Analysis of Patient Photograph-Based Electronic Informed Consent Implementation in HMS Khanza at a Hospital
DOI:
https://doi.org/10.54099/aijbs.v6i2.2001Keywords:
Electronic Informed Consent, Electronic Medical Record, Biometric Authentication, Operational Efficiency, Change ManagementAbstract
Purpose – This study aims to analyze the effectiveness and efficiency of implementing patient photograph-based electronic informed consent (e-IC) at Puri Adhya Paramita Hospital, evaluate managerial challenges in work culture adaptation to digital systems, and examine the compliance with legal aspects, medical ethics, and data security. Methodology/approach – A descriptive qualitative approach with a case study design was applied at Puri Adhya Paramita Hospital. Data were gathered through in-depth interviews with eight purposively selected key informants (the Director, doctors, nurses, medical records officers, IT staff, patients, the District Health Office, and the Chairman of the IDI Ethics Committee), along with observation and documentary reviews. Data analysis utilized Miles and Huberman's interactive model and triangulation techniques. Findings – The findings indicate that the implementation of photograph-based e-IC significantly improves medical administration efficiency through paperless operations and robust photo metadata tracking (time, location, and device). Managerially, initial staff resistance and patient confusion were successfully mitigated using Kurt Lewin’s change management model and proactive communication. Legally and ethically, this system is legally valid under the Indonesian ITE Law and Minister of Health Regulation No. 24 of 2022, while respecting patient autonomy by providing manual alternatives if patients refuse to be photographed. Security is maintained through the internal HMS database encryption and access control restrictions compliant with the Personal Data Protection (PDP) Law.
Novelty/value – This study provides scientific novelty by empirically evaluating the use of patient biometric photographs as primary evidence of daily medical consent in hospitals, addressing the gap in national technical regulations regarding biometric data protection in electronic medical records.
Keywords: Electronic Informed Consent, EMR, Patirnt Photograph, Digitalization Efficiency, Medical Etics, Change Management
References
Astromskė, K., Peičius, E., & Astromskis, P. (2021). Ethical and legal challenges of informed consent applying artificial intelligence in medical diagnostic consultations. AI and Society, 36(2), 509–520. https://doi.org/10.1007/s00146-020-01008-9
Azis, A. M., & Irjayanti, M. (2024). Strengthening the accuracy and visibility of supply chain management data in the coffee industry. Cogent Business and Management, 11(1), 1–18. https://doi.org/10.1080/23311975.2024.2380811
Bhattacharjee, M., Kaposy, C., Grossman, M. R., & Marshall, Z. (2023). Patient photographs on Google Images: a commentary on informed consent, copyright, and privacy laws. Law, Innovation and Technology, 15(2), 536–557. https://doi.org/10.1080/17579961.2023.2245684
Castro, C. F. de, Quintana, A. M., Olesiak, L. da R., & München, M. A. B. (2020). Informed consent form in healthcare. Revista Bioética, 28(3), 522–530. https://doi.org/10.1590/1983-80422020283416
Chane, W., Birhanu, B., & Suga, Y. (2020). Quality of informed consent among patients who underwent major surgical procedure in a tertiary care hospital, Addis Ababa, Ethiopia. Open Access Surgery, 13, 27–33. https://doi.org/10.2147/oas.s250532
Cohen, E., Byrom, B., Becher, A., Jörntén-Karlsson, M., & Mackenzie, A. K. (2023). Comparative effectiveness of eConsent: Systematic review. Journal of Medical Internet Research, 25(1), e43883. https://doi.org/10.2196/43883
