1. 🎯 Sprint Summary
| Sprint | 5.4 (DICOM Viewer + Radiology Workflow) |
| Duration | 6 - 26 Sep 2027 (3 weeks) |
| Modules | M6 LABS + M4 extension · DICOMweb client · radiology workflow |
| Goal | DICOMweb viewer integrated into M4 encounter screen · radiologist workflow for partner clinics · in-clinic ultrasound capture · AI flag for abnormal findings · 3+ radiologist clinics linked · 100+ studies/week viewed in-encounter · v1.2 phase closeout |
| Capacity | 5 FTE (2 BE + 1 FE + 0.5 prompt + 1 DevOps + 0.5 radiologist consultant) + 0.5 Founder + 0.5 Doc Zam |
| Velocity target | 85 SP |
| Demo date | 26 Sep 2027 — v1.2 phase closeout · 20 tenants live |
2. 🩻 Imaging Modalities (v1.2 launch)
X-Ray — Most common. CR/DR images · single + multi-frame. Common in: chest, MSK, dental.
Ultrasound (US) — In-clinic capture (point-of-care). Cine loops + still frames. Common in: OG, MSK, abdominal.
CT — Multi-slice viewing · MPR (multiplanar reconstruction) basic · partner clinic referral.
MRI — Multi-sequence viewing · partner clinic referral.
Mammography — Specialised viewer · partner clinic referral.
v1.2 priority: X-ray + Ultrasound (in-clinic). CT/MRI/Mammo viewable but expert reading is at partner radiologist clinic. Full PACS partnership in v1.3+.
3. 🚦 Pre-Sprint Gate Checklist
- Sprint 5.3 demoed and signed off · KKM eHIS integration live
- DICOMweb library evaluated (OHIF Viewer · Cornerstone.js · dwv) · OHIF chosen
- Radiologist consultant onboarded (3 weeks · external · radiology workflow design)
- 3+ partner radiologist clinics signed letters of intent
- In-clinic ultrasound integration tested (Sonosite + Mindray BLE/USB)
- PACS partner identified for production storage (DCM4chee · Orthanc evaluated)
- AI flag model selected (e.g., MedGemini Multimodal · or GPT-4o vision)
- Storage capacity audit · DICOM image retention policy
4. 🧩 Sprint Scope
- DICOMweb Server (Orthanc): Self-host PACS backend · QIDO/WADO/STOW · per-tenant storage isolation
- OHIF Viewer Integration: Embedded in M4 encounter screen · keyboard shortcuts · measurements · windowing
- Study Manager: List studies for patient · time-ordered · across tenants if consented (M8) · across KKM eHIS if linked (5.3)
- In-Clinic Ultrasound Capture: Sonosite/Mindray DICOM SCU · auto-tag patient + encounter · push to PACS
- Radiologist Workflow (Partner Clinic): Read queue · report template (BI-RADS, RECIST · disease-specific) · sign-off · push report to MediEco
- AI Flag Pipeline: Auto-screen X-ray · pneumothorax / pneumonia / fracture flag · doctor reviews flag in M4 before opening report
- Report Bridging: Radiologist report (PDF + structured FHIR DiagnosticReport) → M4 encounter SOAP · auto-cite
- Cross-Tenant Imaging: M8 continuity extension · patient at Tenant A sees imaging from Tenant B (consented)
- v1.2 Closeout Artifacts: Phase retro · 20-tenant dashboard · v1.3 plan kickoff prep
5. 📅 Day-by-Day Plan (15 days)
D1Mon 6 Sep · Orthanc Deployment
Self-host Orthanc PACS · per-tenant isolation · QIDO/WADO/STOW endpoints exposed.
Self-host Orthanc PACS · per-tenant isolation · QIDO/WADO/STOW endpoints exposed.
D2Tue 7 Sep · OHIF Viewer Integration
OHIF embedded in M4 encounter screen · DICOMweb config · auth bridge.
OHIF embedded in M4 encounter screen · DICOMweb config · auth bridge.
D3Wed 8 Sep · Study Manager UI
Patient study list · time-ordered · cross-tenant aware · KKM eHIS linked studies surfaced.
Patient study list · time-ordered · cross-tenant aware · KKM eHIS linked studies surfaced.
D4Thu 9 Sep · In-Clinic Ultrasound (Sonosite)
Sonosite DICOM SCU · auto-tag patient/encounter · push to Orthanc · viewable in M4.
