Table of Contents

    HAD Digital

    A Coordinated Digital Platform for Home Hospitalization in Oncology

    Including the integrated Toxicity Reader module

    Functional Specifications Technical Specifications MVP

    September 2026

    ⚠️ The Problem

    Today's home hospitalization monitoring is fragmented, reactive, and burdensome.

    🕐

    Delayed Detection

    Toxicity symptoms reported by phone may take hours or days to reach the oncologist. Grade 3+ events can escalate before clinical review.

    📄

    Fragmented Information

    PDF reports, phone logs, and paper forms scattered across multiple systems. No single view of patient status for the care team.

    📋

    Administrative Burden

    Nurses spend significant time on phone tag, manual transcription, and chasing missing information instead of patient care.

    Patient 📱 Phone call Nurse 📝 Paper notes Fax / PDF 📃 Unstructured Oncologist ⏰ Delayed review

    🎯 The Vision

    Make home hospitalization as safe as inpatient care through a single coordinated digital platform.

    🏠 Safety Parity

    Home care with the same safety standards as hospital wards — structured monitoring, automated grading, and tiered alerting.

    👥 Unified Platform

    Single source of truth for all care team members — oncologists, nurses, GPs, pharmacists, patients, and caregivers.

    🔍 Early Detection

    Structured CTCAE-based monitoring catches toxicity at Grade 1-2 before it escalates to Grade 3+ emergencies.

    Patient 📱 Digital form HAD Digital Auto-grading Alert engine Timeline 👩‍⚕️ Oncologist 🩺 Care Team ✅ Coordinated

    👥 Key Stakeholders

    Eight roles, each with a clear interface and responsibilities.

    👩‍⚕️

    Hospital Oncologist

    Treatment decisions, toxicity review, regimen management

    👩‍⚕️

    HAD Coordinating Nurse

    Care coordination, alert triage, patient follow-up

    🩺

    Community Nurse

    Home visits, clinical observations, vital signs

    👨‍⚕️

    General Practitioner

    Primary care integration, co-morbidity management

    💊

    Pharmacist

    Medication review, interaction checks, dispensing

    🧑

    Patient

    Self-reporting, questionnaire completion, view guidance

    👨‍👩‍👧

    Caregiver

    Assist patient, receive notifications, proxy reporting

    ⚙️

    Administrator

    User management, system configuration, audit review

    🧬 The Toxicity Reader — Core Feature

    CTCAE v5.0-based structured toxicity assessment with automated grading and tiered alerting.

    • CTCAE v5.0 based grading (Grades 1–5)
    • Structured patient self-reporting via mobile
    • Clinician observation entry during visits
    • Automated grading engine with rule-based logic
    • Tiered alerting: Routine → Urgent → Emergency
    • Complete audit trail of all assessments
    Patient Report CTCAE Mapping Auto-Grade Engine Grade 1 Routine Grade 2 Urgent Grade 3+ Emergency

    📱 Patient Self-Reporting

    Mobile-friendly questionnaire covering 5 CTCAE domains with immediate guidance.

    Five CTCAE Domains

    🫁 Gastrointestinal 🩸 Hematologic 🩹 Dermatologic 🧠 Neurologic 🌡️ Constitutional

    Severity Options

    Each symptom rated: Mild / Moderate / Severe / Life-threatening

    After Submission

    • Immediate self-care guidance for Grade 1
    • Notification to care team for Grade 2+
    • Emergency instructions for Grade 3+
    📋 Daily Symptom Check
    Nausea
    None Mild Severe
    Fatigue
    None Moderate Severe
    Skin Rash
    None Mild Severe
    Submit Report

    📊 Clinician Dashboard

    At-a-glance overview of all active patients, alerts, and recent activity.

    24
    Active Patients
    3
    Pending Alerts
    12
    Reports Today
    2
    Overdue Visits

    Active Alerts

    TimePatientAlertGradeAction
    14:32Martin D.Persistent nausea, unable to eatGrade 2Review →
    13:15Dupont S.Neutrophils 0.8 × 10⁹/L, fever 38.5°CGrade 3Urgent →
    11:40Leroy A.Mild fatigue, Grade 1Grade 1View →

    📅 Care Coordination Timeline

    Chronological feed of all events, filterable by role and event type.

