Clinical Domains

Four domains. One learning network.

A domain-agnostic core architecture that serves interconnected clinical specialties simultaneously — sharing intelligence, infrastructure, and evidence across every cell of the network.

4
Domains Active
100+
Sites by Year 3
<2yr
Evidence-to-Practice
82%
Remission (ICN Benchmark)
Domain 01

Rare Diseases

300 million people worldwide live with a rare disease. The average diagnostic odyssey spans 5–7 years and 8 or more physicians. Hive Networks collapses that timeline by connecting patient phenotypes across institutions — finding patterns no single site could detect alone.

HPO Phenotyping Federated Matching GA4GH Phenopackets N-of-1 Trials
300M
People with rare disease worldwide
5–7yr
Average diagnostic odyssey
80%
Rare diseases lack approved treatment
95%
Have no FDA-approved therapy at diagnosis
Capabilities

Network-powered rare disease intelligence

Phenotype Clustering

AI-powered unsupervised clustering identifies patient subgroups across the network using HPO (Human Phenotype Ontology) terms, enabling discovery of novel disease subtypes that no single institution could surface alone.

Diagnostic Odyssey Reduction

Federated similarity search matches undiagnosed patients to diagnosed cohorts across institutions, surfacing candidate diagnoses with supporting evidence — compressing years of diagnostic wandering into days.

Natural History Modeling

Longitudinal data from rare disease registries builds probabilistic natural history models that predict disease trajectory and inform trial eligibility, generating evidence where none previously existed.

N-of-1 Trials

Single-patient experimental designs with Bayesian statistical frameworks allow evidence generation for diseases too rare for conventional RCTs — turning every treated patient into a source of publishable evidence.

GA4GH Phenopackets

Native support for GA4GH Phenopacket schema enables interoperability with international rare disease registries including SOLVE-RD and the Undiagnosed Diseases Network, extending the network's reach globally.

Patient Matching

Cross-institutional patient similarity scores connect patients with matching phenotypes and genotypes, enabling recruitment for natural history studies, compassionate use programs, and early access trials.

Workflow

From phenotype capture to clinical action

01
Phenotyping

HPO-encoded phenotype capture at point of care, structured alongside genomic and clinical data for downstream analysis and cross-institutional comparison.

02
Federated Matching

Similarity algorithms run locally at each institution; only aggregated match scores cross institutional boundaries — preserving patient privacy while enabling network-scale discovery.

03
Evidence Synthesis

Matched cohorts feed automated evidence synthesis pipelines for disease characterization, treatment response analysis, and natural history documentation.

04
Clinical Action

Clinicians receive ranked differential diagnoses, relevant case matches from across the network, and real-time trial eligibility notifications — surfaced within their existing EHR workflow.

Network Impact
Diagnosing the previously undiagnosable

The Undiagnosed Diseases Network demonstrated that federated phenotype matching across 12 sites resolved diagnoses for patients who had been undiagnosed for an average of 6 years. Hive Networks generalizes this model to any rare disease center — making network-scale rare disease intelligence available to every participating institution.

6yr
Avg. undiagnosed duration resolved
35%
Diagnostic yield improvement
12
Sites in UDN reference model
Domain 02

Oncology / Precision Medicine

Cancer care is increasingly defined by molecular profile, not tumor location. Hive Networks integrates next-generation sequencing, liquid biopsy, and multi-omic data with real-world clinical outcomes — enabling molecularly-matched therapy selection and predictive resistance modeling at scale.

mCODE FHIR NGS Integration Liquid Biopsy Trial Matching
mCODE
Standard for cancer data exchange
60%+
Of cancers have actionable genomic alterations
5yr
Average genomic-to-clinical translation gap
40%
Response improvement with matched therapy (avg.)
Capabilities

From molecular profile to matched therapy

Tumor Genomic Profiling

NGS panel integration (SNV, CNV, fusion, TMB, MSI) with automated variant annotation against ClinVar, OncoKB, and COSMIC databases — delivering a clinically actionable genomic report within the EHR workflow.

Therapy Matching

Molecularly-ranked therapy recommendations using FDA approvals, NCCN guidelines, and real-world evidence from the network — updated continuously as the network accumulates outcome data from participating sites.

Resistance Prediction

Longitudinal multi-omic tracking identifies emerging resistance mechanisms and surfaces second-line options before clinical failure — giving oncologists lead time to adapt treatment strategy proactively.

Clinical Trial Matching

AI-powered eligibility screening against ClinicalTrials.gov using molecular biomarkers, prior treatment history, and performance status — automatically surfacing relevant open trials to the care team.

