The difficulty of remembering so many different passwords, coupled with strict policies requiring frequent password changes for security reasons, flooded the help desks at both hospitals with calls from users locked out of applications. The constant demand for resetting passwords translated into a costly burden. At Lake Forest Hospital, Rosales estimated a 30 percent productivity loss at the help desk as a result of time spent resetting passwords.

By the same token, clinicians didn’t want to spend valuable time on the phone figuring out how to fix passwords when they could be treating patients. “A help desk call from a doctor is a no-win situation,” says Imprivata’s Territory Manager Randy Meader, who worked with Rosales. “Neither sides wants it — it’s a low-value transaction.”

Compliance Concerns

Back in the pre-HIPAA days, every user had the same I.D. for signing on to workstations. It is no longer possible to share I.D.s under HIPAA, which requires hospitals to track everyone who signs on.

Preserving and protecting the privacy of patient data under HIPAA regulations presents major issues for healthcare organizations that have hundreds of people accessing information on a regular basis. In fact, an average of 150 people, from nurses to x-ray technicians to billing staff, view a patient’s medical records during a typical hospital stay, according to the American Health Information Management Association.

OneSign Simply Makes Sense

When United Regional’s Evans told CDW Healthcare Field Account Executive Clay Rudiger he was interested in SSO solutions, Rudiger suggested comparing Imprivata’s OneSign with other software-based solutions Evans had been researching.

The OneSign solution utilizes appliance-based architecture, with redundancy and high availability built in via adjacent identical appliances. “It has a simple user interface, an easy, intuitive learning curve and goes into a hospital’s environment without a lot of hiccups,” Rudiger says. Evans agreed to a live demonstration of OneSign, which CDW Healthcare quickly arranged with Imprivata, who deployed the solution on United Regional’s system and left it running for two days.

Evans and his team were so impressed with OneSign’s simplicity and effectiveness that they decided then and there to go ahead with it rather than continuing to investigate the far more complex and costly software-based solutions. “I don’t care how good the technology is,” Evans says. “If it can’t be installed and supported easily, you may as well skip it.”

CDW Healthcare worked with Imprivata to ensure United Regional had all the necessary equipment in place, enabling OneSign to be completely installed and functional within one week — versus the minimum of a month required for software-based solutions.

United Regional purchased 1000 user licenses, with 400 users — primarily physicians — currently SSO-enabled throughout the hospital via 14 workstations and a terminal server. Using OTP tokens and proximity badges, clinicians can access a dozen applications, including several Eclipsys clinical applications, Track-It (a work order tracing system), Siemens Webconnect, Amicas PACS, GE Centricity and Telemetry, through the hospital’s Physician Portal Page. The Physician Portal Page is a major initiative that allows doctors to access all clinical applications onsite or remotely, and has been a driving force behind the hospital’s SSO implementation.

More than Twice the Reach, Less than Half the Cost

Lake Forest Hospital was on the verge of buying a software-based SSO, but the high price tag forced Rosales and his team to take a step back and reevaluate their options. Lake Forest Hospital, which currently outsources its IT department to Rosales and his team at Eclipsys Corporation, was receptive to other alternatives. When CDW Healthcare Account Manager Mike Kendrick and Field Account Executive Brooke Czaja introduced them to OneSign, they were immediately excited. Kendrick explains, “We demonstrated that we could meet their application needs and their budget, and they also saw the deployment costs would be much lower because OneSign was so easy to use.”

The non-intrusive nature of OneSign and the fact that it was easy to add applications impressed Lake Forest Hospital. “It’s an intuitive solution, so it’s easy to deploy, and it’s appliance-based, so it’s easy to maintain,” Imprivata’s Meader adds. “We don’t change the environment or infrastructure at all. The more you change things, the more possibility you have of breaking things.”

In fact, OneSign was so cost-effective — well under half the expense of the other solution they had considered — and fit their environment so well that Lake Forest Hospital ended up purchasing 2500 user licenses rather than the 1000 they had originally planned on. “We wanted to eliminate generic passwords and user names. With 2500, we can now give every employee their own I.D.,” Rosales said.

Easy to Implement, Easy to Use

Aware that clinician expectations had been raised as a result of their earlier research, Rosales and his team wanted to implement OneSign sooner rather than later.

To make their aggressive timeline a reality, CDW Healthcare’s Kendrick orchestrated the ordering and delivery of the hardware and coordinated closely with Imprivata. Two days after Lake Forest Hospital signed the contract, they had all the equipment onsite. Within four days, Imprivata was handling the installation and training for the initial rollout. “CDW Healthcare and Imprivata were excellent from beginning to end,” Rosales says. “We had a very good experience getting information for this solution, and I was impressed how quickly the equipment arrived.” The first phase of Lake Forest Hospital’s implementation involves familiarizing the IT department, and especially the help desk, with OneSign and enabling initial access to six applications — INVISION Net Access, Lawson, SCI Scheduling, EDM, PACS and MIDAS. The next phase involves piloting the technology with a select group of physician volunteers and additional applications for about a month. After that, they plan to expand the SSO solution within six weeks to all physicians, followed by the rest of the hospital staff, using a combination of biometric fingerprint readers and RF Ideas proximity cards.

Currently, plans call for using the fingerprint readers in low-traffic areas and the proximity cards — which authenticate users slightly faster — in high-traffic areas and for surgeons or other OR staff who often wear gloves.