4 Ways To Reduce the Number of Patient Privacy Audits

Written by Karen Pursch, Director, Patient Privacy Solutions


We all know that as EMRs replace paper records, it is impossible to manually review millions of audit logs to check for potential patient privacy breaches. As a result, in the past, most organizations resorted to random audits. I want to believe that a majority of healthcare organizations are now using technology to automate the monitoring of these patient access logs.

In addition to using technology to automate monitoring, there is another dimension to patient privacy monitoring — doing everything possible to reduce the number of audits that need to be evaluated. It makes sense, right? You want to use monitoring technology to search and find that potential breach, but you also want to make sure that your auditors are spending time on the most likely cases of a patient privacy breach.

Our goal is to help you reduce the time it takes to audit by using a combination of four methods:

  • Filter out “False Positives”
  • Use analytics to apply weights to the audits, and rank by severity
  • Use behavioral analytics to find inappropriate behavior by showing changes in activity/volumes from normal, established (baseline) levels
  • Filter out known routines, users, and devices

False Positives

“False positives” is a term that is often used when looking at reducing the amount of audits by eliminating those audit logs that we know to be appropriate. These are situations that occur between the user and patient that you know have a high percentage of being justifiable. For example: a care team member looks at a patient record when he or she is on duty, and is on the same floor as the patient. If we can flag these types of “False Positives," then there are fewer audits that require review. Security Audit Manager™ flags false positives by filtering out “known likely appropriate” events between a user and a patient — only the questionable access events remain.

Privacy Analytics

We use analytics to find the most probable privacy violations using pre-built algorithms that apply weights to the audits, and then rank by severity. This ensures that the most likely cases of inappropriate access rise to the top. Prioritizing events by risk helps our customers focus on the accesses with the highest probability of being inappropriate. This helps organizations more easily protect patient data and achieve HIPAA and HITECH compliance.

Behavioral Analysis

Many of our customers want to see if users are doing something abnormal, and if there is a spike in their behavior. For example, a care team member typically accesses patient records 10-20 times during a daily work schedule. Healthcare organizations want to know if, for example, a user is accessing 100 patient records during a period of time. This could be insider snooping or, in more severe cases, a disgruntled employee. Or in a cyber security event, someone could be masking as that user and stealing patient information.

Additional Filtering

We also give the auditor the ability to use filtering to exclude known routines such as batch jobs or status board displays. We have extended this filtering to known users such as System and Script users, and known devices such as background jobs, instrument devices, and file servers. You can also filter in specific events to see instances where a user action may have only viewed, printed, or even downloaded a patient record.

All of these methods will increase auditors' productivity, and allow them to focus on those audits that require further investigation and have the highest risk of being inappropriate. This approach helps organizations more easily protect patient data and achieve HIPAA and HITECH compliance while protecting patient trust.  

If you would like more information on this topic, please attend our upcoming webcast on March 15th at 2:00 p.m. ET, Preventing Privacy Breaches.

Topics: patient privacy, patient privacy monitoring, Risk Based auditing, Protecting Patient Trust, False Positives, Privacy Analytics

Subscribe to the Patient Privacy blog.

Receive the latest articles directly in your inbox.
Enter your email address and click SUBSCRIBE:



Ignorance, Bliss, and the Zen of Risk Management

We all probably have heard the old saying “Ignorance is Bliss.”  Many of us, as we get older, look back fondly on our childhood and remember how true that was. Children often have the luxury of...Read More

New HIPAA Enforcer Means Business – Make Sure You’re Prepared

I was very interested to read a recent article in Healthcare Info Security about the new HIPAA enforcer’s plans. Roger Severino, the new director of the Department of Health and Human Services'...Read More

New Lessons on Patient Privacy Breaches and OCR HIPAA Settlements

When I came across this article on HealthITSecurity.com: "5 Lessons Learned in OCR HIPAA Settlements" I knew I wanted to share it with you. It reports on the outcome of the past two years of OCR...Read More

Are you monitoring user reporting in MEDITECH’s Data Repository?

