Three concurrent themes from this session:
═══════════════════════════════════════════════════════════════════
ED ENCOUNTERS — per-stage cards + consolidate→MDM finalize
═══════════════════════════════════════════════════════════════════
UX redesign per Daniel's feedback ("every stage note should be shown,
if AI is told to modify that particular note then the modified version
is used in final mdm"):
- Each generated stage stays on screen as its own editable card with
its own embedded "Don't Miss" panel. No more single rolling note
element that gets replaced on each generation.
- gatherCurrentNotes() reads contenteditable text from each stage card
before any operation (advance, finalize, persist) so inline edits
flow into the next AI call and the final consolidate.
- Stage badge is now state-accurate. "Stage N (recording)" with yellow
background after Add-more before generation; "Stage N" with gray
after generation. Fixes the bug where the badge flipped to Stage 2
the moment Add-more was clicked.
- Save & Done now runs TWO server-side AI calls in /finalize:
1. edConsolidate (new prompt) → polished single final note that
integrates every stage chronologically (HPI / ROS / PE / ED Course /
A&P with disposition).
2. edFinalize (rewritten with full inline 2023 AMA E/M element
rubric — problems / data / risk definitions, level mapping with
concrete examples) → MDM JSON.
- Two new cards render after finalize: blue-bordered Final Consolidated
Note + green-bordered MDM. Stage cards become read-only.
- partial_data on the saved row now stores {stages, finalNote, mdm,
finalized} so resume re-renders the full state.
Why two-call finalize: a single combined prompt makes the model cut
corners on one task. Two focused calls cost ~2× latency at the very end
of an encounter — acceptable since finalize is a one-time terminal
action, not a per-stage hot path.
Files: public/components/ed-encounter.html, public/js/ed-encounters.js,
src/routes/edEncounters.js, src/utils/prompts.js (edConsolidate added,
edFinalize rewritten).
═══════════════════════════════════════════════════════════════════
EXTENSIONS / PAGERS — visual polish
═══════════════════════════════════════════════════════════════════
Multiple iterations based on Daniel's feedback:
- Layout: align-items:flex-start so action buttons stay pinned top-right
when long numbers wrap (was align-items:center → buttons drifted into
the text area, causing visible overlap).
- Number: word-break:break-all + min-width:0 + font-feature-settings:tnum
so long numbers wrap within their column instead of pushing under the
buttons. Click-to-copy with a 0.55s green flash + ✓ copied badge.
- Phone/pager Font Awesome icon next to the number in the type color —
at-a-glance type signal (replacing an earlier 3px left stripe that
Daniel found visually bulky).
- Name: font-weight 700, font-size 14.5px, color g900, letter-spacing
-0.012em — scan-target headline typography for long lists.
- Alternating subtle backgrounds by index (white vs #fafbfc) so a long
list reads as distinct rows.
- Hover: card lifts 1px with a soft shadow; action buttons fade from
55% to 100% opacity. Cubic-bezier transition on transform.
- Entrance: staggered fade-up animation per card (35ms × index, capped
at 12). prefers-reduced-motion media query disables motion.
- Empty state: 48px FA icon + heading instead of plain gray text.
Files: public/js/extensions.js, public/css/styles.css.
═══════════════════════════════════════════════════════════════════
DOCS REORGANIZATION + APPLICATION-LOGIC DOCS + ADMIN VIEWER
═══════════════════════════════════════════════════════════════════
Document moves (preserving git history via git mv):
BROWSER_WHISPER_SETUP.md → docs/browser-whisper-setup.md
BROWSER_WHISPER_TROUBLESHOOTING.md → docs/browser-whisper-troubleshooting.md
DEVELOPER_GUIDE.md → docs/developer-guide-extended.md
EMBEDDINGS_SETUP.md → docs/embeddings-setup.md
FEATURES_EXPLAINED.md → docs/features-explained.md
IMPROVEMENTS.md → docs/improvements.md
OPENID_SETUP.md → docs/openid-setup.md
TRANSCRIPTION_OPTIONS.md → docs/transcription-options.md
README.md updated with the new paths + a Documentation section that
links to docs/logic/ at the top.
New application-logic doc series (~8,300 lines total) at docs/logic/.
