Autonomous Clinical Infrastructure
Autonomous Medicine for a World in Need.
Certified clinical decisions at machine speed. Physician-verified and fully auditable.
Why now
Healthcare is a distribution problem.
The global physician shortage is structural — 4.3 million doctors short. Training more doctors alone will not close the gap fast enough. Validated clinical workflows, running as infrastructure, can.
Problem framing
Context before mechanism.
Problem
Scale is increasing while clinician time is finite and safety expectations are non-negotiable.
Constraint
Clinical autonomy requires deterministic verification boundaries, not unconstrained AI outputs.
Approach
Certuma's Hybrid Deterministic Architecture combines LLM reasoning with a hard validation layer. Autonomy exists within explicit, auditable boundaries.
Deterministic clinical pathway
From narrative to verified decision.
Clinical inputs are structured, validated through deterministic reasoning, and delivered as auditable, physician-reviewable decisions.
Patient input
“Burning when I pee since yesterday, going every 20 minutes, no fever, and no back pain.”

Structured output
Final diagnosis
Acute uncomplicated cystitis
Confidence: 0.93
Rule criteria matched; no pyelonephritis red flags detected.
Workflow
Safety is not a claim.
It is the product.
Certuma routes every in-scope plan through physician verification. That workflow is the point: fast turnaround without removing accountability.
Certuma
Patient view
Today’s check-in
What are you feeling right now?
My throat hurts when I swallow. No trouble breathing. It started two days ago.
Risk status
In scope
Next step
Physician review
Plan snapshot
This will appear after sign-off.
Preview
Hydration + rest
Pain relief per label
Escalate if worse
Activity
Check-in saved
09:14Safety gates run
09:16Queued for sign-off
09:1901
Conversational intake that becomes a clinical record
Patients describe what is happening in natural language. Certuma continuously structures the details: onset, severity, associated symptoms, negatives, history, medications, allergies, and risk factors.
02
Hybrid Deterministic Architecture gates before any plan is drafted
Red flags, contraindications, interaction checks, scope limits, and uncertainty thresholds run through the deterministic verification layer. If something is emergent or out of scope, the system escalates instead of guessing.
03
A licensed physician reviews, edits, and signs
Clinicians see structured intake, highlighted risks, and a draft plan with supporting evidence. They approve, edit, or escalate; changes are captured with reason codes and a durable audit trail.
04
Patients receive a plan they can act on
Plain language, clear next steps, and a clean summary that can be shared with an existing doctor. The experience avoids ambiguity and “medical word salad.”
Safety
Deterministic Integrity: explicit, auditable, and regulatory-aligned.
Certuma adds a deterministic verification layer to LLM reasoning. Unvalidated paths are rejected. Uncertainty is escalated. Every decision is auditable.
Safety gates
Deterministic checks that run before physician verification and before patient delivery.
Emergent red flags
Detect and escalate urgent symptoms
Escalate, do not draft
Contraindications
Screen common exclusions and safety limits
Block unsafe options
Allergies and interactions
Medication conflicts and risk flags
Prevent harmful suggestions
Scope limits
Out-of-scope conditions
Escalate to appropriate care
Uncertainty thresholds
Low-confidence situations
Require clinician review
Provenance capture
Guideline and version tracing
Audit-ready record
Team & Clinical governance
Built by operators, clinicians, and AI engineers.
Our team brings deep experience building and scaling healthcare and technology businesses, combined with clinical, regulatory, and AI engineering.

Martin Varsavsky
Chief Executive Officer
5x unicorn founder with 30+ years of company-building experience and 10+ years in FDA-regulated medical technology.
- • Founder and chairman of multiple category-defining companies, including Prelude Fertility, the largest IVF network in the United States.
- • Co-founder and chairman of Overture Life, building automation systems for FDA-regulated embryology workflows.
- • Co-founder and chairman of Gameto (FDA IND, Phase 3); board member at Vitara (FDA Breakthrough Device, IDE filed).
- • Previously founded Jazztel, Viatel, and Eolia Renovables, with honors including European Telecommunications Entrepreneur of the Year and Columbia University's Pickering Prize.

