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#24366 09/15/2010 11:28 AM
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Wish the signature we import for our scripts, also appeared on the orders where it says "electronic signature".

I am in a rural area where they aren't set up to receive electronic orders yet. Now that we are using Updox, if the signature was there, the order could be sent by fax without having to print the page, sign it and then fax it.



Vicki Roberts, MD
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You have to actually sign the order? That's crazy.


Bert
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Bert #24383 09/15/2010 11:10 PM
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Not sure if you have access to the pdf before you send it, but you could just use the digital signature from there.


Bert
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Bert #24389 09/16/2010 2:31 AM
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I agree it's crazy to have to physically sign it. We're talking swampeast MO.
Didn't understand what you were talking about accessing the pdf-can you clarify?


Vicki Roberts, MD
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Originally Posted by vroberts
Wish the signature we import for our scripts, also appeared on the orders where it says "electronic signature".

I am in a rural area where they aren't set up to receive electronic orders yet. Now that we are using Updox, if the signature was there, the order could be sent by fax without having to print the page, sign it and then fax it.
Try and work with whatever agency is not accepting the electronic signature. Often there is no rhyme or reason, just somebody who wants things done their way.
I have seen the radiology department not accepting those orders and then they blithely send out their reports with an electronic signature!
Don't blindly give in, it just encourages them to continue.
Ask them to send you a self-addressed stamped envelope if they want an original signature.

Greg

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There are places (usually medical supply) that state they cannot accept the computer stamp. When I challenged them one company stated "Oh we thought it was a stamp, but HCFA allows use of computerized signature" I have been including the phrase "this is a computerized signature not a stamp and is acceptable to HCFA but if you will not accept it send me a SASE and original not copy for signature." I have not had an issue since that.

With the orders, I was challenged by the hospital and I told them the other hospitals accept it and if they are not willing, I can and will take my business elsewhere. They acquiesed.


Wendell
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Originally Posted by DoctorWAW
I have been including the phrase "this is a computerized signature not a stamp..." I have not had an issue since that.
Wendell, I can't tell you how much I like this idea. Especially since it works. I am trying to think of all the other areas in my practice where I could apply this.
For example "I know I cannot fax you scripts for controlled substances. This prescription for Percocet is NOT for a controlled substance".
The possibilities are endless.


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Originally Posted by vroberts
Now that we are using Updox, if the signature was there, the order could be sent by fax without having to print the page, sign it and then fax it.

Try importing the order into Updox, then select it to edit it, and use the pencil tool to create a unique signature over the "Electronic Signature" box on the order. Or contact the Updox tech support by email, and they'll help you import a signature into Updox that you can place in any document.


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Originally Posted by Greg Phillips
Originally Posted by vroberts
Wish the signature we import for our scripts, also appeared on the orders where it says "electronic signature".

I am in a rural area where they aren't set up to receive electronic orders yet. Now that we are using Updox, if the signature was there, the order could be sent by fax without having to print the page, sign it and then fax it.
Try and work with whatever agency is not accepting the electronic signature. Often there is no rhyme or reason, just somebody who wants things done their way.
I have seen the radiology department not accepting those orders and then they blithely send out their reports with an electronic signature!
Don't blindly give in, it just encourages them to continue.
Ask them to send you a self-addressed stamped envelope if they want an original signature.

Greg



Thanks for the ideas Greg. My radiologist really is trying to help. Just today the hospital finally got to where it can receive electronic prescriptions. I am thankful for each little step we make forward.


Vicki Roberts, MD
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Hey John, Just dawned on me what you said about importing into Upodx. We have only used Updox one week, but can already tell it is going to make a big difference in our practice.


Vicki Roberts, MD
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Vicki,

First, I remember when day one with AC lab requests. The lab has taken every single one without an issue. Radiology wanted a signature. I was passive-aggressive, and it drove me crazy. Finally sat down with It and Security and they gave me a list of like 18 things I had to meet. I told them I did when in actuality I met about five. But, they haven't had an issue since.

The problem is they don't see the forest for the trees. Do they really think someone is going to download AC, write for a scoliosis series, enter a valid rule out and diagnosis and take it to the hospital? Would someone want an x-ray that badly. And, of course, the result would come to our office, and we would question it. But, who would do that? Those who would would probably be trying to get Oxys.

OK, the pdf. All Adobe PDFs (can't speak for all the Acrobats out there), allow you to make a stamp. The trick is making a translucent stamp rather than an opaque one. The latter is obvious when the opaque white part blocks out part of the order. But, with a translucent one you can stamp right over it. In fact, I go out of my way to cover something so it looks real. The other key is to make sure the signature you make looks like your original, e.g. terrible. If you need help making one, I can show you if I can find my cheat sheet. You can also have it done through the web for $35.00. Sounds like a lot but....

