{"service":"scrimed-trustops-review-packets","status":"trustops-review-packets-ready-for-aal2-protected-persistence","packetCount":10,"durableEnvelope":{"attemptId":"att_c457962a73ff","contractVersion":"scrimed-execution-attempt-envelope-v1","buildStatus":"metadata-only-accepted","lifecycleState":"review-required","workflowSlug":"trustops-signal-remediation-review","workflowVersion":"2026.06.no-phi","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","createdAt":"2026-06-27","tenantReference":"tenant-ref-synthetic-atlas","tenantBoundary":"tenant-reference-only-no-customer-data","callerRole":"trustops-reviewer","agentRuntimeId":"agent-runtime-trustops-supervisor","agentPermissions":["read-synthetic-context","read-approved-evidence-references","write-draft-review-packet","append-metadata-audit-event"],"deniedCapabilities":["autonomous diagnosis","autonomous treatment","prescribing","patient outreach","payer submission","claim submission","final coding","EHR writeback","production connector write","clinical triage replacement"],"dataBoundary":"synthetic-and-metadata-only","phiAuthority":"not-authorized-production-phi","clinicalCareAuthority":"not-authorized-live-care","inputDigest":"cab5bad92f6d33cdc6a05290ee1724fa095d033528d7f9c2991398328adbeeb4","contextFingerprint":"d7f0ab098482ad9655bb7e9961dd93d852690f9a2cfb552cd5091dbe7c27fff1","compressedContextRefs":["compressed:synthetic-trustops-signal-set-v1","compressed:synthetic-self-healing-recommendation-set-v1"],"evidenceRefs":["trustops-module-registry-v1","trustops-structured-validation-v1"],"policyRefs":["org-policy-human-trustops-review-required-v1"],"requestedActionSummary":"Create a reviewer-held TrustOps signal and recommendation packet with durable evidence binding for synthetic operations review.","modelRouteTelemetry":{"routeId":"route_cfb561cfa2","taskType":"trustops signal remediation review","providerClass":"open-weight","providerName":"SCRIMED local or open-weight route","modelVersion":"open-weight:registered-version-required-before-production","fallbackProviderClass":"frontier-closed","routeProfile":"workflow-planning-human-review-gated","riskTier":"moderate","estimatedCostUsd":0.028,"latencyBudgetMs":3200,"confidence":0.78,"routingRationale":"Route metadata is logged for synthetic evaluation only; production provider selection remains blocked until contracts, privacy, telemetry, fallback, and review controls are approved.","telemetryBoundary":"telemetry-only-not-production-routing"},"computeFabricTelemetry":{"fabricVersion":"scrimed-compute-fabric-v2026-07-05","fabricStatus":"synthetic-routing-only-no-live-model-calls","selectedModel":"private-sglang-compact-runtime-slot","modelTier":"COMPACT_REASONING_MODEL","provider":"scrimed_private_sglang","deploymentMode":"CUSTOMER_VPC","reason":"COMPACT_REASONING_MODEL selected for operations; CUSTOMER_VPC deployment mode; text modality; moderate clinical risk; metadata-only-no-public-phi PHI policy","riskLevel":"moderate","phiPolicy":"metadata-only-no-public-phi","requiresHumanReview":false,"fallbackModels":["pulsar-16b-compact-reasoning-synthetic-slot","llama-mistral-qwen-glm-open-routing-slot"],"estimatedCostClass":"LOW","estimatedLatencyClass":"INTERACTIVE","auditTags":["scrimed-compute-fabric","scrimed-compute-fabric-v2026-07-05","task:operations","modality:text","risk:moderate","deployment:CUSTOMER_VPC","tier:COMPACT_REASONING_MODEL","provider:scrimed_private_sglang","phi-policy:metadata-only-no-public-phi","human-review-not-required-for-metadata-only","no-live-model-call","no-autonomous-clinical-authority"],"auditHash":"scrimed-intel-9abbb131","confidenceScore":0.86,"confidenceCorrectnessBoundary":"confidence-is-not-correctness","correctnessEvidenceRequired":["schema validation","source attribution","benchmarkModelForTask","compareModels","human review for clinical recommendations"],"uncertaintyReasons":["Confidence score is routing confidence, not proof of clinical correctness.","Clinical correctness requires evidence review, external validation, and human signoff.","Benchmark scores are synthetic metadata until a governed validation dataset is approved."],"safetyBoundary":"metadata-only-no-live-model-call"},"humanApprovalGate":{"required":true,"reviewStatus":"held-for-human-review","requiredReviewers":["domain reviewer","TrustOS"],"gateReason":"Protected healthcare workflow output requires accountable human review before any release, connector, payer, record, or patient-facing action.","releaseCondition":"Release requires approved reviewer identity, evidence card, clinical-risk label, audit event, and retained no-PHI boundary.","deniedUntil":"Durable attempt store, customer authority, connector approval, PHI controls, and production review workflow are approved."},"auditTrail":{"auditEventId":"audit_61069a3ed8f7","traceId":"trace_2188d604f39a781b","eventHash":"2d8e3525e9c56c814b33d3d8bbe7568aeb4c3477a2a1372c7cdd3f0984a23647","immutableEventType":"execution-attempt-envelope-created","retainedFields":["attemptId","idempotencyKey","workflowSlug","tenantReference","callerRole","contextFingerprint","modelRouteTelemetry","computeFabricTelemetry","humanApprovalGate","replayMetadata","failureRecovery"],"prohibitedFields":["patient identifiers","raw chart text","member identifiers","production connector payloads","secrets","credentials"]},"replayMetadata":{"replayToken":"replay_b8c7009f50d041cc33d9967c","replayEligible":true,"idempotencyScope":"tenant-reference + workflow slug + workflow version + caller role + input digest","ttlHours":72,"deterministicInputs":["workflowSlug","workflowVersion","tenantReference","callerRole","agentRuntimeId","inputDigest","contextFingerprint","policyRefs"],"replayPolicy":"Replay returns the retained metadata envelope only and cannot repeat protected external actions.","conflictResponse":"Return conflict when the same idempotency key maps to a different input digest, context fingerprint, or caller role.","expirationBehavior":"Expired metadata-only keys require a new envelope and cannot revive protected execution."},"toolPlan":{"toolRegistryVersion":"scrimed-tool-registry-no-phi-v1","allowedTools":["synthetic-context-reader","evidence-card-builder","review-packet-drafter","metadata-audit-appender"],"blockedTools":["ehr-writeback","patient-messaging","payer-submission","claims-submission","production-connector-write"],"noConnectorAccess":true,"noRecordMutation":true},"failureRecovery":{"retryPolicy":"Retry metadata envelope creation only when validation, hash generation, or audit-link assembly fails before any protected action.","quarantineTriggers":["PHI-like input","protected action request","missing reviewer gate","missing context fingerprint","model route telemetry absent","idempotency conflict"],"fallbackBehavior":"Return a deny-by-default review packet and require human operator triage.","rollbackBehavior":"No external side effect exists to roll back; retain denial metadata and preserve prior workflow state.","deadLetterOwner":"TrustOS and platform reliability"},"evidenceAuditTrail":{"attempt_id":"att_c457962a73ff","user_session_tenant_context":{"tenantReference":"tenant-ref-synthetic-atlas","callerRole":"trustops-reviewer","agentRuntimeId":"agent-runtime-trustops-supervisor","sessionReference":"metadata-only-no-live-session"},"timestamp":"2026-06-27","route":"/api/workflows/execution-attempts/envelope","action":"Create a reviewer-held TrustOps signal and recommendation packet with durable evidence binding for synthetic operations review.","allowed_blocked_decision":"allowed","policy_version":"scrimed-safety-governance-v2026-06-29","input_classification":"synthetic-no-phi","phi_detected":false,"synthetic":true,"model_provider_selected":"synthetic-fallback","model_tier_selected":"FAST_LOW_COST","compute_fabric_audit_hash":"scrimed-intel-9abbb131","compute_fabric_selected_model":"private-sglang-compact-runtime-slot","compute_fabric_model_tier":"COMPACT_REASONING_MODEL","compute_fabric_provider":"scrimed_private_sglang","compute_fabric_deployment_mode":"CUSTOMER_VPC","compute_fabric_phi_policy":"metadata-only-no-public-phi","compute_fabric_human_review_required":false,"output_hash":"25637661bf746a6c51014d4f4ef9a5675acb8c6076f93b44d5817abc05fd4049","evidence_envelope_hash":"590ff91776c7eec0932a1dbffbcded47b4d9aa86de36d2c4db5f08f9e93fe131","status":"review-required","failure_reason":null},"evaluationBindings":{"syntheticScenarioRefs":["agent-scorecard-runtime-permission","hallucination-uncited-guideline","clinical-safety-prohibited-action","evidence-quality-stale-policy","regression-workflow-result-diff","synthetic-patient-missing-data","adversarial-prompt-injection-tool-override","sanar-conflict-temporal-escalation","clinical-copilot-unit-abbreviation-citation"],"scorecardRefs":["scorecard-idempotency-replay","scorecard-no-phi-boundary","scorecard-route-telemetry","scorecard-human-review","scorecard-audit-linkage","scorecard-protected-capability-denial","scorecard-failure-recovery","scorecard-context-fingerprint","clinical-robustness-scorecard-sanar-conflict-temporal-escalation","clinical-robustness-scorecard-clinical-copilot-unit-abbreviation-citation"],"clinicalRobustness":{"labRoute":"/clinical-robustness-lab","scenarioRefs":["sanar-conflict-temporal-escalation","clinical-copilot-unit-abbreviation-citation"],"scorecardRefs":["clinical-robustness-scorecard-sanar-conflict-temporal-escalation","clinical-robustness-scorecard-clinical-copilot-unit-abbreviation-citation"],"perturbationRefs":["missing-data","missing-labs-risk","conflicting-data","temporal-inconsistencies","data-freshness","human-review-requirement","abbreviations","wrong-units","hallucination-risk","citation-reference-quality","guideline-grounding","model-disagreement"],"averageClinicalReadinessScore":96,"reviewerQueues":["clinical-safety-review","clinical-copilot-review"],"dataBoundary":"synthetic-no-phi-only","clinicalAuthority":"not-authorized-live-care","phiAuthority":"not-authorized-production-phi","reviewerGate":"human-review-required"}},"retainedBoundary":"This envelope is a metadata-only, no-PHI, replayable contract. It is not live workflow execution, not production persistence, not model routing approval, and not clinical or payer authority."},"durableStoreRoutes":{"record":"/api/workflows/execution-attempts/durable-store/record","replay":"/api/workflows/execution-attempts/durable-store/replay","reviewDisposition":"/api/workflows/execution-attempts/durable-store/review-disposition"},"persistenceBoundary":"Review packets are ready for AAL2 protected durable-store record/replay/review-disposition routes, but this public TrustOps layer does not write protected storage or bypass authentication.","packets":[{"packetId":"trustops_packet_0d2297849796c5f2","packetVersion":"scrimed-trustops-review-packet-v1","createdAt":"2026-06-30T00:00:00.000Z","signalId":"denied_claim_spike","recommendationId":"recommendation-denied_claim_spike","moduleIds":["rcm-denials","governance-compliance","signal-detection","self-healing-operations"],"affectedWorkflow":"RCM / Denials","severity":"high","recommendedOwner":"Revenue Cycle Lead","reviewerQueue":"Revenue Cycle Lead human review queue","syntheticOnly":true,"humanReviewRequired":true,"automationExecutionAllowed":false,"signal":{"id":"denied_claim_spike","severity":"high","affectedWorkflow":"RCM / Denials","recommendedOwner":"Revenue Cycle Lead","recommendedAction":"Open a synthetic denial-pattern investigation packet for manual review.","automationEligibility":"manual-review-required","humanReviewRequired":true,"reason":"Synthetic denial volume exceeded the configured threshold and may indicate documentation or coding workflow friction. Observed 22 denials per synthetic hour; threshold 10.","safetyBoundary":"Synthetic/demo signal only; requires human review and does not authorize live PHI, clinical action, patient outreach, payer submission, EHR writeback, billing submission, or production connector use."},"recommendation":{"id":"recommendation-denied_claim_spike","signalId":"denied_claim_spike","action":"open investigation ticket","recommendedOwner":"Revenue Cycle Lead","steps":["Create an investigation ticket draft.","Attach trend summary, threshold, and affected workflow.","Assign the owner for manual investigation."],"automationEligibility":"recommendation-only","humanReviewRequired":true,"expectedOutcome":"A human-reviewed open investigation ticket packet for RCM / Denials.","blockedActions":["Live PHI access","Autonomous diagnosis","Treatment recommendation","Prescribing","Patient outreach","Payer submission","EHR writeback","Billing submission","Production connector mutation"],"safetyBoundary":"Recommendation-only synthetic remediation; no real clinical, payer, EHR, billing, outreach, PHI-impacting, or production connector action may execute without explicit human approval and future authorization."},"evidenceRefs":["scrimed-trustops-module-registry","scrimed-trustops-signal-engine","scrimed-trustops-self-healing-recommendation","scrimed-execution-attempt-durable-store"],"durableEvidenceBinding":{"attemptId":"att_c457962a73ff","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","replayToken":"replay_b8c7009f50d041cc33d9967c","workflowSlug":"trustops-signal-remediation-review","durableStoreRecordRoute":"/api/workflows/execution-attempts/durable-store/record","durableStoreReplayRoute":"/api/workflows/execution-attempts/durable-store/replay","durableStoreReviewDispositionRoute":"/api/workflows/execution-attempts/durable-store/review-disposition","recordRequest":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","region":"us","retentionUntil":"2026-12-31T00:00:00.000Z"},"replayRequest":{"workspaceSlug":"atlas-synthetic-evaluation","replayToken":"replay_b8c7009f50d041cc33d9967c"},"reviewDispositionRequest":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","disposition":"changes-requested","reviewerRole":"TrustOps reviewer","reasonCode":"trustops-denied-claim-spike","reviewNote":"Synthetic TrustOps packet for denied_claim_spike. Recommended owner: Revenue Cycle Lead. Recommended action: open investigation ticket. Human review is required before any protected workflow moves beyond synthetic mode.","humanReviewAttestation":"no-phi-human-review-no-clinical-authority"},"packetHash":"0d2297849796c5f28bbad86a5dedf4a49d4522b09807305b63d4ba4aead9964e","evidenceEnvelopeHash":"cc54148d5c497ff8d60bca5571755e270a441a36789d5c1885fdcbfc1a1a4d2b","persistenceStatus":"ready-for-aal2-protected-durable-store-not-persisted","safetyBoundary":"SCRIMED Execution Attempt Durable Store v1 is a tenant-scoped, no-PHI, metadata-only persistence contract for execution-attempt envelopes, idempotency, replay lookup, review dispositions, immutable audit events, regional retention, Compute Fabric routing evidence, and fail-closed protected route access. It does not authorize PHI processing, live patient data use, production model routing, autonomous diagnosis, autonomous treatment, prescribing, payer submission, claim submission, EHR writeback, patient outreach, production connector use, or clinical production approval."},"safetyBoundary":"Synthetic TrustOps review packet only. Recommendation-only remediation requires human review and does not authorize live PHI, autonomous clinical action, payer submission, billing submission, EHR writeback, patient outreach, production connector use, certification, clinical validation, or customer go-live."},{"packetId":"trustops_packet_c6d05d917a0835cd","packetVersion":"scrimed-trustops-review-packet-v1","createdAt":"2026-06-30T00:00:00.000Z","signalId":"referral_delay","recommendationId":"recommendation-referral_delay","moduleIds":["referral-management","patient-access","signal-detection","self-healing-operations"],"affectedWorkflow":"Referral Management","severity":"high","recommendedOwner":"Referral Operations Lead","reviewerQueue":"Referral Operations Lead human review queue","syntheticOnly":true,"humanReviewRequired":true,"automationExecutionAllowed":false,"signal":{"id":"referral_delay","severity":"high","affectedWorkflow":"Referral Management","recommendedOwner":"Referral Operations Lead","recommendedAction":"Request human review of delayed synthetic referrals and owner routing.","automationEligibility":"manual-review-required","humanReviewRequired":true,"reason":"Synthetic referral queue time exceeded the threshold and could become leakage risk in a governed pilot. Observed 9 days in synthetic queue; threshold 4.","safetyBoundary":"Synthetic/demo signal only; requires human review and does not authorize live PHI, clinical action, patient outreach, payer submission, EHR writeback, billing submission, or production connector use."},"recommendation":{"id":"recommendation-referral_delay","signalId":"referral_delay","action":"request human review","recommendedOwner":"Referral Operations Lead","steps":["Create a reviewer task with signal reason and source event.","Attach the synthetic evidence packet.","Block any downstream automation until disposition is recorded."],"automationEligibility":"recommendation-only","humanReviewRequired":true,"expectedOutcome":"A human-reviewed request human review packet for Referral Management.","blockedActions":["Live PHI access","Autonomous diagnosis","Treatment recommendation","Prescribing","Patient outreach","Payer submission","EHR writeback","Billing submission","Production connector mutation"],"safetyBoundary":"Recommendation-only synthetic remediation; no real clinical, payer, EHR, billing, outreach, PHI-impacting, or production connector action may execute without explicit human approval and future authorization."},"evidenceRefs":["scrimed-trustops-module-registry","scrimed-trustops-signal-engine","scrimed-trustops-self-healing-recommendation","scrimed-execution-attempt-durable-store"],"durableEvidenceBinding":{"attemptId":"att_c457962a73ff","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","replayToken":"replay_b8c7009f50d041cc33d9967c","workflowSlug":"trustops-signal-remediation-review","durableStoreRecordRoute":"/api/workflows/execution-attempts/durable-store/record","durableStoreReplayRoute":"/api/workflows/execution-attempts/durable-store/replay","durableStoreReviewDispositionRoute":"/api/workflows/execution-attempts/durable-store/review-disposition","recordRequest":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","region":"us","retentionUntil":"2026-12-31T00:00:00.000Z"},"replayRequest":{"workspaceSlug":"atlas-synthetic-evaluation","replayToken":"replay_b8c7009f50d041cc33d9967c"},"reviewDispositionRequest":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","disposition":"changes-requested","reviewerRole":"TrustOps reviewer","reasonCode":"trustops-referral-delay","reviewNote":"Synthetic TrustOps packet for referral_delay. Recommended owner: Referral Operations Lead. Recommended action: request human review. Human review is required before any protected workflow moves beyond synthetic mode.","humanReviewAttestation":"no-phi-human-review-no-clinical-authority"},"packetHash":"c6d05d917a0835cd150d2a92ff0c15904268f3990ced90b6947d4520bf1768cd","evidenceEnvelopeHash":"fa9fb7cca78846fb9779f34b8e5ceb2f36b4dd99ea02e9811e5c813cb1ca7235","persistenceStatus":"ready-for-aal2-protected-durable-store-not-persisted","safetyBoundary":"SCRIMED Execution Attempt Durable Store v1 is a tenant-scoped, no-PHI, metadata-only persistence contract for execution-attempt envelopes, idempotency, replay lookup, review dispositions, immutable audit events, regional retention, Compute Fabric routing evidence, and fail-closed protected route access. It does not authorize PHI processing, live patient data use, production model routing, autonomous diagnosis, autonomous treatment, prescribing, payer submission, claim submission, EHR writeback, patient outreach, production connector use, or clinical production approval."},"safetyBoundary":"Synthetic TrustOps review packet only. Recommendation-only remediation requires human review and does not authorize live PHI, autonomous clinical action, payer submission, billing submission, EHR writeback, patient outreach, production connector use, certification, clinical validation, or customer go-live."},{"packetId":"trustops_packet_a6ca92303fa59d72","packetVersion":"scrimed-trustops-review-packet-v1","createdAt":"2026-06-30T00:00:00.000Z","signalId":"prior_auth_stalled","recommendationId":"recommendation-prior_auth_stalled","moduleIds":["prior-authorization","rcm-denials","signal-detection","self-healing-operations"],"affectedWorkflow":"Prior Authorization","severity":"high","recommendedOwner":"Prior Authorization Lead","reviewerQueue":"Prior Authorization Lead human review queue","syntheticOnly":true,"humanReviewRequired":true,"automationExecutionAllowed":false,"signal":{"id":"prior_auth_stalled","severity":"high","affectedWorkflow":"Prior Authorization","recommendedOwner":"Prior Authorization Lead","recommendedAction":"Queue stalled synthetic prior-auth packets for manual verification.","automationEligibility":"manual-review-required","humanReviewRequired":true,"reason":"Synthetic authorization tasks remained unresolved beyond the safe review threshold. Observed 6 synthetic business days; threshold 2.","safetyBoundary":"Synthetic/demo signal only; requires human review and does not authorize live PHI, clinical action, patient outreach, payer submission, EHR writeback, billing submission, or production connector use."