"The improvement in workflow efficiencies gave clinicians back more time to focus on patient care which was informed by accurate NEWS2 scores and trustworthy data automatically collated into the EPR.” Kevin Grice, Digital Programme Manager, PMO, Health Informatics, The Rotherham NHS Foundation Trust
Business Challenge – How to electronically record Patient Vital Signs
The Rotherham NHS Foundation Trust is a combined acute and community trust providing services at Rotherham Hospital and across the borough to a population of 264,700 people. The Trust had been using Imprivata Enterprise Access Management (formerly OneSign) since 2015 for single sign on, so staff were familiar with tap and go for accessing patient information and systems, such as electronic patient records (EPR). However, in 2021 the Trust instigated a new project around the use of observation devices to collect and record vital signs information for in-patients.
The overall aims of the project were to produce rich EPR data; enhance clinical workflows; reduce or remove paperwork; create comprehensive audit trails and help improve patient outcomes. A variety of solutions and systems are involved in the process. The Trust uses two EPR solutions – MEDITECH and TPP SystmOne. MEDITECH is used to generate orders which are sent electronically to the laboratory, which reduces the amount of manual data entry needed.
The Trust also uses the National Early Warning Score (NEWS2). Various measurements taken including respiration rate, oxygen saturation, blood pressure, pulse rate, cognition and temperature are collected to improve the detection and response to clinical deterioration. Welch Allyn/HillRom medical devices were selected to produce such measurements.
The key challenge for the Trust became how to seamlessly join together all the elements of the solution in a way which simplified processes for clinicians and improved the efficiency of workflows while maintaining full data, audit trails and system security.
The Solution – Fast access to integrated patient information from multiple devices
The components of the Trust’s desired solution were in place but a means to knit them together more efficiently was needed. Imprivata Medical Device Access was chosen as the right tool to make this a reality. The Trust needed interconnected medical devices to play an increasingly valuable role in the delivery of patient care, enabling data to be captured, aggregated, transmitted, and analysed in real time.
Such advanced capabilities bring new security threats, as each device represents a potential point of exposure of patient information and can be the target of cyber attack. Enforcing authentication through manual entry of usernames and passwords to access data from devices creates tedious, inefficient workflows that impede the delivery of care. The Trust used Imprivata’s authentication management platform to replace the cumbersome manual entry of user data with fast, automated authentication through the simple tap of a badge.
The Welch Allyn/HillRom devices are configured to use the secure hospital WiFi and once authentication using Imprivata has taken place patient readings are pushed straight through to the EPR. The patient record is updated in real time enabling speedier decisions using the accurate NEWS2 score, which feeds into a traffic light system and flags potential problems on a patient dashboard in real time. The system will also show if observations for a particular patient are late, meaning nurses can react rapidly.
The Trust’s clinical staff were already familiar with Imprivata solutions for use to access desktops and WoWs and so extending their use to medical devices kept the same style of tap on/tap off access so new workflows were easily adopted. The Imprivata solution was essentially transparent to users meaning clinicians didn’t need to think about secure access, in sharp contrast to the previous manual entry of user IDs and passwords and transcription of data between systems.
Next steps
After the success of this project around the use of observation devices to collect and record vital signs information, the Trust is beginning a Proof of Concept study using Imprivata solutions to securely access Seca scales to collect weight and height data. Initially this will be used for baby weighing scales where measurement collection is currently a manual process. Secure readings will enable accurate calculations for adjustments to feeding and the prescribing of any required drugs.
Clinicians will benefit from a unified authentication process prior to each Seca measurement and weighing using existing Imprivata credentials. Imprivata Medical Device Access will simplify yet another process by the wider adoption of a well-accepted solution which has become transparent and effortless for Rotherham’s clinicians.
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