diff --git a/.env.example b/.env.example index 262f379..b8b7bf7 100644 --- a/.env.example +++ b/.env.example @@ -33,6 +33,15 @@ OPENAI_API_KEY=sk-your-openai-key # Leave unset to auto-detect (uses AWS when AWS_BEDROCK_REGION is configured). # TRANSCRIBE_PROVIDER=aws +# Option C: Local Whisper (privacy-first, no cloud API needed) +# Requires whisper.cpp or faster-whisper installed on the server. +# TRANSCRIBE_PROVIDER=local +# WHISPER_MODEL_SIZE=small # tiny, base, small, medium, large +# WHISPER_BINARY=whisper-cpp # or: whisper, faster-whisper +# WHISPER_MODEL_PATH= # custom path to .bin model file +# WHISPER_LANGUAGE=en +# WHISPER_THREADS=4 # defaults to CPU count - 1 + # Amazon Transcribe Medical — better accuracy for clinical dictation # Knows drug names, diagnoses, procedures, SOAP terminology # HIPAA eligible (ensure your AWS account has a BAA) diff --git a/public/components/chart.html b/public/components/chart.html index cb0c928..5a6d8c2 100644 --- a/public/components/chart.html +++ b/public/components/chart.html @@ -80,7 +80,7 @@

Instructions (optional)

- +
@@ -97,7 +97,7 @@
- +
diff --git a/public/components/dictation.html b/public/components/dictation.html index 8603e94..ff5447a 100644 --- a/public/components/dictation.html +++ b/public/components/dictation.html @@ -76,7 +76,7 @@
- +
diff --git a/public/components/encounter.html b/public/components/encounter.html index ca368ac..ff79907 100644 --- a/public/components/encounter.html +++ b/public/components/encounter.html @@ -73,7 +73,7 @@
- +
diff --git a/public/components/hospital.html b/public/components/hospital.html index 386b90d..77a369e 100644 --- a/public/components/hospital.html +++ b/public/components/hospital.html @@ -124,7 +124,7 @@

Additional Instructions (optional)

- +
@@ -145,7 +145,7 @@
- + diff --git a/public/components/sickvisit.html b/public/components/sickvisit.html index edafb0e..1e19a30 100644 --- a/public/components/sickvisit.html +++ b/public/components/sickvisit.html @@ -99,7 +99,7 @@
- +
diff --git a/public/components/wellvisit.html b/public/components/wellvisit.html index 52ffba2..7df535f 100644 --- a/public/components/wellvisit.html +++ b/public/components/wellvisit.html @@ -297,7 +297,7 @@
- +
diff --git a/public/css/styles.css b/public/css/styles.css index 6ba8b9f..1714f29 100644 --- a/public/css/styles.css +++ b/public/css/styles.css @@ -156,8 +156,9 @@ body{font-family:'Inter',system-ui,sans-serif;background:var(--g50);color:var(-- .model-tag{font-size:10px;padding:2px 7px;background:var(--g200);border-radius:4px;color:var(--g600);} /* REFINE BAR */ -.refine-bar{display:flex;gap:6px;padding:10px 16px;border-top:1px solid var(--g200);background:var(--g50);align-items:center;flex-wrap:wrap;} -.refine-input{flex:1;min-width:200px;padding:7px 12px;border:1.5px solid var(--g300);border-radius:6px;font-size:13px;font-family:inherit;} +.refine-bar{display:flex;gap:6px;padding:10px 16px;border-top:1px solid var(--g200);background:var(--g50);align-items:flex-start;flex-wrap:wrap;} +.refine-input{flex:1;min-width:200px;padding:7px 12px;border:1.5px solid var(--g300);border-radius:6px;font-size:13px;font-family:inherit;resize:vertical;} +textarea.full-input{resize:vertical;} .refine-input:focus{outline:none;border-color:var(--blue);box-shadow:0 0 0 3px var(--blue-light);} /* CLARIFY BOX */ diff --git a/src/routes/hospitalCourse.js b/src/routes/hospitalCourse.js index a95900e..4539b8b 100644 --- a/src/routes/hospitalCourse.js +++ b/src/routes/hospitalCourse.js @@ -81,7 +81,7 @@ router.post('/generate-hospital-course', authMiddleware, async (req, res) => { prompt += `\n\nADDITIONAL INSTRUCTIONS FROM PHYSICIAN:\n${additionalInstructions}`; } - if (physicianMemories) clinicalData += '\n\n[PHYSICIAN TEMPLATES — use as formatting reference only]\n' + physicianMemories + '\n[END TEMPLATES]'; + if (physicianMemories) clinicalData += '\n\n[PHYSICIAN PREFERENCES & LEARNED PATTERNS — Apply these preferences to your output. These reflect how this physician writes notes, their preferred style, terminology, and corrections from past outputs. Adapt your response accordingly, but user instructions in the current prompt take priority if they conflict.]