HIPAA is often seen as a dull legal set of rules, but for a developer, it has a direct impact on code and architecture. Let’s break down what the standard actually requires.
In simple terms, HIPAA requires that Protected Health Information (PHI):
- is accessible only to authorized personnel,
- is transmitted and stored securely,
- is auditable (who accessed it and when),
- can be restored after failures.
Where HIPAA Actually Affects .NET Code
1. Authentication and Authorization
- Strict roles, so-called RBAC (role-based access control): minimal privileges for each account and no “shared” accounts.
- Support for access auditing.
2. Logging
Sometimes less logging is better. The key points:
- PHI must not end up in logs. Personal information in stack traces is a problem. So sometimes it’s better not to log at all than to log “carefully.”
3. Encryption
Encryption should always be applied, both for stored data and data in transit. This includes:
- HTTPS,
- encrypted storage in the cloud,
- no secret words or passwords in connection strings, etc.,
- all secrets stored in a Key Vault.
4. Cloud and Security
Using the cloud ≠ automatic security. Simply using Azure or AWS does not make a system HIPAA-compliant.
Typical pitfalls:
- publicly accessible storage accounts,
- overly broad IAM permissions,
- test environments with real data.
For a .NET developer, this means:
- understanding basic cloud security settings,
- not treating infrastructure as “someone else’s responsibility,”
- participating in deployment architecture discussions.
HIPAA is always a shared responsibility.
5. Audit and Reproducibility
HIPAA assumes that:
- user actions can be tracked,
- data changes can be explained,
- the system behaves predictably.
In applications, this translates to:
- thoughtful database design,
- audit trails,
- soft delete and versioning.
Conclusion
HIPAA does not require perfect code or legal expertise.
It requires conscious engineering decisions, careful handling of data, and well-thought-out architecture. If designed properly, HIPAA compliance becomes part of standard engineering discipline.