Tap ‘N Go for Providers

A summary of the purpose and functionality of Tap ‘N Go is provided below to ensure awareness and adoption across sites. Two scenarios – maintaining the patient context on the exam room workstation and pre-charting activity in the provider’s office prior to entering the exam room – are also detailed below.

In Summary:

  • The goal of Tap ‘N Go is to expedite the user authentication process when providers and care team members enter and exit the exam room.
  • Tap ‘N Go pads will now be deployed to all of the physician offices so that the providers will benefit from a more efficient method of authenticating their Windows sessions.
  • The purpose of Tap ‘N Go is to maintain the context of a patient in an exam room while different users come in and out of the room and open the patient’s chart.
      • This protects against potential patient safety issues resulting from a user opening the wrong chart.
      • After pre-charting work in the provider’s office is completed and saved, the provider should close the chart and end their Epic session before proceeding to an exam room.
      • See pre-charting workflow scenario (2) below

Full Communication:

Goal/Purpose of Imprivata’s Tap ‘N Go:

Tap ‘N Go functionality, provided by Imprivata, has been implemented on the RWJBH Epic platform to enhance patient safety and support increased efficiency in the “exam room to exam room” workflow.

The organizationally-approved workflow is based on maintaining the patient context on the workstation located in the patient’s exam room, allowing care team members who are entering and exiting the exam room, to “tap in” and tap out” without having to enter their user credentials and re-identify the patient.

The workstations that have been placed in the exam rooms are generic/shared workstations and are connected to Epic via a virtual desktop infrastructure. This hardware configuration was designed to support the Epic-approved secure workflow which does not recommend patient context roaming. Fully roaming profiles would enable having the workstation in the exam room display whatever patient chart the Provider, MA or technician has open under their credentials which may be the patient in the room or may be an entirely different patient. This increases the opportunity for unintentionally documenting and ordering in the wrong chart and is therefore not best practice.

Nursing stations in the practices have also been equipped with Tap ‘N Go pads, providing the medical assistants with a more efficient method of authenticating their Windows sessions by not having to type login credentials and user passwords.

On 6/1/21, it was announced that Tap ‘N Go pads will be deployed to all of the physician offices so that the providers will also benefit from a more efficient method of authenticating their Windows sessions. It is important to understand that using Tap ‘N Go in the provider office will not permit the Epic patient chart [patient context] that is open on the office laptop to travel with the provider’s user-credentials, regardless of where the provider taps-in next, as this would not be in keeping with the decision to prevent patient context roaming. Finally, carrying a laptop computer from room to room would subvert this recommended and approved workflow and introduce risks to patient safety.

Workflow Scenarios:

  1. The following scenario illustrates how the approved process will work based on maintaining the patient context on the workstation located in the patient’s exam room:
    • Patient Sally is in Exam Room A. The Medical Assistant (MA) taps-into Epic on the exam room workstation and establishes Patient Sally’s context by identifying the patient and determining the correct patient’s encounter.
    • The MA performs all tasks as necessary with the patient, taps-out and leaves the room.
    • The provider comes into the room, taps-in, and starts the exam and documentation process immediately [no need for patient lookup].
    • The provider taps-out when exam is completed and then moves on Exam Room B where Patient Adam is already roomed with patient context established on the Exam Room B workstation by the MA. Provider has only to tap-in to start the documentation on Patient Adam.
    • Back in Exam Room A, after the provider has departed, the MA re-enters the room, taps-in, and performs any follow-up activity that is resultant from the provider examination. He/she does a final tap-out and escorts Patient Sally from Exam Room A. [in some practices MA’s do not always return to the room or escort the patient out when the provider is finished. Providers will need perform the final tap out so that room no longer has the context of the patient just seen. This may be less of a concern if the MA always resets the context when they room a new patient].
    • The room is prepared for the next patient and the scenario repeats with Exam Room B and all other exam rooms.

2. The following scenario illustrates the pre-charting activity in the provider office with the addition of the Tap ‘N Go pads before seeing patients in the exam rooms:

    • IN THE PROVIDER OFFICE: The provider taps-in to the workstation or laptop. This tap will authenticate the Windows session and a password will be required [a password will not be required again for 4 hours]. Click on the Epic icon to begin a session in Epic. No login credentials will be required to be entered.
    • In Epic, the provider will perform a patient look up to begin any pre-charting activity
    • After pre-charting work is completed and saved, the provider should close the chart and end their Epic session before proceeding to an exam room. Any information captured during pre-charting in the provider office is now part of the patient chart and available to anyone who accesses the patient chart, but this patient context will not travel with the provider’s credentials at their next tap-in.
    • The provider enters the exam room for the patient that has been prepared and identified in Epic by the MA. The provider taps-in and starts the exam and documentation process for the patient in this exam room [no need for patient lookup].
    • The provider taps-out when exam is completed and then moves on to the next exam room where the patient is already roomed with patient context established on the exam room workstation by the MA. Provider has only to tap-in to start the documentation on this patient.

 

After the provider has departed, the MA re-enters the room, taps-in, and performs any follow-up activity that is resultant from the provider examination. He/she does a final tap-out and escorts the patient from the exam room [In some practices, MA’s do not always return to the room or escort the patient out when the provider is finished. Providers will need perform the final tap out so that room no longer has the context of the patient just seen. This may be less of a concern if the MA always resets the context when they room a new patient.]