Informed consent is a cornerstone of medical practice, ensuring ethical treatment decisions and patient-centred care.
Despite its central role in safe and effective care, the way consent is sought and recorded hasn’t meaningfully evolved in decades. In most settings, it still relies on paper forms, vague conversations, and inconsistent documentation, far removed from the realities of modern healthcare and the expectations of patients today.
The gap between ideal and reality
Clinicians know that informed consent isn’t just about a signature, it’s about supporting and empowering patients to make informed, shared decisions about their care. However, many patients leave consent conversations feeling confused, rushed, or unaware of key risks and alternative treatments. This disconnect is not due to a lack of care or professionalism, but rather is a structural problem. Outdated tools and fragmented processes contribute to this ongoing issue.
Paper consent forms remain the norm in most hospitals. They offer no standardised framework for discussions, no consistent way to present complex information, and rely on handwritten notes, providing little support for either the patient or the clinician. The result is huge variation between individuals and departments, not because clinicians disagree on what good consent looks like, but because paper just isn’t a reliable way to deliver it.
Consider the example of cancer care. After receiving a life-changing diagnosis, patients are often asked to weigh up complex treatment options under emotional distress, frequently in a limited time window. Even when care spans multiple investigations and consultations, the consent conversation is still expected to fit into a single appointment, and patients are presented with generic consent forms that often fail to adequately convey the complexity of their decisions.
Why now?
That might have been tolerated a decade ago, but healthcare has moved on, and so have patients. Care is more complex. Multidisciplinary teams, novel therapies, and more engaged, better resourced patients mean that consent conversations must now cover more ground than ever before. At the same time, medicolegal standards have risen, and the consequences of poor documentation are more serious.
We also know more about what good communication looks like. We understand how patients process risk, and know that people need time and space to make decisions, especially when those decisions involve deeply personal trade-offs. And yet, the consent process, one of the most important interactions in healthcare, rarely reflects these insights.
The burden on clinicians
The consequences of this outdated system are felt not just by patients but by clinicians as well. Many clinicians want to have high-quality, personalised conversations with patients, but are constrained by limited time, inconsistent documentation, and the pressure to simply “get the form signed”.
There’s also the everyday administrative burden: locating the right paper form, scanning and uploading documents, and following up when forms are incomplete or missing. These tasks absorb time and attention while adding little clinical value. For busy clinical teams, it’s yet another friction point in already stretched workflows.
In practice, all of this can lead to defensive consent: long lists of risks, minimal discussion, and a process focused on legal protection rather than understanding. It’s not what any of us want, but it’s the product of a system that hasn’t kept up with the needs of care today.
What digital consent can make possible
The shift from paper to digital in consent is not just about efficiency, it represents an opportunity to have a more consistent, transparent, and empathetic consent process. Digital tools can provide patients with clear, accessible information they can review before and after appointments – not just an electronic version of the paper form, but a more dynamic, supportive experience that allows for deeper reflection and more meaningful conversations.
When using digital consent, patients are no longer solely relying on their memory of a rushed conversation. Instead, they can revisit complex information at their own pace, engage in discussions based on their personal values and concerns, and feel more empowered in their decision-making.
For clinicians, digital tools reduce the administrative load, freeing up time and cognitive effort for the parts of the conversation that matter most.
Maintaining the human connection
This isn’t about replacing human conversations with screens, quite the opposite. Digital consent can create the conditions for more meaningful, human discussions. It shifts the focus away from filling out a form, and back to what matters: exploring preferences, weighing up options, and building trust.
That said, it’s critical that digital tools don’t create new barriers. Not every patient is confident with technology. Any digital consent application must include accessibility support for those who need it, and offer non-digital alternatives where appropriate.
The goal is not to automate consent, but to improve it, by making it more consistent and understandable. The consent process is not an administrative checkbox, but a human conversation, grounded in trust, mutual respect, and understanding. Technology should enable that conversation, not replace it.
Moving forward
It’s becoming increasingly clear that the paper consent process often falls short of meeting the needs of patients and clinicians. We have a chance to make consent more consistent, more understandable, and more human. To move beyond a process that ticks boxes and toward one that builds confidence and trust.
It’s time for consent to stop being the weakest part of the care journey – and start becoming one of its strongest, supported by digital tools that help make the process more consistent, understandable, and human. The challenge is being recognised internationally, with conversations happening across health systems, including Australia and Ireland, as recently reported in Pulse+IT.
Have your say with our poll question:
Can we do a better job of obtaining patient consent?
IF YES – what have been your experiences with patient consent?
It would be unwise to ignore the role that medico-legal practitioners (and courts) continue to play in considering how IFC can develop in the future.
While not an explicit part of the process at the clinical phase, the propensity for courts to become explorers of missed risk conversations well after the clinical relationship has completed, has led to the “template” approach when documenting possible adverse events. Each time the courts uncover a new risk, the templates just grow longer (and less of a tool for generating clinical conversations).
Can we do a better job? YES. Experience has been: Perfunctory.
YES: TBH, it’s not only about the consent, the important pieces missing is the patient portal. Having a good constructed patient portal with the ability to manage patient’s demographic information, medical/medication history, appointments, consent, view previous diagnostic result, and correspondence… Currently there are applications available such as HotDoc, but most of them are only appointment focus only.
YES In this day and age it would be better to obtain consent digitally
YES: it’s about the conversation, not having a digital form.
YES: Often patients coerced into signing consent without proper explanations of treatments, options (in plain English).
YES All of the challenges outlined in the article . Definitely not meaningful or value added
YES: Fragmented and I consistent. There is a specific use case for building a learning health system where routinely collected data is used to improve care.
YES: I deal with the financial consent. It can difficult to know what unexpected costs the patient might face throughout their inpatient stay due to lack of transparency between the hospital and the VMO. Yet it’s my job to manage the patient’s expectation in this regard.