\n' + physicianMemories + '\n[END PREFERENCES]'; const result = await callAI([ { role: 'system', content: prompt }, diff --git a/src/routes/hpi.js b/src/routes/hpi.js index ed86c08..853f988 100644 --- a/src/routes/hpi.js +++ b/src/routes/hpi.js @@ -13,7 +13,7 @@ router.post('/generate-hpi-encounter', authMiddleware, async (req, res) => { const prompt = setting === 'inpatient' ? PROMPTS.hpiInpatient : PROMPTS.hpiEncounter; var context = `Patient: ${patientAge || 'Unknown'}, ${patientGender || 'Unknown'}\nSetting: ${setting || 'outpatient'}\n\nTRANSCRIPT:\n${transcript}`; - if (physicianMemories) context += '\n\n[PHYSICIAN TEMPLATES — use as formatting reference only]\n' + physicianMemories + '\n[END TEMPLATES]'; + if (physicianMemories) context += '\n\n[PHYSICIAN PREFERENCES & LEARNED PATTERNS — Apply these preferences to your output. These reflect how this physician writes notes, their preferred style, terminology, and corrections from past outputs. Adapt your response accordingly, but user instructions in the current prompt take priority if they conflict.]\n' + physicianMemories + '\n[END PREFERENCES]'; const result = await callAI([ { role: 'system', content: prompt }, @@ -35,7 +35,7 @@ router.post('/generate-hpi-dictation', authMiddleware, async (req, res) => { const prompt = setting === 'inpatient' ? PROMPTS.hpiInpatient : PROMPTS.hpiDictation; var context = `Patient: ${patientAge || 'Unknown'}, ${patientGender || 'Unknown'}\nSetting: ${setting || 'outpatient'}\n\nDICTATION:\n${transcript}`; - if (physicianMemories) context += '\n\n[PHYSICIAN TEMPLATES — use as formatting reference only]\n' + physicianMemories + '\n[END TEMPLATES]'; + if (physicianMemories) context += '\n\n[PHYSICIAN PREFERENCES & LEARNED PATTERNS — Apply these preferences to your output. These reflect how this physician writes notes, their preferred style, terminology, and corrections from past outputs. Adapt your response accordingly, but user instructions in the current prompt take priority if they conflict.]\n' + physicianMemories + '\n[END PREFERENCES]'; const result = await callAI([ { role: 'system', content: prompt }, diff --git a/src/routes/sickVisit.js b/src/routes/sickVisit.js index 19a4aa3..0a7f76c 100644 --- a/src/routes/sickVisit.js +++ b/src/routes/sickVisit.js @@ -49,7 +49,7 @@ router.post('/sick-visit/note', authMiddleware, async function(req, res) { } if (physicianMemories) { - context += '[PHYSICIAN TEMPLATES — use as formatting reference only]\n' + physicianMemories + '\n[END TEMPLATES]\n\n'; + context += '[PHYSICIAN PREFERENCES & LEARNED PATTERNS — Apply these preferences to your output. These reflect how this physician writes notes, their preferred style, terminology, and corrections from past outputs. Adapt your response accordingly, but user instructions in the current prompt take priority if they conflict.]\n' + physicianMemories + '\n[END PREFERENCES]\n\n'; } var result = await callAI([ diff --git a/src/routes/soap.js b/src/routes/soap.js index 0eefc1d..64cf04c 100644 --- a/src/routes/soap.js +++ b/src/routes/soap.js @@ -21,7 +21,7 @@ router.post('/generate-soap', authMiddleware, async (req, res) => { } var context = `Patient: ${patientAge || 'Unknown'}, ${patientGender || 'Unknown'}\n\nINPUT:\n${transcript}`; - if (physicianMemories) context += '\n\n[PHYSICIAN TEMPLATES — use as formatting reference only]\n' + physicianMemories + '\n[END TEMPLATES]'; + if (physicianMemories) context += '\n\n[PHYSICIAN PREFERENCES & LEARNED PATTERNS — Apply these preferences to your output. These reflect how this physician writes notes, their preferred style, terminology, and corrections from past outputs. Adapt your response accordingly, but user instructions in the current prompt take priority if they conflict.]