VoiceAssist Client Development & Enhancement Roadmap

Version: 2.1 (Final Decisions Made) Date: 2025-11-21 Status: ✅ Ready for Implementation - Milestone 1 Starting Branch: client-roadmap-reconciliation

🎉 Critical Decisions Finalized (2025-11-21)

All 8 critical questions resolved! Development can proceed immediately.

See OPEN_QUESTIONS.md for detailed rationale.

🎯 Executive Summary

This unified roadmap integrates:

1. Deferred backend features from Phases 4-6 (voice pipeline, medical AI, integrations)
2. Three client applications (web app, admin panel, documentation site)
3. Platform enhancements (design system, accessibility, i18n, PWA, telemetry)
4. External integrations (medical databases, EMR/FHIR systems)
5. Advanced capabilities (multi-modal AI, advanced RAG, operational excellence)

Current Status:

• ✅ Backend Core: 100% Complete (Phases 0-15, HIPAA-compliant, production-ready)
• ✅ Critical Decisions: All 8 resolved (2025-11-21)
• ⏳ Deferred Backend Features: Identified and scheduled (Milestones 2-6)
• 🚀 Client Applications: Starting NOW (Milestone 1-2, 20 weeks)
• ⏳ Platform Enhancements: Planned across all milestones

Total Timeline: 52+ weeks (6 major milestones) Team Size: 2-3 developers (scaling to 4-6 for advanced features)

📋 Table of Contents

1. Completed Work Summary
2. Outstanding Tasks Overview
3. Milestone Breakdown
4. Feature Catalog
5. Dependencies & Prerequisites
6. Open Questions & Decisions
7. Success Metrics
8. Risk Management

1. Completed Work Summary

Backend Development (Phases 0-15) ✅

Status: 100% Complete, Production Ready

Quality Metrics Achieved:

• ✅ Code coverage: 95% (target: 90%)
• ✅ HIPAA compliance: 42/42 requirements
• ✅ Performance: P95 120ms, 5000 req/s throughput
• ✅ Security: 0 critical vulnerabilities
• ✅ Documentation: 15,000+ lines

2. Outstanding Tasks Overview

2.1 Deferred Backend Features (from Phases 4-6)

Category A: Voice Pipeline Completion

• Text-based streaming chat (MVP completed in Phase 4)
• Full voice pipeline with WebRTC
• Voice Activity Detection (VAD)
• Echo cancellation and noise suppression
• Barge-in support
• Voice authentication
• OpenAI Realtime API integration

Category B: Advanced Medical AI

• OpenAI embeddings (MVP completed in Phase 5)
• Single-hop RAG (MVP completed in Phase 5)
• BioGPT/PubMedBERT integration
• Multi-hop reasoning
• Query decomposition
• Cross-document synthesis
• Confidence scoring

Category C: External Medical Integrations

• UpToDate API integration (no budget, deferred)
• OpenEvidence API integration (free tier, Milestone 5)
• PubMed integration (free, Milestone 5 - highest priority)
• Clinical practice guidelines (free, CDC/WHO, Milestone 5)
• Clinical trial databases (future consideration)
• Drug information systems (future consideration)

Category D: Nextcloud Integration Completion

• CalDAV service (MVP completed in Phase 6)
• WebDAV file indexer (MVP completed in Phase 6)
• Email service skeleton (MVP completed in Phase 6)
• OIDC authentication
• Complete email integration (IMAP/SMTP)
• CardDAV contacts
• Frontend Nextcloud app packaging

2.2 Client Applications (98 Features Total)

Web App - 55 Features

• Authentication & User Management: 5 features
• Chat Interface: 12 features
• Voice Mode: 8 features
• Clinical Context: 6 features
• File Management: 4 features
• Citations & Sources: 5 features
• Conversation Management: 5 features
• Advanced Features: 10 features

Admin Panel - 38 Features

• Dashboard: 8 features
• Knowledge Base Management: 12 features
• AI Model Configuration: 6 features
• Analytics: 6 features
• Integration Management: 6 features

Documentation Site - 15 Features

• Content Management: 5 features
• Interactive Elements: 5 features
• Navigation: 5 features

Detailed Specs Available:

• Web App Feature Specs
• Admin Panel Feature Specs
• Docs Site Feature Specs

2.3 Platform Enhancements

Category E: Design & UX

• Design tokens package (@voiceassist/design-tokens)
• WCAG 2.1 AA accessibility compliance
• Storybook component documentation
• Dark mode theme
• Responsive design (320px to 4K)

Category F: Internationalization

• react-i18next infrastructure
• English (en-US) - Primary
• Spanish (es-ES) - Secondary
• Arabic (ar-SA) - For Middle East
• RTL (Right-to-Left) support
• Date/time/number formatting

Category G: Offline & PWA

• Service worker implementation
• Cache-first strategy for static assets
• IndexedDB for offline storage
• Background sync
• PWA manifest and install prompt
• Encrypted local storage (HIPAA-compliant)

Category H: Telemetry & Analytics

• Client-side telemetry package (@voiceassist/telemetry)
• Core Web Vitals tracking
• Error tracking (Sentry integration)
• User analytics (privacy-focused)
• Integration with Grafana

Category I: Client-Side Security

• PHI detection at client level
• Pattern matching for common PHI
• Redaction before logging
• Warning prompts for potential PHI
• Local audit trail

2.4 Integration Expansions

Category J: EMR/FHIR Integration

• HL7 FHIR R4 standard support
• Patient resource access
• Epic MyChart integration
• Cerner integration
• Allscripts integration
• SMART on FHIR authorization

Category K: Multi-Modal AI

• Medical image analysis (GPT-4 Vision)
• DICOM support
• Video analysis
• Structured data visualization
• Lab results charting

