Electronic Signatures

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Electronic Signatures

GSG-103

Revision A

Purpose ... 1

Audience ... 1

Scope ... 2

Introduction ... 2

Security Considerations ... 2

E-Signature Passphrase Technical Specifications ... 3

Definitions ... 3

E-Signature Formats ... 4

Establishing Your E-Signature Passphrase ... 5

Creating E-Sig Passphrase in tConsult Cart ... 5

Creating E-Sig Passphrase in tConsult Web ... 7

Changing Your E-Signature Passphrase ... 9

Changing E-Sig Passphrase in tConsult Cart ... 9

Changing E-Sig Passphrase in tConsult Web ... 11

Signing a Form ... 13

Signing a Form in tConsult Cart ... 13

Signing a Form in tConsult Web ... 15

Administrator Tasks ... 16

Resetting an E-Signature Passphrase to Null ... 16

Adding a Signature Field to a Form ... 20

Purpose

This document explains how to set up and use electronic signatures (e-signatures) in the AFHCAN tConsult Web and tConsult Cart software.

Audience

This document is written for users and administrators. Users create or change their own e-signature passphrase, which can be used to electronically sign forms. Administrators have the ability to reset a user’s e-signature passphrase to a null value (blank) using the tConsult Web interface.

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Getting Started Guide Electronic Signatures

Scope

This document is based on AFHCAN tConsult Web and tConsult Cart software, Version 5.0. The focus of this document is e-signatures and how to use them. At the time of this writing, the only place where e-signatures can be used in the AFHCAN software is on custom-designed forms.

Introduction

An e-signature serves the same purpose as signing a paper document with a pen: the presence of the signature is evidence that you personally authorized an action or verified some information.

Security Considerations

The e-signature feature utilizes a passphrase to authenticate your electronic signature. The presence of your e-signature on a form implies that you intentionally entered your passphrase and pressed a Sign button adjacent to the passphrase field. If your passphrase is sufficiently strong and known only to you, an electronic signature holds the same validity as a pen-and-ink signature.

Note: In this document, the term password will refer to the user’s login password, while the term

passphrase will refer to the e-signature passphrase.

In general, a passphrase is similar to a password. Good security practices require the use of a passphrase that cannot be guessed by people who know you (e.g., your pet’s name). A strong passphrase will include numbers, special characters, randomly placed capital letters, etc. In the AFHCAN software, a system administrator can never discover or set your passphrase, he or she can only reset the passphrase to a null value (no characters). If your passphrase is null, the system guides you to establish a passphrase when a signature is called for.

The e-signature passphrase is not the same as your login password.

Note: Be aware that your login password is not considered strong if it can be easily guessed. With a weak or non-secure login password, someone else may be able to log into the AFHCAN system using your login credentials (username and login password), set your e-signature passphrase, and sign documents that you will be responsible for. AFHCAN recommends using a strong login password (as well as a strong e-signature passphrase) and keeping both confidential. AFHCAN also recommends that your login password and your e-signature passphrase be

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E-Signature Passphrase Technical Specifications

Table 1 lists the technical specifications of the e-signature passphrase.

Table 1

Passphrase technical specifications

Parameter Value

maximum number of characters virtually unlimited minimum number of characters 1

permitted characters alphanumeric and special characters prohibited characters none 1

case sensitivity yes

data entry checking no

Note 1: The system will not accept a passphrase consisting of only space characters.

Definitions

Special terms and abbreviations used in this document are defined in Table 2.

Table 2

Definitions of terms and acronyms

Term or Acronym Definition

custom forms forms created by administrators using the Forms Designer e-signature an electronic signature

ES electronic signature

GMT Greenwich Mean Time (approximately the same as UTC below) login credentials the username / password combination entered by a user to gain

access to a system or service

login password the specific password associated with an assigned username

null the status of an information field when it contains no data whatsoever (the character obtained when the space bar is pressed is a blank space; it is considered a character and therefore is considered data) passphrase similar to a password, but potentially more complex, that pertains to

electronic signatures

password a confidential sequence of letters, numbers, and other characters a user types in to gain access to a system or service

standard forms forms created by AFHCAN and embedded within the AFHCAN software as a standard feature of the software (not user-editable) tConsult Cart a software program installed on an AFHCAN Cart (or any personal

computer) allowing AFHCAN cases to be created and sent to another provider for a consultation

tConsult Web a user interface system allowing providers to receive, read, modify, and send AFHCAN cases via the internet

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Term or Acronym Definition

username a name assigned by an administrator for use by a user during login UTC Coordinated Universal Time (the acronym is based on a compromise

with the French acronym for: Temps Universel Coordonné); UTC is the international reference for calculating the correct time in the world’s various time zones (formerly called Greenwich Mean Time; also called Zulu time)

E-Signature Formats

Figures 1 and 2 show the structure and components of an e-signature on forms.

