Little Elm Orthopedic & Spine Rehab, PC staff may use electronic signatures on all computer-generated documentation. An electronic signature will serve as authentication on patient record documents generated via Agency Manager.

To utilize current technology in the provision of patient care

All personnel Procedure: 1. Little Elm Orthopedic & Staff Rehab, PC staff may create patient documentation via computer system. 2.For the purpose of the electronic medical record, and documents printed from the electronic medical record, the employee's use of an Electronic Signature Passcode after authenticating with their system Log In password will serve as her/his legal signature. 3. The agency-based application administrator will issue each employee a system User Name and a temporary password. The user will create a new password upon initial log in to Agency Manager. 4.An Electronic Signature Passcode will be generated by the employee and will only be accessible to the employee. 5.Each user will be required to change their Log In authentication password: a. upon his/her password being reset by an agency-based application administrator b. every 60 days C. at the employee's discretion 6.If an Electronic Signature Passcode must be reset, only the software vendor with employee authentication may reset the Electronic Signature Passcode. 7.After completion of a clinical document by the clinician, her/his Electronic Signature Passcode must be entered to submit the clinical document to the case manager. 8.Each employee documenting electronically in the electronic medical record will be required to sign an Electronic Documentation & Signature Authenticity Agreement. This Agreement will require that he/she: a. Ensure the security of his/her Log In authentication password and Electronic Signature Passcode information, which may not be shared with anyone, b. Exit the electronic medical record software at the end of each working day, when the computer will not be used for clinical documentation, and when the computer is out of her/his possession, and C. Review all documentation prior to submission. 9. Each employee will review documentation and make necessary corrections per agency policy to documents returned by a case manager at which time the clinician will be required to re-enter the Electronic Signature Passcode to re-submit the documentation. 10.In the event of system downtime that results in the employee's inability to use the electronic documentation system, the employee will complete records manually. 11. Each user must keep his/her Log In User Name, password, and Electronic Signature Passcode confidential. Only the agency-based administrator may reset a user's LogIn authentication password. 12. Upon termination of employment; the administrator will immediately disable the employee user's credentials to prevent access to the electronic medical record.

Agency Manager's electronic signature system uses a dual password process to ensure authentic electronic signatures. Each Agency Manager user has a system password (Log In authentication password) that must be updated every 60 days to ensure continued access to the system. When an electronic signature will be utilized to sign clinical documentation, the user will provide an additional signature password (Electronic Signature Passcode) to sign the document within the system. When an electronic signature is applied to a document, the time and date are stored for later retrieval. If at any time a document that has been electronically signed is re- opened or otherwise edited, the electronic signature will be destroyed and must be reentered by the user upon resubmission of the clinical documentation. Log In authentication passwords are created and assigned at the agency level. Electronic Signature Passcodes are created by individual users, and subsequently managed by Kinnser Software, Inc. If a user forgets her/his Electronic Signature Passcode, the user must be authenticated by Kinnser prior to resetting the Passcode. Resetting the Electronic Signature Passcode cannot be done at the agency level to ensure the security of the dual password process.

Little Elm Orthopedic & Spine Rehab, PC

ELECTRONIC DOCUMENTATION & SIGNATURE AUTHENTICITY AGREEMENT

I understand that Little Elm Orthpedic & Spine Rehab, PC staff may use electronic signatures on all computer-generated documentation. An electronic signature will serve as authentication on patient record documents and other agency documents generated in the electronic system. For the purpose of the computerized medical record and other documentation for agency purposes, I acknowledge the combined use of my Electronic Signature Passcode and Log In authentication password will serve as my legal signature. I further understand that an agency-based administrator issues initial employee passwords and that I will create an Electronic Signature Passcode within the software application. Log In authentication passwords must be updated every 60 days by the user, as well as on an as-needed basis if system security is breached. I understand that prior to exporting documentation to the agency server, I am required to review and authenticate, by use of electronic signature, my documentation on the field- based or office computer. I understand that I am responsible for the security and accuracy of information entered into Agency Manager, and as such, I will: Not share or otherwise compromise my electronic signature credentials (Log In authentication password or Electronic Signature Passcode) Exit the online application at the end of each working day or whenever the computer is not in my immediate possession Not save my Log In password and Electronic Signature Passcode on the computer, but will enter them upon each access of the application Review all of my documentation online prior to submitting to the agency server