Security Compliance
The Australian legal baseline
Privacy Act 1988 (Cth) + 13 Australian Privacy Principles. Health information is sensitive information under APP 3 — collection requires consent and a direct connection to your functions, and the bar for use, disclosure and cross-border transfer is materially higher than for ordinary personal information.
The small business exemption does not save you. The <$3M-turnover exemption is voided if you provide a health service or hold health records — s.6D(4)(b). A pre-revenue startup handling PROM data is a full APP entity from day one. This is the single most commonly missed obligation in Australian health tech.
No controller/processor split. Unlike GDPR, Australian law treats you as an APP entity in your own right if you hold the information. You cannot contract your way into being a mere processor. Both you and the clinic have independent obligations over the same record.
Notifiable Data Breaches scheme (Privacy Act Pt IIIC). Suspected eligible breach → assess within 30 days → if likely serious harm and you can’t remediate, notify OAIC and affected individuals as soon as practicable. Health data almost always clears the serious-harm threshold. Build the assessment runbook before you need it; 30 days sounds generous until you’re mid-incident.
APP 8 / cross-border disclosure. Sending data offshore makes you accountable for the recipient’s acts as if they were your own, unless an exception applies. In practice: host in an Australian region (ap-southeast-2/4, australia-east) and keep every subprocessor’s data residency documented. Clinics will ask, and “our vendor is US-based but SOC 2 certified” is not an answer under APP 8.
Current reform state, since this is moving: Tranche 1 (the Privacy and Other Legislation Amendment Act 2024) passed 29 November 2024, assent 10 December 2024, covering enhanced regulator powers, tiered penalties, automated decision transparency, code-making powers, the statutory tort, and doxxing offences. The statutory tort commenced 10 June 2025, and automated decision-making transparency requirements commence 10 December 2026. The tort matters commercially: individuals can now sue you directly for a serious invasion of privacy, independent of any OAIC action, with no turnover threshold. Tranche 2 remains a Government commitment rather than enacted law — no bill has passed and no commencement date is fixed, though the Attorney-General confirmed in February 2026 Senate estimates that the Government is progressing it, with no timetable announced. Expected scope: a “fair and reasonable” test independent of consent, GDPR-style individual rights including erasure, a broader definition of personal information covering online identifiers, and removal of the employee and small-business exemptions. Design your data model assuming erasure and export will become mandatory.
State health privacy laws stack on top. NSW Health Records and Information Privacy Act 2002, Vic Health Records Act 2001, ACT Health Records (Privacy and Access) Act 1997. If your clinic customers are public health services in those states, they’ll flow those obligations down to you contractually. Queensland public-sector customers bring the Information Privacy Act 2009 (Qld) and its IPPs/NPPs.
Also check, don’t assume: whether your product is a Software as a Medical Device under the TGA. Pure questionnaire delivery and outcome reporting normally falls inside the exclusions for administrative/record-keeping software, but the moment you add scoring that flags a clinical action, risk-stratification, or anything recommending a course of treatment, you may be in the SaMD regime. That is a regulatory conversation, not an engineering one — get a written opinion early, because it changes your entire QMS burden.
The certification landscape
| Framework | What it is | When you need it |
|---|---|---|
| SOC 2 Type II | AICPA attestation report on controls over an observation window. Not a certification — an auditor’s opinion. | US buyers, mid-market and up. The default ask in North America. |
| ISO/IEC 27001:2022 | Certifiable ISMS standard. Accredited body issues a 3-year certificate with annual surveillance. | Australian, EU, and enterprise buyers. Better recognised outside the US. |
| ISO/IEC 27701 | Privacy extension to 27001 — a PIMS. | Signals privacy maturity; useful in health. |
| ISO/IEC 27017 / 27018 | Cloud security / cloud PII controls. Cheap add-ons to a 27001 audit. | Ticks boxes on questionnaires. |
| ISO/IEC 42001 | AI management system. | Relevant the moment you ship an ML-derived outcome prediction. |
| HIPAA | US health data. Not a certification — you attest, and sign BAAs. | Only if you have US covered-entity customers. |
| GDPR | EU/UK. Also not certifiable. DPA + SCCs + Art. 30 records. | EU customers or EU data subjects. |
| Essential Eight (ACSC) | Maturity Levels 0–3 across eight mitigations. | Australian government and enterprise questionnaires reference it constantly. |
| IRAP | Australian government assessment against the ISM. | Only for Commonwealth/state government hosting. Expensive. |
| HITRUST CSF | Prescriptive, health-focused, certifiable. | US hospital systems sometimes mandate it. Very costly. |
| PCI DSS | Card data. | Almost certainly avoidable — use Stripe and stay SAQ-A. |
My recommendation for an Australian MedTech SaaS: ISO 27001 first, SOC 2 second, and only when a named deal requires it. ISO is better recognised by Australian health customers, produces a reusable management system rather than a point-in-time report, and the certificate is a one-page artifact you can hand over — SOC 2 reports are 60+ pages under NDA, which procurement teams find annoying. Do them together if you’re also selling into the US; the control overlap is roughly 80% and joint audits are commonly discounted.
