Cloudflare Native • Palantir-inspired for SMB Healthcare

HealthForge
The Business Brain for Regional Healthcare

An ontology-powered operating system. Unified data. AI agents that understand your clinic. Built on Cloudflare for local and regional facilities.

PA
Parker Agee • Agee Ventures • July 1, 2026
v1.0 • Master Spec
CORE LAYER
Ontology + Actions
Semantic + Kinetic
INFRASTRUCTURE
Cloudflare Stack
Durable Objects + SQLite + Workers AI
TARGET
Dental + Medspa First
Then regional clinics
TIME TO PILOT
3–5 months
Focused execution
01 — VISION

Executive Vision & Opportunity

Local and regional healthcare facilities operate with fragmented data across EHRs, billing tools, spreadsheets, and compliance binders. This creates blind spots, revenue leakage, compliance risk, and decision fatigue.

HealthForge is a lightweight, AI-native, ontology-based "business brain" / digital twin purpose-built for SMB and regional healthcare. It unifies data into a living semantic model that teams and AI agents can query and act upon in plain business language.

Why It Fits Your Portfolio

  • • Extends ChairGuard into full ontology foundation
  • • Reuses BrokerShield / SubAssure / FieldService Cloudflare patterns
  • • Leverages your local West TN healthcare network for pilots

Target ICP

Primary: Independent dental practices & small groups (TN/MS/AR)
Secondary: Medspas & aesthetic clinics (Zenoti users)
Tertiary: Regional operators wanting unified ops without enterprise cost
Core Value Proposition
“Ask your clinic anything in English and get actionable answers + one-click actions.”
Unified 360° view • Automated brain briefs • Compliance guardian • Predictive optimization • Agentic workflows
02 — BRANDING

Proposed Names

HealthForge (recommended)
OntoForge
ClinicForge
HealthBrain Ontology
PracticeGraph OS

Tagline: “The operating system for your clinic’s data — ontology-powered, AI-native, built for regional healthcare.”

03 — ONTOLOGY

High-Level Ontology Model

Semantic Layer (Objects + Links) + Kinetic Layer (Actions) — inspired directly by Palantir Foundry.

Core Object Types

Facility / Location
Properties
name, address, type (dental|medspa|primary|multi), timezone, settings, status
Key Links
has_many Providers • Patients • Appointments • Equipment • ComplianceArtifacts
Provider / StaffMember
Properties
name, role, credentials, schedule_preferences, email, active
Key Links
works_at Facility • performs Appointments • certified_in ComplianceArtifacts
Patient (Operational Overlay)
Properties
external_id, demographics_summary, risk_flags, consent_status, last_visit, recall_due
Key Links
has_many Appointments • Bills
Note: Full clinical data stays in source EHR
Appointment / Encounter
Properties
scheduled_start/end, status, type, operatory, outcome
Key Links
belongs_to Patient • scheduled_with Provider • at Facility • includes Services • generates Bill
Service / Procedure
Properties
code (CDT/CPT), description, duration_minutes, base_price, category
Key Links
requires InventoryItems • performed_in Appointments
Bill / Claim / Payment
Properties
amount, status, payer, denial_reason, submitted_date
Key Links
for Appointment • from Patient
InventoryItem / Supply
Properties
name, sku, current_stock, reorder_point, unit_cost, expiration
Key Links
used_in Procedures • stored_at Facility
Equipment / Asset
Properties
name, type, serial, purchase_date, maintenance_schedule, status
Key Links
located_at Facility • maintained_by Providers
ComplianceArtifact
Properties
type (license|cert|training|policy), entity, issue_date, expiry_date, status, document_link
Key Links
belongs_to Provider or Facility

Actions (Kinetic Layer)

schedule_appointment
check_in_patient / complete_encounter
update_inventory (auto-reorder)
flag_compliance_risk
generate_daily_ops_brief (AI)
run_no_show_prediction
create_patient_recall_task
sync_with_ehr
Implementation: Per-tenant Durable Object with SQLite (objects + links tables, indexes, full-text/Vectorize support). Rich bidirectional links with properties on edges.
04 — ARCHITECTURE

Cloudflare Architecture

Strong per-tenant isolation. Every facility gets its own dedicated “brain database”.

Key Innovation: Durable Objects + SQLite per Tenant

One Durable Object instance per facility/account with embedded SQLite. True multi-tenant isolation, strong consistency, powerful graph queries, and local compute. Scales beautifully while keeping PHI boundaries clean.

