Audit Logging

Comprehensive audit logging for ONC and HIPAA compliance.

Requirement

Every access to Protected Health Information (PHI) must be logged.

• Who: User ID
• What: Resource accessed (e.g., Patient/123)
• When: Timestamp
• Action: Read/Write/Delete
• Where: Source IP

Architecture

1. Application Event: Spring Boot publishes an AuditLogEvent.
2. Async Listener: Captures event to minimize latency.
3. Persistence:
   • Hot Storage: PostgreSQL audit_logs table (Recent access).
   • Cold Storage: JSON logs shipped to S3/CloudWatch (Long-term retention).

Database Schema

CREATE TABLE audit_logs (
    id BIGSERIAL PRIMARY KEY,
    user_id VARCHAR(50),
    org_id BIGINT,
    action VARCHAR(20),     -- READ, CREATE, UPDATE
    resource_type VARCHAR(50), -- PATIENT, ENCOUNTER
    resource_id VARCHAR(50),
    ip_address VARCHAR(45),
    timestamp TIMESTAMP
);

Implementation

Automatic Entity Listeners

Using Hibernate Envers or JPA EntityListeners.

@EntityListeners(AuditListener.class)
public class Patient { ... }

Manual Logging

For sensitive read operations (viewing a chart).

auditService.log(
    currentUser,
    Action.READ,
    "Patient",
    patientId,
    "Viewed patient dashboard"
);

Viewing Logs

Administrators can view audit logs via the Compliance Dashboard. Logs are immutable and cannot be deleted by standard users.

Retention Policy

• Minimum: 6 years (HIPAA requirement).
• Archiving: Logs > 1 year are moved to S3 Glacier.