Mobility in Hospitals: Engaging Key Stakeholders

Friday, 24 May 2013

Healthcare IT, Policy, Technology

By Jianggan Li | 9 May 2012 | Views: 1772

At a recent FutureHealth breakfast dialogue, CIOs from Singapore’s public hospitals exchanged perspectives and experiences on the challenges, risks and benefits involved in enabling clinicians to bring their own devices. Report: Jianggan Li.

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The rigid model of the IT department provisioning everything from devices and software suites to network and security is giving away to user demand for devices and applications that are beautiful to look at, easy to use and which can be mastered without specialised training.

“When was the last time that a doctor rushed, with excitement, to get a device issued by the IT department?” asked Yaj Malik, Area Vice President of Citrix Systems, setting up the scene for the recent FutureHealth breakfast dialogue. “A paradigm shift is taking place; users expect information to follow them as they move.”

“Work is being transformed from a place to an activity, an experience,” he added.

BYOD strategy

Embracing this change, Barwon Health, a regional health authority in the Australian state of Victoria, has embarked on a BYOD (bring your own device) journey. Ann Larkins, CIO of Barwon Health, noted: “We have an increasingly distributed workforce which wants to bring its own devices into the work environment.”

Coping with that demand, the authorities are allowing people to bring in devices and having a set of rules governing their use. A virtualised platform and proper authentication allow users to work on any device and pick up sessions from another device easily.

iPads at work

Singapore’s National University Health System (NUHS), which is comprised of the National University Hospital and the University’s medicine and dentistry faculties, allows clinicians to use their iPads at work.

Dr Mahendran Maliapen, NUHS’s Director of Academic Informatics, led the project, which enabled 400 clinicians to log into different systems with a single sign-on on a daily basis. A private cloud was built to allow resources on demand. Currently, 1200 logins are recorded every day.

Associate Professor Lim Thiam Chye of NUHS, who is a plastic surgeon, uses the system on a daily basis. As a plastic surgeon, Dr Lim needs to constantly engage with patients, many of whom are from overseas. The system allows him to easily pull out information, including images, to make decisions as well as to offer explanations to patients.

Two-factor authentication was put in place, and those who bring their own devices were made legally responsible for the data they access.

A suite of clinical applications are accessible once clinicians log into the system and the passwords for all these applications are stored, allowing easy access through single sign-on. And when a password for a particular application is about to expire, users will get an alert prompting them to change the password.

“Having multiple passwords for different applications was a big pain point for clinicians, many of whom keep their passwords under their laptop or used nurses’ passwords to access because they couldn’t find theirs,” Dr Mahendran says. “We solved that problem.”

In addition to ensuring smooth data exchange in the backend, NUHS makes sure that all iPad connections are done through 3G. Wi-Fi sessions are not allowed and logins through Wi-Fi will be rejected.

Dr Mahendran said rules need to be in place on who should have preferential login during peak usage periods. Devices are tracked to ensure that one user only has one device logged in at any point in time. Sessions will be automatically transferred when the user moves onto another device.

Moving forwards, Dr Mahendran plans to extend the system to allow access through smart phones. He also wants to roll out a new authentication method called voice biometrics. A series of tests he conducted showed that the technology was accurate and stable.

Business Model

For organisations to allow BYOD, a business model is essential to make the programme sustainable. Malik shared that at Citrix Systems, each employee is entitled to a US$2,100 allowance once every three years to purchase his own device. “Although this might sound like a lot of money, for the devices we issue, we are spending on average around US$3,000 per employee over the same period of time,” he commented. “We do not have to worry about servicing and lost devices anymore.”

Malik suggested that for ward-based staff who just need transactional processes, it might be a good approach to have a shared pool of devices they can sign in to use and return at the end of their shifts.

From a device point of view, most participants believed that among all the available options, tablets have the best future within the healthcare environment. The issue of ‘patchy wireless connections’ has been largely resolved; weight and battery life are also less of a concern. The only remaining challenge before tablets can really take off is input methods, which need to be more accurate and easy to use.

The full, unabridged version of this article will be published in FutureGov Asia-Pacific magazine’s May-June issue.

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