The Global Healthcare Agent Registry & Routing Authority (GHARRA) is like DNS for healthcare AI agents — a federated, zero-trust registry where healthcare systems discover, verify, and securely connect to AI services across organisations and national borders. Patient data never enters the registry.
When a healthcare system needs an AI agent — a diagnostic model, a scheduling assistant, a claims processor — GHARRA provides the lookup, verification, and secure connection in three steps.
Query the registry by capability, jurisdiction, or protocol. GHARRA returns matching agents with their trust metadata and connection details.
The policy engine evaluates jurisdiction rules, protocol compatibility, and organisational permissions to determine a valid connection path.
GHARRA issues a cryptographic trust bundle containing the agent's public key, endorsed capabilities, and a time-limited access token.
GHARRA operates as a federated hierarchy. Each tier controls its own data, policies, and trust boundaries. No tier can see or override the data of another without explicit delegation.
Maintains the global schema, protocol specifications, and root certificate authority. Does not store agent records or patient data. Publishes the federated discovery protocol that all sovereign nodes implement.
Each country or jurisdiction operates its own sovereign registry. Controls which agents are approved for use within its borders, enforces local data residency rules, and manages national trust policies.
Hospitals, health systems, and care networks register and manage their own agents. Organisational registries inherit sovereign policies but can apply stricter local rules. Agent credentials are issued at this level.
GHARRA stores only agent metadata — capabilities, endpoints, certificates, and policies. A three-layer detection pipeline scans every registration and update to ensure no patient data is ever persisted.
Analyses the shape of incoming payloads against known clinical data structures (FHIR resources, HL7 segments, CDA sections) and rejects any that match patient-data patterns.
Scans all string values for clinical identifiers, patient names, dates of birth, medical record numbers, and other terms associated with protected health information (PHI).
Pattern-matches against known identifier formats — NHS numbers, Medicare IDs, Social Security formats, ICD codes embedded in free text — and blocks any match from persistence.
Every discovery request and agent connection is evaluated against the full policy set. Rules are composable, auditable, and enforceable at every tier of the federation.
Requesting system and target agent must share an approved jurisdiction path in the federation hierarchy.
The requested communication protocol must be supported by both the caller and the target agent.
Agent certificates must be current, properly chained to the issuing organisational registry, and not revoked.
The requested action must fall within the agent's registered and endorsed capability set.
Connection routing must comply with the sovereign registry's data residency and cross-border transfer rules.
Per-agent and per-organisation rate limits prevent abuse and ensure fair access across the federation.
Connections can be restricted to approved operating windows defined by the organisational registry.
Every policy evaluation is logged with the full decision context — who requested, what was evaluated, and what was decided.
In clinically urgent situations, authorised users can bypass standard policy with full audit logging and mandatory post-incident review.
GHARRA is protocol-agnostic at the registry layer. Agents register the protocols they support, and the discovery engine matches callers to compatible endpoints.
Symphonix Nexus Agent-to-Agent protocol. JSON-RPC 2.0 with Server-Sent Events for real-time clinical delegation between agents.
Standard RESTful HTTP APIs. The most widely supported integration pattern for healthcare systems and electronic health records.
Direct integration with the BulletTrain platform's external connector API for systems already running on the Symphonix stack.
Fast Healthcare Interoperability Resources (FHIR) Release 4. Native support for FHIR-based agent interactions and SMART on FHIR authorisation.
High-performance Remote Procedure Calls (gRPC) with Protocol Buffers. Ideal for low-latency, high-throughput agent-to-agent communication.
GHARRA supports multiple authentication mechanisms to meet the security requirements of diverse healthcare environments, from cloud-native systems to on-premises infrastructure.
Signed tokens using RS256, ES256, or EdDSA algorithms. Supports short-lived access tokens with refresh rotation, audience-scoped claims, and federation-aware issuer chains. Compatible with existing OAuth 2.0 infrastructure.
Certificate-based mutual authentication per RFC 8705. Both the calling system and the target agent present X.509 certificates chained to the federation's certificate authority. Provides transport-layer identity verification.
Token binding per RFC 9449 prevents token replay and theft. Each request includes a proof that the sender holds the private key associated with the token, providing defence against man-in-the-middle attacks.
Cross-tier key distribution ensures that sovereign and organisational registries can independently verify tokens issued by other tiers without calling back to the root. Supports offline verification for air-gapped deployments.
See the registry in action
GHARRA is hosted and operated by Symphonix Health. Subscribe to discover and use agents across the global registry — we handle federation, trust, and governance. An integration bridge connects every BulletTrain deployment to the full agent ecosystem.
Hosted • Pay-per-use • Zero patient data • Federated • Sovereign-ready