A Patient eSignature Case Study
Northern Regional Hospital
Creating a better experience for healthcare workers and patients
Northern Regional Hospital, located in Mount Airy, North Carolina, has been carrying out its mission to provide the residents of its community with access to quality and affordable healthcare since 1957. Northern Regional Hospital is a 133-bed hospital that encompasses a wide number of services including cardiology, pediatrics, and women’s health services. Additionally, Northern Regional is certified as an Advanced Primary Stroke Center by The Joint Commission. Northern Regional Hospital is also one of the largest employers in the region, with over 1,000 caregivers alongside their state-of-the-art Surgery Center, which houses a wide range of inpatient and outpatient procedures such as orthopedic, gastroenterological, urological, and general surgeries. Northern Regional is also the only hospital in the region to receive a Four-Star Designation by the Centers for Medicare and Medicaid (CMS). Northern Regional Hospital’s primary goal is to improve the health of the surrounding communities, one patient at a time.
As such, Northern Regional Hospital adopted patient eSignature Technology by deploying Access’s eSignature Platform for registration areas and informed consents at bedside. Patient forms are now accessible instantly upon completion and there is no paper scanning involved, which has drastically reduced paper usage and created a more efficient patient forms process. In shifting towards a paperless environment, Northern Regional streamlined patient throughput, reduced hard costs associated with printing and scanning, and improved the overall experience for both patients and clinicians.
PATIENT ESIGNATURE Case Study Highlights
- HIM staff role growth by verifying patient information and electronic patient form building.
- eForms approach is praised and adopted by Risk Managers in removing compliance issues.
- Patient electronic form interoperability makes audits easy and accessible.
- Access Automation freeing up registrars to focus on the patient’s care needs and not forms process’
- Creating a better experience for healthcare workers and patients.
- Eliminating “Scanning Only” department, removing paper costs and unnecessary workloads
- Enterprise-wide patient information and instant accessibility across 10 connected facilities.
Life Before Paperless Patient eSignature
Northern Regional Hospital’s registration and consent process was largely paper-based, which created inefficiencies, added unnecessary costs, and made an already difficult experience for patients more difficult when met with loads of paper forms. The hospital would print out patient information packets that included everything from demographics to financial responsibility forms that needed to be signed by the patient. Once the patient completed the forms, they would be physically scanned into the system and routed to the patient chart—a long, drawn-out manual process that was highly inefficient and a nightmare for compliance.
Jane Ayers, Northern Regionals’ Financial Systems Analyst of 36 years, remembers the situation vividly: “Oh my! Paper processing was all manual and very slow with many people involved.” she recalls.
In the past, Northern Regional Hospital had an entire team and room devoted to printing consents and scanning them. The labor-intensive, manual process was a problem for compliance, particularly because of what is sometimes called “Frankenstein” forms, where a form has been copied so many times that it’s distorted and illegible.
“Just for the paper forms themselves, We had a printing press operation that is long since gone. And now the forms people have access to, are a good, clean copy. They have not been copied 25 times and they are not off center. Access software makes a difference, where we can really keep up with the forms, as they’re updated electronically. So you always have the most recent version with the most recent date being used with patients. Selecting a form when needed has saved a ton on paper costs.” says Ayers.
While paper printing was certainly a hard cost, it was far from the only benefit of implementing Electronic Patient eSignature. Northern Regional also had a team within the Health Information Management (HIM) department that was devoted entirely to scanning the patient forms manually, requiring another touchpoint in their hospitals’ manual paper process.
“We had a ‘scanning only’ [section] in our medical records department, where all of the patient’s files and forms would come to them once somebody was discharged. They would organize the forms by type, and scan all that paperwork in, which was a lot to manage. “
Financial Systems Analyst, Northern Regional Hospital
The eSignature Experience for Health Information Management Staff
With the onset of eSignature technology, paper forms became unnecessary and the labor-intensive scanning required of HIM departments was virtually eliminated, resulting in not only an impact on physical aspects of handling paper and storage, but also an impact on their hospital workforce. Northern Regional, like many other hospitals with limited staff resources, choose to redirect existing staff to new roles within the organization.
