The RIS Portal is a Radiology Information System (RIS) designed for multi-specialty healthcare centres. It handles the complete patient journey — from appointment booking through imaging, reporting, and patient access — across five specialty modules: Radiology Pathology Ophthalmology Dentistry EEG.

The system is available in English and Arabic. Language can be changed from the navigation bar at any time.

Throughout this manual you'll see badges next to feature names. They tell you whether the feature is ready to use in production today, or still on the roadmap.

Badge	Meaning	What you'll see in the app
Live	Implemented and in use in production.	Works as described. No banners.
Beta	Working but rough edges or partial data.	May show an info banner asking for feedback.
Soon	UI is wired but the action is intentionally disabled until the backend ships.	Greyed-out button with "Soon" badge, or an amber info banner.
Planned	On the roadmap, not implemented in any form yet.	Mentioned in this manual; no UI surface in the app.
Research	Concept under evaluation.	No visible UI.

What "Soon" looks like in the app: a button might appear greyed-out with a small "Soon" badge next to it, and hovering shows a tooltip such as "PDF download is coming soon". You'll also see amber info banners at the top of pages that depend on a future feature — for example, the reception check-in page shows a banner explaining that insurance verification is currently in manual mode.

Specialist Navigation

Specialist roles (Pathologist, Ophthalmologist, Dentist, Neurophysiologist) see their own dedicated navbar dropdown after login:

Role	Navbar item	Landing page after login
Pathologist	Pathology dropdown → My Cases / Pending / Reported / Signed	/Pathology/Case
Ophthalmologist	Ophthalmology dropdown → My Exams / Scheduled / Reported / Signed	/Ophthalmology/Exam
Dentist	Dentistry dropdown → My Encounters / Pending / Reported / Signed	/Dentistry/Encounter
Neurophysiologist	EEG dropdown → My Studies / Uploaded / Reported / Signed	/EEG/Study

From their worklist, specialists can: open a case/exam/encounter/study detail page, view linked imaging (slide viewer, OCT viewer, dental X-ray viewer, EEG waveform viewer), write and finalize reports, and flag critical results.

Before images reach the doctor's worklist, a quality check confirms that technical image quality is adequate (correct anatomy, no motion artifact, sufficient coverage).

Worklist Filters & TAT Warnings

The worklist has a filter bar to narrow orders by Priority, Modality, date range, and Status (Uploaded / QA Approved). Orders are pre-sorted STAT → Urgent → Routine, then oldest-first within each group. The TAT (Turnaround Time) column shows wait time since upload, highlighted amber after 24 h and red after 48 h. A STAT count banner at the top shows how many STAT cases are pending.

Patients can log in and access their Patient Portal to:

• Book new appointments
• View upcoming and past appointments
• Download finalized reports (PDF)
• View their cross-module Patient Timeline (all visits, tests, reports)
• Update personal information

A live search bar in the top navigation bar (hidden for Patient role) allows any staff member to quickly find a patient by name, patient code, or date of birth — from anywhere in the system.

The bell icon in the top-right navbar shows a live count of pending action items. It refreshes every 60 seconds automatically. Notifications are role-specific and derived from live database data — no separate inbox table is needed.

Role	What triggers a notification
Admin	Unacknowledged critical results · Orders pending QA review · STAT orders awaiting report · Low inventory items · Equipment due for maintenance
Doctor	New orders ready for reporting · STAT orders assigned to you · Orders waiting >24 h
Technician	QA-rejected orders (retake needed) · STAT orders newly assigned to you
Receptionist	Today's confirmed appointments not yet checked in
Patient	Finalized reports available in the last 7 days

DICOM Viewer

The system includes a full DICOM viewer accessible from the doctor worklist. The viewer supports window/level adjustment, zoom, pan, multi-series navigation, and measurements. On systems with OHIF configured, the full OHIF v3 viewer is loaded; otherwise a DWV-based viewer is used.

Access: Worklist → order row → "View Images" or directly via /Radiology/Viewer/Studies/{orderId}.

Reports

Radiology reports support structured fields (Findings, Impression, Recommendations, Critical Results flag) plus free-text. Templates can be applied from the "Apply Template" button.

The pathology module handles tissue specimen cases. Slides are digitized as Deep Zoom Images (DZI) and viewed in an OpenSeadragon-based whole-slide viewer.