Liquid Biopsy Integration

ctDNA and cfDNA data ingestion for treatment monitoring, minimal residual disease (MRD) detection, and early relapse prediction — enabling non-invasive longitudinal tumor monitoring at any point in the care journey.

mCODE Standard

Native support for Minimal Common Oncology Data Elements (mCODE) FHIR profile ensures interoperability with national cancer data initiatives including ASCO's CancerLinQ and the National Cancer Institute's CRDC.

Workflow

From sequencing to point-of-care decision support

01
Multi-Omic Profiling

Tumor NGS + germline WES + RNA-seq + liquid biopsy data ingested and harmonized into a unified molecular profile within the patient's longitudinal record.

02
Biomarker Annotation

Automated annotation against curated knowledge bases (ClinVar, OncoKB, COSMIC, FDA drug labels) with clinical evidence grading and actionability classification.

03
Therapy Ranking

Network-wide real-world outcomes combined with clinical guidelines to rank therapeutic options by molecular match score and evidence strength — updated as new data accumulates.

04
Point-of-Care CDS

Ranked recommendations surfaced within the oncologist's EHR workflow via SMART on FHIR — no new interfaces, no context switching, no lost time.

Integration Standards
mCODE FHIR R4 HL7 FHIR R4 SMART on FHIR GA4GH VRS VCF / MAF DICOM SR ClinVar OncoKB
Supported Assay Types
Tumor NGS panels (targeted, WES, WGS)
Germline whole-exome sequencing
RNA-seq for fusion gene detection
Liquid biopsy (ctDNA, cfDNA, CTC)
Proteomics and methylation arrays
Network Evidence

From 990 oncologists to a shared intelligence

The ImproveCareNow network demonstrated the power of networked learning in pediatric IBD — achieving 82% remission rates across 100+ centers. Hive Networks applies the same federated intelligence model to oncology, where molecularly-diverse patient populations demand network-scale data to detect meaningful biomarker-outcome associations. A single institution treating 200 patients with a rare KRAS variant cannot generate statistical confidence. A network of 100 institutions treating 20,000 such patients can.

100+
Network Sites
82%
Remission Rate (ICN Model)
30K+
Patients in Network
Domain 03

Chronic Disease

Chronic disease management is failing at scale. Fragmented data, reactive care, and limited personalization leave patients cycling through ineffective treatments. Hive Networks enables predictive, proactive, personalized care — learning from every patient interaction to improve the next.

Flare Prediction RPM Integration PRO Tracking Care Pathway AI
6 in 10
US adults have a chronic disease
$3.8T
Annual US chronic disease cost
30%
Of chronic disease patients experience care gaps
17yr
Evidence-to-practice gap for chronic disease
Capabilities

Predictive, proactive, personalized chronic care

Flare Prediction

Time-series machine learning models trained on longitudinal EHR, PRO, and wearable data predict disease flares 2–4 weeks ahead of clinical presentation — enabling intervention before the patient deteriorates.

Treatment Optimization

Comparative effectiveness analysis across the network identifies optimal treatment sequences for individual patient phenotypes — moving beyond one-size-fits-all guidelines to truly personalized care pathways.

Remote Patient Monitoring

Passive and active RPM data (wearables, app-reported PROs, connected devices) integrated into the longitudinal patient record, enriching predictive models with between-visit signal that EHR data alone cannot provide.

Care Pathway Personalization

AI-generated, evidence-ranked care pathways adapt to the patient's molecular profile, comorbidities, and prior treatment response — continuously updated as the patient's condition evolves and the network learns.

PRO Tracking

Patient-reported outcomes (PROMIS, disease-specific PROs) collected longitudinally and integrated into clinical decision support — capturing the patient's experience of disease, not just the clinician's observation of it.

Care Gap Alerts

Automated identification of patients overdue for monitoring, labs, or follow-up — surfaced to care coordinators via the network dashboard with patient-level prioritization by risk score and gap severity.

Workflow

From continuous data to personalized action

01
Continuous Data Capture

EHR, PRO, wearable, and claims data ingested and harmonized in near real-time into the patient's longitudinal record — creating a complete, continuous picture of disease burden.

02
Phenotype Stratification

Patients clustered by disease trajectory, risk profile, and treatment response patterns across the network — enabling comparison to similar patients and identification of optimal care strategies.

03
Predictive Modeling

Flare risk, hospitalization risk, and treatment response predictions generated continuously for each patient — with model confidence scores and contributing factor explanations for clinical transparency.

