We sat down with FormFast’s Product Manager, Yancey Stout, to gain her insight into the process challenges hospitals face today regarding informed consent, and to learn more about FormFast’s Mobile Bedside Consent Solution and the advantages it brings to both clinicians and patients.
Lauren: While advances in technology have led to the digitization of many critical processes across healthcare organizations, the informed consent process is still often paper-based. Can you describe the risks and liabilities associated with paperless consent processes?
Yancey: So the most obvious issues we hear about from our healthcare clients are related to lost or misplaced paper consent forms. A lot of times in emergency situations, the staff in the E.R. are busy taking care of patients, so they will put the forms in their pocket, or on the stretcher, and forget about them. As a result, the information won’t get put into the right hands to get archived in the EHR.
In addition, the scanning process alone can lead to errors and lost forms. Even when things go smoothly with the patient and physician properly signing the document, there needs to be an error-proof system to get signed forms scanned into the HIM system; and during that time, they often don’t get to the right place, at the right time to be scanned into the system at the speed that is needed.
Finally, there is a concern with ensuring documents are scanned appropriately – meaning they are indexed the right way and matched to the appropriate medical record. These are three possible areas where errors can occur, which are all a result of human intervention in the process. Whereas within electronic consent, is archived by the system, instead of humans, which can eliminate the possibility for error.
Additionally, we recently heard from some facilities that forms aren’t always filled out appropriately, and signatures are forgotten here, or forgotten there. As a result, the form isn’t any good to them. So in a situation of litigation, or if an issue occurs during a procedure, and they need the form, and it’s not filled out correctly, then it’s not going to serve its purpose – making the physician and/or the organization liable. With an electronic process, validation occurs within the system and ensures all fields are filled out appropriately. It paves the way for a much better situation to ensure compliance.
Lauren: Some organizations rely on tethered electronic signature pads to capture a patient’s signature. Is this an effective method?
Yancey: As far as capturing the signature, it does effectively accomplish that. However, it’s more of an issue of convenience for the clinician and for the patient experience.
From the standpoint of the clinicians, they are wheeling around a cart, which makes it a more cumbersome process. They have to navigate through the room and need to clear a bigger space for the device to sit to effectively reach the patient. This process can take extra time and clinicians don’t have much to spare.
In regards to the patient experience, patients are often lying down in bed because of pain or injury – the reason why they are there in the first place – and leaning over to sign something that is tethered is often painful or not very enjoyable. It is a much better experience when you can put something untethered in front of them so they can then adjust it to whichever position is best for them. So it’s thinking about the patient experience here – delivering a patient-centered process.
Additionally, a lot of the tethered devices make it more difficult to properly review the form with the physician performing the informed consent process. It’s hard for them to see all of the information at once, because it’s typically not on the tethered device, but on a different screen. Plus, in some cases, they may not have an actual form to review. We have placed heavy focus on delivering the best possible informed consent process. Many people are visual and are going to retain and understand the information much better if they can see the form and see the actual text there that the physician is going over, not just hear it. So with the more tablet-like device, patients have the ability to review the entire form, and have that visual experience, in addition to the auditory.
Lauren: Describe the need that FormFast saw in today’s marketplace for a truly mobile bedside consent solution.
Yancey: Some EHR systems, which honestly are the center of technology nowadays for healthcare organizations, do offer the tethered aspect of an electronic signature capability. But that wasn’t being implemented by hospitals in a lot of cases, for the reasons we’ve already discussed. In addition to that, there has been a shift in the industry. Healthcare organizations have taken care of a lot of other technological needs, and they have their EHR in place. They have their ICD10 in place.
They are now asking the questions: “What are the remaining paper processes that we have?”, “What are the remaining processes that drain clinician time?”, “Where can we improve the patient experience?” And the answer is: consents at the bedside.
Post registration is basically a process that has yet to be addressed with many, many facilities. So in looking at that, and the fact that the EHR systems weren’t necessarily focused on providing a true mobile solution, this was a great way for us to complement the EHR system, and offer a solution to hospitals for them to improve this overlooked process.
Lauren: Can you describe how the consent process works with FormFast’s mobile solution?
Yancey: Of course. So, when a nurse or physician are going to start the informed consent process, they’re going to typically be in the EHR system with the patient’s record pulled up. From there, they can link to the forms that are available to them – typically a collection of consent forms for different procedures. Having already selected the patient through the EHR, they link into this list of forms. They can select one of those forms, and the form actually comes up in a signature capture application. Here, with the patient, the physician can go through that informing process, review the form and discuss the procedure.