Sonosite DICOM SCU · auto-tag patient/encounter · push to Orthanc · viewable in M4.
D5Fri 10 Sep · Mid-Demo + Mindray
Mindray ultrasound · live capture demo · second device class verified.
Mindray ultrasound · live capture demo · second device class verified.
D6Mon 13 Sep · AI Flag Pipeline (X-ray)
Auto-screen on STOW · pneumothorax/pneumonia/fracture flags · M4 surface flag pre-report.
Auto-screen on STOW · pneumothorax/pneumonia/fracture flags · M4 surface flag pre-report.
D7Tue 14 Sep · Radiologist Read Queue
Partner radiologist clinic Filament page · queue · prioritisation · workflow.
Partner radiologist clinic Filament page · queue · prioritisation · workflow.
D8Wed 15 Sep · Report Templates
BI-RADS · RECIST · disease-specific templates · structured FHIR DiagnosticReport.
BI-RADS · RECIST · disease-specific templates · structured FHIR DiagnosticReport.
D9Thu 16 Sep · Report Bridging to M4
Radiologist report → SOAP auto-cite · doctor sees report in encounter.
Radiologist report → SOAP auto-cite · doctor sees report in encounter.
D10Fri 17 Sep · Mid-Demo Round 2
End-to-end: ultrasound capture → AI flag → radiologist read → SOAP cited.
End-to-end: ultrasound capture → AI flag → radiologist read → SOAP cited.
D11Mon 20 Sep · Cross-Tenant Imaging
M8 extension · patient consents · imaging from Tenant B visible at Tenant A · audit.
M8 extension · patient consents · imaging from Tenant B visible at Tenant A · audit.
D12Tue 21 Sep · 3 Radiologist Clinics Onboarded
3 partner radiologist clinics linked · workflow live · sample reports flowing.
3 partner radiologist clinics linked · workflow live · sample reports flowing.
D13Wed 22 Sep · Hardening + Storage Audit
Performance · OHIF load times · storage retention enforced.
Performance · OHIF load times · storage retention enforced.
D14Thu 23 Sep · Production Test (Doc Zam)
Doc Zam tenant flips on · 3 ultrasounds captured · 1 X-ray flagged · clinically reviewed.
Doc Zam tenant flips on · 3 ultrasounds captured · 1 X-ray flagged · clinically reviewed.
D15Fri 24 Sep · Demo Prep + v1.2 Retro Compilation
Demo deck · phase closeout narrative · 20-tenant milestone.
Demo deck · phase closeout narrative · 20-tenant milestone.
+Sat 25 Sep · 20th Tenant Onboarding
20th tenant onboarded via 4.3 wizard · live by EOD.
20th tenant onboarded via 4.3 wizard · live by EOD.
+Mon 26 Sep · v1.2 Phase Closeout Demo
9am phase demo · 11am sprint retro · 12pm v1.2 phase retro · 2pm v1.3 plan kickoff.
9am phase demo · 11am sprint retro · 12pm v1.2 phase retro · 2pm v1.3 plan kickoff.
