Mariner Health
Planning documents

Draft · v0.1

Product Requirements — Mariner Health

Mariner Health is a central care hub for parents and caregivers supporting individuals with possible or diagnosed ASD or ADHD. It helps families organize observations, medical and educational records, resources, and next steps before, during, and after evaluation.

1. Problem

Today's parents act as project managers across pediatricians, developmental specialists, therapists (OT, SLP, ABA), schools (IEP/504 teams), insurers, and pharmacies. Information is fragmented across patient portals, PDFs, emails, calendars, and school platforms. Parents lose time re-explaining history, miss follow-ups, and struggle to advocate at care-team meetings.

2. Non-goals for MVP

  • Not a medical device. Not a diagnostic tool. Not clinical decision support.
  • No replacement for a care team. Every recommendation is a preparation aid.
  • No PHI in the system until BAAs and a HIPAA review are complete.

3. Personas

A formal diagnosis is never required to create a profile or use organizational resources. The product supports families who are noticing early signs, waiting for evaluation, or coordinating established care after diagnosis.

  • Primary parent (owner): creates the family, uploads records, invites others.
  • Co-parent: full access to a child's records and settings.
  • Invited caregiver (grandparent, nanny): scoped read/comment access.
  • Care-team viewer (therapist, teacher): time-limited, per-document access.

4. The AI insight contract

Every AI-generated insight in the product MUST answer three questions and MUST refuse to render if any field is missing. This is enforced by a Zod schema on the server function that generates insights and by the InsightCard component.

type Insight = {
  conclusion: string;      // 1–2 sentences, plain language
  why: {
    source_doc_id: string; // uploaded document the insight came from
    page: number;          // page reference for citations
    quote: string;         // short excerpt supporting the conclusion
    guideline?: string;    // optional evidence-informed reference
  };
  next_step: string;       // one concrete action the parent can take
  confidence: "low" | "medium" | "high";
  disclaimer: "Not medical advice.";
};

5. MVP user stories

  1. As a parent, I can create a family and add one or more children without entering a diagnosis.
  2. As a parent or caregiver, I can record early observations and questions while a child is too young for diagnosis or waiting for evaluation.
  3. As a parent, I can invite a co-parent or caregiver with a specific role.
  4. As a parent, I can upload a document (IEP, evaluation report, visit summary) tied to a specific child.
  5. As a parent, I see the extracted summary and can correct fields before it's saved to the timeline.
  6. As a parent, I receive an AI insight card showing conclusion, source citation, and next step.
  7. As a parent, I can view a chronological timeline per child.
  8. As an owner, I can view an audit log of who accessed which records.
  9. As any user, I can revoke another caregiver's access at any time.
  10. As a parent, I can optionally add a profile photo of my child (stored in the private per-family bucket, opt-in, removable at any time, excluded from AI prompts).
  11. As a parent, I can opt in to a daily task summary delivered at a time I choose (default 7:00 AM local) via SMS or email, listing today's to-dos and upcoming appointments across all my children.
  12. As a parent, I can push those same to-dos to my preferred task app — Google Tasks, Apple Reminders, or Apple Notes — via per-user OAuth (App User Connectors), and revoke the integration at any time.
  13. As a parent, I can enable a hands-free reminder read-out through Amazon Alexa or Apple Home / Siri Shortcuts so reminders are spoken aloud on my smart speaker.
  14. As a parent, I can export an audience-tailored summary of my child's profile and progress (e.g. for a school counselor, new babysitter, or pediatrician), review it before sending, and optionally schedule it to recur on a chosen cadence.

5b. Audience-tailored export & recurring share

Parents can generate a shareable summary of a child's profile and progress. What appears in the export is filtered by audience preset so recipients only see what they need — an application of the HIPAA "minimum necessary" principle.