SOC 2 mechanics
- Trust Services Criteria: Security (mandatory, “Common Criteria”), Availability, Confidentiality, Processing Integrity, Privacy. Scope to Security + Availability + Confidentiality. Add Privacy only if a customer demands it — it roughly doubles the work and Australian law already covers you.
- Type I = design of controls at a point in time. Type II = operating effectiveness over a window, typically 3 months (first report) then 12 months. Type I is a stepping stone with limited sales value; several buyers won’t accept it. Go Type II with a 3-month window if you’re time-pressured.
- Timeline: 2–4 months of readiness/remediation, then the observation window, then 3–6 weeks of fieldwork and report writing. Realistically 6–9 months from cold start.
- Cost: AU$15–35k for the audit itself at startup scale, plus AU$10–25k/yr for a compliance automation platform, plus a penetration test (AU$8–20k). Budget AU$40–70k for year one, roughly 60% of that recurring.
- Exceptions in the report aren’t fatal — a report with two documented exceptions and management responses is normal. A report with a qualified opinion is a problem. Auditors vary wildly in rigour; a cheap auditor’s clean report gets discounted by sophisticated buyers who recognise the firm.
ISO 27001 mechanics
- The ISMS is the deliverable, not the controls. Scope statement, risk assessment methodology, risk register, risk treatment plan, Statement of Applicability justifying each of the 93 Annex A controls as applicable or not, internal audit programme, and management review minutes. Auditors spend more time on those than on your infrastructure.
- Annex A 2022 structure: 93 controls in four themes — Organisational (37), People (8), Physical (14), Technological (34). Eleven controls were new in the 2022 revision: threat intelligence, cloud services security, ICT readiness for business continuity, physical security monitoring, configuration management, information deletion, data masking, data leakage prevention, monitoring activities, web filtering, secure coding.
- Audit cycle: Stage 1 (documentation review) → Stage 2 (full audit) → certificate → surveillance audits at 12 and 24 months → full recertification at 3 years.
- Use a JAS-ANZ accredited certification body. Unaccredited certificates exist, are cheaper, and get rejected by careful buyers.
- The 2022 transition deadline has passed — any certificate you obtain now is against the 2022 edition.
The controls that actually matter
Every framework converges on the same list. This is the engineering work:
Access - SSO + MFA everywhere, enforced, no exceptions for founders. - RBAC with documented least privilege; quarterly access reviews with evidence (a signed spreadsheet is genuinely acceptable). - Joiner/mover/leaver process with same-day deprovisioning. Auditors will pick a terminated employee and demand the timestamps. - No shared accounts. No long-lived cloud keys — OIDC federation for CI, IAM roles for compute.
Data - Encryption in transit (TLS 1.2+, HSTS) and at rest (KMS-managed, key rotation documented). - Documented data classification and retention schedule, with actual deletion jobs — not just a policy claiming deletion happens. - Backups encrypted, and restore tested with a dated record. Untested backups fail audits and disasters equally.
Change - Version control with mandatory peer review on protected branches. Branch protection is auditable evidence; a “we always review” claim is not. - CI/CD with automated tests, dependency and secret scanning, SAST. Deployment approval trail. - Separated environments; no production data in dev or staging, ever. For health data this is the one that ends companies. If you need realistic data, build a synthetic generator.
