12 Pitfalls of Electronic Patient Signatures in Registration

     

So you want a paperless registration process? OK, cool! All you have to do is 1] find a few vendors 2] schedule demos 3] select a winning vendor 4] negotiate the price 5] negotiate a contract 6] sign the agreement 7] implement the solution and 8] everyone lives happily ever after…

That is until the real word interferes with your project and everything goes to heck.

Like literally every other technology ever made, eSignature has some pitfalls. We vendors usually do a pretty good job of demoing a perfect solution, so let me arm you with the 12 pitfalls of electronic signature software so that you can avoid them and really live happily ever after. 

1] eForm content on the device

How are you going to get patients to sign the eForms? Most hospitals choose some form of an LCD device in the registration area. Unfortunately, many pick a device that captures a signature without showing any form-relevant content.

You ask the patient to sign, but all they see is a blank line with an “x” next to it. It’s common for them to feel wicked uncomfortable (I live near Boston, so the dialect is rubbing off on me.) consenting to anything on a device that does not actually clue them in to what they really are signing.

Signing off on a healthcare form is way different than signing off on a credit card purchase to buy that drone you want.


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2] Stylus batteries

About those LCD devices that I just mentioned—some of them have batteries in the little stylus. You know what that means? The batteries will die. You know when they’re going to die? 3:18 a.m.

3] Signature security

Again, we’re talking about electronic signatures in healthcare and not some silly retail purchase. What advanced measures are in place to ensure the security of the signature on the form? Is it just an image of a signature on top of an image of a form, or is there more to it? Consider how you would protect yourself if a patient sued you because someone “forged” their signature.

4] You still have to scan paper—OMG

Believe it or not, some electronic signature solutions capture an electronic signature on an electronic form BUT are unable to send it electronically into the patient’s EHR through an enterprise content management (ECM) system. So, if you can’t do that super-basic thing, your staff must print out the electronically signed document just to scan it back into your ECM system. Not cool!

5] Expansion beyond registration

This one is simple. Are you buying a solution that you can use ONLY in registration? Or can you also use it at the patient’s bedside, radiology and even in the back office? Yeah, patients sign a lot of forms in registration (unless you’re in Canada or part of the NHS in the United Kingdom), but they and other people also need to sign forms in other areas of the hospital. Is that swanky solution you’re buying going to work in other areas? It needs to.

Also, what if you want to use a different eSignature device in those different areas? Will your solution let you do that or are you locked into a certain type of LCD device?

6] What happens if the patient has a heart attack?

What does this have to do with anything? Well, what if a patient is at registration signing five forms, they electronically sign two of them, but then they clutch their chest in pain?

Do you…

A] Take the patient in for immediate care?

B] Ask the patient to hurry up and sign the other three forms?

If you answered “b,” then please find another career. I would highly recommend a cable company’s customer service department for you. Anyway, here’s the point: you may need to stop part way through the signature process and pick up where you left off at a different area of the hospital later, and potentially (hold your breath now for dramatic effect) have the patient continue the electronic signature capture process using a different device than what they were using in registration. (OK, you can breathe now. And thanks for playing along.)

7] LCD devices and WOWs

Do you want to use eSignatures at the bedside? Great! Now picture this: you hook up a swanky LCD device to your workstation on wheels (WOW) and you hand that LCD device back and forth to patients for a few days. Guess what’s gonna happen quickly? That itsy-bitsy cord that connects the LCD device to your PC is going to wear out, and then it’s going to constantly come unplugged from your LCD device.

Yup, that’s the point of failure on those things. I advise asking your electronic signature vendor about this and then watch them either break under the pressure of your question and steely gaze or rise to the occasion and answer your question with earth-shattering bravado.

8] Can you make that wireless?

No! Just no, OK? Ask the question if you want, but do NOT use wireless LCD devices in registration. Even though they don’t have legs, they walk off anyway. Use an iPad if you want, and that’s totally cool, but expect some of those sweet little devices to show up on Craigslist being sold by some guy named Dale. (If your name is Dale and you’re reading, please know that I make ZERO apologies for this comment. Anyway, Dale, I’m sure you’ll 100 percent agree with me, because you’ve 100 percent done something like this.)

9] Data on the device

Based on my previous point, if you do have a wireless device, then expect them to walk away sometimes. When they do, what you do NOT want is for the aforementioned Dale to get his hands on patient data. A leak of patient data is going to cost you waaaaaaaaaay more than that device you just lost.

10] Warranty

Only one person in my 12 years of selling eSignature solutions has ever asked me about warranties. People, we’re talking about hardware here. And might I remind you that you’re in healthcare—an industry that’s notoriously tough on hardware. What happens when these devices break? Ask about warranties. Trust me, it will save you some green.

11] Disinfecting devices

Patients are disgusting. Make sure the device can be cleaned with nothing short of molten lava, or a comparable hospital-grade disinfectant. It’s a major bummer when you find out that you can’t adequately clean your device.

12] Patient perception

This is one thing that few people ever consider, but it’s one of the most important. When you buy an eSignature solution, there is a tangible aspect to that technology. Patients will be physically touching and signing on these devices.

We’ve all signed off on things electronically and have our own experience as to how some devices are just complete garbage. DON’T buy garbage LCD devices for your patients to sign. Quality devices kick off a quality patient experience—especially in the registration. Because that’s where your patients will be forming their first impression of your facility, and we all know how many shots we have a making a good first impression. (Dale, it’s one. You only have one shot!)

OK, if you made it through my 12 pearls of wisdom, then congrats. You now hold the power to strike fear in the hearts of a lot of electronic signature vendors. Now the question is, what will you do with this newfound power?

Always remember what Charles Xavier from the X-Men series says, “With great power comes great responsibility.” If it were me though, I’d make them sweat!

About The Author - Cody Strate

For more than 10 years, Cody has helped healthcare organizations worldwide eliminate the costs and risks of paper through e-forms and e-signature solutions. In addition to helping others achieve their paperless goals, Cody finds time to put his biochemistry degree to work in the kitchen testing out new recipes on his unsuspecting family.

Feel free to email me here.