Roadmap 2027: What We Are Building Next

Ciyex has reached a significant milestone. The core EHR platform is stable, FHIR-native, and serving real clinical workloads. The patient portal gives patients direct access to their health data. The telehealth module brings care to communities that distance or mobility would otherwise exclude. But there is much more to build. This roadmap outlines the major initiatives planned for 2027, each driven by the same principle that guides everything we do: healthcare technology should serve patients first, and it should be accessible to everyone.

AI-Powered Clinical Documentation

Provider burnout is a public health crisis. Studies consistently show that physicians spend more time on documentation than on direct patient care, with estimates of 1 to 2 hours of charting for every hour of patient contact. This burden drives providers out of practice, reduces the time available for each patient, and contributes to medical errors caused by fatigue.

Ciyex will introduce an AI clinical documentation assistant that listens to the patient-provider conversation (with explicit patient consent) and generates structured SOAP notes in real time. The system will:

• Transcribe the conversation using speech-to-text models optimized for medical terminology
• Extract clinical entities: symptoms, diagnoses, medications, allergies, procedures mentioned in the conversation
• Generate a draft SOAP note organized into Subjective, Objective, Assessment, and Plan sections
• Map to standard terminologies: ICD-10 codes for diagnoses, SNOMED CT for clinical findings, RxNorm for medications
• Present the draft for provider review before it becomes part of the permanent medical record

The provider retains full control. The AI generates a draft; the provider reviews, edits, and signs it. No AI-generated content enters the medical record without human approval.

We are evaluating both hosted language models and self-hostable models for this feature. For organizations with strict data residency requirements, the ability to run the AI model on-premises or in their own cloud environment is essential. Patient conversation data must never leave the organization's control without explicit consent.

Population Health Analytics

Individual patient care is necessary but not sufficient. Community health centers and public health organizations need to understand patterns across their entire patient population:

• What percentage of diabetic patients have had an HbA1c test in the last 6 months?
• How many patients with hypertension have blood pressure readings above target?
• Which patients are overdue for cancer screenings (mammography, colonoscopy, cervical cancer)?
• What are the immunization rates for children in the practice, and where are the gaps?

Ciyex will add population health dashboards that aggregate FHIR data across the patient panel to surface these insights. The system will use clinical quality measure (CQM) definitions from CMS and HEDIS specifications to calculate standard quality metrics automatically.

Key capabilities planned:

1. Care gap identification: Automatically flag patients who are missing recommended preventive services based on age, sex, diagnoses, and clinical guidelines
2. Risk stratification: Identify high-risk patients who may benefit from proactive outreach, care coordination, or case management
3. Chronic disease registries: Track cohorts of patients with specific conditions (diabetes, COPD, heart failure) and monitor aggregate outcomes over time
4. Quality reporting: Generate reports for MIPS (Merit-based Incentive Payment System) and other value-based payment programs, reducing the administrative burden of quality reporting
5. Social determinants of health (SDOH): Incorporate Z-codes and SDOH screening data to understand how non-clinical factors affect health outcomes in the patient population

Ciyex Hub: The SMART on FHIR App Marketplace

No single EHR can meet every clinical need. Dermatology practices need imaging tools. Behavioral health practices need PHQ-9 scoring. Pediatric practices need growth chart plotting. Rather than building every specialized feature into the core platform, Ciyex is building a marketplace for SMART on FHIR applications.

