Add Digital Signature Professional Medical Consent with airSlate SignNow

Add eSignature Professional Medical Consent

hello everyone thank you for joining me today and i hope everyone is staying safe and healthy it's been about six months since the world was turned upside down by this pandemic and it's safe to say that everyone has been forced to adapt to a new normal in their personal and professional lives as we continue to navigate this new world today i'll be sharing five best practices for remote patient engagement education and consenting that we've been working on since way before coveted 19 but have been modified and adopted rapidly as we find ways to continue to provide high quality care while maintaining a safe environment by way of introduction my name is jeff isner i'm the co-founder and co-ceo of engagedmd it's important to me to not only disclose my background but also to share why i've been asked to speak on this important topic today we founded engagedmd in 2014 with the goal of modernizing the way that patient education and informed consent is managed at fertility clinics our software platform now helps support the patient education and consent journey for approximately forty percent of fertility cycles in the us and roughly one in three patients in the uk our approach has always been to provide comprehensive digital experiences for patients to learn about their treatment journey and complete their patient paperwork in the comfort of home and it's never been more necessary than now today we'll be walking through best practices that we've learned over the years in our work and through our interactions with the clinics that we serve around the world so let's start with the basics this chart shows the number of patients that were added to our platform across all of our clinics by month of course in mid-march things started to shut down and we experienced a significant dip in the number of new patient appointments through april as the world navigated the beginning of the pandemic as things started to reopen we've seen a large backload of patients that continues through june and our preliminary july numbers are in line with june this creates a very simple and obvious challenge how do we maintain an exceptional patient experience while reducing the traditional touch points that could lead to exposure right away we saw limitations on when partners can join appointments modified use of our physical spaces a sharp increase in tile health usage and new workflows introduced across the board fortunately patients still want to move forward with treatment and fulfill their goals of a healthy family meaning that volumes will persist at this level unfortunately it looks like covet will be here for a while these are not temporary measures and we need to continue to adjust our protocols and workflows to optimize our practices and minimize health risks which takes me to best practice number one creates an intentional balance of the virtual and physical the cdc defines a close contact as any individual within six feet of an infected person for at least 15 minutes while stopgap solutions may have been implemented at the start of reopening it's necessary to ensure that these longer-term workflows create an intentional balance of items that must be done in office such as testing monitoring procedures while identifying as many opportunities as possible to maintain an exceptional experience even if remote the goal here is to create a personal connection with your patients without actually being in person this is a sample journey that we use to help identify as a company where we can better support digital experiences of the practices that we partner with items in green are areas that we feel can be handled remotely and oftentimes digitized and partially automated the fact of the matter is that today's patients didn't want to travel into the office when they didn't have to before covet 19. there has never been a better opportunity to improve the patient experience by utilizing technology to create desirable digital interactions leading up to the appointments that are better suited for in person if you don't already have a committee for building consistent comprehensive virtual processes into your patient journey now's the time but it doesn't stop there make sure you're reviewing your processes periodically and evaluating the plethora of tools that can help optimize your workflows which takes me to best practice number two embrace video calls and visual aids this is going to last longer than we originally thought it's time to embrace video calls and tile up as a permanent fixture and use telehealth intentionally and across the board not just with physicians but with your nursing teams your financial staff and more the chart on the right here shows an ama study about physician usage of digital health tools for telehealth engagement and clinical decision support the dark blue bars are the percentage of physicians using these tools in 2016 versus the teal bars in 2019 as you can see the trend was already heading in this direction and now we have a real forcing function that's causing even faster adoption a few tips to keep in mind as you find your long-term telehealth solution the american medical association has a phenomenal telehealth implementation playbook on their website that can help you assess tools and implement a solid and secure program don't forget about patient privacy and hipaa compliance hhs of course loosen rules as we all scramble to implement telehealth but a breach of confidentiality is never a good look for your practice or for your patients when you're actually in your video calls make sure that you're utilizing high quality visual aids to address multiple modalities we'll dig into this in much more detail later in the presentation but a small investment in proper visuals can significantly improve patient retention of information and patient experience pre-recorded videos take this to a whole new level and provide consistency and comprehensiveness video calls provide the opportunity to create a much more personal experience than simply a phone call so make sure that your setting is appropriate to create