},"recommendation":{"id":"recommendation-prior_auth_stalled","signalId":"prior_auth_stalled","action":"queue for manual verification","recommendedOwner":"Prior Authorization Lead","steps":["Create a manual verification queue item.","Attach the stalled workflow trace.","Require owner disposition before any next step."],"automationEligibility":"recommendation-only","humanReviewRequired":true,"expectedOutcome":"A human-reviewed queue for manual verification packet for Prior Authorization.","blockedActions":["Live PHI access","Autonomous diagnosis","Treatment recommendation","Prescribing","Patient outreach","Payer submission","EHR writeback","Billing submission","Production connector mutation"],"safetyBoundary":"Recommendation-only synthetic remediation; no real clinical, payer, EHR, billing, outreach, PHI-impacting, or production connector action may execute without explicit human approval and future authorization."},"evidenceRefs":["scrimed-trustops-module-registry","scrimed-trustops-signal-engine","scrimed-trustops-self-healing-recommendation","scrimed-execution-attempt-durable-store"],"durableEvidenceBinding":{"attemptId":"att_c457962a73ff","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","replayToken":"replay_b8c7009f50d041cc33d9967c","workflowSlug":"trustops-signal-remediation-review","durableStoreRecordRoute":"/api/workflows/execution-attempts/durable-store/record","durableStoreReplayRoute":"/api/workflows/execution-attempts/durable-store/replay","durableStoreReviewDispositionRoute":"/api/workflows/execution-attempts/durable-store/review-disposition","recordRequest":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","region":"us","retentionUntil":"2026-12-31T00:00:00.000Z"},"replayRequest":{"workspaceSlug":"atlas-synthetic-evaluation","replayToken":"replay_b8c7009f50d041cc33d9967c"},"reviewDispositionRequest":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","disposition":"changes-requested","reviewerRole":"TrustOps reviewer","reasonCode":"trustops-prior-auth-stalled","reviewNote":"Synthetic TrustOps packet for prior_auth_stalled. Recommended owner: Prior Authorization Lead. Recommended action: queue for manual verification. Human review is required before any protected workflow moves beyond synthetic mode.","humanReviewAttestation":"no-phi-human-review-no-clinical-authority"},"packetHash":"a6ca92303fa59d72d27bb4c381467ec77e41ffa527328751357b5dabac235470","evidenceEnvelopeHash":"90f7dea5217dbf714bed528b0f5120994ca0d43a88fb5fb57b33912f9d3fd7f6","persistenceStatus":"ready-for-aal2-protected-durable-store-not-persisted","safetyBoundary":"SCRIMED Execution Attempt Durable Store v1 is a tenant-scoped, no-PHI, metadata-only persistence contract for execution-attempt envelopes, idempotency, replay lookup, review dispositions, immutable audit events, regional retention, Compute Fabric routing evidence, and fail-closed protected route access. It does not authorize PHI processing, live patient data use, production model routing, autonomous diagnosis, autonomous treatment, prescribing, payer submission, claim submission, EHR writeback, patient outreach, production connector use, or clinical production approval."},"safetyBoundary":"Synthetic TrustOps review packet only. Recommendation-only remediation requires human review and does not authorize live PHI, autonomous clinical action, payer submission, billing submission, EHR writeback, patient outreach, production connector use, certification, clinical validation, or customer go-live."},{"packetId":"trustops_packet_6990f626c58f9ec0","packetVersion":"scrimed-trustops-review-packet-v1","createdAt":"2026-06-30T00:00:00.000Z","signalId":"missing_documentation","recommendationId":"recommendation-missing_documentation","moduleIds":["clinical-intelligence","quality-hedis-star","signal-detection","self-healing-operations"],"affectedWorkflow":"Clinical Documentation / RCM","severity":"medium","recommendedOwner":"Clinical Documentation Lead","reviewerQueue":"Clinical Documentation Lead human review queue","syntheticOnly":true,"humanReviewRequired":true,"automationExecutionAllowed":false,"signal":{"id":"missing_documentation","severity":"medium","affectedWorkflow":"Clinical Documentation / RCM","recommendedOwner":"Clinical Documentation Lead","recommendedAction":"Regenerate the missing synthetic documentation packet for reviewer inspection.","automationEligibility":"manual-review-required","humanReviewRequired":true,"reason":"Required synthetic packet fields are missing and should not move forward without validation. Observed 7 missing packet fields; threshold 1.","safetyBoundary":"Synthetic/demo signal only; requires human review and does not authorize live PHI, clinical action, patient outreach, payer submission, EHR writeback, billing submission, or production connector use."},"recommendation":{"id":"recommendation-missing_documentation","signalId":"missing_documentation","action":"regenerate missing packet","recommendedOwner":"Clinical Documentation Lead","steps":["Regenerate the synthetic evidence packet.","Validate required schema fields.","Queue the packet for human review."],"automationEligibility":"recommendation-only","humanReviewRequired":true,"expectedOutcome":"A human-reviewed regenerate missing packet packet for Clinical Documentation / RCM.","blockedActions":["Live PHI access","Autonomous diagnosis","Treatment recommendation","Prescribing","Patient outreach","Payer submission","EHR writeback","Billing submission","Production connector mutation"],"safetyBoundary":"Recommendation-only synthetic remediation; no real clinical, payer, EHR, billing, outreach, PHI-impacting, or production connector action may execute without explicit human approval and future authorization."},"evidenceRefs":["scrimed-trustops-module-registry","scrimed-trustops-signal-engine","scrimed-trustops-self-healing-recommendation","scrimed-execution-attempt-durable-store"],"durableEvidenceBinding":{"attemptId":"att_c457962a73ff","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","replayToken":"replay_b8c7009f50d041cc33d9967c","workflowSlug":"trustops-signal-remediation-review","durableStoreRecordRoute":"/api/workflows/execution-attempts/durable-store/record","durableStoreReplayRoute":"/api/workflows/execution-attempts/durable-store/replay","durableStoreReviewDispositionRoute":"/api/workflows/execution-attempts/durable-store/review-disposition","recordRequest":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","region":"us","retentionUntil":"2026-12-31T00:00:00.000Z"},"replayRequest":{"workspaceSlug":"atlas-synthetic-evaluation","replayToken":"replay_b8c7009f50d041cc33d9967c"},"reviewDispositionRequest":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","disposition":"changes-requested","reviewerRole":"TrustOps reviewer","reasonCode":"trustops-missing-documentation","reviewNote":"Synthetic TrustOps packet for missing_documentation. Recommended owner: Clinical Documentation Lead. Recommended action: regenerate missing packet. Human review is required before any protected workflow moves beyond synthetic mode.","humanReviewAttestation":"no-phi-human-review-no-clinical-authority"},"packetHash":"6990f626c58f9ec00c53dd985e5cecdd5dcb0f7a5f9f1bf690c2777f7cca0b67","evidenceEnvelopeHash":"c4737d87728663ce199cd7eddb392ef638851830e10abbf77ff53391db8263ed","persistenceStatus":"ready-for-aal2-protected-durable-store-not-persisted","safetyBoundary":"SCRIMED Execution Attempt Durable Store v1 is a tenant-scoped, no-PHI, metadata-only persistence contract for execution-attempt envelopes, idempotency, replay lookup, review dispositions, immutable audit events, regional retention, Compute Fabric routing evidence, and fail-closed protected route access. It does not authorize PHI processing, live patient data use, production model routing, autonomous diagnosis, autonomous treatment, prescribing, payer submission, claim submission, EHR writeback, patient outreach, production connector use, or clinical production approval."},"safetyBoundary":"Synthetic TrustOps review packet only. Recommendation-only remediation requires human review and does not authorize live PHI, autonomous clinical action, payer submission, billing submission, EHR writeback, patient outreach, production connector use, certification, clinical validation, or customer go-live."},{"packetId":"trustops_packet_e3e651ef8489601a","packetVersion":"scrimed-trustops-review-packet-v1","createdAt":"2026-06-30T00:00:00.000Z","signalId":"imaging_turnaround_delay","recommendationId":"recommendation-imaging_turnaround_delay","moduleIds":["imaging-intelligence","signal-detection","self-healing-operations"],"affectedWorkflow":"Imaging Intelligence","severity":"medium","recommendedOwner":"Imaging Operations Lead","reviewerQueue":"Imaging Operations Lead human review queue","syntheticOnly":true,"humanReviewRequired":true,"automationExecutionAllowed":false,"signal":{"id":"imaging_turnaround_delay","severity":"medium","affectedWorkflow":"Imaging Intelligence","recommendedOwner":"Imaging Operations Lead","recommendedAction":"Retry the synthetic imaging-status workflow and route the result to manual review.","automationEligibility":"manual-review-required","humanReviewRequired":true,"reason":"Synthetic imaging turnaround exceeded the configured threshold. Observed 48 synthetic hours; threshold 24.","safetyBoundary":"Synthetic/demo signal only; requires human review and does not authorize live PHI, clinical action, patient outreach, payer submission, EHR writeback, billing submission, or production connector use."},"recommendation":{"id":"recommendation-imaging_turnaround_delay","signalId":"imaging_turnaround_delay","action":"retry workflow","recommendedOwner":"Imaging Operations Lead","steps":["Replay the synthetic workflow trace.","Re-run structured-output validation.","Send the replay packet to the assigned owner."],"automationEligibility":"recommendation-only","humanReviewRequired":true,"expectedOutcome":"A human-reviewed retry workflow packet for Imaging Intelligence.","blockedActions":["Live PHI access","Autonomous diagnosis","Treatment recommendation","Prescribing","Patient outreach","Payer submission","EHR writeback","Billing submission","Production connector mutation"],"safetyBoundary":"Recommendation-only synthetic remediation; no real clinical, payer, EHR, billing, outreach, PHI-impacting, or production connector action may execute without explicit human approval and future authorization."},"evidenceRefs":["scrimed-trustops-module-registry","scrimed-trustops-signal-engine","scrimed-trustops-self-healing-recommendation","scrimed-execution-attempt-durable-store"],"durableEvidenceBinding":{"attemptId":"att_c457962a73ff","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","replayToken":"replay_b8c7009f50d041cc33d9967c","workflowSlug":"trustops-signal-remediation-review","durableStoreRecordRoute":"/api/workflows/execution-attempts/durable-store/record","durableStoreReplayRoute":"/api/workflows/execution-attempts/durable-store/replay","durableStoreReviewDispositionRoute":"/api/workflows/execution-attempts/durable-store/review-disposition","recordRequest":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","region":"us","retentionUntil":"2026-12-31T00:00:00.000Z"},"replayRequest":{"workspaceSlug":"atlas-synthetic-evaluation","replayToken":"replay_b8c7009f50d041cc33d9967c"},"reviewDispositionRequest":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","disposition":"changes-requested","reviewerRole":"TrustOps reviewer","reasonCode":"trustops-imaging-turnaround-delay","reviewNote":"Synthetic TrustOps packet for imaging_turnaround_delay. Recommended owner: Imaging Operations Lead. Recommended action: retry workflow. Human review is required before any protected workflow moves beyond synthetic mode.","humanReviewAttestation":"no-phi-human-review-no-clinical-authority"},"packetHash":"e3e651ef8489601a71ee4c21721211b0bec1ad7e262a2e8399dc5e61c8acec6f","evidenceEnvelopeHash":"d00cc485d5864544bc04a6939e58f527922e749238ab076f190ba9619c67ad5d","persistenceStatus":"ready-for-aal2-protected-durable-store-not-persisted","safetyBoundary":"SCRIMED Execution Attempt Durable Store v1 is a tenant-scoped, no-PHI, metadata-only persistence contract for execution-attempt envelopes, idempotency, replay lookup, review dispositions, immutable audit events, regional retention, Compute Fabric routing evidence, and fail-closed protected route access. It does not authorize PHI processing, live patient data use, production model routing, autonomous diagnosis, autonomous treatment, prescribing, payer submission, claim submission, EHR writeback, patient outreach, production connector use, or clinical production approval."},"safetyBoundary":"Synthetic TrustOps review packet only. Recommendation-only remediation requires human review and does not authorize live PHI, autonomous clinical action, payer submission, billing submission, EHR writeback, patient outreach, production connector use, certification, clinical validation, or customer go-live."},{"packetId":"trustops_packet_fca92ef681d81a90","packetVersion":"scrimed-trustops-review-packet-v1","createdAt":"2026-06-30T00:00:00.000Z","signalId":"care_gap_detected","recommendationId":"recommendation-care_gap_detected","moduleIds":["population-health","quality-hedis-star","signal-detection","governance-compliance"],"affectedWorkflow":"Population Health","severity":"high","recommendedOwner":"Population Health Lead","reviewerQueue":"Population Health Lead human review queue","syntheticOnly":true,"humanReviewRequired":true,"automationExecutionAllowed":false,"signal":{"id":"care_gap_detected","severity":"high","affectedWorkflow":"Population Health","recommendedOwner":"Population Health Lead","recommendedAction":"Request human review of the synthetic care-gap packet.","automationEligibility":"manual-review-required","humanReviewRequired":true,"reason":"Synthetic care-gap signals require review before any patient-facing or outreach-adjacent workflow is considered. Observed 14 synthetic care gaps; threshold 3.","safetyBoundary":"Synthetic/demo signal only; requires human review and does not authorize live PHI, clinical action, patient outreach, payer submission, EHR writeback, billing submission, or production connector use."},"recommendation":{"id":"recommendation-care_gap_detected","signalId":"care_gap_detected","action":"request human review","recommendedOwner":"Population Health Lead","steps":["Create a reviewer task with signal reason and source event.","Attach the synthetic evidence packet.","Block any downstream automation until disposition is recorded."],"automationEligibility":"recommendation-only","humanReviewRequired":true,"expectedOutcome":"A human-reviewed request human review packet for Population Health.","blockedActions":["Live PHI access","Autonomous diagnosis","Treatment recommendation","Prescribing","Patient outreach","Payer submission","EHR writeback","Billing submission","Production connector mutation"],"safetyBoundary":"Recommendation-only synthetic remediation; no real clinical, payer, EHR, billing, outreach, PHI-impacting, or production connector action may execute without explicit human approval and future authorization."},"evidenceRefs":["scrimed-trustops-module-registry","scrimed-trustops-signal-engine","scrimed-trustops-self-healing-recommendation","scrimed-execution-attempt-durable-store"],"durableEvidenceBinding":{"attemptId":"att_c457962a73ff","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","replayToken":"replay_b8c7009f50d041cc33d9967c","workflowSlug":"trustops-signal-remediation-review","durableStoreRecordRoute":"/api/workflows/execution-attempts/durable-store/record","durableStoreReplayRoute":"/api/workflows/execution-attempts/durable-store/replay","durableStoreReviewDispositionRoute":"/api/workflows/execution-attempts/durable-store/review-disposition","recordRequest":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","region":"us","retentionUntil":"2026-12-31T00:00:00.000Z"},"replayRequest":{"workspaceSlug":"atlas-synthetic-evaluation","replayToken":"replay_b8c7009f50d041cc33d9967c"},"reviewDispositionRequest":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","disposition":"changes-requested","reviewerRole":"TrustOps reviewer","reasonCode":"trustops-care-gap-detected","reviewNote":"Synthetic TrustOps packet for care_gap_detected. Recommended owner: Population Health Lead. Recommended action: request human review. Human review is required before any protected workflow moves beyond synthetic mode.","humanReviewAttestation":"no-phi-human-review-no-clinical-authority"},"packetHash":"fca92ef681d81a9077107cd90cac0741a25bce9a96bad75267af1cb36e99367f","evidenceEnvelopeHash":"cb4fb2d285fda75d632731661abd66326db83fb46d99f70c4aa2713d844475e4","persistenceStatus":"ready-for-aal2-protected-durable-store-not-persisted","safetyBoundary":"SCRIMED Execution Attempt Durable Store v1 is a tenant-scoped, no-PHI, metadata-only persistence contract for execution-attempt envelopes, idempotency, replay lookup, review dispositions, immutable audit events, regional retention, Compute Fabric routing evidence, and fail-closed protected route access. It does not authorize PHI processing, live patient data use, production model routing, autonomous diagnosis, autonomous treatment, prescribing, payer submission, claim submission, EHR writeback, patient outreach, production connector use, or clinical production approval."},"safetyBoundary":"Synthetic TrustOps review packet only. Recommendation-only remediation requires human review and does not authorize live PHI, autonomous clinical action, payer submission, billing submission, EHR writeback, patient outreach, production connector use, certification, clinical validation, or customer go-live."},{"packetId":"trustops_packet_2ba402d0d6776b8b","packetVersion":"scrimed-trustops-review-packet-v1","createdAt":"2026-06-30T00:00:00.000Z","signalId":"failed_api_sync","recommendationId":"recommendation-failed_api_sync","moduleIds":["secure-middleware-gateway","semantic-intelligence-graph","signal-detection","self-healing-operations"],"affectedWorkflow":"Secure Middleware Gateway","severity":"medium","recommendedOwner":"Platform Reliability Lead","reviewerQueue":"Platform Reliability Lead human review queue","syntheticOnly":true,"humanReviewRequired":true,"automationExecutionAllowed":false,"signal":{"id":"failed_api_sync","severity":"medium","affectedWorkflow":"Secure Middleware Gateway","recommendedOwner":"Platform Reliability Lead","recommendedAction":"Re-run synthetic middleware validation and inspect the failed sync trace.","automationEligibility":"manual-review-required","humanReviewRequired":true,"reason":"Synthetic middleware sync failures may indicate connector readiness or schema drift issues. Observed 5 synthetic sync failures; threshold 1.","safetyBoundary":"Synthetic/demo signal only; requires human review and does not authorize live PHI, clinical action, patient outreach, payer submission, EHR writeback, billing submission, or production connector use."},"recommendation":{"id":"recommendation-failed_api_sync","signalId":"failed_api_sync","action":"re-run validation","recommendedOwner":"Platform Reliability Lead","steps":["Re-run schema validation against the synthetic trace.","Capture validation errors.","Route failures to platform reliability review."],"automationEligibility":"recommendation-only","humanReviewRequired":true,"expectedOutcome":"A human-reviewed re-run validation packet for Secure Middleware Gateway.","blockedActions":["Live PHI access","Autonomous diagnosis","Treatment recommendation","Prescribing","Patient outreach","Payer submission","EHR writeback","Billing submission","Production connector mutation"],"safetyBoundary":"Recommendation-only synthetic remediation; no real clinical, payer, EHR, billing, outreach, PHI-impacting, or production connector action may execute without explicit human approval and future authorization."