This may be true for some large players in coastal states but definitely not true in general
Your typical non-coastal state run health system does not have model access outside of people using their own unsanctioned/personal ChatGPT/Claude accounts. In particular even if you have model access, you won't automatically have API access. Maybe you have a request for an API key in security review or in the queue of some committee that will get to it in 6 months. This is the reality for my local health system. Local models have been a massive boon in the way of enabling this kind of powerful automation at a fraction of the cost without having to endure the usual process needed to send data over the wire to a third party
That access is over a limited API and usually under heavy restrictions on the healthcare org side (e. g., only use a dedicated machine, locked up software, tracked responses and so on).
Running a local model is often much easier: if you already have data on a machine and can run a model without breaching any network one could run it without any new approvals.
HIPAA systems at any sane company will not have "a straight connect" to anything on Asure, AWS or GCP. They will likely have a special layer dedicated to record keeping and compliance.
Your typical non-coastal state run health system does not have model access outside of people using their own unsanctioned/personal ChatGPT/Claude accounts. In particular even if you have model access, you won't automatically have API access. Maybe you have a request for an API key in security review or in the queue of some committee that will get to it in 6 months. This is the reality for my local health system. Local models have been a massive boon in the way of enabling this kind of powerful automation at a fraction of the cost without having to endure the usual process needed to send data over the wire to a third party