the experience that you want your patients to have it's also helpful if you have auditable records on the various interactions that occur with your patients which takes me to best practice number three and the part of the presentation that i'm really really passionate about as it's been our company's area of focus for the past five plus years patient education of course is a critical part of any fertility journey there's a massive amount of information that's conveyed to patients as they learn about their diagnosis treatment pathways consent decisions how to pay for treatment medication administration and much more what was traditionally handled through multiple in-person appointments and teach classes is now being done remotely so how can we provide the tools to better engage our patients leading to better experiences outcomes and retention well i know i'm biased but video has been proven time and time again to be the most effective way to educate people but these best practices can be applied to any learning tools that you're using there are three high-level components that should contribute to your design as you build out an educational program the first is cognitive load the fundamental tenet of cognitive load theory is that the quality of educational programs will be higher if consideration is given to the limitations of a person's working memory the second is engagement meaning that you should include elements that help promote engagement so your patients actually read or watch what you're providing to them and the third is active learning meaning that you should provide tools to help patients process the information and to monitor their own understanding so these high-level theories are really great but what are some tangible ways to actually implement the first is segmenting segmenting is a chunking of information to allow learners to engage with small pieces of new information as well as to give them control over the flow of new information it helps manage intrinsic load can also help connect various concepts by emphasizing the structure of the new information within the greater context studies have shown that after about six minutes of video engagement and attention drops off of a cliff so keep your chunks succinct and specific to a topic segmenting also provides control over the flow of new information which allows patients to progress at a rate that works best for them the next two best practices help patients focus on what's important at the right time signaling is the use of on-screen text or symbols to highlight what's really important to pay attention to and to target particular elements of the video for processing in their working memory this can reduce extraneous load by simplifying the task of determining which elements within a complex sequence of things that are happening on the screen are actually important and it can also help emphasize connections within the information animations do a great job of bringing the viewer into a scene quickly highlighting where to focus within that scene and then connecting the topic to the next scene weeding is the elimination of interesting but extraneous information that just doesn't contribute to the learning goal we're naturally attracted as humans to jazz things up but oftentimes we actually distract by getting too fancy for example music or complex backgrounds or just extra features within a scene that require patients to judge whether or not they should be paying attention to them increases the extraneous load and can reduce learning instead of introducing everything at once build topics up over time so that you start with a very simple visual and start to add on different elements only as they're absorbed matching modality which i alluded to earlier is possibly the most important topic to take away from the webinar what i mean by matching modality is the process of using both the audio or verbal channel and the visual pictorial channel to convey new information finding the right balance to fit the particular type of information to the most appropriate channel for example showing an animation of a process on screen while narrating it uses both channels giving patients dual and complementary streams of information to highlight features i've got two examples from engaging these older set of content that's being decommissioned on the right side of the screen these examples explain exactly what not to do on the top video there's what we like to call a talking hat being used to explain a topic this overloads a verbal channel and makes no use of the visual channel because watching the speaker does not convey any additional information on the bottom video we're showing an animation while also showing printed text on screen this only uses the visual channel using both channels to convey appropriate and complementary information has been shown in studies to increase retention of information and to increase engagement with videos but this idea applies to more than just videos as i mentioned earlier in the presentation you should be cognizant of matching modalities by using good visual aids during your consultations via telehealth and last but not least you should provide an active learning experience by using interactive features to enhance engagement after you've segmented your educational experience you can provide tools that allow patients to control their movement through the various segments this not only allows your patients to review previous topics but provides a layer of organization and cohesiveness that leads to better learning outcomes we also recommend integrating interactive questions into the learning experience studies have consistently shown an increase in comprehension using this approach and we also have multiple studies that were performed using engagemd that are being discussed in the journal club on friday that further reiterates this concept moving on to best practice number four and away from patient education there's a slew of paperwork that needs to be filled out and managed at a fertility practice and it's really hard to do this on pen and paper without all the additional in-person interactions with a witness or a notary e-signature