Evaluation of a proximity card authentication system for health care settings.
BACKGROUND
Multiple users access computer workstations in busy clinical settings, requiring many logins throughout the day as users switch from one computer to another. This can lead to workflow inefficiencies as well as security concerns resulting from users sharing login sessions to save time. Proximity cards and readers have the potential to improve efficiency and security by allowing users to access clinical workstations simply by bringing the card near the reader, without the need for manual entry of a username and password.


OBJECTIVE
To assess the perceived impact of proximity cards and readers for rapid user authentication to clinical workstations in the setting of an existing electronic health record with single sign-on software already installed.


METHODS
Questionnaires were administered to clinical faculty and staff five months before and three months after the installation of proximity card readers in an inpatient birthing center and an outpatient obstetrics clinic. Open-ended feedback was also collected and qualitatively analyzed.


RESULTS
There were 71 and 33 responses to the pre- and post-implementation surveys, respectively. There was a significant increase in the perceived speed of login with the proximity cards, and a significant decrease in the self-reported occurrence of shared login sessions between users. Feedback regarding the system was mostly positive, although several caveats were noted, including minimal benefit when used with an obstetric application that did not support single sign-on.


CONCLUSIONS
Proximity cards and readers, along with single sign-on software, have the potential to enhance workflow efficiency by allowing for faster login times and diminish security concerns by reducing shared logins on clinical workstations. The positive feedback was used by our health system leadership to support the expanded implementation of the proximity card readers throughout the clinical setting.
School of Information, University of Michigan, Ann Arbor, MI, USA.
Jacqueline
J
Fontaine
School of Information, University of Michigan, Ann Arbor, MI, USA; Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
Kai
K
Zheng
Department of Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI, USA.
Cosmas
C
Van De Ven
Department of Systems Science and Industrial Engineering, Binghamton University, Binghamton, NY, USA.
Huiyang
H
Li
Medical Center Information Technology, University of Michigan Health System, Ann Arbor, MI, USA.
James
J
Hiner
Medical Center Information Technology, University of Michigan Health System, Ann Arbor, MI, USA.
Kathy
K
Mitchell
Medical Center Information Technology, University of Michigan Health System, Ann Arbor, MI, USA.
Stephen
S
Gendler
Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA; School of Information, University of Michigan, Ann Arbor, MI, USA. Electronic address: hanauer@umich.edu.
David A
DA
Hanauer
D001291:Attitude of Health Personnel; D016494:Computer Security / Q000295:instrumentation*; D016288:Computer Terminals; D003219:Confidentiality; D057286:Electronic Health Records / Q000295:instrumentation*; D006751:Hospital Information Systems; D006801:Humans; D011795:Surveys and Questionnaires; D014584:User-Computer Interface
Attitude of health personnel; Computer security; Hospital information systems; Medical records systems, computerized; Workflow