Pulmosaic Terms of Use

Version: pulmosaic-terms-2026-10-01 Effective date: October 1, 2026

These Terms of Use ("Terms") are an agreement between you and AME Foresight LLC, a Kansas limited liability company ("AME Foresight," "we," "us," or "our"). They govern your use of the Pulmosaic iOS app, the pulmosaic.com website, and related services (together, "Pulmosaic").

Please read them carefully. By creating an account, tapping to accept, or using Pulmosaic, you agree to these Terms and confirm that you have read our Privacy Policy. If you do not agree, do not use Pulmosaic.

1. Who may use Pulmosaic

Pulmosaic is for licensed health care professionals only. To use it you must:

be at least 18 years old and able to enter a binding contract;
be a clinician with an active individual National Provider Identifier (NPI) and complete the verification Pulmosaic asks for;
use Pulmosaic in your professional capacity and within your lawful scope of practice; and
be located in the United States.

Pulmosaic has no patient accounts. Patients, caregivers, and other members of the public may not create accounts or use the clinician tools.

NPI verification confirms a public registry record. It is not credentialing, and it does not confirm that you are licensed for any particular activity. You are responsible for holding the licenses and permissions your work requires.

2. What Pulmosaic is

Pulmosaic is an educational tool for clinicians. It helps you organize structured case information and review evidence-linked educational content about pulmonary disease. It also offers case-based teaching from clinician educators (Section 6).

The clinical decision support in Pulmosaic is designed for independent review by a clinician:

It works from information you enter. It displays considerations, missing information, and literature sources so you can see the basis for each item and decide for yourself whether it applies.
Pulmosaic software does not analyze or interpret medical images. CT screenshots you upload are only stored and displayed for human reviewers and educators.
It does not make a diagnosis, order tests, prescribe, or direct treatment.

3. What Pulmosaic is not

Not medical care. AME Foresight does not practice medicine and does not provide medical, radiology, or other professional health care services through Pulmosaic.
No physician-patient relationship. Using Pulmosaic does not create a physician-patient or other treatment relationship between any patient and AME Foresight or any educator.
Not for urgent or emergency use. Pulmosaic is not monitored in real time. Do not use it, or wait for it, when a decision is time-sensitive.
Not a substitute for the full record or formal review. Pulmosaic content does not replace the complete medical record, examination, formal radiology or pathology interpretation, specialist consultation, multidisciplinary discussion, or your judgment.
Not complete. Pulmosaic does not cover every disease, finding, drug, or situation. If Pulmosaic does not mention something, that does not mean it is absent or unimportant.

4. You keep clinical responsibility

You are solely responsible for every clinical decision you make, including diagnosis, testing, treatment, prescribing, referral, documentation, and communication with patients. You must verify any information against the source record and current professional standards before relying on it.

Pulmosaic content, including teaching commentary from educators, is educational information for you. It is never an instruction to take or withhold any action for a particular patient.

5. Your account

You sign in with Apple. Apple may share your name and an email address (or a private relay address) with us according to your Apple settings.
Keep your device secure and do not share your account. You are responsible for activity under your account.
Tell us promptly at chase@ameforesight.com if you suspect unauthorized access.
You may review and revoke active sessions in the app.

Educator, radiology educator, privacy reviewer, and library editor roles are by invitation only. People in those roles also sign a separate agreement with AME Foresight. If that agreement conflicts with these Terms, the separate agreement controls for that role.

6. Case-based teaching

This section covers Pulmosaic Case-Based Teaching, where you submit a de-identified case and receive teaching from clinician educators. It applies each time you submit a request.

6.1 How it works

The format follows case-based teaching models such as Project ECHO, where experienced clinicians teach around a de-identified case.

You submit a de-identified case made of structured fields, with dates shown only relative to the submission date. You may add a small number of still CT screenshots, as the app specifies. You choose one to three teaching questions from a fixed list. There are no free-text questions.
Before any educator sees your request, a Pulmosaic privacy reviewer checks it for identifying information. We may reject any request or image.
If you included CT screenshots, a thoracic radiologist educator first writes a teaching read of the screenshots. This is teaching about imaging features. It is not a radiology interpretation or report.
An interstitial lung disease (ILD) educator then answers each question you selected with a teaching point, supporting evidence, and what would change the answer. The educator may add a take-home point, what the material cannot show, and further reading.
You may be able to request additional independent commentaries, as the app allows. Each commentary stands on its own. Pulmosaic does not combine them, count votes, or issue a consensus.

