Using Aventura to Support IT Security Innovation at MemorialCare Health System

Nurse-PasswordFrom 2010 to 2013 more than 29 million patient healthcare records were compromised in nearly 1,000 reported security breaches. A recent study from Stanford University and Kaiser Permanente says that more than half of those instances involved deliberate unauthorized access to data or attempted theft of hardware where the data resided. The report says intentional hacking to steal data has risen from 12 percent to 27 percent as a portion of all data breaches during that period.

To combat this growing threat, healthcare organizations are constantly looking for ways to enhance IT security. MemorialCare Health System, a six-hospital, integrated delivery system in southern California with more than 200 locations in Los Angeles and Orange counties, is finding that using Aventura’s Roaming Aware Desktop (RAD) platform supports its comprehensive approach to security risks.

“It’s all about containing patient data within the four walls of the enterprise,” says Scott Raymond, Executive Director of Information Services. “We’ve been very proactive about data security at MemorialCare.” 

Engaging VDI
The organization has employed a traditional IT environment: installing their Epic EHR and other applications locally on computer workstations with security safeguards like hard drive encryption, port blocking, log in credentialing, and locked workstations.

MemorialCare decided to further enhance their security strategy by moving to a Virtual Desktop Infrastructure (VDI) with thin clients and VMware View to further reduce risks that conventional desktop installations may present.

Enabling Roaming with Aventura’s RAD
A key component of the strategy is the use of the Aventura RAD platform. RAD allows clinicians to tap in, authenticate their username and password with their badge, verify their credentials, access Epic and other required apps, and allows that desktop to ‘follow’ them wherever they go so they can continue their work on any computing device in the system.

“Aventura simplifies password management by minimizing the number of times users have to use it to access the systems,” says Raymond. “It allows us to have those credentials hidden and use Single Sign-On (SSO) through a dual authentication process. Once signed in, users can take that Epic session with them wherever they go and not have to keep signing in.”

“We chose Aventura in part because we felt it was a system that would grow with us as we continue to develop our virtual environment.

For a more in depth look at security in particular and roaming Epic, click here to sign up for Scott Raymond’s webinar MemorialCare: A Case Study on Roaming the EHR in the ER on September 10.

MemorialCare Innovation Fund, LP is an investor in Aventura.

A Nurse’s Perspective: Shifting the Focus from the Computer to the Patient

Nurse-BlogNursing today involves far more than just “nursing.” While the patient is always the top priority, sometimes technology gets in the way of hands-on therapeutic care because updating medical records, documenting the administration of medications, and noting any nurse interventions adds up to many hours clicking on the keyboards of a computer per week.

Most nurses are fairly skilled users of technology. We regularly access EHRs, bar-coded medication administration systems, scheduling programs, patient tracking systems, automated communication programs, and more. Typically each of these programs require a separate log-on and password to ensure patient data remains secure. Unfortunately all these log-ons and passwords are not only hard to remember, they also create inefficient workflows.

With all the time nurses spend in front of the computer, it’s a wonder they have enough time in the day to provide direct patient care!

Consider this hypothetical nursing workflow:

  • From a device in a clinical area, a nurse logs into the hospital’s network. This requires a user name that might be 5-10 characters long, plus a password that might be eight or more characters and includes a combination of at least one number and one upper case and one lower case letter.
  • The nurse then accesses the EMR, entering another user name and another (complex) password.
  • After completing documentation in the EMR, the nurse decides to enter an update in the scheduling system. Another user name and password must be entered.
  • The nurse then gets called to a patient room. Before walking away from the computer, the nurse must log out of the system and each of the open programs.
  • Once in the patient room, the nurse needs to verify some details in the patient’s record. Using the computer in the patient room, the nurse logs into the system, then the EMR, then pulls up the specific patient record.
  • Before leaving the patient room, the nurse logs out of the system and all open programs.

Keep in mind that depending on the speed of the system, which may vary throughout the day – the nurse may have to wait a few seconds … or perhaps a minute or more – to log into each program. In a typical 12-hour nursing shift, a nurse may log into the system 60 times and thus spend one or morehours a day simply waiting on this non-value added work.

As a nurse, I know first-hand how common these inefficient and frustrating workflows are in healthcare. Usability issues are common because too few vendors seek the voice of clinicians when designing their products.

Aventura, however, is different. When creating our products, we rely on input from multiple clinicians and are committed to delivering solutions that adapt to how clinicians prefer to work.

