Identity & Access

A vendor-neutral Identity Broker — plus a clinical Authorization Decision Service.

Neriant is not permanently dependent on Cognito, Keycloak, Okta, Entra or NHS CIS2. Identity providers are pluggable. The clinical access brain — RBAC, ABAC, PBAC, consent, treating relationship, break-glass — is owned by the platform.

Architecture

Authentication is brokered. Authorization is clinical.

Users & systems
CliniciansPatientsAdminsAPIs & integrations
Identity providers
CognitoKeycloakEntra IDOkta / Auth0NHS CIS2eIDAS / EUDILDAPSAML / OIDC
Vendor-neutral Identity Broker

Claim normalization · federation · token exchange · tenant context · session context

Clinical Authorization Decision Service

RBAC · ABAC · PBAC · consent · care-relationship · break-glass · audit evidence

Clinical surface
EHR modulesHIEFHIR APIsPatient portalCounsel AIAnalytics

Identity Broker

One normalized identity model. Pluggable everything underneath.

The broker translates whatever the upstream IdP issues into a stable internal structure every clinical module understands.

Normalized attributePurpose
User IDStable internal identity for clinician, patient, admin, service account or integration.
Tenant IDSeparates SaaS tenants, hospital groups, regional HIE participants and sovereign deployments.
Organisation IDLinks the user to a trust, hospital, clinic, lab, payer, government agency or care network.
Role & job functionDoctor, nurse, pharmacist, administrator, researcher, patient, auditor, or integration service.
Professional registrationGMC, NMC, state medical board, nursing council, pharmacy regulator, country-specific registries.
Care setting & departmentWard, clinic, specialty, ED, theatre, pharmacy, lab, imaging.
Authentication assuranceMFA, smartcard, passkey, NHS CIS2, SAML, OIDC, biometric — recorded with the session.
Session riskDrives step-up authentication and additional checks for sensitive actions.

Authorization Decision Service

In healthcare, role-based access alone isn't enough.

Access depends on clinical context, consent, duty of care, regulatory rules, professional responsibility and patient safety. The ADS is where those decisions live.

Can this clinician view this patient record?
Can this nurse administer medication on this ward?
Can this pharmacist verify or modify an order?
Can this user access mental-health, sexual-health, HIV, maternity or genetic records?
Can this clinician override a restriction under break-glass emergency access?
Can this organisation view shared-care or HIE data from another provider?
Can this user export, print or share patient data?
Can this researcher access de-identified, pseudonymised or identifiable data?
Can this user run Counsel AI against patient data?
Can this API client access FHIR resources for this tenant and scope?
Contextual
Treating relationship, ward, on-duty, care team, time of day.
Consent-aware
Patient consent, opt-outs, jurisdictional restrictions.
Break-glass
Justified emergency overrides, fully audited end-to-end.
Cross-organisation
Shared-care, HIE, cross-border — with provenance.

Pluggable identity providers

Use the right IdP for the deployment.

AWS Cognito
SaaS tenants, patient apps, B2B federation
Federated
Keycloak
Single-tenant, on-prem, sovereign cloud
Federated
NHS CIS2
NHS clinicians via smartcard / federated login
Federated
Microsoft Entra ID
Hospital SSO in US and EU enterprises
Federated
Okta / Auth0
Health-system workforce SSO
Federated
Ping / ForgeRock
Large IDN federated identity
Federated
National eID / eIDAS
EU citizen and professional identity
Federated
LDAP / SAML / OIDC
Legacy enterprise directories and IdPs
Federated