Paper-based consent forms have always been the standard for hospitals—until now. An increasing number of hospitals are searching for an electronic signature solution that enables them to present their patients with eSignature capture options in order to eliminate paper, improve the patient experience, speed up the registration process, and provide a more secure process. While electronic signature solutions such as Docusign are commonplace in other aspects of our everyday lives, they may not always be a good fit for the incredibly unique needs of a healthcare environment. At Access, we have over 20 years of healthcare-focused and HIPAA-compliant eSignature experience. In helping over 1,000 hospitals across the globe, we have learned everything there is to know about successfully implementing eSignature technology, and we want to share those insights with you here. 

Top 10 Tips to Start a Successful eSignature Project Now 

  1. Find a Champion Department 
  2. Look Forward to Other Departments 
  3. Talk to Stakeholders 
  4. Consider eSignature Device Logistics 
  5. Consider eSignature Device Peripherals 
  6. Gather Your Forms 
  7. Evaluate Your Processes 
  8. Talk to HIM Because Crap Rolls Down Hill 
  9. Be Security-Focused 
  10. Consider Reaching Beyond the Walls of Your Hospital 


   1. Find a Champion Department 

The success of your eSignature project largely depends upon your people. While you may have identified the perfect process in the perfect department to use as your launchpad for eSignature, if the people in that department are not on board with these changes, then success is unlikely. 5 Steps to Getting an E-Signature Project Off to a Good Start suggests that,

“Having workers at every organizational level ready to show their peers how useful the technology is can make it much easier to spur widespread adoption.”  

A solid step one for your eSignature project would be to ensure that the people you’re starting with are eager and on board. Therefore, you must start in an area where the people are excited about the project and ready to disrupt the status quo. In Access’s Enterprise Patient eSignature Strategy Guide, we recommend a three-step approach to implementing eSignature in Registration first by starting simple, gaining success, and then expanding into other departments. Converting your registration process to electronic signature is an easy win that you can strategically build upon. The forms are simple, and the gains are big, with an average paper reduction of 85%. Registration is also a high-visibility department, which means the success you see there will likely spark interest and buy-in from stakeholders, department heads, and other department end-users. Once you have successfully rolled out eSignature to Registration, then you can expand into clinical areas where forms are more complex because they require data entry and multiple signatures from multiple parties who are in various locations across the hospital. 

  2. Look Forward to Other Departments 

While you may have your eyes set squarely on a single department to roll out eSignature in the near-term, do not limit your vision. Consider the next few departments and form processes you would like to target and take a special look at any unique aspect of those scenarios. In other words, the eSignature needs of other departments might be beyond the needs of your starting department, and you do not want to get an eSignature solution that is pigeonholed into a single application use. Ensure that what you get can work across multiple areas of your enterprise.  

  • Before moving forward, pass any Department you are considering for a patient electronic signature solution through the Access eSignature Readiness Checklist. Do not roll out eSignature in any department where you cannot readily supply answers to these questions. 


  • Is the department head enthusiastic about using eConsents? (This is huge – move on to another department if not.) 
  • Are there other key stakeholders in favor of the solution? 
  • How complex are the Consents and other forms? 
  • What is the volume and throughput of paper forms in this department compared to others? 
  • Which forms have the greatest potential to cut costs? 
  • Which forms will save time for clinicians? 
  • How big of a threat are these forms to patient experience? 
  • Are the department’s form-driven processes simple or complicated? 
  • Is there a functional process in place that can easily be replicated electronically, or are changes needed which could involve the forms committee, compliance, legal, and others? 
  • Does documentation stay in the department or does it go to other individuals and departments? 
  • Is there hardware in place, such as eSignature pads and tablets, or will these need to be purchased? 
  • What accessories – charging stations, outlets, etc. – are available, and how well do these match the device needs for the eConsent solution? 
  • Talk to Stakeholders 

While this may seem obvious, there are many hospitals that move forward to roll out an eSignature solution in a department without ever actually discussing the solution with them. Not surprisingly, this can generate a bit of frustration from the staff in this department and they may not be as eager to roll the solution out. If you discuss the proposition of rolling out an eSignature solution with them, you’ll help create willing participants in paperless change—and you might even learn a thing or two about how to best manage implementation in that department. 