    14:32
    Patient self-report — Martin D. reported nausea (moderate), fatigue (mild)
    14:35
    Alert Auto-graded: Nausea → Grade 2. Notification sent to HAD nurse.
    13:15
    Lab result — Dupont S. Neutrophils: 0.8 × 10⁹/L
    13:16
    Alert Neutropenia + fever → Grade 3. Emergency protocol activated.
    11:00
    Home visit — Community nurse visited Leroy A. Vitals stable.
    09:30
    Treatment — Martin D. Cycle 3 Day 1 infusion completed.

    Event Types

    📋 Reports 👁️ Observations 🔔 Alerts 💬 Messages 📊 Grades

    Role Filters

    Each role sees events relevant to their scope. Patients see their own reports and guidance. Oncologists see all clinical events. Nurses see coordination events.

    Quick Actions

    • Add clinical observation
    • Send message to care team
    • Escalate to oncologist
    • Mark alert as reviewed

    🔔 Tiered Alerting System

    Automated escalation based on CTCAE grade with defined response times and protocols.

    🟢

    Grade 1 — Routine

    Recorded in timeline only.

    Response: Next scheduled review

    Notify: None (passive)

    Action: Self-care guidance to patient

    🟠

    Grade 2 — Urgent

    Notification within defined delay.

    Response: Within 2 hours

    Notify: HAD nurse + Oncologist

    Action: Clinical review required

    🔴

    Grade 3+ — Emergency

    Immediate notification.

    Response: Immediate

    Notify: All care team members

    Action: Emergency protocol activation

    Grade 1 → Timeline Grade 2 → Alert (2h SLA) Grade 3+ → Emergency NOW

    💊 Treatment Plan View

    Complete view of the patient's current treatment regimen, cycle schedule, and supportive care.

    Current Regimen — Patient: Martin D.

    ProtocolFOLFOX6 (modified)
    CycleCycle 3 of 6
    DayDay 1 of 14
    Next Treatment2026-09-19
    StatusOn Track

    Medications

    DrugDoseSchedule
    Oxaliplatin85 mg/m²Day 1
    Leucovorin400 mg/m²Day 1
    5-FU bolus400 mg/m²Day 1
    5-FU infusion2400 mg/m²46h

    Supportive Care Prescriptions

    Ondansetron 8mg — Anti-emetic Dexamethasone 8mg — Day 1-3 G-CSF — If neutrophils < 1.0 Loperamide — PRN diarrhea

    📤 Toxicity Summary Export

    On-demand generation of structured clinical reports for medical records and handovers.

    Report Contents

    • Patient identification and treatment protocol
    • All toxicity grades with timestamps
    • Complete event timeline
    • Alert history with response times
    • Clinician observations and notes
    • Treatment modifications made

    Export Formats

    📄 PDF 📊 Structured Data 🖨️ Print-Ready
    📋 Toxicity Summary — Martin D.

    Patient: Martin, Denis | DOB: 1958-03-12

    Protocol: FOLFOX6 | Cycle: 3/6

    Report Period: 2026-09-01 → 2026-09-05


    Toxicity Events:

    • 09/03 — Nausea: Grade 1 (patient report)

    • 09/04 — Nausea: Grade 2 (patient report) → Alert sent

    • 09/05 — Fatigue: Grade 1 (patient report)


    Alerts: 1 urgent (reviewed by Dr. Besson, 45min response)

    Max Grade: Grade 2

    🏗️ Technical Architecture

    Lightweight, portable, zero-dependency architecture designed for healthcare environments.

