Bring Your Own Device (BYOD) Initiative Enable Clinical Transformation by Gregg Malkary, Managing Director, SPYGLASS Consulting Group

Transcription

1 Bring Your Own Device (BYOD) Initiative Enable Clinical Transformation by Gregg Malkary, Managing Director, SPYGLASS Consulting Group A SPYGLASS CONSULTING GROUP HEALTH CARE STUDY

2 WHITE PAPER Bring Your Own Device (BYOD) Initiative Enable Clinical Transformation TABLE OF CONTENTS Bring Your Own Device (BYOD) 2 Initiatives Enable Clinical Transformation Physicians are Eager to Use 2 Mobile Solutions at the Point of Care Hospital IT Faces Significant Challenges to Support Mobile Solutions 3 Hospital IT Requires Next- 4 Generation Networking Management Solutions to Support BYOD Customer Story: Henry Ford Health System6 Customer Story: Western 7 Maryland Regional Medical Center Conclusion 8 For Additional Information 8 Bring Your Own Device (BYOD) Initiatives Enable Clinical Transformation Hospital IT organizations nationwide are starting to deploy BYOD initiatives that allow hospital-based and affiliated physicians to use their personal mobile devices on the hospital s wireless local area network (WLAN) to access patient information regardless of their physical location. When successfully deployed, BYOD initiatives have the ability to transform clinical workflows by: Improving physician access to information Enhancing communication, collaboration and care coordination Streamlining interdisciplinary workflow processes Increasing physician, patient and guest satisfaction This white paper will identify the opportunities and challenges for physician BYOD solutions within a healthcare setting and explore how next generation network management solutions can support the secure deployment, management and monitoring for a wide range of Wi-Fi-enabled devices across the organization. Physicians are Eager to Use Mobile Solutions at the Point of Care Physicians are mobile professionals. There are more than 954,000 physicians in the United States that control more than 80 percent of the nation s healthcare spending through the delivery of patient services and referrals 1. They are mobile professionals constantly on the go as they travel between their offices, clinics and the corridors of affiliated hospitals. They have a constant need to access clinical information and communicate with colleagues, care team members, patients and their families. Physicians are widely embracing mobile solutions. Smartphones, laptop computers and next generation tablets are increasingly used by physicians to support their daily workflows. Solution adoption is being driven by the availability of innovative consumer-oriented technologies that are inexpensive, lightweight, easy-to-use and capable of leveraging cellular and Wi-Fi connectivity. Physicians are using mobile solutions for communications, managing personal information (contacts, calendar), Bring Your Own Device (BYOD) Initiative Enable Clinical Transformation White Paper 2

3 surfing the Internet, consuming personal content (news, information and entertainment) and location-based services. Mobile applications are integrated with the device and are also available for free or at a nominal charge through cloud-based application stores. Physicians want to use mobile solutions at the point of care. Mobile solutions support and enhance clinical workflow processes while physicians make their rounds at the hospital. These solutions increase their flexibility and convenience to communicate or access patient information regardless of their physical location to: Communicate with colleagues, team members and patients Review recent laboratory results Prescribe medications electronically Generate clinical documentation View radiological images Capture patient billing charges Browse the Internet for medical reference materials Hospital IT Faces Significant Challenges to Support Mobile Solutions Hospital IT has been resistant to supporting personal mobile devices on the hospital s WLAN. According to a recent Spyglass Consulting Group report, Point of Care Computing for Physicians 2012, 75 percent of healthcare organizations interviewed were resistant to supporting physician s personal mobile devices on the hospital s WLAN2. Hospital IT believes mobile devices are less secure, less reliable and more expensive to support and maintain than traditional desktop computers that are widely deployed throughout the organization. Existing wireless LANs are not reliable and scalable to support mobile solutions. Mobile solutions require a highly-reliable and scalable WLAN infrastructure to support point of care computing and communications. The Spyglass report also found that 29 percent of healthcare organizations were concerned about the quality and reliability of their WLAN infrastructure. Overloaded access points, wireless dead zones and poor access point transitions resulted in dropped network connections. This poor deployment of wireless LANs has negatively affected the quality of patient care and reduced the productivity of healthcare workers3. Mobile solutions pose security risks to hospital s WLAN. Hospital IT operates in a highly-regulated industry. HIPAA privacy rules, as defined by the Department of Health and Human Services, require healthcare organizations to closely guard and protect patient health information. According to the HITECH Act 2009, healthcare organizations found guilty of data breaches can be fined upwards of $1.5 million per incident and be required to notify the local media if the breach involves more than 500 patient records4. Approximately 25 percent of data breaches originate from laptop computers and other mobile devices. Hospital IT believes that physician-owned mobile devices could introduce malicious attacks, malware and viruses to the hospital s WLAN, which would lead to performance degradation and potential security breaches. The most common concerns regarding physician-owned mobile devices include: Lost/stolen devices: Physicians mobile devices can be easily lost or stolen. Device security: Physicians often do not use their device s integrated security because it impedes their productivity. Device monitoring: Physicians are resistant to allowing hospital IT to monitor, manage and control their devices because they find it intrusive. Virus and malware protection: Physicians mobile devices lack security software to detect and eliminate viruses and malware resident on their mobile devices. Hospital IT lacks dedicated resources to support mobile solutions. Hospital IT has limited resources to support mobile devices on the hospital s WLAN. Their top priority is addressing the federal government s meaningful use requirements, which include the deployment and support of electronic medical records, computerized physician order entry and quality indicators reporting. Failure to address these requirements could negatively affect the hospital s bottom line through reduced payer reimbursement. IT projects such as mobile device support are often considered a secondary priority. Bring Your Own Device (BYOD) Initiative Enable Clinical Transformation White Paper 3

