# SCRIMED Public Market Readiness Brief

## Control
- Status: capital-efficiency-kpi-stack-ready
- Proof stack: public-market-readiness-capital-efficiency-kpi-stack
- Brief proof stack: public-market-readiness-board-brief-no-financial-advice
- Protected operator metric capture: aal2-protected-operator-metric-capture-no-phi
- Protected metric rollups: aal2-finance-reviewed-metric-rollups-no-phi
- Protected metric rollup packets: aal2-audited-board-metric-packets-no-phi
- Protected metric trend reviews: aal2-board-trend-review-no-phi
- Protected metric trend packets: aal2-audited-board-trend-packets-no-phi
- Protected board scorecards: aal2-rolling-quarter-board-scorecards-no-phi
- Protected board scorecard packets: aal2-audited-board-scorecard-packets-no-phi
- Protected finance methodology gates: aal2-finance-methodology-gates-no-phi
- Protected finance methodology packets: aal2-audited-finance-methodology-gate-packets-no-phi
- Protected external approval evidence: aal2-qualified-external-approval-evidence-links-no-phi
- Protected external approval evidence packets: aal2-audited-external-approval-evidence-link-packets-no-phi
- Protected release decisions: aal2-qualified-release-decision-workflow-no-phi
- Protected release decision packets: aal2-audited-release-decision-claim-registry-packets-no-phi
- Protected named reviewer sign-offs: aal2-named-reviewer-signoff-metadata-no-phi
- Protected named reviewer sign-off packets: aal2-audited-named-reviewer-signoff-packets-no-phi
- Protected distribution lockbox: aal2-external-distribution-lockbox-disabled-no-phi
- Protected distribution lockbox packets: aal2-audited-distribution-lockbox-packets-no-phi
- Protected release authority attestations: aal2-external-release-authority-attestations-disabled-no-phi
- Protected release authority attestation packets: aal2-audited-release-authority-attestation-packets-no-phi
- Protected evidence-room recipient attestations: aal2-evidence-room-recipient-attestations-disabled-no-phi
- Protected evidence-room recipient attestation packets: aal2-audited-evidence-room-recipient-attestation-packets-no-phi
- Protected evidence-room access-log reconciliation: aal2-evidence-room-access-log-reconciliation-disabled-no-phi
- Protected evidence-room access-log reconciliation packets: aal2-audited-evidence-room-access-log-reconciliation-packets-no-phi
- Protected evidence-room provider adapters: aal2-evidence-room-provider-adapter-contracts-disabled-no-phi
- Protected evidence-room provider adapter packets: aal2-audited-evidence-room-provider-adapter-packets-no-phi
- Protected provider security reviews: aal2-provider-security-review-workbench-no-phi
- Protected provider security review packets: aal2-audited-provider-security-review-packets-no-phi
- Protected procurement evidence registry: aal2-procurement-evidence-registry-no-sensitive-artifacts
- Protected procurement evidence registry packets: aal2-audited-procurement-evidence-registry-packets-no-sensitive-artifacts
- Route: /public-market-readiness
- API: /api/public-market-readiness
- Protected metric route: /pilot-workspace/access
- Protected metric API: /api/pilot-workspaces/{workspaceSlug}/operator-metrics
- Protected rollup route: /pilot-workspace/access
- Protected rollup API: /api/pilot-workspaces/{workspaceSlug}/metric-rollups
- Protected rollup packet API: /api/pilot-workspaces/{workspaceSlug}/metric-rollups/{snapshotId}/packet
- Protected trend route: /pilot-workspace/access
- Protected trend API: /api/pilot-workspaces/{workspaceSlug}/metric-trends
- Protected trend packet API: /api/pilot-workspaces/{workspaceSlug}/metric-trends/{reviewId}/packet