6. 📦 Deliverables
| FR | Item | SP |
|---|---|---|
| FR-5.4.1 | Orthanc PACS deployment · per-tenant | 5 |
| FR-5.4.2 | OHIF viewer integration in M4 | 8 |
| FR-5.4.3 | Study manager · time-ordered list | 5 |
| FR-5.4.4 | Sonosite ultrasound DICOM SCU | 5 |
| FR-5.4.5 | Mindray ultrasound DICOM SCU | 5 |
| FR-5.4.6 | AI flag pipeline (X-ray pneumothorax/pneumonia/fracture) | 8 |
| FR-5.4.7 | Radiologist read queue + Filament | 5 |
| FR-5.4.8 | Report templates (BI-RADS · RECIST · disease) | 8 |
| FR-5.4.9 | FHIR DiagnosticReport bridge to M4 | 5 |
| FR-5.4.10 | Cross-tenant imaging (M8 extension) | 8 |
| FR-5.4.11 | 3 partner radiologist clinics onboarded | 5 |
| FR-5.4.12 | Storage retention + audit policy | 3 |
| FR-5.4.13 | Production rollout · Doc Zam tenant | 5 |
| FR-5.4.14 | v1.2 phase closeout artifacts | 5 |
| FR-5.4.15 | 20th tenant onboarded | 5 |
| TOTAL | 85 SP |
7. 👥 Team Capacity
| Role | Allocation | Focus |
|---|---|---|
| Eng Lead / BE | 1.0 FTE | Orthanc · DICOMweb · cross-tenant |
| BE Dev 3 (DICOM specialist) | 1.0 FTE | Modality SCU · AI flag pipeline · report bridge |
| FE Dev | 1.0 FTE | OHIF embed · study manager · radiologist Filament |
| Prompt Eng | 0.5 FTE | SOAP cite from report · AI-flag explanation |
| DevOps | 1.0 FTE | PACS storage · scale · monitoring |
| Radiologist consultant | 0.5 FTE | Workflow design · report template review · AI flag clinical accuracy |
| Founder | 0.5 FTE | Partner radiologist clinic BD · v1.2 closeout · v1.3 prep |
| Doc Zam | 0.5 FTE | Doctor-side workflow review · clinical sign-off |
| QA | 0.5 FTE | End-to-end imaging · cross-tenant · perf |
8. 🔔 Sprint Ceremonies
- Mon 6 Sep 9am — Sprint Planning (90 min)
- Daily 9am — Standup (15 min · radiologist consultant joins Tue/Thu)
- Fri 10 Sep + Fri 17 Sep 4pm — Mid-sprint demos (45 min each)
- Tue 21 Sep 4pm — Partner radiologist onboarding review (60 min)
- Mon 26 Sep 9am — Sprint Demo + v1.2 Phase Closeout (90 min)
- Mon 26 Sep 11am — Sprint Retro (60 min)
- Mon 26 Sep 12pm — v1.2 Phase Retro (60 min)
9. 🩺 Sign-off Items
- DICOMweb compliance verified (QIDO/WADO/STOW)
- OHIF viewer performance acceptable (load < 3s for 100MB study)
- Sonosite + Mindray ultrasound capture workflow clinically usable
- AI flag accuracy ≥ 85% on 50 sample X-rays (radiologist gold)
- Report templates clinically representative (radiologist sign-off)
- Cross-tenant imaging audit trail complete
- 3 partner radiologist clinics live + accepting reads
- Storage retention policy aligned with compliance
- v1.2 phase closeout · written attestation: "v1.2 production-ready"
- Final demo (26 Sep) — Doc Zam + radiologist consultant sign-off
10. 🎬 v1.2 Phase Closeout Demo — 26 Sep 9am (90 min)
| Time | Segment |
|---|---|
| 0-10 | v1.2 narrative · 4 sprints + Phase Closeout · 20 tenants live |
| 10-20 | Live ultrasound capture · auto-tag · viewable in M4 |
| 20-30 | X-ray AI flag · pneumothorax flagged · doctor sees in M4 pre-report |
| 30-40 | Radiologist queue · report drafted · signed · pushed to MediEco SOAP |
| 40-50 | Cross-tenant imaging via M8 · KKM eHIS linked imaging from 5.3 |
| 50-65 | v1.2 metrics walk: 20 tenants · M11 chronic care 40%+ · BCN/Tamil 15%+ · eHIS 30%+ · DICOM 100+/wk |
| 65-75 | Doc Zam + radiologist consultant phase attestation: "v1.2 production-ready" |
| 75-85 | v1.3 plan walkthrough · Q4 2027 · multi-state expansion · 40-tenant target |
| 85-90 | Founder closing remarks · Phase 5 retrospective intro |
11. 🛡️ Contingency
| Risk | Trigger | Response |
|---|---|---|
| OHIF performance issue | Load > 5s for 100MB study | Switch to Cornerstone3D-only · or thumbnail-first then full load |
| Modality SCU compatibility | Vendor SCU non-standard | Vendor-specific adapter · escalate to manufacturer support |
| AI flag accuracy poor | < 80% sample acc | Doctor override mandatory · ship without auto-flag · iterate post-launch |
| Partner radiologist delay | Onboarding slip | Phase exit at 2 partners · grow to 3+ in v1.3 |
| Storage cost spike | DICOM volume larger than estimated | Cold storage tier · per-tenant retention policy enforced strictly |
| 20th tenant onboarding slips | Tenant 19 still onboarding | Phase exit at 19 tenants · re-baseline target · v1.2 still successfully closed |