2.5 Operational Excellence

Category L: Advanced Monitoring

• AI model performance metrics
• Business metrics (MAU, DAU, NPS)
• Predictive analytics
• ML-based anomaly detection

Category M: Cost Optimization

• OpenAI API cost reduction (caching, prompt optimization)
• Infrastructure right-sizing
• Storage optimization

Category N: Resilience Testing

• Chaos engineering framework
• Failure injection testing
• Network partition testing
• Regular game days

3. Milestone Breakdown

Milestone 1: Frontend Foundation (Weeks 1-10)

Objective: Establish monorepo, design system, and build core web app

Duration: 10 weeks Team: 2-3 developers Priority: CRITICAL

Phase 0: Foundation & Setup (Weeks 1-2) ✅ COMPLETE

Status: ✅ Complete (2025-11-21) Branch: client-roadmap-reconciliation Commit: 517cddb

Tasks Completed:

1. ✅ Monorepo Setup

   • ✅ Initialized pnpm workspaces (pnpm 10.23.0)
   • ✅ Configured Turborepo 2.6.1 for build orchestration
   • ✅ Set up shared packages structure (apps/, packages/)
   • ✅ Configured TypeScript paths and references

2. ✅ Design Tokens Package (@voiceassist/design-tokens v1.0.0)

   • ✅ Medical color palette (blue #0080FF, teal #00AFAF)
   • ✅ Typography scales (system fonts, 10 sizes)
   • ✅ Spacing system (4px/8px grid, 40+ tokens)
   • ✅ Border radius, shadows, z-index scales
   • ✅ Full TypeScript support with type exports

3. ✅ Component Library Foundation (@voiceassist/ui v1.0.0)

   • ✅ Tailwind CSS 3.4+ configuration
   • ✅ Radix UI primitives integration
   • ✅ Button component (5 variants, 3 sizes)
   • ✅ Storybook 8.0 with a11y addon
   • ✅ Class variance authority for variants

4. ✅ Shared Packages

   • ✅ @voiceassist/types - Complete TypeScript type definitions
   • ✅ @voiceassist/api-client - Type-safe Axios client with interceptors
   • ✅ @voiceassist/utils - Utilities with PHI detection & redaction (HIPAA)
   • ✅ @voiceassist/config - Tailwind, TypeScript, ESLint configs

5. ⏳ CI/CD Pipeline (Deferred to Phase 1)

   • ⏳ GitHub Actions workflows
   • ⏳ Husky git hooks

Deliverables:

• ✅ Monorepo structure operational (pnpm-workspace.yaml, turbo.json)
• ✅ Design tokens package with 200+ tokens
• ✅ Component library foundation (Button + utils)
• ✅ Storybook running on port 6006
• ✅ 6 shared packages built and functional
• ✅ All packages build successfully with Turbo caching

Success Criteria:

• ✅ All packages can be imported across apps
• ✅ Storybook accessible at http://localhost:6006
• ✅ pnpm build succeeds (all 7 packages)
• ✅ PHI detection utilities tested and working
• ⏳ CI/CD passes on pull requests (deferred)

Phase 1: Web App Core (Weeks 3-6) 🚧 IN PROGRESS

Status: Week 3 - Authentication (75% Complete) Branch: client-roadmap-reconciliation Latest Commit: 75404a8

Tasks:

1. Authentication & User Management (Week 3) ⏳ 75% COMPLETE

   • ✅ Email/password login page with validation
   • ✅ User registration page with password strength indicator
   • ✅ Session management with JWT (Zustand store)
   • ✅ Protected route implementation (React Router guards)
   • ✅ Responsive layout with header, sidebar, navigation
   • ⏳ User profile management (deferred to Week 4)
   • ⏳ OAuth integration (Google, Microsoft) (deferred to Milestone 2)

2. Chat Interface Foundation (Week 4)

   • Chat layout with sidebar and main area
   • Message rendering (markdown, code blocks)
   • Real-time streaming responses via WebSocket
   • Citation inline display
   • Loading states and skeletons

3. Basic Voice Mode (Week 5)

   • Push-to-talk voice input
   • Real-time transcription display
   • Audio response playback
   • Voice settings (speed, volume)
   • Note: Advanced features (VAD, WebRTC, barge-in) deferred to Milestone 2

4. File Upload (Week 6)

   • PDF upload and preview
   • Image upload and display
   • Progress indicators
   • File size limits
   • Error handling

Deliverables:

• ✅ Web app deployed to staging
• ✅ Authentication flow complete
• ✅ Chat interface functional with streaming
• ✅ Basic voice mode operational
• ✅ File upload working

Success Criteria:

• Users can register, login, and chat
• Streaming responses render correctly
• Basic voice input works
• Files upload successfully
• 80% test coverage
• Performance: < 2s initial load

Phase 2: Web App Advanced (Weeks 7-10) 🚧 IN PROGRESS

Status: Week 8 - Citations Complete (50% Complete) Latest Commit: 157e2a3

Tasks:

1. Clinical Context (Week 7) ✅ COMPLETE

   • ✅ Patient demographics form
   • ✅ Problems list management
   • ✅ Medications list
   • ✅ Lab values input
   • ✅ Vitals tracking
   • ✅ Context-aware queries
   • ✅ Keyboard shortcut (⌘I)
   • Commit: 9626960

2. Citations & Sources (Week 8) ✅ COMPLETE

   • ✅ Citation sidebar
   • ✅ Source highlighting via expandable citations
   • ✅ Search/filter across all citation fields
   • ✅ Direct source links (PubMed, DOI, URLs)
   • ✅ Citation export (Markdown/Text)
   • ✅ Keyboard shortcut (⌘C)
   • Commit: 157e2a3

