PAGING BIOMETRICS STAT!

Aug 1, 2004 12:00 PM, By RANDY SOUTHERLAND

There are few places as busy as the emergency room of a big city hospital. For hospitals in Ohio, like Columbus' Mt. Carmel Health System, the task of managing patients is complicated by federal and state regulations that have placed new strains on the emergency room staff. Strict regulations for the handling and dispensing of pharmaceuticals, enforced by the state's Pharmaceutical Board, have mandated that the hospital find a new way of handling the dispensing of drug orders for patients. At the same time, the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) also established strict new standards of data security for patient information.

For Mt. Carmel's administration and medical staff, meeting these requirements while still delivering a high standard of care was a questionable feat in a department still using old-fashioned charts and filing paper records.

Yet, the benefits of technology could go far beyond simply meeting legal mandates. The practice of writing everything down on paper was an inefficient means of capturing everything that took place with a patient — from procedures to administration of medications. Many items that should be billable, for example, might be lost and never make it to the billing department.

The answer was in automation and a new level of access control.

“Basically [the department's procedures] were a manual process for keeping track of patients as well as writing down orders and clinical findings,” says Stephen Ura, vice president and chief technology officer for Carey, N.C.-based A-4 Health Systems.

His company was retained by Mt. Carmel to implement an automated software management program to eliminate the familiar paper charts. The solution proved to be the company's HealthMatics ED, a comprehensive Emergency Department Information System that automates patient registration, triage, tracking, nursing and physician charting, disposition, charge capture and reporting into a central database.

It proved to be a tremendous change for the three-campus hospital system.

“The big thing that this system does for us is that it gets rid of the paper charts,” says Les Boyer, manager of applications support and client services at Mt. Carmel. “So where before you came into the ER and you had a chart assigned to you and your results and other data went into a folder.”

Putting patient data on a mainframe computer was an important step in meeting privacy requirements while optimizing the efficiency of the ER's operation. However, it did not meet the security requirements of dispensing controlled medications. The state's regulations required a dual form of authentication for each person working in the ER who had the authority to dispense narcotic drugs. Elsewhere, other health care institutions had tried various methods for implementing this requirement. Some hospitals decided that their doctors should enter both a user ID and password while others even required the answering of a series of questions known only to the user. But those methods were cumbersome and did not fit into the fast pace of the ER.

Ura decided that biometrics was the answer. The search began for the right system of biometric readers and operating software that could be easily integrated with the Healthmatics program.

“Our challenge was to find a vendor that had the appropriate software and hardware that we were looking for,” Ura says. “A lot of vendors out there had biometric readers and software that went along with them, but we needed to be able to control the software within our application rather than externally. We also needed to be able to run through the Citrix or Windows terminal server.”

The software was available from Bellevue, Wash.-based SAFLINK Corp.

Using the company's Software Development Kit (SDK), A-4 was able to design and deploy a solution to integrate its management system with the biometric readers.

The SDK allows for the integration of SAFLINK's off-the-shelf SAFremote Authenticator, a product that enables biometric sign-on for secure roaming sessions and remote access to network programs within the Citrix MetaFrame and Citrix NFuse environments with A-4's HealthMatics ED software.

“It allows them to take their application and, anytime there is an authentication required, they can call SAFSolution, which is our software package for the Microsoft environment,” says Luke Thomas, director of commercial sales for SAFLINK.

Within this application, users can log into the system using just their user name and fingerprint identification. The system is able to sort out narcotics orders from general pharmacy orders and can provide a second requirement for authentication, Thomas says.

“So it really serves two purposes,” he says. “One is to meet the state requirements on pharmacy orders, and the second is to create ease of use by eliminating the passwords.”

At Mt. Carmel, the process required first collecting fingerprints from the 500 users at three hospitals — Mt. Carmel East and West and St. Ann's. Prints are taken from a finger on each hand — in this case, the index finger to provide a second option if there's a problem with one print.

“From that point on they can use any PC in the department to log into the Healthmatics application,” explains Boyer.

In addition to desktop computers, doctors have been outfitted with wireless Tablet PCs, while nurses favor laptops on carts. The Startek Fingerprint Sensor, a small 1½-inch-wide finger reader provided by SAFLINK, allows for log-on into the system.

Now new technology replaces archaic systems. Doctors no longer scrawl notes in an illegible hand on paper. Instead, they type notes directly into their Tablet PCs at the patient's bedside or, with a small microphone, they read them into a voice recognition software program that automatically types them into a Word document.

While the world of medicine has been noted for its conservative approach, Mt. Carmel's medical staff has happily adopted the efficiencies of modern software management and access control technology.

FOR THE RECORD…

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