AC 6.1.2 anyway to include an "image" of your signature that was signed from a tablet on the "Orders" that can be printed to give to a hospital for blookwork, etc. Right now it has Doctors Name with "(Electronic Signature) underneath. I think it would look really slick it if just had the doctors real signature stored somewhere in AC and then when you print it its presigned just as an "Electronic Signature".

Anyone find a way do to this?

Correct: My hospital wont accept an electronic signature for anything, except prescriptions...funny...you could make a mistake and kill a patient with a drug...you can sign that electronically, but you cannot get a simple urine test without a true signature..

There is no reason for them not to accept it. I would threaten to send patients elsewhere, say to Labcorp or Quest.

this excerpt is from an article in Medical Economics which discusses the forms of electronic signature that CMS deems acceptable.

when i preview the order requisition slip, all that it says is ordering physician, and my name is in that section. none of the verbage as mentioned above exxists to make it cms compliant. i am having a lot of flack from the hospital lab about this , i wish ACwould have a fix for it in their next update! what does everyone think??

yes we need a quick document that we can generate that doesnt need to be hand signed. Then I can send it to the local hospital through updox/fax

What I do Sambo is create a template under the orders section.
I create all labs from the custom order section, I do not use the AC labs at all.
when I right click in the custom order field, one of my templates is called "aaadocsignature" thereby pushing this to the top of the alphabetical list.

The template reads "electronically signed by Adam Lauer, D.O."

I have added this line to all lab order sets that we created. So the only time I actually have to add the signature template is when I free type an order, then I add this line.

We have two hospitals in Bangor, ME. One does not require any "electronically signed by" verbiage. The other one however does require it. By adding it to all custom orders, there is never a question and never a call back. I also have patients who live as far away as 50-75 mile radius from Bangor. We routinely deal with 6 other hospitals in those other towns. They all seem very happy with this line added to all of our lab and radiology orders.

It works very nicely for our office.

Perhaps I am misunderstanding, but I think the original issue has gotten lost. We started with:

In Admin options, under "User Accounts"..."Edit an existing user"...you have the option to put in a signature. Having done this, when I print an order (for blood work, imaging, etc) it is signed with that signature, just as a prescription would be. Is this not what you are looking for?

Not all labs will accept the digital image of a signature, at least not the 6-8 hospitals that we deal with in our geographic locale. It might be worth investing in a short phone call to your local labs before pasting the digital image to everything.

right, most labs in my area do NOT accept the electronic image of my signature. i tried to do that initially, but it did not solve the problem!

It's dumb rules they won't take a scanned image of your signature, but they will take the words "this is my electronic signature."

OK, here are some ideas for digital signatures. Again, as Leslie says, if you have options, meet with the president of the hospital and tell them you will go elsewhere:

First, this has been around for over two years. You can browse to your own signature and it should show up in most places you use a signature. It's been a while and some things have changed. Best when used with a trasnparent signature.



Make a "digital doctor" We gave the username zsignature, so it would fall to the bottom of the sign on. It's what you put in the name that counts.



When you go to choose what signature you want, rather than choosing yours which will not count, choose the Digitally signed by... (this has to be the last thing you do). Nice thing about this is everyone can use it.



This results in the following digital signature:



Finally, it is always good to make a transparent signature. There is a new program out, cheap and easy. You can use Adobe Photo Shop, there is a user on here than can help and then there are those on the Internet where you email your signature, they do it, and email it back. I have my transparent signature everywhere including in my PDFs. One good thing and one bad thing. Good: I always make sure I overlap something in the PDF so it appears like a real signatuer, Bad: Since you are trying to do it right, you as I tend to write a very good signature rather than your usual scribble.



Radiology vs Lab. In general, the lab is always more accommodating. In fact the alway have been.

Radiology: MUST have "Digitally signed by..." Also, must have faxed order, you can't call it in and then fax it. Likely to to their not getting paid. Also, if they wanted x-ray of hand and wrist and you wrote write and hand, they make you do it over. I usually just write x-ray of whole body with digitial signature and wait for them to tell me what to write. And, if I write x-ray of left hand, but the patient's right hand is hanging on by one tendon and bloody, they won't believe the patient.

Lab, you can write your signature with a crazyon. But, don't know a BMP from a LDH. And, they refuse to ask their signature. Also, if you just biopsied someone's liver in your office but you put the name down wrong, they will call you and throw away the specimen. They have no idea what VPA is, and they make you write down Valproic acid. So, I just write Depakote.

But, my newest and greatest pathetic "what makes medicine cost money" is you can no longer write "Nebulizer for asthma" the diagnosis being necessary for over a year here. But, you can write for Vincristine and Methotrexate just like that, but you must write Face to Face Encoutner of whatever date you saw them last.

Wow, Indiana must either be much more progressive or way behind the times. None of the labs, radiology or hospitals still require any of the verbiage Bert mentions. They all take my regular old digital signature. The only ones who do not are mail order pharmacies in Arizona and DMEs billing Medicare. All of those are told to mail me the original papers if they want an original signature. When everything first went digital, the local hospital tried to make us hand sign orders which the patient had to hand deliver to them. I told them I would then refer my patients to Labcorp. It did not take long at all for them to change their minds. They said they had to "run it through legal". Maybe it helped that their "legal" is my patient

I think it was that Bob Knight was head of the hospital association.

For us it is basically like Leslie. A "transparent" signature in AC is pretty hard to differentiate from a regular signature, especially once it has been faxed. Maybe they don't know, or maybe it just gives them plausible deniability ("it looked like a real signature to us"), but they all accept them here.

Bert,

Don't ever give up your chair here in Indiana!

What program is that?

Aren't chairs safe there? I have never seen one thrown.

Wendell, I can't remember.

I can't remember the last time I wrote just one Rx for a patient, or signed only one page for the monthly facility MARs, or a single place for the home care orders. And if you use an electronic transparent signature, it looks perfect & identical on the forms at each area. So it's obviously not "signed". So I just use the pencil tool on Updox for forms, and I sign the Rxs by hand.

I don't think I am doing any more .pngs or .jpgs.

I'll just write, "Make a new doctor called....then click on him and you will see the digital signature where it would says Electronic Signature. You could see it if I took the trouble to make a .jpg, but I don't want to go to all that trouble. Kinda like the SharePoint thing. At least I can admire Sandeep's efforts. Now those are some good .jpgs.

You guys are making it too hard on yourself. I had this issue with all the mri/xray things that I would sned out of my office for. THey wouldn't take it at first because it said electronic signature...

I simply called the head of the labs/xray/radiology/hospitals (yes it took me a bit initially but worth it)..i simply told them, here is how much i send you, in today's age we aer all electronic...if you aren't up with the times, i will send to your hospital/lab which is your competitor becuase they take the script and order the way it is. let me know what you want to do.

it was that simple and was fixed in a week.

Simple and fixed if you have a competitor to send to.