Knack Health vs. AWS, Azure, and Google Cloud for HIPAA-Compliant Healthcare Apps

If you’re building a healthcare app and need HIPAA compliance, the major cloud providers are probably on your radar. AWS, Microsoft Azure, and Google Cloud all offer HIPAA-eligible infrastructure. They’re the gold standard for enterprise healthcare platforms and large health systems.

They’re also frequently the wrong choice for the team that built a healthcare prototype in Lovable and needs to get to production.

This post explains what HIPAA compliance on the major cloud platforms actually requires, what you get with Knack Health instead, and how to decide which path is right for your situation.

What “HIPAA-eligible” actually means on AWS, Azure, and Google Cloud

All three major cloud providers participate in HIPAA compliance programs. They’ll sign a Business Associate Agreement and provide infrastructure that can be configured to meet HIPAA’s technical requirements. That’s the important caveat: can be configured.

HIPAA compliance on a cloud platform is not a feature you turn on. It’s a responsibility you take on. When you sign a BAA with AWS, Azure, or Google Cloud, you’re agreeing to use their infrastructure in a way that meets HIPAA requirements — and you’re responsible for making sure that’s actually happening.

Here’s what that means in practice.

What building HIPAA-compliant infrastructure on AWS actually involves

AWS is the most common cloud platform for healthcare apps and the most detailed example of what DIY HIPAA infrastructure requires.

Database layer: You’ll provision an RDS instance (typically PostgreSQL or MySQL) with encryption at rest enabled. You’ll configure automated backups, set retention policies, and ensure the instance is not publicly accessible. If you need high availability, you’ll configure Multi-AZ deployment.

Networking: You’ll set up a Virtual Private Cloud (VPC) to isolate your environment. This means configuring subnets (public and private), security groups to control inbound and outbound traffic, and network ACLs. Your application servers go in private subnets; a load balancer sits in the public subnet and terminates HTTPS traffic.

Access controls: You’ll use AWS IAM to define who and what can access which resources. This means creating roles, policies, and permission boundaries — and auditing them regularly to ensure no over-permissioned roles exist.

Audit logging: You’ll enable AWS CloudTrail to log all API calls and management events. You’ll configure CloudWatch for application-level logging and set up alerts for anomalous access patterns. Log retention must meet HIPAA requirements.

Encryption in transit: All traffic must be encrypted. You’ll provision TLS certificates (via ACM or a third party), configure your load balancer to terminate HTTPS, and ensure all internal service communication is also encrypted.

Application layer: None of the above covers your application. You still need to build authentication, session management, role-based access controls, and audit logging at the application level — not just the infrastructure level.

Compliance program: The technical infrastructure is only part of HIPAA. You also need a documented risk analysis, written security policies, workforce training, incident response procedures, and vendor management documentation. AWS doesn’t provide any of this.

Ongoing maintenance: Every configuration decision above needs to be maintained as your application evolves. New services, new integrations, new team members with new access levels — each change is a potential compliance event that needs to be reviewed and documented.

For a team with a dedicated DevOps engineer and a compliance consultant, this is manageable. For a healthcare founder or operator who built a prototype in Lovable, it’s a full-time infrastructure project before the application even exists.

If you’re evaluating Supabase specifically, see that comparison here. →

Azure and Google Cloud: same principle, different interfaces

Microsoft Azure and Google Cloud follow the same model. Both offer HIPAA-eligible infrastructure programs, both will sign BAAs, and both leave the compliance configuration to you.

Azure’s HIPAA implementation involves configuring Azure Policy, Azure Security Center, Azure Monitor, and Azure Active Directory — with similar complexity to AWS. Google Cloud’s approach involves Cloud Audit Logs, VPC Service Controls, Cloud KMS for encryption key management, and IAM configuration.

The specifics differ, but the principle is identical: you get HIPAA-eligible infrastructure, and the responsibility for using it correctly is yours.

What Knack Health provides instead

Knack Health is a no-code application platform with HIPAA compliance built into the infrastructure. The distinction from the cloud platforms is fundamental: you’re not configuring your way into compliance — you’re building on a platform where compliance is already in place.

Here’s what that looks like concretely:

Hosting: All Knack Health HIPAA apps run on AWS GovCloud — the same underlying infrastructure, but configured and maintained by Knack, not by you.

Encryption: AES-256 encryption at rest and TLS 1.2+ in transit are handled at the platform level. You don’t configure this. You can’t accidentally misconfigure it.

Locked-on security defaults: Inactivity timeout, password complexity requirements, brute force protection, and forced HTTPS are enabled by default on all HIPAA plans and cannot be disabled. On a cloud platform, each of these is a configuration decision you make and maintain.

Audit logging: Record change logs — who modified what and when — are built into the platform. This supports HIPAA audit requirements without requiring you to build or maintain a logging system.

Access controls: Role-based permissions, page-level access controls, and record-level filtering are built into Knack’s no-code builder. You define who sees what through a visual interface, not IAM policies.

BAA: Included with every Knack Health HIPAA plan. Executed before PHI enters the platform.

Support team lockout: On HIPAA plans, Knack’s support team has zero access to your app data by default. You must explicitly grant access — the inverse of the default on standard plans.

