Blockchain-Based Electronic Signatures Streamline Workflows

By Bevey Miner

If the pandemic has taught us anything, it’s the fragility of our technology systems. Providers relying on paper forms have found this to be an especially painful lesson.

A recent Forrester survey found that digital documentation is moving from a convenience to a business necessity. Senior IT and business decision-makers said digital document processes help their organizations maintain business resilience, reduce business risk, and open up revenue opportunities. They see digital documents as “true enablers” of improved customer and employee experience. Forty percent of respondents said digital documents have been linked to increased customer satisfaction and employee productivity during the pandemic; importantly, they anticipate these benefits will last beyond the pandemic as well.

Practices that want to be resilient in emergencies and better serve their patients should move to all-digital systems. Those that don’t will quickly be left behind. Happily, going digital can also make complying with HIPAA and other privacy regulations more affordable.

One major piece of the digital puzzle is electronic signatures on a variety of forms, including intake and consent forms. In this article, we’ll explore this state-of-the-art technology and look at where electronic signatures can remove friction and redundancy for providers.

Intake, discharge, and more

Patients and providers must sign more forms than ever before, and regulations about keeping that information safe and accessible have grown more strict.

Patient onboarding comes to mind, involving HIPAA forms about disclosures of protected health information (PHI) as well as consent for tests, treatments, and surgeries. When the onboarding involves an inpatient stay, the attending or treating provider must sign the admission form. Patient discharge is another good example, with the provider signing off on a patient’s suitability to leave the facility and the patient certifying they’ve discussed and received a discharge plan and relevant therapy notes. Sometimes, a caregiver’s signature is also required.

A number of other important processes involve signatures:

  • Authorization for home healthcare. The Centers for Medicare and Medicaid Services allows providers to use an electronic signature to sign Form 485 for home healthcare services.
  • Admission to an assisted living or long-term care facility. Transitions of care are less onerous for patients and families when the forms involved in the process are digital.
  • Medical requests and updates. Digital documents eliminate delays and reduce work for providers.
  • Provider credentialing. Electronic signatures help ensure providers can be quickly vetted and set up in the billing system.
  • Human resources activities. HR departments can dramatically streamline their processes with electronic signatures.

The role of blockchain

Most of these process examples require three elements to go digital. First, the signature must clearly indicate the signer’s intent, be recorded and retained, and adhere to standards for record integrity. (In essence, the law requires providers to prove that the patient signed a document willingly and with full knowledge of its legally binding nature.) Second, all documents containing PHI must be protected in a HIPAA-compliant manner, which includes the security of personal data and the means to quickly retrieve it. Third, electronic signatures must streamline the process, saving providers time and money and reducing friction for patients.

Today’s electronic signature solutions provide all three elements. They vary in features—including their ease of use and ability to integrate into existing solutions—and affordability. But the most important consideration is whether they use state-of-the-art security measures, such as blockchain.

The technology behind cryptocurrencies like Bitcoin is the most secure avenue available to protect patient data, including signatures. Just as important, blockchain-based data is broadcast to numerous, decentralized private or external networks, and each update is recorded chronologically. Any attempt to alter that data will create an additional recorded update. That means providers can easily demonstrate to auditors that their patient data is secure and has not been altered or compromised since being placed in electronic storage.

Benefits for physician practice workflows

The benefits of implementing an electronic signature solution cannot be overstated for practices, considering the numerous processes that the technology can streamline. Still, given the highly regulated nature of U.S. healthcare, providers must be diligent in selecting an electronic signature solution to maintain compliance with HIPAA laws.

Compared to paper-based workflows, electronic signatures can eliminate significant friction and redundancy, representing quality-of-life improvements that patients increasingly demand. Yet a recent survey shows that 72% of providers still use paper and manual processes for check-in, a huge disconnect from consumers who have become accustomed to contactless options during the pandemic. Nearly eight in 10 patients want contactless options to remain in the future, including online check-ins, digital payments, and electronic communications.

Providers cannot afford to overlook a solution that offers both top-of-the-line performance and security. Implementing the right electronic signature solution can streamline healthcare workflows and free staff from manually gathering and securely storing patient signatures.

Any viable electronic signature solution will be built with healthcare in mind. However, given the highly regulated nature of healthcare, privacy and security should be top considerations when choosing among available solutions.


Electronic signatures provide important benefits to providers by eliminating redundancies, reducing friction, streamlining workflows, and ensuring maximally secure storage.

The patient experience encompasses every aspect of care: making an appointment, reminders, check-in procedures, staff friendliness, time spent waiting, physician/technician care, billing, and payment. Creating frictionless throughput including electronic signatures can increase patient satisfaction.

For providers to achieve peace of mind regarding their electronic signature solution, they should consider whether the technology contains security protocols to ensure that PHI and other sensitive data is stored and protected in a manner that ensures compliance with HIPAA. That law’s Privacy Rule and Security Rule demands both the security of personal data and the means to quickly retrieve the data.

Bevey Miner serves as global health IT strategy/chief marketing officer for Consensus Cloud Solutions, Inc. With more than 20 years’ experience in healthcare technology and digital health, she has been instrumental in leading strategy, product management, business development, marketing, and commercialization. Miner has led innovation in care coordination, patient engagement, population health, and interoperability as well as advocating for policy change with federal and state government.