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HIPAA/PHI AI Gateways

Compliant AI Architectures for Healthcare and Regulated Industries

The Challenge: AI Agents and Protected Data

Healthcare organizations want AI agents for coding, documentation, and workflow automation—but face significant compliance challenges. How do you leverage powerful AI capabilities while maintaining HIPAA compliance and protecting PHI?

The answer lies in specialized gateway architectures that create secure boundaries between your protected data and AI services, enabling productive use while maintaining audit trails and compliance controls.

Gateway Architecture Patterns

Data Sanitization Gateway

Automatically strip or mask PHI before data reaches external AI services.

Pattern-based PII/PHI detection

Reversible tokenization for response rehydration

Audit logging of all transformations

Configurable rules by data type and context

Private Deployment Gateway

Self-hosted or BAA-covered AI services within your compliance boundary.

Azure OpenAI with BAA

AWS Bedrock (Claude) with compliance controls

Google Vertex AI with healthcare certifications

Self-hosted open-source models

Synthetic Data Gateway

Generate compliant synthetic datasets for AI training and testing.

Statistically representative fake data

Maintains data relationships without PHI

Useful for development and testing environments

Enables AI experimentation without risk

Federated AI Gateway

Process data locally while leveraging cloud AI capabilities.

Local model inference on sensitive data

Cloud models for non-PHI tasks only

Hybrid architecture with clear boundaries

Model updates without data exposure

Platform Compliance Options

Major AI platforms offer varying levels of healthcare compliance support:

Azure OpenAI Service

Microsoft offers BAAs for Azure OpenAI. Data processed in your Azure tenant with enterprise compliance controls.

HIPAA BAA Available

AWS Bedrock (Claude)

Anthropic's Claude available through AWS with existing healthcare compliance frameworks and BAAs.

HIPAA Eligible via AWS

Google Vertex AI

Gemini models through Vertex AI with Google Cloud's healthcare and life sciences compliance certifications.

Healthcare API Available

Implementation Considerations

Audit Trail Requirements

Every AI interaction involving potential PHI must be logged with user identity, timestamp, data accessed, and AI responses. Design your gateway to capture comprehensive audit data.

Data Residency

Understand where your data is processed and stored. Some AI services may route through multiple regions. Gateway architectures should enforce data residency requirements.

Model Training Concerns

Ensure your AI provider does not use your data for model training. Enterprise agreements typically include data usage restrictions—verify this explicitly.

Minimum Necessary Principle

Design prompts and workflows to use only the minimum PHI necessary for the task. Gateway rules should enforce data minimization automatically.

Common Use Cases

Clinical Documentation

AI-assisted note generation, discharge summaries, and clinical correspondence with PHI sanitization gateways.

Code Generation for EHR

Development teams using AI coding assistants with gateways that prevent accidental PHI exposure in prompts.

Data Analysis & Reporting

Population health analytics and reporting with synthetic data generation for AI-powered insights.

Consulting Services

I help healthcare organizations design and implement compliant AI architectures:

Gateway architecture design tailored to your compliance requirements

Platform selection and BAA evaluation

Implementation guidance for sanitization and audit systems

Developer training on compliant AI usage patterns