DECISION SUPPORT ONLY  ·  NOT A DIAGNOSTIC DEVICE  ·  CLINICAL JUDGMENT REMAINS WITH THE HEALTH WORKER  ·  PROTOTYPE v0.1 UNVALIDATED
Offline-first clinical decision support Υποστηριξη κλινικης αποφασης χωρις συνδεση

TriageOS TriageOS

WHO IMCI-referenced protocol engine for community health workers. Runs entirely offline on any device. All records encrypted on-device with AES-256-GCM. Zero data transmitted to any server.

Μηχανη πρωτοκολλου αναφορας WHO IMCI για κοινοτικους επαγγελματιες υγειας. Λειτουργει πληρως εκτος συνδεσης. Ολες οι εγγραφες κρυπτογραφουνται στη συσκευη.

Draft v0.1 -- Unvalidated. Research and field protocol reference only.
0 Triages Τριαζ
0 Today Σημερα
0 Referred Παραπομπες
2 Protocols Πρωτοκολλα
40%
Reduction in clinical processing time vs. paper forms (projected, Phase 1 research target)
100%
Data stays on device -- no PHI transmitted to any server, ever
2
Live WHO IMCI protocols -- P-01 Childhood Pneumonia, P-02 Malaria -- plus full patient assessment and outbreak monitoring

Built for the absolute edge

No connectivity required. No cloud dependency. Works on any device, in any condition.

01

Select protocol

Choose the relevant WHO IMCI protocol or run a full patient assessment. No setup, no login required after first use.

02

Answer prompts

The engine guides you through the clinical decision tree. Each question maps directly to WHO IMCI criteria.

03

Get outcome and record

Receive a clear, evidence-based recommendation. Save the encounter as an encrypted local record.

What makes it different

[+]

AES-256-GCM encryption

Every record is encrypted on-device before storage using PBKDF2-derived keys. Unreadable without the local device salt. Tamper-evident SHA-256 hash chain.

[/]

Fully offline

Service worker caches all assets. Works without internet, without cellular, on any Android or iOS device from the browser. No app store required.

[#]

WHO IMCI decision engine

Deterministic rule core hard-coded to WHO IMCI guidelines. 100% confidence because it is protocol logic, not machine learning. It does not learn how to diagnose.

[*]

Behavioral confidence scoring

Micro-time fingerprinting flags rushedly completed triages. Every record carries a confidence index. Sells verified, audited data to health ministries, not raw numbers.

[~]

FHIR R4 and DHIS2 export

Export any session as a standard HL7 FHIR R4 Bundle or DHIS2-compatible JSON. Plugs directly into national health information systems.

[T]

TAP Engine

Extended screening protocol for patients with active neural implant devices. Generates a cryptographic SHA-256 tamper-evident record of the assessment. Lives in its own panel inside the app.

Built for legal clarity

The architecture is specifically designed to address GDPR, WHO interoperability requirements, and SaMD classification concerns.

GDPR compliance by architecture

All PHI stays on the worker's device. The hosting provider (static file CDN) never processes patient data -- no Business Associate Agreement required. Right to deletion is a one-button local database wipe. First-use consent is logged with timestamp.

Not a Software as a Medical Device

TriageOS is a Clinical Decision Support Tool (CDST). Under FDA guidance, CDSTs that present WHO guideline information and require clinical practitioner interpretation are generally not regulated as SaMD. Final clinical judgment always rests with the health worker.

WHO interoperability ready

Records export as HL7 FHIR R4 Bundles with SNOMED CT coding. DHIS2-compatible JSON export is built in. The deterministic decision engine is open to peer review. Clinical test suite is in development.

Session security

2-minute idle timeout automatically wipes in-memory triage state. Records remain encrypted in local storage. Workers re-confirm to resume. No biometric or password required -- designed for low-end hardware.

