Healthcare apps fail HIPAA audits not because teams skip encryption — they fail because of access logging, BAAs with subprocessors, and uncontrolled PHI flow into analytics tools. Here’s the production architecture checklist we use for every Codewyse healthcare client.
Encryption everywhere
TLS 1.3 in transit, AES-256 at rest, application-level field-encryption for sensitive PHI columns. Use a managed KMS (AWS KMS, GCP KMS) and rotate keys annually.
Access control with least-privilege RBAC
Define roles narrow enough that revoking one doesn’t break three workflows. Audit every PHI read AND write. Quarterly access reviews are a HIPAA requirement, not a nice-to-have.
Subprocessor BAAs
Every vendor that touches PHI needs a Business Associate Agreement. AWS, GCP, Azure, Datadog, Sentry, Twilio, SendGrid all offer them — but you must request and sign them. No BAA, no PHI.
Analytics without PHI leakage
Posthog, Mixpanel, Google Analytics — none can receive PHI. Build a thin event-mapping layer that strips PHI before it reaches your analytics SDKs. One forgotten field is a reportable breach.
Backup and disaster recovery
Daily encrypted backups, quarterly restore drills, documented RTO/RPO. HIPAA expects you to prove you can recover, not just say you can.
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