Commit graph

66 commits

Author SHA1 Message Date
Daniel
f3e2714e6f set clinical prompt pool target 2026-05-08 08:52:29 +02:00
Daniel
dfaf8f15db use indexed assistant prompt examples 2026-05-08 08:44:34 +02:00
Daniel
7c1b17dfee tighten chart review source coverage 2026-05-08 07:10:00 +02:00
Daniel
d734f4945b honor admin default model selections 2026-05-08 06:49:50 +02:00
Daniel
25329c59af normalize LiteLLM embedding requests 2026-05-08 06:11:36 +02:00
Daniel
f86b7cf1b7 extract STT provider handling 2026-05-08 06:05:39 +02:00
Daniel
d6dccd2c65 simplify TTS provider handling 2026-05-08 06:00:33 +02:00
Daniel
16b4746b0a refactor clinical assistant backend utilities 2026-05-08 00:55:58 +02:00
Daniel
68a422a7ad restore assistant streaming 2026-05-08 00:26:10 +02:00
Daniel
d99605c3c0 stabilize assistant and add diagrams 2026-05-08 00:23:00 +02:00
Daniel
65661a54c7 fix assistant stream truncation handling 2026-05-07 23:02:26 +02:00
Daniel
baf05198a8 refactor clinical assistant prompt handling 2026-05-07 22:52:46 +02:00
Daniel
60d726a293 feat: stream clinical assistant responses 2026-05-07 17:26:10 +02:00
Daniel
624d084b49 feat: improve clinical assistant export and citations 2026-05-07 17:15:26 +02:00
Daniel
503f5afaad feat: ED multi-stage UX, extensions polish, docs viewer + application-logic docs
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.
2026-04-28 03:09:38 +02:00
Daniel
560ec43f8b feat: don't-miss tooltip after notes + bedside suture selector
#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.
2026-04-28 03:09:38 +02:00
Daniel
50e640149a feat: ED encounters + notes model selector; remove AI corrections; fix notes framing
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.
2026-04-28 03:09:38 +02:00
Daniel
66ecc2246b feat(pe-guide): step-by-step OSCE checklist, Bates/Nelson/Hutchison sourced
Replaces the generic one-line-per-component format with a step-level
checklist. Each exam component now contains 3–13 discrete steps, each
with its own Normal/Abnormal/Skip toggle and optional abnormal note.
Physician ticks the exam off step-by-step; report generation
summarises at the component level but knows exactly which steps were
performed.

Example — previously the adolescent "Cranial nerves (II–XII)" was a
single row: "How to perform: Full formal adult-pattern exam. Expected:
All cranial nerves intact." That's unhelpful. Now it's 14 discrete
steps: CN I, CN II acuity, CN II fields, CN II fundoscopy, CN II/III
pupils, CN III/IV/VI EOM, CN V sensation V1/V2/V3, CN V motor, CN V
corneal, CN VII forehead/eye-close/smile/puff, CN VIII, CN IX/X, CN
XI, CN XII — each with specific method and expected finding. Same
depth for MSK: scoliosis = 5 discrete steps (standing inspection,
Adam forward-bend, rib-hump check, scoliometer, plumb-line), joint
stability = 8 named tests (Lachman, anterior drawer, varus/valgus,
McMurray, apprehension, Neer/Hawkins, anterior drawer ankle, talar
tilt), Beighton = 5 per-joint measurements, etc.

Sources cited in code header: Bates' Guide 13th ed, Nelson Textbook
22nd ed, Hutchison's Clinical Methods 25th ed, Fenichel Clinical
Pediatric Neurology 8th ed.

Backend route accepts the flat step array (grouped by component on
the server), passes structured text to the AI with methods and
expected findings per step. Prompts updated to summarise at the
component level rather than step-by-step, so output is clinically
readable.

Scope: MSK + Neuro × 6 age groups (newborn, infant, toddler, preschool,
school-age, adolescent). More systems follow the same pattern —
append to PE_DATA.
2026-04-22 17:15:27 +02:00
Daniel
46b3a2f678 feat(pe-guide): Physical Exam Guide tab — OSCE reference + narrative report
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.
2026-04-22 16:52:13 +02:00
Daniel
ac0460b1fe fix(security): timing-safe forgot-password + redact log file writer
Two independent PHI-leak hardenings folded together:

1. forgot-password timing oracle
   The hit path previously did SELECT + token gen + UPDATE + SMTP send
   before responding; the miss path returned after the SELECT. An
   attacker could distinguish registered emails by response latency
   (SMTP RTT is hundreds of ms). Response is now sent immediately after
   Turnstile, with the DB and email work fired-and-forgotten in a
   background async block. Hit and miss take identical wall-clock time.

   Also hardened req.body.email to tolerate missing/non-string input
   instead of throwing 500.

