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)
Calculators tab with 7 tools:
- BP Percentile (AAP 2017) with age/sex/height classification
- BMI Percentile (CDC 2000) with extended obesity classification
(Class 1/2/3 using % of 95th percentile per CDC 2022)
- Growth Charts: weight-for-age, length-for-age, head circumference,
weight-for-length (WHO/CDC LMS), Fenton preterm (22-50 weeks)
- Bilirubin: AAP 2022 phototherapy threshold + Bhutani nomogram
with Nelson Table 137.1 risk factors for severe hyperbilirubinemia
- Vital Signs by Age (Harriet Lane) with quick reference formulas
(estimated weight, min SBP, ETT size, maintenance fluids 4-2-1)
- Body Surface Area (Mosteller formula)
- Weight-Based Dosing with max cap and volume calculation
Fix growth chart sub-tab navigation (pills scoped separately from
top-level nav to prevent panel disappearing)
- Replace browser prompt() with inline UI for: 2FA disable (password field),
admin password reset (inline input), admin test email (inline input)
- Remove all password breach warning UI (login, register, settings)
Backend HIBP check endpoint remains but is no longer called from frontend
- Remove model cost display from dropdown and header badge
- Hide empty cost-badge element in header
- Fix model dropdown to flat list (no category grouping)
- Add FAQ tab with accordion sections: Getting Started, AI & Models,
Voice & Transcription, Saving & Export, Privacy & Security,
Well Visit & Sick Visit, Learning Hub, Troubleshooting
- Documents how AI learns from physician edits (correction tracker)
- Fix FAQ accordion (CSP was blocking inline script, moved to app.js)
- Patch all 5 npm vulnerabilities: nodemailer 8.0.5, xmldom, basic-ftp,
path-to-regexp (npm audit now reports 0 vulnerabilities)
- Remove model category grouping from dropdown (flat list, no optgroups)
- Fix model dropdown dark background on options (white bg, dark text)
- Update FAQ model guidance to reflect admin-managed model selection
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
Provides two transcription options:
1. Browser Whisper (Offline, Batch) - RECOMMENDED
- 100% offline, zero network calls
- HIPAA-compliant, audio never leaves device
- Highest accuracy (Whisper)
- Processes after recording (batch mode)
- Models self-hosted, bundled in v2
2. Web Speech API (Real-time, Streaming) - EXPERIMENTAL
- Real-time transcription (see words as you speak)
- Uses browser's built-in speech recognition
- ⚠️ Sends audio to cloud (Chrome/Edge → Google)
- ⚠️ NOT HIPAA-compliant
- Requires user consent with clear warnings
Features:
- Settings UI for both options
- Clear privacy warnings for Web Speech
- Mutual exclusion (only one active at a time)
- Browser detection shows which provider is used
- Confirmation dialog before enabling Web Speech
Use Cases:
- Clinical/HIPAA: Use Browser Whisper only
- Personal/Non-clinical: Can use Web Speech for real-time feedback
- Maximum privacy: Browser Whisper (offline)
- Maximum speed: Web Speech (if privacy not required)
Implementation:
- speechRecognition.js: Web Speech API wrapper
- transcriptionSettings.js: Settings UI handler
- Privacy info displayed per browser
User can choose based on their privacy vs. speed preference.
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
OIDC/SSO:
- New /api/auth/oidc route with PKCE for secure authorization
- Supports Azure AD, Okta, Keycloak, PocketID, Google, any OIDC provider
- Admin configurable: issuer, client ID/secret, button label
- Option to disable local auth (force SSO only)
- Auto-creates users on first SSO login, links existing by email
- SSO button on login page, hidden until admin enables OIDC
Firefox:
- Show info toast on first recording that live preview requires
Chrome/Edge; server-side transcription still works in all browsers
Login flash:
- Auth screen now hidden by CSS default (#auth-screen{display:none !important})
- auth.js shows it only when there is no valid token or token is expired
- No more flash of login page on refresh for logged-in users
Presentation quiz option (AI Generate panel):
- Presentation type now shows optional quiz question toggle (same as article)
- Backend: when questionCount>0, returns JSON {marpMarkdown, questions[]}
instead of plain Marp markdown
- applyAiContent fills both the Marp textarea and question blocks for presentations
Viewer revert:
- Removed the viewer presentation card change (user wants markdown as-is)
- Removed dangling viewer button wiring
Feed/CMS list:
- Presentation type shows correct icon (fa-presentation-screen) and
label "Slides" in the CMS content list
REVERT: httpOnly cookie auth removed — reverts to JWT in localStorage.
The cookie implementation broke the login page (always-hidden auth screen).
localStorage token approach is restored fully:
- Login/register return token in JSON body
- getAuthHeaders() sends Authorization: Bearer header
- Session check reads localStorage token on load
- clearSession() removes localStorage token
Fix: slide preview padding — section elements now have 40px 48px padding
so text is not flush against the frame edges.
