Implementing a mandatory password change policy at an academic medical institution.

UW Medicine implemented a new policy requiring users to change passwords at least once every 120 days. In the first two password change cycles, many users did not take action upon notification, and their passwords expired, causing high help desk loads. Compliance and support loads improved in subsequent cycles. We conclude that policy changes requiring user behavior modification should be seen as a cultural change, and the implementation strategy should consider socio-technical factors.

A randomized, controlled trial of an automated wireless messaging system for diabetes.

BACKGROUND: Aggressive management of blood glucose reduces future diabetes-related complications, but this is difficult to achieve. METHODS: This randomized, controlled study tested the effect of using a wireless two-way pager-based automated messaging system to improve diabetes control through facilitated self-management. The system sent health-related messages to patients, with automatic forwarding of urgent patient responses to the health care team. RESULTS: Participants in both the experimental (pager) and the control groups experienced an average hemoglobin A1c decrease of 0.1-0.3%. More patients in the pager group were normotensive, and more felt that their health care was better by the end of the study. A total of 79% of participants enjoyed using the pager, and 68% wanted to continue using the system. CONCLUSIONS: Utilizing a wireless, automated messaging system in clinical practice is a feasible, low-cost, interactive way to facilitate diabetes self-management, which is acceptable to patients. While providing a convenient way for patients and providers to communicate, this system can support automated recording and ready retrieval of these real-time interactions.