6.2 About the educators

Educators are clinicians who contract with AME Foresight as independent contractors. They are not your consultants and are not treating the patient.
Educators are anonymous to you, and you are anonymous to them. Pulmosaic shows each educator's credential summary and disclosed financial relationships from the prior 24 months, not their name.
Educators teach from the limited material submitted. They do not see the full record or a full CT study.

6.3 What the teaching is not

Teaching commentary is education for you. It is not:

a diagnosis or treatment recommendation for the patient;
a radiology interpretation, second opinion, consultation, or consult note;
a review of the full CT, the full record, or any finding outside the teaching questions; or
an assessment of nodules, masses, cancer, pulmonary embolism, or incidental findings.

An educator may flag that an image appears to show something outside the scope of teaching (for example, a possible mass or effusion). That notice is a prompt for you to arrange appropriate review. It is not a finding, and the absence of a notice means nothing about the images.

6.4 Your submission obligations

For every request, you agree that:

No direct identifiers. You will not submit names, record or accession numbers, exact dates, dates of birth, addresses, contact details, facility names, facial images, or any other identifying information, anywhere in the case or in any image, including overlays, borders, and surrounding screen content.
Authority. You are authorized to use and share the material for this purpose, and doing so is consistent with applicable law, your employer's or institution's policies, and any agreement that binds you.
Attestation. You will complete the image attestation truthfully for each submission.
Learning purpose. The request is for your own learning. It is not urgent, and you will not delay a decision about any patient while waiting for a response.
Minimum necessary. You will submit only what the teaching questions need.

If you discover that you submitted identifying information, tell us right away at chase@ameforesight.com.

6.5 No follow-up and no contact

Each commentary is final when submitted. There is no follow-up exchange between you and an educator. You must not try to identify or contact an educator about a case, inside or outside Pulmosaic.

6.6 How you may use the teaching

You may use teaching commentary for your own professional education. You must not:

place a commentary in a patient's medical record or present it as a consultation, radiology report, diagnosis, or treatment recommendation;
describe separate commentaries as a consensus or as a conclusion of Pulmosaic; or
use a commentary for advertising, litigation, insurance, utilization review, or disability decisions.

6.7 Timing and availability

We do not guarantee that an educator will be available, when a response will arrive, or that a request will be completed. We may close a request without a response if it is out of scope, fails privacy review, or no eligible educator is available.

6.8 Teaching Case Library

The Teaching Case Library lets verified clinicians learn from completed teaching cases.

Default setting. When you submit a request, the library setting is on unless you turn it off. You can change it at any time until the case is published.
Editorial review. After the teaching is complete, a library editor reviews the case again for identifying information and may generalize details such as age, pattern, and exposures before publishing it.
What is published. The de-identified case, CT screenshots, teaching questions, and educator commentary. Your identity is never shown.
After publication. A published entry is kept separately from your account and has no link to it. It cannot be withdrawn through your account, and it remains in the library if you delete the case or your account.
Reading the library. You may use library entries for your own education. You must not redistribute them outside Pulmosaic or try to identify any patient, requester, or educator.

6.9 Educator payment and independence

Educators may receive a fixed honorarium for each teaching commentary. The amount never depends on the content, the patient, any diagnosis or treatment, agreement with another educator, or any sponsor's interest. We plan to fund honoraria through unrestricted educational grants administered by an accredited continuing medical education (CME) provider. Grant funders do not choose educators, see requests or commentary, influence content, or receive educator identities or user data.

7. Learning reflections and CME

Pulmosaic lets you record a learning reflection after reading teaching commentary or a library entry. Pulmosaic does not issue CME credit, and no credit is available today. If credit becomes available, it will be awarded only by an accredited CME provider under its own requirements. We will tell you before any of your records are shared with that provider for credit.

8. Free service and funding

Pulmosaic is free for clinicians. We do not show advertising and we do not sell your data. If we ever introduce a fee, we will tell you in advance and you will not be charged unless you agree.

9. Your content

"Your Content" means information and material you enter or upload, including case information, CT screenshots, reflections, and feedback.