“Now, it’s totally changed. HIM staff members’ jobs have changed to more of a verifying that everything’s okay, versus doing the actual scanning. And they are at a point now, where several team members are going to become our forms builders. So, they have moved from scanning forms to creating them electronically. It has totally changed what they were doing, which is great!” says Ayers.
eForms Management Improving Compliance and Risk
While automation, auto-filled demographic patient information, and information verification is all much easier when done electronically, Northern Regional’s Risk Manager also sees the benefits of the electronic process when it comes to compliance. She remembers how difficult it was before they could lean on technology for certain securities.
Ayers explains, “Our risk manager here has actually done several of our form builds in the last couple of years, so she really understands what we get out of keeping forms up to date, and not having to chase one down, or pull one out of a drawer, when we get a surveyor in. Whether it’s just something that is done every three years, or unannounced, there are surveyors in all the time. So it’s nice when they’re able to look in the file, and all the data they need is organized and available. It looks good, and it’s readable. Great for compliance.”
Patient eSignature has allowed Northern Regional to feel prepared and organized when a surveyor comes in for an audit, with the confidence that their electronic process ensures accurate, up-to-date consent is being captured and stored electronically within the patient chart.
“The patient forms are routed directly into the patient’s record once it has been completed. You don’t have to search for a form, or go get another copy, or accidentally grab the wrong copy of something, because of a form policy change. So, it has helped streamline the forms process, and they are available immediately. It’s also really handy to have patient information on the floors once they arrive, because it helps everybody,” Ayers says.
Patient eSignature Experience in Registration & the Impact on Registrars’
One of the most significant impacts that Patient eSignature has had on Ayers and her team at Northern Regional is patient registration. Prior to Patient eSignature, patients would have to start the registration process all over again with each visit. It also required registrars, who were sometimes new employees, to memorize which forms were needed and in which situations, which is difficult when a hospital relies in part on temporary staffing. This created an environment where new employees–namely Registrars—could do their jobs without having to memorize patient form logic. With Access eSignature Platform, forms are called based on specific workflows between Access eForms Software and MEDITECH.
Ayers says, “Access eSignature helps Registrars because they do not have to memorize which Insurance requires a particular form. With Access eForms a packet is already set up for them. Forms populate and patients sign them. So, registrars don’t really have to know what particular forms a specific type of patient needs. They just register the patient. And because we’ve got the flow set up for the forms in packets, it helps registrars a lot.”
Northern Regional is an expansive network of hospitals and connected physician clinics, so having access to patient information immediately at Registration has been greatly beneficial. The seamless interconnectivity between MEDITECH and Access eSignature software has allowed for seamless information exchange.
Ayers explains, “We also have ten physician offices that we purchased as a part of the hospital. And, because of the interconnectivity and the ability to see things better within MEDITECH, and the scanning capabilities for the driver’s license and insurance cards, the entire process for registration staff has improved greatly.”
eSignature Implementation for Surgical Services Informed Consents
Paper consents and manual processes have a higher risk of human error, with consequences that wreak havoc on many surgical departments due in part to illegibility, outdated information, and lost paper consents. According to JAMA statistics in Paper Informed Consents Sabotage Your Surgical Services Economies, as much as 14% of surgical delays are due to lost paper consents, wasting precious dollars and risking harm to the hospital’s reputation.
For example, an average hospital performing 10,000 surgeries per year would lose about 13,000 surgical minutes each year due to lost consent delays, equivalent to $1.8 million. Furthermore, the impact on a hospital’s reputation and the patient’s experience suffers when additional consents have to be captured due to loss or surgeries have to be rescheduled. Electronic processes, on the other hand, are automated with built in verification processes, ensuring that all information is always accounted for within the patient chart.
Ayers expands by saying, ” Paper informed consents had been a problem before. The Clinical Consents process now is much better. Better because of the speed of information. No one is really handling a piece of paper. And you are not laying it down to get lost. It’s signed, it’s in their record, and all that happens, quick.”