3. Conversation Management (Week 9) ⏳ IN PROGRESS

   • ⏳ Conversation history with search
   • ⏳ Conversation folders
   • ⏳ Conversation sharing
   • ⏳ Conversation templates
   • ⏳ Export to PDF/Markdown

4. Advanced Features (Week 10) ✅ PARTIALLY COMPLETE

   • ✅ Message editing and regeneration
   • ✅ Conversation branching (Commit: a37068e)
   • ✅ Keyboard shortcuts (⌘B, ⌘I, ⌘C, ⌘/)
   • ⏳ Performance optimization
   • ⏳ Accessibility audit and fixes

Deliverables:

• ✅ Clinical context fully functional
• ✅ Citations and sources working
• ⏳ Conversation management in progress
• ✅ Advanced features partially complete
• ⏳ WCAG 2.1 AA compliance pending
• ⏳ Performance optimization pending

Success Criteria:

• Clinical context integrates with queries
• Citations displayed correctly
• Conversation history works
• Accessibility score: WCAG 2.1 AA
• Performance: < 2s load, < 100ms interactions

Milestone 2: Admin Panel & Voice Pipeline (Weeks 11-20)

Objective: Build admin panel, complete full voice pipeline, add OIDC auth

Duration: 10 weeks Team: 2-3 developers Priority: HIGH

Phase 3: Admin Panel Core (Weeks 11-13)

Tasks:

1. Dashboard (Week 11)

   • Real-time metrics display
   • System health indicators
   • Active sessions monitor
   • API usage graphs
   • Alert notifications

2. Knowledge Base Management (Week 12)

   • Document library table
   • Bulk document upload
   • Document metadata editing
   • Indexing queue management
   • Document preview and search

3. Basic Analytics (Week 13)

   • Query analytics dashboard
   • Response time histograms
   • Usage trends
   • Export reports

Deliverables:

• ✅ Admin panel deployed to staging
• ✅ Dashboard operational with real-time metrics
• ✅ KB management fully functional
• ✅ Analytics dashboard complete

Phase 4: Admin Panel Advanced (Weeks 14-16)

Tasks:

1. AI Model Configuration (Week 14)

   • Model selection interface
   • Model routing rules
   • Temperature/parameters tuning
   • Model testing interface

2. Integration Management (Week 15)

   • Nextcloud configuration UI
   • Calendar integration setup
   • Email integration UI
   • Integration health checks

3. Advanced Analytics (Week 16)

   • Cost breakdown by service
   • Popular topics tracking
   • User retention cohorts
   • Predictive analytics

Deliverables:

• ✅ AI model configuration complete
• ✅ Integration management working
• ✅ Advanced analytics operational

Phase 5: Documentation Site (Weeks 17-18)

Tasks:

1. Content & Navigation (Week 17)

   • Next.js 14 app setup
   • MDX content integration
   • Sidebar navigation
   • Search with Algolia
   • Dark mode

2. Interactive Elements (Week 18)

   • Code playgrounds
   • Interactive examples
   • Video tutorials
   • Diagrams (Mermaid)
   • Version control

Deliverables:

• ✅ Documentation site deployed
• ✅ All content migrated
• ✅ Search functional
• ✅ Interactive elements working

Phase 6: Integration & Polish (Weeks 19-20)

Tasks:

1. Deferred Backend: OIDC Authentication (Week 19)

   • OIDC client configuration
   • SSO flow with Nextcloud
   • Token refresh and revocation
   • MFA integration

2. Deferred Backend: Voice Pipeline Completion (Week 20)

   • WebRTC audio streaming
   • Voice Activity Detection (VAD)
   • Echo cancellation
   • Barge-in support
   • Voice authentication
   • OpenAI Realtime API integration

3. Client-Side: PHI Detection (Week 19-20)

   • Pattern matching for PHI
   • Redaction before logging
   • Warning prompts
   • Local audit trail

Deliverables:

• ✅ OIDC authentication complete
• ✅ Full voice pipeline operational
• ✅ PHI detection at client level
• ✅ All three apps production-ready

Success Criteria:

• SSO works with Nextcloud
• Voice latency < 500ms
• PHI never in telemetry/logs
• All apps deployed to production

Milestone 3: Advanced AI & Enhancements (Weeks 21-28)

Objective: Integrate specialized medical models, advanced RAG, platform enhancements

Duration: 8 weeks Team: 2 developers Priority: HIGH

Tasks

Weeks 21-22: BioGPT/PubMedBERT Integration

• Evaluate and benchmark medical models
• Set up GPU infrastructure for inference
• Integrate BioGPT for medical embeddings
• Integrate PubMedBERT for entity recognition
• Fine-tune on medical datasets
• A/B testing vs OpenAI embeddings

Weeks 23-24: Advanced RAG Techniques

• Hybrid search (semantic + keyword/BM25)
• Cross-encoder re-ranking
• Query expansion (synonyms, abbreviations)
• Contextual retrieval (conversation history)
• Metadata filtering (source type, date, evidence level)

Weeks 25-26: Multi-Hop Reasoning

• Query decomposition
• Multi-step reasoning chains
• Cross-document synthesis
• Confidence scoring per step

Weeks 27-28: Email Integration & Monitoring

• Complete email integration (IMAP/SMTP)
• Email parsing and summarization
• Advanced monitoring (AI model metrics, business metrics)
• Predictive analytics

Deliverables:

• ✅ BioGPT/PubMedBERT integrated
• ✅ Advanced RAG operational
• ✅ Multi-hop reasoning working
• ✅ Email integration complete
• ✅ Advanced monitoring deployed

Success Criteria:

• RAG precision improved by 20%
• Medical query accuracy > 90%
• Email integration functional
• AI model performance tracked

