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Audit Trail

ChatMD maintains a complete, tamper-evident record of every clinical AI interaction. When clinicians use AI to query patient records, summarize medical histories, or retrieve lab results, each action is automatically logged with full context—who accessed what, when, and why.

Why Audit Trails Matter in Healthcare

HIPAA requires covered entities to track access to protected health information. Beyond regulatory compliance, comprehensive audit trails serve critical functions:

  • Malpractice defense — Demonstrate exactly what information the care team accessed and when decisions were made
  • Regulatory audits — Provide OCR with detailed access logs showing your PHI tracking practices
  • Quality assurance — Review how clinicians use AI assistance to identify training opportunities
  • Incident investigation — Trace the sequence of events when investigating potential breaches or inappropriate access

What Gets Logged

Every AI interaction with patient data captures:

  • Who — The clinician or care team member who initiated the query
  • What — The patient records, lab results, or clinical notes accessed
  • When — Precise timestamp of the interaction
  • Context — The department, care team, and clinical conversation where access occurred
  • Outcome — Whether the query succeeded and what information was returned

Tamper-Evident Integrity

ChatMD uses cryptographic chaining to ensure audit records cannot be altered without detection. Each log entry is mathematically linked to the previous entry, creating an unbroken chain that proves:

  • No entries have been deleted
  • No entries have been modified after the fact
  • No entries have been inserted out of sequence

This integrity verification is essential when presenting audit logs to regulators, legal counsel, or in court proceedings. You can demonstrate with certainty that the records accurately reflect what occurred.

Long-Term Preservation

When audit logs reach their retention limit, they are archived before deletion. This preserves the ability to verify the integrity chain historically—critical for responding to legal discovery requests or regulatory inquiries that may span years after the original clinical interaction.

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