ISCaD GmbH · Wedemark · since 2000

Architecture, Governance and Migration
of Clinical Data.

Over 30 years of experience processing and analyzing structured and unstructured clinical data. Specialized in interoperability, semantic integrity and sustainable data architectures — grounded in our own formal research (AION · SILD).

SILD Signal-Loss
Inspection at
Data-boundaries
Our research product

Clinical data can lose meaning in transfer.

Even when the transfer succeeds technically.

When a clinical finding is transferred from a hospital information system to a FHIR server, information can be lost — even when the transfer succeeded technically and the target validation passes. SILD compares source and target along four loss patterns from the FM-4 model. For today’s technical classification: statements about coverage presuppose a declared model and fixed decomposition and variation assumptions; one finding can involve several patterns at once. The result is traceable findings against agreed review rules — not a general proof of lossless transfer.

Source data
CDR / HIS
FHIR R4
Export
Target data
FHIR Server
Detected
Analysis
SILD
analyzes

Inputs of every review: matched source and target data plus review rules agreed in writing — not the target data alone.

Four loss patterns from FM-4 — one example each:

Example
Finding with unresolvable order reference (ORCbasedOn)
Reference Severing
Example
SNOMED CT code with laterality → ICD-10-GM code without side marker
Type Narrowing
Example
Anesthesia 08:12–11:4700:00–23:59 (all-day)
Temporal Collapse
Example
ICD-10-GM without diagnostic certainty (V/A/Z/G)
Attribute Dropping

The cards show possible anomalies, not findings: a missing reference resolution, a missing side marker or an empty single field does not by itself prove information loss — the information may be preserved elsewhere, in another coding or with a converted unit. Whether agreed information is actually missing depends on the complete target context and the review rules. No clinical priorities follow from the pattern labels.

Basis: FM-4 (self-archived, not peer-reviewed preprint) · examples without clinical severity levels · Open Source AGPL-3.0 SILD verstehen — die wichtigsten Fragen (in German) → github.com/fmatten/SILD
30+
Years
Clinical & Data IT
6 Papers
On Zenodo · Open Access
FM-1 · FM-2 · CAIRN · AION · SILD · Scaling
HL7 FHIR
v2 · v3 · R4 · CDA · DICOM
Profiles · IG · Validation
FM-4
Formal model
Preprint on Zenodo
AGPL 3.0
Open Source
codeberg.org/fm2-project
A concrete entry point · SILD Pilot

Traceable review of a data transfer.

The SILD Pilot reviews one defined transfer source → target: up to 1,000 unambiguously matched source/target pairs from released test data or effectively anonymised data, against up to ten review rules agreed in writing — for example value and unit, code and code system, or time period. Paid pilot. Binding fixed price once the scope of review has been jointly defined. The 30-minute initial call is free of charge and without obligation.

01

Review agreement

Together we fix in writing: source data and target data, mapping, review rules, versions, responsible persons and a secure transfer channel. Feasibility is clarified before you commission the pilot.

02

Review run and report

One status per case and review rule — met, deviation evidenced, unresolved, not reviewable, not applicable — with evidence, denominator and review coverage, plus a machine-readable findings list. No global percentage.

03

Next steps

Prioritised technical next steps, assigned to the responsible teams for review, and an explanatory call. One limited re-test after an agreed correction is included.

For: hospitals, medical care centers, registries, insurers, public bodies and service providers who want a traceable review of a specific data transfer — migration, export or interface.
Scientific Foundation

AION & CAIRN — the formal grounding.

SILD is based on a formal model. The foundations — Allen relations, DAG-based type hierarchies, causal inference, ε-differential privacy — are published as their own scientific ecosystem: AION as the formal model, CAIRN as the Python reference implementation. Open Source under AGPL-3.0, as self-archived preprints on Zenodo (not yet peer-reviewed), available on PyPI.

FM-3 · Theory · Model

AION

Algebraic Interval Ontology for Clinical Networks

Formal model for clinical data: 13 Allen relations, DAG-based formal type system with model-related SMT checks (Z3), causal inference, explainable AI, ε-differential privacy.

aion-clinical.eu
FM-2 · Python · Implementation

CAIRN

Clinical Interoperability Reference Architecture

Python reference implementation with bidirectional FHIR R4 mapping, HL7 v2 adapters, MLLP listener — and the SILD detector as integrated component. Current version aion-clinical 2.0.7.

aion-clinical.eu
Live Demo
AION Clinical in action — try it directly in your browser.
demo.aion-clinical.de
About the company

ISCaD GmbH — Independent Software, Consulting and Development.

Clinical data architecture is a discipline — not an improvisation

Founded in 2000, based in Wedemark near Hannover, Germany. Specialized in architecture, governance and migration of clinical data — especially where the transition between systems becomes critical: FHIR profiling, semantic integrity, data migration.

Our own formal research in the AION / CAIRN / SILD ecosystem with eight self-archived preprints on Zenodo — not peer-reviewed. AGPL-3.0 open source. Commercial licenses on request.

