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G. Gellert



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    EP01 - e-Poster Session 1 (ID 52)

    • Event: e-Health 2018 Virtual Meeting
    • Type: e-Poster Session
    • Track: Clinical Delivery
    • Presentations: 1
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      EP01.08 - The Clinical Impact of Workstation Single Sign-on (ID 16)

      G. Gellert, CHRISTUS Health (affiliate); Irvings/US

      • Abstract
      • Slides

      Purpose/Objectives: Following implementation of SSO, CHRISTUS set out to assess the impact in reducing clinician time logging in to various clinical software programs, and in financial savings from migrating to a thin client that enabled replacement of traditional hard drive computer workstations. A total of 65,202 logins across 6 CHRISTUS Health hospitals were sampled systematically during a 7-day period among 2256 active clinical end users for time saved in 6 facilities when compared to pre-implementation. Dollar values were assigned to the time saved by 3 groups of clinical end users: physicians, nurses and ancillary service providers.

      Methodology/Approach: We share quantitative data on clinician time savings and recurrent computer hardware expenditure savings resulting from the implementation of SSO. We selected a 7 day observation period of SSO usage in May 2016 across 5 general community/general hospitals and 1 children’s hospital in Texas and Louisiana. There were 65,202 logins to the enterprise EHR. Potential SSO clinical users across the enterprise are 22,011. Of these, 5078 were based in the 6 hospitals evaluated, of which 2256 were active users (44.4%). Mean login durations were multiplied by the number of total first of shift and subsequent logins across all 6 hospitals for a 7 day period of evaluation and reporting in May 2016. We calculated the dollar cost savings or value in liberating time for each of 3 categories of clinicians utilizing SSO – physicians, nurses and ancillary personnel. In our SSO implementations in these 6 facilities, 28% of clinical users were physicians,54% were nurses, and 18% were from ancillary departments. For nurses, we utilized the national average wage of $34.50. We collapsed physical therapists, dieticians and respiratory therapists into a single category of ancillary users and averaged their respective average hourly wages as $32.20. We collapsed all other medical specialties into a single category and averaged the physician hourly wage rate reported in the U.S. Department of Labor occupational employment statistical database rate ($95 per hour) with that reported by Becker’s Hospital Review 2015 data ($165 per hour) for a rate of $130 per hour.

      Finding/Results: *Results*: The reduction of total clinician login time over the 7-day period showed a net gain of 168.3 hours per week of clinician time – 28.1 hours (2.3 shifts) per facility per week. Annualised, more than 1461 hours of mixed physician and nursing time is liberated per facility per year. The annual dollar cost savings of this reduction of time expended logging in is $92,146 per hospital per year and $1,658,745 per year in the first phase implementation of 18 hospitals. The computer hardware equipment savings due to desktop virtualization increased annual savings to $2,333,745. Qualitative value contributions to clinician satisfaction, reduction in staff turnover, facilitation of adoption of EHR applications, and other benefits of SSO have also been realised.

      Conclusion/Implications/Recommendations: Based on this evaluation of the impact of SSO implementation,SSO is delivering substantial clinical value, recurrent annual ROI and net cost savings to the first 6 facilities implemented withinour hospital system.

      140 Character Summary: Attend this session to learn about the research published in the International Journal of Medical Informatics on The Clinical Impact of Workstation SSO.

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