},"evidenceRefs":["scrimed-trustops-module-registry","scrimed-trustops-signal-engine","scrimed-trustops-self-healing-recommendation","scrimed-execution-attempt-durable-store"],"durableEvidenceBinding":{"attemptId":"att_c457962a73ff","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","replayToken":"replay_b8c7009f50d041cc33d9967c","workflowSlug":"trustops-signal-remediation-review","durableStoreRecordRoute":"/api/workflows/execution-attempts/durable-store/record","durableStoreReplayRoute":"/api/workflows/execution-attempts/durable-store/replay","durableStoreReviewDispositionRoute":"/api/workflows/execution-attempts/durable-store/review-disposition","recordRequest":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","region":"us","retentionUntil":"2026-12-31T00:00:00.000Z"},"replayRequest":{"workspaceSlug":"atlas-synthetic-evaluation","replayToken":"replay_b8c7009f50d041cc33d9967c"},"reviewDispositionRequest":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","disposition":"changes-requested","reviewerRole":"TrustOps reviewer","reasonCode":"trustops-failed-api-sync","reviewNote":"Synthetic TrustOps packet for failed_api_sync. Recommended owner: Platform Reliability Lead. Recommended action: re-run validation. Human review is required before any protected workflow moves beyond synthetic mode.","humanReviewAttestation":"no-phi-human-review-no-clinical-authority"},"packetHash":"2ba402d0d6776b8b4ae6ca8e349b4fe28d79d00b5e0cd3f294385be558e3813a","evidenceEnvelopeHash":"c0ebfa00db3b72ad4d8f2a8bfec3512f805d38a849ba30710b5df78a2c7d02e3","persistenceStatus":"ready-for-aal2-protected-durable-store-not-persisted","safetyBoundary":"SCRIMED Execution Attempt Durable Store v1 is a tenant-scoped, no-PHI, metadata-only persistence contract for execution-attempt envelopes, idempotency, replay lookup, review dispositions, immutable audit events, regional retention, Compute Fabric routing evidence, and fail-closed protected route access. It does not authorize PHI processing, live patient data use, production model routing, autonomous diagnosis, autonomous treatment, prescribing, payer submission, claim submission, EHR writeback, patient outreach, production connector use, or clinical production approval."},"safetyBoundary":"Synthetic TrustOps review packet only. Recommendation-only remediation requires human review and does not authorize live PHI, autonomous clinical action, payer submission, billing submission, EHR writeback, patient outreach, production connector use, certification, clinical validation, or customer go-live."},{"packetId":"trustops_packet_0a9a6b12099a08a4","packetVersion":"scrimed-trustops-review-packet-v1","createdAt":"2026-06-30T00:00:00.000Z","signalId":"duplicate_patient_context","recommendationId":"recommendation-duplicate_patient_context","moduleIds":["patient-journey-memory","semantic-intelligence-graph","governance-compliance","self-healing-operations"],"affectedWorkflow":"Patient Journey Memory","severity":"critical","recommendedOwner":"Data Governance Lead","reviewerQueue":"Data Governance Lead human review queue","syntheticOnly":true,"humanReviewRequired":true,"automationExecutionAllowed":false,"signal":{"id":"duplicate_patient_context","severity":"critical","affectedWorkflow":"Patient Journey Memory","recommendedOwner":"Data Governance Lead","recommendedAction":"Reconcile duplicate synthetic contexts through manual verification.","automationEligibility":"manual-review-required","humanReviewRequired":true,"reason":"Duplicate context signals are safety-sensitive even in synthetic mode and must block automation. Observed 2 synthetic duplicate contexts; threshold 1.","safetyBoundary":"Synthetic/demo signal only; requires human review and does not authorize live PHI, clinical action, patient outreach, payer submission, EHR writeback, billing submission, or production connector use."},"recommendation":{"id":"recommendation-duplicate_patient_context","signalId":"duplicate_patient_context","action":"reconcile duplicate records","recommendedOwner":"Data Governance Lead","steps":["Create a duplicate-context reconciliation packet.","Compare only synthetic context identifiers.","Require data-governance review before any merge-like recommendation."],"automationEligibility":"recommendation-only","humanReviewRequired":true,"expectedOutcome":"A human-reviewed reconcile duplicate records packet for Patient Journey Memory.","blockedActions":["Live PHI access","Autonomous diagnosis","Treatment recommendation","Prescribing","Patient outreach","Payer submission","EHR writeback","Billing submission","Production connector mutation"],"safetyBoundary":"Recommendation-only synthetic remediation; no real clinical, payer, EHR, billing, outreach, PHI-impacting, or production connector action may execute without explicit human approval and future authorization."},"evidenceRefs":["scrimed-trustops-module-registry","scrimed-trustops-signal-engine","scrimed-trustops-self-healing-recommendation","scrimed-execution-attempt-durable-store"],"durableEvidenceBinding":{"attemptId":"att_c457962a73ff","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","replayToken":"replay_b8c7009f50d041cc33d9967c","workflowSlug":"trustops-signal-remediation-review","durableStoreRecordRoute":"/api/workflows/execution-attempts/durable-store/record","durableStoreReplayRoute":"/api/workflows/execution-attempts/durable-store/replay","durableStoreReviewDispositionRoute":"/api/workflows/execution-attempts/durable-store/review-disposition","recordRequest":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","region":"us","retentionUntil":"2026-12-31T00:00:00.000Z"},"replayRequest":{"workspaceSlug":"atlas-synthetic-evaluation","replayToken":"replay_b8c7009f50d041cc33d9967c"},"reviewDispositionRequest":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","disposition":"escalated","reviewerRole":"TrustOps reviewer","reasonCode":"trustops-duplicate-patient-context","reviewNote":"Synthetic TrustOps packet for duplicate_patient_context. Recommended owner: Data Governance Lead. Recommended action: reconcile duplicate records. Human review is required before any protected workflow moves beyond synthetic mode.","humanReviewAttestation":"no-phi-human-review-no-clinical-authority"},"packetHash":"0a9a6b12099a08a4f67848f6c2bc9e37f73e500452b936feb93a9bfb7501e941","evidenceEnvelopeHash":"64ab925d635bc5794953dd89ea7b876c7a516ad9fa27d1530783c6e34c9dcefc","persistenceStatus":"ready-for-aal2-protected-durable-store-not-persisted","safetyBoundary":"SCRIMED Execution Attempt Durable Store v1 is a tenant-scoped, no-PHI, metadata-only persistence contract for execution-attempt envelopes, idempotency, replay lookup, review dispositions, immutable audit events, regional retention, Compute Fabric routing evidence, and fail-closed protected route access. It does not authorize PHI processing, live patient data use, production model routing, autonomous diagnosis, autonomous treatment, prescribing, payer submission, claim submission, EHR writeback, patient outreach, production connector use, or clinical production approval."},"safetyBoundary":"Synthetic TrustOps review packet only. Recommendation-only remediation requires human review and does not authorize live PHI, autonomous clinical action, payer submission, billing submission, EHR writeback, patient outreach, production connector use, certification, clinical validation, or customer go-live."},{"packetId":"trustops_packet_66c9f6c71259c993","packetVersion":"scrimed-trustops-review-packet-v1","createdAt":"2026-06-30T00:00:00.000Z","signalId":"low_confidence_agent_output","recommendationId":"recommendation-low_confidence_agent_output","moduleIds":["clinical-intelligence","governance-compliance","signal-detection","self-healing-operations"],"affectedWorkflow":"Clinical Intelligence","severity":"critical","recommendedOwner":"Clinical QA Lead","reviewerQueue":"Clinical QA Lead human review queue","syntheticOnly":true,"humanReviewRequired":true,"automationExecutionAllowed":false,"signal":{"id":"low_confidence_agent_output","severity":"critical","affectedWorkflow":"Clinical Intelligence","recommendedOwner":"Clinical QA Lead","recommendedAction":"Pause automation and route the synthetic agent output to qualified review.","automationEligibility":"manual-review-required","humanReviewRequired":true,"reason":"Low-confidence clinical-adjacent outputs must not continue without reviewer disposition. Observed 42 confidence score; threshold 70.","safetyBoundary":"Synthetic/demo signal only; requires human review and does not authorize live PHI, clinical action, patient outreach, payer submission, EHR writeback, billing submission, or production connector use."},"recommendation":{"id":"recommendation-low_confidence_agent_output","signalId":"low_confidence_agent_output","action":"pause automation","recommendedOwner":"Clinical QA Lead","steps":["Mark the synthetic workflow as automation-paused.","Attach the confidence or safety reason.","Require qualified reviewer approval before continuing."],"automationEligibility":"recommendation-only","humanReviewRequired":true,"expectedOutcome":"A human-reviewed pause automation packet for Clinical Intelligence.","blockedActions":["Live PHI access","Autonomous diagnosis","Treatment recommendation","Prescribing","Patient outreach","Payer submission","EHR writeback","Billing submission","Production connector mutation"],"safetyBoundary":"Recommendation-only synthetic remediation; no real clinical, payer, EHR, billing, outreach, PHI-impacting, or production connector action may execute without explicit human approval and future authorization."},"evidenceRefs":["scrimed-trustops-module-registry","scrimed-trustops-signal-engine","scrimed-trustops-self-healing-recommendation","scrimed-execution-attempt-durable-store"],"durableEvidenceBinding":{"attemptId":"att_c457962a73ff","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","replayToken":"replay_b8c7009f50d041cc33d9967c","workflowSlug":"trustops-signal-remediation-review","durableStoreRecordRoute":"/api/workflows/execution-attempts/durable-store/record","durableStoreReplayRoute":"/api/workflows/execution-attempts/durable-store/replay","durableStoreReviewDispositionRoute":"/api/workflows/execution-attempts/durable-store/review-disposition","recordRequest":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","region":"us","retentionUntil":"2026-12-31T00:00:00.000Z"},"replayRequest":{"workspaceSlug":"atlas-synthetic-evaluation","replayToken":"replay_b8c7009f50d041cc33d9967c"},"reviewDispositionRequest":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","disposition":"escalated","reviewerRole":"TrustOps reviewer","reasonCode":"trustops-low-confidence-agent-output","reviewNote":"Synthetic TrustOps packet for low_confidence_agent_output. Recommended owner: Clinical QA Lead. Recommended action: pause automation. Human review is required before any protected workflow moves beyond synthetic mode.","humanReviewAttestation":"no-phi-human-review-no-clinical-authority"},"packetHash":"66c9f6c71259c99375e69bb53dd0fb7b0085089f368d579290f19575381bf1f2","evidenceEnvelopeHash":"9a7fe08186f056b4fd2c8ac2de7f96bd1198bf6bccae65cf846598e5c86b71d7","persistenceStatus":"ready-for-aal2-protected-durable-store-not-persisted","safetyBoundary":"SCRIMED Execution Attempt Durable Store v1 is a tenant-scoped, no-PHI, metadata-only persistence contract for execution-attempt envelopes, idempotency, replay lookup, review dispositions, immutable audit events, regional retention, Compute Fabric routing evidence, and fail-closed protected route access. It does not authorize PHI processing, live patient data use, production model routing, autonomous diagnosis, autonomous treatment, prescribing, payer submission, claim submission, EHR writeback, patient outreach, production connector use, or clinical production approval."},"safetyBoundary":"Synthetic TrustOps review packet only. Recommendation-only remediation requires human review and does not authorize live PHI, autonomous clinical action, payer submission, billing submission, EHR writeback, patient outreach, production connector use, certification, clinical validation, or customer go-live."},{"packetId":"trustops_packet_1c6f6133871dd400","packetVersion":"scrimed-trustops-review-packet-v1","createdAt":"2026-06-30T00:00:00.000Z","signalId":"compliance_sensitive_task","recommendationId":"recommendation-compliance_sensitive_task","moduleIds":["governance-compliance","secure-middleware-gateway","semantic-intelligence-graph","self-healing-operations"],"affectedWorkflow":"Governance / Compliance","severity":"critical","recommendedOwner":"Compliance Lead","reviewerQueue":"Compliance Lead human review queue","syntheticOnly":true,"humanReviewRequired":true,"automationExecutionAllowed":false,"signal":{"id":"compliance_sensitive_task","severity":"critical","affectedWorkflow":"Governance / Compliance","recommendedOwner":"Compliance Lead","recommendedAction":"Escalate the synthetic sensitive task to compliance review.","automationEligibility":"manual-review-required","humanReviewRequired":true,"reason":"Compliance-sensitive task classification requires explicit human review and retained hard stops. Observed 1 sensitive synthetic task; threshold 1.","safetyBoundary":"Synthetic/demo signal only; requires human review and does not authorize live PHI, clinical action, patient outreach, payer submission, EHR writeback, billing submission, or production connector use."},"recommendation":{"id":"recommendation-compliance_sensitive_task","signalId":"compliance_sensitive_task","action":"escalate to compliance","recommendedOwner":"Compliance Lead","steps":["Create a compliance escalation packet.","Attach policy boundary and signal details.","Pause related automation recommendations until compliance review completes."],"automationEligibility":"recommendation-only","humanReviewRequired":true,"expectedOutcome":"A human-reviewed escalate to compliance packet for Governance / Compliance.","blockedActions":["Live PHI access","Autonomous diagnosis","Treatment recommendation","Prescribing","Patient outreach","Payer submission","EHR writeback","Billing submission","Production connector mutation"],"safetyBoundary":"Recommendation-only synthetic remediation; no real clinical, payer, EHR, billing, outreach, PHI-impacting, or production connector action may execute without explicit human approval and future authorization."},"evidenceRefs":["scrimed-trustops-module-registry","scrimed-trustops-signal-engine","scrimed-trustops-self-healing-recommendation","scrimed-execution-attempt-durable-store"],"durableEvidenceBinding":{"attemptId":"att_c457962a73ff","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","replayToken":"replay_b8c7009f50d041cc33d9967c","workflowSlug":"trustops-signal-remediation-review","durableStoreRecordRoute":"/api/workflows/execution-attempts/durable-store/record","durableStoreReplayRoute":"/api/workflows/execution-attempts/durable-store/replay","durableStoreReviewDispositionRoute":"/api/workflows/execution-attempts/durable-store/review-disposition","recordRequest":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","region":"us","retentionUntil":"2026-12-31T00:00:00.000Z"},"replayRequest":{"workspaceSlug":"atlas-synthetic-evaluation","replayToken":"replay_b8c7009f50d041cc33d9967c"},"reviewDispositionRequest":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","disposition":"escalated","reviewerRole":"TrustOps reviewer","reasonCode":"trustops-compliance-sensitive-task","reviewNote":"Synthetic TrustOps packet for compliance_sensitive_task. Recommended owner: Compliance Lead. Recommended action: escalate to compliance. Human review is required before any protected workflow moves beyond synthetic mode.","humanReviewAttestation":"no-phi-human-review-no-clinical-authority"},"packetHash":"1c6f6133871dd400d8a2322fd8bb527ebd90f5453034635e27798e06cb0e18e0","evidenceEnvelopeHash":"7f4eb73199f4dfe179b938658fc76dff3285506a3717b3726123b57b31a4534c","persistenceStatus":"ready-for-aal2-protected-durable-store-not-persisted","safetyBoundary":"SCRIMED Execution Attempt Durable Store v1 is a tenant-scoped, no-PHI, metadata-only persistence contract for execution-attempt envelopes, idempotency, replay lookup, review dispositions, immutable audit events, regional retention, Compute Fabric routing evidence, and fail-closed protected route access. It does not authorize PHI processing, live patient data use, production model routing, autonomous diagnosis, autonomous treatment, prescribing, payer submission, claim submission, EHR writeback, patient outreach, production connector use, or clinical production approval."},"safetyBoundary":"Synthetic TrustOps review packet only. Recommendation-only remediation requires human review and does not authorize live PHI, autonomous clinical action, payer submission, billing submission, EHR writeback, patient outreach, production connector use, certification, clinical validation, or customer go-live."}],"validation":{"status":"pass","checks":[{"check":"trustops-review-packets-generated","passed":true,"detail":"Every synthetic TrustOps signal has a replayable review packet."},{"check":"trustops-review-packets-schema-valid","passed":true,"detail":"Every TrustOps review packet passes structured validation."},{"check":"durable-record-payloads-valid","passed":true,"detail":"Every TrustOps review packet includes a durable-store record payload that references the server-known TrustOps envelope."},{"check":"durable-replay-payloads-valid","passed":true,"detail":"Every TrustOps review packet includes a valid metadata-only replay payload."},{"check":"durable-review-disposition-payloads-valid","passed":true,"detail":"Every TrustOps review packet includes a valid no-PHI human-review disposition payload."},{"check":"recommendation-only-no-execution","passed":true,"detail":"TrustOps review packets cannot execute real-world remediation."}],"packetValidations":[{"schemaVersion":"scrimed-trustops-schema-v2026-06-30","valid":true,"errors":[]},{"schemaVersion":"scrimed-trustops-schema-v2026-06-30","valid":true,"errors":[]},{"schemaVersion":"scrimed-trustops-schema-v2026-06-30","valid":true,"errors":[]},{"schemaVersion":"scrimed-trustops-schema-v2026-06-30","valid":true,"errors":[]},{"schemaVersion":"scrimed-trustops-schema-v2026-06-30","valid":true,"errors":[]},{"schemaVersion":"scrimed-trustops-schema-v2026-06-30","valid":true,"errors":[]},{"schemaVersion":"scrimed-trustops-schema-v2026-06-30","valid":true,"errors":[]},{"schemaVersion":"scrimed-trustops-schema-v2026-06-30","valid":true,"errors":[]},{"schemaVersion":"scrimed-trustops-schema-v2026-06-30","valid":true,"errors":[]},{"schemaVersion":"scrimed-trustops-schema-v2026-06-30","valid":true,"errors":[]}],"durableRecordValidations":[{"ok":true,"value":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","region":"us","retentionUntil":"2026-12-31T00:00:00.000Z","envelope":{"attemptId":"att_c457962a73ff","contractVersion":"scrimed-execution-attempt-envelope-v1","buildStatus":"metadata-only-accepted","lifecycleState":"review-required","workflowSlug":"trustops-signal-remediation-review","workflowVersion":"2026.06.no-phi","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","createdAt":"2026-06-27","tenantReference":"tenant-ref-synthetic-atlas","tenantBoundary":"tenant-reference-only-no-customer-data","callerRole":"trustops-reviewer","agentRuntimeId":"agent-runtime-trustops-supervisor","agentPermissions":["read-synthetic-context","read-approved-evidence-references","write-draft-review-packet","append-metadata-audit-event"],"deniedCapabilities":["autonomous diagnosis","autonomous treatment","prescribing","patient outreach","payer submission","claim submission","final coding","EHR writeback","production connector write","clinical triage replacement"],"dataBoundary":"synthetic-and-metadata-only","phiAuthority":"not-authorized-production-phi","clinicalCareAuthority":"not-authorized-live-care","inputDigest":"cab5bad92f6d33cdc6a05290ee1724fa095d033528d7f9c2991398328adbeeb4","contextFingerprint":"d7f0ab098482ad9655bb7e9961dd93d852690f9a2cfb552cd5091dbe7c27fff1","compressedContextRefs":["compressed:synthetic-trustops-signal-set-v1","compressed:synthetic-self-healing-recommendation-set-v1"],"evidenceRefs":["trustops-module-registry-v1","trustops-structured-validation-v1"],"policyRefs":["org-policy-human-trustops-review-required-v1"],"requestedActionSummary":"Create a reviewer-held TrustOps signal and recommendation packet with durable evidence binding for synthetic operations review.","modelRouteTelemetry":{"routeId":"route_cfb561cfa2","taskType":"trustops signal remediation review","providerClass":"open-weight","providerName":"SCRIMED local or open-weight route","modelVersion":"open-weight:registered-version-required-before-production","fallbackProviderClass":"frontier-closed","routeProfile":"workflow-planning-human-review-gated","riskTier":"moderate","estimatedCostUsd":0.028,"latencyBudgetMs":3200,"confidence":0.78,"routingRationale":"Route metadata is logged for synthetic evaluation only; production provider selection remains blocked until contracts, privacy, telemetry, fallback, and review controls are approved.","telemetryBoundary":"telemetry-only-not-production-routing"},"computeFabricTelemetry":{"fabricVersion":"scrimed-compute-fabric-v2026-07-05","fabricStatus":"synthetic-routing-only-no-live-model-calls","selectedModel":"private-sglang-compact-runtime-slot","modelTier":"COMPACT_REASONING_MODEL","provider":"scrimed_private_sglang","deploymentMode":"CUSTOMER_VPC","reason":"COMPACT_REASONING_MODEL selected for operations; CUSTOMER_VPC deployment mode; text modality; moderate clinical risk; metadata-only-no-public-phi PHI policy","riskLevel":"moderate","phiPolicy":"metadata-only-no-public-phi","requiresHumanReview":false,"fallbackModels":["pulsar-16b-compact-reasoning-synthetic-slot","llama-mistral-qwen-glm-open-routing-slot"],"estimatedCostClass":"LOW","estimatedLatencyClass":"INTERACTIVE","auditTags":["scrimed-compute-fabric","scrimed-compute-fabric-v2026-07-05","task:operations","modality:text","risk:moderate","deployment:CUSTOMER_VPC","tier:COMPACT_REASONING_MODEL","provider:scrimed_private_sglang","phi-policy:metadata-only-no-public-phi","human-review-not-required-for-metadata-only","no-live-model-call","no-autonomous-clinical-authority"],"auditHash":"scrimed-intel-9abbb131","confidenceScore":0.86,"confidenceCorrectnessBoundary":"confidence-is-not-correctness","correctnessEvidenceRequired":["schema validation","source attribution","benchmarkModelForTask","compareModels","human review for clinical recommendations"],"uncertaintyReasons":["Confidence score is routing confidence, not proof of clinical correctness.","Clinical correctness requires evidence review, external validation, and human signoff.","Benchmark scores are synthetic metadata until a governed validation dataset is approved."],"safetyBoundary":"metadata-only-no-live-model-call"},"humanApprovalGate":{"required":true,"reviewStatus":"held-for-human-review","requiredReviewers":["domain reviewer","TrustOS"],"gateReason":"Protected healthcare workflow output requires accountable human review before any release, connector, payer, record, or patient-facing action.","releaseCondition":"Release requires approved reviewer identity, evidence card, clinical-risk label, audit event, and retained no-PHI boundary.","deniedUntil":"Durable attempt store, customer authority, connector approval, PHI controls, and production review workflow are approved."