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# HAD Digital — Full Project Execution Plan

Document status: Draft v0.1 Date: 5 September 2026 Prepared under: AI Project Governance Standard v3.9 Specification precedence: HAD_Digital_Specifications.docx governs all decisions


Table of Contents

  1. Project Capabilities (What the MVP Delivers)
  1. Full Build Steps (Every Action from Start to Finish)
  1. Dependencies (Internal and External)
  1. Risks (Comprehensive Register)
  1. Assumptions and What Breaks If Wrong
  1. Success Criteria

1. PROJECT CAPABILITIES — What the MVP Delivers

1.1 Clinical Capabilities

#CapabilityDescriptionSpec Reference
CAP-01Patient Toxicity Self-ReportingPatients and caregivers complete structured questionnaires mapped to CTCAE v5.0 domains (GI, hematologic, dermatologic, neurologic, constitutional). Mobile-friendly, large touch targets, minimal text.FR-1, S7.2
CAP-02Clinician Observation EntryHome nurses and clinicians enter structured clinical findings: vital signs, skin/wound observations, directly observed toxicity signs.FR-2
CAP-03Automated CTCAE GradingRule engine maps structured inputs to CTCAE v5.0 grades 1-5 per adverse event term. Combines patient-reported and clinician-reported data. Grades >=2 flagged provisional until clinician confirmed.FR-3, S7.3
CAP-04Tiered Clinical AlertingAutomatic routing: Routine (timeline only), Urgent (notification to HAD nurse within defined delay), Emergency (immediate notification to on-call oncologist). Triggered by grade + AE type + physician-defined protocol.FR-4, S7.4
CAP-05Patient GuidanceContext-aware guidance shown after symptom report: self-care advice vs contact the team now vs go to emergency. Physician-validated content.FR-10

1.2 Coordination Capabilities

#CapabilityDescriptionSpec Reference
CAP-06Shared Care TimelineChronological, role-filtered feed of all events per patient episode: reports, observations, alerts, decisions, messages.FR-5
CAP-07Secure MessagingDirect messaging between care-team members, attachable to specific alerts or timeline events. Audit trail maintained.FR-6
CAP-08Treatment Plan ViewRead-facing display of current systemic therapy protocol, supportive-care prescriptions, home-visit/infusion schedule.FR-7
CAP-09Role-Based Access ControlEach actor sees only information appropriate to their role and relationship to the patient episode. 8 roles: oncologist, HAD coordinating nurse, community nurse, GP, pharmacist, patient, caregiver, admin.FR-9

1.3 Documentation Capabilities

#CapabilityDescriptionSpec Reference
CAP-10Toxicity Summary ExportOn-demand generation of structured toxicity summary for insertion into hospital record and follow-up letters. Includes per-symptom grades, timeline, alert history.FR-8
CAP-11Audit TrailImmutable log of who entered, viewed, modified or acted on each data point, with timestamps. Every clinically relevant action recorded.FR-11

1.4 Technical Capabilities

#CapabilityDescription
CAP-12Standalone .exeSingle Windows executable; no installation; no external runtime; double-click to launch
CAP-13Zero DependenciesNo Python, no Docker, no pip, no npm, no external services required on end-user machine
CAP-14Portable DeploymentCopy to USB or network share; run from any Windows 10/11 machine
CAP-15Simple PatchingDrop-in file overwrite; database and config preserved; schema migrations automatic
CAP-16Local-FirstCore functions work without internet; AI engine connector requires network
CAP-17AI Engine ConnectorPluggable adapter for GLM, Kimi, Gemini, Claude, GPT (per GOV-B7). Stub adapter for offline demo.
CAP-18Named-User LoginPassword-hashed at scrypt; 5-fail lockout; session cookies (per GOV-B7.1)
CAP-19SQLite DatabaseZero-config; file-based; portable; schema designed for PostgreSQL migration
CAP-20Demo DataAuto-seeded on first run: 3 sample patients, pre-loaded CTCAE terms, sample reports and alerts

1.5 User Experience Capabilities

#CapabilityDescription
CAP-21Mobile-First Patient UIResponsive design; large touch targets; minimal text; works on phones and tablets
CAP-22Desktop Clinician DashboardFull-featured dashboard with timeline, alerts, entry forms, export functions
CAP-23Multi-Role LandingEach role sees a customized home screen with relevant actions and data
CAP-24Guidance After ReportPatient receives immediate, actionable guidance based on reported symptoms