4 COMMUNITY-BASED PHYSICIAN Rounding at the hospital uses an Apple ipad to access patient information only while connected to the hospital s WLAN. MEDICAL/SURGICAL STAFF NURSE Uses a VoIP handset for clinical communications with colleagues and care team members and to receive text-based notifications generated by the nurse call system. VoIP handsets are locked down by MAC address and have no capabilities of accessing clinical information systems or the Internet. HOSPITAL PATIENTS AND THEIR VISITORS Use their laptop computers on the guest access services network to access personal and surf the Internet. Network bandwidth is limited to < 1MB/sec. Internet filters restrict access to offensive confidentiality, integrity, and availability. Mobile device support could require additional network administrators to manage the WLAN infrastructure and provision hundreds, if not thousands, of temporary and permanent devices. Help desk personnel with specialized skills, knowledge and training in mobile technologies may also be required to support end user connectivity problems. Hospital IT Requires Next-Generation Networking Management Solutions to Support BYOD Hospital IT organizations deploying BYOD initiatives require next generation network management solutions that can provide a highly-reliable, scalable wireless infrastructure to protect patient information, deliver guaranteed Quality of Service and remotely manage a wide range of Wi-Fi-enabled devices. HOSPITAL IT MUST DEFINE AN ENTERPRISE-WIDE MOBILE STRATEGY. Hospital IT should work with a professional services organization that has the appropriate knowledge, experience and expertise to help them define a comprehensive enterprise-wide strategy for mobile and wireless technologies to ensure successful business and clinical transformation. Strategy, policies and procedures must clearly identify who can use their mobile devices on the hospital s network; which devices, operating systems and application software can used; and how mobile devices will be secured, managed, monitored and supported. NETWORKING SOLUTIONS MUST PROVIDE A HIGHLY- RELIABLE, SCALABLE AND UBIQUITOUS WIRELESS NETWORK. In order to support mobile computers and other Wi-Fi-enabled devices connected to the hospital s WLAN, hospital IT must select a networking solution that is: Highly available: The WLAN architecture must provide %uptime to ensure that physicians always have access to critical patient information and are able to communicate with colleagues and care team members especially during emergency situations. Scalable: The WLAN architecture must be highly-scalable to support hundreds, if not thousands, of additional mobile computers along with other Wi-Fienabled devices such as patient monitors, biomedical devices and RTLS tags to support real-time tracking applications.. Ubiquitous: The WLAN coverage must be ubiquitous to ensure that physicians always have wireless connectivity regardless of their physical location within the facility including administrative offices, conference rooms, clinical care environments, patient rooms, stairwells and even within the elevators shafts. Bring Your Own Device (BYOD) Initiative Enable Clinical Transformation White Paper 4

