Bridging Innovation and Governance: A Systematic Literature Review of Artificial Intelligence, Electronic Medical Records, and Legal Protection in Healthcare
DOI:
https://doi.org/10.38035/gijlss.v3i2.411Keywords:
Artificial Intelligent, Electronic Medical Records, Legal Protection, Systematic Literature ReviewAbstract
The rapid digital transformation in healthcare has resulted in the extensive implementation of artificial intelligence (AI) and electronic medical records (EMR), providing significant enhancements in data-driven clinical decision-making and operational efficiency. The objective is to discern prevailing research trends, delineate significant difficulties, and offer strategic insights that harmonize innovation with governance. A systematic literature review, 20 peer-reviewed journal papers published from 2017 to 2024 were chosen based on relevance, methodological rigor, and contribution to the discourse. The data indicate that although AI substantially improves healthcare delivery, its incorporation into EMRs exceeds the establishment of cohesive legal protections. Principal themes encompass data security, liability uncertainty, algorithmic bias, and institutional preparedness. The study indicates that addressing this gap necessitates a multidisciplinary strategy that integrates legal, technical, and ethical factors. Regulatory change, patient-centric policies, and stakeholder collaboration are crucial for the responsible implementation of AI in healthcare.
References
A. B. del Río-Lanza, A. Suárez-Vázquez, L. Suárez-Álvarez, and V. Iglesias-Argüelles, “Mobile health (mhealth): facilitators and barriers of the intention of use in patients with chronic illnesses,” J Commun Healthc, vol. 13, no. 2, 2020, doi: 10.1080/17538068.2020.1777513.
A. BENAHMIDA, ETHICAL CHALLENGES OF AI IN HEALTHCARE. research-api.cbs.dk, 2024. [Online]. Available: https://research-api.cbs.dk/ws/portalfiles/portal/108045502/1845662_MasterThesis_A.Benahmida_158615.pdf
A. ?artolovni, A. Tomi?i?, and E. L. Mosler, “Ethical, legal, and social considerations of AI-based medical decision-support tools: a scoping review,” International Journal of Medical …, 2022, [Online]. Available: https://www.sciencedirect.com/science/article/pii/S1386505622000521
A. Kurek, D. Langholz, and A. Ahmed, “Closing the Look in AI, EMR and Provider Partnerships: The Key to Improved Population Health Management?,” Telehealth and Medicine Today, vol. 7, no. 5, 2022, doi: 10.30953/thmt.v7.370.
A. S. Ahuja, “The impact of artificial intelligence in medicine on the future role of the physician,” PeerJ, 2019, [Online]. Available: https://peerj.com/articles/7702/
B. Singh, “Blockchain technology in renovating healthcare: Legal and future perspectives,” … healthcare through artificial intelligence and internet of …, 2023, [Online]. Available: https://www.igi-global.com/chapter/blockchain-technology-in-renovating-healthcare/324943
C. B. Goldberg et al., “To do no harm — and the most good — with AI in health care,” 2024. doi: 10.1038/s41591-024-02853-7.
C. Cath, “Governing artificial intelligence: ethical, legal and technical opportunities and challenges,” Philosophical Transactions of the Royal Society …, 2018, doi: 10.1098/rsta.2018.0080.
C. E. Haupt and M. Marks, “AI-generated medical advice—GPT and beyond,” JAMA, 2023, [Online]. Available: https://jamanetwork.com/journals/jama/article-abstract/2803077
C. Richie, “Environmentally sustainable development and use of artificial intelligence in health care,” Bioethics, vol. 36, no. 5, 2022, doi: 10.1111/bioe.13018.
C. Wang, S. Liu, H. Yang, J. Guo, Y. Wu, and J. Liu, “Ethical considerations of using ChatGPT in health care,” Journal of Medical Internet …, 2023, [Online]. Available: https://www.jmir.org/2023/1/e48009/
C. Y. Hsieh, C. C. Su, S. C. Shao, S. F. Sung, S. J. Lin, and ..., “Taiwan’s national health insurance research database: past and future,” Clinical …, 2019, doi: 10.2147/CLEP.S196293.
