What is built, running, and verified
EKLIS is no longer a proposal. Every phase in this plan is implemented and running: 73 automated backend tests, a gated build pipeline, and a recorded verification of each phase's hero flow on the deployed system. This page states plainly what works, what is deliberately stubbed, and what is still needed from you.
Delivered capability
| Phase | Working today | Evidence |
|---|---|---|
| P1 done | Multi-tenant provisioning · staff roles & permissions · immutable audit on every patient-data access · LOINC test compendium · order entry · barcode labels (Zebra + PDF) · scanner-first accessioning with two-identifier confirmation · result entry with automatic H/L/HH/LL flagging · verification · report PDFs with corrected-version handling | Order → labels → accession → result → verify → PDF, run end to end on the deployed system |
| P2 done | Interface engine as its own process (ASTM E1381/E1394 and HL7 v2 MLLP, durable message log) · auto-verification with versioned rule sets · QC with Westgard multirules gating release · critical-value closed loop requiring read-back · physician portal · reference-lab send-outs with manifests · read-only patient portal | A real analyzer session over TCP filed a result that auto-released and reached the ordering physician's portal; a critical value was held and closed only after documented notification |
| P3 done | Payers & fee schedule · medical necessity with ABN gating · claims generated on completion · export, denial worklist, resubmission, payment posting, denial analytics · field collection with chain of custody and offline-safe replay · direct-to-consumer ordering · operator console · multi-site scoping · subscription billing metered from real accession volume | An insured order produced a clean claim that was exported and paid; a consumer order reached the phlebotomist's draw list; monthly usage produced a platform invoice |
| P4 done | FHIR R4 diagnostics API · toxicology prescribed-vs-detected consistency · CAP/COLA inspection evidence pack · microbiology with susceptibilities, cascade reporting and antibiogram · ELR public-health reporting · pharmacogenomics with CPIC guidance · assisted operations · lab-to-lab network · EHR connector profiles with generated interface specifications | A reportable organism queued a valid HL7 public-health message; a genotype produced drug guidance flagged against the patient's medications; a test routed to a partner laboratory and its result came back automatically |
Deliberately stubbed — and honest about it
Four integrations cannot be finished without your commercial credentials. Each is built as a documented adapter that refuses rather than pretends: nothing is ever recorded as charged, verified, submitted, or paid unless it actually happened.
| Integration | Current behaviour | Needed from you |
|---|---|---|
| Card payments (DTC) | Simulated approval, labelled "simulated payment" in the consumer's confirmation and in the payment ledger | Stripe account and keys |
| Insurance eligibility | Deterministic development stub, never presented as a real payer response | 270/271 clearinghouse credentials |
| Claim submission | Clean-claim payload is built and stored; transmission is behind the adapter | Clearinghouse choice and account (decision C-05) |
| Public-health ELR | Valid HL7 message is generated and queued; submission returns an explicit error and the message stays queued | State health department endpoint and onboarding |
Gates before real patient data
Signed HIPAA BAA
Hosting under a Business Associate Agreement in a US region. No real patient data exists in the system until this is in place.
Analyzer network isolation
ASTM and HL7 have no protocol-level authentication — an industry reality. Each instrument connection needs network isolation before a real analyzer is attached.
Your hero-flow sign-off
Thirteen verified flows are recorded in the security register awaiting your confirmation. That gate is yours by design, not ours.
Not built, deliberately
Blood bank / transfusion. That software is an FDA-regulated medical device requiring 510(k) clearance. It stays out of scope rather than being approximated.