This page is structured as a working reference architecture document for healthcare cloud - the kind we'd present in your next architecture review. If the architecture is right, the engagement reasoning is obvious.

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6 layers

Reference architecture layers we defend

4 weeks

The fixed-scope architecture review

3 ways

Ways healthcare organizations engage Logiciel

Identity is the first design surface in any healthcare cloud architecture because every subsequent layer depends on it. The reference architecture we defend:

This layer is where most healthcare cloud architecture audits surface their first material findings. We treat identity as architecture, not as IT hygiene.

Details

The Layer Every Healthcare Cloud Architecture Has to Get Right First.

Details · 01

Centralized identity provider (Okta, Azure AD, Ping) federating across cloud accounts and SaaS estate. Workforce identity, machine identity, and patient/consumer identity each handled in their respective planes - not collapsed.

Details · 02

Federated IAM across cloud providers with consistent role naming, permission boundaries, and just-in-time elevation patterns. AWS IAM Identity Center, Azure Entra, or GCP IAM federated through SSO.

Details · 03

Just-in-time access elevation for production environments

Standing access is the exception, not the default.

Details · 04

PHI access logging at the IAM layer, not retroactively at the data layer. Every PHI-adjacent action attributable to an identity, with audit trail retained per HIPAA and per the data classification of the resource.

Details · 05

Machine identity hardening

short-lived credentials, workload identity federation (no long-lived service account keys), credential rotation governance.

What we build

The Layer That Determines What's Possible Above It.

Multi-account / multi-subscription / multi-project segmentation by default. Workloads with materially different PHI exposure live in separate cloud accounts with explicit, audited connectivity between them.

What we build

Hub-and-spoke or transit-gateway topology for shared services (egress, security inspection, on-prem connectivity). Single chokepoints make audit and compliance defensible.

What we build

Private connectivity for PHI flows: VPC endpoints (AWS PrivateLink), Private Endpoints (Azure), Private Service Connect (GCP). PHI traffic that doesn't traverse the public internet, by design.

What we build

Egress filtering and inspection for any environment with PHI. Workloads can't exfiltrate accidentally because the network forbids it.

What we build

Connectivity to legacy and on-prem through ExpressRoute, Direct Connect, Interconnect, or SD-WAN - designed deliberately, not accumulated.

What we build

The Layer Where HIPAA Meets the Cloud's Default Behavior.

Encryption-at-rest with customer-managed keys (CMK) for any storage holding PHI. Provider-managed encryption is insufficient evidence in regulatory contexts.

↳ What we build

Key management hardened: dedicated KMS keys per workload sensitivity tier, rotation policies enforced, key access audited.

↳ What we build

PHI tagging at the resource layer so cost, access, and lineage tooling can reason about PHI as a first-class attribute.

↳ What we build

Data residency designed deliberately - single-region for residency-sensitive workloads, multi-region for resilience, with the trade-off documented for the compliance team.

↳ What we build

Backup, retention, and immutability policies matching HIPAA retention requirements and your specific data governance posture. Backups themselves treated as PHI when applicable.

↳ What we build

Highlights

The Layer Where Modern Cloud-Native Patterns Meet Healthcare Constraints.

Container-first for new workloads.

What it meansKubernetes (EKS, AKS, GKE) for stateful and complex workloads; serverless (Lambda, Functions, Cloud Run) for event-driven and low-frequency workloads. The choice per workload, not as a global default.

Managed services preferred over self-managed

What it meanswhere the BAA and feature set support the workload. Reduced operational burden is real value when paired with explicit accountability for the managed-service control gaps.

Multi-region active-active for revenue-critical workloads

What it means(patient-facing portals, scheduling, telehealth). Active-passive with documented RTO/RPO for operational workloads. Single-region acceptable for back-office workloads where the trade-off is explicit.

Hybrid cloud architecture where legacy demands it.

What it meansEHR adjacencies, legacy clinical systems, and on-prem regulatory infrastructure connect to cloud through ExpressRoute / Direct Connect with the architecture designed deliberately, not absorbed.

Multi-cloud where regulatory, vendor risk, or workload economics justify it.

What it meansMost healthcare organizations end up multi-cloud not by design but by accumulation; we redesign it deliberately.

Under the hood

The Layer That Carries the BAA, the Audit, and the Regulator Conversation.

HIPAA-aligned posture

Security Rule and Privacy Rule controls mapped to specific architectural components, with evidence collection automated.

Included

HITRUST control mapping for organizations pursuing certification

designed in, not retrofitted.

Included

SOC 2 Type II evidence collection for HealthTech SaaS providers

control evidence flowing automatically into a SOC 2 collection point (Drata, Vanta, Secureframe, or self-hosted).

Included

BAA execution at the platform layer, with downstream BAAs (cloud provider, managed services, third-party SaaS) cataloged and current.

Included

Continuous compliance posture management

AWS Config, Azure Policy, GCP Organization Policy, plus third-party CSPM (Wiz, Orca, Lacework) where the workload sensitivity justifies it.

