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Even in medium-sized hospitals, thousands of medical records are created every day. These documents have to be archived over many years. This is important for having access to information for later treatments of patients and for potential legal disputes. The latter makes signing of medical records important. The process of getting rid of paper in hospitals is quite challenging for many reasons. Using digital signatures is definitely one of these challenges. This article will report on this process and on experiences made in an Austrian medium-sized hospital.