Care Circle Protocol
OutsideINsights transforms real-world observation into clinical intelligence without violating privacy or creating bidirectional clinical conversations.
Uni-Directional Signal Architecture
Privacy-preserving flow inspired by NAT (Network Address Translation) protocols.
Care Circle
Non-Clinical Observers
OutsideINsights
Clinical Intelligence
Allowed: Inbound Signals
"Mom seems more confused today."
"He hasn't left his room in 2 days."
Allowed: Input Requests
Server-side rendered surveys (1-2-3 Check-Up, PHQ-9) and specific provider queries.
Blocked: Outbound Data
Diagnoses, Medications, Lab Results, Provider Notes are never shared back.
The "NAT" Protocol for Healthcare
Just as a Network Address Translation (NAT) firewall allows devices to send requests out to the internet without exposing their internal IP addresses to incoming threats, the Care Circle Protocol allows support networks to send signals in without exposing patient data out.
Critical Rule
Uni-Directional Flow: Information flows only from the Care Circle to the Clinical System. No clinical data (diagnoses, notes, labs) ever flows back to the Care Circle.
Core Definitions
Authorized Observer Network
A "Care Circle" is not a chat group. It is a verified network of non-clinical sensors.
- Family Members: "Mom isn't eating."
- Community Supports: "He missed his ride to the center."
- Allied Health: "Mobility has decreased this week." (PT/OT)
The "Acknowledgement Only" Standard
When a Care Circle member submits an observation, they receive a standardized acknowledgement:
"Thank you. Your observation has been recorded and added to the clinical record."
Authorized Inbound Requests
The system can send specific requests to the Care Circle to gather structured data. These are input-only links rendered server-side:
-
Routine 1-2-3 Check-Up:
- Simple "Better / Same / Worse" pulse check.
- Sent at clinically defined intervals (e.g., weekly).
-
Targeted Context (Stage 2/3):
- Specific, clinically-validated surveys (e.g., PHQ-9, GAD-7) triggered by drift.
- Example: "Please complete this brief mobility questionnaire regarding [Patient Name]."
-
Physician-Initiated Open Text:
- Only when explicitly triggered by the provider.
- Requests a single sentence of context.
- Example: "Dr. Smith requests a brief update on [Patient Name]'s sleep patterns."
Crucially: These requests never contain clinical status, diagnoses, or medication lists. They are strictly questions.
Patient Control & Consent
The inclusion of a patient's name in any outbound request is specifically authorized by the patient in writing during onboarding.
Consent can be withdrawn at any time via:
- The Patient App: "Privacy Settings" > "Revoke Care Circle Access"
- Provider Dashboard: Any clinician can instantly revoke access upon request.
- Direct Appeal: Emailing HIPAA@codepause.com for immediate administrative revocation.
Why This Matters
1. Protects HIPAA Compliance
By strictly preventing the outbound flow of PHI (Protected Health Information), the system is designed to protect against accidental disclosure to unauthorized family members.
2. Preserves Clinical Boundaries
Clinicians are not expected to manage a group chat. The system ingests signals asynchronously, triages them, and presents them only when relevant (Stage 2/3).
3. Captures the "Invisible 97%"
Care Circle signals are often the first indicator of drift, appearing days or weeks before a patient self-reports a problem or presents at the ER.