Why You Need Privacy-First eSignatures in Healthcare

By definition, healthcare documents contain some of the most sensitive information there is about a patient. The move away from traditional, secure systems to new, digital platforms has therefore been somewhat more delayed in healthcare due to privacy concerns – and correctly so. 

With the amount of sensitive information contained in healthcare documents, even the slightest chance of a privacy breach is unacceptable. Efficiency improvements nonetheless, only a privacy-first eSignature provider that offers full end-to-end encryption should be trusted with patient data. 

Healthcare is a complex topic, often requiring large amounts of written information to be stored and consulted. Therefore, the move from paper-based, wet signatures to eSignatures can significantly improve the entire process around patient communication. 

Here’s How eSignatures Help You Digitize Healthcare 

How many documents do you sign each month? From discharge forms to sick leave certificates, as a healthcare practitioner, that number is likely in the hundreds for you. 

And while there’s no doubt that every single document is necessary and highly valuable to the patient, any minute spent signing paper documents and trying to get patient signatures is also a minute not spent with patients. 

• Moving to eSignatures can help save up to 80% of time and money spent on getting documents signed. 
• And not only are eSignatures faster, but they’re also much more convenient because documents can be signed from any device with internet access.
• Whether your patients struggle to travel because of the condition they’re in, or they are working flexibly and potentially quite far away from your practice: By using eSignatures, their location becomes irrelevant, as long as they have internet access. 

Further, by integrating right into your existing health information system, the threshold to adopting eSignatures is extremely low. There is no new, complex process to incorporate into your workflow: Keep using the systems you currently use and simply plug in your new eSignature solution.

Abandoning paper also comes with other benefits, both to your bottom line and the environment around you. 

• There is no cost for paper and printing equipment, and nothing needs to be sent via snail mail and paid postage.
• And besides the material cost, there is labor involved: Whether you do it yourself or have admin staff to help you with those tasks, chances are that you pay for a significant amount of hours of just handling paper documents. Have you ever added up the combined cost of those items per month? 
• Just as important, moving to eSignatures helps preserve the environment: Where old-school wet signatures require paper, which is made from this finite resource called trees, eSignatures are fully digital. Your computer is likely running all day already, meaning there is literally zero additional environmental impact.

However, there are use cases where a paper-based document is still required: Be that because of legal requirements or a patient who cannot access digital records for the time being. Solutions like Digital Twin present the perfect hybrid: Documents can be created and signed online and then printed as required. The paper copy then contains a QR code which is the key to a digital copy, stored in a secured data center and only accessible with the code in hand. The eSignature provider does not have access to those documents, but both the provider and the client can access them quickly and verify the authenticity of the printed version. 

But all those obvious benefits of eSignatures in healthcare become irrelevant if the most critical aspect is not prioritized: Patient privacy. And while many providers offer the convenience, few actually provide the secure environment needed to fully make the move to digital signatures without worrying about compromising privacy. 

Here’s Why You Need Privacy-First eSignatures in Healthcare

Most countries feature strict privacy laws regarding any kind of healthcare information. Making sure your eSignature provider is 100% compliant with even the most stringent privacy laws is of the essence. Luckily, it’s easy to check whether that’s the case with your provider. 

Here’s what to look out for. 

A privacy-first eSignature provider…	What that means for your patient data
Will always encrypt your documents end-to-end	Confidentiality is guaranteed
Will never limit what type of document you can sign	No matter how delicate the contents, you can sign online
Cannot hand your data over to anyone	No law enforcement agency can gain access to your patients’ details
Is safe of any privacy breach	Even if hacked, no data is leaked
Cannot access your data via a backdoor	There is no access, full stop
Does not ask for any privilege	Confidential information is nobody’s business but yours and the patients’
Should never provide smart management tools	No AI algorithm can read your documents
Makes sure nobody is listening in	Your documents are never at risk, no matter the internet connection you’re on

Not quite sure if your eSignature provider checks all of the boxes above? Here’s what each item means in detail. 

Here’s what any eSignature provider focused on your privacy should be doing. 

They offer asymmetric end-to-end encryption

Unless the encryption you’re using is asymmetric and end-to-end, there’s a chance it can be circumvented. Even though “encryption” is usually mentioned somewhere on their website, for many eSignature providers, it’s unfortunately barely more than a marketing term. Server-side encryption, symmetric encryption (using the same key to encrypt and decrypt), or – it almost goes without saying – no encryption at all present a serious privacy risk for your sensitive patient documents. 

Your documents should be accessible for two parties only: The patient in question and yourself. If your provider is offering asymmetric end-to-end encryption, where all the data gets encrypted on your own machine and never floats around unencrypted, you can trust the system with any document whatsoever. 

They can confidentially handle any type of document 

Because most eSignature providers offer insufficient encryption for sensitive patient data, many organizations limit what type of document can be signed digitally. The so-called “no-sign lists” are a clear sign of mistrust: Whoever is in charge of security knows that privacy cannot be guaranteed without proper encryption. This leads to unnecessary additional work and opens the door for human error with potentially devastating results. 

Trust is binary: It’s either there or it’s not. No-sign lists attempt to establish grey areas, but they’re prone to error and are fundamentally flawed. If you can’t trust your eSignature provider with sensitive information, you can’t trust them at all. Full stop. 