De Sutter, E., Zaçe, D., Boccia, S., Di Pietro, M. L., Geerts, D., Borry, P., & Huys, I. (2020). Implementation of electronic informed consent in biomedical research and stakeholders’ perspectives: Systematic review. Journal of Medical Internet Research, 22(10), e19129. https://doi.org/10.2196/19129
Dzi, K. T. J., Ndong, O. N., Menkem, E. Z., & Tendongfor, N. (2025). Bioethics knowledge, attitudes, and practices among healthcare professionals in Cameroon: a cross sectional analytical observational study of doctors and nurses in Cameroon’s Southwest Region. Discover Public Health, 22(1), 1–12. https://doi.org/10.1186/s12982-025-00419-7
Gesualdo, F., Daverio, M., Palazzani, L., Dimitriou, D., Diez-Domingo, J., Fons-Martinez, J., Jackson, S., Vignally, P., Rizzo, C., & Tozzi, A. E. (2021). Digital tools in the informed consent process: a systematic review. BMC Medical Ethics, 22(1), 1–14. https://doi.org/10.1186/s12910-021-00585-8
Goldschmitt, M., Gleim, P., Mandelartz, S., Kellmeyer, P., & Rigotti, T. (2025). Digitalizing informed consent in healthcare: a scoping review. BMC Health Services Research, 25(1), 1–15. https://doi.org/10.1186/s12913-025-12964-7
Husna, N., Nurman, M., & Nugroho, Y. (2025). Pembentukan Peraturan Pemerintah tentang Face Recognition Technology ditinjau dari Undang-Undang Nomor 27 Tahun 2022 tentang Perlindungan Data Pribadi. Akses Jurnal Hukum, 17(2), 78–92. https://doi.org/10.36841/akses.v3i2.7126
Iype, J. K., & Sebastian, S. (2024). Comparative Analysis of State-of-the-Art Face Recognition Models: FaceNet, ArcFace, and OpenFace Using Image Classification Metrics. Communications in Computer and Information Science, 1973, 222–234. https://doi.org/10.1007/978-3-031-50993-3_18
Jaana, M., MacPhee, E., Sherrard, H., & Walker, M. (2024). Sustaining e-health innovations in a complex hospital environment: learning through evidence. Frontiers in Digital Health, 6, e1346085. https://doi.org/10.3389/fdgth.2024.1346085
Kamla AL-Aufi, & Basant Kumar. (2024). Computational Sciences and Sustainable Technologies (Vol. 1973). Springer Nature Switzerland. https://doi.org/10.1007/978-3-031-50993-3
Kaur, K., Waqas, R., Kaur, H., Mumtaz, M., Majeed, N., Ali, S. e. R., Ali, K., Shehata Abdelmesih, S., & Rehman, L. (2025). Bridging the Gap: A Systematic Review of Digital Consent Tools to Enhance Participation and Procedures in Low-Resource Settings. Cureus, 17(1), e94280. https://doi.org/10.7759/cureus.94280
Mazzochi, A. T., Dennis, M., & Chun, H. Y. Y. (2023). Electronic informed consent: effects on enrolment, practical and economic benefits, challenges, and drawbacks—a systematic review of studies within randomized controlled trials. Trials, 24(1), 1–19. https://doi.org/10.1186/s13063-022-06959-6
Meaney, P. A., Hokororo, A., Ndosi, H., Dahlen, A., Jacob, T., Mwanga, J. R., Kalabamu, F. S., Joyce, C. L., Mediratta, R., Rozenfeld, B., Berg, M., Smith, Z. H., Chami, N., Mkopi, N., Mwanga, C., Diocles, E., & Agweyu, A. (2024). Implementing adaptive e-learning for newborn care in Tanzania: an observational study of provider engagement and knowledge gains. BMJ Open, 14(2), e077834. https://doi.org/10.1136/bmjopen-2023-077834
Muhire, J., Badru, S., Nakatumba-Nabende, J., & Marvin, G. (2024). Interpretable drug resistance prediction for patients on anti-retroviral therapies (ART). Communications in Computer and Information Science, 1973, 43–53. https://doi.org/10.1007/978-3-031-50993-3_4
Ngoliwa, C., Chakwiya, C., Gondwe, J., Nsomba, E., Nkhoma, V., Reuben, M., Chantunga, L., Liwonde, P., Mangani, E., Kudowa, E., Makhaza, L., Toto, N., Sochera, T., Chikaonda, T., Morton, B., Henrion, M. Y. R., Dula, D., Gordon, S. B., & Chirwa, A. E. (2024). Piloting electronic informed consenting in a pneumococcal human infection study in Blantyre, Malawi. Wellcome Open Research, 9, 233. https://doi.org/10.12688/wellcomeopenres.20770.1
