## Description

Brief description of the changes and their purpose.

Fixes #(issue number)

## Type of Change

Please delete options that are not relevant.

- [ ] Bug fix (non-breaking change which fixes an issue)
- [ ] New feature (non-breaking change which adds functionality)
- [ ] Breaking change (fix or feature that would cause existing functionality to not work as expected)
- [ ] Documentation update
- [ ] Security improvement
- [ ] Performance improvement
- [ ] Code refactoring

## Medical Data and Compliance

- [ ] This change affects PHI (Protected Health Information) handling
- [ ] This change affects DICOM processing
- [ ] This change affects encryption/decryption
- [ ] This change affects audit logging
- [ ] HIPAA compliance reviewed
- [ ] GDPR compliance reviewed
- [ ] No compliance implications

## Security Review

- [ ] This change affects cryptographic operations
- [ ] This change affects key management
- [ ] This change affects data sanitization
- [ ] Security implications reviewed
- [ ] No security implications

## Testing

- [ ] Tests added for new functionality
- [ ] Tests updated for changed functionality
- [ ] All existing tests pass
- [ ] Security tests included
- [ ] Integration tests updated
- [ ] Manual testing completed

## Code Quality

- [ ] Self-review of own code completed
- [ ] Code follows the style guidelines
- [ ] Linting passes (black, flake8)
- [ ] Type hints added where appropriate
- [ ] Docstrings added/updated
- [ ] Comments added for complex logic

## Documentation

- [ ] README.md updated
- [ ] API documentation updated
- [ ] Usage examples updated
- [ ] Security documentation updated
- [ ] No documentation changes needed

## Backwards Compatibility

- [ ] This change is backwards compatible
- [ ] This change requires a major version bump
- [ ] Migration guide provided for breaking changes
- [ ] Deprecation warnings added for removed features

## Performance Impact

- [ ] Performance impact assessed
- [ ] Benchmarks run (if applicable)
- [ ] Memory usage considered
- [ ] No performance impact

## Deployment Considerations

- [ ] Environment variables changes documented
- [ ] Configuration changes documented
- [ ] Database migration required
- [ ] KMS configuration changes required
- [ ] No deployment considerations

## Additional Notes

Add any other context about the pull request here.

### Screenshots

If applicable, add screenshots to help explain your changes (ensure no PHI is visible).

### Related Issues

List any related issues or dependencies.

## Reviewer Checklist

For reviewers to complete:

- [ ] Code review completed
- [ ] Security review completed (if applicable)
- [ ] Medical compliance review completed (if applicable)
- [ ] Testing verified
- [ ] Documentation reviewed
- [ ] Ready to merge
