Tether is built for healthcare from the ground up. Every architectural decision, from database design to API structure, is made with patient data protection as the primary constraint.
All protected health information (PHI) is encrypted at rest using AES-256 and in transit using TLS 1.3. Database fields containing patient data use column-level encryption with keys managed through a dedicated key management service.
Each practice's data is logically isolated using row-level security (RLS) policies enforced at the database level. No practice can access, query, or view another practice's patient data under any circumstance.
Tether follows the HIPAA minimum necessary standard. Users only see the data required for their role. Role-based access controls (RBAC) are enforced at the application and database layers.
Every access to PHI is logged with timestamp, user identity, action type, and affected records. Audit logs are immutable, retained for a minimum of 6 years, and available for compliance review on request.
All Tether team members complete HIPAA training before accessing any system that handles PHI. Training is refreshed annually and supplemented with ongoing security awareness education.
Tether maintains a documented incident response plan with defined escalation paths, notification timelines compliant with the HIPAA Breach Notification Rule, and post-incident review procedures.
AES-256 encryption at rest. TLS 1.3 for all data in transit. Column-level encryption for PHI fields in PostgreSQL. Encryption keys rotated on a scheduled basis.
Multi-factor authentication available for all accounts. Session tokens are short-lived with automatic expiration. Password policies enforce complexity and rotation requirements.
All traffic routed through HTTPS. API endpoints are rate-limited and protected against common attack vectors including SQL injection, XSS, and CSRF. Infrastructure monitored 24/7.
Automated daily backups with point-in-time recovery capability. Backups are encrypted and stored in geographically separate regions. Recovery procedures tested quarterly.
Uploaded referral PDFs are processed in memory, parsed by AI, and stored in encrypted object storage. Documents are never cached in plaintext. Access is scoped to the sending and receiving practice only.
E-fax transmissions are sent via a HIPAA-compliant fax provider with a signed BAA. Fax documents are encrypted during transmission and at rest. Delivery confirmations are logged and auditable.
Patient notifications sent via HIPAA-compliant messaging provider with a signed BAA. Messages contain minimum necessary information. TCPA consent is obtained and recorded before any outreach.
All third-party vendors that process, store, or transmit PHI are evaluated for HIPAA compliance and required to execute Business Associate Agreements before integration.
Practice user uploads a referral PDF or fills the form. Data is transmitted over TLS 1.3 to Tether's API. Input is validated and sanitized server-side before processing.
The PDF is parsed using AI models to extract structured patient data. Processing occurs in an isolated compute environment. The original PDF is stored encrypted. Extracted data is written to the practice's RLS-scoped database rows.
If the receiving practice is on Tether, the referral appears in their dashboard instantly via encrypted real-time channels. If not, an e-fax is generated and transmitted via HIPAA-compliant fax infrastructure with delivery confirmation.
Both practices see referral status updates in real time. All status changes are logged in the audit trail. When the visit is completed, the referring provider is notified and the referral record is marked complete.
Referral data is retained according to healthcare record retention requirements (minimum 7 years). Practices can request data export or deletion in compliance with applicable regulations. Deletion is verified and logged.
Tether executes a Business Associate Agreement (BAA) with every practice before any PHI is processed. Our BAA covers all aspects of the Tether platform.