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arXiv · 2610.31354

ClinGuard: a governance framework for reliable, transparent, and auditable clinical coordination

Kaiyuan Wu·Aditya Nagori·Nicoleta J. Economou·Robert M. Califf·Rishikesan Kamaleswaran
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Abstract

ClinGuard is a model-agnostic governance framework that treats clinical coordination as patient-scoped, policy-bound transactions rather than free text. An independent sentinel layer validates and governs agent-proposed actions, escalates when needed, and executes approved actions through limited-privilege connectors. Each transaction is linked to a tamper-evident audit record, while an outcomes monitor informs future autonomy decisions. Using MIMIC-IV-FHIR and skilled-nursing-facility placement, we distinguish retrospective demonstration from proposed prospective evaluation in this work.

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Kaiyuan Wu, Aditya Nagori, Nicoleta J. Economou, Robert M. Califf, Rishikesan Kamaleswaran. 2026-10-22. ClinGuard: a governance framework for reliable, transparent, and auditable clinical coordination. https://arxiv.org/abs/2610.31354

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