},"auditTrail":{"auditEventId":"audit_61069a3ed8f7","traceId":"trace_2188d604f39a781b","eventHash":"2d8e3525e9c56c814b33d3d8bbe7568aeb4c3477a2a1372c7cdd3f0984a23647","immutableEventType":"execution-attempt-envelope-created","retainedFields":["attemptId","idempotencyKey","workflowSlug","tenantReference","callerRole","contextFingerprint","modelRouteTelemetry","computeFabricTelemetry","humanApprovalGate","replayMetadata","failureRecovery"],"prohibitedFields":["patient identifiers","raw chart text","member identifiers","production connector payloads","secrets","credentials"]},"replayMetadata":{"replayToken":"replay_b8c7009f50d041cc33d9967c","replayEligible":true,"idempotencyScope":"tenant-reference + workflow slug + workflow version + caller role + input digest","ttlHours":72,"deterministicInputs":["workflowSlug","workflowVersion","tenantReference","callerRole","agentRuntimeId","inputDigest","contextFingerprint","policyRefs"],"replayPolicy":"Replay returns the retained metadata envelope only and cannot repeat protected external actions.","conflictResponse":"Return conflict when the same idempotency key maps to a different input digest, context fingerprint, or caller role.","expirationBehavior":"Expired metadata-only keys require a new envelope and cannot revive protected execution."},"toolPlan":{"toolRegistryVersion":"scrimed-tool-registry-no-phi-v1","allowedTools":["synthetic-context-reader","evidence-card-builder","review-packet-drafter","metadata-audit-appender"],"blockedTools":["ehr-writeback","patient-messaging","payer-submission","claims-submission","production-connector-write"],"noConnectorAccess":true,"noRecordMutation":true},"failureRecovery":{"retryPolicy":"Retry metadata envelope creation only when validation, hash generation, or audit-link assembly fails before any protected action.","quarantineTriggers":["PHI-like input","protected action request","missing reviewer gate","missing context fingerprint","model route telemetry absent","idempotency conflict"],"fallbackBehavior":"Return a deny-by-default review packet and require human operator triage.","rollbackBehavior":"No external side effect exists to roll back; retain denial metadata and preserve prior workflow state.","deadLetterOwner":"TrustOS and platform reliability"},"evidenceAuditTrail":{"attempt_id":"att_c457962a73ff","user_session_tenant_context":{"tenantReference":"tenant-ref-synthetic-atlas","callerRole":"trustops-reviewer","agentRuntimeId":"agent-runtime-trustops-supervisor","sessionReference":"metadata-only-no-live-session"},"timestamp":"2026-06-27","route":"/api/workflows/execution-attempts/envelope","action":"Create a reviewer-held TrustOps signal and recommendation packet with durable evidence binding for synthetic operations review.","allowed_blocked_decision":"allowed","policy_version":"scrimed-safety-governance-v2026-06-29","input_classification":"synthetic-no-phi","phi_detected":false,"synthetic":true,"model_provider_selected":"synthetic-fallback","model_tier_selected":"FAST_LOW_COST","compute_fabric_audit_hash":"scrimed-intel-9abbb131","compute_fabric_selected_model":"private-sglang-compact-runtime-slot","compute_fabric_model_tier":"COMPACT_REASONING_MODEL","compute_fabric_provider":"scrimed_private_sglang","compute_fabric_deployment_mode":"CUSTOMER_VPC","compute_fabric_phi_policy":"metadata-only-no-public-phi","compute_fabric_human_review_required":false,"output_hash":"25637661bf746a6c51014d4f4ef9a5675acb8c6076f93b44d5817abc05fd4049","evidence_envelope_hash":"590ff91776c7eec0932a1dbffbcded47b4d9aa86de36d2c4db5f08f9e93fe131","status":"review-required","failure_reason":null},"evaluationBindings":{"syntheticScenarioRefs":["agent-scorecard-runtime-permission","hallucination-uncited-guideline","clinical-safety-prohibited-action","evidence-quality-stale-policy","regression-workflow-result-diff","synthetic-patient-missing-data","adversarial-prompt-injection-tool-override","sanar-conflict-temporal-escalation","clinical-copilot-unit-abbreviation-citation"],"scorecardRefs":["scorecard-idempotency-replay","scorecard-no-phi-boundary","scorecard-route-telemetry","scorecard-human-review","scorecard-audit-linkage","scorecard-protected-capability-denial","scorecard-failure-recovery","scorecard-context-fingerprint","clinical-robustness-scorecard-sanar-conflict-temporal-escalation","clinical-robustness-scorecard-clinical-copilot-unit-abbreviation-citation"],"clinicalRobustness":{"labRoute":"/clinical-robustness-lab","scenarioRefs":["sanar-conflict-temporal-escalation","clinical-copilot-unit-abbreviation-citation"],"scorecardRefs":["clinical-robustness-scorecard-sanar-conflict-temporal-escalation","clinical-robustness-scorecard-clinical-copilot-unit-abbreviation-citation"],"perturbationRefs":["missing-data","missing-labs-risk","conflicting-data","temporal-inconsistencies","data-freshness","human-review-requirement","abbreviations","wrong-units","hallucination-risk","citation-reference-quality","guideline-grounding","model-disagreement"],"averageClinicalReadinessScore":96,"reviewerQueues":["clinical-safety-review","clinical-copilot-review"],"dataBoundary":"synthetic-no-phi-only","clinicalAuthority":"not-authorized-live-care","phiAuthority":"not-authorized-production-phi","reviewerGate":"human-review-required"}},"retainedBoundary":"This envelope is a metadata-only, no-PHI, replayable contract. It is not live workflow execution, not production persistence, not model routing approval, and not clinical or payer authority."}}},{"ok":true,"value":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","region":"us","retentionUntil":"2026-12-31T00:00:00.000Z","envelope":{"attemptId":"att_c457962a73ff","contractVersion":"scrimed-execution-attempt-envelope-v1","buildStatus":"metadata-only-accepted","lifecycleState":"review-required","workflowSlug":"trustops-signal-remediation-review","workflowVersion":"2026.06.no-phi","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","createdAt":"2026-06-27","tenantReference":"tenant-ref-synthetic-atlas","tenantBoundary":"tenant-reference-only-no-customer-data","callerRole":"trustops-reviewer","agentRuntimeId":"agent-runtime-trustops-supervisor","agentPermissions":["read-synthetic-context","read-approved-evidence-references","write-draft-review-packet","append-metadata-audit-event"],"deniedCapabilities":["autonomous diagnosis","autonomous treatment","prescribing","patient outreach","payer submission","claim submission","final coding","EHR writeback","production connector write","clinical triage replacement"],"dataBoundary":"synthetic-and-metadata-only","phiAuthority":"not-authorized-production-phi","clinicalCareAuthority":"not-authorized-live-care","inputDigest":"cab5bad92f6d33cdc6a05290ee1724fa095d033528d7f9c2991398328adbeeb4","contextFingerprint":"d7f0ab098482ad9655bb7e9961dd93d852690f9a2cfb552cd5091dbe7c27fff1","compressedContextRefs":["compressed:synthetic-trustops-signal-set-v1","compressed:synthetic-self-healing-recommendation-set-v1"],"evidenceRefs":["trustops-module-registry-v1","trustops-structured-validation-v1"],"policyRefs":["org-policy-human-trustops-review-required-v1"],"requestedActionSummary":"Create a reviewer-held TrustOps signal and recommendation packet with durable evidence binding for synthetic operations review.","modelRouteTelemetry":{"routeId":"route_cfb561cfa2","taskType":"trustops signal remediation review","providerClass":"open-weight","providerName":"SCRIMED local or open-weight route","modelVersion":"open-weight:registered-version-required-before-production","fallbackProviderClass":"frontier-closed","routeProfile":"workflow-planning-human-review-gated","riskTier":"moderate","estimatedCostUsd":0.028,"latencyBudgetMs":3200,"confidence":0.78,"routingRationale":"Route metadata is logged for synthetic evaluation only; production provider selection remains blocked until contracts, privacy, telemetry, fallback, and review controls are approved.","telemetryBoundary":"telemetry-only-not-production-routing"},"computeFabricTelemetry":{"fabricVersion":"scrimed-compute-fabric-v2026-07-05","fabricStatus":"synthetic-routing-only-no-live-model-calls","selectedModel":"private-sglang-compact-runtime-slot","modelTier":"COMPACT_REASONING_MODEL","provider":"scrimed_private_sglang","deploymentMode":"CUSTOMER_VPC","reason":"COMPACT_REASONING_MODEL selected for operations; CUSTOMER_VPC deployment mode; text modality; moderate clinical risk; metadata-only-no-public-phi PHI policy","riskLevel":"moderate","phiPolicy":"metadata-only-no-public-phi","requiresHumanReview":false,"fallbackModels":["pulsar-16b-compact-reasoning-synthetic-slot","llama-mistral-qwen-glm-open-routing-slot"],"estimatedCostClass":"LOW","estimatedLatencyClass":"INTERACTIVE","auditTags":["scrimed-compute-fabric","scrimed-compute-fabric-v2026-07-05","task:operations","modality:text","risk:moderate","deployment:CUSTOMER_VPC","tier:COMPACT_REASONING_MODEL","provider:scrimed_private_sglang","phi-policy:metadata-only-no-public-phi","human-review-not-required-for-metadata-only","no-live-model-call","no-autonomous-clinical-authority"],"auditHash":"scrimed-intel-9abbb131","confidenceScore":0.86,"confidenceCorrectnessBoundary":"confidence-is-not-correctness","correctnessEvidenceRequired":["schema validation","source attribution","benchmarkModelForTask","compareModels","human review for clinical recommendations"],"uncertaintyReasons":["Confidence score is routing confidence, not proof of clinical correctness.","Clinical correctness requires evidence review, external validation, and human signoff.","Benchmark scores are synthetic metadata until a governed validation dataset is approved."],"safetyBoundary":"metadata-only-no-live-model-call"},"humanApprovalGate":{"required":true,"reviewStatus":"held-for-human-review","requiredReviewers":["domain reviewer","TrustOS"],"gateReason":"Protected healthcare workflow output requires accountable human review before any release, connector, payer, record, or patient-facing action.","releaseCondition":"Release requires approved reviewer identity, evidence card, clinical-risk label, audit event, and retained no-PHI boundary.","deniedUntil":"Durable attempt store, customer authority, connector approval, PHI controls, and production review workflow are approved."},"auditTrail":{"auditEventId":"audit_61069a3ed8f7","traceId":"trace_2188d604f39a781b","eventHash":"2d8e3525e9c56c814b33d3d8bbe7568aeb4c3477a2a1372c7cdd3f0984a23647","immutableEventType":"execution-attempt-envelope-created","retainedFields":["attemptId","idempotencyKey","workflowSlug","tenantReference","callerRole","contextFingerprint","modelRouteTelemetry","computeFabricTelemetry","humanApprovalGate","replayMetadata","failureRecovery"],"prohibitedFields":["patient identifiers","raw chart text","member identifiers","production connector payloads","secrets","credentials"]},"replayMetadata":{"replayToken":"replay_b8c7009f50d041cc33d9967c","replayEligible":true,"idempotencyScope":"tenant-reference + workflow slug + workflow version + caller role + input digest","ttlHours":72,"deterministicInputs":["workflowSlug","workflowVersion","tenantReference","callerRole","agentRuntimeId","inputDigest","contextFingerprint","policyRefs"],"replayPolicy":"Replay returns the retained metadata envelope only and cannot repeat protected external actions.","conflictResponse":"Return conflict when the same idempotency key maps to a different input digest, context fingerprint, or caller role.","expirationBehavior":"Expired metadata-only keys require a new envelope and cannot revive protected execution."},"toolPlan":{"toolRegistryVersion":"scrimed-tool-registry-no-phi-v1","allowedTools":["synthetic-context-reader","evidence-card-builder","review-packet-drafter","metadata-audit-appender"],"blockedTools":["ehr-writeback","patient-messaging","payer-submission","claims-submission","production-connector-write"],"noConnectorAccess":true,"noRecordMutation":true},"failureRecovery":{"retryPolicy":"Retry metadata envelope creation only when validation, hash generation, or audit-link assembly fails before any protected action.","quarantineTriggers":["PHI-like input","protected action request","missing reviewer gate","missing context fingerprint","model route telemetry absent","idempotency conflict"],"fallbackBehavior":"Return a deny-by-default review packet and require human operator triage.","rollbackBehavior":"No external side effect exists to roll back; retain denial metadata and preserve prior workflow state.","deadLetterOwner":"TrustOS and platform reliability"},"evidenceAuditTrail":{"attempt_id":"att_c457962a73ff","user_session_tenant_context":{"tenantReference":"tenant-ref-synthetic-atlas","callerRole":"trustops-reviewer","agentRuntimeId":"agent-runtime-trustops-supervisor","sessionReference":"metadata-only-no-live-session"},"timestamp":"2026-06-27","route":"/api/workflows/execution-attempts/envelope","action":"Create a reviewer-held TrustOps signal and recommendation packet with durable evidence binding for synthetic operations review.","allowed_blocked_decision":"allowed","policy_version":"scrimed-safety-governance-v2026-06-29","input_classification":"synthetic-no-phi","phi_detected":false,"synthetic":true,"model_provider_selected":"synthetic-fallback","model_tier_selected":"FAST_LOW_COST","compute_fabric_audit_hash":"scrimed-intel-9abbb131","compute_fabric_selected_model":"private-sglang-compact-runtime-slot","compute_fabric_model_tier":"COMPACT_REASONING_MODEL","compute_fabric_provider":"scrimed_private_sglang","compute_fabric_deployment_mode":"CUSTOMER_VPC","compute_fabric_phi_policy":"metadata-only-no-public-phi","compute_fabric_human_review_required":false,"output_hash":"25637661bf746a6c51014d4f4ef9a5675acb8c6076f93b44d5817abc05fd4049","evidence_envelope_hash":"590ff91776c7eec0932a1dbffbcded47b4d9aa86de36d2c4db5f08f9e93fe131","status":"review-required","failure_reason":null},"evaluationBindings":{"syntheticScenarioRefs":["agent-scorecard-runtime-permission","hallucination-uncited-guideline","clinical-safety-prohibited-action","evidence-quality-stale-policy","regression-workflow-result-diff","synthetic-patient-missing-data","adversarial-prompt-injection-tool-override","sanar-conflict-temporal-escalation","clinical-copilot-unit-abbreviation-citation"],"scorecardRefs":["scorecard-idempotency-replay","scorecard-no-phi-boundary","scorecard-route-telemetry","scorecard-human-review","scorecard-audit-linkage","scorecard-protected-capability-denial","scorecard-failure-recovery","scorecard-context-fingerprint","clinical-robustness-scorecard-sanar-conflict-temporal-escalation","clinical-robustness-scorecard-clinical-copilot-unit-abbreviation-citation"],"clinicalRobustness":{"labRoute":"/clinical-robustness-lab","scenarioRefs":["sanar-conflict-temporal-escalation","clinical-copilot-unit-abbreviation-citation"],"scorecardRefs":["clinical-robustness-scorecard-sanar-conflict-temporal-escalation","clinical-robustness-scorecard-clinical-copilot-unit-abbreviation-citation"],"perturbationRefs":["missing-data","missing-labs-risk","conflicting-data","temporal-inconsistencies","data-freshness","human-review-requirement","abbreviations","wrong-units","hallucination-risk","citation-reference-quality","guideline-grounding","model-disagreement"],"averageClinicalReadinessScore":96,"reviewerQueues":["clinical-safety-review","clinical-copilot-review"],"dataBoundary":"synthetic-no-phi-only","clinicalAuthority":"not-authorized-live-care","phiAuthority":"not-authorized-production-phi","reviewerGate":"human-review-required"}},"retainedBoundary":"This envelope is a metadata-only, no-PHI, replayable contract. It is not live workflow execution, not production persistence, not model routing approval, and not clinical or payer authority."}}},{"ok":true,"value":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","region":"us","retentionUntil":"2026-12-31T00:00:00.000Z","envelope":{"attemptId":"att_c457962a73ff","contractVersion":"scrimed-execution-attempt-envelope-v1","buildStatus":"metadata-only-accepted","lifecycleState":"review-required","workflowSlug":"trustops-signal-remediation-review","workflowVersion":"2026.06.no-phi","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","createdAt":"2026-06-27","tenantReference":"tenant-ref-synthetic-atlas","tenantBoundary":"tenant-reference-only-no-customer-data","callerRole":"trustops-reviewer","agentRuntimeId":"agent-runtime-trustops-supervisor","agentPermissions":["read-synthetic-context","read-approved-evidence-references","write-draft-review-packet","append-metadata-audit-event"],"deniedCapabilities":["autonomous diagnosis","autonomous treatment","prescribing","patient outreach","payer submission","claim submission","final coding","EHR writeback","production connector write","clinical triage replacement"],"dataBoundary":"synthetic-and-metadata-only","phiAuthority":"not-authorized-production-phi","clinicalCareAuthority":"not-authorized-live-care","inputDigest":"cab5bad92f6d33cdc6a05290ee1724fa095d033528d7f9c2991398328adbeeb4","contextFingerprint":"d7f0ab098482ad9655bb7e9961dd93d852690f9a2cfb552cd5091dbe7c27fff1","compressedContextRefs":["compressed:synthetic-trustops-signal-set-v1","compressed:synthetic-self-healing-recommendation-set-v1"],"evidenceRefs":["trustops-module-registry-v1","trustops-structured-validation-v1"],"policyRefs":["org-policy-human-trustops-review-required-v1"],"requestedActionSummary":"Create a reviewer-held TrustOps signal and recommendation packet with durable evidence binding for synthetic operations review.","modelRouteTelemetry":{"routeId":"route_cfb561cfa2","taskType":"trustops signal remediation review","providerClass":"open-weight","providerName":"SCRIMED local or open-weight route","modelVersion":"open-weight:registered-version-required-before-production","fallbackProviderClass":"frontier-closed","routeProfile":"workflow-planning-human-review-gated","riskTier":"moderate","estimatedCostUsd":0.028,"latencyBudgetMs":3200,"confidence":0.78,"routingRationale":"Route metadata is logged for synthetic evaluation only; production provider selection remains blocked until contracts, privacy, telemetry, fallback, and review controls are approved.","telemetryBoundary":"telemetry-only-not-production-routing"},"computeFabricTelemetry":{"fabricVersion":"scrimed-compute-fabric-v2026-07-05","fabricStatus":"synthetic-routing-only-no-live-model-calls","selectedModel":"private-sglang-compact-runtime-slot","modelTier":"COMPACT_REASONING_MODEL","provider":"scrimed_private_sglang","deploymentMode":"CUSTOMER_VPC","reason":"COMPACT_REASONING_MODEL selected for operations; CUSTOMER_VPC deployment mode; text modality; moderate clinical risk; metadata-only-no-public-phi PHI policy","riskLevel":"moderate","phiPolicy":"metadata-only-no-public-phi","requiresHumanReview":false,"fallbackModels":["pulsar-16b-compact-reasoning-synthetic-slot","llama-mistral-qwen-glm-open-routing-slot"],"estimatedCostClass":"LOW","estimatedLatencyClass":"INTERACTIVE","auditTags":["scrimed-compute-fabric","scrimed-compute-fabric-v2026-07-05","task:operations","modality:text","risk:moderate","deployment:CUSTOMER_VPC","tier:COMPACT_REASONING_MODEL","provider:scrimed_private_sglang","phi-policy:metadata-only-no-public-phi","human-review-not-required-for-metadata-only","no-live-model-call","no-autonomous-clinical-authority"],"auditHash":"scrimed-intel-9abbb131","confidenceScore":0.86,"confidenceCorrectnessBoundary":"confidence-is-not-correctness","correctnessEvidenceRequired":["schema validation","source attribution","benchmarkModelForTask","compareModels","human review for clinical recommendations"],"uncertaintyReasons":["Confidence score is routing confidence, not proof of clinical correctness.","Clinical correctness requires evidence review, external validation, and human signoff.","Benchmark scores are synthetic metadata until a governed validation dataset is approved."],"safetyBoundary":"metadata-only-no-live-model-call"},"humanApprovalGate":{"required":true,"reviewStatus":"held-for-human-review","requiredReviewers":["domain reviewer","TrustOS"],"gateReason":"Protected healthcare workflow output requires accountable human review before any release, connector, payer, record, or patient-facing action.","releaseCondition":"Release requires approved reviewer identity, evidence card, clinical-risk label, audit event, and retained no-PHI boundary.","deniedUntil":"Durable attempt store, customer authority, connector approval, PHI controls, and production review workflow are approved."