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submission"]},{"slug":"prior-authorization-packet-plan","name":"Prior Authorization Packet Plan","route":"/agents/prior-authorization-agent","owner":"Prior Authorization Agent","executionMode":["synthetic-pilot","enterprise-assessment"],"plannerSteps":["identify payer policy source","map missing evidence","draft review packet","attach reviewer checkpoint"],"routerRules":["route to PayerIQ","require RCM reviewer","block payer submission","attach policy trust card"],"specialistAgents":["Prior Authorization Agent","Revenue Cycle Agent","TrustQA Verification Agent"],"humanApprovals":["Payer or RCM review","Governance review"],"trustChecks":["Evidence attribution","Boundary verification","Human approval checkpoint"],"deniedCapabilities":["coverage guarantee","medical necessity determination","autonomous payer submission"]},{"slug":"documentation-review-plan","name":"Documentation Review 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clinician-guided review"],"routerRules":["route to Sanar AI","require clinical reviewer","require evidence timestamp","block reimbursement claim"],"specialistAgents":["Clinical Intelligence Agent","Interoperability Agent","Governance Agent"],"humanApprovals":["Clinical review","Executive sponsor review","Governance review"],"trustChecks":["Evidence attribution","Boundary verification","Human approval checkpoint"],"deniedCapabilities":["reimbursement guarantee","autonomous patient monitoring","clinical outcome claim"]}],"observabilitySignals":[{"metric":"Task throughput","route":"/observability#throughput","purpose":"Track plan creation, routed tasks, sandbox runs, held outputs, and completed reviews.","escalation":"Escalate if workflow queues exceed buyer SLA or review aging threshold."},{"metric":"Override rate","route":"/observability#overrides","purpose":"Measure how often humans reject, modify, or override agent outputs.","escalation":"Escalate to TrustQA when override rate rises above pilot threshold."},{"metric":"Escalation rate","route":"/observability#escalations","purpose":"Track safety, evidence, policy, RBAC, and ambiguity escalations.","escalation":"Escalate to governance when recurring issue category appears."},{"metric":"Trust metrics","route":"/observability#trust","purpose":"Measure confidence distribution, citation completeness, validation freshness, and release blocks.","escalation":"Block promotion when trust-card completeness falls below threshold."},{"metric":"Revenue and access impact","route":"/observability#impact","purpose":"Track time saved, denial-risk signals, revenue leakage surfaced, access bottlenecks, and documentation quality signals.","escalation":"Escalate to executive review before any ROI claim leaves pilot context."}],"hipaaReadyArchitectureControls":["Tenant isolation","Least-privilege RBAC","Business Associate Agreement readiness","Encryption in transit and at rest","Immutable audit trail","Human approval checkpoints","No PHI in synthetic pilots","Prompt-injection and tool-abuse monitoring","Incident response and emergency shutdown policy","Regional retention and data-residency planning"],"interoperabilityConformance":{"service":"scrimed-interoperability-conformance-evaluations","status":"synthetic-conformance-evaluations-ready","boundary":"SCRIMED conformance evaluations execute deterministic checks against synthetic fixtures and declared connector contracts. 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A synthetic pass is not certification, partner acceptance, production authorization, or permission to exchange live healthcare data.","validatedAt":"2026-06-09T12:00:00.000Z"},{"slug":"smart-app-launch-authorization","name":"SMART App Launch Authorization Test Kit","route":"/interoperability/evaluations/smart-app-launch-authorization","apiRoute":"/api/interoperability/evaluations/smart-app-launch-authorization","standardIds":["smart-app-launch","hl7-fhir"],"contractSlug":"fhir-clinical-record-intake","contractRoute":"/contracts/fhir-clinical-record-intake","fixtureRoute":"/integrations/fixtures/fhir-clinical-record-intake","agentOwner":"Interoperability Agent","targetProfile":"SMART App Launch 2.2.0 with FHIR R4 launch context","checks":[{"id":"smart-registry-target","label":"SMART registry target","category":"contract","scope":"synthetic","status":"pass","evidence":"hl7-fhir, smart-app-launch, clinical-terminology","detail":"The FHIR intake contract explicitly binds SMART App Launch."