Understand
5-minute read
Cascade, on one page.
What it is, how it fits with the standards medicine already uses, and what it does and doesn't protect.
§ 1
The problem
A person's health record is in twenty places, and none of them is theirs.
Portals, devices and apps each hold a piece. The law now gives people their records, but what arrives is a FHIR bundle or a C-CDA archive built for exchange between institutions. Each app that tries to bring the pieces together invents its own data model, so the record can't move on to the next app.
Cascade is a shared model for that record, kept on the person's side, written in the codes clinicians and their systems already use.
§ 2
The idea
A folder of files, in three layers.
A pod is a folder of plain RDF (Turtle) files on the person's device, laid out to Solid conventions. Any tool can open it. The CLI can encrypt it at rest with a passphrase.
§ 3
Provenance
Every record says where it came from.
Clinical and health records require it, and validation fails without it. A clinician weighing a blood pressure needs to know whether a nurse took it or a watch did.
ClinicalGeneratedProduced in a clinical setting, under a clinician's supervision
EHRVerifiedImported from a health system's record, such as MyChart
DeviceGeneratedMeasured by a device or wearable
PatientReportedThe patient's account, recorded by someone else
SelfReportedEntered by the person themselves
AIExtractedPulled out of a document by AI
§ 4
Change
Nothing is silently overwritten.
What arrived from a source stays as it arrived. Corrections, merges of duplicates from two hospitals, and retractions are written as a separate layer on top. You can always see the original and what changed it.
§ 5
Why small apps matter
Many collectors, one record.
Some of the most useful health data never reaches the chart: a teacher's rating of a child's attention, a standing heart rate at home, a symptom diary. Purpose-built apps collect it well. When they write Cascade, it can land in the same record as the clinical data, with its provenance, instead of in another silo.
That record is what lets families manage care, learn what their records say, and take a bigger part in decisions. See the apps doing this.
§ 6
Plainly
What Cascade is not
- Not an EHR or a FHIR server. It's a format and tools that sit beside them.
- Not a cloud service. There's no Cascade server holding anyone's records.
- Not a sharing or consent system, yet. Today you share by exporting a file.
- Not certified or "HIPAA compliant". That depends on how an app is built and run.
- Not a diagnosis tool. Apps may help people organise and ask; clinicians decide.
- Not finished. It's alpha. See the status page.
§ 7
If you are…
A clinician or researcher
Codes you know, with a source on every fact.
Records carry SNOMED CT, LOINC and RxNorm codes and, being RDF, can be queried with SPARQL. Provenance tells you what to trust. Compared with FHIR and openEHR
A patient or family
You'll meet Cascade inside an app.
Apps built on it keep your records in files on your device. Each app's page says what it stores and who can read it. Apps using Cascade
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