Checklist: Vendor Questions to Ask Before Buying an AI-Powered Rehab Tool

Before you sign: the pre-purchase checklist to avoid costly surprises with AI rehab tools

If you're a clinician, rehab director, or procurement lead shopping for an AI-powered recovery platform in 2026, your top concerns are clear: secure, compliant cloud hosting; measurable uptime and resilience; predictable financial risk; and smooth integrations into clinical workflows. Recent events — from major cloud outages in mid‑January 2026 to hyperscale vendors launching sovereign clouds — make this moment critical. Use this checklist to ask the right vendor questions and verify answers before you buy.

"Sovereign cloud launches and public outages in early 2026 show healthcare buyers must treat cloud posture and SLAs as clinical safety requirements, not optional features."

Why this checklist matters in 2026

Two trends changed the purchasing playbook this year. First, major cloud vendors have introduced sovereign cloud offerings (for example, AWS launched an independent European Sovereign Cloud in January 2026) to meet regional data‑sovereignty and regulatory demands. Second, high‑profile outages in January 2026 exposed systemic single‑provider risks — making uptime, multi‑region redundancy, and explicit vendor continuity plans business‑critical items for healthcare providers and payers.

Combine those trends with the rapid adoption of AI in remote rehabilitation and you have a landscape where a vendor's security posture, contractual guarantees, and financial health directly affect patient care continuity and regulatory exposure.

How to use this checklist

Use the sections below as an interrogation framework. For each question, request documentary proof and follow the verification steps. Score vendors on compliance artifacts, operational transparency, resilience, and exit-readiness. Vendors who refuse documentation, provide vague answers, or cannot meet basic contractual commitments should be escalated to legal and IT risk teams.

1) Security & compliance posture — the must‑have questions

Key questions to ask

• Do you sign a Business Associate Agreement (BAA)? Provide a template.
• Which certifications and attestations do you maintain? (e.g., FedRAMP Moderate/High, SOC 2 Type II, ISO 27001, HIPAA compliance reports)
• If FedRAMP‑authorized, is yours a JAB authorization or Agency ATO? Can we review the System Security Plan (SSP) and Plan of Action & Milestones (POA&M)?
• Do you perform third‑party penetration tests and vulnerability scans? Can you share recent executive summaries and remediation timelines?
• How is data encrypted in transit and at rest? Who controls encryption keys — you or the customer? Do you offer BYOK or HSM‑backed CMKs?
• Describe your identity and access controls: zero‑trust architecture, least privilege, log retention, and privileged access reviews.
• What logging and monitoring integrations are available (SIEM, Splunk, Datadog)? Can audit logs be exported to our environment?

What to request and verify

• Request SOC 2 Type II report and redacted SSP/POA&M for FedRAMP status. Validate issuance dates and scope.
• Confirm the scope covers the specific product modules you will use (AI model inference, patient data storage, clinician dashboards).
• Validate pen test summaries were performed within the last 12 months and that critical findings are either fixed or have acceptable mitigations.
• Verify encryption standards (TLS 1.3, AES‑256, FIPS 140‑2/3 where required).

2) Sovereignty & data residency — questions inspired by 2026 cloud trends

Regional sovereignty is no longer theoretical. Public vendors now offer physically and logically separated sovereign clouds. You must decide whether your organization needs a vendor that can commit to local cloud regions, or deploy to a customer‑controlled environment.

Questions to ask

• Where will patient data be stored, processed, and backed up? Name the regions and cloud providers.
• Do you support deployment into sovereign clouds (e.g., AWS European Sovereign Cloud) or customer‑owned/cloud‑brokered hosted environments?
• Can you commit to contractual data residency clauses and not transfer data outside agreed boundaries without written consent?
• What controls ensure data is logically separated from other tenants and physically separated where required?

Verification steps

• Ask for an architecture diagram showing data flows, ingress/egress points, and storage locations.
• Request a written data residency addendum and test the vendor's ability to demonstrate proof of region (console screenshots, service endpoints).
• Confirm whether subcontractors or model providers may move data—get a list of subprocessors and their locations and enter contractual approvals.

3) Uptime, SLA & resilience — treat SLAs as clinical safety metrics

Outages affect care delivery. SLAs for uptime, incident response, and data recovery must be concrete and measurable.

