Better Managing Patient Relationships
and Information with eSignature
U.S. ESIGN Act – In 2000, the U.S. Electronic Signatures in
Global and National Commerce (ESIGN) Act established
electronic records and signatures as legally binding, having
the same legal effects as traditional paper documents and
Electronic signature – The Electronic Signatures in Global
and National Commerce Act (ESIGN) defines an “electronic
signature” as an “electronic sound, symbol or process,
attached to or logically associated with a contract or other
record and executed or adopted by a person with the intent
to sign the record.”
In healthcare, there are dozens of necessary processes
and just as many forms and other documentation required
to support them. There are also complex workflows
and systems to be updated, processes to be kicked
off—all based on signatures from patients, doctors,
supervisors, and vendors, among many others. The need
for documentation is understandable given government
regulations and compliance requirements.
Today, technology can dramatically reduce the complexities and
volume of paper, extensive document storage, and logistics associated
with getting the right document to the right place at the right time.
Electronic signature technology can help drive compliance while
positioning healthcare organizations to better manage patient
relationships and information to drive more efficient operations
and reduce costs. Nevertheless, many healthcare companies are
compelled to keep doing things the old way. Why? Concerns about
the costs, legalities, complexities, and security of electronic signatures.
As discussed in this whitepaper, electronic signatures are nothing to
fear. In fact, many leading healthcare organizations are embracing
electronic signatures, and discovering the benefits and ease
associated with them. Electronic signature technology, which has
been legally binding in the United States and Europe for more than
10 years, makes it possible to complete virtually any kind of healthcare
document online without pen and paper. In addition, such technology
can integrate with little to no customization with many healthcare
systems and software to drive a much better patient experience,
greater efficiency, lower costs, and improved compliance.
In this whitepaper we will discuss the role electronic signature
technology plays in healthcare documentation processing, the benefits
of eSignatures, and several important criteria to consider when
selecting an electronic signature solution.
Reasons to Consider the Electronic Signature
Electronic signatures are a legally binding way to complete most any
type of documentation, making it fast and easy for individuals and
organizations to complete, sign and store forms and other documents.
The benefits of using electronic signatures are many:
Lowered costs – Costs for paper, printing, faxing, and overnighting
are reduced significantly.
Increased productivity – The best eSignature solutions reduce work-
hours associated with rekeying data by easily integrating with systems
that automatically update customer-inputted information and store
Enhanced patient and doctor satisfaction – Through eSignatures,
healthcare institutions can provide greater convenience and service
with anywhere, anytime signing from any Internet-connected device.
Faster document cycle times – The convenience of eSignature cuts
the time to get documents signed from weeks down to minutes.
What’s more, the leading solution will only return documents when
they are complete, eliminating signing errors and missing information.
Verification of signers’ identity – Third-party identity management
and authentication can offer additional safety and security to further
ensure the privacy and security of patient information.
Increased compliance – Documents are returned in good order—
complete and legally-binding—with a court-admissible audit trail.
2. WHITE PAPER docusign.com
Nearly 72% of adults are frustrated with completing paper-
based forms, documents or business agreements.
Electronic Signatures Streamline Processes
Forms that require signatures typically kick off other important
processes within an organization. Even something as simple as a
new patient completing and signing their intake forms in a doctor’s
waiting room indicates she is ready to see the physician. Today’s paper
processes entail manually handling these steps—re-keying customer
information and/or data, scanning, and communicating next steps—
which can create delays and errors.
Using a solution to electronically execute healthcare documentation,
however, allows for the completed paperwork to be automatically filed
in the proper system with data from form fields uploaded to other
downstream systems without re-keying. A doctor can be notified that
her patient is ready to see her the minute the forms are complete
Using a Software-as-a-Service electronic signature solution, such
as DocuSign, forms can be stored securely online in the cloud or
copied to an electronic health records (EHR) system automatically,
and accessible anytime, anywhere on any Internet-connected device,
so there’s no need for paper storage and destruction services. In fact,
eSignature solutions even allow you to set record delete dates so that
old records are automatically and confidentially “shredded.”
Although electronic signatures have been legal since 2000, they’ve
become commonplace in the past couple of years. Many healthcare
institutions use electronic signatures as a competitive differentiator,
boosting patient convenience and satisfaction, and as a means towards
achieving better operational efficiency and reduced costs—all of which
are critical in today’s healthcare environment.
The Time Is Now
Several factors indicate that the healthcare industry is ready to make
the shift to easy, fast, secure electronic signatures.
Rising costs – According to a May 2011 report from PwC Health
Research Institute, “Health reform is pressuring employers, providers,
insurers, and drugmakers to be more cost conscious.”
Technology readiness – Until recently internal patient records systems
were slow to be updated, as there was a fear of insecurity for extremely
sensitive patient data. Now that confidence is growing in electronic
health records, the next step is to automate the data input and
signatures to streamline the end-to-end process for maximum efficiency.
Frustration with the status quo – A 2010 Harris Interactive survey
found nearly 72 percent of adults are frustrated with completing paper-
based forms, documents or business agreements. This is generally
compounded when patients are confronting the hassles of paperwork
when already feeling ill, or when it delays needed urgent care.
The right electronic signature solutions—those with forms
integration—eliminate these frustrations. Form fields provide the
space and character counts for the required data so that patients can
quickly and easily entered required information. eSignature delivers
convenience by enabling consumers to sign and return without having
to print, fax, mail, or overnight completed documents. And, form fields
that automatically pull and update patient data (which has been keyed
in via computer or mobile device directly, to remove the challenges
of messy handwriting) eliminate the need to rekey data and thereby
Considerations in Electronic Signatures
When it comes to selecting an electronic signature provider, there are
a number of considerations:
Ease of Use – The easier you can make the process for doctors, staff,
and patients, the happier all will be. Find an electronic signature
solution that is efficient and simple, that doesn’t require expensive
programs or delayed software downloads. Remember, the easier it is,
the greater acceptance by users and the faster it is to complete.
Security – For healthcare documents, security is extremely important.
Look for a provider that offers SAS 70 Type II tested data centers and
solutions, as well as one which maintains a comprehensive array of
technical measures to protect documents and patient information.
A robust set of customer-controlled settings and deep user
identification and authentication options can provide further privacy
and security protection.
Visibility – It is important to track each step as a document goes
through the approval process. Instead of requiring a staff member to
shepherd a document from approval to approval, find an electronic
signature service that does it for you, one that enables multiple people
to sign the same document in the correct order, as well as sending
automatic reminders to expedite the process.
Legality – Integrated signer authentication, a complete audit trail, and
a tamper-proof virtual seal of the signed document are a necessity to
ensure legality, as well as a secure and encrypted web interface.
Mobility – With people increasingly on the go and managing
their lives through mobile devices, the speed and accessibility are
essential. Look for a solutions provider with a versatile and secure
option that allows documents to be sent, signed, tracked, and stored
in a mobile environment.