Milestone 4: Platform Enhancements (Weeks 29-36)

Objective: i18n, data visualization, feedback loops, cost optimization

Duration: 8 weeks Team: 2 developers Priority: MEDIUM

Tasks

Weeks 29-30: Internationalization

• react-i18next infrastructure
• English (primary), Spanish, Arabic
• RTL support
• Translation management (Crowdin/Lokalise)
• Date/time/number formatting

Weeks 31-32: Data Visualization & Feedback

• Lab results visualization
• Vital signs charting
• Disease progression timelines
• User feedback collection system
• Continuous learning pipeline

Weeks 33-34: Telemetry Package

• Client-side telemetry (@voiceassist/telemetry)
• Core Web Vitals tracking
• Error tracking (Sentry)
• User analytics (privacy-focused)
• Integration with Grafana

Weeks 35-36: Cost Optimization & Chaos Engineering

• OpenAI API cost reduction
• Infrastructure right-sizing
• Storage optimization
• Chaos engineering framework
• Failure injection testing

Deliverables:

• ✅ 3 languages supported
• ✅ Data visualization complete
• ✅ Feedback system operational
• ✅ Telemetry integrated
• ✅ Cost per query reduced by 25%
• ✅ Chaos engineering deployed

Success Criteria:

• Multi-language support verified
• Feedback collection active
• Telemetry data in Grafana
• Cost reduction achieved

Milestone 5: External Integrations (Weeks 37-44)

Objective: Integrate medical databases, Nextcloud app packaging, GDPR

Duration: 8 weeks Team: 2 developers Priority: HIGH

Tasks

Weeks 37-39: UpToDate & OpenEvidence

• UpToDate API integration (license required)
• OpenEvidence API integration
• Clinical decision support workflows
• Drug interaction checking
• Evidence-based medicine queries

Weeks 40-42: PubMed Integration

• PubMed API integration
• Literature search
• Citation management
• Automated reference generation

Weeks 43-44: Nextcloud App Packaging & GDPR

• Package web app as Nextcloud app
• Package admin panel as Nextcloud app
• Nextcloud app store submission
• Auto-update mechanism
• GDPR compliance enhancements
  • Right to be forgotten
  • Data portability
  • Consent management

Deliverables:

• ✅ UpToDate integrated
• ✅ OpenEvidence integrated
• ✅ PubMed integrated
• ✅ Nextcloud apps in app store
• ✅ GDPR compliant

Success Criteria:

• 3 external sources integrated
• Nextcloud apps available
• GDPR features functional

Milestone 6: Advanced Features (Weeks 45-52)

Objective: Offline/PWA, CardDAV, advanced audit, multi-modal AI

Duration: 8 weeks Team: 2 developers Priority: MEDIUM

Tasks

Weeks 45-47: Offline Mode & PWA

• Service worker implementation
• IndexedDB for offline storage
• Background sync
• PWA manifest and install prompt
• Encrypted local storage (HIPAA-compliant)
• Auto-expiration of offline data

Weeks 48-49: CardDAV & Advanced Audit

• CardDAV contacts synchronization
• Physician directory integration
• Advanced audit logging
  • Immutable audit trail
  • Anomaly detection
  • Session replay

Weeks 50-52: Multi-Modal AI

• Medical image analysis (GPT-4 Vision)
• DICOM support
• Video analysis
• Lab results visualization
• Treatment outcome dashboards

Deliverables:

• ✅ PWA installable
• ✅ Offline mode functional (non-PHI)
• ✅ CardDAV integrated
• ✅ Advanced audit deployed
• ✅ Image analysis operational

Success Criteria:

• Offline mode works (non-PHI only)
• PWA meets all criteria
• Image analysis accurate
• Advanced audit functional

4. Feature Catalog

4.1 Web App Features (55 Total)

See: WEB_APP_FEATURE_SPECS.md for detailed specifications

4.2 Admin Panel Features (38 Total)

See: ADMIN_PANEL_FEATURE_SPECS.md for detailed specifications

4.3 Documentation Site Features (15 Total)

See: DOCS_SITE_FEATURE_SPECS.md for detailed specifications

5. Dependencies & Prerequisites

5.1 Technical Dependencies

For Milestone 1 (Frontend Foundation):

• ✅ Backend API (Phases 0-15 complete)
• ✅ WebSocket endpoint (/api/realtime/ws)
• ✅ Authentication API (/api/auth/*)
• ✅ Chat API endpoints
• ✅ File upload API endpoints
• Design system assets (colors, logos, icons)
• Brand guidelines

For Milestone 2 (Admin Panel & Voice):

• ✅ Admin API (/api/admin/*)
• ✅ KB management API (/api/admin/kb/*)
• OIDC provider configuration (Nextcloud)
• WebRTC infrastructure
• Audio codec optimization

For Milestone 3 (Advanced AI):

• GPU infrastructure for BioGPT/PubMedBERT
• Training datasets (licensed)
• Model evaluation framework

For Milestone 5 (External Integrations):

• UpToDate license (~$500-1000/month)
• API keys for OpenEvidence, PubMed
• Hospital partnerships for EMR integration

5.2 Team Dependencies

Milestone 1-2 (Weeks 1-20):

• 2-3 frontend developers (React/TypeScript)
• 1 UI/UX designer (part-time, for design system)

Milestone 3-4 (Weeks 21-36):

• 1-2 frontend developers
• 1 AI/ML engineer (for BioGPT/PubMedBERT)

Milestone 5-6 (Weeks 37-52):

• 1-2 frontend developers
• 1 integration engineer (for EMR/FHIR)
• 1 DevOps engineer (for infrastructure scaling)

5.3 External Dependencies

Required Licenses:

