title: Using external data sources to improve audit trail analysis.
abstract: Audit trail analysis is the primary means of detection of inappropriate use of the medical record. While audit logs contain large amounts of information, the information required to determine useful user-patient relationships is often not present. Adequate information isn't present because most audit trail analysis systems rely on the limited information available within the medical record system. We report a feature of the STAR (System for Text Archive and Retrieval) audit analysis system where information available in the medical record is augmented with external information sources such as: database sources, Light-weight Directory Access Protocol (LDAP) server sources, and World Wide Web (WWW) database sources. We discuss several issues that arise when combining the information from each of these disparate information sources. Furthermore, we explain how the enhanced person specific information obtained can be used to determine user-patient relationships that might signify a motive for inappropriately accessing a patient's medical record.
authors.affiliation: Department of Health Management and Informatics, University of Missouri-Columbia School of Medicine, USA.
authors.forename: R L
authors.initials: RL
authors.lastname: Herting
authors.forename: P V
authors.initials: PV
authors.lastname: Asaro
authors.forename: A C
authors.initials: AC
authors.lastname: Roth
authors.forename: M R
authors.initials: MR
authors.lastname: Barnes
mesh_terms: D016494:Computer Security; D003219:Confidentiality; D019992:Databases as Topic / Q000458:organization & administration; D006801:Humans; D016247:Information Storage and Retrieval; D016347:Medical Records Systems, Computerized; D011369:Professional-Patient Relations; D009626:Terminology as Topic