System Flow
Mermaid rendered
flowchart TB subgraph Users["Users / Staff / Admins"] direction TB Browser[Browser / Mobile] end subgraph Frontend["Frontend (Pages + React)"] Dashboard[Dashboard + NL Search + Graph Viz] end subgraph Workers["Cloudflare Workers API Layer"] direction TB NL[NL Query Handler → Workers AI] Action[Action Executor] ETL[Integration Orchestrator] Auth[AuthZ / ACL Enforcer] end subgraph Brain["Per-Tenant Durable Object (HealthForgeBrain)"] SQLite[(Embedded SQLite Ontology: objects, links, actions_log, metrics)] end subgraph Supporting["Supporting Services"] R2[R2 Files & PDFs] Vectorize[Vectorize Embeddings] KV[KV Cache] Queues[Queues + Alarms] AI[Workers AI] end subgraph Sources["Source Systems"] Dentrix[Dentrix API Exchange] Zenoti[Zenoti API + Webhooks] FHIR[FHIR R4] CSV[CSV / PDF Uploads] end Browser --> Dashboard Dashboard --> Workers NL --> SQLite Action --> SQLite ETL --> Sources Workers --> Brain Brain --> Supporting Supporting --> Sources
Full stack: Workers (Hono) • Durable Objects + SQLite • R2 + Vectorize • Workers AI • Queues • KV • Pages frontend. GitHub Actions + wrangler for deployment.
05 — INTELLIGENCE

AI & Agent Capabilities

Conversational Interface

Natural language to deep ontology insights + explanations + suggested next actions. “Show me high no-show risk patients next week who need low-stock supplies.”

Daily Brain Briefs

Auto-generated personalized report: KPIs vs prior period, risks (compliance, inventory, no-shows), opportunities, agent recommendations. Delivered in-app + email.

Proactive Agents

  • Compliance Guardian — scans nightly for expiring items
  • Revenue Optimizer — identifies leakage & suggests actions
  • Patient Experience & Operations agents

RAG + Grounding + Extensibility

Every response cites ontology state + source docs. Users/admins can define custom rules and agents that query/update the ontology.

06 — ROADMAP

Development Roadmap

0
Foundation (1–2 weeks)
Finalize name & repo • Detailed ontology spec v0.1 • Cloudflare Enterprise + BAA confirmation • Compliance kickoff with attorney
1
MVP Prototype (4–8 weeks)
Tenant DO provisioning + core ontology in SQLite • Workers API + basic NL query • Simple dashboard • CSV/Zenoti or ChairGuard integration • Internal test. Success metric: Import sample data → NL query works.
2
Core Value (2–3 months)
Expand ontology (billing, inventory, compliance) • Full actions engine • Dentrix partner integration + Zenoti deep connector • AI briefs + 2–3 proactive agents • Graph viz • Pilot with 2–5 local practices
3
Scale & Polish (3–6 months)
Production hardening • More connectors (FHIR) • Advanced predictive models • Custom fields & low-code extender • Stripe billing • Public launch / paid pilots • Regional benchmark feature
Total to first paying pilot: 3–5 months with focused effort.
07 — TECH

Tech Stack & Repo Structure

Recommended Stack (Your Pattern)
Language: TypeScript
Backend: Workers + Hono + DOs
DB: SQLite via Durable Objects
AI: Workers AI + Vectorize
Frontend: Pages + React + Tailwind
IaC/CI: wrangler + GitHub Actions
Suggested Repo
github.com/parkeragee/healthforge
I can scaffold the full folder structure and initial files (ontology/types.ts, brain DO class, schema.sql, etc.) immediately.

Key Risks & Mitigations

HIPAA Tenant DO isolation + BAA + phased PHI approach. Engage attorney early.
Integrations Hybrid (API + AI parsing). Leverage ChairGuard learnings. White-glove onboarding for pilots.
Adoption Killer NL UX + immediate value (compliance alerts, revenue insights).

Go-to-Market (High-Level)

Pricing: Location-based SaaS ($99–299/mo base) + usage/AI add-ons.
GTM Phase 1: Your existing dental/medspa contacts + local Tipton County networks.
Flywheel: More tenants → better AI & benchmarks → more value.
Cross-sell opportunity with ChairGuard, SubAssure, and bookkeeping services.
08 — ACTION

Immediate Next Steps

1. Decide & Align →
Name, dental-first priority, PHI scope boundaries.
2. Ontology Deep Dive →
I can expand to full v0.1 spec with every property, link, action, and sample queries.
3. Compliance Kickoff →
Contact Cloudflare for current BAA scope on DO/SQLite/Vectorize/AI. Engage healthcare attorney.
4. Tech Spike / Prototype →
Create healthforge repo + basic tenant DO + SQLite ontology + simple NL query endpoint. I can scaffold files now.

This is a massive opportunity that plays to every strength in your portfolio and local position.

It can become the unifying platform underneath ChairGuard and future verticals.