Electronic Signatures in E-Healthcare: The Need for a Federal Standard

Healthcare, like many industries, is fast embracing the benefits of modern information technology ( IT ). The wide range of available publications on the use of IT in healthcare indicates that IT provides the promise of faster and more comprehensive information about all aspects of the healthcare delivery process, to all classes of its consumers - patients, doctors, nurses, insurance adjudicators, health inspectors, epidemiologists, and biostatisticians. But the drive towards electronic information in health care is not rooted merely in efficiency; more recently, significant emphasis has been placed on patient safety issues raised by the Institute of Medicine\u27s ( IOM ) year 2001 quality report on the subject. It is believed that the deficiencies indicated in that report can be substantially overcome by the use of IT in health care. However, to make this transition successful and complete, all aspects of health care delivery, information management, and business transactions, have to be logically migrated into the electronic world. This includes the function and use of the signature. The use of signatures in business contexts has traditionally provided two functions of legal significance: 1) evidence that can attribute documents to a particular party, and 2) indication of assent and intent that the documents have legal effect. In the recent decades, state and federal statutes have substantiated these functional attributes to digital or electronic signatures. Many of these statutes derive from model codes, such as the Uniform Electronic Transactions Act ( UETA ), that attempt to standardize use and technology surrounding electronic signatures. Subsequent sections will attempt to identify gaps in the standards which prevent true transaction portability. Lack of portability defeats one of the fundamental goals of health care IT solutions - improved efficiency. The discussion will end with a proposal for a uniform federal statutory scheme for standardized electronic signatures for health care