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Blog|Articles|October 14, 2026

15 ways to keep your EHR audit trail from sinking a malpractice defense

Fact checked by: Chris Mazzolini

Plaintiffs' attorneys now pull the EHR audit trail as routinely as the chart. Here's how to make sure yours tells the story you need it to.

When a malpractice case reaches discovery, the chart is no longer the only record that matters. Plaintiffs' attorneys now routinely request the EHR audit trail, the metadata showing who opened a note, how long they spent on a result and when every edit and signature happened. A closed-claims analysis by The Doctors Company found EHR-related claims climbed from seven in 2010 to an average of 22.5 a year in 2017 and 2018, with copy-and-paste and prepopulated fields each a factor in 13 percent of them.

The pressure is building. A New York bill that would require disclosure of metadata, audit trail and log-in information in malpractice actions has been reintroduced in Albany every session since 2021. Ambient AI scribes have added a new layer: in April, patients filed a proposed class action against Sutter Health and MemorialCare over visits recorded by an AI documentation tool.

An audit trail can sink a defense or save one, and which it does depends on habits your physicians and staff build now. Here are 15 places to start.


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