Co-signing notes
Setting up accounts for multiple signatures
There are times when an organization may require more than one signature for clinical documentation. Often this falls into either a supervision requirement, state medicare requirements, or as procedural requirements for the organization. To set up multiple signatures on documentation:
The administrator would login to their account. Navigate to the "Configuration" area. In the second navigation row, select the "User Management option. Scroll to the Staff Role table at the bottom of the tab. By default there are several staff roles, students are the only role that are initially set up to require two signatures. You may modify signing permissions of any group to add or remove signature requirements.
If the situation is for supervision then the default settings are likely sufficient. Simply assign users who will be supervising and signing off on other staff's notes to the "Supervisor" group. Then assign any staff requiring supervision to the "Student" group. Supervisor's will have the ability to view, sign, or request edits on documentation created by the student.
If the situation is for state medicare requirements, you may require a physicians signature on all or selected documentation. Clinics in this situation generally add signature requirements to the "Therapist" role consistent with the regulations. The supervising physician then is either assigned to the "supervisor" group or has an additional role created in the table with the appropriate permissions.
Depending on your organization's needs you may need to create additional staff roles to accommodate signing requirements. These allow you to categorize staff according to the specific permissions they need and the signature relationships between hierarchical relationships. You may have up to twelve distinct staff roles within the organization. If you require more, please contact our technology team for assistance.
How Notes are finalized
The requirements for any documentation are established when it is created and are displayed along the system timestamps along the top. When two signatures are required the creator of the note will see a "Finalize" in place of the usual "sign and save." Once they have entered their signature the file will appear in the patient list of supervisors when the filters are set to "Others (action required). The supervisor may then review the note. They will see a "Finalize" in place of the usual "sign and save" if the documentation is correct they will sign off on the work. If the documentation requires edits, they can choose to click "Request edits" instead. This places the file back into the creators "Action required" list until they make the changes and sign the modified form.
