Solutions

A roster of 1,650 roles

Access is derived from roles grouped in permission tiers T0 to T9 and TS. This is the design roster. The pilot enforces tiers and care-team scope; the full permission matrix is Coming in Wave 2.

How to read this

Columns show the count of roles in each family by tier, and whether the role can order, sign and prescribe under the design. They are design intent, not verified behavior for every role. Names are examples from the roster.

Roles per permission tier, 1,650 in total.
Tier	Roles
T0	60
T1	140
T2	115
T3	247
T4	375
T5	486
T6	112
T7	34
T8	44
T9	30
TS	7

Physicians

Family	Roles	Tiers	Order	Sign	Prescribe	Examples
Physician (MD/DO)	236	T5: 236	Yes	Yes	Yes	Allergy and Immunology Physician; Anesthesiologist; Adult Cardiac Anesthesiologist

Advanced practice providers

Family	Roles	Tiers	Order	Sign	Prescribe	Examples
Nurse Practitioner	56	T5: 55, T6: 1	Yes 55 / No 1	Yes 55 / Cosign 1	Yes 55 / No 1	Family Nurse Practitioner; Adult-Gerontology Primary Care Nurse Practitioner; Adult-Gerontology Acute Care Nurse Practitioner
Physician Assistant	39	T5: 38, T6: 1	Yes 38 / No 1	Yes 38 / Cosign 1	Yes 38 / No 1	Physician Assistant (General); Physician Assistant, Medical; Physician Assistant, Surgical
Anesthesia and surgical first-assist APP	4	T5: 1, T6: 1, T4: 2	Yes 1 / No 1 / P 2	Yes 3 / Cosign 1	P 1 / No 3	Certified Registered Nurse Anesthetist; Chief Nurse Anesthetist; Anesthesiologist Assistant
Midwifery	4	T5: 3, T4: 1	Yes 3 / P 1	Yes 3 / O 1	Yes 2 / P 1 / No 1	Certified Nurse-Midwife; Certified Midwife; Certified Professional Midwife
Clinical Nurse Specialist	24	T5: 22, T6: 2	Yes 22 / No 2	Yes 22 / Cosign 2	P 22 / No 2	Acute Care Clinical Nurse Specialist; Adult Health Clinical Nurse Specialist; Critical Care Clinical Nurse Specialist

Nursing

Family	Roles	Tiers	Order	Sign	Prescribe	Examples
Registered Nurse and nursing leadership	141	T4: 117, T3: 12, T6: 11, T2: 1	P 117 / No 24	O 128 / Cosign 11 / No 1 / C 1	No	Registered Nurse (General); Medical-Surgical Registered Nurse; Telemetry Registered Nurse
Licensed practical / vocational / psychiatric nurse	9	T4: 9	P	O	No	Licensed Practical Nurse; Licensed Vocational Nurse; Ambulatory Licensed Practical Nurse
Nursing support and long-term/home care aides	26	T3: 18, T2: 6, T1: 1, T6: 1	No 25 / P 1	O 16 / No 9 / Cosign 1	No	Certified Nursing Assistant; Patient Care Technician; Nursing Technician

