September, 2011

1. Physician Electronic Signature inMeditech 5.64.21 September, 2011 Page 1

2. ELECTRONIC SIGNATURE (e-SIG) All MHS Physicians can request electronic signature privileges through their respective HIM departments and/ or Medical staff offices Any HIM report viewed in “Other Reports” in EMR menu can be signed electronically 24/7 in hospital and remotely. Includes H&Ps, Discharge summaries, operative reports, and consults. Can sign and edit documents sequentially or sign at one time. The same E-SIG can be used in CPOE Unsigned verbal/telephone orders and progress notes still require a manual signature at this time in HIM at MDMC and MCMC. Electronic Notice of Participation needs to be completed in the HIM department for authorization of participation Page 2

3. GETTING STARTED 1 • Select the Meditech icon on your PC • Put in your Meditech physician user name and hit Tab key • Put in your Meditech password and hit Tab key • Last entry is HCIS “LIVE” hit Enter to go to Meditech desktop 2 2 Page 3

4. ASSIGN e-SIG PIN NUMBER • Depending on your role, you may have a different menu to select than another provider. Menu name shows at “#1” below • From “ITS”, go to “Change Password or Create PIN”, then “Create/Change Your e-Sig PIN” • From “EMR”, go to “Change Password or Create PIN”, then “Create/Change Your e-Sig PIN” 2 1 3 1 3 2 “ITS” “EMR” Page 4

5. ASSIGN e-SIG PIN NUMBER • Enter your Meditech password • Enter what you want for your New PIN number. It can be four digits • Enter twice and click OK • This will enable your new PIN number for e-Signature • Once your PIN has been filed, you will receive a confirmation 1 2 4 3 Page 5

6. e-SIGNING DOCUMENTS • Again, depending on your role, you may have a different menu to select than another provider. Menu name shows at “#1” below • From ITS, click “Provider”, then follow the instructions on the next slide 2 1 “ITS” Page 6

7. e-SIGNING DOCUMENTS • This only applies if you got here from the “ITS” menu • Once in the Provider screen, click on “Sign” Page 7

8. e-SIGNING DOCUMENTS • Again, depending on your role, you may have a different menu to select than another provider. Menu name shows at “#1” below • From “EMR”, click “Sign Documents” 1 “EMR” 2 8 Page 8

9. e-SIGNATURE DOCUMENTS SCREEN • This applies for all users • Your patient documents to be signed will show in this window • You can: • Edit - Allows editing to be done • View - View only • Sign – Sign documents with pin number • Sort – Allows sorting of reports • Unsign – Allows unsigning of reports • Signing can be done one at a time or sequentially by placing a check next to multiple reports to review/sign (most efficient) • Each report will show sequentially • Your PIN number will be asked once at end • It is recommended to only select 5 documents at a time to eSign Page 9

10. SEQUENTIAL e-SIGNATURE PROCESS • This is recommended as the most efficient process • Select all patients by clicking the “Select” button • In the pop-up window, click “Check All Documents”, then click “OK” • Once the system evaluates the reports, click “Sign” 2 3 1 4 Page 10

11. SEQUENTIAL e-SIGNATURE PROCESS • The report(s) will now display • If no changes are necessary, click “Sign”, which will place this signed document in a queue for later signature PIN number completion at end of session. If you need to fix the report, click “Edit” • You will now be taken to the next document for review… • Repeat the steps for each report Page 11

12. SEQUENTIAL e-SIGNATURE PROCESS • The number of reports you have reviewed and signed will show in a pop-up window • Select “Sign” as a final confirmation • Or “Go Back” if you need to make changes (Edit, Unsign, etc) • Or “Cancel” Page 12

13. SEQUENTIAL e-SIGNATURE PROCESS • You will now enter your PIN to complete the e-Signature process Page 13

14. CONFIRMATION OF DOCUMENTS SIGNED STATUS • Check the right hand “Signed” column to confirm your documents have an electronic signature, which shows as a “Y”. • EMR will show in Other Reports as Signed status in a few minutes after completion of signing Y Page 14

