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Improve Your Healthcare Practice Security With Audit Logs

Posted on March 15, 2023 by Jean Eaton in Blog

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How to Improve Your Healthcare Practice Security With Audit Logs

When was the last time that you reviewed your access logs in your healthcare practice?

 

In our policies, procedures, risk assessments, and privacy impact assessment submissions, we indicate the reasonable safeguards that we expect to implement in our practices to protect the privacy and security of health information.

But policies and good intentions alone isn’t enough.

We also need to take action on our policies.

We have tools, like audit logs, available to us. Audit logs of our computer and software systems are available to monitor users who have accessed the system and the information contained in the systems.

Audit Log Image

Audit logs monitor and records the transactions of users’ activities in your computer network and your electronic medical record (EMR). It is an automated, real-time recording of who did what, and when, in your system.

For example, when a user logs in to your computer network at the beginning of the work day, the user name, date, time, and perhaps the workstation identifier is recorded in the audit log.

When the user logs into the EMR and creates, views, modifies, or prints from a specific patient record, each activity is recorded in the audit log. In this way, the audit log records both the activity of each user and, in each patient’s electronic medical record, who has accessed that patient’s health information.

You MUST implement, use, and monitor your audit logs

The regular review of the audit logs can demonstrate that the administrative, technical, and physical safeguards that we implement to protect the health information, our people, and our assets are working. Review of audit logs can also identify weaknesses so that corrective action can be taken to improve our privacy and security strategy.

For example, when you review your audit log, you may see that an employee (authorized user) is accessing the EMR after clinic hours. When you investigate, you find out that the billing clerk is doing the billing submission from home.

This might be OK in your healthcare practice (or not). But, now you know what is happening iin your clinic EMR after hours and you can take appropriate action.

 

Audit Logs Are Valuable Metadata

Taken from a different point of view, the audit log provides important additional information, or metadata, about the care and treatment of the patient. Knowing who created a clinic note, wrote a prescription, or reviewed a test result provides a story about the care that the patient received. For this reason, the audit log of the EMR is usually required by legislation to be maintained for the entire retention period of the patient’s record. This is generally 10 or more years for adult patients and longer if the patient was a child at the time that they were a patient or client in your practice.

 

How You Can Use Audit Logs to Improve the Security of Health Information In Your Practice

Snooping, or viewing someone’s health information for an unauthorized use, is not uncommon in healthcare. Snooping is always a breach of confidentiality and trust that our patients give to us.

Sometimes, snooping is because someone is concerned or curious about a family member or friend and don’t intend to do anything ‘bad’ with that information.

We also know that people will sometimes access information for malicious means – that is,  using a ‘criminal intent’ or to be mean or disparaging to the individuals involved.

Say No to Snooping

When you regularly review your audit logs, you

  • Create a deterrent to all users to check something out ‘just this once, no one will know’.
  • Find potential threats or weaknesses in your current systems that you can improve to better mitigate your risks.

Custodians have an obligation to ensure reasonable safeguards to protect the privacy and security of health information. This means having appropriate policies and procedures in place and demonstrate and document that you have implemented your plans.

 

Action Steps That You Should Do Now

Use these points as a checklist to help you start using your audit logs to improve security in your healthcare practice.

  • Computer Network System Audit Log
    • Ensure that your computer network system has audit logging enabled.
    • Access and review your audit log. Don’t skip this step! Don’t assume that your audit logging is properly set up. You must discover how to access the audit log and record the procedure so that you can quickly access the audit log in the event that you have a privacy and security breach or routine security audit.
    • Determine how long your audit log information is accessible or retained. Is it included in your routine backup files? Legislative retention requirements differ but you probably want to keep the audit logs accessible for six months or longer.
    • Can you automate an audit log reporting tool to make it easier to review your audit logs regularly? Who in your healthcare practice is responsible to do this?
  • Electronic Medical Records (EMR) / Electronic Health Records (EHR) System Audit Log
    • Most health information legislation and regulations now require EMR / EHR to include an integrated audit log / access log. Confirm that you have enabled your EMR / EHR audit log.
    • Access and review your audit log. Don’t skip this step! Don’t assume that your audit logging is properly set up. You must discover how to access the audit log and record the procedure so that you can quickly access the audit log in the event that you have a privacy and security breach or routine security audit.
    • Determine how long your audit log information is accessible or retained. Is it included in your routine backup files? Legislative retention requirements differ but you probably want to keep the audit logs accessible for as long as you retain the entire patient record – generally, 10 or more years years.
    • Can you automate an audit log reporting tool to make it easier to review your audit logs regularly? Who in your healthcare practice is responsible to do this? Check out the Practice Management Nuggets Podcast

      How AI Improves EMR Auditing | Episode #094 with Rob Pruter from SPHER.