Built with 5 parallel doc-writing agents per Daniel's "use multiple
agents" directive. Each doc explains how a part of the app actually
works — application logic, data flow, design decisions, sacred zones,
how-to-extend recipes — at a depth that lets a new dev (or an AI
assistant) modify the code confidently.
docs/logic/README.md — index + recommended reading order
docs/logic/architecture.md (2166 L) — frontend IIFE pattern, lazy tab
load, backend route convention,
schema, encryption, deployment
docs/logic/clinical-notes.md (1546L) — every note tab + helper trio
docs/logic/bedside-and-calculators.md (1373L) — bedside ES module
pocket + calculators + PE Guide
+ suture selector
docs/logic/auth-admin-learning.md (1281L) — auth (local+OIDC+2FA) +
admin panel + Learning Hub
(Quiz engine logic at sub-detail
only — TODO follow-up)
docs/logic/ai-and-voice.md (1128 L) — callAI 5-provider routing,
prompts, voice/STT, helper trio
docs/logic/ed-encounters.md (821 L) — multi-stage ED + MDM (this
session's worked example)
Admin-only docs viewer:
- New route /api/admin/docs/{tree,file}: recursively walks docs/, returns
the tree as JSON; /file?path=X validates path stays inside docs/ and
renders markdown via marked. Both gated by req.user.role==='admin'.
- New tab "Docs" (book icon) in the sidebar, hidden by default and
revealed in auth.js when user.role==='admin' (same pattern as the
existing Admin and CMS tabs).
- New component public/components/admin-docs.html: split-pane layout
with a tree sidebar + filter input + a markdown reader pane.
- New module public/js/admin-docs.js: lazy-loads the tree on first tab
activation, renders collapsible folders, persists expanded state and
last-opened path via UIState. Server-rendered HTML so no client
markdown parser needed.
- CSS for the viewer (responsive split-pane, code-block styling, table
scrolling, etc.).
- Mounted at /api/admin/docs (NOT /api) — important: mounting a router
with router.use(authMiddleware) at /api accidentally 401s every other
/api/* path (caught and fixed during testing — /api/health was 401'ing).
Files: docs/* (moved + new), README.md, public/components/admin-docs.html
(new), public/js/admin-docs.js (new), src/routes/adminDocs.js (new),
public/index.html (tab + section + script), public/js/auth.js (admin
gate + logout cleanup), public/css/styles.css (viewer styles), server.js
(mount).
═══════════════════════════════════════════════════════════════════
KNOWN GAPS (TODO follow-ups)
═══════════════════════════════════════════════════════════════════
- Learning Hub quiz engine (MCQ / multi-select / T-F scoring + attempt
tracking + progress dashboard) is covered at the architectural level
in docs/logic/auth-admin-learning.md but not drilled into the quiz
data model and scoring flow. Worth a focused follow-up doc.
- ED finalize: if MDM step JSON parse fails, server returns 502 with
the consolidated finalNote in the error payload, but client doesn't
surface the partial result. Add a "MDM failed, retry" affordance.
- No e2e Playwright coverage for ED encounters or the new docs viewer.
#2 — Don't-miss tooltip (encounters HPI + sick visit, max 5)
- New POST /api/dont-miss returning {points: [{point, why}]} capped at 5
(cap defended both in the prompt and server-side .slice(0,5))
- New dontMissTooltip prompt in prompts.js
- New suggestDontMiss() helper in app.js mirroring suggestBillingCodes;
inserts an orange-bordered card next to the note output, silent on empty
- Wired into liveEncounter.js (encounter HPI) and sickVisit.js. Not added
to wellvisit/soap/hospital/chart per spec.
#1 — Bedside suture selector
- New ES module public/js/bedside/sutures.js (~300L) following the
burns.js pattern: site × age × tension × cosmetic × contamination ×
hours-since-injury → material, size, technique, removal day range,
glue/Steri-strip alternative, warnings, tetanus reminder.
- 15 anatomic sites covered (face, eyelid, lip vermilion, intraoral,
ear, scalp, neck, trunk, upper/lower ext, hand, foot, joint surface,
genitalia, fingertip).
- Bites: cat/human → don't-close-primarily warning; dog bite to hand →
loose-approximation note. Heavy contamination → delayed primary
closure. >12h non-face/scalp → judgment call note.
- Removal days shown as ranges (3–5, 7–10, 10–14) per source norms,
not single midpoints.
- Subungual hematoma trephination guidance corrected: any painful
hematoma with intact nail and no displaced fracture (especially if
25–50% or more), per current UpToDate guidance.
- Inline citation: Roberts & Hedges 7e (2019), Fleisher & Ludwig 8e,
AAP Section on EM, UpToDate (Pope JV).
- Pill registered in sub-nav SECTIONS + bedside/index.js. Persists
active state via existing UIState helper.
All 46 tests pass.
