Suggestions and decisions are different things
Most of what the system does is suggest. It reads a note and proposes terms. It ranks genes and gives reasons. It drafts which evidence criteria seem to apply to a variant. All of that is work a person could do, done faster and more consistently, and with the sources attached.
A decision is a different kind of act. When a classification goes into a report, a family and their doctors will act on it. Someone has to be answerable for it, and that someone has to be a person with the training and the standing to be.
What a signature means here
In the case record, a classification or a report has a state. A proposal is a proposal until a person with the right role reviews it and signs it. The signature carries a name, a time and the versions of the case, the model and the knowledge the person was looking at.
Models and automated agents cannot sign. This is not a setting an administrator can switch off. An agent can open a task, attach what it found and wait. It cannot move a proposal into the signed state. A report is approved by a person, never by an automatic process.
What this protects against
- A confident wrong answer. A model can produce a fluent, plausible classification that is wrong. A person who has to sign it has to read the evidence under it first.
- Drift. If results flowed straight into reports, a change in a model or a knowledge release could change a report nobody had looked at.
- Diffused responsibility. When something goes wrong in a review, “the system did it” is not an answer. A signed record says who looked and what they saw.
What it costs, and why we accept it
It is slower than a pipeline that writes the report by itself. A signature is a step that someone has to find time for, and in a busy lab that is a real cost.
We think the cost sits in the right place. The work that is slow and repetitive, such as gathering sources and checking each criterion against them, is the work we try to take off the team. The judgement stays with them. The product is built so that a person can spend their time on that judgement and not on assembling what it rests on.
Roles, not just people
Signing is tied to a role as well as a person. Someone who can edit a note may not be able to sign a classification, and someone who can sign for one organisation has no standing in another. The role is checked each time, from the person’s account and memberships, not from what the page they are looking at claims.
That is dull to build and easy to get wrong in a way nobody notices until it matters, which is why we spent time on it before the parts of the product that look better in a demonstration.