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Add ClinicOps synthetic proof
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‎README.md‎

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@@ -37,6 +37,13 @@ Agent intent -> Action Card -> Agent Action Gateway -> Decision Receipt -> devel
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| 03 | MCP Risk Gate | `npm run proof:mcp-risk-gate -- --dry-run --json` |
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| 04 | CommerceOps Fire Drill | `npm run proof:commerceops-fire-drill -- --dry-run --json` |
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Applied proof cases also include:
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```bash
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npm run proof:clinicops-synthetic -- --dry-run --json
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npm run verify:clinicops-synthetic
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```
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No downstream execution by Neura. The developer-owned runtime decides whether to execute, revise, escalate, or stop after reading the receipt.
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Distribution proof:
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- Decision Receipt Standard: the working receipt shape for what was authorized before execution.
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- MCP Risk Gate: tool-call intent binds to server, tool, target, actor, and params hash.
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- CommerceOps Fire Drill: commerce actions receive receipts before money-moving or customer-facing execution.
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- ClinicOps Synthetic Proof: regulated-style synthetic actions receive receipts before scheduling, patient-message, prior-auth, insurance follow-up, or policy-exception execution.
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Run:
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npm run verify:mcp-risk-gate
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npm run proof:commerceops-fire-drill -- --dry-run --json
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npm run verify:commerceops-fire-drill
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npm run proof:clinicops-synthetic -- --dry-run --json
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npm run verify:clinicops-synthetic
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```
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Docs:
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- [`docs/agent-action-firewall.md`](docs/agent-action-firewall.md)
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- [`docs/mcp-risk-gate.md`](docs/mcp-risk-gate.md)
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- [`docs/commerceops-fire-drill.md`](docs/commerceops-fire-drill.md)
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- [`docs/clinicops-synthetic-proof.md`](docs/clinicops-synthetic-proof.md)
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MCP Risk Gate applies the same foundation at the tool-call boundary. It shows how an MCP-style call intent binds a receipt to the exact server, tool, target, actor, and params hash before runtime-owned execution.
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CommerceOps Fire Drill applies the foundation to a Shopify-style merchant workflow. It shows how routine tracking replies, refunds, discounts, address changes, cancellations, and unsupported customer promises are allowed, revised, escalated, or stopped before execution.
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This is a synthetic dry-run proof. It does not touch Shopify, payment rails, customer accounts, production systems, external message channels, MCP providers, or real data. It does not claim provider approval, marketplace listing, compliance certification, production integration, partnership, or downstream execution by Neura.
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ClinicOps Synthetic Proof applies the foundation to regulated-style synthetic workflows. It shows how scheduling changes, patient-message drafts, prior-auth notes, insurance follow-up, and policy exceptions are escalated, revised, or stopped before external use.
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This is a synthetic dry-run proof. It does not touch Shopify, payment rails, customer accounts, production systems, external message channels, MCP providers, real provider systems, real insurer systems, real EHRs, real scheduling systems, real patient messages, or real data. It does not claim provider approval, insurer approval, marketplace listing, compliance certification, HIPAA compliance, medical advice, clinical accuracy, production integration, partnership, or downstream execution by Neura.
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## Ecosystem Availability: Use Neura Today
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‎docs/agent-action-gateway.md‎