    HTML / CSS / JS Mobile-first Frontend Python HTTP Server stdlib only (http.server) Business Logic Grading · Alerts · Auth SQLite Database Portable · Single file 🔌 Pluggable AI Engine Connector

    Key Design Decisions

    • Standalone .exe — no installation required
    • Zero dependencies — Python stdlib only
    • SQLite database — portable, single file
    • HTML/CSS/JS frontend — mobile-first responsive
    • Pluggable AI engine connector for future ML
    • RESTful API between frontend and backend

    Why This Stack?

    Healthcare IT environments are restrictive. No admin rights, no internet, no package managers. This architecture runs from a USB stick on any Windows machine.

    🚀 Deployment & Portability

    Designed for the most restrictive healthcare IT environments.

    📦

    Single .exe

    Self-contained executable. Double-click to run. No installation, no registry, no DLLs.

    💾

    USB Stick

    Run directly from a USB drive. Take your system to any workstation. Data travels with you.

    🔒

    No Admin Rights

    Zero privilege escalation. Runs in user space. Compatible with locked-down hospital PCs.

    Simple Drop-in Patching

    Replace the .exe to update. Database is separate and preserved. No migration scripts needed for MVP.

    Platform Support

    Windows 10 / 11 (primary). macOS and Linux builds possible with PyInstaller cross-compilation.

    🔐 Security & Compliance

    Healthcare-grade security built into every layer of the system.

    🛡️ Access Control

    Role-based access control (RBAC). 8 distinct roles with scoped permissions. Session timeout management.

    🔑 Authentication

    Password hashing with scrypt. Secure session tokens. CSRF protection on all state-changing operations.

    📝 Audit Trail

    Immutable audit log of all actions. Who did what, when. Full traceability for clinical governance.

    🌐 Web Security

    Content Security Policy (CSP) headers. XSS protection. Input validation and sanitization.

    📊 Data Model

    GDPR-ready data model. Patient data minimization. Right to erasure support. Data export capability.

    🔒 Transport

    Local-only by default. No data leaves the machine unless explicitly configured. HTTPS when networked.

    ✅ MVP Scope

    Clearly defined scope with measurable deliverables.

    12
    Core Features
    19
    System Requirements
    20
    Components
    12
    Interfaces

    Demo data included for immediate stakeholder testing.

    Core Feature Checklist

    • Patient self-reporting (CTCAE questionnaire)
    • Clinician observation entry
    • Automated toxicity grading engine
    • Tiered alerting system
    • Clinician dashboard
    • Care coordination timeline
    • Treatment plan view
    • Toxicity summary export
    • User and role management
    • Audit trail
    • Patient management
    • System configuration

    🗺️ Roadmap

    From MVP to production in structured phases.

    MVP Phases (66–74 working days)

    Phase 0
    Project setup, scaffolding, demo data (4d)
    Phase 1
    Authentication and user management (6d)
    Phase 2
    Patient management and data model (6d)
    Phase 3
    Toxicity Reader — core engine (10d)
    Phase 4
    Patient self-reporting interface (8d)
    Phase 5
    Clinician dashboard and alerts (10d)
    Phase 6
    Timeline, treatment plan, export (10d)
    Phase 7
    Security hardening and audit (6d)
    Phase 8
    Packaging, testing and demo prep (6d)

    Journey

    MVP Demo

    Working prototype with demo data. Stakeholder validation.

    Pilot

    Clinical pilot with real patients. Feedback loop. Refinement.

    Production

    Full deployment. Multi-site support. Monitoring and support.

    V2 Vision

    📡 Connected Devices 🇫🇷 Mon Espace Santé 🤖 ML Risk Scoring

    ❓ Questions & Next Steps

    Open Questions for Stakeholders

    • Which oncology centre for the pilot phase?
    • Patient recruitment criteria and consent process?
    • Integration with existing hospital information systems?
    • Regulatory pathway for medical device classification?
    • Training plan for care team members?

    Next Actions

    • Stakeholder sign-off on MVP scope
    • Budget approval for Phase 0-2
    • Identify pilot site and clinical champion
    • Begin Phase 0: project scaffolding

    HAD Digital

    Thank you for your attention

    September 2026