Technology has accelerated business exponentially over the past four decades. When Bill Gates wrote “Business at the Speed of Thought” in the 90s, his predictions seemed unattainable. In hindsight, they were quaint.
Businesses have taken advantage of software to improve processes for both customers and employees. Technology can make things run faster, more accurately, and with less effort. But when applied indiscriminately, that same technology can do as much harm as good.
eSignature Apps – Misapplied and Overused
An example is the use of eSignature apps like DocuSign. When DocuSign was launched, it seemed revolutionary. Being able to capture signatures on contracts electronically gave the false impression of greatly improved efficiency. And indeed, it was something of an improvement. But companies have realized that using an eSignature app to handle every document that needs a signature does not always serve employees or customers. In some cases, it downright does not work. Consider the following:
- eSignature apps can take employees outside an established process. If you didn’t have the time to redesign the process that you introduced eSignature to, then in fact the old process didn’t “go-away”(didn’t get shorter), you simply added an extra step (in other words, more work).
- Minor mistakes require another full cycle. At least with paper, one could white-out and correct the form. With eSignature apps, the whole form has to be repopulated, resent, and resigned. Case in point, I recently completed a loan application from my bank. I mixed up one number on the form. My banker simply sent me the form, completely blank, for me to fill in again and sign. It was efficient for the banker, but aggravating for the customer (me).
- To address information asymmetry between provider and patient, agreements such as consents & election statements are typically reviewed together in person. These agreements don’t translate well to a process where the contract is emailed to the patient who is expected to read and understand it on their own. With the narrative from the provider missing, the end result is a frustrated buyer in the best case and errors in the worst case. In some healthcare settings (ex: hospice) a simple error can lead to non-billable days that can never be recovered.
- Agreements designed for 8.5×11 sheets of paper aren’t legible when viewed on a mobile phone. This is obvious, but the vast majority of eSignature apps simply shrink PDF documents onto the phone’s 5” screen. Unfortunately, for senior members of our society, their smartphone may be the only electronic device they are comfortable using. Asking a 70-year-old to read a PDF squeezed down to fit on their smartphone is both silly and unfair.
What Went Wrong?
How did we end up in this situation? DocuSign revenues were near $1B in 2020. How could it possibly be the wrong answer? There are several factors that have led to the overuse of eSignature apps in healthcare.
The first and obvious is Covid. During the early months of the pandemic, healthcare organizations desperate to digitize paperwork with patients who could no longer be seen in person quickly adopted eSignature apps. Get an account today and start signing up patients tomorrow. And frankly, it was probably a good decision for the short-term. It plugged a hole and did so immediately.
Second, eSignature apps do make sense in some situations. In finance and accounting, when both parties are closely involved, where both parties are at a desk with a large monitor, and signing a contract is just a formality at the end, eSignatures make all the sense in the world. It is easy and logical for IT departments to look at the success and assume all departments would / could use the product in the same way.
As Covid’s impact on society continues to linger into another year, the limitations of this stop gap are becoming more evident.
What are Organizations Doing Now?
As the dust settles and healthcare organizations have to reflect, they are evaluating how eSignature technologies fit into a broader patient onboarding process. Leading organizations are going further and thinking about how the entire admissions process could be redesigned with ‘virtual’ experiences in mind, obtaining electronic signatures being just one in many steps that could be conducted online.
Inventing an online experience doesn’t have to happen from scratch. In fact, it doesn’t take long to find other industries that have struggled in 2020 and found hybrid online + in-person models to serve their customers. For example, you can open a bank account without ever stepping foot into a branch. To meet KYC (Know Your Customer) regulations, banks have adopted technologies to verify your identity. In the arena of car sales, Carvana has catapulted into a national brand because you can buy and trade in your vehicle, without ever meeting anyone in person.
In both these examples, electronic signatures play an obvious role. But the success of these models depended on so much more than taking a paper contract, scanning it to a PDF, and emailing it for a signature. These organizations have succeeded by revamping their entire onboarding process, and neatly incorporating electronic signatures somewhere in the middle of it. For more examples, see our article Rethinking Admissions in Response to Covid.
So what to do with your eSignature app?
The biggest impediment to progress is managers defending a prior decision. It is understandable if you had chosen to use an eSignature app in 2020. Changing your mind now isn’t an admission of failure or of making a mistake. Rather you did the best with what was available at the time. You are simply moving on to a more mature solution. It is akin to giving up your tricycle as a kid. Eventually, you just outgrow it.
There will also be some departments in your company that will insist on using DocuSign. That’s great, they should continue. But just because eSignature apps may make sense for the finance department, doesn’t mean it is appropriate for customer access or admission nurses.
The best news is that almost all eSignature apps are sold as a SAAS (Software As A Service) model. That makes the decision to transition to something better easy. Simply discontinue your contract and move on. It’s 2021!
Organizations (and patients) are never going back to paper and doing everything in-person again. Now is a great time to think long term and more deeply about this permanent shift to digital. It is a good time to stop overusing eSignature apps.
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