When ready, the patient can sign right there on the tablet device and hand it right back to the physician, for them to sign – making the process very streamlined. Once that physician has signed and submitted that form, the form is immediately archived to the EHR. Which means that that form is available to all other members of the care team – in the OR, in the nurse station, etc. – whoever needs to see that form can immediately pull it up in the EHR.
So there’s no delay in care and clinical staff no longer have to waste time looking to see – was it signed, is it complete, is it there? With FormFast, it’s always there. From there, the patient has the procedure and we move on.
Lauren: Does FormFast integrate with other core healthcare systems?
Yancey: Yes, we do. We integrate very well with the major EHR systems, such as Epic, Cerner, MEDITECH, McKesson and Allscripts. We interface well with using HL7. And we’re looking at developing new technology as well, looking into the future, with FHIR.
Lauren: With FormFast, what type of mobile devices can be used to capture patient signatures at the point-of-care?
Yancey: We are compatible with a wide range of tablets, but iPads work extremely well and are our recommended device. We also work well with Microsoft Surface Pro tablets.
Lauren: What separates FormFast mobile bedside consent from other solutions in the marketplace today?
Yancey: First and foremost, it is our experience and thorough understanding of the healthcare industry. We have software that has been interfacing and integrating with EHR systems and other hospital operational systems for over 20 years. We understand the unique needs of clinicians and physicians, as we are constantly interacting with our clients to better understand what they’re looking for and the challenges that they see. We’re also very focused on the patient experience and how our mobile bedside consent solution can improve it.
Most importantly, it is our focus on patient safety and compliance that really sets us apart from other companies. Just recently, we created an app that actually reads the barcode off the patient’s wrist and automatically takes you into that patient’s forms that need to be signed – leaving no question about which patient is signing which consent form. This protects the organization, the patient and the clinician.
Lauren: What benefits does this solution bring to healthcare organization and its staff?
Yancey: Sure. There are a couple of major ones surrounding risk and compliance. Hospitals can ensure that those consent forms are properly stored and archived for any litigation issues that may arise later on. Hospitals can rest assured that consent forms are going to be accessible in these situations – there aren’t going to be any lost or inappropriately filled out forms. In addition, hospitals can streamline a process that clinicians and physicians have to complete in order to provide patient care. The informed consent process is more than an administrative process, – so we want to minimize the time spent on forms, so they can spend more time answering a patient’s questions and attending to their specific care needs.
As we automate the process, we are in turn saving the organization money and time. Consent automation decreases the cost of resources – such as toner, paper, etc. – associated with printing forms on-demand and then getting them signed. There are several facilities we’ve worked with that have saved a significant amount of money by not having to store all these forms. Because they were paying for separate storage space. It also eliminates the time needed to scan documents into the system. Ultimately, we want to save hospital’s time, money and any prevent exposure to liability and compliance issues, allowing them to focus on patient care – their core mission.
Lauren: How does the solution shape the patient experience?
Yancey: We are constantly working to improve the patient experience. Down the road, there’s going to be even more improvements to make the experience more beneficial to the patient. I think it is an important point to make that we are focused on how this affects the patient. They’re making a decision; it’s not just about signing the form. They’re making an informed decision about having a procedure and putting their trust in the organization and their physician.
We realize what is at stake here, and that is why we are continuously working to make the process better. From our perspective as a trusted health IT vendor, assisting the hospitals in improving the experience is very important to us. We’re going to continue to work in this forward direction.
Lauren: What is the number one reason you would tell a healthcare organization, that is currently paper-based or partially automated, to implement FormFast’s bedside consent solution?
Yancey: In my opinion, the number one reason to implement our solution is to dramatically improve the consent process for both clinicians and patients. The informed consent process affects so many people, and enhancing and streamlining it will result in big benefits that will be felt enterprise-wide.
Have more questions about FormFast’s Mobile Bedside Consent Solution? Contact us today.
Yancey Stout is a Product Manager at FormFast, the healthcare industry’s leading provider of eForms, Workflow and eSignature technologies. As a technology professional, Yancey Stout has worked with software from development to support, for more than 15 years. Meeting the challenges of healthcare customers with great software solutions is her passion. Connect with Yancey on LinkedIn.