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OpenEvidence Multi-Environment Setup

openevidence-multi-env-setup

Multi Env Setup for OpenEvidence.

SKILL.md

Full skill instructions

OpenEvidence Multi-Environment Setup

Overview

OpenEvidence clinical AI requires strict environment separation to maintain HIPAA compliance across the data lifecycle. Development uses only synthetic patient data with no PHI access, staging operates on de-identified datasets for clinical validation, and production handles full PHI under BAA-covered infrastructure. Each environment enforces its own audit logging, encryption, and access control policies. Misconfigured environments risk PHI exposure and regulatory violations, making environment validation a hard requirement at startup.

Environment Configuration

const openEvidenceConfig = (env: string) => ({
  development: {
    apiKey: process.env.OPENEVIDENCE_API_KEY_DEV!, baseUrl: "https://api.dev.openevidence.com/​v1",
    dataClassification: "synthetic", phiEnabled: false, auditLevel: "basic", encryptionRequired: false,
  },
  staging: {
    apiKey: process.env.OPENEVIDENCE_API_KEY_STG!, baseUrl: "https://api.staging.openevidence.com/​v1",
    dataClassification: "de-identified", phiEnabled: false, auditLevel: "full", encryptionRequired: true,
  },
  production: {
    apiKey: process.env.OPENEVIDENCE_API_KEY_PROD!, baseUrl: "https://api.openevidence.com/​v1",
    dataClassification: "phi", phiEnabled: true, auditLevel: "full", encryptionRequired: true,
  },
}[env]);

Environment Files

# Per-env files: .env.development, .env.staging, .env.production
OPENEVIDENCE_API_KEY_{DEV|STG|PROD}=<api-key>
OPENEVIDENCE_BASE_URL=https://api.{dev.|staging.|""}openevidence.com/​v1
OPENEVIDENCE_DATA_CLASS={synthetic|de-identified|phi}
OPENEVIDENCE_PHI_ENABLED={false|false|true}
OPENEVIDENCE_AUDIT_LEVEL={basic|full|full}
OPENEVIDENCE_BAA_ID=<baa-id>          # production only

Environment Validation

function validateOpenEvidenceEnv(env: string): void {
  const suffix = { development: "_DEV", staging: "_STG", production: "_PROD" }[env];
  const required = [`OPENEVIDENCE_API_KEY${suffix}`, "OPENEVIDENCE_BASE_URL", "OPENEVIDENCE_DATA_CLASS"];
  if (env === "production") required.push("OPENEVIDENCE_BAA_ID");
  if (env !== "development") required.push("OPENEVIDENCE_AUDIT_LEVEL");
  const missing = required.filter((k) => !process.env[k]);
  if (missing.length) throw new Error(`Missing OpenEvidence vars for ${env}: ${missing.join(", ")}`);
  if (env === "production" && process.env.OPENEVIDENCE_PHI_ENABLED !== "true")
    throw new Error("HIPAA violation: PHI must be enabled in production");
}

Promotion Workflow

# 1. Run clinical queries against synthetic data in dev
curl -X POST "$OPENEVIDENCE_BASE_URL/​query" \
  -H "Authorization: Bearer $OPENEVIDENCE_API_KEY_DEV" -d @synthetic-query.json

# 2. Validate with de-identified data in staging (audit logs required)
curl -X POST "$OPENEVIDENCE_BASE_URL/​query" \
  -H "Authorization: Bearer $OPENEVIDENCE_API_KEY_STG" -d @staging-query.json

# 3. Verify HIPAA audit trail exists for all staging queries
curl "$OPENEVIDENCE_BASE_URL/​audit/​logs?env=staging" \
  -H "Authorization: Bearer $OPENEVIDENCE_API_KEY_STG" | jq '.totalEntries'

# 4. Deploy to production (requires BAA verification)
OPENEVIDENCE_BAA_ID=baa-2026-001 npm run deploy -- --env production --hipaa-check

Environment Matrix

SettingDevStagingProd
Data TypeSynthetic onlyDe-identifiedFull PHI
PHI AccessNoNoYes (BAA required)
Audit LoggingBasicFullFull + HIPAA trail
Encryption at RestOptionalRequiredRequired (AES-256)
Access ControlDeveloper onlyClinical QA teamAuthorized clinicians
BAA RequiredNoNoYes

Error Handling

IssueCauseFix
HIPAA validation failed at startupPHI_ENABLED not set in productionSet OPENEVIDENCE_PHI_ENABLED=true in prod env file
BAA ID missingProduction deploy without BAA referenceAdd OPENEVIDENCE_BAA_ID from compliance team
403 on PHI endpointDev/​staging key used against prod APIUse environment-specific API key with correct scope
Audit log gap detectedStaging queries not loggedVerify OPENEVIDENCE_AUDIT_LEVEL=full in staging env

Resources

Next Steps

See openevidence-deploy-integration.

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