Four changes batched:
1. ED Encounters tab (new) — multi-stage emergency note with don't-miss
tooltips and 2023 E/M MDM finalize. New route /api/ed-encounters
(generate per-stage + finalize MDM), new ed-encounters.js owning all
client logic, new ed-encounter.html component, new template_ed memory
category. Persists draft to localStorage every keystroke and to
saved_encounters on stage advance. encounters.js touched only to
register the new tab in sessionStorage restore + tabMap (save and
idempotency code untouched).
2. Notes model selector — /notes/from-voice now accepts a client-supplied
model (validated by the existing callAI allow-list); falls back to the
admin default. Added <select class="tab-model-select"> to notes.html
so the existing app.js populator handles options + default.
3. Remove AI-learning-from-corrections — deleted correctionTracker.js,
POST /memories/correction, the corrections branch in
/memories/context, the settings UI section, the FAQ entry, and all
dead trackAIOutput/saveCorrection guards in callers. Legacy
correction_* DB rows are filtered (NOT LIKE) rather than dropped, so
no destructive migration.
4. Fix notes AI framing — /notes/from-voice prompt no longer assumes
"physician dictation". Plain notes (shopping lists, reminders,
ideas) now match the dictation tone instead of being forced into
clinical structure.
All 46 tests pass.
Symptom Daniel reported: "note recording, not working nor going into
textbox". Root cause was on the server side — /api/notes/from-voice
asked the AI for HTML in its prompt, but real-world models return
markdown ~25% of the time. Tiptap's setContent only renders HTML;
markdown comes through as literal text or a partial render, looking
like the textbox didn't fill.
Server (src/routes/notes.js):
• New toHtmlBody() helper. If the AI returned real HTML (any
block tag), pass through. Otherwise run through `marked` so
markdown becomes <p>/<h*>/<strong>/etc.
• Strips ```json / ```html code fences before JSON parsing.
• Stricter JSON-recovery: only accepts {title|body} parsed shape;
falls back to wrapping the AI's full reply via toHtmlBody().
• Final guard: if body would be empty after sanitisation, wrap
the raw transcript so the user can at least edit it manually.
Client (public/js/notes.js):
• applyGeneratedNote prefers _editor.commands.setContent over a
full remount — avoids the toolbar-reattach flicker + the brief
window where the body looked empty.
• Logs to console when the editor target is missing or Tiptap
setContent throws, so a future regression is greppable.
Plus the two infra fixes Daniel approved earlier in the same
session — keeping them in this commit since they're already
deployed and tested:
• src/db/database.js: cleanup interval handle exposed; server
shutdown now clearInterval()s it before pool.end(). Removes
the SIGTERM → 9-second-hang → Docker SIGKILL race.
• src/routes/audioBackups.js: switch multer.memoryStorage() to
diskStorage with cleanup. 10 concurrent 25 MB uploads no
longer pin 250 MB of RAM. Identical user-visible perf since
upload is wire-bound.
New dep: marked@latest (used server-side only in toHtmlBody).
New "Notes" tab under Clinical Tools — a per-user scratchpad that's
explicitly NOT fed into AI prompts (distinct from user_memories).
Two-pane layout: searchable list on the left, rich-text editor with
title + save/edit/delete on the right.
Backend:
migrations/…_add-personal-notes.js — personal_notes table
(id, user_id → users ON DELETE CASCADE, title, body, created_at,
updated_at) with indexes on user_id + (user_id, updated_at).
src/routes/notes.js — CRUD + one AI endpoint:
GET /api/notes list, newest-updated first
GET /api/notes/:id fetch one
POST /api/notes create (title + body required)
PUT /api/notes/:id update
DELETE /api/notes/:id remove
POST /api/notes/from-voice transcript → { title, body }
via callAI (admin-controlled
provider — never selectable by
the clinician).
Body + title encrypted at rest via the same cryptoUtil used for
user_memories; 500-note per-user cap; 200-char title / 50 KB
body limits.
Frontend:
public/components/notes.html — empty-state card ("Hello 👋"),
sidebar list with search, editor head with voice-bar (Dictate /
Pause / Resume / Stop + live timer + pulse indicator), Tiptap
body, metadata footer. Uses existing .tp-* toolbar classes.
public/js/notes.js — lazy-init on first tab activation; Tiptap
editor built from window.Tiptap (same bundle the Content
Manager uses); delegated list clicks; Ctrl/Cmd+S to save;
uses app.js's AudioRecorder + transcribeAudio so the STT
pipeline is shared. On stop → transcribe → /api/notes/from-
voice → drop the AI-structured title + body into the editor;
clinician reviews then saves.
public/css/styles.css — 70 lines of .notes-* styles (card
layout, warm empty-state with gradient icon + tips, pulse
animation for the recording indicator, focus states, hover
nudges).
public/sw.js — bump cache from pedscribe-v12 → pedscribe-v12-
notes1 so clients pick up the new module/component.