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npm run verify:decision-receipt-standard
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npm run proof:mcp-risk-gate -- --dry-run --json
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npm run proof:commerceops-fire-drill -- --dry-run --json
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npm run proof:clinicops-synthetic -- --dry-run --json
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```
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| Step | Proof | What it confirms |
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| 03 | MCP Risk Gate | MCP-style tool calls bind to exact server, tool, target, actor, and params hash before runtime-owned execution |
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| 04 | CommerceOps Fire Drill | Commerce actions such as refunds, discounts, address changes, cancellations, replies, and promises receive receipts before execution |
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Applied proof cases can extend the ladder without changing the core four-step Gateway proof. ClinicOps Synthetic Proof is one such applied case for regulated-style synthetic workflows:
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```bash
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npm run verify:clinicops-synthetic
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```
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## Output
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The full ladder returns one JSON artifact with:
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- a generic proposed agent action
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- an MCP-style tool-call boundary
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- a money-moving commerce workflow
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- a regulated-style synthetic workflow
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Different contexts, same Relay mechanism:
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No downstream execution by Neura.
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It does not touch Shopify, payment rails, fulfillment systems, customer accounts, customer-message channels, real MCP servers, production systems, external providers, private payloads, or real customer records.
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It does not touch Shopify, payment rails, fulfillment systems, customer accounts, customer-message channels, real MCP servers, production systems, external providers, private payloads, real customer records, PHI, real provider systems, real insurer systems, real EHRs, real scheduling systems, real patient messages, or real prior-authorization submissions.
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It does not claim provider approval, marketplace listing, compliance certification, production integration, partnership, public token issuance, Registry auto-approval, or downstream execution by Neura.
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It does not claim provider approval, insurer approval, marketplace listing, compliance certification, HIPAA compliance, medical advice, clinical accuracy, production integration, partnership, public token issuance, Registry auto-approval, or downstream execution by Neura.
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Developer-owned runtimes still execute, revise, escalate, or stop downstream actions after reading the receipt.
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‎docs/clinicops-synthetic-proof.md‎

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# ClinicOps Synthetic Proof
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ClinicOps Synthetic Proof is a local dry-run proof of Neura Relay as the Agent Action Gateway for regulated-style, policy-heavy synthetic operations.
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It shows a synthetic workflow agent proposing scheduling, patient-message, prior-auth, insurance follow-up, and policy-exception actions, then receiving a Decision Receipt before anything external happens.
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## Core Path
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```text
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Synthetic ClinicOps intent -> Action Card -> Agent Action Gateway -> Decision Receipt -> developer-owned review or restraint
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```
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## Run The Proof
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```bash
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npm run proof:clinicops-synthetic -- --dry-run --json
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npm run verify:clinicops-synthetic
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```
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The proof covers five synthetic regulated-style actions:
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| Scenario | Decision | Why |
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| --- | --- | --- |
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| Scheduling change requiring policy check | `human_review` | Policy-sensitive schedule changes need review before update or notice. |
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| Patient message draft requiring human review | `human_review` | Patient-facing administrative messages need qualified review before external use. |
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| Prior-auth draft requiring evidence refs | `human_review` | Prior-auth notes need policy, evidence, and reviewer authority before external use. |
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| Insurance follow-up requiring allowed channel | `revise` | The external channel is not confirmed, so the action must be revised. |
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| Policy exception without approval | `stop` | The exception lacks owner approval and complete supporting evidence. |
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## Outputs
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Each scenario produces:
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- a synthetic Action Card;
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- a Decision Receipt;
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- policy and evidence basis;
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- required reviewer or owner authority;
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- allowed next step;
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- blocked downstream actions;
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- attribution fields for proof measurement;
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- boundary flags showing no real regulated workflow action occurred.
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## Files
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```text
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examples/clinicops-synthetic-proof/fixtures/*.json
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examples/clinicops-synthetic-proof/scenarios/*.json
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examples/clinicops-synthetic-proof/receipts/*.receipt.json
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examples/clinicops-synthetic-proof/manifest.json
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examples/clinicops-synthetic-proof/run-proof.mjs
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scripts/verify-clinicops-synthetic-proof.mjs
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```
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## Boundary
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ClinicOps Synthetic Proof uses synthetic data only. It does not use PHI, real patient data, real provider systems, real insurer systems, real EHRs, real scheduling systems, real patient messages, or real prior-authorization submissions.
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It does not claim HIPAA compliance, medical advice, clinical accuracy, provider approval, insurer approval, compliance certification, production healthcare integration, partnership, listing, endorsement, or downstream execution by Neura.

