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Current Limitations & Technical Debt

Overview​

This document provides a comprehensive list of current limitations in the LyfeAI Provider Platform. Understanding these limitations is crucial for planning future development work and setting realistic expectations.

Frontend Limitations​

1. Mock Data Dependencies​

  • Charts and Analytics: All graphs display static mock data
  • Patient Lists: Some demo patients are hardcoded
  • Appointments: Sample appointments don't reflect real scheduling
  • Metrics: Dashboard numbers are placeholder values

2. State Management​

  • No Global State: Using React context minimally
  • Form State: Some forms lose data on navigation
  • Session Persistence: User preferences not saved
  • Optimistic Updates: UI doesn't update until refresh

3. Component Architecture Issues​

// Example of overly large component
// app/patients/[id]/page.tsx has 1000+ lines
// Should be broken into:
- PatientHeader
- PatientTabs
- PatientMedications
- PatientAllergies
- PatientNotes

4. Missing UI Features​

  • Drag-and-drop: For appointment scheduling
  • Keyboard shortcuts: For power users
  • Offline indicators: When connection lost
  • Loading skeletons: Inconsistent implementation
  • Error boundaries: Not comprehensive

Backend Limitations​

1. Authentication System​

// Current mock auth in lib/use-auth.ts
const mockUsers = [
  { email: "[email protected]", role: "admin" },
  { email: "[email protected]", role: "doctor" }
  // Hardcoded users - no real authentication
]

Issues:

  • No password validation
  • No session management
  • No refresh tokens
  • No MFA support
  • No password reset

2. API Structure​

  • No REST standards: Inconsistent endpoint naming
  • No versioning: API changes break clients
  • No rate limiting: Vulnerable to abuse
  • No caching: Every request hits database
  • No pagination: Large datasets crash browser

3. Database Issues​

Schema Problems​

-- Example: medications table lacks critical fields
CREATE TABLE medications (
  id UUID PRIMARY KEY,
  patient_id UUID REFERENCES patients(id),
  name TEXT,
  dosage TEXT
  -- Missing: prescriber, pharmacy, refills, interactions
);

Missing Indexes​

-- Queries are slow without proper indexes
-- Need indexes on:
- patients.mrn
- appointments.provider_id
- medications.patient_id
- notes.created_at

No Audit Trail​

  • Changes not tracked
  • No version history
  • Cannot restore deleted data
  • Compliance issues for healthcare

4. Real-time Features Not Implemented​

// Supabase real-time is configured but unused
// Need to implement:
- Live appointment updates
- Chat message delivery  
- Notification system
- Collaborative editing
- Status indicators

Integration Limitations​

1. FHIR Implementation Gaps​

  • Resources Supported: Only Patient and DocumentReference
  • Missing Resources: Encounter, Procedure, DiagnosticReport
  • No FHIR Server: Can't query external FHIR endpoints
  • Limited Validation: Accepts invalid FHIR data
  • No Terminology Service: Can't validate medical codes

2. External System Integrations​

// All integrations are UI-only mockups
const integrations = {
  epic: "Not implemented",
  cerner: "Not implemented", 
  labcorp: "Not implemented",
  pharmacies: "Not implemented"
}

3. Document Processing Limitations​

  • File Types: Only PDF and images
  • Size Limit: Undefined, will crash on large files
  • OCR Accuracy: Depends on document quality
  • Language Support: English only
  • Handwriting: Poor recognition

Security Limitations​

1. Authentication & Authorization​

  • No OAuth: Can't integrate with enterprise SSO
  • Weak Sessions: Using localStorage tokens
  • Missing RBAC: Role checks in frontend only
  • No API Keys: For service-to-service auth

2. Data Protection​

// Sensitive data exposed in responses
return {
  patient: {
    ssn: "123-45-6789", // Should be masked
    dob: "1980-01-01",  // Should check permissions
  }
}

3. HIPAA Compliance Gaps​

  • No Encryption at Rest: Database unencrypted
  • No Audit Logs: PHI access not tracked
  • Missing BAA: With cloud providers
  • No Access Controls: Anyone can export data
  • Weak Password Policy: No requirements enforced

4. Infrastructure Security​

  • Exposed Keys: Some in frontend code
  • No WAF: Vulnerable to common attacks
  • Missing CSP: XSS vulnerabilities
  • No Pen Testing: Security not validated

