Technical Platform

Five tiers. One intelligence layer.

A layered, microservices-based architecture with federated data fabric and AI-native design — built to scale from 5 pilot sites to 100+ institutions without re-architecture.

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Platform at a glance

Data Standard
FHIR R4 Native — full resource coverage with real-time streaming and batch ingestion
Privacy Model
Differential Privacy (ε ≤ 1.0) — no raw patient data ever leaves institutional boundaries
EHR Integration
SMART on FHIR — certified for 21st Century Cures interoperability requirements
Security Framework
OAuth 2.0 + HIPAA/HITECH — SOC 2 Type 2 audited with immutable audit trails
Evidence Velocity
<2 Year Evidence-to-Practice — from literature ingestion to point-of-care recommendation
Network Scale Target
100+ Sites — global architecture built for international deployment without re-design
Technical Architecture

Five-tier platform

Layered, microservices-based architecture with federated data fabric and AI-native design — each tier is independently scalable.

1
Data Ingestion & Harmonization
Foundation

FHIR R4 native ingestion with AI-powered NLP to unlock the 80% of clinical information locked in unstructured notes. Supports HL7 v2 ADT/ORU/ORM messages, CDA documents, CSV flat files, and direct EHR adapters. Automated OMOP CDM mapping enables immediate compatibility with existing research networks. Real-time streaming and batch ingestion pipelines operate in parallel with data quality scoring and automated provenance tracking at every record.

FHIR R4 Native AI-Powered NLP HL7 v2 CDA OMOP CDM Real-Time Streaming Data Quality Scoring Provenance Tracking
2
Federated Data Fabric
Privacy-First

Local data nodes deployed at each institution ensure raw patient data never traverses institutional boundaries. ε-differential privacy (ε ≤ 1.0) governs all federated learning aggregations with mathematically provable privacy guarantees. Cross-silo federated learning allows the network to train shared models on distributed data. GDPR and HIPAA compliant node architecture with encrypted data manifests and secure aggregation protocols enable collective intelligence without collective exposure.

Differential Privacy Local Nodes No Raw Data Movement Cross-Silo Federated Learning GDPR Compliant Encrypted Manifests Secure Aggregation
3
AI & Analytics Engine
Intelligence

The cognitive core of the platform. Diagnostic clinical decision support with full explainability via LIME and SHAP. Therapeutic matching through multi-omic profiling aligns patients to molecularly-matched therapies. Prognostic models incorporate survival analysis and time-to-event modeling. Deep learning for genomic signatures enables variant interpretation at scale. Digital twin patient simulation supports treatment planning and risk stratification. Natural language generation produces narrative clinical summaries. A versioned model registry ensures reproducibility and regulatory auditability across every model deployed to the network.

Diagnostic CDS Therapeutic Matching Prognostic Models Survival Analysis Multi-Omic Deep Learning Digital Twins NLG Clinical Summaries Model Registry
4
Clinical Application Layer
Point of Care

SMART on FHIR EHR-embedded applications launch natively within Epic, Cerner, and Oracle Health workflows — no separate login, no context switching. Network-wide dashboards and Statistical Process Control (SPC) charts surface quality and outcomes data in real time. The research workbench provides biostatisticians and investigators a secure analytics environment. AI-powered clinical trial matching surfaces eligible NCT studies at the point of care. Patient-reported outcome (PRO) capture integrations collect structured data directly from patients. Automated care gap alerts drive proactive outreach across the network.

SMART on FHIR Epic / Cerner / Oracle Network Dashboards SPC Charts Research Workbench Trial Matching PRO Capture Care Gap Alerts
5
Governance & Security
Trust Layer

HIPAA/HITECH compliance is the architectural foundation, not an afterthought. OAuth 2.0 and SAML 2.0 SSO integration connects to every institutional identity provider. Immutable audit trails anchored via blockchain-style hashing capture every data access, model inference, and clinical recommendation. AI bias detection and model fairness metrics run continuously against every deployed model. The model registry maintains version lineage with full explainability (LIME/SHAP) surfaced at the point of care. Role-based access control and data use agreements govern what each institutional participant can see and query across the network.

