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Setting up HIPAA compliant e-signatures for patient forms

Written by Liyanda Tembani | November 21, 2024

Healthcare providers can use e-signatures for patient forms if they ensure HIPAA compliance. By choosing a vendor with HIPAA compliant features, such as encryption, signing a business associate agreement (BAA) for data protection, verifying patient identities during log-in, and preventing tampering, organizations can be secure while using patient forms. 

 

Understanding HIPAA compliance for e-signatures

According to an Elsevier-PMC COVID-19 Collection study, an e-signature combines an image with a digital signature. It enables individuals or systems to electronically mark documents, facilitating secure authentication and innovative document management. E-signatures verify user identities and authorize transactions through standalone systems, networks, or the Internet. The HIPAA guidelines for handling protected health information (PHI) apply to electronic signatures. Healthcare organizations must ensure that e-signature processes meet both the Privacy and Security Rules to be compliant. Organizations must safeguard patient information, control access to e-signed documents, and verify that e-signatures are legally binding.

One of the first steps in compliance is establishing a BAA with any e-signature vendor. A BAA is a contract that outlines the vendor’s responsibilities for protecting PHI on behalf of the healthcare provider. Without a BAA, using an e-signature provider for PHI would be a HIPAA violation, so choose vendors willing to sign this agreement.

 

Considerations for using e-signatures in healthcare

  • Patient consent: Patients need to understand and explicitly agree to using e-signatures. To address this, include a consent clause in the electronic form. Also, give patients an alternative option, such as signing a paper form.
  • Identity verification: HIPAA requires that entities verify the person signing is the patient or an authorized representative. Common methods include secure logins, MFA, or identity verification processes. 
  • Document integrity: E-signature systems should lock forms post-signature to ensure documents remain unchanged after signing. Tamper-evident seals or audit trails can help maintain authenticity, providing a timestamped record of all actions, including who signed and when. 

 

Selecting a HIPAA compliant e-signature solution

When selecting an e-signature provider, ensure they meet the HIPAA security requirements and adequately protect PHI. Choose a vendor that commits to HIPAA compliance, signs a BAA, and provides transparency about its security practices. Confirm that the provider offers encryption for PHI in transit and at rest, along with audit trail capabilities to track document access details, like IP addresses, dates, and times. 

Related: Considerations for HIPAA compliant online form vendors

 

Implementing e-signatures in your healthcare practice

Online form providers like Paubox offer HIPAA compliant e-signature capabilities for consent, treatment authorizations, and intake forms. Start by uploading or designing your forms within the platform, ensuring they’re routed securely to the patient and locked after signing to prevent changes. Configure the platform to store completed forms in a HIPAA compliant system automatically. Additionally, train your staff on secure handling practices, including guidelines for accessing, storing, and sharing e-signed documents. Also, stress the significance of regular audits to maintain compliance during this training.

 

Addressing concerns and potential challenges

  • Patient understanding and consent: Communicate clearly with patients about how their e-signature will be used and why it’s secure.
  • Technology access: Some patients may lack access to technology. Offering alternatives, such as paper forms, helps with inclusivity.
  • HIPAA audits: HIPAA audits can include examining your e-signature setup. Regularly review processes, update security features and ensure all e-signature practices align with current HIPAA standards.

 

FAQs

Can e-signatures be used for telehealth consent forms?

Yes, e-signatures can be used to simplify telehealth consent by allowing remote signing, as long as the process is secure and meets HIPAA standards for protecting PHI.

 

Is patient training or instruction needed for using e-signatures?

While not always required, offering a brief guide or support can help patients understand how to sign electronically, especially if they are unfamiliar with the process, ensuring ease and compliance.

 

How can I verify if an e-signature provider’s security practices are HIPAA compliant?

Check for specific features like encryption standards, access controls, and audit trail capabilities. Additionally, you can ask the provider for their HIPAA compliance documentation and BAA options.