Easing hospitalist electronic health record burden through clinical workstation single sign-on

Abstract

Background: Computer workstation single sign-on (SSO) was implemented in 19 hospitals to reduce manual keyboard login and expedite access to the electronic health record (EHR) and clinical applications. Objective: To quantify hospitalists time liberated from EHR keyboard to focus on patient care, and estimate financial value of this time for hospitalists. Methods: Login duration prior to and after SSO implementation were compared in eight hospitals. Using national estimates of hospitalist hourly wage, dollar values of time liberated from keyboard were calculated, stratified by different levels of total EHR use. Results: Following SSO implementation, first of shift login decreased 5.3 seconds (15.3%), and reconnect duration decreased 20.4 seconds (69.9%). The volume of hospitalist EHR use among all physician end users comprises 70%-90% of all electronic documentation and clinical orders issued, yielding an annual range of 10,302 hours (or 858.5 12-hour shifts) to 13,245 hours (or 1,103.8 12-hour shifts) in hospitalist time liberated from keyboard for patient care, with recurrent annual value of $1,164,126 to $1,496,685. Conclusions: Hospitalists gained meaningful amounts of time for patient care from SSO implementation. This time accrued to substantial financial value. SSO eases the EHR burden of hospitalists, and facilities using hospitalists extensively should consider SSO implementation.