Electronic signatures aid transcription efficiencies
Physicians can choose whether to use them
The record had been filed with a physician’s electronic signature affixed to the bottom. But the record was incomplete — the transcriptionist left several blanks where she didn’t understand the physician’s words.
This was the fear of Joyce Graves, ART, director of health information management (HIM) at Hinsdale (IL) Surgical Center when her facility adopted electronic report authentication.
It never happened. Instead, Hinsdale achieved its goal of increasing efficiency in the transcription process.
At Hinsdale, electronic signatures are used based on a physician’s preference. "Doctors are not required to have one, but it works well if they agree to it," Graves says.
If they agree, the physicians read the hospital’s policy and sign a document, which states that the physicians agree to having an "electronic signature" line affixed to each record at the end of their dictation. "It goes right on to the transcription report," Graves says. Only a few of the 140 physicians at Hinsdale have not agreed to use the electronic signature.
The physicians are then assigned secret four-digit ID numbers. When they call into the system, they give that ID number, which identifies them as being the user.
"[Participating physicians] dictate into a telephone line," Graves says. "They can do that within our facility or from any telephone. It goes to the service and then the service downloads it to the individual transcriptionist."
When the reports are returned from the transcription service, Graves proofreads them while she is coding them. She then forwards them to the physicians. "They have a 72-hour window from the time that they receive a report to make corrections to it. After that, it’s assumed that everything is correct in the report. The doctor can hand-write in any additions or the doctor can write all over it and ask that it be edited and corrected and retyped."
Doctors have option of old form
If the reports need to be retyped, physicians may request during the dictation that they do not want to have the electronic signature attached to the record. They also might say this because the report is long or includes some words that they think that the transcriptionist might misspell. "Then we’ll just get a report that has a line on it for a signature," she explains.
Hinsdale’s policy regarding the electronic signature is in line with that of the Joint Commission on Accreditation of Healthcare Organizations in Oakbrook Terrace, IL, Graves says. (For more information about the Joint Commission’s policy, see box, at left.)
"It’s our responsibility to make sure that the phrase electronic signature’ is at the end of each report provided that there are no obvious errors in the report or blanks. If it seems like a complete report, then it’s marked with the electronic signature type stamp," she says. Physicians, however, have the responsibility to make sure they have received all of their reports.
The electronic signature system has saved Hinsdale quite a lot of time. "It used to be that we would get the reports from the transcription service, and we would have to make a copy right away," Graves explains.
"We would put the original in the chart and mail out the copy. The doctor would have to read it, sign it, and mail it back to us." That would often result in an unsigned copy staying in the chart for more than a week, she adds.
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