IEEE White Paper : EPHI Definitions:2025

The growing complexity and integration of electronic health records (EHRs) demand urgent modernization of audit data and audit trail standards. This paper examines current auditing standards for electronic protected health information (ePHI), highlighting their limitations in ensuring transparency, accountability, and interoperability in an increasingly digital and AI-integrated healthcare environment. Definitions and minimum data elements need to account for new realities of AI activity, device-generated data, inter-provider communications, and health information transfer. These deficiencies hinder the verification of medical record integrity and completeness, especially in critical settings such as clinical decision-making, quality control, and legal review. This paper proposes comprehensive revisions to audit data and audit trail standards, with an emphasis on usability and exportability in standardized formats.