Kept from v3.14: AI panel context-aware options (word count, slide count,
quiz question toggle), delete confirmation wording per content type.
AI Generate panel:
- Content type synced from editor on open
- Article/Pearl: optional word count field
- Presentation: optional slide count field
- Questions row: checkbox toggle for article/pearl (optional), always on for quiz,
hidden for presentation; count input shown only when enabled
- Backend: passes wordCount/slideCount to prompt; questionCount=0 skips questions
Delete confirmation:
- Wording built dynamically from content type
- Presentation: no mention of questions
- Quiz: "All quiz questions will be permanently removed"
- Article/pearl: "Any quiz questions attached will also be removed"
Auth refactor — JWT → httpOnly cookie:
- Backend: setAuthCookie() sets ped_auth as httpOnly, Secure, SameSite=Lax, 7d
- Backend: clearAuthCookie() on POST /api/auth/logout (new endpoint)
- Backend: auth middleware reads ped_auth cookie first, falls back to Bearer header
- Login/register: no longer return token in JSON body; cookie is the session
- Frontend: getAuthHeaders() returns only Content-Type (no Authorization header)
- Frontend: session check uses /api/auth/me via cookie (no localStorage token)
- Frontend: clearSession() calls /api/auth/logout to clear cookie server-side
- Frontend: no token in localStorage; window.AUTH_TOKEN removed
- All FormData fetches use credentials:'same-origin' (cookie sent automatically)
- index.html: optimistic auth-screen hide (removed localStorage token check)
Tested: login, logout, /api/auth/me, admin routes, FormData uploads, cookie httpOnly
flag, 401 without cookie, cookie cleared on logout.
Delete bar bug:
- Root cause: .lh-delete-confirm-bar{display:flex} defined after .hidden{display:none}
so flex overrode hidden (no !important on global .hidden rule)
- Fix: remove display:flex from base rule, use .lh-delete-confirm-bar:not(.hidden){display:flex}
so hidden class always wins regardless of CSS order
Slide preview (replace window.open + document.write approach):
- Backend /preview-slides now returns JSON: {css, slides[]} (individual <section> HTML)
- In-page full-screen modal with dark overlay, white slide frame
- Prev/Next arrow buttons, dot indicators, slide counter
- Keyboard navigation (arrow keys, Escape to close)
- Touch/swipe support for mobile
- Overlay click closes modal
- No popups required, works in all browsers
Marp textarea:
- Placeholder updated to guide users: "Click AI Generate above to create slides"
- Makes it clear AI is the primary authoring path; textarea for review/edits
- Bundle Tiptap 2 (StarterKit, Link, Underline) with esbuild into
public/vendor/tiptap.bundle.js — fully self-hosted, no CDN needed
- Remove Quill (quill.min.js, quill.snow.css, patchQuillTooltip hack)
- Headless Tiptap editor: custom toolbar (bold/italic/underline/strike,
headings, lists, blockquote, code, link) with active-state highlighting
- Link insertion: inline link bar below toolbar (no popup, no tooltip)
— type URL, press Apply or Enter; Remove button to unset
- Mini editor for question text and option text (same toggle UX)
- ProseMirror content styles: headings, lists, blockquote, code, links
Quill tooltip: move tooltip element to document.body via patchQuillTooltip()
so overflow:hidden on .cms-main cannot clip it. Recalculates position from
container-relative to viewport (fixed) coordinates with viewport clamping.
Removes overflow:hidden from quill wrappers; applies border-radius to toolbar/container.
Registration: hide #show-register by default in HTML; reveal only after
registration-status fetch confirms enabled=true. Endpoint already returns 403
when disabled — no backend change needed.
- wellVisit.js now handles tabChanged for vaxschedule and catchup tabs
so renderFullSchedule() and renderCatchUp() fire when those tabs open
- Replace Quill CDN with local /vendor/quill.min.js + quill.snow.css
(CDN was unreachable in local/offline environments)
- Replace textarea+toolbar with Quill.js (free, MIT) for body editor
- Full WYSIWYG: headings, bold/italic, lists, blockquote, code, link (inline, no popup)
- Rich Text toggle button on each question text field and option text field
- Plain textarea by default; toggle activates mini Quill editor per field
- New 'Multiple Select' question type: checkboxes, all correct must be chosen
- Backend scoring: allCorrectChosen && noWrongChosen
- Results show all correct options highlighted, wrong selections flagged
- quiz display uses sanitizeHtml for question/option text (supports formatted HTML)
- sanitizeHtml allows Quill class attrs (ql-indent, etc.)
