Patient Record Portability
Patients should be able to take their dental records with them. Chairside makes this automatic, instant, and cross-vendor — using FHIR R4 with zero PHI on the registry.
Records That Travel With the Patient
Chairside includes a built-in patient portability registry called Foundation. When a patient visits a new dental office, their complete clinical history — X-rays, treatment plans, clinical notes, prescriptions, medications, allergies — transfers instantly between Chairside deployments.
This works across vendors. A patient at a practice using Vendor A’s Chairside deployment can transfer records to a practice using Vendor B’s deployment. The transfer is direct between offices — Foundation only facilitates the lookup.
How a Transfer Works
Five steps, fully automated, with patient consent at every stage.
Patient visits new office
New office searches Foundation by patient identity hash
Foundation responds
Returns which Chairside instances have this patient’s records
Transfer requested
New office sends RSA-signed consent token directly to old office
Records packaged
Old office builds a FHIR R4 Bundle with the patient’s clinical data
Transfer complete
Records delivered directly — Foundation never sees the clinical data
Zero-Knowledge Architecture
Foundation stores no patient health information. Not names, not dates of birth, not clinical data. Only:
- SHA-256 hashes of patient identity — opaque, one-way, irreversible
- Instance endpoints — which Chairside deployments have records for that hash
- Public keys — RSA keys for verifying consent tokens during transfers
A Foundation database breach would expose zero patient information. This design allows Foundation to operate without HIPAA compliance concerns — it has no access to protected health information by design.
FHIR R4 Compliance
Transfers use the HL7 FHIR R4 standard — the same interoperability framework used in medical healthcare. The transfer bundle includes:
- Patient demographics
- Conditions (medical history)
- MedicationRequest (prescriptions)
- AllergyIntolerance
- Procedure (completed treatments)
- DocumentReference (clinical notes)
Using an industry standard means Chairside records can eventually interoperate with medical EHR systems as well.
Protected by the License
Patient portability is a license requirement, not just a feature. Chairside uses Apache 2.0 with a supplemental term (Section 10.1) that ensures every deployment maintains portability.
Any deployment of the Work MUST NOT remove, disable, break, or degrade the patient record portability features. Portability cannot be conditioned on vendor identity, payment, or any factor other than valid patient consent.
This means every Chairside deployment — regardless of who operates it — participates in the portability network. Patients can always transfer their records.
Explore the Foundation
Zero-knowledge patient registry, FHIR R4 transfers, RSA consent tokens. See the code.