Visitor Management for Hospitals – Perspectives on the past and present of patient visitor management

Matthew Lewis, Product Marketing Director at HID Global, and Clete Bordeaux, HID Global Healthcare Business Development Director discuss how security and facilities directors have viewed visitor management historically and what has changed in the last 2 years. 

Transcript

Speaker 1: 0:01

Powering trusted identities of the world's people, places and things. Every day, millions of people in more than 100 countries use our products and services to securely access physical and digital places over 2 billion things that need to be identified, verified, and tracked are connected through HID Global's technology.

Speaker 2: 0:23

Welcome back, everyone doing another episode, and I'm here with cleat again today, and we're gonna talk a little more healthcare, uh, cleat last time. You and I spoke a little bit about Covids's impact on, on healthcare, especially as it related to, um, visitor management and the management of mm-hmm<affirmative> visiting populations and inpatients outpatients, all those fun things. Um, Let's, let's start there. So a lot changed with COVID. I have to think some of those changes are carrying through to today. I know there's a lot of, I know I go to the airport, you know, it's talking about all the federal mandates, so I, I assume there's federal mandates, local CDC mandates, I guess, um, even for healthcare, how much of that has changed and, and made some sort of impact on, on the hospitals that, that we're talking to out there in the market these days?

Speaker 3: 1:15

Well, they they've all been impacted and mm-hmm<affirmative>, you know, you, you listed some of the ones that could apply. Is it federal? Is it local? Yes. It's all of those actually. Yeah. There's at the federal level. What we all have come to understand and know those famous digit, those famous, uh, letters, CDC. Yeah. There guidance there's um, and an important distinction actually between aviation and healthcare. Mm-hmm<affirmative>, you know, aviation, there's actually some, some teeth to it. It's actually a regulation and yeah, the enforceable, it's not the same exactly on healthcare, but, um, the good ones are always following some form of guidance. So again, at the federal level, their CDC, they get into, some of them have, um, state level controls or department of health. I heard about that, that type of stuff in New York, they have separate directives from them that they have to comply with. Okay. Then there's, um, there's Accredited healthcare institutions, um, and they're private, but they are recognized and scored so that if you hear them talk about J CO uh, the joint commission on accreditation, they also have standards that they put out and, and you're deemed if you don't comply with the standards of, of what they expect of a hospital. So, um, okay. There's all of that that they need to comply to, in addition to what they do, even at each facility level, their senior leadership can determine I'd like this place to feel like X. And so there, you know, from, so going back from the individual level, all the way up to, uh, federal guidance of the CDC, they all had to comply with someone in some way, shape or form.

Speaker 2: 3:02

Got it. And that trickled then through to the, the policies, the processes are, yes, they're all putting in place. So if you think of some of the core things of visitor management, all of these things you're talking about had to, in some way, either change or amend, or maybe make more strict some of the visitor restriction policies or the way they controlled physical access throughout, or in fact, some of the things that I think are changing maybe even most rapidly are how all these systems are talking to each other, uh, physically, I guess, logically, digitally, whatever. Um, that is, but the way in which we're integrating the system into maybe an EMR or EHR electronic health or medical record for, uh, type of system, uh, system of record or something like that. So all of these things I have to think have been changed some maybe rapidly, right?

