Kesiapan Penggunaan Tanda Tangan Elektronik Tersertifikasi pada Rekam Medis Elektronik di RSU X Tasikmalaya

Abstract

The implementation of electronic medical records requires secure and accountable authentication of medical documents, including certified electronic signatures. At RSU X Tasikmalaya, non-certified electronic signatures were still used, resulting in additional verification processes, particularly in claims. This study aimed to analyze the readiness for implementing certified electronic signatures in electronic medical records at RSU X using the Doctor’s Office Quality-Information Technology (DOQ-IT) framework. A descriptive qualitative design was employed. Four informants representing managerial, medical records, information technology, and admission perspectives were selected using purposive sampling. Data were collected through semi-structured interviews, observations, and document analysis, with source and technique triangulation. The results showed that readiness for implementing certified electronic signatures was not fully optimal across the four DOQ-IT domains. Human resource readiness was suboptimal because training had not been conducted systematically or evenly. Organizational culture was generally adaptive to digital technology, although resistance and shared account practices remained barriers to accountability. Leadership governance was supported by internal policies, cross unit coordination, implementation planning, and budget preparation, but operational procedures had not been established. Technological infrastructure had a technical foundation to support implementation, although infrastructure performance was uneven and individual access controls required strengthening. RSU X was therefore not fully ready for comprehensive implementation of certified electronic signatures. Technical training, transition support, operational SOPs, individual user accounts, and network capacity strengthening are recommended to support secure, consistent, and sustainable implementation.