1. 🎯 Sprint Summary
| Sprint | 7.3 (M14 CARDIO · Cardiology Deep) |
| Duration | 14 Feb - 5 Mar 2028 (3 weeks · 15 working days) |
| Module | M14 CARDIO · third specialty |
| Goal | ECG analysis with AI flag · 5 risk scores · CPG anticoagulation pathway · HF stratification · cardiologist HITL · 70 tenants total |
| Capacity | 5 FTE (2 BE + 1 FE + 1 prompt + 0.5 DevOps + 1 Onboarding) + 0.5 Founder + 0.5 Doc Zam + 0.5 cardiology advisor |
| Velocity target | 95 SP |
| Demo date | 5 Mar 2028 |
2. 🧩 Module Scope
- ECG Capture + AI Analysis: 12-lead ECG upload (DICOM-WV or PDF) · AI flag for STEMI · AF · long QT · LBBB · LVH · pre-cardiologist gate
- 5 Risk Scores: CHA2DS2-VASc · HAS-BLED · TIMI · GRACE · Framingham 10-year ASCVD
- Anticoagulation Pathway (CPG-driven): AF: CHA2DS2-VASc ≥ 2 → DOAC vs warfarin · HAS-BLED counter-balance · INR follow-up
- Heart Failure Stratification: NYHA I-IV · ACC/AHA stages A-D · BNP/NT-proBNP integration · echo data parsing
- Cardio CPG Library: AF · ACS · CHF · HTN · IHD · DOAC dosing · MOH/ESC/AHA guidelines
- Cardiologist HITL Queue: Specialist override · cardio-specific severity · ECG abnormal triage
- Cardiac Patient Tracking: Long-term BP/HR/lipids/HbA1c trends · adherence to anticoagulation · time-in-therapeutic-range (TTR)
- Cardio Encounter Tabs: M4 extends · ECG viewer · risk score widget · CPG quick-ref
- Cardiac Wearables Bridge: Apple Watch ECG/AFib alerts (M10 extension) · cardio-specific alerts · cardiologist daily queue
- Pre-Cardio Telehealth: Cardiologist remote review (M4+ Telehealth extension) · 1-day SLA on flagged ECGs
3. 📊 Clinical Risk Scores
CHA2DS2-VASc — AF stroke risk (C/H/A2/D/S2/V/A/Sc · 0-9 points). Gates anticoagulation decision per AF CPG.
HAS-BLED — Bleeding risk for anticoag (H/A/S/B/L/E/D · 0-9). Counter-balance to CHA2DS2-VASc.
TIMI — UA/NSTEMI 14-day composite endpoint risk (Killip class · age · biomarkers).
GRACE — In-hospital + 6-month mortality (NSTEMI/STEMI). Killip class · ECG · creatinine.
Framingham 10-year ASCVD — Primary prevention risk · age · sex · cholesterol · BP · diabetes · smoking.
4. 🚦 Pre-Sprint Gate Checklist
- Sprint 7.2 closeout · M13 OG live
- Cardiology advisor onboarded (4 weeks · MOH-recognised cardiologist)
- ECG AI model evaluated (PhysioNet 12-lead trained · or third-party API)
- 5 risk score algorithms validated against published reference values
- Anticoagulation CPG indexed (MOH AF · ESC 2024 · AHA 2023)
- 5 cardio CPGs indexed in pgvector
- Apple Watch HealthKit ECG bridge extended (M10 + M14)
- 2 cardio-leaning tenant clinics + 1 hospital cardiologist on-call
5. 📅 Day-by-Day Plan (15 days)
D1Mon 14 Feb · Schema + ECG Storage
DB migrations · DICOM-WV / PDF ECG storage · viewer integration.
DB migrations · DICOM-WV / PDF ECG storage · viewer integration.
D2Tue 15 Feb · ECG AI Analysis Pipeline
PhysioNet model deploy · STEMI/AF/long QT/LBBB/LVH detection · pre-flag in M4.
PhysioNet model deploy · STEMI/AF/long QT/LBBB/LVH detection · pre-flag in M4.
