Evaluation of an Electronic Signature Consent Expansion Project

In July, 1999, the Uniform Law Commission (ULC) approved and recommended the ESIGN Act, enabling electronic signatures to have the same legal status as that of handwritten signatures in America (Tank & Whitaker, 2019). Therefore, this change allows paper consent forms for procedures in a healthcare setting to become electronic, in turn helping healthcare systems integrate it into their electronic health records. Making the transition from paper to electronic allows the health system to have greater control over their consent forms than previous methods due to the application integrating with their electronic health record (EHR) charting system. Talukdar (2003) notes that using electronic signatures for consent forms and other healthcare documentation is essential for "enabling access to relevant patient information from multiple encounters" and having "a significant positive impact on the quality, consistency, and timeliness of data and information" ( p. 102).Patients and healthcare systems can also store consent forms once completed and have immediate access to them at any time and from anywhere (Win& Fulcher, 2007). Before implementation of the electronic consent project, consent forms on medical units at the healthcare system where this project took place were printed on paper forms and all fields such as procedures, names, dates, times, and signatures were checked by a clinical staff member for completion before they were scanned into the patient's chart. Sometimes these checks were not made and incomplete consent forms w ere saved into patient's chart, which can be problematic for ensuring patient safety and ensuring no errors exist when undergoing accreditation by a certification body, such as Det Norske Veritas (DNV). To improve the process of signing paper consent forms and to eliminateincomplete forms scanned into patient's charts, the health system implemented an application for paper consent forms to be transitioned to an electronic platform to ensureno incomplete data are uploaded to the patient's chart. Use of the electronic consent form application is expected to eliminate the need to keep track of dates, times, names, checkboxes, procedures, and signatures as the application automatically keeps track of the input and will not let you save a consent form until all data fields are completed (J. Gleed, personal communication, January 26, 2021). The evaluation of the electronic consent expansion project is a quality improvement project to benefit the health system studied and its informatics team for future rollouts and implementation of similar projects. This evaluation will give context regarding the importance of transitioning to electronic consent forms which is vital for compliance of consent forms in the future.The goals of this project are to validate the importance and understand the impactof transitioning from paper consent forms to electronic consent forms. Therefore, theobjectives of this project are to: a ) evaluate the impact of the electronic consent application on clinicians, b) describe and evaluate how clinicians are using the application in their workflow, and c) evaluate the change in the completeness of the documentation