D. D. Farhud and S. Zokaei, “Ethical issues of artificial intelligence in medicine and healthcare,” Iran J Public Health, 2021, [Online]. Available: https://pmc.ncbi.nlm.nih.gov/articles/PMC8826344/
Dewan Perwakilan Rakyat dan Presiden Republik Indonesia, Undang-Undang Republik Indonesia Nomor 27 tahun 2022 tentang Perlindungan Data Pribadi. 2022.
F. Doshi-Velez, M. Kortz, R. Budish, C. Bavitz, and ..., “Accountability of AI under the law: The role of explanation,” arXiv preprint arXiv …, 2017, [Online]. Available: https://arxiv.org/abs/1711.01134
F. Pesapane, C. Volonté, M. Codari, and F. Sardanelli, “Artificial intelligence as a medical device in radiology: ethical and regulatory issues in Europe and the United States,” Insights Imaging, 2018, doi: 10.1007/s13244-018-0645-y.
F. Z. Ouariach and S. Ahmed, “Ethical and Legal Dimensions of AI in Healthcare: A Deep Learning Perspective,” … Intelligence in Healthcare Law, 2025, doi: 10.1201/9781003538462-6.
G. A. Kaissis, M. R. Makowski, D. Rückert, and ..., “Secure, privacy-preserving and federated machine learning in medical imaging,” Nature Machine …, 2020, [Online]. Available: https://www.nature.com/articles/s42256-020-0186-1
G. Maliha, S. Gerke, I. G. Cohen, and R. B. Parikh, “Artificial Intelligence and Liability in Medicine: Balancing Safety and Innovation,” Milbank Quarterly, vol. 99, no. 3, 2021, doi: 10.1111/1468-0009.12504.
G. Nittari, R. Khuman, S. Baldoni, G. Pallotta, and ..., “Telemedicine practice: review of the current ethical and legal challenges,” Telemedicine and e …, 2020, doi: 10.1089/tmj.2019.0158.
H. Roberts, J. Cowls, J. Morley, M. Taddeo, V. Wang, and ..., The Chinese approach to artificial intelligence: an analysis of policy, ethics, and regulation. Springer, 2021. doi: 10.1007/978-3-030-81907-1_5.
J. Krive, M. Isola, L. Chang, T. Patel, M. Anderson, and R. Sreedhar, “Grounded in reality: artificial intelligence in medical education,” JAMIA Open, vol. 6, no. 2, 2023, doi: 10.1093/jamiaopen/ooad037.
J. Morley et al., “The ethics of AI in health care: A mapping review,” 2020. doi: 10.1016/j.socscimed.2020.113172.
K. M. Gala, “Ethical and Legal Considerations in AI-Driven Health Cybersecurity,” International Journal of Scientific Research in …, 2024, [Online]. Available: https://www.researchgate.net/profile/Krunal-Gala/publication/385122367_Ethical_and_Legal_Considerations_in_AI-Driven_Health_Cybersecurity/links/6733127969c07a4114450347/Ethical-and-Legal-Considerations-in-AI-Driven-Health-Cybersecurity.pdf
L. Mosch, L. Agha-Mir-Salim, M. M. Sarica, F. Balzer, and A. S. Poncette, “Artificial Intelligence in Undergraduate Medical Education,” in Studies in Health Technology and Informatics, 2022. doi: 10.3233/SHTI220597.
M. B. Forcier, H. Gallois, S. Mullan, and ..., “Integrating artificial intelligence into health care through data access: can the GDPR act as a beacon for policymakers?,” … Law and the Biosciences, 2019, [Online]. Available: https://academic.oup.com/jlb/article-abstract/6/1/317/5570026
M. K. Hossain, J. Sutanto, P. W. Handayani, A. A. Haryanto, J. Bhowmik, and V. Frings-Hessami, “An exploratory study of electronic medical record implementation and recordkeeping culture: the case of hospitals in Indonesia,” BMC Health Serv Res, vol. 25, no. 1, Dec. 2025, doi: 10.1186/s12913-025-12399-0.
M. Rizal and Y. Yani, “Cybersecurity Policy and Its Implementation in Indonesia,” JAS (Journal of ASEAN Studies), vol. 4, no. 1, 2016, doi: 10.21512/jas.v4i1.967.
N. Ettaloui, S. Arezki, and T. Gadi, “An overview of blockchain-based electronic health record and compliance with GDPR and HIPAA,” … Artificial Intelligence and Smart Environment, 2023, doi: 10.1007/978-3-031-48573-2_58.
