Engineering Manifesto v1.0.4

The Case for Deterministic Healthcare

Why we are explicitly building infrastructure, not magic.

01. The Entropy Crisis

Healthcare operations tend toward entropy. You start with ten simple eligibility rules. Two years later, you are maintaining a 4,000-row spreadsheet, three hard-coded "hack" files in your backend, and a team of nurses manually checking charts because nobody trusts the software anymore.

We call this the Enumeration Trap. When you treat medical reality as a flat list of codes rather than a structure, complexity grows exponentially. Maintenance becomes impossible. Errors become inevitable.

02. The False Promise of AI

The industry's current answer to this complexity is "Let AI handle it." This is dangerous. Large Language Models are probabilistic. They guess.

In clinical operations, 80% accuracy is a failure. You cannot tell an auditor, "The AI felt the patient was eligible." You need certainty. You need a trace. You need a policy.

"Reliability is not an accident. It is a design constraint."

03. The Physics of the Problem

The solution is not more intelligence; it is better structure. Medical knowledge is not a list; it is a tree.

  • Hypertension is a concept (Root).
  • I10 is a manifestation of that concept (Leaf).

If we map our policies to the concepts rather than the codes, the complexity collapses. One rule covers 400 codes. Exceptions are handled explicitly. The system becomes deterministic again.

04. Our Pledge

No Black Boxes

If we can't explain why a decision was made via a structured trace, we won't output it.

No Hallucinations

Our engine uses strict inheritance logic and explicit overrides, never probabilistic guessing.

Infrastructure First

We build for the 10-year horizon, ensuring backward compatibility and version stability.

Make decisions you can defend.

Join the movement toward deterministic operations.

Access the Engine