Biblio
According to a 2011 survey in healthcare, the most commonly reported breaches of protected health information involved employees snooping into medical records of friends and relatives. Logging mechanisms can provide a means for forensic analysis of user activity in software systems by proving that a user performed certain actions in the system. However, logging mechanisms often inconsistently capture user interactions with sensitive data, creating gaps in traces of user activity. Explicit design principles and systematic testing of logging mechanisms within the software development lifecycle may help strengthen the overall security of software. The objective of this research is to observe the current state of logging mechanisms by performing an exploratory case study in which we systematically evaluate logging mechanisms by supplementing the expected results of existing functional black-box test cases to include log output. We perform an exploratory case study of four open-source electronic health record (EHR) logging mechanisms: OpenEMR, OSCAR, Tolven eCHR, and WorldVistA. We supplement the expected results of 30 United States government-sanctioned test cases to include log output to track access of sensitive data. We then execute the test cases on each EHR system. Six of the 30 (20%) test cases failed on all four EHR systems because user interactions with sensitive data are not logged. We find that viewing protected data is often not logged by default, allowing unauthorized views of data to go undetected. Based on our results, we propose a set of principles that developers should consider when developing logging mechanisms to ensure the ability to capture adequate traces of user activity.