<![CDATA[Abstract: In the era of sensitive health data and frequent cyberattacks, securing electronic medical records (EMR) has become a critical challenge. This study proposes a hybrid encryption framework combining Affine and AES algorithms with an AI-based key management module to enhance EMR security while maintaining efficiency. A dataset of 1,000 simulated records was evaluated using five cryptographic configurations: Affine-only, AES-only, RSA-only, Affine–AES, and Affine–AES with AI. Performance was measured through encryption/decryption latency and ciphertext size, while security was assessed under brute-force, SQL injection, and phishing simulations. The AI decision tree for key generation was evaluated using accuracy, precision, recall, F1-score, and entropy metrics. Results show that the AI-enhanced hybrid method eliminates brute-force success, introduces only minor latency overhead, and generates high-entropy keys with reliability above 98%. These findings indicate that integrating AI-based dynamic key regeneration into hybrid encryption can improve EMR security while remaining practical for clinical and cloud-based healthcare systems. Future work should involve real clinical datasets and explore post-quantum cryptographic extensions. Keywords: AI key management; attack resistance; encryption performance; electronic medical records; hybrid encryption Abstrak: Di era meningkatnya sensitivitas data kesehatan dan maraknya serangan siber, perlindungan Rekam Medis Elektronik (RME) menjadi tantangan penting. Penelitian ini mengusulkan kerangka enkripsi hibrida yang menggabungkan algoritma Affine dan AES dengan modul manajemen kunci berbasis AI untuk meningkatkan keamanan RME tanpa mengorbankan efisiensi. Dataset simulasi berisi 1.000 entri diuji menggunakan lima konfigurasi kriptografi: Affine-only, AES-only, RSA-only, Affine–AES, serta Affine–AES dengan AI. Performa diukur melalui latensi enkripsi/dekripsi dan ukuran ciphertext, sedangkan keamanan dievaluasi melalui simulasi serangan brute force, SQL injection, dan phishing. Model decision tree untuk manajemen kunci dinilai menggunakan metrik akurasi, presisi, recall, F1-score, dan entropi. Hasil menunjukkan bahwa metode hibrida dengan AI menghilangkan keberhasilan brute force, menambah overhead latensi yang minimal, serta menghasilkan kunci berentropi tinggi dengan reliabilitas di atas 98%. Temuan ini menunjukkan bahwa regenerasi kunci dinamis berbasis AI dalam skema enkripsi hibrida dapat meningkatkan keamanan RME sekaligus tetap praktis untuk sistem klinis dan layanan kesehatan berbasis cloud. Penelitian selanjutnya disarankan menggunakan dataset klinis nyata dan mengeksplorasi kriptografi pascakuantum. Kata kunci: enkripsi hibrida; ketahanan serangan; kinerja enkripsi; manajemen kunci berbasis AI; rekam medis elektronik]]>
