Overview
CMS is collaborating with DHHS Office of the National Coordinator for Health IT (ONC) to develop a method to replace wet signatures with digital signatures for medical documents and transactions. Through working with the Standards and Interoperability (S&I) Framework, CMS has identified requirements within the following major topics for Author of Record (AoR):
These topics are focused on meeting requirements for signature non-repudiation and data integrity.
The Author of Record pilots are focused on four different types of signatures:
1) Signatures on transactions (see esMD use case 1 and use case 2)
2) Signatures on bundles of documents using the IHE DSG standards as defined in Author of Record Level 1 Implementation Guide.
3) Signatures on individual C-CDAs using the XADES-X-L standard defined in the HL7 Digital Signatures Implementation Guide.
4) Delegation of rights assertions using a SAML assertion as defined in the guides.