Armando Cuesta, MD
Chief Medical Officer
Physician-executive focused on clinical quality, evidence-based pathways, and accountable scale in AI-enabled care delivery.
- • Co-inventor of MedCanon, the deterministic clinical reasoning layer behind Certuma's safety gates and physician verification workflow.
- • Founding Partner at Korion Life Sciences; 15+ years leading scientific diligence and portfolio strategy across biotech, medtech, and genomics (Europe, Israel, U.S.).
- • Co-Founder of Praetorian Bio, developing a first-in-class vaccine approach to prevent dental caries and periodontal disease.
- • Postdoctoral fellowship at Icahn School of Medicine at Mount Sinai in machine learning and translational medicine (peer-reviewed publications; 100+ citations).
- • MD; MBA (Cornell); MS Health Policy and Economics (Weill Cornell). Fellow, New York Academy of Medicine.

Joe Scanlin
Chief Technology Officer
Founder-operator and inventor with deep expertise in physical AI, computational linguistics, and applied medical informatics.
- • Co-inventor of MedCanon, the deterministic clinical reasoning layer that structures narrative intake into auditable, physician-verifiable decision outputs.
- • Founded and exited Scanalytics, an award-winning physical AI company with technology spun out of a U.S. Department of Energy ARPA-E research program.
- • Built the Myome genomic analysis platform (AI-driven interpretation of genetic variants).
- • "Representation Before Retrieval" (a novel approach to integrating structured knowledge into LLM systems).
- • Developed a six-index cognitive-motor function framework (CMFI family) now used in clinical-trial validation of neurological and functional outcomes.
- • Built eli, an AI application using computational linguistics to identify and attenuate mental health deterioration.

Jesus Mejia
Chief Legal Officer
Legal and governance executive focused on cross-border structuring, regulatory risk, and board-level decision quality in complex healthcare and technology environments.
- • 15+ years advising principals, boards, and investment committees on governance design, capital allocation, and long-term risk control.
- • Leads conflict-of-interest and incentive-alignment decisions where governance, regulation, and strategic optionality are tightly linked.
- • Previously served in legal leadership roles at Overture Life, Gameto, Goggo Network, FON, and Jazzya Investments, with investment committee experience at MVB Fund.
- • Background spans venture capital, family investment platforms, and founder-led companies across health, biotech, AI-enabled businesses, and infrastructure-adjacent sectors.

Bruno Marino
Head of Digital Products
Product-focused entrepreneur with a track record of scaling high-complexity healthtech and digital commerce operations.
- • Co-Founder and former CEO of Flora Fertilidad (Mexico), an AI-driven reproductive health company where he pioneered patient-centered financing and outcome-based care models powered by proprietary data and intelligent automation.
- • Held senior leadership roles at Vitau (Healthtech/Pharmacy) and VTEX (Enterprise E-commerce), specializing in scaling digital operations and customer success for high-growth, technology-first organizations across the region.
- • Led digital transformation and omnichannel strategy for Farmacity, Argentina's leading pharmacy chain, managing high-scale digital channels in one of the market's most strictly regulated healthcare environments.
Clinicians
Physician oversight at scale — structured, auditable, and efficient.
A review queue designed for speed and clarity: structured intake, highlighted risks and uncertainty, a draft plan with evidence, and a verification UI optimized for edits when needed.
Prioritized queue
Urgency surfaced in plain language; clinicians can approve quickly when appropriate.
Edit-first verification
Modify any element of a plan and capture structured reasons for each change.
Durable audit trail
Immutable logs and encounter provenance support compliance and continuous improvement.
Review queue
A verification surface that keeps the clinician in control.
Chest discomfort, intermittent, 6 hours
Structured intake complete; safety gates passed
High attention
Escalate suggested
Urinary symptoms, 3 days
Structured intake complete; safety gates passed
In scope
Ready to review
Rash, new medication started
Structured intake complete; safety gates passed
Drug-related
Review required
Headache with photosensitivity
Structured intake complete; safety gates passed
In scope
Ready to review
Edits captured
Every physician modification is logged with a structured reason so the system remains auditable and improves from verified clinical feedback.
Request access
Get early access to autonomous clinical infrastructure.
