Patch a Patient. Watch the fan-out.
FHIR resource viewer. Pick a resource, apply a patch, watch SMART App Launch fan out to payer endpoints with provenance.
the FHIR R5 resource of record
Patient is the canonical demographic record under FHIR R5 §3.1. address, telecom, identifier, communication.language, and the USCDI v4 patient-demographics group all live here. Updates go through RFC 6902 JSON Patch so writers never replace the whole resource by accident.
Anatomy — operational specs
authorization for app + system access
SMART App Launch v2 handles both EHR-launched and backend-services flows. The backend flow uses RFC 7523 client-credentials with a signed JWT assertion; scopes are USCDI-aligned (system/Patient.rs, user/Coverage.r). Tokens are short-lived by policy; refresh is by re-assertion, never by long-lived bearer.
Anatomy — operational specs
decision support at workflow points
CDS Hooks v2.0 lets external services subscribe to clinical workflow points (patient-view, order-select, order-sign, encounter-discharge). Hooks fire with a typed context; responses are zero-or-more Cards. MedicineOS uses the hook stream as the trigger for fan-out, alerting, and prior-auth (Da Vinci CRD/DTR/PAS).
Anatomy — operational specs
the payer's view of eligibility
Coverage is the FHIR R5 resource that ties a Patient to a payer plan, with payor reference, period, class (group/plan/subplan/network), and beneficiary. MedicineOS reads Coverage from each payer's USCDI v4 endpoint and patches in lockstep with Patient so eligibility doesn't drift.
Anatomy — operational specs
orders, referrals, prescriptions
ServiceRequest is the resource for orders — labs, imaging, referrals, and prescriptions (joined to MedicationRequest). NCPDP SCRIPT 2025 handles ePrescribing transitions; RxChange and NewRx notifications keep adherence series joined by patient_id when pharmacies move.
Anatomy — operational specs
MedicineOS, in one line
health, made inspectable.
Click anything. The same primitives that compose the rest of the Transaction Science family — receipts, joules, signed transport — show up here too. The family is one system.