“The use of e-signature has certainly increased, and we’re now looking at our needs and plans for the next five years,” says Kishore Reddipeta with Stanford Children’s Health.

Nov 04 2021

Healthcare Systems Make the Move from Paper to Digital

E-signature solutions have helped healthcare organizations weather the COVID-19 pandemic and accelerate their digital transformation efforts.

Several years ago, Stanford Children’s Health rolled out Adobe Sign to streamline signatures and approvals for IT contracts. Then in spring 2020, the COVID-19 pandemic hit, and the e-signature solution went from an optional tool to a mission-critical application.

“The pandemic not only accelerated the need for digital transformation, but it also accelerated the use of various digital solutions that we already had in our environment,” says Kishore Reddipeta, director of web systems and technologies for Stanford Children’s. “The use of e-signature has certainly increased, and we’re now looking at our needs and plans for the next five years.”

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The pandemic was a catalyst for e-signature adoption at healthcare organizations across the U.S., with providers using the technology to both speed up business processes and streamline patient-related paperwork. Still, many organizations have lagged behind on widespread deployment or haven’t explored the solution yet.

“There’s still a lot of opportunity to digitize those signing workflows,” says Holly Muscolino, research vice president for content strategies and the future of work at IDC. “Then there’s the next step, which is to truly transform those workflows. You can more or less replicate paper workflows digitally, but to truly transform those processes, organizations need to fully leverage solutions like content workflow. That will be an ongoing evolution.”

E-Signatures Enhance Clinical Workflows

Stanford Children’s saw immediate ­benefits from deploying Adobe Sign. The approval and signature process for contracts shrank from days to minutes, Reddipeta says. The organization also saved money on paper and printing costs, and it saw improvements in workforce productivity. Stanford Children’s has now started using the application in clinical settings, helping streamline paperwork for patients’ families.

“We want to continue to improve the patient experience,” Reddipeta says. “Private sector companies are providing a digital experience for their customers, and patients expect the same experience from health systems. It’s no longer an option. Adopting e-signature platforms helps us bring that digital experience to families.”

MIMIT Health in Melrose Park, Ill., uses DocuSign for patient registration and consent forms, and it has integrated the tool with its electronic medical records system. The organization turned to DocuSign Agreement Cloud to increase efficiency and collaboration, break down data silos and accelerate previously bottlenecked processes.

“Going paperless is a very important part of scaling up in healthcare,” says Manish Goomar, the director of digital systems for MIMIT Health. “What really made us go for it was the customer experience.”

When MIMIT Health analyzed its use of DocuSign, the organization found a 40 to 50 percent productivity increase among the staffers responsible for registering patients. It has also seen significant adoption among patients, who are using DocuSign to complete forms online at home or on iPad devices when they arrive for their appointments.

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Enabling E-Signature Security to Protect Patient Data

Not long ago, many healthcare providers eschewed the public cloud, worried about the vulnerability of patients’ health information. Today, a number of providers have come to view cloud-based tools as a way to enable patient privacy and boost security.

“A piece of paper can go missing,” Goomar says. “When it’s digital in the cloud, you have audit trails. You can put processes in place so the information can’t be deleted, and you can see who’s accessing it. You can’t do that with paper.”

Almost all products from leading e-signature companies are HIPAA compliant, Muscolino adds. “People are concerned about security, but the reality is that these tools are more secure because you don’t have paper documents that can be lost or misplaced,” she says.

Source: Forrester, “The Total Economic Impact of Adobe Sign,” August 2019

Although security and compliance features are baked in with e-signature solutions, it is still important for organizations to layer their own governance frameworks on top, Reddipeta says. “Governance is a key foundation for all of our digital ­transformation efforts,” he adds.

For instance, Stanford Children’s established a support structure to ensure its e-signature environment continues to operate smoothly and entered into a HIPAA compliance agreement with Adobe. Additionally, as with all of the organization’s digital transformation efforts, the e-signature solution ­underwent a mandatory comprehensive security review process.

“We want to ensure that any business process or workflow that we’re digitizing is thoroughly reviewed for all security best practices and controls,” Reddipeta says.

E-Signatures Remove Roadblocks in Healthcare Workflows

Tidewell Hospice, based in Sarasota, Fla., saved 2,700 pages of printing per month after moving from paper-based processes to DocuSign. It also saved $120,000 annually from the reduction in both printing costs and employee hours spent managing certain business processes.

Before the organization implemented DocuSign, only 26 percent of in-home hospice visits were two hours or less. After the move, that number increased to 42 percent.

“Prior to DocuSign, nurses or social workers would have to go out with the patient forms and get the patient to sign them or try to find a family member or caregiver with power of attorney,” says Joseph Eckert, director of IT applications at Empath Health, Tidewell’s parent company. “It was the same with physicians. Before, we would take the certificate of eligibility and stuff it in an envelope and mail it to them, or else fax it or even drive the form to their office.”

The new technology didn’t just accelerate workflows and cut down on paper; it decreased the number of unreimbursed visits, helping the organization recoup revenue that was previously lost.

“We only have so many days to get the paperwork in,” Eckert says. “If we don’t get the patient forms into the Centers for Medicare & Medicaid Services in that time frame, then we can’t file claims for visits until we do. Before DocuSign, we heard quite often of nurses and aides going to see patients, and we couldn’t bill because we didn’t get the correct forms done.”

DocuSign has shortened that time frame, Eckert says. “The number of unbillable visits has gone down dramatically.”

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Adding Value Through E-Signature Integration

Varian Medical Systems, a Palo Alto, Calif.-based company that specializes in cancer-treating devices and software, relies on Adobe Sign to facilitate remote work and reduce the redundancies and delays associated with paper-based processes.

The company integrates Adobe Sign with several other tech tools, which multiplies its benefits, says Robert Xu, enterprise application solutions manager at Varian.

For instance, Varian’s engineering reports are generated in Salesforce, but the signatures for those reports are completed through Adobe Sign. The company also integrates the tool with Workday, primarily for hiring: When the company sends offer letters to prospects, the new hires digitally sign them using Adobe Sign.

Integrations with other tools can take days or months, depending on the complexity of the application, Muscolino says.

“Adopting a solution for a one-time signature is pretty easy,” she says. “The challenge is greater when organizations integrate these tools with other enterprise applications, and vendors offer varying amounts of support for that. Larger vendors have more robust application programming interfaces and connectors. We’ve asked organizations how long it took to deploy these integrations, and it varied significantly depending on the use case.”

The biggest benefit that Varian has seen from its e-signature integrations is time savings, Xu says. It can take several days to obtain signatures using a paper format, he says, and even after that, people need to scan and convert the documents into an electronic format, making for a “redundant and time-consuming” process.

The e-signature solution has been critical, especially during the pandemic, when in-person options are limited.

“Everybody is remote, and everything needs to be done from your cellphone or your laptop,” Xu says. “It’s really mandatory. It’s less about savings and more about the fact that you simply have to do the signing in the electronic format.” 

Photography by Cody Pickens