The brands look separate — a triage site, a class, a coach, a surgeon tool. They are four roles in a single patient record. Follow one episode from first symptom to final code: at every step the model proposes, a check that is not the model verifies, a named human signs, and a hash seals it. The receipts chain into one longitudinal, audit-survivable record.
Synthetic patient · demonstration only · not coding or medical adviceA two-minute screener sorts the knee pain: mechanical OA, not an inflammatory arthritis — the right patient for a conservative-first pathway, not a straight-to-surgery referral. Routed accordingly.
The knee-OA class — what the diagnosis means, what conservative care can and can’t do, when surgery is warranted — completed before a surgical decision. Informed, on the record.
Home-exercise RTM with a validated outcome captured at baseline and follow-up: KOOS-JR 42 → 44 after 12 weeks — minimal functional gain despite documented adherence. Conservative care given a fair, measured trial; now a surgical candidate on evidence, not a hunch. This is the PRO the value-based contract pays on.
TKA performed. The op-note reads as 27447; the model proposes the codes and quotes the supporting line, then the deterministic CMS NCCI engine checks each one — the model does not grade its own work — and the surgeon signs. One code came back a caution to resolve before submission.
Nothing above lives in a silo. Each step emitted a receipt — what was proposed, what external source verified it, who signed, and a hash that seals it — and they chain into a single longitudinal record of the whole episode, from first symptom to final code.
The model read; an external check said yes or no at every step; a named human signed; a hash made it tamper-evident. PHI never left the record — the proof travels, the note stays home.
Not the surgeon (buys coding) or the PT (buys tracking). The risk-bearing entity — the ACO, the ACCESS participant, the bundle-holder, the provider-owned plan — is the only one who needs the entire record:
The homepage shows the network. This shows one patient moving through it — every output seen, every signer controlled, the whole audit trail owned. Where does that check live in your stack?