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EMS Setup - Signatures Setup

Purpose Statement

This article demonstrates how to define and configure your department's ePCR signature requirements, including signature blocks, form language, and workflows to ensure proper signature collection and compliance with regulatory requirements.

Background Information

Department signature needs encompass the comprehensive strategy for collecting electronic signatures within ePCR documentation. This includes identifying all parties who may need to sign the ePCR (personnel, patients, receiving facilities, witnesses, and patient representatives), determining the specific circumstances that trigger each signature requirement, and establishing the regulatory or operational reasons behind them.

The signature setup process involves three main components: Signature Blocks (which define the data elements and demographics captured), Form Language (the official text accompanying signature reasons), and Workflows (conditional requirements for signature collection). This systematic approach ensures compliance while supporting proper documentation workflows.

Required Permissions

To complete this task, users need the following First Due permissions:

EMS Setup - Manage

  • Allow

EMS Setup - Manage Field Customization

  • Allow

These permissions ensure users can access the EMS Setup module, configure signature blocks, create form language, and establish workflows for signature requirements.

Video

Step-by-Step Guide

Step 1: Navigate to Signature Setup
  1. Navigate to EMS Setup and select Signature Setup
  2. Collaborate with your department's Administration and Billing teams to establish a comprehensive signature collection strategy
     
Navigate to EMS Setup and select Signature Setup
Step 2: Access Signature Blocks Configuration and Manage Existing Signature Blocks
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Info:

Signature Blocks defines which data elements appear in the ePCR for capturing the signature graphic, type of person signing, demographics, and their reason for signing.
 
Most common Signature blocks: Crew, Patient, Patient Representative, Receiving Facility, Witness
 
Please refer to our EMS Setup - Signature Blocks Knowledge Base Article for further setup guidance.

 

  1. From the Signature Blocks tab, you can build new signature blocks or manage existing ones
  2. To create new signature blocks, select "+Add Signature Block"
  3. Set signature blocks as default by enabling the toggle
    1. Defaulted Signature Blocks are always visible; non-defaulted blocks can be chosen by providers using "Add Signature Block"
  4. Edit signature blocks using the pencil icon
  5. Delete signature blocks using the trashcan icon
     
From the Signature Blocks tab you are able to Build your Signature Blocks or manage existing.
Step 3: Build Patient Signature Block
  1. Start by giving the Block a Name
  2. Use dropdowns to complete other required fields
  3. Set Default Values and choose to Allow Edit/Delete signatures
  4. When Type of Person Signing is defined as "Patient" and Optional Fields include "Full Name," the Patient Name will automatically populate from the ePCR Information Section
  5. Select all potential Reasons for Signing that crews would need when obtaining Patient signatures
  6. Choose the Is Patient Signature Block to indicate whether the patient will sign this signature type
  7. Select Save when completed
     
Building the Patient Signature Block
Step 4: Build Crew Signature Block
  1. When Optional Field of "Crew Member" is selected, Crew Signatures can be set to "Fill" with stored user signatures when crew members are signed into First Due
  2. Select all potential Reasons for Signing that crews would need when signing the ePCR
  3. Set Default Values and Allow Edit/Delete signatures options
  4. Note: Provider acknowledgement is a custom NEMSIS value (refer to EMS Setup - Adding Custom Values for NEMSIS Questions Knowledge Base Article)
  5. Select Save when completed
 
Building the Crew Signature Block
Step 5: Access Form Language Configuration
 
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Info:

Form Language defines the official text that accompanies a Reason for Signature, ensuring compliance, accuracy, and proper documentation. Any Reason for Signing selected in the Signature Block setup will not be available in the ePCR unless it has an associated Form Language
 
Please refer to EMS Setup - Form Language Knowledge Base Article for further setup guidance.

 

  1. From the Form Language tab, you can create, edit, or delete Form Language
  2. Select "+Add" to begin creating new Form Language
  3. Use pencil icon to edit existing Form Language
  4. Use trashcan icon to delete existing Form Language
  5. Bulk delete using checkboxes and trashcan icon next to "+Add"
  6. Rearrange order by dragging and dropping using the three bar stack
     
From the Form Language tab you are able create, edit, or delete Form Langauge.
Step 6: Define Form Language for All Reasons
 
  1. Form Language setup defines the official text that accompanies a Reason for Signature
  2. Important: Any Reason for Signing selected in Signature Block setup will not be available in the ePCR unless it has associated Form Language
  3. Create Form Language for every Reason for Signature configured in your signature blocks
Define Form Language for ALL Reasons for Signature
Step 7: Create Workflows for Type of Person Signing
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Info:

Building Workflows for Signature Blocks: 
 
Please refer to our Setting up the ePCR - Workflows Knowledge Base Article for further guidance on how to write basic workflows
 
  1. Write an Error workflow on the "Type of Person Signing" field to require it be answered within every signature block
  2. This ensures proper documentation even if the field wasn't defaulted in Signature Setup or was de-selected by the provider
Workflows to Require Type of Person Signing
Step 8: Create Workflows for Signature Graphics and No Signature Reason
  1. Write Error workflows to require either:
    1. Signature Graphic field is completed, OR
    2. No Signature Reason field is completed
  2. This ensures crews provide either a physical signature graphic or a legitimate reason for no signature
     
Workflows on the Signature Graphic and No Signature Reason
Step 9: Configure Signature Group Workflows
  1. Write workflows to require crews to collect specific signatures conditionally
  2. Use the Signature Group as the "NEMSIS field" to write workflows
  3. Example: Require Patient Signature when transport disposition shows unit transported or patient refused transport
  4. Adjust workflows accordingly for each type of person needed to sign the ePCR conditionally
Workflows on the Signature Group

Best Practices

  1. Collaborate with Administration and Billing teams before configuring signature requirements
  2. Use Default setting for the most commonly obtained signatures
  3. Create comprehensive Form Language for all signature reasons to ensure compliance
  4. Test signature workflows thoroughly before deployment to production
  5. Document all signature requirements and their regulatory or operational justifications
  6. Train staff on signature collection procedures and system functionality
  7. Regularly review and update signature requirements based on regulatory changes
  8. Consider creating signature blocks for all potential signers: Crew, Patient, Patient Representative, Receiving Facility, Witness
  9. Ensure workflows account for various scenarios and transport dispositions

Troubleshooting & FAQs

Why isn't a Reason for Signing available in the ePCR? 
  1. Any Reason for Signing selected in Signature Block setup requires associated Form Language to be available in the ePCR.
How do I make certain signature blocks always appear? 
  1. Use the Default toggle to make signature blocks always visible in the ePCR.
What happens if I don't create workflows for signature requirements? 
  1. Without workflows, signature collection becomes optional rather than conditionally required, which may impact compliance.
Can I require different signatures based on transport disposition? 
  1. Yes, use Signature Group workflows to conditionally require specific signatures based on various factors including transport disposition.
How do I ensure signature compliance across different scenarios? 
  1. Create comprehensive workflows that account for all transport dispositions and patient care scenarios your agency encounters.