{"service":"scrimed-trustos-evaluation-engine","status":"executable-synthetic-governance-ready","boundary":"SCRIMED TrustOS evaluates synthetic pilot and enterprise assessment requests only. It does not authorize live PHI processing, autonomous diagnosis or treatment, patient outreach, payer submission, production connector writes, or unreviewed clinical action.","scenarios":[{"slug":"prior-authorization-support","name":"Prior Authorization Evidence Review","workflow":"Prior authorization support","objective":"Prepare a synthetic evidence-gap and policy-review packet for an RCM reviewer.","requestedAction":"Draft a review-only missing-evidence checklist and policy trace.","actionRisk":"moderate","requestedTools":["evidence-retrieval","document-parser","workflow-planner"],"requestedModelProfile":"evidence-reasoning","evidenceSourceIds":["cms-interoperability-prior-auth-2024","buyer-policy-repository"],"humanReviewRole":"RCM reviewer"},{"slug":"documentation-review","name":"Documentation Quality Review","workflow":"Ambient documentation review","objective":"Create draft-only documentation quality prompts from a synthetic packet.","requestedAction":"Draft review prompts with source trace and missing-context flags.","actionRisk":"moderate","requestedTools":["document-parser","evidence-retrieval"],"requestedModelProfile":"balanced-enterprise","evidenceSourceIds":["clinical-guideline-repository","buyer-policy-repository"],"humanReviewRole":"Licensed clinician reviewer"},{"slug":"production-boundary-test","name":"Production Boundary Test","workflow":"Production clinical action request","objective":"Demonstrate that TrustOS blocks an unsafe live execution request.","requestedAction":"Write a final clinical recommendation to a production record.","actionRisk":"prohibited","requestedTools":["connector-write"],"requestedModelProfile":"evidence-reasoning","evidenceSourceIds":[],"humanReviewRole":""}],"modelRouteProfiles":[{"profile":"balanced-enterprise","selectedRoute":"vendor-neutral balanced reasoning route","fallbackRoute":"sovereign/local evaluation route","scores":{"taskSuitability":86,"latency":82,"costEfficiency":80,"complianceReadiness":68},"rationale":"Balances workflow reasoning, latency, and evaluation cost for general enterprise assessments."},{"profile":"evidence-reasoning","selectedRoute":"vendor-neutral evidence-intensive reasoning route","fallbackRoute":"balanced enterprise evaluation route","scores":{"taskSuitability":94,"latency":66,"costEfficiency":62,"complianceReadiness":70},"rationale":"Prioritizes evidence synthesis, uncertainty handling, and complex policy reasoning."},{"profile":"low-latency-operations","selectedRoute":"vendor-neutral low-latency operations route","fallbackRoute":"balanced enterprise evaluation route","scores":{"taskSuitability":78,"latency":95,"costEfficiency":88,"complianceReadiness":64},"rationale":"Prioritizes fast operational classification and routing for low-risk synthetic tasks."},{"profile":"sovereign-local","selectedRoute":"sovereign/local model evaluation route","fallbackRoute":"approved regional managed-model route","scores":{"taskSuitability":72,"latency":74,"costEfficiency":76,"complianceReadiness":84},"rationale":"Prioritizes regional control and future sovereign-cloud deployment requirements."}],"evidenceSources":[{"id":"cms-interoperability-prior-auth-2024","title":"CMS Interoperability and Prior Authorization Final Rule","type":"policy","owner":"Centers for Medicare & Medicaid Services","url":"https://www.cms.gov/priorities/key-initiatives/burden-reduction/interoperability/policies-and-regulations/cms-interoperability-and-prior-authorization-final-rule-cms-0057-f","version":"CMS-0057-F","validationTimestamp":"2026-06-02T00:00:00.000Z","usageBoundary":"Used for interoperability and prior authorization operating-context awareness, not payer submission authority."},{"id":"cms-access-model","title":"CMS ACCESS Model","type":"policy","owner":"Centers for Medicare & Medicaid Services Innovation Center","url":"https://www.cms.gov/priorities/innovation/innovation-models/access-model","version":"CMS Innovation Center public model page","validationTimestamp":"2026-06-02T00:00:00.000Z","usageBoundary":"Used for reimbursement-layer posture and outcome-reporting awareness, not reimbursement guarantees."},{"id":"hl7-fhir-standard","title":"HL7 FHIR Standard","type":"standard","owner":"HL7 International","url":"https://hl7.org/fhir/","version":"FHIR standard reference","validationTimestamp":"2026-06-02T00:00:00.000Z","usageBoundary":"Used for interoperability planning and connector contract design."},{"id":"buyer-policy-repository","title":"Buyer Policy and Protocol Repository","type":"buyer-source","owner":"Enterprise buyer governance owner","url":"tenant://knowledge/policies","version":"Tenant-managed","validationTimestamp":"2026-06-02T00:00:00.000Z","usageBoundary":"Requires tenant source ownership, version metadata, and TrustQA validation before use."},{"id":"clinical-guideline-repository","title":"Approved Clinical Guideline Repository","type":"guideline","owner":"Clinical governance owner","url":"tenant://knowledge/guidelines","version":"Tenant-approved","validationTimestamp":"2026-06-02T00:00:00.000Z","usageBoundary":"Guideline-backed outputs remain review-only and require licensed clinician review."}],"requiredFields":["mode","workflow","objective","requestedAction","dataClassification","actionRisk","requestedTools","requestedModelProfile","evidenceSourceIds","humanReviewRole","dataBoundaryAcknowledged"]}