DownStream
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Who We Serve

Healthcare organizations make commitments every day. DownStream helps make sure they don't get lost.

Contracts across healthcare often contain security, privacy, compliance, reporting, audit, operational, and assurance obligations that outlive the negotiation itself.

DownStream helps organizations turn those commitments into a structured, traceable record — so the teams responsible for meeting them can see what was agreed to, where it came from, and what evidence supports it.

Know what you've agreed to. Prove every commitment.

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Built for the organizations that carry the commitment

Business associates and HealthTech companies are often the first teams that need a structured record of customer-specific requirements.

Business Associates

Understand what your customers have actually required of you.

For business associates, every customer agreement can introduce a different set of expectations around security, breach notification, subcontractors, audit rights, insurance, business continuity, evidence, and reporting.

As the customer base grows, those commitments become increasingly difficult to manage manually.

Common pain points

  • Different customers negotiate different incident-notification windows.
  • Security addenda may impose requirements beyond a standard BAA.
  • Subprocessor and flow-down obligations can vary by customer.
  • Customers may require specific certifications, reports, or evidence.
  • Contractual requirements may exceed your internal standard.
  • Sales, Legal, Security, and Compliance may each maintain different records.

How DownStream helps

DownStream gives business associates a centralized way to identify customer-specific commitments, compare them against organizational standards, track supporting evidence, and answer assurance questions with greater confidence.

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HealthTech Companies

Scale customer commitments without scaling spreadsheets and manual review.

HealthTech and digital health companies often move quickly. Sales closes new customers. Legal negotiates agreements. Security answers questionnaires. Compliance manages frameworks. Engineering delivers the product.

But every new customer can introduce another layer of commitments.

Common pain points

  • Enterprise customers negotiate unique security requirements.
  • Sales and Legal may agree to obligations that Security discovers later.
  • Different customers require different reports, certifications, and controls.
  • Contractual requirements may become stricter than the company's standard baseline.
  • Assurance requests consume increasing amounts of Security and Compliance time.
  • Growth makes spreadsheets and manual tracking unsustainable.

How DownStream helps

DownStream helps HealthTech companies build a structured system of record for customer commitments — from contract language through obligations, internal standards, controls, and supporting evidence. That makes it easier to scale enterprise sales without losing visibility into what the company has promised.

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Covered Entities

Keep vendor and partner commitments visible after the contract is signed.

Health systems, hospitals, physician groups, clinics, and other covered entities manage hundreds or thousands of agreements with vendors, service providers, technology companies, and data partners.

The challenge is not just knowing what HIPAA requires. It is knowing what your organization has separately committed to through contracts, BAAs, security addenda, service agreements, and other negotiated terms.

Common pain points

  • Different vendors impose different security and privacy requirements.
  • Incident and breach notification deadlines vary by agreement.
  • Audit rights and assurance obligations are scattered across contracts.
  • Data deletion, retention, and return requirements can conflict across agreements.
  • Security teams may not know what Legal negotiated months earlier.
  • Evidence needed to prove compliance is often stored in separate systems or inboxes.

How DownStream helps

DownStream extracts and organizes contractual obligations, connects them to relevant frameworks and internal controls, and gives security, privacy, compliance, and legal teams a shared view of what must actually be done.

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Payors

Bring consistency to complex vendor, partner, and service-provider obligations.

Health plans and payors work across broad ecosystems of vendors, administrators, service providers, analytics partners, technology platforms, and healthcare organizations.

Each agreement can create different requirements around data protection, reporting, security, service continuity, and regulatory support.

Common pain points

  • Contract requirements vary across vendors and business units.
  • Security and privacy commitments are difficult to standardize.
  • Reporting and notification obligations may have different timelines.
  • Vendor assurance documentation is collected inconsistently.
  • Operational commitments may be difficult to trace back to their contractual source.
  • Compliance teams may spend significant time validating what was actually agreed to.

How DownStream helps

DownStream creates a structured record of contractual commitments across agreements, making it easier to identify inconsistencies, surface stricter requirements, and connect obligations to internal controls and supporting evidence.

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Healthcare Clearinghouses

Keep trading-partner and service obligations from becoming invisible operational risk.

Clearinghouses sit at the intersection of healthcare organizations, payors, providers, and technology partners, creating a dense network of contractual relationships and operational commitments.

Those agreements can contain overlapping requirements around security, privacy, availability, incident response, data exchange, and auditability.

Common pain points

  • Multiple trading partners may impose different contractual requirements.
  • Operational and technical obligations may be embedded across several agreement types.
  • Security and privacy commitments may differ between counterparties.
  • Audit and reporting requirements can be difficult to track consistently.
  • Teams may struggle to determine which requirement is the strictest.
  • Evidence supporting contractual commitments may be fragmented across systems.

How DownStream helps

DownStream helps clearinghouses identify, organize, and compare contractual obligations across agreements while preserving the source language and traceability needed for review and assurance.

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Built for the teams responsible for the commitment

DownStream is designed for the teams that inherit contractual obligations after the agreement is signed.

Security

Understand security commitments, notification deadlines, audit rights, and required controls.

Privacy

Track data handling, retention, deletion, subprocessor, and privacy obligations.

Compliance

Connect contractual commitments to relevant frameworks and organizational standards.

Legal

Maintain traceability from operational obligations back to the original agreement language.

Risk

Surface requirements that exceed internal standards or introduce additional operational exposure.

Operations

Track service, reporting, continuity, and other commitments that require ongoing execution.

One contract can create obligations across the entire organization.

DownStream helps bring those obligations together.

Know what you've agreed to.

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