Speaker 3: 4:00

Yes. Some were changed very rapidly. A, uh, great example of that is, um, and this was one of our clients, but they have an older version of software and it was serving them perfectly. They were, they were going above and beyond what was recommended to them by, um, a security risk consultant that identified that they should have some form of visitor management. They were well above and beyond. Everything was great. COVID hit. And they said, Hey, what can you do to help us limit our senior leadership wants us to limit the number of people per patient. And, you know, to your point about some of these things changing quickly, we did an emergency upgrade for them, uh, right in the middle of COVID. And we did it all remotely, of course, but that was specifically to give them that enhancement of allowing them to go from a, a zero visitor environment to a controlled environment of, of actually keeping to the number of patients per so, and that, that, that turnaround took 10 days in 10 days, they were able to do what they could not do prior, and then that allowed them to change their level of care. But for the rest of the industry, again, they had to do something. And what those, what those things were varied. So when you talk about integration with visitor management systems, when you talk about integration with systems, that was the good places. The good places were able to do that, but, you know, the low hanging fruit was we have to stop every Matt Lewis that comes in here. So the ones that could not do any type of more advanced visitor management had to at least get to the point of sticky badges, because like we discussed last time, they couldn't stay in a zero visitor situation for very long. Yeah. Once they started to let people come through inpatient, outpatient, outpatient, visitors, all that stuff, they had to have some kind of handle on it, even if that just meant, um, writing on pieces of paper, having you stop at a desk. So the industry chains forever from that point, um, from, from the input that we get from most people that will, will never, uh, change. But what you said a second ago, about the integrations, going back to that side, that's the good ones. The good ones have realized, okay. We, the one and probably the one ones with more resources and, and more at stake. Yeah. Like we talked about those children's facilities on the last episode, they're more secure environments. Those are the ones that are more likely to, uh, push the envelope and want a more sophisticated layer of access control. Mm-hmm<affirmative> want to be able to manage, um, their access based on the relationship, cuz all those things lead to population control. I know that sounds like a sci-fi movie, but<laugh> that, that really is some of the terms they use. They they're trying to manage the entire population in the facility. It's not just Matt going to see his kid. There's also a different Matt. That is a pharmacy vendor. There's also a roving nurse Matt that needs to get there. Oh. And relieve some of the people that have been working for days straight. So there's, it's, it's truly population control within a healthcare environment. And, and some of those more advanced facilities looked to do that with advanced visitor management. Mm-hmm

Speaker 2: 7:18

<affirmative>. Yeah. And, and so you started to go down a path of question. I was about to follow up with cuz you mentioned inpatient, you mentioned outpatient. Then you actually just said like vendors and nursing staff and, and yes. You know, I've been to some hospitals where it's a, um, uh, especially you see this in like prenatal and, and stuff like that, where you have a visiting doctor. And so you've got all of these, not users<laugh> um, not talking about accessing a computer here. You've yeah. You've got all these visitors. Yeah.

Speaker 3: 7:49

Well identities is, is what we, there you go. Thinking about how we are first talking to a healthcare facility and, and, and, and one of our, one of our talking points is they are more different types of identity in healthcare than what you would see in most other industries. Yeah. You know, at a standard, you know, we'll take a standard downtown Chicago, um, office building, you know, there's going to be employees, there's business visitors, and probably some contractors, you know, but then when you come to, uh, healthcare environment, I think we already named, we already named four. I think we named inpatient. We named outpatient, the visitors associated with each one of those, which are gonna be different. That's four right there that does not get into clergy, uh, contractors, uh, Contract, contract, contract labor. I mean, it is at, at minimum, I think it was, I'm thinking about our slide. We're looking at like seven different types of identities in every healthcare facility and they all need some form of access management, um, in most cases, but the lowest hanging fruit is we have to at least be aware of them in our facility per COVID.

Speaker 2: 9:08

So I think at, I heard you throw this number out one time when we were talking probably half of, and it's a rough number, especially given the type of, of complex or network we're talking about. But if half of the population is there in some sort of visitation of an inpatient capacity, and we just talked about the, the complexity there, or they're around all the other types of quote unquote visitors to a hospital facility between that and just the increase in the needs around policies and procedures. What are the hospitals gonna do for the other half population? If, if, if a large proportion of the, the emphasis to date had been on more of those inpatient facilities where you or I are getting checked in or a loved one is getting checked in. What about the rest of that population? Is that now of equal importance to the hospital? Or is it let's make sure we've got those, those other areas as secure as possible and then we'll move on or how, how are hospitals thinking about that based on your interactions with them?

Speaker 3: 10:18

So it, it falls into a couple different buckets. Okay.