2. FULL BUILD STEPS — Every Action from Start to Finish

Phase 0: Project Setup and Framing

StepActionDeliverableOwnerEstimated Effort
0.1Ratify this execution plan with Dr Kais Aldabbagh and Zaid Al DabbagSigned-off planMaster Brain1 day
0.2Classify project as STANDARD per GOV-A1.8Classification recordMaster Brain30 min
0.3Create project folder structure per GOV-F300_Governance, 01_System, 02_Requirements, 03_Architecture, 04_Build, 05_Test, 06_Archive, 07_DeliverablesRegistrar1 hour
0.4Initialize all registersRequirements Register, Interface Register, Risk Register, Defect Register, Change Log, Decision Log, Assumptions RegisterRegistrar2 hours
0.5Register all requirements from MVP plan (REQ-SYS-01 through REQ-SYS-19, REQ-CON-01 through REQ-CON-08) with all 11 mandatory fieldsPopulated Requirements RegisterRegistrar3 hours
0.6Register all interfaces (IF-01 through IF-12)Populated Interface RegisterRegistrar1 hour
0.7Register all risks (RSK-01 through RSK-15)Populated Risk RegisterRisk Agent1 hour
0.8Create the Master Brain state fileMaster_Brain_State.md with purpose, objectives, plan baseline, live statusMaster Brain1 hour
0.9Run GOV-B2.1 framing checkFraming artefact verified against all 10 itemsVerifier30 min

Phase 0 Exit Gate: All registers populated; framing artefact complete; project classified; Master Brain state initialized.


Phase 1: Discovery and Requirements Refinement

StepActionDeliverableOwnerEstimated Effort
1.1Identify and prioritize CTCAE v5.0 terms for MVPCTCAE_Term_Subset.md — list of prioritized terms per domain (GI, hematologic, dermatologic, neurologic, constitutional)Clinical Advisor + Architect2 days
1.2Define escalation protocol defaultsEscalation_Protocol.md — grade-based routing rules (grade 1 = routine, grade 2 = urgent, grade 3+ = emergency) with overridesClinical Advisor1 day
1.3Decompose requirements into user storiesUser_Stories.md — each REQ broken into testable user stories with acceptance criteriaArchitect2 days
1.4Design UI wireframes for all screensWireframes/ folder — patient self-report flow, clinician dashboard, timeline view, alert management, treatment plan, exportUX Lead3 days
1.5Define role-permission matrixRole_Permissions.md — which roles can access which screens, data, and actionsArchitect + Clinical Advisor1 day
1.6Define data entities and relationshipsData_Model_Draft.md — Patient, Episode, Treatment Plan, Toxicity Report, Grade, Alert, Message, Timeline Event, UserArchitect1 day
1.7Review wireframes and user stories with stakeholdersSign-off on wireframes and storiesMaster Brain1 day

Phase 1 Exit Gate: CTCAE terms prioritized; escalation protocol defined; user stories complete; wireframes approved; data model drafted.


Phase 2: Architecture and Design

StepActionDeliverableOwnerEstimated Effort
2.1Finalize database schema (SQLite)schema.sql — all tables, columns, constraints, indexes, foreign keysArchitect2 days
2.2Design API contract (all endpoints)API_Contract.md — every HTTP endpoint with method, path, request/response schema, auth requirementsArchitect2 days
2.3Design CTCAE grading rule formatctcae_rules_schema.json — JSON schema for rule definitions; sample rules for 3 termsArchitect + Clinical Advisor1 day
2.4Design alert routing logicAlert_Routing.md — how grades map to alert tiers; notification targets per tier; escalation delaysArchitect + Clinical Advisor1 day
2.5Design config.json schemaconfig_schema.json — all configurable parameters with defaults and descriptionsArchitect0.5 day
2.6Design schema migration systemMigration_Runner.md — how migrations are stored, ordered, executed, and rolled backArchitect0.5 day
2.7Design build and packaging scriptBuild_Script.md — PyInstaller configuration, build modes (A/B/C), version stamping, smoke testArchitect0.5 day
2.8Design AI adapter interfaceAI_Adapter.md — base adapter class, required methods, error handling, credential managementArchitect0.5 day
2.9Create system breakdown (N-squared matrix)SYSTEM_BREAKDOWN.md — all 20 components with dependencies mappedArchitect1 day
2.10Baseline all architecture artifactsBaselined architecture setChange Controller0.5 day

Phase 2 Exit Gate: Database schema finalized; API contract complete; all interfaces defined; system breakdown created; artifacts baselined.