Included

Incident response runbooks for PHI exposure, regulatory reporting events, and security incidents - documented, exercised, audit-ready.

Included

What we build

The Layer That Determines Whether the Architecture Earns Continued Investment.

Observability across infra, applications, and PHI access

metrics, traces, logs, security events. Centralized SIEM for security-sensitive signals.

SLOs on revenue-critical and clinically-critical workloads.

Patient portal availability, scheduling availability, telehealth latency. SLO-driven on-call.

Incident response discipline

Severity classification, blameless postmortems, incident metrics tracked over time.

FinOps applied to healthcare workloads

which run distinctively cost-sensitive at scale. Reserved-instance / savings-plan / committed-use discipline, idle resource reaping, intelligent tiering, multi-cloud cost comparability.

Cost allocation per service line / business unit

so the AI initiative, the EHR adjacency platform, and the patient portal each carry their own cost story.

In focus

The Four-Week Architecture Review.

Week 1

Current-state assessment. We catalog your cloud estate - accounts, networks, workloads, PHI surface, compliance posture, operational maturity.

Week 2

Gap analysis. We compare current state to the reference architecture layer by layer. Gaps are scored by HIPAA risk, operational risk, and cost.

Week 3

Target architecture and roadmap. Layered remediation roadmap with engineering effort, sequencing, and the right partner mix (Logiciel, internal, alternative vendors) for each remediation.

Week 4

Executive readout. Formal readout to your CIO, CISO, or VP Cloud Architecture with the artifact your leadership team can use to fund the remediation work.

In focus

Three Ways Healthcare Organizations Engage Logiciel for Cloud Architecture.

The math doesn't work. AI reliability is a platform problem with a real engineering specialization behind it - not a side project a feature engineer absorbs.

Architecture Review (4 weeks, fixed scope)

The diagnostic engagement above. Most common starting point.

Architecture Design & Implementation Lead (6–18 months).

Logiciel architects design and lead the implementation of the target architecture alongside your cloud engineering organization.

Fractional Chief Cloud Architect (ongoing).

A senior Logiciel cloud architect serves as your fractional architecture leader, typically 8–16 hours per week, for multi-year programs.

Selected work

Tailored engineering for your industry.

Zeme · Real Estate Cut development costs 50% and launched 3× faster with dedicated dev teams.

Real Estate

Cut development costs 50% and launched 3× faster with dedicated dev teams.

Leap · Construction Scaled to 7-figure ARR with AI-augmented software teams.

Construction

Scaled to 7-figure ARR with AI-augmented software teams.

KW · Real Estate 56M+ workflows automated, saving agents 30% time with AI-powered tasks.

Real Estate

56M+ workflows automated, saving agents 30% time with AI-powered tasks.

Resources

Insights for tech leaders.

Whitepaper · PDF

Cloud Architecture for Compliant Healthcare Workloads

Whitepaper · PDF

The Agentic AI Architecture Blueprint

Whitepaper · PDF

AI-Native Product Architecture Blueprint

In their words

What our clients say.

Teams that needed to ship fast, and did. Here's what partnering with Logiciel felt like from the inside.

I would highly recommend them to anyone looking to scale quickly or needing support in engineering, product, or QA.

Patrick Fingles

CEO, Leap

We don't just call them Logiciel; they're part of the Zeme team. Within the first week they were contributing meaningfully to our codebase.

Elior Alayev

Founder & CEO, Zeme

The Logiciel team worked tirelessly and built everything we needed, with security and best practices across our entire platform. It allowed us to become #1 in our industry, and we couldn't have done it without them.

David Buzzelli

Co-Founder, JobProgress

Questions

Frequently asked questions.

What are cloud architecture services in a healthcare context?

Cloud architecture services in healthcare cover the design, assessment, and implementation of cloud platforms that support clinical, operational, financial, and AI workloads under HIPAA, HITRUST, SOC 2, and applicable state regulations. The work spans identity and IAM design, network segmentation, data and storage architecture, workload architecture (containers, serverless, managed services), security and compliance posture, and the operations layer that keeps the architecture defensible over time.

Multi-cloud, hybrid, or single-cloud - what's right for healthcare?

The right answer is workload-specific and shaped by three factors: regulatory and vendor-risk requirements (do you need to demonstrate cloud-vendor neutrality to regulators or enterprise customers), legacy integration depth (how much on-prem clinical infrastructure has to coexist with cloud workloads), and workload economics (do specific workloads run materially better on a specific cloud). Most US healthcare organizations end up hybrid + multi-cloud not by design but by accumulation; the architecture review redesigns deliberately.

How do you handle PHI in cloud architectures?

PHI handling is designed at every layer - identity (access logging, JIT elevation), network (private connectivity, segmentation), data (customer-managed encryption keys, residency, retention), workload (BAA-eligible services only, accountability for control gaps in managed services), and security (HIPAA-aligned posture, evidence collection automated). PHI is treated as a first-class architectural attribute, not as a compliance retrofit.

