Jetmobile

Secure printing for HIPPA-compliant patient care reports

Profile of the challenge

The institution: an American university hospital with four main hospital buildings covering an area of eight square city blocks on the hospital campus.  The hospital has 5,853 full-time employees, 131 fellows, 928 active medical staff, 932 licensed acute care beds, and 180 subacute and long-term care beds. Eighty nursing units provide clinical services to hospital's 1,100+ beds in the areas of perioperative, medical/surgical, ambulatory and critical care and they produce highly confidential patient care reports, detailing medications, diet, IVs, etc., that can contain hundreds of pages.  Depending on the nursing unit, new reports get printed on HP LaserJet 4100 and 4200 workgroup printers every one-to-four hours. Every four hours, all reports become obsolete, requiring output of a completely new set of reports-by patient and by nursing unit.  Each unit generates 10-12,000 output pages per day.

As the project manager explained, "We were spending a lot of resources for large volumes of volatile information. We needed better control of printed output because, with so many nursing units spread across four main hospital buildings, security is always an issue.  Although these printers are not in public access areas, they do store information that only authorized personnel should access."

Compliance to regulation was also a key issue for the hospital management.  All these documents fall under HIPAA and JCAHO compliance rules.  Both the Health Insurance Portability and Accountability Act of 1996 and the Joint Commission on Accreditation of Healthcare Organizations (the nation's predominant standards-setting and accrediting body in health care) set standards for the management of and access to patient health data stored or transmitted in electronic form.

Another issue to be tackled was downtime due to power outages and other emergencies. Patient care reports are stored in printers. When the hospital loses power, workers fall back on a paper system.  The project manager wanted to be able to deliver online information even during downtimes.

The SecureJet solution
To deal with these and other matters, the project manager evaluated the existing reporting process and turned to the SecureJet smart card printing solution (SecureJet Auth-SC) from Jetmobile.  The SecureJet Auth-SC printing solution consisted of:

• A software component (SecureJet solution and the appropriate driver installed on originating computers).
• Smart cards (plastic cards similar to credit cards, containing electronic memory, that are inserted into readers).
• SecureJet reader terminals (with display and heavy-duty keyboard) installed on destination printers (each reader terminal is plugged into the printer parallel port on a selected printer).

All authorized users (physicians, nurses) are given secure smart cards that are used to identify each individual.  User identification is required for ALL print jobs-documents are printed only when users identify themselves at the printer by inserting their smart cards into the SecureJet readers. 

SecureJet Auth-SC secures print jobs all the way from the application to the controlled delivery onto paper.  Print jobs are "wrapped" (encrypted) on PCs, ERP and Unix systems, sent electronically over the network, stored on the destination HP printer hard drive, and decrypted at print time, when only the appropriate nursing units can retrieve them.  Additionally, all print jobs are tracked and logged.
 
Rolling out the SecureJet solution

The roll-out plan of the SecureJet solution began with an initial conversion of 100 printers in the nursing units (from a total of 650 University hospital HP LaserJet printers). The hospital initially ordered 15 units, installing the first in January 2003, in postoperative nursing units. The hospital oversaw its smart card administration through a desktop support group.  SecureJet installation and software updates were done remotely.
"Jetmobile created a win/win situation with the use of SecureJet at the hospital.  They were very helpful in getting the product pilot review, pitching the product to senior management, and then tailoring to our needs.  Without the success of this first installation phase, we wouldn't have proceeded to rolling out the SecureJet solution all across the hospital.  The SecureJet solution may eventually reach even further into the hospital system."

For the modern hospital, the term "critical care" means lots of paper.  In the nursing units that provide clinical services, nursing assignments carry a substantial patient care load.  For the restoration of patient health, the essential nursing personnel who tend patients must greatly rely on the computerized POE process.  The electronic ordering of medications significantly reduces risks posed by handwritten orders, and computerized alerts and guidance help prevent medication errors. 

"We chose the SecureJet solution because of the economical benefits it provided and because it is HIPPA-compliant, only those persons who need to review a report can do so. Compatibility with the hospital's installed base of HP LaserJet printers was crucial. The installed base of printers is 85 percent 4100s and 10-15 percent 4200s.This ratio will reverse in twelve months," said the project manager."