Admin-controlled STT provider: the recorder posts its audio blob
to the existing /api/transcribe (Google / LiteLLM / ElevenLabs /
Browser Whisper — whatever admin wired up in Settings). Users
cannot pick the provider from this UI.
8 new spec files covering sections previously only smoke-tested:
- ai-endpoints-contract.spec.js — hits 8 real AI endpoints via request
context and fails if the response leaks TypeError / ReferenceError /
'Cannot read properties of undefined' / 'is not defined' / 'is not a
function'. This is the class of bug that shipped the PE-narrative
regression to prod because every page-level mock prevented the real
handler from running.
- encounter-workflow.spec.js — generate HPI, refine, clear transcript.
- encounter-save-load.spec.js — save draft, load popover, repopulate.
- wellvisit-workflow.spec.js — byvisit, milestones, SSHADESS (12+
reveal), visit note.
- vaxschedule-content.spec.js — schedule + catch-up panels populate
beyond "Loading".
- chart-review-workflow.spec.js — generate + load popover.
- learning-tab.spec.js — search filter, category pills, feed.
- settings-faq-dictation.spec.js — voice/password/2FA/Nextcloud
sections, FAQ expand/collapse, dictation generate flow.
Baseline fixes:
- Added CORS_ORIGINS + API_RATE_LIMIT_MAX env overrides so the e2e
container accepts the browser's Origin header and can absorb the
full suite's API traffic without tripping the 200/min guard.
- Server's /api/ rate limit is now configurable via
API_RATE_LIMIT_MAX (default stays 200).
- extensions-crud: replaced native page.on('dialog') listeners with
#confirm-modal-ok clicks (we moved off native confirm()).
- pe-guide-smoke + extensions-crud: mobile viewport opens the hamburger
before clicking sidebar tabs.
- fixtures.js: /api/refine mock uses 'refined' (real API shape), not
'content'. /api/chart-review replaced with /api/generate-chart-review.
Suite: 230 passed / 0 failed in 4m36s.
User-visible changes:
- Removed the REAL / SYNTH badge from each sound card. User feedback:
"ridiculous". Cards now just show the sound title + description +
player, no distinction beyond the player type (native <audio controls>
for recordings, play/stop/progress bar for synth).
- Removed the "real recordings; synth labelled SYNTH" subtitle from
the sounds library header.
- Single-playback policy across the whole PE Guide: when any sound
starts (audio or synth), every other playing sound stops. Covers:
audio → audio (pause the previous), audio → synth, synth → audio,
synth → synth. Listeners attach on each .pe-audio 'play' event and
on every synth play-button click.
E2E infrastructure fixes (for the test failures we hit):
- auth-gated-smoke.spec.js now imports test + loginAs from the shared
fixtures.js so the token cache is unified across every spec. Without
this, each spec file's module-scoped _tokenCache multiplied logins
and hit the 10/15min rate limit.
- server.js: /api/auth/login rate limit is now configurable via
LOGIN_RATE_LIMIT_MAX env var (default 10, prod unchanged).
- docker-compose.e2e.yml: LOGIN_RATE_LIMIT_MAX="500" so Playwright's
two-project (chromium + mobile-chrome) multi-worker runs can do
their logins without tripping the cap. Prod container unaffected.
- fixtures.js console.error allowlist expanded to suppress known
non-bugs: Cross-Origin-Opener-Policy warnings on http:// e2e
server, transient 401/403/404/503 resource loads, ERR_BLOCKED_BY_CLIENT.
New top-level tab positioned after Physical Exam Guide. Per-user
directory of hospital phone extensions and pagers — grouped by location
then type, searchable, soft-deleted.
Data:
- New table user_phone_extensions (id, user_id, location, name, number,
type CHECK (extension|pager), notes, trashed_at, timestamps).
Partial indexes on active vs trashed rows for fast filtering.
- Not PHI — hospital internal phone directory. Plaintext.
API (all user-scoped, all params validated):
- GET /api/extensions?trash=1&q=text — list active or trash, optional search
- POST /api/extensions — create
- PUT /api/extensions/:id — update (requires all three core fields)
- DELETE /api/extensions/:id — soft-delete (sets trashed_at)
- POST /api/extensions/:id/restore — un-trash
- DELETE /api/extensions/:id/purge — hard-delete (only if trashed)
All :id params parsed + validated (positive integer) before query.
