Oral cancer screening · Offline-first · Clinic devices
Screening that works where the internet doesn't.
OncoFix is a screening station for a clinic room. A health worker records a patient, captures the mouth under controlled light, and gets a structured assessment back in minutes — with no connection, no cloud account and no specialist needing to be in the building. When a network does appear, everything syncs and nothing is lost.
Why this exists
The disease is survivable. Getting seen in time is the hard part.
Oral cancer is one of the few cancers you can actually look at. Caught early it is treatable; caught late it is disfiguring and often fatal. The gap between those two outcomes is not usually medicine — it is access: the nearest person qualified to look properly is hours away, the referral is a guess, and the patient does not come back.
The places where that gap is widest are also the places with the worst connectivity. Which is why almost every digital screening tool built so far — upload a photo, wait for a server to answer — fails exactly where it is needed most. OncoFix starts from the opposite assumption: there is no internet, and the device has to be useful anyway.
Constraint 01
No connection
The screening must complete end to end with the network cable unplugged. Sync is a convenience that happens later, never a dependency.
Constraint 02
No specialist in the room
The person operating it is a health worker, not an oncologist. Every step has to be guided well enough that the output is consistent between two different operators on two different days.
Constraint 03
No IT department
It is one box in a clinic. It has to survive power cuts, update itself, and be recoverable without anyone travelling to it.
The visit
Six minutes, start to finish.
The whole product is shaped around one session with one patient, because a screening camp does forty of them in an afternoon and every extra step gets multiplied by forty.
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Intake
Who the patient is, and the history that actually matters for this condition — tobacco and betel use, alcohol, how long the complaint has been there. Short, in plain language, and answerable by the patient themselves.
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Guided capture
Fixed cameras under consistent lighting, so the image of a mouth taken in a dim rural clinic is comparable to one taken anywhere else. The operator is told what to frame rather than left to judge it.
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Breath reading
A sensor reading taken alongside the images, recorded as one more signal on the assessment rather than as an answer on its own.
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Assisted review
The captured session is analysed on the device itself and returns a structured assessment — what was seen, where, and how confident the model is about it. This runs locally; the images do not leave the machine to be looked at.
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The clinician decides
The assessment is presented to the person in the room, who agrees, disagrees or escalates. Their decision is what goes into the record — not the model's.
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Referral and follow-up
A patient flagged for a second look leaves with a record that a referral centre can actually act on, and the clinic keeps a list of who is owed a follow-up rather than trusting a notebook.
Offline-first
The network is a bonus, not a requirement.
Every patient, assessment and image is written to the device first and marked unsynced. When a connection appears — a phone hotspot, an evening at the district office, a satellite link that comes and goes — the queue drains in the background and the marks clear. Losing the connection halfway leaves the queue exactly where it was rather than half-uploaded.
Every connection the device makes is outbound. Nothing dials in to it, no port is opened for it, and no hospital network administrator is asked to make an exception — which is the difference between a device that gets installed and one that sits in a cupboard waiting for an IT approval that never comes.
Being clear about it
What OncoFix does not do.
A screening tool that oversells itself is worse than no screening tool, because the false reassurance travels further than the device does. So, plainly:
It does not diagnose anybody.
OncoFix is a screening aid. It helps a health worker decide who needs to be looked at again by someone more qualified, and it makes that decision more consistent than an unaided glance. It is not a substitute for examination, biopsy or a specialist opinion, and it never returns a diagnosis.
- A clean result is not an all-clear, and the record does not present it as one.
- A flagged result is a reason to refer, not a finding to tell a patient.
- The clinician's decision overrides the assessment and is what gets recorded.
- Clinical validation and regulatory clearance are their own work, separate from the software, and are not claimed here.
The fleet
A hundred boxes in a hundred clinics, none of which you can visit.
A device deployed to a rural clinic cannot be maintained by sending someone. So the fleet layer was built as a product in its own right, and it runs independently of the screening application — if the medical software crashes or is deleted entirely, the device still reports in and can still be recovered remotely.
- ProvisioningA new unit registers itself on first connection. Nobody types a configuration file in a clinic.
- HeartbeatRegular check-ins carrying disk, memory, load and whether the screening service is actually up — queued locally while offline and flushed later.
- Remote commandsRestart the service, reboot the box, pull the logs, run a health check — all requested by the device on its own schedule, never pushed into the clinic's network.
- Updates that can fail safelyDownloaded in the background, installed at a sensible moment, and rolled back automatically if the application does not come back up.
- Sync bridgeScreening records leave the device only when a connection exists, and only in the direction they are meant to travel.
Status
In clinical build.
The device, the screening flow, the offline record and the fleet layer exist and run. What comes next is field work: more captured sessions, more clinicians disagreeing with the model, and the validation that has to be done properly before anything on this page is offered as a medical claim.