Your practice management software says "AI-powered." Your production says otherwise. This is the governance model that closes the gap.
Every AI deployment passes through 12 cryptographically-signed gates. No bypass. No exceptions. No "urgent" deploys without verification. This is what makes AI board-defensible in a DSO.
Patient records, imaging metadata, and scheduling feeds verified before AI touches them. Corrupt feeds and PHI exposure caught at the boundary.
Full test suite must pass against your PMS, imaging, and billing stack. No exceptions for urgency. If the test fails, the deploy fails.
Hash-verified artifact comparison. If the output changed, you know exactly why — down to the commit.
Risk-tiered: confidence above 85% auto-executes. 70-85% requires validation. Below 70% escalates. Clinical decisions always escalate to a dentist.
HMAC-signed audit trail. "Done" is cryptographically verifiable, not a chat message.
HIPAA logging, model drift detection, rollback triggers, board reporting. Gates 6-12 in the full checklist.
20 questions to ask before buying another AI tool. Plus a free 30-minute AI readiness assessment.
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