ER, virtually

When a hospital assigns roles to its disparate health care staff, it not only specifies what kind of information that health care worker is permitted to obtain, it also creates communities of common interest. And that’s “pretty cool.”

That, in any event, is what the South East Regional Health Authority (SERA) discovered when it implemented a solution – Role Oriented Access Management (ROAM) – from AnyWare Group of Saint John, N.B. to secure mobile access to patient information systems, the online library and administration e-mail.

For example, when radiologists log in to their home or office-based systems they all have a common looking desktop. That, according to AnyWare CEO Gerry Verner, is like having their own little community,

“Because it’s role-based, a hospital could have more than 20 different information systems,” Verner said.

“You have people that work in the accounting department, physicians and lab technicians. There may also be a pharmacist out in his own community outside the hospital or a physician with a stand-alone clinic.”

That physician may need access to one of the 20 systems, so the CIO of the hospital can identify it and grant access to it.

“You can segregate people based on their role and create profiles for them so that the information each may get or receive is different,” he said. “You can have 40 different types of roles or 100 and 40 different things that those people are allowed to have access to.”

When the hospital has that fully set that up, he said, it’s almost like a light switch – the CIO decides who gets access to what and then flips the switch.

ROAM provides secure remote access and communications infrastructure that includes an Integrated Desktop Portal, SSL VPN security, as well as the role-based Identity Management.

Radiology is a great example because ROAM works with systems like Picture Archiving and Communications System (PACS) that radiologists use as a core function of their job, according to Jacques Lirette, CIO, SERA.

SERA is one of eight health authorities in New Brunswick with a tertiary care centre and maritime referral centre for acute and trauma cases, covering New Brunswick, Prince Edward Island and northern Nova Scotia.

Lirette said a 3 a.m. call to on-call physicians and specialists used to mean they had to go to the hospital to take a look at x-rays.

“With things like PACS, within seconds after the patient gets their x-ray, the radiologist goes to their home set-up and calls up the same image the emergency room (ER) is seeing and makes a diagnosis and calls the ER physician,” he said. “It’s a convenience for them.”

In fact every “ology” has its own technology, according to Lirette.

“If you’re a urologist you have ultrasounds, and most of that technology is now digital and connected somehow to SERA information systems.”

A lot of the various technologies are connected to SERA’s electronic medical records (EMR) and the storage facility where the hospital saves all images, Lirette said.

“All hospital information is what is provided to hospital physicians on their computer. They can take that information anywhere on the facility and anywhere on the Internet.”

There are two key factors that are working in favor an extension of current applications, according to Verner.

“The first is video compression, the ability to send video with fewer bits,” he said. “We have only seen that happen relatively recently. People had said you would never be able to send video over the Internet, and now you can.”

Compression is allowing more information to be sent over the same bandwidth, he said.

“The second is the capacity of the pipes themselves, the network connections that supply the bandwidth based on their size,” Verner said. “The way that the health care system is built now, a lot of consultation is done simply through phone communication. They talk to each other.”

Lirette said that if he was an emergency room physician and had a case he needed to access or have a specialist consult on, he would simply call or page that person.

“All I say is ‘log on to ROAM and let’s talk about what we are both looking at,’” he said. “Then the physician provides their diagnosis or recommended course of treatment.” 060896

Brian Eaton ( is editor of

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