How ThinIdentity conceptualized an innovative healthcare product: Interview with Joe Jaudon

It’s hard to avoid talk about the rising costs of health care these days. And if you are like me, you would love to apply your best business analysis efforts to help solve the problem. But the myriad of organizations, stakeholders, processes, and technologies involved seems so complex and overwhelming that it’s difficult to figure out where to start. A few weeks back I learned about a company who has found a way to cut through the complexity to offer up an elegant solution to a significant aspect of the problem and help curb rising IT costs in health care.

ThinIdentity, a Denver start-up, has built a solution that improves work-flow for doctors and nurses by providing instant, context sensitive access to medical applications and patient data.  Joe Jaudon, founder of ThinIdentity and chief technology officer, shared some insights into how his company approached the product development process.

Finding the right health care problem to solve

Question: How did ThinIdentity identify the problem or opportunity ?

Answer: From my experience working at Denver Health, one of the biggest IT headaches was the desktops.  Not only were they costly and difficult to maintain, but they were also an impediment for doctors and nurses to efficiently get their jobs done.   By this I mean, every time a doctor or nurse needed to access applications, the process could take anywhere between 30 seconds to often times minutes.

When you multiply this times the 50+ times a day they have to access their desktop, there was a significant loss of productivity each day by the providers.  We set a goal at that time to consistently provide access to applications from any station in less than 10 seconds and significantly reduce the cost of the desktop infrastructure.

Evaluating hospital stakeholder needs

Question: What stakeholders did you consider in defining the product?

Answer: We defined the product with three stakeholder groups in mind:

• Caregivers: Improve provider workflow, and also enable the increased use of point of care clinical application access and Computer Physician Order Entry (CPOE).  We believed at the time, and are proving it now, that through these objectives we would reduce medication administration error rates.  Improved caregiver workforce satisfaction, which in turn improves patient care, was also a goal.
• IT: Reduce the cost and complexity of desktop environment.  Unlike “normal” business users, the Hospital end users continually use different machines.  As such the desktops would get slower and slower as time went on as each user used the machine a little differently.  This would cause expense both from a hardware refresh standpoint, but also a manpower standpoint as the PC’s would have to re-imaged each time a new or updated machine or application came online.  It required many hours for the desktop support team to manage this complex environment.
• CxO: Reduce IT costs, improve workforce satisfaction, and assistant in creating a compliant and secure environment.  Of course as with most hospital CEO’s, improving patient care was also high on the list.

Question: I imagine you needed to make some trade-offs between the needs and wants of the different groups. Can you give me an example? How did you make the final decision?

Answer: Actually, in our case, the ThinIdentity solution nicely meets the needs of all three constituents.  In fact, as we discuss our solution with perspective clients we attempted to engage with representatives from the three stakeholders groups to show them the benefits of the solution not only for them, but for all those involved.  It really is a win-win-win scenario.

How technical advancements enable change in health care business processes

Question: Are there recent advancements in technology that enabled ThinIdentity to build this particular product? In other words, would this product have been possible 2 years ago? 5 years ago?

Answer: Desktop virtualization was really in its infancy stages only 5 years ago, and while we understood the possibilities created by desktop virtualization, we did not have very good insight into what engineering and development needed to occur in order to properly implement a solution that could fully integrate existing software applications and devices.

Almost all software programs and devices were designed to work in a distributed computing environment (like your existing laptop or PC) and none of them ever contemplated that an individual could be accessing their existing session from multiple locations (smooth roaming).  I had been working on what has become the ThinIdentity solution for almost the entire 5 years and it took that entire time to develop and commercialize the software and intellectual property that we have today.

Question: Now that hospitals have access to a product like ThinIdentity, what changes in their processes are possible?

Answer: If we look at caregivers using ThinIdentity who now have instant access to their applications and data from any terminal, the meaningful use of electronic medical applications becomes possible.  For example, doctors are ordering tests and medication at the bedside as opposed to taking manual notes and entering them at a later time. This not only reduces possible errors, but  tests are being ordered real time and throughput, particularly in emergency department, has significantly improved for our customers.

When nurses are administering medication, they now quickly login in the patient room, and then scan the patient and the medication to make sure there is a match before administering the medication.  This process significantly reduces medication administration errors.  All of these process changes are not only a big win for the hospital, but significantly improve and reduce the cost of patient care.

From an IT department perspective, instead of having 1 desktop support person for every 200-400 desktops, who is constantly out in the field fixing poor performing desktops or other issues, a hospital only needs 1 desktop support person for every 1500 terminals. Plus they never need to leave their desk and this makes both the IT staff and the patient happier.  All desktop management, upgrades, policy management, etc is now handled through easy to use tools on their desktop.  And even when a provider reports a problem, the desktop support engineer can quickly shadow the provider’s session to assess and resolve the problem.  In addition, because the ThinIdentity solution is usually deployed with dual authentication, smart card access, the IT department has a clear record of all desktop interactions.  We are all very excited to see all the process changes that will be enabled because of our solution.

Looking at the Return on Investment (ROI) for hospitals

Question: How does a hospital executive measure the ROI on investing in your product?

Answer: We have spent considerable resources to develop a comprehensive Total Cost of Ownership (TCO) model that will compare a potential client’s environment versus the ThinIdentity solution, and then show them how much money they will save over a given period of time.

The key elements we focus on are:

1. Reducing the cost and time for the desktop refresh cycle. Our desktops should be refreshed every 10 – 12 years vs. a PC which is typically every 3 – 4 years.
2. Environmental savings.  Our solution utilizes a device that draws 4 watts of power vs. a typical PC at around 100 watts.  This can equate to annual savings of $90-100 per year per desktop.
3. Staffing and support savings.  As hospital move to a centrally managed desktop, with no intelligence or operating system on the desktop devices, it enables them to significant save or redeploys their desktop resources.

While not captured in our tool, another key measurement for any hospital is how much more efficient will the providers be once on our solution.  At Denver Health, the average doctor is at least 30 minutes more productive today thanks to the ThinIdentity solution.  With 300 doctors this equates to productivity savings for the hospital of $3.7M annually.

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