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The ADA Two-Question Rule and the Case Against AI Documentation Checks for Service Dogs

AI documentation checks for service dogs may be technically feasible, but they violate ADA intent. A legal and clinical analysis of what verification technology should actually do.

Dr. Patrick Fisher, PhD, LPC, NCC · July 18, 2026
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Clinical Decision Support vs Clinical Decision Making: Where the FDA SaMD Line Falls in 2026

The FDA SaMD framework draws a hard regulatory line between clinical decision support and medical devices. Here is where that line falls in 2026.

Dr. Patrick Fisher, PhD, LPC, NCC · July 15, 2026
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Applying the NIST AI Risk Management Framework to Nonprofit Clinical AI Deployment

The NIST AI Risk Management Framework offers nonprofit healthcare organizations a practical governance structure for clinical AI: board oversight, audit logging, model cards and incident response without enterprise budgets.

Dr. Patrick Fisher, PhD, LPC, NCC · July 11, 2026
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Algorithmic Bias in Mental Health Triage: The Subgroup Validation Gap

Training set demographics rarely match deployment populations in mental health AI. Here is what subgroup validation actually requires and where the field stands in 2026.

Dr. Patrick Fisher, PhD, LPC, NCC · July 8, 2026
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Computer Vision for Service Dog Public Access Assessment: Canine Pose Estimation, Behavioral Markers and the Limits of Single-Camera Evaluation

A technical review of DeepLabCut and SLEAP applied to service dog public access behavioral assessment, including detectable markers and the hard limits of single-camera video.

Dr. Patrick Fisher, PhD, LPC, NCC · July 4, 2026
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HIPAA-Compliant Screening Infrastructure: What the BAA Chain Actually Requires

The BAA chain in AI-assisted clinical screening spans LLM vendors, vector databases, logging layers, and hosting. Here is what compliance actually requires.

Dr. Patrick Fisher, PhD, LPC, NCC · July 1, 2026
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FHIR R4 Integration for Nonprofit Clinical Workflows Without EHR Partnership

FHIR R4 integration for nonprofit clinical platforms without EHR partnership: SMART on FHIR auth, Patient/Observation/Questionnaire resources and interop pitfalls.

Dr. Patrick Fisher, PhD, LPC, NCC · June 27, 2026
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Large Language Models in Clinical Intake: Where the Evidence Actually Stands

A systematic review of 2026 evidence on LLM clinical intake from JAMA, NEJM AI and Lancet Digital Health: what is validated for triage, extraction and decision support.

Dr. Patrick Fisher, PhD, LPC, NCC · June 24, 2026
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HANK AI and the Purpose-Specific Assistant Pattern: Why Narrow-Scope LLM Deployment Outperforms General Chatbots in Nonprofit Healthcare

HANK AI uses a purpose-specific LLM architecture to outperform general chatbots in nonprofit healthcare support, with domain-locked RAG and clinical scope constraints.

Dr. Patrick Fisher, PhD, LPC, NCC · June 20, 2026
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Audit Logging Requirements for Clinical AI Systems Under HIPAA and the 21st Century Cures Act

What audit logs clinical AI systems actually need under HIPAA audit controls, OCR breach response expectations, and 21st Century Cures information blocking rules.

Dr. Patrick Fisher, PhD, LPC, NCC · June 17, 2026
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Consent for AI-Assisted Clinical Evaluation: Beyond the Checkbox

AI informed consent in clinical settings demands far more than a signature. Explore disclosure requirements, comprehension validation and IRB standards for 2026.

Dr. Patrick Fisher, PhD, LPC, NCC · June 13, 2026
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The ADA Two-Question Rule and the Case Against AI Documentation Checks for Service Dogs

AI documentation checks for service dogs may be technically feasible in 2026, but they violate ADA intent. Here is the legal and ethical analysis.

Dr. Patrick Fisher, PhD, LPC, NCC · June 10, 2026
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Biometric Authentication for Handler-Dog Team Documentation: Privacy-Preserving Verification at Scale

Privacy-preserving biometric verification of handler-dog teams: template storage, liveness detection, ADA documentation doctrine and HIPAA-compliant deployment architecture.

Dr. Patrick Fisher, PhD, LPC, NCC · June 6, 2026
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Clinical Decision Support vs Clinical Decision Making: Where FDA's SaMD Line Falls in 2026

FDA's SaMD framework in 2026 determines whether AI clinical tools need 510(k) clearance or qualify as CDS. Here is where the line actually falls.

Dr. Patrick Fisher, PhD, LPC, NCC · June 3, 2026
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Retrieval-Augmented Generation Over Clinical Guidelines: Practical Architecture for DSM-5-TR, APA and NICE

How to build RAG systems over DSM-5-TR, APA and NICE guidelines using clinical chunking strategies, grounding scores and citation fidelity architecture.