Performance Limitations​

1. Frontend Performance​

  • Bundle Size: 2.5MB initial load
  • No Code Splitting: Everything loads at once
  • Image Optimization: Missing for user uploads
  • Memory Leaks: In real-time connections

2. Backend Performance​

// Example: N+1 query problem
const patients = await getPatients();
for (const patient of patients) {
  patient.medications = await getMedications(patient.id);
  patient.allergies = await getAllergies(patient.id);
  // Makes 100+ queries for 50 patients
}

3. Scalability Issues​

  • No Caching Layer: Redis not implemented
  • Single Database: No read replicas
  • No CDN: Static assets served from origin
  • Memory Usage: Loads entire datasets

Deployment & DevOps Limitations​

1. Environment Configuration​

# Problems with current setup:
- Environment variables in multiple places
- No validation of required vars
- Secrets committed to repo (removed but in history)
- No environment parity

2. CI/CD Pipeline​

  • No Automated Tests: Deploys without verification
  • No Staging Environment: Direct to production
  • Manual Deployments: No GitOps workflow
  • No Rollback: Can't revert bad deploys

3. Monitoring & Observability​

  • No APM: Can't track performance
  • No Error Tracking: Sentry not configured
  • Missing Logs: Console.log debugging only
  • No Alerts: Don't know when things break

Data Quality Issues​

1. No Validation​

// Example: Patient data accepted without validation
const createPatient = async (data: any) => {
  // No schema validation
  // Accepts invalid phone numbers, SSNs, etc.
  return await supabase.from('patients').insert(data);
}

2. Inconsistent Formats​

  • Dates: Mix of formats (MM/DD/YYYY vs ISO)
  • Phone Numbers: No standardization
  • Names: No normalization
  • Addresses: No validation

3. Referential Integrity​

  • Orphaned Records: Deleted patients leave notes
  • Missing Constraints: Can assign to non-existent providers
  • Duplicate Data: Same patient multiple times

Missing Features (Backend Required)​

1. Clinical Features​

  • Prescription writing (DEA integration)
  • Lab order placement
  • Insurance verification
  • Prior authorization
  • Referral management
  • Clinical decision support rules

2. Administrative Features​

  • Billing/coding
  • Report generation
  • Audit trails
  • User management
  • System configuration
  • Backup/restore

3. Communication Features​

  • Secure messaging backend
  • Video consultation infrastructure
  • Appointment reminders
  • Patient portal API
  • Notification delivery

Technical Debt Summary​

High Priority (Security/Compliance)​

  1. Implement real authentication
  2. Add audit logging
  3. Encrypt sensitive data
  4. Fix authorization checks
  5. Add input validation

Medium Priority (Functionality)​

  1. Build missing API endpoints
  2. Implement real-time features
  3. Add database indexes
  4. Fix N+1 queries
  5. Implement caching

Low Priority (Performance/UX)​

  1. Code splitting
  2. Image optimization
  3. Loading states
  4. Error boundaries
  5. Keyboard navigation

Recommendations for New Team​

Immediate Actions​

  1. Security Audit: Identify and fix vulnerabilities
  2. Real Authentication: Replace mock system
  3. API Standards: Implement REST/GraphQL properly
  4. Test Coverage: Add unit and integration tests
  5. Documentation: Document all endpoints

Architecture Decisions Needed​

  1. State Management: Redux vs Zustand vs Context
  2. API Pattern: REST vs GraphQL vs tRPC
  3. Testing Strategy: Jest vs Vitest, E2E approach
  4. Deployment Target: Vercel vs AWS vs Azure
  5. Monitoring Stack: DataDog vs New Relic vs Custom

Resource Requirements​

  1. Backend Developer: For API completion
  2. DevOps Engineer: For infrastructure
  3. Security Consultant: For HIPAA compliance
  4. QA Engineer: For test automation
  5. Technical Writer: For documentation

Conclusion​

While the current implementation successfully demonstrates the product vision through its UI, significant backend work remains to create a production-ready healthcare platform. The limitations documented here should guide prioritization of development efforts, with security and compliance taking precedence given the healthcare domain.

The good news is that the architecture is sound and the UI provides a clear specification for what needs to be built. With proper resources and systematic approach to addressing these limitations, the platform can fulfill its potential as a comprehensive provider solution.