    • User activity recorded in an audit log is often visible to subsequent EMR users when they access a patient record. In the course of routine workflow, users may observe and question inappropriate access to an individual patient record. Instruct your users to notify the clinic manager or privacy officer if the audit log indicates a suspicious activity.
    • Include the review of audit logs as part of your routine privacy and security monthly audit.

Click the link below to get your copy of the audit templates and the training video!

I Want the Audit Templates to Improve Privacy and Security!

Are you already a member of Practice Management Success?

The instructional video and Privacy and Security Monthly Audit Template is already in your membership!

Click the button now to go to the membership to access your resources.

Go to my Practice Management Success membership

 When we know better, we can do better…

Jean Eaton is constructively obsessive about privacy, confidentiality, and security especially when it comes to the handling of personal health information. If you would like to discuss how I can help your practice, just send me an email. I am here to help you.

Jean L. Eaton
Your Practical Privacy Coach
INFORMATION MANAGERS

audit log, EMR, health care, healthcare practice, medical, reasonable safeguards

How AI Improves EMR Auditing

Posted on September 8, 2020 by Jean Eaton in Blog

Healthcare providers and clinic managers have three common myths about EMR user monitoring auditing.

Myth #1 – The electronic medical record EMR automatically does all the auditing – I don’t have to do anything

Myth #2 – I don’t have to audit my users – I know them

Myth #3 – I won’t have to worry about this until I have a breach

Rob Pruter, the User Monitoring Expert at SPHER is my guest on this episode of Practice Management Nuggets For Your Healthcare Practice!

He’s going to share with us how to protect your practice and your patients when you use Artificial Intelligence (AI) technology that can recognize unusual activities and generate a warning message.

Finally, an easy way to perform user monitoring and quickly recognize risks from external bad actors and employee snooping incidents!

Rob Pruter's #1 Tip to Healthcare Providers, Clinic Managers, and Privacy Officers

Nobody goes to the doctor to get their identity stolen! Click to Tweet

My Favorite Takeaways From The Podcast

  • Patients trust their healthcare providers – not just about their medical information, but personally identifying information, too.
  • Identity and access management is critical! Everyone needs a unique user ID.
  • Increasingly important given the trend to remote access and browser based EMR access. Don't be complacent just because you can't see the users.
  • Artificial Intelligence (AI ) technology can quickly recognize unusual activities and generate a timely warning message so that you can react appropriately.
  • You don’t know when someone’s credentials have been compromised. People’s personal circumstances change. You need to demonstrate reasonable safeguards including user monitoring.
  • Designate a person (privacy officer, compliance officer) in the organization responsible to ensure regular review of users’ behaviour. This has a significant impact on decreasing the likelihood of being impacted by a privacy and security breach.
  •  

Featured Guest: Rob Pruter

SPHER Inc.

Rob is the Chief Revenue Officer at SPHER, Inc.

He is responsible for all global sales, marketing, and partner revenue at SPHER, Inc.

For the past 20 years, he has successfully built marketing programs and partner alliances in the healthcare IT space with larger companies and innovative start-ups.

He has a passion for protecting patient privacy and cybersecurity for the healthcare industry.

And he is my new best friend with a passion to improve audit log monitoring!

To find more from Rob, download the brochure from SPHER!

 

Be sure to tune in to my interview with Rob Pruter

How AI Improves EMR Auditing | Episode #094

 

Listen To The Podcast Here
#PracticeManagementNugget, AI, artificial intelligence, audit log, audit trail, clinic manager, compliance, healthcare, medical, podcast, review, Rob Pruter, SPHER, user monitoring

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