Single Sign-On: Benefitting healthcare now and in the future
Sarah Hanbridge, Chief Clinical Information Officer, Leeds Teaching Hospitals NHS Foundation Trust
Our latest blog is from Sarah Hanbridge, Chief Clinical Information Officer (CCIO) at Leeds Teaching Hospitals NHS Foundation Trust, who shares her experience of Single Sign-On (SSO). A pioneer of working on SSO projects starting nine years ago, Sarah discusses her findings from successful rollouts of the technology in three different NHS Trusts.
The early days ‘going digital’
My first encounter with Single Sign-On (SSO) technology was when I was working on a pilot in an Accident and Emergency (A&E) department over nine years ago. Although I started my nursing career as a ‘paper nurse’, I was looking at digital methods of access management and quickly saw the benefits that they provided.
At the time on the short stay surgical ward, nursing staff had to access up to seven systems on a daily basis, including anaesthetic records, theatre records and treatment plans, all with different passwords. From time and motion studies during the pilot we saw how working with SSO released significant nursing time back to care, time otherwise spent on logging onto the many systems.
Streamlining workflows
SSO really streamlined our processes with one single logon used to access the different clinical applications. It proved to be a pivotal moment in demonstrating the difference that digital tools could make to empowering our nurses’ workflow.
We were in the infancy of our journey from analogue to digital and so it was also a case of gaining the hearts and minds of staff and changing people's thinking. Fortunately, it didn't take long, because they could physically see the difference SSO made. That was the beauty of SSO, there was no gimmick – it did what it said on the tin.
Early buy-in made a difference
Working on the pilot I acted as the bridge between the clinical and digital teams. My message was that it was going to reduce time, enable efficient workflows and give more time to care for patients. The buy-in was an easy process. We didn’t make SSO mandatory but found that people quickly wanted to sign up and see the difference it made for themselves.
When I moved to a specialist NHS Foundation Trust, we had similar success with our SSO rollout, albeit within a different setting. As a comprehensive cancer centre, it is predominantly outpatient-focused, rather than inpatient, using twelve different systems for treatments and patient care. With the number of applications increasing due to new technologies being introduced, there was an even stronger case for SSO.
Working with the clinicians was helpful in driving projects forward. Thanks to their nursing backgrounds, they were able to help us to optimise the technology so that patient and staff experiences were considered and prioritised. This helped us to introduce changes that would improve patient care.
My top five learnings
From my experience of working on each SSO implementation, I noted five key findings:
Clinical workflow
The complexity within organisations results in different clinical workflows. It is important to look at these for each department and outline a process map.From outpatients to inpatients to specialist locations within the hospital, each area has different ways of accessing information as well as technology tools.
In the early project days, we were working with workstations on wheels. Now, with advances in mobile technology, there are less restrictions on moving around wards and departments to access different systems. The Imprivata clinicalworkflow specialistsunderstand clinical practice and worked with our clinicians within each specialty or directorate to work through the challenges and propose solutions.
Technical know-how
Working with any third party, it’s important that they understand all the systems that are used to connect and integrate new solutions effectively. For example, at the specialist Trust, the chemotherapy treatment system was the most widely used system and needed to be considered a priority in the clinical workflows.
Clinical safety
In all the projects that I worked on, I was part of the clinical safety process, which highlighted to me how SSO acts as a security mechanism in terms of governance and people accessing information. It helps improve the audit trails and, when required, with addressing complaints. This information helps shape clinical practice improvement by identifying opportunities to refine workflows and improve patient care.
Positive patient experience
SSO can give us a ‘golden thread’ that runs through the systems that we use. By enabling consistent access to patient information, it helps us to access different information about patients quickly and easily within the organisation. With this umbrella of overarching governance and clinical safety, we can more easily follow a patient’s journey as they move through the hospital, supporting a smoother and more positive care experience.
Safe policy and practices
There is no doubt that SSO has influenced challenging current practices in terms of securing patient data, storage, and access and compliance with Information Governance, all ultimately helping to provide a clinical safety net.
What the future looks like
As a CCIO, I know that organisation culture is top of mind for leaders. Getting digital buy-in and staff engagement is vital to the success of any technology deployment. The great thing about SSO is that it speaks for itself - the benefits can be quickly seen, which helps with rapid, successful adoption.
In my current role, I am looking much wider at systems used across healthcare and considering how we can be more efficient. Having looked at joining the digital dots across different providers within an organisation during my previous experiences, I am looking forward to working in this wider picture. Identifying the gaps and how we can be more joined up across our acute, primary, and tertiary care.
Imprivata has led research on this topic, focusing on accessing data securely and safely across departments within an organisation. It is an area which I think will become more critical as we look forward to delivering the NHS 10 year plan, while improving patient experience and safety across the healthcare system.n opportunity to enhance patient experience and strengthen safety across the entire healthcare system.
It can be challenging working with multiple organisations, teams and different vendors. Shared information can help improve the way we plan our health and care services for the future, collaboratively across organisational boundaries.
Learn more about how to optimise clinical workflows and solution investments.