D3Wed 16 Feb · CHA2DS2-VASc + HAS-BLED Calculators
Risk score engine · live calculation · score widget in M4 encounter.
Risk score engine · live calculation · score widget in M4 encounter.
D4Thu 17 Feb · TIMI + GRACE + Framingham
3 more risk scores · auto-population from labs/vitals · trend over time.
3 more risk scores · auto-population from labs/vitals · trend over time.
D5Fri 18 Feb · Mid-Demo + Anticoag CPG
Anticoag pathway · CHA2DS2 ≥ 2 + HAS-BLED weighing · DOAC selection · advisor sign-off.
Anticoag pathway · CHA2DS2 ≥ 2 + HAS-BLED weighing · DOAC selection · advisor sign-off.
D6Mon 21 Feb · Heart Failure Stratification
NYHA · ACC/AHA stages · BNP/NT-proBNP integration · echo parser.
NYHA · ACC/AHA stages · BNP/NT-proBNP integration · echo parser.
D7Tue 22 Feb · Cardio CPG RAG
5 CPGs indexed · CitationEnforcer specialty filter · MOH/ESC/AHA cite.
5 CPGs indexed · CitationEnforcer specialty filter · MOH/ESC/AHA cite.
D8Wed 23 Feb · Cardiologist HITL Queue
Specialist override · cardio-specific severity · 1-day SLA on abnormal ECG.
Specialist override · cardio-specific severity · 1-day SLA on abnormal ECG.
D9Thu 24 Feb · Cardiac Wearables Bridge
Apple Watch ECG/AFib · cardiologist daily queue · alert routing.
Apple Watch ECG/AFib · cardiologist daily queue · alert routing.
D10Fri 25 Feb · Mid-Demo Round 2
Cardio advisor reviews 30 mock cardio encounters · clinical accuracy.
Cardio advisor reviews 30 mock cardio encounters · clinical accuracy.
D11Mon 28 Feb · Cardiac Patient Tracking
Long-term trends · TTR · adherence · annual review trigger.
Long-term trends · TTR · adherence · annual review trigger.
D12Tue 29 Feb · Pre-Cardio Telehealth (M4+ Ext)
Cardiologist remote review · 1-day SLA · video consult flow.
Cardiologist remote review · 1-day SLA · video consult flow.
D13Wed 1 Mar · Cardio Encounter Tabs (M4 Ext)
ECG viewer · risk score widget · CPG quick-ref · advisor input.
ECG viewer · risk score widget · CPG quick-ref · advisor input.
D14Thu 2 Mar · Production Test (2 cardio clinics + advisor)
2 cardio clinics flip on production · advisor on-call · monitor 24h.
2 cardio clinics flip on production · advisor on-call · monitor 24h.
D15Fri 3 Mar · Demo Prep + 70th Tenant
Demo deck · 70-tenant milestone · cardio adoption metrics.
Demo deck · 70-tenant milestone · cardio adoption metrics.
+Mon 5 Mar · Sprint Demo + Retro
9am demo · 11am retro · 2pm 7.4 (API + Marketplace) prep.
9am demo · 11am retro · 2pm 7.4 (API + Marketplace) prep.
