Hi All,
We (I) have been tasked to write a policy on acceptable use for Electronic Signatures within MidCentral DHB. I am keen to learn how others have approached this issue. There is a narrow view of just referring to the electronic sign-off for results or e-prescribing of medications. The wider view might also include the use of electronic signatures on documents including clinical letters and reports.
Thanks for your help with this.
Greig
Hmm, I don’t think we have a policy we just went right ahead and started using right signature and away we went with documents. Prescribing is built into our CWS so likewise no policy. I will be interested with what you come up with.
When I was at SDHB, I insisted on the ability to sign (or at least officially ‘own’) an anaesthetic assessment as part of the development of their Anaesthesia Preoperative Assessment Clinic System (with @lance.elder) This was tied to their network password (good old Active Directory [AD] working as it should), and only applied once per assessment / major change. This functionality has subsequently been replicated in other systems within SDHB (I think - @damon can correct me if this is a bit grandiose)
Medchart effectively does the same thing (albeit without the nice AD bit), and allows this for batch changes.
In Birmingham (with an e-prescribing centric EPR), this same sort of implementation was used. In fact, overused. It was forced on the user excessively, and as a result was annoying, slowed workflows, and encouraged bad password practice (make it as easy to type as possible).
The key is getting out of the ‘paper signature’ mindset, and see this as an opportunity for positive digital transformation. Clearer ownership of decisions can often be achieved by simply recording the user who made the directive passively, or perhaps seeking a confirmational ‘tick’. Save ‘signatures’ (really digital user re-validation) for things that truly matter as it has a workflow cost.
The whole thing must really be viewed from the user perspective(s) in concert with the organisational - this is often neglected to our collective detriment. Learn from Google et al, who have this nailed.