This project is a HIPAA-compliant secure storage platform addressing vulnerabilities in U.S. healthcare data infrastructure. Tailored for small and mid-sized providers, it offers enterprise-grade tools for secure storage, retrieval, and management of Protected Health Information (PHI). It integrates patient consent management with real-time OTP verification and includes a tamper-proof blockchain audit trail. Built with .NET 8, Azure services, React, OpenFGA, and Keycloak, it ensures compliance with U.S. federal cybersecurity frameworks, supports digital modernization, and implements responsibility-spread key management for zero-trust decryption through multi-party collaboration.
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Zero-Trust PHI Protection: Combines AES-256 encryption, Azure Blob Storage, Key Vault, and OpenFGA to ensure that only explicitly authorized services (via JWT + policy) can access encrypted PHI mitigating ~$10B annual breach costs (Ponemon Institute, 2023).
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Dynamic, Scalable Access Control: Replaces rigid RBAC with OpenFGA’s fine-grained policies, enabling precise access by role and relationship (e.g., Admin: all; Nurse: Identifiers & Medical Records).
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Seamless Interoperability: Provides secure RESTful APIs (POST, GET, PUT, DELETE) that integrate easily with EHR and telehealth systems while preserving encryption and authorization policies.
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Responsibility-Spread Key Management: Uses Azure Key Vault, Blob Storage, and OpenFGA to isolate encryption keys from data and enforce departmental separation requiring multi-party collaboration for decryption.
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Affordable Data Protection-as-a-Service (DPaaS): Deployable via Azure for ~$0.255/year per GB, saving $50K–$100K annually compared to legacy systems supporting HIPAA compliance in underserved communities.
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Tamper-Proof Audit Trail: Offers immutable blockchain logging via Azure Confidential Ledger, ensuring secure patient consent and unalterable record-keeping for compliance.
- Azure Blob Storage and Key Vault for scalable, separated storage and key handling
- Azure Confidential Ledger provides immutable, tamper-evident storage for audit trails of patient consent
- OpenFGA for fine-grained access control by role and relationship
- Token-based authentication (JWT) via Keycloak
- Secure REST API endpoints tested via Swagger
- Dockerized microservice architecture for rapid deployment
- Stronger Protection Against Breaches: AES-256 encryption is virtually uncrackable, outperforming outdated methods like SHA-1, 3DES, and AES-128 still used in legacy systems. It defends against brute-force and emerging quantum-based threats.
- Regulatory Compliance: Meets HIPAA, HITECH, and GDPR standards for safeguarding sensitive health data.
- End-to-End Data Security: Ensures data at rest and in transit is encrypted, protecting against system compromise or insider threats.
- Separation of Duties: Keys reside in Azure Key Vault, requiring OpenFGA policy validation and token-based access for decryption.
- Resilience in Multi-Tenant Environments: Isolates key access per data category and role, limiting breach impact.
- Trust & Legal Assurance: Provides legal defensibility in audits or breach investigations, reducing financial and reputational risk.
- Uses Azure Confidential Ledger for tamper-proof, blockchain-based logging.
- Creates an immutable audit trail for PHI access and patient consent events.
- Leverages Trusted Execution Environments (TEEs) for confidential computing.
- Complies with HIPAA 164.312(b) audit control standards.
- Prevents alteration of access logs by admins, developers, or insiders.
- Enhances zero-trust security and legal audit defensibility.
The PHI Secure Storage UI is a lightweight React application serving as the front-end interface for this secure backend. Check Frontend
Use Case: A rural clinic uses this UI to manage encrypted PHI, allowing clinicians to retrieve records by category (e.g., medical history, insurance data...) while keeping access tightly controlled and auditable.
Access full technical documentation below:
Backend Design – Includes architecture diagrams, encryption models, and flow logic: 📄 Architecture Overview
Frontend (React UI) – Implementation details and usage guide available in the UI README: 📄 UI README
To run the project, configure your appsettings.json and docker-compose.override.yml with environment-specific values:
appsettings.json
"KeyVaultUrl": "<your-key-vault-url>",
"ConnectionsVaultUrl": "<your-connections-vault-url>",
"LedgerEndpoint": "<your-ledger-endpoint>"docker-compose.override.yml
environment:
- AZURE_CLIENT_ID=<your-client-id>
- AZURE_TENANT_ID=<your-tenant-id>
- AZURE_CLIENT_SECRET=<your-client-secret>
Run the Project
git clone https://github.com/ramital/SecureStorage
docker-compose up -d
Includes:
- SecureStorage API (C#)
- OpenFGA auth server (PostgreSQL backend)
- Keycloak (OIDC Provider)
- React UI for PHI access
| Feature | Real-World Benefit | Compliance Impact |
|---|---|---|
| AES-256 Encryption | Protects PHI, reducing breach risk by 50% (per NIST SP 800-53) | Meets HIPAA/NIST standards |
| Key Vault + Blob Storage | Prevents developer/admin overreach with key/data isolation | Enforces separation of duties |
| Azure Confidential Ledger | Provides tamper-proof, blockchain-based audit trail | Ensures immutable record-keeping |
| OpenFGA Access Control | Dynamic policies tied to roles (e.g., Nurse, Doctor..,) | Supports least privilege & auditability |
| React UI + API Integration | Makes secure PHI access user-friendly for non-technical staff | Enables compliant workflows |
| Docker Deployment | Simplifies setup, scaling, and CI/CD integration reducing, infrastructure overhead | Promotes easier adoption and environment consistency |
This solution directly supports federal goals in:
- Digital Health Modernization: Aligns with HHS Cybersecurity Strategy 2023.
- Telehealth Expansion: Enables secure infrastructure for remote diagnostics.
- Workforce Development: Provides open-source toolkits and interfaces.
- Data Protection for Underserved Populations: Offers modular, cost-effective deployments.
📋 Metrics:
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100% Encrypted PHI (at rest & in transit) (by design; validated in test environment)
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~99% Uptime during test cycles (estimated from controlled testing)
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~50% Risk Reduction from access violations (projected based on security architecture)
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Scalable to Enterprise-Grade PHI handling (designed for future enterprise workloads; scalability projections based on architecture)
- Fork the repo
- Create a feature branch
- Submit a pull request
MIT. LICENSE.
Developed and maintained by Ahmad Rami El Tal, HIMSS Digital Member (2025).