Critical SLA questions

• What uptime % do you guarantee for patient‑facing services, clinician dashboards, and APIs? (Aim for 99.95%+ for critical services.)
• How are uptime calculations made? Which exclusions (maintenance windows, force majeure) apply?
• What are your RTO (Recovery Time Objective) and RPO (Recovery Point Objective) for full system failures and regional failures?
• What financial remedies (service credits) apply for SLA breaches, and how are they calculated and capped?
• Describe your incident response process: time to acknowledge, time to remediate, communications cadence, and post‑incident reporting.
• What multi‑region and multi‑cloud redundancy options exist? Can critical components run in another sovereign cloud or on our premises in emergencies?

Practical SLA validation

• Ask for a sample SLA clause and map it to your clinical availability needs. Require explicit RTO/RPO numbers and credits tied to patient impact.
• Request historical uptime reports for the last 12 months. Validate reported incidents against public outage trackers and news (e.g., January 2026 outage dashboards).
• Confirm runbooks and tabletop exercise reports related to region failover and business continuity tests.

Sample SLA clause: "Provider guarantees 99.95% monthly uptime for the clinician dashboard and 99.9% for patient mobile services. In the event uptime falls below guaranteed levels, the customer will receive service credits equal to X% of monthly fees per 0.1% outage, up to Y% cap. RTO for critical patient services shall be <4 hours; RPO <1 hour."

4) Financial health & business continuity — avoiding vendor failure risk

AI startups can be volatile. Review financial health to avoid mid‑contract shutdowns, product sunsetting, or price shocks. Public corporate actions (acquisitions, debt restructuring) often change product roadmaps — the BigBear.ai example in 2025–26 shows how an acquisition of a FedRAMP‑approved AI platform can be positive but also introduces new risks.

Questions to ask

• What is your current runway / months of operating cash at current burn rate? (For public vendors, request recent financial statements.)
• Who are your primary investors and are there concentration risks or single large customer dependencies?
• Do you maintain product continuity protections—source code escrow, data escrow, or committed transition services if the vendor ceases operations?
• How often do you update pricing? Are there caps on annual increases? What happens to services on acquisition?

Mitigations and contractual protections

• Negotiate source code or data escrow with automated release criteria (bankruptcy, insolvency, or inability to support production).
• Require a migration and transition plan with staffed transition support and reasonable fees carved into the contract.
• Include a clause requiring 6–12 months notice and transitional support before discontinuing a product or module.

5) Integration, APIs & clinical workflow fit

An AI rehab tool must plug into EMRs, device telemetry, scheduling systems, and clinician workflows with minimal manual work.

Technical fit questions

• What APIs and SDKs do you provide? Are they documented with OpenAPI/Swagger? Include rate limits and SLAs for API availability.
• Do you support healthcare standards: FHIR, HL7 v2, DICOM for imaging, and relevant device protocols?
• How do you handle patient identity matching and consent? Do you support identity proofing and patient opt‑out mechanisms?
• Can you provide a full integration test plan and sample data (redacted) for validation in our staging environment?

Verification and pilot recommendations

• Run a time‑boxed integration pilot focused on core EHR workflows. Validate real clinician tasks rather than synthetic tests.
• Require horizontal and vertical metrics: API latency percentiles (p50, p95, p99), error rates, and end‑to‑end task completion time for clinicians and patients.
• Ask for integration runbooks and an assigned technical integration lead from the vendor for the pilot period.

6) Support, training & operational readiness

Operational support makes or breaks adoption. Avoid vendors that treat onboarding as an upsell.

Questions to ask

• What levels of support do you offer (standard, premium, enterprise)? Are clinical support hours covered (onshore vs. offshore)?
• Is training included? Describe clinician, IT, and patient training curricula and materials. Do you offer train‑the‑trainer programs?
• What is your average time to onboard a site like ours (size, integration complexity)? Provide examples or case studies.

Actionable acceptance criteria

• Define measurable onboarding milestones: data ingestion, EHR integration, clinician acceptance testing, and go‑live readiness checks.
• Document success criteria for pilots (e.g., 80% clinician task completion without vendor support within 30 days).

7) Contract language & negotiation levers

Get legal involved early. Technical promises need legal teeth.