Which cloud providers do you work with?

AWS, Microsoft Azure, Google Cloud, Oracle Cloud Infrastructure (where workloads benefit), and on-prem / private cloud environments where required. Logiciel's healthcare cloud practice is vendor-neutral - we design against the right architecture and recommend a provider mix based on workload requirements, existing investments, and BAA posture.

How long does it take to remediate a healthcare cloud architecture?

The 4-week architecture review produces a prioritized roadmap with effort estimates. Remediation programs typically run 6–18 months for material architectural gaps and ongoing for incremental improvement. The pace is determined by organizational change capacity and the cloud estate scale, not by Logiciel's capacity.

What does a cloud architecture engagement cost?

The 4-week architecture review is a fixed-price engagement. Architecture Design & Implementation Lead engagements run on a multi-quarter engagement model scaled to scope. Fractional Chief Cloud Architect engagements run on quarterly retainer. The review produces specific numbers for your context.

Will you work with our existing cloud team?

Yes - that's the design. Most engagements partner with an existing cloud engineering organization. We design for collaboration, knowledge transfer, and ongoing internal operation. Several long-term healthcare engagements have evolved into a smaller partnership footprint as the internal team grew into the architectural maturity the engagement produced.

Let's build

The Four-Week Review That Produces a Working Reference Architecture for Your Healthcare Cloud.

The architecture review is the smallest credible engagement that produces a defensible target architecture and a prioritized remediation roadmap. Most healthcare cloud leaders use the artifact to align the executive team and the security/compliance function on a multi-quarter remediation program.

Book a cloud architecture review

Cloud Architecture Services for Healthcare.

See Logiciel in action.

The Layer Every Healthcare Cloud Architecture Has to Get Right First.

Centralized identity provider (Okta, Azure AD, Ping) federating across cloud accounts and SaaS estate. Workforce identity, machine identity, and patient/consumer identity each handled in their respective planes - not collapsed.

Federated IAM across cloud providers with consistent role naming, permission boundaries, and just-in-time elevation patterns. AWS IAM Identity Center, Azure Entra, or GCP IAM federated through SSO.

Just-in-time access elevation for production environments

PHI access logging at the IAM layer, not retroactively at the data layer. Every PHI-adjacent action attributable to an identity, with audit trail retained per HIPAA and per the data classification of the resource.

Machine identity hardening

The Layer That Determines What's Possible Above It.

Multi-account / multi-subscription / multi-project segmentation by default. Workloads with materially different PHI exposure live in separate cloud accounts with explicit, audited connectivity between them.

Hub-and-spoke or transit-gateway topology for shared services (egress, security inspection, on-prem connectivity). Single chokepoints make audit and compliance defensible.

Private connectivity for PHI flows: VPC endpoints (AWS PrivateLink), Private Endpoints (Azure), Private Service Connect (GCP). PHI traffic that doesn't traverse the public internet, by design.

Egress filtering and inspection for any environment with PHI. Workloads can't exfiltrate accidentally because the network forbids it.

Connectivity to legacy and on-prem through ExpressRoute, Direct Connect, Interconnect, or SD-WAN - designed deliberately, not accumulated.

The Layer Where HIPAA Meets the Cloud's Default Behavior.

The Layer Where Modern Cloud-Native Patterns Meet Healthcare Constraints.

Container-first for new workloads.

Managed services preferred over self-managed

Multi-region active-active for revenue-critical workloads

Hybrid cloud architecture where legacy demands it.

Multi-cloud where regulatory, vendor risk, or workload economics justify it.

The Layer That Carries the BAA, the Audit, and the Regulator Conversation.

HIPAA-aligned posture

HITRUST control mapping for organizations pursuing certification

SOC 2 Type II evidence collection for HealthTech SaaS providers

Continuous compliance posture management

The Layer That Determines Whether the Architecture Earns Continued Investment.

Observability across infra, applications, and PHI access

SLOs on revenue-critical and clinically-critical workloads.

Incident response discipline

FinOps applied to healthcare workloads

Cost allocation per service line / business unit

The Four-Week Architecture Review.

Week 1

Week 2

Week 3

Week 4

Three Ways Healthcare Organizations Engage Logiciel for Cloud Architecture.

Architecture Review (4 weeks, fixed scope)

Architecture Design & Implementation Lead (6–18 months).

Fractional Chief Cloud Architect (ongoing).

Tailored engineering for your industry.

Cut development costs 50% and launched 3× faster with dedicated dev teams.

Scaled to 7-figure ARR with AI-augmented software teams.

56M+ workflows automated, saving agents 30% time with AI-powered tasks.

Insights for tech leaders.

Cloud Architecture for Compliant Healthcare Workloads

The Agentic AI Architecture Blueprint

AI-Native Product Architecture Blueprint

What our clients say.

Frequently asked questions.

The Four-Week Review That Produces a Working Reference Architecture for Your Healthcare Cloud.