In my experience, hospitals typically don't add any kind of PHI access logging to their Data Repository reports. This seems like a gap in PHI monitoring. It may be true that HIPAA provides an...Read More

How Beaufort Memorial Hospital Handles Vendor Risk Management

Recently, Ed Ricks, CIO at Beaufort Memorial Hospital had an interview with Marianne Kolbasuk McGee with HealthcareInfo Security. It is a very relevant and timely discussion since The Department of...Read More

Use Patient Trust as a Competitive Advantage

I recently read this article from HealthData Management — Privacy, security issues cause consumers to distrust HIT — published on January 9th, 2017. With all the news going on today...Read More

Do Your Partners Handle PHI With Care? Not Sure?

A great deal of your hospital’s patient information is now handled by outside partners — physician practices, outside labs, insurance companies, and many others. In an ideal world, you could trust...Read More

OCR to Expand Compliance Reviews of Small Healthcare Breaches

The Health and Human Services (HHS) Office for Civil Rights (OCR) announced in August, that it has launched a new initiative to more widely investigate HIPAA breaches of protected health information...Read More

Security app helps hospital pass CMS risk assessment, HIPAA audit

Iatric Systems customer, Ed Ricks, CIO of Beaufort Memorial, shares that “technology can produce useful details to further prove your privacy compliance efforts to federal auditors.” In this recent...Read More

Healthcare — today's biggest ransomware target

It's no surprise to me that healthcare is now a prime target of cyber-criminals using ransomware to extort money. They want to go after a business that cannot function without access to its data and...Read More

OCR is doing a good thing by making us “Eat our Vegetables”

Healthcare is, at its core, based on relationships. And, as with any relationship, trust is foundational to building and maintaining a strong relationship. Trust can be fragile and fleeting. It can...Read More

Why You Should Embrace an OCR Audit

News that your organization could be facing an audit is usually cause for anxiety and much gnashing of teeth. At best, it means scrambling to assemble the required information before the deadline...Read More

Reducing Improper Access of Patient Records by 98%

When hospital clinicians are accessing patient records thousands of times daily, how do you spot the access that’s questionable or worse? Trying to comply with privacy rules can tie a hospital’s IT...Read More

4 Ways To Reduce the Number of Patient Privacy Audits

We all know that as EMRs replace paper records, it is impossible to manually review millions of audit logs to check for potential patient privacy breaches. As a result, in the past, most...Read More

Map Your Way to a Successful Patient Privacy Program

I have had many conversations with our customers regarding patient privacy monitoring, including the importance of capturing and mapping key data elements such as Guarantor/Subscriber, Next of Kin,...Read More

Risk Based Patient Privacy Monitoring

Healthcare Privacy and Information Security programs have evolved substantially in recent years. This is due not only to the requirements of Meaningful Use, HIPAA, and HITECH, but due to the growing...Read More

My Trip to the Clinic and Protecting Patient Privacy

One internal value that has always been strong at Iatric Systems is that our Founder and CEO, Joel Berman, cares for his “family” by providing the best healthcare insurance and wellness plans...Read More

Could Your Organization Demonstrate HIPAA Compliance?

On September 30th, CynergisTek and Iatric Systems teamed up to host a complimentary webinar, “How to Prepare Your Organization for an OCR HIPAA Audit.” In this informative session, industry...Read More

Are You Ready for the Return of OCR’s HIPAA Audit Program?

One thing is for sure…you don’t want to wait until you get a notification letter from the Office for Civil Rights (OCR) to start preparing for a HIPAA compliance audit. Organizations that are going...Read More

Privacy breaches cost $5.6 billion a year

$5.6 billion.  $5,600,000,000.  Seeing the amount, instead of just reading the amount, gives it more meaning — at least to me it does. That rather large number is how much privacy breaches...Read More

Riding the Magic Omnibus

Every day I want to cry (too much Omnibus)How can I protect your PHI (too much Omnibus)I'm confused and at a loss (too much Omnibus)So can you please explain Omnibus (too much Omnibus) I may be...Read More

How To Justify Your Patient Privacy Program

When I talk to the privacy staff at healthcare organizations, they tell me that they understand the benefits of using technology for their patient privacy program, but they’re having a difficult time...Read More

What is Reasonable and Appropriate under the HIPAA Security Rule?

I am often faced with the following question from customers: "Can you tell me specifically what we need to do to comply with HIPAA’s information system activity review requirement…What is ‘reasonable...Read More

Let’s face it, protecting patient privacy has never been healthcare’s strong suit

In a recent report, "2015 Data Breach Investigations Report," conducted by Verizon, analysts put healthcare security under the microscope and identified that insider snooping (think employee snooping...Read More