Large language models can summarize clinical notes, structure unstructured records, assist with research, and make complex medical knowledge easier to retrieve. However, these capabilities introduce a fundamental question: where does sensitive healthcare data go during inference?
Data sovereignty means maintaining control over where data is stored, processed, backed up, and audited. For healthcare organizations, this extends beyond database residency. Prompts, retrieval results, vector embeddings, model outputs, logs, and temporary files may all contain protected health information. If any component silently depends on an external service, the organization can lose visibility into its data lifecycle.
An on-premises architecture keeps inference close to the source. Clinical records remain inside infrastructure governed by the healthcare organization, while internal policies determine which users, model