Healthcare regulators understand five things: approvals, authority, audit trails, compliance, and explainability. The challenge in an AI-assisted workflow is not generating the recommendation — it is ensuring only authorized actions execute, and that every decision can be explained later. Decionis is the control plane that sits between the recommendation and the action, and leaves a signed Decision Dossier behind it.
Built on the same execution control plane already governing 2,000+ approval gates in production — now scoped for the workflows a health system actually has to defend in an audit.
Healthcare organizations increasingly route consequential actions through AI-assisted and automated workflows:
A recommendation is not authority. Decionis verifies that the right approval level is present before the referral, the authorization, or the purchase commits.
When a reviewer, a CMS auditor, or a plaintiff's attorney asks “who approved this and on what basis,” the answer is a signed chain of custody that existed at the moment of the decision — not a reconstructed log.
The hard part of governing a live clinical workflow is the boundary between human judgment and system logic — and proving it held. Decionis is designed to be pressure-tested on exactly that line.
On a gray-zone case, Decionis can deliberately restrain — hold the action pending review rather than block it outright. The verdict is a recommendation with authority context, never a clinical determination.
A Hold or denial that requires a licensed clinician cannot be finalized until that clinician submits a confirmation event. The dossier records the human confirmation, not just the system verdict.
When a clinician overrides a Hold, the original dossier stays intact and the exception attaches as an Override Dossier with the reviewer's rationale. Repeated overrides surface as Policy Drift for governance to act on.
Decionis deliberately stays out of diagnosis — a hard regulatory path. It starts where the decision is about authority and spend, not clinical judgment.
A workflow or model recommends a referral. Decionis evaluates risk score, specialist criteria, and network status against your protocol and returns proceed, hold, or escalate before the referral action commits — with the reasoning signed into a dossier.
Patient request → recommendation → Decionis → proceed / hold / escalate → referral action → Decision Dossier
Replace manual review, email approvals, and inconsistent decisions with policy evaluation, authority verification, and escalation routing. Every determination carries the policy version that governed it and a licensed-clinician confirmation event where the law requires one.
Auth request → policy evaluation → authority verification → escalation routing → Decision Dossier
Govern spend thresholds, approval authority, and supplier exceptions for equipment, pharmaceuticals, and services. Zero PHI, zero EHR dependency, zero clinical risk — the safest place to prove the control plane and generate the first evidence pack.
Requisition → threshold & authority check → escalate to CMO/CFO → signed Decision Dossier
Nothing is enforced before the evidence supports it. Shadow mode is the most important stage: the control plane observes a live workflow and produces dossiers without blocking anything, so trust is earned before authority is granted.
Map the workflow, approval paths, compliance requirements, and escalation paths. Deliverable: a Decision Map.
Convert policy manuals, SOPs, and approval matrices into Decision Graphs. Walked rule-by-rule with your governance lead.
Nothing is blocked. Nothing changes. Decionis observes what would proceed, what would escalate, and where policy drifts — producing a Decision Dossier for every observed decision.
Enable proceed, hold, and escalate on one workflow — not the whole organization. A kill switch returns any workflow to shadow mode instantly.
An approval log records that someone clicked approve. A Decision Dossier records the authority behind it — designed as a legal instrument, cryptographically chained so it is tamper-evident, and verifiable without an account.
The category discipline is the point. Decionis governs process authority, not clinical judgment.
We are working with a small set of health-portfolio design partners — and the peers they bring — to pressure-test where the system decides versus where the clinician decides, on real workflows. Start with procurement: zero PHI, zero EHR dependency, and a signed evidence pack in eight weeks of shadow mode.
