# Electronic and Digital Signatures (Overview)

CPRS now has two types of signatures: electronic and digital. Electronic signatures, which have been available for some time, require an electronic signature code that can be created at your site. Digital signatures in CPRS are now required to comply with new Drug Enforcement Agency’s (DEA) regulations for identifying a prescriber that orders outpatient controlled substances.

There are three different levels of keys that influence what can be done with orders, including which dialog CPRS brings up when signing orders. Although actual practice at each site may vary, the three levels are usually referred to in these ways:

- OREMAS is the clerk key.
- PROVIDER key: Establishes the key holder as default provider when entering orders and the provider who will receive results notifications.
- ORELSE key: Assigned to users authorized to release provider’s orders, typically assigned to non-privileged RNs (and may be assigned to LVN/LPNs as clinically appropriate).
- ORES key: Assigned to users authorized to write and sign orders, typically privileged providers.

In CPRS, users who hold the ORES key have additional privileges and are sometimes required to enter more information than those who hold the ORELSE or OREMAS key. ORES key holders (usually an ordering provider) must enter information regarding service connection, environmental conditions or specific treatment factors, such as ionizing radiation, Agent Orange, etc.

This section describes the differences between electronic and digital signatures, gives an overview of service connection and treatment factors, and then gives the steps for the various ways users will sign orders. For example, users can sign orders several different ways:

· Review / Sign Changes... enables users to sign all orders from the current ordering session. Using this method, the user could write a number of orders and create documents and then sign all items at the same time.

· Sign selected... enables users to highlight one or more orders and then sign them. When the dialog displays, only the selected orders or documents will display for signature.

· Select New Patient brings up the signature dialog that includes all unsigned orders for the current patient before opening another patient record. The orders are broken into three groups, the user's orders from this ordering session, the user's unsigned orders for the patient from previous ordering sessions, and unsigned orders for the patient written by other users. The user can then select and deselect the orders to be signed.

· Exiting the chart (closing CPRS) brings up the same dialog as selecting a new patient (see above).

CPRS provides three methods for signing orders and documents. You can sign orders and documents together from the Review / Sign Changes dialog or you can sign orders and documents separately using the Sign Selected Orders and Sign Documents Now commands.

Related topics

Digital Signature: PKI Overview

Review / Sign Changes Dialog

Sign Selected Orders Command

Sign Note Now and Sign Discharge Summary Now Commands

Add to Signature List

Viewing Unsigned Notes or Discharge Summaries

Identify Additional Signers

Electronic Signature (overview)