At its core, break glass access is about keeping care moving when the normal permission model gets in the way of safe treatment. Outpatient clinics lean heavily on role based access to protect privacy and stay aligned with the HIPAA Security Rule. That is good practice, but it can slow throughput when a clinician or covering provider cannot see what they need in the moment.
If there is no clearly defined emergency option, staff invent their own. That might mean asking a colleague to pull data on their behalf, copying pieces of a chart into messages, or skipping checks they know would be ideal. Over time those workarounds erode both privacy and efficiency. A formal break glass process, supported by your systems, gives people a sanctioned way to act quickly and still leave a trail you can explain to a regulator or to a patient.
Break glass access also helps you keep least privilege realistic. Instead of widening everyone’s regular rights “just in case” and living with the noise, you preserve tighter everyday access and reserve the override for situations that genuinely threaten safety or continuity. When that override is coupled with a unified view of communication, such as a single inbox that consolidates calls, texts, and emails, the front office can move faster without guessing where information lives. That is the direction of tools that provide an AI powered front office for healthcare and it is relevant even if you are still on more basic systems today.
In simple terms, break glass access in healthcare is a controlled, emergency only override that lets an authorized user view or act on patient records that are normally restricted. It should be rare, it should be clearly justified, and it should always be logged.
Most clinics already rely on role based access. Front desk staff see one slice of data, billers another, clinicians still another. Break glass access sits on top of that model and acknowledges a hard truth of outpatient care. Once in a while, someone who does not normally own a chart needs to see enough of it to make a safe decision.
A useful definition has four parts.
If your policy or your vendor implementation is missing any of those elements, you can still call it break glass, but it will be harder to defend.
Although every electronic health record and communication platform implements the details differently, the pattern is consistent.
The starting point is a written policy that defines when emergency access is allowed. Clinics usually include situations such as imminent harm, serious safety concerns, or urgent treatment decisions where information is clearly not reachable through normal channels. The policy should state that break glass use is rare, must be tied to a legitimate need, and will always be reviewed later.
In the software, break glass often appears as a specific button or elevated role. When a user triggers it, the system should at minimum:
Some organizations also require a second factor, such as re entering a password, to underscore the gravity of what is happening.
A credible break glass approach leans on logging rather than on trust alone. The system needs to record the user, the time, the records viewed, and any changes made. In a more mature configuration, those events are flagged for privacy or security officers and summarized on a regular schedule. Frameworks such as the HIPAA Security Rule summary and the NIST catalog of security controls in NIST SP 800 53 both reinforce the expectation that emergency access be governed, not improvised.
Finally, someone has to look back. A simple monthly review of break glass events can answer three questions. Was this truly an emergency as defined in our policy. Did the user access more than was necessary. Do we need to adjust training, workflows, or baseline permissions so that the same situation does not require break glass next time.
When that cycle runs reliably, break glass becomes a stabilizing tool rather than a loophole.
If you have little or no formal emergency access process today, you can build one without turning your operations upside down.
Throughout that process, keep your broader technology strategy in view. Solum Health’s positioning as a unified inbox plus AI intake automation for outpatient facilities, specialty ready and integrated with EHR and practice management systems and built to deliver measurable time savings, is one example of how front office design and emergency access go hand in hand. A consistent architecture makes it easier to implement a single, coherent emergency rule instead of one rule per tool.
Four problems come up repeatedly when clinics start to formalize break glass.
When in doubt, you can cross check definitions and related concepts in the Solum Health glossary and the operational essays on the Solum Health blog. Both are useful companions as you refine policy language.
What is break glass access in healthcare?
Break glass access in healthcare is an emergency only override that lets authorized users reach patient records they normally cannot access, under tightly defined conditions, with full logging and later review. It exists to protect patient safety without discarding role based privacy controls.
Is break glass access required for HIPAA compliance?
HIPAA does not use the term break glass, but it does expect covered entities to have emergency access procedures for systems that hold electronic protected health information. A clear, documented break glass process is one of the most straightforward ways to demonstrate that you have thought about how to maintain access during emergencies while still controlling who sees what.
Who should be allowed to use break glass access?
Only a small, well trained group should have this capability, typically licensed clinicians, clinical leaders, and a few designated operations staff. The goal is not to show mistrust, it is to make training, monitoring, and support practical.
How often should break glass access be used?
It should be rare. If you start to see frequent events, treat that as a signal. Either your policy language is too loose or your everyday access model does not match how work actually happens.
What should be logged during a break glass event?
At a minimum, the system should record who initiated the override, the time, the patient records accessed, the actions taken, and the reason given. Those details allow you to audit for misuse, refine training, and answer questions from patients or regulators with confidence.
If you want to make progress without turning this into a year long project, keep it concrete.
If, by the end of that period, you can explain to a colleague exactly when break glass is allowed, which systems it touches, and how you verify that it is used appropriately, you are already ahead of many peers. From there, it is mostly refinement and the steady work of keeping policy, technology, and front line practice in sync.