Ownership. You keep any rights you have in Your Content.
License to operate Pulmosaic. You grant AME Foresight a non-exclusive, royalty-free license to host, store, copy, process, transmit, and display Your Content as needed to provide, secure, support, and improve Pulmosaic, and to comply with law. This includes showing case material to privacy reviewers, educators, and library editors. This license ends when Your Content is deleted, except for copies kept as described in the Privacy Policy.
License for the Teaching Case Library. If your library setting is on when a case is published, you also grant AME Foresight a perpetual, irrevocable, worldwide, royalty-free, non-exclusive license to edit, further de-identify, generalize, reproduce, display, and distribute that case, its CT screenshots, and its teaching questions to verified clinicians, and to create teaching materials from them.
Limits on our use. We will not sell Your Content, use it for advertising, or use it to train general-purpose artificial intelligence models.
Feedback. If you send suggestions about Pulmosaic, we may use them without obligation to you. This does not give us rights in patient information.

You are responsible for Your Content and confirm that you have the rights needed to grant these licenses.

10. Acceptable use

You must not:

submit identifying patient information or material you are not authorized to share;
attempt to identify any patient, requester, or educator;
share your account, impersonate anyone, or misstate your credentials;
use Pulmosaic unlawfully or outside your professional scope;
present Pulmosaic content or teaching commentary as a diagnosis, order, prescription, radiology report, or consultation;
scrape, copy in bulk, reverse engineer, probe, or disrupt Pulmosaic, or bypass any security, privacy, or access control, except where law expressly allows;
upload malicious code or anything unlawful, infringing, or harassing;
use Pulmosaic for patient steering, unlawful referral, or any payment or arrangement that violates health care fraud and abuse laws; or
use Pulmosaic content to build a competing product without our written permission.

11. Our intellectual property

Pulmosaic, including its software, design, educational text, content organization, and the Pulmosaic name and marks, belongs to AME Foresight or its licensors. Subject to these Terms, we grant you a limited, personal, non-exclusive, non-transferable, revocable license to use Pulmosaic for its intended professional educational purpose.

Guidelines, articles, and other third-party materials cited in Pulmosaic belong to their owners. A citation or link does not mean the owner endorses Pulmosaic, and we are not responsible for third-party sites or services.

12. Privacy and health information

Our Privacy Policy explains how we handle information. Pulmosaic is designed for de-identified case information. We do not sign business associate agreements with individual users, and these Terms are not a business associate agreement. If your institution has a separate written agreement with AME Foresight, including a business associate agreement, that agreement controls for the information it covers.

13. Changes to Pulmosaic

We may add, change, suspend, or remove features, and we update clinical content as evidence and guidelines change. We do not promise that Pulmosaic will always be available or free of errors.

14. Suspension and termination

You may stop using Pulmosaic at any time. You can export your data and delete your account in the app.

We may suspend or end your access if you violate these Terms, if your credentials cannot be verified or are no longer valid, to protect patients, users, or Pulmosaic, if the law requires it, or if we discontinue Pulmosaic. Where practical and safe, we will give notice and a chance to export your data.

Sections 3, 4, 6.3, 6.5, 6.6, 6.8, 9, and 11 through 21 survive termination.

15. Disclaimer of warranties

TO THE FULLEST EXTENT PERMITTED BY LAW, PULMOSAIC, ITS CONTENT, AND ALL TEACHING COMMENTARY ARE PROVIDED "AS IS" AND "AS AVAILABLE," WITHOUT WARRANTIES OF ANY KIND. AME FORESIGHT DISCLAIMS ALL EXPRESS AND IMPLIED WARRANTIES, INCLUDING MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, TITLE, NON-INFRINGEMENT, AND ACCURACY. WE DO NOT WARRANT THAT PULMOSAIC WILL BE UNINTERRUPTED, SECURE, ERROR-FREE, COMPLETE, OR CURRENT, OR THAT ANY CONTENT IS SUITABLE AS THE BASIS FOR A CLINICAL DECISION.

