Healthcare has an integration problem that AI is about to make worse. Thousands of clinical AI agents are being built in isolation — with no standard way to discover, trust, or coordinate with each other. We fix that.
BulletTrain is the orchestration platform. GHARRA is the agent registry. Nexus A2A is the communication protocol. Together, they let clinical AI agents find each other, prove they're trustworthy, and collaborate on patient care — all under full governance.
BulletTrain is free. Install it on your own infrastructure — like Linux for healthcare interoperability. 160+ microservices, native FHIR R4, HL7v2, CDA, X12, DICOM support, real-time terminology mapping across SNOMED CT, ICD-10, ICD-11, LOINC, CPT, RxNorm, and dm+d.
GHARRA is hosted. The agent registry is operated by Symphonix Health as a managed service. Subscribers register their agents, discover others, and pay for agent usage. Revenue funds continued innovation on the platform — new agents, new capabilities, better governance tooling.
The integration bridge connects them. Every BulletTrain installation includes a bridge to GHARRA that exposes subscribed agents to customers. When a hospital deploys BulletTrain, it immediately gains access to the full agent ecosystem — triage, imaging, pharmacy, discharge, consent, compliance — orchestrated through governed clinical workflows. The bridge is why BulletTrain can be free: it's the on-ramp to the agent economy.
Nexus A2A is the protocol underneath. JSON-RPC 2.0 with 13-point route admission validation. 25 reference agents. 7,000+ test scenarios. 100% pass rate. Every interaction is governed, audited, and consent-verified.
┌──────────────────────────────────────────────┐
│ BulletTrain (HIE) │
│ Orchestration · Routing · Terminology │
│ Free · Self-hosted · 160+ μs │
└──────────────────┬───────────────────────────┘
│
Integration Bridge
│
┌──────────────────▼───────────────────────────┐
│ GHARRA Registry │
│ Discovery · Trust · Federation · Billing │
│ Hosted · Pay-per-use · Managed │
└──────────┬───────────────────┬───────────────┘
│ │
┌──────────▼──────┐ ┌───────▼───────────────┐
│ Nexus A2A │ │ Nexus A2A │
│ Agent ←→ Agent│ │ Agent ←→ Agent │
└──────────┬──────┘ └───────┬───────────────┘
│ │
┌────▼────┐ ┌──────▼──┐ ┌─────▼────┐ ┌────────▼──┐
│ Triage │ │ Imaging │ │ Pharmacy │ │ Discharge │
│ Agent │ │ Agent │ │ Agent │ │ Agent │
└─────────┘ └─────────┘ └──────────┘ └───────────┘
| Zero patient data in the registry | GHARRA never stores or proxies PHI. Three-layer detection blocks it at the gateway. |
| Emergency care is never blocked | Break-glass override bypasses all gates except authentication. Not by policy. Not by billing. |
| 13-point admission control | Every agent-to-agent request passes identity, trust, consent, jurisdiction, and governance checks. |
| Built on OpenHIE | WHO-endorsed Health Information Exchange architecture, extended for AI agent orchestration. |
| Free platform, paid agents | BulletTrain adoption drives the network. The integration bridge connects every installation to GHARRA's agent ecosystem. More hospitals = more agents = more value for everyone. |
- Health system CIOs/CTOs — deploy BulletTrain for free, subscribe to agents as you need them
- Enterprise architects — standards-based interoperability with governed AI agent orchestration
- AI engineers — build agents that plug into a global discovery and trust network
- Digital health startups — reach every BulletTrain deployment through GHARRA
- National health programmes — deploy AI-native infrastructure at scale with federated governance
Visit symphonix-health.com to explore the platform, read the documentation, and book a walkthrough.
📖 Documentation · 🏥 Clinical Governance · 🔒 Trust & Governance · 📅 Book a Walkthrough
Named for Aneurin Bevan, founder of the NHS. Healthcare infrastructure should be available to all.