How TriageOS compares

Feature TriageOS CommCare ODK Paper IMCI
Fully offline (no connectivity needed) Yes Yes Yes Yes
On-device encryption at rest Yes -- AES-256-GCM, PBKDF2 key Yes -- AES-256, key tied to CommCare login password Optional -- must be configured per form N/A
PHI ever transmitted to external server Never -- stays on device only Yes -- syncs to CommCare cloud on reconnect Yes -- syncs to ODK Central on reconnect Never
WHO IMCI decision logic built in Yes -- hardcoded deterministic engine Configurable -- must be built by implementer Configurable -- form design only, no logic engine Yes
HL7 FHIR R4 export Yes -- generated on device, downloaded locally Pro plan and above only No native FHIR export No
DHIS2-compatible export Yes -- generated on device, downloaded locally Yes -- via MOTECH integration module Yes -- via ODK Central API + DHIS2 connector No
Behavioral data confidence scoring Yes -- micro-time fingerprinting, built in No No No
GDPR deletion of patient records Yes -- single-button local wipe, instant Via provider -- requires contacting Dimagi support Via provider -- depends on hosting arrangement N/A -- physical destruction of paper
Runs in browser, no app install Yes -- PWA, any Android / iOS browser No -- requires CommCare Collect Android app No -- requires ODK Collect Android app N/A
Cost to field worker / NGO Free Free Standard tier / paid plans from $120/mo Free self-hosted / paid managed from $199/mo Free

Run your first triage

No login. No internet. No server. Open the app, answer the prompts, get a WHO-referenced recommendation.

Offline
Dashboard
Local session summary
Offline-first AES-256-GCM
0
Total triages
0
Today
0
Referred
0%
Referral rate
Alerts
Awaiting field data.
Recent triages
Worker Protocol Age group Outcome Time
No triages yet
Export and compliance
Protocol library
WHO IMCI-referenced clinical decision protocols
v0.1 draft

P-01 -- Childhood Pneumonia

WHO IMCI  ·  Age 2 months to 5 years  ·  5 steps
Active

P-02 -- Malaria Triage

WHO IMCI  ·  Origin-aware routing  ·  RDT-guided
Active

P-03 -- Diarrhea and Dehydration

WHO IMCI  ·  Coming soon
Planned

P-04 -- Severe Acute Malnutrition

WHO IMCI + MUAC  ·  Coming soon
Planned

TAP Engine -- Neuro-Digital Screening

Synaptic Split Framework  ·  BCI patients  ·  SSF Type I / Type II
Active

Full Patient Assessment

AVPU  ·  CRT  ·  MUAC  ·  Respiratory timer  ·  Vitals
Active
P-01 -- Childhood Pneumonia
WHO IMCI  ·  Age 2 months to 5 years
Offline Encrypted
--
Age group
--
Breaths/min
--
Danger signs
P-01 -- Step 1
What is the child's age group?
Select the age category that applies to this child.
P-02 -- Malaria Triage
WHO IMCI  ·  Origin-aware routing  ·  RDT-guided
Offline Encrypted
--
Fever
--
Danger signs
--
RDT result
P-02 -- Origin
Select patient region of origin
P-02 uses origin-aware routing. In the absence of an RDT, the patient's region of origin determines whether presumptive treatment is recommended. This does not replace clinical judgment.
Patient Assessment
AVPU  ·  CRT  ·  MUAC  ·  Vitals  ·  Respiratory timer
Offline Encrypted
AVPU -- Consciousness Level
Select one
A
Alert
V
Voice
P
Pain
U
Unresponsive
P or U = refer immediately. A = normal. V = monitor closely.
Capillary Refill Time (CRT)
Press nail bed 5 seconds, release, count to pink
2 sec
Normal refill
>3 sec
Prolonged -- poor perfusion
MUAC -- Mid-Upper Arm Circumference
Left arm, midpoint, relaxed
≥125mm
Normal
115-124mm
Moderate MAM
<115mm
Severe SAM
Respiratory Rate Timer
Count breaths over 60 seconds
60
seconds
Temperature
ASSESSMENT SUMMARY
AVPU --
CRT --
MUAC --
Temperature --
Resp rate --
DANGER INDICATORS
No danger indicators detected yet. Complete fields above.
Assessment saved and encrypted on this device.
Outbreak Intelligence
Anomaly Shadow Engine -- geographic and temporal clustering analysis
Local analysis only
0
Total encounters
0
Referrals
0%
Referral rate
DUAL-ENGINE ARCHITECTURE Engine A (Deterministic Core): Strict WHO IMCI flowchart logic. 100% confidence. Never adapts -- it is hardcoded to clinical textbooks.
Engine B (Anomaly Shadow Engine): Runs silently. Analyzes this session's triage history for geographic and temporal anomalies only. Does not modify diagnosis logic.
PROTOCOL DISTRIBUTION
No data yet
OUTCOME FREQUENCY
No data yet
ANOMALY DETECTION STATUS
Run triages to activate outbreak intelligence.
TAP Engine
Technology Audit Protocol  ·  Synaptic Split Framework  ·  Neuro-Digital Screening
SHA-256 chain Research
RESEARCH CORRELATION
Implements the Synaptic Split Framework (SSF) and Technology Audit Protocol (TAP) from the paper "The Patient Medicine Cannot Diagnose" (Amrin Majumder, May 2026).
The SSF distinguishes Type I (biological) from Type II (neuro-digital) neurological dysfunction in patients with active BCI devices. A cryptographic SHA-256 hash is generated for each classification -- a tamper-evident assertion that the assessment occurred as recorded, without transmitting any patient data.
TAP -- Pre-screen
Does the patient have an active Brain-Computer Interface (BCI) device?
Includes Neuralink, deep brain stimulators (DBS), responsive neurostimulators (RNS), cochlear implants with neural interfaces, or any closed-loop adaptive stimulation device.
0 TAP record(s) stored
About TriageOS
Architecture  ·  Legal position  ·  Data and privacy  ·  Roadmap

