Frequently Asked Questions

15. Frequently Asked Questions

This page answers questions a new reader is likely to have after skimming the architecture pages but before reading the source directly. Each answer points back to the relevant wiki page for the full treatment.

Is MedIntelOS safe to use in a real hospital or clinical workflow? No, and the maintainers say so explicitly. The README describes the project as an "alpha, educational system, not a production EHR, not a complete FHIR implementation, not a medical device, and not evidence of regulatory compliance." See Introduction and Motivation and Validation Strategy and Evidentiary Gaps for the full reasoning behind that boundary.

If the scoring rules (qSOFA, NEWS2, etc.) are published and validated, why isn't the software? Because a published clinical instrument and a specific software implementation of it are validated separately. qSOFA and NEWS2 are well-studied in the clinical literature, but this particular codebase has not undergone the analytical and clinical validation, human-factors testing, or regulatory review that would be required to trust it at the bedside. See The Clinical Decision Support Subsystem, Section 5.5.

Does the federated learning module actually protect patient privacy? It implements the correct mechanical shape of gradient clipping and Gaussian-mechanism noise addition, and raw data never leaves a participant site. What it does not provide is a formal privacy accountant tracking cumulative loss across rounds, or cryptographic secure aggregation — both of which a production system needs before its differential-privacy parameters are operationally meaningful. See The Federated Learning Subsystem, Section 6.2.

Why is the aggregation class called SecureAggregator if it isn't cryptographically secure? The class's own docstring corrects this directly, stating that despite the retained public name, it does not implement a cryptographic secure-aggregation protocol. The name reflects an earlier design intent; the documentation was updated to prevent it from being read as a stronger guarantee than the code provides. See The Federated Learning Subsystem, Section 6.1.

Can the audit hash chain be tampered with? Within a single running process, no — any edit to a recorded entry changes its hash, which breaks the link to every subsequent entry and is caught by verify(). Across a compromised host, yes in principle — an attacker with in-memory write access could rewrite the whole chain and recompute every digest consistently. This is why the documentation is explicit that the chain needs a durable, externally-anchored sink in production. See The Tamper-Evident Audit Layer, Section 7.3.

Can a patient's consent record ever truly be deleted from the blockchain? No. executeGDPRErasure can mark a consent as revoked and record an erasure-proof hash, but it cannot delete the historical fact that the consent once existed, because ledger history is append-only by construction. This is exactly why the project's data rules forbid writing PHI or identifiers on-chain, even as a hash. See Blockchain-Mediated Consent Management, Section 8.4.

Why does the API use a single static API key instead of a real identity provider? By design, so the authentication boundary is easy to see and reason about in a small reference implementation. Production mode refuses the built-in development key and enforces a 24-character minimum for any replacement, but this is described as a configuration guard, not a credential-management solution — OIDC/OAuth2, short-lived credentials, and tenant isolation are still required for production use. See Security Architecture and Threat Model, Section 9.3.

What would it take to move MedIntelOS toward a production-viable system? See Comparison to Production-Grade Systems for a pillar-by-pillar breakdown, and Limitations, Ethics, and Future Work for the maintainers' own stated priorities.

Where do I start if I want to run the project locally? See Getting Started for the local development workflow, including Docker Compose, environment configuration, and the test/lint commands used in CI.

---

Previous: ← Glossary of Terms · Next: Getting Started →