Auditing AI Access to Electronic Health Records: HIPAA Compliance, Challenges, Solutions, and Future Directions

Abstract

The integration of artificial intelligence (AI) into healthcare, especially within Electronic Health Records (EHRs), is transforming clinical workflows and data management. However, this evolution introduces new complexities for regulatory compliance, particularly under the Health Insurance Portability and Accountability Act (HIPAA). Traditional EHR audits focus on human users, but as AI agents increasingly access sensitive patient data, audit frameworks must evolve to ensure accountability, transparency, and compliance. This article explores the regulatory requirements, technical challenges, and practical solutions for auditing AI access to EHRs, illustrated by recent real-world case studies.