Review Of The Legality And Security Aspects Of Electronic Signature Use In Electronic Medical Records At Bakti Pajajaran Regional Public Hospital

Abstract

The implementation of electronic signatures in electronic medical records (EMRs) is intended to strengthen authentication, document integrity, accountability, and legal certainty in digital health services. This study reviewed the legality and security of electronic signature use in EMRs at Bakti Pajajaran Regional Public Hospital. A normative-empirical legal design with a descriptive qualitative approach was applied. Primary legal materials and relevant secondary literature were examined, while field data were obtained through in-depth interviews, observation, and documentation from 30 purposively selected informants representing medical records personnel, nurses, midwives, nutritionists, radiographers, information technology staff, and the head of the medical records installation. The study found that all 237 healthcare providers had used electronic signatures in the hospital information environment; however, none of the clinical electronic signatures were certified. The only certified electronic signature was used by the hospital director for administrative documents through the SRIKANDI application. Twenty of 32 reviewed medical record forms had been converted to electronic format, whereas 12 forms, particularly consent-related documents, remained manual. Major barriers included limited storage infrastructure, financing constraints, insufficient periodic socialization, and the absence of a dedicated standard operating procedure. These findings indicate that administrative adoption alone does not ensure adequate legal assurance and information security. The hospital should accelerate certified electronic signature implementation, establish specific governance procedures, strengthen security infrastructure, and provide sustainable organizational and financial support.