  • Audience presets (MVP):
    • School counselor / IEP team: diagnosis tags (if parent opts in), IEP/504 highlights, classroom accommodations, therapist recommendations relevant to school, upcoming school-relevant appointments. Excludes medications and clinical visit notes by default.
    • Babysitter / short-term caregiver: allergies, emergency contacts, current medications and dosing times, sensory/behavioral supports, comfort routines, sleep & meal preferences. Excludes diagnoses, evaluations, and full medical history.
    • Pediatrician / specialist: full medical timeline, medications, prior evaluations, therapy progress notes, growth & developmental milestones, insurance info. Excludes school-only artifacts unless attached.
    • Custom: parent hand-picks sections and individual documents.
  • Review-before-send: every export renders a preview screen. The parent must explicitly approve the contents; nothing leaves the system until they do. Preview shows a diff-style list of what will be included vs. hidden.
  • Delivery options: download PDF, copy a time-limited secure link (link expires and is revocable), or email directly to a saved recipient. Secure links require the recipient to verify via one-time code.
  • Recurring / automated exports: the parent can schedule any audience preset to send on a cadence (e.g. monthly to the school counselor, weekly to a co-parent). Each recurring share requires:
    • A named recipient with a verified delivery channel.
    • An auto-send toggle vs. a review-first toggle. Review-first sends the parent a notification with a preview link; nothing goes out until they approve.
    • A visible next-send date and a one-click pause/cancel.
  • Provenance & audit: every export writes an audit-log entry (who exported, audience preset, recipient, timestamp, included section IDs and document IDs, hash of the rendered payload). Recurring shares log every send.
  • AI-assisted summarization: when the export includes an AI-written narrative (e.g. "Progress since last month"), it follows the same 3-question contract — Conclusion / Why (with source citations) / Next step — and is clearly labeled as AI-generated and "not medical advice."
  • Consent: creating a recipient and enabling recurrence are separate consent actions in the Consent Center, revocable at any time. Revocation immediately cancels all pending scheduled sends for that recipient.

5a. Notification & task-integration details

  • Daily summary content: today's appointments, medication reminders, open insight "next steps," and any caregiver-assigned tasks. Never includes diagnoses, raw quotes from records, or other PHI beyond the minimum needed to act.
  • Channels: SMS (via a BAA-covered SMS provider only), email (via a BAA-covered transactional email provider only), and in-app.
  • Task-app sync: one-way push by default (Mariner Health → external app). Two-way sync is a roadmap item and requires explicit opt-in.
  • Voice assistants: Alexa Skill and Apple Shortcut. Voice replies contain task titles and times only — never clinical detail.
  • Consent: each channel and each integration is a separate toggle in the Consent Center and can be revoked without affecting the rest of the account.

6. Screen inventory (MVP)

  • Marketing / landing (public)
  • Sign in / sign up / MFA enrollment / password reset
  • Onboarding: create family → add child → invite co-parent
  • Child dashboard: timeline, recent documents, open insights
  • Document intake: upload → processing → extracted summary → confirm
  • Document detail: page viewer with citations back to insights
  • Insight detail: full Conclusion / Why / Next step view
  • Caregivers: list, invite, role change, revoke, audit log
  • Consent center: per-caregiver, per-child, per-data-type toggles
  • Child profile: name, DOB, optional diagnosis status/tags, optional profile photo, sharing settings
  • Notifications & integrations: daily summary schedule, SMS/email channel toggles, connected task apps (Google Tasks, Apple Reminders, Apple Notes), voice-assistant setup (Alexa, Apple Home)
  • Export center: audience preset picker, contents preview/diff, delivery method, recurring-share schedule, recipients list, send history
  • Account: profile, password, MFA, appearance (light / dark / system), sign out

7. Core workflow — upload to insight

Parent selects child
      │
      ▼
Drag & drop PDF / photo
      │
      ▼
Client-side: file type + size check, consent checkbox
      │
      ▼
Upload to private per-family Storage bucket
      │
      ▼
Server fn: OCR + structured extraction (min-necessary excerpt sent to AI)
      │
      ▼
Draft summary shown to parent for confirmation
      │
      ▼
On confirm: write to timeline + generate Insight (Conclusion/Why/Next step)
      │
      ▼
InsightCard rendered with citation link back to source page

8. Roadmap beyond MVP

  • Care-team calendar (Google/Apple/Outlook) with appointment prep packets
  • School integrations (IEP goal tracking, progress-note ingest)
  • FHIR portal connectors (Epic MyChart, Athena, Cerner) via SMART on FHIR
  • Insurance denial-appeal helper
  • Medication tracker with pharmacy sync
  • Native mobile apps