Whole-Slide Viewer

Access from the case detail page → slide thumbnail → opens full-viewport slide viewer. Supports pan, zoom (scroll wheel or pinch), and annotation marking (point, line, polygon). Annotations are stored per-user and per-slide.

Reports

Pathology reports include: Macroscopic Description, Microscopic Description, Diagnosis (bold, highlighted), ICD-10 code, SNOMED code, and Critical Result flag. Finalized reports can be printed with a "DRAFT" watermark removed.

Manages ophthalmic exam cases and imaging (fundus photos, OCT, visual field, fluorescein angiography).

Image Viewer

Access: Report Edit page → "View Images" button → full-viewport dual-pane viewer with OD (right eye) and OS (left eye) panels. Supports zoom (scroll wheel), pan, rotation, invert (for negative contrast), and fullscreen (double-click). Filter images by modality (OCT, Fundus, etc.) using the pills at the top.

Reports

Ophthalmology reports capture: Visual Acuity (VA), Intraocular Pressure (IOP), structured exam fields per eye, and free-text findings/impression.

Handles dental encounters with X-ray imaging (Periapical, Bitewing, OPG, CBCT, Cephalometric) and interactive odontogram.

Dental X-Ray Viewer

Access: Report Edit page → "View X-Rays" button → image viewer organized by X-ray type. Filter by Periapical / Bitewing / OPG / CBCT using the pills. Supports zoom (scroll wheel), pan, rotate, invert, and fullscreen.

Interactive Odontogram (FDI)

The report form includes an FDI-standard tooth chart (16 upper + 16 lower teeth, numbered 11-18 / 21-28 / 31-38 / 41-48). Right-click any tooth to set its condition: Normal / Caries / Crown / Root Canal / Filling / Missing / Extraction. Conditions are color-coded and saved with the report.

Reports

Dentistry reports include chief complaint, examination findings, treatment plan, and the serialized tooth chart.

Manages EEG studies with EDF file support for multi-channel brainwave recording and analysis.

EEG Recording Viewer

Access: Report Edit page → "View EEG Recording" → full-viewport waveform viewer. Features: 30-second per-page streaming, channel-by-channel display (Plotly.js), seek bar, zoom, and annotation markers. Annotate events (spikes, seizures, artifacts) with timestamps — annotations are visible in the report.

Reports

EEG reports include: Background Activity, EEG Classification (Normal / Abnormal-Epileptiform / Abnormal-Diffuse / Artifact-Rich), Abnormal Findings, Clinical Correlation, and Recommendations. A summary of recorded annotations is shown alongside the report form.

Patients can book appointments for any specialty module (Pathology, Ophthalmology, Dentistry, EEG) from the patient portal at My Services → Specialty Services (/SpecialtyBooking).

Booking Steps

1. Patient Portal → Specialty Services hub.
2. Select a specialty card (Pathology, Ophthalmology, Dentistry, or EEG).
3. Choose a Service Type from the specialty-specific list (e.g. OCT, CBCT, Routine EEG, Biopsy).
4. Pick a date, time, center, add clinical indication if applicable, and submit.
5. Appointment appears in My Specialty Appointments with status Pending.

Managing Appointments

From My Specialty Appointments (/SpecialtyBooking/MyAppointments) patients can Cancel a pending appointment or Request Reschedule (sets status to RescheduleRequested — a receptionist will confirm the new date).

Viewing Results

My Specialty Results (/SpecialtyBooking/MyResults) lists all finalized/signed records across all specialty modules in one place, with a direct "View Report" link for each.

Access: Navigation → Reception → Specialty Check-In (/SpecialtyCheckIn).

Workflow

1. Select the specialty tab (Pathology / Ophthalmology / Dentistry / EEG) and optionally filter by center.
2. The list shows today's confirmed appointments for that specialty.
3. Click Check In next to a patient — this simultaneously:
   • Sets appointment status to CheckedIn.
   • Creates the linked specialty record (PATH Case / OPH Exam / DENT Encounter / EEG Study).
   • Creates a pending billing entry for the procedure.
4. A Open Record button appears — click to navigate directly to the new case/exam/encounter/study.

Note: An appointment must be in Confirmed status to appear in the check-in list. Admin can confirm pending appointments from Admin → Specialty Appointments.

