Challenges for Log Based Detection of Privacy Violations during Healthcare Emergencies

The widespread adoption of Electronic Health Records (EHR) increases the requirement for sufficient auditing mechanisms enabled with health information technologies to protect against deliberate and accidental information misuses. Shared information environments improve the quality of healthcare. Healthcare environments are characterized by unanticipated emergency situations where access to information is essential. The ordinary work-flow of the health system may need to be violated in emergency situations in a \textit{break-the-glass} approach. Hence, a purely preventive approach for information access use is not adequate for the current trends of electronic healthcare systems. Instead, after-the-fact justification of patient data access violations is required. Assessing root causes for unusual human behaviours is feasible through maintenance and analysis of appropriate event logs. Here we describe the challenges of detecting information privacy violations of current EHR systems during emergency situations. We define how a log file with additional information could be used to detect deviations from expected sequences of events during emergency situations in healthcare.