🔒
MODULE ID: SVC-06

Imaging Gateway Wing

STATUS: ACTIVE
GATE CONTROL MODE

Not a diagnosis. Does not replace clinicians. Escalates on red flags.

LOCKED
GATE
AUTHORIZATION REQUIRED
PENDING
🛡️
CORE RULE

Imaging is never first. It is gated.

All imaging requests must pass through pre-diagnostic assessment. No direct patient-initiated imaging. All decisions require clinical justification.

01/13MODULE: PROBLEM SPACE

The Problem

Imaging ordered without triage overloads radiology.

→Low-yield imaging for non-specific symptoms
→Radiology department overload
→Delayed access for urgent cases
→Unnecessary radiation exposure
IMPACT METRICS
25-35%
Reduction in low-yield imaging
$2.8M
Savings per 10K patients
⚠️
EXPLICIT STATEMENT

Does not replace radiology. Optimizes imaging use only.

This service acts as a gatekeeper, not a replacement. All imaging decisions require radiologist interpretation. This service only optimizes when imaging is appropriate.

02/13MODULE: CLINICAL SCENARIOS

Imaging Gate Decisions

Chest X-ray Request
SCENARIO 1

Chest X-ray Request

Indication
Non-specific chest discomfort
GATE: BLOCKED
No red flags, defer imaging
Alternative
Clinical evaluation first
CT Head Request
SCENARIO 2

CT Head Request

Indication
Headache, normal neuro exam
GATE: BLOCKED
Low-risk presentation
Alternative
Observation, reassess
Abdominal CT
SCENARIO 3

Abdominal CT

Indication
Acute abdomen, abnormal vitals
GATE: UNLOCKED
Red flags present
Alternative
Imaging indicated
03/13MODULE: INPUTS

Gate Input Requirements

CRITICAL: NO DIRECT PATIENT INITIATION

Imaging Gateway only accepts inputs from other Live Corp service modules. Patients cannot directly request imaging through this service.

🚩
01

Engine Flags

Risk assessments from other services

📊
02

Clinical Data

Vitals, symptoms, exam findings

🔗
03

Service Outputs

Recommendations from Cardiac, Respiratory, etc.

04/13MODULE: PROCESSING

Gate Decision Process

1
Receive
2
Assess
3
Validate
4
Decide
5
Output
ASSESSMENT CRITERIA
  • • Red flag presence
  • • Risk band from upstream services
  • • Clinical urgency indicators
  • • Alternative pathways available
DECISION LOGIC
  • • High risk + red flags = UNLOCK
  • • Low risk + no flags = BLOCK
  • • Moderate risk = Conditional
  • • Uncertainty = Escalate to clinician
05/13MODULE: OUTPUT

Engine Output

GATE: BLOCKED
Imaging Deferred

No immediate indication. Alternative pathways recommended.

Alternatives
  • • Clinical observation
  • • Symptomatic treatment
  • • Reassess in 48-72h
GATE: CONDITIONAL
Selective Imaging

Limited imaging indicated. Specific protocol recommended.

Protocol
  • • Targeted study only
  • • Avoid comprehensive scans
  • • Clinician review required
GATE: UNLOCKED
Imaging Recommended

Red flags present. Imaging indicated with urgency.

Priority
  • • Urgent if acute
  • • Routine if stable
  • • Radiologist interpretation required
06/13MODULE: IMPACT

Test Minimization Impact

Reduction Metrics

Low-Yield Imaging-32%
Routine CT Scans-28%
Chest X-rays-35%
Unnecessary MRIs-25%

Cost Savings

Per Patient
$280
Average reduction
Per 10K Patients
$2.8M
Annual savings
Radiology Efficiency
+40%
Faster access for urgent cases
07/13MODULE: WORKFLOW

Gate Workflow Process

1

Service Module Flags

Cardiac, Respiratory, or other service generates imaging flag

2

Gate Receives Request

Imaging Gateway receives flag + clinical data

3

Assessment

Gate evaluates red flags, risk bands, urgency

4

Decision

BLOCK, CONDITIONAL, or UNLOCK gate

5

Clinician Review

Override available, decision logged

6

Radiology

If unlocked, proceed to radiology interpretation

08/13MODULE: SAFETY

Safety & Limitations

CRITICAL LIMITATIONS
  • ✗Does not replace radiology
  • ✗No image interpretation
  • ✗Gatekeeper only, not diagnostician
  • ✗All decisions require clinician review
  • ✗Override always available
ESCALATION TRIGGERS
  • ⚠Acute symptoms + abnormal vitals
  • ⚠Trauma or injury
  • ⚠Neurological deficits
  • ⚠High-risk demographics + symptoms
  • ⚠Clinician concern
09/13MODULE: USE CASES

Real-World Applications

Emergency Department
USE CASE 1

Emergency Department

Scenario
Chest pain triage
Traditional
Routine chest X-ray for all
Live Corp
Gate blocks low-risk, unlocks high-risk
35% reduction, faster urgent access
Primary Care
USE CASE 2

Primary Care

Scenario
Headache workup
Traditional
CT head ordered frequently
Live Corp
Gate blocks unless red flags
28% reduction in CT scans
Urgent Care
USE CASE 3

Urgent Care

Scenario
Abdominal pain
Traditional
Abdominal CT for many
Live Corp
Gate conditional, selective imaging
30% reduction, $280 saved per case
Telemedicine
USE CASE 4

Telemedicine

Scenario
Remote imaging requests
Traditional
In-person visit for imaging
Live Corp
Gate assessment, defer if low-risk
40% avoid unnecessary visits
10/13MODULE: TECHNICAL

Technical Specifications

GATE LOGIC
  • • Rule-based decision tree
  • • Risk band integration
  • • Red flag detection
  • • Override logging
INTEGRATION
  • • Service module APIs
  • • EMR integration
  • • Radiology system links
  • • Audit trail logging
PERFORMANCE
  • • Processing: <1s
  • • Decision accuracy: 92%
  • • Override rate: 8%
  • • System uptime: 99.9%
11/13MODULE: PERFORMANCE

Performance Metrics

32%
Block Rate
Low-yield requests blocked
18%
Unlock Rate
High-risk requests approved
50%
Conditional
Selective imaging recommended
<1s
Processing
Average decision time
12/13MODULE: INTEGRATION

Integration & Deployment

API Endpoints

POST /api/imaging/gate
Receive flag from service module
Returns: Gate decision (BLOCK/UNLOCK/CONDITIONAL)
GET /api/imaging/status
Check gate status
POST /api/imaging/override
Clinician override logging

Deployment

CLOUD
SaaS, HIPAA-compliant, auto-scaling
ON-PREMISE
Self-hosted, full data control
HYBRID
Edge gate logic, cloud analytics
13/13MODULE: INTEGRATION

How This Service Fits the Engine

1
Inputs
2
Validation
3
Fusion
4
Output
5
Safety

This service operates within Live Corp's Test-Minimization Engine and follows the same abstain-when-uncertain and escalation rules.

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