Patient Experience with eSignature Technology
Northern Regional serves over 100,000 patients each year, as the healthcare of choice across diverse communities spanning the Virginia/North Carolina border in an area that includes Mount Airy, Pilot Mountain, and other communities. Northern Regional also has the earned privilege of being named a top 100 hospital with a 5-star rating from CMS, and part of delivering exceptional care is having technology to drive better business processes and patient experience.
“It is a very positive thing for patients to be able to sign their forms electronically and not have to handle paper and pen. They just sign in when they get here. The experience has been more streamlined, which has really helped,” Ayers explains.
While implementing new patient facing technology involves a learning curve for patients, Northern Regional looks to healthcare technology to provide the best service possible. Relying on paper forms is not ideal; however, it is still an option in the rare cases where it is necessary. Access eSignature provides options to fit the needs of patients regardless of age, reading level, education, and even language, offering consent content in 18 different languages. Providing form options are at the fingertips of the registrars and forms are easy for patients to use.
“Our staff finds Access eSignature very easy to use. It is easy to read what they’re signing. It’s easy to sign it, and then patients can get a copy if they wish. All this technology keeps us where we need to be as an organization with our focus being on our patient’s experience. And those are all good, positive things,” says Ayers.
Why a MEDITCH Relationship Makes a Difference Working with 3rd Party Vendors
For 20 years, Access has worked with MEDITECH as a pioneering partner in Healthcare eSignature to advance processes and improve connections in working with hospitals during implementations. MEDITECH also uses Access for several of their own back-office processes requiring eSignature and resells Access eForms as a part of their MAAS offering, which requires a partnership built on years of dedication and trust.
” The Access and MEDITECH relationship has helped things go smooth. It’s like the software products just work hand in hand. The relationship has been there to aid whatever we were doing in Expanse and our switch over. It was just very, I don’t know, smooth.” says Ayers.
Access eSignature has the privilege of being MEDITECH’s chosen preferred eSignature partner for Expanse, made possible by providing the best integrated experience and building trust over the years. In fact, MEDITECH named Access eForms an Alliance core vendor. The result for hospitals is a seamless experience where users are not aware they are using a third party software – it’s embedded within MEDITECH.
Says Ayers, “Using Access eForms within Expanse, is a lot smoother than working with other third-party vendors. For new employees it is just a part of their daily operations. They never had to go out of MEDITECH and go into another software, so they don’t even blink with Access. It is a part of MEDITECH Expanse for them.”
Commitment as a Responsible, Trusted Healthcare Vendor
In being a responsible third party vendor, Access goes beyond the standard to provide highly responsive 24/7 support to hospitals. Ironically, Ayers has to buffer her support and form build requests, as she laughingly explains,
“They respond very quick when you have something. They’re quickly jumping on the system to look, or they’re calling you back immediately. To the point that when you have several things happen at one time, you have to wait before putting a ticket in. I’m like, okay, I can’t put that Access request in yet, because I don’t have time to talk to them right this second, because they’re going to call back fast. You know what I’m saying? It’s like I have wait and put that in just a minute, when I can actually sit here, because they’re going to call right back. You know, it’s that quick.”
Healthcare eSignature Platform Results Looking Back
The Access eSignature Platform has had a profound impact on Northern Regional’s patient consent process, removing clerical obstacles with automation while keeping up with a 5-star CMS rating. The Access eSignature Platform has had a tremendously increased Northern Regional’s ability to improve compliance and the patient experience to provide better care.
With Access, Northern Regional has been able to eliminate paper-based processes that were costly and inefficient, allowing for a better work environment for new Registrars and a more streamlined experience for patients. The relationship with MEDITECH has also been extremely beneficial in helping the transition to Access eForms go smoothly and seamlessly within Expanse. Access is a committed and trusted healthcare vendor that has been able to provide Northern Regional with the tools they need to improve their operations.
Ayers concludes, “It’s been very positive and I think the patients appreciate it. We’ve got several good reviews. And this technology has helped a lot to keep us where we need to be on the cutting edge with healthcare operations.”