All queries parameterized, every WHERE includes user_id scoping.
UI (public/js/extensions.js + components/extensions.html):
- Search bar with 200ms debounce, server-side LIKE on location/name/number/notes
- Add button expands inline form — location (with datalist of existing
locations for autocomplete), name/dept, number, type, optional notes
- Each entry renders as a card: big monospace number, dept, type badge,
edit + delete inline
- Grouped by location → type (Extensions / Pagers subheaders)
- Trash view: toggle shows trashed items with Restore + Purge actions
- Trash count badge on the Trash button updates after every delete/restore
- Delete requires confirm() dialog, then soft-delete (easy to undo)
- Purge from trash requires a second confirm() ("cannot be undone")
- Esc closes the form; form resets between Add and Edit
New top-level tab (positioned after Catch-Up Schedule) combining two
functions:
1. Study reference — for each (age group, system) shows OSCE-style
components with technique, expected normal finding, and abnormal-
feature watch-list.
2. Documentation generator — physician marks each component
Normal / Abnormal (with free-text detail) / Skip; AI produces a
two-section report (Technique + Findings), narrative or structured
list format.
Scope v1: MSK + Neuro × 6 age groups (newborn, infant, toddler,
preschool, school-age, adolescent). More systems can be added to the
embedded PE_DATA in peGuide.js without route changes.
Files:
- src/routes/peGuide.js — POST /api/generate-pe-narrative (mirrors
milestone-narrative pattern: AppRole-level
injection guard, clinical audit category,
PHI redaction upstream already in place)
- src/utils/prompts.js — peGuideNarrative + peGuideList prompts,
structured two-section output
- public/components/pe-guide.html — demographics bar + sub-pills + cards
- public/js/peGuide.js — embedded PE_DATA (all clinical content),
render + state + AI call
- public/index.html — tab button, section, script include
- server.js — mount route at /api
No schema change. No PHI stored — findings live in memory only, exported
via existing copy/read-aloud/Nextcloud actions.
ES module script tags (<script type="module">) always send an Origin
header on fetch, even for same-origin requests. The global cors()
middleware was rejecting /js/bedside/index.js with 500 in the e2e
harness because the container's internal origin
(http://pediatric-ai-scribe:3000) is not in APP_URL/CORS_ORIGINS.
Production was unaffected (real users hit APP_URL, which is allowed),
but the fix is architecturally correct either way: CORS belongs on
the API boundary, not on static file serving. All protected routes
are under /api/*.
Unblocks the bedside smoke suite — now 26/26 green.
Safety net for upcoming refactors:
- 26 Playwright smoke tests via @playwright/test 1.50.0 in an official
Playwright container (no host Node needed). Covers every Bedside sub-pill,
the age→weight estimator, dose calculators (seizure/sepsis/anaphylaxis/
burns/airway), and interactive widgets (lightbox, vent SVG).
- `npm run e2e` wrapper runs tests inside mcr.microsoft.com/playwright:v1.50.0-noble
on the ped-ai_default Docker network so no host port mapping is needed.
- public/e2e-harness.html + public/js/e2e-bootstrap.js load the calculators
component without the SPA auth wall (scripts external to satisfy CSP).
Server:
- server.js now re-reads public/index.html on mtime change instead of
caching at boot. Fixes the "edit HTML, restart container" friction.
- CSP upgradeInsecureRequests disabled in helmet config; Caddy still
enforces HTTPS at the reverse-proxy layer in production.
1. Build-ID cache busting (server.js):
- Compute a BUILD_ID at boot: git HEAD short hash if available,
else /app/BUILD_ID file, else random-on-boot.
- On first request for /, rewrite every local /js/*.js and
/css/*.css reference in index.html to include ?v=BUILD_ID.
Cached once at startup so subsequent renders are free.
- X-Build-Id response header + GET /api/build expose it for
debugging.
- Eliminates the "works after hard-refresh" class of bugs: every
deploy gets a new build ID, so browsers fetch fresh JS/CSS on
the very next page load.
2. Optimistic encounter locking wired into the client
(public/js/encounters.js):
- On resumeEncounter(): stash enc.version into
window._encounterVersions[id]
- On saveEncounter(): send expected_version in the POST body
when we have one.
- Server returns 409 if another tab/device wrote first → user
sees "Someone else edited this encounter. Reload to see the
latest version." instead of silently clobbering the prior save.
- On success, remember the new server-assigned version for the
next save.
