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Clinical Care Navigator

Read this first

Architectural demonstration on fully synthetic Synthea data. Not a medical device. Does not diagnose. Not a substitute for care. Not a screener, a triage tool, or a symptom checker.

A patient-facing clinical assistant that is allowed to say "I won't answer that" — and whose refusal is enforced by the architecture, measured in production, and tunable by the clinical owner rather than the vendor.

The problem

A patient reads their own portal record and does not understand it. "My A1c came back 7.8 — what does that mean?" An assistant that answers is useful. An assistant that answers everything is a liability, because the same text box also receives "should I stop taking my metformin?", "do I have lupus?", and "I have crushing chest pain."

Healthcare AI is not blocked by model quality. It is blocked by the absence of an auditable refusal path.

What this shows

How a question flows: pre-flight gate, scoped agent, post-flight checks, then publish, a clinician review queue, or a safe pre-written reply

Policy runs before the model and after it, and the second half is not a replay of the first — it assesses the retrieved evidence and the drafted answer on its own authority. See The guardrail sandwich.

Status

Phase 0 — template transplant. The walking skeleton streams end to end; the clinical system is being built on top of it.