Agents for Healthcare
Building production agents for clinical decision support, patient documentation, and medical Q&A — with HIPAA compliance, safety guardrails, and the principle that AI assists clinicians but never replaces clinical judgment.
Quick Reference
- →HIPAA compliance requires a BAA with your LLM provider — no BAA means no PHI in prompts, period
- →Never replace clinical judgment: the agent suggests, the clinician decides
- →Cite medical literature (PubMed, UpToDate) for every clinical claim — reject uncited outputs
- →Implement emergency detection that immediately escalates life-threatening queries to a human
- →PII middleware must strip PHI from logs, traces, and any data sent to third-party services
HIPAA Compliance Architecture
HIPAA is not a suggestion — it is a federal requirement with penalties up to $1.5M per violation category per year. Before you write a single line of agent code, you need the compliance infrastructure in place. The most critical piece: a Business Associate Agreement (BAA) with every vendor that touches Protected Health Information (PHI).
| Component | HIPAA Requirement | Implementation |
|---|---|---|
| LLM Provider | BAA required if PHI is in prompts | Use Azure OpenAI or AWS Bedrock (BAA available); or strip PHI before calling the API |
| Vector database | BAA required if storing PHI embeddings | Self-host Qdrant/Weaviate or use a HIPAA-compliant managed service |
| Logging / tracing | PHI must not appear in logs | PII middleware strips PHI before logging; use audit-grade storage |
| Data at rest | Encryption required (AES-256) | Encrypt vector stores, databases, and file storage |
| Data in transit | TLS 1.2+ required | Enforce HTTPS everywhere; no plaintext API calls |
| Access control | Minimum necessary standard | Role-based access; clinicians see only their patients' data |
If your LLM provider does not offer a BAA, you cannot send PHI in prompts. Period. Use the PII middleware to strip all PHI before the API call, and restore it in the response for authorized users only.