I will answer this as a physician general response. Hospital notes are
different. All are require signature.  Reading (and signing) a clinic note
almost doubles the work. Depositions and court testimony I have seen seem to
have no bearing on whether or not the note is signed - even when there are
typo's or other errors. We had a case go to trial using a "pre-FileMan" EMR
with signed hand-written notes (physician preferred writing to dictating),
and the printed computerized (unsigned) notes became the evidence in the
trial. I don't think anyone ever read the handwritten notes. 

Today I type my notes and find them loaded with typo's and errors. I don't
initial them, though I occasionally think I we need to start initialing the
note. 

I have been dictating notes for over 30 years and typing my own notes for
the past 2 years, using computer in practice since 1970 and used
computerized medical records since 1985. As a strong advocate of EMR I still
appreciate the challenge of getting notes "signed off." I understand an
Agency of the Federal Government adopting such standards. However, for
private practice, it sure would be nice to be able to turn it off.

Thanks,
thuran

P.S.: How many of you notice MSWord likes to convert EHR to HER? Maybe EHR
is a bad acronym.

> -----Original Message-----
> From: [EMAIL PROTECTED] [mailto:hardhats-
> [EMAIL PROTECTED] On Behalf Of Joseph Dal Molin
> Sent: Sunday, March 13, 2005 9:48 PM
> To: [email protected]
> Subject: Re: [Hardhats-members] Need help programmatically signing a
> progress note
> 
> Kevin,
> 
> Could you describe the doctor's reluctance in more detail....if I
> understand the work flow the doc's dictate a note...it gets typed and
> the doc needs to sign it for it to be seen....so what they are resisting
> is keying in their electronic signatures repeatedly for a batch of
> transcribed notes...is this a case of keyboardphobia?  It will be
> helpful to know what doc's don't like about using VistA as much as what
> they like....thank you for bringing this to our attention.
> 
> Are they still reviewing the transcription for accuracy and how are they
> doing this? Perhaps integrating a finger print scanner or smart card for
> capturing a signature would be a good alternative.
> 
> Joseph
> 
> Kevin Toppenberg wrote:
> > I need some help.  I have been stuck on this one point
> > for several days.
> >
> > The doctors at my group are not willing to sit at a
> > computer and sign their notes electronically.  And
> > notes are not visible to others unless they are
> > signed.
> 
> 
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