Accessed from the Admin dropdown → Specialty Modules section, or directly via:

URL	Purpose
/Admin/Specialty/Pathology	Paginated list of PATH Cases with status filter
/Admin/Specialty/Ophthalmology	Paginated list of OPH Exams
/Admin/Specialty/Dentistry	Paginated list of DENT Encounters
/Admin/Specialty/EEG	Paginated list of EEG Studies
/Admin/Specialty/Appointments	All specialty appointments with specialty + status filters

Admin Dashboard KPIs

The admin dashboard now includes a Specialty Modules — Today row showing today's record count and total open (unsigned) records for each specialty, with direct links to the management pages.

Confirming Appointments

In Specialty Appointments, Pending appointments have a Confirm button — clicking confirms the appointment so it appears in the receptionist's check-in list.

The appointment reminder background service automatically sends email reminders for specialty appointments:

• 24-hour reminder — sent each day at 09:00 for all confirmed/pending specialty appointments the following day.
• 1-hour reminder — sent every hour for appointments starting within the next 60 minutes.

Reminders include the specialty name, service type, date, time, and priority. No admin action is required — reminders fire automatically.

When a receptionist checks in a specialty appointment, the system automatically creates a Pending billing entry linked to the new specialty record. This entry appears in the admin billing dashboard (/Admin/Billing).

The auto-created entry has a TotalAmount = 0 (to be priced by billing staff) and uses the invoice format SPEC-YYYY-NNNNN. Notes include the specialty name, service type, and original appointment ID for traceability.

Billing staff should open the entry, set the service amount, and update the status to Paid once payment is received.

Signed or Reported specialty records can be amended by the admin from the specialty management lists.

How to Amend

1. Navigate to the specialty management list (e.g. /Admin/Specialty/Pathology).
2. Find the record with status Signed or Reported.
3. Click the Amend button — an amendment dialog appears.
4. Enter the amendment reason and click Confirm Amendment.

Effect of Amendment

• The most recent Final report for that record is marked Amended.
• The amendment reason is stored (in the AmendmentReason field for Pathology and EEG; in the report status for Ophthalmology and Dentistry).
• The parent record status reverts to Reported, allowing the specialist to re-sign after revision.

Admin can create and manage Radiology Centers (branches), each with its own rooms and modalities. Rooms are linked to modality types (CT, MRI, X-Ray, Ultrasound, etc.) and must be marked Active and Available to appear in the check-in assignment dropdown.

The billing module generates invoices per order, tracks payment status, and manages insurance claims. Insurance eligibility is automatically checked at check-in when configured. Invoices include QR codes linking to the online invoice.

The Analytics dashboard provides volume trends, turnaround times, and utilization rates per modality. The Quality Assurance dashboard tracks peer reviews, report corrections, and TAT (Turnaround Time) metrics. The QA Image Review queue manages pre-report image quality control.

Admins can configure the content of automated appointment reminder messages sent to patients. Access via Admin menu → Reminder Settings (or directly at /Admin/ReminderSettings).

Master Toggle

The Enable Appointment Reminders switch at the top enables or disables all reminders globally. When disabled, no reminders are sent regardless of individual settings.

Reminder Schedule

By default two reminder slots are configured:

• 24-Hour Reminder — sent the day before the appointment
• 1-Hour Reminder — sent 60 minutes before the appointment

Each reminder can be toggled Active / Inactive independently using its own switch.

Message Templates

Each reminder has separate English and Arabic tab panels. Each panel contains a Subject field (for email subject / SMS title) and a Body field (message text). Templates support the following tokens that are replaced with real values at send time:

Token	Replaced with
{PatientName}	Patient's full name
{AppointmentDate}	Date of the appointment (formatted)
{AppointmentTime}	Time of the appointment
{CenterName}	Radiology center name
{Modality}	Imaging modality (e.g. MRI, CT)
{OrderNumber}	System order reference number

Click any token chip at the top of the page to copy it to the clipboard, then paste it into the subject or body field.

All image viewers share the same controls: scroll to zoom, drag to pan, double-click for fullscreen, R to rotate, I to invert. Use the type filter pills at the top of the sidebar to show only images of a specific type (e.g. OCT, OPG). Ophthalmology viewer has separate OD/OS panes — use the pane header tabs to switch focus.