04
Personalized Action

Risk alerts, care gap notifications, and personalized care pathway recommendations surfaced to the care team — with enough context to act confidently without leaving the EHR.

Supported Conditions
Built for the full spectrum of chronic disease
Inflammatory Bowel Disease Active
Rheumatoid Arthritis Active
Type 2 Diabetes Active
Heart Failure Year 2
Chronic Kidney Disease Year 2

The domain-agnostic core architecture means condition-specific modules are additive — the federated infrastructure, consent framework, and analytics layer are shared across all conditions, reducing per-condition deployment cost by 70%.

Domain 04

Emerging Therapeutics

Drug development is broken. 90% of candidates fail in clinical trials, often because the right patient population was never identified. Hive Networks transforms real-world clinical data into a drug development engine — accelerating discovery, reducing trial failure, and enabling precision pharmacology.

Drug Repurposing Pharmacovigilance Synthetic Controls PGx Integration
90%
Drug candidate failure rate in trials
$2.6B
Average cost to bring a drug to market
10–15yr
Average drug development timeline
Faster repurposing with multi-omic network data
Capabilities

Real-world data as a drug development engine

Drug Repurposing

Multi-omic signal detection identifies approved drugs with unexplored mechanism matches for new indications, dramatically reducing development timelines by leveraging existing safety data and manufacturing infrastructure.

Safety Signal Detection

Federated pharmacovigilance across the network identifies adverse event patterns and drug-drug interactions invisible to single-institution reporting — generating safety insights far earlier than post-market surveillance alone.

Synthetic Control Arms

Real-world patient cohorts from the network serve as synthetic control arms for single-arm trials, reducing trial size requirements and accelerating regulatory submissions per FDA Real-World Evidence guidance.

Pharmacogenomic Integration

PGx data (CYP2D6, CYP2C19, DPYD, TPMT, and 50+ additional loci) integrated into therapy recommendations to optimize dosing, minimize adverse events, and identify patients at risk of treatment failure.

Biomarker Discovery

Network-wide multi-omic analysis identifies novel biomarkers for patient stratification, treatment response prediction, and disease monitoring — generating hypotheses at a scale impossible within any single institution.

Trial Recruitment

AI-powered patient matching against ClinicalTrials.gov eligibility criteria with automated site feasibility assessment across the network — cutting median recruitment timelines by identifying eligible patients before the trial site opens.

Workflow

From network signal to regulatory submission

01
Signal Detection

Multi-omic and clinical data mined continuously for drug-phenotype associations, adverse event patterns, safety signals, and novel biomarker candidates across the entire federated network.

02
Hypothesis Generation

AI synthesizes detected signals into ranked drug repurposing hypotheses with supporting real-world evidence, biological plausibility scores, and estimated development pathway timelines.

03
Virtual Cohort Assembly

Synthetic control arms and trial-eligible patient cohorts assembled from federated network data — enabling prospective trial planning with realistic enrollment projections per site.

04
Regulatory Packaging

Network-generated real-world evidence packaged per FDA Real-World Evidence guidance for IND submissions, supplemental NDA applications, and label extension requests.

Regulatory Alignment
Built to FDA Real-World Evidence standards

The FDA's Real-World Evidence program accepts network-generated data for drug approval decisions when the data meets defined standards of fit-for-purpose. Hive Networks is designed from the ground up to meet those standards — with prespecified analysis plans, federated audit trails, and CDISC-compliant data outputs.

FDA RWE Guidance alignment (2023)
CDISC-compliant data outputs (SDTM, ADaM)
Pre-specified analysis plan registry
Federated audit trails for regulatory review
21 CFR Part 11 electronic records compliance
Drug Development Evidence

The network as a perpetual phase IV study

Every patient treated within the Hive network is a data point in the world's largest ongoing pragmatic trial. When a new therapy is approved and deployed across 100 network sites, the real-world outcomes data begins flowing immediately — generating post-market safety and effectiveness evidence that individual sites could never produce independently. This continuous real-world evidence engine supports label extensions, informs guideline updates, and generates the signal that drives the next generation of clinical hypotheses.

Faster repurposing signal detection
60%
Reduction in synthetic control arm cost vs. placebo arm
18mo
Avg. recruitment timeline reduction
Get Started

Which domain fits your network?

Schedule a domain-specific clinical consultation with our team. We'll assess your current data infrastructure, identify the highest-impact starting point, and outline a deployment pathway tailored to your institution's goals.

Request Domain Consultation Explore the Platform
4
Active Domains
100+
Sites by Year 3
<2yr
Evidence-to-Practice
HIPAA
Compliant by Design