Clinical impact and value of workstation single sign-on

- Single sign on (SSO) is an emerging 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 healthcare 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 translated 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 substantial financial return on investment.

BackgroundCHRISTUS Health began 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.ObjectiveTo 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.MethodsFollowing 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.ResultsThe reduction of total clinician login 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.ConclusionsSSO had a positive impact on clinician efficiency and productivity in the 6 hospitals evaluated, and is an effective and cost-effective method to liberate clinician time from repetitive and time consuming logins to clinical software applications.