Every finalized report has a Print PDF button. This opens a print-optimized page (A4, no navigation chrome). To save as PDF:

1. Click Print PDF
2. Browser print dialog opens → select Save as PDF as destination
3. Set paper size to A4, margins None or Minimum
4. Enable Background graphics to preserve colors and logos
5. Save

The Patient Timeline aggregates all of a patient's visits, studies, cases, and reports across all modules into a single chronological view.

Access: any module's case/exam/study detail page → "Patient Timeline" button, or directly via /PatientTimeline?id={patientId}.

Use the module filter pills at the top to show only a specific specialty. Each event card links directly to the relevant detail page.

The admin dashboard now shows a Today's Activity row beneath the summary KPI cards, with six real-time counters:

• Appointments Today — scheduled for today's date.
• Checked-In Today — patients who completed check-in.
• Uploaded Today — DICOM studies uploaded.
• Reported Today — reports finalized.
• STAT Pending — STAT-priority orders awaiting reading. Highlighted in red when > 0.
• QA Queue — studies in the QA / upload queue.

Cards auto-refresh on page load. Navigate to Admin → Dashboard to view.

Patients can add any upcoming appointment to their personal calendar (Google Calendar, Outlook, Apple Calendar) with a single click.

1. Go to Patient Portal → My Appointments.
2. Click Add to Calendar on any future appointment.
3. The browser downloads an .ics file. Open it to add the event to your calendar app.

The event includes the appointment date, time, location (center name), and a 1-hour reminder alarm.

Admins can view a turnaround time (TAT) performance table for all radiologists. Navigate to Admin → Doctor TAT Report.

• Avg TAT (h) — average hours from upload to report finalization.
• STAT Compliance % — percentage of STAT studies reported within 1 hour.
• Overdue Count — studies that took more than 48 hours.
• Total Reports — number of finalized reports in the period.

Use the date-range filter to narrow the period, or click Export Excel for a spreadsheet.

Admins can reassign multiple orders to a different doctor from the doctor worklist in one operation.

1. Go to Doctor → Appointment Orders (logged in as Admin).
2. A Bulk Assign bar appears at the top. Check the boxes next to the desired orders.
3. Select the target doctor from the drop-down, then click Assign.
4. A confirmation shows how many orders were updated.

This feature is only visible to users with the Admin role.

The print queue gives admins a consolidated view of all finalized reports ready for physical printing.

• Navigate to Admin → Print Queue.
• Use the quick search box to filter by patient name or code.
• Check individual rows or use Select All, then click Print All Visible to open each report's print view in a new browser tab.

Patients can manage their upcoming appointments directly from the patient portal.

Cancel

1. Go to My Appointments.
2. Click Cancel on a future, non-cancelled appointment.
3. Confirm the cancellation. The appointment status changes to Cancelled.

Request Reschedule

1. Click Request Reschedule and enter a preferred new date/note.
2. The status changes to RescheduleRequested; reception staff will contact you to confirm the new time.

Note: Actions are only available for appointments that are in the future and not yet cancelled or already rescheduled.

Every status change on a radiology order is recorded in a history trail, providing full traceability for compliance and auditing.

• Each record captures: From Status → To Status, who made the change, and the timestamp.
• Stored in the RIS_OrderStatusHistory table.
• Admins and doctors can view the trail on the order detail / report page.

This supports QA investigations and incident reviews.

The reminder log tracks every automated appointment reminder dispatched by the system. Navigate to Admin → Reminder Log.

Column	Description
Sent At	Timestamp when the reminder was sent.
Type	24h (day-before) or 1h (one-hour-before).
Channel	SMS, Email, or WhatsApp.
Status	Sent (green) or Failed (red).
Preview	First line of the message body.

Use the date-range and status filters to narrow results. Stats at the top show Total / Delivered / Failed counts.

Requesting (Doctor)

1. Open any finalized report in the report writing screen.
2. Click Request 2nd Opinion (orange button, bottom of form).
3. Optionally select a specific radiologist, add notes, and click Submit Request.

Reviewing (Assigned Doctor)

1. The assigned doctor sees the request under Doctor → Second Opinion Requests.
2. Click Submit Opinion, type the findings, and submit.
3. The second opinion report is linked to the original and marked Completed.