\n' + physicianMemories + '\n[END PREFERENCES]'; const result = await callAI([ { role: 'system', content: prompt }, diff --git a/src/routes/transcribe.js b/src/routes/transcribe.js index 6eff469..47e0fb8 100644 --- a/src/routes/transcribe.js +++ b/src/routes/transcribe.js @@ -3,6 +3,7 @@ const router = express.Router(); const multer = require('multer'); const { whisperClient } = require('../utils/ai'); const { transcribeWithAWS, isAWSTranscribeConfigured } = require('../utils/transcribeAWS'); +const { transcribeWithLocal, isLocalWhisperConfigured } = require('../utils/transcribeLocal'); const { authMiddleware } = require('../middleware/auth'); const upload = multer({ storage: multer.memoryStorage(), limits: { fileSize: 25 * 1024 * 1024 } }); @@ -14,6 +15,7 @@ const upload = multer({ storage: multer.memoryStorage(), limits: { fileSize: 25 // otherwise → use OpenAI Whisper function getTranscribeProvider() { var env = process.env.TRANSCRIBE_PROVIDER; + if (env === 'local') return 'local'; if (env === 'aws') return 'aws'; if (env === 'openai') return 'openai'; // Auto-detect: prefer AWS when Bedrock is already configured @@ -29,6 +31,11 @@ router.post('/transcribe', authMiddleware, upload.single('audio'), async (req, r try { if (!req.file) return res.status(400).json({ error: 'No audio' }); + if (provider === 'local') { + var text = await transcribeWithLocal(req.file.buffer, req.file.mimetype || 'audio/webm'); + return res.json({ success: true, text: text, provider: 'local-whisper' }); + } + if (provider === 'aws') { if (!isAWSTranscribeConfigured()) { return res.status(400).json({ error: 'AWS Transcribe not configured. Set AWS_BEDROCK_REGION.' }); diff --git a/src/routes/wellVisit.js b/src/routes/wellVisit.js index 0fce7ac..72bab44 100644 --- a/src/routes/wellVisit.js +++ b/src/routes/wellVisit.js @@ -187,7 +187,7 @@ router.post('/well-visit/note', authMiddleware, async function(req, res) { context += diagnoses + '\n\n'; } if (physicianMemories) { - context += '[PHYSICIAN TEMPLATES — use as formatting reference only]\n' + physicianMemories + '\n[END TEMPLATES]\n\n'; + context += '[PHYSICIAN PREFERENCES & LEARNED PATTERNS — Apply these preferences to your output. These reflect how this physician writes notes, their preferred style, terminology, and corrections from past outputs. Adapt your response accordingly, but user instructions in the current prompt take priority if they conflict.]\n' + physicianMemories + '\n[END PREFERENCES]\n\n'; } // Add growth reference and feeding guidance for this age diff --git a/src/utils/transcribeLocal.js b/src/utils/transcribeLocal.js new file mode 100644 index 0000000..fc3ddcd --- /dev/null +++ b/src/utils/transcribeLocal.js @@ -0,0 +1,178 @@ +// ============================================================ +// LOCAL WHISPER TRANSCRIPTION — uses whisper.cpp or faster-whisper +// ============================================================ +// Requires: whisper.cpp binary or faster-whisper-cli installed on the host. +// Set TRANSCRIBE_PROVIDER=local and optionally WHISPER_MODEL_SIZE, WHISPER_BINARY. + +var { execFile } = require('child_process'); +var fs = require('fs'); +var path = require('path'); +var os = require('os'); +var crypto = require('crypto'); +var logger = require('./logger'); + +var WHISPER_BINARY = process.env.WHISPER_BINARY || 'whisper-cpp'; +var WHISPER_MODEL_SIZE = process.env.WHISPER_MODEL_SIZE || 'small'; +var WHISPER_MODEL_PATH = process.env.WHISPER_MODEL_PATH || ''; +var WHISPER_LANGUAGE = process.env.WHISPER_LANGUAGE || 'en'; +var WHISPER_THREADS = process.env.WHISPER_THREADS || String(Math.max(2, os.cpus().length - 1)); + +/** + * Check if local Whisper is available + */ +function isLocalWhisperConfigured() { + return process.env.TRANSCRIBE_PROVIDER === 'local'; +} + +/** + * Detect which whisper binary is available + * Supports: whisper-cpp, whisper, faster-whisper + */ +function detectBinary(callback) { + var candidates = [WHISPER_BINARY, 'whisper-cpp', 'whisper', 'faster-whisper']; + var tried = 0; + function tryNext() { + if (tried >= candidates.length) return callback(null); + var bin = candidates[tried++]; + execFile(bin, ['--help'], { timeout: 5000 }, function(err) { + if (!err || (err.code !== 'ENOENT' && err.code !