We go to the bank and use an ATM to get cash or make a deposit. We arrive at the airport and check in for our flight using a kiosk. But we go to our doctor or local hospital and we get a clipboard, pencil, and several pages of forms to fill out. Worse yet, we move to a different department in the same institution and it’s likely we’ll be asked to fill those forms all over again. It doesn’t have to be that way.

-How Progressive Healthcare Organizations Are Using Patient Self-Service Kiosks and Devices

Amen!!

We are doing this with the patient health history and it is great. There are still some major enhancements that need to be made in how that data becomes part of the patient’s medical record, but it is so much better than paper. I think we’re getting close to having the signature done at the kiosk. The technology is there. Kiosk check-in really revolutionizes what happens at patient check in. The next step for us is to be able to check in patients at the kiosk without going to the front desk. In fact, once the magnetic card readers are here, patients will be able to check in with the swipe of their ID card.

I’ve recently been working with a doctor who is starting a brand new office in May. He has asked for some help in selecting an EMR, choosing computer hardware and he even mentioned creating a website for his new clinic. You’ll be seeing the results of my labors posted in my EMR Implementation Ideas and EMR Features which has been transgressed since I started my EMR and HIPAA blog.

I’ve created a lot of different websites in the past. However, I wasn’t sure what I should include in a new clinical website. Sure, I could put the basic hours, contact us, about us information. I also know there are a lot of things that could be done with a patient health portal. However, that really depends on which EMR is chosen and not what I was asked to build.

I found a post that talks a little about what could be done with a clinical website:

A good website can be a great benefit to your practice and deserves consideration. Your practice’s website, if constructed carefully, can bring you operational efficiencies, financial gains and improvements in quality of care and documentation without the high cost and difficulty of transition that EMRs involve. If the physicians in your practice are technology-shy, starting with an interactive website can help them become comfortable with IT.

Many physicians have a limited idea of the value of a practice website. They think of it as a resource for information about the practice such as locations, physicians, services that you provide, and contact information. A website that contains this important information is a good start. By adding HIPAA-compliant interactive features that allow patients to communicate directly with your practice, you can do even more. Examples of such features are pre-registration pages that collect patient demographic information prior to a visit and verify insurance information prior to the appointment, features that allow existing patients to request appointments and/or prescription renewals, on-line bill paying, and provision of on-line advice to existing patients.

This definitely points to the need of a patient portal, but it looks like there is definitely some value in a clinical website. I think the thing that this post missed was a doctor’s blog on healthy living and links to other patient education that would be beneficial. I think this would definitely set you apart form other doctors in the area.

Someone recently referred to me as a technical writer which really caught me off guard. I’ve always hated english and pretty much any writing assignment that was given me. However, I can write on this blog or on other forums for hours and not even bat an eye. Not sure what that really means.

This new found interest in writing left me very interested in an blog post by Neil Versel about Healthcare Journalist’s lack of interest in Healthcare IT. Here’s an excerpt:

Given the fact that conference registration was close to 350 and that there were only four other sessions going on at the time, I was disappointed. Health correspondents from metropolitan daily papers mostly stayed away. This tells me that the average health correspondent does not understand the significance of IT, even though the session was entitled, “IT: Its promise for changing health care.” Reporters continue to write about how the American health system is broken, but they ignore one of the most obvious cures.

I don’t think this is unique to Healthcare. In fact, I think journalists are becoming so sensationalized that they often worry more about the story than reporting. I think that’s why blogs are so refreshing.

The New York Times had a recent article casted some needed reality on what could still happen even with an EMR system. I think it is good to offer a nice dose of reality to those wanting to implement an EMR. EMR consultant will often tell you that you can make more money, treat patients more effectively and have it brew your coffee. While this can be the case(except for probably the coffee), there is always two possible outcomes for every decision. EMR is a complex decision that depends on thousands of factors. Miss an important one and you might be in trouble. Ok, now I’ll get off my EMR selection bandwagon.

