Appendix A — Decision records

Executive summary

All 32 architecture decision records, with their status as each record states it: 28 accepted and 4 proposed. The index is generated from docs/adr/, so a new decision appears here in the same change that adds it.

Index

0001
Decision
Tier‑1 voice/STT architecture for Scribe and Perio
Status
Accepted
0002
Decision
Periodontal index semantics: inclusive pocket thresholds, examined-site denominators
Status
Accepted
0003
Decision
Thin clinical encounter spine
Status
Accepted
0004
Decision
Imaging Intelligence clinical control plane
Status
Accepted
0005
Decision
Separate clinical and research/annotation planes
Status
Accepted
0006
Decision
Signed Faurenis model release boundary
Status
Accepted
0007
Decision
A correlation key for verifier safety events
Status
Proposed
0008
Decision
Document-vs-imaging finding authority
Status
Proposed
0009
Decision
Forward-only database migrations
Status
Accepted
0010
Decision
Modular monolith boundaries
Status
Accepted
0011
Decision
HTTP and event contract ownership
Status
Accepted
0012
Decision
Expand/migrate/contract deployment policy
Status
Accepted
0013
Decision
Application and database recovery
Status
Accepted
0014
Decision
Architecture manifests as release gates
Status
Accepted
0015
Decision
Clinical document storage — local disk vs. GCS
Status
Proposed
0016
Decision
Operatory is a presentation over resources, not a new table
Status
Accepted
0017
Decision
Operatory state has one canonical owner per row; no component creates a second store
Status
Accepted
0018
Decision
Operatory waitlist, recall and confirmation workflows are separate auditable records
Status
Accepted
0019
Decision
Operatory appointment requirements are versioned configuration; briefings are deterministic seven-field projections
Status
Accepted
0020
Decision
Documented encounters are the customer-facing usage unit
Status
Accepted
0021
Decision
Co-signature is removed from the Tier-1 plan
Status
Accepted
0022
Decision
The six-day visible countdown over seven-day retention is a deliberate margin
Status
Accepted
0023
Decision
Operatory board mutation is enforced at the write, behind a constant, and the constant is flipped only by a named clinical owner
Status
Accepted
0024
Decision
Canonical clinical claims carry an explicit subject scope; only structurally patient-bound claims may act for a patient
Status
Accepted
0025
Decision
A typed Copilot turn runs the pipeline the server picks, not the lane's one prompt
Status
Accepted
0026
Decision
One Faurenis voice across the app
Status
Accepted
0027
Decision
The Faurenis voice OS: one microphone, Soniox ears, Live on demand
Status
Accepted
0028
Decision
The concierge as a full LLM
Status
Accepted
0029
Decision
Moving a document to another patient
Status
Accepted
0030
Decision
Addressed speech confirms a Live action, and the wake opens Live outside an encounter
Status
Proposed
0031
Decision
Voice speaks by default
Status
Accepted
0032
Decision
Verbatim speech-to-text may run on an unbound capture before binding
Status
Accepted

ADR	Decision	Status
0001	Tier‑1 voice/STT architecture for Scribe and Perio	Accepted
0002	Periodontal index semantics: inclusive pocket thresholds, examined-site denominators	Accepted
0003	Thin clinical encounter spine	Accepted
0004	Imaging Intelligence clinical control plane	Accepted
0005	Separate clinical and research/annotation planes	Accepted
0006	Signed Faurenis model release boundary	Accepted
0007	A correlation key for verifier safety events	Proposed
0008	Document-vs-imaging finding authority	Proposed
0009	Forward-only database migrations	Accepted
0010	Modular monolith boundaries	Accepted
0011	HTTP and event contract ownership	Accepted
0012	Expand/migrate/contract deployment policy	Accepted
0013	Application and database recovery	Accepted
0014	Architecture manifests as release gates	Accepted
0015	Clinical document storage — local disk vs. GCS	Proposed
0016	Operatory is a presentation over `resources`, not a new table	Accepted
0017	Operatory state has one canonical owner per row; no component creates a second store	Accepted
0018	Operatory waitlist, recall and confirmation workflows are separate auditable records	Accepted
0019	Operatory appointment requirements are versioned configuration; briefings are deterministic seven-field projections	Accepted
0020	Documented encounters are the customer-facing usage unit	Accepted
0021	Co-signature is removed from the Tier-1 plan	Accepted
0022	The six-day visible countdown over seven-day retention is a deliberate margin	Accepted
0023	Operatory board mutation is enforced at the write, behind a constant, and the constant is flipped only by a named clinical owner	Accepted
0024	Canonical clinical claims carry an explicit subject scope; only structurally patient-bound claims may act for a patient	Accepted
0025	A typed Copilot turn runs the pipeline the server picks, not the lane's one prompt	Accepted
0026	One Faurenis voice across the app	Accepted
0027	The Faurenis voice OS: one microphone, Soniox ears, Live on demand	Accepted
0028	The concierge as a full LLM	Accepted
0029	Moving a document to another patient	Accepted
0030	Addressed speech confirms a Live action, and the wake opens Live outside an encounter	Proposed
0031	Voice speaks by default	Accepted
0032	Verbatim speech-to-text may run on an unbound capture before binding	Accepted

Reading an ADR

Each record states its context, the decision, the alternatives rejected and the consequences, and is cited by number wherever it binds in this specification. An accepted ADR can still describe something not yet built; the module chapters say which.

SOURCE OF TRUTH

docs/adr/