Healthcare SaaS: Preventing HIPAA Catastrophe

Critical Vulnerability #1: PHI Data in Plain Text Logs

Copilot's "helpful" logging exposed everything:

// AI-generated patient data handler
const updatePatientRecord = async (patientId, data) => {
  // Copilot suggested "comprehensive logging"
  console.log(`Updating patient ${patientId} with data:`, {
    ...data,
    ssn: data.ssn,
    diagnosis: data.diagnosis,
    medications: data.medications,
    insurance: data.insuranceDetails
  });
  
  try {
    const result = await db.patients.update(patientId, data);
    
    // Log for "debugging"
    logger.info('Patient update successful', {
      patient: result,
      changes: JSON.stringify(data)
    });
    
    return result;
  } catch (err) {
    // Exposed patient data in error logs too!
    logger.error(`Failed to update patient ${patientId}`, {
      error: err.stack,
      patientData: data
    });
  }
}

Impact: Every patient update logged SSN, diagnosis, medications, and insurance details in plain text. These logs were stored for 90 days and backed up to S3.

Critical Vulnerability #2: Weak Encryption for Data at Rest

The AI misunderstood HIPAA encryption requirements:

// AI's "secure" patient data storage
class PatientDataEncryption {
  constructor() {
    // Base64 is NOT encryption!
    this.encrypt = (data) => Buffer.from(JSON.stringify(data)).toString('base64');
    this.decrypt = (data) => JSON.parse(Buffer.from(data, 'base64').toString());
  }
  
  async savePatientData(patient) {
    // AI thought this was "encrypted at rest"
    const encrypted = this.encrypt(patient);
    await fs.writeFile(
      `./patient_data/${patient.id}.enc`,
      encrypted
    );
  }
}

// Also found: MD5 hashing for patient passwords
const hashPassword = (password) => {
  return crypto.createHash('md5').update(password).digest('hex');
};

Impact: 2.8 million patient records stored with Base64 encoding (not encryption). Anyone with file access could read all PHI data.

Critical Vulnerability #3: Missing Access Controls on API

AI forgot that not everyone should see all patient data:

// AI-generated patient API endpoints
app.get('/api/patients/:id', async (req, res) => {
  // No authorization check!
  const patient = await getPatient(req.params.id);
  res.json(patient);
});

app.get('/api/patients', async (req, res) => {
  // Returns ALL patients to ANY authenticated user
  const patients = await db.patients.findAll();
  res.json(patients);
});

// Search endpoint exposed everything
app.post('/api/search', async (req, res) => {
  const { query } = req.body;
  
  // SQL injection + data exposure
  const results = await db.query(`
    SELECT * FROM patients 
    WHERE name LIKE '%${query}%' 
    OR ssn LIKE '%${query}%'
    OR diagnosis LIKE '%${query}%'
  `);
  
  res.json(results);
});

Impact: Any authenticated user (including patients) could access any other patient's complete medical history.

8 Critical HIPAA Violations