The research and AMA editorial really puts an interesting perspective on how an EMR can cause bad side effects. A few examples they use is the number of screens needed to get to a prescription, the small print used for names, and system outages. I can see how these things could be concerns. However, there are solutions to these problem. The success of failure of an EMR system is more a matter of perspective than anything else. I personally feel that my implementation of an EMR system is somewhat of a failure because it doesn’t solve ALL of a clinic’s problems. The other day someone was touring our facility and they asked the Health Center director her opinion on the implementation of the EMR. She was very satisfied and very happy with EMR. That made me feel really good. I guess I can look at the EMR and know we are doing our very best with what I was given. How satisfying is that? Fantastic!!

Moral of the Story: Don’t be naive that ALL problems will be solved and an EMR won’t cause any new problems. Progress is defined as solving more problems than you create.

eHealth Initiative Launches Interactive Application
This eHealth Initiative looks like it has some pretty good promise. I espescially like the statistics given at the beginning about the effect that EMR and Healthcare IT could have on the healthcare expense throughout the nation. I expect to see a lot more of these Healthcare initiatives to come out of the woodwork.

Electronic Health Records and the Future of Automated Smart Communications
Smart communications is a great concept in EMR and EHRs. EMR vendors better make sure they integrate this. I see this as a possibly defining characteristic for EMR vendors trying to differentiate themselves.

I briefly mentioned Face Authentication in a previous post. As a result of that post the vendor from Sensible Vision contacted me and got me a demo model right away. I must admit that their service was impeccable. All the way up the scale I’ve been impressed with the company and all I did was a demo.

Today they issued pricing on their FastAccess product that is very reasonable compared to other biometric devices. I’ve attached the release below and here’s a short review of the product with certainly more details to come as I continue to use it.

Setup
Setting up the FastAccess was a piece of cake. I got the box with only 15 minutes before I had to be somewhere. I unboxed the product, read the instructions(yes I always feel I must read the instructions on new products) and installed it on my computer. In 15 minutes I had it recognize my face and automatically log me in. The other nice part is that the set was really nothing but plug the camera in and run the CD install file. On restart it starts learning who you are when you log in. Couldn’t have been simpler. I repeated this process on my laptop so I could show my wife and had it set up in 5 minutes(booting my computer took longer than setup).

Facial Recognition/Training
Training facial recognition is much different than other biometrics. Fingerprint biometrics requires you to “train” it to know your fingerprint. Facial recognition(at least with FastAccess) is continually updating every time you login. In fact, it stores 90-100 different biometric “faces” that identify you. The biggest fault with this model is that initially the recognition is poorer than fingerprint recognition. However, with time I’ve seen that it actually is more reliable and recognizes you quicker than fingerprint. Not to mention it recognizes you just coming into view. No need to reach and hold your finger or eye to something. The lazy part of me loves that.

Active Directory Integration
FastAccess has very nice integration with active directory. The best part is that they have two methods of implementing active directory integration. First, they can extend the active directory schema. While this is a common practice, it is difficult to convince my system administrator to do since it can’t be rolled back if we decide we don’t want to do it anymore. Second, FastAccess can be implemented using existing active directory fields. This means that you can test the active directory implementation without extending the schema. I plan on doing this in the near future and you can expect a review of it soon.

Strong Audit Controls
Looking over the audit logs they are pretty standard for what you would need to satisfy HIPAA. Having active directory manage this type of audit control would be key to me.

Continuous Security
The biggest advantage to facial recognition is that it is continuously verifying your access. My biggest problem with fingerprint biometrics had to do with not having a way to easily lock the workstation. Facial recognition biometrics is constantly monitoring to see you are the authorized person. If you leave then it locks the computer. This really changes the way you deal with authentication since it can create a true single sign on.

Security Screen Capture
This idea is inegnious. Since you have a camera you might as well capture a picture of the person that was signed on to a machine. Imagine them saying they didn’t log in and you can show them the picture taken when they did log in. Fantastic!! There is also talk of using this technology as a digital signature. I’d love that with my EMR.

