Diagnosis: Security

Healthcare system balances security with efficiency

• By Sharon Steinhoff-Smith
• Dec 01, 2006

JUST as physicians recommend that their patients obtain treatment early before a condition worsens, Intermountain Healthcare (IHC) also is addressing the issue of security before problems occur. In addition to providing excellent outcomes for its patients, IHC is stepping forward to raise the bar for security systems by providing ID cards tied to access control systems.

Threats of terrorism and bioterrorism brought a new dimension to healthcare in the United States following 9/11, encouraging healthcare centers to enhance security systems and prevent unauthorized movement.

Threats of terrorism and bioterrorism brought a new dimension to healthcare in the United States following 9/11, encouraging healthcare centers to enhance security systems and prevent unauthorized movement. Healthcare workers still need freedom of access, especially in emergency situations, when they have to move quickly to access medication, equipment and supplies.

"When we put one more barrier in front of them, it becomes a huge dissatisfier," said Mike Rawson, director of safety, security and environmental health for IHC. "We want to provide ease of access, but at the same time, an increased level of security. It's a balancing act.

"In the past, hospitals have always created an open and welcoming atmosphere. As healthcare systems increase levels of security, they create additional inconvenience to patients, visitors and employees. In a system the size of Intermountain Healthcare, increased inconvenience can be a significant challenge to patient and employee relations."

Intermountain Healthcare began with 15 hospitals donated by the Church of Jesus Christ of Latter-day Saints in 1975. Today, it is an integrated system of physicians, health plans and 21 hospitals from Burley, Idaho, to St. George, Utah, with most of its facilities in the Salt Lake Valley. It strives to be a model healthcare system -- an example worthy of emulation by others -- not only in clinical outcomes, but also in cost efficiencies and operations. Its access card program is part of that plan.

Doing More with Less
ID cards are used throughout the hospital to serve two functions: visual identification and access control.

"We added proximity access control in all hospitals in 2006," Rawson said. "Before that, we used cards with a bar code for identification and payroll, along with a typical key system. Now, we have proximity access control throughout the entire system, using a Kronos time and attendance system with DSX, Continental and C-CURE access control software."

The cards allow employees to enter authorized areas, record time and attendance and provide visual identification for patients and visitors. Employees, licensed clinical practitioners, volunteers, students, vendors and even families of patients who experience an extended stay are issued cards with varying levels of access and security.

"We have used Fargo printers ever since we began printing cards," Rawson said. "Fargo was recommended by our access control system providers."

Today, IHC has 30 printers with direct-to-card technology. The printhead comes in direct contact with the card, producing sharp facial images and fine detail around area such as the eyes, enhancing the ability to make visual identifications.

"Some of our smaller, rural hospitals use Fargo's smaller Persona C30 printers," Rawson said, "as they may only make one or two cards a month."

Rawson was responsible for selecting the printer, assisted by representatives from human resources and security, where the printers reside. He knew he wanted double-sided printing with a speed component suitable for a large, interdisciplinary health system. He also knew the printer had to be reliable, but to anticipate any minor issues, he looked for a company with service technicians in Salt Lake Valley. Finally, he wanted strong, quality performance and clear printed cards.

"Mike liked the simplicity of the DTC printers," said Bob Barber, of Interstate Business Products, who sold the printers to IHC. "They are easy to clean and operate, and they run quietly."

A New Look
In January, IHC went through a rebranding, changing the spelling of its name and adopting a new logo. This required re-badging all 25,000 employees, 3,400 physicians on staff, 500 volunteers, 1,000 students (interns, residents and those on rotation), 300 vendors and others.

"We accomplished all of this within five months," Rawson said. "Only one hospital will still be waiting for an upgrade to a proximity system after this year."

Employees, physicians and volunteers at IHC now wear white horizontal badges that display their photo and name. There is one exception. Because of increased security surrounding the care of infants, clinical caregivers who transport infants wear bright, pink cards to identify themselves easily from a distance. A bar code on the back of employee and physician cards enables them to use the access control system for time and attendance and to record attendance at in-service and training meetings.

Students and instructors receive vertical badges with color-coded graphic designs that vary depending on the time of year. Vendors, visitors, contractors and temporary employees receive generic, vertical badges without any bar code or Intermountain logo. As an added security measure, vendor badges expire annually.

Upcoming Security Features
According to Rawson, Intermountain currently is evaluating a 3-D bar code for patient identification at some future point. The system would include a wrist band for the patient, allowing patients and clinicians to be identified easily and securely, while their activity is documented.

"We also continue to discuss the value of smart cards, and will add that technology when the need presents itself," Rawson said.

In the meantime, IHC has made tremendous strides in consolidating its identification cards and access control system.

"Clinicians with responsibilities and privileges at multiple hospitals drove the need for a single card," Rawson said. "They didn't want to carry half a dozen cards with them."

And to solve the problem of getting physician to wear ID cards, Intermountain turned to integration.

"We tied access control to the parking lots and dining rooms," Rawson said. "By wearing the identification card, physicians can easily access parking areas, entrances, elevators and dining areas.

"With today's printers, we can make an attractive ID card that individuals are proud to wear. Most people understand the need to be adequately identified to the patients they serve."

Rawson admits the real, quantifiable benefit will be down the road, when IHC recovers the upfront costs of the security system. There is no question that the decision to use ID cards for increased security has been a healthy investment.

"You can't do tomorrow's business with yesterday's equipment," Barber said.