Signing the BAA is the easy 1%. The 99% that decides whether you are actually compliant, and breach-free, is how you configure the cloud. This whitepaper is the architect's guide to the compliant landing zone that makes the secure path the default.
Under the shared-responsibility model the provider secures the infrastructure and you secure everything on it, yet 80% of healthcare cloud breaches come from misconfiguration: an unencrypted bucket, an over-permissive role, missing logs.
A compliant landing zone bakes encryption, isolation, least-privilege access, and audit logging into the foundation, so the secure configuration is the default and the misconfiguration cannot happen.
The most expensive misunderstanding in healthcare cloud is where the provider's responsibility ends and yours begins.
The breaches happen not because the controls are hard but because they are left to individual discretion.
A compliant healthcare cloud is not a checklist applied after the fact, it is a landing zone where every workload inherits encryption, isolation, access control, and logging by default.
Necessary but not sufficient. Build PHI workloads only on HIPAA-eligible services covered by the agreement, accessed via AWS Artifact.
Use a multi-account structure and preventive policy-as-code so non-compliant configurations cannot be deployed.
AES-256 with customer-managed keys, TLS 1.2+ in transit, private VPCs, and network segmentation inherited by every workload.
RBAC, MFA everywhere, and no standing broad permissions to PHI.
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