12,000 hours saved per year by digitising informed consents

The challenge: 10,000 paper consents a month

Informed consent is one of the most legally loaded documents in a hospital: Spanish patient-autonomy law (Ley 41/2002) requires it to exist, to be signed before the procedure, and to be retrievable years later. Hospital Sant Pau was handling more than 10,000 paper consents every month: printing, pen-and-ink signing at admissions or on the ward, physical transport and manual scanning into the clinical record.

That circuit carried three costs. Clinical time: admissions and nursing staff printing, chasing and filing paper. Legal exposure: any document that travels on paper can be lost or scanned against the wrong patient — and an unfindable consent is a serious legal contingency. Audit overhead: preparing a review meant weeks of locating documents in physical archives.

The starting requirement was clear: remove the paper without changing the care workflow — the patient signs wherever they are (admissions, ER, operating room) — and without breaking the clinical traceability of the electronic health record.

The solution: biometric signing integrated with the EHR

Biometric signature was deployed on tablets in admissions, the ER and the operating room: the patient signs by hand on the screen and the system captures the pressure, speed and acceleration of the stroke — court-grade evidence, the functional equivalent of signing on paper, without asking patients for certificates or apps.

The signed document is automatically filed into the electronic health record via HL7, attached to the correct care episode. No scanning, no physical transport, no parallel archive: the consent is born digital and lives in the EHR from the first second.

• →Templated, versioned consents: each clinical service keeps its approved models; when a committee updates a text, the new version takes effect in a controlled way and there is a record of which version each patient signed.
• →Hospital identity sign-on (SAML SSO): clinicians manage no new credentials and every action is logged under their identity.
• →Environment aligned with Spain's ENS Medium level and GDPR for health data — the same framework we apply in healthcare and in ENS document management.

Results

The headline number: 12,000 staff hours saved per year — the sum of printing, signature-chasing, scanning and filing work that no longer exists. At admissions, time spent on consent dropped by 87%: what used to be a paper circuit is now a gesture on the tablet inside the patient's own registration.

Since full rollout across all 14 wards, the hospital processes 12,000 digital consents per month with zero lost documents. And the metric leadership values most: audit preparation went from weeks of physical archive work to an instant query — every consent is findable by patient, episode, service and document version.

The complete project — from analysis to full deployment with training — ran in 8 weeks, with a 2-ward pilot in week 5. The same pattern is in production at Hospital Mutua Terrassa, with more than 250 active processes.

What made it work

Timeline