Speaker 2: 10:21

We,

Speaker 3: 10:22

In some cases we need to do more advanced access management for some of those populations. And we'll just say that's inpatients and their visitors. Yeah. That requires a little bit more advanced, um, access management for them, contact tracing for them. Those are the people that are up on secure units potentially have, uh, more exposure to infectious disease, things like that. So there's that side of it. But to your point, there's a whole bunch of other people in the hospital, people that are just coming in for, um, a standard x-ray a standard physical, uh, they're not going to be exposed up on secure units. There's the visitors that came with those people. And I think you said at the beginning, that can be roughly half of the population in the facility. So it, it goes back to a word I said a second ago. There's still part of the population though. Yeah. So whereas before, um, you know, in years prior to 20, I would have facilities that want to talk to us and Hey, CLE help us with our inpatient visitor management. They didn't care much about outpatient now they do. And for a separate reason, they they're still looking at it as overall population control. Even though all I did was bring my mom there. Um, she's there for an x-ray. I am still someone to be concerned with from potentially a contact tracing perspective. Uh, I am still someone to be concerned with from a, um, total population at any given time perspective. Yeah. Limiting the number of people in a certain area. We have hospitals doing that. They will only allow 100 people in their waiting area at any given time, things like that, things that they never did before. And in many cases they're trying to, to use technology to manage that.

Speaker 2: 12:12

Okay. So that, that was exactly what I was about to ask. They're looking for something to address all of these in one shot basically. Now,

Speaker 3: 12:22

If they

Speaker 2: 12:22

Can, if they

Speaker 3: 12:23

Can. And remember that, did it, you know, many of them didn't do anything like this, so they're just starting to understand what's out there. Yeah. What can it, so the number of R the number of RFIs RFQ RFPs is, is through the roof compared to years prior, because they're really just learning, you know, they, they they've now understood their needs because of the last two years they've got senior leadership direction. Budgeting has happened. All those things happened over the last two years now, they're really trying to see, okay, well, how, how do we do it? Who does what, uh, they talk amongst each other, which is, um, awesome. And I love being a part of an industry that does that. They it's very collaborative. It's not in a competitive environment. That's great. They are trying to learn what the best approach is. And so in healthcare, they will absolutely call a hospital across town and say, Hey, how are you effectively managing your whatever scenario in your emergency room? Because they're genuinely looking for the best outcome.

Speaker 2: 13:28

That's awesome. I, I know not every industry,

Speaker 3: 13:32

Exactly

Speaker 2: 13:33

Luxury almost has is, is the right word. It has that luxury of, of kind of being that non-competitive, um, thing. So it's, it's really that what's, what's the saying all tides raise ships or whatever. Um, so that's, that's a great thing to think about what, um, so let's take a minute to you. You can do a soft plug here. Um, don't get too salesy on me, but we talked a little bit about some of the, some of the ins and outs so far around the needs and a little bit of the solution. What are some of the core things at the heart of a solution that, uh, either inpatient or outpatient or any of those other groups, um, but what are some of the core things that someone listening needs to start thinking through? Like, I, I, we talked about controlling of populations and different types, so imagining like there's processes, they need to think about and how workflows happen and, and what systems are needing to talk together is that are some of those, the right words, I guess that I'm saying yes,

Speaker 3: 14:37

Yes. Um, what advice I would give them or some of the more important things for them to think about? Yeah, of course I would. I would assume we're at that point where they've already done something and determined that they need to do more so as they start to my advice to, to those that may be listening and that are trying to think of what their next step is. I, I would think it probably begins with ensure the software, because we're past the point of doing this without software. We're past the point, doing it with, with, with warm bodies and writing with a Sharpie on a sticky badge. We're past that point, uh, uh, a Sharpie and a sticky badge, can't run a contact tracing report after the fact, um, a contact, a, a sticky badge, and a Sharpie still has security officers and, uh, retired volunteer staff looking in your full epic Cerner Metatech systems, looking through full patient records, which is an undesirable scenario for almost every facility. I talk to, they're still doing that to determine what room this visitor needs to go to, or what area of the hospital is outpatient is going to. So I think the first thing to consider is a system that is going to integrate with whatever your electronic health record is. Yeah. Epic cer or Meditech. I think that is the low hanging fruit start there.<affirmative> I would not consider a solution that not, that did not at least perform that function. And, and again, the idea behind that is sure, you can, you can order visitor management off Amazon, and that's not a joke. You really can just order something off Amazon that is going to take my ID and kick out a badge, but that, and kick out a sticky badge, but that doesn't help with contact tracing reporting. Yeah. That I may need to do that. Doesn't help that doesn't get my volunteer staff out of these full blown patient records that we did not want them to have access to. Yeah. Um, you know, so me understanding where this is headed and, and all the different things that you may need to do to be in compliance that really all starts with having a system that integrates with your electronic medical record system. I would, I would say that would be my advice to someone looking to begin their search begin there.

