Electronic Medical Records as Evidence in Medical Malpractice Litigation: Challenges to Patient Access and Evidentiary Equality

Abstract

Electronic medical records have become essential sources of evidence in disputes concerning the quality and legality of medical treatment. In medical malpractice litigation, however, patients may face significant difficulties obtaining, interpreting, and presenting electronic medical records that are primarily controlled by healthcare institutions. This article examines the evidentiary position of electronic medical records in Indonesian medical malpractice disputes, with particular emphasis on patient access and equality of arms between patients and healthcare providers. Using normative legal research, the study analyzes evidentiary principles, medical record regulations, patient rights, and procedural aspects of medical dispute resolution. The analysis indicates that electronic records possess substantial evidentiary value because they document clinical decisions, treatment chronology, prescriptions, and professional interactions. Nevertheless, unequal access to records, uncertainty regarding their authenticity and integrity, and patients' limited technical understanding may create structural disadvantages. The article argues that evidentiary fairness requires stronger mechanisms for patient access, preservation, authentication, and disclosure of electronic medical records. It proposes procedural safeguards that would enable patients to obtain relevant records without compromising legitimate confidentiality interests. Strengthening the evidentiary status and accessibility of electronic medical records would contribute to more balanced medical dispute resolution and enhance accountability within Indonesia's healthcare system.