Logging of Actions - Inadequate Logging

OpenEMR Development
1

wpennington wrote on Tuesday, March 22, 2005:

Logging within OpenEMR provides the date, time, user, group and information entered, but does not show the information deleted, the computer entering the information or other information to identify the user. 

Correct logging should show at least:
A.  Date:
B.  Time;
C.  User;
D.  Group;
E.  Area accessed;
F.  Patient accessed;
G.  Detailed information on the area accessed;
H.  Information added or modified;
I.  Original information or deleted information.

Access Control. 
OpenEMR lacks role based access control.  As a result of this missing feature, multiple may be logged in with the same user name and password.  Because two users can be logged in at the same time with the same user name, additional security is needed to identify which person entered the information, and what information was changed. 

With the current logging, a user could enter information into an encounter, and 30 days later revise that information.  The new information would appear, but the modified information is lost.   All trail of the original information is deleted. 

All log information is kept in the same Admin accessible area as all other data.  This information should be segregated so that it is not accessed

2

drbowen wrote on Tuesday, March 22, 2005:

I agree.

I would like to see the ability to change old form data restricted to a very small group of administrative users.  Changes outside a specified "editing period" should not be modifiable except by one of the users with administrative privileges. 

A reasonable editing period will vary with the practice and probably range 1-3 days.  Practices that use dictation and transcription by a third party will need a longer edit time.  Ideally the edit time should be under control of the practice "sysadmin". Adjustments to this could then be made based on the usual working methods of the individual practice.

Walt’s ideas above would provide a much better audit trail.  The HIPPA requires patients to be allowed to edit their own data and correct inaccuracies.  Of course in OpenEMR as it currently exists, this will cause the original data to be wiped out and lost. 

The practitioner may find this to be objectionable and not agree with the changes.  This will also more easily allow patients to change their medical information for secondary gain. 

Sam Bowen, MD