Allied health

Family	Roles	Tiers	Order	Sign	Prescribe	Examples
Respiratory care and sleep	18	T4: 16, T6: 2	P 14 / No 4	O 16 / Cosign 2	No	Certified Respiratory Therapist; Registered Respiratory Therapist; Critical Care Respiratory Therapist
Rehabilitation and therapy	70	T4: 56, T3: 13, T6: 1	P 42 / No 28	O 63 / C 5 / No 1 / Cosign 1	No	Physical Therapist; Cardiopulmonary Physical Therapist; Neurologic Physical Therapist
Imaging and radiation therapy	32	T4: 24, T6: 3, T3: 2, T2: 2, T1: 1	P 24 / No 8	O 25 / Cosign 3 / No 4	No	Radiologic Technologist (Radiography); Portable Radiography Technologist; Operating Room Radiologic Technologist
Cardiovascular technologists	9	T4: 7, T3: 2	No 4 / P 5	O	No	Cardiovascular Invasive Specialist; Electrophysiology Technologist; Electrocardiographic Technician
Neurodiagnostic technologists	6	T4: 6	No	O 5 / C 1	No	Electroencephalographic Technologist; Electroneurodiagnostic Technologist; Nerve Conduction Study Technologist
Surgical services support and sterile processing	11	T4: 2, T1: 1, T2: 4, T6: 3, T3: 1	No 10 / P 1	O 3 / No 5 / Cosign 3	No	Surgical Technologist; Surgical Assistant; Sterile Processing Technician
Eye care	16	T4: 3, T3: 6, T5: 7	No 9 / Yes 7	O 9 / Yes 7	No 9 / P 7	Ophthalmic Medical Technician; Ophthalmic Assistant; Optometric Technician
Pharmacy	39	T4: 23, T3: 11, T2: 1, T6: 4	P 5 / Yes 16 / No 18	O 24 / No 6 / Cosign 4 / C 5	No 23 / P 16	Staff Pharmacist; Clinical Pharmacist; Ambulatory Care Pharmacist
Laboratory, pathology support and blood bank	42	T4: 21, T3: 14, T1: 1, T6: 5, T7: 1	No	O 30 / C 2 / No 4 / Cosign 4 / Yes 2	No	Medical Laboratory Scientist; Medical Laboratory Technician; Clinical Chemistry Technologist
Nutrition and dietetics	20	T4: 17, T6: 2, T2: 1	P 15 / No 5	O 16 / C 2 / No 1 / Cosign 1	No	Registered Dietitian Nutritionist; Critical Care Dietitian; Pediatric Dietitian
Social work, community health and patient support	27	T4: 14, T3: 11, T6: 2	P 14 / No 13	O 23 / C 2 / Cosign 2	No	Clinical Social Worker; Medical Social Worker; Emergency Department Social Worker
Case management and care coordination	10	T4: 2, T3: 4, T2: 2, T6: 1, T5: 1	P 2 / No 7 / Yes 1	O 6 / No 2 / Cosign 1 / Yes 1	No 9 / Yes 1	Hospital Case Manager (RN); Case Manager (Social Work); Care Coordinator
Spiritual care	6	T3: 3, T6: 1, T0: 1, T2: 1	No	O 1 / C 2 / Cosign 1 / No 2	No	Chaplain; Chaplain Resident; Clinical Pastoral Education Student
Child life, pediatric education and early intervention	6	T3: 5, T4: 1	No	O 4 / C 1 / No 1	No	Certified Child Life Specialist; Child Life Assistant; Hospital Teacher
Language services	5	T3: 3, T2: 1, T6: 1	No	No 4 / Cosign 1	No	Qualified Medical Interpreter; Sign Language Interpreter; Medical Translator
Clinical ethics	2	T3: 2	No	O	No	Clinical Ethicist; Ethics Committee Member
Patient advocacy	2	T3: 1, T6: 1	No	O 1 / Cosign 1	No	Patient Advocate; Patient Experience Manager
Genetic counseling	5	T4: 5	P	O	No	Genetic Counselor; Cancer Genetic Counselor; Prenatal Genetic Counselor
Clinical office and unit support	14	T3: 9, T4: 1, T2: 4	No 13 / P 1	O 6 / C 1 / No 7	No	Medical Assistant; Specialty Medical Assistant; Pediatric Medical Assistant

Behavioral health

Family	Roles	Tiers	Order	Sign	Prescribe	Examples
Behavioral health clinicians	48	T5: 24, T3: 4, T4: 19, T6: 1	Yes 24 / No 10 / P 14	Yes 24 / O 21 / C 2 / Cosign 1	No 47 / P 1	Clinical Psychologist; Clinical Psychologist (Clinical Specialty); Clinical Child and Adolescent Psychologist

