Oregon Clinic Improves Access to Electronic Medical Records

By Claire Swedberg

Central Oregon Ear, Nose and Throat LLC is using an RFID system to save time and increase the security of files, by granting tagged personnel automatic access to electronic records as they approach a computer.

Security measures instituted at medical centers typically require that each staff member input an authorized user name and password in order to access a patient's electronic medical records (EMR), and then to close that file prior to stepping away from the computer. Central Oregon Ear, Nose and Throat (ENT), LLC., a clinic in Bend, Ore., has calculated that this process consumes many hours of time every year, as its team of six physicians and six nurses must input passwords before each task, wait for them to be accepted and then sign out again when finished.

Central Oregon ENT resolved this problem thanks to an RFID solution provided by Proxense. With the company's product, ProxAccess, RFID tags in ID badges are verified upon entering a room and coming within range of a reader, thereby triggering a computer to permit employees access to EMR files, with the EMR software application or just the file shutting down again as they leave that area. Twice daily, a fingerprint scan is required as well, in order to confirm that the individual using the system is indeed the person identified on the badge. The benefits, says Ryan Gallivan, an otolaryngologist at the clinic, are twofold: Employees save time otherwise spent logging in and out of PCs numerous times every day, and security is better ensured since the system automatically closes the EMR application when a user leaves the vicinity (something that could be forgotten in a busy clinic environment).

Ryan Gallivan

On any given day, Gallivan sees an average of 28 patients, and during each visit, he generally opens that patient's file two times or more. Based on his visitation schedule, he estimates that he signs in and out approximately 150 times per day. If each process takes five seconds, he says, that totals more than 48 hours of wasted time annually—time, he adds, that he'd rather spend attending to patients.

Proxense's automatic sign-on/-off system utilizes a combination of biometrics and RFID to authenticate an EMR system user before his or her fingers ever touch a keyboard, providing that individual with instant access to the files he or she is permitted to open.

With the system, says David Brown, Proxense's chief technology officer, each staff member wears a Proxense ID badge with a built-in active 2.4 GHz RFID tag that stores a unique ID number linked in the back-end ProxAccess software to details about that individual, such as his or her name, position and permitted file access. A fingerprint scanner that typically includes a built-in RFID reader (the entire device, which the company calls a BioSensor, measures 1.5 inches by 3 inches, and stands 0.5 inch tall) is plugged into each PC station via a USB cable. When an individual nears a computer, the reader captures the unique ID number encoded to that person's badge tag. At the beginning of each shift, the user must first place or swipe his or her forefinger on the fingerprint scanner for authentication. This prevents others from using that person's badge to access files permitted only to that particular badge holder. Once the user's fingerprint has been compared against the ID number of the badge and approved, the EMR file immediately opens, and that staff member can then get to work. As soon as the worker leaves the PC, the file closes, but upon returning, that person can reopen the file without a fingerprint scan, as long as the RFID badge is being worn.

The Proxense software resides on a server on Central Oregon ENT's back-end system, where it can track the usage of each PC and control the opening or closing of files. The clinic's system is configured to require a fingerprint authentication twice each day. These two daily scans, however, constitute a very small percentage of the times that most health-care personnel actually access the EMR system, Gallivan says, thus making the RFID technology a great benefit. "One of the beauties we've been able to achieve is quick user changes on any desktop," he states. Previously, nurses and physicians were authorized to use only specific PCs, and were required to sign in and out every time they needed to access a file. With the RFID system, they can approach any PC and open any file that they are authorized to access.

Each computer can be configured differently according to a user's particular needs, says Richard Camden, Proxense's VP of RF technology. Some PCs may require a closer read range than others, depending on the activity taking place around that computer. For example, in a doctor's office in which space is tight, the read range could be as close as 5 feet, to provide the most security possible (for example, ensuring that no one accesses the PC while a doctor has stepped outside his or her door). In a larger nurses' station, however, at which a nurse might step farther away from the computer to a file cabinet and then back again, the read range can be longer—as much as 30 feet, Camden says.

In addition, the system allows for configuring a separate read range for signing in and out. The badges' RFID tags beacon once every 45 milliseconds via a proprietary air-interface protocol, though the beacon's transmission rate is also configurable. "I wanted technology that would maximize my workflow, and I'd been interested in RTLS [real-time location systems]," Gallivan says. The system went live in early January of this year, and Gallivan says it is working as he had expected, with no technical problems.

The solution also helps the clinic ensure that it complies with the U.S. government's Health Insurance Portability and Accountability Act (HIPPA), by not leaving files open that could result in security breaches—which can lead to penalties meted out by the U.S. Department of Health and Human Services or the Centers for Medicare & Medicaid Services (CMS).

Central Oregon ENT also hopes to expand the system to employ Proxense' RTLS asset-management solution on the same software platform. In that case, the clinic would need to have Proxense readers installed throughout the facility, and apply Proxense 2.4 GHz battery-powered asset tags to those items it wishes to track. Gallivan hopes to begin utilizing the RTLS later this year.