5 NETWORKING SOLUTIONS MUST PROTECT PATIENT INFORMATION. Hospital IT must be able to protect patient information from mobile computers and other Wi-Fi-enabled devices connected to the hospital s WLAN. There are important technologies that hospital IT teams can leverage to enable better control and provide an excellent user experience for BYOD solutions. Network access control and network reporting tools can leverage network assets to enable a successful BYOD solution. Network access control tools provide enterprise-wide visibility to ensure the right end users have access to the right information at the right time. Digital identities provide controlled access to the hospital s resources based upon the user, location, device, operating system and application software. End users may have unrestricted access to corporate resources, limited access to specific types of corporate data or Internet usage only. Network reporting tools enable network administrators to track and report mobile device usage and potential security threats to patient information ensuring regulatory compliance with state and federal agencies such as Joint Commission and the Centers for Medicare, HIPAA and Medicaid. Virtual Desktop Interface (VDI) integration through vendors such as Citrix and VMware enable end-users to access their remote desktop environments through a thin client. This ensures patient information is not stored on the device, reducing the potential risk of a security breach. NETWORKING SOLUTIONS MUST DELIVER GUARANTEED QUALITY OF SERVICE (QOS). Hospital IT must be able to provide guaranteed QoS for mobile computers and other Wi-Fi-enabled devices connected to the hospital s WLAN. Quality of Service management tools reduce the risk of service interruption and ensure optimal and predictable performance for all Wi-Fi-enabled devices. Network administrators can set traffic rules, limit bandwidth and prioritize network flow for specific users, devices and applications. High-priority network traffic could include nurses accessing critical patient information or a medical device transmitting patient vital signs data to the electronic medical record. Lowpriority network traffic could include a patient or visitor viewing a YouTube video on their laptop. NETWORKING SOLUTIONS MUST ENABLE REMOTE MANAGEMENT OF WI-FI-ENABLED DEVICES. Hospital IT must be able to remotely provision, monitor and manage mobile computers and other Wi-Fi-enabled devices connected to the hospital s WLAN. Device self-provisioning tools simplify network management and reduce network administration costs. End users can self-register their mobile computers and then have them automatically authenticated and authorized based upon an existing digital identity. Network monitoring tools provide network administrators with enterprise-wide visibility of all trusted Wi-Fi-enabled devices and identify how they are using hospital s resources. Help desk professionals can quickly identify trouble areas by registered user, device type, operating system, applications, location and IP address. NETWORKING SOLUTIONS MUST PROVIDE INTEGRATION WITH LEADING MOBILE DEVICE MANAGEMENT TOOLS. Hospital IT must be able to integrate Mobile Device Management (MDM) solutions with the underlying WLAN infrastructure from leading vendors such as AirWatch, Mobile Iron and Symantec. These solutions provide network administrators with more robust capabilities to secure, monitor, manage and support mobile computers and other Wi-Fi-enabled devices connected to the hospital s WLAN. Functionality includes over-the-air application distribution, sandboxing to remotely wipe patient data from mobile devices and the ability to remotely configure mobile devices. Network management solutions provide what systems management tools like MDM platforms don t granular access provisioning of the network as a resource and monitoring of the systems leveraging network resources. Robust network management tools augment MDM platforms by providing detailed reporting for both hospital-owned and clinician-owned devices, including when the system was on-boarded, when it was used and the permissions the system had to the various protected medical assets. Bring Your Own Device (BYOD) Initiative Enable Clinical Transformation White Paper 5