6. 📦 Deliverables
| FR | Item | SP |
|---|---|---|
| FR-14.1 | ECG storage + viewer (DICOM-WV / PDF) | 5 |
| FR-14.2 | ECG AI analysis pipeline (5 conditions) | 13 |
| FR-14.3 | 5 risk score calculators (CHA2DS2/HAS-BLED/TIMI/GRACE/Framingham) | 13 |
| FR-14.4 | Anticoagulation CPG-driven pathway | 8 |
| FR-14.5 | Heart failure stratification (NYHA + ACC/AHA + BNP) | 5 |
| FR-14.6 | 5 cardio CPG library + RAG | 5 |
| FR-14.7 | Cardiologist HITL queue + 1-day SLA | 5 |
| FR-14.8 | Apple Watch ECG/AFib bridge (M10 ext) | 5 |
| FR-14.9 | Cardiac patient long-term tracking + TTR | 5 |
| FR-14.10 | Pre-cardio telehealth (M4+ ext) | 5 |
| FR-14.11 | Cardio encounter tabs (M4 ext) | 5 |
| FR-14.12 | Production rollout · 2 cardio clinics | 5 |
| FR-14.13 | Cardiology advisor sign-off (30 sample) | 5 |
| FR-14.14 | Pen-test light + 70th tenant | 5 |
| FR-14.15 | Compliance pack update (cardio) | 3 |
| TOTAL | 92 SP |
7. 👥 Team Capacity
| Role | Allocation | Focus |
|---|---|---|
| Eng Lead / BE | 1.0 FTE | Risk scores · anticoag pathway · cross-module |
| BE Dev 2 | 1.0 FTE | ECG AI pipeline · wearable bridge · M10 ext |
| FE Dev | 1.0 FTE | ECG viewer · risk widgets · cardio tabs |
| Prompt Eng | 1.0 FTE | Cardio CPG corpus · CHA2DS2 narrative · DOAC selection |
| DevOps | 0.5 FTE | ECG storage · DICOM ingestion |
| Onboarding Lead | 1.0 FTE | 2 cardio clinics + 70th tenant |
| Founder | 0.5 FTE | Cardiology advisor BD · M14 launch |
| Doc Zam | 0.5 FTE | Cross-specialty oversight |
| Cardiology advisor | 0.5 FTE (heavy) | 30-sample · CPG validation · HITL design · ECG model review |
8. 🔔 Sprint Ceremonies
- Mon 14 Feb 9am — Sprint Planning (90 min)
- Daily 9am — Standup (15 min · cardio advisor joins Tue/Thu)
- Fri 18 + Fri 25 Feb 4pm — Mid-sprint demos (60 min each)
- Wed 23 Feb 4pm — Cardiologist 30-sample review (3 hours)
- Mon 5 Mar 9am — Sprint Demo (60 min)
- Mon 5 Mar 11am — Sprint Retro (60 min)
9. 🩺 Sign-off Items
- ECG AI flag accuracy ≥ 90% on PhysioNet test set + 50 advisor samples
- 5 risk scores match published reference values on 30 cases each
- Anticoag pathway: 30 sample cases match advisor manual recommendation
- HF stratification: NYHA + ACC/AHA staging clinically appropriate
- Cardiologist HITL queue: 1-day SLA met on flagged ECGs
- Apple Watch AFib alerts route correctly · cardiologist daily queue
- Pre-cardio telehealth flow legally + clinically defensible
- Production rollout: 2 cardio clinics live · 0 P0 incidents
- Final demo (5 Mar) — written sign-off · cardio advisor + Doc Zam
10. 🎬 Demo Agenda — 5 Mar 9am (60 min)
| Time | Segment |
|---|---|
| 0-5 | v2.0 narrative · M14 third specialty · 70-tenant milestone |
| 5-15 | ECG upload · AI flag STEMI · cardiologist HITL queue · 1-day SLA |
| 15-25 | AF patient · CHA2DS2-VASc + HAS-BLED · DOAC pathway suggested · doctor reviews |
| 25-35 | Apple Watch AFib alert · cardiologist daily queue · escalation |
| 35-45 | HF patient · NYHA staging · BNP integration · trends graph |
| 45-55 | Pre-cardio telehealth · video consult · ambient SOAP |
| 55-60 | Doc Zam + cardio advisor sign-off · 7.4 (API+Marketplace) prep |
11. 🛡️ Contingency
| Risk | Trigger | Response |
|---|---|---|
| ECG AI accuracy poor | < 85% on test set | Cardiologist mandatory override · ship as "cardiologist review queue helper" not auto-flag |
| Risk score calc mismatch | Reference variance | Pin to MOH/ESC/AHA reference · cardiologist override |
| Cardio advisor unavailable | Personal/clinical conflict | Backup advisor · slip 30-sample review |
| Anticoag pathway disagreement | Advisor dispute on 5+ cases | Conservative default · doctor manual override · iterate post-launch |
| 2 cardio clinics onboarding slow | Specialty shy | Phase exit at 1 cardio clinic · 2nd in 7.4 stretch |