Figure 1

Structure and components of an e-signature during data entry

Figure 2

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Establishing Your E-Signature Passphrase

It is a good idea to establish your e-signature passphrase as soon as possible. Certain forms require a signature. If you enter information into a form before your e-signature passphrase has been established, you may get into a situation where the only way forward is to close the form without the signature. The form will be discarded along with all information entered.

Establishing your e-signature passphrase applies only if the passphrase is null (blank). Your e-signature passphrase will be null if you have never established it, or if the administrator has reset it.

Note: If your e-signature passphrase is null, you will be asked to enter your current login password along with your new passphrase.

Note: Contact your organization’s IT department for any guidance on creating and securing e-signature passphrases.

Creating E-Signature Passphrase in tConsult Cart

The following illustrations show how to establish your e-signature passphrase using the tConsult Cart software:

Figure 3

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Figure 4

Enter login password and e-signature passphrase

Figure 5

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Creating E-Signature Passphrase in tConsult Web

The following illustrations show how to establish your e-signature passphrase using tConsult Web:

Figure 6

Clicking on My Settings

Figure 7

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Figure 8

Enter login password and e-signature passphrase

Figure 9

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Figure 10

Confirmation message

Changing Your E-Signature Passphrase

You always have the option to change your e-signature passphrase. Your organization’s IT department may have recommendations or policies on how often a password needs to be changed. If you forget your e-signature passphrase, ask your administrator to reset it.

Note: The security and confidentiality of your passphrase (and your password) is your

responsibility. Change your passphrase any time there is a risk it has been compromised.

Changing E-Signature Passphrase in tConsult Cart

The following illustrations show how to change your e-signature passphrase using tConsult Cart:

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Figure 11

Click on My Settings

Figure 12

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Figure 13

Save the new e-signature passphrase

Changing E-Signature Passphrase in tConsult Web

The following illustrations show how to change your e-signature passphrase using tConsult Web:

Figure 14

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Figure 15

Click on E-Signature

Figure 16

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Figure 17

Confirmation message

Signing a Form

Signing a form is a two-step process: first enter your e-signature passphrase, then press the

Sign button adjacent to the passphrase field.

Note: It is best to complete the two steps of signing a form before trying to save it.

Note: A signed form can be edited. The edited version is saved into the case as “edit 2” or “edit 3” and so on. The most recent edited version is displayed in the case. All previous versions of a signed form can be viewed by editing the current form.

Signing a Form in tConsult Cart

Preparation:

1. Using the tConsult Cart software, create or open a case and identify the patient. 2. On the Add To Case screen, click the Forms button.

3. Select the desired form and enter the desired information.

Note: Not all forms include a signature field.

The following illustrations show how to sign a form within tConsult Cart (it is assumed the above three steps have been completed):

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Figure 18

Signing a form in tConsult Cart

Figure 19

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Signing a Form in tConsult Web

Preparation:

1. Using the tConsult Web interface, click on Patient and search for an existing real or test patient, or create a new patient, as applicable.

2. With the desired patient selected, click on Create Case in the Options area of the patient information window.

3. With the new case displayed, click on Add Form in the Add to Case area. 4. Select the desired form and enter the desired information.

Note: Not all forms include a signature field.

The following illustrations show how to sign a form within tConsult Web:

Figure 20

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Figure 21

Saving the signed form in tConsult Web

Note: On saving, the software will automatically close the form window.

Administrator Tasks

Administrative tasks related to e-signatures are handled entirely within the tConsult Web interface.

Resetting an E-Signature Passphrase to Null

If a user forgets his or her e-signature passphrase, the only option is to reset the passphrase to its original null state. The user will then be able to create a new passphrase as described in previous sections of this document.

Note: Administrators are in a good position to advise the user about good practices and

organizational policies on passphrase requirements and security.

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Figure 22

Open the providers window

Figure 23

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Figure 24

Edit provider’s information

Figure 25

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Figure 26

Click on the Reset E-Signature button

Figure 27

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Figure 28

Finish by closing window

Adding a Signature Field to a Form

For information on adding a signature field to a form, refer to GSG-101, Getting Started Guide, tConsult Forms Designer.