Phase 3: Change Control Setup

StepActionDeliverableOwnerEstimated Effort
3.1Establish change control processChange_Control_Process.md — how CRs are raised, classified, approved, implemented, verifiedChange Controller0.5 day
3.2Initialize change logChange_Log.md with empty templateChange Controller30 min
3.3Create archive-before-change procedureArchive_Procedure.md — how snapshots are taken before any changeChange Controller30 min
3.4Baseline all planning artifactsBaselined planning setChange Controller0.5 day

Phase 3 Exit Gate: Change control process established; all artifacts baselined; ready to build.


Phase 4: Implementation (Build)

StepActionDeliverableOwnerEstimated Effort
4A: Backend Core
4A.1Implement config manager (C19)config_manager.py — reads/writes config.json; defaults; key documentationBuilder0.5 day
4A.2Implement database manager and schema creation (C14)database.py — SQLite connection; schema creation; migration runner (C18)Builder1 day
4A.3Implement audit logger (C13)audit_logger.py — immutable log; timestamps; attributionBuilder0.5 day
4A.4Implement user store and authentication (C3)user_store.py — scrypt hashing; session management; 5-fail lockoutBuilder1 day
4A.5Implement role-based access control (C3)rbac.py — permission checks per role; episode-scoped accessBuilder0.5 day
4B: Clinical Engine
4B.1Implement CTCAE grading engine (C4)ctcae_engine.py — loads rules from JSON; maps inputs to grades; provisional flaggingBuilder2 days
4B.2Implement alert engine (C5)alert_engine.py — grade-to-tier mapping; notification routing; escalation delaysBuilder1 day
4B.3Implement guidance engine (C12)guidance_engine.py — symptom-to-guidance mapping; content loadingBuilder1 day
4B.4Create CTCAE rules data (sample set)ctcae_rules.json — rules for prioritized terms; proprietary; not in public artifactsBuilder + Clinical Advisor2 days
4B.5Create guidance contentguidance/ folder — per-symptom guidance text (self-care vs contact team vs emergency)Clinical Advisor1 day
4C: Backend API
4C.1Implement HTTP server and routing (C2)server.py — request handling; static file serving; CSP headers; containment checksBuilder1 day
4C.2Implement auth API endpoints/api/login, /api/logout, /api/whoamiBuilder0.5 day
4C.3Implement patient API endpoints/api/patients (CRUD), /api/episodes, /api/treatment-plansBuilder1 day
4C.4Implement toxicity report API endpoints/api/reports (submit, list, get), /api/gradesBuilder1 day
4C.5Implement alert API endpoints/api/alerts (list, acknowledge, escalate)Builder0.5 day
4C.6Implement timeline API endpoint/api/timeline (chronological events per episode, role-filtered)Builder0.5 day
4C.7Implement messaging API endpoints/api/messages (send, list, link to event)Builder0.5 day
4C.8Implement export API endpoint/api/export/summary (structured toxicity summary)Builder0.5 day
4C.9Implement AI adapter interface (C15)adapters/base.py, adapters/stub.py, adapters/glm.pyBuilder1 day
4C.10Implement chat API endpoint/api/chat (requires auth; routes to adapter)Builder0.5 day

