Blog / Introducing Cascade Bridge
June 15, 2026 · ~1,400 words · Product & vision

Introducing Cascade Bridge: Patient-Owned Health Data, Connected and AI-Ready

Cascade Bridge is a reference application for the Cascade Protocol. It collects health data from any source, connects it into a single deduplicated knowledge graph with full provenance, and gives patients genuine control: explore, augment, query with on-device AI, and share selectively. We submitted it to the ONC EHIgnite Challenge, and the full narrative is now public.

Cascade Bridge EHIgnite FHIR Knowledge Graph Patient-Owned Data AI Agents

The 21st Century Cures Act and ONC's December 2023 EHI export mandate gave every patient a legal right to their complete health record. Over 45,000 certified providers now offer single-patient EHI exports, and TEFCA facilitated the exchange of more than 500 million records by early 2026. The data transport problem is largely solved, and FHIR is its centerpiece.

But access is not the same as usability. What arrives at the patient is a raw FHIR bundle, a sprawling C-CDA XML archive, or an unstructured PDF. These formats were engineered for institution-to-institution exchange, not for a patient managing a chronic condition across five providers. FHIR is an exceptional shipping container, but it does not deliver usable, readable, or actionable information to patients. Cascade Bridge is the application that does.

Collect. Connect. Control.

Patients face three distinct barriers, and Cascade Bridge is organized around closing each one.

1

Collect

EHI exports from any FHIR or C-CDA system, PDFs and scans, wearable streams, and self-reported data flow into one encrypted, patient-owned pod. No format is rejected.

2

Connect

Every record becomes RDF anchored to standard codes. The reconcile engine deduplicates, fuses observations, and preserves conflicts with provenance and trust ranking.

3

Control

Explore your record by meaning, correct it without erasing the source, ask on-device AI with citations, and share selectively through a health wallet.

The Cascade Bridge data flow: patient-owned EHI, multi-provider EHRs, and wellness devices feed import and parsing pipelines; a knowledge graph and AI reconciliation write to a provenance-tracked, encrypted Cascade pod; the patient controls access through a secure SDK.
How data moves through the three C's: collected into a zero-access pod, connected via an RDF knowledge graph with strict provenance, and controlled by the patient through a secure SDK.

An earlier framing of these three C's used "Communicate" as the third pillar. Working through the EHIgnite submission sharpened our thinking: communication is just one thing a patient does with a unified record. The deeper promise is control: correcting records while preserving source authority, reasoning over them with AI, responding to living updates like a genomic reclassification, and sharing selectively on the patient's own terms. Control is the superset, and it is the right third pillar.

Why we built it as an EHIgnite submission

Interactive 3D health knowledge graph rendered by Cascade Bridge, with conditions, medications, labs and supplements as distinct shapes and a flagged drug interaction.
The interactive 3D health graph in Cascade Bridge. Color encodes provenance; shape encodes type.

The ONC EHIgnite Challenge asks a pointed question: now that single-patient EHI export is a legal right, how do we turn those exports into something usable, readable, and actionable? That is exactly the gap the Cascade Protocol was designed to close, so Cascade Bridge became our answer. The submission forced us to be concrete about the whole journey, from a universal-receiver import pipeline, through an RDF reconciliation engine that resolves real-world conflicts without destroying authority, to patient-facing experiences that are impossible with static files: AI Q&A with a live citation for every claim, a BRCA2 variant that reclassifies itself when a consortium publishes an advisory patch, and a wallet-mediated SMART Health Check-in that kills the paper clipboard.

The thread that ties it together is the same one that runs through everything we build: provenance as a non-negotiable primitive, validated at write-time, so that an AI agent never has to guess whether a heart-rate reading came from a Fitbit or an ICU monitor.

Running today, open by design

Cascade Bridge is not a theoretical architecture. The core pipeline already runs in production. POTS Check is live on the App Store, built entirely on the Cascade Protocol Swift SDK. The cascade CLI and agent perform lossless FHIR and C-CDA conversion with multi-source reconciliation and on-device AI, available now on npm. The TypeScript, Python, and Swift SDKs and the full specification are published and documented on this site. The integrated Bridge app and the production SMART Health Check-in wallet are what we are building next.

Because the protocol underneath is open, every new application inherits the full Collect-Connect-Control stack and only authors the Layer 3 vocabulary it needs. That is how a focused, single-condition app like POTS Check and a whole-record app like Cascade Bridge live on the same foundation.

Read the full story

The complete Cascade Bridge narrative, including the patient walkthrough, the standards-alignment detail, the cross-domain reasoning example, and the wireframes, is on the Cascade Bridge page. Our full ONC EHIgnite Phase 1 submission is available as a PDF.

Explore Cascade Bridge Read the EHIgnite narrative (PDF) Developer docs

Further reading

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