Case study: How access to essential NHS Spine has aided one Trust

“Fast access to NHS spine enabled applications has been a game changer for us, the benefits from Imprivata have been immediate.” – Chris Bellerby, ICT specialist, North Tees and Hartlepool NHS Foundation Trust

North Tees and Hartlepool NHS Foundation Trust is an integrated hospital and community services healthcare organisation serving around 400,000 people in Hartlepool, Stockton and parts of County Durham. It also provides bowel and breast screening services as well as other community-based services to a wider population in Teesside and Durham.

In September 2017 North Tees and Hartlepool NHS Foundation Trust was named as one of 18 second wave NHS digital pioneers, also known as Fast Followers. The Trust has been aligned to a Global Digital Exemplar, Royal Liverpool and Broadgreen University Hospitals NHS Trust, to establish proven models that can be rolled out across the NHS more broadly.

In March 2019, North Tees and Hartlepool NHS Foundation Trust received recognition as top Trust in England for A&E Performance. It was ranked in first place out 131 trusts for its ability to see patients within four hours of arriving at its Accident and Emergency care department.

Business Challenge

North Tees and Hartlepool NHS Foundation Trust were keen to explore how technology could improve efficiency and reduce risk in a pressurised environment such as A&E where time is a major factor in determining patient outcomes. With clinicians in A&E needing to access NHS Spine and other essential clinical applications from multiple locations within the department, the Trust were keen to investigate how to speed up access without weakening secure practices, whilst also delivering the highest level of patient care.

The Solution

In phase one of the project, Imprivata OneSign Single Sign-on and Authentication Management was selected and deployed within A&E. The faster Single Sign On (SSO) process made an immediate impact to the speed in which clinicians could access applications. Laptop and desktop mobile work stations were fitted with card readers enabling staff to log in and out of the system by tapping their smart cards against the card readers.

However, accessing NHS Spine enabled applications remained a lengthy process requiring clinicians to go through the authentication process each time they required access.

“It can take up to 25 seconds to log into NHS Spine which doesn’t sound onerous however the time soon adds up. When you have to perform this workflow several times per patient, per shift, and multiply it by the number of clinicians, it becomes a significant administrative burden,” commented Chris Bellerby.

The Trust decided to resolve this issue by deploying Imprivata Spine Combined Workflow which delivers the same No Click Access to NHS Spine enabled applications at the point of care. NHS Spine allows information to be shared securely through national services such as the Electronic Prescription Service, patient Summary Care Records and the e-Referral Service. It helps doctors to decide quickly on life-saving treatment by providing vital information at the point of care.

“The patient is always the priority and anything that impedes staff from providing the best care is a hinderance. Security has to work for the clinicians and system users because if it doesn’t, then it isn’t working at all. The time-consuming process to access essential medical applications almost encouraged staff to find an insecure work around, deploying Imprivata has eliminated that.”

Phase one of the project was swiftly extended to include the Emergency Assessment Unit and Rapid Access Clinics. This enabled clinical staff that work across the three areas to enjoy a consistent user experience.

R D Southward, consultant emergency medicine, consultant sport & exercise medicine, North Tees & Hartlepool NHS Foundation Trust, said: “Imprivata makes my life a lot easier managing multiple logins. It is a big step forward on Information Governance in a busy department with large throughput and multi-device working.”

Improved information governance

The ease and speed of tap and go access to applications and NHS Spine has removed the burden of remembering multiple passwords for applications. Today, the Trust has 21 clinical applications profiled within Imprivata OneSign and staff only have to remember one password to access all 21 applications. With users now accessing the system with their own smart cards, audit logs are accurate and diagnostic tests and prescribed medications are attributed to the correct clinician.

Nick Roper, consultant physician, clinical lead, responsive care at North Tees and Hartlepool NHS Foundation Trust said: “We have eliminated insecure practices such as leaving cards in workstations, sharing credentials and writing passwords down on notes stuck to monitors. This has not only improved security practices but also audit logs ensuring compliance with CQC guidelines.

“Imprivata speeds up the use of PCs saving valuable clinical time. It also reduces Information Governance risk as cards are not left in machines.”

Virtualised environment

In addition to mobile desktop and laptop units, North Tees and Hartlepool NHS Foundation Trust operate a virtual desktop environment using Citrix XenApp. Imprivata Virtual Desktop Access extends the single sign-on capabilities to virtual desktops, allowing users to log in and out of the system, with a tap of their smart badge, without interrupting their session.

A&E, the Rapid Access Clinics and the Emergency Assessment Unit are fast-paced environments where timely decision making is absolutely vital. Clinicians can tap into the system, access NHS Spine applications and see the summary care records for the patient they are caring for.

“Not all patients enter the units conscious so being able to immediately access information on medications and allergies can make all the difference to the outcome of the patient,” commented Chris Bellerby.

Results and benefits

  • Fast and secure access to NHS Spine applications at the point of patient care has improved efficiency and decision making. Staff are able to focus on patient care and utilise essential clinical applications quickly, making informed decisions without delays and improving patient outcomes.
  • The No Click Access to applications using smart cards has improved audit trails and data governance. Staff are actively involved in ensuring security practices are maintained because the workflows complement rather than impede their daily activities.
  • There are 21 applications that have been profiled within Imprivata OneSign. With login times now reduced to the speed it takes to tap a smart card against a card reader, the time saving has been significant. More importantly, technology now complements how clinicians work, delivering real benefits in a pressurized environment where time is of the essence.

Chris Bellerby concludes: “Phase two of the project will deliver the benefits of Imprivata OneSign to the operating theatres. The solution has already made a significant impact in A&E, the Rapid Access Clinics and the Emergency Assessment Unit. The operating theatres are another area of the hospital where time and access to essential patient information are critical factors in care scenarios. Implementing Imprivata has been a leap forward in achieving digital transformation, improving patient care and enabling staff to work without technological barriers.”



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