| 4D: Frontend — Patient | | | | | | 4D.1 | Build login page | login.html — responsive; role selection; password field | Builder | 0.5 day | | 4D.2 | Build patient self-report form (C6) | report.html — structured questionnaire; CTCAE domains; large touch targets | Builder | 2 days | | 4D.3 | Build patient guidance display | guidance.html — context-aware guidance after report; clear action items | Builder | 1 day | | 4D.4 | Build patient home screen | patient_home.html — recent reports, upcoming schedules, quick report button | Builder | 0.5 day | | 4E: Frontend — Clinician | | | | | | 4E.1 | Build clinician dashboard | dashboard.html — summary cards, recent alerts, pending actions | Builder | 1 day | | 4E.2 | Build clinician observation entry form (C7) | observation.html — vital signs, clinical findings, toxicity signs | Builder | 1.5 days | | 4E.3 | Build care coordination timeline (C8) | timeline.html — chronological feed; event types; role filtering; detail view | Builder | 2 days | | 4E.4 | Build alert management view | alerts.html — list of alerts; acknowledge; escalate; filter by tier | Builder | 1 day | | 4E.5 | Build treatment plan view (C10) | treatment_plan.html — regimen, cycle schedule, supportive care | Builder | 1 day | | 4E.6 | Build messaging interface (C9) | messages.html — thread view; attach to event; send/receive | Builder | 1 day | | 4E.7 | Build export view (C11) | export.html — select date range; generate summary; download | Builder | 0.5 day | | 4E.8 | Build admin/user management view | admin.html — user CRUD; role assignment; password reset | Builder | 1 day | | 4F: Styling and Polish | | | | | | 4F.1 | Implement responsive CSS framework | app.css — mobile-first; breakpoints; role-based color coding | Builder | 1 day | | 4F.2 | Implement client-side JavaScript | app.js — API calls; form handling; dynamic content; error states | Builder | 2 days | | 4F.3 | Implement empty/loading/error states for all views | All views handle: no data, loading, error, permission denied | Builder | 1 day | | 4G: Demo Data and Testing | | | | | | 4G.1 | Create demo data seed script | seed_demo.py — 3 patients, treatment plans, sample reports, alerts | Builder | 1 day | | 4G.2 | Write unit tests for CTCAE engine | test_ctcae.py — test grading logic for each sample term | Builder | 1 day | | 4G.3 | Write unit tests for auth and RBAC | test_auth.py — login, lockout, permission checks | Builder | 0.5 day | | 4G.4 | Write unit tests for API endpoints | test_api.py — all endpoints; happy path + error cases | Builder | 1 day | | 4G.5 | Write integration tests | test_integration.py — full flow: login -> report -> grade -> alert -> timeline | Builder | 1 day |

Phase 4 Exit Gate: All components implemented; all unit tests passing; demo data seeds correctly; application runs locally.


Phase 5: Integration

StepActionDeliverableOwnerEstimated Effort
5.1Integrate frontend with backend APIAll API calls working from browser; error handling completeIntegrator1 day
5.2Integrate CTCAE engine with report submissionReport submission -> grading -> alert -> timeline flow working end-to-endIntegrator0.5 day
5.3Integrate alert engine with messaging and timelineAlerts appear on timeline; notifications sent; messaging linkedIntegrator0.5 day
5.4Integrate export with timeline and grading dataSummary export pulls correct data; format is clinically usefulIntegrator0.5 day
5.5Integration testing — full patient journeyComplete flow: patient reports -> grading -> alert -> clinician reviews -> exportIntegrator1 day
5.6Integration testing — all rolesEach role logs in; performs their primary actions; sees correct dataIntegrator1 day
5.7Record integration test resultsIntegration_Test_Results.md — pass/fail per interface, per roleIntegrator0.5 day

Phase 5 Exit Gate: All interfaces tested; full patient journey works; all roles functional; integration defects logged.


Phase 6: Verification and Validation

StepActionDeliverableOwnerEstimated Effort
6.1Independent verification against all REQsV&V_Report.md — every REQ checked against acceptance criteria; evidence citedIndependent Verifier2 days
6.2Security reviewSecurity_Review.md — password hashing, session management, RBAC, CSP, containment, audit trailRisk Agent1 day
6.3Usability reviewUsability_Review.md — patient forms tested for readability; clinician dashboard tested for workflowValidator1 day
6.4Performance checkPerformance_Check.md — grading response time; page load times; database query timesVerifier0.5 day
6.5Run Part I compliance audit (all 55 checks)Compliance_Audit.md — every line pass/fail with evidenceVerifier1 day
6.6Fix any FAIL itemsDefect fixes; re-verifyBuilder1-3 days
6.7Clinical validation of grading logicClinical_Validation.md — clinical advisor reviews grading rules and sample outputsClinical Advisor1 day
6.8Stakeholder demo and feedbackFeedback_Log.md — recorded feedback from Dr Kais and ZaidMaster Brain1 day

Phase 6 Exit Gate: All REQs verified; security passed; Part I audit passed (or FAILs documented with waivers); clinical validation complete; stakeholder feedback incorporated.


