Does HIPAA require log monitoring?

Short answer: yes. HIPAA requires audit controls that record and examine activity in systems containing ePHI, and regular review of that activity. It does not name a specific tool, but collecting logs without anyone reviewing them does not meet the requirement.

01

What the rule says

  • Audit controls (45 CFR 164.312(b)): hardware, software or procedures that record and examine activity in systems that contain or use ePHI.
  • Information system activity review (164.308(a)(1)(ii)(D)): regularly review records such as audit logs, access reports and security incident tracking reports.
  • Log-in monitoring (164.308(a)(5)(ii)(C)): procedures for monitoring log-in attempts and reporting discrepancies.

02

What to log

  • Sign-ins and failed sign-ins, especially to email and remote access.
  • Access to your EHR or practice management system.
  • Firewall and VPN activity.
  • Admin changes: new accounts, permission changes, disabled security tools.

03

How practices meet it

Small practices rarely have staff to read logs every day. A monitored SIEM collects the logs in one place, alerts on suspicious activity and keeps the audit trail. Cytek's SIEM runs inside Safeguard™, reviewed by our analysts.

FAQ

Frequently asked questions

How often should logs be reviewed?

HIPAA says regularly and leaves the frequency to your risk analysis. Automated monitoring with alerts is the most reliable approach.

How long should we keep logs?

HIPAA requires documentation to be retained for six years. Many organizations keep security logs long enough to investigate incidents and support that documentation. Decide your period in your policies.

Does Microsoft 365 log activity automatically?

It keeps audit logs, but retention depends on your license, and nobody reviews them unless you set that up.

Sources: 45 CFR 164.312, technical safeguards · 45 CFR 164.308, administrative safeguards. This page is general information, not legal advice.

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