‎examples/clinicops-synthetic-proof/fixtures/cases.json‎

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[
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{
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"synthetic_case_id": "CL-204",
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"case_type": "prior_authorization",
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"case_summary": "Synthetic administrative case for local proof only.",
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"appointment_context": {
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"appointment_ref": "appt:CL-204-A",
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"requested_change": "earlier_slot",
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"policy_sensitive_reason": true,
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"review_required": true
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},
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"message_context": {
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"draft_ref": "message:CL-204-follow-up",
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"message_purpose": "administrative_next_steps",
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"contains_medical_advice": false,
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"external_use_requires_review": true
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},
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"prior_auth_context": {
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"packet_ref": "prior_auth:CL-204",
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"policy_notes_ref": "policy_notes:CL-204",
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"payer_requirement_ref": "payer_requirement:CL-204",
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"review_required": true
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},
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"insurance_context": {
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"queue_ref": "insurance_queue:CL-204",
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"allowed_channel_confirmed": false,
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"external_follow_up_requires_review": true
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},
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"exception_context": {
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"exception_ref": "exception:CL-204",
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"owner_approval_present": false,
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"supporting_evidence_complete": false
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},
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"boundary": {
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"synthetic_data_only": true,
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"phi_used": false,
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"real_provider_system_touched": false,
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"real_insurer_system_touched": false,
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"real_patient_message_sent": false
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}
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}
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]

‎examples/clinicops-synthetic-proof/fixtures/channels.json‎

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{
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"internal_review_queue": {
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"channel_ref": "channel:internal_review_queue",
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"external": false,
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"allowed_for_dry_run": true
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},
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"synthetic_patient_message": {
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"channel_ref": "channel:synthetic_patient_message",
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"external": true,
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"allowed_for_dry_run": false
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},
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"synthetic_insurer_submission": {
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"channel_ref": "channel:synthetic_insurer_submission",
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"external": true,
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"allowed_for_dry_run": false
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},
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"synthetic_clinic_system_write": {
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"channel_ref": "channel:synthetic_clinic_system_write",
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"external": false,
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"allowed_for_dry_run": false
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}
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}

‎examples/clinicops-synthetic-proof/fixtures/policies.json‎

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{
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"clinicops.synthetic.scheduling.policy_check": "Scheduling changes with policy-sensitive reason codes require qualified human review before schedule update or patient notice.",
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"clinicops.synthetic.patient_message.review_required": "Patient-facing administrative message drafts require qualified human review before external use.",
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"clinicops.synthetic.prior_auth.evidence_refs_required": "Prior-authorization drafts require policy notes, referral or order notes, payer requirement refs, and qualified human review before external use.",
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"clinicops.synthetic.insurance_follow_up.allowed_channel": "Insurer-facing follow-up must use an allowed channel; if the channel is not confirmed, the action must be revised or sent to review.",
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"clinicops.synthetic.policy_exception.owner_approval_required": "Policy exceptions cannot be applied without owner approval and complete supporting evidence.",
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"synthetic_data_only": true
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}

‎examples/clinicops-synthetic-proof/fixtures/reviewer-roles.json‎

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{
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"qualified_human_reviewer": {
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"role_ref": "qualified_human_reviewer",
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"can_approve_external_patient_message": true,
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"can_approve_prior_auth_packet": true,
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"can_approve_schedule_change": true,
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"can_apply_policy_exception": false
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},
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"clinic_operations_owner": {
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"role_ref": "clinic_operations_owner",
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"can_approve_external_patient_message": false,
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"can_approve_prior_auth_packet": false,
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"can_approve_schedule_change": true,
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"can_apply_policy_exception": false
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},
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"policy_exception_owner": {
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"role_ref": "policy_exception_owner",
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"can_approve_external_patient_message": false,
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"can_approve_prior_auth_packet": false,
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"can_approve_schedule_change": false,
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"can_apply_policy_exception": true
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}
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}

‎examples/clinicops-synthetic-proof/manifest.json‎

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{
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"proof": "clinicops-synthetic-proof",
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"capability": "ClinicOps Synthetic Proof",
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"receipt_standard": "neura-decision-receipt-v0.1-draft",
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"command": "npm run proof:clinicops-synthetic -- --dry-run --json",
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"verify_command": "npm run verify:clinicops-synthetic",
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"scenario_count": 5,
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"decisions_required": ["human_review", "revise", "stop"],
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"scenarios": [
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"scheduling-change-policy-check",
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"patient-message-human-review",
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"prior-auth-draft-human-review",
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"insurance-follow-up-channel-revise",
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"policy-exception-without-approval-stop"
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],
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"boundary": {
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"synthetic_data_only": true,
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"phi_used": false,
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"real_provider_system_touched": false,
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"real_insurer_system_touched": false,
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"real_ehr_touched": false,
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"real_scheduling_system_touched": false,
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"real_patient_message_sent": false,
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"real_prior_authorization_submitted": false,
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"downstream_execution_performed_by_neura": false,
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"hipaa_compliance_claimed": false,
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"medical_advice_claimed": false,
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"clinical_accuracy_claimed": false,
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"provider_approval_claimed": false,
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"insurer_approval_claimed": false,
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"compliance_certification_claimed": false
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}
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}

