Engine v4 — live in patient cohorts

The intelligent twin.
Reasoning, not reporting.

A continuously-updating model of you — fused from every signal modern medicine can capture, and capable of asking the questions a clinician would, if they could sit with you for a decade.

Six engines, one twin.

Most "AI health" products bolt one model onto a dashboard. Averra is a stack — six engines, in continuous bidirectional dialogue with the physical you. Each is built at the frontier; together, they form something the field has been chasing for two decades.

01 · Cognitioni.

A personal foundation model.

A pretrained transformer over millions of multi-omics and clinical profiles, fine-tuned on you. A resting heart rate of 58 means something specific to your biology — not the population average. This is what the field calls an intelligent twin: a model that reasons, learns and decides, not a database that reports.

Frontier alignmentFMs · multi-omics integration
02 · Sensingii.

Continuous multimodal fusion.

Wearables, glucose, sleep, labs, imaging, microbiome, mood, environment — normalised into a single time-aware record. The twin works because the constellation does, not because any one biomarker tells the truth.

Streams14 modalities · 1 record
03 · Predictioniii.

Forward trajectories, with honest confidence.

1, 5 and 25-year horizons expressed as ranges, not single points pretending to be certainty. A confidence cone widens with uncertainty and narrows as new evidence arrives — the way a careful clinician actually thinks.

Horizons1y · 5y · 25y
04 · Reasoningiv.
SLEEP +45m ALCOHOL ÷2 ZONE 2 +2h/wk CREATINE 5g

Counterfactual simulation, in your numbers.

Generative in-silico avatars — patient-specific simulations of how a change in sleep, training load, or pharmacology would propagate through your physiology. The twin answers what changes for me?, rehearsed virtually before anything is rehearsed in vivo.

EngineQSP · mechanistic + learned
05 · Sovereigntyv.

Federated, never extracted.

Your raw data never leaves your sovereign vault. The twin learns locally; only encrypted gradients return to the population model. This is what makes the platform deployable in regulated systems — NHS, EMA, HIPAA — without the data-governance bottlenecks that stall every other foundation-model rollout in healthcare.

ComplianceFHIR · GDPR · SOC 2 · HIPAA
06 · Privacyvi.

Zero-knowledge by construction.

Homomorphic encryption on inference, secure multi-party computation on cohort queries, attestable enclaves on training. The twin can answer questions about you without anyone — including us — being able to read you.

CryptographyFHE · SMPC · TEE

Where the field is, and where we sit.

— 2002

Mirror twin

Static digital replicas. NASA aerospace doctrine, ported to medicine.

— 2017

Functional twin

Surgical rehearsal, cardiac flow simulation, in-silico clinical trials.

— 2024

Shadow twin

Self-adaptive models with continuous wearable + omics sync.

2026 — now

Intelligent twin

Reasoning, learning, decision-making. Foundation-model spine. This is where Averra lives.

A second opinion that never sleeps.

Doctors don't need another dashboard. They need a colleague who has read every page of a patient's chart, every lab from every quarter, every wearable trace since onboarding — and who can answer questions in the cadence of a real consultation.

Averra surfaces the twin to clinicians as a structured second opinion: ranked hypotheses, the evidence behind each one, and counterfactual scenarios the doctor can rehearse before prescribing. The clinician remains in the loop. The twin earns its confidence by being right, repeatedly, in their own caseload.

"It is the difference between reading a patient's notes and actually understanding them. The twin doesn't replace the consultation — it gives me ten years of context in the first ninety seconds." — Consultant cardiologist · pilot cohort, 2026
M· Patient 0241 Twin v4.2 · synced 12s ago
Biological age
41.6 yrs
▼ 2.3 vs chronological
VO₂ max
52 ml/kg/min
▲ 3.1 / 90d
HRV (RMSSD)
68 ms
▲ steady
ApoB
98 mg/dL
▲ trending up
Twin · hypothesis
Cardiometabolic drift — ApoB trajectory crosses the 100 mg/dL threshold at roughly 14 months on current behaviour. Counterfactual: shifting evening meal composition (− saturated fat, + Zone-2 frequency) moves crossover beyond 5-year horizon with 0.81 confidence.
Twin · flag
Sleep architecture has shortened slow-wave fraction for 11 of last 14 nights. Not yet clinical, but cohort priors associate this pattern with HRV regression at 8-week lag. Worth raising in next consult.

Every signal — no signal alone.

A single biomarker rarely tells the truth. The twin is precise because the constellation is — heart rate variability read against sleep architecture, against training load, against last quarter's bloodwork, against a decade of family history.

α
Continuous

Streams from wearables, rings, patches and continuous glucose monitors.

  • HR · HRV
  • Resp
  • Temp
  • Sleep stages
  • CGM
β
Episodic

Quarterly bloodwork, imaging panels, gut and hormonal markers.

  • Bloodwork
  • MRI / DXA
  • Microbiome
  • Hormones
γ
Static

Genome, family history, lifelong clinical record, prescriptions.

  • WGS
  • Methylome
  • EHR
  • Family hx
δ
Contextual

Training, nutrition, mood, environment — the variables most studies discard.

  • Training
  • Nutrition
  • Mood
  • Air · light