• UpToDate API license (~$500-1000/month)
• OpenEvidence API access
• PubMed API key (free)
• Algolia DocSearch (docs site)
• Sentry (error tracking)

Optional/TBD:

• DataDog or New Relic (telemetry)
• Crowdin or Lokalise (i18n)
• FHIR compliance certification

6. Open Questions & Decisions

6.1 Design & UX (5 questions)

Q1: Design System Availability

Question: Does a design system already exist (Figma/Sketch files)? Impact: HIGH - Affects Week 1-2 timeline Options:

• A) Existing design system available → Use as-is, create tokens from it
• B) Partial design system → Complete missing pieces
• C) No design system → Create from scratch using medical UI best practices

Provisional Answer: Assume Option C (no existing design system). Plan to:

• Use medical UI references (Medscape, UpToDate, Epic MyChart)
• Create professional medical color palette (blues, teals, grays)
• Prioritize trust-building design language
• Timeline: 2 weeks for complete design system

Decision Needed By: Before Milestone 1 starts

Q2: Storybook Setup

Question: Should Storybook be part of the initial monorepo setup? Impact: MEDIUM - Affects Week 1-2 tasks Options:

• A) Yes, set up Storybook in Week 1-2 → Better component documentation
• B) Defer to Week 10+ → Faster initial setup

Provisional Answer: Recommend Option A. Benefits:

• Component documentation from day 1
• Visual testing during development
• Accessibility testing integration (axe-core)
• Easier collaboration with designers

Decision Needed By: Week 1

Q3: Component Library Strategy

Question: Should we use shadcn/ui as-is or fork and customize? Impact: MEDIUM - Affects maintainability Options:

• A) Use shadcn/ui as-is → Easier updates
• B) Fork and customize → More control, harder updates

Provisional Answer: Recommend Option A with theme customization via design tokens. Fork only if needed later.

Q4: Dark Mode Priority

Question: Should dark mode be MVP or can it be deferred? Impact: LOW - Can be added later Options:

• A) MVP (Week 2) → More work upfront
• B) Defer to Week 10+ → Faster MVP

Provisional Answer: Recommend Option B (defer to Week 10). Focus on light mode first, add dark mode in Polish phase.

Q5: Mobile App Strategy

Question: Should we plan for mobile apps (iOS/Android) or stick to responsive web? Impact: HIGH - Future roadmap Options:

• A) Responsive web only (PWA) → Simpler
• B) Native mobile apps later → Better UX, more complex

Provisional Answer: Recommend Option A for now. Build excellent responsive PWA, evaluate native apps after Milestone 2 based on user feedback.

6.2 Infrastructure & Operations (4 questions)

Q6: Deployment Strategy

Question: Should frontend apps deploy to the same Ubuntu server or separate infrastructure? Impact: HIGH - Affects deployment architecture Options:

• A) Same Ubuntu server → Simpler, single point of failure
• B) Separate infrastructure (Vercel/Netlify for frontend) → Better scalability
• C) Kubernetes cluster for all → Most complex, most scalable

Provisional Answer: Recommend Option B (hybrid approach):

• Backend: Ubuntu server (existing, production-ready)
• Frontend: Vercel or Netlify (static hosting, global CDN)
• Benefits:
  • Frontend updates don't affect backend
  • Global CDN for faster load times
  • Automatic SSL and preview deployments
  • Free tier sufficient for testing

Decision Needed By: Week 1-2

Q7: Staging Environments

Question: Do we need separate staging/production environments for frontend? Impact: MEDIUM - Affects testing workflow Options:

• A) Yes, separate staging → Safer, more resources needed
• B) No, test locally + preview deployments → Faster, riskier

Provisional Answer: Recommend Option A. Set up:

• Staging: staging.voiceassist.asimo.io, staging-admin.voiceassist.asimo.io
• Production: voiceassist.asimo.io, admin.voiceassist.asimo.io
• Use Vercel/Netlify preview deployments for PRs
• Staging environment for final QA before production

Q8: CI/CD Platform

Question: What CI/CD platform is preferred (GitHub Actions, GitLab CI, CircleCI)? Impact: LOW - Most platforms are similar Options:

• A) GitHub Actions → Already using for backend
• B) GitLab CI → If moving to GitLab
• C) CircleCI → Additional cost

Provisional Answer: Recommend Option A (GitHub Actions). Benefits:

• Already configured for backend
• Tight integration with GitHub
• Free for public repos, generous limits for private
• Good monorepo support with Turborepo

Q9: Telemetry Provider

Question: Which telemetry provider is preferred (Sentry, DataDog, New Relic)? Impact: MEDIUM - Affects cost and features Options:

• A) Sentry → Good error tracking, affordable
• B) DataDog → Full observability, expensive
• C) New Relic → Balanced, moderate cost
• D) Self-hosted (Grafana Loki + Tempo) → Free, more work

Provisional Answer: Recommend Option A (Sentry) for client-side errors + Option D (self-hosted) for backend observability:

• Client-side: Sentry ($26/month for 50k errors/month)
• Backend: Existing Grafana stack (Prometheus, Loki, Jaeger)
• Benefits: Best of both worlds, reasonable cost

Budget: ~$300-500/month for Sentry (production volume)

Decision Needed By: Week 19 (when implementing telemetry package)

6.3 External Dependencies (5 questions)

Q10: UpToDate Licensing

Question: What's the budget for UpToDate licensing (~$500-1000/month)? Impact: HIGH - Affects Milestone 5 Options:

• A) Approved budget → Integrate UpToDate
• B) No budget → Focus on free sources (PubMed, OpenEvidence)

Provisional Answer: Budget approval needed. UpToDate provides:

• 11,500+ clinical topics
• Drug interaction database
• Diagnostic algorithms
• Evidence-based recommendations

Alternative: If no budget, focus on:

• PubMed (free)
• OpenEvidence (free tier)
• Clinical practice guidelines (free)

Decision Needed By: Before Milestone 5 (Week 37)

Q11: External API Priorities

Question: What's the priority for each external integration? Impact: MEDIUM - Affects Milestone 5 sequencing Options: Rank priority:

• UpToDate
• OpenEvidence
• PubMed
• Clinical trial databases
• Drug information systems

Provisional Answer: Recommend prioritization:

1. PubMed (P1) - Free, large dataset, essential for citations
2. OpenEvidence (P1) - Free tier, evidence-based medicine
3. UpToDate (P0 if licensed, P3 if not) - Best clinical decision support
4. Drug information (P2) - Important for safety
5. Clinical trials (P3) - Nice to have

Decision Needed By: Week 35

Q12: EMR Integration Targets

Question: Are there specific hospital partners or EMR systems to target first? Impact: HIGH - Affects Milestone 7+ (future) Options:

• A) Specific hospital partnership → Focus on their EMR
• B) Most popular EMRs → Epic, Cerner, Allscripts
• C) Generic FHIR → Works with all compliant systems

Provisional Answer: Recommend Option C (generic FHIR first):

• HL7 FHIR R4 standard support
• Works with most major EMRs
• Start with read-only (patient data access)
• Expand to read-write later

Timeline: Defer to Milestone 7+ (Month 13+)

Decision Needed By: Before starting EMR integration work

Q13: Hospital Partnership Timeline

Question: What's the timeline for hospital partnership discussions? Impact: MEDIUM - Affects EMR integration planning Options:

• A) Active discussions ongoing → Plan for near-term integration
• B) No active partnerships → Focus on generic FHIR

Provisional Answer: Assume Option B for now. Focus on:

• Generic FHIR R4 support
• Demo environment with synthetic data
• Case studies and pilot programs

Decision Needed By: Month 6

Q14: FHIR Certification

Question: Is there budget for HL7 FHIR compliance certification? Impact: MEDIUM - Affects EMR integration credibility Cost: ~$5,000-10,000 Options:

• A) Yes → Pursue certification
• B) No → Self-certification

Provisional Answer: Defer certification to Month 12+. First:

• Build FHIR R4 support
• Test with major EMRs
• Validate compliance
• Then pursue certification if needed for partnerships

6.4 Compliance & Security (3 questions)

Q15: Offline Mode PHI

Question: What are the regulatory constraints on offline PHI storage? Impact: HIGH - Affects Milestone 6 Options:

• A) PHI allowed offline with encryption → Full offline mode
• B) PHI not allowed offline → Non-PHI only
• C) Unsure → Consult compliance officer

Provisional Answer: Recommend Option C → Consult with HIPAA compliance officer. Preliminary approach:

• Assume Option B (non-PHI only) for safety
• Offline mode for:
  • Conversation history (de-identified)
  • Medical knowledge base articles
  • User preferences
• No offline storage for:
  • Patient demographics
  • Clinical context
  • Lab results
  • Any identifiable data

Decision Needed By: Before Milestone 6 (Week 45)

Q16: GDPR Priority

Question: Is European deployment a near-term goal? Impact: MEDIUM - Affects Milestone 5 Options:

• A) Yes → GDPR compliance in Milestone 5
• B) No → Defer GDPR to later

Provisional Answer: Recommend Option B (defer unless European deployment is confirmed). If needed:

• Right to be forgotten (user data deletion)
• Data portability (export user data)
• Consent management
• Data residency options

Decision Needed By: Week 40

Q17: Data Residency Options

Question: Should we implement data residency options (US, EU regions)? Impact: MEDIUM - Affects architecture Options:

• A) Yes → Multi-region deployment
• B) No → US-only for now

Provisional Answer: Recommend Option B (US-only) initially. Multi-region can be added later:

• Deploy to US East initially
• Add EU region if needed for GDPR
• Use global CDN for frontend (Vercel/Netlify)

6.5 AI & Machine Learning (5 questions)

Q18: GPU Infrastructure

Question: Do we have budget/resources for GPU infrastructure? Impact: HIGH - Affects Milestone 3 Cost: ~$500-1500/month for GPU instances Options:

• A) Yes → BioGPT/PubMedBERT integration
• B) No → Continue with OpenAI embeddings

Provisional Answer: Recommend Option A if budget allows:

• AWS EC2 g4dn.xlarge (~$500/month)
• Or use serverless inference (AWS SageMaker, Hugging Face Inference API)
• Benefits:
  • Medical-specific embeddings (higher accuracy)
  • Lower cost per query (vs OpenAI)
  • Data sovereignty

Decision Needed By: Week 20 (before Milestone 3)

Q19: Model Training Strategy

Question: Should we fine-tune models or use prompt engineering? Impact: MEDIUM - Affects accuracy and cost Options:

• A) Fine-tune models → Higher accuracy, more work
• B) Prompt engineering only → Faster, less control
• C) Hybrid → Fine-tune embeddings, prompt engineer LLM

Provisional Answer: Recommend Option C (hybrid):

• Fine-tune: Embeddings (BioGPT/PubMedBERT) for better retrieval
• Prompt engineering: LLM (GPT-4) for generation
• Benefits: Best of both worlds

Q20: Model Evaluation

Question: What's the strategy for model evaluation and benchmarking? Impact: MEDIUM - Affects quality assurance Options:

• A) Manual evaluation by medical experts
• B) Automated benchmarks (MedQA, PubMedQA)
• C) Hybrid

Provisional Answer: Recommend Option C (hybrid):

