AVINA Operating Hub · Architecture Phase · Internal · Kelly + Fabian
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Physician-led in-residence clinical care for UHNW principals and their family offices, built behind a separate intelligent platform. Dubai LLC holdco, US Professional Corporation for clinical delivery, single-operator model.

Architecture phase → Launch 01/07/2027 Calculating...
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Critical path blocked: Elizabeth Mortazavi MD has not yet signed the Medical Director Agreement. No US PC formation, no HIPAA BAAs, no clinical operations until this signature is on file.

Owner: Kelly · AHD-MEDICAL-DIRECTOR-AGREEMENT-v0.1
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01 Jul 2027
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Critical path blocker

Elizabeth MD Agreement not yet signed. No US PC, no HIPAA BAAs, no clinical operations until signature is on file.

Owner: Kelly
legal/AHD-MEDICAL-DIRECTOR-AGREEMENT-v0.1

Decision Status

Recently locked
Next up (pending)

What's moving this week

Launch Timeline

Architecture phase → 01/07/2027
Build horizon
MilestoneTargetStatusGate
Architecture lock24/04/2026DoneHub v1 shipped
Elizabeth MD Agreement signed15/05/2026BlockingAll downstream
US international tax counsel opinion15/05/2026BlockingIncorporation spend
Platform name + domain locked15/05/2026PendingCreative spend
Counsel retained30/05/2026PendingEntity formation
Dubai LLC formed (IFZA)30/06/2026PendingTax opinion clear
US Professional Corporation formed (CA)30/06/2026PendingElizabeth signed
BAAs signed (Supabase, Deepgram, AWS, Zoho)31/07/2026PendingUS PC formed
EMR selected + configured31/08/2026PendingElizabeth input
Nursing curriculum published30/09/2026PendingProtocol library FNL
First family office outreach wave01/10/2026PendingBrand + docs ready
Beta engagement (pilot client)01/01/2027PendingFull ops ready
Commercial launch01/07/2027PendingAll milestones

Decision Tree

From ARCHITECTURE-LOCKED v1.0

Commitments Register

Critical path + open items
CommitmentOwnerStatusGate / Target
Elizabeth signs Medical Director AgreementKellyBlockingBefore any capital deployment
Platform name + domain lockedFabian + KellyPendingTarget 15/05/2026
US international tax counsel opinion (CFC vs check-the-box)Fabian + KellyBlockingBefore any incorporation spend
Counsel retained (US healthcare + UAE dual-entity)Kelly + FabianPendingShortlist revise for UAE capability
Dubai LLC formation (IFZA)FabianPendingGated on tax counsel opinion
US Professional Corporation formation (CA)Fabian + CounselPendingGated on Elizabeth MD Agreement
EMR selected (DrChrono vs Elation)Elizabeth MDPendingAwaiting Elizabeth input
BAAs signed (Supabase, Deepgram, AWS, Zoho, DrChrono)FabianPendingGated on US PC formation
Zoho One configured (non-PHI zone)FabianPendingPost-BAA
Protocol Library rewritten (Jose's gaps fixed)Elizabeth MD + Gemini ProPendingRoute to Gemini Pro per discipline

Forced Decisions

0 / 10 decided

    Activity Log

    All Hub actions

    Architecture + Source of Truth

    Architecture

    Locked Decisions v1.0

    Two-entity structure, tech stack, data zones, acquisition channel, critical path, 14 hard rules. The single source of truth.

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    Synthesis

    Research Synthesis v1.0

    Consolidated findings from first 6 NEXUS seats. NAD evidence gap, white space confirmation, AB5 impact, HHA costs, EKRA exposure.

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    Legal + Entity Structure

    Legal / Entity

    SEAT 16: Dubai LLC + US PC Structure

    IFZA free zone + CA friendly-PC + MSO bridge. CFC/GILTI warning: Dubai may cost MORE tax than domestic. Check-the-box election likely optimal.

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    Legal / Tax

    SEAT 16A: CFC/GILTI Tax Modelling

    At sub-$5M revenue, Dubai adds tax cost with no US benefit. Provisional: elect disregarded entity, keep IP in US.

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    Legal / Entity

    SEAT 16B: Dubai Free Zone Comparison

    IFZA vs DMCC vs Mainland. IFZA recommended: $7-10K Year 1, 5-10 day setup. Banking risk exists for all US-owned UAE entities.

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    Legal / Ops

    SEAT 11: Zoho One Stack

    $37/user/mo All-Employee, US DC, BAA-confirmed for CRM+Books+Vault+Mail. DrChrono for EMR. PHI never crosses into Zoho.

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    Clinical

    Clinical / Safety

    SEAT 12: 10X Protocol Rewrite

    Jose's thiamine 100mg oral = critically subtherapeutic. Gold std 500mg IV TID. Bernese method MANDATORY for fentanyl.

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    Clinical / AI

    SEAT 09: Nurse AI Copilot

    3-layer system: pre-deploy training, in-residence shift, handover. Anthropic + Groq BAA. Mac mini M4 edge inference.

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    Platform + Technology

    Platform / Hub

    SEAT 13: Hub Architecture

    Supabase Auth + HIPAA add-on, 11 roles, per-engagement RLS. Deepgram Nova-3 Medical for voice. Infra ~$30-40K AUD/yr.

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    Platform / Patterns

    SEAT 08: EMYTH Port

    Port: reflective CORS, /log endpoint, cloudId writeback, smoke gate, 9-table normalised schema.

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    Platform / Client

    SEAT 07: Client Portal

    Three zones (Pre/Active/Post), role-scoped RLS by engagement. Magic-link FO auth. Signature moments.

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    Platform / EMR

    SEAT 18: EMR Comparison

    DrChrono = iPad-native, cheaper. Elation = API-first, modern UX. Provisional: Elation for AI + Zoho sync.

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    Marketing, Brand + Distribution

    Marketing / GEO

    SEAT 15: SEO + Marketing + Data Strategy

    LLM discovery is primary Y1. Wikipedia = 48% of ChatGPT citations. EKRA: no volume-based comp.

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    Market / Competitive

    SEAT 17: US Competitive Landscape

    White space confirmed at intersection of in-residence + IV + NAD + FO language. Speed to market = primary moat.

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    Brand / Naming

    SEAT 14: Platform Naming

    Recommended: AVINA PRINCIPAL. Stay in Avina family. "Detox" banned from public brand.

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    Ops / Voice

    SEAT 10: Kelly PLAUD Synthesis

    Kelly = "the data centre" / "fixer". Pantone-kid case = ChatGPT inbound, no gatekeeper. 1,400 hrs/yr ceiling.

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    Intelligence by Date

    Most recent first

    Recently Added

    Last 4 seats

    Document Registry

    v0.1 / v1.0 / FNL

    v1.0 Ready

    Reviewed and ready for sign-off

    v0.1 Drafts

    First drafts, not yet reviewed

    By Folder

    Clinical / Business / Legal / Compliance / Sales / Research / Brand

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