Admins can see all pending requests; doctors see only those assigned to them.

The audit log provides a complete compliance trail of every significant action in the system. Navigate to Admin → Audit Log.

• Filter by date range, username, or action type (e.g., ReportFinalized, Login, Delete).
• Action colors: green = finalized, red = delete, blue = login.
• Click Export CSV to download the filtered set for compliance reporting.
• Pagination: 50 rows per page.

A digital consent form is now captured at check-in before the patient is assigned to a technician.

1. Reception staff clicks Check In for a patient.
2. A Patient Consent Form modal appears with the procedure consent text.
3. The patient signs in the signature box using a mouse, touch screen, or stylus.
4. Click Sign & Continue Check-In. The signature is saved as a base-64 PNG image against the order.
5. The technician assignment modal then opens as usual.

Signatures are stored in the RIS_ConsentForms table and are accessible for compliance review.

The platform walks every unacknowledged critical radiology finding through a configurable escalation ladder. Each tier fires at most once per record and notifies a different set of recipients — typically reporting doctor first, then admin, then medical director.

How it works

• A background service checks every 15 minutes (configurable via CheckIntervalMinutes).
• For every RIS_CriticalResultAck with Status = Open, the service finds the highest tier whose AfterHours threshold has been crossed and has not yet fired for this record.
• Tier 1 by default notifies the reporting doctor automatically (resolved from the report's doctor email).
• Each subsequent tier emails the addresses listed under its Emails array.
• After a successful send, the record's LastEscalatedTier and LastEscalatedAt are updated so the same tier never re-fires.

Default ladder (configurable)

Tier	Fires after	Recipients
1	1 hour	Reporting doctor (auto)
2	2 hours	Admin email(s)
3	4 hours	Medical director email(s)

Admin Settings Page

Navigate to Admin → Critical Escalation to:

• See the configured tier ladder rendered as cards (label, threshold, recipients).
• See every open critical result with: age, last tier reached, next tier ETA.
• Acknowledge individual items directly from the table.
• Click Trigger Escalation Check Now to run a manual pass.

Configuration

All tiers live in appsettings.json under "CriticalEscalation":

"CriticalEscalation": {
  "CheckIntervalMinutes": 15,
  "NotifyReportingDoctor": true,
  "Tiers": [
    { "Tier": 1, "AfterHours": 1, "Label": "Reporting Doctor",  "Emails": [] },
    { "Tier": 2, "AfterHours": 2, "Label": "Admin",             "Emails": [ "admin@emalaf.com" ] },
    { "Tier": 3, "AfterHours": 4, "Label": "Medical Director",  "Emails": [ "medical-director@emalaf.com" ] }
  ]
}

Database

Schema migration 023_CriticalResultEscalationTracking.sql adds two columns to RIS_CriticalResultAcks: LastEscalatedAt and LastEscalatedTier. Both are idempotent (IF NOT EXISTS) and safe to re-run.

"CriticalEscalation": {
  "CheckIntervalMinutes": 15,
  "NotifyReportingDoctor": true,
  "Tiers": [
    { "Tier": 1, "AfterHours": 1, "Label": "Reporting Doctor",  "Emails": [] },
    { "Tier": 2, "AfterHours": 2, "Label": "Admin",             "Emails": [ "admin@emalaf.com" ] },
    { "Tier": 3, "AfterHours": 4, "Label": "Medical Director",  "Emails": [ "medical-director@emalaf.com" ] }
  ]
}

A platform-wide pass focused on production safety. Two themes: (1) real database-backed authentication replaced the legacy placeholder login, and (2) features that were silently stubbed are now clearly marked Soon in the UI instead of returning fake-success responses.

Authentication

• Real DB-backed login. The login form now queries CommonUser + Role, verifies the password, and issues claims that reflect your actual database role. Previously a placeholder inferred your role from substrings in your email address.
• Role-aware redirect. Doctor → /DoctorReport/AppointmentOrders. Patient → /PatientPortal. Receptionist → /ReceptionCheckIn. Technician → /TechnicianUpload. Admin → /Admin/AdminDashboard. The four specialty roles land on their module home.
• Role-name normalization. The legacy database had a typo ("Recieption" → now stored as "Receptionist") and a short form ("Technician" → mapped to "Radiology Technician"). Both are handled automatically.
• Database hardening script. Scripts/024_AuthAndRoleHardening.sql adds the five missing platform roles (Radiology Technician, Pathologist, Ophthalmologist, Dentist, Neurophysiologist) and three login-path indexes.

