kchapple wrote on Saturday, December 14, 2013:
I have pushed a 5th revision, which includes hashing and verification of the signatures themselves, and reversing the order of the log. This is all I had time to do today before I went on vacation. The stuff that is left is mostly style and doesn’t require database changes. As far as basic functionality, I should be done, and would appreciate some more testing before any final revisions. I likely won’t be able to get to any further revisions until 12/23.
Reverse the ordering of signatures (ie. most recent should be at bottom). This is important because then the signature stamp is signing off on whatever is above the signature stamp, which is what physicians are accustomed to when signing orders and notes. For example, when I sign a note, I would be signing off on all the signatures and addendums prior to my signature.
This was done.
Place addendum above the applicable signature. This is also important, because I am signing off on it so it should go above the signature stamp.
This was done.
Do a sha1 hash of the addendum itself in a new sql column (ie. hash_addendum). This is part of the note so needs to be hashed like the main note to prove no changes were made to addendum post-hoc.
This was done.
In the report, do not show anything if there are no signatures. No reason to show this in report and will make physicians feel uncomfortable sending reports with empty signature messages in it.
Not done yet.
In the report, do not show the “eSign Log” label above the signature stamps for forms (just show the addendums and signature stamps). I’d also argue to remove this label in the encounter screen also for forms since it is not just a log (ie. the addendums will end up containing clinical information).
Not done yet.
In the report, make the pdf output option signature stamps readable.
I didn’t have an issue on FF on Mac, will have to test with other browsers.
If esign is turned off, still need to show existing esignature/addendums if they exist, especially for the forms (need to realize that the addendum/signatures may contain part of note so it still needs to be shown).
This was done.
Change “eSign” button label to just “Sign”
Not done.
If time would be nice to add a Sign button to one of the forms (for example, the SOAP note place a Sign Note button to right of Save Note button), Even better to get a “Sign” button to right of the “Save” button in the LBF forms, since LBF forms are heavily used and you get them all with just one change.
Not done.
Once above is done, this thing is super ready for commit to codebase and I’d argue that community will likely want the both globals for Allowing E-Signing Individual Forms and Locking an e-signed form individually as turned on by default. The structure you have with above items incorporated are extremely useful because a huge range of things can be done, for example simply signing/freezing notes and then adding signed addendums (can range from clinical information to why the note was deleted for example, wrong patient) to things like a academic structure where an intern signs, resident signs with addendum and then attending signs with addendum. Very cool and that’s just talking about forms, considering your framework can also be extended on any category of items in the openemr database. Again, very cool.
Thanks for your input, and looking forward to contributing this code!
Ken