How MedSightAI Meets HIPAA Requirements (on Microsoft Azure)

What we do.
MedSightAI transcribes clinician–patient conversations using Azure AI Speech, generates structured notes with the Azure OpenAI Service, and delivers them securely to the care team through our Azure-hosted application and APIs. Because we process protected health information (PHI), we implement safeguards required by the HIPAA Security Rule (administrative, technical, physical), adhere to the Privacy Rule’s minimum necessary standard, and maintain breach-response procedures under the Breach Notification Rule**.**

Shared Responsibility & BAA

MedSightAI operates on Microsoft Azure services that support HIPAA compliance under a Business Associate Agreement (BAA) with Microsoft. In this shared responsibility model**:**

  • Azure provides secure, compliant infrastructure controls (facilities, physical protections, core cloud services).

  • MedSightAI configures and manages application-level and organizational controls (access, logging, policies, training, incident response).

Safeguard Summary

Administrative Safeguards

  • Risk management: Periodic HIPAA risk analyses, risk register maintenance, and remediation tracking.

  • Policies & training: Workforce HIPAA training, role-based access, sanctions for violations, vendor reviews, and change management.

  • Audit & monitoring: Access log reviews, configuration baselines, security alert monitoring; documented incident response and breach notification procedures.

  • Business continuity: Tested backup/restore, disaster recovery runbooks, and emergency-mode operations.

Technical Safeguards

  • Identity & access: Microsoft Entra ID (Azure AD), RBAC, MFA, least-privilege roles, just-in-time elevation.

  • Network protection: Azure Virtual Networks, NSGs, Private Link/Endpoints to keep PaaS traffic off the public internet; egress restrictions.

  • Encryption: TLS 1.2+ in transit; AES-256 at rest; secrets/keys in Azure Key Vault with rotation, soft-delete, and purge protection (CMK available).

  • Logging & audit trails: Centralized via Azure Monitor/Defender; immutable log storage and retention aligned with evidentiary requirements.

  • Data handling: PHI confined to MedSightAI’s Azure tenant. Azure OpenAI prompts/outputs remain within the Azure boundary and are not used for model training. Minimum-necessary data capture and retention enforced.

Physical Safeguards

  • Facilities & devices: Azure data center controls (badging, surveillance, environmental protections). MedSightAI-managed endpoints use asset management, full-disk encryption, and enforced lock/timeout policies.

Service Data Flows (High Level)

  1. Audio ingestion → Azure AI Speech (STT) in MedSightAI’s tenant.

  2. Transcripts → Azure OpenAI Service for note generation within designated Azure region(s).

  3. Storage & delivery → Encrypted databases and APIs (Azure SQL/Blob) via private networking and RBAC.

  4. Observability → Centralized monitoring and alerts feeding incident response.

Evidence Available to Customers

  • HIPAA risk analysis and risk register

  • Security policies, standards, and training records

  • Data-flow diagrams and asset inventories

  • Access control matrices and sample access reviews

  • Logging/monitoring configurations and sample audit logs

  • Backup/DR test results and incident-response runbooks

  • Microsoft BAA confirmation and in-scope Azure services

External Audits & Customer Assurance

  • Current state: MedSightAI runs an internal HIPAA compliance program and self-assesses against HIPAA requirements.

  • Customer assurance: We provide documented evidence (above) during security reviews and due diligence.

  • Roadmap: Prepared to engage independent auditors (HIPAA/HITRUST mapping or SOC 2 Type II with HIPAA criteria) when required by customers or market demand.

Appendix: HIPAA Security Rule – MedSightAI Control Mapping


Safeguard Implementation HIPAA Type MedSightAI Control Category Specification


Administrative Security Management Required Periodic HIPAA risk Process (Risk analyses, maintained risk Analysis & Risk register, remediation Management) tracking.

               Sanction Policy      Required      Documented sanctions for
                                                  HIPAA violations.

               Information System   Required      Access log reviews,
               Activity Review                    security alerts, baseline
                                                  configuration checks,
                                                  centralized monitoring.

               Assigned Security    Required      Designated Security Officer
               Responsibility                     overseeing HIPAA program.

               Workforce Security   Addressable   Role-based access, HR
               (Authorization,                    onboarding/offboarding
               Supervision,                       controls.
               Termination)                       

               Information Access   Required      RBAC in Azure AD, least
               Management                         privilege, periodic access
                                                  reviews.

               Security Awareness & Required      Workforce HIPAA/privacy
               Training                           training, phishing
                                                  simulations, refresher
                                                  courses.

               Security Incident    Required      Documented incident
               Procedures                         response plan with breach
                                                  notification procedures.

               Contingency Plan     Required      Tested backup/restore, DR
               (Backup, DR,                       runbooks, emergency-mode
               Emergency Mode,                    operations tested annually.
               Testing)                           

               Evaluation           Required      Annual HIPAA security
                                                  self-assessment and
                                                  readiness reviews.

               Business Associate   Required      BAA with Microsoft for
               Contracts                          Azure services; vendor
                                                  reviews for other third
                                                  parties.

Physical Facility Access Required Azure data center Controls protections (badging, surveillance, environmental safeguards).

               Workstation Use      Required      Policies for workforce
                                                  devices, screen-lock,
                                                  no-PHI-on-personal-device
                                                  enforcement.

               Workstation Security Addressable   Asset inventory, disk
                                                  encryption, endpoint
                                                  management (MDM).

               Device & Media       Required      Asset tracking, secure
               Controls                           disposal process, encrypted
                                                  backups.

Technical Access Control Required Entra ID unique logins, JIT (Unique ID, elevation, auto-lock Emergency Access, policies, AES-256 at rest, Auto Logoff, TLS 1.2+ in transit. Encryption)

               Audit Controls       Required      Centralized logs in Azure
                                                  Monitor/Defender, immutable
                                                  storage, retention for
                                                  evidentiary needs.

               Integrity            Addressable   Hashing & checksums in
                                                  storage, change monitoring
                                                  via Defender.

               Person/Entity        Required      MFA, SSO with Entra ID.
               Authentication                     

               Transmission         Required      TLS 1.2+/1.3 enforced;
               Security                           private endpoints/Private
                                                  Link for internal traffic.

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