== 127)) return callback(bin); + tryNext(); + }); + } + tryNext(); +} + +/** + * Convert audio buffer to WAV using ffmpeg (whisper.cpp needs 16kHz mono WAV) + */ +function convertToWav(inputPath, callback) { + var wavPath = inputPath + '.wav'; + execFile('ffmpeg', [ + '-i', inputPath, + '-ar', '16000', + '-ac', '1', + '-f', 'wav', + '-y', wavPath + ], { timeout: 30000 }, function(err) { + if (err) return callback(err, null); + callback(null, wavPath); + }); +} + +/** + * Transcribe audio buffer using local Whisper + * @param {Buffer} audioBuffer - Audio data + * @param {string} mimeType - MIME type of the audio + * @returns {Promise} Transcribed text + */ +function transcribeWithLocal(audioBuffer, mimeType) { + return new Promise(function(resolve, reject) { + // Write buffer to temp file + var ext = '.webm'; + if (mimeType && mimeType.includes('wav')) ext = '.wav'; + else if (mimeType && mimeType.includes('mp3')) ext = '.mp3'; + else if (mimeType && mimeType.includes('ogg')) ext = '.ogg'; + else if (mimeType && mimeType.includes('mp4')) ext = '.mp4'; + + var tmpDir = os.tmpdir(); + var tmpFile = path.join(tmpDir, 'whisper_' + crypto.randomBytes(8).toString('hex') + ext); + + fs.writeFile(tmpFile, audioBuffer, function(err) { + if (err) return reject(new Error('Failed to write temp audio: ' + err.message)); + + // Convert to WAV for whisper.cpp compatibility + convertToWav(tmpFile, function(convErr, wavPath) { + var audioPath = convErr ? tmpFile : wavPath; + + detectBinary(function(binary) { + if (!binary) { + cleanup(tmpFile, wavPath); + return reject(new Error( + 'Local Whisper not found. Install whisper.cpp (https://github.com/ggerganov/whisper.cpp) ' + + 'or faster-whisper (pip install faster-whisper). Set WHISPER_BINARY env var if using a custom path.' + )); + } + + var args = buildArgs(binary, audioPath); + logger.info('[LocalWhisper] Running: ' + binary + ' ' + args.join(' ')); + + execFile(binary, args, { timeout: 120000, maxBuffer: 10 * 1024 * 1024 }, function(execErr, stdout, stderr) { + cleanup(tmpFile, wavPath); + + if (execErr) { + logger.error('[LocalWhisper] Error:', execErr.message); + if (stderr) logger.error('[LocalWhisper] stderr:', stderr.substring(0, 500)); + return reject(new Error('Local Whisper transcription failed: ' + execErr.message)); + } + + // Parse output — whisper.cpp outputs timestamped lines like [00:00:00.000 --> 00:00:05.000] text + var text = parseOutput(stdout); + if (!text || !text.trim()) { + return reject(new Error('Local Whisper returned empty transcription')); + } + + resolve(text.trim()); + }); + }); + }); + }); + }); +} + +/** + * Build command-line args based on the detected binary + */ +function buildArgs(binary, audioPath) { + if (binary.includes('faster-whisper')) { + // faster-whisper CLI + var args = ['--model', WHISPER_MODEL_SIZE, '--language', WHISPER_LANGUAGE]; + if (WHISPER_THREADS) args.push('--threads', WHISPER_THREADS); + args.push(audioPath); + return args; + } + + // whisper.cpp style + var args = ['-f', audioPath, '-l', WHISPER_LANGUAGE, '-t', WHISPER_THREADS, '--no-timestamps']; + if (WHISPER_MODEL_PATH) { + args.push('-m', WHISPER_MODEL_PATH); + } else { + // whisper.cpp uses model names like ggml-small.bin + args.push('-m', 'models/ggml-' + WHISPER_MODEL_SIZE + '.bin'); + } + // Medical vocabulary hint via initial prompt + args.push('--prompt', 'Medical patient encounter. Pediatric. Clinical terms, diagnoses, medications.'); + return args; +} + +/** + * Parse whisper output into clean text + */ +function parseOutput(stdout) { + if (!stdout) return ''; + // whisper.cpp with --no-timestamps outputs plain text + // whisper.cpp with timestamps: [00:00:00.000 --> 00:00:05.000] Hello world + var lines = stdout.split('\n'); + var text = []; + for (var i = 0; i < lines.length; i++) { + var line = lines[i]; + // Strip timestamp prefix if present + var match = line.match(/^\[[\d:.]+\s*-->\s*[\d:.]+\]\s*(.*)$/); + if (match) { + text.push(match[1].trim()); + } else if (line.trim() && !line.startsWith('whisper_') && !line.startsWith('main:')) { + // Plain text line (skip whisper.cpp log lines) + text.push(line.trim()); + } + } + return text.join(' '); +} + +/** + * Clean up temp files + */ +function cleanup(tmpFile, wavPath) { + try { fs.unlinkSync(tmpFile); } catch(e) {} + if (wavPath) { try { fs.unlinkSync(wavPath); } catch(e) {} } +} + +module.exports = { transcribeWithLocal, isLocalWhisperConfigured };