As compared to paper based signatures there is an increased dependability on electronic signatures for an increased protection of documents and patient records in healthcare facilities. Thereby this paper will discuss an importance of electronic signatures in addition to the advantages that they have in order to be implemented in healthcare, business and e-commerce. Introduction Signature is more known as a script that has been designed by an individual and is associated with that very individual.
Signatures in some cases have been associated with seals used for protection. In general, signatures are an evidence of the fact that all intentions made in a certain document have been approved by the individual signing it. Purposes of signatures are the same as that of normal and usual signatures as all intentions made in an electronic document are approved by an individual who undersigns a document with an electronic signature (Brazell, 2004, p. 23). Many definitions have been given in relation to the electronic signature.
All in all these definitions highlight the fact that as compared to hand written signatures, electronic signatures are more protective and sealed thereby there is an increased reliability associated with electronic signatures. Defining Electronic Signatures First definition that needs a mention here is given by US Code. It defines an electronic signature as an electronic sound, or a symbol that represents documents in a unique way as these symbols are associated with these documents in a legal manner.
According to this definition symbols are adopted and chosen by an individual who wishes to sign, seal and protect a document thereby making sure that all intentions are accepted by that very individual. The US code argues that the signatures can be embedded in transmissions of electronic documents observed during transmission of facsimiles. The electronic signature can also take the form of Morse code in case of electronic message transmission as the signs are embedded inside the message.
Realizing an importance of the protective and sealing protection offered by electronic signatures, there is an increased use of encrypted electronic messages in fields that are more sensitive about integrity of documents thereby e-commerce, healthcare, government office are observed to frequently adopt the technology of electronic signatures (Schellekens, 2004, p. 56). Legal standing of these electronic signatures has been well established thereby the laws of EU and US recognize electronic signatures holding the same legal importance as ordinary signatures on documents.
Legal issues and consequences that are associated with electronic signatures are same as normal and usual signatures. Historical Perspective of Electronic Signatures Electronic signatures have been known to exist since before the American Civil War. Electronic signatures date back to 1860s when electronically encrypted messages were being used by the help of Morse codes in telegraphy. Telegraphy in those days was used to send messages that were more secret and in agreements to terms that were presented in certain kinds of enforceable contracts.
Legal standing of these electronic messages dates back to 1869 when an importance of these telegraphically encrypted documents was enforced by the New Hampshire Supreme Court (United Nations Commission on International Trade Law, 2002, p. 78). In order to ensure protection, and time sensitive delivery of protected documents to safer places, in 1980s, many organizations started working on electronic signatures in order to encrypt documents.
For encrypting highly sensitive documents, fax machines were used. Nevertheless in this case it has been seen that although original signatures used to be on the paper, but images of signatures and transmission used to be in an electronic format thereby ensuring increased protection. Recently it has been seen that various legal interventions have been made in order to enhance protection offered by electronic signatures.
It has been added by the US courts that documents that can be protected and sealed by electronic signatures can include emails, PIN codes that are used for ATM transactions in banks, credit or debit sllip that needs to be protected by signing it with a digital pen pad device, installing kinds of software that comes with a clickwrap software license agreement along with documents that are often signed online that need enhanced protection.
It has been recorded that the first document signed in an electronic way was between two sovereign nations, United States and Ireland in a communique that jointly recognized an importance of electronic signatures in trading and e-commerce (Katsikas, Lopez, and Pernul, 2005, p. 78). Enforcing Electronic Signatures United States has defined electronic signatures in legal ways and a set of requirements have been set that help in qualifying an electronic signatures as authentic.
These requirements and qualifications of electronic signatures were designed by National Conference of Commissioners on Uniform State Laws (NCCUSL) in 1999 when this US based government organization released Uniform Electronic Transactions Act (UETA). UETA has defined electronic signatures as electronic symbols that are associated with a certain document in relation to which all intention have been accepted by the individual who owns and signs the particular document. There are many laws that echo core concepts of electronic signatures and these are also observed to be the same in U. S.
ESign Act that was presented and implemented in the year of 2000. Many states in United States have been working on the laws and jurisdiction in relation to the electronic signatures and more than 47 states in United States along with the District of Columbia, and the US Virgin Islands have enacted and have been using UETA in an active manner. Only three states as New York, Illinois and Washington have not enacted UETA. New York has designed its own rule that recognizes electronic signatures as legal and the law that represents these signatures is Electronic Signatures and Records Act (ESRA) (Boss, and Kilian, 2008, p.
67). Other countries that have started assigning legal values to electronic signatures include Canada. The definition of electronic signatures given by Canadian legal authorities is generic and different from the one given by the US authorities. Generic definition of signature given by the Canadian Department Of Justice says that an electronic signature contains a chain of letters, symbols, and numbers encrypted in a digital format associated with a certain electronic document that belongs to an individual or a certain organization (Snijders, and Weatherill, 2003, p. 45).