},{"id":"least-privilege-control","label":"Least-privilege control declared","category":"authorization","scope":"synthetic","status":"pass","evidence":"deployment-approved FHIR R4/R4B profile; CapabilityStatement; US Core and USCDI alignment where applicable; SMART scopes for approved applications","detail":"The contract requires approved SMART scopes before applications receive FHIR access."},{"id":"synthetic-data-boundary","label":"Synthetic data boundary","category":"privacy","scope":"synthetic","status":"pass","evidence":"syntheticOnly=true","detail":"Authorization evaluation remains separated from live patient context."},{"id":"scope-matrix","label":"Approved scope matrix","category":"authorization","scope":"live-readiness","status":"block","evidence":"Tenant decision required","detail":"Define user, patient, system, launch, and offline-access scopes per application and role."},{"id":"audience-validation","label":"Token audience validation","category":"security","scope":"live-readiness","status":"block","evidence":"Partner endpoint test required","detail":"Validate aud, issuer, discovery metadata, signing keys, and token lifetime against the partner."},{"id":"launch-context-test","label":"Launch-context and revocation tests","category":"security","scope":"live-readiness","status":"block","evidence":"Partner acceptance required","detail":"Test EHR launch, standalone launch, patient context, revocation, and session termination."},{"id":"authorization-audit","label":"Authorization audit linkage","category":"governance","scope":"live-readiness","status":"block","evidence":"Durable audit decision required","detail":"Link token, tenant, role, patient context, purpose-of-use, and reviewer events without capturing secrets."}],"requiredEvidence":[{"label":"SMART-bound integration contract","status":"available","route":"/contracts/fhir-clinical-record-intake","detail":"FHIR intake contract declares SMART scope approval as a conformance target."},{"label":"Application scope matrix","status":"required-before-live","detail":"Approved least-privilege scopes by application, tenant, role, and launch context."},{"label":"Authorization server test report","status":"required-before-live","detail":"Discovery, audience, issuer, signing, token, launch, revocation, and session tests."}],"liveBlockers":["Production identity provider and tenant-isolation decision","Approved least-privilege scope matrix","Patient-context authorization, consent, and purpose-of-use controls","Partner authorization-server and launch-context testing","Durable authorization audit and security acceptance"],"sourceUrls":["https://hl7.org/fhir/smart-app-launch/"],"status":"synthetic-pass","liveReadiness":"live-blocked","passedChecks":3,"blockedChecks":4,"boundary":"SCRIMED conformance evaluations execute deterministic checks against synthetic fixtures and declared connector contracts. A synthetic pass is not certification, partner acceptance, production authorization, or permission to exchange live healthcare data.","validatedAt":"2026-06-09T12:00:00.000Z"},{"slug":"dicomweb-imaging-exchange","name":"DICOMweb Imaging Exchange Test Kit","route":"/interoperability/evaluations/dicomweb-imaging-exchange","apiRoute":"/api/interoperability/evaluations/dicomweb-imaging-exchange","standardIds":["dicom-dicomweb","ihe-profiles"],"contractSlug":"dicom-imaging-exchange","contractRoute":"/contracts/dicom-imaging-exchange","fixtureRoute":"/integrations/fixtures/dicom-imaging-exchange","agentOwner":"Interoperability Agent","targetProfile":"DICOM current edition with deployment-scoped DICOMweb services","checks":[{"id":"dicom-fixture-present","label":"Synthetic imaging fixture present","category":"fixture","scope":"synthetic","status":"pass","evidence":"fixture-dicom-imaging-exchange-v1","detail":"A deterministic imaging metadata fixture is bound to the DICOM contract."},{"id":"dicomweb-services","label":"DICOMweb service coverage","category":"service","scope":"synthetic","status":"pass","evidence":"QIDO-RS, WADO-RS, STOW-RS","detail":"Synthetic scope declares query, retrieve, and store service families."},{"id":"pixel-data-separation","label":"Metadata and pixel-data separation","category":"privacy","scope":"synthetic","status":"pass","evidence":"includesPixelData=false","detail":"The current fixture validates metadata workflows without production image or pixel data."