Is The Day of the Password going Away ?

Although Microsoft is one of the most-attacked companies globally, the company allows 90 percent of its employees to log on to the corporate network without a password, according to CNBC.

Microsoft is not the only company looking to leave passwords in 2019. Google is testing alternatives to passwords along with Cisco.

Microsoft's Chief Security Officer Bret Arsenault called this a reflection on the "password less future" the company has been talking about for years. To eliminate the need for passwords, Microsoft has developed products to remove the need to memorize a string of confusing terms and phrases.

Rather, the technology company has employees choose between different options, including Windows Hello and the Authenticator app, which provides alternatives for logging into a computer network, such as facial recognition and fingerprints, CNBC reports.  Windows Hello addresses the following problems with passwords:

Strong passwords can be difficult to remember, and users often reuse passwords on multiple sites.
Server breaches can expose symmetric network credentials (passwords).
Passwords are subject to replay attacks.
Users can inadvertently expose their passwords due to phishing attacks.

In a survey some time ago the amount of time revealed primary care doctors spending 6 hours daily on EHR data entry. The study determined providers spend over half the workday on EHR data entry.

The advantage of SSO (single sign-on) is easily calculated.

Single sign-on (SSO) is a technology intended to facilitate easier and faster use of EHRs and other clinical information technology applications.

Single sign-on utilizes authentication to increase information security, but quantitative evaluation of its financial value to health care institutions has not been reported.

This study of SSO implementation in 6 general hospitals found meaningful time savings of 1461.2 hours per facility per annum for physicians, nurses and ancillary end users of clinical information technology.

These time savings translate into a substantial recurrent financial return from SSO implementation, estimated at $92,146 per facility per year, and $1,658,745 per annum in our first phase implementation of 18 hospitals.

Migration to a thin client as part of SSO implementation also yielded a substantial financial return on investment.

Implementation of computer workstation single sign-on (SSO) in 2015. SSO technology utilizes a badge reader placed at each workstation where clinicians swipe or “tap” their identification badges.

This model incorporates the CAC reader into the keyboard itself (right upper left)





There are a variety of other iterations: The CAC (computer access card) may also contain other identifying features, such as photo and/or fingerprint. The SSO card can be multifunction with designated zone controls, such as ED, O.R. I.C.U.  The card can also be used as a time stamp identifying time logged in or location control.

Objective
To assess the impact of SSO implementation in reducing clinician time logging in to various clinical software programs, and in financial savings from migrating to a thin client that enabled replacement of traditional hard drive computer workstations.

Methods
Following the implementation of SSO, a total of 65,202 logins were sampled systematically during a 7 day period among 2256 active clinical end users for time saved in 6 facilities when compared to pre-implementation. Dollar values were assigned to the time saved by 3 groups of clinical end users: physicians, nurses and ancillary service providers.

Results
The reduction of total clinician log in time over the 7 day period showed a net gain of 168.3 h per week of clinician time – 28.1 h (2.3 shifts) per facility per week. Annualized, 1461.2 h of mixed physician and nursing time is liberated per facility per annum (121.8 shifts of 12 h per year). The annual dollar cost savings of this reduction of time expended logging in is $92,146 per hospital per annum and $1,658,745 per annum in the first phase implementation of 18 hospitals. Computer hardware equipment savings due to desktop virtualization increases annual savings to $2,333,745. Qualitative value contributions to clinician satisfaction, reduction in staff turnover, facilitation of adoption of EHR applications, and other benefits of SSO are discussed.

Conclusions

The studies document series cost impact of wasted time for logins. It eliminates the overuse of the same password for different programs.

Military and VA hospitals and the DOD AMEDD system have used this method for many years. It would be an easy and cost-effective solution to eliminate wasted times. The SSO can also require an additional step for 2 step authentication and/or an additional password for added security

Why Microsoft is saying goodbye to passwords:

Central Illinois HIE Shuts Down

Members tell CIHIE that services were becoming ‘duplicative’ of what their health IT vendors offer

DAVID RATHS

 APRIL 29, 2019

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What is the forecast for the half-life of Health Information Exchanges?  The playing field has changed substantially since the onset of the electronic health record.  What does the future for HIEs portend?  Will they disappear? The intent of the ONCIT to force EHR vendors to build systems that were interoperable appears to have worked.  HIEs are no longer necessary for disparate electronic health records to communicate with each other.

Some public health information exchanges continue to struggle with sustainability. The Communities of Illinois Health Information Exchange (CIHIE) stopped providing services in February, saying that health system members told the HIE that their investment in CIHIE was becoming “duplicative.”

Originally established in 2009 as a nonprofit collaborative and formerly called the Central Illinois Health Information Exchange, the CIHIE grew to include 73 hospitals, more than 375 primary care and specialty clinics, an emergency transport provider, as well as more than 70 long-term care facilities, home health agencies and other ancillary healthcare settings. Authorized healthcare providers had secure access to more than 5.5 million patient records in 20 counties in the Peoria, Bloomington, Champaign and Decatur areas.

The organization did not return a message seeking comment, but in an explanation on its website, CIHIE said it still believes that timely access to patient records minimizes wait time for treatment, reduces costly duplication of services and supports safer care. “However, healthcare looks different today than it did when we began in 2009. There are now viable alternatives to exchanging data that did not exist when CIHIE was formed.”

CIHIE said that in 2009, as it was conceptualized around a conference room table, even hospitals located in the same community weren’t sharing records across organizational boundaries. There were many different vendors in the market and not enough uniformity to make electronic exchange possible. Fax, mail, and hand-delivery were required to get records from one place to another and many physician practices were still on paper.