6 Customer Story: Henry Ford Health System Henry Ford Health System (Detroit, MI) is a not-for-profit, integrated healthcare delivery network that is widely regarded as one of the nation s top healthcare providers. It is comprised of more than 140 teaching facilities, hospitals, clinics, physicians offices, nursing homes and hospices committed to servicing the healthcare needs of patients in southeastern Michigan. In April 2011, hospital IT initiated a program entitled icomply to address physician demands to use their personal mobile devices on the hospital s network, while addressing privacy and security awareness through end-user training. The icomply Program is Henry Ford s ongoing program designed to increase workforce awareness and improve compliance with the complex rules related to information privacy and security. With icomply, more than 1600 hospital-based and affiliated physicians are allowed to use their smartphones, laptop computers and tablets to securely access corporate , patient healthcare information and other enterprise resources. Henry Ford Health System is enjoying the benefits of: Enterprise-wide mobile strategy. Hospital IT defined a comprehensive enterprise-wide strategy for personal device usage on the hospital s WLAN. Physicians wishing to use their devices are required to attend a training session to learn about the rules, policies and procedures for mobile device usage. They are also required to sign a zero-tolerance policy agreement if found to be non-compliant, their mobile access to the hospital s network is be terminated. Reliable, secure and scalable wireless network. Hospital IT leveraged an existing enterprise-class wireless network from Extreme Networks to support icomply to provide more than 4.2 million square feet of ubiquitous wireless coverage throughout HFHS member organizations across Michigan. Network management tools from Extreme Networks enable hospital IT to control mobile access to hospital resources, prioritize and manage mobile network traffic and monitor mobile device usage across the enterprise. Mobile device management tools. Hospital IT collaborated with AirWatch to deploy a mobile device management solution to enforce mobile policies, regulate end user behavior, contain costs and manage risks across multiple device platforms. Hospital IT is able to ensure a safe and reliable network by: Registering mobile devices: Mobile devices on the hospital s network are required to be registered with a unique hardware MAC address. Enforcing password policy: Mobile devices capable of storing patient information are required to leverage password protection. Encrypting data: Mobile devices including Smartphones, laptops, tablets, flash drives and external hard drives capable of storing patient information are required to use local data encryption. Disabling Apple icloud: Mobile device data and applications are not allowed to be backed up to Apple icloud because the backed up data is not accessible and controllable by hospital IT. Remotely wiping lost devices: Mobile devices that are lost or stolen will be remotely wiped clean of all corporate and personal data. Enabling anti-virus protection: Mobile devices must enable security software to guard against viruses, Trojan horses, worms and malware that could be introduced through SMS messages, downloadable content, public Wi-Fi or via Bluetooth connections. To increase patient satisfaction, hospital IT expanded its current BYOD initiative to allow patients and their guests to use their own personal mobile devices on the guest access services network. Patients and guests are able to surf the Internet for news, information and entertainment while in patient rooms, patient treatment areas and other common areas around the hospital for free as long as they agree to the terms and conditions of use on the HFHS initial guest splash page. Bring Your Own Device (BYOD) Initiative Enable Clinical Transformation White Paper 6

