01
Pre-visit interview
Patient + Chiron
The patient completes a structured pre-visit interview by Chiron on the patient portal. History, ROS, social context, red-flag triggers. Output structured for the consultation.
Decision support. Each step below is structured so the system documents and the clinician decides. Every clinical artifact passes through a must-review-before- final gate before the clinician signs. ChironAI does not make a regulatory clearance claim; see Disclosures.
ChironAIHow it works
One consultation, ten steps, every primitive composed.
ChironAI is not ten products glued together. It is one consultation flow with ten checkpoints. The same audit chain stamps every step. The same must-review-before-final gate runs at every AI artifact. The clinician decides; the system documents.
The flow, ten checkpoints
02
Consultation start
Clinician
The clinician opens the visit with the pre-visit context already in the chart. Risk flags are surfaced; nothing has to be re-asked.
03
Chief complaint and history
Clinician
Structured chief complaint captured. ChironAI surfaces relevant prior visits, prior imaging, prior labs from the 10M-token longitudinal context.
04
AI consultation
Chiron + clinician
Chiron generates differentials, ranked by Bayesian confidence with discriminating features called out. Where the case spans domains (e.g., causation), specialist DEs consult.
05
Imaging and labs
Chiron
When imaging or labs are part of the visit, the multi-pass radiology architecture and the ten-pattern lab library compose with the differential to refine the assessment.
06
Clinical assessment
Clinician
Source-grounded assessment composed by Chiron. Every statement traceable to the source field that produced it. The clinician reviews and edits.
07
Treatment plan
Chiron + clinician
Guideline-anchored treatment options surfaced with confidence calibration. Drug interactions and step-therapy flags surface inline. The clinician decides.
08
SOAP note
Chiron
The SOAP note auto-drafts from the consultation context with source-grounded assessment. Composed in the patient’s language at the clinician’s discretion.
09
Physician sign-off
Clinician
The must-review-before-final gate. The clinician reviews, edits, and signs. SHA-256 hash captured at signature time; tamper-evident from this point forward.
10
Multi-language export
System
Patient instructions exported in the patient’s language at the patient’s reading level. Clinical note retained for the chart. The visit closes.
Step 01 \u00b7 Pre-visit
Patient-completed intake before the consultation begins.
ChironAI™ CDSPre-visit interview
Chief complaint. Recurring headaches over the last 3 weeks.
Surfaced for clinician attention
- · New onset of recurring headaches in patient with no recent history of headaches — flag for clinical attention.
- · Recent initiation of combined hormonal contraception — relevant to migraine work-up.
- · Reported features (unilateral, throbbing, photophobia, nausea) consistent with migraine without aura per ICHD-3 criteria.
Step 04 \u00b7 AI consultation
Differentials, ranked.
ChironAI™ CDSDifferential diagnosis \u00b7 chest pain
Must review before final
Decision-support output. Clinician review and attestation required before this content is signed into the chart.
Presentation. 54-year-old male with acute substernal chest pain radiating to left arm, 2-hour duration, diaphoretic.
Acute coronary syndrome (NSTEMI)
AHA/ACC NSTEMI- Troponin I 0.18 ng/mL (elevated above 0.04 threshold)
- ST depression in V4–V6 on ECG
- TIMI risk score: 4 (intermediate)
Aortic dissection
IRAD- No tearing quality, no inter-scapular radiation
- Equal BPs both arms
- D-dimer not yet available
Pulmonary embolism
Wells PE- Wells score: 1.5 (low probability)
- No tachypnea, SpO2 97% on room air
- No risk factors (recent immobilization, OCP use, malignancy)
Step 05 \u00b7 Imaging
Time-critical findings surface architecturally.
ChironAI™ CDSXR · Right tibia / fibula, 2 views
Must review before final
Decision-support output. Clinician review and attestation required before this content is signed into the chart.
AO/OTA42-B2.1Critical
Red-Alert findings
- Open displaced fracture pattern — surgical orthopedics consultation indicated within 6 hours.
Time-critical. Surface to the supervising clinician for action.
Impression. Spiral oblique fracture of the right tibial diaphysis at the mid-shaft, with mild lateral displacement and angulation. Associated comminuted fragment laterally. Fibular shaft intact.
Step 06 \u00b7 Clinical assessment
Every statement traces to its source.
ChironAI™ CDSSource-grounded assessment
Must review before final
Decision-support output. Clinician review and attestation required before this content is signed into the chart.
A1c 7.8% — above target (< 7.0% for this patient profile per ADA Standards of Care 2026). (source: Lab: HbA1c 7.8%, 2026-04-22)
Source — Lab. HbA1c 7.8% 2026-04-22
eGFR 78 mL/min/1.73m² with no microalbuminuria — stable kidney function, supportive of intensified glucose-lowering therapy. (source: Lab: eGFR 78 / UACR < 30, 2026-04-22)
Source — Lab. eGFR 78 / UACR < 30 2026-04-22
Blood pressure above ADA 2026 target (<130/80) for this patient with diabetes — hypertension management warrants intensification. (source: Vitals: 138/86 mmHg, 2026-05-12)
Source — Vitals. 138/86 mmHg 2026-05-12
Step 07 \u00b7 Treatment plan
Guideline-anchored options with confidence calibration.
ChironAI™ CDSTreatment plan options
Must review before final
Decision-support output. Clinician review and attestation required before this content is signed into the chart.
Diagnosis. Newly diagnosed stage 1 hypertension in a 47-year-old male, no prior CV events.
Guideline anchor. AHA/ACC 2017 Hypertension Guidelines, ADA 2026 (diabetes co-management considerations).
First-line ACE inhibitor monotherapy (e.g., lisinopril 10 mg daily)
Patient is non-Black, with normal eGFR, and has a low-to-moderate ASCVD 10-year risk. ACE inhibitors are first-line per AHA/ACC and ADA 2026 in this profile.
Thiazide diuretic (e.g., chlorthalidone 12.5 mg daily)
Acceptable first-line alternative per AHA/ACC. Particularly favored where edema-prone or salt-sensitive profile is suspected.
Calcium channel blocker (e.g., amlodipine 5 mg daily)
Acceptable first-line alternative. Particularly favored where ACE-i contraindicated, cough side effect history, or Black race per JNC-8 guidance retained in AHA/ACC.
A note to the reader