They comply with the law but don’t expose your data

There are likely laws that threaten the privacy of your documents – by your own government and any of its allies. Most countries have laws that allow government agencies to ask any sort of digital data provider to hand over customer data under certain circumstances. International intelligence-sharing agreements clearly outline a number of countries that freely share digital information if required. And even if your country is not on that list: Specific agreements like the US CLOUD Act aim for the same liberties – or even more – between all participating members. 

You want to work with a provider that complies with the law – but at the same time does not threaten the privacy of your patients. The only way to talk that fine line is by offering asymmetric end-to-end encryption: Your eSignature provider can hand over your data as requested, but no one can read it. 

They protect your data – even when breached

Cybercrime is on the rise, and a hacking attack has become a question of “when” rather than “if.” No matter how good their IT security, any eSignature provider can be hacked. In fact, the bigger they are, the juicier a target they present for any hacking attack. The only way to guarantee the privacy of your data when that hack happens is to encrypt your documents properly. 

If your eSignature provider does not have a way to access your data, neither will anyone hacking into their system. Even the slightest chance of a privacy breach should be a big red flag. Ask yourself: What would happen if all your patient data was suddenly to a public server, plain for anyone to see? Or worse, how much would you pay as a ransom to prevent that from happening? 

They do not have any backdoor access to your documents

Often implicit and sometimes very explicit: Many eSignature providers maintain backdoor access to your documents. Whether it’s sold as an essential security feature or simply part of how their encryption works, this presents a security threat that is unacceptable to anyone handling sensitive patient data.

If there is a technical way to access your unencrypted documents, someone will find and abuse it. That may not happen in 99% of cases. Still, the 1% can create such a privacy nightmare that any provider keeping “legitimate” access options open should be ruled out automatically. There is no scenario where your provider should “need” to access your data – full stop. 

They don’t have a “rule of least privilege”

Initially designed only to allow access to employees who absolutely need it to perform their job, the “rule of least privilege” is fundamentally flawed. While it’s certainly a good idea to keep access to a minimum and not allow any employee to read your unencrypted documents, the question remains: Why would any employee – no matter how senior or important – ever require access to your documents in the first place? 

The only rule acceptable is the one of “no privilege.” Not a single employee should be able to access your unencrypted patient data. Job descriptions change, the people filling the jobs change, human error happens – and disgruntled employees are sometimes capable of doing serious damage. If there’s any privilege at all, you’ll never know who has access to your data – until it might be too late.

They don’t offer any “smart” document tools

Anything sold as “smart” usually means Artificial Intelligence – and AI needs access to your documents to do anything smart with them. They are excellent marketing terms: “Life-cycle management and analytics” or “Proposal management software” sound like useful features – and they often are. But the fact remains that some algorithm you have no control over is reading your documents in plain format, analyzing and learning from every single one you upload. 

If AI has access, who else does? Even if a tool is smart enough to shave a few minutes off your regular workflow and do so without actually creating more work somewhere else, those savings are simply not worth risking the privacy of your patients for. As a rule of thumb, stay away from anything called “smart” if you care about data privacy. 

They protect your documents from prying eyes

It’s not a straight line from your computer to your recipients’ device – it’s zig-zagged and full of potential risks. If you’re working from home, your neighbor could be listening in: Hacking the average home wifi is quick and simple. If you’re at a coffee shop, the owner could be siphoning off all the data you send across their Wifi – you’d never know. If your recipient is using a public WiFi in a place somewhat less concerned about internet privacy than where you are – whoever’s running that WiFi can grab a copy of every document they receive. 

As incredible and useful as it is, the internet reeks of loopholes and bad actors willing to exploit them. For the average user, there is simply no way to ensure the security of all the links that make up the network their documents travel across. Therefore, there’s only one solution: Using an eSignature provider that encrypts documents on your device and allows the recipient to decrypt them locally on theirs, using a separate key. That way, no matter who’s listening in, they’ll only get heavily encrypted documents that are of no use to them. 

The Bottom Line

Ask yourself: What would happen if only a fraction of the sensitive patient data you handle made their way into the public – let alone all of it? 

The best-case scenario would likely be a considerable embarrassment and loss of your reputation. The worst-case scenario could have severe legal consequences, depending on the privacy laws of your country. 

There is no doubt that eSignatures are the future. We’re quickly moving into a time where location becomes more and more irrelevant: People work from anywhere, travel is quick and easy, and everyone is used to communicating instantly on their devices. 

Mainly for privacy reasons, healthcare providers have long struggled with taking the leap to go digital with their sensitive patient documents. And rightly so: Trusting the wrong eSignature provider could have devastating consequences for everyone involved. 

There is only one option guaranteed to preserve everyone’s privacy, no matter what: Using asymmetric, end-to-end encryption. The documents are encrypted on your computer, even within the systems you already use if required. The only people who have access to the unencrypted version are you and your patient – nobody else. 

You’ll be amazed what eSignatures can do for your healthcare practice – especially when you include hybrid options like Digital Twin. And by opting for the right provider, you will not only save time but also rest assured that the privacy of your patients is guaranteed – no matter what.