Interview Series: Daniel Johnston, Clinical Workflow Specialist, Imprivata

In our latest interview we asked Daniel Johnston at digital identity specialists, Imprivata, a few questions. In the interview we explore how the company’s technologies are supporting healthcare providers during the COVID-19 pandemic and talk about some of the solutions and projects coming up over the next 12 months.

Could you tell me a bit about yourself and your organisation?

We provide identity, authentication, and access management solutions that are purpose-built to solve healthcare’s unique workflow, security, and compliance challenges. Our solutions are used by healthcare organisations around the world, and by over two thirds of NHS Trusts.

My chief responsibility as part of a team of clinical workflow specialists at Imprivata is to lead on evaluating the clinical value and impact of Imprivata’s technology internationally, in addition to being the Clinical Safety Officer. A key part of my role is to work closely with customers and healthcare organisations to advise on the clinical practice of healthcare IT security and optimise Imprivata implementations within each unique healthcare setting.

As well as my work with Imprivata I’m a registered nurse, trained as an emergency nurse practitioner, specialising in Emergency Medicine at Cambridge University Hospitals NHS Foundation Trust.

How has your organisation responded over the past few weeks during the COVID pandemic?

During the COVID-19 pandemic it has been heartening to see the global healthcare community coming together to share ideas and play their part in whatever way they can.

At Imprivata, we committed to doing everything we can to help, including taking the very practical step of providing no-cost licenses for Confirm ID for Remote Workers, and for Imprivata Mobile (previously called GroundControl). This supported healthcare organisations around the world to empower remote workers and safeguard critical systems and sensitive patient data, so that IT departments could mobilise staff immediately without worrying about budgets.

Imprivata Confirm ID for Remote Access improves security by enabling two-factor authentication for remote network access, cloud applications, Windows servers and desktops, and other critical systems and workflows.  It also offers convenient authentication methods such as push token notification that can be leveraged across workflows, allowing healthcare organisations to add a layer of security that is familiar, fast, and efficient for users.

A couple of examples of how this has worked in practice:

The solution was implemented at Coventry and Warwickshire Partnership Trust to deliver secure home working for more than 4,000 staff in just a couple of days over the weekend before full lockdown.

Imprivata Mobile licences have been supplied to Bridgeway Security Solutions for its Phones for Patients charity initiative. Donated old phones are secured and wiped of all previous data, and distributed to NHS organisations, and care homes for use by people who are in isolation due to infection control measures. To date, 8,000 devices have been pledged/donated, and 121 care homes and hospitals have benefitted from the free phones.

What impact has COVID-19 had on health tech?

COVID-19 has provided a catalyst for change. It has provided the impetus for many trusts to start using mobile technology, both in enabling people to work from home, with doctors and clinicians providing online consultations, and within hospitals and care homes, as mobile devices are used in a variety of different ways to provide contactless consultations and communications with patients. NHS Trusts have achieved in days and weeks, transformations and uptake of technology what would otherwise have taken upwards of five years to complete under more ordinary circumstances. The feedback we have received from clinicians and admin staff alike has been remarkable

Digital ID has proven to be pivotal in enabling the enormous changes we have seen taking place in healthcare. Digital ID used to be simply a matter of a clinician sitting at desk and logging in with a smartcard to gain access to all the different applications that they need to do their job. With mobile and remote working the situation has become hyper-complex. In order to meet the demands of the COVID-19 outbreak, not only were many clinicians and care workers redeployed to where they were most needed, many thousands of doctors and nurses re-joined the workforce.  All of these people needed to be furnished with the correct credentials and login details to access the systems they needed for their new jobs. At the same time, many staff started to work from home, or from different locations, using different devices (home PCs, laptops, zero clients, tablets and smartphones) to access clinical systems, all of which require slightly different applications.

In the rush to provision staff for new roles in new locations, it’s important to manage the process.  For security and compliance purposes, we need to maintain a log of who has access to what and to revise access to systems as peoples’ roles change. This is where role-based identity streamlines the entire process ensuring that healthcare organisations are able to track who had access to which devices and to sensitive patient data at any point in time.

Could you tell me about one of your projects over the past 12 months?

Bolton NHS Foundation Trust is one of our long standing customers. We’ve just successfully completed a proof of concept project which highlighted the efficiencies and advantages which Imprivata Identity Governance™ (IDG) can bring to NHS Trusts facing high demand for services, tight budgets and complex systems environments.

