The chart is only part of the record.
Audit logs and system metadata can show when a chart was accessed, when an entry changed, and how that activity relates to the clinical timeline. E-Hounds extracts and interprets these records across platforms including Epic and Meditech.
We compare the visible medical record with the underlying system history, identify discrepancies, and document what the data supports. The methods and findings are prepared for review by counsel and examination in court.
For plaintiff counsel.
We identify who accessed a patient's chart, when entries were made or modified relative to the event at issue, and whether the produced record matches what the system logged.
Our work involving major Florida hospital systems has identified discrepancies between testimony and underlying audit data. Reports tie the findings to their sources and explain the technical record for judges and juries.
For defense counsel.
Independent examination can help evaluate allegations of alteration, spoliation, or late entry. We distinguish routine system behavior, autosaves, view events, and legitimate re-signs from activity requiring further explanation.
We also review opposing expert methodology. Platform-specific event definitions and system behavior matter when deciding what an audit trail establishes and what it does not.
Connect the chart to the underlying data.
EMR audit trails
Access events, chart opens, order entry, modification histories, and post-event edits from Epic, Meditech, and other hospital platforms.
Timing and modification history
Entries made, changed, or re-signed after an event, compared with the clinical narrative. The analysis can reveal discrepancies or support consistency with a provider's account.
Telemetry and device data
Cardiac monitoring, fetal-monitoring strips, infusion-pump logs, anesthesia records, and other medical-device data examined alongside the chart. Retention and rotation periods inform preservation priorities.
Imaging and metadata
PACS studies, acquisition timestamps, modality information, and DICOM headers assessed against the chronology in dispute.
Hosted EMR access logs
Tenant access logs, federation events, and administrator activity examined for evidence of who accessed the system, from where, and using which credentials.
Support the technical questions and the testimony.
The analyst who performs the examination can prepare an expert declaration, sit for deposition, and testify at trial. Methods and source records are documented so other qualified experts can review and challenge the work.
We prepare targeted deposition questions for hospital technical consultants, platform administrators, and risk-management witnesses. The work can also address device-data storage, document-retention policies, and hosted EMR access history.
Scoping the engagement.
Describe the platform, timeframe, side represented, and the disputed event or entry. Include which records and audit logs have been produced and any preservation deadlines.