Dentistry and other licensed practitioners

Family	Roles	Tiers	Order	Sign	Prescribe	Examples
Dentistry	24	T5: 15, T4: 4, T3: 1, T2: 2, T1: 1, T6: 1	Yes 15 / No 7 / P 2	Yes 14 / O 4 / C 2 / No 3 / Cosign 1	Yes 15 / No 9	General Dentist; Endodontist; Orthodontist
Podiatry	11	T5: 10, T3: 1	Yes 10 / No 1	Yes 9 / C 2	P 10 / No 1	Podiatrist; Podiatric Foot and Ankle Surgeon; Foot Surgery Podiatrist
Chiropractic	13	T5: 12, T3: 1	P 12 / No 1	Yes 12 / C 1	No	Chiropractor; Chiropractic Independent Medical Examiner; Chiropractic Internist
Complementary and other practitioners	13	T4: 5, T3: 3, T5: 1, T1: 3, T2: 1	P 4 / Yes 2 / No 7	O 8 / Yes 2 / No 3	No 12 / P 1	Acupuncturist; Naturopathic Physician; Homeopathic Practitioner

EMS and prehospital

Family	Roles	Tiers	Order	Sign	Prescribe	Examples
EMS and prehospital	25	T3: 5, T4: 10, T6: 2, T2: 3, T1: 2, T0: 3	No 15 / P 10	C 1 / O 13 / Cosign 2 / No 9	No	Emergency Medical Responder; Emergency Medical Technician; Advanced Emergency Medical Technician

Administration and executive

Family	Roles	Tiers	Order	Sign	Prescribe	Examples
Patient access, registration and scheduling	34	T2: 24, T1: 4, T3: 2, T6: 4	No	No 28 / O 2 / Cosign 4	No	Patient Access Representative; Registrar; Emergency Department Registrar
Human resources	15	T2: 13, T6: 1, T9: 1	No	No 13 / Cosign 2	No	Human Resources Generalist; Recruiter; Payroll Specialist
Medical staff office and physician leadership	21	T2: 4, T6: 10, T3: 1, T5: 6	No 15 / Yes 6	No 4 / Cosign 10 / O 1 / Yes 5 / C 1	No 15 / Yes 6	Credentialing Specialist; Credentialing Manager; Medical Staff Professional
Executive and administration	54	T9: 23, T8: 9, T2: 5, T1: 12, T6: 3, T3: 2	No	Cosign 36 / No 16 / O 2	No	Chief Executive Officer; Chief Operating Officer; Chief Financial Officer

Security and emergency management

Family	Roles	Tiers	Order	Sign	Prescribe	Examples
Security and public safety	44	T1: 27, T6: 7, T9: 1, T0: 2, T3: 3, T7: 1, T2: 3	No	No 33 / Cosign 8 / O 3	No	Security Officer; Senior Security Officer; Security Officer Trainee
Emergency management	21	T3: 4, T6: 10, T1: 1, T2: 5, T4: 1	No 20 / P 1	Cosign 14 / No 6 / O 1	No	Emergency Management Coordinator; Director of Emergency Management; Hospital Incident Commander

Revenue cycle and HIM

Family	Roles	Tiers	Order	Sign	Prescribe	Examples
Revenue cycle	31	T3: 20, T2: 6, T6: 2, T9: 1, T8: 2	No	No 24 / O 2 / Cosign 5	No	Medical Biller; Professional Billing Specialist; Facility Billing Specialist
Health information management, coding and documentation	35	T3: 22, T8: 3, T6: 4, T5: 1, T2: 5	No 34 / Yes 1	No 24 / C 1 / Cosign 7 / O 2 / Yes 1	No 34 / Yes 1	Inpatient Coder; Outpatient Coder; Emergency Department Coder

IT and biomedical engineering

Family	Roles	Tiers	Order	Sign	Prescribe	Examples
Information technology and information security	43	T7: 31, T3: 2, T8: 1, T9: 2, T1: 5, T6: 2	No	No 36 / O 2 / Cosign 5	No	Systems Administrator; Network Administrator; Network Architect
Biomedical / clinical engineering	11	T1: 8, T6: 2, T7: 1	No	No 9 / Cosign 2	No	Biomedical Engineer; Biomedical Equipment Technician; Imaging Equipment Service Engineer

