We recently spoke with Andrew Harrison, principal product manager – international at Imprivata about the future of EPRs and how Imprivata’s solutions support effective optimisation and user adoption. Andrew shared some key examples of best practices and gave his own insights into secure access for clinicians.
How Imprivata supports EPRs
To kick things off, Andrew gave an overview of the current pressures being faced by healthcare organisations, outlining how they are “under constant pressure to drive digital transformation and ensure the technology being used is efficient and helps hospitals deliver effective patient care”. Elaborating on this, he noted how a lot of this pressure centres around “optimising for user productivity and maximising for security”, which he added needs to be done “quickly and consistently, often with very few resources”.
Andrew shared Imprivata’s role of “balancing the scales”, helping to tackle these issues by allowing for both productivity and security without having to compromise. “We facilitate seamless user access to EPRs to accelerate adoption, which in turn helps hospitals maximise their investment and reduce the threat vector,” he said, before highlighting the company’s focus on protecting against both external and internal security threats.
Delving deeper into security, Andrew also noted how “medical devices don’t evolve very quickly because they are very highly regulated. So the technologies that reside on these devices aren’t always up to date and hackers from the outside world know that”. He explained how Imprivata is aiming to combat this with their solutions, stating, “our mission is to make access simple and secure through the strategic use of digital identity”.
Effective strategies for faster and more positive user adoption
When asked about which strategies have proven most effective when driving faster user adoption, Andrew outlined that the key thing to do is “make it easy”. He elaborated by stating that, “a clinician’s job is to help people and patients get better, not to interact with technology. That’s just a byproduct of what we need them to do.” This is what Imprivata’s portfolio of products are primarily focused on access, Andrew noted, “whether that be access to a medical device or access to a mobile device or access to a traditional workstation”.
Andrew then went on to highlight an example of where he’s seen “good uptake” and strategy, referring to a project Imprivata worked on in Manchester where “there were multiple different hospitals that all converged to become one large trust that then rolled out Epic”. He noted how this was a “very large deployment, where they went live with Epic on 8,000 iOS devices for their EPR” and that one of the reasons it was successful was because of Imprivata’s mobile product solution, Mobile Access Management, “which allows a clinician to arrive at a bank of shared mobile devices, tap their badge and get that device instantly configured for them with Epic”.
Examples of how Imprivata’s solutions have been used to help EPR optimisation
Sharing more examples of successful EPR optimisation, Andrew went on to mention Imprivata’s Oracle Health customers, that use the NHS Spine for authentication and access, concentrating on the Royal Free Group in particular. “Before we were involved in the picture, clinicians had to put a physical smart card in the reader to connect to the Spine and get into Oracle Health. And traditionally that was not fast,” Andrew said.
He explained how Imprivata has had Spine access products for the last seven or eight years, which Andrew helped to build at the very beginning. He shared how he visited “a number of hospitals in the UK and benchmarked how long it took clinicians to gain access to their Spine applications” with this work highlighting the key problem within the system, “at best logon took 10 to 20 seconds. At worst, it was minutes”.
After discovering this, Imprivata were able to help tackle these timing issues through their Spine product, which is now known as Imprivata Virtual Smart, which connects clinicians to the Spine almost instantly. Andrew shared, “we measure Imprivata Virtual Smartcard access time in milliseconds, rather than tens of seconds or worse”, with the ultimate goal to make this time discrepancy “look invisible to the clinician”.
Speaking further on the use of smart cards, Andrew explained how they “don’t really stack up in a today’s world where people use many Apple iOS and other devices, as NHS smartcards really only work on Windows”, before adding that “people want to move to EPRs that support all sorts of mobile devices and a smartcard really isn’t the answer anymore”. Andrew noted progress made in this area to improve technology based on modern standards, highlighting the new version of the NHS Spine’s Identity Service, CIS2 as an example, as it now supports multiple authentication options instead of just Windows.
