The government has recently announced that a £40m fund will be used to help reduce logon times across the NHS. For me, having worked exclusively with NHS organisations for the last 7+ years, this comes as no surprise. “Logon times” is most likely the #1 IT problem that plagues NHS staff every day and there is no doubt this funding will deliver improvements – if it is invested in the right way.
Logon Time can be Subjective
My experience has shown the term ‘logon time’ is a subjective one. For clinicians who only care about access to their clinical systems and information as quickly as possible, this can be the total time from pressing the power button on the workstation all the way through to viewing the required patient record. To the IT department this can sometimes mean simply the Windows logon process itself.
In the past some IT departments have responded by continuously throwing new PCs at the problem, not fully understanding that the problem is much wider than the individual performance of the unit, and low and behold the same problems persist.
“It is frankly ridiculous how much time our doctors and nurses waste logging on to multiple systems. Too often outdated technology slows down and frustrates staff.” Matt Hancock, Health Secretary
Regardless of the opinion or the term ‘Logon time’ there are 5 fundamental steps between the clinician and the information they require:
- Power on the workstation
- Logon to Windows
- Load clinical system(s)
- Logon to clinical system(s)
- Locate the appropriate clinical record
Each step must be streamlined and continuously monitored in order to provide staff with the right platform to provide efficient and safe patient care.
How can Logon Times be Improved?
Key to delivering improvements is getting visibility into the extent of the problem across each step, eliminating the hear-say and anecdotes from users and instead working with real, insightful data. This should go wider than just workstation performance to include statistics from the service desk, such as how long it takes to reset a user’s password from the time they call to the time they can logon to Windows and their clinical systems, as well as any trends that are having a negative impact on overall system performance.
The next step is to assess the wider aspects of the environment that can have a massive impact on the ‘logon time’ and building (and executing against) a remediation plan to help resolve bottlenecks and inefficiencies within the infrastructure. Significant time can be chiselled off the logon time by implementing ‘quick win’ fixes (in a controlled way).
It’s not just about the Time to Logon
The second biggest (IT related) problem we see across our NHS customers is passwords, and the sheer number of different username and password combinations that are needed to access clinical (and non-clinical) systems. Whilst many NHS organisations have invested in single sign-on and password reset technology many have struggled when it comes to end-user adoption.
“NHS staff currently have to log in to multiple computer programmes when tending to a patient, with each programme requiring its own login details. Some staff need to log into as many as 15 different systems.” Department of Health and Social Care
As many frontline clinicians will logon to several different workstations during their shift these issues only compound, lead to greater frustrations which then encourage workarounds such as sharing passwords/sessions (a massive red flag for Information Governance and invalidating any digital audit trail). Such behaviours, despite being used with the best intentions also violate DSPT (Data Security and Protection Toolkit) and Cyber Essentials, something that every NHS organisation is striving towards before 2021.
How Best to Move Forward?
There are a variety of point solutions that can each help to improve the ‘logon time’ but a more holistic and long-term approach is needed. This can only be accomplished with a clinical-grade desktop platform that provides logon-times in seconds through the tap of a smartcard (in fast-moving areas), giving clinicians the ability to quickly move around from workstation to workstation with a desktop session that follows them – streamlining the clinical workflow.
The use of real-time analytics and custom dashboards that focus on what’s important to the overall user experience, and automation that immediately identifies near-breached thresholds and nips issues in the bud without any human intervention, are all key to delivering an excellent experience for clinicians.
Obtaining a holistic viewpoint of the desktop estate, applications and end-user requirements is an important step to take before wide scale improvements can be realised. Management and IT should look to gain a better understanding of the current state of their environment, allowing them to determine the suitability of the solutions that can help to resolve these issues.
Written by Craig Pickford, End User Computing Architect at Block
Block is an IT innovation business, offering expert consultancy, business transformation and managed services that help healthcare organisations to define and achieve their digital aspirations.
We combine our deep vertical insight with proven technical expertise, and work in partnership with our clients to deliver impactful, measurable and sustainable business change through technology.
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