- Protected scorecard route: /pilot-workspace/access
- Protected scorecard API: /api/pilot-workspaces/{workspaceSlug}/board-scorecards
- Protected scorecard packet API: /api/pilot-workspaces/{workspaceSlug}/board-scorecards/{scorecardId}/packet
- Protected finance methodology route: /pilot-workspace/access
- Protected finance methodology API: /api/pilot-workspaces/{workspaceSlug}/finance-methodology
- Protected finance methodology packet API: /api/pilot-workspaces/{workspaceSlug}/finance-methodology/packet
- Protected external approval evidence route: /pilot-workspace/access
- Protected external approval evidence API: /api/pilot-workspaces/{workspaceSlug}/external-approval-evidence
- Protected external approval evidence packet API: /api/pilot-workspaces/{workspaceSlug}/external-approval-evidence/packet
- Protected release decision route: /pilot-workspace/access
- Protected release decision API: /api/pilot-workspaces/{workspaceSlug}/release-decisions
- Protected release decision packet API: /api/pilot-workspaces/{workspaceSlug}/release-decisions/packet
- Protected named reviewer sign-off route: /pilot-workspace/access
- Protected named reviewer sign-off API: /api/pilot-workspaces/{workspaceSlug}/reviewer-signoffs
- Protected named reviewer sign-off packet API: /api/pilot-workspaces/{workspaceSlug}/reviewer-signoffs/packet
- Protected distribution lockbox route: /pilot-workspace/access
- Protected distribution lockbox API: /api/pilot-workspaces/{workspaceSlug}/distribution-lockbox
- Protected distribution lockbox packet API: /api/pilot-workspaces/{workspaceSlug}/distribution-lockbox/packet
- Protected release authority attestation route: /pilot-workspace/access
- Protected release authority attestation API: /api/pilot-workspaces/{workspaceSlug}/release-authority-attestations
- Protected release authority attestation packet API: /api/pilot-workspaces/{workspaceSlug}/release-authority-attestations/packet
- Protected evidence-room recipient attestation route: /pilot-workspace/access
- Protected evidence-room recipient attestation API: /api/pilot-workspaces/{workspaceSlug}/evidence-room-recipient-attestations
- Protected evidence-room recipient attestation packet API: /api/pilot-workspaces/{workspaceSlug}/evidence-room-recipient-attestations/packet
- Protected evidence-room access-log reconciliation route: /pilot-workspace/access
- Protected evidence-room access-log reconciliation API: /api/pilot-workspaces/{workspaceSlug}/evidence-room-access-log-reconciliation
- Protected evidence-room access-log reconciliation packet API: /api/pilot-workspaces/{workspaceSlug}/evidence-room-access-log-reconciliation/packet
- Protected evidence-room provider adapter route: /pilot-workspace/access
- Protected evidence-room provider adapter API: /api/pilot-workspaces/{workspaceSlug}/evidence-room-provider-adapters
- Protected evidence-room provider adapter packet API: /api/pilot-workspaces/{workspaceSlug}/evidence-room-provider-adapters/packet
- Protected provider security review route: /pilot-workspace/access
- Protected provider security review API: /api/pilot-workspaces/{workspaceSlug}/provider-security-reviews
- Protected provider security review packet API: /api/pilot-workspaces/{workspaceSlug}/provider-security-reviews/packet
- Protected procurement evidence registry route: /pilot-workspace/access
- Protected procurement evidence registry API: /api/pilot-workspaces/{workspaceSlug}/procurement-evidence
- Protected procurement evidence registry packet API: /api/pilot-workspaces/{workspaceSlug}/procurement-evidence/packet
- Updated: 2026-06-20

