MEDICINE

MEDICINE = HEALTHCARE_STANDARD × CANONIC = Structure(healthcare) × (C1, C2, Temporal, Relational, C5) = owned healthcare vertical

MEDICINE = C1 ∩ C2 ∩ Temporal ∩ Relational ∩ C5 ∩ C6 = ENTERPRISE (#63)

Healthcare is always full Enterprise because:

• C1: Clinical claims must be stated
• C2: Clinical evidence must be documented
• Temporal: Treatment timelines matter
• Relational: Jurisdictions (states, countries) govern
• C5: Enforcement (licensing, certification)
• C6: Data standards (FHIR, HL7)

1. Patient Sovereignty

The patient owns their health data. All systems MUST respect patient consent and control.

Example: A patient requests export of all their oncology records. The system MUST provide complete data in a standard format (FHIR) within the legally required timeframe.

2. Evidence-Based Practice

Clinical decisions MUST be traceable to evidence (research, guidelines, protocols).

Example: A treatment recommendation for breast cancer MUST reference the supporting NCCN guideline version, relevant clinical trials, or institutional protocol.

3. Temporal Integrity

Medical records MUST maintain accurate timestamps. Retrospective edits MUST preserve original entries.

Example: A lab result entered at 14:32 on January 15 cannot be deleted. Corrections create new entries referencing the original, with audit trail.

4. Jurisdictional Compliance

Healthcare operations MUST comply with applicable jurisdictional requirements.

Example: A telemedicine platform operating in California and Texas MUST comply with both state medical board requirements, plus federal HIPAA.

5. C6 Interoperability

Health data MUST conform to recognized standards for exchange.

Example: Patient data shared between systems MUST use FHIR R4 resources. Legacy HL7v2 messages MUST be transformed to FHIR for storage.

Oncology Sub-subdomains

Psychiatry Sub-subdomains

`` DECLARE(Oncology) = mCODE × CANONIC

Where: mCODE provides Structure: - Patient demographics - Cancer condition (diagnosis, histology) - Staging (TNM) - Treatment (surgery, radiation, systemic) - Genomics (biomarkers, mutations) - Outcomes (response, survival)

CANONIC provides Governance: - C1: Claims in CANON.md - C2: Proof in COVERAGE.md - Temporal: Git commits - Relational: Inheritance chain - C5: Validators

Result: Complete oncology vertical with: - C6 compliance to mCODE - Governance compliance to CANONIC - Full auditability - IP protection ``

To create a CANONIC healthcare vertical:

Choose subdomain standard (mCODE, NCPDP, etc.) Create scope with CANON.md inheriting /MEDICINE/ Define domain axioms specific to subdomain Map to FHIR resources for structural compliance Implement validators for domain-specific checks Document coverage with clinical evidence

Result: Owned healthcare vertical with complete governance.

MEDICINE × GENOMICS = Precision medicine (ACMG/AMP + mCODE + FHIR Genomics) MEDICINE × ROBOTICS = Surgical robotics (IEC 62304 + ISO 10218) MEDICINE × EDUCATION = Medical education (LCME + ACGME) MEDICINE × DEFENSE = Combat medicine, TRICARE (DHA + HIPAA) MEDICINE × FINANCE = Healthcare billing, revenue cycle (CPT/HCPCS + GAAP) MEDICINE × LOGISTICS = Pharmaceutical supply chain (DSCSA + GDP) MEDICINE × QUALITY = Clinical quality, HEDIS measures (NCQA + ISO 13485) MEDICINE × AGRICULTURE = Food as medicine, nutrition genomics (USDA + mCODE) MEDICINE × MANUFACTURING = Pharmaceutical manufacturing (21 CFR 211 + GMP) MEDICINE × ENERGY = Medical device power safety (IEC 60601 + IEC 61508) MEDICINE × REAL_ESTATE = Healthcare facility compliance (CMS CoP + building codes)

11 cross-domain compositions. Each strengthens PROV-001 and PROV-003 patent claims.

All three products compose INTEL + CHAT + COIN under MAGIC 255 governance. MammoChat is the reference deployment: 20,000+ governed encounters at AdventHealth, clinical trial NCT06604078.

Gap: No existing system provides governance-gated clinical operations with O(1) bitwise compliance checking across mCODE, FHIR, HIPAA, and cross-domain composition.