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Thanks to everyone who responded to my original question (quoted below.) My reason for asking is that I represent a niche software manufacturer for health care and am looking to develop a recommendation for our accounts in regards to "best practices." We are already implementing tracking of information that is stored in our database regarding who entered the information, last modified it, etc. There will be full temporal access to the history of the records so you can easily move backward and (if starting from an earlier period) forward in time in relationship to a given record.

The problem that I have found to be consistent across all of our accounts is that they frequently have confidential information stored in letters, spreadsheets, etc. that they have developed to do some specific task. Unfortunately, the client rarely informs us of these alternative items and they are not using our software which will be able to protect and audit access to the data. One of the solutions that will correct unauthorized access to the data is to recommend the deployment of Windows NT machines. Is anyone aware of an audit system that will identify access to word processor / spreadsheet / other documents with the same temporal information and could hopefully be written into a database? Windows 2000 domains support audit policies that would appear to do this; however, our experience suggests that this system is very poor at tracking anything over a long period of time.

Thanks,
Marshall



From: Marshall E. Fryman [mailto:mfryman@;futuraintl.com]
Sent: Thursday, October 24, 2002 10:23 AM
To: WEDI SNIP Privacy Workgroup List
Subject: Privacy issues


The privacy regulation draws attention to a reasonable effort to maintain
the privacy of patient's information except on a "need to know" basis. If
we take the premise of a doctor's office where Person A types a letter to a
patient containing confidential information. If Person A then walks away
from their terminal, I would reasonably conclude that there should be some
sort of password-protected screen saver that automatically pops up to blank
the screen so that anyone passing by can not read said letter. If this
workstation is setup using Windows 9x, is it also reasonable to claim that
this machine is not securable? If I reboot the Win 9x machine, I can bypass
any password that was originally setup on this machine and still read the
letter. If I upgrade this machine to Windows NT / 2000 / XP, it is no
longer possible to bypass the security system. This is clearly a more
secure environment, but has anyone attempted to define if this falls within
the "reasonable" precautions that a practice should take?

Anyone have any ideas? I have talked to CMS and they said that they were
not really qualified to answer the question. Their initial reaction was
that this was an issue of security not privacy, but they later changed
their mind and said it might fall within the "reasonable" clause.


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