2. logger.file redaction
   logger.info/warn/error wrote straight to /app/data/logs/YYYY-MM-DD.log
   without going through redact(). Current callers are metadata-only and
   safe, but any future caller writing logger.error('boom', req.body)
   would silently drop PHI to disk. Route both message and optional data
   through redact() — same helper the audit path already uses. Benign
   startup messages pass through unchanged; SSN/phone/email/DOB patterns
   are tokenised, long note-body-shaped text is truncated.
2026-04-22 01:01:00 +02:00
Daniel
a76aead242 fix: auth/API logging to Loki, TTS voice auto-detection, STT ElevenLabs support
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- Add logger.audit/access calls to auth route (login, login_failed,
  login_blocked, register, password_changed, 2fa_backup_code_used,
  2fa_backup_codes_regenerated) — these previously only wrote to DB
  via raw SQL, bypassing Loki shipper
- Replace logger.info with logger.apiCall in callAI() so every AI call
  ships to Loki with model, tokens, cost, duration
- Add device identifier (parsed user agent) to audit and access logs
- Fix TTS voice/model provider mismatch: auto-detect Vertex voices
  (Puck, Charon, Kore, etc.) and ElevenLabs voice IDs, override model
  to match provider regardless of what model was previously set
- Fix TTS discovery: model IDs saved to tts.voice are detected and
  redirected to tts.model (regex for openai-tts, elevenlabs, vertex-tts)
- Fix STT transcription route: add scribe/elevenlabs/transcri to the
  isTranscriptionModel regex so ElevenLabs Scribe uses /audio/transcriptions
  endpoint instead of chat completions
- Remove OpenObserve/SigNoz code from logger (reverted to Loki-only)
2026-04-19 21:26:49 +02:00
Daniel
d79d9eeded feat: neonatal calculator, DOCX/PPTX/ODT/EPUB support, gateway-agnostic URL helper, TTS/STT fixes
- Add neonatal assessment calculator: GA classification (extremely preterm through
  post term), weight-for-GA percentile (AGA/SGA/LGA) using Fenton 2013 LMS data,
  birth weight category (ELBW/VLBW/LBW/normal/macrosomia)
- Add DOCX support via mammoth, PPTX/ODT/EPUB via jszip in Learning Hub content
  generator file upload
- Add gatewayUrl() helper for consistent API URL construction — handles
  LITELLM_API_BASE with or without /v1 suffix, works with any OpenAI-compatible
  gateway (LiteLLM, Bifrost, etc.)
- Fix TTS model/voice separation: discovery now tags items as MODEL or VOICE,
  auto-detects provider from voice name (Vertex, ElevenLabs, OpenAI)
- Fix STT discovery to include ElevenLabs Scribe and Chirp models
- Fix TTS discovery to include ElevenLabs and Vertex voices alongside models
- Fix admin model test to bypass allowlist check (skipAllowlistCheck) so
  discovered models can be tested before adding
- Fix Nextcloud token decryption in learningAI.js WebDAV browse and file import
- Fix admin embedding test to show DB model name instead of hardcoded default
- Fix admin STT test to use correct endpoint for Whisper models
- Add AI gateway migration guide to configuration docs
- Add Grafana dashboard JSON for Loki log visualization
2026-04-19 02:17:06 +02:00
Daniel
63f77aa9cf Batch of security + scale fixes
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.
2026-04-14 05:24:40 +02:00
Daniel
8893e484fd Enforce server-side LLM model whitelist + scope idle timeout to writes
Two findings from review:

1. callAI() previously accepted any model string from the client.
   POST /api/hpi with { model: "openai/o1" } would call the reasoning
   model regardless of whether the operator enabled it. Added
   getAllowedModelIds() in src/utils/models.js (60s TTL DB-backed
   cache) and a guard at the top of callAI() that rejects with
   "model_not_permitted" when the requested ID isn't in the active
   roster. No model supplied → silent fallback to DEFAULT_MODEL.

2. Middleware was updating user_sessions.last_activity on every
   request, including GETs. Client-side polling (/api/auth/me
   heartbeats, dashboard refreshes, log tail calls) kept sessions
   alive indefinitely, defeating the 24h sliding idle policy. Now
   only POST/PUT/DELETE/PATCH count as "user activity". GETs are
   read-only and often automated — they no longer extend the
   session. Idle enforcement still runs on every method, so a
   24h-idle user still gets kicked on their next GET.
2026-04-14 05:15:55 +02:00
Daniel
b5abbb69fc Add node-pg-migrate for versioned schema changes + better mobile UA labels
Infrastructure only — no existing data or tables modified.

  src/db/migrate.js           — programmatic runner, fires at boot after
                                 the existing idempotent initDatabase()
  migrations/1744600000000...  — intentionally empty example, documents
                                 the file shape. Registered in the new
                                 pgmigrations tracking table so it won't
                                 rerun.
  .node-pg-migraterc.json     — CLI config (migrations-dir, utc naming)
  docs/migrations.md          — workflow + conventions
  package.json                — migrate:up/down/new/status npm scripts
                                 (status is a direct pgmigrations query
                                 since node-pg-migrate v7 lacks a status
                                 subcommand)

src/utils/sessions.js:
  - parseUserAgent now recognizes the Capacitor wrapper (UA suffix
    "PedScribe-Android" / "PedScribe-iOS") and labels sessions
    "PedScribe (Android)" instead of "Chrome on Android".

