South Warwickshire authorises shared smartcard use

South Warwickshire General Hospitals NHS Trust has confirmed that its board has agreed that clinicians working in part of its A&E Department can share smartcards to access patient records.

The trust passed the policy after deciding that the lengthy log-in times, averaging 60-90 seconds, it takes staff to log-on to the hospital’s new patient administration system (PAS) every time they use it was not acceptable in a busy A&E environment.

South Warwickshire’s new iSoft iPM PAS, which is connected to a national data spine, has been supplied by Computer Sciences Corporation as part of the NHS National Programme for IT (NPFIT) modernisation programme. Reports of lengthy log-ins have also reported from other trusts that have received NPfIT systems connected to the spine.

Following implementation of their new iPM Patient Administration System by CSC in December, the trust’s board allowed clinicians in A&E to share smartcards due to the lengthy login times for the new PAS.

A spokesperson for the trust told EHI: “Count the time in your head and think of all the patients in A&E, 60 – 90 seconds is a long time.”

The trust told E-Health Insider that they are not breaking guidelines laid out in the National Care Records Service Acceptable use Policy as section 5.8 allowed for team/group working practices within A&E.

In a statement, the trust said: “South Warwickshire General Hospitals NHS Trust confirm that the two computers used solely by clinicians and positioned in a secure area in our A&E department are not accessible by anyone other than clinical staff in A&E. We would like to reiterate that this is a unique arrangement made for a specific purpose and that smart cards are used by single individuals in all other areas in the trust

In a January report to the trust’s board, acting director of Information Technology, Duncan Robinson said that the and the PCs concerned were predominantly used for the look-up of diagnostic results, which did not require the use of a smartcard as these clinical functions are carried out by non-NPfIT systems.

He added: “Having consulted with A&E directly, and also with the IT helpdesk to confirm no incidents had been logged relating either to shared smartcards or PCs staying logged into new PAS while unattended. I am able to confirm the shared smartcard approach has worked successfully within the identified clinical areas.”

A spokesperson for the British Medical Association commented: “We would not support the sharing of smartcards by NHS staff accessing computerised patient records. Sharing access not only puts at risk the security of the system but also disrupts the audit trail which tracks who has accessed parts of the record.”

However Dr Jeremy Harrison, A&E Consultant at Warwick Hospital said: “This arrangement means that precious time is saved in a very busy area, ensuring that we treat our patients as efficiently as possible. This one very specific and time limited arrangement contributes to our team approach to patient care.”

The trust said that it would review arrangements if log-in times were reduced "We have implemented the latest hardware and software in readiness for the Connecting for Health planned improvements in log on times, at which point we will review this one arrangement.”

Connecting for Health says that it has commissioned software upgrades that will eventually significantly reduce log-in times.