Every V3ra product runs on one system.
It decides what runs, checks what comes back and delivers it.
And it writes every step down.
VAS
V3ra Autonomy Substrate
The system underneath every V3ra product.
The patient’s arrival, vitals and own words.
Acuity, the moment the patient arrives.
Reasoning that shows its sources.
Documentation and codes from what was decided.
Every chart checked against what was billed.
Receives every signal, records it, decides what runs, checks what comes back and delivers it.
Every step, written once, in order.
01 What VAS is
The operating system underneath V3ra.
Every V3ra product runs on it.
Products on top.
The Intake Pod, Pulse, Clinical Intelligence, Sync and Chart Audit.
One system beneath.
It runs what each product needs and checks what comes back.
A record under everything.
Every step, written once.
02 Every surface
Every V3ra surface, one autonomy layer.
The waiting room, the emergency department, your health records and the revenue office. Four places, four teams, one system underneath.
VAS follows the encounter, not the department.
The patient moves from room to room. The encounter isn't handed off. VAS carries it.
Nothing entered twice.
What the Intake Pod captured is what the physician sees, what goes to your EHR and what Sync codes from.
Connected end to end.
The Intake Pod, physician review, Sync and Chart Audit all run on VAS today. Your EHR connects at your pilot.
- Acute coronary syndromeMost likelyECGHistoryPatient’s words
- Stable anginaConsiderHistory
- A line with no sourceHeld back
- 99285Emergency visit, high complexitySupported
- 99406Tobacco counselling, 4 minutesFound
The vitals and the patient’s own words.
- Critical values flagged and sent
- Even if the analysis fails
The encounter and Pulse’s acuity.
- Every cited value found in the chart
- One line held back
The physician’s decision and the note.
- Codes kept with the same encounter
- Never submitted by VAS
Three engines, the same facts, one record.
03 Pulse, Clinical Intelligence, Sync
VAS doesn’t replace the engines. It runs them.
Each engine does one job. VAS decides when it runs, what it gets and where its answer goes.
VAS and Pulse
Acuity, the moment the patient arrives.
A critical value is flagged and sent, even if the analysis fails.
VAS and Clinical Intelligence
Reasoning that has to show its sources.
A line that can’t be traced to the chart is held back.
VAS and Sync
Revenue from what was actually decided.
Codes come from the physician’s decision. VAS never submits a claim.
Three engines. One record.
The same encounter, the same facts, the same record.
04 Every event
Receive, record, decide, check, deliver.
Every event takes the same five steps in the same order: a result, a note, an arrival, a correction.
Receive.
Signed, from a known source, the moment it happens. Nothing arrives twice.
Record.
Written down before anything runs, so the record never depends on what happens next.
Decide.
The facility's level and every stop switch decide what VAS may do with it.
Check.
Every value a recommendation cites must be found in the source. A critical value reaches the physician even when the analysis fails or its lines are held back.
Deliver.
To the physician on shift, with its evidence. At Shadow, VAS only records.
Every event gets an outcome.
Delivered, held or refused, and written down either way. Nothing is dropped.
05 Three autonomy levels
How much autonomy do you give it?
Autonomy isn't a switch. It's three levels, and every facility sits at exactly one.
Shadow.
VAS watches and records. It shows no one and sends nothing, not even to the review queue. Every facility starts here.
Advisory.
VAS recommends. A physician decides on every recommendation, and only an accepted decision goes further.
Autonomous.
VAS carries out what it proposes, within the rules your administrator set. The physician sees every action as it happens.
It steps itself down.
If its checks start failing, or physicians overrule it more than your limit allows, VAS drops a level on its own, tells your administrator and records why.
06 Who controls it
Your administrator sets its authority.
Not V3ra. The people who run your facility decide how far VAS goes, and they can pull it back at any moment.
Up takes a reason.
Raising the level takes a written reason. Autonomous also takes an explicit confirmation.
Down takes nothing.
Stepping down or stopping VAS needs no reason and no call to us.
It can step itself down.
If its checks start failing, or physicians overrule it more than your limit allows, VAS drops a level on its own and tells your administrator why. Going back up still takes a person and a reason.
Stop it at any size.
Every facility, one facility, one physician or one feature. Each switch is separate.
Every change is written down.
Who changed the level, when, and the reason they gave.
07 Every action leaves a record
VAS remembers what happened.
What it received, what it knew, what it decided, what it did, and who changed it.
Each entry seals the one before.
Every entry carries the fingerprint of the entry before it, so a missing or altered entry shows.
Written once.
Entries are only ever added. The database refuses a change or a deletion, including from us.
Autonomy without a black box.
Anyone you authorise can replay exactly what VAS did and why.
08 Physicians can correct it
The physician has the last word.
Every recommendation can be accepted, overridden or annotated.
Overridden, in their own words.
An override records what changed and why, in the physician's words, at the moment they decide.
Linked, not overwritten.
The correction is written against the recommendation it corrects. Both stay in the record.
09 How the system can learn
It doesn't learn just because someone clicked.
A correction is evidence. It changes nothing until it has been validated and cleared.
Calibration first.
Before anything retrains, VAS measures how well its confidence matches physician judgement.
A gate, not a slope.
Retraining needs thousands of real-patient decisions from several physicians, a clinical safety sign-off and a way back.
Learned once, shared by choice.
Once cleared, what V3ra learns at one hospital improves it for every hospital that turns on sharing. Sharing is off unless a hospital turns it on, and patient data doesn't leave.
Today, nothing has cleared.
No model retrains on physician decisions today.
10 What VAS cannot do
VAS has boundaries.
Some actions need a physician or your administrator. Some, nobody can make it do.
It can't act above its level.
Only your administrator raises it, and when its checks fail it steps itself down. An Advisory recommendation goes nowhere without a physician's accept.
It can't change the past, or teach itself.
The record refuses edits and deletions. Retraining waits for clearance.
It doesn't leave your facility.
Nothing is sent outside your facility unless you turn it on.
11 A live encounter
Follow one encounter through every layer.
A 58-year-old with chest pressure walks up to the Intake Pod. Illustrative, from the door to the record.
The door.
The Intake Pod takes vitals and the patient's own words. VAS receives them, writes them down and checks the level.
The engines.
Pulse sets the acuity. Clinical Intelligence reasons, with sources. VAS checks every cited value and delivers it.
The physician.
The attending overrides to ESI 1. The correction is written against the recommendation.
The revenue.
Sync codes the visit from what was actually decided.
This is the system underneath V3ra.
Every surface, every engine, every decision and every correction, on one operating architecture.
Film
Sixty seconds of VAS running.
The real system, recorded on an illustrative encounter. No stock footage, no patient data.
- 0:00 An arrival at the Intake Pod reaches VAS and is written down.
- 0:10 Facility A’s level is checked: Advisory.
- 0:18 Pulse sets ESI 2; Clinical Intelligence reasons, and a line with no source is held back.
- 0:32 The physician overrides to ESI 1, in their own words.
- 0:44 The record verifies, entry by entry.
- 0:52 An administrator turns one physician’s switch off.
Muted and captioned, never autoplaying with sound. The poster shows VAS at rest; reduced motion gets the still.
12 See VAS in action
See VAS run a real encounter.
Forty minutes with the people who built it: one encounter through every layer, the three levels, the record and the stop switches, running live and put to your questions.
Runs on VAS