For example, the Aventura Roaming Aware Desktop (RAD) provides users with authenticated access with the single tap of a secure card – eliminating the need to enter all those user names and passwords. RAD then immediately launches all the correct clinical applications based on the user’s location (operating room versus patient room, for example). RAD also delivers an extra layer of enterprise security through privacy screen functionality, idle disconnect, and intelligent printer reassignment.

If you are a nurse, this means you are spending less time on the computer and more time at the bedside and actually “nursing.” That’s a boost to both patient and nurse satisfaction, and contributes to improved safety and better outcomes.

Technology is essential in healthcare. At Aventura we believe that by listening to the clinician voice, we are better able to create solutions that allow nurses to maintain the right balance of technology and touch when delivering care.

Regina Cole, DNP, RN-BC, NEA-BC, CPHIMS, FHIMSS

Dr. Cole is an informatics leader with over 20 years of practice, strategic, operational and academic experience in healthcare information technology and nursing. Her clinical background is in adult critical care; she was licensed as a Nurse Practitioner and held CCRN certification for over 20 years. She is the acting Chief Nursing Information Officer (CNIO) for Aventura.

“Aventura is right up there with sliced bread and butter!”

Bonny RobertsAs vice president of customer experience, I regularly talk with customers to understand their needs and learn how we can better serve our clients. Some days I end up with a long list of suggestions for improving the company and our platform. Other days, I can’t help but smile and say, “Yes! We’re making a difference!”

Of course it’s a really great day when a customer tells you your product is right up there with sliced bread and butter. That’s exactly what the folks at Republic County Hospital recently told us.

Republic County HospitalRepublic, a 25-bed critical access hospital in Belleville, Kansas implemented our Aventura Roaming Aware Desktop solution in March 2015. Republic discovered Aventura when searching for a single sign-on option to navigate their multiple layers of security.

Like many organizations, Republic runs several different applications and each requires users to enter a separate log-on and password. Ed Stiner, Republic’s director of information technology, noted that “It not only took a long time to log in because you might need to enter credentials for two, three, or four different applications, it also took a good memory because you had to remember all the log-ons and passwords.” Stiner added that users would regularly forgot their credentials, requiring administrators to log in and perform a reset.

Another problem was that users had to continually log on and off computers as they moved around the hospital. The process was so time-consuming and cumbersome that the physicians had actually quit using the system.

After reviewing several SSO alternatives, Republic selected Aventura’s platform, which offered the functionality they required and was compatible with their existing IT infrastructure. A few months after the implementation we checked in with Stiner and other members of Republic’s management team to see how things were going – and were thrilled to hear their positive feedback.

Stiner noted that within two weeks of going live, they had seen a “huge decrease” in the number of password resets and forgotten passwords and doctors were using the system more than ever before.

Surgical Services and Outpatient Director Rebecca Brown told us the workflow was “so much easier and the staff frustration level was 90% less.” Director of Nursing Diane Reed added that they had been able to increase the amount of time staff spent in patients’ rooms by 85% and nurses were now charting at the bedside.

“Before the staff wasn’t charting in the room because it took too long with all the multiple log-ons to get in and out of the system. Now we just tap, click, and we are in and out in no time.” Reed believes patient care is enhanced and charting is more likely to be accurate because nurses are entering information “right when it happens,” rather than after rounding all the patients.

Aventura The Republic team estimates that Aventura’s platform is saving staff “hours” a day – leading Brown to declare the solution is, “right up there with sliced bread and butter!”

From a financial perspective, CFO Barry Bottger also gave the Aventura solution a thumbs up. “The startup cost wasn’t all that bad for what it has done to employee satisfaction and morale. The ongoing cost is minimal and it’s definitely been worth the investment.”

Finally, we even heard great feedback from the top: CEO Blaine Miller confirmed that the Aventura solution has been worth the investment. “We are always concerned about HIPAA compliance and the need to have strong passwords. Aventura has eliminated our constant challenge of resetting passwords and ensuring that our staff remembered them because now the system handles it.”

Miller summed it up by adding, “Happy nurses and happy doctors make for a happy administrator.”

And obviously happy customers like Republic definitely make all of us at Aventura very happy!

Imagine how much time your staff could save in a day and what that could mean at your hospital.  If you’d like to learn more about Republic’s implementation of the Aventura solution, please let me know!

- Bonny Roberts, VP of Customer Experience