><CUSP> White Paper – SAPIENTIA HEALTH

><CUSP>

Clinical Understanding Support Platform (CUSP)
A White Paper by Sapientia Health Public Trust

Executive Summary

The Clinical Understanding Support Platform (CUSP) is a clinician-facing digital framework for capturing, structuring, and communicating diagnostic reasoning across the continuum of care. Designed to work within existing electronic health record (EHR) systems via FHIR-compatible APIs, ><CUSP> bridges the gap between raw clinical data and the cognitive process that underlies medical judgment.

This white paper outlines the problem ><CUSP> addresses, its technical and ethical foundations, implementation strategies, and its value for clinical integrity, communication, and patient safety.

Problem Statement

In modern healthcare, diagnosis is often documented as a static label, divorced from the context, rationale, and alternatives that inform clinical thinking. This loss of reasoning continuity leads to critical breakdowns particularly during handoffs and discharge, exposing patients to treatment errors and clinicians to cognitive overload, bias, and burnout.

The problem is not only the quality of diagnoses, but the quality of how diagnoses are understood and communicated over time.

What Is ><CUSP>?

CUSP (Clinical Understanding Support Platform) is a structured, interoperable reasoning layer that:

Captures diagnostic narratives, uncertainty, and differential logic at the point of care
Integrates seamlessly with EHRs through FHIR-compatible APIs
Embeds reflective clinical judgment into the patient record
Promotes accountability, transparency, and longitudinal understanding

Core Capabilities

Iterative Reasoning Capture
Supports versioned updates to clinical impressions, allowing clinicians to revise, annotate, and reflect across the diagnostic journey.
Interoperability by Design
Built on SMART on FHIR architecture for EHR integration, avoiding proprietary lock-in.
Clinical Metadata Layer
Associates each diagnosis with structured metadata: rationale, references, alternatives considered, and the context of formulation.
Continuity-Aware Communication
Facilitates improved communication across handoffs, transitions of care, and interdisciplinary teams.
Auditability and Ethics
Provides a transparent trail of clinical reasoning, supporting peer review, quality improvement, and education.

Use Cases

Enhancing inpatient-to-outpatient handoffs
Capturing rationale during diagnostic uncertainty
Documenting shared decision-making with patients and families
Supporting second-opinion reviews
Building structured data for research into diagnostic safety

Alignment with Sapientia Health Values

><CUSP> operationalizes the trust’s core values of compassion, generosity, and wisdom. It honors the process of clinical understanding, not just its outcomes, and protects space for thoughtful medicine within increasingly data-driven systems.

Next Steps

Sapientia Health invites health systems, research institutions, and health IT partners to collaborate on pilot implementations, shared learning, and further development of the ><CUSP> framework.

To request a demonstration or discuss potential integration, contact us at www.sapientiahealth.org.