N. Khalid, A. Qayyum, M. Bilal, A. Al-Fuqaha, and ..., “Privacy-preserving artificial intelligence in healthcare: Techniques and applications,” Computers in Biology and …, 2023, [Online]. Available: https://www.sciencedirect.com/science/article/pii/S001048252300313X
N. Naik, B. M. Hameed, D. K. Shetty, D. Swain, M. Shah, and ..., “Legal and ethical consideration in artificial intelligence in healthcare: who takes responsibility?,” Frontiers in …, 2022, doi: 10.3389/fsurg.2022.862322.
O. R. Okonji, K. Yunusov, and B. Gordon, “Applications of Generative AI in Healthcare: algorithmic, ethical, legal and societal considerations,” arXiv preprint arXiv:2406.10632, 2024, [Online]. Available: https://arxiv.org/abs/2406.10632
P. Onu, A. Pradhan, and ..., “AI in Smart Manufacturing: An Ethical and Legal Perspective,” 2024 4th International …, 2024, [Online]. Available: https://ieeexplore.ieee.org/abstract/document/10850928/
R. J. Chen, J. J. Wang, D. F. K. Williamson, T. Y. Chen, and ..., “Algorithmic fairness in artificial intelligence for medicine and healthcare,” Nature biomedical …, 2023, [Online]. Available: https://www.nature.com/articles/s41551-023-01056-8
S. Harrer, P. Shah, B. Antony, and J. Hu, “Artificial intelligence for clinical trial design,” Trends Pharmacol Sci, 2019, [Online]. Available: https://www.cell.com/trends/pharmacological-sciences/fulltext/S0165-6147(19)30130-0?dgcid=raven_jbs_etoc_email
S. Hertling, G. Matziolis, and I. Graul, “The role of the Internet as a source of medical information for orthopedic patients,” Orthopade, 2022, doi: 10.1007/s00132-022-04238-5.
S. M. Liao, “Ethics of AI and Health Care: Towards a Substantive Human Rights Framework,” Topoi, vol. 42, no. 3, 2023, doi: 10.1007/s11245-023-09911-8.
S. M. Varnosfaderani and M. Forouzanfar, “The role of AI in hospitals and clinics: transforming healthcare in the 21st century,” Bioengineering, 2024, [Online]. Available: https://www.mdpi.com/2306-5354/11/4/337
S. Reddy, S. Allan, S. Coghlan, and P. Cooper, “A governance model for the application of AI in health care,” 2020. doi: 10.1093/jamia/ocz192.
T. Panch, H. Mattie, and L. A. Celi, “The ‘inconvenient truth’ about AI in healthcare,” NPJ Digit Med, 2019, [Online]. Available: https://www.nature.com/articles/s41746%E2%80%90019%E2%80%900155%E2%80%904
V. Bilgram and F. Laarmann, “Accelerating innovation with generative AI: AI-augmented digital prototyping and innovation methods,” IEEE Engineering Management …, 2023, [Online]. Available: https://ieeexplore.ieee.org/abstract/document/10115412/
WHO, Global Strategy on Digital Health 2020-2025. World Health Organization, 2021.
Y. Mintz and R. Brodie, “Introduction to artificial intelligence in medicine,” Minimally Invasive Therapy and Allied Technologies, vol. 28, no. 2, 2019, doi: 10.1080/13645706.2019.1575882.
Z. Ahmed, K. Mohamed, S. Zeeshan, and X. Q. Dong, “Artificial intelligence with multi-functional machine learning platform development for better healthcare and precision medicine,” Database, 2020, doi: 10.1093/database/baaa010/5809229.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Ade Netra Kartika, Binsar Jon Vic
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright :
Authors who publish their manuscripts in this journal agree to the following conditions:
- Copyright in each article belongs to the author.
- The author acknowledges that the Greenation International Journal of Law and Social Sciences (GIJLSS) has the right to be the first to publish under a Creative Commons Attribution 4.0 International license (Attribution 4.0 International CC BY 4.0).
- Authors can submit articles separately, arrange the non-exclusive distribution of manuscripts that have been published in this journal to other versions (for example, sent to the author's institutional repository, publication in a book, etc.), by acknowledging that the manuscript has been published for the first time at GIJLSS.