CIHIE said these limiting factors are no longer true. “Federal investments in policymaking, vendor certifications, and incentive funding have shifted the market. Software vendors now recognize the importance of making data more portable and less proprietary.”

As CIHIE’s participating organizations have assessed the capabilities that now exist with their own vendors, they told the HIE that their investment in CIHIE was becoming duplicative. “Our board has listened to these concerns and believes the responsible action is to cease services so that there is no longer a financial requirement being placed on organizations to support an independent exchange.” Perhaps the health system members are all using the same EHR vendor and so are sharing patient data that way. 

CIHIE said it has provided participants with information about other ways to connect with healthcare exchange services, noting that there may be resources available through their own software vendor, through the state, or through national exchanges.

The closure of the CHIE and perhaps other Health Information Exchanges may impact other non-providers such as health plans, pharmacies, worker compensation plans. They are often granted access to EHR data through a Health Information Exchange. There are also legal issues since anyone using an HIE have business associate agreements with the HIE. Will direct EHR-EHR interoperability require legal business associate agreements?

Even though regional health information exchanges exist many providers chose to not use them for a variety of reasons.  Lack of interest may also have contributed to closure of an HIE.

Are EHRs truly ready for the changes ?

Inevitably each regional HIE disbandment will require specific instructions to maintain EHR connectivity for provider-hospital-provider medical records.

Humana and Doctor on Demand Launch Virtual Primary Care Plan to Bring More Services with Lower Costs to Patients, Insurers, and Employers |

Doctor On Demand® and Humana Inc. (NYSE: HUM) today announced the launch of On Hand™, an innovative and affordable health plan that centers on comprehensive care.

Many health insurers and integrated health plans are not waiting for patients or providers to adopt telemedicine platforms.  Health Plans such as Humana and others have established telehealth presence, adopting their own platforms.  They have discovered the cost savings reducing clinic visits, early treatment with easy accessibility.  The time and cost factor for most patients can involve a half or even a whole day investment. Office visits have a copay of $0 and a copay of $5 for labs.

Health insurer Humana and virtual care provider Doctor On Demand has announced the launch of On Hand, an innovative and affordable health plan that centers on comprehensive virtual primary care for members. On Hand addresses the number one reason small businesses don’t offer health insurance– cost — by offering a plan 50% lower than the industry standard monthly premiums.

The platform allows a potential patient to sign up, find a primary care physician, make an appointment and have a virtual visit from home, work or wherever from a desktop, smartphone or tablet PC.  All fees are fully disclosed.  Some insurance plans are already integrated into the Doctor on Demand Platform, and the platform allows you to search for your plan.

On Hand Primary Care Plan Overview

Employers and members who elect this primary care plan will gain access to a breadth of in-network virtual care services, as well as an expanded clinical care team to help navigate the healthcare system. Patients will have one dedicated primary care physician and access to preventive care, urgent care and behavioral health— all through video visits. On Hand will provide patients with a standard medical device kit consisting of a digital blood pressure cuff, thermometer, and log

“Patients will also get access to their digital health records, secure messaging and have more control over how they are shared. If needed, patients will receive doctor or specialist referrals for in-person visits that stay within Humana’s network, all supported by the clinical care team to help seamlessly coordinate continued care.

Humana and Doctor on Demand Launch Virtual Primary Care Plan to Bring More Services with Lower Costs to Patients, Insurers, and Employers | Business Wire:

Best Buy, Target jump into at-home medical device market |

FDA Cleared and Reviewed*


Remote medical monitoring is reaching the consumer market at retail businesses such as Target, and Best Buy.  This is a major development for consumers.  This development opens a door for promotion, education and also competitive pricing for such devices.  Remote medical monitors are no longer a niche in health information technology, Best Buy and Target signal the beginning of a new age.  These devices will soon appear on the shelves in the health section or pharmacy alongside thermometers, blood pressure, and glucose monitors.

It simplifies the provider's direction for patients as to how to obtain a device. FDA approved, it does not require a prescription. A consumer can purchase a device on impulse.  However, a patient should consult with their physician to see if he approves and has access to reading the results.

Tyto's Remote Monitor

What's Included

A TytoHome telehealth visit is $59, possibly less if health insurance covers medical phone consultations, the company said. Tyto Care works with LiveHealth Online, which is an offer for those who buy the devices at BestBuy.com and live outside of current coverage areas. Otherwise, the company is partnering with regional healthcare systems to provide medical care to consumers throughout the country, according to the release. That includes the not-for-profit healthcare system Sanford Health for users in Minnesota, North Dakota, and South Dakota.

No matter what monitor you chose, it is only part of a system.  The remote monitor must be integrated as a one end-to another, the clinicians' office.  It requires a secure reliable network, either by cellphone or internet connection. Optimally it should integrate with the electronic health record to capture the images and the voice content. As part of the integrated electronic health record, it must be interoperable in accordance with ONCHIT guidelines.

Tyto monitor is cloud-based. If there are no local providers Tyto provides a network of qualified telemedicine providers that will help you until you are able to see your personal physician.

Telemedicine is growing exponentially and the latest availability should be checked out by telephone with Tytos.

Be wary of any telehealth provider, and use due diligence.

This article is neither a recommendation or testimonial for Tyco.  It is provided only as an informative service


FDA Cleared and Reviewed*







Best Buy, Target jump into at-home medical device market | Healthcare Dive: TytoHome