No-code data management: Tables, fields, relationships, pages, forms, and workflows are all managed through a visual interface. No SQL, no backend developers, no infrastructure decisions.

What you’re responsible for: operating your app correctly. Defining the right user roles. Managing your workforce policies. Building the right access controls for your specific use case. The infrastructure compliance is Knack’s job. The application compliance is yours — but Knack gives you the tools to do it without engineering resources.

The real cost comparison

The cost of cloud infrastructure for HIPAA apps is rarely just the hosting bill.

A realistic AWS HIPAA setup for a production healthcare application — RDS, EC2 or ECS, ALB, CloudTrail, CloudWatch, VPC, ACM — runs $200–600/month in infrastructure costs depending on scale, before any application development. Add a DevOps engineer (even part-time) to set it up and maintain it, and you’re looking at $5,000–15,000 in setup costs and ongoing maintenance overhead. Add a compliance consultant for the risk analysis and policy documentation: another $5,000–20,000 for initial setup.

None of that includes the application itself.

Knack Health HIPAA plans start at $625/month and include unlimited apps, unlimited users, unlimited builders, fully managed compute, a signed BAA, and HIPAA-compliant infrastructure on AWS GovCloud. The compliance infrastructure cost is the subscription. There’s no DevOps setup, no compliance consultant for the infrastructure layer, and no ongoing maintenance burden for the hosting environment.

When cloud platforms are the right choice

This isn’t an argument that AWS, Azure, and Google Cloud are wrong for healthcare apps. They’re the right choice in specific situations:

Large-scale platforms with custom requirements. If you’re building a platform that needs to integrate directly with hospital EHR systems via custom HL7/FHIR middleware, process high-volume clinical data in real time, or meet enterprise security requirements that go beyond standard HIPAA compliance, you likely need the flexibility of a cloud platform and the engineering team to support it.

Organizations with existing cloud infrastructure. If your organization already runs on AWS with a DevOps team managing it, adding a HIPAA-compliant workload to that environment is a reasonable extension of existing capabilities.

Highly custom application architectures. If your app requires functionality that no-code platforms can’t support — complex real-time processing, specialized data pipelines, custom AI model serving — you’ll need infrastructure you can configure to your specifications.

For everyone else — healthcare founders, clinical operators, digital health startups, and mid-size healthcare organizations building custom tools without a dedicated engineering team — Knack Health removes the infrastructure burden while providing the same compliance outcome.

Side-by-side comparison

	AWS / Azure / GCP	Knack Health
BAA available	Yes — you sign separately	Yes — included with HIPAA plan
HIPAA-compliant by default	No — you configure compliance	Yes — built into the platform
Infrastructure setup required	Yes — significant	No
DevOps expertise required	Yes	No
Ongoing maintenance burden	Yes	No — managed by Knack
Application development	Separate — you build everything	No-code builder included
Audit logging	You configure (CloudTrail, etc.)	Built in — record change logs
Access controls	IAM policies — you configure	Visual role builder — no code
Encryption	You configure and verify	Platform-level — always on
Monthly infrastructure cost	$200–600+ before app development	Starting at $625/mo, all-inclusive
Time to HIPAA-compliant app	Months	Days to weeks
Best for	Engineering teams, enterprise scale	Operators, founders, no-code builders

Getting started

If you’re building a healthcare app and need HIPAA compliance without the infrastructure overhead, Knack Health HIPAA plans include everything: managed hosting on AWS GovCloud, encryption, audit logging, access controls, a signed BAA, and a no-code platform to build and operate your app.

Talk to our team → View HIPAA plans and pricing. →

FAQs: Knack Health vs. AWS, Azure, and Google Cloud for HIPAA

Does Knack Health run on AWS?

Yes. All Knack Health HIPAA apps are hosted on AWS GovCloud — the same underlying cloud infrastructure used by many enterprise healthcare platforms, configured and maintained by Knack at the platform level.

Can I migrate from AWS to Knack Health?  

Yes, though the process depends on what’s currently built. If your data lives in a relational database on AWS, it can typically be exported and imported into Knack Health. Our team can walk through your setup and help plan the transition. And you can read more about HIPAA-compliant app migrations here.

Is Knack Health less flexible than building on AWS? 

It’s a different kind of flexibility. AWS gives you infrastructure flexibility — you can configure anything. Knack Health gives you application flexibility — you can build and change your app quickly without engineering resources. For teams who need custom infrastructure control, AWS is the right choice. For teams who need to build and iterate on a healthcare app without infrastructure expertise, Knack Health is.

Does Knack Health support EHR integrations? 

Knack Health supports integrations via Knack Flows (500+ no-code integrations) and via the Knack API for custom connections. For direct EHR integrations requiring custom HL7/FHIR middleware, contact our team to discuss your specific use case.

What if my compliance requirements go beyond standard HIPAA? 

Knack Health is SOC 2 Type II certified and HIPAA-aligned. For organizations with requirements beyond standard HIPAA — state-level regulations, enterprise security questionnaires, or custom contractual requirements — contact our team to discuss whether Knack Health HIPAA Enterprise is the right fit.