Everything You Should Know about AWS HIPAA Compliance

Quick Summary

What is AWS HIPAA Compliance?

AWS itself is not HIPAA certified (because no such certification exists).
Instead, AWS offers:

• A HIPAA BAA you can sign
• A list of HIPAA-eligible services (like S3, EC2, Lambda, etc.)
• Tools for encryption, access control, auditing, etc.

But you, the customer, must:

• Build your system securely using AWS tools
• Encrypt PHI data
• Restrict access
• Monitor for security issues

AWS provides the tools, but it’s your responsibility to use them correctly to ensure HIPAA compliance.

How to Build HIPAA-Compliant Architectures on AWS

Building a HIPAA-compliant architecture on AWS requires secure cloud services, proper data handling, and strict access controls. While AWS offers the tools and infrastructure, healthcare organizations must implement and manage them responsibly.

Step 1: Sign the AWS BAA and Identify PHI Scope

Start by signing the AWS Business Associate Addendum (BAA), which authorizes the use of AWS’s HIPAA-eligible services. Next, clearly identify where Protected Health Information (PHI) exists in your systems and map data lifecycle: collection → processing → storage → transmission → deletion.

Step 2: Choose HIPAA-Eligible AWS Services and Separate PHI Workloads

Only use HIPAA-eligible AWS services covered under the BAA, such as EC2, S3, RDS, and Lambda. To reduce risk and simplify compliance, separate PHI-related workloads by placing them in dedicated AWS accounts or isolated environments.

Step 3: Design a Secure Network for PHI

Deploy PHI systems inside Virtual Private Clouds (VPCs), preferably within private subnets (hidden parts of the cloud not exposed to the internet), to limit exposure. Use security groups (rules that allow or block traffic for specific resources) and network ACLs (additional security rules for entire subnets) to control incoming and outgoing traffic carefully. For remote access, rely on secure methods like VPN or AWS Direct Connect to ensure data stays protected.

Step 4: Encrypt PHI Data at Rest and in Transit

Enabling encryption using AWS Key Management Service (KMS) can protect data stored in databases, backups, and storage. Likewise, it can safeguard data traveling between services and users by enforcing secure transmission protocols such as TLS or SSL.

Step 5: Implement Strong Identity and Access Controls

Manage permissions carefully by applying the principle of least privilege through AWS Identity and Access Management (IAM). This means giving users and services only the access they require. To strengthen security further, multi-factor authentication (MFA) must be required for all privileged users, and temporary security credentials must be used whenever possible to reduce risks.

Step 6: Enable Logging and Continuous Monitoring

Activate AWS CloudTrail to log all API activities, providing a clear audit trail. Complement this with continuous monitoring tools like Amazon CloudWatch and GuardDuty to detect unusual or suspicious behaviour promptly. Store logs securely and review them regularly to maintain compliance and security.

AWS HIPAA Compliance Best Practices

Once your AWS HIPAA-compliant architecture is in place, maintaining compliance requires more than just the proper setup. It involves day-to-day discipline, regular checks, and a culture of responsibility. Here are some practical AWS HIPAA compliance best practices to help you stay compliant over time:

1. Keep Policies and Documentation Updated

HIPAA Compliance on AWS isn’t static. As your AWS environment grows or changes, make sure your internal policies, documentation, and data handling procedures are updated regularly. This helps avoid confusion and prepares you for audits or assessments anytime.

2. Use Automation to Enforce Compliance

Manual checks can miss things. Use automation tools like AWS Config or AWS Systems Manager to monitor your environment for misconfigurations continuously. Automated alerts can help you respond faster to issues before they become compliance threats.

3. Perform Regular Internal Reviews

Schedule periodic AWS security audits of your infrastructure, permissions, and data flows. Even if nothing seems broken, risks can emerge over time, especially as services, roles, or team members change. An internal audit mindset helps catch issues early.

4. Test Incident Response Plans

Having a response plan is good, but testing it is better. Run simulations or tabletop exercises to see how your team would handle a data breach or security event involving PHI. This improves readiness and reduces panic during real incidents.

5. Monitor Vendors and Integrations

If your setup includes third-party tools or external partners, ensure they meet HIPAA standards too. Recheck their compliance status regularly and have agreements in place that clearly define responsibilities and roles.

6. Promote a Culture of Compliance

Technology alone doesn’t keep data safe, people do. Train your team regularly on security awareness and HIPAA responsibilities. Encourage habits like reporting suspicious behavior and following access controls, even for routine tasks.

Conclusion