UCSF Medical CenterCTG – April 3, 2014

Project: e-Form/e-Signature (Proof of Concept)

BCD Project Manager: Sheryl Shah

UCSF Medical Center

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The presenter(s):

Objective:

Sheryl Shah, PMO Project Manager, Ryan Mendonca (APeX Optime) and Cora Hardin (APeX Optime) and our Kryptiq/DocuSign partners

Demonstrate outcome of the “technical proof of concept” to confirm maturity/functionality of e-Form/e-Signature vendor solution prior to developing a full business case and implementation strategy.

Scope: Proof of Concept

Create digital form with discreet data fields (patient demographics) with integration from APeX

Dual e-signature & workflow (Patient and Provider) of a surgical consent inside and outside of the organization

Integration of Consent Status in Apex so provider/staff easily know that the consent has been signed.

Electronic Signature Platform

Healthcare Workflow Integration

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“Is” “Is Not”

• Focus on Surgical Consent Form Only • Admission/Registration forms• Other Consents forms

• Demonstrating Use of Mobile Platform within UCSF

• “Virtual” e-sig/e-form (ie) via email, My Chart

• Focused on “in person” consent review and signature and dual signature (patient/physician)

• “Virtual” e-sig/e-form (ie) via email, My Chart

• Uni-directional Integration with APeX within Anesthesiologist workflow once consent is signed and Update OpTime Status board

• Bi-directional interface between APeX and Krytiq/Docu-sign for patient demographics, procedure information, etc.

• Signed form stored in APeX • Signed form stored in ECM

Today’s Prototype Demo:

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Scanning Signed Forms:Kidney & Liver Transplant

DeptVolume of

pts# of consents

per ptMin spent

scanning/consentTotal annual minutes

spentTotal annual

hoursPre Kidney 1200 5 3 18000 300

Pre Kidney- LD DWUI 400 4 3 4800 80

Pre Kidney- LD DWUII 175 6 3 3150 52.5

Pre Liver 504 5 3 7560 126

558.5

• Other issues to consider:

• Cost of transporting forms from outreach clinics• Cost of potential lost documentation (regulatory)• Potential HIPAA issues- scanned under wrong patient• Unfulfilling busy work for staff

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Demo

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Patient Forms requiring Signature• Terms & Condition of Admission **• Authorization for Surgery/Special Dx

Procedure **• Terms and Condition of Service **• Notice of Privacy Practices **• Patient Financial Responsibilities **• MediCare Rights• Advance Directives• Physician Order of Life Sustaining Treatment

(POLST)• Dog Therapy Consent Form (Peds Only)

• Patient Consent for Electronic Exchange

• Patient Consent to Photograph

• Patient Property Record

• Transfusion Consent• Consent to receive IM• ECMO Consent

• Observer Consent Form (to watch surgery)**

• Post Emergency Care Stabilization Form

• Refusal to permit medication• Refusal to allow eye treatment• Refusal to permit blood transfusion

• Leave Hospital Against Medical Advice

• Authorization for Release of Medical Record

• Transplant **• UNOS Multiple Listing Form **• Consent for Unusual Kidney **

• OB/GYN• Hysterectomy Consent• Consent for Sterilization

Forms included in Transplant man hour estimate in prior slide**

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Next Steps: Based on successfully completing a “technical” proof of

concept Determine High-level direction today.

Prioritization of impacted areas: ROI, High Risk Areas Identify business representatives to participate in planning

efforts Focus on specific use cases: Operational workflows to guide

technical development needs Determine opportunities to lean processes and drive to

standardization

Determine full cost estimates for further development and implementation

Present back to CTG in June 2014