Security & compliance
Built like PHI depends on it. Because it does.
Security is the architecture here, not a checklist run at the end. A threat model and a security architecture come before any feature that touches patient data, we work only with BAA-eligible vendors, and every state change in the system lands in an audit trail that cannot be edited.
- Tenant isolation
- Row-level, org-scoped queries
- Audit trail
- Append-only, actor and reason
- Vendors
- BAA-eligible only
Posture
The controls, stated plainly.
Every claim below describes how the platform is built, and can be checked against the system in an evaluation. None of it is a certification claim — HIPAA has no certification to hold up, so we describe the architecture instead.
- 01
Access control
Role-based access across 18 defined roles, granted on least privilege and narrowed further by attribute where a role alone is too broad. MFA and SSO, automatic logout and session management, and break-glass access that is always recorded and reviewed.
- 02
Encryption and data handling
Data is encrypted in transit and at rest, and application secrets live in managed secret storage rather than config files. Retention rules, secure deletion, legal hold, and patient data export are handled as product behavior, not one-off database work.
- 03
Tenant isolation
Every record carries its organization, and every query is scoped to it at the data-access layer in PostgreSQL. There is no query path in the application that can read across organizations.
- 04
PHI hygiene
No patient identifiers or clinical detail in application logs, analytics, error reports, push-notification previews, or unsecured SMS. Dispatch offers carry the minimum a clinician needs to accept a visit, and clinical detail stays out of general scheduling fields.
- 05
Resilience
Encrypted backups with restore drills, so recovery is something we have practiced rather than assumed. Disaster recovery and business continuity planning, security monitoring, and a defined incident response path.
- 06
Supply chain
Dependency scanning runs as a blocking gate in CI, so a flagged package stops the build instead of filing a ticket. Vendors are BAA-eligible only, tracked with vendor-risk review and signed agreements on file.
Audit
An audit trail you never have to reconstruct.
When a payer, a surveyor, or your own compliance officer asks what happened to a visit, the answer is already written down. It was written at the moment it happened, by the system, not assembled later from calendars and inboxes.
- Every state change is a record: schedule edits, note signatures, rules-engine overrides, record amendments, authorization decisions.
- Each entry names the actor, the time, and the reason. The reason is captured at the moment of the change, not reconstructed from memory afterwards.
- Entries are append-only. A correction is a new entry — nothing is rewritten or removed.
- Access reports show who opened which record and when. Wound-image access is logged in its own right, and download and print are restricted by role.
Audit trail · 4 Mar
Append only
- 08:12:07Schedulervisit.rescheduledPatient requested a later window
- 09:41:52Field cliniciannote.signedVisit documentation complete
- 10:03:18Clinical leadai_measurement.overriddenMeasured edge differs from the AI estimate
- 11:26:40Director of nursingwound_image.viewedWeekly healing review
- 13:47:11Billing specialistclaim.hold_releasedAuthorization received from payer
- 16:02:33Compliance officerbreak_glass.reviewedAfter-hours access justified and closed
AI governance
AI that never signs the chart.
AI in AtSite OS is decision support and nothing more. It drafts, it suggests, it extracts — and then a licensed human decides.
Everything the model produces is labeled as AI-generated, stays editable, and has to be confirmed by a person before it becomes part of a signed record. There is no auto-signing, no autonomous ordering, and no silent change to anything already in the chart.
Each suggestion is shown with its confidence and the source data it drew from, so a clinician can judge it rather than trust it. Model and prompt versions are recorded alongside the output, which means any suggestion can be traced back to exactly what produced it.
We monitor accuracy and errors in production, including false positives and false negatives, and clinicians can send feedback from the screen where they disagreed. Every AI feature can be disabled on its own and rolled back without disturbing the rest of the platform.
We do not train models on customer patient data without explicit written authorization. AI runs through the Anthropic Claude API, a BAA-eligible vendor, for document extraction, drafting, and operational intelligence.
What AI can do
- Draft a visit note from what the clinician documented in the field
- Suggest wound measurements from a photograph, with its confidence and source image shown
- Flag a possible deterioration trend for a human to look at
- Suggest billing codes and surface the documentation gaps behind them
- Extract structured data from a referral packet or an authorization letter
What AI cannot do
- Sign a note, an assessment, or any part of the legal record
- Place an order or change a plan of care
- Alter a record silently, or after it has been signed
- Take any action that a named human has not confirmed first
Shared responsibility
We provide the controls. You run the program.
AtSite OS provides the technical controls: access and identity, audit, tenant isolation, encryption, retention and deletion, and data export. Your organization runs the compliance program around them — policies, workforce training, risk analysis, business associate agreements, and breach procedures. The platform is designed to support that program and to produce the evidence your privacy officer will ask for.
Ask for our security architecture overview in your demo, and hand it straight to your IT reviewer.
AI drafts. It never signs.
Bring the reviewer
Put your security team in the room.
Bring your security questionnaire to the demo. We would rather answer it live, with the people who built the control, than trade documents for three weeks.