# Fossible Works — Complete Site Content

> Fossible Works builds enterprise-grade, ai native, digital health infrastructure on open-source foundations. We specialize in Medplum FHIR implementation, open-source EHR (Fossible HIS), self-hosted healthcare infrastructure, and AI-augmented product development. Our stack is also agent-ready — every layer exposes REST APIs for developers and MCP (Model Context Protocol) servers for AI agents. We serve healthcare builders in the USA and India.

## Company Overview

Fossible Works Inc. is a digital health product development company headquartered in Albany, NY (USA) with operations in Bangalore, India. We help hospitals, clinics, diagnostic chains, health-tech startups, and government health programs build and deploy open-source healthcare IT systems — with full ownership, no vendor lock-in, and zero per-user licensing.

The same open-source, API-first architecture that makes our stack self-hostable also makes it agent-ready: Hydra MCP for operations and ERP, Medplum MCP for clinical FHIR data. Every entity is a self-describing, queryable object with built-in access control, validation, and version history.

### What We Do

We build enterprise-grade, ai native digital health infrastructure on open-source foundations. Our tech choices afford an engagement promise of 100% tech ownership — your data, your software. Total freedom. No vendor lock-ins.

### Mission

We are convinced that Open Source Software (OSS) is no longer on the fringes but is at the heart of all major tech companies, proving itself as a powerful catalyst for growth complementing strategic IT and application landscapes. Our mission is to enhance OSS adoption to drive impactful digital transformations across enterprises.

### Core Values

1. Do one thing and do it well
2. Transparency and authenticity
3. Privacy and Security
4. Unparalleled delivery quality
5. Support for OSS Sustainability

### Expertise

- Healthcare IT & Informatics
- Digital Health Products
- Full Stack Development
- Deployments & DevOps
- AI & Automation
- Integrations & Interoperability

### Locations

- USA & North America: Fossible Works Inc., Albany, NY
- India: Bhive AKR Tech Park, Bangalore

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## Product: Fossible HIS

**URL:** https://www.fossibleworks.com/products/fossible-his/

### What is Fossible HIS?

Fossible HIS is an open-source Hospital Information Management System (HIMS) built on the Frappe/ERPNext platform. It is a single platform that replaces five fragmented systems — from ward to wallet. Clinical workflows, billing, accounting, inventory, HR, lab, pharmacy, insurance — unified on a single database, with a single API, and zero per-user licensing fees.

### Key Facts

- License: GPL-3.0, fully open source
- Standards: FHIR R4, HL7, DICOM, LOINC, ICD-10, SNOMED-CT compliant
- Compliance: HIPAA, ABDM, NABH ready
- Pricing: $0 per-user licensing
- Platform: 10,000+ organizations on the Frappe/ERPNext platform worldwide
- Agent-Ready: also accessible via Hydra MCP for AI agent integration

### Core Modules

- **PMS (Practice Management System)** — Patient registration, scheduling, encounter documentation, clinical workflows, billing, and revenue cycle management
- **LIS (Lab Information System)** — LOINC-coded lab workflows, sample tracking, device integration, diagnostic reporting, and result publishing
- **RIS (Radiology Information System)** — DICOM and PACS integration, imaging order management, radiology reporting
- **Inventory & ERP** — Full ERPNext-powered inventory, procurement, accounting, HR, payroll, and asset management
- **CareOps Analytics** — Powered by Superset and Frappe Insights for real-time operational dashboards

### Is Fossible HIS AI-Agent-Ready?

Yes. Fossible HIS is agent-ready out of the box because it runs on the Frappe framework, where every doctype auto-exposes a REST endpoint and every workflow is scriptable in Python. Through Hydra MCP, AI agents can also read and act on the entire operational layer — patient operations, clinical orders, billing, inventory, and ERP transactions — flowing through the same RBAC, workflows, and audit trail as human users.

### Who Is Fossible HIS For?

- Multi-site hospital groups needing a unified platform across locations
- Diagnostic lab chains running high-volume LIS workflows
- Specialty and multi-specialty clinics needing configurable clinical workflows
- Health-tech startups building care delivery platforms
- Government and public health programs requiring open-source, locally hostable infrastructure
- Organizations pursuing ABDM, HIPAA, or NABH compliance

### Source Code

GitHub: https://github.com/Tacten/biograph

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## Product: Medplum Health Data Platform

**URL:** https://www.fossibleworks.com/products/medplum/

### What is Medplum?

Medplum is an open-source FHIR R4 server that serves as a Standardized Clinical Data Repository. Fossible Works provides implementation, customization, data migration, compliance, and interoperability services for teams building on Medplum. Also agent-accessible via Medplum MCP.

