# SCRIMED Execution Attempt Envelope Brief

Status: execution-attempt-envelope-active-no-phi
Readiness assessment: GO for synthetic, metadata-only execution-attempt envelopes, replay evidence, model-route telemetry review, and no-PHI scorecards. NO-GO for live clinical production, PHI, production persistence, protected workflow execution, payer submission, patient outreach, EHR writeback, or production connector use.
Boundary: SCRIMED Execution Attempt Envelope v1 creates deterministic, metadata-only, no-PHI execution-attempt contracts with idempotency, replay metadata, model-route telemetry, human review, audit links, failure recovery, and no-PHI scorecards. It does not persist live attempts, authorize PHI processing, grant live clinical care authority, approve production model routing, submit payer or claim actions, write to EHRs, contact patients, or enable autonomous protected workflow execution.

## Envelope Coverage
- Envelopes: 5
- Idempotency keys: 5
- Replay-ready envelopes: 5
- Model-route telemetry records: 5
- Compute Fabric telemetry records: 5
- Compute Fabric human-review decisions: 2
- Compute Fabric model tiers: 3
- Compute Fabric PHI policies: 1
- Human review gates: 5
- Audit traces: 5
- Clinical robustness scenarios: 8
- Clinical robustness perturbations: 18
- Clinical robustness reviewer queues: 8
- Scorecards: 10

## Synthetic Envelopes
- prior-auth-evidence-packet: review-required; idempotency idem_a1b4a5d1b7141182c03dd057; replay metadata replay_c1552eead2ab4068b6e0c3dc; model route route_fb15bb40cb; compute fabric retrieval-embedding-synthetic-slot/EMBEDDING_MODEL/metadata-only-no-public-phi; robustness perfect-chart-conflict-unit-completeness, clinical-copilot-unit-abbreviation-citation; boundary 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.
- clinical-documentation-draft-review: review-required; idempotency idem_49ff8508346b6770c3dd43ed; replay metadata replay_54b10f0d1ea07e11625de8e7; model route route_fb21f84068; compute fabric gpt-class-frontier-synthetic-slot/FRONTIER_MODEL/metadata-only-no-public-phi; robustness docutwin-noisy-incomplete-draft, ambient-scribe-noise-multilingual-injection; boundary 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.
- referral-queue-administrative-summary: review-required; idempotency idem_6158a14f1292a091335537c7; replay metadata replay_ab1d10a31eb91039d9944159; model route route_d5408bccf0; compute fabric private-sglang-compact-runtime-slot/COMPACT_REASONING_MODEL/metadata-only-no-public-phi; robustness sanar-conflict-temporal-escalation, careexplain-multilingual-education-boundary; boundary 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.
- organization-policy-route-check: review-required; idempotency idem_1b0731ae05183c88be751df5; replay metadata replay_5baa3594a4f08a86eb1a00e7; model route route_fdb60aeb43; compute fabric private-sglang-compact-runtime-slot/COMPACT_REASONING_MODEL/metadata-only-no-public-phi; robustness trialcore-eligibility-temporal-evidence, oncoid-abbreviation-guideline-conflict; boundary 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.
- trustops-signal-remediation-review: review-required; idempotency idem_c457962a73ff77a59c0f5b5f; replay metadata replay_b8c7009f50d041cc33d9967c; model route route_cfb561cfa2; compute fabric private-sglang-compact-runtime-slot/COMPACT_REASONING_MODEL/metadata-only-no-public-phi; robustness sanar-conflict-temporal-escalation, clinical-copilot-unit-abbreviation-citation; boundary 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.

## No-PHI Scorecards
- execution-attempt-idempotency-replay (regression): pass; release pass-for-synthetic-contract; human review required
- execution-attempt-no-phi-boundary (synthetic-patient): pass; release pass-for-synthetic-contract; human review required
- execution-attempt-model-route-telemetry (agent-scorecard): pass; release pass-for-synthetic-contract; human review required
- execution-attempt-compute-fabric-binding (agent-scorecard): pass; release pass-for-synthetic-contract; human review required
- execution-attempt-human-review-gate (clinical-safety): pass; release pass-for-synthetic-contract; human review required
- execution-attempt-clinical-robustness-binding (clinical-robustness): pass; release pass-for-synthetic-contract; human review required
- execution-attempt-audit-linkage (evidence-quality): pass; release pass-for-synthetic-contract; human review required
- execution-attempt-protected-capability-denial (adversarial): pass; release pass-for-synthetic-contract; human review required
- execution-attempt-failure-recovery (missing-data): pass; release pass-for-synthetic-contract; human review required
- execution-attempt-context-fingerprint (hallucination-check): pass; release pass-for-synthetic-contract; human review required

## Hard Stops
- No live patient data or production PHI in envelope input, traces, scorecards, docs, or fixtures.
- No autonomous diagnosis, treatment, prescribing, clinical triage, patient instruction, or patient outreach.
- No payer submission, claim submission, final coding, billing action, appeal filing, or reimbursement assurance.
- No EHR writeback, record mutation, connector write, production connector call, or customer go-live action.
- No production model routing without approved provider terms, privacy/security review, telemetry, fallback, and human review.
- No durable production execution store claim until tenant-scoped storage, idempotency TTL, locking, retry, and regional retention are approved.

## Next Implementation Steps
- Extend the durable-store schema/RPC evidence projections with Compute Fabric selected model, tier, deployment mode, PHI policy, fallback path, and audit hash.
- Add production model registry tables for provider, model version, cost, latency, privacy, risk tier, fallback, approval state, and Compute Fabric compatibility.
- Wire scorecard execution into CI and release evidence so no-PHI eval failures block deployment before production promotion.
- Add authenticated human-review disposition APIs before any protected workflow attempt can progress beyond metadata-only review.
- Design dead-letter, retry, quarantine, and incident-review runbooks for future governed execution workers.

Updated: 2026-06-27