THE FIVE TESTS OF A REAL REVIEW
A working definition of verifiable human review of AI-generated clinical output
Version 1.0 — July 19, 2026 — hashcare.com/real-review

A human review of an AI-generated clinical output is REAL if and only if it
passes all five tests:

1. LICENSED AND MATCHED. The reviewer holds an active license appropriate to
   the decision, verified against the primary source (NPI checked against CMS
   NPPES at review time), and matched to the jurisdiction and specialty of the
   case.

2. INDEPENDENT. The reviewer is organizationally independent of the developer
   of the AI system under review, and the reviewer's compensation does not
   depend on the direction of the verdict.

3. ENGAGED, NOT ASSUMED. Genuine engagement is measured, not presumed: a
   defined sample of determinations is independently double-reviewed, and
   inter-reviewer agreement statistics are computed and disclosed. A review
   process that cannot show its disagreement rate cannot show its engagement.

4. RECEIPTED. Every determination produces a tamper-evident receipt at signing
   — what was reviewed (by content hash), the verdict, the reviewer's
   credential class, and the timestamp — verifiable by any third party without
   trusting the reviewing organization.

5. DURABLE. Receipts are anchored so they outlive the operator: committed to a
   public, independently verifiable timestamp (for example, Bitcoin via
   OpenTimestamps) and retained for the full audit period.

What does NOT count: an organizational certification alone (it attests
policies, not decisions); a human with override rights who is "in the loop for
now" inside a workflow designed for full automation; an unmeasured sign-off
queue; an attestation without a receipt.

This definition claims ACCOUNTABILITY and VERIFIABILITY — not accuracy.
Published evidence on human-AI teaming is mixed; unmeasured human review can
underperform either party alone. That is why Test 3 requires measurement
rather than presence.

Published by the operators of a physician review network; the conflict is
disclosed, and the definition is free for anyone to adopt, meet, or exceed.
This exact text is hash-anchored in the public registry — verify it at
hashcare.com/verify.