Internal documentation — not for public distribution
Protocol Health Club © 2026

HIPAA Compliance Overview

What HIPAA actually requires, what applies to Protocol Health Club, and the implementation roadmap.

What HIPAA Actually Requires

HIPAA does not require VPN or MFA. It requires "reasonable safeguards" — what counts as reasonable depends on your risk level and scale.

RequirementWhat it meansStatus
Encryption in transitHTTPS everywhere⚠️ Planned — Cloudflare
Encryption at restDB + files encrypted⚠️ Partial
Access controlIndividual logins per staff member⚠️ In progress — Next-Auth
Audit logsWho accessed/changed what, when✅ Pipeline trace in SQLite
Automatic logoffSession timeouts⚠️ With Next-Auth
BAA with vendorsSigned agreements with AWS, GHL, Bedrock❌ Not yet signed

Common HIPAA Violations

What actually gets clinics in trouble — not missing MFA, but:

  • Unencrypted data sent over HTTP (not HTTPS)
  • Shared logins — no individual audit trail
  • Using Google Drive / Dropbox without a BAA
  • Unencrypted laptops or servers with PHI
  • No breach notification process

What We Store and Where

DataLocationPHI?Risk
Pipeline run metadataSQLite runs tableNames onlyLow
Step trace (AI input/output)SQLite steps tableBiomarker valuesMedium
Generated client PDF/output/*.pdfYes — full reportHigh
Raw uploaded PDF/tmp/ (transient)YesMedium
GHL contact dataGoHighLevel serversYesHandled by GHL
Prompts sent to ClaudeBedrock (transient, in-flight only)YesLow

Implementation Roadmap

Phase 1 — Now (no AWS admin needed)

  • ☐ Tailscale — private network access, no open ports
  • ☐ Next-Auth login — individual accounts per staff member
  • ☐ Session timeout — auto-logout after 30 min idle

Phase 2 — Soon (one AWS admin ask)

  • ☐ Open port 443 in AWS Security Group
  • ☐ Cloudflare in front — free HTTPS, hides server IP
  • ☐ Nginx reverse proxy

Phase 3 — Before scaling

  • ☐ BAA with AWS — free, request at aws.amazon.com/compliance
  • ☐ BAA with GoHighLevel — check enterprise plan
  • ☐ EBS disk encryption — AWS admin task
  • ☐ Automated backups to S3

Phase 4 — At scale

  • ☐ MFA — one config line in Next-Auth when ready
  • ☐ Secrets moved to AWS Secrets Manager
  • ☐ Penetration test
  • ☐ SOC 2 audit