Pointing an AI Agent at PHI: Drawing the Trust Boundary
How we put an AI agent on PHI without expanding the attack surface — by architecting the model as the least-trusted, most-contained, and most-observable component in the system.
HIPAA-Ready AI · Agentic Systems
Building Secure
AI Pipelines
Embracing the Shift-Left approach in agentic development & AI architecture design — from Day Zero.
Threat-modeled first · Evidence from Day Zero
HIPAA-ready AI and agentic systems for healthcare — secure by design, audit-ready by default.
01 — Pillars
01
Shift-Left by Default
Security enters at the first design session, not the final audit.
02
Built Around PHI
Minimized, de-identified, encrypted — by default, not exception.
03
Agentic-Aware
Autonomous agents open new attack surfaces. We design against them.
04
Audit-Ready by Design
Logging, lineage, and the evidence your assessors expect — already in place.
02 — Shift-Left
Don't bolt security on at the end.
By the time most teams think about security, the data's flowing and the model's live — and every fix is a costly retrofit. We move it forward.
- 01Threat model before architecture locks.
- 02HIPAA requirements shape the design.
- 03Controls in every pipeline stage.
- 04Evidence wired in from Day Zero.
03 — Pipeline
We secure the whole pipeline — not just the model.
Stage 01→
Ingestion
PHI de-identified and minimized before it ever reaches a model.
Stage 02→
Training
Poisoning defenses, least-privilege identities, privacy-preserving methods for data that can't move.
Stage 03
Inference
Input guardrails, PII output filtering, anomaly monitoring, and circuit breakers.
04 — Defenses
Agents change the threat model. We change with it.
OWASP Agentic Top 10MITRE ATLASNIST AI RMF
01
Prompt injection & goal hijacking
Injection defenses at every input surface.
02
Tool misuse & excessive agency
Tool access scoped, gated, and logged.
03
Identity & privilege abuse
Every action runs under a constrained identity.
04
Supply-chain & provenance
Models and dependencies vetted, pinned, and verified.
05
Memory & context poisoning
Integrity controls on what your agent “knows.”
06
Untraceable actions
Every action traces back, logs scrubbed of PHI.
05 — HIPAA
We don't hand-wave HIPAA. We engineer to it.
Privacy Rule
Security Rule
Breach Notification Rule
Compliance is your obligation — our job is to make it defensible. We build to the Privacy, Security, and Breach Notification Rules: access controls, encryption in transit and at rest, audit logging, minimum-necessary handling, and de-identification where PHI doesn't need to flow.
We work within your BAAs and leave you the evidence trail to prove it. When the audit comes, you're walking your assessor through a system built to pass.
06 — Process
From idea to audit-ready, in production.
01
Threat Model & Scoping
Know what you're protecting, and from whom.
02
Secure Architecture
Controls and HIPAA mapped before build.
03
Build & Harden
Least-privilege, secrets management, guardrails baked in.
04
Validate & Red-Team
We attack it before anyone else can.
05
Operate & Evidence
Monitoring and audit docs, ready on Day One.
5+
Years in regulated
healthcare
healthcare
Built against the OWASP Agentic Top 10, MITRE ATLAS, and the NIST AI RMF — the frameworks your assessors already trust.
Case Study · On Medium
Pointing an AI Agent at PHI: Drawing the Trust Boundary
How we put an AI agent on PHI without expanding the attack surface — by architecting the model as the least-trusted, most-contained, and most-observable component in the system.
Read the series →07 — FAQ
Straight answers.
Do you guarantee HIPAA compliance?
No honest vendor can — it's your ongoing legal obligation. We make it defensible: safeguards built in, documented, and audit-ready.
What does shift-left mean for me?
Security at design time, not after launch. Cheaper, and far more effective.
Can you secure agents, not just models?
Yes — it's a core focus. Agents carry risks traditional AppSec doesn't cover.
Will you work with our cloud and tooling?
Yes. We design around your environment, not a rebuild.
08 — Updates
What's new.
CMN Extraction Agent is Live
Happy to announce that our CMN agent is currently up, and aiding in the CMN processing lifecycle!
Building AI in healthcare? Don't bolt security on at the end.
Let's design it in from Day Zero.
Book a Security ReviewStart with a threat model/Get a Day Zero assessment