Here is a real crazy thing. The pharmacists would not accept a blank script with electronic signature underneath my name. But, they would take "Digitally signed by Albert Adams, M.D. So, I changed by name to first name: Digitally signed by Albert" and my last name to Adams, so it came out "Digitally signed by Albert Adams, M.D.

The next irony is that since I now use ePrescribe and only fax about 5% of what I used to, I have gone back to the Electron Signature only, and they accept it every time. The big issue with these companies is that many of them you can't call them on it. As much as I would like to not send scripts to Wal-Mart, if my patients want to go there, I can't really not let them.


Bert
Pediatrics
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Bert #24487 09/19/2010 10:37 PM
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Hi Gang,

I did just find where the radiologist signs it but doesn't have his signature, LOL. I have been working with the folks at the hospital and they will not bend on the signature. I am going to go back to them now that I see that they let the radiologist sign it without a visible signature, but ask me for even more than they provide.
Thanks for all the great ideas and things to get me thinking. I'll let you know after I talk to them again.
Thanks


Vicki Roberts, MD
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Hi Vicki,

Sorry about your plight. Can we take odds on the outcome? The fact that the radiologist doesn't have to sign it is that 1) it is more of an inside thing -- they need to know who read it and 2) the number of steps and requirements which are built into their system cannot be duplicated by yours/ours.

If you don't have Photoshop and most don't ($$$$$), you can always download the trial version. Some of the links below overlap, but I think three are by Dave Korpi. All of these are "relatively" easy to do, but if you just can't do it, then Dave will do it for you for $35.00. It seems like a lot, but there are two reasons why I think it isn't. 1) On the same page where he allows you to pay him, he shows you how to do it for free, and 2) this is obviously an important thing for you, and you will have a transparent or translucent signature forever. The difference between a translucent sig and an opaque sig are huge. There is no way to tell if the signature is real or not. You can use it as a PDF stamp or import it into AC or both. I would look at the last link first.

http://www.spsu.edu/cs/faculty/bbrown/papers/signature_pdf.html

http://www.gregledet.net/?p=5

http://www.youtube.com/watch?v=vKu0_3Aib3M

http://ginseed.com/index.php/2010/0...-acrobat-ms-word-or-any-legal-documents/

http://tinyurl.com/transparent-sig


Bert
Pediatrics
Brewer, Maine

Bert #24492 09/20/2010 1:44 AM
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Originally Posted by Bert
Hi Vicki,

Sorry about your plight. Can we take odds on the outcome? The fact that the radiologist doesn't have to sign it is that 1) it is more of an inside thing -- they need to know who read it and 2) the number of steps and requirements which are built into their system cannot be duplicated by yours/ours.

If you don't have Photoshop and most don't ($$$$$), you can always download the trial version. Some of the links below overlap, but I think three are by Dave Korpi. All of these are "relatively" easy to do, but if you just can't do it, then Dave will do it for you for $35.00. It seems like a lot, but there are two reasons why I think it isn't. 1) On the same page where he allows you to pay him, he shows you how to do it for free, and 2) this is obviously an important thing for you, and you will have a transparent or translucent signature forever. The difference between a translucent sig and an opaque sig are huge. There is no way to tell if the signature is real or not. You can use it as a PDF stamp or import it into AC or both. I would look at the last link first.

http://www.spsu.edu/cs/faculty/bbrown/papers/signature_pdf.html

http://www.gregledet.net/?p=5

http://www.youtube.com/watch?v=vKu0_3Aib3M

http://ginseed.com/index.php/2010/0...-acrobat-ms-word-or-any-legal-documents/

http://tinyurl.com/transparent-sig


Can't wait to try it!! Thanks


Vicki Roberts, MD
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Nothing to it. I used Adobe Photoshop. Don't buy it, though. It's very expensive. Personally, if you can't get it, I would pay a professional to do it. You have to be sure when you use the magic eraser, that you get all of the white out of the middle of round things like. Roberts. Of course, just because it says Roberts, doesn't mean your signature will look anything like that, lol.

Another mistake people make is since they figure this will be their signature forever is to try to write a nice signature. It will start by writing it on a white sheet of paper so write a bunch that are your normal illegible (if they are) signatures. Just pretend you are between patients with five in the waiting room, and your MA comes up for a signature. Just sign it like that.


Bert
Pediatrics
Brewer, Maine


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