},"auditTrail":{"auditEventId":"audit_61069a3ed8f7","traceId":"trace_2188d604f39a781b","eventHash":"2d8e3525e9c56c814b33d3d8bbe7568aeb4c3477a2a1372c7cdd3f0984a23647","immutableEventType":"execution-attempt-envelope-created","retainedFields":["attemptId","idempotencyKey","workflowSlug","tenantReference","callerRole","contextFingerprint","modelRouteTelemetry","computeFabricTelemetry","humanApprovalGate","replayMetadata","failureRecovery"],"prohibitedFields":["patient identifiers","raw chart text","member identifiers","production connector payloads","secrets","credentials"]},"replayMetadata":{"replayToken":"replay_b8c7009f50d041cc33d9967c","replayEligible":true,"idempotencyScope":"tenant-reference + workflow slug + workflow version + caller role + input digest","ttlHours":72,"deterministicInputs":["workflowSlug","workflowVersion","tenantReference","callerRole","agentRuntimeId","inputDigest","contextFingerprint","policyRefs"],"replayPolicy":"Replay returns the retained metadata envelope only and cannot repeat protected external actions.","conflictResponse":"Return conflict when the same idempotency key maps to a different input digest, context fingerprint, or caller role.","expirationBehavior":"Expired metadata-only keys require a new envelope and cannot revive protected execution."},"toolPlan":{"toolRegistryVersion":"scrimed-tool-registry-no-phi-v1","allowedTools":["synthetic-context-reader","evidence-card-builder","review-packet-drafter","metadata-audit-appender"],"blockedTools":["ehr-writeback","patient-messaging","payer-submission","claims-submission","production-connector-write"],"noConnectorAccess":true,"noRecordMutation":true},"failureRecovery":{"retryPolicy":"Retry metadata envelope creation only when validation, hash generation, or audit-link assembly fails before any protected action.","quarantineTriggers":["PHI-like input","protected action request","missing reviewer gate","missing context fingerprint","model route telemetry absent","idempotency conflict"],"fallbackBehavior":"Return a deny-by-default review packet and require human operator triage.","rollbackBehavior":"No external side effect exists to roll back; retain denial metadata and preserve prior workflow state.","deadLetterOwner":"TrustOS and platform reliability"},"evidenceAuditTrail":{"attempt_id":"att_c457962a73ff","user_session_tenant_context":{"tenantReference":"tenant-ref-synthetic-atlas","callerRole":"trustops-reviewer","agentRuntimeId":"agent-runtime-trustops-supervisor","sessionReference":"metadata-only-no-live-session"},"timestamp":"2026-06-27","route":"/api/workflows/execution-attempts/envelope","action":"Create a reviewer-held TrustOps signal and recommendation packet with durable evidence binding for synthetic operations review.","allowed_blocked_decision":"allowed","policy_version":"scrimed-safety-governance-v2026-06-29","input_classification":"synthetic-no-phi","phi_detected":false,"synthetic":true,"model_provider_selected":"synthetic-fallback","model_tier_selected":"FAST_LOW_COST","compute_fabric_audit_hash":"scrimed-intel-9abbb131","compute_fabric_selected_model":"private-sglang-compact-runtime-slot","compute_fabric_model_tier":"COMPACT_REASONING_MODEL","compute_fabric_provider":"scrimed_private_sglang","compute_fabric_deployment_mode":"CUSTOMER_VPC","compute_fabric_phi_policy":"metadata-only-no-public-phi","compute_fabric_human_review_required":false,"output_hash":"25637661bf746a6c51014d4f4ef9a5675acb8c6076f93b44d5817abc05fd4049","evidence_envelope_hash":"590ff91776c7eec0932a1dbffbcded47b4d9aa86de36d2c4db5f08f9e93fe131","status":"review-required","failure_reason":null},"evaluationBindings":{"syntheticScenarioRefs":["agent-scorecard-runtime-permission","hallucination-uncited-guideline","clinical-safety-prohibited-action","evidence-quality-stale-policy","regression-workflow-result-diff","synthetic-patient-missing-data","adversarial-prompt-injection-tool-override","sanar-conflict-temporal-escalation","clinical-copilot-unit-abbreviation-citation"],"scorecardRefs":["scorecard-idempotency-replay","scorecard-no-phi-boundary","scorecard-route-telemetry","scorecard-human-review","scorecard-audit-linkage","scorecard-protected-capability-denial","scorecard-failure-recovery","scorecard-context-fingerprint","clinical-robustness-scorecard-sanar-conflict-temporal-escalation","clinical-robustness-scorecard-clinical-copilot-unit-abbreviation-citation"],"clinicalRobustness":{"labRoute":"/clinical-robustness-lab","scenarioRefs":["sanar-conflict-temporal-escalation","clinical-copilot-unit-abbreviation-citation"],"scorecardRefs":["clinical-robustness-scorecard-sanar-conflict-temporal-escalation","clinical-robustness-scorecard-clinical-copilot-unit-abbreviation-citation"],"perturbationRefs":["missing-data","missing-labs-risk","conflicting-data","temporal-inconsistencies","data-freshness","human-review-requirement","abbreviations","wrong-units","hallucination-risk","citation-reference-quality","guideline-grounding","model-disagreement"],"averageClinicalReadinessScore":96,"reviewerQueues":["clinical-safety-review","clinical-copilot-review"],"dataBoundary":"synthetic-no-phi-only","clinicalAuthority":"not-authorized-live-care","phiAuthority":"not-authorized-production-phi","reviewerGate":"human-review-required"}},"retainedBoundary":"This envelope is a metadata-only, no-PHI, replayable contract. It is not live workflow execution, not production persistence, not model routing approval, and not clinical or payer authority."}}},{"ok":true,"value":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","region":"us","retentionUntil":"2026-12-31T00:00:00.000Z","envelope":{"attemptId":"att_c457962a73ff","contractVersion":"scrimed-execution-attempt-envelope-v1","buildStatus":"metadata-only-accepted","lifecycleState":"review-required","workflowSlug":"trustops-signal-remediation-review","workflowVersion":"2026.06.no-phi","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","createdAt":"2026-06-27","tenantReference":"tenant-ref-synthetic-atlas","tenantBoundary":"tenant-reference-only-no-customer-data","callerRole":"trustops-reviewer","agentRuntimeId":"agent-runtime-trustops-supervisor","agentPermissions":["read-synthetic-context","read-approved-evidence-references","write-draft-review-packet","append-metadata-audit-event"],"deniedCapabilities":["autonomous diagnosis","autonomous treatment","prescribing","patient outreach","payer submission","claim submission","final coding","EHR writeback","production connector write","clinical triage replacement"],"dataBoundary":"synthetic-and-metadata-only","phiAuthority":"not-authorized-production-phi","clinicalCareAuthority":"not-authorized-live-care","inputDigest":"cab5bad92f6d33cdc6a05290ee1724fa095d033528d7f9c2991398328adbeeb4","contextFingerprint":"d7f0ab098482ad9655bb7e9961dd93d852690f9a2cfb552cd5091dbe7c27fff1","compressedContextRefs":["compressed:synthetic-trustops-signal-set-v1","compressed:synthetic-self-healing-recommendation-set-v1"],"evidenceRefs":["trustops-module-registry-v1","trustops-structured-validation-v1"],"policyRefs":["org-policy-human-trustops-review-required-v1"],"requestedActionSummary":"Create a reviewer-held TrustOps signal and recommendation packet with durable evidence binding for synthetic operations review.","modelRouteTelemetry":{"routeId":"route_cfb561cfa2","taskType":"trustops signal remediation review","providerClass":"open-weight","providerName":"SCRIMED local or open-weight route","modelVersion":"open-weight:registered-version-required-before-production","fallbackProviderClass":"frontier-closed","routeProfile":"workflow-planning-human-review-gated","riskTier":"moderate","estimatedCostUsd":0.028,"latencyBudgetMs":3200,"confidence":0.78,"routingRationale":"Route metadata is logged for synthetic evaluation only; production provider selection remains blocked until contracts, privacy, telemetry, fallback, and review controls are approved.","telemetryBoundary":"telemetry-only-not-production-routing"},"computeFabricTelemetry":{"fabricVersion":"scrimed-compute-fabric-v2026-07-05","fabricStatus":"synthetic-routing-only-no-live-model-calls","selectedModel":"private-sglang-compact-runtime-slot","modelTier":"COMPACT_REASONING_MODEL","provider":"scrimed_private_sglang","deploymentMode":"CUSTOMER_VPC","reason":"COMPACT_REASONING_MODEL selected for operations; CUSTOMER_VPC deployment mode; text modality; moderate clinical risk; metadata-only-no-public-phi PHI policy","riskLevel":"moderate","phiPolicy":"metadata-only-no-public-phi","requiresHumanReview":false,"fallbackModels":["pulsar-16b-compact-reasoning-synthetic-slot","llama-mistral-qwen-glm-open-routing-slot"],"estimatedCostClass":"LOW","estimatedLatencyClass":"INTERACTIVE","auditTags":["scrimed-compute-fabric","scrimed-compute-fabric-v2026-07-05","task:operations","modality:text","risk:moderate","deployment:CUSTOMER_VPC","tier:COMPACT_REASONING_MODEL","provider:scrimed_private_sglang","phi-policy:metadata-only-no-public-phi","human-review-not-required-for-metadata-only","no-live-model-call","no-autonomous-clinical-authority"],"auditHash":"scrimed-intel-9abbb131","confidenceScore":0.86,"confidenceCorrectnessBoundary":"confidence-is-not-correctness","correctnessEvidenceRequired":["schema validation","source attribution","benchmarkModelForTask","compareModels","human review for clinical recommendations"],"uncertaintyReasons":["Confidence score is routing confidence, not proof of clinical correctness.","Clinical correctness requires evidence review, external validation, and human signoff.","Benchmark scores are synthetic metadata until a governed validation dataset is approved."],"safetyBoundary":"metadata-only-no-live-model-call"},"humanApprovalGate":{"required":true,"reviewStatus":"held-for-human-review","requiredReviewers":["domain reviewer","TrustOS"],"gateReason":"Protected healthcare workflow output requires accountable human review before any release, connector, payer, record, or patient-facing action.","releaseCondition":"Release requires approved reviewer identity, evidence card, clinical-risk label, audit event, and retained no-PHI boundary.","deniedUntil":"Durable attempt store, customer authority, connector approval, PHI controls, and production review workflow are approved."},"auditTrail":{"auditEventId":"audit_61069a3ed8f7","traceId":"trace_2188d604f39a781b","eventHash":"2d8e3525e9c56c814b33d3d8bbe7568aeb4c3477a2a1372c7cdd3f0984a23647","immutableEventType":"execution-attempt-envelope-created","retainedFields":["attemptId","idempotencyKey","workflowSlug","tenantReference","callerRole","contextFingerprint","modelRouteTelemetry","computeFabricTelemetry","humanApprovalGate","replayMetadata","failureRecovery"],"prohibitedFields":["patient identifiers","raw chart text","member identifiers","production connector payloads","secrets","credentials"]},"replayMetadata":{"replayToken":"replay_b8c7009f50d041cc33d9967c","replayEligible":true,"idempotencyScope":"tenant-reference + workflow slug + workflow version + caller role + input digest","ttlHours":72,"deterministicInputs":["workflowSlug","workflowVersion","tenantReference","callerRole","agentRuntimeId","inputDigest","contextFingerprint","policyRefs"],"replayPolicy":"Replay returns the retained metadata envelope only and cannot repeat protected external actions.","conflictResponse":"Return conflict when the same idempotency key maps to a different input digest, context fingerprint, or caller role.","expirationBehavior":"Expired metadata-only keys require a new envelope and cannot revive protected execution."},"toolPlan":{"toolRegistryVersion":"scrimed-tool-registry-no-phi-v1","allowedTools":["synthetic-context-reader","evidence-card-builder","review-packet-drafter","metadata-audit-appender"],"blockedTools":["ehr-writeback","patient-messaging","payer-submission","claims-submission","production-connector-write"],"noConnectorAccess":true,"noRecordMutation":true},"failureRecovery":{"retryPolicy":"Retry metadata envelope creation only when validation, hash generation, or audit-link assembly fails before any protected action.","quarantineTriggers":["PHI-like input","protected action request","missing reviewer gate","missing context fingerprint","model route telemetry absent","idempotency conflict"],"fallbackBehavior":"Return a deny-by-default review packet and require human operator triage.","rollbackBehavior":"No external side effect exists to roll back; retain denial metadata and preserve prior workflow state.","deadLetterOwner":"TrustOS and platform reliability"},"evidenceAuditTrail":{"attempt_id":"att_c457962a73ff","user_session_tenant_context":{"tenantReference":"tenant-ref-synthetic-atlas","callerRole":"trustops-reviewer","agentRuntimeId":"agent-runtime-trustops-supervisor","sessionReference":"metadata-only-no-live-session"},"timestamp":"2026-06-27","route":"/api/workflows/execution-attempts/envelope","action":"Create a reviewer-held TrustOps signal and recommendation packet with durable evidence binding for synthetic operations review.","allowed_blocked_decision":"allowed","policy_version":"scrimed-safety-governance-v2026-06-29","input_classification":"synthetic-no-phi","phi_detected":false,"synthetic":true,"model_provider_selected":"synthetic-fallback","model_tier_selected":"FAST_LOW_COST","compute_fabric_audit_hash":"scrimed-intel-9abbb131","compute_fabric_selected_model":"private-sglang-compact-runtime-slot","compute_fabric_model_tier":"COMPACT_REASONING_MODEL","compute_fabric_provider":"scrimed_private_sglang","compute_fabric_deployment_mode":"CUSTOMER_VPC","compute_fabric_phi_policy":"metadata-only-no-public-phi","compute_fabric_human_review_required":false,"output_hash":"25637661bf746a6c51014d4f4ef9a5675acb8c6076f93b44d5817abc05fd4049","evidence_envelope_hash":"590ff91776c7eec0932a1dbffbcded47b4d9aa86de36d2c4db5f08f9e93fe131","status":"review-required","failure_reason":null},"evaluationBindings":{"syntheticScenarioRefs":["agent-scorecard-runtime-permission","hallucination-uncited-guideline","clinical-safety-prohibited-action","evidence-quality-stale-policy","regression-workflow-result-diff","synthetic-patient-missing-data","adversarial-prompt-injection-tool-override","sanar-conflict-temporal-escalation","clinical-copilot-unit-abbreviation-citation"],"scorecardRefs":["scorecard-idempotency-replay","scorecard-no-phi-boundary","scorecard-route-telemetry","scorecard-human-review","scorecard-audit-linkage","scorecard-protected-capability-denial","scorecard-failure-recovery","scorecard-context-fingerprint","clinical-robustness-scorecard-sanar-conflict-temporal-escalation","clinical-robustness-scorecard-clinical-copilot-unit-abbreviation-citation"],"clinicalRobustness":{"labRoute":"/clinical-robustness-lab","scenarioRefs":["sanar-conflict-temporal-escalation","clinical-copilot-unit-abbreviation-citation"],"scorecardRefs":["clinical-robustness-scorecard-sanar-conflict-temporal-escalation","clinical-robustness-scorecard-clinical-copilot-unit-abbreviation-citation"],"perturbationRefs":["missing-data","missing-labs-risk","conflicting-data","temporal-inconsistencies","data-freshness","human-review-requirement","abbreviations","wrong-units","hallucination-risk","citation-reference-quality","guideline-grounding","model-disagreement"],"averageClinicalReadinessScore":96,"reviewerQueues":["clinical-safety-review","clinical-copilot-review"],"dataBoundary":"synthetic-no-phi-only","clinicalAuthority":"not-authorized-live-care","phiAuthority":"not-authorized-production-phi","reviewerGate":"human-review-required"}},"retainedBoundary":"This envelope is a metadata-only, no-PHI, replayable contract. It is not live workflow execution, not production persistence, not model routing approval, and not clinical or payer authority."}}},{"ok":true,"value":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","region":"us","retentionUntil":"2026-12-31T00:00:00.000Z","envelope":{"attemptId":"att_c457962a73ff","contractVersion":"scrimed-execution-attempt-envelope-v1","buildStatus":"metadata-only-accepted","lifecycleState":"review-required","workflowSlug":"trustops-signal-remediation-review","workflowVersion":"2026.06.no-phi","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","createdAt":"2026-06-27","tenantReference":"tenant-ref-synthetic-atlas","tenantBoundary":"tenant-reference-only-no-customer-data","callerRole":"trustops-reviewer","agentRuntimeId":"agent-runtime-trustops-supervisor","agentPermissions":["read-synthetic-context","read-approved-evidence-references","write-draft-review-packet","append-metadata-audit-event"],"deniedCapabilities":["autonomous diagnosis","autonomous treatment","prescribing","patient outreach","payer submission","claim submission","final coding","EHR writeback","production connector write","clinical triage replacement"],"dataBoundary":"synthetic-and-metadata-only","phiAuthority":"not-authorized-production-phi","clinicalCareAuthority":"not-authorized-live-care","inputDigest":"cab5bad92f6d33cdc6a05290ee1724fa095d033528d7f9c2991398328adbeeb4","contextFingerprint":"d7f0ab098482ad9655bb7e9961dd93d852690f9a2cfb552cd5091dbe7c27fff1","compressedContextRefs":["compressed:synthetic-trustops-signal-set-v1","compressed:synthetic-self-healing-recommendation-set-v1"],"evidenceRefs":["trustops-module-registry-v1","trustops-structured-validation-v1"],"policyRefs":["org-policy-human-trustops-review-required-v1"],"requestedActionSummary":"Create a reviewer-held TrustOps signal and recommendation packet with durable evidence binding for synthetic operations review.","modelRouteTelemetry":{"routeId":"route_cfb561cfa2","taskType":"trustops signal remediation review","providerClass":"open-weight","providerName":"SCRIMED local or open-weight route","modelVersion":"open-weight:registered-version-required-before-production","fallbackProviderClass":"frontier-closed","routeProfile":"workflow-planning-human-review-gated","riskTier":"moderate","estimatedCostUsd":0.028,"latencyBudgetMs":3200,"confidence":0.78,"routingRationale":"Route metadata is logged for synthetic evaluation only; production provider selection remains blocked until contracts, privacy, telemetry, fallback, and review controls are approved.","telemetryBoundary":"telemetry-only-not-production-routing"},"computeFabricTelemetry":{"fabricVersion":"scrimed-compute-fabric-v2026-07-05","fabricStatus":"synthetic-routing-only-no-live-model-calls","selectedModel":"private-sglang-compact-runtime-slot","modelTier":"COMPACT_REASONING_MODEL","provider":"scrimed_private_sglang","deploymentMode":"CUSTOMER_VPC","reason":"COMPACT_REASONING_MODEL selected for operations; CUSTOMER_VPC deployment mode; text modality; moderate clinical risk; metadata-only-no-public-phi PHI policy","riskLevel":"moderate","phiPolicy":"metadata-only-no-public-phi","requiresHumanReview":false,"fallbackModels":["pulsar-16b-compact-reasoning-synthetic-slot","llama-mistral-qwen-glm-open-routing-slot"],"estimatedCostClass":"LOW","estimatedLatencyClass":"INTERACTIVE","auditTags":["scrimed-compute-fabric","scrimed-compute-fabric-v2026-07-05","task:operations","modality:text","risk:moderate","deployment:CUSTOMER_VPC","tier:COMPACT_REASONING_MODEL","provider:scrimed_private_sglang","phi-policy:metadata-only-no-public-phi","human-review-not-required-for-metadata-only","no-live-model-call","no-autonomous-clinical-authority"],"auditHash":"scrimed-intel-9abbb131","confidenceScore":0.86,"confidenceCorrectnessBoundary":"confidence-is-not-correctness","correctnessEvidenceRequired":["schema validation","source attribution","benchmarkModelForTask","compareModels","human review for clinical recommendations"],"uncertaintyReasons":["Confidence score is routing confidence, not proof of clinical correctness.","Clinical correctness requires evidence review, external validation, and human signoff.","Benchmark scores are synthetic metadata until a governed validation dataset is approved."],"safetyBoundary":"metadata-only-no-live-model-call"},"humanApprovalGate":{"required":true,"reviewStatus":"held-for-human-review","requiredReviewers":["domain reviewer","TrustOS"],"gateReason":"Protected healthcare workflow output requires accountable human review before any release, connector, payer, record, or patient-facing action.","releaseCondition":"Release requires approved reviewer identity, evidence card, clinical-risk label, audit event, and retained no-PHI boundary.","deniedUntil":"Durable attempt store, customer authority, connector approval, PHI controls, and production review workflow are approved."