},{"id":"no-diagnostic-interpretation","label":"Diagnostic interpretation prohibited","category":"clinical-safety","scope":"synthetic","status":"pass","evidence":"diagnostic interpretation, production image exchange, unreviewed record mutation","detail":"The connector may exchange approved artifacts but cannot interpret images or issue diagnosis."},{"id":"dicom-fixture-validation","label":"Deterministic fixture validation","category":"quality","scope":"synthetic","status":"pass","evidence":"10/10 checks passed","detail":"Required imaging signals, safeguards, trace, prohibited actions, and review gates must pass."},{"id":"part-2-conformance-statement","label":"DICOM Part 2 conformance statement","category":"conformance","scope":"live-readiness","status":"block","evidence":"Deployment artifact required","detail":"Retain a deployment-specific conformance statement covering supported roles and services."},{"id":"transfer-syntax-deid","label":"Transfer syntax and de-identification tests","category":"security","scope":"live-readiness","status":"block","evidence":"Partner test required","detail":"Validate accepted transfer syntaxes, metadata handling, de-identification, and failure behavior."},{"id":"imaging-identity-audit","label":"Identity, consent, audit, and security profile","category":"governance","scope":"live-readiness","status":"block","evidence":"Production controls not approved","detail":"Approve endpoint identity, purpose-of-use, consent, audit linkage, and applicable IHE security profiles."}],"requiredEvidence":[{"label":"Synthetic DICOMweb fixture","status":"available","route":"/integrations/fixtures/dicom-imaging-exchange","detail":"Metadata-only request with QIDO-RS, WADO-RS, STOW-RS, and prohibited diagnostic interpretation."},{"label":"Integration fixture validation","status":"available","route":"/integrations/fixture-validation","detail":"10 deterministic checks currently pass."},{"label":"DICOM Part 2 conformance statement","status":"required-before-live","detail":"Deployment roles, services, transfer syntaxes, security, and limitations."},{"label":"Partner DICOMweb acceptance report","status":"required-before-live","detail":"Endpoint, service, transfer syntax, de-identification, error, and audit tests."}],"liveBlockers":["Deployment-specific DICOM Part 2 conformance statement","Partner DICOMweb endpoint and transfer syntax acceptance testing","Approved de-identification and metadata-minimization profile","Endpoint identity, consent, purpose-of-use, and durable audit","Imaging informatics, privacy, security, and clinical governance approval"],"sourceUrls":["https://www.dicomstandard.org/current","https://profiles.ihe.net/"],"status":"synthetic-pass","liveReadiness":"live-blocked","passedChecks":5,"blockedChecks":3,"boundary":"SCRIMED conformance evaluations execute deterministic checks against synthetic fixtures and declared connector contracts. A synthetic pass is not certification, partner acceptance, production authorization, or permission to exchange live healthcare data.","validatedAt":"2026-06-09T12:00:00.000Z"},{"slug":"hl7-v2-adt-event-feed","name":"HL7 v2 ADT / Order / Result Event Test Kit","route":"/interoperability/evaluations/hl7-v2-adt-event-feed","apiRoute":"/api/interoperability/evaluations/hl7-v2-adt-event-feed","standardIds":["hl7-v2","clinical-terminology"],"contractSlug":"hl7-event-feed","contractRoute":"/contracts/hl7-event-feed","fixtureRoute":"/integrations/fixtures/hl7-event-feed","agentOwner":"Interoperability Agent","targetProfile":"Deployment-selected HL7 v2 ADT, ORM, and ORU message profiles","checks":[{"id":"hl7-fixture-present","label":"Synthetic HL7 event fixture present","category":"fixture","scope":"synthetic","status":"pass","evidence":"fixture-hl7-event-feed-v1","detail":"A deterministic event fixture must remain bound to the HL7 connector contract."},{"id":"hl7-synthetic-only","label":"Synthetic-only event assertion","category":"privacy","scope":"synthetic","status":"pass","evidence":"syntheticOnly=true","detail":"The test kit must reject production messages and patient identifiers."},{"id":"hl7-message-family","label":"ADT message family declared","category":"structure","scope":"synthetic","status":"pass","evidence":"messageType=ADT_A08","detail":"The fixture declares an administrative event without authorizing a live interface-engine channel."},{"id":"hl7-required-segments","label":"Required segment coverage","category":"profile","scope":"synthetic","status":"pass","evidence":"MSH, EVN, PID, PV1, ORC","detail":"The synthetic message carries the core header, event, patient-reference, and visit segments needed for routing tests."