HIPAA / HITECH OAuth 2.0 SAML SSO Immutable Audit Trails Bias Detection LIME / SHAP RBAC Data Use Agreements
Evidence-Based Medicine

Living evidence engine

From static guidelines to dynamic knowledge. The platform continuously ingests, appraises, synthesizes, applies, and generates clinical evidence.

1
Capture

PubMed, Cochrane Library, ClinicalTrials.gov, FDA drug label updates, WHO guidelines, and network-generated real-world evidence (RWE) streams feed a continuous ingestion pipeline. Automated de-duplication, citation tracking, and publication-type classification ensure the knowledge base remains current without manual curation overhead.

PubMed Cochrane Library ClinicalTrials.gov FDA Label Updates WHO Guidelines RWE Streams
2
Appraise

AI-assisted GRADE scoring (Grading of Recommendations, Assessment, Development and Evaluation) automates the structured appraisal of each new publication, with a clinical expert review layer for high-impact evidence. Confidence scoring, bias risk assessment, and study quality classification are applied to every source, enabling downstream synthesis to weight evidence appropriately.

GRADE Scoring Expert Review Layer Confidence Scoring Bias Risk Assessment Quality Classification
3
Synthesize

A dynamic knowledge graph continuously maps disease–biomarker–therapy–outcome relationships across the entire appraised evidence base. Network meta-analysis, indirect treatment comparisons, and Bayesian evidence synthesis aggregate findings across heterogeneous data sources — including randomized trials, observational studies, and network-generated real-world evidence — to produce ranked, context-aware recommendations.

Knowledge Graph Network Meta-Analysis Bayesian Synthesis Indirect Comparisons
4
Apply

Point-of-care clinical decision support is surfaced directly within the EHR via SMART on FHIR. Recommendations are ranked by evidence strength and contextualized to the individual patient's molecular profile, phenotype, comorbidities, and prior treatment history. Clinicians see not just what to consider, but why — with evidence citations, confidence levels, and SHAP-based explanations for every AI-assisted recommendation.

SMART on FHIR CDS Evidence Ranking Molecular Context SHAP Explanations
5
Generate

The network does not merely consume evidence — it produces it. Pragmatic embedded trials, N-of-1 studies, and registry linkage generate prospective real-world evidence directly from clinical care at network sites. This evidence is fed back into the Capture stage, closing the continuous learning loop and progressively reducing the evidence-to-practice gap toward the platform's target of under two years.

Pragmatic Trials N-of-1 Studies Registry Linkage RWE Generation Continuous Learning Loop
Integrations

Built for the ecosystem you have

Standards-native integration with every major EHR, data warehouse, and clinical research platform.

Epic & Cerner
SMART on FHIR app launch and CDS Hooks integration enable native embedding within clinician workflows. Full FHIR R4 API coverage certified for 21st Century Cures Act interoperability requirements. No separate login or context switch for clinicians.
HL7 & FHIR R4
Full FHIR R4 resource support across all clinical domains. HL7 v2 ADT, ORU, and ORM message parsing with AI-assisted semantic normalization maps legacy message formats to structured FHIR resources without manual transformation rules.
Genomic Platforms
VCF ingestion and GA4GH standards integration including Phenopackets, Beacon API, and Variant Representation Specification (VRS). ClinVar and gnomAD annotation pipelines enrich variant data with population frequency and clinical significance at scale.
Research & Registries
Bidirectional data flows with REDCap, i2b2, OMOP CDM, PCORnet, ImproveCareNow, and PEDSnet. Semantic mapping pipelines translate between registry schemas and FHIR R4 resources with AI-assisted field-level alignment and confidence scoring.
Identity & Access
OAuth 2.0 and SAML 2.0 connect to institutional identity providers for single sign-on. SMART on FHIR launch context and scopes govern application-level permissions. Multi-factor authentication, attribute-based access control, and data use agreement enforcement are applied at every access boundary.
Cloud & Deployment
AWS, Azure, GCP, on-premise, and hybrid deployment models supported. Kubernetes orchestration with Terraform infrastructure-as-code ensures reproducible, auditable deployments across environments. 99.9% SLA with automated failover and regional data residency options for international compliance.
Data Migration

Zero-data-loss migration

Migration is not just a transfer — it's an upgrade. Every dataset is enriched with modern terminologies, NLP extraction, quality scoring, and AI-readiness indexing.