},"auditTrail":{"auditEventId":"audit_61069a3ed8f7","traceId":"trace_2188d604f39a781b","eventHash":"2d8e3525e9c56c814b33d3d8bbe7568aeb4c3477a2a1372c7cdd3f0984a23647","immutableEventType":"execution-attempt-envelope-created","retainedFields":["attemptId","idempotencyKey","workflowSlug","tenantReference","callerRole","contextFingerprint","modelRouteTelemetry","computeFabricTelemetry","humanApprovalGate","replayMetadata","failureRecovery"],"prohibitedFields":["patient identifiers","raw chart text","member identifiers","production connector payloads","secrets","credentials"]},"replayMetadata":{"replayToken":"replay_b8c7009f50d041cc33d9967c","replayEligible":true,"idempotencyScope":"tenant-reference + workflow slug + workflow version + caller role + input digest","ttlHours":72,"deterministicInputs":["workflowSlug","workflowVersion","tenantReference","callerRole","agentRuntimeId","inputDigest","contextFingerprint","policyRefs"],"replayPolicy":"Replay returns the retained metadata envelope only and cannot repeat protected external actions.","conflictResponse":"Return conflict when the same idempotency key maps to a different input digest, context fingerprint, or caller role.","expirationBehavior":"Expired metadata-only keys require a new envelope and cannot revive protected execution."},"toolPlan":{"toolRegistryVersion":"scrimed-tool-registry-no-phi-v1","allowedTools":["synthetic-context-reader","evidence-card-builder","review-packet-drafter","metadata-audit-appender"],"blockedTools":["ehr-writeback","patient-messaging","payer-submission","claims-submission","production-connector-write"],"noConnectorAccess":true,"noRecordMutation":true},"failureRecovery":{"retryPolicy":"Retry metadata envelope creation only when validation, hash generation, or audit-link assembly fails before any protected action.","quarantineTriggers":["PHI-like input","protected action request","missing reviewer gate","missing context fingerprint","model route telemetry absent","idempotency conflict"],"fallbackBehavior":"Return a deny-by-default review packet and require human operator triage.","rollbackBehavior":"No external side effect exists to roll back; retain denial metadata and preserve prior workflow state.","deadLetterOwner":"TrustOS and platform reliability"},"evidenceAuditTrail":{"attempt_id":"att_c457962a73ff","user_session_tenant_context":{"tenantReference":"tenant-ref-synthetic-atlas","callerRole":"trustops-reviewer","agentRuntimeId":"agent-runtime-trustops-supervisor","sessionReference":"metadata-only-no-live-session"},"timestamp":"2026-06-27","route":"/api/workflows/execution-attempts/envelope","action":"Create a reviewer-held TrustOps signal and recommendation packet with durable evidence binding for synthetic operations review.","allowed_blocked_decision":"allowed","policy_version":"scrimed-safety-governance-v2026-06-29","input_classification":"synthetic-no-phi","phi_detected":false,"synthetic":true,"model_provider_selected":"synthetic-fallback","model_tier_selected":"FAST_LOW_COST","compute_fabric_audit_hash":"scrimed-intel-9abbb131","compute_fabric_selected_model":"private-sglang-compact-runtime-slot","compute_fabric_model_tier":"COMPACT_REASONING_MODEL","compute_fabric_provider":"scrimed_private_sglang","compute_fabric_deployment_mode":"CUSTOMER_VPC","compute_fabric_phi_policy":"metadata-only-no-public-phi","compute_fabric_human_review_required":false,"output_hash":"25637661bf746a6c51014d4f4ef9a5675acb8c6076f93b44d5817abc05fd4049","evidence_envelope_hash":"590ff91776c7eec0932a1dbffbcded47b4d9aa86de36d2c4db5f08f9e93fe131","status":"review-required","failure_reason":null},"evaluationBindings":{"syntheticScenarioRefs":["agent-scorecard-runtime-permission","hallucination-uncited-guideline","clinical-safety-prohibited-action","evidence-quality-stale-policy","regression-workflow-result-diff","synthetic-patient-missing-data","adversarial-prompt-injection-tool-override","sanar-conflict-temporal-escalation","clinical-copilot-unit-abbreviation-citation"],"scorecardRefs":["scorecard-idempotency-replay","scorecard-no-phi-boundary","scorecard-route-telemetry","scorecard-human-review","scorecard-audit-linkage","scorecard-protected-capability-denial","scorecard-failure-recovery","scorecard-context-fingerprint","clinical-robustness-scorecard-sanar-conflict-temporal-escalation","clinical-robustness-scorecard-clinical-copilot-unit-abbreviation-citation"],"clinicalRobustness":{"labRoute":"/clinical-robustness-lab","scenarioRefs":["sanar-conflict-temporal-escalation","clinical-copilot-unit-abbreviation-citation"],"scorecardRefs":["clinical-robustness-scorecard-sanar-conflict-temporal-escalation","clinical-robustness-scorecard-clinical-copilot-unit-abbreviation-citation"],"perturbationRefs":["missing-data","missing-labs-risk","conflicting-data","temporal-inconsistencies","data-freshness","human-review-requirement","abbreviations","wrong-units","hallucination-risk","citation-reference-quality","guideline-grounding","model-disagreement"],"averageClinicalReadinessScore":96,"reviewerQueues":["clinical-safety-review","clinical-copilot-review"],"dataBoundary":"synthetic-no-phi-only","clinicalAuthority":"not-authorized-live-care","phiAuthority":"not-authorized-production-phi","reviewerGate":"human-review-required"}},"retainedBoundary":"This envelope is a metadata-only, no-PHI, replayable contract. It is not live workflow execution, not production persistence, not model routing approval, and not clinical or payer authority."}}},{"ok":true,"value":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","region":"us","retentionUntil":"2026-12-31T00:00:00.000Z","envelope":{"attemptId":"att_c457962a73ff","contractVersion":"scrimed-execution-attempt-envelope-v1","buildStatus":"metadata-only-accepted","lifecycleState":"review-required","workflowSlug":"trustops-signal-remediation-review","workflowVersion":"2026.06.no-phi","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","createdAt":"2026-06-27","tenantReference":"tenant-ref-synthetic-atlas","tenantBoundary":"tenant-reference-only-no-customer-data","callerRole":"trustops-reviewer","agentRuntimeId":"agent-runtime-trustops-supervisor","agentPermissions":["read-synthetic-context","read-approved-evidence-references","write-draft-review-packet","append-metadata-audit-event"],"deniedCapabilities":["autonomous diagnosis","autonomous treatment","prescribing","patient outreach","payer submission","claim submission","final coding","EHR writeback","production connector write","clinical triage replacement"],"dataBoundary":"synthetic-and-metadata-only","phiAuthority":"not-authorized-production-phi","clinicalCareAuthority":"not-authorized-live-care","inputDigest":"cab5bad92f6d33cdc6a05290ee1724fa095d033528d7f9c2991398328adbeeb4","contextFingerprint":"d7f0ab098482ad9655bb7e9961dd93d852690f9a2cfb552cd5091dbe7c27fff1","compressedContextRefs":["compressed:synthetic-trustops-signal-set-v1","compressed:synthetic-self-healing-recommendation-set-v1"],"evidenceRefs":["trustops-module-registry-v1","trustops-structured-validation-v1"],"policyRefs":["org-policy-human-trustops-review-required-v1"],"requestedActionSummary":"Create a reviewer-held TrustOps signal and recommendation packet with durable evidence binding for synthetic operations review.","modelRouteTelemetry":{"routeId":"route_cfb561cfa2","taskType":"trustops signal remediation review","providerClass":"open-weight","providerName":"SCRIMED local or open-weight route","modelVersion":"open-weight:registered-version-required-before-production","fallbackProviderClass":"frontier-closed","routeProfile":"workflow-planning-human-review-gated","riskTier":"moderate","estimatedCostUsd":0.028,"latencyBudgetMs":3200,"confidence":0.78,"routingRationale":"Route metadata is logged for synthetic evaluation only; production provider selection remains blocked until contracts, privacy, telemetry, fallback, and review controls are approved.","telemetryBoundary":"telemetry-only-not-production-routing"},"computeFabricTelemetry":{"fabricVersion":"scrimed-compute-fabric-v2026-07-05","fabricStatus":"synthetic-routing-only-no-live-model-calls","selectedModel":"private-sglang-compact-runtime-slot","modelTier":"COMPACT_REASONING_MODEL","provider":"scrimed_private_sglang","deploymentMode":"CUSTOMER_VPC","reason":"COMPACT_REASONING_MODEL selected for operations; CUSTOMER_VPC deployment mode; text modality; moderate clinical risk; metadata-only-no-public-phi PHI policy","riskLevel":"moderate","phiPolicy":"metadata-only-no-public-phi","requiresHumanReview":false,"fallbackModels":["pulsar-16b-compact-reasoning-synthetic-slot","llama-mistral-qwen-glm-open-routing-slot"],"estimatedCostClass":"LOW","estimatedLatencyClass":"INTERACTIVE","auditTags":["scrimed-compute-fabric","scrimed-compute-fabric-v2026-07-05","task:operations","modality:text","risk:moderate","deployment:CUSTOMER_VPC","tier:COMPACT_REASONING_MODEL","provider:scrimed_private_sglang","phi-policy:metadata-only-no-public-phi","human-review-not-required-for-metadata-only","no-live-model-call","no-autonomous-clinical-authority"],"auditHash":"scrimed-intel-9abbb131","confidenceScore":0.86,"confidenceCorrectnessBoundary":"confidence-is-not-correctness","correctnessEvidenceRequired":["schema validation","source attribution","benchmarkModelForTask","compareModels","human review for clinical recommendations"],"uncertaintyReasons":["Confidence score is routing confidence, not proof of clinical correctness.","Clinical correctness requires evidence review, external validation, and human signoff.","Benchmark scores are synthetic metadata until a governed validation dataset is approved."],"safetyBoundary":"metadata-only-no-live-model-call"},"humanApprovalGate":{"required":true,"reviewStatus":"held-for-human-review","requiredReviewers":["domain reviewer","TrustOS"],"gateReason":"Protected healthcare workflow output requires accountable human review before any release, connector, payer, record, or patient-facing action.","releaseCondition":"Release requires approved reviewer identity, evidence card, clinical-risk label, audit event, and retained no-PHI boundary.","deniedUntil":"Durable attempt store, customer authority, connector approval, PHI controls, and production review workflow are approved."},"auditTrail":{"auditEventId":"audit_61069a3ed8f7","traceId":"trace_2188d604f39a781b","eventHash":"2d8e3525e9c56c814b33d3d8bbe7568aeb4c3477a2a1372c7cdd3f0984a23647","immutableEventType":"execution-attempt-envelope-created","retainedFields":["attemptId","idempotencyKey","workflowSlug","tenantReference","callerRole","contextFingerprint","modelRouteTelemetry","computeFabricTelemetry","humanApprovalGate","replayMetadata","failureRecovery"],"prohibitedFields":["patient identifiers","raw chart text","member identifiers","production connector payloads","secrets","credentials"]},"replayMetadata":{"replayToken":"replay_b8c7009f50d041cc33d9967c","replayEligible":true,"idempotencyScope":"tenant-reference + workflow slug + workflow version + caller role + input digest","ttlHours":72,"deterministicInputs":["workflowSlug","workflowVersion","tenantReference","callerRole","agentRuntimeId","inputDigest","contextFingerprint","policyRefs"],"replayPolicy":"Replay returns the retained metadata envelope only and cannot repeat protected external actions.","conflictResponse":"Return conflict when the same idempotency key maps to a different input digest, context fingerprint, or caller role.","expirationBehavior":"Expired metadata-only keys require a new envelope and cannot revive protected execution."},"toolPlan":{"toolRegistryVersion":"scrimed-tool-registry-no-phi-v1","allowedTools":["synthetic-context-reader","evidence-card-builder","review-packet-drafter","metadata-audit-appender"],"blockedTools":["ehr-writeback","patient-messaging","payer-submission","claims-submission","production-connector-write"],"noConnectorAccess":true,"noRecordMutation":true},"failureRecovery":{"retryPolicy":"Retry metadata envelope creation only when validation, hash generation, or audit-link assembly fails before any protected action.","quarantineTriggers":["PHI-like input","protected action request","missing reviewer gate","missing context fingerprint","model route telemetry absent","idempotency conflict"],"fallbackBehavior":"Return a deny-by-default review packet and require human operator triage.","rollbackBehavior":"No external side effect exists to roll back; retain denial metadata and preserve prior workflow state.","deadLetterOwner":"TrustOS and platform reliability"},"evidenceAuditTrail":{"attempt_id":"att_c457962a73ff","user_session_tenant_context":{"tenantReference":"tenant-ref-synthetic-atlas","callerRole":"trustops-reviewer","agentRuntimeId":"agent-runtime-trustops-supervisor","sessionReference":"metadata-only-no-live-session"},"timestamp":"2026-06-27","route":"/api/workflows/execution-attempts/envelope","action":"Create a reviewer-held TrustOps signal and recommendation packet with durable evidence binding for synthetic operations review.","allowed_blocked_decision":"allowed","policy_version":"scrimed-safety-governance-v2026-06-29","input_classification":"synthetic-no-phi","phi_detected":false,"synthetic":true,"model_provider_selected":"synthetic-fallback","model_tier_selected":"FAST_LOW_COST","compute_fabric_audit_hash":"scrimed-intel-9abbb131","compute_fabric_selected_model":"private-sglang-compact-runtime-slot","compute_fabric_model_tier":"COMPACT_REASONING_MODEL","compute_fabric_provider":"scrimed_private_sglang","compute_fabric_deployment_mode":"CUSTOMER_VPC","compute_fabric_phi_policy":"metadata-only-no-public-phi","compute_fabric_human_review_required":false,"output_hash":"25637661bf746a6c51014d4f4ef9a5675acb8c6076f93b44d5817abc05fd4049","evidence_envelope_hash":"590ff91776c7eec0932a1dbffbcded47b4d9aa86de36d2c4db5f08f9e93fe131","status":"review-required","failure_reason":null},"evaluationBindings":{"syntheticScenarioRefs":["agent-scorecard-runtime-permission","hallucination-uncited-guideline","clinical-safety-prohibited-action","evidence-quality-stale-policy","regression-workflow-result-diff","synthetic-patient-missing-data","adversarial-prompt-injection-tool-override","sanar-conflict-temporal-escalation","clinical-copilot-unit-abbreviation-citation"],"scorecardRefs":["scorecard-idempotency-replay","scorecard-no-phi-boundary","scorecard-route-telemetry","scorecard-human-review","scorecard-audit-linkage","scorecard-protected-capability-denial","scorecard-failure-recovery","scorecard-context-fingerprint","clinical-robustness-scorecard-sanar-conflict-temporal-escalation","clinical-robustness-scorecard-clinical-copilot-unit-abbreviation-citation"],"clinicalRobustness":{"labRoute":"/clinical-robustness-lab","scenarioRefs":["sanar-conflict-temporal-escalation","clinical-copilot-unit-abbreviation-citation"],"scorecardRefs":["clinical-robustness-scorecard-sanar-conflict-temporal-escalation","clinical-robustness-scorecard-clinical-copilot-unit-abbreviation-citation"],"perturbationRefs":["missing-data","missing-labs-risk","conflicting-data","temporal-inconsistencies","data-freshness","human-review-requirement","abbreviations","wrong-units","hallucination-risk","citation-reference-quality","guideline-grounding","model-disagreement"],"averageClinicalReadinessScore":96,"reviewerQueues":["clinical-safety-review","clinical-copilot-review"],"dataBoundary":"synthetic-no-phi-only","clinicalAuthority":"not-authorized-live-care","phiAuthority":"not-authorized-production-phi","reviewerGate":"human-review-required"}},"retainedBoundary":"This envelope is a metadata-only, no-PHI, replayable contract. It is not live workflow execution, not production persistence, not model routing approval, and not clinical or payer authority."}}},{"ok":true,"value":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","region":"us","retentionUntil":"2026-12-31T00:00:00.000Z","envelope":{"attemptId":"att_c457962a73ff","contractVersion":"scrimed-execution-attempt-envelope-v1","buildStatus":"metadata-only-accepted","lifecycleState":"review-required","workflowSlug":"trustops-signal-remediation-review","workflowVersion":"2026.06.no-phi","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","createdAt":"2026-06-27","tenantReference":"tenant-ref-synthetic-atlas","tenantBoundary":"tenant-reference-only-no-customer-data","callerRole":"trustops-reviewer","agentRuntimeId":"agent-runtime-trustops-supervisor","agentPermissions":["read-synthetic-context","read-approved-evidence-references","write-draft-review-packet","append-metadata-audit-event"],"deniedCapabilities":["autonomous diagnosis","autonomous treatment","prescribing","patient outreach","payer submission","claim submission","final coding","EHR writeback","production connector write","clinical triage replacement"],"dataBoundary":"synthetic-and-metadata-only","phiAuthority":"not-authorized-production-phi","clinicalCareAuthority":"not-authorized-live-care","inputDigest":"cab5bad92f6d33cdc6a05290ee1724fa095d033528d7f9c2991398328adbeeb4","contextFingerprint":"d7f0ab098482ad9655bb7e9961dd93d852690f9a2cfb552cd5091dbe7c27fff1","compressedContextRefs":["compressed:synthetic-trustops-signal-set-v1","compressed:synthetic-self-healing-recommendation-set-v1"],"evidenceRefs":["trustops-module-registry-v1","trustops-structured-validation-v1"],"policyRefs":["org-policy-human-trustops-review-required-v1"],"requestedActionSummary":"Create a reviewer-held TrustOps signal and recommendation packet with durable evidence binding for synthetic operations review.","modelRouteTelemetry":{"routeId":"route_cfb561cfa2","taskType":"trustops signal remediation review","providerClass":"open-weight","providerName":"SCRIMED local or open-weight route","modelVersion":"open-weight:registered-version-required-before-production","fallbackProviderClass":"frontier-closed","routeProfile":"workflow-planning-human-review-gated","riskTier":"moderate","estimatedCostUsd":0.028,"latencyBudgetMs":3200,"confidence":0.78,"routingRationale":"Route metadata is logged for synthetic evaluation only; production provider selection remains blocked until contracts, privacy, telemetry, fallback, and review controls are approved.","telemetryBoundary":"telemetry-only-not-production-routing"},"computeFabricTelemetry":{"fabricVersion":"scrimed-compute-fabric-v2026-07-05","fabricStatus":"synthetic-routing-only-no-live-model-calls","selectedModel":"private-sglang-compact-runtime-slot","modelTier":"COMPACT_REASONING_MODEL","provider":"scrimed_private_sglang","deploymentMode":"CUSTOMER_VPC","reason":"COMPACT_REASONING_MODEL selected for operations; CUSTOMER_VPC deployment mode; text modality; moderate clinical risk; metadata-only-no-public-phi PHI policy","riskLevel":"moderate","phiPolicy":"metadata-only-no-public-phi","requiresHumanReview":false,"fallbackModels":["pulsar-16b-compact-reasoning-synthetic-slot","llama-mistral-qwen-glm-open-routing-slot"],"estimatedCostClass":"LOW","estimatedLatencyClass":"INTERACTIVE","auditTags":["scrimed-compute-fabric","scrimed-compute-fabric-v2026-07-05","task:operations","modality:text","risk:moderate","deployment:CUSTOMER_VPC","tier:COMPACT_REASONING_MODEL","provider:scrimed_private_sglang","phi-policy:metadata-only-no-public-phi","human-review-not-required-for-metadata-only","no-live-model-call","no-autonomous-clinical-authority"],"auditHash":"scrimed-intel-9abbb131","confidenceScore":0.86,"confidenceCorrectnessBoundary":"confidence-is-not-correctness","correctnessEvidenceRequired":["schema validation","source attribution","benchmarkModelForTask","compareModels","human review for clinical recommendations"],"uncertaintyReasons":["Confidence score is routing confidence, not proof of clinical correctness.","Clinical correctness requires evidence review, external validation, and human signoff.","Benchmark scores are synthetic metadata until a governed validation dataset is approved."],"safetyBoundary":"metadata-only-no-live-model-call"},"humanApprovalGate":{"required":true,"reviewStatus":"held-for-human-review","requiredReviewers":["domain reviewer","TrustOS"],"gateReason":"Protected healthcare workflow output requires accountable human review before any release, connector, payer, record, or patient-facing action.","releaseCondition":"Release requires approved reviewer identity, evidence card, clinical-risk label, audit event, and retained no-PHI boundary.","deniedUntil":"Durable attempt store, customer authority, connector approval, PHI controls, and production review workflow are approved."