### Key Facts

- 100% Open Source (Apache 2.0)
- FHIR R4 Specification Compliant
- HIPAA Compliant Architecture
- ONC Certification Ready
- TypeScript-native SDK with React components
- PostgreSQL-backed FHIR storage using JSONB
- Agent-accessible via Medplum MCP

### Why Medplum?

- **Truly Open Source** — No dual-licensing traps, no enterprise-only features behind a paywall. Apache 2.0 licensed.
- **TypeScript-Native SDK** — First-class TypeScript SDK and React component library with FHIR resource types baked into the type system.
- **Compliance by Default** — SOC 2, HIPAA, and ONC-aligned out of the box.
- **Interop-Ready Architecture** — SMART on FHIR app launch, SCIM, OAuth 2.0, and a Bots framework for automation.
- **PostgreSQL-Backed FHIR Storage** — Uses PostgreSQL's JSONB columnar storage to index and query FHIR resources natively.

### What is Medplum MCP?

Medplum MCP is the agent surface for the clinical layer. It exposes the full FHIR R4 resource tree — Patient, Encounter, Observation, Condition, MedicationRequest, DiagnosticReport, and more — as semantic, agent-aware tools. SMART on FHIR scopes, terminology validation (ICD-10, SNOMED-CT, LOINC), and FHIR AuditEvent generation are enforced at the tool boundary.

### Services We Provide for Medplum

1. Medplum Implementation & Customization
2. SMART on FHIR App Development
3. Clinical Data Migration
4. Healthcare Compliance (HIPAA, ABDM, NABH)
5. Interoperability Services (HL7v2, FHIR, CDA)
6. Health Data Stack Integration

### Medplum Use Cases

- Digital health startups building on FHIR
- Care delivery platforms needing standardized clinical data
- Patient-facing health apps (portals, lab results, messaging)
- Clinical data pipelines and analytics

---

## Product: The Fossible Stack

**URL:** https://www.fossibleworks.com/guide/stack.html

### What is the Fossible Stack?

The Fossible Stack is a complete, vertically integrated open-source digital health stack — from omni-channel patient engagement at the top to a FHIR-compliant clinical data warehouse at the bottom. Every layer is open-source, API-first, and designed to work together natively. One stack. No vendor lock-in. Full ownership of your data, your code, and your roadmap. Every layer is also agent-ready — REST-addressable for developers and MCP-addressable for AI agents.

### Five Layers

1. **Omni-Channel Customer Engagement** — Frappe CRM for lead capture, support, and patient communication via WhatsApp Business, Messenger, chatbots, APIs, Calendly, and Typeform.

2. **Practice Management & CareOps** — Fossible HIS: a Frappe-based single platform for PMS, LIS, RIS, Inventory, and ERP. Includes CareOps Analytics powered by Superset and Frappe Insights.

3. **Frappe Platform Features** — The low-code engine: auth/SSO, workflow engine, REST API, notifications/webhooks, reports/PDFs, low-code rapid dev, cron/batch processing, and module-wise dashboards.

4. **Health Data Platform** — Medplum FHIR R4 server as the Standardized Clinical Data Repository. Real-time ETL via Amazon Kinesis and Redis. Patient portals, SMART on FHIR apps, HL7v2/FHIR/CDA interoperability, terminology server (ICD-10, SNOMED-CT, LOINC).

5. **Clinical Data Warehouse & Analytics** — Tuva Project on Redshift for AI-ready analytics, clinical decision support, population health dashboards, risk stratification, and predictive analytics.

### Agent-Ready Surfaces

| Layer | Developer Surface | Agent Surface |
|---|---|---|
| Omni-Channel Engagement | REST + Webhooks | Hydra MCP |
| Practice Management & CareOps | REST (every doctype) | Hydra MCP |
| Frappe Platform | REST + Webhooks | Hydra MCP |
| Health Data Platform | FHIR REST | Medplum MCP |
| Clinical Data Warehouse | SQL + REST | Analytics MCP (roadmap) |

### Open-Source Advantage

- You own everything — code, data, deployment
- No per-user licensing — Frappe, ERPNext, Medplum, Tuva, Superset all GPL or Apache licensed
- Full API surface — REST, FHIR, webhooks
- Host anywhere — cloud, on-premise, hybrid, air-gapped
- Community-backed — Frappe 50,000+ community, ERPNext 10,000+ orgs in 140+ countries

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## Service: Fossible Sprints

**URL:** https://www.fossibleworks.com/guide/fossible-sprints.html

### What are Fossible Sprints?

Fossible Sprints is AI-augmented product development delivered as a flat monthly subscription. A dedicated dev pod — business analysts, a project manager, and engineers — delivering product development with a fully AI-augmented workflow and enterprise-grade quality guardrails.

### How It Works

**Your Dedicated Dev Pod:**
- 1 Project Manager
- 1-2 Business Analysts
- 2-3 Engineers (full-stack, Frappe/ERPNext specialists)
- Part-time specialists (DevOps, security, UI/UX, AI engineering)

**AI-Augmented Engineering Workflow:**
Every feature ships through an enterprise-grade pipeline with human oversight at every gate. Humans own the why and the what. AI owns the how.