Imprivata IDG, which was launched in the UK at the end of February to help healthcare organisations streamline the onboarding and deprovisioning of user accounts, while controlling access to sensitive patient data, and ensuring compliance with GDPR regulations.

Bolton NHS FT is an integrated care organisation with around 4,000 employees providing care and support in the community from nearly 40 sites, including over 20 health centres and clinics, as well as delivering services such as district nursing and health visiting. To be most effective when working with patients, it is critical that all frontline roles can access the appropriate clinical and admin systems from the minute they start work, wherever they are working.

We’ve been working with Phillipa Winter, Chief Informatics Officer, Bolton NHS Foundation Trust.  Philippa first saw Imprivata IDG at a conference in the USA, before it became available in the UK, and immediately knew it would be a great fit for our Trust and the wider NHS.

The Proof of Concept project enabled the Trust to automatically grant users access to the many applications and systems associated with their job roles which they need to work with patients. Imprivata IDG means clinicians can deliver high-quality care with immediate access to the right systems and patient information, with tight security and detailed audit trails.

The barriers which have traditionally made it difficult and slow for users to gain timely access to systems have been removed enabling care providers to be more productive, confident that they are complying with data regulations.

What are you working on at the moment and what is coming up over the next 12 months?

We’re most excited to take Imprivata into the future of digital identity. That’s really the next stage for our company. Clinicians are increasingly mobile and want their identity to follow them around. Everything we do today is wrapped around a component of clinician digital identity, from providing secure and efficient access to systems to enabling streamlined identity and access management.

This is all within the changing landscape of hybrid cloud environments, connected medical devices and the need to access data anywhere-anytime-anyplace. The goal to achieve interoperability and provide cross-organisational care will require a fine balance between security and convenience.

Imprivata Identity Governance (IDG) is our latest offering, it provides an end-to-end solution with precise role-based access controls, automated provisioning and de-provisioning, streamlined auditing processes, and analytics. It enables NHS Trusts and other organisations to:

  • Introduce precise role-based data access for all staff ;
  • Increase productivity of clinical staff by removing barriers to technology;
  • Strengthen data security with faster threat evaluation and remediation;
  • Better manage compliance with analysis of usage data via dashboards;
  • Reduce IT costs by automating identity management; and
  • Provide a self-service portal for users to manage their own accounts.

Imprivata IDG is part of the fully integrated Imprivata platform for Identity and Access Management which includes Imprivata OneSign® Single Sign On, Imprivata Confirm ID for Clinical Workflows, and Imprivata OneSign Spine Combined Workflow.

Can you tell me about some of the challenges and successes?

I see extraordinary bits of kit, and I also see it poorly adopted probably due to the clinical-technical divide, due to an insufficient bridge between the technical audiences and the clinical audiences.

There is a huge amount of effort taking place within individual disciplines but there needs to be closer collaboration and communication of understanding each other’s problems and each other’s solutions.

My top piece of advice would be to engage your clinical end users first in any planned design and implementation of technology, and how is it going to be adopted and communicated. It sounds remarkably simple but within the NHS it is remarkably complex to deliver on. Adoption and change management with early engagement within the clinical setting and thinking of the patient – always work from the patient out, I don’t think I’ve seen anything go wrong if you actually put the patient first. I think I’m still constantly amazed that it seems to be a new concept.

Can you tell me about one thing (career or personal or both) most proud of?

My career has led me to be a part of some extraordinary work with inspiring people and patients. Having practiced in USA and continue to in the UK, one area of life I feel very fortunate to have been involved with, is emergency medicine research all haling back to having co-founded an EM research program at Beth Israel Deaconess Medical Center, a Harvard University Teaching Hospital in Boston, MA. There we innovated with new technologies, biomarker research, public health initiatives with global collaborations. This later led to being inspired to apply and be a recipient of an NIHR research fellowship at Florence Nightingale School of Nursing Midwifery, Kings College London where I established my interest in human factors research in emergency departments. All experiences that has made me to be passionate about improving patient care, in some of toughest settings to understand how to increase safety and innovate.

What’s the best piece of career advice you have ever received?

Leading is an opportunity to help others follow their passion.

What advice would you give to anyone aspiring to work in health tech?

If interested in health tech, always consider the person and community who are the patients and seek understanding of the problem looking to be resolved; people not technology.

What’s your go-to entertainment programme at the moment?

I have to admit to being a die-hard Star Trek fan so just binged on Picard! So good!