Capability

Implementation

Delta checks

Most recent prior result inside a per-analyte window; absolute and/or percent limits, any or all

Trend analysis

Least-squares slope (units/day) over the analyte's trend window

Reference and critical ranges

Age bands and sex; unknown sex evaluated against the narrowest combined interval; critical limits make cases stat

Interference detection

HIL (hemolysis, icterus, lipemia) index rules per analyte with bias direction and flag/withhold action

Implausible combinations

Same-specimen rules, e.g. hemolysis with high potassium, K2EDTA carry-over (high K, low Ca), delayed separation, dextrose-line contamination

Plausibility and units

Physiologically implausible values and unit mismatches hold the result

Patient-based real-time QC

SMA or EWMA over truncated patient results per instrument and analyte; alarm, look-back list, recovery; shared across replicas

Evidence packet

Result, prior results, findings with citation text, specimen results, QC snapshot, catalogue digest, provenance record, SHA-256 digest

Pathologist review queue

Priority and SLA from the catalogue, claims, director override, decisions bound to the evidence digest, escalation of overdue cases

Agent proposals

Agents may propose a disposition; recorded as pending_human_approval, never changes state

Governed catalogue

Every threshold cites a source; production refuses an unapproved catalogue

Never-release invariant

No route, tool or skill releases; the service refuses to start under a policy that would let an agent release or decide

MCP

Official mcp SDK (FastMCP, streamable HTTP) at /mcp, seven typed tools, authenticated, authorized and audited

A2A

Agent Card at /.well-known/agent-card.json; JSON-RPC message/send at /a2a

Identity

Enterprise OIDC and agent-identity-fabric credentials; local policy plus fabric authorization, most restrictive wins

Narrative (optional)

De-identified, advisory draft via the agentic-core model router with ContentGuard on input and output

Audit

Hash-chained, Ed25519-signed events per replica; verification endpoint

Observability

Prometheus metrics, OpenTelemetry traces, JSON logs with correlation IDs, SLO alerts, Grafana dashboard

Endpoint

Caller

Purpose

POST /v1/screenings

LIS middleware, agents (results:screen), technologists

Screen a batch; returns dispositions, findings, case IDs

GET /v1/results/{id}

Staff, agents (results:read)

Result with outcome and review state

GET /v1/patients/{id}/analytes/{loinc}/trend

Staff, agents

Prior results and trend

GET /v1/review-queue

Staff, agents (cases:read)

Cases by priority and due time

GET /v1/cases/{id}

Staff, agents

Case with evidence packet

POST /v1/cases/{id}/claim, /decision

Pathologist, lab director

Human review

POST /v1/cases/{id}/proposals

Agents (review:propose)

Proposal pending human approval (202)

GET /v1/qc/pbrtqc

Staff, agents (qc:read)

Moving-statistic state per instrument and analyte

GET /v1/catalogue

Staff, agents

Catalogue governance, digest, sources

POST /v1/audit/verify

Auditor, lab director

Verify this replica's audit chain

/mcp

MCP clients

Tools: screen_results, get_result, patient_trend, review_queue, get_case, propose_disposition, pbrtqc_status

/.well-known/agent-card.json, POST /a2a

A2A peers

Skills: screen-results, review-queue, get-case, propose-disposition

Layer

Location

Container image

Dockerfile (non-root uid 10001, read-only root filesystem compatible)

Helm chart

deployments/helm/lab-result-integrity (StatefulSet, PDB, HPA, NetworkPolicy, ServiceMonitor; approved catalogue required)

Namespace and secret sync

deployments/kubernetes (restricted Pod Security, External Secrets)

Cloud infrastructure

deployments/terraform/gcp (primary: Cloud SQL, Cloud KMS, Secret Manager, retention-locked GCS, GKE Workload Identity), plus aws and azure