As healthcare providers embrace the accountable care model and related initiatives aimed at improving patient experiences and outcomes, IT faces the associated infrastructure challenges and seemingly conflicting technology goals. Mobility, for example, raises numerous security and compliance issues that must be addressed to protect patient health information and minimize risks that could impact quality of care. Budget issues exacerbate the problem, especially since lack of security can result in costly troubleshooting and management inefficiencies.
At North Kansas City Hospital, a 451-bed acute care facility that focuses on providing 'uniquely personal care,' IT and care providers have evolved an infrastructure model that seamlessly blends mobility and security at the point of care. The new computing solution introduces virtual desktop infrastructure to the clinical areas, replaces PCs with zero clients (small footprint devices used to securely access virtual desktop environments) and strengthens security while simultaneously saving time for the care providers.
The primary goal for the new point-of-care solution was to improve patient outcomes by empowering a highly mobile care team. IT set out to address the inefficiencies that were previously hindering caregivers while ensuring compliance with HIPAA, ISO 9001 and other relevant regulations. Other goals included minimizing the total cost of ownership and maximizing productivity for all of the point-of-care teams.
Addressing IT questions and user complaints
Prior to this deployment, conversion to an electronic health records system had created a significant challenge for point-of-care teams and IT. At the start of a shift, each clinician or member of the nursing staff would "claim" a PC near his or her area. They would then come back to that device to do their work, as that was the only way to avoid a repeat of the time-consuming login and EHR application launch process. Other staff members would respect the employee's claim to a PC, even if the logged-in user did not need the system at that point in time.
The hospital and satellite clinics were consequently over-provisioned with PCs that were often idle. The PCs took up a lot of space and time from the support staff. IT questioned the need for so many PCs, while the care providers complained that they needed more stations and a faster, simpler login process that would make it easy to work from any computing station.
Zero clients and "tap-in, tap-out" login automation
With help from a healthcare solution provider, and by listening carefully to what the clinicians and care providers needed, IT discovered a combination of technologies that could satisfy the need for a better-managed and more user-friendly infrastructure. In the data center, North Kansas City Hospital introduced VMware Horizon View. Throughout the hospital and its clinics, PCs were replaced with zero clients employing Teradici PCoIP technology. Compared to PCs, the PCoIP zero clients operate quieter and cooler and consume far less energy.
The zero clients improve endpoint security because content remains in the data center; there is nothing to steal or infect. And session timeouts have been configured so that content does not display if a user walks away without closing the session.
At a higher level, the main user goal for the virtual desktop sessions was to streamline the login and start-up of the primary EHR application. Achieving both security and user convenience required two new access management solutions: Imprivata No Click Access authentication and badge readers for tap-in, tap-out initiation of sessions.
The new healthcare computing solution also delivers superior viewing experiences, which are especially critical for the physicians who depend on high-fidelity imaging at the point of care.
The correlation – saving time and saving lives
Today, 700 new zero clients and the easy tap-in, tap-out badge access have truly changed the way that teams work throughout the hospital and clinics. Since login and session start-up is so easy, employees are quick to release stations to others and territorial attitudes around device ownership have disappeared. Much more than just a convenience, the increased mobility of the care providers and the saved time translate directly into improved quality of care, which ultimately saves lives.
For IT, the zero clients offer easier and faster deployments, simplified management and result in fewer support calls from end users. Due to less time spent deploying, configuring, updating and troubleshooting endpoints, IT has been able to shift resources to other projects and services that benefit patients. IT can also respond more rapidly to other organizational requests; building out extra capacity is much easier and faster.
The operating efficiencies around the VDI deployment have also led to a change in how NKCH purchases equipment. In the past, PCs were introduced on three-year leases. Now, zero clients are purchased and the hospital conservatively expects to get five or six years of life out of the new endpoints.
A model of efficiency
Through this and other technology advances, North Kansas City Hospital has become a leader in healthcare information technology. The hospital just submitted its application for stage 2 meaningful use, level 1, a step only 3 percent of hospitals nationwide can claim. Meanwhile, the technology team tells this success story to clinicians across the country that are considering zero clients. Word is spreading because the model works — virtual desktops, with the right access solutions, improve staff productivity and reduce equipment idle time. The implementation proves the efficacy of VDI and represents an exciting change at the point of care.
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