Concussion Clearance-Record AI Agent

What this agent does

Assembles the file, never the clearance

A player is removed on suspicion, and the record names who removed them and when, before any diagnosis.

A jurisdiction is configured, not assumed: its provider list read from that state, dated, and re-checked.

Reason

A signature is filed, and its class is checked against that list — completeness only, never clinical opinion.

A form is prescribed in Ohio, and since 30 April 2025 a clearance on other paper is incomplete.

A step is proposed, and it opens only on a named clinician confirming it — the agent advances nothing.

Decide

A step advanced early, or raised before return-to-learn is clear, is recorded as a deviation to explain.

A California club runs a seven-day floor its school neighbours do not, and one template cannot hold both.

Out

A file is kept whole — the removal, each step, the signer, the form and the deviations, against the athlete.

Execute write actions only inside the approval boundaries agreed during implementation.

→ Product statement

The agent assembles and checks the file; a named provider of the class that jurisdiction permits signs, and no readiness is reported.

Example workflow

One incident, removal to clearance

AgentHuman

1Player removed from playCoach, game official, athletic trainer or team physician, on suspicion alone

2File assembledThe remover and the time, the jurisdiction, the setting and who was present, each with its source

3Progression recordedEach step, the clinician who advanced it, the interval and the return-to-learn state

4Controls appliedProvider-class checks, prescribed-form checks, interval and return-to-learn deviation flags

No human action required

Stages 1 to 4 run unaided, and nothing is cleared at any of them — the agent is recording, and the clinical lane opens at the completeness gate.

5DecisionBranches at the completeness gate

File complete

Goes to the team physician to sign.

Anything missing

Adds an oversight-lead read first.

Clinician review

The file is held with its steps, its provider-class check and its gaps.

Mark complete · Attach evidence · Refer to the physician

Complete — signed by a named provider▼

6Medical record updatedOnly where write access and clinical policy allow it

7Outcome evaluatedProvider-class fit, missing evidence, deviation outcomes and what a later review found

Corrections

Every clinician correction is counted in the evaluation.

What should not run autonomously

Human approval stays in control

Outside the boundary — human approval required8 items

Clearing an athlete, or implying one is ready.

Advancing any step in the progression.

Judging whether a provider was clinically right.

Deciding a removal, or overriding one.

Automation boundaryAgent acts unaided

✓Record the removal, the remover and the time.

✓Check the signature against that jurisdiction list.

✓Hold each step closed until the treating clinician confirms it in writing.

✓Flag deviations and gaps, and hold the file open until the signatures land.

Nothing clears here — a named provider signs, inside the boundaries agreed at build.

Signing or issuing the written clearance.

Scoring, rating or ranking any athlete.

Showing fixtures, availability or days lost.

Changes to the jurisdiction register or flags.

Example output

One incident file, annotated

The claim two years on is ordinary negligence — Texas §38.159 creates no cause of action to bring.

Clearance record · single incidentIllustrative example

Athlete

Removed by

Step reached

Signed by

Confidence

Form used

High-school football, Ohio

Athletic trainer on duty, named on the record

Step 4 of 6, held

Not yet signed

Incomplete

Board model form required

As receivedTaken from the removal record and the clinician entries — nothing on this side is judged by the agent.

What the file holds The removal record Step-by-step entries Who was in the room

Why no readiness hereA step recorded is a paperwork fact, and never an opinion that the athlete is ready to return.

ActionMark completeAttach evidenceRefer to the physician

What the score decidesBelow the configured threshold the file picks up an oversight-lead read before.

Value

Where AI adds value

The same four claims, placed at the point in the workflow where each one applies.

Where the value landsValue 01 – 04

Every incidentFrom the removal record

03Recording

Record it, then gate it

Our triage agent owns the minute of the injury; this record owns everything after it.

01Approved path

No readiness output, ever

No score, no traffic light, no percentage that reads as fitness — the file reports what is documented.

02Human review

Where the availability call lands

Our load agent holds the flag for the named medical staff, who decide availability; this page is that decision.

04Build an evidence trail

The step, the clinician who advanced it and the physician who cleared stay on the record.

Integrations

Typical integrations

Five system groups connect to the same agent. Which of them are in scope is decided in discovery.

