Clinical EMR Overview: User Permissions - Staff delegates

Overview

A staff delegate is a Staff Level user authorized to take clinical or administrative actions on behalf of a provider. This guide explains what delegates can do, the difference between provider-level and practice-level delegation, and how to set each one up.

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What is a staff delegate?

In Elation, only Provider Level users (prescribing & non-prescribing) can sign orders, prescriptions, referrals, and visit notes by default. A staff delegate is a Staff Level user who has been granted permission to perform one or more of those actions on a specific provider's behalf — without needing a provider-level account.

Staff delegates always act under a provider's authority. Their name appears alongside the ordering provider's on any document they execute, creating a clear audit trail.

Important: Staff delegates do not get their own signing authority. Every action they take is attributed to the provider who authorized them. The provider remains the rendering clinician of record.

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Delegation Types

Elation distinguishes between two scopes of delegation. Understanding which one applies to each task is the key to configuring permissions correctly.

Provider-level - Authorized delegate

Set by an individual provider in their own user settings (only provider can see). Access granted by individual staff user. 

• Sign Prescriptions
• Sign Orders
• Edit Signed Bills
• Edit and Send referrals

Practice-level - User Group Delegates

Configured by an Admin in practice-wide settings. Access granted by user group. Any admin can view and update.  

• Sign Prescriptions
• Sign Orders
• Edit Signed Bills
• Sign referrals

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Side-by-side comparison

	Provider-level delegate	Practice-level permission
Who sets it up	The individual provider, in their own User Settings	An Admin user, in
Where to configure	Settings > User Settings > Provider Managed Delegates	Settings > Admin Users Only > Admin Managed Delegates
Scope	One provider ↔ one staff member	All users of a defined user group
Typical use case	MA or scribe signing Rx or orders for their assigned physician	Billing staff editing charges across the practice
Affects which providers	Only the authorizing provider	All providers in the practice

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Common configurations

Medical assistant or scribe

Assign as a provider-level delegate for the provider(s) they support. Grant Rx, Orders, and/or Referrals as needed. The provider still reviews and signs visit notes.

Dedicated billing staff

Enable billing permissions at the practice level so they can edit charges across all providers. If they also need to edit billing on specific signed notes, the relevant providers should also add them as a Billing Delegate in User Settings.

Front office staff

Typically do not need delegate permissions. Standard Staff Level access covers scheduling, messaging, and chart management without delegation.