## Thesis
SCRIMED is healthcare intelligence infrastructure, not another AI model company.

While frontier labs burn billions to build general intelligence, SCRIMED captures healthcare-specific value by owning the workflow, trust layer, data loops, governance evidence, interoperability path, and measurable outcomes around healthcare operations.

## Efficient Healthcare Intelligence
SCRIMED should own healthcare workflows, trust evidence, and outcomes while using model routing, task-specific agents, open/closed model optionality, and token-cost controls to avoid frontier-model dependency.

## Internal KPI Stack
### Cost per governed workflow
- ID: cost-per-workflow
- Category: unit-economics
- Unit: USD per completed workflow packet
- Formula: (model cost + infrastructure cost + review labor + support allocation) / completed governed workflow packets
- Target direction: lower-is-better
- Maturity: synthetic-measurement-ready
- Audit source: AgentOS task trace, QA evidence ledger, proof-packet release audit, and workflow result validation.
- Proof route: /workflows/results
- Boundary: Synthetic and protected-pilot workflows only until buyer-approved production baselines exist.

### Cost per patient interaction equivalent
- ID: cost-per-patient-interaction
- Category: unit-economics
- Unit: USD per synthetic or approved pilot interaction
- Formula: (agent execution cost + routing cost + human-review cost) / synthetic or approved pilot interaction count
- Target direction: lower-is-better
- Maturity: protected-pilot-measurement-required
- Audit source: Protected pilot sessions, buyer demo sessions, and approved customer baselines.
- Proof route: /pilot-workspace/access
- Boundary: No live patient interaction is authorized. Current use is a pilot-equivalent metric definition.

### Cost per chart review
- ID: cost-per-chart
- Category: unit-economics
- Unit: USD per synthetic or approved chart-review work order
- Formula: (document intelligence cost + model extraction cost + TrustQA review cost + reviewer time) / chart-review work orders
- Target direction: lower-is-better
- Maturity: synthetic-measurement-ready
- Audit source: DocuTwin work orders, Trust Cards, and manual QA evidence packets.
- Proof route: /modules/docutwin
- Boundary: No PHI, record mutation, diagnosis insertion, or final note filing is authorized.

### Cost per prior authorization support packet
- ID: cost-per-prior-auth
- Category: unit-economics
- Unit: USD per packet draft
- Formula: (policy retrieval cost + document parsing cost + model drafting cost + reviewer time) / prior-auth packet drafts
- Target direction: lower-is-better
- Maturity: synthetic-measurement-ready
- Audit source: Agent Workspace work orders, Atlas evidence layer, and proof packet audit.
- Proof route: /agent-workspace
- Boundary: No payer submission, coverage determination, or medical-necessity decision is authorized.

### Cost per denial appeal support draft
- ID: cost-per-denial-appeal
- Category: unit-economics
- Unit: USD per reviewable appeal draft
- Formula: (claim-context parsing + policy evidence retrieval + draft generation + qualified review allocation) / appeal-support drafts
- Target direction: lower-is-better
- Maturity: synthetic-measurement-ready
- Audit source: RCM Agent work orders, TrustOS reviewer checkpoints, and governance packets.
- Proof route: /workflows/results
- Boundary: No final coding, billing, appeal submission, or reimbursement guarantee is authorized.

### Time saved per clinician
- ID: time-saved-per-clinician
- Category: workflow-value
- Unit: minutes saved per reviewed workflow
- Formula: buyer-approved baseline minutes - SCRIMED-assisted minutes for the same governed workflow
- Target direction: higher-is-better
- Maturity: protected-pilot-measurement-required
- Audit source: Buyer baseline, protected pilot result packet, reviewer sign-off, and QA evidence.
- Proof route: /pilot-evidence
- Boundary: This is an operational-efficiency metric, not a clinical outcome claim.

### Revenue protected per payer or provider workflow
- ID: revenue-protected
- Category: workflow-value
- Unit: USD at-risk revenue surfaced for qualified review
- Formula: reviewed denial risk, missing-evidence exposure, or leakage opportunity identified under buyer-approved methodology
- Target direction: higher-is-better
- Maturity: protected-pilot-measurement-required
- Audit source: Revenue workflow result packets, buyer finance review, and approved value methodology.
- Proof route: /pricing
- Boundary: Revenue protected is a reviewed operational signal, not a reimbursement promise or audited financial result.

### Compliance log completeness
- ID: compliance-log-completeness
- Category: compliance-governance
- Unit: percentage of governed events with required metadata
- Formula: governed events with required audit metadata / total governed events
- Target direction: higher-is-better
- Maturity: synthetic-measurement-ready
- Audit source: Protected pilot audit events, TrustOS decisions, QA packets, and activation attestations.
- Proof route: /audit
- Boundary: Log completeness does not equal compliance certification or regulator acceptance.

### Gross margin by offer
- ID: gross-margin-by-offer
- Category: margin-discipline
- Unit: percentage margin by package
- Formula: (contracted package revenue - model cost - infrastructure cost - implementation labor - support allocation - reviewer allocation) / contracted package revenue
- Target direction: within-approved-band
- Maturity: external-finance-review-required
- Audit source: Pricing model, sales deal room, finance review, usage logs, and delivery time tracking.
- Proof route: /pricing
- Boundary: Requires finance-reviewed cost accounting before external reporting or investor diligence use.