},{"id":"hl7-replay-and-timestamp","label":"Replay and timestamp controls","category":"reliability","scope":"synthetic","status":"pass","evidence":"message validation required; dead-letter handling; dead-letter invalid messages; preserve original timestamp; timestamp preservation; support replay policy; event replay policy; no autonomous clinical workflow trigger until reviewed","detail":"Event replay and original source time must stay explicit to prevent silent workflow-state drift."},{"id":"hl7-fixture-validation","label":"Deterministic fixture validation","category":"quality","scope":"synthetic","status":"pass","evidence":"10/10 checks passed","detail":"Required signals, safeguards, traces, prohibited actions, and live-review gates must pass."},{"id":"hl7-version-profile","label":"Version and message-profile selection","category":"conformance","scope":"live-readiness","status":"block","evidence":"Trading-partner artifact required","detail":"Pin the sending system version, trigger events, segment cardinality, Z-segments, vocabulary, and acknowledgement profile."},{"id":"hl7-engine-acceptance","label":"Integration-engine ACK/NACK acceptance","category":"reliability","scope":"live-readiness","status":"block","evidence":"Partner testing required","detail":"Test ACK/NACK, dead-letter, retry, ordering, duplicate, timeout, and replay behavior with the approved interface engine."},{"id":"hl7-identity-consent-audit","label":"Identity, purpose, and durable audit","category":"governance","scope":"live-readiness","status":"block","evidence":"Production controls not approved","detail":"Approve tenant isolation, patient-context authorization, purpose-of-use, retention, and durable event audit before live routing."}],"requiredEvidence":[{"label":"Synthetic HL7 event fixture","status":"available","route":"/integrations/fixtures/hl7-event-feed","detail":"Deterministic ADT event metadata with required segments, replay controls, and no-writeback boundaries."},{"label":"Integration fixture validation","status":"available","route":"/integrations/fixture-validation","detail":"10 deterministic checks currently pass."},{"label":"Deployment message profile","status":"required-before-live","detail":"Version-pinned events, segments, Z-segments, code sets, acknowledgements, and error behavior."},{"label":"Interface-engine acceptance report","status":"required-before-live","detail":"ACK/NACK, retry, duplicate, order, dead-letter, replay, security, and monitoring evidence."}],"liveBlockers":["Deployment-specific HL7 v2 version and message-profile selection","Approved interface-engine channel, network route, and endpoint identity","ACK/NACK, retry, duplicate, ordering, dead-letter, and replay acceptance testing","Patient-context authorization, purpose-of-use, retention, and durable audit","Integration architecture, privacy, security, workflow-owner, and clinical governance approval"],"sourceUrls":["https://www.hl7.org/implement/standards/product_section.cfm?section=13","https://profiles.ihe.net/"],"status":"synthetic-pass","liveReadiness":"live-blocked","passedChecks":6,"blockedChecks":3,"boundary":"SCRIMED conformance evaluations execute deterministic checks against synthetic fixtures and declared connector contracts. A synthetic pass is not certification, partner acceptance, production authorization, or permission to exchange live healthcare data.","validatedAt":"2026-06-09T12:00:00.000Z"},{"slug":"x12-payer-rcm-evidence","name":"X12 Payer / RCM Evidence Test Kit","route":"/interoperability/evaluations/x12-payer-rcm-evidence","apiRoute":"/api/interoperability/evaluations/x12-payer-rcm-evidence","standardIds":["x12","clinical-terminology"],"contractSlug":"claims-utilization-dataset","contractRoute":"/contracts/claims-utilization-dataset","fixtureRoute":"/integrations/fixtures/claims-utilization-dataset","agentOwner":"Revenue Cycle Agent","targetProfile":"Trading-partner-selected X12 eligibility, authorization, claim, remittance, and acknowledgement guides","checks":[{"id":"x12-fixture-present","label":"Synthetic payer fixture present","category":"fixture","scope":"synthetic","status":"pass","evidence":"fixture-claims-utilization-dataset-v1","detail":"A deterministic payer-data fixture must remain bound to the claims and utilization contract."