Medical Advisor, Impact Demonstration, Imprivata, San Antonio, Texas, USA
Department of Emergency Medicine, Harvard Medical School, Boston, Massachusetts, USA.
BMJ Health Care Inform. 2022 Nov;29(1). doi: 10.1136/bmjhci-2022-100680.
Surging volumes of patients with COVID-19 and the high infectiousness of SARS-CoV-2 challenged hospital infection control/safety, staffing, care delivery and operations as few crises have. Imperatives to ensure security of patient information, defend against cybersecurity threats and accurately identify/authenticate patients and staff were undiminished, which fostered creative use cases where hospitals leveraged identity access and management (IAM) technologies to improve infection control and minimise disruption of clinical and administrative workflows.
Working with a leading IAM solution provider, implementation personnel in the USA and UK identified all hospitals/health systems where an innovative use of IAM technology improved facility infection control and pandemic response management. Interviews/communications with hospital clinical informatics leaders collected information describing the use case deployed.
Eight innovative/valuable hospital use cases are described: symptom-free attestation by clinicians at shift start; detection of clinician exposure/contact tracing; reporting of clinician temperature checks; inpatient telehealth consults in isolation units; virtual visits between isolated patients and families; touchless single sign-on authentication; secure access enabled for rapid expansion of personnel working remotely; and monitoring of temporary worker attendance.
No systematic, comprehensive survey of all implemented IAM client sites was conducted, and other use cases may be undetected. A standardised reporting/information sharing vehicle is needed whereby IAM use cases aiding facility pandemic response and infection control can be disseminated.
Clinical care, infection control and facility operations were improved using IAM solutions during COVID-19. Facility end-user innovation in how IAM solutions are deployed can improve infection control/patient safety, care delivery and clinical workflows during surges of epidemic infectious diseases.
大量的 COVID-19 患者和 SARS-CoV-2 的高传染性给医院感染控制/安全、人员配备、护理提供和运营带来了前所未有的挑战。确保患者信息安全、防范网络安全威胁以及准确识别/认证患者和员工的必要性并未减弱,这促使医院创造性地利用身份访问和管理 (IAM) 技术来改善感染控制并最大程度减少临床和行政工作流程的中断。
与领先的 IAM 解决方案提供商合作,美国和英国的实施人员确定了所有利用 IAM 技术创新改善设施感染控制和大流行应对管理的医院/医疗系统。与医院临床信息学领导者的访谈/沟通收集了描述部署用例的信息。
描述了八个创新/有价值的医院用例:临床医生在轮班开始时进行无症状证明;检测临床医生暴露/接触追踪;报告临床医生体温检查;隔离单元中的住院远程医疗咨询;隔离患者与家属之间的虚拟探视;无接触单点登录认证;为远程工作的人员快速扩展提供安全访问;以及临时工人出勤情况的监控。
没有对所有实施的 IAM 客户端站点进行系统、全面的调查,可能还有其他用例未被发现。需要一个标准化的报告/信息共享工具,以便传播有助于设施大流行应对和感染控制的 IAM 用例。
在 COVID-19 期间,IAM 解决方案改善了临床护理、感染控制和设施运营。在传染病流行高峰期,设施最终用户在部署 IAM 解决方案方面的创新可以改善感染控制/患者安全、护理提供和临床工作流程。