Yes. Just like you can create a Route 53 resource record that points to an address outside AWS, you can set up health checks for parts of your application running outside AWS, and you can fail over to any endpoint that you choose, regardless of location. For example, you may have a legacy application running in a datacenter outside AWS and a backup instance of that application running within AWS. You can set up health checks of your legacy application running outside AWS, and if the application fails the health checks, you can fail over automatically to the backup instance in AWS.