HIPAA and GDPR are the two most consequential data protection frameworks any healthcare or technology organisation is likely to encounter. They share a common purpose, protecting sensitive personal data, but they differ significantly in scope, enforcement mechanisms, and compliance obligations. For organisations operating across the Atlantic, understanding where they align, where they clash, and how to satisfy both simultaneously is not optional. It is a legal necessity. What Is HIPAA? The Health Insurance Portability and Accountability Act was enacted by the U.S. Congress in 1996. Its original purpose was to modernise the flow of healthcare information and ensure the portability of health insurance coverage. Over time, it became primarily known for its data protection requirements, administered by the U.S. Department of Health and Human Services (HHS) and enforced by the Office for Civil Rights (OCR). HIPAA is built around three core rules. The Privacy Rule governs how Protected Health Information (PHI) may be used and disclosed. The Security Rule sets standards for safeguarding electronic PHI (ePHI). The Breach Notification Rule establishes mandatory reporting timelines when PHI is compromised. Who Needs to Be HIPAA Compliant? HIPAA applies to covered entities, healthcare providers, health plans, and healthcare clearinghouses, and to their business associates: any third-party organisation that handles PHI on their behalf. If you build software that processes patient data for a U.S. hospital, you are a business associate. If you store medical records in the cloud for an insurance company, you are a business associate. A Business Associate Agreement (BAA) is the formal contract that governs this relationship. What Types of Data Does HIPAA Protect? HIPAA protects Protected Health Information (PHI): any individually identifiable information relating to a person’s past, present, or future physical or mental health condition, the provision of healthcare, or the payment for healthcare. This includes names, dates of birth, Social Security numbers, medical record numbers, and any data that could be used to identify a patient in connection with their health. Electronic PHI, the subset stored or transmitted digitally, is subject to the Security Rule’s additional technical requirements. What Is GDPR? The General Data Protection Regulation came into force across the European Union on 25 May 2018, replacing the 1995 Data Protection Directive. It is the world’s most comprehensive data privacy law, and its extraterritorial reach means it extends well beyond Europe’s borders. The GDPR is enforced by national Data Protection Authorities (DPAs) and coordinated at the European level by the European Data Protection Board (EDPB). Unlike HIPAA, GDPR is not sector-specific. It applies to any organisation processing the personal data of EU residents, regardless of industry. Who Needs to Be GDPR Compliant? Any organisation that processes the personal data of individuals located in the European Union, regardless of where the organisation is based. A U.S. hospital treating European patients, a SaaS company offering services to German users, or a health app collecting data from French residents all fall within GDPR’s scope. The regulation applies to both data controllers (organisations that determine how and why data is processed) and data processors (third parties that process data on a controller’s behalf). What Types of Data Does GDPR Protect? GDPR protects all personal data: any information relating to an identified or identifiable natural person. Health data is explicitly designated a special category under GDPR Article 9, commanding heightened protection alongside biometric data, genetic data, racial or ethnic origin, religious beliefs, and sexual orientation. HIPAA vs GDPR: Key Differences at a Glance Feature HIPAA GDPR Jurisdiction United States only EU + extraterritorial reach Sector Healthcare only All sectors Regulatory body HHS / OCR National DPAs / EDPB Data covered PHI only All personal data Consent model Treatment-based exceptions Explicit consent required Breach notification 60 days (proposed: 72 hours) 72 hours Max fine $1.9M per violation category/year €20M or 4% of global turnover DPO required No Sometimes Right to erasure Limited Yes Scope and Geographic Reach HIPAA’s reach is defined by entity type: it applies to covered entities and business associates operating within the United States. Whether a patient holds EU citizenship is irrelevant to HIPAA jurisdiction. What matters is whether the organisation providing care or processing health data operates within the U.S. healthcare system. GDPR’s reach is defined by the location of the data subject, not the organisation. Article 3 of the GDPR gives it explicit extraterritorial effect. If your organisation targets or monitors EU residents, GDPR applies, regardless of where you are headquartered, where your servers are located, or what industry you operate in. Types of Data Protected: Personal Data vs Protected Health Information (PHI) This is the sharpest structural difference between the two frameworks. HIPAA is focused exclusively on health data in the context of healthcare delivery or payment. GDPR covers all personal data, from email addresses and IP addresses to medical records and genetic profiles. Health data under GDPR is a subset of the broader personal data category, not the totality of it. An organisation that is fully HIPAA-compliant may still be in violation of GDPR if it mishandles employee data, marketing data, or website analytics. Legal Basis for Data Processing GDPR requires organisations to identify a valid legal basis before processing any personal data. For health data, that typically means explicit consent or one of the specific derogations in Article 9(2), such as processing necessary for medical diagnosis or the provision of healthcare. This is a meaningful threshold; pre-ticked boxes, bundled consent, or vague terms of service do not meet GDPR’s standard. HIPAA takes a different approach. It permits covered entities to use and disclose PHI for treatment, payment, and healthcare operations without obtaining patient consent. Authorisation is required only in specific circumstances, such as disclosures for marketing purposes or release of psychotherapy notes. Important: GDPR’s explicit consent requirement creates real friction for U.S. healthcare organisations treating EU patients. A hospital cannot rely on its standard HIPAA-compliant intake forms to satisfy GDPR. The legal bases must be documented separately, and consent forms must meet the GDPR’s granularity requirements. Regulatory Authority and Enforcement HHS OCR is