Aspirus Wausau Hospital simplifies access to Epic EMR, enables CPOE with Imprivata
- Providers entering passwords up to 120 times per shift, which detracted from patient care
- Laborious log-in process impeded CPOE adoption
- Previous single sign-on product lacked functionality to simplify access to clinical applications
- Simplified access to Epic and other applications supports nearly 100 percent CPOE adoption
- Seamless log in and reauthentication process saves times while ensuring compliance with HIPAA and IT security regulations
- Fast, secure No Click Access to clinical applications enables providers to remain focused on patient care
Aspirus Wausau Hospital, part of the Aspirus Healthcare System, is a 321-bed facility serving north central Wisconsin and the Upper Peninsula of Michigan. Known for its world-class cardiovascular program, Aspirus Wausau Hospital also provides leading cancer, trauma, women’s health and spine and neurological care. In 2013, Becker’s Hospital Review recognized Aspirus Wausau Hospital in its list of “100 Great Community Hospitals.”
Aspirus prides itself on providing care providers with the latest in information technology to enhance their ability to deliver high-quality patient care. But although the hospital had been using electronic medical records (EMR) technology from Epic for years, the system was not being utilized to its full potential.
The business challenge
In 2012, the Aspirus IT staff recognized an opportunity to increase EMR adoption while also meeting Meaningful Use objectives by mandating computerized provider order entry (CPOE). This presented a challenge, however, because it exposed significant deficiencies in how care providers were accessing the EMR and related applications.
“As we move forward with digital health records and have physicians and providers working directly with computers, we try to do everything we can to improve their efficiency,” said Todd Richardson, vice president and CIO at Aspirus. “When we established a go-live date for CPOE of September 2012, we realized that we needed to address the laborious log-in process our users were forced to go through when accessing the EMR and other systems.”
Specifically, users were required to enter different passwords for each program they needed to access, which was a process that had to be repeated every time they logged into a workstation. Based on research conducted by the Aspirus IT staff, some care providers were entering passwords as many as 120 times per shift.
“In a given shift, we see patients throughout several different departments of the hospital, which requires us to constantly log in and out of different workstations and clinical applications depending on the individual case,” said Dr. Larry Gordon, medical director of informatics at Aspirus and practicing internal medicine and pediatrics physician. “Previously, we were required to enter a different set of credentials each time we wanted to access the EMR, the EKG retrieval system, PACS, our radiology retrieval system or any other clinical application. This was an extremely frustrating process that slowed down work flows and took the focus off the patient.”
Imprivata to the rescue
To enable faster access to applications and help simplify its IT environment, Aspirus identified single sign-on (SSO) as a possible solution. However, the initial SSO product the IT staff evaluated proved to add to the hospital’s IT complexity, not simplify it. Specifically, it lacked tight integration with Epic, so each time an update was issued for the EMR system, Aspirus would be required to map those changes in the SSO product. With its go-live date for CPOE looming, Richardson and his staff realized they needed to find an alternative solution.
“When I joined Aspirus, the team was looking at an SSO product that lacked the functionality we needed to solve our password management and authentication challenges,” said Richardson. “Fortunately, I had experience at previous organizations with Imprivata OneSign®, which I knew to be a robust solution for providing fast, secure No Click Access® to clinical applications and information. Not only is Imprivata easy to use for clinicians, but its integration with Epic makes it easy to deploy and manage for IT. The only question was whether we could get Imprivata up-and-running by our CPOE go-live date.”
With just three months until it was scheduled to be live with CPOE, Aspirus brought Imprivata in for pilot testing. Two weeks later, the IT staff began the deployment, and shortly after that, Imprivata was fully rolled out to about 100 servers, 500 workstations and 2,000 users. Richardson and his team conducted training sessions to help clinicians understand how to use Imprivata and how it is designed to improve workflow efficiency. After just two or three weeks of staff education, Imprivata was embraced across the hospital as a welcome upgrade over the tedious process clinicians were previously forced to deal with to access applications and information.
“From the moment we were set up with Imprivata, we started to realize the considerable benefits. Instead of being forced to remember a laundry list of passwords and spend time logging in and out of each and every application, we could now simply tap our badge at any workstation and instantly get access to all the systems and information we need,” said Dr. Gordon. “It is clear that Imprivata develops its solutions with the clinician perspective in mind because it is an unobtrusive, easy-to-use technology that allows me to spend more time focusing on what matter most—the patient.”
Aspirus was fully operational with Imprivata OneSign in time to meet its go-live date for CPOE. Thanks to the ease with which Imprivata enables access to Epic and other applications, clinicians almost exclusively use CPOE for all order entry. Using proximity cards to quickly and securely re-authenticate with the simple tap of their badge, physicians can place orders and input additional information electronically without disrupting workflow.
Imprivata also significantly reduces the number of times clinicians must enter their passwords. Instead of inputting credentials 120 times per shift, Aspirus staff is required to re-authenticate with Imprivata by entering a password just once every four hours, saving valuable time that can be devoted to patient care. In addition to simplifying and enhancing how clinicians use technology, Imprivata helps Richardson and his staff comply with HIPAA and IT security regulations.
“Clinicians understand the importance of keeping patient information protected at all times, but they do not like the added layers of complexity that IT security solutions typically add,” said Richardson. “Our job is to make sure systems and data are secure while also making it as easy as possible for providers to access all of the applications they need to enable them to focus on patient care. Imprivata allows us to accomplish this by delivering a solution that satisfy both IT and clinician requirements.”
Looking to the future
Based on the success of its Imprivata deployment, Aspirus is in the process of bringing CPOE capabilities to its other facilities. The IT staff is also looking at how it can leverage Imprivata to enable other technologies that increase clinical workflow efficiency and help providers deliver high-quality patient care.
For example, the hospital is currently piloting desktop virtualization. Richardson and his staff recognized that requiring providers to wait two minutes or in some cases, five minutes or more for a workstation to boot up significantly decreases the efficiency of clinical workflows and detracts from patient care. To address this, Aspirus is testing thin and zero client endpoint devices integrated with Imprivata to allow clinicians to quickly and securely access the applications they need, when they need them.
“The move to virtualized desktops is all about speed and efficiency for our providers. The ability to give them roaming access to their desktops can enhance the delivery of patient care, but only if the process does not add complexity and slow down clinical workflow,” said Richardson. “Imprivata will allow us to fully optimize our virtual desktop infrastructure by enabling fast, secure access to Epic and other clinical applications at the point of care.”
In addition to desktop virtualization, Aspirus is moving towards electronic prescribing of controlled substances (EPCS) to allow its providers to electronically prescribe schedule II-IV substances as defined by the U.S. Drug Enforcement Administration (DEA). With Epic certified for EPCS and Imprivata able to support all of the two-factor authentication modalities allowed by the DEA, the Aspirus IT and clinical staff view EPCS as much more efficient and secure than its existing process of generating a printed script.
Aspirus is also evaluating Imprivata Cortext, a HIPAA-compliant text messaging solution that enables clinicians to securely send text and picture messages from their smartphone, tablet or computer, which improves communications efficiency and promotes broader collaboration.
“Unlike most vendors, Imprivata understands challenges from both the IT and clinical perspective, which results in solutions for things like EPCS, desktop virtualization and secure texting that address our real-world challenges,” said Richardson. “We consider Imprivata to be a highly strategic partner and an integral component to our long-term IT plans.”