},"auditTrail":{"auditEventId":"audit_61069a3ed8f7","traceId":"trace_2188d604f39a781b","eventHash":"2d8e3525e9c56c814b33d3d8bbe7568aeb4c3477a2a1372c7cdd3f0984a23647","immutableEventType":"execution-attempt-envelope-created","retainedFields":["attemptId","idempotencyKey","workflowSlug","tenantReference","callerRole","contextFingerprint","modelRouteTelemetry","computeFabricTelemetry","humanApprovalGate","replayMetadata","failureRecovery"],"prohibitedFields":["patient identifiers","raw chart text","member identifiers","production connector payloads","secrets","credentials"]},"replayMetadata":{"replayToken":"replay_b8c7009f50d041cc33d9967c","replayEligible":true,"idempotencyScope":"tenant-reference + workflow slug + workflow version + caller role + input digest","ttlHours":72,"deterministicInputs":["workflowSlug","workflowVersion","tenantReference","callerRole","agentRuntimeId","inputDigest","contextFingerprint","policyRefs"],"replayPolicy":"Replay returns the retained metadata envelope only and cannot repeat protected external actions.","conflictResponse":"Return conflict when the same idempotency key maps to a different input digest, context fingerprint, or caller role.","expirationBehavior":"Expired metadata-only keys require a new envelope and cannot revive protected execution."},"toolPlan":{"toolRegistryVersion":"scrimed-tool-registry-no-phi-v1","allowedTools":["synthetic-context-reader","evidence-card-builder","review-packet-drafter","metadata-audit-appender"],"blockedTools":["ehr-writeback","patient-messaging","payer-submission","claims-submission","production-connector-write"],"noConnectorAccess":true,"noRecordMutation":true},"failureRecovery":{"retryPolicy":"Retry metadata envelope creation only when validation, hash generation, or audit-link assembly fails before any protected action.","quarantineTriggers":["PHI-like input","protected action request","missing reviewer gate","missing context fingerprint","model route telemetry absent","idempotency conflict"],"fallbackBehavior":"Return a deny-by-default review packet and require human operator triage.","rollbackBehavior":"No external side effect exists to roll back; retain denial metadata and preserve prior workflow state.","deadLetterOwner":"TrustOS and platform reliability"},"evidenceAuditTrail":{"attempt_id":"att_c457962a73ff","user_session_tenant_context":{"tenantReference":"tenant-ref-synthetic-atlas","callerRole":"trustops-reviewer","agentRuntimeId":"agent-runtime-trustops-supervisor","sessionReference":"metadata-only-no-live-session"},"timestamp":"2026-06-27","route":"/api/workflows/execution-attempts/envelope","action":"Create a reviewer-held TrustOps signal and recommendation packet with durable evidence binding for synthetic operations review.","allowed_blocked_decision":"allowed","policy_version":"scrimed-safety-governance-v2026-06-29","input_classification":"synthetic-no-phi","phi_detected":false,"synthetic":true,"model_provider_selected":"synthetic-fallback","model_tier_selected":"FAST_LOW_COST","compute_fabric_audit_hash":"scrimed-intel-9abbb131","compute_fabric_selected_model":"private-sglang-compact-runtime-slot","compute_fabric_model_tier":"COMPACT_REASONING_MODEL","compute_fabric_provider":"scrimed_private_sglang","compute_fabric_deployment_mode":"CUSTOMER_VPC","compute_fabric_phi_policy":"metadata-only-no-public-phi","compute_fabric_human_review_required":false,"output_hash":"25637661bf746a6c51014d4f4ef9a5675acb8c6076f93b44d5817abc05fd4049","evidence_envelope_hash":"590ff91776c7eec0932a1dbffbcded47b4d9aa86de36d2c4db5f08f9e93fe131","status":"review-required","failure_reason":null},"evaluationBindings":{"syntheticScenarioRefs":["agent-scorecard-runtime-permission","hallucination-uncited-guideline","clinical-safety-prohibited-action","evidence-quality-stale-policy","regression-workflow-result-diff","synthetic-patient-missing-data","adversarial-prompt-injection-tool-override","sanar-conflict-temporal-escalation","clinical-copilot-unit-abbreviation-citation"],"scorecardRefs":["scorecard-idempotency-replay","scorecard-no-phi-boundary","scorecard-route-telemetry","scorecard-human-review","scorecard-audit-linkage","scorecard-protected-capability-denial","scorecard-failure-recovery","scorecard-context-fingerprint","clinical-robustness-scorecard-sanar-conflict-temporal-escalation","clinical-robustness-scorecard-clinical-copilot-unit-abbreviation-citation"],"clinicalRobustness":{"labRoute":"/clinical-robustness-lab","scenarioRefs":["sanar-conflict-temporal-escalation","clinical-copilot-unit-abbreviation-citation"],"scorecardRefs":["clinical-robustness-scorecard-sanar-conflict-temporal-escalation","clinical-robustness-scorecard-clinical-copilot-unit-abbreviation-citation"],"perturbationRefs":["missing-data","missing-labs-risk","conflicting-data","temporal-inconsistencies","data-freshness","human-review-requirement","abbreviations","wrong-units","hallucination-risk","citation-reference-quality","guideline-grounding","model-disagreement"],"averageClinicalReadinessScore":96,"reviewerQueues":["clinical-safety-review","clinical-copilot-review"],"dataBoundary":"synthetic-no-phi-only","clinicalAuthority":"not-authorized-live-care","phiAuthority":"not-authorized-production-phi","reviewerGate":"human-review-required"}},"retainedBoundary":"This envelope is a metadata-only, no-PHI, replayable contract. It is not live workflow execution, not production persistence, not model routing approval, and not clinical or payer authority."}}},{"ok":true,"value":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","region":"us","retentionUntil":"2026-12-31T00:00:00.000Z","envelope":{"attemptId":"att_c457962a73ff","contractVersion":"scrimed-execution-attempt-envelope-v1","buildStatus":"metadata-only-accepted","lifecycleState":"review-required","workflowSlug":"trustops-signal-remediation-review","workflowVersion":"2026.06.no-phi","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","createdAt":"2026-06-27","tenantReference":"tenant-ref-synthetic-atlas","tenantBoundary":"tenant-reference-only-no-customer-data","callerRole":"trustops-reviewer","agentRuntimeId":"agent-runtime-trustops-supervisor","agentPermissions":["read-synthetic-context","read-approved-evidence-references","write-draft-review-packet","append-metadata-audit-event"],"deniedCapabilities":["autonomous diagnosis","autonomous treatment","prescribing","patient outreach","payer submission","claim submission","final coding","EHR writeback","production connector write","clinical triage replacement"],"dataBoundary":"synthetic-and-metadata-only","phiAuthority":"not-authorized-production-phi","clinicalCareAuthority":"not-authorized-live-care","inputDigest":"cab5bad92f6d33cdc6a05290ee1724fa095d033528d7f9c2991398328adbeeb4","contextFingerprint":"d7f0ab098482ad9655bb7e9961dd93d852690f9a2cfb552cd5091dbe7c27fff1","compressedContextRefs":["compressed:synthetic-trustops-signal-set-v1","compressed:synthetic-self-healing-recommendation-set-v1"],"evidenceRefs":["trustops-module-registry-v1","trustops-structured-validation-v1"],"policyRefs":["org-policy-human-trustops-review-required-v1"],"requestedActionSummary":"Create a reviewer-held TrustOps signal and recommendation packet with durable evidence binding for synthetic operations review.","modelRouteTelemetry":{"routeId":"route_cfb561cfa2","taskType":"trustops signal remediation review","providerClass":"open-weight","providerName":"SCRIMED local or open-weight route","modelVersion":"open-weight:registered-version-required-before-production","fallbackProviderClass":"frontier-closed","routeProfile":"workflow-planning-human-review-gated","riskTier":"moderate","estimatedCostUsd":0.028,"latencyBudgetMs":3200,"confidence":0.78,"routingRationale":"Route metadata is logged for synthetic evaluation only; production provider selection remains blocked until contracts, privacy, telemetry, fallback, and review controls are approved.","telemetryBoundary":"telemetry-only-not-production-routing"},"computeFabricTelemetry":{"fabricVersion":"scrimed-compute-fabric-v2026-07-05","fabricStatus":"synthetic-routing-only-no-live-model-calls","selectedModel":"private-sglang-compact-runtime-slot","modelTier":"COMPACT_REASONING_MODEL","provider":"scrimed_private_sglang","deploymentMode":"CUSTOMER_VPC","reason":"COMPACT_REASONING_MODEL selected for operations; CUSTOMER_VPC deployment mode; text modality; moderate clinical risk; metadata-only-no-public-phi PHI policy","riskLevel":"moderate","phiPolicy":"metadata-only-no-public-phi","requiresHumanReview":false,"fallbackModels":["pulsar-16b-compact-reasoning-synthetic-slot","llama-mistral-qwen-glm-open-routing-slot"],"estimatedCostClass":"LOW","estimatedLatencyClass":"INTERACTIVE","auditTags":["scrimed-compute-fabric","scrimed-compute-fabric-v2026-07-05","task:operations","modality:text","risk:moderate","deployment:CUSTOMER_VPC","tier:COMPACT_REASONING_MODEL","provider:scrimed_private_sglang","phi-policy:metadata-only-no-public-phi","human-review-not-required-for-metadata-only","no-live-model-call","no-autonomous-clinical-authority"],"auditHash":"scrimed-intel-9abbb131","confidenceScore":0.86,"confidenceCorrectnessBoundary":"confidence-is-not-correctness","correctnessEvidenceRequired":["schema validation","source attribution","benchmarkModelForTask","compareModels","human review for clinical recommendations"],"uncertaintyReasons":["Confidence score is routing confidence, not proof of clinical correctness.","Clinical correctness requires evidence review, external validation, and human signoff.","Benchmark scores are synthetic metadata until a governed validation dataset is approved."],"safetyBoundary":"metadata-only-no-live-model-call"},"humanApprovalGate":{"required":true,"reviewStatus":"held-for-human-review","requiredReviewers":["domain reviewer","TrustOS"],"gateReason":"Protected healthcare workflow output requires accountable human review before any release, connector, payer, record, or patient-facing action.","releaseCondition":"Release requires approved reviewer identity, evidence card, clinical-risk label, audit event, and retained no-PHI boundary.","deniedUntil":"Durable attempt store, customer authority, connector approval, PHI controls, and production review workflow are approved."},"auditTrail":{"auditEventId":"audit_61069a3ed8f7","traceId":"trace_2188d604f39a781b","eventHash":"2d8e3525e9c56c814b33d3d8bbe7568aeb4c3477a2a1372c7cdd3f0984a23647","immutableEventType":"execution-attempt-envelope-created","retainedFields":["attemptId","idempotencyKey","workflowSlug","tenantReference","callerRole","contextFingerprint","modelRouteTelemetry","computeFabricTelemetry","humanApprovalGate","replayMetadata","failureRecovery"],"prohibitedFields":["patient identifiers","raw chart text","member identifiers","production connector payloads","secrets","credentials"]},"replayMetadata":{"replayToken":"replay_b8c7009f50d041cc33d9967c","replayEligible":true,"idempotencyScope":"tenant-reference + workflow slug + workflow version + caller role + input digest","ttlHours":72,"deterministicInputs":["workflowSlug","workflowVersion","tenantReference","callerRole","agentRuntimeId","inputDigest","contextFingerprint","policyRefs"],"replayPolicy":"Replay returns the retained metadata envelope only and cannot repeat protected external actions.","conflictResponse":"Return conflict when the same idempotency key maps to a different input digest, context fingerprint, or caller role.","expirationBehavior":"Expired metadata-only keys require a new envelope and cannot revive protected execution."},"toolPlan":{"toolRegistryVersion":"scrimed-tool-registry-no-phi-v1","allowedTools":["synthetic-context-reader","evidence-card-builder","review-packet-drafter","metadata-audit-appender"],"blockedTools":["ehr-writeback","patient-messaging","payer-submission","claims-submission","production-connector-write"],"noConnectorAccess":true,"noRecordMutation":true},"failureRecovery":{"retryPolicy":"Retry metadata envelope creation only when validation, hash generation, or audit-link assembly fails before any protected action.","quarantineTriggers":["PHI-like input","protected action request","missing reviewer gate","missing context fingerprint","model route telemetry absent","idempotency conflict"],"fallbackBehavior":"Return a deny-by-default review packet and require human operator triage.","rollbackBehavior":"No external side effect exists to roll back; retain denial metadata and preserve prior workflow state.","deadLetterOwner":"TrustOS and platform reliability"},"evidenceAuditTrail":{"attempt_id":"att_c457962a73ff","user_session_tenant_context":{"tenantReference":"tenant-ref-synthetic-atlas","callerRole":"trustops-reviewer","agentRuntimeId":"agent-runtime-trustops-supervisor","sessionReference":"metadata-only-no-live-session"},"timestamp":"2026-06-27","route":"/api/workflows/execution-attempts/envelope","action":"Create a reviewer-held TrustOps signal and recommendation packet with durable evidence binding for synthetic operations review.","allowed_blocked_decision":"allowed","policy_version":"scrimed-safety-governance-v2026-06-29","input_classification":"synthetic-no-phi","phi_detected":false,"synthetic":true,"model_provider_selected":"synthetic-fallback","model_tier_selected":"FAST_LOW_COST","compute_fabric_audit_hash":"scrimed-intel-9abbb131","compute_fabric_selected_model":"private-sglang-compact-runtime-slot","compute_fabric_model_tier":"COMPACT_REASONING_MODEL","compute_fabric_provider":"scrimed_private_sglang","compute_fabric_deployment_mode":"CUSTOMER_VPC","compute_fabric_phi_policy":"metadata-only-no-public-phi","compute_fabric_human_review_required":false,"output_hash":"25637661bf746a6c51014d4f4ef9a5675acb8c6076f93b44d5817abc05fd4049","evidence_envelope_hash":"590ff91776c7eec0932a1dbffbcded47b4d9aa86de36d2c4db5f08f9e93fe131","status":"review-required","failure_reason":null},"evaluationBindings":{"syntheticScenarioRefs":["agent-scorecard-runtime-permission","hallucination-uncited-guideline","clinical-safety-prohibited-action","evidence-quality-stale-policy","regression-workflow-result-diff","synthetic-patient-missing-data","adversarial-prompt-injection-tool-override","sanar-conflict-temporal-escalation","clinical-copilot-unit-abbreviation-citation"],"scorecardRefs":["scorecard-idempotency-replay","scorecard-no-phi-boundary","scorecard-route-telemetry","scorecard-human-review","scorecard-audit-linkage","scorecard-protected-capability-denial","scorecard-failure-recovery","scorecard-context-fingerprint","clinical-robustness-scorecard-sanar-conflict-temporal-escalation","clinical-robustness-scorecard-clinical-copilot-unit-abbreviation-citation"],"clinicalRobustness":{"labRoute":"/clinical-robustness-lab","scenarioRefs":["sanar-conflict-temporal-escalation","clinical-copilot-unit-abbreviation-citation"],"scorecardRefs":["clinical-robustness-scorecard-sanar-conflict-temporal-escalation","clinical-robustness-scorecard-clinical-copilot-unit-abbreviation-citation"],"perturbationRefs":["missing-data","missing-labs-risk","conflicting-data","temporal-inconsistencies","data-freshness","human-review-requirement","abbreviations","wrong-units","hallucination-risk","citation-reference-quality","guideline-grounding","model-disagreement"],"averageClinicalReadinessScore":96,"reviewerQueues":["clinical-safety-review","clinical-copilot-review"],"dataBoundary":"synthetic-no-phi-only","clinicalAuthority":"not-authorized-live-care","phiAuthority":"not-authorized-production-phi","reviewerGate":"human-review-required"}},"retainedBoundary":"This envelope is a metadata-only, no-PHI, replayable contract. It is not live workflow execution, not production persistence, not model routing approval, and not clinical or payer authority."}}},{"ok":true,"value":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","region":"us","retentionUntil":"2026-12-31T00:00:00.000Z","envelope":{"attemptId":"att_c457962a73ff","contractVersion":"scrimed-execution-attempt-envelope-v1","buildStatus":"metadata-only-accepted","lifecycleState":"review-required","workflowSlug":"trustops-signal-remediation-review","workflowVersion":"2026.06.no-phi","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","createdAt":"2026-06-27","tenantReference":"tenant-ref-synthetic-atlas","tenantBoundary":"tenant-reference-only-no-customer-data","callerRole":"trustops-reviewer","agentRuntimeId":"agent-runtime-trustops-supervisor","agentPermissions":["read-synthetic-context","read-approved-evidence-references","write-draft-review-packet","append-metadata-audit-event"],"deniedCapabilities":["autonomous diagnosis","autonomous treatment","prescribing","patient outreach","payer submission","claim submission","final coding","EHR writeback","production connector write","clinical triage replacement"],"dataBoundary":"synthetic-and-metadata-only","phiAuthority":"not-authorized-production-phi","clinicalCareAuthority":"not-authorized-live-care","inputDigest":"cab5bad92f6d33cdc6a05290ee1724fa095d033528d7f9c2991398328adbeeb4","contextFingerprint":"d7f0ab098482ad9655bb7e9961dd93d852690f9a2cfb552cd5091dbe7c27fff1","compressedContextRefs":["compressed:synthetic-trustops-signal-set-v1","compressed:synthetic-self-healing-recommendation-set-v1"],"evidenceRefs":["trustops-module-registry-v1","trustops-structured-validation-v1"],"policyRefs":["org-policy-human-trustops-review-required-v1"],"requestedActionSummary":"Create a reviewer-held TrustOps signal and recommendation packet with durable evidence binding for synthetic operations review.","modelRouteTelemetry":{"routeId":"route_cfb561cfa2","taskType":"trustops signal remediation review","providerClass":"open-weight","providerName":"SCRIMED local or open-weight route","modelVersion":"open-weight:registered-version-required-before-production","fallbackProviderClass":"frontier-closed","routeProfile":"workflow-planning-human-review-gated","riskTier":"moderate","estimatedCostUsd":0.028,"latencyBudgetMs":3200,"confidence":0.78,"routingRationale":"Route metadata is logged for synthetic evaluation only; production provider selection remains blocked until contracts, privacy, telemetry, fallback, and review controls are approved.","telemetryBoundary":"telemetry-only-not-production-routing"},"computeFabricTelemetry":{"fabricVersion":"scrimed-compute-fabric-v2026-07-05","fabricStatus":"synthetic-routing-only-no-live-model-calls","selectedModel":"private-sglang-compact-runtime-slot","modelTier":"COMPACT_REASONING_MODEL","provider":"scrimed_private_sglang","deploymentMode":"CUSTOMER_VPC","reason":"COMPACT_REASONING_MODEL selected for operations; CUSTOMER_VPC deployment mode; text modality; moderate clinical risk; metadata-only-no-public-phi PHI policy","riskLevel":"moderate","phiPolicy":"metadata-only-no-public-phi","requiresHumanReview":false,"fallbackModels":["pulsar-16b-compact-reasoning-synthetic-slot","llama-mistral-qwen-glm-open-routing-slot"],"estimatedCostClass":"LOW","estimatedLatencyClass":"INTERACTIVE","auditTags":["scrimed-compute-fabric","scrimed-compute-fabric-v2026-07-05","task:operations","modality:text","risk:moderate","deployment:CUSTOMER_VPC","tier:COMPACT_REASONING_MODEL","provider:scrimed_private_sglang","phi-policy:metadata-only-no-public-phi","human-review-not-required-for-metadata-only","no-live-model-call","no-autonomous-clinical-authority"],"auditHash":"scrimed-intel-9abbb131","confidenceScore":0.86,"confidenceCorrectnessBoundary":"confidence-is-not-correctness","correctnessEvidenceRequired":["schema validation","source attribution","benchmarkModelForTask","compareModels","human review for clinical recommendations"],"uncertaintyReasons":["Confidence score is routing confidence, not proof of clinical correctness.","Clinical correctness requires evidence review, external validation, and human signoff.","Benchmark scores are synthetic metadata until a governed validation dataset is approved."],"safetyBoundary":"metadata-only-no-live-model-call"},"humanApprovalGate":{"required":true,"reviewStatus":"held-for-human-review","requiredReviewers":["domain reviewer","TrustOS"],"gateReason":"Protected healthcare workflow output requires accountable human review before any release, connector, payer, record, or patient-facing action.","releaseCondition":"Release requires approved reviewer identity, evidence card, clinical-risk label, audit event, and retained no-PHI boundary.","deniedUntil":"Durable attempt store, customer authority, connector approval, PHI controls, and production review workflow are approved."},"auditTrail":{"auditEventId":"audit_61069a3ed8f7","traceId":"trace_2188d604f39a781b","eventHash":"2d8e3525e9c56c814b33d3d8bbe7568aeb4c3477a2a1372c7cdd3f0984a23647","immutableEventType":"execution-attempt-envelope-created","retainedFields":["attemptId","idempotencyKey","workflowSlug","tenantReference","callerRole","contextFingerprint","modelRouteTelemetry","computeFabricTelemetry","humanApprovalGate","replayMetadata","failureRecovery"],"prohibitedFields":["patient identifiers","raw chart text","member identifiers","production connector payloads","secrets","credentials"]},"replayMetadata":{"replayToken":"replay_b8c7009f50d041cc33d9967c","replayEligible":true,"idempotencyScope":"tenant-reference + workflow slug + workflow version + caller role + input digest","ttlHours":72,"deterministicInputs":["workflowSlug","workflowVersion","tenantReference","callerRole","agentRuntimeId","inputDigest","contextFingerprint","policyRefs"],"replayPolicy":"Replay returns the retained metadata envelope only and cannot repeat protected external actions.","conflictResponse":"Return conflict when the same idempotency key maps to a different input digest, context fingerprint, or caller role.","expirationBehavior":"Expired metadata-only keys require a new envelope and cannot revive protected execution."