Clinician Time Savings and Financial Value of Workstation Single Sign-On and Access Management in the United Kingdom and Ireland

Abstract

Background: Single sign-on and access management (SSO/AM) can improve clinician user efficiency and satisfaction by expediting login. The impact of SSO/AM has been quantified in the US and other valuable operational, clinical, and epidemiological utilities of SSO/AM have been described. The authors conducted the first non-US and largest analysis to evaluate the clinical workflow impact and financial value of SSO/AM implementation in the United Kingdom and Republic of Ireland through direct sampling and quantification of actual clinician login times pre- and post-implementation in eight health systems and 55 hospitals across four nations.

Methods: Login time duration before and after SSO/AM implementation was directly measured to determine and compare login durations. Financial value of clinician time freed from keyboard to care for patients was calculated using conservative national estimates of clinician hourly wages.

Results: SSO/AM impact and the financial value of clinician time freed from login across 55 participating hospitals was 54.1 million GBP (USD $68.7million)peryearrecurrent,or965,464GBP(US$ 1.2 million) per year per facility, derived from an average mean clinician annual time savings of 316 hours freed from keyboard typing. This time freed from keyboard typing can be used to focus on patient care delivery and improving throughput, while concurrently achieving and ensuring compliance with patient confidentiality and organizational cybersecurity imperatives. If the distribution of technology configurations, login workflows and workarounds deployed in the reported 55 hospitals are representative of the other eligible 307 facilities in these four nations, an additional 5.9 million 12-hour shifts of clinician time may be freed from keyboard typing annually, valued conservatively at GBP 0.86-1.16 billion (USD $1.09-$ 1.47 billion).

Conclusions: SSO/AM has been deployed successfully to accelerate and ease identity authentication and access to the EHR, clinical applications, and patient data in the United Kingdom and Ireland, where it supplants clinician manual keyboard login. Clinicians in the UK and Ireland benefit from increased time to provide patient care delivered by SSO/AM, and secure EHR/clinical application login workflows have been simplified and expedited.

Keywords: EHR workflow; clinical workstation cybersecurity; clinician EHR burnout; computer workstation login; patient personal health information confidentiality; single sign-on and access management.