The Ciyex Hub will allow:

• App developers to publish SMART on FHIR applications that integrate with Ciyex
• Practice administrators to browse, install, and configure apps for their organization
• Clinicians to launch apps directly from the patient chart with full clinical context

The marketplace supports three tiers of integration:

Tier	Description	Example
Tier 1: Native Plugins	Bundled with the platform, tightly integrated	Vaultik file storage, Care Gaps
Tier 2: Sandboxed Plugins	Run in a JavaScript sandbox with controlled API access	Custom clinical calculators, form builders
Tier 3: SMART on FHIR	External web applications launched via SMART protocol	Specialty-specific tools, third-party integrations

The Hub handles app installation, license management, configuration storage, and the SMART launch flow. When a clinician clicks on an installed app in the patient chart, the system:

1. Looks up the app's service URL from the app_installations table
2. Generates a SMART launch token with the current patient and encounter context
3. Opens the app in a new panel or tab with the appropriate OAuth2 scopes

This architecture means that adding a new clinical capability to Ciyex requires zero changes to the core platform code. App developers register in the marketplace, practices install via the Hub, and the generic app proxy handles the rest.

Mobile Applications

Patients and providers increasingly expect mobile access to healthcare tools. Ciyex will develop native mobile applications for both audiences:

Patient Mobile App (iOS and Android)

• View upcoming appointments and check in remotely
• Access lab results, medications, and immunization records
• Secure messaging with the care team
• Telehealth visit participation with push notification reminders
• Health data sharing via Apple Health and Google Health Connect integration

Provider Mobile App

• Review and approve prescription refill requests
• Respond to secure messages during off-hours
• View the daily schedule and patient summaries
• Receive critical lab result notifications
• Quick access to patient demographics and allergy information

Both apps will authenticate through Keycloak and access data via the same FHIR APIs used by the web interface, ensuring data consistency across all access points.

Insurance Verification and Revenue Cycle Management

For practices that depend on insurance reimbursement, verifying patient coverage before the visit prevents claim denials and reduces the administrative burden of appeals and re-submissions. Ciyex will add:

• Real-time eligibility verification through integration with major clearinghouses
• Batch verification for the next day's appointments, run automatically overnight
• Coverage details display showing copay, deductible, coinsurance, and authorization requirements
• Automated claim status tracking with alerts for denied or pending claims
• Bulk insurance card processing where scanned or photographed insurance cards are parsed using AI to extract payer, member ID, group number, and plan details

This capability is especially important for safety-net clinics and FQHCs that serve patients with Medicaid, where eligibility can change monthly and coverage verification is essential for financial sustainability.

Clinical Decision Support

Beyond CDS Hooks integration with external services, Ciyex will build native clinical decision support features:

• Drug interaction checking using the National Library of Medicine's DailyMed database and NCCI PTP edits
• Allergy cross-referencing that warns when a prescribed medication shares a drug class with a documented allergy
• Preventive care reminders based on USPSTF guidelines, age, sex, and risk factors
• Dose range checking that flags prescriptions outside standard dosing ranges for the patient's age and weight
• Clinical pathway support for common conditions (chest pain evaluation, diabetes management, depression screening) with evidence-based step-by-step guidance

All decision support will be configurable at the organization level, allowing practices to enable or disable specific rules based on their clinical context and patient population.

Community-Driven Development

Every item on this roadmap is shaped by feedback from the clinicians, patients, and developers who use Ciyex. Our prioritization process is transparent:

• Feature requests are tracked as GitHub issues and discussed openly
• Quarterly planning is informed by community voting and advisory board input
• Development progress is visible in public project boards
• Release notes document every change with clinical context for why it matters

We do not build features because they are technically interesting. We build features because a nurse told us the current workflow wastes 20 minutes per shift, or because a patient could not find their vaccination records, or because a clinic director showed us the spreadsheet they use because the EHR lacks a needed report.

How to Get Involved

The roadmap is ambitious, and we need help. There are many ways to contribute:

• Developers: Pick up issues on GitHub, especially those labeled with the 2027 milestone
• Clinicians: Join our advisory board to provide clinical input on feature design
• Designers: Help us create intuitive interfaces for complex clinical workflows
• Translators: Make Ciyex accessible in more languages
• Advocates: Spread the word to clinics and organizations that could benefit from open source healthcare technology

Healthcare belongs to everyone. The technology that supports it should too. Here is what we are building in 2027. We invite you to build it with us.