Wooster Community Hospital: The First MEDITECH Hospital in Ohio to Achieve Positive Identification with CPOE
Patient safety is a top priority at Wooster Community Hospital. In 2006, the hospital's leadership team demonstrated this commitment to patient safety with the decision to implement MEDITECH's CPOE and eliminate paper-based orders. However, as a 150-bed acute care facility in Ohio, Wooster needed to comply with regulations by the Ohio State Board of Pharmacy requiring the use of positive identification for anyone ordering or administering medications electronically. MEDITECH recognized this need to authenticate users within its HCIS and collaborated with Forward Advantage on Authentication Manager, a solution exclusive to the MEDITECH market. Wooster went live with both CPOE and Authentication Manager in the summer of 2009 and became the first MEDITECH hospital in the state of Ohio to achieve positive identification with CPOE.
An Authentication Solution for MEDITECH
Authentication Manager is an application programming interface (API) that integrates directly to the MEDITECH HCIS and allows for users to authenticate with devices such as fingerprint biometrics, smart cards, and proximity cards. Hospitals can use the same authentication method within their MEDITECH applications that they use for single sign-on. For example, a clinician can log onto a workstation with a fingerprint scanner, and then later use the same method of authentication for bedside medication verification or CPOE.
Streamlining the authentication process adds security and convenience to solutions like CPOE, while improving workflow and increasing technology adoption. "Authentication Manager eliminates the need for end users to remember passwords and PINs. This not only speeds user workflow, but increases adoption among clinicians who are more likely to use a system, like CPOE, if it doesn't require an additional password to remember," says Mark Valutkevich, director of product management for Forward Advantage. "We expect to see more states follow in Ohio's footsteps by regulating positive identification with CPOE."
An Efficient Implementation and Reliable Support
Authentication Manager was implemented at Wooster in 2009 in tandem with MEDITECH's CPOE. Wooster had been using the fingerprint biometric authentication included in the Imprivata OneSign Single Sign-On solution prior to this implementation. With the majority of fingerprint readers already in place, deploying the Authentication Manager piece was a simple process. "Wooster was the first MEDITECH hospital in Ohio to go through this, so naturally there were some unknowns we had to work through with Forward Advantage," says Eric Gasser, application coordinator at Wooster. "We've been very pleased with Forward Advantage's implementation and the support they've provided."
Authenticating Wooster's Physicians and Nurses
Clinicians at Wooster with medication ordering and administration privileges authenticate orders with the touch of a finger. After an electronic order is submitted into the system, Authentication Manager prompts the user to press their finger to the fingerprint reader attached to the computer. If a physician is working in a remote environment without a fingerprint scanner, they can connect to the hospital via VMware and sign off on an electronic order by answering two security questions.
Authentication Manager and Wooster's fingerprint readers are also used to positively identify nurses administering medications. Coupled with the hospital's MEDITECH Electronic Medication Administration Record and Bedside Medication Verification applications, the solution contributes to a high level of patient safety.
Benefits of CPOE and Authentication Manager
Prior to implementing CPOE, medication orders at Wooster were either handwritten and signed by a physician or transcribed by a nurse before being delivered to the Pharmacy department. There are a multitude of problems associated with handwritten orders, including illegibility, compromised security, time delays, and a lack of automated allergy and interaction checking at the time of ordering. "With CPOE, a doctor enters an order and automatically receives an alert if there's a potential patient allergy or drug interaction," says Gasser. "Patient safety is the primary motivation for this technology, but it also allows patients to receive their medications much faster than they would with a paper-based system."
Authentication Manager adds convenience to CPOE and helps increase user adoption. Systems that require too many steps are not likely to be popular with busy providers. Additionally, without an authentication solution, many providers tend to write down their passwords and PINs, causing a security issue for hospitals. With Authentication Manager, the process is simplified, as physicians and nurses do not need to remember multiple passwords and PINs. "Our doctors are very satisfied with the fingerprint readers and how they work with our CPOE system," says Gasser. "We required a solution that is easy to use, maintain, and manage at the administrative level."
Setting an Example for Other Hospitals
The Ohio State Board of Pharmacy performs site visits to hospitals having recently implemented CPOE to ensure that the authentication piece meets regulations. "The Board visited our site and scrutinized the system before giving it their blessing," says Gasser. "They were so pleased with our solution that a member of the Board told me they use Wooster as an example for other hospitals looking to achieve positive identification."
Wooster has a number of exciting new initiatives underway including gearing up to meet Stage One of ARRA's Meaningful Use requirements this year. The hospital will also be implementing MEDITECH's Emergency Department Manager (EDM), which it plans to integrate with Authentication Manager.
"We appreciate the opportunity to expand on our existing relationship with Wooster," says Lee Howard, vice president of client services for Forward Advantage. "They've been utilizing our Communication Director server for report distribution since 2004 and for downtime reporting since 2010. Their deployment of the Authentication Manager API is a significant step in their ability to comply with Ohio State Board of Pharmacy requirements, as well as their adoption of CPOE. We look forward to continuing to work with them in the future."
About Forward Advantage
Since 1993, Forward Advantage has provided solid solutions that integrate seamlessly with healthcare information systems; offering products developed in collaboration with MEDITECH for report distribution, HIE products and services, data migration, and identity management. Forward Advantage has over 1,200 installations worldwide and is in the leading position to provide innovative and cost-effective solutions for MEDITECH customers. More information on Forward Advantage’s product and services can be found at www.forwardadvantage.com.
About Wooster Community Hospital
Wooster Community Hospital is a 150-bed full-service acute care hospital. The hospital offers a complete range of inpatient and outpatient services including, CT Scan, MRI, PET / CT Scan, Wound Healing Center, Progressive Care Unit, Home Health Care Services, Ambulatory Care Center, and Cardiac Catheterization Laboratory. For more information, please visit www.woosterhospital.org