7 Customer Story: Western Maryland Regional Medical Center Western Maryland Regional Medical Center (Cumberland, MD) is not-for-profit regional hospital with 275-licensed beds providing a wide-range of medical services for patients living in the tri-state area of Maryland, West Virginia and Pennsylvania. In 2009, hospital IT deployed a secure, reliable, and scalable enterprise-class wireless network from Extreme Networks to support a wide-range of mission- and life critical wireless computing, communications and monitoring applications to address the needs of hospital workers as well as patients and their visitors. Comprehensive wireless assessment. Siemens Managed Services conducted a comprehensive wireless assessment of the facility to understand how radio frequency signals propagated from room-to-room and floor-to-floor. The wireless network was designed providing more than 575,000 square feet of coverage with adequate bandwidth, capacity and signal strength to ensure continuous device connectivity throughout the 7-story building. Physician BYOD program. Hospital IT initiated a physician BYOD program to improve access to patient information and increase physician satisfaction. Approximately 120 hospital-based and affiliated physicians are allowed to use their personal mobile devices on a dedicated virtual LAN to access patient medical records stored within the Meditech EMR, view radiological images stored within the PAC system and record patient document using cloud-based version of Nuance s Dragon natural language speech recognition. Desktop virtualization tools from Citrix ensured that no patient health information is stored on physician devices. Mobile Medication Carts. Hospital IT deployed 91 mobile medication carts from Stinger to streamline nursing workflow and enhance patient safety. Mobile medication carts are wirelessly enabled computers-on-wheels (COWS) with locked medication drawers and an integrated bar code scanner. These carts allow nurses to retrieve all their patient s medications (for a single dosing period), place them into individually labeled medication drawers and bring them to the patient s bedside for administration. An integrated bar code scanner ensures the five rights of medication management: right patient, right time, right medication, right dose and right route. There are also 50 more carts used to do part of the BMV process and documentation. Stinger carts have interchangeable batteries and WMHS is able to monitor the batteries via the Wi-Fi. VOIP communications. Hospital IT deployed more than 500 Ascom VoIP phones to enhance communication, collaboration and care coordination between and among nurses, care team members and patients. VoIP phones were also integrated with the patient bedside alarm. If the patient prematurely exits their bed, the alarm system sends a text-based notification to the nurse s phone. Wi-Fi-based telemetry monitoring. Hospital IT has deployed 49 Wi-Fi-enabled medical telemetry devices from Spacelabs on the hospital s WLAN to continuously monitor the condition and status of high-risk telemetry patients. With Wi-Fi-enabled monitoring, patients are no longer restricted to a hospital bed or a telemetry unit and can freely roam around the hospital. IV Pumps. Hospital IT has deployed 469 Bbraun IV pumps. These pumps connect to Wi-Fi to receive drug library updates and report patient and drip rates back to a proprietary system. This saves Biomed and Pharmacy staff time because traditionally Biomed had to collect each pump and manually update the drug library. Also when reviewing patients treatment, BMV allows caregivers to see the drug and the IV pump software shows the delivery rate. Patient BYOD. Hospital IT has initiated a patient BYOD program to increase patient satisfaction. Patients, family members and visitors can use their personal devices on the free guest access services network to surf the Internet to access news, information and entertainment. Patient BYOD has helped increase The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAPHS) scores. Approximately 300 patients, guests and visitors are using the guest access services network on a daily basis. In the future, Western Maryland Regional Medical Center plans to use the Wi-Fi network to support video conferencing. Bring Your Own Device (BYOD) Initiative Enable Clinical Transformation White Paper 7

8 Conclusion Physician Bring Your Own Device (BYOD) initiatives enable clinical transformation by allowing hospital-based and affiliated physicians to use their personal mobile devices on the hospital s WLAN to access patient information and to communicate with colleagues, care team members and patients regardless of their physical location. Mobile solutions enhance their communications, streamline their workflow processes and increase their overall satisfaction because they are no longer dependent upon a desktop computer or fixed location telephone. BYOD initiatives require hospital IT to define comprehensive enterprise-wide policies and procedures for personal device usage on the hospital WLAN. Physicians must understand what mobile devices and applications may be used, and how their devices must be secured to protect patient information and ensure regulatory compliance. BYOD initiatives require hospital IT to make investments in nextgeneration network management solutions that can Provide a highly-reliable, scalable and ubiquitous infrastructure: Uptime availability of % ensures that physicians can access critical patient information and can communicate with colleagues and care team members, especially during emergency situations. A highly-scalable architecture enables hospital IT to support hundreds, if not thousands, of additional mobile computers and other Wi-Fienabled devices on the hospital s WLAN. Protect patient information and the hospital network: Network access-control tools ensure physicians have access to the right information at the right time based upon their digital identity. Device-enabled password protection and data encryption can protect patient information stored on a lost or stolen device. Device security software can help prevent mobile devices from introducing malicious attacks, malware or viruses to the hospital s WLAN. Accessing clinical information systems through a virtual desktop interface (VDI) ensures that patient information is not stored on the device to avoid a potential security breach. Deliver guaranteed Quality of Service: Network administration tools enable hospital IT to set traffic rules, limit bandwidth and prioritize network flow for specific users, devices and applications ensuring optimal and predictable network performance. Remotely provision, manage and monitor mobile computers: Auto self-provisioning tools simplify network management and reduce network administration costs. A centralized management console can quickly identify and isolate trouble areas by user, device type, operating system, application and location. For Additional Information Gregg Malkary, Managing Director Spyglass Consulting Group Menlo Park, CA Phone Extreme Networks, Inc. All rights reserved. Extreme Networks and the Extreme Networks logo are trademarks or registered trademarks of Extreme Networks, Inc. in the United States and/or other countries. All other names are the property of their respective owners. For additional information on Extreme Networks Trademarks please see Specifications and product availability are subject to change without notice Bring Your Own Device (BYOD) Initiative Enable Clinical Transformation White Paper 8