Integration of electronic signatures and timestamps to secure clinical archiving and KeywordsSecurity, digital signature, electronic signature, authentication system Summary Context: Integration of electronic signatures embedded in health care processes in Germany challenges health care service and supply facilities. The suitability of the signature level of an eligible authentication procedure is confirmed for a large part of documents in clinical practice. However, the concrete design of such a procedure remains unclear. Objective: To create a summary of usable user authentication systems suitable for clinical workflows.