In many outpatient clinics, the riskiest user accounts are not shadowy outsiders, they are familiar staff who still have old permissions no one ever cleaned up. When you add turnover, cross coverage, and new software to that mix, access rights drift quietly away from reality.
A quarterly user access review is a structured process that brings that drift back in line. Every three months, you pull a current list of users and permissions across your key systems, then you decide whether each one still matches the person’s role. It is a simple concept, but the impact touches security, throughput, and workload.
From a compliance perspective, regular access review is one of the ways clinics show that they are taking the spirit of the HIPAA Privacy Rule seriously, not just the letter of a policy manual. And from a risk standpoint, research on healthcare data breaches has found that both external attacks and unauthorized internal access play a role in many incidents. If you only focus on firewalls and ignore who still has credentials, you are protecting half the picture.
There is also a very practical operations angle. When people have the right permissions, and only the right permissions, they spend less time bumping into access errors and fewer minutes hunting down someone who can click a button for them. Over a quarter, that shows up as smoother scheduling, faster billing follow up, and fewer back office surprises.
Platforms that centralize front office work, for example pairing a unified inbox with AI intake automation for outpatient facilities, make these reviews easier to execute, because you can see messages, intake tasks, and user roles in one place instead of across five tools. Solum Health positions itself in exactly this way, as an AI powered unified inbox and AI intake automation layer for outpatient facilities, specialty ready and integrated with EHR and practice management systems, and built to deliver measurable time savings rather than vague promises. When access reviews line up with that kind of environment, you get both tighter control and cleaner workflows.
If your clinic is already investing in areas like automating pre visit workflows, ai driven patient communications, or a centralized patient messaging hub, a quarterly user access review is the governance layer that keeps all of that progress from being undercut by outdated permissions.
A quarterly user access review is a recurring governance practice, not a one time clean up. On a set schedule, typically once every three months, you:
You repeat that cycle for each critical system that touches patient data or operationally sensitive information. That includes electronic health records, scheduling and billing platforms, any system that supports patient onboarding, your patient messaging tools, and any unified front office platforms you rely on for things like insurance prior authorization automation or secondary billing workflow.
In plain terms, a quarterly user access review is your opportunity to ask, “If we were granting this access from scratch today, would we still say yes to this exact set of permissions?”
If you want to get this off the ground in the next quarter instead of someday, it helps to think in steps.
Start with systems that hold patient information, that move money, or that gate key workflows. For most outpatient clinics, that list includes:
If you use Solum Health for a unified inbox plus intake automation, or if you rely on related capabilities such as intake prefill from EHR, interoperability standards, or workflow automation, include those environments as well.
For each system in scope, export a list of users, their roles, and their current permissions. Many tools let you filter for inactive accounts, accounts that have never logged in, or accounts that have not logged in for several months. Flag those for review.
If you have an IT partner, ask them to standardize these exports so they are easy to scan side by side. The more consistent the reports, the less time your operations team will spend decoding them.
Access decisions should sit with people who understand how work actually flows. That usually means a combination of:
Give reviewers a simple rule set. For example, each account can be marked as “keep as is”, “reduce access”, or “remove”, with a short note if the decision is not obvious.
Once decisions are in, someone needs to apply the changes. This is where clinics often stall, because the work is tedious and it is easy to postpone. To avoid that, schedule a short window with IT or the vendor support team to process the updates in bulk.
Be sure to keep a record of what changed, who approved it, and when it was done. If you ever face a question about an incident or an audit, that trail of decisions matters just as much as your written policy.
Treat the review like you treat recurring credentialing, payer updates, or staff evaluations. Put it on the calendar for the same week every quarter. Over time, your team will treat it as a normal part of running the practice, not a special project.
If you are already working toward better care team collaboration and smoother medical coding automation, this rhythm will feel familiar. It is the same idea, a repeated, structured check to keep complexity from sliding back into chaos.
A few patterns show up frequently when clinics try to implement quarterly user access reviews.
The first is partial coverage. A team might review the EHR and forget the intake portal or messaging platform. If a system can see protected health information or move money, it needs to be in scope.
The second is overly broad roles. Over time, it can feel easier to grant “super user” access than to work through more precise permissions. That habit eventually produces accounts that are both risky and hard to unwind. When you review roles, look for opportunities to narrow them without blocking real work.
The third is lack of follow through. Decisions get made, but no one owns the last mile of applying them. To fix that, make a specific person responsible for submitting tickets or updates and closing the loop. It does not have to be the administrator, but it should be someone whose job description includes this duty.
Finally, some clinics struggle with scattered communication channels. If staff are splitting their day between phones, inboxes, portals, and multiple intake tools, access can be hard to see in one frame. A centralized approach, such as the unified inbox model described on Solum’s Solutions and How it works pages, makes it easier to review who can touch which workflow and which patient messages.
Quarterly reviews are a practical minimum for outpatient clinics that handle sensitive patient data and rely on multiple systems. Some organizations add monthly spot checks for the highest risk roles, but a consistent quarterly cycle will already improve your posture significantly.
Most regulations do not specify a particular frequency, however they do expect covered entities to limit access to the minimum necessary and to evaluate that access on a regular basis. A quarterly cadence is widely seen as a reasonable, defensible interpretation of that expectation.
Ownership usually sits with the practice administrator or operations leader, supported by IT or security staff for the technical pieces. Department leads should be involved, because they understand which staff truly need which permissions.
Any system that stores, displays, or moves patient information, financial data linked to patients, or critical operational data should be included. That list typically covers your EHR, practice management system, intake and onboarding tools, messaging platforms, and any automation that touches referrals, prior authorizations, or billing.
At a minimum, keep copies of user and role reports, a summary of decisions, records of changes applied, and the names and roles of the people who conducted and approved the review. Over time, that history helps you explain your controls to auditors, payers, and leadership.
If you want to move from concept to practice, the path is straightforward.
In the next week, pick three systems to start with and identify who will review access for each one. In the next month, run your first full quarterly user access review on those systems and document what you did. Before the quarter ends, schedule the next review on the calendar and decide whether to add more systems to the scope.
As your clinic expands its use of automation, from portal integration to encounter note automation and other front office improvements, this simple recurring practice will help keep your access map as current as your technology. It is not dramatic work, but it is the kind of quiet discipline that keeps patients safer, staff more focused, and your operations ready for whatever the next quarter brings.
