# OZI-RIS Secondary Roadmap

Last reviewed: 17 July 2026  
Owner: L33T Digital  
Current authorized milestone: **P2 — Core RIS interoperability**

This checklist complements `ROADMAP.md`. Work must proceed in priority order unless clinical governance approves a different sequence.

## P0 — Release blockers (complete)

- [x] Make report finalization, version snapshot, signature, and notification creation transactional
- [x] Prevent partially finalized or unsigned reports
- [x] Make issued reports immutable
- [x] Require signed correction/addendum events for post-finalization changes
- [x] Remove raw AI/provider error messages from user responses
- [x] Prevent identifiable clinical data from reaching AI providers without approved controls
- [x] Add AI usage audit records and mandatory human verification
- [x] Complete Composer and npm vulnerability audits
- [x] Review and commit the current uncommitted changes
- [x] Create and test database backup and restoration procedures
- [x] Document clinical downtime and post-restoration reconciliation
- [x] Confirm all test records are excluded from production migration

## P1 — Security and patient safety (penetration test deferred)

- [x] Add configurable multi-factor authentication for administrators and clinical users
- [x] Introduce configurable inactivity timeout and forced logout
- [x] Terminate sessions after password, role, or account-status changes
- [x] Add account lockout and administrator unlock workflow
- [x] Review password policy and compromised-password protection
- [x] Add emergency break-glass access with reason and enhanced auditing
- [x] Add audit-log retention, export, and tamper-evidence controls
- [x] Ensure security events generate administrator alerts
- [x] Add malware scanning and quarantine for attachments
- [x] Review permitted attachment formats, especially DOC/DOCX
- [x] Add strict download security headers
- [x] Verify production TLS, cookies, proxy settings, and debug configuration
- [ ] Complete independent penetration testing; deferred by owner, automated authorization-boundary tests are in place

## P2 — Core RIS interoperability (active)

- [ ] Implement DICOM Modality Worklist
  - [x] Implement secured RIS MWL contract and native C-FIND gateway
  - [x] Complete local loopback C-ECHO and end-to-end MWL simulator validation
  - [x] Validate supervised C-ECHO/C-FIND and assigned-exam filtering with Fuji DR-ID 300CL / Console Advance
  - [x] Add administrator-managed workstation endpoints and per-workstation push routing for scheduled and arrived/walk-in exams
  - [ ] Confirm the Fuji console removes a completed item after a fresh query; reconcile its saved workstation IP
  - [ ] Deploy and validate with each modality/vendor at site
- [ ] Implement Modality Performed Procedure Step
  - [x] Implement N-CREATE/N-SET gateway, workflow matching, and reconciliation
  - [x] Receive a physical Fuji N-CREATE `IN PROGRESS` event and validate live N-SET `COMPLETED` handling (`0x0000`)
  - [x] Prevent delayed `IN PROGRESS` messages from reopening a terminal MPPS
  - [x] Mark the optional MWL/MPPS worklist **Stable — Alpha 1** after supervised Fuji validation; keep it default-off pending approval of each production modality/vendor
  - [ ] Capture a new operator-generated Fuji N-SET `COMPLETED` event after Finish
  - [ ] Deploy and validate MPPS status/dataset behavior with each modality/vendor
- [x] Store DICOM Study Instance UID and relevant series/instance identifiers
- [x] Reconcile accession numbers between RIS, modality, and PACS
- [x] Add controlled PACS viewer launch and DICOMweb query support
- [ ] Implement storage-commitment status where required
  - [x] Implement RIS commitment result/status and SOP tracking contract
  - [ ] Deploy PACS/Orthanc N-ACTION/N-EVENT-REPORT and validate failure behavior
- [x] Add failed or unmatched study reconciliation queue
- [ ] Produce a DICOM conformance statement
  - [x] Produce development integration baseline
  - [x] Record local Orthanc/DICOMweb/MWL site-validation evidence
  - [ ] Complete product and gateway conformance claims after site validation
- [ ] Validate against ISO 12052:2026 and the current DICOM edition

## P3 — HIS/EHR integration

- [ ] Select HL7 v2, FHIR, or a controlled combination
- [ ] Implement external patient demographic synchronization
- [ ] Implement imaging order/ServiceRequest intake
- [ ] Return finalized DiagnosticReport results linked to ImagingStudy
- [ ] Support order cancellation and amendment messages
- [ ] Add interface acknowledgement, retry, idempotency, and duplicate detection
- [ ] Add interface monitoring and reconciliation dashboards
- [ ] Implement patient-information reconciliation across connected systems

## P4 — Malaysian clinical governance

- [ ] Approve a User Access Control Policy
- [ ] Define medical-record ownership and custodian responsibilities
- [ ] Configure retention periods by record category
- [ ] Implement approved record-disposal workflows
- [ ] Add disclosure and medical-report request tracking
- [ ] Add consent withdrawal and communication-preference history
- [ ] Complete privacy-impact and security-risk assessments
- [ ] Confirm PDPA and applicable MOH policy obligations
- [ ] Establish medical-record and clinical-governance review processes
- [ ] Document incident notification and investigation procedures

## P5 — Reporting quality

- [x] Provide an editor-neutral reporting layer with an administrator-selected default and safe fallback
- [x] Preserve templates, sanitization, signatures, and report versions across editor choices
- [ ] Clinically approve report templates by modality and procedure
- [ ] Require meaningful report content before signing
- [ ] Add structured findings and impression fields where appropriate
- [ ] Add report turnaround-time targets and escalation
- [ ] Formalize critical-result escalation timeframes and failed-contact handling
- [ ] Expand peer-review sampling and discrepancy classification
- [ ] Add report correction and addendum audit views
- [ ] Validate PDF and print layouts clinically and legally

## P6 — Operations and reliability

- [x] Define recovery-point and recovery-time objectives
- [ ] Automate encrypted backups and scheduled restoration tests
- [ ] Monitor database availability, storage, queue, and notification failures
- [ ] Monitor attachment storage capacity
- [ ] Add centralized structured logs and application-performance monitoring
- [ ] Create operational health dashboards and alerts
- [ ] Establish deployment, rollback, and maintenance procedures
- [ ] Separate development, testing, staging, and production environments

## P7 — Testing and release validation

- [ ] Run the 100 Malaysian test patients through representative workflows
- [x] Test appointment, walk-in, and exam-request pathways
- [ ] Test every study status transition
- [ ] Test preliminary, final, correction, and addendum reporting
- [ ] Complete browser-level clinical usability validation for every selectable report editor
- [ ] Test critical-result escalation and patient merging
- [ ] Test all roles and permission boundaries
- [ ] Add browser end-to-end, concurrency, double-submission, load, and volume tests
- [ ] Conduct multidisciplinary user-acceptance testing
- [ ] Complete a controlled pilot before general deployment

## P8 — Technical maintenance

- [ ] Resolve Sass deprecation warnings
- [x] Review framework and frontend dependency versions
- [ ] Enable automated dependency advisories and CI security checks
- [ ] Add CI for tests, build, and formatting
- [ ] Refactor compressed migrations and controllers
- [ ] Increase unit and integration-test coverage
- [ ] Maintain architecture, API, deployment, recovery, release, and changelog documentation