Age parser (src/routes/billing.js):
- Now sums year + month + week + day matches so "4 yr 11 mo"
(59 months) correctly maps to the 5-11y billing bracket instead
of being billed as 1-4y. Added bounds sanity check.
Graceful SIGTERM shutdown (server.js):
- Closes the HTTP listener first, then drains batched audit queues,
then ends the Postgres pool. 9-second hard deadline to beat
Docker's 10-second SIGKILL. Previously an in-flight note save
during a container restart could truncate the write.
Explicit LLM fallback opt-in (src/utils/ai.js):
- The OpenRouter / LiteLLM silent fallback now requires admin
setting `ai.allow_model_fallback = true` (default: false). If
primary fails and fallback is disabled, the error is surfaced
to the caller. Prevents silent spillover from a BAA-covered
primary to a non-covered fallback.
Prompt injection delimiters (src/utils/promptSafe.js):
- Wraps user transcripts, dictations, refine-instructions, and
pasted documents in <UNTRUSTED_*>...</UNTRUSTED_*> tags and
appends an explicit system instruction telling the model to
treat the wrapped content as data rather than commands.
- Applied to soap.js, hpi.js, refine.js. Extend to other AI
routes incrementally.
Cross-tab logout sync (public/js/authFetch.js, auth.js):
- BroadcastChannel('pedscribe-auth') — logout in one tab posts
a message; all sibling tabs clear state and reload, dropping
any PHI-containing UI immediately.
Backup code race-free consumption (src/routes/auth.js):
- tryConsumeBackupCode() now uses a Postgres transaction with
SELECT ... FOR UPDATE so concurrent login attempts using the
same code serialize. First wins, second sees the already-
shortened array.
Optimistic encounter locking (migrations/...add-encounter-version):
- saved_encounters.version INTEGER NOT NULL DEFAULT 1
- POST /api/encounters/saved accepts an expected_version and
rejects with 409 if the row has advanced. Falls back to
last-write-wins if the client doesn't pass one (backward compat).
Audit log batching (src/utils/auditQueue.js):
- Audit / api_log / access_log writes are buffered in memory and
flushed every 1s or every 50 entries via one multi-row INSERT.
Under load this reduces DB pressure by ~50x. On SIGTERM the
shutdown path drains the queue before exiting.
- App-layer AES-256-GCM crypto helper (src/utils/crypto.js)
- Nextcloud tokens encrypted at rest; transparent migration on next use
- Audio backups encrypted at rest (version byte 0x01 envelope); legacy
rows still decrypt as-is until overwritten
- argon2id password hashing via src/utils/passwords.js with bcrypt
fallback; bcrypt hashes rehashed to argon2id on next successful login.
argon2 package is optional — server keeps running with bcrypt only
until npm install adds the native dep
- PHI redactor for audit log details (src/utils/redact.js) — strips SSN,
phone, email, DoB, long IDs; caps at 500 chars; detects note bodies
- DOMPurify (cdnjs, SRI-pinned) replaces custom regex sanitizer in
Learning Hub content rendering
- SRI integrity hashes added for Font Awesome CSS and Chart.js
- Magic-byte file-type verification on document uploads
(src/utils/fileType.js)
- Generic 500 error responses via src/utils/errors.js applied to
nextcloud and audioBackups; full detail still logged server-side
- DATA_ENCRYPTION_KEY env documented in .env.example
Deploy: requires rebuild of the container image to pick up the new
files and `npm install` (adds argon2). Existing users keep working
because bcrypt stays available and crypto helpers pass through
plaintext when the key is not yet set in dev.
- JWT_SECRET fails fast at startup in production
- CORS fails closed if APP_URL + CORS_ORIGINS are both missing
- Explicit HSTS (1y, includeSubDomains, preload)
- Rate limit sensitive auth endpoints (change-password, 2FA)
- /api/health now returns {ok:true}; details gated behind admin auth
- Login enumeration removed — generic 401 + dummy bcrypt on miss
- ReDoS guard: 20KB input cap on /suggest-codes
- showToast uses textContent, no innerHTML
- clearSession() clears service worker caches on logout
- OIDC state is now HMAC-signed and stateless (survives restart)
- SSRF guard on admin-set OIDC issuer (blocks private IPs, requires HTTPS)
Adds docs/mobile-build.md covering APK build, release, git push,
keystore, and troubleshooting for both PedScribe and PedsHub apps.
New feature: after generating any clinical note, the app automatically
suggests relevant billing codes displayed as clickable chips below the output.
