Healthcare Technology Featured Article

March 08, 2021

The State of PDFs and Digital Documentation in Healthcare

Five Areas in Which Digital Makes a Difference

The healthcare industry has seen remarkable advances in digital technology over the last decade. But, despite efforts to fully digitize the healthcare landscape, paper and other means of legacy documentation persist in many organizations.

New survey results from HIMSS suggest that, while the opportunity to leverage digital documentation more effectively is great, adoption lags in the age of digital healthcare. While most respondents said they incorporate some PDFs and digital documents in their workflows, only 8% reported being entirely digital in 2020.

“We wanted to have a better understanding of the healthcare end-users of PDF solutions, and we wanted to understand the factors that drive adoption,” said Stephen Wellman, vice president of content strategy at HIMSS, about the survey. Wellman, a 20-year veteran in the digital marketplace, reported that, while respondents agreed that PDF editors were essential and beneficial to their organizations, issues such as ease of use and cost were key barriers to adoption. “There is an opportunity for PDF editors to be easier to use across the organization,” he said.

Key takeaways from HIMSS survey

The main takeaway from the survey was that, while two in three organizations reported using digital documentation, the overwhelming majority (92%) still relied on paper in their day-to-day. Wellman pointed out from the findings that there is a clear opportunity to access PDF documents across more situations. The survey found that only patient education materials and patient information documents were generated, reviewed or edited digitally by one in two organizations. Notes from rounds (23%) and immunizations (21%) were the least used situations for PDF adoption.

According to respondents, two big challenges to implementing PDF editors were the necessity of printing multiple forms, followed by patient access. However, Wellman noted that neither challenge affected most organizations: Only one in four respondents cited the necessity of printing many documents as the top challenge they faced. One in three reported patients not having access as their primary barrier.

The survey also suggested a disconnect between what healthcare organizations want from a PDF editor and what end-users experience. Fewer than 50% of respondents reported that their PDF was extremely successful in any one area: Providing seamless integration and cost-effective solutions appeared to be the most significant gaps. Although one in three respondents agreed that their PDF solutions were efficient, only 14% reported it made documentation easier for all users.

Fortunately, there are opportunities to explore new solutions on the market: Wellman found most respondents used or were familiar with Adobe Acrobat, a “top-of-mind” but costly solution in the field. “But that’s changing,” Wellman said, “as more healthcare organizations are discovering new solutions entering the healthcare arena.”

Five areas in which digital makes a difference

  Deboshree Sarkar, Foxit

In light of these findings, I have highlighted five areas where using digital documentation can make a difference to healthcare workflows. In no particular order:

Forms processing

Healthcare organizations process countless forms daily, which not only amasses a considerable amount of data, but also often involves accumulating sensitive patient information. Whether it’s a patient onboarding form, insurance verification, release of information document, patient health history or patient referral form, clients have described a more effective and patient-friendly experience after switching to a PDF solution.

It’s because they’ve removed multiple opportunities for user-error. By creating custom form fields within the documents, organizations can assign restrictions to each area (for example, only allowing numbers in the field for insurance ID), thereby making the form more straightforward and accessible across multiple platforms, like a patient’s mobile device. Furthermore, using 2D technology, an editable PDF solution can digitally stamp a barcode on the form containing the variable data entered by the end-user. This allows it to be easily transferable and accurately captured into the healthcare organization’s databases or applications.

Security and compliance

To be HIPAA-compliant, all medical record information shared with third parties must have the ability for users to search and redact any information that could identify people individually. PDFs can also be password-protected and sanitized. By sanitize, we mean strip out the hidden information, such as comments, file attachments and other metadata.  Using redaction, password protection and sanitization features, medical providers can securely share valuable information in real time with different institutions without putting any patient’s privacy at risk. HIPAA also requires healthcare organizations to retain their records for a minimum of six years from the date of creation. By using a PDF format called PDF/A, where A stands for archiving, organizations can compress mass quantities of documents for long-term preservation.

Approvals and signatures

Signing documents by hand can be error-prone and time-consuming. Digital documentation can also help eliminate the paper-based signature process and associated bottlenecks. I recommended working with a PDF vendor that offers multiple signing capabilities, whether it’s e-signing, a simple stamping with signature images, or full digital signatures that go through third-party certificate authorities, like Verisign or Entrust.

Systems integration

As the survey results show, healthcare organizations want a PDF editor to integrate with their other systems and applications. Many of our healthcare customers use various document management systems, so the ability to open, edit, save directly to and from these systems is crucial.

Review and collaboration

Whether it’s checking patient cards or working with medical research teams, knowledge workers will often need to provide feedback within documents. Sharing information via annotation or comments are common ways of reinforcing collaboration within healthcare teams. But, paper is cumbersome and printed annotations only slow down the process. Sarkar recommended using a PDF editor that offers shared review features for team members.

Doing more with documents

Documentation using paper is costly, wasteful and time-consuming. To support organizations as they transition to digital documents, PDF vendors must address all three of these problems. There are many ways to reduce the amount of paper and manual entry still involved in healthcare today. As the HIMSS survey suggests, transitioning to a dynamic PDF solution can support organizations on the path toward digital transformation.

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By Special Guest
Deboshree Sarkar, Product Marketing Manager, Foxit ,


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