1
Discovery & Profiling
Assessment

Automated source system inventory runs schema analysis, data quality assessment, volume estimation, and field-level data profiling across all candidate source systems. Identifies data gaps, encoding inconsistencies, missing value patterns, and referential integrity violations. Outputs a comprehensive Data Quality Report with a prioritized remediation plan before a single record is migrated.

Schema Analysis Data Quality Assessment Volume Estimation Field-Level Profiling Quality Report
2
Semantic Mapping
Translation

AI-assisted FHIR R4 resource mapping with confidence scoring at the field level. Mappings above the confidence threshold are applied automatically; low-confidence mappings are routed to a human-in-the-loop validation queue for clinical informaticist review. Comprehensive terminology mapping to SNOMED CT, LOINC, RxNorm, and ICD-10/ICD-11 modernizes legacy code sets in place.

FHIR R4 Mapping Confidence Scoring Human-in-the-Loop SNOMED CT LOINC RxNorm ICD-10 / ICD-11
3
Transform & Enrich
Upgrade

The FHIR R4 conversion pipeline executes the validated mappings at scale. NLP extraction runs against historical clinical notes to surface structured concepts previously buried in free text — diagnoses, symptoms, medications, procedures, and findings. Terminology modernization, AI-readiness indexing, and de-identification pipelines for federated learning cohorts are applied to every record during transformation.

FHIR R4 Conversion NLP Extraction Terminology Modernization AI-Readiness Indexing De-Identification
4
Validate & Reconcile
Quality Gate

Schema validation confirms structural conformance of every FHIR resource produced. Semantic consistency checks verify that translated concepts preserve clinical meaning. Quantitative reconciliation compares record counts, date ranges, and referential integrity between source and target. Clinical subject matter expert review is structured for domain-specific validation — ensuring that a pediatric gastroenterologist, not just an informaticist, confirms IBD data integrity.

Schema Validation Semantic Consistency Quantitative Reconciliation Clinical SME Review Referential Integrity
5
Parallel Operations & Cutover
Go-Live

A parallel run period operates both source and Hive systems simultaneously, with automated divergence monitoring flagging any discrepancy between outputs. Clinician user acceptance testing follows a structured sign-off protocol. Live cutover is executed with rollback capability maintained for 30 days. Source data is archived for 12 months post-migration, available for audit and reconciliation queries without requiring source system access.

Parallel Run Divergence Monitoring Clinician UAT Rollback Capability 12-Month Archive
Source System Estimated Timeline
Hive Networks (new deployment) 6 weeks
PEDSnet (OMOP CDM) 8–10 weeks
ImproveCareNow 8–10 weeks
EHR Direct (Epic / Cerner) 10–12 weeks
REDCap / Custom Registry 8–12 weeks
Molecular / Genomic Data 6–8 weeks
Security & Compliance

Trust by design

Security is not a layer on top — it is woven into the architecture. Every component is designed to meet the highest standards in healthcare data governance.

HIPAA & HITECH

Full HIPAA Security Rule compliance across all platform components and deployment environments. HITECH breach notification procedures with documented response timelines. Annual risk assessments using the NIST Cybersecurity Framework. Business Associate Agreements (BAAs) executed with all sub-processors and cloud infrastructure providers.

Federated Privacy

Differential privacy with ε ≤ 1.0 is applied to all federated learning aggregations, providing mathematically provable bounds on individual-level information leakage. No raw patient data leaves institutional boundaries under any network operation. Secure multi-party computation is employed for sensitive analyses requiring cross-institutional coordination.

Audit & Explainability

Immutable audit trails capture every data access event, model inference call, and clinical recommendation delivery — timestamped, user-attributed, and hash-anchored for tamper evidence. LIME and SHAP-based model explainability is surfaced to clinicians at the point of care alongside every AI-assisted recommendation, satisfying both regulatory and ethical requirements for algorithmic transparency.

SOC 2 Type 2

Annual SOC 2 Type 2 audits cover the Security, Availability, and Confidentiality trust service criteria. An independent penetration testing program and continuous vulnerability management identify and remediate weaknesses before they can be exploited. Reports are available to network members under NDA upon request.

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