Phase 7: Packaging and Delivery

StepActionDeliverableOwnerEstimated Effort
7.1Create build script (C20)build.py — PyInstaller configuration; Mode A/B/C; version stampingBuilder1 day
7.2Build Mode A (single .exe)dist/HAD Digital.exe — single file, all embeddedBuilder0.5 day
7.3Build Mode B (folder bundle)dist/HAD_Digital/ — .exe + data + static + configBuilder0.5 day
7.4Smoke test Mode A on clean Windows VMLaunch .exe; open browser; login; submit report; verify gradingVerifier0.5 day
7.5Smoke test Mode B on clean Windows VMSame as 7.4; also test patching (overwrite .exe, preserve DB)Verifier0.5 day
7.6Smoke test USB portabilityCopy Mode B to USB; run from USB on different machineVerifier0.5 day
7.7Create README.txtQuick-start: how to run, how to patch, how to configure, demo credentialsBuilder0.5 day
7.8Create VERSION.txtVersion number, build date, git hash, component versionsBuilder30 min
7.9Create CHANGELOG.txtWhat changed since last versionBuilder30 min
7.10Create Help Hub (GOV-G1)Help_Hub/ folder — troubleshooting, glossary, deliverables map, FAQBuilder1 day
7.11Create deliverables map (GOV-G4)Deliverables_Map.md — every file, its purpose, its locationBuilder0.5 day
7.12Archive all build artifacts06_Archive/ — dated snapshots of all deliverablesChange Controller0.5 day
7.13Final Part I auditRe-run all 55 checks on final deliverablesVerifier0.5 day

Phase 7 Exit Gate: .exe builds successfully; smoke tests pass; USB portability confirmed; documentation complete; final audit passed.


Phase 8: Handover and Close-Out

StepActionDeliverableOwnerEstimated Effort
8.1Create handover file (GOV-F9.9)Handover.md — purpose, governance, requirements, tools, registers, live stateMaster Brain0.5 day
8.2Create cold-start testCold_Start_Test.md — an operator with only the folder can state purpose, baseline, open items, next actionVerifier0.5 day
8.3Run cold-start testVerifier uses only the folder to answer all cold-start questionsVerifier0.5 day
8.4Harvest reusable lessonsLessons_Learned.md — what worked, what didn't, what to improveImprovement Agent0.5 day
8.5Close-out reportCloseout_Report.md — every request logged with % complete; every phase reconciled; zero Open itemsMaster Brain1 day
8.6Transfer pack creation (GOV-F9.11)Transfer_Pack/ folder — everything needed to hand the project to another teamMaster Brain1 day
8.7Final stakeholder sign-offSigned acceptance from Dr Kais and ZaidMaster Brain1 day

Phase 8 Exit Gate: Handover complete; cold-start test passed; lessons harvested; close-out report delivered; stakeholder sign-off received.


Summary: Total Estimated Effort

PhaseDays
Phase 0: Project Setup2
Phase 1: Discovery8
Phase 2: Architecture7
Phase 3: Change Control1
Phase 4: Implementation25-30
Phase 5: Integration5
Phase 6: Verification7-10
Phase 7: Packaging6
Phase 8: Handover5
Total66-74 working days

This is approximately 3-4 months of focused work, assuming a single builder. With parallel agents (per GOV-C3.1), phases can overlap and the timeline compresses to approximately 2-2.5 months.


