Audit Logging Configuration

Overview

Audit logging is a critical feature for maintaining accountability and visibility into how patient data is accessed. Dermi Atlas Professional includes a configurable logging system that tracks user activity, system access, and data operations.

This data is essential for security incident investigations and is often a requirement for healthcare privacy compliance (such as HIPAA and PIPEDA).

Logging Levels

Dermi Atlas Manager allows administrators to configure the depth of logging based on storage capacity and compliance needs.

Essential Logging

Essential logging captures high-level security events with minimal impact on storage.

Events captured:

• Authentication: Successful logins, failed attempts, logouts.
• Account Security: Password changes, email updates, 2FA modifications.
• Session Activity: Session termination and remote logouts.

Best for: Practices with limited storage capacity or lower regulatory reporting requirements.

Comprehensive Logging

Comprehensive logging provides a granular audit trail of almost all user interactions within the system.

Events captured:

• All Essential logging events.
• Patient Access: Viewing patient records or searching for patients.
• Data Operations: Creating, updating, deleting, or recovering patients, entries, and images.
• Exports: Generating PDFs or downloading images.
• Consent: Recording or revoking consent.
• Navigation: Accessing specific pages or sections.

Best for: Practices subject to strict audit requirements (e.g., HIPAA) or those requiring detailed forensic data in the event of an incident.

Configuring Audit Logging

Audit logging is configured globally via the Dermi Atlas Manager desktop application.

To change the logging level:

1. Open Dermi Atlas Manager on the host computer.
2. Navigate to Options > Advanced.
3. Locate the Audit Logging setting.
4. Select Essential or Comprehensive.
5. Apply the configuration.

Note: Changes to logging levels apply to future events only. Previously recorded logs retain their original detail.

Audit Log Structure

Audit logs are stored in the local database. Each entry typically contains:

• Timestamp: Exact date and time of the event.
• Actor: The account that performed the action.
• Operation Type: The specific operation (e.g., View, Create, Delete, Recover, Login, Enable 2FA).
• Resource Type: The type of object affected (e.g., patient, entry, image, account).
• Context: Reference to the affected resource or related entity.
• Metadata: Optional additional context (e.g., IP address, device information).
• Operation Data: Details of the change, including before and after states where applicable.

Accessing Audit Data

For Individual Users

Users can view their own security history to verify their account integrity:

1. Sign in to Dermi Atlas Professional.
2. Navigate to Options > Account.
3. Select Activity Logs.

For Patient History

Clinical actions related to a specific patient record are viewable within the patient record:

1. Open the specific Patient Record.
2. Navigate to the Details > View Logs.
3. This view filters logs to show consent changes, image uploads, and access events relevant to that patient.

System-Wide Data

For comprehensive audits or incident response, administrators rely on the system database. Since audit logs are stored locally, they are included in all System Backups generated by Dermi Atlas Manager.

Retention and Deletion Handling

How audit logs are handled during deletion depends on the Data Deletion Policy configured in Dermi Atlas Manager. By default, logs associated with deleted records are retained for 120 months (10 years) to satisfy both US (HIPAA) and Canadian (PHIPA/CPSO) compliance requirements. Records involving minors may require extended retention under applicable provincial or state law.

Configuring Retention Period

Administrators can configure the retention period through Dermi Atlas Manager:

1. Open Dermi Atlas Manager on the host computer.
2. Navigate to the Preferences page.
3. Locate the Data Retention Period section.
4. Enter the desired retention period (valid range: 1 to 600 months).
5. Click Save to apply the changes.

Important: Changes to the retention period are applied retroactively to all existing deleted records and their associated audit logs. Reducing the retention period may cause previously deleted records to be permanently removed sooner. Extending it will delay their removal.

For targeted removal of specific records or other manual database operations, see Configuring Data Retention for Deleted Records.

Account Deletion

Account deletion always permanently removes all patient data and associated audit logs belonging to that account, regardless of the configured Data Deletion Policy. There is no software mechanism to recover a deleted account or its audit history. Maintaining system backups via Dermi Atlas Manager is the only way to preserve this data.

Deletion Policy Options

The Data Deletion Policy, configured in Dermi Atlas Manager, determines how audit logs are handled when patients, entries, or images are deleted:

• Recoverable: All historical audit logs are preserved and marked for deferred deletion. Logs remain accessible for the full retention period, maintaining a complete audit trail alongside the deleted data.
• Standard: Historical audit logs are removed at the time of deletion. A single deletion event is logged and retained for the configured retention period.
• Permanent: All associated audit logs are permanently removed immediately. No audit trail is preserved for the deleted data.

Recommendation: For strict compliance environments, the Recoverable or Standard Data Deletion Policy is preferred to maintain a historical record of access, even after data is deleted.

Best Practices

1. Regular Reviews: Establish a schedule to review access logs for unusual activity, such as access during non-business hours or repeated failed login attempts.
2. Backup Security: Because audit logs are contained within system backups, ensure your backups are stored securely to preserve the integrity of your audit trails.
3. Capacity Planning: "Comprehensive" logging generates more data. Monitor your host computer's storage space to ensure sufficient capacity.