Computer use powered by local/cloud models for regulated industries?

The local models seem powerful enough to be capable of running basic local computer use. This is a computer use agent/harness built via claude code, and powered by qwen3.8 flash next nvfp4. Drawing a simple image of its choice took 12m 1s, but a lot of that time was spent by the agent trying to figure out a WebGL bug. For what it did, it seems relatively fast. Prefill speed \~1000 tps, gen speed \~50 tps. I went to openai’s devday a couple days ago, and it seems like cloud models that are very smart and fast, like “astra ultrafast”, can perform work even quicker, for a premium.

Does anyone have experience with computer use agents/harnesses that are open-source and plug-n-play, that are robust enough to be used in regulated fields such as law/medicine? How do people deal with regulations, such as making such workflows HIPAA compliant in medicine? Experiences with helping users ensure that workflows are completed accurately? And whether they go with local or cloud models to power computer use?