Regulatory compliance engines for healthcare.

Information governance, clinical safety, and payer integrity rules encoded once and evidenced continuously. Built for IG committees, auditors, and regulators.

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Overview

Regulatory compliance engines infrastructure for healthcare, built to the standard institutions in this sector are required to operate.

XVICA designs, builds, and operates this layer for healthcare clients in the UK, US, Canada, and Australia. The work is specified against the regulatory regime, the operational profile, and the examination expectations of this sector before any code is written.

01Why it matters

What healthcare cannot get wrong here.

Information governance decisions affect whether services can go live.
Clinical-safety obligations are personal to the Clinical Safety Officer.
Payer integrity is scrutinised through specific fraud typologies.
Interoperability mandates come with audit expectations attached.

02Regulatory posture

Named regimes, mapped controls

Regulatory requirements are translated into explicit control requirements, then mapped to tests and evidence collection. Nothing is implied.

UK healthcare

NHS DSPT, Caldicott Principles, DCB0129/DCB0160 clinical risk management, NICE guidance where applicable, and the NHS standard contract.

US healthcare

HIPAA, HITECH, 21st Century Cures information-blocking rule, CMS payment integrity rules, and state insurance regulation.

Data protection

UK GDPR Article 9, documented DPIAs for sensitive processing, and CQC information-governance expectations for providers.

03Reference architecture

Design decisions distinctive to this intersection

Components and design choices that recur across our work for this sector. Each deployment is specified individually.

Information-governance rule engine

Access, transfer, and secondary-use decisions encoded as rules tied to documented lawful bases.

Clinical-safety hazard log

DCB0129 hazard log maintained in-system; linked to the engineering change that introduced or mitigated the hazard.

Payer integrity rules

Unbundling, upcoding, duplicate-claim, and phantom-provider detection as first-class rule families with case workflow.

Evidence for IG committees

Output in the form IG committees actually review — not raw logs, not marketing dashboards.

Auditability across care boundaries

Evidence that survives provider-to-payer handoffs and regional boundaries.

04XVICA's approach

How we work in healthcare.

Healthcare compliance is not a single regime; it is the overlap of information governance, clinical safety, and financial integrity, each enforced by a different function with different evidence expectations. We build the engine to serve all three on the same underlying rules so that an IG committee, a Clinical Safety Officer, and a payer-integrity auditor are reviewing different cuts of the same signed, versioned evidence. In practice, that collapses the duplicate review cycles that typically slow healthcare rollouts, makes the clinical-safety case defensible without a separate documentation project, and gives the payer integrity function rule-family detections that match the fraud typologies healthcare actually sees — rather than generic transaction-monitoring tuned for retail banking.

05Engagement