Monitoring - Centralised, tamper-resistant logging with defined retention (12 months is the common expectation). - Alerting with a documented on-call path and evidence of triage. - Vulnerability management with SLAs by severity (e.g. critical 7 days, high 30) and patch evidence.
Process - Incident response plan, tested annually via tabletop, with the NDB 30-day assessment clock built in. - BCP/DR with stated RTO/RPO and an annual test. - Vendor risk management: subprocessor register, their certifications on file, review cadence. - Security awareness training annually, background checks on hire, signed policy acknowledgements. - Annual penetration test by an external firm; remediation tracked to closure.
SaaS-specific: multi-tenancy
The architectural risk no framework asks about clearly, and the one that will actually hurt you:
- Tenant isolation is your highest-severity bug class. Postgres Row-Level Security with a session-scoped tenant ID gives you defence at the database layer rather than relying on every Django queryset having a
.filter(clinic=...). In Django, a middleware settingSET LOCAL app.tenant_idplus RLS policies means a forgotten filter leaks nothing. This is cheap insurance and I’d implement it before any certification work. - Write an automated isolation test suite — for every endpoint, tenant A’s token requesting tenant B’s object IDs must return 404, not 403 (403 confirms existence). Run it in CI. This is the single highest-value security test in a multi-tenant SaaS.
- IDOR via sequential IDs — use UUIDs for anything externally referenced.
- Background jobs and exports are the usual isolation blind spot: Celery tasks and CSV generators frequently bypass the request-scoped tenant context.
- Per-tenant encryption keys get asked about by enterprise health buyers. Usually over-engineering at your stage; know the answer (“KMS-managed, per-region, with envelope encryption”) and move on.
The commercial artifacts
You’ll need these regardless of certification:
- Security questionnaires — SIG Lite, CAIQ, or the customer’s bespoke 300-row spreadsheet. Maintain a canonical answer bank; this is the highest-ROI hour you’ll spend. A trust centre page (public policies, certs, subprocessor list, uptime) deflects a meaningful fraction of them.
- Data Processing Agreement with subprocessor list and change-notification terms.
- BAA if any US covered entity is involved.
- Clear shared responsibility documentation — what you secure vs what the clinic secures. Clinics will ask who’s liable when their receptionist reuses a password.
Automation platforms
Vanta, Drata, Secureframe, Sprinto. Use one. They connect to AWS/GCP, your IdP, HR system and repos, continuously collect evidence, and map it to multiple frameworks at once. AU$10–25k/yr, and they save more engineering time than they cost.
Honest limits: they automate evidence collection, not control implementation. They produce a dashboard that says 94% compliant while your policies are unread boilerplate and nobody has ever run the incident tabletop. Auditors have learned to look past the dashboard. Treat the tool as a filing cabinet, not a compliance strategy.
Sequencing for where you likely are
- Now, regardless of customers: Australian region hosting, MFA + SSO, RLS tenant isolation, no prod data outside prod, encrypted tested backups, a written NDB response runbook, a real privacy policy and collection notice. All engineering-cheap, all legally required, none of it needs an auditor.
- When the first deal stalls on security: trust centre page, questionnaire answer bank, DPA template, subprocessor register. Weeks, not months.
- When a named deal requires a certificate, or you’re raising: pick ISO 27001, buy a platform, allow 6–9 months.
- Don’t start compliance work speculatively before a customer asks. It’s a six-figure distraction that produces nothing a pre-PMF company needs. The exception is the legal baseline in step 1 — that isn’t optional and isn’t compliance, it’s just the job.
Failure modes
- Treating the certificate as the goal, then failing surveillance a year later because nobody ran access reviews.
- Scoping SOC 2 to include Privacy TSC because it sounded thorough.
- Production data in a staging database “just for debugging this one thing”.
- No subprocessor register, then discovering an engineer wired in a US analytics SaaS that receives patient identifiers in URL paths.
- Assuming the small business exemption applies. It doesn’t, for you.
- Policies written by the platform’s template generator that describe a company you aren’t. Auditors interview staff; when your policy says quarterly access reviews and no one has done one, that’s an exception.