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Delivering MDE-NG with an AI-Native Development Lifecycle
When the U.S. Department of Veterans Affairs needed a next-generation Medical Disability Examination (MDE-NG) platform, the stakes were high: a complex federal system spanning 13+ VA handbooks, serving 6 regions and 25M+ annual examinations, delivered on a tight timeline with stringent compliance requirements.
Infinite answered with an AI-native development lifecycle (AI-DLC) — pairing Claude powered agents and a structured knowledge tree with human-in-the-loop governance. The result is a live, production-ready system built with 90%+ AI generated code, redefining how complex federal systems are delivered.
Business Challenge
Complex Federal Requirements
- The MDE-NG Performance Work Statement spans 13+ VA handbooks with stringent compliance and regulatory requirements.
Tight Timeline, Massive Scale
- A production-grade system meeting all VA/VBA standards — supporting 6 regions, 25M+ annual examinations, and international operations.
Traditional Approach Limitations
- Manual coding could not keep pace with the velocity of requirements, putting both schedule and quality at risk.
Solution Approach
Knowledge Tree
A structured repository of MDE-NG PWS requirements, VA handbooks, medical examination domain knowledge, AWS architecture patterns, and reusable code libraries.
AI Agents + MCPs
Claude-powered agents using Model Context Protocols for context-aware retrieval, .NET code generation, SQL optimization, and test authoring.
HITL Governance
Human-in-the-loop review at critical gates — plan approvals, QA, security validation, and compliance checks.
Automated Testing
A full test automation suite with risk-based, agentic validation integrated into CI/CD.
Benefits
Infinite delivered a complete AI-DLC for MDE-NG: a structured knowledge tree feeding multi-agent code generation, governed by human review and continuous automated testing. The HIPAA compliant .NET/AWS/MS SQL platform is live and production-ready — with engineers focused on architecture, strategy, and reviews instead of manual coding.
The AI-DLC Lifecycle: Continuous Collaboration
Approve Plan
Validate AI-generated architecture against requirements.
Manual Verify
QA testing, security validation, compliance checks.
Review & Merge
Code review, architectural review, approval gates.
Development Process: Feedback Loops at Scale
AI agents generate .NET backend code, database schemas, and API endpoints. Automated unit, integration, and compliance tests run immediately, engineers review and validate the logic, and feedback loops iterate until every gate and requirement passes.
Technology Stack & Infrastructure
Backend: .NET Core / ASP.NET on EC2, ECS, and Lambda — 90%+ AI-generated.
Data Layer: MS SQL Server on RDS and DynamoDB — schema auto-generated.
API Gateway: RESTful APIs via API Gateway and CloudFormation — OpenAPI compliant.
Storage: Secure document store on S3 with encryption and versioning — HIPAA compliant.
Benefits
100% PWS Compliance: All MDE-NG requirements implemented and validated.
90%+ AI Code Generation: Dramatically reduced manual coding effort.
6 Regions: Scaled to all US regions plus international operations.
25M+ Examinations: Annual ESR processing capacity.
Key Engagement Highlights
The AI-native approach made MDE-NG the blueprint for delivering complex federal systems with AI augmentation:
Quality & Compliance
Continuous automated testing — unit, integration, end-to-end, compliance, and performance — with requirements traceability validated at every gate.
Human Oversight
Engineering-led code review, compliance officer validation of HIPAA and security controls, and manual QA sign-off before every release.
Team Leverage
Engineers focus on architecture, strategy, and reviews — while AI agents handle the heavy lifting of code production.
Driving Innovation, Delivering Excellence
Through the strategic integration of Claude-powered agents, a structured knowledge tree, and human-in-the-loop governance, Infinite has proven that AI-native development is production-ready for complex federal systems. With 100% PWS compliance, 90%+ AI-generated code, and capacity for 25M+ annual examinations across 6 regions, MDE-NG demonstrates a faster, higher-quality path to federal modernization.
Partnering for Continued Success
Infinite continues to expand the AI-DLC methodology across VA systems and federal programs — growing the knowledge tree, scaling agent infrastructure, and establishing an AI-native center of excellence. This is not the future of development; it is happening now.