### Model cost per Trust Card
- ID: model-cost-per-trust-card
- Category: cost-control
- Unit: USD per evidence-backed recommendation card
- Formula: (retrieval cost + model route cost + validation cost + reviewer allocation) / Trust Cards generated
- Target direction: lower-is-better
- Maturity: definition-ready
- Audit source: Atlas Trust Cards, model-router logs, validation records, and reviewer status.
- Proof route: /atlas
- Boundary: Trust Cards remain review support, not autonomous clinical decisions.

## Protected Operator Metric Capture
- Model cost: Model, routing, retrieval, validation, and retry cost for a governed workflow window. Unit: usd. KPI: model-cost-per-trust-card. Proof: /public-market-readiness. Discipline: Use model routing, smaller task-specific models, retrieval-first execution, and retry budgets.
- Human review time: Operator, reviewer, clinician-adjacent, or sales-engineering review minutes for a governed workflow window. Unit: minutes. KPI: time-saved-per-clinician. Proof: /pilot-workspace/access. Discipline: Track review load so SCRIMED can price human-in-the-loop safety without hiding labor cost.
- Delivery hours: Implementation, QA, sales engineering, governance, or delivery hours spent on a scoped no-PHI workflow window. Unit: hours. KPI: gross-margin-by-offer. Proof: /pricing. Discipline: Separate implementation services from platform license and protect enterprise gross margin.
- Proof packet count: Audited or generated proof packets released for a governed workflow window. Unit: count. KPI: compliance-log-completeness. Proof: /qa-evidence. Discipline: Treat proof production as a repeatable evidence factory, not one-off consulting labor.
- Workflow volume: Completed synthetic, protected-pilot, or buyer-demo workflow packets in a measurement window. Unit: count. KPI: cost-per-workflow. Proof: /workflows/results. Discipline: Normalize operating cost by workflow output so SCRIMED can price against value and throughput.

## Unit Economics Packages
### Workflow Intelligence Assessment
- Commercial stage: paid assessment
- Price signal: Starts at $50k; typical range $75k-$150k fixed fee
- Measurable value:
- workflow friction map
- automation candidate scorecard
- governance gap register
- pilot success criteria
- Cost drivers:
- discovery hours
- workflow analysis
- buyer workshops
- executive findings
- Margin discipline: Keep scope fixed, cap workshop hours, reuse SCRIMED assessment templates, and convert qualified accounts into higher-value pilots.
- Proof routes: /pricing, /pilot-deal-room, /pilot
- Boundary: Assessment output is operational intelligence, not legal, clinical, or regulatory advice.

### Synthetic Pilot Evaluation
- Commercial stage: sellable pilot
- Price signal: Starts at $150k; typical range $200k-$500k for 45-90 days
- Measurable value:
- cost per governed workflow
- time saved estimate
- workflow friction reduced
- Trust Card completeness
- production-readiness gates
- Cost drivers:
- agent runs
- synthetic workflow design
- proof packets
- review meetings
- QA evidence
- Margin discipline: Use task-specific agents, deterministic synthetic fixtures, bounded model routes, and reusable governance packets.
- Proof routes: /product, /evaluation, /qa-evidence, /demos
- Boundary: Synthetic data only; no PHI, diagnosis, payer submission, patient outreach, or live execution.

### Protected Enterprise Pilot
- Commercial stage: protected pilot
- Price signal: Starts at $750k; typical range $1M-$2.5M for 90-180 days
- Measurable value:
- buyer-approved workflow baseline
- reviewer acceptance rate
- override and escalation rates
- cost per work order
- readiness gates closed
- Cost drivers:
- tenant setup
- identity controls
- human review
- security diligence
- governance operations
- Margin discipline: Charge separately for connectors, implementation, evidence vault controls, custom support, and regional compliance work.
- Proof routes: /pilot-workspace/access, /clinical-care-activation, /trust-safety-operations
- Boundary: Protected pilot does not authorize live clinical execution until external approvals and customer-specific controls pass.

### Enterprise Operating License
- Commercial stage: annual platform license
- Price signal: Annual platform license starts at $2.5M; enterprise range $3M-$12M+
- Measurable value:
- workflows under governance
- departments served
- model cost per workflow
- audit completeness
- expansion revenue
- Cost drivers:
- platform support
- workflow count
- connectors
- monitoring
- customer success
- Margin discipline: Separate platform license from implementation services and charge add-ons for workflow, connector, region, and support expansion.
- Proof routes: /pricing, /observability, /deployment-profiles
- Boundary: Production terms require signed scope, security review, privacy controls, and human-review operating procedures.

