Five questions to ask any clinical AI vendor about data sovereignty
Almost every clinical AI vendor describes its product as secure and compliant. For a CISO or privacy officer, the useful question is not whether a promise is made, but whether the architecture makes it enforceable.
There is a difference between sovereignty by contract and sovereignty by architecture. A contract says a vendor will not misuse your data. An architecture makes it impossible for data to reach the vendor at all. The five questions below help tell the two apart.
1. Where Does the Model Run, and Whose Account Is It?
If inference runs on the vendor’s infrastructure, patient data leaves your environment by definition, however well it is protected on arrival. A good answer: models run in your own cloud account or data centre, under your billing and your security controls.
2. What Leaves Your Environment, Exactly?
Even self-hosted products often send logs, traces or usage data back to the vendor, and those can contain prompts and outputs. A good answer: a specific, allowlisted list of operational metrics, with no content, that your team can inspect and switch off.
3. Can the Vendor Reach In?
Standing administrator roles and stored credentials are a path into your environment, whatever the contract says. A good answer: the vendor holds no credentials and no permanent access role, and every change arrives as a release your team can review.
4. What Happens If You Leave?
Your knowledge base, adapted models and evaluation history are valuable assets. A good answer: they are stored in your account in standard formats and keep working without the vendor.
5. Who Decides When the Model Changes?
Hosted AI services can update or retire a model without notice, changing clinical behaviour overnight. A good answer: model versions are pinned, and a new one goes live only after it has passed your own evaluation and your approval.
Why This Matters Beyond Security
These questions protect more than data. They protect your ability to evidence compliance, to control clinical risk, and to keep the value you build. A vendor that can answer all five clearly has designed for your independence, not just for your signature.
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