Speaker 2: 17:03

Okay. What's step two, step three. We don't have to go to step five, but what, what are the next couple of things that logically they bring on after that?

Speaker 3: 17:14

I would say, look for, and this goes to what we all experience WFH work from home<laugh> even in a healthcare environment. I have, I interface with security directors and, and security teams regularly that are in some way, shape or form in a flexible work from home environment. So understanding that pick a solution that also supports that. So I would say again, if you're gonna order something on Amazon and it gets delivered to you in the USB, that only operates on the PC that's in front of you, that's not forward thinking you ask what, step two, I say, step two would say, get a web app. Something that can still be supported in a work from home environment.

Speaker 2: 17:58

Yeah. Makes total sense. The entire world shifted very rapidly on yes. How applications are are accessible. So that, that makes complete sense.

Speaker 3: 18:06

You're now expected to be able to run reports from home. You are expected to be able to check metrics from home. You should have yeah. Software that supports that.

Speaker 2: 18:16

Yeah. Makes sense. All right. So we've got EHR, EMR integration, or some capacity like that. We've got web app what's next. And then we'll probably wrap after that one.

Speaker 3: 18:31

So if I had to give a bullet point number three, to someone looking to go down this at this point, you're probably really starting to get, if you've done those first two things, um, you can manage the vast majority of concerns that have been placed upon the shoulders of security teams in healthcare. Yeah. You, you may now get a chance to exercise some of the things that you always wanted to, and this is a pretty, pretty common thing in healthcare. You know, once they got the directive to do more, they really did more. Now we're talking about protecting some of our mom and baby units with access control.

Speaker 2: 19:08

Okay.

Speaker 3: 19:08

Um, and, and, you know, these are not pie in the sky ideas anymore. I regularly have conversations with people that are, um, securing elevators now and doing access control for visitors on their<affirmative>. They have optical barriers in place so that they are only allowing certain numbers of people into the facility and having a positive, um, positive idea of the number when they leave the facility, then they get, these are more advanced concepts and they typically are going to center around access control.

Speaker 2: 19:42

Yeah. Or I guess also sounds like basically also access control is kind of that the physical manifestation, but you've gotta have the policies that dictate that control. Right. Or yes. Restrict back to the population conversation earlier. Do some of that too. So, yes.

Speaker 3: 20:00

And to be clear, access control, access management, that stuff is it's always there. Yeah. But what I, what I, what I mean by 0.3 is a solution that can tie in,

Speaker 2: 20:10

Ah,

Speaker 3: 20:10

You go to the existing access control you have in your facility. Got, got it. Start to have some specific visitor policies that marry with your existing access control.

Speaker 2: 20:24

Okay. That's I think that is a good, good meaty topic for us to pick up on next time. Um, visitor policy, lot

Speaker 3: 20:33

Stuff happening right there. That that's a good place to talk about. There's a lot of cool things happening

Speaker 2: 20:37

Now. Awesome. Awesome. Well, Cleat again, I appreciate it. Uh, we'll call that one, a wrap, and we'll talk about, uh, visitor policy restriction, policy, population policies next time. Uh, again, always learn something with you. So thanks for taking the time with me Cleat and, uh, we'll catch up later.

Speaker 3: 20:54

Of course. Thanks for your time.

Speaker 2: 20:56

Yep. Thanks everyone for listening.