Audit trail generation for patient record views

Purpose

1.1. Ensure every access/view of patient records in alcoholism treatment programs is logged to satisfy regulatory, privacy, and internal policy requirements.
1.2. Enable real-time monitoring and historical auditing for compliance investigations and incident response.
1.3. Support automated reporting and traceability, identifying who accessed patient data, when, and from where, including purpose of view if possible.
1.4. Demonstrate transparency in handling PHI (Protected Health Information) for HIPAA and related regulations.
1.5. Facilitate audits required for funding/accreditation and minimize risks linked to unauthorized data access in addiction recovery services.

Trigger Conditions

2.1. Any user authentication event leading to patient record access.
2.2. API call, database query, or UI-based interaction involving retrieval or display of patient information.
2.3. Scheduled batch operations or automated system scans that touch patient records.
2.4. Third-party EHR integrations or external API requests involving patient data.
2.5. Metadata change events indicating record views within monitored systems.

Platform Variants

3.1. Salesforce Health Cloud
• Feature/Setting: Platform Event Triggers on patient record objects; configure Flow or Apex triggers to log all record views.
3.2. Microsoft Dynamics 365 Healthcare
• Feature/Setting: Audit logs for entity views; enable ‘Audit Read Access’ and use Power Automate to push logs to Secure Storage.
3.3. Epic EHR
• Feature/Setting: Use Epic Hyperspace Audit Trails, configure Events API to publish access events externally.
3.4. Cerner Millennium
• Feature/Setting: ‘Cerner Command Language’ audit logging; enable and route logs for all patient chart view events.
3.5. Athenahealth
• Feature/Setting: Athenahealth API Webhooks for record access events; post to custom endpoint.
3.6. MEDITECH Expanse
• Feature/Setting: Application event auditing; configure report generation for all record access.
3.7. Allscripts
• Feature/Setting: Enterprise Audit Trail; subscribe to FHIR-based Resource Access event stream.
3.8. MongoDB
• Feature/Setting: Configure Database Auditing for read operations on patient collections; forward logs to SIEM.
3.9. PostgreSQL
• Feature/Setting: pgaudit extension; enable SELECT statement auditing on patient tables.
3.10. Amazon RDS (Any Engine)
• Feature/Setting: Enable database activity streams; configure triggers for SELECT/read on patient records.
3.11. Microsoft Azure SQL Database
• Feature/Setting: Advanced Threat Protection; enable audit logs for query/record read events.
3.12. Google Cloud Healthcare API
• Feature/Setting: Enable Data Access Audit Logs for FHIR store resource views.
3.13. Okta
• Feature/Setting: System Log API; subscribe to user-access events linked to healthcare resource applications.
3.14. Auth0
• Feature/Setting: Event hooks for login and app resource access; route logs to logging system.
3.15. AWS CloudTrail
• Feature/Setting: Monitor API calls to patient resource endpoints; configure EventBridge Rules to forward access logs.
3.16. Google Workspace
• Feature/Setting: Access Transparency Reports; monitor Google Sheets/Docs used for patient data.
3.17. Slack
• Feature/Setting: Audit Logs API; configure triggers for messages/files containing patient data.
3.18. Jira Service Management
• Feature/Setting: Issue Field/View Audit Log; enable and automate extract of patient record-related activities.
3.19. ServiceNow
• Feature/Setting: Audit History Table for all patient module accesses; automate export by scheduled job.
3.20. Zendesk
• Feature/Setting: Event Webhooks for ticket record viewing; post structured logs to secure storage.
3.21. InterSystems IRIS for Health
• Feature/Setting: HealthShare Audit; enable audit records on patient data access and integrate with external log sinks.
3.22. SAP Health Engagement
• Feature/Setting: Data Access Logging; configure for all read actions on patient data entities.

Benefits

4.1. Centralizes evidence of compliance for easier audit preparation.
4.2. Warns administrators of abnormal or suspicious access patterns.
4.3. Highlights training needs where improper access occurs.
4.4. Prevents data misuse and supports forensic investigations.
4.5. Provides legal defense via complete access history.
4.6. Builds trust with patients by demonstrating robust controls.
4.7. Reduces risk of fines or loss of certification due to non-compliance.
4.8. Supports process improvement by identifying workflow inefficiencies.