Production Deployment · Hermann Concierge

AI Healthcare
Infrastructure

Production AI systems handling patient communication, clinical triage, and practice operations. Deployed on multi-layer auditable infrastructure with HITL gates at every clinical decision point.

4
Production Systems
7
Control Layers
3
Integration Points
24/7
Autonomous Operation
Systems Deployed

What Runs in Production

Each system below is a self-contained module deployed on shared infrastructure. All four run concurrently, sharing identity, audit, and escalation layers.

System 1

SMS Triage Engine

Handles inbound patient text messages across multiple practice lines. Recognizes members by phone number — zero login, zero app download. Routes refill requests, schedules appointments, performs symptom assessment with graduated escalation. Closes clinical loops: automated follow-up with physician alert on non-response. Built on Twilio infrastructure with SHA-256 hash-chained audit logging.

System 2

Voice AI Handler

Answers practice phone lines with four-level triage logic: routine scheduling → symptom assessment → urgent physician alert → emergency dispatch instruction. Members never wait on hold. Distinguishes chest pain from a refill request using clinical protocol routing. Vapi-powered with branded voice. Same phone number — zero member behavior change.

System 3

Clinical Loop Closer

Post-consult and post-triage follow-up automation. After every interaction, the system checks back. Responses logged. Non-responses flagged. Escalation with pre-collected context to the physician. Closes the loop that human staff typically lose — the system remembers every open interaction across every member.

System 4

Analytics Dashboard

Real-time dashboards showing utilization, response metrics, and operational throughput. Designed for practice administrators monitoring member engagement across multiple locations. Clean interface with zero training required. Data refresh is live — no batch processing, no overnight reconciliation.

Technical Stack

What It Runs On

Infrastructure

Docker PostgreSQL Ubuntu VPS Traefik SSL/TLS

Communication Layer

Twilio SMS Vapi Voice AI WebSocket Gateway REST API

AI & Orchestration

Claude Sonnet GPT-4o Intent Router Multi-Agent Delegation MCP Servers

Compliance & Monitoring

SHA-256 Audit Chain Watchdog Recovery Exponential Backoff Encryption at Rest HIPAA BAA
Architecture

Seven Independently Auditable Control Layers

Each layer can be inspected, tested, and stopped independently. No single point of failure. No single point of trust.

I
Runtime
Docker containers on production servers. Postgres database. Zero dependency on third-party platforms that could disappear.
II
Identity
Members recognized by phone number. Zero login. Zero app download. The AI knows who is texting before it responds.
III
Data
Clinical protocols encrypted at rest. Never used to train external models. Data stays within the practice boundary.
IV
Tools
Twilio SMS. Vapi voice. Secure API endpoints. Every tool call logged. Every external service selected for compliance readiness.
V
Payment
Zero agent-initiated spend. All financial actions gated behind human approval. The AI cannot spend a cent without authorization.
VI
Observability
SHA-256 hash-chained audit trail. Every decision logged. Every action traceable. Independent verification — not self-reported by the AI.
VII
Kill Switch
HITL mandatory at every clinical decision. The AI can be stopped at the runtime, identity, gateway, or payment layer. Multiple redundancy.
Deployment

How It Goes Live

1

Protocol Ingestion

Clinical protocols — triage rules, escalation thresholds, follow-up cadences — are structured into the AI's routing engine. The practice defines the rules. The AI encodes them. No generic medical training data — only the practice's own protocols.

2

Validation Against Real Cases

The AI runs against historical cases and edge conditions. Every response is reviewed. Protocols are refined until triage accuracy meets the practice's clinical standard. Human clinicians make every validation decision.

3

Live Deployment With Audit Trail

The AI goes live handling real traffic. Every response logged. Every escalation reviewed. Metrics tracked: response time, triage accuracy, loop closure rate. New locations connect to the same trained system — no re-training, no re-validation.

Capabilities

What This Deployment Demonstrates

🔐
HIPAA-Ready Architecture
Encryption, audit trails, HITL gates, BAA-covered infrastructure
📡
Multi-Channel AI
SMS + Voice + Web from a single orchestration layer
🔄
Closed-Loop Automation
Follow-up, flagging, and escalation without human initiation
📊
Real-Time Analytics
Live dashboards with no batch processing, no overnight lag
🧩
Modular System Design
Each system is self-contained, sharing identity and audit layers
One-Touch Expansion
New locations connect to trained systems in under 48 hours
🛡️
Multi-Layer Kill Switch
Runtime, identity, gateway, and payment layers — independently stoppable
📝
Immutable Audit Trail
SHA-256 hash chain. Every decision independently verifiable