Commentary: time to sign off on signout.

The physician signout note is a widely used clinical document that supports patient safety and care continuity during patient handoff in the hospital. Despite its centrality to patient care, the signout note is not considered an official document, and it is, therefore, not generally standardized or taught to medical trainees, nor is it usually integrated into electronic health records (EHRs). This commentary outlines several of the potential advantages to establishing the physician signout note as an official part of the medical record, such as the facilitation of information flow between signout notes and other parts of the patient chart and the possibility of integrating decision support tools into this important aspect of the clinical workflow. The authors address frequently encountered concerns regarding the establishment of the signout note as an official part of the medical record. They conclude by making recommendations for integrating signout notes into EHRs and using modern, social Web technologies in such an implementation.