A Workflow for Patient Electronic Signatures and Document Storage

Transcription

1 A Workflow for Patient Electronic Signatures and Document Storage Presented by: Margery Beck System Analyst Jennifer Boldin Application Support Analyst

2 MIMA: Independent 125-provider multi-specialty group practice in Melbourne, FL 132,000 active patients 840 employees 200 servers 1400 workstations 60 applications

3 This presentation will cover the implementation of Visual Signature Capture in order to streamline patient check-in and front office workflow including: Understand the opportunity to streamline the front office workflow Insight and lessons learned from implementing a signature capture solution in a large multispecialty environment Ongoing support challenges and future plans for deployment

4 Visual Signature Capture is a web based program Compatible with Internet Explorer, Firefox, Safari, Android Direct connection with the EMR database SERVER MIMA uses VM environment for servers Windows Server 2008 SP2 4 GB RAM 32 Bit OS Network folder for PDF storage controlled by security group access

5 Protecting ipads from Damage / Theft Rubberized cases for ipads Attach stylus to ipad Use of ipad is in controlled environment, in staff view at all times Locate my ipad enabled Moved all Apps out of patient view

6 Allow additions and customizations of documents by the clinic Create templates that can use observations and/or data symbols Documents link to patient s EMR chart Prevent documents from being modified in any way once they have been signed Ability to review signed documents and documents pending patient signature

7 Previous Workflow Current Workflow Staff reviews patient s EMR chart Staff reviews patient s EMR chart Patient completes/signs documents Patient completes/signs documents on ipad Staff scan documents into EMR Manually index patient and document info Manually add Obs No staff intervention

8 Monitored 1 physician for 3 weeks where 2 different registration forms were used on Visual Signature Capture Average of 15 patients a week needed to sign at least 1 document Average of 5 patients a week needed to sign 2 documents Equals 25 documents a week Multiply by 125 physicians at MIMA = 3,125 documents a week

9 Eliminate paper documents that would need to be filed or scanned into the patient chart Allow patient to sign the document(s) electronically when checking in or out of the clinic Develop flexible workflows for each clinic/specialty Ability to manage patient and document queues Add and remove patients or pending documents as needed Easy retrieval of documents from EMR

10 Visual Signature Capture is template driven Templates are customizable Any document currently requiring a signature and/or information from the patient can be customized into a template

11 Check boxes Drop Down Lists

12 Check boxes with Edit Fields Allows one or several options to be selected Allows additional information to be entered

13 Radio Buttons with Edit Field Allows ONE option to be selected Allows additional information to be entered Required fields are also an available option when creating templates

14 Example of MIMA s HIPPA form

15 Each form can have one or many observations attached. HIPAA form is imported with 1 observation stating that the form was filled out. Health History forms can be imported with several Observations. Examples: Family History Smoke status/history Preventative Care (Flu & Pneumonia vaccine, etc.)

16 Staff log into application using their EMR login

17 Staff will pre-populate the patients to the Visual Signature Capture application from the Physician s schedule. Staff will add any forms needing to be signed to each patient.

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21 Staff log s the patient into application using a unique PIN number

22 The PIN number is assigned by the system at the time the patient is added to the queue

23 The list of documents requiring signature appear under the patient s name. Clicking the Sign button will open the form for the patient to sign

24 The patient then reviews and signs the document, then clicks the Submit button.

25 Once the Submit button is clicked, the document is saved and stored.

26 Signed documents are available to be viewed in the History tab of the Visual Signature Capture application. The documents are view only and cannot be altered.

27 Clicking the Submit button starts the process of generating the HL7 message which is sent to the LinkLogic Data In folder and then on to EMR.

28 The documents are then available in the patient s EMR chart. Any Observations attached to the form(s) are also populated to EMR.

29 Have a plan for what documents are most often needed and start there with building your templates Flexibility is key with creating office workflows Have a backup plan for patients who are not comfortable using the computer or ipad to sign the documents When setting up computers/ipads for patient use, keep privacy in mind Strategize how to keep the ipads from walking away

30 Addition of all Health History Questionnaires / ROS forms Addition of specialty specific forms Pain Management OB/GYN Auto populating patient list from EMR appointment book. Integration with our online patient portal to allow patients to sign documents prior to coming into the office

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