HIPAA-Ready Cloud Landing Zone for Healthcareon AWS and Terraform
A global IVF platform serving 250+ fertility clinics ran its entire estate inside one AWS account, with patient data sharing a boundary with test data. Kansoft rebuilt the foundation as a multi-account landing zone on Terraform — provisioning fell from roughly 48 hours to minutes, and audit readiness became continuous rather than a project.
250+ clinics, four regions, one AWS account.
Meddilink runs an EMR platform built specifically for assisted reproductive technology, managing the full fertility patient lifecycle from first consultation through to live birth outcomes. More than 250 clinics across India, Europe, the Middle East and emerging APAC markets depend on it.
That footprint puts the platform in several regulatory regimes at once. Every clinic handles protected health information, and every new market adds another set of data-protection expectations. The business was growing faster than the infrastructure underneath it.
No isolation. Patient data shares a boundary with test data.
Production isolated. Guardrails block non-conforming resources at creation.
Five consequences of one architectural decision.
The estate was not failing day to day. It had become the limiting factor on how fast the business could enter new markets, and the exposure grew with every clinic added.
No isolation for patient data
Production, staging and development shared one account. PHI sat alongside test data with no defensible boundary and no way to enforce environment-specific access controls.
Provisioning took ~48 hours
Every environment and every clinic onboarding needed hands-on configuration. The infrastructure team became the bottleneck on expansion.
No preventive governance
Without Service Control Policies or centralised guardrails, any team could provision anything. Tagging, permitted resource types and security configuration were conventions rather than controls.
Audit readiness unachievable
Operating across jurisdictions, the platform had to evidence how it meets HIPAA, GDPR and regional requirements. A shared account with no isolation left gaps documentation could not close.
Expansion had no foundation
Moves into Europe, the Middle East and APAC needed multi-region deployment, data residency controls and centralised security monitoring. None of it existed.
Build the foundation clean, then migrate — rather than retrofit a live estate.
Retrofitting isolation into a running single-account estate means changing the boundaries around data already in production, which is the riskiest possible way to handle PHI. Building a clean structure alongside it, proving the controls, then moving workloads in sequence keeps patient data inside a known boundary at every step.
Foundation
Account structure on AWS Organizations and Control Tower, networking topology and identity. Dedicated accounts for production, staging, development, security, logging, shared services and networking. Nothing moved until the boundaries existed and were tested.
Automation
A library of reusable, versioned Terraform modules covering networking, compute, storage, IAM, security controls and monitoring — built and proven against non-production workloads first.
Governance
Service Control Policies for preventive control at the organisation level, Sentinel and Open Policy Agent for detective control, plus centralised logging and alerting — switched on before production workloads arrived.
Migration
Workloads moved in risk order, lowest criticality first, each validated against the new controls before the next began.
Chosen so every control is reviewable, not just present.
Each choice maps to the same constraint — keep PHI inside a defensible boundary, make provisioning repeatable, and leave an audit trail as a by-product of how the work is done.
From one shared account to a foundation that expands by pattern.
Four measured changes between the single-account estate and the multi-account landing zone now in production.
Four changes that mattered as much as the numbers.
The trigger was commercial rather than technical. What the platform gained was a foundation that supports expansion instead of constraining it.
PHI isolated at the account level
A defensible boundary that supports multi-region expansion with appropriate data residency controls, rather than a policy document describing one.
Audit readiness became continuous
Complete change trails, automated policy checks and preventive controls mean evidence is produced on request rather than assembled ahead of an audit.
Configuration drift effectively gone
All environments held in version-controlled state, so what is running matches what was reviewed.
New markets extend a pattern
Entering a region now means extending an existing, proven structure instead of rebuilding foundations — which was the point of the exercise.
How the work was shaped.
Governance built into the foundation, not retrofitted onto it.
Translating regulatory controls into architectural patterns is the part that decides whether a healthcare platform can scale across regions without its compliance posture degrading. Running as a dedicated team meant context carried forward between phases, and the ongoing maintenance arrangement means the Terraform modules and policies keep evolving with the platform rather than freezing at handover.
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