After this Canadian Department Of Justice has defined an electronic signature by arguing that electronic signature in contrast to normal signatures possess some distinct properties that define these signatures. Canadian law that talks about the digital signatures in accordance to the protection of electronic documents is PIPEDA. PIPEDA’s secure electronic signature regulations argue that electronic signatures are those that are designed, applied and verified in a specific manner. European Union has also given its rules and regulations in accordance to the use of electronic signatures in document protection systems.
These laws have been published in the EC Official Journal. These laws are referred to as the Directive 1999/93/EC of the European Parliament and of the Council while officially these are more often referred as the EU Directive on Electronic Signatures or the EU Electronic Signatures Directive. These were published on 13th December 1999 (Adams, and Lloyd, 2003, p. 78). Maintaining Legal Nature of Electronic Signatures Various laws and jurisdictions have been defined that help e-commerce and trade to incorporate the advantages of electronic signatures in daily business deals that can help in increased document protection.
It has been realized that at a local and an international level there is a need to incorporate certain document protection systems that can help in easy working and trustworthy document sharing within different parties. 1. Definitions of PIPEDA (Personal Information Protection and Electronic Documents Act) An electronic signature can be defined as being safe when a. It is unique to an individual b. Technology that is being used in order to generate signatures are under the control and only being used by the person who creates the signature thereby adding to the level of uniqueness.
c. The technology being used to create signatures should be able to represent an individual who has created the signatures. d. The electronic signatures are to be linked with an electronic document in various ways. One way that has been defined by Personal Information Protection and Electronic Documents Act argues that the electronic document should be able to identify, by the help of electronic signatures associated with it, if any changes have been made to this document after signatures were associated with the document originally (Kehal, and Singh, 2005, p. 78).
2. The Electronic Signatures in Global and National Commerce Act This law was passed by the US congress in relation to the electronic signatures and this law has defined and authorized the electronic signatures in three steps. a. The term ‘electronic’ in electronic signatures has been highlighted as something that possesses digital, symbolic, magnetic, wireless, electromagnetic, electric properties. b. Electronic record on the other hand has been defined as a document, contract that has been generated, created, shared, discussed, and sent by using electronic means.
c. Electronic signatures have been defined by The Electronic Signatures in Global and National Commerce Act as an electronic sound, symbol or a process that is legally and authoritatively associated with a document created by an individual holding rights to create, sign and decrypt the document in any manner thereby ‘patenting’ the document (Pathak, 2007, p. 34). Other similar definitions have been given by the following acts that relate to the use of electronic signatures. a. Government Paperwork Elimination Act, US
b. Federal Reserve 12 CFR 202 c. UETA d. Commodity Futures Trading Commission 17 CFR Part 1 Sec. 1. 3. Creation of Electronic Signatures: Public Key Infrastructures (PKI) Importance of electronic signatures has been realized since long as it has been seen that these are more important in protecting the legal status of documents in a comparative manner. Thereby secure and much complex ways have been identified that can define electronic signatures in ways that ensure their legal status in order to protect records.
Creation of electronic signatures depends on asymmetrical cryptographic method. This method ensures that the kinds of protection status being encrypted in the document are only approachable by the person who creates the signatures on the document. Thereby two kinds of keys are used in this case and these are referred to as public and private cryptographic keys. The theoretical fundamentals and practicalities of the asymmetric cryptographic key were laid down in 1976 (Doukidis, Mylonopoulos, and Pouloudi, 2004, p. 79).
In accordance to the theory and recent ways that have been developed for electronically signing a document, a number is calculated that represents the length of a document and this number is referred to as the checksum of a particular document. This checksum is calculated by using a hash function. This is the case where a private key is used which is more representative of the person signing the document. Thereby signature is represented by private key which in the end is attached to a document. This private key is thereby a signature of the document. Role of Public Key
Another key that plays an important role in this case is a public key. An important that is played by a public key is that the signature’s and relevant document can be checked by the public key. Public key as the name indicates is freely and easily available to any individual within the public. Decryption of the electronic key is performed by the help of an electronic signature. Integrity Check An integrity check is an important part of electronic signature allocation. It has been seen that integrity of a document can be checked by recalculating the checksum number that was allocated to the document originally.
As was done during the calculation of checksum, the recalculation of checksum is also done with the help of hash functions. Integrity of the document can be validated if the checksums are identical ensuring that the integrity of the document is intact (Rice, and American Bar Association, Section of Litigation, 2005, p. 78). Role of Certificates Public keys and cryptographic keys are the most important part of the electronic signature creation thereby there is a need of a system that can authorize the genuine nature of these keys. Both of these keys are authorized by a certificate.
Certificates are specially created electronic documents that associate and connect the public key with the key holder’s identification data that in this case has to be unique. On the other hand in order to provide increased protection it has been observed that to ensure increased protection, certificates are also electronically signed by the certification providers that are also authorized. All these links and methodologies designed to sign the documents make sure that document is signed, encrypted and decrypted by using the public key only by the person who has created the document.