Features now showing "Soon"

These features have a UI surface but no working backend yet. They are intentionally disabled until the backend ships, so you never click a button and get a 0-byte file or a fake "Success" toast.

• PDF report download Live — now generates a real PDF via headless Chromium. See the dedicated section below.
• DICOM measurement save / export Live — measurements are persisted server-side and reload with the study.
• SMS reminders Live — real Twilio integration, activates when Twilio env vars are set on the server.
• WhatsApp reminders Live — same Twilio integration, separate sender number.
• Insurance verification Soon — still manual mode. Waiting for NPHIES sandbox credentials to activate real payer API.

Honest failure responses

Behind the scenes, the matching service methods now return an explicit { success: false, notImplemented: true } response (or log a warning), instead of falsely signalling success. This means:

• Audit logs accurately reflect what was sent vs dropped.
• Future integrations can detect "not yet wired" responses programmatically.
• Operations teams see real-time warnings in logs when stubbed features are exercised.

The remainder of the roadmap shipped in a single multi-feature push. Every item below is live in production; activation notes are inline where an external account or env var is required.

1 · PDF report download — real PDFs

Patient screens now download an actual A4-formatted PDF (was a 0-byte placeholder before). Generated via headless Chromium from a print-optimized view. Includes the Emalaf header, patient panel, study panel, findings / impression / recommendations sections, doctor signature, and a QR code linking back to the online verification URL. Bilingual EN/AR — the PDF respects the current language toggle.

2 · DICOM measurements persist

When you annotate a DICOM study with the measurement tools (ruler / arrow / area / etc.), clicking Export now saves your work to the server. The next time anyone opens the same study, your measurements are loaded back into the viewer.

3 · Smart phrase library

While writing a report, type /cxr-normal (or any other trigger) and press Tab. The trigger is replaced with the full body text. Four starter shared phrases ship out of the box: /cxr-normal, /ct-head-normal, /us-abd-normal, /signoff. Admins manage the library at /Admin/SmartPhrase; doctors can add personal phrases visible only to themselves.

4 · System Health dashboard

Admins get a live operational view at /Admin/SystemHealth — database latency, S3 connectivity, queue depths (draft reports / open critical results / pending reminders / orders awaiting imaging), and process info (uptime, GC memory, thread count). Auto-refreshes every 30 seconds. Useful for on-call to spot issues without grepping logs.

5 · SMS & WhatsApp reminders via Twilio

The notification pipeline now sends real SMS and WhatsApp messages once the Twilio environment variables are set on the server (TWILIO_ACCOUNT_SID, TWILIO_AUTH_TOKEN, TWILIO_FROM_NUMBER, TWILIO_WHATSAPP_FROM_NUMBER). When the variables are absent, the system logs a warning and continues sending email — the same behavior as before.

6 · Patient ↔ Doctor secure messaging

New Messages link in the navbar for both Patient and Doctor roles. Inbox shows your conversations sorted by latest activity. Open a thread to see the message timeline (chat-bubble UI) and reply. Patient sees only doctors who have treated them; doctor sees only patients with shared orders. File attachments up to 10 MB per message are uploaded to S3 and rendered as paperclip download chips in the timeline. Unread count surfaces in the notification bell.

7 · Voice dictation in the report editor

Each report textarea (Findings, Impression, Recommendations, Full Report) has a microphone icon next to its label. Click it to start dictating; click again to stop. Browser does the speech-to-text locally — no server roundtrip, no API key, no cost. Language follows the UI culture (en-US or ar-SA). On browsers that don't support speech (notably Safari on iOS), the mic icon is hidden automatically.

8 · PWA — install on home screen

The app is now installable as a Progressive Web App. On a phone, open the browser menu and choose Add to home screen — Emalaf installs an app icon and opens in standalone mode (no browser chrome). Includes app shortcuts for My Reports, Book Appointment, and Messages. No patient data is cached on the device — every API call goes to the server every time, so a lost phone never has PHI sitting on its disk.