},{"id":"x12-synthetic-only","label":"Synthetic-only payer assertion","category":"privacy","scope":"synthetic","status":"pass","evidence":"syntheticOnly=true","detail":"The test kit cannot accept live member, subscriber, policy, claim, or payer credentials."},{"id":"x12-structured-lines","label":"Structured line metadata","category":"structure","scope":"synthetic","status":"pass","evidence":"lineCount=3","detail":"Synthetic line-level metadata supports deterministic completeness and denial-risk checks."},{"id":"x12-lineage-and-partition","label":"Lineage and access partitioning","category":"governance","scope":"synthetic","status":"pass","evidence":"de-identification option required; lineage metadata required; schema versioning required; partition access by role; access partitioning; no final reimbursement determination","detail":"Payer evidence must preserve source lineage and role-scoped access."},{"id":"x12-no-final-reimbursement","label":"Final reimbursement prohibited","category":"financial-safety","scope":"synthetic","status":"pass","evidence":"final reimbursement decision; unpartitioned access; unversioned schema change","detail":"SCRIMED may prepare or validate evidence but cannot determine reimbursement or submit a transaction."},{"id":"x12-fixture-validation","label":"Deterministic fixture validation","category":"quality","scope":"synthetic","status":"pass","evidence":"10/10 checks passed","detail":"Required claims signals, safeguards, lineage, trace, and prohibited actions must pass."},{"id":"x12-version-guide","label":"Transaction version and guide selection","category":"conformance","scope":"live-readiness","status":"block","evidence":"Licensed guide and partner decision required","detail":"Select transaction sets, implementation guides, companion guides, code sets, and version pins with the trading partner."},{"id":"x12-partner-acknowledgement","label":"Trading-partner acknowledgement testing","category":"reliability","scope":"live-readiness","status":"block","evidence":"Clearinghouse or payer acceptance required","detail":"Test envelope validation, acknowledgements, rejection paths, duplicates, retries, balancing, and reconciliation."},{"id":"x12-human-submission-gate","label":"Human submission authority","category":"governance","scope":"live-readiness","status":"block","evidence":"Payer submission remains disabled","detail":"A named authorized operator, approved workflow, contract, audit trail, and explicit release gate are required before any payer-facing action."}],"requiredEvidence":[{"label":"Synthetic payer and claims fixture","status":"available","route":"/integrations/fixtures/claims-utilization-dataset","detail":"Line-level metadata, lineage, denial signal, and no-final-reimbursement boundary."},{"label":"Integration fixture validation","status":"available","route":"/integrations/fixture-validation","detail":"10 deterministic checks currently pass."},{"label":"Trading-partner implementation profile","status":"required-before-live","detail":"Licensed implementation guide, companion guide, transaction scope, version, code sets, and endpoint rules."},{"label":"Payer or clearinghouse acceptance report","status":"required-before-live","detail":"Envelope, acknowledgement, rejection, duplicate, retry, balancing, security, and reconciliation evidence."}],"liveBlockers":["Trading-partner agreement and licensed implementation or companion guides","Transaction set, version, endpoint, code-set, and acknowledgement selection","Payer or clearinghouse conformance, rejection, duplicate, retry, and reconciliation testing","Authorized operator, least-privilege identity, audit, retention, and release workflow","Revenue-cycle, compliance, privacy, security, legal, and payer-owner approval","Payer submission remains disabled until separately authorized"],"sourceUrls":["https://x12.org/products/health-care","https://x12.org/resources"],"status":"synthetic-pass","liveReadiness":"live-blocked","passedChecks":6,"blockedChecks":3,"boundary":"SCRIMED conformance evaluations execute deterministic checks against synthetic fixtures and declared connector contracts. A synthetic pass is not certification, partner acceptance, production authorization, or permission to exchange live healthcare data.","validatedAt":"2026-06-09T12:00:00.000Z"}],"updated":"2026-07-10"},"exposedRoutes":["/agents","/evaluation","/workflows","/memory","/audit","/trust","/trust-os","/observability","/interoperability","/interoperability/evaluations"],"updated":"2026-06-09"}