• Automated: Use MedQA, PubMedQA, USMLE questions
• Manual: Clinical experts review 100 sample queries
• Continuous: A/B testing in production with feedback

Q21: Multi-Modal AI Use Cases

Question: What medical image analysis use cases are highest priority? Impact: MEDIUM - Affects Milestone 6 Options: Rank priority:

• Radiology (X-ray, CT, MRI)
• Dermatology (skin lesions)
• Pathology (microscopy)
• Wound assessment
• ECG interpretation

Provisional Answer: Recommend prioritization:

1. Dermatology (P1) - Simpler, well-defined, large training datasets
2. Wound assessment (P1) - Useful for telehealth
3. ECG interpretation (P2) - Requires specialized models
4. Radiology (P3) - Most complex, liability concerns
5. Pathology (P3) - Requires specialized hardware

Decision Needed By: Week 45

Q22: Medical Image Datasets

Question: Do we have access to labeled medical image datasets? Impact: HIGH - Affects Milestone 6 Options:

• A) Yes, licensed datasets → Train custom models
• B) No → Use pre-trained models only (GPT-4 Vision)

Provisional Answer: Recommend Option B (pre-trained models) initially:

• GPT-4 Vision for general medical images
• Evaluate accuracy before investing in custom models
• Datasets available if needed:
  • HAM10000 (dermatology, free)
  • ChestX-ray14 (radiology, free)
  • MIMIC-CXR (radiology, requires license)

Q23: AI Diagnosis Liability

Question: What are the liability considerations for AI-assisted diagnosis? Impact: HIGH - Legal/regulatory Options:

• A) Decision support only (no diagnosis) → Lower liability
• B) Diagnostic assistance with disclaimers → Medium liability
• C) Full diagnostic system → High liability, FDA approval

Provisional Answer: Recommend Option A (decision support only):

• Clear disclaimers: "For educational and decision support purposes only"
• "Not a substitute for professional medical judgment"
• "Always verify with primary sources and clinical guidelines"
• No direct diagnostic claims
• User acknowledgment on first use

Decision Needed By: Before any image analysis feature

6.6 Summary of Open Questions

Total Questions: 23 Critical Decisions (needed before starting): 8

• Q1: Design system availability
• Q2: Storybook setup
• Q6: Deployment strategy
• Q10: UpToDate licensing
• Q15: Offline mode PHI
• Q18: GPU infrastructure
• Q22: Medical image datasets
• Q23: AI diagnosis liability

Medium Priority (needed by specific milestones): 10 Low Priority (can be decided later): 5

7. Success Metrics

7.1 Technical Metrics

Performance:

• Frontend initial load: < 2s
• Time to interactive: < 3s
• API P95 latency: < 200ms
• Voice mode latency: < 500ms
• WebSocket connection stability: > 99%
• Cache hit rate: > 90%

Quality:

• Test coverage: > 80% (client), > 90% (backend)
• Code review completion: 100%
• Security vulnerabilities: 0 critical, 0 high
• Accessibility: WCAG 2.1 AA (automated + manual)
• TypeScript strict mode: 100%

Reliability:

• System uptime: > 99.9%
• Error rate: < 0.1%
• RTO: < 30 minutes
• RPO: < 1 minute

7.2 Business Metrics

Adoption:

• Monthly Active Users (MAU) - Target: 1,000 by Month 6
• Daily Active Users (DAU) - Target: 300 by Month 6
• DAU/MAU ratio: > 30%
• Feature adoption rates
• User retention (30-day): > 60%
• User retention (90-day): > 40%

Satisfaction:

• Net Promoter Score (NPS): > 50
• User satisfaction (CSAT): > 4.5/5
• Support ticket volume: < 5% of MAU
• Query success rate: > 85%

Efficiency:

• Time to answer: < 30 seconds
• Queries per session: 3-5 average
• Session duration: 5-10 minutes average
• Cost per query: decreasing trend

7.3 AI Quality Metrics

RAG Performance:

• Retrieval precision: > 85%
• Retrieval recall: > 80%
• Answer accuracy: > 90%
• Citation relevance: > 95%

User Feedback:

• Positive feedback rate: > 80%
• Correction rate: < 10%
• Query reformulation rate: < 20%
• Sources cited per answer: 2-4 average

8. Risk Management

8.1 High-Risk Items

1. Frontend Development Timeline Overrun

• Risk: 20-week timeline may extend due to complexity
• Probability: MEDIUM
• Impact: HIGH
• Mitigation:
  • Agile approach with 2-week sprints
  • MVP features first (defer nice-to-have)
  • Parallel development when possible
  • Buffer time in each phase
• Contingency:
  • Phased rollout (web app → admin panel → docs site)
  • Defer advanced features to Milestone 4+
  • Add developer if needed

2. Voice Pipeline Complexity

• Risk: Full voice pipeline (WebRTC, VAD, barge-in) more complex than estimated
• Probability: MEDIUM
• Impact: HIGH
• Mitigation:
  • Start with basic push-to-talk (Week 5)
  • Evaluate WebRTC early (Week 10)
  • Consider commercial solutions (Twilio, Agora)
  • Budget 3-4 weeks for full pipeline (Week 20)
• Contingency:
  • Use OpenAI Realtime API only (simpler)
  • Defer advanced features (VAD, barge-in) to Milestone 4

3. External API Costs

• Risk: UpToDate, OpenAI costs may exceed budget
• Probability: MEDIUM
• Impact: MEDIUM
• Mitigation:
  • Caching (Redis, IndexedDB)
  • Rate limiting per user
  • Cost monitoring dashboard
  • Monthly budget alerts
• Contingency:
  • Usage caps (queries per user per day)
  • Tiered access (free tier with limits)
  • Alternative providers (BioGPT instead of OpenAI)

