Navigating the "Valley of Death": An Open-Source, Modular Framework for Generative AI in Healthcare

Generative AI (GenAI) adoption remains limited, particularly in under-resourced settings, despite its many applications. This disparity arises from fragmented integration, privacy concerns, and the translational gap (often called the "Valley of Death"). To address these barriers, we propose a modular reference architecture and implementation tools for health organizations to orchestrate GenAI. The architecture encompasses locally hosted LLMs, containerized GenAI and user interface (UI) modules, Fast Healthcare Interoperability Resources (FHIR) based interfaces, and built-in observability. Furthermore, we present an initial open-source prototype that includes the supporting tools and exemplar modules.