Known limits and roadmap

AI and evaluation

• Rolling outSelf-hosted clinical models and adapter training
  Qwen3-8B adapters, MedGemma critic and verifier, embeddings and entailment on the GPU worker
• PlannedModel-upgrade merge gate
  Implemented and disarmed; armed at clinical launch
• Rolling outClinician-authored validation corpora
  The locked set in use today is synthetic
• ProductionCopilot model overrides
  Recorded owner decisions, not evaluation results; the 3.8-era evaluation report is awaiting adjudication
• PlannedPersistent vector index
  Dense retrieval embeds per query today
• PlannedCurated guideline content
  Schema exists; no content is written by the application yet
• PlannedStructured clinical guidance (decision trees, dose calculators)
  Specified; not built

Clinical modules

• PlannedImaging AI findings for clinicians
  Refused until a signed release is approved; DPIA pending
• PlannedReview V2 cross-modal synthesis
  Blocked behind a regulatory gate
• ShadowContradiction engine and plan safety rules
  Evaluate and record; do not block yet
• PlannedDocument re-attribution
  ADR 0029 accepted; flag off
• PlannedSpeaker diarization and audio retention in Scribe
  Implemented behind flags that default off
• PlannedLive spoken confirmation, wake word, live actions
  ADR 0030 proposed; flags default off
• Planned3D patient geometry, CAD engines, CBCT volumetrics
  Specified in the 3D Studio plan
• PlannedSafety-event correlation key
  ADR 0007 proposed

Platform

• PlannedBackup-purge worker for patient erasure
  Erasure queues purge jobs; nothing executes them yet. Restores replay erasure tombstones in the meantime
• PlannedClinical document uploads to Cloud Storage
  Stored on instance disk today (ADR 0015)
• PlannedWebhook signature verification per production connector
  Wired for the reference connector
• PlannedVersioned contracts package and OpenAPI
  ADR 0011 describes it; contracts live in Zod schemas today
• PlannedConnection pooler
  Designed; not in the path
• PlannedSigned load baseline for the capacity envelope
  Envelope provisional
• PlannedContract phase of migrations
  No migration has reached contract yet; all are expand, migrate or verify
• ShadowPer-call credit pricing
  Computed and recorded, not charged

Regulatory

• PlannedMDR and AI Act classification
  Hypotheses recorded; legal and notified-body review required
• PlannedImaging conformity readiness
  Readiness review records open blockers
• PlannedPatient Mode summative human-factors validation
  Open item in its invariant document