The Med Board · a Backstaff Board for clinical AI

Produce reviewable evidence for clinical AI workflows.

Your health system runs AI documentation, decision-support, and triage tools. Planisphere measures how each behaves, whether outputs drift, and which tools duplicate each other. It prepares records mapped to FDA PCCP and §1557 review while charts stay inside your network.

00 ·

You can’t govern what you can’t measure.

HHS §1557 · HIPAA review mapping · FDA SaMD / PCCP · ONC HTI-1 · CMS Utilization-Management

A hosted clinical AI tool is a black box. It documents, it triages, it recommends — and every one of those outputs runs through rules that put the responsibility on the health system, not the vendor. The FDA’s PCCP framework demands you control and monitor change in a SaMD tool. HHS §1557 demands the tool not discriminate across protected classes. ONC HTI-1 demands decision-support transparency, and CMS scrutinizes AI in utilization-management coverage decisions. The measurement is designed so the chart never enters the audit surface; only the signed record crosses the boundary.

None of those questions can be answered by a vendor’s 510(k) summary or a marketing claim. They require a measurement of how the tool actually behaves — taken on your fleet, repeatable by an adversary, and produced without shipping a single chart to anyone.

01 ·

What the Med Board measures.

One reading · two payoffs: a smaller bill and a defensible record

The Med Board points the Astrolabe at your fleet of clinical AI tools and grades each one on three axes. The same measurement saves money and survives a review.

Distinctness
Are two tools answering identically?
cut the duplicate licenses
Drift
Is the tool degrading over time?
catch silent model swaps
Faithfulness
Do the outputs stay grounded?
FDA PCCP · HHS §1557

The smaller bill. Health systems rarely run one AI tool — they run several, often with overlapping mandates bought by different service lines. When the Med Board clusters them by behavior, the tools that produce the same outputs collapse into the same group. Every duplicate is a license you can drop without losing a capability. The measurement names which ones.

The defensible record. The tools that survive get graded against the doctrine — and every grade is signed. When a surveyor, a payer, or a plaintiff’s expert asks how you knew the tool was reliable, you have a record, not an assurance.

02 ·

Proof for every output.

Supervision evidence, not policy promises · FDA PCCP · HHS §1557

Every time a clinical tool produces an output, the Med Board emits one signed, tamper-evident record of the output's behavior against your reliability bar — cryptographically tied to a behavioral measurement of the model, but carrying none of the underlying chart. For a CMIO, that is how you evidence a tool's behavior against its PCCP and §1557 gates without the proof ever touching PHI: the record crosses the boundary, the chart never does. When a regulator, a payer, or your own quality committee asks how the health system supervised its AI, this is the record you hand them.

The anchors are the ones your compliance office already works from: the FDA Predetermined Change Control Plan (Dec 2024 final guidance) for SaMD change control, HHS §1557 nondiscrimination, and HIPAA — with the evidence record showing PHI stayed inside the health system while each gate was documented. For EU deployments, the same chain can support Article 12-style record-keeping continuity.
03 ·

The doctrine it maps to.

Ten canonical atoms · every link is the reference home for one concept

The Med Board is not a separate model. It is the Astrolabe reading shaped for clinical practice: the contracts it asserts at runtime, the doctrinal anchors it scores against, and the substrate primitives that make the record byte-for-byte reproducible by a third party.

The audit happens in code. audit_medicine(responses, clinical_band=…) checks all five mapped review areas — HHS §1557, HIPAA data-minimization posture, FDA SaMD/PCCP, ONC HTI-1, and CMS Utilization-Management — before it returns; then it scores every doctrinal axis and emits the record through the Port — the same boundary the Law Board, the School Board, and the War Board ship through. Want the full corpus? The complete pin-and-state reference lives at the Medicine corpus surface.

04 ·

Next step.

One scoping call · one Phase 0 audit · one signed evidence record

The first engagement is a scoping conversation. Tool inventory, hosting topology, the clinical band (decision-support, ambient-documentation, utilization-management, samd, or predictive-dsi), the doctrine anchor (HHS §1557 / FDA SaMD-PCCP / ONC HTI-1 / CMS UM / system-specific), and the target review date. We return a Phase 0 scope and an evidence-record delivery date. No PHI changes hands at any stage.

——— evidence domain · medicine · HHS §1557 · HIPAA review mapping · FDA SaMD / PCCP · ONC HTI-1 · CMS Utilization ———
REF

Need the full medicine evidence map?

The buyer brief ends above. The full reference map lives in the corpus hub.

Use this page to decide whether Planisphere fits the workflow. Use the hub when internal or external compliance needs the complete inventory: 69 compliance anchors, 50 state routes, and comparison pages for health-system AI governance.