## Model Efficiency Controls
- Task-specific agent routing: Route narrow workflow tasks to specialized agents instead of a single large general-purpose agent. Cost control: Use deterministic preprocessing, small-model classification, and retrieval-before-generation before escalating to premium models. Safety control: Escalate uncertainty and high-risk clinical-adjacent content to human review. Proof: /agents
- Open and closed model optionality: Keep model-provider abstraction so SCRIMED can route between frontier APIs, healthcare-specific models, open-weight models, and future sovereign deployments. Cost control: Choose the least expensive route that satisfies safety, latency, context, and evidence requirements. Safety control: Do not route PHI-sensitive or regulated tasks without approved deployment controls. Proof: /healthcare-intelligence-os
- Token and evidence budgets: Attach workflow-level budgets for context size, evidence retrieval depth, model calls, retries, and reviewer effort. Cost control: Track cost per workflow, Trust Card, chart, prior-auth packet, and denial draft. Safety control: Block budget-driven shortcuts that remove citations, confidence, or review gates. Proof: /observability
- Workflow-owned data loops: Optimize around customer workflow outcomes rather than generic benchmark scores. Cost control: Invest in reusable workflow traces, corrections, and governance packets that improve future runs without retraining foundation models. Safety control: Use deidentified or synthetic feedback until privacy and customer data rights are approved. Proof: /pilot-evidence

## Compliance Logs
- Protected pilot audit events: owner TrustOS, engineering, and tenant admins. Source: Tenant-scoped Supabase audit events and proof-packet release logs. Metric use: Compliance log completeness, customer proof, and buyer diligence. Proof: /pilot-workspace/access. Boundary: No PHI, secrets, or live medical records are stored in current protected packets.
- QA evidence ledger: owner Engineering and trust operations. Source: Dated smoke, build, manual-run, and no-secret QA evidence. Metric use: Release discipline, defect visibility, and investor diligence. Proof: /qa-evidence. Boundary: QA evidence is product reliability evidence, not certification.
- Clinical activation dossier and approvals: owner Clinical governance, legal, security, privacy, and operations. Source: No-PHI AAL2 clinical activation readiness attestations and packets. Metric use: Hard-gate closure, readiness posture, and regulated deployment planning. Proof: /clinical-care-activation. Boundary: Readiness attestations do not authorize live clinical care.
- Buyer diligence and secure evidence vault readiness: owner Sales operations, legal, privacy, and security. Source: Buyer room, diligence packets, and disabled-by-default vault readiness controls. Metric use: Customer proof, revenue-stage maturity, and enterprise procurement readiness. Proof: /pilot-deal-room. Boundary: Sensitive buyer document storage remains disabled until approved controls exist.
- Protected operator metric ledger: owner Founder, finance advisor, product, and trust operations. Source: AAL2 tenant-scoped no-PHI captures for model cost, review time, delivery hours, proof-packet count, and workflow volume. Metric use: Unit-economics discipline, board review, pricing posture, and finance-readiness coverage. Proof: /pilot-workspace/access. Boundary: Operator metrics are aggregate operating metadata, not audited financial reporting, securities offering material, valuation assurance, reimbursement assurance, or clinical validation.
- Trust Safety Operations: owner Trust, safety, legal, security, communications, and executive leadership. Source: Incident, copyright, public-claims, safety, escalation, and continuous-improvement registers. Metric use: Public-company operating discipline and brand-risk control. Proof: /trust-safety-operations. Boundary: Current registers do not replace managed 24/7 SOC, counsel review, or insurance decisions.

