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Sovereign AI at the Front Door of Care: A Physically Unidirectional Architecture for Secure Clinical Intelligence

Vasu Srinivasan, Dhriti Vasu

Abstract

We present a Sovereign AI architecture for clinical triage in which all inference is performed on-device and inbound data is delivered via a physically unidirectional channel, implemented using receive-only broadcast infrastructure or certified hardware data diodes, with no return path to any external network. This design removes the network-mediated attack surface by construction, rather than attempting to secure it through software controls. The system performs conversational symptom intake, integrates device-captured vitals, and produces structured, triage-aligned clinical records at the point of care. We formalize the security properties of receiver-side unidirectionality and show that the architecture is transport-agnostic across broadcast and diode-enforced deployments. We further analyze threat models, enforcement mechanisms, and deployment configurations, demonstrating how physical one-way data flow enables high-assurance operation in both resource-constrained and high-risk environments. This work positions physically unidirectional channels as a foundational primitive for sovereign, on-device clinical intelligence at the front door of care.

Sovereign AI at the Front Door of Care: A Physically Unidirectional Architecture for Secure Clinical Intelligence

Abstract

We present a Sovereign AI architecture for clinical triage in which all inference is performed on-device and inbound data is delivered via a physically unidirectional channel, implemented using receive-only broadcast infrastructure or certified hardware data diodes, with no return path to any external network. This design removes the network-mediated attack surface by construction, rather than attempting to secure it through software controls. The system performs conversational symptom intake, integrates device-captured vitals, and produces structured, triage-aligned clinical records at the point of care. We formalize the security properties of receiver-side unidirectionality and show that the architecture is transport-agnostic across broadcast and diode-enforced deployments. We further analyze threat models, enforcement mechanisms, and deployment configurations, demonstrating how physical one-way data flow enables high-assurance operation in both resource-constrained and high-risk environments. This work positions physically unidirectional channels as a foundational primitive for sovereign, on-device clinical intelligence at the front door of care.

Paper Structure

This paper contains 87 sections, 9 theorems, 8 equations, 7 tables.

Table of Contents

  1. Introduction
  2. Threat Model and Scope
  3. Adversary Model
  4. Scope and Assumptions
  5. What This Paper Does Not Claim
  6. Attack Surface Decomposition
  7. Structured Attack Surface Model
  8. Internet-Connected Terminal Attack Surface
  9. Sovereign AI Architecture Attack Surface
  10. Malicious Input via Broadcast Channel
  11. Broadcast Datacasting as Sovereign Inbound Channel
  12. General Broadcast Datacasting Model
  13. Satellite broadcast.
  14. Radio datacasting.
  15. Addressed Payload Delivery over Broadcast
  16. ...and 72 more sections

Key Result

Theorem 3.1

Under the Sovereign AI Architecture, the remote attack surface reachable by a remote adversary $\mathcal{A}_r$ is empty.

Theorems & Definitions (26)

  • Definition 2.1: Remote Adversary $\mathcal{A}_r$
  • Definition 2.2: Physical Adversary $\mathcal{A}_p$
  • Definition 3.1: Attack Surface
  • Definition 3.2: Remote Attack Surface
  • Definition 3.3: Attack Surface Decomposition
  • Theorem 3.1: Remote Attack Surface Elimination (Architectural)
  • proof
  • Definition 4.1: Unidirectionality (Receiver-Side)
  • Theorem 4.1: Return Channel Absence Under Hardware-Enforced Configuration
  • proof
  • ...and 16 more