Audit Log
A record of system activity (logins, record access, configuration changes) that can be reviewed to detect inappropriate access or system compromise.
1 min read · Last reviewed May 23, 2026
At a glance
- Category
- Security
- Primary sources
- 2
- Workspace handoff
- compliance binder →
Where this comes up
This sits inside the security risk analysis under 45 CFR 164.308(a)(1)(ii)(A) — workstation controls, EHR access roles, ePHI transmission encryption, audit logging, vendor risk, and incident response. Reviewers expect dated evidence of the control, not a policy PDF that says it exists.
Full definition
What it is in practice
45 CFR 164.312(b) requires audit controls — hardware, software, and procedural mechanisms that record and examine activity in systems containing ePHI. NIST SP 800-66 Rev. 2 recommends regular log review and retention aligned with the entity's risk analysis.
How it shows up in your practice
Enable EHR access logs. Sample-review them on a documented cadence (monthly or quarterly) and investigate anomalies. Snooping cases — staff reading the chart of a celebrity, neighbor, or family member — are a frequent OCR-investigation trigger.
Sources
- 45 CFR 164.312 — Technical safeguardshttps://www.ecfr.gov/current/title-45/section-164.312
- NIST SP 800-66 Rev. 2 — HIPAA Security Rule Implementation Guidehttps://csrc.nist.gov/pubs/sp/800/66/r2/final
Set up your audit-log review schedule in the Compliance Binder
Open compliance binder →Related terms
- SecurityAccess ControlsTechnical policies and procedures that allow only authorized persons or software programs to access ePHI.
- SecurityTechnical SafeguardsTechnology and the policy and procedures for its use that protect ePHI and control access to it.
- SecuritySnooping InvestigationA documented investigation when audit logs show a workforce member accessed a patient record without a legitimate treatment, payment, or operations purpose.
- SecuritySanctions PolicyThe HIPAA-required policy that imposes appropriate consequences on workforce members who violate the covered entity's privacy and security policies.
D3rx is a healthcare-billing and compliance research aid maintained by D3rx Inc. Articles are drafted by an LLM (Anthropic Claude) against primary HHS, OCR, CMS, eCFR, NIST, and state-regulator publications, and reviewed for restraint and source fidelity by the D3rx team.
Reviewer status: a named credentialed reviewer (CHC, CHPC, or healthcare attorney) is being engaged. Until that engagement is finalized, this page does not claim credentialed review.
Related across the archive
- GlossaryAccess ControlsTechnical policies and procedures that allow only authorized persons or software programs to access ePHI.
- GlossaryTechnical SafeguardsTechnology and the policy and procedures for its use that protect ePHI and control access to it.
- GlossarySanctions PolicyThe HIPAA-required policy that imposes appropriate consequences on workforce members who violate the covered entity's privacy and security policies.
- GlossarySnooping InvestigationA documented investigation when audit logs show a workforce member accessed a patient record without a legitimate treatment, payment, or operations purpose.
- GlossaryAdministrative SafeguardsPolicies and procedures designed to manage the selection, development, implementation, and maintenance of security measures protecting ePHI.
- ComplianceAnnual HIPAA Training Curriculum (What to Cover + How to Document)A 2026 annual HIPAA training curriculum for small healthcare practices — eight required modules under 45 CFR 164.530(b) and 45 CFR 164.308(a)(5), with documentation templates.
- RegulationNIST Cybersecurity Framework 2.0The 2024 update to the NIST CSF added the Govern function alongside Identify, Protect, Detect, Respond, and Recover — providing a common language for organizational cybersecurity risk management.
- SRAHIPAA Contingency Plan for a Small PracticeWhat the Security Rule contingency plan standard at 45 CFR 164.308(a)(7) actually requires, including data backup, disaster recovery, emergency mode operation, and testing — for a small practice.
This glossary entry is a research aid for billing and compliance staff. It does not provide legal, medical, or financial advice and does not replace counsel. References cited link to primary sources at HHS, OCR, CMS, eCFR, NIST, and the relevant payer or industry body.