A HIPAA-compliant build starts with the Business Associate Agreement. Until that's countersigned, no protected health information moves between you and the development partner. Cardinal countersigns BAAs the same day they're requested.
After the BAA, the architecture matters. PHI controls cover what data enters the system, where it's stored, who can read it, and what happens when the access pattern is anomalous. Encryption at rest and in transit is table stakes. Audit logging (immutable, queryable, retained) is the part most builds get wrong because it's invisible to users.
AI features add a second layer. Lovable, v0, and Bolt cannot configure PHI-safe LLM calls for you. Cardinal's Redactor sits between the application and any external model, tokenising PHI before the API call leaves your environment. That's how production HIPAA platforms ship AI features without violating the privacy rule.