Pictures and Twins
I tried to see what I could do to fool the camera and nothing really worked. I imagine this is theoretically possible, but it would have to be a picture in the exact same place as the biometric match. FastAccess tells me that they add in environmental variables(such as light) which makes it much more difficult to fool. So far so good. The idea of twins is addressed in the documentation. I’ll be testing it on my wife and her twin sister to see how that goes. Sometimes it freaks me out how much they look alike.

Accuracy
In an EMR or healthcare environment FastAccess has designed it properly. Sometimes it didn’t recognize me and so it required me to enter my password and then after logging in, it stores another biometric image. While this could be annoying to some doctors, I see this as an essential key to proper authentication.

Instant Desktop Switching
This seems like it is a somewhat new module being developed by Sensible Vision. The idea is that multiple people can log in to the same account and have a different desktop. This currently works espescially well with Internet Explorer and a few other selected applications. I imagine this list will grow over time. They offered to make it work for my favorite apps. One interesting note is that they have it working for Cerner’s EMR. I’ll be having them develop it for Medicat EMR(my EMR)

Random Points
Since FastAccess is constantly checking for facial recognition, when you answer the phone that changes what your face looks like. This isn’t really a problem since they store 90-100 different biometric “prints”. You just have to “train” it to know what you look like with a phone in hand.

One nice feature is that you can turn off continuous facial recognition when you have a presentation. It lets you disable the recognition for a specified period of time. It also recognizes any keyboard or mouse input and disables locking when it sees either.

Here’s the Press Release:
Sensible Vision Innovates Biometric Facial Recognition for Continuous Computer Access Control and Authentication

FastAccess Virtually Eliminates Passwords, Makes Computer Easier to Use and Ensures Privacy Compliance and Identity Management

Introductory Pricing of $99 per Desktop License

Covert, Michigan, April 3, 2006 – Sensible Vision, an innovator of continuous authentication solutions, today revolutionized computer access control and authentication by replacing a user’s password with their face. Sensible Vision’s FastAccess™ is a powerful yet simple solution that uses patent-pending biometric facial recognition to automatically and continuously authenticate user log-in and instantly secure the computer when the user leaves. This virtually eliminates login passwords, makes the computer significantly more secure and easier to use, and strengthens access control auditing for privacy and identity management policies.

“Because a person’s face is unique and always with them, it is ultimately the ideal password and the best way of continuously ensuring who is accessing the computer,” said George Brostoff, CEO of Sensible Vision. “This is a new paradigm for secure and simplified computer access that goes well beyond initial log-in and inactivity timers. FastAccess identifies and authenticates users in less time than it takes to enter a password and knows the second they leave their computers. These breakthroughs make it a simple, secure and low-cost approach for securing the computer and network.”

Read more…

The Healthcare blogposium is all set to go on April 18-19. This should be an interesting experience.

The Objective: to help flesh out The Clinical Informatics Wiki started by Dean Sittig with a dozen or more new entries, so that this wikipedia-like resource will become more useful for all.

You can find more info on the event at HealthNex

Now I just have to decide the topic I want to take. Something definitely EMR related, but I’ve really liked biometrics lately. Maybe I’ll have to do biometrics and EMR. Any other thoughts?

Shahid over at HealthCare IT Guy pointed me to a good whitepaper done by iHealthReports called Open Source Primer for Healthcare(warning: pdf file).

I think this whitepaper couldn’t have been more timely. Anyone whose read this EMR and HIPAA blog knows I love the statistics of this website as much as the posting itself (which really says something since I love posting). Free EMR has to be the biggest search term I get on this website (HIPAA Lawsuits may be the only exception, but I think those numbers are inflated because of technorati’s referral method)

Either way, everyone wants to know about Free EMR offerings and many open source EMR programs make you think it is free. I can tell you now that open source doesn’t always mean free. In fact, most open source EMR projects still have many costs in support, implementation, enhancements, etc etc etc. However, there are some other important advantages to open source EMR projects. The white paper does a good job helping figure out what open source means in healthcare. Take a look and let me know what you think.