How safe is ChatGPT in a medical setting? Can you use Google Gemini with PHI? This complete guide breaks down what healthcare organizations must know about using AI under HIPAA.
The explosion of Large Language Models (LLMs) like ChatGPT and Gemini has opened up powerful new use cases in healthcare — from generating clinical notes to automating patient support.
But when AI touches Protected Health Information (PHI), the risks change entirely.
Under HIPAA, even submitting a patient’s name in a prompt could violate compliance — unless that data is handled in a HIPAA‑safe manner.
🎧 Watch this expert discussion from HIPAA Vault:
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“If it’s free, you’re the product,” says Gil Vidals, HIPAA expert and founder of HIPAA Vault.
“You must read the privacy policies, and you need a Business Associate Agreement. Without it, it’s not compliant.”
Let’s explore how to stay on the right side of HIPAA when using LLMs.
Why HIPAA Matters for AI & LLMs
HIPAA regulates how healthcare organizations handle PHI — which includes names, diagnoses, prescriptions, phone numbers, emails, and more.
When you use AI to process or analyze this data, you must meet HIPAA’s standards, including:
- The Privacy Rule
- The Security Rule
- The Breach Notification Rule
“That prompt itself — where does it go? That’s the question. That’s where PHI may live,” Adam Z (co-host) points out.
Even typing a patient’s name into a chatbot is a risk if the model is not HIPAA-compliant.
What Makes an LLM HIPAA-Compliant
An LLM is not HIPAA-compliant by default. Both the vendor and the user must meet strict conditions.
👉 Great breakdown here: TechMagic – HIPAA Compliant LLMs Explained
| HIPAA Requirement | What It Means for LLM Use |
| BAA | Vendor must sign a Business Associate Agreement |
| Encryption | TLS and encryption at rest required |
| No model training on PHI | Prompts must not be used to improve the model |
| Audit logging | Every action must be logged and monitored |
Pro Tip: The Compliant LLM framework on GitHub is a good open-source starting point for HIPAA-safe AI builds.
Don’t leave HIPAA compliance to chance.
Talk to experts at HIPAA Vault: Contact Us Here »
Deployment Models: SaaS, API, or Self-Hosted
Public SaaS (ChatGPT.com, consumer Gemini)
- Easy to use
- Not HIPAA compliant
- No BAA
- Prompts may be stored or reused
Avoid for any PHI.
API-Based Integration
- Use Gemini via Google Vertex AI or ChatGPT API
- Add filters, audit logging, tokenization
- HIPAA-safe with a BAA
“The API is the bridge,” says Gil. “That’s how your prompt safely reaches the model.”
Self-Hosted LLMs
- Host open-source models (e.g., Meta LLaMA) on your secure servers
- Offers maximum control
- Requires full HIPAA management
Is ChatGPT HIPAA Compliant?
✅ ChatGPT Enterprise / API
- OpenAI’s Enterprise offering supports BAAs
- Prompts not used for training
- Encryption + audit logging
🚫 ChatGPT Free or Pro
- No BAA
- Prompts may be logged
- Not HIPAA-compliant
“Use the $20 Pro version only if it’s for general productivity — not for anything with patient data,” Gil warns.
fInstead of risking noncompliance with free tools, build a HIPAA-safe chatbot.
Request a Quick Quote from HIPAA Vault.
Is Google Gemini HIPAA Compliant?
✅ Gemini for Google Workspace (Enterprise)
- Covered under Google’s HIPAA-eligible services
- Must be used with Workspace Enterprise + BAA
- Prompts are isolated
🚫 Gemini (Consumer)
- No BAA
- Not HIPAA-safe
👉 See Nightfall AI’s analysis for a detailed breakdown of Gemini’s compliance limits.
Where to Get HIPAA-Compliant ChatGPT or LLM Tools
Trusted options include:
- HIPAA Vault – secure AI hosting
- Paubox – AI + email security
- LightIT – compliant chatbot development
Best Practices for Healthcare AI Compliance
- Sign a BAA with all AI providers
- Use Google Vertex AI or Azure OpenAI for HIPAA-ready APIs
- Tokenize PHI in prompts
- Keep audit logs
- Train staff
“Your infrastructure might be compliant — but your app might not be,” Gil explains. “It’s your responsibility to bridge that gap.”
– Want a HIPAA-ready LLM deployment tailored for your healthcare organization?
Contact HIPAA Vault today and get expert guidance.
FAQs
Key Takeaways
- Free AI tools like consumer ChatGPT or Gemini are never HIPAA compliant
- Enterprise versions of both can be, with a BAA
- APIs are the most practical route for startups
- Self-hosting offers control, but is complex and costly
- Take the next step toward HIPAA-compliant AI.
Contact HIPAA Vault to speak with compliance experts today.
