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HIPAA → Best Practices
Best practices for HIPAA-compliant healthcare web hosting
Private practices and health tech companies don’t get hacked because they lack tools. They get hacked because their web stack grows faster than their guardrails.
So what does that mean for tech leaders who need reliability, security, and predictable costs without a 50-person infra team? Let’s get into it.
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1. Understand why HIPAA hosting is different today
Healthcare delivery moved from the clinic to the browser. Portals exchange lab results and care plans, home health relies on mobile backends, and telehealth turned edge devices into PHI endpoints. Your web tier is now part of care delivery, not just marketing.
- PHI everywhere: Portals, APIs, mobile apps, data pipelines, and vendor integrations all handle PHI, not just the EHR
- Third-party blast radius: Your risk increasingly sits with vendors and hosting partners; a BAA alone doesn’t reduce likelihood or impact
- Enterprise requirements, lean teams: Mid-market providers still need enterprise controls, SLOs, and auditability—just without enterprise headcount.
2. Go beyond the BAA
A Business Associate Agreement is necessary, but it doesn’t encrypt a database or rotate a key. Treat the BAA as the legal envelope around controls you can actually evidence.
- Know your PHI flows: Map where PHI is created, processed, stored, transmitted, and destroyed; include logs, caches, temp files, and backups
- Encryption by default: TLS 1.2+ in transit; AES-256 at rest for databases, object storage, volumes, and backups; managed key rotation with separation of duties
- Logging and detection you can audit: Centralized logs, encrypted storage, EDR/NDR, coverage checks for new hosts and services, and alert runbooks
- Patching with SLOs: OS and middleware patch windows, emergency zero-day process, and change tickets that show “what/when/who”
- DR you’ve rehearsed: Defined RPO/RTO per app; encrypted, off-platform backups; quarterly restore tests with artifacts
- Vendor governance: Inventory every SaaS/PaaS that touches PHI, capture their controls, and tie them to your own risk register.
3. Design for compliance that scales
Growth creates compliance drift—usually during “just spin it up” moments. Build friction in the right places so speed and safety stop competing.
- Gated app intake: Require a lightweight questionnaire for any new app or vendor (hosting location, data types, auth model, logging, backup expectations)
- Change discipline: Codify firewall rules, golden images, and base hardening; use infrastructure-as-code where feasible to make “secure” the default
- Live inventories: Service catalog, asset list, and dependency map owned by IT; auto-discover new nodes and insist on day-0 logging/EDR enrollment
- Post-M&A hardening sprint: Identity consolidation, certificate review, shared secrets rotation, and quick wins (exposed ports, stale admin accounts, weak cipher suites)
4. Build reliability and uptime into your security model
Availability and security aren’t separate goals—they reinforce each other. Case in point: many attacks begin with a DDoS or outage event that distracts teams and weakens defenses.
Design hosting environments with built-in failure domains and tested recovery plans so downtime never becomes the attacker’s entry point.
- HA where it helps: Hardware HA for critical infra, database replication, load balancers, and per-tier failover plans sized to your traffic patterns
- Real failure isolation: N+1 or better for power, cooling, and network; split control plane and data plane; avoid single shared storage for unrelated workloads
- Backups done right: Encrypted at source and in transit; stored in a secondary region or provider; protected from your primary credentials; weekly restore drills
- Proactive operations: Environmental monitoring (power/weather), generator tests, paging on synthetic checks for portals, APIs, and DNS health
- Measurable SLOs: Uptime and latency targets per user-facing path; error budgets to guide change freezes around seasonal surges (open enrollment, flu season)
6. Use proven architecture patterns
These patterns fit mid-market providers with enterprise requirements and lean teams.
- Single-DC HA + fast DR: Active-active within the DC; backups replicated out-of-region; RTO in hours, RPO in minutes for patient-facing apps
- Dual-DC active-passive: Hot/warm for portals and care-critical APIs; health checks and scripted failover; quarterly game-days to validate
- Zero-trust edge: WAF, DDoS protection, IP allowlists for admin paths, mutual TLS for service-to-service, and per-tenant network segments for PHI
- Secure admin access: Bastion hosts with MFA and short-lived certificates; no direct SSH/RDP from the internet; session recording on privileged access
- Observability mapped to audits: Logs and metrics retained per policy; dashboards for access, patch cadence, backup health, and change events
7. Evaluate hosting vendors against a compliance checklist
Choosing a HIPAA hosting provider isn’t just about ticking boxes on a sales sheet. The right partner should prove they can deliver security, uptime, and audit support in ways that match your compliance obligations.
