<![CDATA[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]]>
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