Nijhawan, L., Janodia, M., Muddukrishna, B., Bhat, K., Bairy, K., Udupa, N., & Musmade, P. (2013). Informed consent: Issues and challenges. Journal of Advanced Pharmaceutical Technology and Research, 4(3), 134–140. https://doi.org/10.4103/2231-4040.116779
Reeves, J. J., Mekeel, K. L., Waterman, R. S., Rhodes, L. R., Clay, B. J., Clary, B. M., & Longhurst, C. A. (2020). Association of electronic surgical consent forms with entry error rates. JAMA Surgery, 155(8), 777–778. https://doi.org/10.1001/jamasurg.2020.1014
Rheina Sayla, Dinda Putri, Muhammad Arby Fahrezi, & Abdul Fattah Nasution. (2024). Peran data dan informasi dalam teori sistem organisasi. Student Scientific Creativity Journal, 3(1), 156–164. https://doi.org/10.55606/sscj-amik.v3i1.4830
Rijal Husni, M. A. (2022). Aspek keamanan dan privasi penerapan informed consent elektronik di unit kamar bedah RSU Anna Medika Madura Bangkalan. Jurnal Rekam Medis dan Informasi Kesehatan, 5(2), 72–80. https://doi.org/10.31983/jrmik.v5i2.8376
Rowbotham, M. C., Astin, J., Greene, K., & Cummings, S. R. (2013). Interactive Informed Consent: Randomized Comparison with Paper Consents. PLoS ONE, 8(3), e58603. https://doi.org/10.1371/journal.pone.0058603
Sintyasari, D., & Risdawati, I. (2025). Urgensi reformasi hukum kesehatan di era digital: Antara etika, privasi data, dan perlindungan hak pasien. Indonesia Journal of Business Law, 4(2), 1–14. https://doi.org/10.47709/ijbl.v4i2.5878
Skelton, E., Drey, N., Rutherford, M., Ayers, S., & Malamateniou, C. (2020). Electronic consenting for conducting research remotely: A review of current practice and key recommendations for using e-consenting. International Journal of Medical Informatics, 143, e104271. https://doi.org/10.1016/j.ijmedinf.2020.104271
Trihandari Widyatania, D., Pratiwi, R., Vistanada, D., & Langit, S. (2025). The role of Kurt Lewin model change management in tourism human resource management in responding to National Data Center crisis. International Conference on Management and Communication, 1(1), 187–200. https://doi.org/10.33292/IConMC.v1i1.xxx
Vera Nurfajriani, W., Ilhami, M. W., Mahendra, A., Sirodj, R. A., Afgani, W., Negeri, U. I., Fatah, R., & Abstract, P. (2024). Triangulasi data dalam analisis data kualitatif. Jurnal Ilmiah Wahana Pendidikan, 10(17), 826–833. https://doi.org/10.5281/zenodo.13929272
Warriner, A. H., Foster, P. J., Mudano, A., Wright, N. C., Melton, M. E., Sattui, S. E., Calmbach, W., Curtis, J. R., Kilgore, M., Lewis, C. E., Pace, W., & Saag, K. G. (2016). A pragmatic randomized trial comparing tablet computer informed consent to traditional paper-based methods for an osteoporosis study. Contemporary Clinical Trials Communications, 3, 32–38. https://doi.org/10.1016/j.conctc.2016.02.003
Wijaya, M. I. (2025). Leadership styles and EMR adoption: insights from Bali’s primary care clinics. Leadership in Health Services, 38(3), 402–424. https://doi.org/10.1108/LHS-01-2025-0003
Yusof, M. Y. P. M., Teo, C. H., & Ng, C. J. (2022). Electronic informed consent criteria for research ethics review: a scoping review. BMC Medical Ethics, 23(1), 1–15. https://doi.org/10.1186/s12910-022-00849-x
Zondag, A. G. M., Hollestelle, M. J., van der Graaf, R., Nathoe, H. M., van Solinge, W. W., Bots, M. L., Vernooij, R. W. M., Haitjema, S., De Borst, G., Bots, M. L., Hollander, M., Emmelot, M. H., de Jong, P. A., Lely, A. T., Nathoe, H. M., Hoefer, I. E., van der Kaaij, N. P., Ruigrok, Y. M., Verhaar, M. C., & Visseren, F. L. J. (2024). Comparison of the response to an electronic versus a traditional informed consent procedure in terms of clinical patient characteristics: Observational study. Journal of Medical Internet Research, 26(1), e54867. https://doi.org/10.2196/54867
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 I Made Satria Adi Harta, Anton Mulyono Azis, Helni Mutiarsih Jumhur
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
This work is licensed under a 