Backend (src/routes/billing.js):
- POST /api/suggest-codes endpoint analyzes note text
- Extracts diagnoses from Assessment section via regex
- Looks up ICD-10 codes: local common pediatric map (40+ conditions)
first, then NLM Clinical Tables API for unknown terms
- Suggests CPT E/M codes based on note type, visit complexity,
ROS/PE system counts, and MDM level estimation
- Supports: outpatient (new/established), well visit (age-based),
ED, inpatient (admit/subsequent/discharge)
Frontend (public/js/app.js):
- suggestBillingCodes() renders collapsible card with ICD-10 and CPT chips
- Click any chip to copy the code to clipboard
- Shows E/M level assessment (diagnosis count, ROS, PE, MDM complexity)
- Disclaimer: "Suggestions only. Always verify codes."
Integration: called after note generation in all 6 tabs
(encounter, SOAP, sick visit, well visit, hospital course, chart review)
Security:
- Add session management: users can view/revoke active sessions in Settings
- Add password change in Settings (requires current password, HIBP check)
- Force logout all sessions on password reset
- Fix logout to destroy server-side session (was only clearing cookie)
- Add trust proxy for correct client IP in rate limiting and audit logs
- Add CORS support for multiple domains (CORS_ORIGINS env var)
- Add HIBP breach check endpoint and inline warnings on password fields
Audit logging:
- Add audit logging to all 24 PHI-handling endpoints across 13 route files
- Covers: generation, transcription, TTS, refine, encounters, documents, Nextcloud
- All fire-and-forget (no response delay)
AI improvements:
- Refine now includes original source material (transcript, notes, labs)
so AI can reference the full input when modifying output
- Add correction tracking (trackAIOutput) to sick visit and well visit tabs
- Fix sickvisit missing from encounter save noteIdMap
UI fixes:
- Non-blocking busy bar for transcription and AI generation (replaces full-screen overlay)
- Fix encounter recording: hide record button during recording (was showing two stop buttons)
- Fix ROS/PE "All WNL" stacking duplicate event handlers; add Clear buttons
- Enlarge AI instructions textarea in Learning Hub CMS
Domain:
- Primary domain now app.pedshub.com, with scribe.pedshub.com and peds.danvics.com as CORS origins
- Add Cloudflare Turnstile to login, register, and password reset forms
- Switch AI provider to LiteLLM, transcription to OpenAI Whisper
- Change domain to scribe.pedshub.com
- Fix PPTX export: add tables, bold/italic, numbered lists, code blocks, blockquotes
- Fix announcement banner close button (CSP was blocking inline onclick)
- Fix auth middleware: empty Bearer token now falls through to cookie auth
- Fix audio backups: only save on transcription failure, stop auto-deleting on success
- Soften AI correction injection to prevent model hallucination from correction history
- Fix LiteLLM TTS model name handling (no incorrect openai/ prefix)
- Expand AI instructions textarea in Learning Hub CMS
- Update README for v6 with all features and providers
- Add comprehensive docs/: architecture, API reference, database schema,
authentication, AI providers, speech, learning hub, configuration, deployment
Features:
- Admin can add, edit, and delete developmental milestones via dashboard
- Milestones stored in PostgreSQL (developmental_milestones table)
- Client-side loads milestones from API instead of static file
- Import script to migrate existing static data to database
- Organized by age group and domain
- Supports sorting and filtering
Admin UI:
- New section in Admin panel for milestone management
- Filter by age group
- Add/Edit modal with validation
- Delete with confirmation
- Auto-complete for age groups and domains
API Endpoints:
- GET /api/milestones-data - Public endpoint for authenticated users
- GET /api/admin/milestones - List all milestones (admin only)
- GET /api/admin/milestones/meta - Get age groups and domains
- POST /api/admin/milestones - Create milestone
- PUT /api/admin/milestones/:id - Update milestone
- DELETE /api/admin/milestones/:id - Delete milestone
- POST /api/admin/milestones/bulk-import - Bulk import
Usage:
1. Run import script: node scripts/import-milestones.js
2. Access Admin dashboard → Developmental Milestones section
3. Add/Edit/Delete milestones as needed
BREAKING FIX: Browser Whisper now fully self-contained
Previous issue:
- Loaded transformers.js from cdn.jsdelivr.net
- Downloaded models from cdn-lfs.huggingface.co
- Failed in corporate/clinical networks with firewall
- Stuck at "Initializing..." with no progress
