University Hospitals transforms clinical onboarding with day one access

The bottleneck of manual provisioning

In the critical environment of healthcare, ensuring clinicians have precise, credential-based access to Electronic Health Record (EHR) systems is a necessity. Historically, University Hospitals managed this through manual workflows that were slow, labor-intensive, and prone to operational friction. These legacy processes resulted in several primary challenges:

• Lost productivity: New hires waited 5-7 business days for full system access, delaying their ability to care for patients.
• IT burden: Highly skilled IT staff spent countless hours on repetitive data entry and help desk tickets.
• Inconsistent experience: The slow onboarding process created a negative first impression for sought-after clinical talent.
• Compliance risks: Manual processes increased the risk of human error, making it difficult to maintain strict "least-privilege" access controls required for HIPAA and other regulations.

University Hospitals' leadership recognized that attracting top-tier talent and ensuring seamless operations required a complete transformation: moving from manual processes to a fully automated access lifecycle.

Intelligent, automated orchestration

At the center of University Hospitals' transformation is 'Day One Access'—a groundbreaking initiative that automates onboarding across five enterprise systems. With SailPoint acting as the primary 'traffic controller,' the system manages all identity decisions autonomously, eliminating the need for manual processing.

The solution connects:

• Oracle E-Business Suite: The source of truth for employee data.
• Role Validation Tracker (RVT): A proprietary database that maps job roles to specific access permissions.
• Cornerstone LMS: To verify that mandatory training is complete.
• Epic EHR: The clinical system where patient care is documented.

Upon hiring a new clinician, the automated system immediately identifies their role and determines the precise access required for the position. This seamless process ensures that staff receive only the necessary permissions. Simultaneously, the system assigns a role-specific training curriculum, directing users to complete all education and compliance modules required for safe, effective patient care.

As soon as a clinician completes their training, SailPoint automatically detects the milestone and provisions their Epic account without manual intervention. This ensures immediate access to essential tools while maintaining a detailed, automated log of the entire process. For University Hospitals, this comprehensive audit trail simplifies compliance and provides leadership with a transparent, policy-aligned record of every access decision.

"The automated solution eliminates substantial manual effort across multiple teams, enabling reallocation of highly skilled resources from transactional work to higher-value strategic activities," said Arihanth Mullangi, Deputy Chief Information Security Officer at University Hospitals.

The results: efficiency, security, and scalability

The SailPoint implementation delivered immediate and quantifiable results. By transitioning from manual workflows to intelligent automation, University Hospitals realized substantial business value within its first nine months of operation.

Operational Excellence

• Speed to productivity: The time to provision full access dropped from 5-7 days to just 2-4 hours after training completion.
• Massive throughput: The system processed 11,521 Epic account activations and 7,353 new accounts with zero manual intervention for standard scenarios.
• Scalability: High-volume hiring periods are now handled at the same speed as individual hires, without requiring additional IT staff.

Enhanced User Experience

• Day one readiness: New caregivers arrive to find their accounts ready and training materials accessible immediately.
• Seamless re-hiring: The system intelligently recognizes returning employees. If their training is current, their access is reactivated instantly without redundant retraining.
• Leadership confidence: Hiring managers no longer need to chase access request forms, allowing them to focus on clinical leadership.

Strengthened Security and Compliance

• Risk reduction: Automated revocation ensures access is removed immediately upon termination.
• Regulatory confidence: A complete, automated audit trail that supports HIPAA and Joint Commission requirements.
• Precision access: The system enforces strict role-based controls, ensuring staff have exactly the access they need—no more, no less.

Lessons from a groundbreaking project

University Hospitals automated onboarding system is a testament to the power of innovation and visionary leadership. By navigating complex technical challenges without the benefit of external roadmaps, the team developed every integration and workflow in-house. This self-driven approach not only solved a critical problem but also built deep technical expertise and a lasting sense of organizational ownership.

This multi-year initiative was defined by steady investment, iterative refinement, and steadfast executive support. By engineering and maintaining this proprietary solution in-house, University Hospitals accelerated clinician onboarding while establishing a new industry benchmark for secure, scalable identity management. Their success demonstrates that deep organizational ownership and a commitment to sustained innovation can transform complex obstacles into a blueprint for excellence.