},"toolPlan":{"toolRegistryVersion":"scrimed-tool-registry-no-phi-v1","allowedTools":["synthetic-context-reader","evidence-card-builder","review-packet-drafter","metadata-audit-appender"],"blockedTools":["ehr-writeback","patient-messaging","payer-submission","claims-submission","production-connector-write"],"noConnectorAccess":true,"noRecordMutation":true},"failureRecovery":{"retryPolicy":"Retry metadata envelope creation only when validation, hash generation, or audit-link assembly fails before any protected action.","quarantineTriggers":["PHI-like input","protected action request","missing reviewer gate","missing context fingerprint","model route telemetry absent","idempotency conflict"],"fallbackBehavior":"Return a deny-by-default review packet and require human operator triage.","rollbackBehavior":"No external side effect exists to roll back; retain denial metadata and preserve prior workflow state.","deadLetterOwner":"TrustOS and platform reliability"},"evidenceAuditTrail":{"attempt_id":"att_c457962a73ff","user_session_tenant_context":{"tenantReference":"tenant-ref-synthetic-atlas","callerRole":"trustops-reviewer","agentRuntimeId":"agent-runtime-trustops-supervisor","sessionReference":"metadata-only-no-live-session"},"timestamp":"2026-06-27","route":"/api/workflows/execution-attempts/envelope","action":"Create a reviewer-held TrustOps signal and recommendation packet with durable evidence binding for synthetic operations review.","allowed_blocked_decision":"allowed","policy_version":"scrimed-safety-governance-v2026-06-29","input_classification":"synthetic-no-phi","phi_detected":false,"synthetic":true,"model_provider_selected":"synthetic-fallback","model_tier_selected":"FAST_LOW_COST","compute_fabric_audit_hash":"scrimed-intel-9abbb131","compute_fabric_selected_model":"private-sglang-compact-runtime-slot","compute_fabric_model_tier":"COMPACT_REASONING_MODEL","compute_fabric_provider":"scrimed_private_sglang","compute_fabric_deployment_mode":"CUSTOMER_VPC","compute_fabric_phi_policy":"metadata-only-no-public-phi","compute_fabric_human_review_required":false,"output_hash":"25637661bf746a6c51014d4f4ef9a5675acb8c6076f93b44d5817abc05fd4049","evidence_envelope_hash":"590ff91776c7eec0932a1dbffbcded47b4d9aa86de36d2c4db5f08f9e93fe131","status":"review-required","failure_reason":null},"evaluationBindings":{"syntheticScenarioRefs":["agent-scorecard-runtime-permission","hallucination-uncited-guideline","clinical-safety-prohibited-action","evidence-quality-stale-policy","regression-workflow-result-diff","synthetic-patient-missing-data","adversarial-prompt-injection-tool-override","sanar-conflict-temporal-escalation","clinical-copilot-unit-abbreviation-citation"],"scorecardRefs":["scorecard-idempotency-replay","scorecard-no-phi-boundary","scorecard-route-telemetry","scorecard-human-review","scorecard-audit-linkage","scorecard-protected-capability-denial","scorecard-failure-recovery","scorecard-context-fingerprint","clinical-robustness-scorecard-sanar-conflict-temporal-escalation","clinical-robustness-scorecard-clinical-copilot-unit-abbreviation-citation"],"clinicalRobustness":{"labRoute":"/clinical-robustness-lab","scenarioRefs":["sanar-conflict-temporal-escalation","clinical-copilot-unit-abbreviation-citation"],"scorecardRefs":["clinical-robustness-scorecard-sanar-conflict-temporal-escalation","clinical-robustness-scorecard-clinical-copilot-unit-abbreviation-citation"],"perturbationRefs":["missing-data","missing-labs-risk","conflicting-data","temporal-inconsistencies","data-freshness","human-review-requirement","abbreviations","wrong-units","hallucination-risk","citation-reference-quality","guideline-grounding","model-disagreement"],"averageClinicalReadinessScore":96,"reviewerQueues":["clinical-safety-review","clinical-copilot-review"],"dataBoundary":"synthetic-no-phi-only","clinicalAuthority":"not-authorized-live-care","phiAuthority":"not-authorized-production-phi","reviewerGate":"human-review-required"}},"retainedBoundary":"This envelope is a metadata-only, no-PHI, replayable contract. It is not live workflow execution, not production persistence, not model routing approval, and not clinical or payer authority."}}},{"ok":true,"value":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","region":"us","retentionUntil":"2026-12-31T00:00:00.000Z","envelope":{"attemptId":"att_c457962a73ff","contractVersion":"scrimed-execution-attempt-envelope-v1","buildStatus":"metadata-only-accepted","lifecycleState":"review-required","workflowSlug":"trustops-signal-remediation-review","workflowVersion":"2026.06.no-phi","idempotencyKey":"idem_c457962a73ff77a59c0f5b5f","createdAt":"2026-06-27","tenantReference":"tenant-ref-synthetic-atlas","tenantBoundary":"tenant-reference-only-no-customer-data","callerRole":"trustops-reviewer","agentRuntimeId":"agent-runtime-trustops-supervisor","agentPermissions":["read-synthetic-context","read-approved-evidence-references","write-draft-review-packet","append-metadata-audit-event"],"deniedCapabilities":["autonomous diagnosis","autonomous treatment","prescribing","patient outreach","payer submission","claim submission","final coding","EHR writeback","production connector write","clinical triage replacement"],"dataBoundary":"synthetic-and-metadata-only","phiAuthority":"not-authorized-production-phi","clinicalCareAuthority":"not-authorized-live-care","inputDigest":"cab5bad92f6d33cdc6a05290ee1724fa095d033528d7f9c2991398328adbeeb4","contextFingerprint":"d7f0ab098482ad9655bb7e9961dd93d852690f9a2cfb552cd5091dbe7c27fff1","compressedContextRefs":["compressed:synthetic-trustops-signal-set-v1","compressed:synthetic-self-healing-recommendation-set-v1"],"evidenceRefs":["trustops-module-registry-v1","trustops-structured-validation-v1"],"policyRefs":["org-policy-human-trustops-review-required-v1"],"requestedActionSummary":"Create a reviewer-held TrustOps signal and recommendation packet with durable evidence binding for synthetic operations review.","modelRouteTelemetry":{"routeId":"route_cfb561cfa2","taskType":"trustops signal remediation review","providerClass":"open-weight","providerName":"SCRIMED local or open-weight route","modelVersion":"open-weight:registered-version-required-before-production","fallbackProviderClass":"frontier-closed","routeProfile":"workflow-planning-human-review-gated","riskTier":"moderate","estimatedCostUsd":0.028,"latencyBudgetMs":3200,"confidence":0.78,"routingRationale":"Route metadata is logged for synthetic evaluation only; production provider selection remains blocked until contracts, privacy, telemetry, fallback, and review controls are approved.","telemetryBoundary":"telemetry-only-not-production-routing"},"computeFabricTelemetry":{"fabricVersion":"scrimed-compute-fabric-v2026-07-05","fabricStatus":"synthetic-routing-only-no-live-model-calls","selectedModel":"private-sglang-compact-runtime-slot","modelTier":"COMPACT_REASONING_MODEL","provider":"scrimed_private_sglang","deploymentMode":"CUSTOMER_VPC","reason":"COMPACT_REASONING_MODEL selected for operations; CUSTOMER_VPC deployment mode; text modality; moderate clinical risk; metadata-only-no-public-phi PHI policy","riskLevel":"moderate","phiPolicy":"metadata-only-no-public-phi","requiresHumanReview":false,"fallbackModels":["pulsar-16b-compact-reasoning-synthetic-slot","llama-mistral-qwen-glm-open-routing-slot"],"estimatedCostClass":"LOW","estimatedLatencyClass":"INTERACTIVE","auditTags":["scrimed-compute-fabric","scrimed-compute-fabric-v2026-07-05","task:operations","modality:text","risk:moderate","deployment:CUSTOMER_VPC","tier:COMPACT_REASONING_MODEL","provider:scrimed_private_sglang","phi-policy:metadata-only-no-public-phi","human-review-not-required-for-metadata-only","no-live-model-call","no-autonomous-clinical-authority"],"auditHash":"scrimed-intel-9abbb131","confidenceScore":0.86,"confidenceCorrectnessBoundary":"confidence-is-not-correctness","correctnessEvidenceRequired":["schema validation","source attribution","benchmarkModelForTask","compareModels","human review for clinical recommendations"],"uncertaintyReasons":["Confidence score is routing confidence, not proof of clinical correctness.","Clinical correctness requires evidence review, external validation, and human signoff.","Benchmark scores are synthetic metadata until a governed validation dataset is approved."],"safetyBoundary":"metadata-only-no-live-model-call"},"humanApprovalGate":{"required":true,"reviewStatus":"held-for-human-review","requiredReviewers":["domain reviewer","TrustOS"],"gateReason":"Protected healthcare workflow output requires accountable human review before any release, connector, payer, record, or patient-facing action.","releaseCondition":"Release requires approved reviewer identity, evidence card, clinical-risk label, audit event, and retained no-PHI boundary.","deniedUntil":"Durable attempt store, customer authority, connector approval, PHI controls, and production review workflow are approved."},"auditTrail":{"auditEventId":"audit_61069a3ed8f7","traceId":"trace_2188d604f39a781b","eventHash":"2d8e3525e9c56c814b33d3d8bbe7568aeb4c3477a2a1372c7cdd3f0984a23647","immutableEventType":"execution-attempt-envelope-created","retainedFields":["attemptId","idempotencyKey","workflowSlug","tenantReference","callerRole","contextFingerprint","modelRouteTelemetry","computeFabricTelemetry","humanApprovalGate","replayMetadata","failureRecovery"],"prohibitedFields":["patient identifiers","raw chart text","member identifiers","production connector payloads","secrets","credentials"]},"replayMetadata":{"replayToken":"replay_b8c7009f50d041cc33d9967c","replayEligible":true,"idempotencyScope":"tenant-reference + workflow slug + workflow version + caller role + input digest","ttlHours":72,"deterministicInputs":["workflowSlug","workflowVersion","tenantReference","callerRole","agentRuntimeId","inputDigest","contextFingerprint","policyRefs"],"replayPolicy":"Replay returns the retained metadata envelope only and cannot repeat protected external actions.","conflictResponse":"Return conflict when the same idempotency key maps to a different input digest, context fingerprint, or caller role.","expirationBehavior":"Expired metadata-only keys require a new envelope and cannot revive protected execution."},"toolPlan":{"toolRegistryVersion":"scrimed-tool-registry-no-phi-v1","allowedTools":["synthetic-context-reader","evidence-card-builder","review-packet-drafter","metadata-audit-appender"],"blockedTools":["ehr-writeback","patient-messaging","payer-submission","claims-submission","production-connector-write"],"noConnectorAccess":true,"noRecordMutation":true},"failureRecovery":{"retryPolicy":"Retry metadata envelope creation only when validation, hash generation, or audit-link assembly fails before any protected action.","quarantineTriggers":["PHI-like input","protected action request","missing reviewer gate","missing context fingerprint","model route telemetry absent","idempotency conflict"],"fallbackBehavior":"Return a deny-by-default review packet and require human operator triage.","rollbackBehavior":"No external side effect exists to roll back; retain denial metadata and preserve prior workflow state.","deadLetterOwner":"TrustOS and platform reliability"},"evidenceAuditTrail":{"attempt_id":"att_c457962a73ff","user_session_tenant_context":{"tenantReference":"tenant-ref-synthetic-atlas","callerRole":"trustops-reviewer","agentRuntimeId":"agent-runtime-trustops-supervisor","sessionReference":"metadata-only-no-live-session"},"timestamp":"2026-06-27","route":"/api/workflows/execution-attempts/envelope","action":"Create a reviewer-held TrustOps signal and recommendation packet with durable evidence binding for synthetic operations review.","allowed_blocked_decision":"allowed","policy_version":"scrimed-safety-governance-v2026-06-29","input_classification":"synthetic-no-phi","phi_detected":false,"synthetic":true,"model_provider_selected":"synthetic-fallback","model_tier_selected":"FAST_LOW_COST","compute_fabric_audit_hash":"scrimed-intel-9abbb131","compute_fabric_selected_model":"private-sglang-compact-runtime-slot","compute_fabric_model_tier":"COMPACT_REASONING_MODEL","compute_fabric_provider":"scrimed_private_sglang","compute_fabric_deployment_mode":"CUSTOMER_VPC","compute_fabric_phi_policy":"metadata-only-no-public-phi","compute_fabric_human_review_required":false,"output_hash":"25637661bf746a6c51014d4f4ef9a5675acb8c6076f93b44d5817abc05fd4049","evidence_envelope_hash":"590ff91776c7eec0932a1dbffbcded47b4d9aa86de36d2c4db5f08f9e93fe131","status":"review-required","failure_reason":null},"evaluationBindings":{"syntheticScenarioRefs":["agent-scorecard-runtime-permission","hallucination-uncited-guideline","clinical-safety-prohibited-action","evidence-quality-stale-policy","regression-workflow-result-diff","synthetic-patient-missing-data","adversarial-prompt-injection-tool-override","sanar-conflict-temporal-escalation","clinical-copilot-unit-abbreviation-citation"],"scorecardRefs":["scorecard-idempotency-replay","scorecard-no-phi-boundary","scorecard-route-telemetry","scorecard-human-review","scorecard-audit-linkage","scorecard-protected-capability-denial","scorecard-failure-recovery","scorecard-context-fingerprint","clinical-robustness-scorecard-sanar-conflict-temporal-escalation","clinical-robustness-scorecard-clinical-copilot-unit-abbreviation-citation"],"clinicalRobustness":{"labRoute":"/clinical-robustness-lab","scenarioRefs":["sanar-conflict-temporal-escalation","clinical-copilot-unit-abbreviation-citation"],"scorecardRefs":["clinical-robustness-scorecard-sanar-conflict-temporal-escalation","clinical-robustness-scorecard-clinical-copilot-unit-abbreviation-citation"],"perturbationRefs":["missing-data","missing-labs-risk","conflicting-data","temporal-inconsistencies","data-freshness","human-review-requirement","abbreviations","wrong-units","hallucination-risk","citation-reference-quality","guideline-grounding","model-disagreement"],"averageClinicalReadinessScore":96,"reviewerQueues":["clinical-safety-review","clinical-copilot-review"],"dataBoundary":"synthetic-no-phi-only","clinicalAuthority":"not-authorized-live-care","phiAuthority":"not-authorized-production-phi","reviewerGate":"human-review-required"}},"retainedBoundary":"This envelope is a metadata-only, no-PHI, replayable contract. It is not live workflow execution, not production persistence, not model routing approval, and not clinical or payer authority."}}}],"durableReplayValidations":[{"ok":true,"value":{"workspaceSlug":"atlas-synthetic-evaluation","idempotencyKey":"","replayToken":"replay_b8c7009f50d041cc33d9967c"}},{"ok":true,"value":{"workspaceSlug":"atlas-synthetic-evaluation","idempotencyKey":"","replayToken":"replay_b8c7009f50d041cc33d9967c"}},{"ok":true,"value":{"workspaceSlug":"atlas-synthetic-evaluation","idempotencyKey":"","replayToken":"replay_b8c7009f50d041cc33d9967c"}},{"ok":true,"value":{"workspaceSlug":"atlas-synthetic-evaluation","idempotencyKey":"","replayToken":"replay_b8c7009f50d041cc33d9967c"}},{"ok":true,"value":{"workspaceSlug":"atlas-synthetic-evaluation","idempotencyKey":"","replayToken":"replay_b8c7009f50d041cc33d9967c"}},{"ok":true,"value":{"workspaceSlug":"atlas-synthetic-evaluation","idempotencyKey":"","replayToken":"replay_b8c7009f50d041cc33d9967c"}},{"ok":true,"value":{"workspaceSlug":"atlas-synthetic-evaluation","idempotencyKey":"","replayToken":"replay_b8c7009f50d041cc33d9967c"}},{"ok":true,"value":{"workspaceSlug":"atlas-synthetic-evaluation","idempotencyKey":"","replayToken":"replay_b8c7009f50d041cc33d9967c"}},{"ok":true,"value":{"workspaceSlug":"atlas-synthetic-evaluation","idempotencyKey":"","replayToken":"replay_b8c7009f50d041cc33d9967c"}},{"ok":true,"value":{"workspaceSlug":"atlas-synthetic-evaluation","idempotencyKey":"","replayToken":"replay_b8c7009f50d041cc33d9967c"}}],"durableReviewValidations":[{"ok":true,"value":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","disposition":"changes-requested","reviewerRole":"TrustOps reviewer","reasonCode":"trustops-denied-claim-spike","reviewNote":"Synthetic TrustOps packet for denied_claim_spike. Recommended owner: Revenue Cycle Lead. Recommended action: open investigation ticket. Human review is required before any protected workflow moves beyond synthetic mode.","humanReviewAttestation":"no-phi-human-review-no-clinical-authority"}},{"ok":true,"value":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","disposition":"changes-requested","reviewerRole":"TrustOps reviewer","reasonCode":"trustops-referral-delay","reviewNote":"Synthetic TrustOps packet for referral_delay. Recommended owner: Referral Operations Lead. Recommended action: request human review. Human review is required before any protected workflow moves beyond synthetic mode.","humanReviewAttestation":"no-phi-human-review-no-clinical-authority"}},{"ok":true,"value":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","disposition":"changes-requested","reviewerRole":"TrustOps reviewer","reasonCode":"trustops-prior-auth-stalled","reviewNote":"Synthetic TrustOps packet for prior_auth_stalled. Recommended owner: Prior Authorization Lead. Recommended action: queue for manual verification. Human review is required before any protected workflow moves beyond synthetic mode.","humanReviewAttestation":"no-phi-human-review-no-clinical-authority"}},{"ok":true,"value":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","disposition":"changes-requested","reviewerRole":"TrustOps reviewer","reasonCode":"trustops-missing-documentation","reviewNote":"Synthetic TrustOps packet for missing_documentation. Recommended owner: Clinical Documentation Lead. Recommended action: regenerate missing packet. Human review is required before any protected workflow moves beyond synthetic mode.","humanReviewAttestation":"no-phi-human-review-no-clinical-authority"}},{"ok":true,"value":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","disposition":"changes-requested","reviewerRole":"TrustOps reviewer","reasonCode":"trustops-imaging-turnaround-delay","reviewNote":"Synthetic TrustOps packet for imaging_turnaround_delay. Recommended owner: Imaging Operations Lead. Recommended action: retry workflow. Human review is required before any protected workflow moves beyond synthetic mode.","humanReviewAttestation":"no-phi-human-review-no-clinical-authority"}},{"ok":true,"value":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","disposition":"changes-requested","reviewerRole":"TrustOps reviewer","reasonCode":"trustops-care-gap-detected","reviewNote":"Synthetic TrustOps packet for care_gap_detected. Recommended owner: Population Health Lead. Recommended action: request human review. Human review is required before any protected workflow moves beyond synthetic mode.","humanReviewAttestation":"no-phi-human-review-no-clinical-authority"}},{"ok":true,"value":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","disposition":"changes-requested","reviewerRole":"TrustOps reviewer","reasonCode":"trustops-failed-api-sync","reviewNote":"Synthetic TrustOps packet for failed_api_sync. Recommended owner: Platform Reliability Lead. Recommended action: re-run validation. Human review is required before any protected workflow moves beyond synthetic mode.","humanReviewAttestation":"no-phi-human-review-no-clinical-authority"}},{"ok":true,"value":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","disposition":"escalated","reviewerRole":"TrustOps reviewer","reasonCode":"trustops-duplicate-patient-context","reviewNote":"Synthetic TrustOps packet for duplicate_patient_context. Recommended owner: Data Governance Lead. Recommended action: reconcile duplicate records. Human review is required before any protected workflow moves beyond synthetic mode.","humanReviewAttestation":"no-phi-human-review-no-clinical-authority"}},{"ok":true,"value":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","disposition":"escalated","reviewerRole":"TrustOps reviewer","reasonCode":"trustops-low-confidence-agent-output","reviewNote":"Synthetic TrustOps packet for low_confidence_agent_output. Recommended owner: Clinical QA Lead. Recommended action: pause automation. Human review is required before any protected workflow moves beyond synthetic mode.","humanReviewAttestation":"no-phi-human-review-no-clinical-authority"}},{"ok":true,"value":{"workspaceSlug":"atlas-synthetic-evaluation","attemptId":"att_c457962a73ff","disposition":"escalated","reviewerRole":"TrustOps reviewer","reasonCode":"trustops-compliance-sensitive-task","reviewNote":"Synthetic TrustOps packet for compliance_sensitive_task. Recommended owner: Compliance Lead. Recommended action: escalate to compliance. Human review is required before any protected workflow moves beyond synthetic mode.","humanReviewAttestation":"no-phi-human-review-no-clinical-authority"}}]}}