The NHS Pathways clinical decision support environment experienced a dramatic transformation after migrating to AWS. It runs 75% faster now and is able to achieve millions of patient interactions per day. This isn’t a fluke. It is based on healthcare-specific cloud migration approaches that extend traditional DevOps playbooks. Cloud adoption isn’t an ideal lift-and-shift, especially when Protected Health Information is concerned.
The challenge facing healthcare organisations is that they are caught between struggling legacy systems and a list of increasingly complex compliance requirements. The answer is not to sit idle – it is to migrate intelligently with partners who not only understand cloud architecture but also understand the complex world of healthcare regulation.
Rushkar Technology, a premier software development company in India has led dozens of health systems through this transition. They bridge the gap between deep domain expertise and cost-effective offshore services enabling enterprise-class migrations that are affordable to organisations of all sizes.
The HIPAA Compliance Gap Most DevOps Teams Miss
Traditional DevOps is about speed – faster deployments, automated tests, continuous integration. It makes sense for e-commerce or social networks, however, healthcare has its own rules. During a HIPAA-compliant migration, three audit requirements must be met, non-negotiably: protect patient information, ensure data integrity for medical records, and ensure availability for clinical emergencies.
Many general migration teams don’t get the foundations right. They might encrypt data at rest, but skip encryption in transit with database replication. They may segment networks but over-permit IAM policies. Developers may be automated but overlook the audit logging that’s needed every time they access PHI within an application.
The statistics are stark. Between 2024 and 2025, there was an increase of 37% in data breaches associated with misconfigured cloud storage leading to regulatory fines of over $50 million. These were not advanced attacks, rather preventable failures that are just not addressed in generic DevOps procedures.
Rushkar’s Approach Makes Compliance an Architecture
Further, we implement PHIryption at all layers – AES-256 for encryption at rest, TLS 1.3 encryption at rest and in motion, and customer managed keys stored in dedicated HSMs. Role-based access controls are matched to real clinical workflows to make sure surgical residents don’t accidentally open up cardiology records by accident. Automated audit logs all database queries, API calls, and file downloads using tamper-proof timestamps.
By working together with our development company in India, you are not just hiring programmers who write Terraform templates. You’re working with healthcare technology experts who have worked through HIPAA audits, perfected Business Associate Agreements, and created systems that fail penetration testing only once.
AWS vs Azure for Healthcare Workloads
Choosing between AWS healthcare compliance and Azure HIPAA compliance isn’t about picking the “better” platform—it’s about understanding which one aligns with your existing technology stack and operational patterns.
| Feature | AWS Healthcare Compliance | Azure HIPAA Compliance |
| Encryption at Rest | S3 SSE-KMS with FIPS 140-2 validated keys | Azure Storage Service Encryption with customer-managed keys |
| Audit Logging | CloudTrail + Lake Formation for centralized governance | Azure Monitor + Sentinel SIEM with compliance workbooks |
| EHR Integration | Native Epic cloud migration with FHIR API support | Cerner Millennium on Azure with HL7 connectors |
| Database Options | Aurora PostgreSQL/MySQL with automated HIPAA BAA | Azure SQL Database with built-in threat detection |
| Cost Model | Pay-per-request with Reserved Instance discounts | Committed use discounts with Azure Hybrid Benefit for .NET |
Organisations that have already invested in Microsoft ecosystems often find Azure’s integration with active directory, .NET frameworks and Power BI hard to resist. The authentication flow is simpler and the licensing bundles are attractive, and the developer is already familiar with the tools.
But AWS is dominant in Epic cloud migration scenarios. Epic’s partnership with AWS runs deep, with pre-built FHIR APIs, optimised database configurations and reference architectures with battle-testing across hundreds of health systems. If you’re on Epic EHR, AWS is often the path of least resistance.
Rushkar usually advises hybrid approaches for complex enterprises. Store real-time transactional data in Azure SQL Database – your .NET applications will access it with minimal latency. Simultaneously, replicate de-identified datasets to AWS for advanced analytics, machine learning model training, and population health research that takes advantage of the maturity of SageMaker.
Building these types of multi cloud architectures requires expertise that is difficult to locate within the domestic industry at an affordable price. That’s where Hire Dedicated Developer India comes into play in a strategic manner. Our offshore teams have built dozens of healthcare cloud architectures, working through the quirks of VPN (virtual private network) peering between AWS and Azure, moving between platforms for identity federation, and ensuring data sovereignty requirements don’t add compliance nightmares.
The Five-Phase HIPAA-Compliant Migration Roadmap
Every successful healthcare cloud migration has a predictable pattern, however the timeframe and complexity differ wildly based on where you’re starting off.
Phase 1: Discovery & Compliance Audit
You can’t migrate what you don’t understand. This phase includes full mapping of any system that touches PHI – that means your very own EHR, PACS imaging archives, lab info systems, patient portals, RPA bots that do the insurance verification fieldwork, and the end even file shares that are forgotten and clinicians dump CSV exports. Document data flows and identify integration points and establish your compliance baseline. This audit typically leads to some surprises – shadow IT systems we thought didn’t really exist, forgotten databases still receiving HL7 feeds or third party applications with expired Business Associate Agreements.