Key contract items to include

• Data residency and transfer clause with explicit region names.
• BAA and HIPAA indemnity — vendor indemnifies breaches caused by vendor negligence.
• SLA with clear RTO/RPO and defined service credit mechanics tied to financial impact.
• Subprocessor approval process and right to audit subprocessors.
• Escrow and exit assistance including format, timeframe, and transfer fees.
• Change management and product‑sunsetting notice — minimum notice period and transition commitments.

8) Verification playbook — how to validate vendor claims

Ask for artifacts and then validate them. Below is a practical order of operations.

1. Collect documentation: SOC 2, FedRAMP SSP/POA&M, pen test summaries, architecture diagrams, SLA, subcontractor list, financials, and API docs.
2. Run reference checks with three customers in your segment. Ask about outages, support responsiveness, and contract enforcement.
3. Validate certifications and claims with the issuing body (FedRAMP marketplace, ISOs). For FedRAMP check JAB/AOS records.
4. Perform a security technical validation: run a scoped vulnerability assessment and verify log forwarding and encryption configurations in staging.
5. Execute a pilot integration and a failover tabletop exercise to test RTO/RPO in practice.

9) Red flags — when to pause or walk away

• Vendor refuses to sign a standard BAA or provide a FedRAMP/SOC 2 report when handling PHI.
• Vague uptime numbers without concrete RTO/RPO or no historical uptime data.
• No escrow, transition plan, or short notice periods for product changes.
• Unclear subprocessor list or refusal to provide region‑specific data residency commitments.
• Frequent price changes or no caps on annual increases that could materially affect long‑term budgets.

Practical, step‑by‑step checklist you can use in procurement

1. Request core documents (BAA, SOC 2, FedRAMP SSP/POA&M, pen test summary, SLA, subprocessor list).
2. Score vendor answers across four domains: Security (0–30), Resilience (0–25), Integration (0–20), Financial Risk & Contract (0–25).
3. Run a 30–60 day pilot with defined clinical KPIs and integration milestones.
4. Run a simulated outage tabletop with vendor showing failover steps and communications.
5. Negotiate contract additions (escrow, RTO/RPO, data residency, BAA, exit assistance) before production signoff.

Final checklist: 20 essential vendor questions (printable)

1. Do you sign a BAA and provide a template?
2. Which certifications do you hold (SOC 2, ISO 27001, FedRAMP)? Provide reports.
3. Where is patient data stored? List regions and clouds.
4. Can you deploy to a sovereign cloud or customer‑owned environment?
5. Do you support BYOK and HSM‑based key management?
6. What is your guaranteed uptime % for critical services?
7. Provide RTO/RPO values for critical and non‑critical services.
8. Show historical uptime and incident reports for the last 12 months.
9. Who are your subprocessors and where are they located?
10. Do you maintain source code/data escrow? Provide details.
11. What are your financials / runway? Provide audited statements if private.
12. Describe API docs, FHIR support, and integration SDKs.
13. How do you support clinician identity matching and consent?
14. What does onboarding include and what are the timeline estimates?
15. What support tiers exist and SLA for ticket response/escalation?
16. Can you provide pen test summaries and remediation timelines?
17. How do you calculate downtime and what exclusions apply?
18. Do you offer multi‑region failover or cross‑cloud redundancy?
19. What notice will you provide before sunsetting a product or module?
20. Do you indemnify HIPAA breaches caused by vendor negligence?

Closing: make vendor evaluation a clinical safety process

Buying an AI rehab tool in 2026 is not just a product purchase — it's a clinical systems integration challenge with legal, operational, and financial dimensions. Use this checklist to convert vendor marketing into verifiable, contractual commitments. Prioritize vendors that treat security posture, sovereign deployment options, measurable SLAs, and exit readiness as fundamental features—not optional premium add‑ons.

If you want a ready‑to‑use worksheet that maps these questions to risk scores and contract clauses, our procurement team has a downloadable vendor evaluation template tailored for rehab providers and digital therapeutics programs.

Next step: Download the vendor evaluation worksheet, run a one‑week documentation sprint, and require any shortlisted vendor to complete the worksheet before pilot approval. If you’d like help running the pilot or reviewing responses, reach out to our team for a technical and legal review tailored to recovery and rehabilitation workflows.

Call to action

Ready to reduce risk and protect patients? Contact therecovery.cloud for a free 30‑minute vendor review or download our AI Rehab Vendor Evaluation Worksheet to start your procurement sprint.

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