tighten chart review source coverage

public/js/chartReview.js

@@ -13,6 +13,12 @@
 
   var visitIndex = 1;
 
+  function getVisitContent(card) {
+    var el = card.querySelector('.visit-content');
+    if (!el) return '';
+    return (el.innerText || el.textContent || '').trim();
+  }
+
   function resetChartReview() {
     // Clear demographics and fields
     ['cr-age', 'cr-pmh', 'cr-instructions', 'chart-label'].forEach(function(id) {
@@ -91,7 +97,7 @@
     var edVisits = [];
 
     visitsContainer.querySelectorAll('.visit-card').forEach(function(card) {
-      var content = card.querySelector('.visit-content').innerText.trim();
+      var content = getVisitContent(card);
       if (!content) return;
       var vType = card.querySelector('.visit-type').value;
       var entry = {

src/routes/chartReview.js

@@ -35,18 +35,28 @@ router.post('/generate-chart-review', authMiddleware, async (req, res) => {
       prompt = PROMPTS.chartReviewOutpatient;
     }
 
+    const noteCount = (visits || []).length + (subspecialty || []).length + (edVisits || []).length;
+    if (noteCount > 0) {
+      prompt += `\n\nSOURCE COVERAGE REQUIREMENT:\nThe user provided ${noteCount} source note${noteCount === 1 ? '' : 's'}. Account for every numbered source note below, but keep the output short. Summarize each visit only to the extent it guides the next/current visit. Include important labs, medication changes, referrals, follow-up plans, and pending items. If a note is irrelevant or duplicative, say that briefly rather than silently ignoring it.`;
+      clinicalData += `\n\nSource notes provided: ${noteCount}`;
+    }
+
+    let sourceIndex = 0;
     // Include ALL visit data regardless of per-visit type —
     // an outpatient chart review should include subspecialty consults too
     (visits || []).forEach(v => {
-      clinicalData += `\n\n=== OUTPATIENT VISIT (${v.date}) ===\n` + wrapUserText('visit', v.content || '');
+      sourceIndex += 1;
+      clinicalData += `\n\n=== SOURCE NOTE ${sourceIndex} of ${noteCount}: OUTPATIENT VISIT (${v.date || 'no date'}) ===\n` + wrapUserText('visit', v.content || '');
       if (v.labs && v.labs.trim()) clinicalData += `\n--- Labs from this visit (${v.date}) ---\n` + wrapUserText('labs', v.labs);
     });
     (subspecialty || []).forEach(s => {
-      clinicalData += `\n\n=== SUBSPECIALTY: ${(s.specialty || 'Subspecialty').toUpperCase()} — ${s.specialistName || 'Unknown'} (${s.date}) ===\n` + wrapUserText('consult', s.content || '');
+      sourceIndex += 1;
+      clinicalData += `\n\n=== SOURCE NOTE ${sourceIndex} of ${noteCount}: SUBSPECIALTY: ${(s.specialty || 'Subspecialty').toUpperCase()} - ${s.specialistName || 'Unknown'} (${s.date || 'no date'}) ===\n` + wrapUserText('consult', s.content || '');
       if (s.labs && s.labs.trim()) clinicalData += `\n--- Labs from this visit (${s.date}) ---\n` + wrapUserText('labs', s.labs);
     });
     (edVisits || []).forEach(v => {
-      clinicalData += `\n\n=== ED VISIT (${v.date}) ===\n` + wrapUserText('ed_visit', v.content || '');
+      sourceIndex += 1;
+      clinicalData += `\n\n=== SOURCE NOTE ${sourceIndex} of ${noteCount}: ED VISIT (${v.date || 'no date'}) ===\n` + wrapUserText('ed_visit', v.content || '');
       if (v.labs && v.labs.trim()) clinicalData += `\n--- Labs from this visit (${v.date}) ---\n` + wrapUserText('labs', v.labs);
     });
 

src/utils/prompts.js

@@ -135,34 +135,42 @@ ${CORE_RULES}
   // ======================== CHART REVIEW ========================
   chartReviewOutpatient: `You are an expert at summarizing outpatient medical records for chart review/precharting.
 ${CORE_RULES}
+Purpose: create a short guide for the next/current visit, not a full note rewrite.
 Format:
 - Start with: "[Name] is a [age] [gender] with [conditions] here today for [reason]"
 - Include relevant past medical/surgical history
-- Last visit summary: date, what was discussed, plan, labs
+- Visit timeline: briefly account for each provided visit/note in chronological order, but combine duplicative details
 - Recent labs with dates and values
 - Current medications
 - Subspecialty notes: date, specialist, findings, recommendations
 - Pending items
-- Be concise — this is for quick precharting reference`,
+- Prioritize details that guide today's assessment, follow-up, counseling, orders, referrals, labs, or safety checks
+- Be concise — this is for quick precharting reference; avoid copying whole notes`,
 
   chartReviewSubspecialty: `You are an expert at summarizing subspecialty consultation notes.
 ${CORE_RULES}
+Purpose: create a short guide for the next/current visit, not a full note rewrite.
 For each subspecialty note:
 - Date of visit
 - Specialist name/type
 - Key findings
 - Assessment
 - Recommendations/plan
-- Follow-up plan`,
+- Follow-up plan
+- Pending tests, labs, referrals, medication changes, or action items
+- Be concise and mention only details that affect ongoing care`,
 
   chartReviewED: `You are summarizing an ED visit for chart review/hospital course.
 ${CORE_RULES}
+Purpose: create a short guide for the next/current visit, not a full note rewrite.
 Include:
 - Date and time of ED visit
 - Chief complaint
 - Key findings (vitals, exam, labs, imaging)
 - Interventions (IVF, medications, procedures)
-- Disposition (admitted to where, discharge)`,
+- Disposition (admitted to where, discharge)
+- Pending results, return precautions, medication changes, and follow-up needs
+- Be concise and mention only details that affect ongoing care`,
 
   // ======================== SOAP NOTE ========================
   soapFull: `You are an expert medical scribe. Generate a complete SOAP note.

test/clinical-notes-entrypoints.test.js

@@ -121,3 +121,19 @@ test('clinical AI outputs are inserted as text or sanitized output helpers', ()
     assert.match(read(file), pattern, `${file} should not inject generated clinical text as raw HTML`);
   }
 });
+
+test('chart review preserves pasted note coverage cues', () => {
+  const route = read('src/routes/chartReview.js');
+  const script = read('public/js/chartReview.js');
+  const prompts = read('src/utils/prompts.js');
+  assert.match(script, /function getVisitContent\(card\)/);
+  assert.match(script, /el\.innerText \|\| el\.textContent/);
+  assert.match(route, /SOURCE COVERAGE REQUIREMENT/);
+  assert.match(route, /Account for every numbered source note/);
+  assert.match(route, /keep the output short/);
+  assert.match(route, /guides the next\/current visit/);
+  assert.match(route, /SOURCE NOTE \$\{sourceIndex\} of \$\{noteCount\}/);
+  assert.match(prompts, /Purpose: create a short guide for the next\/current visit/);
+  assert.match(prompts, /avoid copying whole notes/);
+  assert.match(prompts, /Pending tests, labs, referrals, medication changes, or action items/);
+});