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. Sign-in, account security, and administration events are recorded at both levels; the level governs clinical events only.

Essential Logging

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

Events captured:

• Authentication: Successful logins, failed sign-in attempts, and two-factor verification outcomes.
• Account Security: Password changes, email updates, 2FA modifications.
• Account Lifecycle: Invitation claims, email verification, account recovery requests, and account deletion.
• Session Activity: Signing out of all devices (session invalidation).
• Administration: Settings changes, account disabling and enabling, member list check-ins and their outcomes, and the deployment purge.

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

Comprehensive Logging

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

Events captured:

• All Essential logging events.
• Patient Access: Opening the Patient Database, a patient record, or a patient Image Pool.
• 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.

Activity is recorded per feature, so a specific area of the record can be isolated later. Full body photography is one example: sessions and the lesion records documented within them are logged under a Full Body resource type that the patient log view can filter on.

Illustrative demo with synthetic data. Learn more

Configuring Audit Logging

Audit logging is configured globally via the Dermi Atlas Manager desktop application, in the Settings group of the Administration area. That area is locked at every launch and is opened by entering the admin passphrase set on the host computer, so the logging level, the deletion policy, and the retention period cannot be changed from a clinician's browser session. See Atlas Manager Administration.

To change the logging level:

1. Open Dermi Atlas Manager on the host computer.
2. Unlock Administration with the admin passphrase and open the Settings group.
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 member account that performed the action; Dermi Atlas Manager, carrying the operator name entered at unlock, for an administrative action; or Dermi Portal for membership applied from the portal.
• 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.

A deployment holds one practice team, and every member of it works on the same clinical records. The actor recorded on each entry is therefore what attributes an action to a person: the entry names the account that performed it, and that attribution stays in the log after the member leaves the team.

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. Scroll to the Notifications & Activity section and select View Logs on the Your Activity Logs card.

For Patient History

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

1. Open the specific Patient Record.
2. On the patient Details page, select View Logs on the Patient Activity Logs card.
3. This view filters logs to show consent changes, image uploads, and access events relevant to that patient.

The drawer holds the team's trail for that patient. Every member opens the same entries, each entry names the member who performed the action beneath its time, and the reader's own entries carry the suffix "(You)". Entries written by another member are shown without that member's IP address and device details.

Action, Resource, Member, and Period filters combine, so a dense history can be narrowed to the events under review. On a team with a single member, the member names and the Member filter are not shown.

Illustrative demo with synthetic data. Learn more

Illustrative demo with synthetic data. Learn more

Under the Essential level no new clinical entry is recorded; a drawer with nothing to list reports that audit logging is set to Essential, and entries recorded earlier under Comprehensive still list.

For Sign-In and Administration Activity

Sign-in and administrative activity on the deployment is read from the Administration Activity card in Dermi Atlas Manager, under the Deployment heading of the Administration area: every member's sign-ins and account security events, and every administrative action, newest first. Clinical activity is not listed there. The card is described in Atlas Manager Administration.

Illustrative demo with synthetic data. Learn more

For an audit that spans every patient, the complete record is the system backup. Since audit logs are stored locally, they are included in the system backups created from Backup Management in 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. Under the default Standard policy, the historical logs for a deleted record are removed at the time of deletion and a single deletion event is retained for the configured retention period; the Recoverable policy retains the full log history for that period instead. The default retention period is 120 months (10 years), which sits above common US and Canadian record-retention expectations. 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. Unlock Administration with the admin passphrase and open the Settings group.
3. Locate the Data Retention Period section.
4. Enter the desired retention period (valid range: 1 to 600 months).
5. Select Apply Changes to save the configuration.

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, so a reduction requires typing the confirmation phrase "REDUCE RETENTION PERIOD" before it is applied. Extending the period will delay their removal.

For targeted removal of specific records, see Configuring Data Retention for Deleted Records.

Account Deletion

Deleting an account on a deployment removes the person, not the practice's records. Patient records, images, and the clinical activity log belong to the team and stay in place, and the entries the departing member wrote keep naming that account as the actor, so the audit trail remains complete. What is removed with the account is its own account and authentication history, which is marked to expire at the end of the configured retention period rather than immediately. The account is also dropped from the assignment list of every patient it was assigned to.

Removing a member in Dermi Portal ends that person's access at the deployment's next check-in and likewise leaves everything they documented with the team; disabling the account under Administration => User Accounts in Dermi Atlas Manager ends it immediately. Neither deletes clinical data.

The only action that removes clinical data and the clinical activity log from a deployment is the Deployment Purge in Dermi Atlas Manager, described in Atlas Manager Administration. It is permanent, it keeps the accounts and the sign-in and administration activity log, and there is no software mechanism to reverse it. Maintaining system backups through Dermi Atlas Manager is the only way to preserve data ahead of it.

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 read the Administration Activity card for sign-in anomalies, such as repeated failed attempts, access outside working hours, or a second factor that has been disabled, and the patient activity log for the records under review.
2. Backup Security: Because audit logs are contained within system backups, ensure backups are stored securely to preserve the integrity of audit trails.
3. Capacity Planning: "Comprehensive" logging generates more data. Monitor the host computer's storage space to ensure sufficient capacity.