The "paper security model" leaves quite a bit to be desired and has a lot of efficiency issues itself, but parts of it carried into an EMR wouldn't be terrible

The "paper security model" leaves quite a bit to be desired and has a lot of efficiency issues itself, but parts of it carried into an EMR wouldn't be terrible. You might have a terminal that allows anyone to use it if an employee credential/bade is within a certain proximity of the device. You might setup terminals in access controlled areas don't even need this measure of security and are always logged in and available. Automatic logoff might only happen if an actual security alert is issued for that floor or section. Then you might have a manager who can reopen specific terminals or wait for the security situation to end and have the terminals automatically reopen. Then all you might need is the terminal to do constant "auditing" of user actions. It could take photographs and do facial recognition of hospital staff when a patient record or action is requested, it could alert internal IT when terminals or staff on one floor access patient information outside of their purview, it could record credential information from RFID badges near the terminal, it could store all this information in a log attached to the record and available to the internal audit team.