Founded
2000 · Wedemark, Lower Saxony, Germany
Legal form
GmbH · HRB 220407 · Local Court Hannover
Management
Friedhelm Matten
CV on LinkedIn →
Focus areas
Clinical data · FHIR / HL7 / DICOM · Interoperability · Migration · Platform architecture
Research
AION · CAIRN · SILD · 8 preprints on Zenodo · FM-1 to FM-4.2 · determination of limits · scaling layer
License
AGPL-3.0 · Commercial on request
Selected projects

What we have built.

A selection of mandates that show methodology and depth of work. The order follows substantive focus, not chronology.

Clinical data · Research 2007 – 2012

Clinical Information & Analytics System

MHH · HL7 · MirthConnect · HAPI · DICOM · ishmed

Web-based analytics system for clinical data at Hannover Medical School. Integration of patient, surgical, heart-lung machine, DICOM and laboratory data via HL7 interfaces. Real-time data as ADT/ORU messages, continuous integration of historical legacy data.

★ Lower Saxony Innovation Prize 2011 — web-based data capture for children with heart disease · €150,000 award
Clinical QA · Pediatric cardiology 2017 – 2020

HL7 Integration & Quality Assurance

Herzzentrum Leipzig · Python · MirthConnect · HDF5 · Parquet · Redis · SQLite

Clinical data integration from HIS, HL7, iMedOne, heart-lung machine and legacy systems. Patient-level data streams supporting national and international quality assurance procedures in pediatric cardiology and pediatric cardiac surgery. Web application for automated QA data entry control and manual correction after release.

Our methodology · CDV 2007 – heute

Clinical Data View (CDV)

ISCaD GmbH · Datenstruktur · Migrationstool

Development of a data structure for managing and analyzing complex structured and unstructured clinical data. Migration tool for consolidating data stocks from subsystems with heterogeneous database structures and types into CDV — the methodological foundation of many of our mandates.

Infrastructure · Server · Security · Object Storage 2021 – 2025

ZFS Server System / SOPHOS Firewall

Media company (undisclosed) · ZFS · SOPHOS · Samba · MinIO · S3

Construction of a ZFS-based server system with distributed replication. Samba server with ACLs for mixed client environments (MacOS / Windows / Linux). SOPHOS firewall as network perimeter with segmented zones for operations, administration and backup. Subsequent migration of data to object storage (MinIO with S3 interface) and development of analytics and administration tools for ongoing operations.

Backend · DevOps 2023 – 2024

Backend Platform & DB Optimization

Cloudeatery GmbH / Yobst GmbH · Python · PostgreSQL · GitLab · WireGuard

Integration of kitchens and online order / delivery processes (Uber, Wolt, Lieferando). PostgreSQL performance tuning, DevOps setup (GitLab, WireGuard), stabilization of production-grade operational structures. Extensive Python development on the backend.

Health · CIO mandate 2013 – 2014

HealthSafe24 — CIO & Shareholder

CIO · Shareholder · External advisor

Responsibility for technology and architecture at HealthSafe24 GmbH as Chief Information Officer and co-shareholder. Subsequently external advisory role for strategic and technical development.

References

A selection of past mandates.

Grouped by domain. A deliberately restrained selection from three decades — not all projects are listed here, some are under confidentiality agreements.

Healthcare · Science
  • Medizinische Hochschule Hannover
  • Herzzentrum Leipzig
  • Herz- und Diabeteszentrum NRW
  • HealthSafe24 GmbH
Public sector · Education
  • Region Hannover
  • Deutscher Industrie- und Handelskammertag
  • Niedersächsisches Studieninstitut
  • Technologie-Zentrum Hannover GmbH
Business · Industry
  • Informix Deutschland GmbH
  • Deutsche Telekom AG
  • T Systems
  • EXPO 2000 GmbH
  • Media company (undisclosed)
  • Cloudeatery GmbH
  • Yobst GmbH
  • Nicolai Sanitätshäuser
Lower Saxony Innovation Prize 2011
Web-based data capture for children with heart disease · €150,000 award · Hannover Medical School
Contact

Ready for a conversation?

Whether SILD Pilot, FHIR profiling, platform migration or a sparring session on your data architecture — we respond within 48 hours.

Address
ISCaD GmbH · Schnippheide 4G
30900 Wedemark · Germany
Email
info@iscad-it.de
Direct
friedhelm.matten@iscad-it.de
Licensing
licensing@iscad-it.de
Phone
+49 5130 9741840
Code & Releases
github.com/fmatten/SILD
codeberg.org/fm2-project/cairn
pypi.org/aion-clinical
01
Initial call (30 min)

Free of charge and without obligation. We understand your use case, check fit and honestly say whether we are the right partner.

02
SILD Pilot or PoC

SILD Pilot: a defined transfer, review rules agreed in writing, binding fixed price once the scope has been jointly defined. Or a PoC for a specific use case — each with a clear go/no-go criterion before any next step.

03
Engagement or ongoing advisory (3–12 months)

Productive implementation with real data flow. Or: ongoing support for defined processes as a reliable extension of your team.