As dental practices become paperless and contracts become electronic, practitioners need to be assured that the validity of their records will not be questioned in a court of law. Electronic data is easily tampered with. As a result, electronic records admitted as evidence in court must have their authorship authenticated, even if evidence of tampering does not exist.
Digital signatures are one way of establishing authenticity. In countries like the United States, India, Brazil, and the European Union, their use is federally regulated. The presence of a digital signature conveys to electronic health records the same good-faith validity as paper records, requiring the burden of proof to fall on the person questioning authenticity.
Digital signatures are legally regulated electronic signatures. A digital signature generates a unique asymmetric cryptographic mark. The mark combines both a private key purchased by the individual, and a public key issued by a third party authority and exclusive to the document.
Limitations of the technology are the requirement that all parties involved, including dentists, laboratories, and patients, possess digital signatures. The authors predict that:
“Soon, every citizen will have a digital signature.”
Presumably limitations will decrease as use of digital signatures becomes more commonplace.
- Electronic records are easier to forge or tamper with than handwritten documents, thus digital signatures are necessary to ensure authentication.
- Digital signatures are not the same thing as electronic signatures. They provide a layer of standardized legal authority.
- Each part of an electronic health record should be signed by its author.
Maruo, I. T., & Maruo, H. (2012). Digital signature of electronic dental records. American Journal of Orthodontics & Dentofacial Orthopedics, 141(5), 662-665. doi:10.1016/j.ajodo.2012.02.012