Open source
Alpha
Spec CC BY 4.0
Health records patients own, in the language medicine already speaks.
The Cascade Protocol™ is an open standard for personal health records. It keeps the codes clinicians use, adds patient-focused vocabulary, and links related facts into one record AI can safely reason over.
§ 1
A specimen record, annotated
Maya's clinic records the prescription. Her dad records what he sees.
1 <urn:uuid:7c1e…> a clinical:Medication ; clinical:drugName "methylphenidate hydrochloride 10 MG" ; 2 clinical:rxNormCode "1091136" ; clinical:status "active" ; 3 cascade:dataProvenance cascade:ClinicalGenerated ; cascade:schemaVersion "1.3" . 4 <urn:uuid:d204…> a checkup:MedicationSummary ; checkup:sourceRecord "urn:uuid:7c1e…"^^xsd:anyURI ; checkup:medicationName "Methylphenidate" ; checkup:brandName "Ritalin" . 5 <urn:uuid:e9b1…> a health:SelfReport ; health:reportDate "2026-10-14T20:30:00-04:00"^^xsd:dateTime ; health:reportType "symptom_tracking" ; health:completionStatus "complete" ; health:reportNotes "Took an hour to fall asleep" ; cascade:dataProvenance cascade:SelfReported ; prov:wasAttributedTo <urn:uuid:5a77…> . # Sam, her dad
- 1A Cascade class with published rules, aligned with FHIR.
- 2A standard RxNorm code. We never mint new vocabulary when a standard exists.
- 3Where it came from: Maya's clinic.
- 4The name the family knows. Ritalin, from the official brand mapping, linked to the clinic's record.
- 5What the family saw, entered by Sam and labeled as his. It stays a note: nothing ties it to the medicine.
An excerpt of a valid record. See the whole file →
§ 2
What you get
Don't invent a health data model. Use one that maps to the standards.
A folder of files the person keeps
Plain Turtle files on their own device, optionally encrypted at rest with a passphrase.
Built on the standards
FHIR, SNOMED CT, LOINC and RxNorm first. Cascade adds terms only where they stop.
Checked by published rules
SHACL shapes say what a valid record is. One command names the field that's wrong.
Provenance on every fact
Clinician, device, patient or AI: software and people can weigh it accordingly.
Runs on your machine
No account, no server. The docs name the few commands that use the network.
Nothing silently overwritten
Originals stay. Corrections and merges are layered on top, so every change is visible.
§ 3
Private by design
No central store of health records to breach.
Cascade gives developers patterns for apps that work without holding readable patient data. Records live with the patient. Where an app needs a server, the server keeps only sealed data it can't open. If that server is breached, it has nothing readable to leak.
Encrypted pods
A published format for encrypting a pod at rest: AES-256-GCM, passphrase-protected keys, conformance test vectors. Draft 1.1; it doesn't yet detect a swapped or rolled-back file.
Sealed collection
Full Picture's pattern: each answer is sealed on the sender's device, the server stores what it can't read, and the family holds the keys. Built on the same format.
Sharing the person chooses
Today a person shares by exporting a file they pick, and the export says who made it. Consent and sharing controls are being designed in the open; they aren't built yet.
§ 4
How the pieces fit
Small apps collect. One record keeps. People take part in their own care.
Purpose-built apps each collect one kind of data well. Because they all write Cascade, what they collect can land in one record the family keeps, and work together there.
Purpose-built apps
Full Picture for ADHD rating forms, POTS Check for screening, or the app you build.
The family's pod
Cascade records with their codes and provenance, beside the clinical record.
Cascade Workbench
Where families manage the record, learn what it says, and bring better questions to the care team.
Have an instrument or a data source worth collecting? Build a collector with us →
§ 5
Cascade in use
Full Picture
Live · early testingParents gather ADHD rating forms from the adults who know their child and bring one packet to the doctor. Uses Cascade's encryption format today; writing answers as Cascade records is in progress. fullpicture.family
Cascade Workbench
In developmentA desktop app where a caregiver gathers a family's records, asks questions with answers that cite the records, and prepares for appointments. Never a diagnosis tool.
POTS Check
On the App StoreAt-home POTS screening with Apple Watch. Results are saved as Cascade records on the phone, using an early version of the protocol. Case study
§ 6
Status, plainly
It's early. Build it with us.
Cascade is alpha: the vocabularies still change, and the changelog says how. We're looking for development partners building health apps who want a data model they don't have to own alone.