3. DEPENDENCIES — What the Project Needs to Succeed

3.1 External Dependencies (Outside the Project Team)

#DependencyWhy NeededRisk If MissingOwner
DEP-01Dr Kais Aldabbagh — clinical inputCTCAE term prioritization; escalation protocol validation; grading rule review; clinical validationNo clinically valid grading logic; cannot pass validationDr Kais
DEP-02Zaid Al Dabbag — project owner decisionsPlan ratification; change approvals; requirement clarifications; sign-offNo authority to proceed; decisions blockedZaid
DEP-03Windows 10/11 test machines (clean VMs)Smoke testing .exe portability; antivirus testing; clean-environment verificationCannot verify zero-dependency claimBuilder
DEP-04PyInstaller (build-time)Packaging Python into .exeCannot build .exeBuilder
DEP-05Python 3.11+ (developer machine)Development runtimeCannot developBuilder
DEP-06Git (version control)Version tracking; build stamping; rollbackNo version history; no traceabilityBuilder
DEP-07CTCAE v5.0 reference documentGrading rules must be based on the official CTCAE standardGrading logic not clinically groundedDr Kais / NCI
DEP-08Sample patient data (anonymized)Demo data for testing and demonstrationCannot demonstrate the systemDr Kais
DEP-09Regulatory counsel (post-MVP)SaMD qualification assessment before clinical pilotCannot deploy beyond demoProject Owner
DEP-10HDS-certified hosting (production)Health data hosting compliance for productionCannot go live with real patient dataProject Owner

3.2 Internal Dependencies (Between Components)

#DependencyFromToNature
DEP-11Database schema must be finalized before any backend codePhase 2 (Architecture)Phase 4A (Backend Core)Blocking
DEP-12CTCAE rules must be defined before grading engine implementationPhase 1 (Discovery) + Clinical InputPhase 4B.1 (CTCAE Engine)Blocking
DEP-13Escalation protocol must be defined before alert enginePhase 1 (Discovery) + Clinical InputPhase 4B.2 (Alert Engine)Blocking
DEP-14Auth system must work before any protected endpointPhase 4A.4 (User Store)Phase 4C.2-4C.10 (All API Endpoints)Blocking
DEP-15API contract must be defined before frontend developmentPhase 2 (Architecture)Phase 4D + 4E (Frontend)Blocking
DEP-16CTCAE engine must work before alert enginePhase 4B.1 (CTCAE Engine)Phase 4B.2 (Alert Engine)Blocking
DEP-17Backend API must work before frontend integrationPhase 4C (Backend API)Phase 5 (Integration)Blocking
DEP-18All components must pass unit tests before integrationPhase 4G (Testing)Phase 5 (Integration)Blocking
DEP-19Integration must pass before verificationPhase 5 (Integration)Phase 6 (Verification)Blocking
DEP-20Verification must pass before packagingPhase 6 (Verification)Phase 7 (Packaging)Blocking

3.3 Knowledge Dependencies

#DependencyWhy NeededHow Addressed
DEP-21Understanding of CTCAE v5.0 grading systemGrading rules must be clinically accurateDr Kais input; CTCAE reference document
DEP-22Understanding of French HAD modelWorkflow must match real clinical practiceSpec document; Dr Kais input
DEP-23Understanding of governance standard v3.9Every decision must complyThis plan; governance document
DEP-24Python packaging knowledgePyInstaller configuration; bundling; troubleshootingBuilder expertise; PyInstaller docs
DEP-25Health data regulations (GDPR, CNIL, HDS)Data handling must complySpec document; regulatory counsel (post-MVP)

3.4 Infrastructure Dependencies

#DependencyPurposeMVP ApproachProduction Approach
DEP-26DatabasePersistent storageSQLite (file-based, zero config)PostgreSQL (HDS-certified host)
DEP-27Web serverServe applicationBundled in .exe (stdlib http.server)Dedicated server/container
DEP-28File storageStatic assets, config, logsLocal filesystem (relative paths)Cloud storage
DEP-29AI engineChat/assistant featureStub adapter (offline) or GLM (with API key)Production adapter with real key
DEP-30NetworkClient-server communicationlocalhost (no network needed)HTTPS with valid certificate

4. RISKS — Comprehensive Register

4.1 Clinical Risks

RSKRiskLikelihoodImpactMitigationContingencyOwner
RSK-01CTCAE grading logic produces incorrect gradesHigh (MVP without full clinical validation)High — patient safetyConservative defaults; all grades >=2 provisional; clinician review mandatory; use official CTCAE referenceRevert to manual grading; flag system as decision-support onlyClinical Advisor
RSK-02Escalation protocol defaults are inappropriateMediumHigh — missed emergenciesUse widely-accepted oncology triage defaults; clinical advisor review; make rules configurableAllow physician override per patientClinical Advisor
RSK-03Patient self-report data is incomplete or inaccurateHighMedium — grading quality affectedStructured questionnaire reduces free-text variability; clinician confirmation for grades >=2; guidance prompts honest reportingCross-reference with clinician observationsUX Lead
RSK-04Guidance content leads to wrong patient actionLowHigh — patient safetyPhysician-validated content; conservative advice (err on side of contact team); clear disclaimersImmediate content update via patchClinical Advisor

