By Mark Dermer MD, Medical Advisor/Consultant, Innovator and Virtual Primary Care Physician
Completing forms is an unavoidable burden for doctors. Still, we can lessen our work effort and optimize efficiency by using tools that manage forms digitally, from the time we first receive them. Digital completion of forms has several advantages:
- Portability – You can work on it from any workstation that connects to your system
- Efficiency – Using PDF software is more efficient than scribbling illegibly on a form. Typing is usually faster than scribbling or using speech recognition software. You will get faster over time as you get better at using the PDF software.
- Privacy Protection – PDF management software offers features such as password protection so patient information is kept confidential.
This tip will describe how to achieve this with PDF (portable document format) files.
The Tool
One example of an excellent tool for managing forms is Adobe Acrobat Pro, which requires a monthly/annual subscription. At the time of writing, the monthly subscription rate for Adobe Acrobat Pro was C$25.99. The paid version of Adobe Acrobat Pro includes features that the free version does not have and are worth the modest investment.
While Adobe first developed the PDF, other software programs for PCs or Macs can also create and manage form completion. I am not familiar with the features these other programs offer, but there are many reviews available to help you make an informed decision on the software that is right for you1.
Regardless of which PDF software you choose, the software must be able to do each of the following to best manage forms in PDF:
- Require secure sign-in with a unique ID and strong password
- Store a high-quality image of your signature
- Protect the PDF files you create with a unique and strong password
- Perform OCR (optical character recognition) on an incoming digital document
- Permit the user to easily add text, complete checkboxes and apply signatures
- Auto-complete text boxes using text that the user has entered in the past
- Allow the user to delete pages, re-order pages and combine multiple PDF files into a single file
Three Key Points
- Ensure that all PDF files are saved in secure storage locations that require user sign-in with a strong password. These can be within your EMR system, on encrypted hard disks permanently installed in your computer, secure USB keys or external drives, or on secure cloud storage services.
- Learn how to convert non-PDF digital documents to PDF format by “printing” the non-PDF document so that your computer stores the PDF digitally rather than printing it on paper. The steps for doing that will depend on the type of computer and operating system you use.
- Establish systematic protocols for file names and unique passwords you use for each file. This will ensure you can precisely identify each PDF and protect its confidential contents.
One-Time Setup:
- Subscribe to Adobe Acrobat Pro (or equivalent) and install the software.
- Protect access to the software using a strong password for either the program itself or the computer where the software is installed.
- Configure the software so that the tools you will use regularly are quickly accessible on the software’s “toolbars.”
- Add a high-resolution image of your signature to your profile.
The Process to Complete Each Form:
- Prepare the incoming form for completion. If possible, delegate these steps to your staff.
a. Create the initial PDF.
- For paper forms, scan to PDF.
- For non-PDF electronic files, including photos of paper documents, open the file and print to PDF.
- For forms that you receive as PDFs via email or downloaded from the web, print it to a “second generation” PDF, which will remove any original formatting that might prevent you from completing all areas of the form.
NOTE: Regardless of how you create the initial PDF, save all PDFs in a designated storage location using a unique file name and a unique strong password.
b. OCR the initial PDF to optimize its usability, then save it again using the same file name and password
Warning: If you delegate these steps to staff, do not provide staff with your PDF software login password. This is because your login allows access to the digital image of your signature, which should only be available to you.
- Complete the prepared PDF.
a. Fill in the relevant text boxes, skipping over the checkboxes to save time switching back and forth between the versions of the cursor that are for text and the one for the checkmark. You can enter text in multiple ways:
- Typing, using auto-complete options when they present themselves.
- Speech recognition
- Copy and paste
b. If there are checkboxes, switch to the checkmark version of the cursor and make a second pass through the document to mark those.
c. Apply the digital image of your signature.
d. Remember to save the file frequently to avoid losing work.
e. When the form is complete, save it to the patient’s EMR chart since third-party forms are part of the medical record. Also, be sure to delete it from any other file storage locations that you may have used during the form completion process.
If you have any questions about your EMR’s functionality or useful tools that are integrated with EMRs certified by OntarioMD, contact support@ontariomd.com. OntarioMD’s services are complimentary for Ontario clinicians who use certified EMRs.