Framework
Retinex Health operates as a covered-entity Business Associate under HIPAA and as a certified Health IT developer under the ONC/ASTP Health IT Certification Program. Controls are designed against:
- HIPAA Privacy Rule (45 CFR 164, Subpart E)
- HIPAA Security Rule (45 CFR 164, Subpart C)
- NIST SP 800-53 Rev. 5 (selected moderate-impact controls)
- NIST SP 800-63B (digital identity)
- ONC/ASTP HTI-1 (HIPAA + cybersecurity hygiene baseline)
Authentication
Every interactive user authenticates with two factors:
- Password: bcrypt-hashed, complexity rules enforced.
- TOTP code: RFC 6238, HMAC-SHA1, 6 digits, 30-second window, ±1 step drift tolerance. See the MFA documentation for the full implementation.
Service-to-service authentication uses JWTs signed with an HS256 secret rotated per environment.
Authorization (RBAC)
Authorization is enforced at the gateway by JwtAuthGuard + PermissionGuard + @ProtectModule(). Permissions are expressed as <module>:<action>. Modules in the catalog:
access_admin— Access Admin UI and role managementdsi— Decision Support Interventionsattachment— Patient attachmentstoc_import— Transition of Care importehi_export— §170.315(b)(10) EHI exportlab— Lab module
Actions: read, write, delete, full.
Encryption
| Layer | Algorithm | Key management |
|---|---|---|
| Transport | TLS 1.2+ (TLS 1.3 preferred), ECDHE+AES-GCM | ACME / managed certificates |
| Database at rest | AES-256 | Provider-managed KMS (Azure) |
| Blob storage (attachments, exports) | AES-256 SSE | Azure Storage Service Encryption |
| EHI export archive | AES-256, 7-Zip encrypted headers (-mhe=on) | Per-archive password, delivered out of band |
| Column-level (selected tokens) | AES-256-GCM | Key from AES_SECRET_KEY env var, rotated per environment |
Audit Logging
A dedicated audit microservice records every privileged action to an append-only store. Records include actor user ID, target resource, source IP, user agent, timestamp, and outcome.
Logged events include:
- Sign-in success / failure
- MFA enrollment, verification, administrator reset
- RBAC permission grants and revocations
- EHI export (single and bulk)
- Patient chart access (read), creation, update, deletion
- Emergency-access (break-glass) elevations
Data Residency & Retention
- Residency. Production data resides in Azure US-East regions by default; non-US residency is available under a Business Associate Agreement.
- Retention. Clinical data is retained per the customer’s organization-level retention schedule; audit records are retained for a minimum of 7 years.
- Backups. Encrypted daily snapshots with 35-day point-in-time restore.
Certifications Held
- ONC/ASTP Health IT Certification — current
- HIPAA Privacy & Security Rules — in scope
- HITRUST CSF readiness — in progress
- SOC 2 Type II — in progress