15. SEQUENTIAL EDITS • This is recommended as the most efficient process, and can be done at the same time as the Sequential Signature process discussed previously • Select all patients by clicking the “Select” button • In the pop-up window, click “Check All Documents” • Then once the system evaluates the reports, click “Edit” 2 3 1 4 May 2008 15 Page 15

16. EDIT REPORT SCREEN • Under description, the first line may either be blank or you may see "Body of Text” (depends on where document was typed) • Click in the “Edit” box, and type “Y” Page 16

17. DOCUMENT EDIT SCREEN • Edit mode usually has the first line in red • You can make your corrections just as in Microsoft Word • For your own benefit you can document your corrections by selecting format and font icon at top of menu toolbar to make the text bold or italics etc Page 17

18. SAVE YOUR EDITS 1 • After making your changes hit the “F12 key” or click the green check on the right side of the screen to save your edits. The “ESC key” exits without saving. • Select “Yes”when prompt asks “File?” 2 • When returned to the General Report Screen (right), click “Save” 3 Page 18

19. SAVE YOUR EDITS • After saving, Meditech confirms the changes have been filed • Select “Close” Page 19

20. NEXT EDIT(S) • If you had selected multiple reports to edit, the Next report will now be available • Select “Next”, and the repeat the steps to Edit your document(s) • If you do not wish to continue, you may select “Stop” Page 20

21. VIEW SIGNED DOCUMENT IN EMR • From “ITS”, click “Provider” • On the “Provider” screen, select “EMR” • From “EMR”, click “View Patients” “EMR” 2 2 1 1 “ITS” 3 “ITS” Page 21

22. VIEW SIGNED DOCUMENT IN EMR • This applies for all users • Select the correct Patient, using any of the methods, such as “Recent Access”, “Any Location”, “Any Record”, etc • Select the correct Visit 1 2 Page 22

23. VIEW SIGNED DOCUMENT IN EMR • Go to “Other Reports” • Select the category at the top • Click the “bubble” under “Report” to see the report 2 3 1 Page 23

24. VIEW SIGNED DOCUMENT IN EMR • Your electronic signature will appear at bottom of document with date and time signed Page 24

25. UNSIGN A SIGNED REPORT • If an important change is missed after a document is signed, you can “UnSign” the document and edit it • Place a check in the checkbox next to the correct Patient/Report • Click “UnSign”, and enter your PIN 1 Y 3 2 Page 25

26. UNSIGN A SIGNED REPORT • Report returns to draft status in EMR shown by lack of “Y” in signed column on right of sign documents screen. • You can Edit document by selecting Edit and doing all steps as before • Re-sign document when you have reviewed your edited corrections Page 26

27. Signed Documents Not Leaving Signing Queue • Rarely, a document may go to EMR as signed and will remain on your signing queue, but this is easy to fix • From “ITS”, go to “Clean Up Sign Documents” • From “EMR”, go to “Clean Up Sign Documents” “ITS” “EMR” 1 1 2 2 Page 27

28. Signed Documents Not Leaving Signing Queue • This applies to all users • Add your Username at “Documents for Provider”, then click OK • This action will not affect status of any of your signed documents in EMR • It only acts as an electronic nudge to get a patient report out and off of your “signing document queue”. 1 3 • Click “Close” • This prompt indicates number of records hung up, and should take all hung up records off of your signing queue • If it does not , contact HIM 2 Page 28

29. CONCLUSION • Congratulations on your completion of the electronic signature module • You should now be able to change your e-SIG PIN number, Sign reports, Edit reports, UnSign reports and Clean Up your queue • If you have any further questions please contact the HIM personnel: • Kelly Wauters and Lori McLemore, MCMC • Jose Ago, MDMC • Jennifer Sayles, MMMC • Valerie Hayes, MRMC • This document is one of five: • Remote Access • Meditech Training • Physician Consult Ordering • Electronic Signature (this document)

30. Contact Information For MDMC, MMMC, MCMC: MHS Help Desk 214-947-1999 MHS Help desk email: helpdesk@mhd.com For MRMC and Bush/Renner: Methodist Richardson Information Systems Helpdesk at (972) 498-4756 MRMC Help desk email: ishelpdesk@richardsonhealth.com MHS does not have a team to come to your office to repair PCs.