HIPAA Security Architecture for Cloud-Native EHRs

Author: Jean Jacques Nya Ngatchou, MD | November 15, 2025

HIPAA compliance is not a checkbox. For cloud-native EHRs, it requires deliberate architecture decisions around encryption, access control, and audit logging.

Cloud changes the threat model

Traditional on-premise EHRs had a simple security perimeter. Cloud-native EHRs have no perimeter. Data flows through APIs, is stored in managed databases, and is accessed from anywhere.

The three pillars of HIPAA technical safeguards

Encryption (TLS 1.2+ in transit, AES-256 at rest), access control (RBAC with least privilege), and audit logging (immutable, queryable, retained).