I just had an idea for a problem that has come up multiple times. You can use layout based forms to produce an electronic signature for your progress notes.
Under admin lists- layout based forms - add this entry
Now this will give you an entry under layout based in an encounter that if selected places an entry called
Electronic signature applied:Reviewed and electronically signed by your name.
Can there be a field in which after the form is saved the response to the field cannot be changed anymore by anybody ? This way nobody else can sign/approve the encounter by replacing the field response.
Also, I see that the audit log showed the change therefore it is an assurance that the logged in provider made the approval.
I have a option that may work for some. We have added (for one customer) a way to save a patient report, “signed” as a PDF to the Document Tree. This provide a fixed, signed, snapshot of the selected medical record. Without “locking” the encounter data.
It requires the addition of fpdf and html2pdf packages which allows converting any HTML display to a PDF on demand and saving it to the doc tree using a slightly modified C_Document.class
Needs some refinement yet … but it might be an option for some
I have been doing a similar thing for PDF’s that I have either obtained as fax to e-mail or scanned. My scanner came with paperport , which if you view a PDF in page view shows a little icon for a rubber stamp in the bottom left menu. That leads to a file where you can place a customized stamp of your review and signature. This can then be affixed to your PDF file as having been reviewed before importing into the document tree.
A side question, does the html2pdf convert all of the pages you view under reports generated by imagemagic, as a single pdf. My experience so far is that only the first page of a multipage document attachment can be printed to PDF out of the reports section.
Combining cverk and Tony’s idea: I created an LBV that shows something similar to -
-Provider Name (data type - Providers)
-Approval Note (static text) - The preceptor approves the patient intake by the undergraduate student, and the patient examination by the medical student, by choosing the field below “Reviewed and electronically signed by the preceptor.” Before saving the form make sure that the EMR shows the preceptor’s login on the top right corner of the screen. Upon saving this form the EMR system will capture a snapshot of the patient information including the demographics, medical history and current encounter then create a report in pdf format which will be saved in the patient’s EMR record permanently.
-Capture data and create PDF report button - (has script to implement the step described above)
-View full encounter report button - (for the preceptor to view the complete encounter)
-Encounter Approval Status (List Box) - Unassigned or “Reviewed and electronically signed by the preceptor.”
-Save button
Add a Category in documents that acts as a repository for all approved “packaged encounters”.
The problem is I do not have the software development talent to create the “pdf” script above. I could just make a wish.
A side question, does the html2pdf convert all of the pages you view under reports generated by imagemagic, as a single pdf. My experience so far is that only the first page of a multipage document attachment can be printed to PDF out of the reports section.
I have only used it to convert plain HTML pages. I did not test it with inline images converted or otherwise. Though I use pdftk to take multiple separate PDF and combine them into one in another (non openemr) web app we developed.
Tony www.mi-squared.com / @tonymi2 oemr.org / @OEMR_org
I’d like to try the solution you have. I’m all for locking a signed encounter and just making an ammendment if they have to change the information in the encounter. So, while OpenEMR does not have that facility and still in decision limbo, may I request for your solution ? I’d like to test it and implement it, if you may.