Cardiovascular patient journey governance — v1
Patient consents.
AI supports.
Authorised health roles decide.
KATLAS signs the receipt.
HealthCierge coordinates cardiovascular journeys across patients, clinicians, pharmacists, researchers and certified community health coaches. Evidence stays under patient or role custody; requests are purpose-bound; authorised roles decide; KATLAS receipts prove what was shared, what was withheld and what action followed.
Operating grammar
Custody · Authority · Receipts
What this demo shows
Patient wallet
Patient-held custody and purpose-bound consent.
Review-worthy signal
Synthetic responsible-AI support signal. Pre-computed, not a live LLM.
Authorised review
Clinician or pharmacist approves or refuses the review route.
Signed receipt
KATLAS proves what was shared, withheld and decided.
The governed journey
- 01Wallet signal
- 02Consent request
- 03Clinician / pharmacist review
- 04Safe exchange / coach support
- 05KATLAS receipt
Step 01 · Patient wallet
Synthetic patient — patient-held custody
Identifiers & consent
Bounded evidence summaries
Care network
role:gp · role:cardiovascular_review_clinician · role:pharmacist_medication_safety · role:certified_health_coach
Step 02 · Responsible AI support
Synthetic responsible-AI support signal
Framing
A synthetic AI-support layer has flagged this patient journey for authorised human review. It has not diagnosed, prescribed or made a care decision.
Review-worthy signal
Wearable trend summary, regulated questionnaire score and medication-context summary indicate that a cardiovascular review route should be considered by an authorised clinician or pharmacist.
Rationale & boundary
The signal is based on synthetic summary evidence only. It does not contain raw wearable streams, raw questionnaire answers, full health records or personal identifiers.
AI supports review routing only. Authorised health roles decide.
Evidence references only
Step 03 · Purpose-bound request
Share cardiovascular risk summary and regulated questionnaire summary with an authorised clinician for review.
Requested by
role:cardiovascular_review_clinician
Purpose
cardiovascular_review_routing
Duration
single-review-session
Allowed roles
role:cardiovascular_review_clinician · role:pharmacist_medication_safety
Consent receipt ref
consent:receipt:HC-7F2A-CV-REVIEW-001
Step 04 · Evidence boundary
Shared for review
Consent receipt reference
consent:receipt:HC-7F2A-CV-REVIEW-001
Wearable trend summary (not raw stream)
ref:wearable:trend-summary
Regulated questionnaire score / summary
ref:cv-questionnaire:v3.2:score-band
Medication / polypharmacy context summary
ref:medication:context-summary
Synthetic AI review-worthy flag
ref:ai:cv-review-flag
Patient-controlled
Withheld
Raw wearable stream
Full health record
Raw questionnaire answers
Full medication history (unless explicitly authorised)
Personal identifiers beyond what is needed
Private notes and raw AI prompt context
Step 05 · Authority gate
Authorised review — clinician or pharmacist decides
Acting as
Live signing unavailable
KATLAS is currently unconfigured. The action will be recorded as an honest unconfigured response — no simulated receipt is produced.
Safety panel
Responsible AI boundary
AI may summarise, flag or route for review.
AI may not diagnose.
AI may not prescribe.
AI may not recommend treatment.
AI may not approve clinical action.
AI may not override patient consent.
AI may not access raw patient data outside the approved evidence boundary.
AI may not send raw patient records to pharma, research or community-support roles.
AI supports the review; authorised health roles make the decision.
Secondary route
Safe pharma & research signal exchange
Position
Pharma / research receives a consented, bounded signal or aggregate reference — not the full patient record.
Possible exchanges
- · Safety signal reference
- · Adverse trend category
- · Cohort eligibility flag
- · Consented research participation status
- · Medication review outcome
Boundary
No raw streams, no full record, no identifiers. Every exchange leaves a signed KATLAS receipt at source.
Secondary route
Certified health-coach follow-up
Scope of support
- · Adherence reminders
- · Lifestyle support
- · Appointment navigation
- · Community check-ins
- · Signposting
Custody
Community support receives only the task and bounded context required to help.
Authority
Clinical decisions remain with authorised clinicians. Coaches do not receive raw clinical records.
Governance extensions · optional
Bounded safety scenarios layered on the primary cardiovascular route — sensitive disclosure, carer authority and care-preference certificates.
Primary v1 remains: wallet signal → consent request → authorised review → KATLAS-signed receipt. The panels below show how HealthCierge governs harder safety cases without changing that core route.
Governance extension · 01
Sensitive diagnostic disclosure
Framing
AI may flag that urgent clinical review is required. It must not disclose or diagnose critical findings directly to the patient. Authorised clinicians manage disclosure, escalation and support. KATLAS records the governance trail.
The patient should not receive a life-changing diagnosis from an automated signal. The governed route ensures authorised clinical review, appropriate communication and an auditable trail.
Governed disclosure flow
- 01Sensitive signal detected.
- 02Disclosure lock applied.
- 03Authorised clinician notified.
- 04Clinician reviews the underlying evidence.
- 05Clinician decides the next step.
- 06KATLAS signs the receipt.
Must not claim
- · AI diagnoses critical conditions.
- · AI communicates critical diagnoses to patients.
- · HealthCierge replaces GP, specialist or clinical pathway.
- · The app performs emergency triage.
Governance extension · 02
Carers, family and delegated authority
Custody
The patient controls their wallet, consent preferences, nominated carers and which evidence can be shared.
Authority
Carers, family members, attorneys or advocates may only act within a defined role and permission boundary.
Receipts
Every access, notification, delegation, refusal, escalation or handoff generates a signed receipt.
| Role | Notify | Bounded summary | Coordinate appt | Medication task | EoL certificate | Full record | Clinical authority |
|---|---|---|---|---|---|---|---|
| Patient | |||||||
| GP | |||||||
| Cardiovascular review clinician | |||||||
| Pharmacist / medication safety reviewer | |||||||
| Certified health coach | |||||||
| Nominated carer | |||||||
| Family contact | |||||||
| Legal representative / attorney | |||||||
| End-of-life care coordinator | |||||||
| Research governance reviewer |
Carers and family act within bounded permissions; full clinical record and clinical decision authority require explicit legal authority where applicable.
Governance extension · 03
End-of-life and care-preference certificates
Framing
Sensitive care-preference certificates remain under patient or authorised-role custody. HealthCierge governs who may see them, when, for what purpose, and what receipt proves the access or handoff.
Boundary
Synthetic governance records only. Not legally validated forms. Legal or clinical validity is out of scope for v1.
Advance care preference summary
cert:advance-care:summary
Visible to
patient · gp · nominated_carer · eol_care_coordinator
Emergency contact / nominated carer certificate
cert:emergency-contact
Visible to
patient · gp · cardiovascular_review_clinician · nominated_carer · eol_care_coordinator
Care coordinator authority certificate
cert:care-coordinator-authority
Visible to
patient · gp · eol_care_coordinator · legal_representative
Medication support permission
cert:medication-support-permission
Visible to
patient · pharmacist_medication_safety · nominated_carer · certified_health_coach
End-of-life care plan reference
cert:eol-care-plan
Visible to
patient · gp · eol_care_coordinator
Bereavement / family notification preference
cert:bereavement-notification-preference
Visible to
patient · eol_care_coordinator · nominated_carer
Organ donation / research preference
cert:donation-research-preference
Visible to
patient · gp · research_governance_reviewer