Phase 2: Classification of Data & Identification of PHI
Not all healthcare data is equally subject to regulation. Aggregate quality metrics may not include PHI. De-identified research datasets have distinct requirements from operative clinical systems. This phase marks all the data elements with their sensitivity and implements the corresponding controls. Encrypt Social Security numbers and patient IDs at the field level. For searchable data, use deterministic encryption schemes. Or apply tokenization for payment card data that would cross to the PCI-DSS territory.
Phase 3: Encrypted Transfer Protocols
Moving TBs of EHR data from on-prem data centres to the cloud regions involves careful orchestration. Standardise on TLS 1.3 for all network transfers. For bulk initial migrations where network bandwidth becomes a bottleneck, leverage AWS DataSync or Azure Data Box for uptake and transfer. Implement checksum validation to examine the integrity of the data while transferring. Our App Developer India teams have fine tuned these migration patterns in dozens of health systems, creating our custom validation scripts that detect corruption before they hit production.
Phase 4: Post Migration Penetration Testing
Before you bring your new cloud environment live, expose it to the same set of attacks that real adversaries will try and make it do. Engage third-party security firms to probe for exposed S3 buckets, see if IAM privilege escalation is possible, attempt SQL injection against your RDS instances, and verify network segmentation actually prevents lateral movement. Rushkar coordinates these engagements, manages remediation of findings, and re-tests until the assessors cannot find anything exploitable.
Phase 5: Ongoing Monitoring Establishment
HIPAA compliance isn’t a one shot-it’s sustained. Deploy AWS CloudWatch Events, or Azure Sentinel, to detect abnormal patterns: unusual API calls from unknown IP addresses, mass data exports outside of normal business hours, privilege promotions or changes made to encryption configurations. Create automated playbooks which trigger incident-response workflows, notify security teams and, in extreme cases, automatically revoke breached credentials.
Executing this roadmap requires the help of specialised talent that will be in a position to understand both cloud platforms and healthcare regulations. Rushkar’s Hire Software Developer India model serves that kind of expertise at offshore prices comparing the 50-60% saving against domestic consulting companies, with no-and often superior-quality standards.
Cost Reality: What Healthcare Organizations Actually Spend
Budgets for mid size hospital healthcare cloud migration projects generally fall between $500,000 and $2 million, including professional services items for architecture and implementation, software licensing for key management and monitoring tools and data transfer costs for initial bulk uploads, third party compliance audits for independent penetration testing and review, and extensive training programmes for both clinical staff and IT operations.
Those numbers scare CFOs until you crunch the numbers of the alternative. Maintaining ageing on-premises infrastructure accounts for 30-40% of IT budgets across hardware refresh cycles, datacentre facilities expenditures and emergency support contracts for EOL systems. Security incidents against unpatched legacy systems have an average remediation cost of over $10 million when you consider regulatory fines, legal costs, credit monitoring for affected patients as well as reputation damage.
Organisations usually see ROI of 12-18 months through dramatic real cuts in hardware maintenance costs, an easier compliance-audit process and better application performance leading to real clinical productivity gains. One community hospital resulted in a 25% reduction in time spent waiting for radiology images to load after migrating PACS to AWS – multiply that over thousands of daily reviews of images and that’s measurable improvement of patient throughput.
Rushkar speeds ROI by reducing their largest variable cost: professional-services fees. Our Hire .NET Developer India Groups provide the same architecture, migration, and optimization work at rates 50-65% less than domestic companies do, making enterprise-grade healthcare cloud transformations affordable for regional hospitals and critical access hospitals that couldn’t reach it before.
Automation vs Manual Configuration
Infrastructure as Code / IaC has transformed the way we go about provisioning our cloud resources, but healthcare migrations are not totally automatable. Some tasks are straightforward to automate, such as: Using Terraform to create VPCs and subnets, Gauss, etc. Define IAM roles with Cloud Formation Define CI/CD pipelines in GitHub Actions. Those things must be fully coded and version controlled and then deployed in the shape of automated workflows.
Other tasks require the expertise of humans. Negotiating Business Associate Agreements with cloud providers requires legal look and re-evaluation that is impossible with a script. Designing Custom Penetration Testing Scenarios That Fit Your Threat Model Needs by Disregard the Hackers Setting the threshold for monitoring is a balance between alert fatigue and recognising actual incidents, an iterative adjustment based upon operational patterns.
Rushkar combines automation and human oversight. We maintain libraries composed of compliant IaC templates that translate HIPAA cloud security rules into enforceable policy-as-code. Automated scanners identify the deviations from security baselines if any, prior to the deployment itself. Experienced security architects will still manually review every template, verify encryption settings, verify that audit logs record all the necessary events, and verify that backup retention meets certain minimum regulatory requirements.
Conclusion: Partner for Success
Healthcare cloud migration is not only about modernising technology. It is the foundation for reliable, scalable systems that help secure sensitive data, leading to better patient care. Choosing Rushkar Technology as your partner provides you proven expertise in Healthcare data secure cloud architectures. You also get access to specialist offshore talent through our Hire dedicated developer India programmes, end-to-end post-migration support from our Hire software developer India teams, and a future-ready platform for AI-powered clinical decision service and value-based care models.
Don’t wait for compliance deadlines and infrastructure failures to send you into a crisis. Contact Rushkar’s software development experts in India today and transform your healthcare IT environment into a strategic advantage that will improve outcomes and reduce risk.