Athletic-training EMRATS · SportsWare
Healthy Roster · Rank One

Eligibility and participationPrivit · FinalForms
State association portals

Clinical systemsEpic · Cerner referrals
Physician practice records

Agent

Concussion clearance records

Reads the record
Checks the class
Holds for the signer

Programme and complianceTeamworks · ARMS
Attestation and policy records

Observability & evaluationOpenTelemetry · Langfuse
Supported monitoring/evaluation sources

Integration availability depends on the client's existing systems and API access.

Agent controls

Six rings between the model and the clearance

Six rings, and the innermost is the tightest. What clears them all is drawn in the map below.

L6 · Outermost — last line of defenceInward → L1 · closest to the model

L6Rollback / safe modePull the agent back to recording only when evaluation or production signals degrade.Roll back

L5Version monitoringTrack model, prompt and jurisdiction-rule changes, with a verified date per state.Track

L4TraceabilityRecord the removal, each step, the signature, the form and each read of the file.Record

L3Clinician gateHold each step and the file for a named clinician; it governs release, not the clinical call.Gate

L2Policy guardrailsTest the file against that state provider list — Texas admits a treating physician only; a failure returns it.Restrict

L1Completeness checksRoute a file with gaps to an oversight-lead read before the physician sees it.Require review

Model coreFile assembled — the removal, the steps, the signature, the form and the gaps

L1 – L2Test whether a file may stand

L3Puts the signature in a clinician's hands

L4 – L5Keep the step and the clinician behind it

L6Holds the file at uncleared when signals degrade

How Nestack evaluates it

Evaluate the whole record — not only the clearance at the end.

Coverage runs the whole depth of the workflow, and every layer is cut by slice.

Surface — the file a review reads

Depth of coverage ▼

E1Final-output evaluationDid the file record a provider class that jurisdiction permits?

E2Step-level evaluationDid the agent use the right state, the right form and the current rule?

E3Tool evaluationDid it read and write the correct athlete and the correct incident?

E4Deviation calibrationDo low-completeness files actually attract more clinician corrections?

E5Slice evaluationHow does performance change across specific jurisdictions?

E6Business outcomeHow many files needed a correction before the physician signed?

Floor — the outcome the programme answers for

Failure modes

Where each failure originates in the agent

Seven failure modes, placed at the stage where each one begins.

Agent lifecycleDirection of processing →

01 · Retrieval1 mode

HT-03

Stale rule set

A state amended, and the register still reads the old class.

Stage gathersThe removal, the jurisdiction, the steps and the form

02 · Reasoning2 modes

HT-04

Wrong provider class taken

A signature is read as good for the wrong state.

HT-06

Deviation dressed as breach

A short interval is rendered as a rule violation.

Stage proposesThe steps, the provider class and completeness

03 · Tool / write2 modes

HT-02

Second signature missed

One authorisation is filed where New York wants two.

HT-05

Foreign clearance relied on

A transfer returns on the sending state rule.

Stage writesOnly where write access and approval policy allow it

04 · Output1 mode

HT-01

Remover not named

In Pennsylvania a coach season turns on that name.

Stage returnsThe file the programme stands behind two years on

05 · Change / Version1 mode

HT-07

Silent register regression

A rule update moves a class without moving the file.

Stage tracksModel, prompt, jurisdiction rules and forms

Sev-1 · an athlete returns uncleared Sev-2 · a wrong provider class is accepted Sev-3 · source degrades, file holds open

See the complete Sports & Fitness failure-mode catalogue →

Affected slices

One jurisdiction absorbs the corrections

A programme-level provider-class figure can read clean while one jurisdiction absorbs the corrections. Nestack reports the clinician-correction rate by jurisdiction, not only in total.

Slice performance — reported separately, not only in aggregateIllustrative example

Slice	Failure rate	Lift	Status
Out-of-state travel incidents	9.2%	3.7×	Review
Washington and open-class states	6.7%	2.7×	Review
Club, camp and business settings	4.4%	1.8×	Watch
Single-school in-state incidents	2.2%	0.9×	Normal

Bar: clinician-correction-rate lift vs. single-school in-state baseline · scale 0–4.0× · tick marks the 2.0× review threshold 2 of 4 slices over threshold

Evidence-linked improvement

The claim will not cite the statute

The loop shuts when the wrong provider class is a regression case. That suite is what the next clearance filed is measured against.

Improvement cycle · five stagesSwitchback — the path turns at Improve and returns at Learn

01Detect

Clinician-correction rate rises in one jurisdiction.