Dr. Patrick Fisher, PhD, LPC, NCC · May 30, 2026
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NIST AI Risk Management Framework for Nonprofit Clinical Deployment: Board Oversight, Audit Logging and Model Cards on a Constrained Budget

How nonprofit healthcare organizations can implement the NIST AI Risk Management Framework with board-level oversight, audit logging and model cards without enterprise budgets.

Dr. Patrick Fisher, PhD, LPC, NCC · May 27, 2026
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Consent for AI-Assisted Clinical Evaluation: Beyond the Checkbox

Informed consent for AI-assisted clinical evaluation demands far more than a checkbox. Explore disclosure requirements, comprehension validation, and IRB obligations for nonprofit AI screening in 2026.

Dr. Patrick Fisher, PhD, LPC, NCC · May 23, 2026
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HANK AI and the Purpose-Specific Assistant Pattern: Why Narrow-Scope LLM Deployment Outperforms General Chatbots in Healthcare Support

HANK AI demonstrates why narrow-scope LLM deployment outperforms general chatbots in healthcare intake through closed RAG, hard guardrails and clinical outcome metrics.

Dr. Patrick Fisher, PhD, LPC, NCC · May 20, 2026
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Large Language Models in Clinical Intake: Where the Evidence Actually Stands

A systematic review of validated evidence on LLM-assisted clinical intake, from triage accuracy to decision support limits, drawing on JAMA, NEJM AI and Lancet Digital Health.

Dr. Patrick Fisher, PhD, LPC, NCC · May 16, 2026
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Algorithmic Bias in Mental Health Triage: The Subgroup Validation Gap

Training set demographics rarely match deployment populations in mental health AI. Here is how subgroup validation, equalized odds and calibration testing close the gap.

Dr. Patrick Fisher, PhD, LPC, NCC · May 13, 2026
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Biometric Authentication for Handler-Dog Team Documentation: Privacy-Preserving Verification at the Edge of ADA Law

Privacy-preserving biometric verification for handler-dog teams: template storage, liveness detection, ADA documentation non-requirement doctrine and fair deployment.

Dr. Patrick Fisher, PhD, LPC, NCC · May 9, 2026
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FHIR R4 Integration for Nonprofit Clinical Workflows Without EHR Partnership

FHIR R4 integration for nonprofits without EHR partnerships: SMART on FHIR authorization, Patient/Observation/Questionnaire modeling and real interop pitfalls.

Dr. Patrick Fisher, PhD, LPC, NCC · May 6, 2026
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Clinical Decision Support vs Clinical Decision Making: Where FDA SaMD Classification Draws the Line

FDA's SaMD framework determines whether AI clinical tools need 510(k) clearance or qualify as exempt CDS. Here is where the line actually sits in 2026.

Dr. Patrick Fisher, PhD, LPC, NCC · May 2, 2026
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Computer Vision for Service Dog Public Access Assessment: A Technical Review of Canine Pose Estimation Models

A technical review of DeepLabCut and SLEAP canine pose estimation models applied to service dog public access evaluation, including behavioral markers and single-camera limits.

Dr. Patrick Fisher, PhD, LPC, NCC · April 29, 2026
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ADA Two-Question Rule and the Case Against AI Documentation Checks

Why AI verification of service dog documentation violates ADA intent despite technical feasibility, exploring legal analysis and disability rights perspectives.

Dr. Patrick Fisher, PhD, LPC, NCC · April 25, 2026
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HIPAA-Compliant Screening Infrastructure: What the BAA Chain Actually Requires

Building HIPAA-compliant AI screening infrastructure requires cascading Business Associate Agreements through every component, from LLM vendors to vector databases, with technical controls that implement minimum necessary standards in prompt design.

Dr. Patrick Fisher, PhD, LPC, NCC · April 22, 2026
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Retrieval-Augmented Generation Over Clinical Guidelines: Practical Architecture for Mental Health AI Systems

Implementing RAG systems over clinical guidelines requires specialized chunking strategies, grounding scores, and hallucination mitigation to support Licensed Clinical Doctors in diagnostic workflows.

Dr. Patrick Fisher, PhD, LPC, NCC · April 22, 2026
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HIPAA Audit Logging Requirements for Clinical AI Systems Under the 21st Century Cures Act

Clinical AI systems under HIPAA require comprehensive audit logging that satisfies OCR breach response expectations and 21st Century Cures Act information blocking provisions.

Dr. Patrick Fisher, PhD, LPC, NCC · April 22, 2026
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