However, he did also recognise that introducing new systems and different versions of the same system can cause some problems as “clinicians are having to unlearn 15 years of Spine access behaviour”. Again, speaking specifically on the Spine updates, Andrew referenced an example in Salisbury NHS Foundation Trust, where they have the Lorenzo EPR system in place. The trust went live with CIS2 and faced the issue of the system not logging them out once they removed their smartcard. “Clinicians would logically think they’d logged out when they removed their smartcard and could walk off,” Andrew said, “But they were still left logged into Lorenzo because the newer CIS2 platform does not log users out when they remove their smartcards.
This led to a collaboration discussion between Imprivata and Dedalus, to trial Imprivata Virtual Smartcard because it “manages the session for the user so they don’t run into any of these problems”. Andrew noted how this helps to “bring it back to the user and to make sure they’re getting fast and quick access”.
Implementing user feedback to improve access
Next, Andrew shared how Imprivata have learned from customer feedback when it comes to implementing their solutions. He said that “sometimes if you show people the light, you get a tsunami of requests,” and how this is especially true when conducting phased rollouts, which is a typical approach for Imprivata “because there are nuances in different care settings”. Andrew shared how this can create a “whisper effect” where people have liked what’s going on in other wards using Imprivata and want to use it too because “it makes their day much easier”.
He went on to explain how the industry is moving away from usernames and passwords, meaning that “clinicians are now being asked to deal with lots of apps and tokens to access different systems”, which is why organisations tend to look for a “convenient authentication experience that spans across all devices, especially shared devices”.
Andrew pointed out that one key problem with this is that “all the big authentication system providers tend to apply the same lens to healthcare as they do to office workers, where they’re designed for one user with one device at one desk. But doctors and nurses don’t work like that because they share devices”. As such “these authenticators don’t really fit the bill for healthcare”, to which Andrew suggested that hospitals need to “think about if the solution works on mobile devices, medical devices and all of the other pieces that are unique to the healthcare industry”.
How Imprivata aligns with the future of EPRs
When asked about what the future of EPRs might look like, Andrew said that a “single source of information is needed for clinicians to facilitate great and effective patient care”. He noted how this should be “instantly accessible on any device that a clinician may use” and how this would align with Imprivata’s overall mission “to make that access ubiquitous everywhere”. Andrew emphasised how important it is “to provide a quick and convenient way of accessing patient information, no matter where you are and no matter what device you’re using”.
Exploring Imprivata’s user-centric offerings further, Andrew added how their products are “generally focused on access, whether that’s our traditional Enterprise Access Management solution that provides single sign on and authentication services or our mobile device access and medical device access solutions”. When looking at how this can help with maintaining security for the future of EPRs, he highlighted Imprivata’s Privileged Access Management solution, which allows IT administrators to do their job “without having access to passwords for all of the special systems and network servers” within the organisation.
He outlined how it also “provides a way to give third parties secure and controlled access to the resources they need and nothing else”, which helps to prevent any safety breaches. “It’s auditable and reportable,” Andrew added, “and you can see exactly what each user is doing” for increased security, which Andrew sees as being essential for the future of system access and a “big topic for Imprivata”.
When looking at the future of access for England in particular, Andrew outlined the unique duality of each clinician having two identities, “there’s their local identity at the hospital and their clinical identity at the national level with the Spine”. Because of this, Imprivata has been concentrating on “converging them so that they have access to both local and national systems all in one go”.
The final thing Andrew noted about Imprivata’s focus for now and the near future, was mobile access, “because this is where we see the EPR world going”. He mentioned Nervecentre and their mobile-first EPR, stating, “they’re prioritising mobile” something that he said can be seen all over the world “where hospitals are moving from the traditional Windows workstation to mobile tablets and smartphones, so that clinicians can be closer to the patient”. Imprivata’s answer to this is their mobile access solution, which Andrew said is about “helping the adoption of that type of system” with a specific “focus on the mobile agenda”.
We’d like to thank Andrew for sharing his keen insights into EPRs and how Imprivata’s solution can enable faster and more effective user adoption.