## Customer Proof Ladder
- Public product proof: buyer commitment Self-guided inspection. Proof: Product console, demos, pricing, Trust Center, and public market readiness.. Revenue signal: Qualified buyer enters pilot intake or sales conversation.. Next gate: Paid assessment scope and no-PHI acknowledgement.
- Paid assessment: buyer commitment Fixed-fee workflow intelligence engagement. Proof: Workflow maps, governance gap register, KPI baseline plan, and pilot recommendation.. Revenue signal: Assessment revenue plus qualified pilot conversion.. Next gate: Synthetic pilot success criteria and sponsor approval.
- Synthetic pilot: buyer commitment 45-90 day governed evaluation. Proof: Synthetic workflow packets, Trust Cards, QA evidence, observability, and buyer diligence export.. Revenue signal: Pilot revenue and expansion case.. Next gate: Protected pilot data boundary, security, legal, privacy, and identity approvals.
- Protected enterprise pilot: buyer commitment Tenant-isolated governed pilot. Proof: AAL2 access, audit events, approval workflow, command intelligence, and proof packets.. Revenue signal: Protected pilot revenue and enterprise license proposal.. Next gate: Signed production controls, human-review SOP, connector validation, and go-live approval.
- Enterprise operating license: buyer commitment Annual or multi-year platform agreement. Proof: Measured workflow value, margin discipline, governance reporting, and expansion roadmap.. Revenue signal: Recurring platform revenue, modules, connectors, regions, and support expansion.. Next gate: Board-level value review and multi-workflow expansion.

## Board Cadence
- Weekly operating review: owner Founder, product, engineering, sales, and trust operations. Signals: build and smoke status, protected route failures, sales intake quality, buyer proof packet readiness, known blockers. Output: fix list, release gate, buyer follow-up, and next build step
- Monthly metric review: owner Founder, finance advisor, sales, product, and delivery. Signals: cost per workflow, pilot conversion, time saved signal, model cost trend, delivery effort by package. Output: pricing adjustments, margin guardrails, and pilot scope standards
- Quarterly governance review: owner Executive leadership, counsel, security, privacy, clinical advisors, and board advisors. Signals: claims register, clinical activation gates, security/privacy blockers, incident trends, enterprise-readiness gaps. Output: approved claims, prohibited claims, risk acceptances, and production readiness decisions
- Investor diligence review: owner Founder, finance, legal, product, and investor relations. Signals: customer proof ladder, unit economics maturity, gross margin assumptions, recurring revenue path, competitive edge. Output: board memo, investor packet, and external-review queue

## Known Boundaries And Workarounds
- No audited financial statements inside SCRIMED yet: External investors cannot treat current KPI stack as audited financial reporting. Workaround: Use the KPI definitions, pricing tiers, sales audit evidence, and proof packets as operating-readiness material while finance and accounting review is completed. Graduation gate: Finance-reviewed chart of accounts, revenue recognition policy, cost allocation, and audit-ready reporting.
- No live clinical outcomes: SCRIMED cannot claim patient-outcome improvement from production deployment. Workaround: Report synthetic and protected-pilot operational metrics only, then graduate to customer-approved outcome studies after legal, clinical, privacy, and data rights approval. Graduation gate: Customer-approved clinical governance protocol, IRB or ethics review when required, and signed data-processing path.
- No PHI-enabled cost telemetry: Patient-level cost per interaction remains a pilot-equivalent definition. Workaround: Use synthetic interactions and buyer-approved aggregate workflow baselines until PHI authorization, BAA/DPA, consent, and production controls exist. Graduation gate: Approved production data boundary, minimum-necessary design, audit controls, and customer authorization.
- No securities offering or valuation guarantee: Investor narrative must stay as strategic positioning, not investment solicitation. Workaround: Keep public-market readiness language framed as internal operating discipline and diligence preparation, with counsel-reviewed materials before fundraising use. Graduation gate: Qualified securities counsel, approved investor materials, and controlled data-room process.
- Secure evidence vault storage remains disabled by default: Sensitive buyer diligence artifacts cannot be uploaded into SCRIMED yet. Workaround: Use metadata-only vault readiness and buyer-approved external secure channels until DLP, malware scanning, encryption, retention, legal hold, and access reviews are approved. Graduation gate: Approved storage provider, security controls, legal terms, incident response, and access-review workflow.

## Boundary
SCRIMED Public Market Readiness organizes KPI definitions, unit-economics discipline, compliance logs, customer proof, governance documentation, model-efficiency controls, and investor narrative for enterprise operating maturity. It is not audited financial reporting, securities offering material, investment advice, accounting advice, tax advice, a valuation guarantee, clinical validation, reimbursement assurance, compliance certification, or live clinical execution authorization.