1) You won't need passwords beyond whatever it takes to log in locally.
2) You can assume the hospital computers are physically secured. (Well, I wouldn't, but apparently they do.)
3) The hospital changes machines very infrequently and probably wants a human in the loop every time a machine changes.
4) You can have certificate generation and registration get handled by the on-site IT staff. It is once in a blue moon, and makes them feel like they're not getting paid 6 figures to clear paper jams and reboot Windows.
5) You can mumble any sort of cryptographic magic to scare away people who know just enough about security to be dangerous.