title: Auditing medical records accesses via healthcare interaction networks.
abstract: Healthcare organizations are deploying increasingly complex clinical information systems to support patient care. Traditional information security practices (e.g., role-based access control) are embedded in enterprise-level systems, but are insufficient to ensure patient privacy. This is due, in part, to the dynamic nature of healthcare, which makes it difficult to predict which care providers need access to what and when. In this paper, we show that modeling operations at a higher level of granularity (e.g., the departmental level) are stable in the context of a relational network, which may enable more effective auditing strategies. We study three months of access logs from a large academic medical center to illustrate that departmental interaction networks exhibit certain invariants, such as the number, strength, and reciprocity of relationships. We further show that the relations extracted from the network can be leveraged to assess the extent to which a patient's care satisfies expected organizational behavior.
authors.affiliation: Dept. of Biomedical Informatics, Vanderbilt University, Nashville, TN, USA.
authors.forename: You
authors.initials: Y
authors.lastname: Chen
authors.forename: Steve
authors.initials: S
authors.lastname: Nyemba
authors.forename: Bradley
authors.initials: B
authors.lastname: Malin
mesh_terms: D016494:Computer Security; D003219:Confidentiality; D058016:Health Facility Administration; D006801:Humans; D007400:Interprofessional Relations; D008485:Medical Audit; D016347:Medical Records Systems, Computerized; D017146:Models, Organizational