When is a PIN code better than a password?

PIN codes are ubiquitous. We use them to withdraw money from ATM cash point machines and make payments with our bank cards. Our electronic devices, smart-phones and apps are protected by PIN codes.

We can also use a PIN code to access our systems at work. An NHS smart-card is similar to a ‘chip-and-PIN’ bank card; you place your card in a reader and enter your passcode. This can be configured to log you onto your computer and integrated to open your clinical applications.

The alternative is to login with a username and password. We typically use these to login to a website to do online shopping, access our online accounts etc. At work many of us have an individual login for our computers and to access each of our clinical systems.

Logging in can be slow and painful however, especially when we have to do it repeatedly. It is one of the causes cited for the increasing ‘clinical burden’ with using IT systems. Password policies also make it hard as we are advised to use ‘complex’ passwords, to change them regularly, and use different passwords in each system.

Have you ever wondered why is that is? Why sometimes we are able to use a simple a PIN code and at other times we need to enter a complex password?

This blog explains why. It also looks at how we can use this knowledge to our advantage.

Some NHS organisations have been innovative in this area – I will discuss some novel approaches that can be used. For example we have implemented a PIN code to unlock our EPR system. A number of organisations have experimented with other simpler ways to authenticate the user.

I thought I would share our reasoning here – how use of a PIN and other measures can enhance both security and usability, in line with the NHS guidance. Also why a conventional login and NHS smart-card may not be sufficient on their own.

It’s all down to how we use our EPRs. I’ll explain why. First let’s quickly review the NHS guidance on this.

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Should we issue NHS staff with personal devices?

There are some things we do every day that seem perfectly normal, but when we stop and think about it – they make no sense at all.

How we use our computers at work is one of them.

This blog looks at the evolution of the personal computer at home and work and asks – is it time to rethink how use our computers in the workplace? Should we change strategy and issue all NHS staff with personal ‘single-user’ devices at work?

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Result acknowledgement: looking for the needle in the haystack.

In my last post I highlighted a serious issue in healthcare.

Failure of hospitals to act on results is causing serious patient harm.

That was a story explaining the root of the problem and how it came to be. A serious but unintended consequence of service redesign.

In this post we look more at the process of signing off results. How do we make sure we don’t miss the critical ones. The proverbial “needle in the haystack”.

Continue reading “Result acknowledgement: looking for the needle in the haystack.”

Failure of hospitals to act on results is causing serious patient harm

We have a serious failing in our hospital healthcare systems that must be addressed. Patients are having clinical tests and the results are being filed in the patient record without anyone having seen them.

The consequences of this can be serious. Failure to act on results can cause delays in diagnosis and treatment. Opportunities for early intervention can be missed. In some cases this can result in premature death and disability.

These cases of serious patient harm are entirely preventable. This blog explains how this situation has come about and what simple steps you can take to address this and protect those you care for.

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EPR: A vision for enhancing clinical workflow

As a clinician I am passionate about improving our clinical systems to make them work better – better for us and for our patients.

As you are reading this, I hope you feel the same way too.

Our systems should enhance our clinical abilities. Compensate for our weaknesses. Help us coordinate patient care and make more efficient use of our time.

Healthcare is increasingly dependent on technology. As clinicians we need our systems better designed and configured to support our needs. With the right approach we can rebuild them..

  • Better for our patients: safer and more integrated patient care
  • Stronger clinical ownership: empower our users and clinical teams
  • Faster to use and access: usability and accessibility are key

This blog explores the “how”. It looks at industry best practice, benchmark user surveys, and approaches used by leading organisations. Plus some personal reflections – the real life patient stories that matter.

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Digitising the National Early Warning Score NEWS2

NEWS2 is the latest version of the National Early Warning Score (NEWS), first produced in 2012 and updated in December 2017, which advocates a system to standardise the assessment and response to acute illness.

Digital NEWS2 Chart

This blog discusses our journey to develop and implement a digital NEWS2 chart. This covers some of the design decisions we made in implementing the national guidance and lessons learned along the way.

I have made the digital NEWS2 chart available as an open source project on Github should others wish to contribute to the project (further details below) and implement it in their own electronic patient record EPR.

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What makes a good clinical calculator?

A clinical calculator takes a selection of individual patient data and uses a formula to calculate a score. The result is used by clinical staff in delivering patient care, and by patients to help them understand their condition.

This blog explores some of the benefits and risks of using clinical calculators and makes a number of recommendations for designing and integrating calculators with the electronic patient record (EPR).

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