Background
A large health system implemented computer workstation single sign-on (SSO) in 19 community hospitals. In SSO technology, manual keyboard login is replaced with an identification badge reader that clinicians swipe for expedited access to the electronic health record (EHR) and clinical applications while roaming the hospital.
Objective
To assess the clinical workflow and financial value of SSO implementation in reducing clinician time logging in to the EHR and clinical applications.
Methods
Mean login time duration before and following SSO implementation was measured over 128 logins during two seven-day periods across eight hospitals selected randomly from 19 facilities where the technology was live. Mean first-of-shift login duration and mean reconnect login duration during the rest of shift were compared prior to and post-SSO implementation. Dollar values of keyboard time saved were calculated for physicians, nurses, and ancillary clinicians. Total facility-wide and enterprise-wide clinician time liberated from keyboard use are reported in hours and in dollar value per week and per year.
Results
Following SSO implementation, first-of-shift login was reduced by 5.3 seconds (15.3 percent), and reconnect login duration in the remainder of the shift was reduced by 20.4 seconds (69.9 percent). The total weekly time savings realized by SSO was 943.4 hours (the equivalent of 78.6 12-hour shifts) across 19 hospitals, a mean of 49.7 hours (4.1 shifts) per facility. Annually, 49,056.8 hours (4,088.1 shifts) of mixed clinician time were liberated from keyboard use for the enterprise, a mean of 2,584.4 hours (215.4 shifts) per facility per year. The annual dollar value of clinician time liberated from keyboard use to care for patients was $3,201,001 for 19 facilities, or $168,474 per hospital. Future savings due to desktop virtualization and use of a thin client device, in lieu of replacing more costly desktop computers, increases the annual financial value conveyed by SSO to $3,330,601.
Conclusions
In the 19 hospitals evaluated, SSO improved clinician efficiency and delivered substantial financial value. The use of SSO is an effective method for liberating clinician time from keyboard use to focus on providing patient care, and can facilitate EHR use.