4. EMR Integration Complexity

• Risk: FHIR integration more complex than estimated
• Probability: HIGH
• Impact: HIGH
• Mitigation:
  • Partner with EMR integration consultants
  • Use FHIR libraries (HAPI FHIR)
  • Start with read-only access
  • Extensive testing with sandbox environments
• Contingency:
  • Focus on most popular EMR systems first
  • Offer manual data entry as fallback
  • Defer to Milestone 7+ (Month 13+)

5. Offline Mode PHI Security

• Risk: PHI exposure in offline storage violates HIPAA
• Probability: LOW
• Impact: CRITICAL
• Mitigation:
  • Consult with HIPAA compliance officer early
  • Encrypted local storage (AES-256)
  • Auto-expiration of offline data
  • Compliance review before launch
• Contingency:
  • Non-PHI offline mode only
  • Require online connection for clinical features

6. Medical AI Accuracy Issues

• Risk: AI provides inaccurate medical information
• Probability: MEDIUM
• Impact: CRITICAL
• Mitigation:
  • Clear disclaimers throughout app
  • Multiple source citations required
  • Confidence scoring shown to user
  • Medical expert review of 100 sample queries
  • Automated benchmarks (MedQA, PubMedQA)
• Contingency:
  • More conservative responses
  • "Consult primary sources" warnings
  • Fallback to search-only mode

8.2 Medium-Risk Items

7. Design System Delays

• Risk: Creating design system from scratch takes longer than 2 weeks
• Mitigation: Use existing medical UI patterns, shadcn/ui base
• Contingency: Extend Phase 0 to 3 weeks if needed

8. Accessibility Compliance

• Risk: WCAG 2.1 AA not achieved on first pass
• Mitigation: Accessibility from day 1, axe-core testing, expert review
• Contingency: Dedicated accessibility sprint in Week 10

9. Multi-Language Support

• Risk: i18n adds complexity, slows development
• Mitigation: Start with English only, add i18n in Milestone 4
• Contingency: Defer to Milestone 5+ if budget allows translation services

10. Performance Issues

• Risk: Frontend performance below targets (< 2s load)
• Mitigation: Performance budget, code splitting, lazy loading, Lighthouse CI
• Contingency: Performance optimization sprint in Week 10

8.3 Low-Risk Items

11. Third-Party Library Changes

• Risk: Breaking changes in React, shadcn/ui, etc.
• Mitigation: Pin versions, review changelogs before updating
• Contingency: Minimal impact, update when convenient

12. Team Availability

• Risk: Developer illness, vacation, etc.
• Mitigation: Cross-training, documentation, overlap
• Contingency: Adjust timeline by 1-2 weeks if needed

9. Appendices

Appendix A: Technology Stack Summary

Frontend Core:

• React 18.2+, TypeScript 5.0+
• Vite 5.0+, pnpm workspaces
• Tailwind CSS 3.4+, shadcn/ui, Radix UI
• Zustand 4.0+ (state)
• React Hook Form 7.0+ (forms)
• React Router 6.0+ (routing)

Backend (Existing):

• FastAPI, Python 3.11+
• PostgreSQL 15 (pgvector), Redis 7, Qdrant
• OpenAI GPT-4, OpenAI embeddings

Testing:

• Vitest (unit), Playwright (e2e)
• React Testing Library
• MSW (API mocking)

CI/CD:

• GitHub Actions
• Vercel or Netlify (frontend hosting)
• Docker (backend)

Monitoring:

• Sentry (client errors)
• Grafana stack (backend observability)

Appendix B: Effort Estimation Summary

Note: Assumes 2-3 developers working in parallel. Some tasks can be parallelized.

Appendix C: Document References

Client Implementation Planning:

• Master Implementation Plan (original 20-week plan)
• Technical Architecture
• Web App Feature Specs
• Admin Panel Feature Specs
• Docs Site Feature Specs
• Integration Guide
• Development Workflow

Continuous Improvement:

• Continuous Improvement Plan (comprehensive 52-week roadmap)
• Continuous Improvement Summary

Backend Phase Reports:

• Phase 4 Completion Report
• Phase 5 Completion Report
• Phase 6 Completion Report
• Implementation Status

Appendix D: Glossary

Key Terms:

• RAG: Retrieval-Augmented Generation
• FHIR: Fast Healthcare Interoperability Resources (HL7 standard)
• OIDC: OpenID Connect (authentication protocol)
• PWA: Progressive Web App
• VAD: Voice Activity Detection
• PHI: Protected Health Information (HIPAA)
• WCAG: Web Content Accessibility Guidelines
• MVP: Minimum Viable Product
• MAU/DAU: Monthly/Daily Active Users
• NPS: Net Promoter Score

10. Conclusion

This unified roadmap provides a comprehensive, reconciled plan for:

1. Completing all deferred backend features from Phases 4-6
2. Building three production-ready client applications
3. Adding platform enhancements (design system, i18n, PWA, telemetry)
4. Integrating external medical databases and EMR systems
5. Advancing AI capabilities (multi-modal, multi-hop, specialized models)

Total Timeline: 52 weeks (12 months) across 6 major milestones Total Features: 98+ across all applications Team Size: 2-3 developers (scaling to 4-6 for advanced features)

Next Steps:

1. Review and approve this roadmap
2. Answer the 23 open questions (8 critical, 10 medium, 5 low priority)
3. Begin Milestone 1, Week 1: Monorepo setup and design tokens
4. Establish monthly roadmap reviews to adjust priorities

Document Version: 2.0 (Reconciled) Author: VoiceAssist Product Team Last Updated: 2025-11-21 Next Review: After Milestone 1 completion (Week 10) Branch: client-roadmap-reconciliation