16. Limitation of liability

TO THE FULLEST EXTENT PERMITTED BY LAW:

AME FORESIGHT AND ITS MEMBERS, MANAGERS, EMPLOYEES, CONTRACTORS, AND AGENTS WILL NOT BE LIABLE FOR ANY INDIRECT, INCIDENTAL, SPECIAL, CONSEQUENTIAL, EXEMPLARY, OR PUNITIVE DAMAGES, OR FOR LOST PROFITS, REVENUE, DATA, OR GOODWILL, ARISING FROM OR RELATED TO PULMOSAIC OR THESE TERMS, EVEN IF ADVISED OF THE POSSIBILITY; AND
THEIR TOTAL LIABILITY FOR ALL CLAIMS ARISING FROM OR RELATED TO PULMOSAIC OR THESE TERMS WILL NOT EXCEED ONE HUNDRED U.S. DOLLARS (US $100).

These limits apply to every theory of liability, including contract, tort, negligence, and strict liability. They do not limit liability that cannot be limited under applicable law, including liability for fraud or willful misconduct.

17. Indemnity

You will defend, indemnify, and hold harmless AME Foresight and its members, managers, employees, contractors, and agents from and against any third-party claim, and related losses, damages, and reasonable attorneys' fees, arising from:

Your Content, including any identifying or unauthorized health information you submit;
your violation of these Terms, applicable law, or your institution's policies; or
your clinical decisions and care of any patient.

We will notify you of a claim, may control its defense with counsel of our choice, and you will cooperate reasonably. You may not settle a claim that imposes obligations on us without our written consent.

18. Governing law and disputes

Governing law. Kansas law governs these Terms and any dispute about Pulmosaic, without regard to conflict-of-law rules.
Try to resolve it first. Before filing a claim, send a written description to chase@ameforesight.com. We will both try in good faith to resolve it within 60 days.
Venue. Any claim must be brought only in the state or federal courts located in Kansas, and you and AME Foresight consent to personal jurisdiction there.
Time limit. To the extent permitted by law, any claim must be filed within one year after it arises, or it is permanently barred.

19. Changes to these Terms

We may update these Terms. Each version has a new version string and effective date. For a material change, we will notify you in the app at least 30 days before it takes effect, unless a shorter time is needed for legal, security, or safety reasons. When the app asks you to accept updated Terms, you will need to accept them to keep using Pulmosaic. We keep prior versions and your acceptance records.

20. Apple App Store terms

If you downloaded Pulmosaic from the Apple App Store:

These Terms are between you and AME Foresight only, not Apple. AME Foresight, not Apple, is solely responsible for Pulmosaic and its content.
Your license is limited to using Pulmosaic on Apple devices you own or control, as permitted by the App Store Usage Rules.
Apple has no obligation to provide maintenance or support for Pulmosaic.
If Pulmosaic fails to conform to any applicable warranty, you may notify Apple, and Apple may refund the purchase price, if any. To the maximum extent permitted by law, Apple has no other warranty obligation for Pulmosaic.
AME Foresight, not Apple, is responsible for addressing any claims relating to Pulmosaic or your use of it, including product liability claims, claims that Pulmosaic fails to meet legal or regulatory requirements, and consumer protection or privacy claims.
AME Foresight, not Apple, is responsible for investigating, defending, settling, and discharging any claim that Pulmosaic infringes a third party's intellectual property rights.
You represent that you are not located in a country subject to a U.S. government embargo or designated as a "terrorist supporting" country, and that you are not on any U.S. government list of prohibited or restricted parties.
You must comply with applicable third-party terms when using Pulmosaic.
Apple and its subsidiaries are third-party beneficiaries of these Terms and may enforce them against you.

21. General terms

Entire agreement. These Terms, the Privacy Policy, and any separate agreement referred to in Section 5 or Section 12 are the entire agreement about Pulmosaic.
Order of priority. A signed institutional agreement or business associate agreement controls for the information it covers. An educator's separate agreement controls for that role. Otherwise these Terms control.
Assignment. You may not transfer these Terms. We may transfer them in a merger, acquisition, reorganization, or sale of assets, subject to the Privacy Policy.
Severability and waiver. If a provision is unenforceable, the rest remains in effect. Not enforcing a provision is not a waiver.
No agency. Nothing in these Terms creates a partnership, employment, or agency relationship.
Events outside our control. We are not responsible for delays or failures caused by events beyond our reasonable control.
Notices. We may send notices in the app or to the email address on your account. Send legal notices to chase@ameforesight.com.

22. Contact

AME Foresight LLC Email: chase@ameforesight.com