Smart Health Trust
Smart Health Trust.
Patient-fiduciary representation at the federated-health utility infrastructure (in formation). Delaware purpose trust constitution forthcoming Q3–Q4 2026.
About
Smart Health Trust is in formation as a Delaware purpose trust constituted to hold patient-fiduciary representation at the governance layer of Smart Health Network. Trust constitution forthcoming Q3–Q4 2026.
The Trust holds patient-fiduciary representation at governance scope because the patient is the architectural primary — the substrate is organized around the patient logical record, and patient interests are the substrate organizing reference, not a downstream concern.
Trust functions at the governance scope — holding, mediating, and advocating. Trust does not operate the substrate. Trust does not control patient data. Trust represents patient interests at the architectural-commitment governance layer.
Trust holds patient-fiduciary representation at governance scope.
Trust mediates between substrate-operator interests and patient-fiduciary interests where they may diverge.
Trust advocates for patients at governance scope — including against the operating company where operational interests diverge from patient interests.
Patient Bill of Rights
The Patient Bill of Rights is the constitutional doctrinal text of the substrate at the patient-fiduciary scope.
Patient rights at the federated-health utility infrastructure are not policy claims; they exist by architectural construction. They are non-modifiable at the architectural-commitment layer.
Architectural commitments
The substrate commitments to patients are non-modifiable at the architectural-commitment layer:
1. Non-aggregation default. Substrate does not aggregate patient records into central stores.
2. Federation-by-default. Operations route to where data lives. Data does not route to central operations.
3. Per-operation authority evaluation. Every operation is evaluated against per-operation authority binding.
4. Patient-fiduciary doctrine. Substrate operates under patient-fiduciary doctrine at the architectural-commitment layer.
5. No operator backdoor. The operating company cannot access patient-claimed data outside per-operation authority. This is an architectural commitment, not a policy claim. Substrate refuses to start in production with an unproven operator identity.
6. Hub payload-blindness with two-views audit chain. The substrate routes operations against patient data without seeing the records; a multi-party signing chain across provider, payer, operating company, and Trust is preserved at every audit chain entry.
These commitments are non-modifiable. They cannot be re-negotiated by any future operator decision, capital event, or political cycle.
For implementation detail and verification, see developers.smarthealthnetwork.org →
Transparency
- Trust independent-action history (when Trust constitution operational)
- Patient Bill of Rights ratification record
- Architectural commitment verification (public ADR registry at developers.smarthealthnetwork.org)
- Annual transparency report