- New dedicated Content Manager tab (WordPress-like layout) with:
- Stats dashboard (published, drafts, categories, quizzes, attempts)
- Sidebar with category tree and filter controls (status, category)
- Table-style content list with search
- Full-page editor with title bar, meta fields, body editor, quiz builder
- Content Manager visible only for admin and moderator roles in sidebar
- Removed CMS from admin panel (admin panel is admin-only again)
- Email templates: fully responsive with max-width, proper mobile breakpoints,
table-based layout for Outlook/Gmail compatibility, no overflow
- Security: escape all user data in emails with escHtml(), escape APP_URL
in verify-email HTML, replace raw err.message with generic errors in auth
- Security: email body from admin settings now HTML-escaped before rendering
- New Learning Hub under Pediatric menu with content feed, category browsing,
search, content viewer, and interactive quizzes (MCQ, true/false)
- Quiz system with per-option wrong-answer explanations and general explanations
- Admin CMS for creating/editing categories, content (articles, pearls, quizzes),
and inline question builder with answer options
- 3-role system: admin (full access), moderator (can manage Learning Hub content),
user (all clinical features + learning hub read access)
- 5 new database tables: learning_categories, learning_content, learning_questions,
learning_options, learning_progress
- User progress tracking with score history per quiz
- Moderators see "Content Manager" tab instead of full Admin panel
- Bedrock: Add 14 non-vendor model models (Amazon Nova, Meta Llama 4, DeepSeek R1/V3,
Mistral Large 3, Cohere Command R+, AI21 Jamba) with verified AWS model IDs
- Bedrock: Implement Converse API for non-Anthropic models (unified cross-model API),
keep native Messages API for vendor model models (best performance)
- Milestones: Add Newborn / 1 month developmental milestones (Gross Motor, Fine Motor,
Language, Social/Emotional, Cognitive) — previously started at 2 months
- Bump version to 3.0.0, docker-compose tag to v3.0
- Copy to Note button now switches to Well Visit → Visit Note subtab
automatically so user sees the result immediately
- Add complete AAP/Nelson developmental milestones for ages 6, 7, 8, 9,
10, and 11 years (Gross Motor, Fine Motor, Language, Social/Emotional,
Cognitive domains each)
- Add corresponding age options to ms-age-group select
- Fix 2FA status stuck at "Loading...": export load2FAStatus globally so
app.js tabChanged handler can call it when navigating via sidebar
- Fix admin models silent failure: add error message + retry button on catch
- Fix save encounter doubles: persist _savedEncId_* to sessionStorage so
page refresh reuses existing record instead of inserting a duplicate;
add _savingInProgress guard to prevent race-condition double-saves
- Desktop sidebar collapsible: add collapse/expand buttons (not collapsed
by default), state saved to localStorage; hidden on mobile
- Copy to Visit Note now also copies SSHADESS assessment to wv-shadess-text
- Store selected visit age in window._wellVisitAge + sessionStorage so
other tabs can read the patient's age
- Bigger screening/vaccine boxes: min-height on wv-vax-list, wv-screen-list,
wv-visit-detail; slightly more padding on vaccine items
- Wire New Patient (clearTab) buttons to document click handler
- Replace horizontal tab-nav with collapsible left sidebar (sticky desktop, slide-in mobile with hamburger toggle)
- Fix tab persistence: use localStorage instead of URL hash; restore last tab after login in enterApp()
- Fix admin CMS models loading: move autoDeleteDays read inside .then() callback (was ReferenceError), switch admin loading from click-only to tabChanged event
- Add Save/Load bars to Hospital Course and Chart Review tabs with popover support
- Add wv (well visit) save handler in encounters.js
- Register load handlers for hospital and chart tabs
- Expand popover prefix list to include hosp and chart
- Wrap save-bar + popover in .save-bar-wrap (position:relative) so the
absolute-positioned popover anchors correctly below the Load button
(previously popovers were outside the save-bar, so had no positioned
ancestor and appeared at the wrong place on screen)
- Remove confirm() dialog from deleteEncounter — encounter disappears
immediately from the popover list after deletion
- ICD-10 diagnoses: replace static-only lookup with live NLM Clinical
Tables API search (clinicaltables.nlm.nih.gov) with 280ms debounce;
results appear in a dropdown below the search input; Enter/click selects
- Add clinicaltables.nlm.nih.gov to CSP connect-src
- Drop unused position:relative from .save-bar (now on .save-bar-wrap)
- Add Well Visit tab with three sub-views: By Visit Age, Full Vaccine Schedule, Catch-Up Schedule
- By Visit Age: shows ICD-10/CPT billing codes, vaccines due with dose info, measurements, sensory/developmental/behavioral/procedure screenings, oral health, notes
- Full Schedule: scrollable table of all vaccines vs all visit ages
- Catch-Up Schedule: per-vaccine minimum ages, intervals, and catch-up notes per CDC 2025
- Add pediatricScheduleData.js (1719-line AAP 2025 Bright Futures dataset)
- Add wellVisit.js for tab logic (lazy-initialized on first tab activation)
- Fire tabChanged CustomEvent on tab switch for lazy initialization
- Add Well Visit CSS styles to styles.css