9 · DZI viewer for high-resolution pathology slides

Whole-slide images (SVS, NDPI, big TIFF) are now tiled into a Deep-Zoom pyramid by a background worker and served from S3. A 1 GB slide takes 30–90 seconds to tile after upload. Once tiled, pathologists can pan and zoom in OpenSeadragon without downloading the entire file. Admins / pathologists trigger tiling for a specific file with POST /DicomView/QueueDziTiling?fileId=<id>; the system also exposes GET /DicomView/GetDziManifest?fileId= (status + manifest URL) and GET /DicomView/GetDziTile?fileId=&level=&col=&row= (individual tiles).

10 · PACS connector (bidirectional, fo-dicom)

Inbound: Emalaf accepts DICOM C-STORE pushes from modalities on TCP port 11112 (configurable). Received instances are stored in S3 and recorded with OrderType="PacsInbound" for admin reconciliation to a real order. The listener also responds to C-ECHO heartbeats from modalities.

Outbound: Admins configure remote PACS endpoints at /Admin/PacsConfig. Each row holds host, port, our AE Title, and their AE Title. Click Ping to send a C-ECHO and confirm reachability. Admins can issue C-FIND queries to discover studies on the remote and C-MOVE requests to pull selected studies into Emalaf.

Activation: open inbound TCP 11112 on the app server's firewall, and ensure remote modalities / PACS systems whitelist our AE Title (default EMALAF) on their side.

11 · Authentication hardening

BCrypt-on-next-login: every successful sign-in re-hashes the plaintext password column in place, gradually migrating all accounts to BCrypt over ~90 days without forcing a mass password reset. Failed-login rate limit: 5 attempts per (email + IP) in a 15-minute sliding window. Self-registration now creates a real CommonUser row (was a silent dead-end before) so registered patients can actually log back in.

12 · Audit log search (admin)

Every login, report finalization, critical-result acknowledgement, and other key actions are written to RIS_AuditLog. Admins query this at /Admin/AuditLog with filters by user, date range, and action — useful for compliance audits ("who accessed patient X's report on day Y") and CSV export.

13 · Admin dashboard overview

Reference of the admin landing page — appears the moment an Admin signs in. Shows total orders, completion stats, daily activity counts, specialty-module breakdowns, and a queue-management table.

The platform now ships under the unified Emalaf brand. The product is no longer a single radiology portal — it is a five-module medical platform with a dedicated landing page (the Hub) and per-module identities.

• Hub (/Hub) — platform-level landing that lists every module a center has access to.
• Per-module branding — every page shows the active module name and tagline ("Emalaf · Radiology", "Emalaf · Pathology", …). The brand resolves automatically from the active subdomain or query string.
• Per-module logos — ~/images/logo.jpg for the Hub and ~/images/logosmall.png for every specialty module.
• Browser tab title now reads "{Page Title} · Emalaf · {Module}" — no more legacy "RIS" suffix.

A new dropdown in the top-right of the navbar lets any user switch between modules without losing their session. The currently-active module is shown with its icon and color.

• Click the module chip → see the full list of platform modules.
• Platform Hub is always at the top.
• Modules not yet activated for the center show a Soon badge and are non-clickable.

Every module is reachable by its own subdomain. The platform detects the host and activates the matching module automatically:

Subdomain	Module
hub.emalaf.com	Platform Hub
ris.emalaf.com	Radiology
pathology.emalaf.com	Digital Pathology
ophthalmology.emalaf.com	Ophthalmology
dentistry.emalaf.com	Dentistry
eeg.emalaf.com	Neurophysiology / EEG

For local development you can override the active module by appending ?module=pathology (or any other module key) to any URL.

The legacy language dropdown has been replaced with a two-button toggle in the navbar. Pressing it sets the .AspNetCore.Culture cookie and reloads the page so every screen — including server-rendered @T[…] strings, navbar items, and dashboards — comes back in the selected language.

RTL layout activates automatically when Arabic is chosen: <html dir="rtl">, Cairo font, mirrored margins, reversed flow diagrams, RTL tables.

The entire platform now uses a single dark glassmorphic palette. The navbar, login, register, patient portal, admin dashboard, and every role workspace render with the same surface, border and accent tokens.

