BulletTrain provides full visibility into every data exchange across your health systems — reliable, governed, and deployed at national scale.
BulletTrain implements the complete Open Health Information Exchange (OpenHIE) reference architecture — the standard used by national health systems worldwide.
Clinical, operational, and AI systems operate in silos. Patient information is scattered across disconnected platforms with no unified view.
Every new connection is a bespoke project. Health systems spend months on point-to-point interfaces that are brittle, costly, and hard to maintain. Without a central orchestration layer, interoperability remains aspirational.
AI models exist but cannot access governed clinical data. Without a safe transport layer, promising AI capabilities remain stranded.
Connect once. The OpenHIE mediator pattern orchestrates every clinical and AI workflow.
Built on the OpenHIE mediator pattern, BulletTrain provides standards-compliant interoperability for every data standard — Fast Healthcare Interoperability Resources (FHIR), Health Level Seven (HL7), Clinical Document Architecture (CDA), X12 transaction sets, and Digital Imaging and Communications in Medicine (DICOM) — through a single orchestration layer with full audit visibility. Includes master patient index, consent management, and clinical terminology services.
AI models connect safely to clinical workflows. Patient data stays local within your sovereignty boundaries. External models receive only de-identified, non-sensitive queries — never raw patient data.
Circuit breakers, dead-letter recovery, event replay, and a message bus with in-memory fallback. Guaranteed delivery means if data enters the platform, it arrives at its destination. Every time.
Health systems receiving WHO funding must demonstrate standards alignment. BulletTrain is designed to meet these requirements.
| WHO Requirement | Standard | BulletTrain Implementation | Status |
|---|---|---|---|
| Interoperability standards | HL7 FHIR R4 | Native Fast Healthcare Interoperability Resources (FHIR) resource support across all services | ✓ Aligned |
| Patient identification | IHE PIX/PDQ | Client Registry with probabilistic matching | ✓ Aligned |
| Document exchange | IHE MHD (ITI-65 through ITI-68) | Shared Health Record with Bundle transactions | ✓ Aligned |
| Terminology standards | SNOMED CT, ICD-10, LOINC | Terminology Service with ConceptMap translation | ✓ Aligned |
| Patient data rights | GDPR, consent management | Consent Registry with versioned consent records | ✓ Aligned |
| Governance & audit | WHO cybersecurity standards | Hash-chained audit trail, clinical safety gates | ✓ Aligned |
| Facility directory | Master Facility List | Health Facility Registry | ✓ Aligned |
| Provider directory | Practitioner credentialing | Health Worker Registry | ✓ Aligned |
| AI governance | EU AI Act, WHO AI guidelines | Multi-model routing with patient data classification | ✓ Aligned |
Architecture based on the OpenHIE Reference Architecture Specification. WHO alignment based on the WHO Global Strategy on Digital Health 2020–2025 and the WHO/ITU Digital Health Platform Handbook.
Deploy a national Health Information Exchange that already implements Integrating the Healthcare Enterprise (IHE) PIX/PDQ, Mobile access to Health Documents (MHD), FHIR R4, and WHO-required terminology standards. No custom development needed.
Audit trails, consent management, clinical safety gates, and patient data sovereignty are core architecture — not optional add-ons. This satisfies WHO cybersecurity and patient rights requirements.
Implement only the components your health system needs today. Start with Client Registry and Shared Health Record. Add Terminology Service, AI agents, and cross-border federation as your capacity grows.
Deploy connections in days, not months. One governed connectivity layer replaces dozens of point-to-point interfaces.
Patient data stays within sovereignty boundaries. AI models operate through a controlled transport layer that enforces data governance at every step.
Every message audited. Every route validated. Complete visibility across every clinical and AI workflow in the system.
Fully managed within national data boundaries. No patient data leaves the jurisdiction.
Core services on-premises with cloud-based orchestration and analytics where policy allows.
Self-contained deployment within your own infrastructure. Complete operational control.
Every data exchange is identified, authorised, audited, and observable. Governance is enforced at the transport layer, not bolted on at the application layer.
FHIR R4, HL7 v2, IHE PIX/PDQ and MHD profiles, SMART-on-FHIR OAuth, OpenHIE mediator pattern. Verified against 7,000+ compliance scenarios.
Every endpoint emits ATNA-aligned audit events with SHA-256 hash chaining, correlation IDs, and PHI redaction. No silent operations.
Policy enforcement, consent verification, guardrail review, and tenant isolation on every runtime action. Emergency break-glass that never blocks critical care.
BulletTrain comprises 160+ production-grade microservices implementing the complete Open Health Information Exchange (OpenHIE) reference architecture — Client Registry, Health Facility Registry, Health Worker Registry, Shared Health Record, Terminology Service, Consent Registry, and Audit Governance. Building this from scratch would require a team of 50+ engineers working for 3+ years. And you would still need to build the agent registry and communication protocol separately.
Each OpenHIE component requires exact implementation of Integrating the Healthcare Enterprise (IHE) profiles — Patient Identifier Cross-referencing / Patient Demographics Query (PIX/PDQ) for patient identification, Mobile access to Health Documents (MHD) for document exchange, and ITI-58 for facility and worker discovery. Getting these right takes months per profile. Getting them wrong means failing World Health Organization (WHO) alignment assessments and losing procurement eligibility. BulletTrain ships with these implemented and tested against 7,000+ scenarios.
Ensemble diagnostics with four independent reasoning strategies. 13-point route admission on every agent-to-agent call. Emergency break-glass that never blocks critical care. Patient data classification at every boundary. These are architectural decisions, not features you add later. Retrofitting governance onto an ungoverned system is the most expensive mistake in health IT.
See BulletTrain in action
See how BulletTrain delivers governed connectivity and guaranteed delivery for your clinical and AI workflows.