Facilities and support services

Family	Roles	Tiers	Order	Sign	Prescribe	Examples
Environmental services	11	T1: 9, T6: 2	No	No 9 / Cosign 2	No	Environmental Services Technician; Terminal Cleaning Technician; Operating Room Environmental Services Technician
Laundry and linen	4	T1: 3, T6: 1	No	No 3 / Cosign 1	No	Laundry Technician; Linen Delivery Aide; Laundry and Linen Manager
Food service	11	T1: 8, T6: 3	No	No 8 / Cosign 3	No	Hospital Cook; Dietary Aide; Tray Delivery Aide
Transport and logistics	11	T1: 4, T2: 4, T6: 1, T0: 2	No	No 10 / Cosign 1	No	Patient Transporter; Patient Transport Lead; Patient Transport Supervisor
Supply chain	15	T1: 10, T2: 1, T6: 2, T3: 2	No	No 11 / Cosign 2 / O 2	No	Purchasing Agent; Materials Management Technician; Central Supply Clerk
Facilities and plant operations	29	T1: 18, T2: 1, T6: 3, T0: 5, T3: 2	No	No 24 / Cosign 3 / O 2	No	Facilities Engineer; Maintenance Technician; Electrician
Other hospital support	6	T1: 2, T0: 3, T2: 1	No	No	No	Health Sciences Librarian; Media and Audiovisual Services Technician; Gift Shop Associate

Privacy, compliance, quality and safety

Family	Roles	Tiers	Order	Sign	Prescribe	Examples
Privacy, compliance and audit	29	T8: 27, T2: 2	No	Cosign 27 / No 2	No	Privacy Officer; Privacy Analyst; Access Audit Analyst
Quality and patient safety	20	T6: 2, T3: 15, T5: 3	No 17 / Yes 3	Cosign 2 / O 14 / Yes 3 / No 1	No 17 / Yes 3	Director of Quality and Patient Safety; Quality Manager; Quality Analyst

Research

Family	Roles	Tiers	Order	Sign	Prescribe	Examples
Research and IRB	30	T5: 2, T4: 5, T3: 12, T2: 4, T1: 4, T8: 2, T6: 1	Yes 3 / No 27	Yes 2 / O 15 / No 10 / Cosign 3	Yes 2 / No 27 / P 1	Principal Investigator; Sub-Investigator; Clinical Research Coordinator

Education and GME

Family	Roles	Tiers	Order	Sign	Prescribe	Examples
Graduate medical education, students and educators	83	T5: 49, T3: 17, T4: 4, T2: 6, T1: 2, T6: 5	Yes 49 / No 30 / P 4	C 65 / O 4 / No 8 / Cosign 5 / Yes 1	P 48 / No 34 / Yes 1	Resident Physician; Intern (PGY-1 Resident Physician); Internal Medicine Resident

Volunteers

Family	Roles	Tiers	Order	Sign	Prescribe	Examples
Volunteers	13	T1: 12, T2: 1	No	No	No	Hospital Volunteer; Infant Cuddler Volunteer; Pet Therapy Volunteer

Patients and proxies

Family	Roles	Tiers	Order	Sign	Prescribe	Examples
Patients, proxies and guardians	18	T0: 18	No	O	No	Patient; Minor Patient; Adolescent Patient with Confidential Care Rights

External roles

Family	Roles	Tiers	Order	Sign	Prescribe	Examples
External parties (interface only)	41	T3: 11, T0: 26, T2: 1, T1: 1, T9: 2	No	O 11 / No 28 / Cosign 2	No	Payer Utilization Review Nurse; Payer Medical Director; Payer Auditor

Service identities

Family	Roles	Tiers	Order	Sign	Prescribe	Examples
Service identities (non-human)	7	TS: 7	No	No	No	Interface Service Identity; Batch Job Service Identity; Sync Service Identity