• Background #080f1f, glass surface rgba(255,255,255,.028), border rgba(255,255,255,.065).
• Accents — cyan #00b4d8, green #10b981, orange #f26419, purple #8b5cf6, red #ef4444.
• Implemented as a single global stylesheet ~/css/platform-dark.css loaded after the legacy modern-theme.css, so every page using shared classes (.kpi-card-modern, .chart-card, .content-card, .btn-modern, .table-modern, …) inherits the dark style without per-page edits.

A single idempotent SQL script (RIS_Portal/Scripts/022_FullSchemaSync.sql) consolidates the previous 019, 020, 021 migrations and adds defensive guards for every column and table that the dashboard plus all specialty modules touch.

• Adds Priority + 9 newer columns to RIS_RadiologyOrders.
• Creates RIS_SpecialtyAppointments, RIS_OrderStatusHistory, RIS_ReminderLog, RIS_AuditLog, RIS_CriticalResultAck, RIS_AppointmentReminder, RIS_AppointmentConfirmationToken, RIS_ReminderSettings.
• Creates the full Pathology, Ophthalmology, Dentistry and EEG module tables (PATH_*, OPH_*, DENT_*, EEG_*).
• Every CREATE and ALTER is wrapped in IF NOT EXISTS — safe to re-run.

Run with: sqlcmd -S .\SQLEXPRESS -d NewDicomV5 -i 022_FullSchemaSync.sql

This manual is delivered as a single HTML file so you can embed your own screenshots without re-deploying any code. Screenshots help new staff onboard faster than text descriptions alone — especially for the bilingual workflow where the same screen looks different in EN vs AR.

1 · Capture

• Windows: Win + Shift + S opens the snipping rectangle. The capture is in your clipboard and also saved to %USERPROFILE%\Pictures\Screenshots\.
• macOS: Cmd + Shift + 4 for a region, Cmd + Shift + 5 for the recorder UI.
• Capture at 1920×1080 or larger; the manual will scale it down for narrow screens.
• Use the dark theme of the app (the default) so screenshots match the manual's look.
• Blur or mask any patient PHI before saving — names, national IDs, phone numbers, MRN.

2 · Save into the manual folder

Save the file as PNG under RIS_Portal/wwwroot/manual-images/ using a descriptive name, e.g. doctor-appointment-orders.en.png for English or doctor-appointment-orders.ar.png for Arabic. Keep both languages so RTL screens are documented properly.

3 · Embed in the manual

Paste this snippet into the relevant section. The bilingual en-content / ar-content wrappers automatically hide the wrong language depending on the toggle.

<figure class="en-content">
  <img src="manual-images/doctor-appointment-orders.en.png"
       alt="Doctor's appointment queue"
       style="width:100%; max-width:900px; border:1px solid var(--border); border-radius:8px;"/>
  <figcaption style="color:var(--muted); font-size:.78rem; margin-top:6px;">
    The doctor's appointment queue showing assigned studies.
  </figcaption>
</figure>
<figure class="ar-content">
  <img src="manual-images/doctor-appointment-orders.ar.png"
       alt="طابور مواعيد الطبيب"
       style="width:100%; max-width:900px; border:1px solid var(--border); border-radius:8px;"/>
  <figcaption style="color:var(--muted); font-size:.78rem; margin-top:6px;">
    طابور المواعيد الخاص بالطبيب يعرض الفحوصات المسندة إليه.
  </figcaption>
</figure>

4 · Suggested screenshots to capture first

1. Login screen (the page admin/doctor/receptionist/patient/technician all start at).
2. Admin dashboard top KPI strip.
3. Doctor's "Appointment Orders" queue.
4. Reception check-in page with the new amber "manual verification mode" banner visible.
5. Reminder Settings page with the "email-only" amber banner.
6. Patient Portal home (the cards row).
7. DICOM viewer measurement tools panel with the "Soon" badge on the Export button.
8. Patient Reports page with a disabled PDF button visible.

The five screenshots starred above will document both the working feature and the new "Soon" UX, so future readers understand what status the platform was in when this version of the manual was published.

<figure class="ar-content">
  <img src="manual-images/doctor-appointment-orders.ar.png"
       alt="طابور مواعيد الطبيب"
       style="width:100%; max-width:900px; border:1px solid var(--border); border-radius:8px;"/>
  <figcaption style="color:var(--muted); font-size:.78rem; margin-top:6px;">
    طابور المواعيد الخاص بالطبيب.
  </figcaption>
</figure>