ClinGuard: a governance framework for reliable, transparent, and auditable clinical coordination

ClinGuard is a model-agnostic governance framework that treats clinical coordination as patient-scoped, policy-bound transactions rather than free text. An independent sentinel layer validates and governs agent-proposed actions, escalates when needed, and executes approved actions through limited-privilege connectors. Each transaction is linked to a tamper-evident audit record, while an outcomes monitor informs future autonomy decisions. Using MIMIC-IV-FHIR and skilled-nursing-facility placement, we distinguish retrospective demonstration from proposed prospective evaluation in this work.