A structured HIPAA-compliant hosting checklist keeps vendor evaluations consistent and prevents gaps that only surface during an incident or audit.
- HIPAA posture: BAA, HIPAA-aligned controls, willingness to share audit artifacts (policies, SOC reports where applicable), and breach notification commitments
- Security stack and practice: EDR, WAF, vulnerability management cadence, etc.
- DR maturity: Documented RPO/RTO, off-platform backups, recent restore test evidence, and failover runbooks
- Support that shows up: 24/7 staffed engineers, named solution architect, change management process, and escalation SLAs
- Pricing transparency: Fixed vs variable line items, scale-up/down terms, and exit plan (data export, assistance, and costs)
- Compliance operations: Log retention options, access review cadence, ticketing integration, and audit assistance in scope
8. Avoid common pitfalls
Most incidents come from process gaps, not missing tools. These are the patterns we see before bad days.
- BAA theater: Contract signed; no encryption, no logs, no DR test
- Unmanaged growth: New nodes not added to firewalls, EDR, backups, or mature change management policies
- Static credentials: Stale admin accounts after turnover or M&A; shared passwords lingering in wikis
- Backup mirages: Snapshots living on the same platform and encrypted by the same compromised keys
- Hidden spend: Bandwidth and egress surprises, or “priority support” upcharges that only appear after an incident
9. Learn from healthcare organizations already succeeding
The most convincing evidence of effective HIPAA hosting comes from organizations already using it in the field.
Real-world examples show how clinics, home health providers, and multi-site practices are scaling securely while keeping costs predictable. These stories highlight what success looks like and the tangible benefits IT leaders can expect.
- Home health platforms: Stable mobile backends so clinicians can route, chart, and bill in the field; no more “everyone is idle in a parking lot” moments
- Multi-site clinics: Predictable scale for portals and scheduling during surges; fewer late-night “open the port on server X” emergencies
- Practice roll-ups and divestitures: Standard landing zones so newly acquired apps get identity, logging, and backups on day one
10. Implement a phased roadmap for HIPAA hosting
Move in phases. Reduce risk early. Capture proof as you go.
- Assess: Map PHI data flows and dependencies; baseline current controls; identify gaps in logging, access, patching, and DR
- Design: Pick HA/DR pattern per app; define RPO/RTO and SLOs; choose pricing model that caps spend
- Migrate: Pilot the most business-critical web app; dual-run when needed; performance test; validate logs, backups, and access
- Harden: Finalize IAM, segment networks, lock down admin paths, rotate shared secrets, and make backups immutable/off-platform
- Operate: Monthly patch SLOs, quarterly restore tests, semiannual tabletop exercises, and continuous service catalog updates
HIPAA web hosting FAQs
Next steps for HIPAA web hosting
HIPAA web hosting is about outcomes you can prove: protected PHI, resilient uptime, and costs your CFO can predict. Done right, your web stack stops being a cost center and starts enabling growth.
Your next move is simple: run a two-hour PHI data-flow and DR reality check—confirm what’s encrypted, what’s backed up off-platform, and what you’ve actually restored in the last 90 days. Use that to pick an architecture pattern and lock in a fixed monthly price.
And remember that website and data security start with HIPAA compliant hosting. That’s where Liquid Web comes in. We offer the widest range of compliance-ready hosting solutions, with 24/7 support, seamless scalability, unbeatable speeds, and more.
Click below to explore options or start a chat with one of our hosting experts now.
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Additional resources
What is HIPAA-compliant hosting? →
A complete beginner’s guide
Why health care businesses require HIPAA compliant databases: 4 key benefits →
How do you find a reliable database provider?
HIPAA guide for small business →
A complete resources for medical SMBs
Kelly Goolsby has worked in the hosting industry for nearly 16 years and loves seeing clients use new technologies to build businesses and solve problems. Kelly loves having a hand in developing new products and helping clients learn how to use them.