tools allow you to complete your paperwork completely remotely all while ensuring that your documents are complete accurate never lost and saving all the headaches and costs associated with printing mailing and scanning any esign solution that you're evaluating needs to be functional within a fertility setting and user friendly for your staff and your patients i could spend the entire hour on the features that you should look for in a solution but here are my top five first conditional logic allows your forms to be intelligent and ensures that they are always complete and as accurate as possible when setting up your initial templates for e-signature you should build this logic directly into the document as a simple example let's take embryo disposition the form should require that a patient makes a selection and only one selection if the patient chooses to donate their embryos to another person for example they're automatically required to fill out the contact information of the recipient and to sign in the right places this conditional logic can get very complex very fast so make sure that the features available are robust moving on to workflow flexibility fertility treatment is a complex process with many parties involved make sure your solution is flexible to the needs of your practice's unique documents for example not all documents require the same people to sign the solution should be able to interpret who needs to sign each document and find the most efficient route for completion next we have interoperability which is so important in healthcare to reduce manual errors and to optimize efficiency make sure that your systems talk to each other and allow for easy transmission of demographic information as well as completed documents back to the patient record number four is template configuration conditional logic and configuring your documents initially can get really painful with fertility documents so don't take any shortcuts here and make sure that your vendor of choice can properly support you through this initial setup with your forms and lastly make sure that your clinic can easily package up the right documents to the right patients it should be seamless and simple to identify and send the right packets for every single type of patient that enters your clinic all this is really important but a functional e-sign solution isn't enough you must also ensure it's compliant and secure especially in the high stakes world of fertility where both patients and partners are making important decisions together so what does that actually mean let's start with the basics the e-sign act or the electronic signatures in global and national commerce act was passed at the federal level in the year 2000 this act solidified the legal landscape for the use of electronic signatures and is defined as and allow me to look at my notes for this one an electronic sound symbol or process attached to or logically associated with a contract or other record and executed or adopted by a person with the intent to sign the record most importantly the esign act establishes that electronic records and signatures carry the same weight and legal effect as traditional paper documents and handwritten signatures additionally these documents and signatures cannot be denied legal effect or enforceability solely because they're in electronic form but there are a few elements that you should be considering in order to be compliance the first is consumer disclosure which means that the signer must actively consent to use an electronic format with the ability to opt out the next is retention of your records which means that the documents must be retained and accessible in an unalterable format to all the people who are entitled to access it this must be done in a secure and tamper-proof manner you should also have thorough auto audit logging in place of all the important activities that occurred on the document for example you should be able to see who the document was sent to who opened it who viewed it who signed the document when where and how like all of your other it platforms you need to have a baa or business associate agreement in place with your chosen vendor as a requirement for hipaa compliance however this alone does not make you hipaa compliant you also need to implement and adhere to appropriate policies workflows and technical controls and last but definitely not least let's talk about signer authentication which is so important in the fertility space there are many ways to implement systems to authenticate the right person is signing the right documents you need to understand the risk between each document that you're having electronically signed and choose the appropriate forms of multi-factor authentication to verify signers in a way that aligns with your risk tolerance the image on the screen shows a form of authentication that we have in place on engaged md where the signer actually needs to take a picture of their id front and back and submit it where it's then mapped up against the database to ensure that it's valid and not expired and that the name matches up with the right signer's name prior to accessing any documentation to electronically sign which takes me to the last slide in our webinar to put it bluntly the world's a very tough place right now every week brings new challenges and the future is still uncertain but from every crisis comes innovation difficult times often act as a forcing function to change the way that we operate both personally and professionally we have an opportunity to reevaluate the way things are done just because they've always been done that way hopefully today's discussion has sparked some ideas on ways that we can leverage technology as a workforce multiplier to effectively increase our patient touch points even if they're not done physically in person even though things are very different from six months ago there are ways to maintain and even improve the experience of your patients and clinical teams as we navigate our new normal thank you so much for tuning in today i'm here to take questions and always accessible via email text message and phone if you'd like to discuss anything further