Add government here too (along with all the firms that service government customers)

Add healthcare. Cannot send our patients data to a cloud provider

A ton of EMR systems are cloud-hosted these days. There’s already patient data for probably a billion humans in the various hyperscalers.

Totally understand that approaches vary but beyond EMR there’s work to augment radiologists with computer vision to better diagnose, all sorts of cloudy things.

It’s here. It’s growing. Perhaps in your jurisdiction it’s prohibited? If so I wonder for how long.

In the US, HIPAA requires that health care providers complete a Business Associate Agreement for any other orgs that receive PHI in the course of doing business [1]. It basically says they understand HIPAA privacy protections and will work to fulfill the contracting provider's obligations regarding notification of breaches and deletion. Obviously any EMR service will include this by default.

Most orgs charge a huge premium for this. OpenAI offers it directly [2].

1: https://www.hhs.gov/hipaa/for-professionals/covered-entities...

2: https://help.openai.com/en/articles/8660679-how-can-i-get-a-...

> Most LLM companies might not even offer it.

I'm pretty sure the LLM services of the big general-purpose cloud providers do (I know for sure that Amazon Bedrock is a HIPAA Eligible Service, meaning it is covered within their standard Business Associate Addendum [their name for the Business Associate Agreeement as part of an AWS contract].)

https://aws.amazon.com/compliance/hipaa-eligible-services-re...

Sorry to edit snipe you; I realized I hadn't checked in a while so I did a search and updated my comment. It appears OpenAI, Google, and Anthropic also offer BAAs for certain LLM services.

I worked a big health care company recently. We were using Azure's private instances of the GPT models. Fully industry compliant.

Even if it's possible, there is typically a lot of paperwork to get that stuff approved.

There might be a lot less paperwork to just buy 50 decent GPU's and have the IT guy self-host.

Europe? US? In Finland doctors can send live patient encounters to azure openai for transcription and summarization.

In the US, it would be unthinkable for a hospital to send patient data to something like ChatGPT or any other public services.

Might be possible with some certain specific regions/environments of Azure tho, because iirc they have a few that support government confidentiality type of stuff, and some that tout HIPAA compliance as well. Not sure about details of those though.