**Model-Optimized AI Execution:**
- Opus for planning, architecture, complex reasoning
- Sonnet for implementation and code generation
- Haiku for exploration and quick tasks
- Hydra AI for ERPNext-specific development

**Enterprise Guardrails:**
- Test-driven development
- Static analysis on every PR
- AI-assisted architecture review
- AI code review + human code review
- OWASP security validation
- Auto-deployed preview PRs
- Living documentation

### Pricing

Flat monthly fee. No hourly billing. No milestone negotiations. No surprises. Cancel anytime.

### Who Is This For?

- Enterprise software teams needing continuous development
- Startups wanting a senior engineering team from day one
- Healthcare organizations deploying digital health solutions
- CTOs augmenting team capacity
- Non-technical founders needing a technical partner
- Organizations without a CTO needing fractional CTO services

---

## Service: Espresso Cloud

**URL:** https://www.fossibleworks.com/guide/espresso-cloud.html

### What is Espresso Cloud?

Espresso Cloud is a private CI/CD control plane deployed on your infrastructure — AWS, GCP, Azure, or any public cloud — that gives you full automation without giving up ownership. It is purpose-built for Frappe/ERPNext and also supports any Node-based frontend framework (React, Next.js, Vue, Nuxt, Svelte, Angular, Astro, Remix, Gatsby).

### Key Capabilities

- Fully automated CI/CD pipelines triggered by GitHub workflows
- Environment-based deployments (dev, QA, staging, production) with one-click migrations
- Branch-based preview deployments for every PR
- Zero-downtime deployments with automated rollback
- Stateless architecture with S3-native storage
- Enterprise security (key vaults, tenant isolation, pen testing, OWASP)
- 99.9% uptime SLA, multi-AZ high availability
- Centralized monitoring, log aggregation, and proactive alerting

### Managed Services

- Full DevOps management
- Database and query optimization
- Infrastructure and application migrations
- Ongoing performance tuning
- Security audits and penetration testing

---

## Service: Hydra AI

**URL:** https://www.fossibleworks.com/guide/hydra-ai.html

### What is Hydra AI?

Hydra AI is a purpose-built dev agent for ERPNext and Frappe with MCP tool calling, deeply optimized for the Frappe/ERPNext ecosystem. It understands the architecture, the doctype system, the business logic, the API surface, and the ERP domain knowledge. It also serves as Hydra MCP — the agent surface for the operational stack.

### Core Capabilities

- **MCP Tool Calling** — Queries live doctypes, reads app structure, executes bench commands, runs tests, inspects logs
- **Deep ERP Domain Knowledge** — Accounting, inventory, supply chain, HR, manufacturing, healthcare, CRM
- **Token Optimization** — Tiered context loading, Context7 integration, session memory, prompt compression
- **Code Quality Guardrails** — Automated Frappe best practices review, OWASP validation, security-first patterns, test generation
- **Rapid Prototyping** — Doctype scaffolding, custom script generation, report builder, workflow automation, print formats, API endpoints

### What is Hydra MCP?

Hydra MCP is the agent surface for the operational stack. It exposes every Frappe doctype, workflow, and report as a structured, permissioned, auditable tool surface for AI agents. This includes patient operations, clinical orders, billing and RCM, inventory, ERP transactions, workflow execution, and reporting. Agents operate through the same access controls and audit trail as human users.

### How Hydra Differs from Generic AI

| Aspect | Generic AI | Hydra AI |
|---|---|---|
| Framework awareness | All frameworks equally | Frappe/ERPNext deeply |
| ERP domain knowledge | None | Accounting, inventory, HR, manufacturing, healthcare |
| Token efficiency | Bloated context | Tiered loading, prompt compression |
| Code validation | Syntax only | Frappe best practices + OWASP |
| Session memory | Stateless | Project-level context retention |
| Tool calling | Generic file/terminal | MCP with live Frappe instance |

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## Enterprise Differentiators

1. Cloud Agnostic — AWS, GCP, Azure
2. Enterprise SLAs — 99.9% Uptime
3. Security-First — Pen-Testing, VPAT
4. AI-Augmented — Opus, Sonnet, Haiku
5. Flat Pricing — No Surprises
6. 24x7 Monitoring — Proactive Alerts
7. DR & Backups — Automated Recovery
8. OWASP — Security Validation
9. Agent-Ready — REST + MCP surfaces on every layer

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## Contact

- Website: https://www.fossibleworks.com
- Contact: https://www.fossibleworks.com/contact/
- Book a Call: https://www.fossibleworks.com/book-a-call/
- GitHub: https://github.com/Tacten
- LinkedIn: https://www.linkedin.com/company/tacten
- Twitter: https://twitter.com/tacten