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What’s the difference between electronic and digital signatures in healthcare?

Written by Hoala Greevy | January 19, 2023

An electronic signature and a digital signature may seem similar, but they are actually quite different. Both are used to authenticate electronic documents, but the methods used to create and verify each type of signature are distinct.

This post will cover the various ways electronic and digital signatures differ as they relate to U.S. healthcare and HIPAA compliance.

 

E-signatures

An electronic signature, also known as an e-signature, is a simple way to sign a document electronically. It can be as simple as typing your name into a document or using a stylus to sign a tablet screen.

The important thing to note is that an electronic signature should be configured to provide proof of identity or authenticity. Some examples are:

  • Email address. Signers enter their own email address, which is compared to the email address used in the invitation.
  • Phone call. Signers must call a phone number and enter their name and access code
  • SMS or iMessage. signers must enter a one-time passcode sent via SMS text message
  • Knowledge-based questions. Signers are asked personal questions gathered from commercially available databases, such as past addresses or vehicles owned
  • Photo ID upload. Signers are verified using their government-issued photo IDs such as passport, driver license or residence permit
  • Electronic or bank based IDs. Signers can submit their login credentials for existing bank accounts or government accounts to prove their identity

 

Digital signatures

A digital signature, on the other hand, uses advanced encryption techniques to ensure the authenticity and integrity of the document being signed. A digital signature uses a digital certificate, which is issued by a trusted third-party organization called a certificate authority (CA). The certificate contains the signer’s public key, which is used to verify the signature, as well as information about the signer’s identity.

The process of creating a digital signature involves the use of a private key, which is kept secret by the signer, and a public key, which is made available to anyone who needs to verify the signature. The signer uses their private key to encrypt the document’s hash, creating the digital signature. The recipient can then use the signer’s public key to decrypt the signature and compare it to the document’s hash, thus verifying the authenticity of the signature.

One of the main benefits of a digital signature is that it provides non-repudiation. This means that the signer cannot later deny having signed the document, as their identity is tied to the signature through the digital certificate. This makes digital signatures particularly useful for legal and financial documents.

Another benefit of digital signature is that it ensures the integrity of the document. As the signature is based on the document’s hash, any changes made to the document after it has been signed will invalidate the signature. This makes digital signatures a useful tool for ensuring that documents have not been tampered with.

 

E-signatures and HIPAA compliance

E-signatures can be HIPAA compliant if they meet certain requirements.

These include:

  • Unique identification of the signer
  • Signature creation date and time
  • Signature authenticity
  • Signature integrity
  • Signature availability

It’s the responsibility of the entity using e-signatures to ensure that they meet these requirements and are in compliance with HIPAA regulations. Additionally, the use of e-signatures must also be consistent with any state laws regarding electronic signatures.

 

Digital signatures and HIPAA compliance

Digital signatures can also be HIPAA compliant if they meet certain requirements.

These include:

  • Unique identification of the signer
  • Signature creation date and time
  • Signature authenticity
  • Signature integrity
  • Signature availability
  • Secure encryption, that protect the confidentiality, integrity and authenticity of the electronic signature.

As we’ve previously mentioned, digital signatures are often considered more secure than e-signatures as they are based on cryptographic algorithms and use secure certificate-based infrastructure to verify both the identity of the signer and the integrity of the signed document.

It’s the responsibility of the entity using digital signatures to ensure that they meet these requirements and are in compliance with HIPAA regulations. Additionally, the use of digital signatures must also be consistent with any state laws regarding electronic signatures.

 

Conclusion

In conclusion, both electronic and digital signatures are used to sign electronic documents, but the methods used to create and verify each type of signature are distinct.

An electronic signature is a simple way to sign a document electronically and should be configured to provide proof of identity or authenticity, whereas digital signature uses advanced encryption techniques to ensure the authenticity and integrity of the document being signed and also provide non-repudiation of the signer.

Both types of signatures can be used in a HIPAA compliant manner.