4.2 Technical Risks

RSKRiskLikelihoodImpactMitigationContingencyOwner
RSK-05PyInstaller .exe flagged by antivirus as suspiciousMediumMedium — blocks deploymentTest on clean VMs; code signing certificate; whitelist instructions for IT departmentsProvide folder bundle (Mode B) as alternative; submit to AV vendors for whitelistingBuilder
RSK-06.exe file size is too large (>200MB)LowLow — distribution delayOptimize PyInstaller excludes; use --onefile for single exe; compressAccept larger size; use folder bundle modeBuilder
RSK-07SQLite concurrent access issuesLow (single-site demo)Medium — data corruptionWAL mode; single-writer design; connection poolingMigrate to PostgreSQL for multi-userArchitect
RSK-08Database schema migration fails on patchLowHigh — data lossAdditive-only migrations; test migrations on copy before applying; backup before patchRestore from backup; manual schema fixBuilder
RSK-09Browser compatibility issuesLowMedium — UI brokenVanilla HTML/CSS/JS; test on Chrome, Edge, Firefox; no framework dependenciesProvide browser-specific CSS fixesBuilder
RSK-10PyWebView adds unexpected complexityMediumMedium — delaysPrefer browser mode for MVP; PyWebView as optional enhancementDrop PyWebView; use browser mode onlyBuilder
RSK-11AI adapter integration failsMediumLow — non-core featureStub adapter for offline demo; AI connector is optional for MVP core functionsShip without AI chat; add in V2Builder
RSK-12Portability issues on different Windows versionsLowMedium — deployment blockedTest on Windows 10 (1903+) and Windows 11; document minimum versionProvide version-specific workaroundsBuilder

4.3 Regulatory and Compliance Risks

RSKRiskLikelihoodImpactMitigationContingencyOwner
RSK-13SaMD qualification required before any clinical useHighHigh — timeline impactMVP is demo/pilot only; engage regulatory counsel early; document intended use carefullyLimit to demonstration; no real patient data until qualificationProject Owner
RSK-14GDPR non-compliance in demo environmentLow (demo only)High — legal exposureNo real patient data in demo; anonymized sample data only; clear demo disclaimersRemove all data; restart with fresh demo dataRisk Agent
RSK-15Governance standard non-complianceMediumMedium — project rejectionFollow GOV-C1.5 stage cycle; run Part I audit; document all deviationsWaiver process (GOV-A1.3) for documented exceptionsMaster Brain

4.4 Project and Resource Risks

RSKRiskLikelihoodImpactMitigationContingencyOwner
RSK-16Clinical advisor unavailable for inputMediumHigh — blocks grading logic and validationSchedule regular input sessions; prepare questions in advance; document assumptions for later validationUse conservative defaults; flag for later clinical reviewMaster Brain
RSK-17Scope creep beyond MVPHighHigh — timeline blowoutStrict adherence to Spec S4.1 scope; every new request goes through change control; out-of-scope list enforcedDefer to V2; log as improvement proposalChange Controller
RSK-18Single builder is a bottleneckHighMedium — timeline impactModular architecture allows parallel work; use sub-agents per GOV-C3.1; prioritize critical pathExtend timeline; add builder resourceMaster Brain
RSK-19Requirements misunderstandingMediumHigh — reworkRequirements register with acceptance criteria; stakeholder review at every gate; wireframes approved before buildChange request process; re-baselineArchitect
RSK-20Demo environment not convincingMediumMedium — stakeholder confidenceRealistic demo data; complete patient journey; all roles functional; pre-seeded scenariosPrepare scripted demo flow; backup static screenshotsBuilder