02Diagnose

The player cleared by someone the statute does not name is read back until one cause remains.

03Improve

Any change goes out numbered, with the jurisdictions that caused it attached.

04Verify

One clearance case still failing is enough to hold the release back.

05Learn

One case joins the suite, one line joins the protocol record.

Learn → DetectThe return edge. The next clearance is measured against a suite one case longer.

Typical build scope

Twelve workstreams across six weeks

The build scope read against the delivery timeline. Week structure follows the six-week plan — discovery, sources, record assembly, evaluation, integration, then production validation and handover.

Workstream Week 1Week 2Week 3Week 4Week 5Week 6

01Clearance workflow discovery and boundary definition.

02EMR, eligibility and clinic sources.

03Jurisdiction, provider-class and form-rule mapping.

04Removal-record ingestion and normalisation.

05Progression gating and evidence binding.

06Completeness scoring and oversight routing.

07Clinician review workflow.

08Medical-record and roster integration.

09Provider-class and step cases.

10Guardrails and clearance controls.

11Step-trail instrumentation.

12Deployment, documentation and Agent Care handover.

12 workstreams · 6 weeks · bar shows the weeks a workstream is active — several run in parallel Final scope and sequence confirmed in discovery

Engagement tiers

What each tier includes

Rows are the capabilities named in each tier's scope. Higher tiers include everything below them.

Capability✓ in scope · — not at this tier PilotOne programme, one state ProductionProduction medical records AdvancedMultiple states / settings

Introduced at Pilot

Record assembly to your rules✓✓✓

Clinician gating✓✓✓

Provider-class baseline✓✓✓

Introduced at Production

Reporting by jurisdiction—✓✓

Review workflow in your systems—✓✓

Approved write-back—✓✓

Medical-record integration—✓✓

Introduced at Advanced

Multi-state provider rules——✓

Multi-programme attestation packs——✓

High incident volume——✓

Multi-state clearance controls——✓

Build price From $5,000 From $8,000 Custom quote

Final build priceConfirmed after discovery based on integrations, workflow complexity, transaction volume, approval controls and deployment requirements.

Separate from buildBuild pricing is separate from recurring Agent Care, which covers managed monitoring, evaluations, incidents and verified improvements after launch.

What we need from you

What you bring, and what we build with it

Each input maps to a piece of build scope and a week in the delivery timeline.

You bringWe build with it

01Your removal and incident intake fields → Removal-record ingestion and file mappingWeek 1

02Representative closed clearance files → Record baseline, step binding and provider-class captureWeek 2

03Your states, prescribed forms and oversight leads → Jurisdiction, provider-class and form mapping, and the boundaryWeek 1

04Access to relevant APIs, feeds or exports → EMR, eligibility and clinic assessment, then integration setupWeek 2

05Clearances you would not want re-read → Step cases and the evaluation suiteWeek 4

06What no clearance record may imply → Completeness scoring, oversight routing, guardrails and gating controlsWeek 3

07Named clinicians and a team physician → Clinician gating workflow, then pilot and production validationWeeks 5–6

Nothing else is required Deployment, documentation and Agent Care handover are ours.

Delivery timeline

Four phases across six weeks

Width here is worked time and not layout space, which is why two bands must share the fifth week.

Phase W1W2W3W4W5W6

Discovery W1

Build W2 – W3

Evaluate W4 – W5

Pilot & Launch W5 – W6

Week focus W1Clearance discovery, jurisdiction mapping and the automation boundary W2Source integration and the record baseline W3Assembly workflow, gating logic and completeness controls W4Evaluation suite, provider-class cases and failure-mode testing W5Medical-record integration, pilot incidents and targeted corrections W6One season run under the team physician, then Agent Care handover

Reading the bandEach bar covers only the weeks its own work is named in. The shared fifth week is real work, not padding.

At the end of W6Once the playing season validates, Agent Care assumes the agent.

DurationSix-week plan shown · typical delivery 4–6 weeks depending on scope confirmed in discovery.

Next step · Sports & Fitness agent

Build a clearance-record agent around the state that governs it.

Tell us how an athlete comes off the field today and which states you play in. A named provider of the class that jurisdiction permits signs the written clearance — never this agent — and when it goes wrong the athlete is already back, and the file is the whole answer.

Discuss this agent →

Nestack Agents · Concussion clearance recordsAGT-SF-15 · Agent Care available after launch