How Intel SGX and Gramine Can Shield Health Data During Cloud Inference

Confidential Computing using Trusted Execution Environments (TEEs) offers a hardware-based approach to protecting sensitive health data processed in the cloud. Intel SGX creates an isolated memory region called an enclave, where data remains encrypted even if the host operating system or root administrator is compromised. A practical pipeline can be built using Intel SGX, the Gramine library OS, and C++, allowing health inference models to run on encrypted inputs without exposing data to the underlying cloud infrastructure. Gramine acts as a bridge between standard Linux binaries and SGX hardware, enabling containerized deployment via Docker without rewriting application code. The approach ensures that both model weights and patient data, such as heart rate readings, stay protected throughout the entire inference lifecycle.