Solution:
- Bundle transformers.js library (~876KB)
- Bundle Whisper tiny.en model (~42MB)
- Serve everything from local server
- Works in ANY network environment
Changes:
- whisperWorker.js: Load transformers from /models/ instead of CDN
- Dockerfile: Download models during Docker build
- Add download script for local dev
- Add comprehensive setup documentation
Docker image size: +~42MB (one-time cost, runtime benefit)
Tested: Works on unrestricted and firewalled networks
ROOT CAUSES FOUND AND FIXED:
1. TTS Preview not working: voicePreferences.js listening for wrong event
- Was: 'tab-loaded' (never dispatched)
- Now: 'tabChanged' (correct event name used by app.js)
- Added immediate init if page already loaded
- Added 500ms delay for DOM readiness
2. Browser Whisper CDN blocked: CSP too restrictive
- Added 'unsafe-eval' to scriptSrc (required by transformers.js)
- Added cdn.jsdelivr.net to connectSrc (worker importScripts)
- Added childSrc directive for worker script loading
- Better error messages in worker
3. Worker loading errors: Now logged with specific reasons
- importScripts wrapped in try-catch
- Posts error message to main thread
- Verifies transformers object exists after load
Testing:
- TTS Preview should now work when clicking Settings tab
- Browser Whisper should load from CDN (or show specific error)
- Console logs will show exact init sequence
- Raise express.json limit from 1MB to 10MB — handles large chart reviews
with many notes (50 full clinic notes ≈ 600KB, well within new limit)
- Client-side: warn user if payload >8MB, friendly toast if >30 notes
- Bump to v13.0.0
- TTS response now includes X-TTS-Provider header (google-tts, litellm/model, elevenlabs)
- Frontend reads header and shows actual provider in toast instead of hardcoded "Adam/ElevenLabs"
- CORS exposes X-TTS-Provider header so frontend can access it
- Updated .env.example: clarify that LITELLM_TTS_MODEL and LITELLM_STT_MODEL
can be either the model_name alias OR the full provider/model path depending
on your LiteLLM config (important for BAA compliance routing)
- TRANSCRIBE_PROVIDER=litellm routes audio to LiteLLM /audio/transcriptions
- TTS_PROVIDER=litellm routes to LiteLLM /audio/speech
- Both auto-detect when LITELLM_API_BASE is set (no extra config needed)
- LITELLM_STT_MODEL (default: whisper-1), LITELLM_TTS_MODEL (default: tts-1)
- LITELLM_TTS_VOICE (default: alloy) — alloy/echo/fable/onyx/nova/shimmer
- ElevenLabs still works if ELEVENLABS_API_KEY is set and TTS_PROVIDER=elevenlabs
- Health endpoint now reports tts provider
- Add Vertex AI provider (Gemini models via @google-cloud/vertexai SDK)
- Add LiteLLM proxy support (OpenAI-compatible, routes to any provider)
- Admin panel: model search/discover from provider API, enable/disable, custom models, set default
- New endpoints: /config/models/discover, /config/models/add-discovered, /config/models/default
- Updated models.js with VERTEX_MODELS and LITELLM_MODELS lists
- Updated health endpoint with vertex + litellm status
Audio Backups:
- New audio_backups table in PostgreSQL (bytea, gzip compressed)
- POST /api/audio-backups — upload with gzip compression (level 6)
- GET /api/audio-backups — list user's backups
- GET /api/audio-backups/:id/audio — download decompressed audio
- DELETE /api/audio-backups/:id — delete backup
- Auto-cleanup every hour (24h expiry)
- Frontend saves to server first, falls back to IndexedDB
- Settings shows source badge (server/local) per backup
AI Corrections:
- Corrections list is now expandable — click to view original vs corrected
- Shows red "Original" and green "Corrected to" sections
- Click arrow to expand/collapse each correction
- Date shown on each correction
- APK: Add WAKE_LOCK, BOOT_COMPLETED, ACCESS_NETWORK_STATE permissions
- APK: Disable allowBackup for medical data security
- APK: AudioRecordingService now acquires wake lock, has stop action in notification
- Serve /.well-known/assetlinks.json for TWA domain verification
- Service worker: cache app shell, stale-while-revalidate for assets, network-first for API
- Admin model management: validate model ID format, prevent built-in conflicts, audit toggle actions, prevent disabling all models
- Bump version to v9.0.0, Docker tag to v9
- Full model management UI in admin panel: toggle models on/off, add custom
model IDs (any OpenRouter/Bedrock ID), set admin-configured default model
- /api/models now returns admin-set default model, frontend respects it
- Toggle switch CSS for clean enable/disable UX
- Backend already had the API endpoints, this adds the missing UI