4.5 Operational Risks (Post-Delivery)

RSKRiskLikelihoodImpactMitigationContingencyOwner
RSK-21Users cannot apply patchesLowMedium — cannot updateSimple drop-in process; README with screenshots; patch notes clearProvide remote support; create video walkthroughBuilder
RSK-22Data loss during patchingLowHigh — clinical data lostDatabase never overwritten by patch; backup instructions in README; schema migration testedRestore from backup; manual data recoveryBuilder
RSK-23Application crashes on startup after patchLowMedium — cannot useSmoke test before release; version rollback procedure documented; previous version archivedRevert to previous .exe; report defectBuilder
RSK-24Users exceed intended scope (real patients in demo)MediumHigh — safety/legalClear disclaimers in application; demo mode label; no HDS certification for demoImmediate stop; data purge; legal reviewProject Owner

5. ASSUMPTIONS AND WHAT BREAKS IF WRONG

#AssumptionConfidenceWhat Breaks If Wrong
ASM-01Python 3.11+ runs on all target Windows machines when bundled by PyInstallerHighCannot build .exe; need alternative packaging (Nuitka, cx_Freeze)
ASM-02SQLite handles the concurrent load of a single-site pilotHighNeed PostgreSQL earlier than planned; adds complexity
ASM-03CTCAE v5.0 terms can be mapped to structured questionnaire questionsHighNeed different input approach; may affect grading accuracy
ASM-04Vanilla HTML/CSS/JS is sufficient for the UIHighNeed framework (Vue/React); adds build step and complexity
ASM-05Clinician users have modern browsers (Chrome/Edge/Firefox)HighNeed to support IE11 or older browsers; significant effort
ASM-06PyInstaller produces a .exe that passes Windows DefenderMediumNeed code signing certificate; additional cost and process
ASM-07The governance standard's stage cycle is achievable within the timelineMediumNeed to compress stages; document waivers for skipped steps
ASM-08Dr Kais can provide clinical input within the discovery phase timelineMediumBlocks grading engine and escalation protocol; delays build
ASM-09The MVP will be used for demonstration only, not with real patientsHighNeed HDS hosting, GDPR compliance, regulatory qualification earlier
ASM-10Drop-in patching is sufficient for the pilot phaseHighNeed installer-based update mechanism; adds complexity
ASM-11The CTCAE grading rules are deterministic (no ML/AI needed for MVP)HighNeed different approach; may affect grading accuracy
ASM-12Users will read the README.txt for patching instructionsMediumNeed in-app update mechanism; adds V2 feature
ASM-13The application runs entirely on localhost for MVP demoHighNeed hosting infrastructure; adds deployment complexity
ASM-14Role-based access control can be implemented with simple session tokensHighNeed OAuth/SAML; adds authentication complexity
ASM-15The governance standard allows STANDARD-class merging of rolesHighNeed full 9-agent staffing; increases overhead

6. SUCCESS CRITERIA

6.1 MVP Delivery Success Criteria

#CriterionHow Verified
SC-01.exe launches on clean Windows 10/11 with no Python installedSmoke test on clean VM
SC-02All 12 core features (F1-F12) functionalFeature checklist; demo walkthrough
SC-03CTCAE grading produces correct grades for sample inputsUnit tests; clinical validation
SC-04Alert routing works for all three tiers (routine/urgent/emergency)Integration test; demo scenario
SC-05All 8 user roles can log in and perform their primary actionsRole-based test matrix
SC-06Database survives patching (overwrite .exe, preserve data)Patch test on copy
SC-07Application runs from USB stick on different machinePortability test
SC-08Zero pip dependencies at runtimeDependency scan of bundled .exe
SC-09Part I compliance audit passes (or FAILs documented with waivers)Audit table
SC-10Stakeholder demo received positive feedbackFeedback log

6.2 Clinical Validation Success Criteria

#CriterionHow Verified
SC-11Grading rules cover prioritized CTCAE termsClinical advisor sign-off
SC-12Escalation protocol matches clinical best practiceClinical advisor sign-off
SC-13Patient guidance content is clinically appropriateClinical advisor sign-off
SC-14Export summary is suitable for clinical record insertionClinical advisor review

6.3 Governance Success Criteria

#CriterionHow Verified
SC-15All requirements traced bidirectionallyRTM orphan counts = 0
SC-16All changes classified before implementationCR log review
SC-17Builder != Verifier on every artifactRACI matrix
SC-18All registers maintained and currentRegister completeness check
SC-19Handover file enables cold-start by new operatorCold-start test
SC-20Lessons harvested and documentedKnowledge folder

END OF EXECUTION PLAN