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 loses meaning in transfer.

Systematically. And mostly unnoticed.

When a clinical finding is transferred from a hospital information system to a FHIR server, information is lost. Not always. But systematically — and nobody notices. SILD analyzes against the mathematical model FM-4 and detects four canonical loss patterns — provably complete: every lossy transfer falls into exactly one of them. The result: formally verifiable audit findings.

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

4 canonical loss patterns SILD detects:

Critical
Finding with unresolvable order reference (ORCbasedOn)
Reference Severing
Critical
SNOMED laterality → ICD-10 (laterality lost)
Type Narrowing
High
Anesthesia 08:12–11:4700:00–23:59 (all-day)
Temporal Collapse
Medium
ICD-10-GM without diagnostic certainty (V/A/Z/G)
Attribute Dropping
Built on FM-4 · Formally verified with Z3 · Open Source AGPL-3.0 github.com/fmatten/SILD
30+
Years
Clinical & Data IT
5 Papers
On Zenodo · Open Access
FM-1 · FM-2 · AION · SILD · Scaling
HL7 FHIR
v2 · v3 · R4 · CDA · DICOM
Profiles · IG · Validation
FM-4
Z3-verified
Our formal model
AGPL 3.0
Open Source
codeberg.org/fm2-project
A concrete entry point · SILD Audit

We measure the loss of meaning in your FHIR operations.

Once your FHIR server is productive and the first API call succeeded, the real discipline begins: ensuring clinical meaning is preserved in every transfer. The SILD Audit delivers a quantified, reproducible inventory — against the mathematical FM-4 model, formally verified with Z3.

01

Analysis

We examine your productive FHIR exports against the FM-4 model and identify occurrences of the four canonical loss patterns — Type Narrowing, Temporal Collapse, Attribute Dropping, Reference Severing.

02

Report

Quantified loss of meaning per pattern and severity — with concrete examples from your data. Reproducible audit protocol that becomes measurable on re-audit.

03

Recommendations

Concrete profile adjustments, mapping corrections and governance responsibilities — no generic best practices, but prioritized measures per identified finding.

For: hospitals, medical care centers, registries, insurers and public bodies running FHIR servers in production.
Scientific Foundation

AION & CAIRN — the formal grounding.

SILD is not a workaround — it's mathematics. The formal 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, published on Zenodo, available on PyPI.

FM-3 · Theory · Model

AION

Algebraic Interval Ontology for Clinical Networks

Formal-mathematical operating system for clinical data. 13 Allen relations, DAG-based type hierarchy (Z3-verified), 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 2.0.1.

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 five open-access publications on Zenodo. 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 · 5 papers on Zenodo
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

Cash Cow Farmers GmbH · 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
  • Cash Cow Farmers GmbH
  • 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 Audit, 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
Discovery call (30 min)

No commitment. We understand your use case, check fit and honestly say whether we are the right partner.

02
SILD Audit or PoC (2–6 weeks)

Concrete use case on real data, demonstrated end-to-end. 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.