SUCCESS STORY: Cottage Health

Cottage Health System Establishes System-Wide eSignature Program

This case study highlights how FormFast’s eSignature solutions collaborates with McKesson’s systems to drive efficiency at Cottage Health System.
Many healthcare facilities are faced with workflow crisis. The challenge is streamlining documentation, which includes admission consent forms. As a result, Cottage Health System has installed McKesson’s Horizon Patient Folder (HPF), the industry leader of archiving systems. HPF works effortlessly with FastFlow’s eSignature module, a component of FastFlow forms automation solution. FastFlow provides a flexible software solution supporting a wide variety of electronic signature capture options to meet the needs of any environment.


When patients are admitted into the facility FastFlow intelligently generates an admission packet, which includes specific documents for each unique visit. One admittance procedure often generates many forms that require multiple signatures.


Forrester Research states, “Imaging technology lowers the cost of healthcare administration. A not-for-profit integrated healthcare system headquartered in Fargo, N.D., saves close to $750,000 a year by scanning patient records. Furthermore, electronic signatures can help enterprises streamline customer onboarding process, save costs, and improve transaction security.”


According to PricewaterhouseCoopers research, “The cost of manually processing a paper invoice is $1.26 per invoice. Whereas electronic invoices can be processed at about one third of the cost, just .36 cents.”


The major benefit is reduced human error and redundancy which, is often caused by pulling incorrect admission and procedure forms or selecting incorrect documents that later causes a stall while waiting for a clinical procedure due to missing documents. Implementing both HPF and eSignature allows the high performance hospital staff to spend less time managing paper documents leaving more time to focus on patient care.


Cottage Health System implemented the program without reservation because they knew the long-term benefits out weighed the short-term obstacles. They knew that implementation was a major shift in workflow and that learning a new system would pose a challenge for staff. As a result, they practiced multiple scenarios and conducted one-on-one training sessions well before the installation date. In addition, Cottage Health System integrated McKesson’s HPF and FormFast’s eSignature application at the same time.


The partnership between McKesson and FormFast was integral and created a streamlined solution that ultimately automated their entire patient registration and admission procedure.


  • Automatically integrate with EMR
  • Eliminate paper consent forms
  • Replace manual scanning with electronic forms
  • Audit compliance
  • Eliminate identify theft
  • Improve patient experience


Integration Options

Electronic Clipboard

A digitizing clipboard that enables the patient to keep a paper copy of the document while the hospital retains the electronic original.


Signature Pad

A display similar to many retail signature capture devices. Available with or without LCD screen display.


Writeable Screens

A stylus-enabled monitor that allows patients to see the electronic document while they are signing on the screen.

“The initial thought was that implementing eSignature into our workflow process would be viewed as signing a receipt at a retail store versus signing off to authorize a surgical procedure. However, patients viewed eSignature as a transparent step in the process. It is very accepted because the majority of patients are accustomed to signing electronically. There hasn’t been resistance since the individual walks away with the original signed copy of their consent form.” Mr. Sam Galvez, System Support Analyst, Cottage Health System.


The solution at Cottage Health System automatically generates documents that require signatures and walks users through the signing process. Once the documents are electronically signed, FastFlow marries the signature to the form creating a legally signed electronic document.


The program allows for additional flexibility that otherwise would be unattainable during the previous admitting process. The extensive report options and alert queue that is generated by eSignature notifies a pre-determined staff member at specified intervals if a document is incomplete due to a missing signature.


Cottage Health System found this feature very helpful as the alert queue triggers an ‘incomplete notice’ document. Once the list of incomplete documents are gathered in the queue, a staff member will then physically visit each patient to retrieve the missing information.


Mr. Galvez concludes, “We chose to implement the program so that we could easily collect signatures by using the electronic clipboard in all of our admission agreements to include: emergency room, ambulatory care, and the entire admissions process.“Our facilities generate on average, over 130,000 signed admission documents per year. We have more than two dozen ClipGem® electronic clipboards in use every day. eSignature is embedded into our entire admissions process. We are now considering extending eSignature to our radiology and other outpatient facilities that don’t currently have a full admitting staff on site.”


Collaboration between FastFlow’s eSignature application and HPF’s archiving system drives efficiency and thoroughness. Cottage Health System relies on both applications to streamline hundreds of signatures each day. Implement eSignature and document archiving into your workflow process to eliminate timeconsuming manual filling and administering forms while revolutionizing your workflow management system.