As Introduced 1
122nd General Assembly 4
Regular Session H. B. No. 243 5
1997-1998 6
REPRESENTATIVES VAN VYVEN-BRADING-CORBIN-HAINES-SCHURING- 8
TAYLOR-TERWILLEGER-TIBERI 9
11
A B I L L
To enact section 3702.40 of the Revised Code to 13
establish standards for using electronic 14
signatures and computer-generated signature codes 15
in records of health care facilities. 16
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO: 18
Section 1. That section 3702.40 of the Revised Code be 20
enacted to read as follows: 21
Sec. 3702.40. (A) AS USED IN THIS SECTION: 23
(1) "HEALTH CARE FACILITY" MEANS ANY OF THE FOLLOWING: 26
(a) A HOSPITAL, AS DEFINED IN SECTION 3727.01 OF THE 29
REVISED CODE;
(b) AN AMBULATORY SURGICAL FACILITY, AS DEFINED IN SECTION 31
3702.30 OF THE REVISED CODE; 34
(c) A FREESTANDING BIRTHING CENTER; 36
(d) A FREESTANDING CARDIAC CATHETERIZATION FACILITY; 38
(e) A FREESTANDING OR MOBILE DIAGNOSTIC IMAGING CENTER; 40
(f) A FREESTANDING DIALYSIS CENTER; 42
(g) A FREESTANDING EMERGENCY FACILITY; 44
(h) AN URGENT CARE CENTER; 46
(i) A FREESTANDING EXTRACORPOREAL SHOCKWAVE LITHOTRIPSY 48
CENTER; 49
(j) A FREESTANDING RADIATION THERAPY CENTER; 51
(k) A HOME HEALTH AGENCY; 53
(l) A HOSPICE CARE PROGRAM, AS DEFINED IN SECTION 3712.01 55
OF THE REVISED CODE; 56
2
(m) A NURSING HOME, RESIDENTIAL CARE FACILITY, OR HOME FOR 58
THE AGING, ALL AS DEFINED IN SECTION 3721.01 OF THE REVISED CODE; 61
(n) AN ADULT CARE FACILITY, AS DEFINED IN SECTION 3722.01 63
OF THE REVISED CODE; 64
(o) A NURSING FACILITY OR INTERMEDIATE CARE FACILITY FOR 66
THE MENTALLY RETARDED, BOTH AS DEFINED IN SECTION 5111.20 OF THE 68
REVISED CODE; 69
(p) A FACILITY OR PORTION OF A FACILITY CERTIFIED AS A 71
SKILLED NURSING FACILITY UNDER TITLE XVIII OF THE "SOCIAL 74
SECURITY ACT," 49 STAT. 620 (1935), 42 U.S.C.A. 301, AS AMENDED. 76
(2) "HEALTH CARE RECORD" MEANS ANY DOCUMENT OR COMBINATION 79
OF DOCUMENTS PERTAINING TO A PATIENT'S MEDICAL HISTORY,
DIAGNOSIS, PROGNOSIS, OR MEDICAL CONDITION THAT IS GENERATED AND 80
MAINTAINED IN THE PROCESS OF THE PATIENT'S TREATMENT AT A HEALTH 81
CARE FACILITY.
(B) ALL WRITTEN NOTES, ORDERS, AND OBSERVATIONS ENTERED 83
INTO A HEALTH CARE RECORD AT A HEALTH CARE FACILITY, INCLUDING 84
ANY INTERPRETIVE REPORTS OF DIAGNOSTIC TESTS OR SPECIFIC 86
TREATMENTS, SUCH AS RADIOLOGIC OR ELECTROCARDIOGRAPHIC REPORTS, 87
OPERATIVE REPORTS, REPORTS OF PATHOLOGIC EXAMINATION OF TISSUE, 88
AND SIMILAR REPORTS, SHALL BE AUTHENTICATED BY THE INDIVIDUAL WHO 89
MADE OR AUTHORIZED THE ENTRY. HEALTH CARE RECORD ENTRIES MAY BE 90
AUTHENTICATED BY HANDWRITTEN SIGNATURES OR HANDWRITTEN INITIALS. 91
THEY ALSO MAY BE AUTHENTICATED BY ELECTRONIC SIGNATURES OR 92
COMPUTER-GENERATED SIGNATURE CODES IF ALL OF THE FOLLOWING APPLY:
(1) THE HEALTH CARE FACILITY ADOPTS A POLICY THAT PERMITS 95
THE USE OF ELECTRONIC SIGNATURES OR COMPUTER-GENERATED SIGNATURE 96
CODES;
(2) THE FACILITY'S ELECTRONIC SIGNATURE OR 99
COMPUTER-GENERATED SIGNATURE CODE SYSTEM UTILIZES A TWO-LEVEL OR
BIOMETRIC ACCESS MECHANISM THAT ASSIGNS A UNIQUE IDENTIFIER TO 100
EACH USER;
(3) THE FACILITY TAKES STEPS TO SAFEGUARD AGAINST USE OF A 103
UNIQUE IDENTIFIER BY ANY INDIVIDUAL OTHER THAN THE ONE TO WHOM IT 104
3
IS ASSIGNED;
(4) THE SYSTEM INCLUDES A PROCESS TO VERIFY THAT THE 107
INDIVIDUAL AFFIXING THE ELECTRONIC SIGNATURE OR
COMPUTER-GENERATED SIGNATURE CODE HAS REVIEWED THE CONTENTS OF 108
THE ENTRY AND DETERMINED THAT THEY ARE WHAT THAT INDIVIDUAL 109
INTENDED;
(5) THE POLICY ADOPTED BY THE FACILITY PURSUANT TO 112
DIVISION (B)(1) OF THIS SECTION PRESCRIBES ALL OF THE FOLLOWING: 113
(a) A PROCEDURE BY WHICH EACH USER OF THE SYSTEM MUST 115
CERTIFY IN WRITING THAT THE USER WILL KEEP THE USER'S UNIQUE 117
IDENTIFIER STRICTLY CONFIDENTIAL; 118
(b) PENALTIES FOR MISUSING THE SYSTEM OR A UNIQUE 121
IDENTIFIER ALLOWING ACCESS TO IT;
(c) TRAINING THAT THE FACILITY MUST PROVIDE TO ALL USERS 123
OF THE SYSTEM AND THAT INCLUDES AN EXPLANATION OF THE APPROPRIATE 125
USE OF THE SYSTEM AND THE CONSEQUENCES FOR NONCOMPLIANCE WITH THE 127
FACILITY'S CONFIDENTIALITY AND SECURITY POLICIES.
THE USE OF AN ELECTRONIC SIGNATURE OR COMPUTER-GENERATED 129
SIGNATURE CODE IN ACCORDANCE WITH THIS SECTION SHALL BE 130
CONSIDERED FOR ALL LEGAL PURPOSES TO BE THE SAME AS A HANDWRITTEN 131
SIGNATURE OR HANDWRITTEN INITIALS.