Architect: Kehinde (Kenny) Samson Ogunlowo | Principal AI Infrastructure & Security Architect
Clearance: Active Secret Clearance | Citadel Cloud Management
Enterprise healthcare workload migration architecture from on-premises clinical systems to Azure Health Data Services and Google Cloud Healthcare API. Based on real-world Cigna implementation serving 15 million+ members with full HIPAA and HITRUST compliance, Epic/Cerner/Meditech interoperability, and AI-powered clinical intelligence.
ON-PREMISES AZURE / GCP CLOUD
──────────────── ────────────────────────────────────
Epic / Cerner / Meditech Azure Health Data Services
HL7 v2 Message Feeds ──────────► FHIR R4 Service
DICOM Medical Imaging ──────────► DICOM Service
CDA Documents ──────────► MedTech Service
Clinical Databases ──────────► Azure Database for PostgreSQL
+ Google Cloud Healthcare API
+ Cloud SQL (pgvector for AI)
SECURITY & COMPLIANCE LAYER
┌─────────────────────────────┐
│ Azure Key Vault (FIPS 140-2)│
│ Cloud DLP (PHI auto-redact) │
│ VPC Service Controls │
│ Audit logging (immutable) │
│ Private endpoints only │
└─────────────────────────────┘
| Standard | Implementation | Compliance |
|---|---|---|
| FHIR R4 | Azure Health Data Services FHIR API | HIPAA Safe Harbor |
| HL7 v2 | Azure MedTech Service, Google Cloud Healthcare HL7v2 | HIPAA |
| DICOM | Azure DICOM Service, PACS migration, AI image analysis | HIPAA |
| SNOMED CT | Terminology server with Azure API for FHIR | Clinical standards |
| LOINC / ICD-10 | Mapped in data pipeline, BigQuery analytics | CMS compliance |
| RxNorm / CPT | Pharmacy and procedure coding in clinical analytics | HIPAA |
- FHIR R4 resource store for all patient records
- HL7 v2 message ingestion and transformation
- DICOM medical imaging archive (50K+ radiology images/month)
- Cross-region disaster recovery with sub-4hr RTO
- Claims processing: LangChain + Azure OpenAI (GPT-4) + RAG — 2M+ claims/month
- Population health analytics: Azure Synapse + BigQuery — 10TB+ daily healthcare data
- Clinical decision support: Readmission risk, chronic disease management, medication adherence
- Medical imaging AI: Azure Cognitive Services Computer Vision for DICOM analysis
- Chronicle SIEM — PHI exfiltration detection, MTD reduced from 45 min to 5 min
- Cloud DLP — Automated PHI de-identification in data pipelines
- Confidential GKE — Encrypted data processing for sensitive patient workloads
- FIPS 140-2 encryption — Cloud KMS with HSM backing for all PHI at rest
- Azure Health Data Services (FHIR, DICOM, MedTech)
- Azure Kubernetes Service (AKS) with HIPAA-compliant node pools
- Azure Database for PostgreSQL with row-level security
- Azure Key Vault with FIPS 140-2 HSM backing
- Microsoft Sentinel for SIEM/SOAR
- Azure Monitor + Application Insights
- Azure Private Endpoints for all PaaS services
- Google Cloud Healthcare API (FHIR, HL7v2, DICOM stores)
- GKE with Confidential VMs and Workload Identity
- Cloud SQL PostgreSQL with pgvector for clinical AI similarity search
- Cloud DLP for automated PHI de-identification
- Chronicle Security Operations
- Assured Workloads for HIPAA compliance
- HIPAA Security Rule — Administrative, Physical, Technical Safeguards
- HITRUST CSF — Full certification roadmap implemented
- FedRAMP High — Assured Workloads configuration for government health programs
- NIST 800-53 — AC, AU, IA, SC, SI control families
- Audit prep time — Reduced from 6 weeks to 5 days via automated compliance validation
- 15 million+ members served with full data integrity
- 99.95% uptime for patient-facing applications
- 85% reduction in unauthorized access incidents
- Mean time to detect threats: 45 min → under 5 min
- FedRAMP High migration completed with automated compliance validation
Kehinde (Kenny) Ogunlowo — citadelcloudmanagement.com | kogunlowo@gmail.com | LinkedIn