  3. Talk to Stakeholders 

While this may seem obvious, there are many hospitals that move forward to roll out an eSignature solution in a department without ever actually discussing the solution with them. Not surprisingly, this can generate a bit of frustration from the staff in this department and they may not be as eager to roll the solution out. If you discuss the proposition of rolling out an eSignature solution with them, you’ll help create willing participants in paperless change—and you might even learn a thing or two about how to best manage implementation in that department.

  4. Consider eSignature Device Logistics 

When people think of eSignature capture devices, they often think of a single type of device such as an LCD pad from Wacom or TopazWhile these are great devices for some areas of the hospital, they may not be a good fit for other areas. For example, eSignature capture at the bedside is often best accomplished with tablets due to device mobility and portability factors.  

Pro Tip | If you find that tablets are better suited for eSignature, have a look at a few different tablets and present them to your team to gain their feedback and opinions. They know their situation better than you and will be quick to point out some blind spots that you may not have thought of.  

  5. Consider eSignature Device Peripherals 

Let us say you have decided that tablets are the way to go for eSignature capture. Wonderful, but that is just the start of what you need to consider. You also need to consider tablet cases (the folks at FutureNova make a great case), charging stations, stylus options, how to secure the devices, and ways to prevent hospital acquired infections (HAI’s). Visit our eSignature Peripherals Guide for more information on these considerations. 

  6. Gather Your Forms 

Again, this may seem obvious, but we have seen so many eSignature projects stall out because of poor preparation. Gather up the forms you wish to digitize and examine them to see if they are appropriately up to dateWe have seen many hospitals realize that the forms they wish to use in an eSignature project are out of compliance and need to go through a complete legal review, which takes precious time. 

  7. Evaluate Your Processes 

Carried over from point six directly above, you must also evaluate your form processes. Do you know where these forms need to go once a patient has electronically signed them? It is as simple as sending these forms to the patient electronic chart in Health Information Management (HIM), but perhaps the signed form needs to be made available to other departments as well. It is good practice in planning for an eSignature project to have your arms wrapped around the process that surrounds the form in addition to the form itself. 

  8. Talk to HIM Because Crap Rolls Down Hill 

Yes, I know that the “crap rolls downhill” phrase is a bit crude, but the saying deeply resonates with HIM Directors. Ultimately, all form processes end up in HIM, and they see their fair share of frustrating items regarding form processes. Asking them about any quirks regarding the forms you are considering for an eSignature project is a great idea because they will tell you about many of the problems they foresee, which means you will not be caught off guard.  

  9. Be Security-Focused 

This is an easy one, but it has a spot on the list because you need to ensure that in all things, you are being smart when it comes to security. Ensure that whatever vendors you consider have top of the line security featuresYou are dealing with overly sensitive PHI here, and some commodity eSignature solutions may not meet the stringent security bar that healthcare requires.  

  10. Consider Reaching Beyond the Walls of Your Hospital 

Patient eSignature is evolving, and the application of eSignature now extends beyond the four walls of your hospital. Telehealth has seen a meteoric rise since the pandemic as more and more patients seek treatment from the safety and security of their homes. In the hospital space, this means that any time you can extend your eSignature solution and capabilities to your patients in the parking lot or at home, you are able to create a quicker and safer contactless check-in process. 


Patient electronic signature is a massively helpful project in terms of saving money and time for your hospital, while also improving the patient experience. eSignature solutions are increasingly finding their way into our everyday lives, but everyday eSignature solutions may not be a good fit for healthcare settings, due to the stringent, complex, and security-conscious needs of hospitals. Tsuccessfully implement your eSignature project, focus on the 10 points outlined above, and should you have a specific question or need, please feel free to give us a call and put our 20 years of experience to good useWe are here for you. 

Access eForms has over 20 years of hospital specific eSignature experience across Epic, Cerner, and MEDITECH systems. If we can be of any help as you pursue, plan for, or consider an eSignature solution, please do not hesitate to reach out. It is our pleasure to help hospitals achieve their goals and provide the superior care that their respective communities deserve. 

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Cody Strate

Written by Cody Strate

For more than 15 years, Cody has provided sales and marketing leadership with the goal of providing the smoothest, easiest, and most pleasurable customer experience imaginable. Cody is a Forbes Communication Council member and lives in Colorado with his wife, two kids, and two dogs.