Ensuring Trust and Accountability in Digital Clinical Workflows
In Ocean, clinician signatures serve a critical role in ensuring that certain actions taken — including sending an eReferral, eConsult, or eSubmission — are authentic, traceable, and compliant with healthcare and privacy legislation. Unlike scanned “wet” signatures or stylized marks, Ocean’s digital signature process is identity-based: the true validation lies in who is signed in, what they did, and when it occurred
This model is consistent with modern digital signing frameworks such as DocuSign, and with electronic medical record (EMR) standards used across Canada’s healthcare systems.
Authentication and Identity Validation
Clinician identity is the foundation of signature integrity in Ocean.
Each clinician:
- Authenticates through a unique Ocean account tied to their organization and site.
- May enable two-factor authentication (2FA) for additional security.
- Can connect their Ocean account to a federated identity provider such as ONE ID (Ontario), ensuring the account corresponds to a verified healthcare professional.
Once signed in, all clinician actions — such as approving a referral or completing a consult — are automatically digitally signed using the clinician’s authenticated credentials. Ocean captures a complete record including username, timestamp, and site ID.
Ensuring every action is:
- Authenticated (the clinician’s identity is verified)
- Authorized (the action is permitted for that role and site)
- Immutable (the record cannot be changed once written).
This design ensures that each signature represents a legally defensible attestation of the clinician’s actions.
The Signature Font: A Visual Confirmation, Not the Validation
When a clinician’s signature appears on an Ocean form or document, it is typically rendered using a signature-style font. This font acts only as a visual cue — a clear indicator to others that the form has been signed — but not the actual security mechanism.
The true signature is captured through the clinician’s secure, authenticated session and recorded in the Ocean audit log, complete with username, timestamp, and site information. These details are written back to the EMR/EHR as part of the permanent medical record. This mirrors DocuSign’s “intent and authentication” model, where the legal validity of the signature derives from the verified identity and immutable audit trail.
Non-Repudiation and Audit Logging
Ocean’s audit subsystem ensures that all clinician actions can be verified and are legally defensible. Each record includes username and site information (serving as the digital signature), timestamp, and action type.
Audit logs are stored online for 60 days for reporting, then archived securely for a minimum of seven years. All logs are immutable, meaning no record can be altered or deleted once written.
Ocean’s infrastructure undergoes regular penetration testing and security audits, ensuring compliance with PIPEDA, PHIPA, and other Canadian privacy frameworks.
Alignment with Industry Best Practices
Ocean’s digital signature framework aligns closely with recognized standards for electronic signatures and healthcare information systems:
| Industry Standard | Ocean Equivalent |
|---|---|
| DocuSign “Intent and Authentication" | Signed-in state, logged event, and timestamp |
| EMR Digital Signature Audit Model | Immutable audit record stored in Ocean and mirrored in the EMR |
| ISO/IEC 27001 & SOC 2 Controls | Encrypted storage, access control, audit retention, 2FA |
| SMART on FHIR / OpenID Connect | Federated identity and single sign-on (SSO) authentication |
Summary:
In Ocean, clinician signatures aren’t just “electronic ink” — they are cryptographically and procedurally validated attestations of clinical action.
By combining authentication, federated identity, audit logging, and standardized security practices, Ocean ensures that every clinician signature:
- Meets non-repudiation requirements
- Aligns with industry best practices like DocuSign and leading EMRs
- Reinforces the integrity of the medical record.
The Result: a digital signature process that is as legally sound and secure as it is frictionless for clinicians.