How Do I Digitally Sign Daily Progress Notes on Same .pdf?

Friday, August 7, 2009
3:20 PM  -0800
Hello Everyone.
I'm a physician, and I am in the position of writing notes that may be introduced into evidence later. I really would like to avoid going to court & litigation, but it seems that I may be headed in that area. I usually keep progress notes of any kind; on house projects, vacations, etc. on one MS Word file and simply update the next entry with a new date and time header like you see at the top of this entry.
For the first time, I find that I must apply a digital signature and secure the notes and show that they were written on the date and at the time specified. And, most of all, I must show proof that the notes were not altered later.
There are many vendors, I understand, who provide digital signatures for Adobe Acrobat Pro v9 for Intel Macintosh. Who is the best?
Also, is it possible to keep a running journal and sign each day's entry? Or does each day require a separate document? Will I end up with 20-30 separate signed .pdf documents at the end of this?
Thanks to all in advance.
-jpk

jpkmd85 wrote:
What is this type of signature called?  I understand it's called a  "class 3" type certificate.
It's not a type of "signature", but a class of digital ID. A "signature" is really shorthand for "electronic digital signature". What a signature really is a pair of cryptographic operations over a given set of data, and in this case the data is just a bunch of bytes in a computer file. One of those operation I'm referring to requires the use of a digital ID, or in the case of creating the signature, specifically the use of the private key portion of a digital ID. The subsequent validation of the signature requires the public key portion of the digital ID. When these keys are generated, they have a symbiotic relationship. By that I mean what one key locks,  only the its corresponding other key can unlock. When you lock something with the private key (which is how a signature gets created), only the corresponding public key can unlock the encrypted data (this is the basis of signature verification). Conversely, if you lock something with the public key (this is the basis of certificate security in Acrobat) only the corresponding private key can unlock it. In the computer world, you can sign any blob of electronic data and it's always the same underlying principle. You can sign e-mail, you can sign Word docs and lots of other things (but most importantly, PDF files because that's what keeps me employed ).
Back to the digital IDs. A digital ID is really comprised of three things. The public key, the corresponding private key, and a set of certificate attributes and extensions that are for the most part plain text. These attributes and extensions that I speak about are the data that defines who the digital ID was issued to (aka the Subject), who issued the digital ID (the Issuer), the validity period, key usage, constraints, serial number, etc. The Certificate Authority (CA) is a company or governmental organization that operates under a set of legal guidelines (lawyers salivate here). There is no electronic magic here, just a bunch of documents. When they issue a digital ID they do it under the auspices of a Certificate Policy (CP) which in turn is enforced by a document called the Certificate Practice Statement (CPS). The CPS details the process by which they (the CA) may issue a digital ID and the rights and responsibilities that the recipient must adhere to. For instance, if you lose the private key (e.g. it was on a laptop that got stolen) you would be obligated to report this to the CA so they could revoke the digital ID. One of the things the CP defines is the assurance level that the CA will go through prior to issuing a digital ID. A high assurance level would require that they (the CA) get proof of ID before issuing you a digital ID, and that you would also agree to the terms of the contract. A low assurance level CA will issue a digital ID without requiring proof of ID. Another way that high assurance CAs work is they issue the digital ID on hardware device (a USB token or a smart card). This is know as two factor identification because it requires something you have (the device) and something you know (the PIN or password).
They key here (no pun intended) is to check with the CA and find out which program they offer that guarentees non-repudiation. If the files will need to be routinly opened on computers other than yours  I would recomend getting a digital ID that chains to the Adobe Root CA, but if the file is going to live on your machine unless extrodinary circumstances arise you could get by with any high assurance digital ID.
Steve

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