Certification service providers play important roles as Trusted Third Party offering services other than certificates for protection of electronic documents. Certification service providers are known to provide a set of directory services that are also related to electronic documents. These are the services that bring the protection provided by the electronic signatures a step ahead. Directory services provide additional measures by which the certificates can be checked for authentication time by time. Advantages of Electronic Signatures
These days there is a need to exchange business in a fast manner that requires and demands exchange of information including documents in a secure manner. It has been realized that exchanging information on a regular basis is more secure in an electronic manner rather on paper. 1. Electronic information takes lesser time to travel as compared to the paper based information thereby there is no time wasted (Mann, Eckert, and Knight, 2000, p. 67). 2. The cost of electronic signature based documents is only needed in the beginning of this setup and there are no additional costs required after its implementation.
3. Because of the electronic nature of documents, there is lesser involvement of human beings other than the ones that are directly involved ensuring security in case of these documents. 4. Because of an electronic nature of these documents there is a lesser chance of interruption and interference in electronic documents that increasingly ensures the protection of these documents. In terms of protection it has been observed that electronic signature based documents are more secure and protected as compared to paper based signatures. 1.
In this case it has been argued that the electronic signatures are not able to be copied as compared to the normal paper based signatures and electronic signatures are implemented on the complete document rather than the last page. 2. In this case it has been observed that as electronic signatures are implemented on whole document thereby there are no chances of any text being maliciously changed in any part of the document. 3. Time stamping is the proof of transmission time of the document thereby transmission dates can be cross checked in order to check the legal status of the document. 4.
Additional restrictions can be imposed on the message content in electronically signed documents. It has been observed that with the consent of the document holder and creator, reader can read and verify the contents of the document (Katsikas, Lopez, and Pernul, 2005, p. 45). Other than these, additional advantages that are offered by the electronically signed documents include streamlining businesses and trade globally and on a local scale. Business chains are better connected when paper documents are removed having a much better control on business with the help of electronic documents.
1. Increased cost are associated with typing documents and sending these through courier and these costs are reduced in case of electronic documents that take lesser time to be emailed and fixed. 2. In case of signing the contracts an important issue used to deal with signing the contracts which is resolved by electronic signature based reinforce bale contracts that are signed anywhere. Electronic Signatures Usage in Medial Healthcare Records Healthcare in the modern days is recognized by an increase in the specialization of medical specialization.
In order to ensure that patient care process is optimized there is an increased cooperation and data exchange between different healthcare institutions. Thereby it has been observed that in order to ensure timely, cost effective and economic patient care, often known as shared care, there is a need to increasingly exchange information with healthcare institutions and medical facilities. The kinds of patient record systems that are adopted these days are increasingly dependent upon the data exchange.
On the other hand it has been realized that there are many shortcomings associated with paper based documents that have been also held responsible for a decreased efficiency of healthcare institutions, thereby there is an increased adoption of electronic signatures on the documents (Boss, and Kilian, 2008, p. 38). In order to ensure that all heath care operations undergo in a proper, streamlined and a secure manner there is a need to implement the technology of electronic signatures to the field of healthcare.
Paper based signatures are time consuming and are less protecting as compared to electronic signatures thereby in the field of healthcare, document authenticity is a critical business operation. There is a set of documents that are in a need to be protected in face of infringements and these documents include patient records, physician diagnosis, order, bills and payments. Thereby based on the set of advantages that have been highlighted in the previous sections healthcare facilities in different countries have started to implement electronic signatures.
Recently there are many changes in United States health departments in order to implement electronic signatures based documents. It has been recently reported that regulations have been passed and implemented by the Drug Enforcement Agency in order to implement electronic signatures on medical prescriptions that are of electronic nature in order to ensure that original prescriptions are checked on the counters of pharmacies rather than cooked ones.
Another law that has been passed by the Veteran’s Health Administration relates to the consent forms that are signed by the patients. In order to protect these forms, protection is being ensured by the implementation of electronic signatures on these forms. In healthcare administration various standards have been defined that link important records and documents with encrypted signatures. Recently a standard has been defined that helps in an authentication of medical records of the patients, an ASTM standard.
In order to electronically sign the radiological images, DICOM standard have been used and are in practice. Most of the documents in medical centers and healthcare institutions are related to signatures, including signatures from families, patients and physicians. Thereby after the creation of these documents it is important that these documents are protected and sealed by the help of electronic signatures. Successes of document security solution lies in the fact of creating documents that are electronically signed thereby are digitally protected.
These protection measures have also been considered important in the case of offline and online business, e-commerce (Adams, and Lloyd, 2003, p. 24). Conclusion Internationally accepted standards have been defined that can help in securing the documents in a better manner. In case of healthcare it has been seen that there is an increased dependency on a long term archiving of patient records as soon as these are created and passed on to the other facilities. International standards have been used to define the signatures in accordance to the advantages that they ensure, as DICOM, XML, and HL7.
In addition to this it has been argued that there is an increased integration of PKIs in healthcare services as these are designed in accordance to the legislations that have been designed in order to ensure document protection. References Adams, C. , and Lloyd, S. (2003). Understanding PKI: concepts, standards, and deployment; considerations, Technology series. Edition 2. Addison-Wesley. Boss, H. A. , and Kilian, W. (2008). The United Nations Convention on the Use of Electronic Communications in International Contracts.
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