‎examples/clinicops-synthetic-proof/receipts/insurance-follow-up-channel-revise.receipt.json‎

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{
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"receipt_id": "dr_20260527_clinicops_insurance_follow_up_revise_001",
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"standard": "neura-decision-receipt-v0.1-draft",
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"created_at": "2026-05-27T21:13:00-04:00",
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"action_card_id": "ac_20260527_clinicops_insurance_follow_up_001",
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"decision": "revise",
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"runtime_instruction": "continue_with_revision",
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"decision_reason": "Insurer-facing follow-up cannot use an unconfirmed external channel; the action must be revised before any external use.",
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"actor": {
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"type": "agent",
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"name": "ClinicOps Demo Agent",
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"runtime": "synthetic_workflow"
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},
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"proposed_action": {
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"action_type": "send_insurer_follow_up",
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"target": "synthetic_case:CL-204:insurance_queue",
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"summary": "Send an insurer-facing follow-up through a channel not confirmed as allowed for this synthetic case.",
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"params_hash": "sha256:clinicops_insurance_follow_up_001",
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"amount_or_value_at_risk": "regulated-style external administrative communication",
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"customer_impact": "synthetic insurer-facing communication tied to administrative workflow"
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},
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"risk": {
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"risk_class": "regulated_synthetic_workflow",
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"consequence_score": 2
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},
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"policy_basis": [
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{
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"policy_ref": "clinicops.synthetic.insurance_follow_up.allowed_channel",
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"summary": "Insurer-facing follow-up must use an allowed channel; if the channel is not confirmed, the action must be revised or sent to review."
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}
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],
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"evidence_basis": [
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{
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"evidence_ref": "synthetic_case:CL-204.insurance_context",
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"summary": "Synthetic insurance context shows the allowed channel has not been confirmed."
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},
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{
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"evidence_ref": "channel:synthetic_insurer_submission",
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"summary": "Synthetic insurer submission is an external channel and is not allowed for dry run execution."
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}
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],
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"authority": {
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"authority_ref": "qualified_human_reviewer",
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"approval_state": "revision_required",
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"required_role": "qualified_human_reviewer"
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},
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"validity": {
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"valid_for_action_type": "send_insurer_follow_up",
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"valid_for_target": "synthetic_case:CL-204:insurance_queue",
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"valid_for_actor": "ClinicOps Demo Agent",
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"params_hash": "sha256:clinicops_insurance_follow_up_001",
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"valid_until": null,
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"invalid_if_changed": ["action_type", "target", "params_hash", "actor", "policy_refs", "evidence_refs", "approval_state", "required_authority_role"]
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},
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"execution": {
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"allowed_next_step": "select_allowed_channel_or_prepare_human_review",
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"blocked_downstream_actions": ["send_insurer_follow_up", "attach_case_packet", "write_to_external_queue"],
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"execution_boundary": "Neura returns a Decision Receipt only; no provider, clinic, scheduling, patient-message, EHR, or insurer system is touched by Neura."
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},
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"trace": {
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"trace_ref": "trace_20260527_clinicops_insurance_follow_up_revise_001",
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"source": "github",
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"campaign": "agent_action_gateway",
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"surface": "clinicops_synthetic_proof"
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},
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"boundary": {
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"synthetic_data_only": true,
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"phi_used": false,
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"downstream_execution_performed_by_neura": false,
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"real_provider_system_touched": false,
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"real_insurer_system_touched": false,
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"real_ehr_touched": false,
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"real_scheduling_system_touched": false,
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"real_patient_message_sent": false,
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"real_prior_authorization_submitted": false,
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"hipaa_compliance_claimed": false,
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"medical_advice_claimed": false,
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"clinical_accuracy_claimed": false,
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"provider_approval_claimed": false,
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"insurer_approval_claimed": false,
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"compliance_certification_claimed": false
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}
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}

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