Build information

Versionv0.1 -- unvalidated
StatusResearch prototype
ProtocolsP-01, P-02, TAP Engine
WHO IMCI ref2014 edition
EncryptionAES-256-GCM / PBKDF2
Export formatsFHIR R4, DHIS2 JSON
LanguagesEN, EL (more planned)

Legal and regulatory position

ClassificationClinical Decision Support Tool (CDST)
SaMD?No -- clinical judgment required. Final decision with CHW.
PHI to serverNever -- all data local only
Hosting roleStatic file CDN only -- no patient data processed
GDPR basisLocal storage only -- controller = device holder
ConsentFirst-use timestamp logged locally
Idle timeout2-minute state wipe

Privacy architecture

Data transmitted to serverNever
Storage locationIndexedDB (on-device)
EncryptionAES-256-GCM
Key derivationPBKDF2 / SHA-256 / 100k iter
Audit chainSHA-256 hash chain
GDPR Art. 17 right to deletionBelow

Export and interoperability

Export local records in standard health interoperability formats. No data is sent to any server during export -- the file is generated locally and downloaded directly.

FHIR R4 export uses SNOMED CT codes and HL7 DeviceUseStatement structure. DHIS2 export follows trackedEntityInstance format. Both exports carry a notice that data is from a decision support prototype, not a validated clinical system.

Roadmap

+P-03 Diarrhea and Dehydration -- WHO IMCI protocol
+P-04 Severe Acute Malnutrition -- MUAC-anchored classification
+Behavioral micro-time fingerprinting -- expanded CHW cognitive load analysis, per-step confidence scoring visible to supervisor dashboard
+Cross-cultural symptom mapping -- cultural idiom bridging for Tigrinya, Arabic, Farsi, French inputs to WHO IMCI indicators
+Predictive supply mapping -- triage velocity used to project medication depletion at local clinics
+Asymmetric Compressed Triage Telemetry (ACTT) -- sub-140-byte encrypted SMS referral packets for zero-data-connection zones
+TAP Engine expansion -- Open-TAP data standard, HL7 FHIR DeviceChangeLog extensions, NDRU consultation pathway
+Academic feasibility study -- Phase 1 UI cognitive load benchmarking vs. paper IMCI; Phase 2 translation fidelity; Phase 3 edge synchronization viability
+University of Athens clinical reviewer partnership -- peer review of decision engine conditional logic and WHO IMCI mapping
+GitHub public engine audit -- open-source the deterministic core for peer review and automated clinical test suite

Clinical and regulatory disclaimer

TriageOS is a clinical decision support tool designed to assist trained community health workers in applying WHO IMCI guidelines. It is not a diagnostic device and does not replace clinical judgment. All outcomes are recommendations that must be interpreted by a qualified health worker.

This prototype (v0.1) has not been validated through clinical trials and has not received regulatory clearance as a Software as a Medical Device (SaMD) from any regulatory authority. It is intended for research, training, and field protocol reference use only.

Implementation of clinical decision support software in live patient environments requires compliance with applicable regulatory frameworks, including CE marking under the EU Medical Device Regulation (MDR) for software meeting SaMD criteria, ethical approval for any clinical pilot study, and organizational data governance policies.

All patient data entered into this application is stored exclusively on the local device using AES-256-GCM encryption and is never transmitted to any server. The hosting provider has no access to any patient data.

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