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    Pediatric office paper chase: Revisited!

    Electronic health records (EHRs) have added complexity to document handling. Dr Schuman reviews what’s new and how to streamline your own office “paper chase.”


    Electronic signatures

    Schools, camps, and daycares usually require health forms, absentee notes, and other paperwork be signed by the provider to demonstrate their authenticity. Fortunately, most EHRs have the capability to insert the phrase “This document has been signed electronically” as well as a time/date stamp authorization at the bottom of the document. By doing so, the user creates a document that is universally accepted, while eliminating the need to physically sign every document generated by the EHR. These EHRs can do this because they require user names and 1 or 2 means of identification (password/pin/fingerprint/secret questions) to permit access to the record system.

    However, what about the forms that need your signature and, ultimately, may be scanned into the record?

    Signature portals and applications

    There are several signing services that facilitate form completion and signing that can help expedite workflow. These range in price from free to $10 or more per month and may be worth implementing into an office document management program. These include market leading services such as DocuSign (San Francisco, California), and Adobe Sign (Adobe Systems; San Jose, California).

    Next: Using practice websites to improve your practice

    You can get free access to Docu-Sign (only for signing documents, and not sending documents for signatures by others) by visiting bit.ly/free-DocuSign. You merely scan documents that need completion into a folder (local, network, or cloud) and use the DocuSign portal to fill out the necessary fields and add a signature. DocuSign costs $25 per month if you want to use it to get others to sign documents you send. You can upload a digital signature into the DocuSign portal by scanning your signature or generating a signature with a stylus and tablet and capturing the signature as a graphic image. Upon document completion, you e-mail the completed document, and download it so it can be loaded into the EHR if necessary. There are just a few steps involved in this process, which makes it easy to use, and you can use the DocuSign mobile application on a tablet to complete the documents as well. The application also enables you to use your finger or a stylus to capture a digitized signature for use on all DocuSign documents.

    Although I’ve long been a fan of Adobe products, Adobe Sign costs $10 per month, is a bit less user friendly compared with DocuSign, and takes a few more clicks and screen changes to accomplish signing a document. The mobile application also pales in comparison to the DocuSign mobile app. Both services maintain an audit trail of all documents signed as well as when the documents were e-mailed to the recipient.

    Andrew J Schuman, MD, FAAP
    Dr Schuman, section editor for Peds v2.0, is clinical assistant professor of Pediatrics, Geisel School of Medicine at Dartmouth, ...


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