Going forward: schema changes go in /migrations as versioned files
with up() + down(); the inline init in database.js is the implicit
baseline for everything already in production.
2026-04-14 05:06:19 +02:00
Daniel
6dffdf91e5 Sliding 24h idle timeout (web) + persistent mobile + 2FA backup codes
Session model:
  Web     — 24h sliding idle timeout enforced server-side via
             user_sessions.last_activity. 30-day JWT + cookie are a
             safety net; middleware is the real clock. Cookie is
             re-set on active use so browsers match the sliding window.
  Mobile  — 365-day JWT, no idle timeout (stays persistent via Keychain
             / Keystore). Detected via User-Agent ("PedScribe" /
             "Capacitor") or X-Client: mobile header.

2FA backup codes:
  - 10 single-use codes generated when 2FA is first enabled
  - Stored as bcrypt hashes in new users.totp_backup_codes column
  - Consumed atomically on successful login fallback (when TOTP fails)
  - Regenerate endpoint (POST /api/auth/2fa/backup-codes) requires
    current password; invalidates prior codes
  - Count endpoint (GET /api/auth/2fa/backup-codes/count) powers a
    "N codes remaining" indicator on the 2FA settings card
  - Modal shows codes exactly once with Copy + Download .txt actions
  - Codes cleared when 2FA is disabled

New files:
  src/utils/platform.js — isMobileClient() helper

Schema migration (idempotent):
  ALTER TABLE users ADD COLUMN IF NOT EXISTS totp_backup_codes TEXT
2026-04-14 04:24:54 +02:00
Daniel
cb17a12172 Security hardening: PHI encryption, argon2, DOMPurify, SRI
- 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.
2026-04-14 02:49:38 +02:00
Daniel
369e440aa1 Enhance audit logging: user agent, session ID, PHI access tracking
Loki logs now include:
- User agent string (browser/device identification)
- Session ID (ties actions to specific login session)
- Status field (success/failure)

New logging:
- encounter_load: logged when user opens a saved encounter (with label)
- copy_to_clipboard: logged when user copies note content (PHI access)
- Client event endpoint: POST /api/logs/client-event (auth required)

Encounter save/delete/load all include the encounter label for
patient identification in audit trail.

HIPAA audit trail now covers: who, what, when, from where, which
device, which session, what patient data, success/failure.
2026-04-11 06:17:05 +02:00
Daniel
7582e3563d Add Loki + Grafana monitoring stack, ntfy notifications, biometric auth
Monitoring:
- docker-compose.monitoring.yml — opt-in Loki + Grafana stack
- Loki config with 6-year retention (HIPAA compliant)
- Grafana auto-provisioned with Loki datasource + PedScribe dashboard
  (login activity, failed logins, clinical actions, API calls, log viewer)
- Logger ships to Loki in parallel with PostgreSQL (fire-and-forget)
- Labels: app=pedscribe, type=audit|api_call|access, category, action

Usage: docker compose -f docker-compose.yml -f docker-compose.monitoring.yml up -d
Grafana at localhost:3003 (admin/pedscribe)

Notifications:
- ntfy push support (src/utils/notify.js)
- Notifications on: login, password change, registration
- Self-hosted, no Firebase dependency

Mobile:
- Biometric auth on app launch (Face ID/Touch ID/fingerprint)
- PIN/password fallback, auto-prompt, skip option
2026-04-11 03:00:52 +02:00
Daniel
d0d65446f6 Add biometric auth, ntfy push notifications, mobile improvements
Mobile:
- Add biometric authentication (Face ID/Touch ID/fingerprint) on app launch
  with PIN/password fallback, auto-prompts on launch, skip option
- Add @aparajita/capacitor-biometric-auth plugin

Backend:
- Add ntfy push notification support (src/utils/notify.js)
  Self-hosted, no Firebase dependency, uses user's existing ntfy instance
- Notifications for: new login, password changed, new registration (admin)
- Topic format: pedscribe-user-{id} for users, pedscribe-admin for admins
- Env: NTFY_URL, NTFY_TOKEN (optional)
2026-04-11 02:35:07 +02:00
Daniel
020e831b3c v6.2: Session management, password change, audit logging, refine context, UI fixes
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
2026-04-08 20:27:45 +02:00
ifedan-ed
f98b9b7b71 feat: Add model search, testing, and TTS/STT/embedding management to admin
- Fix model search for all providers: Bedrock now falls back to built-in
  list (with live ListFoundationModels attempt), Azure returns built-in list
- Add Test button on every model row (built-in, discovered, custom) that
  sends a live prompt and shows response + latency in a toast
- Add TTS management section: search voices from provider API (Google TTS
  voices.list, LiteLLM /v1/models, ElevenLabs /v1/voices), Set as Default
  writes tts.voice/tts.model to DB, runtime respects DB override
- Add STT management section: search models from provider (Gemini, Whisper,
  LiteLLM, OpenAI, local), Set as Default writes stt.model to DB, runtime
  respects DB override in transcribe.js
- Add Embedding models section: search from provider (LiteLLM, Vertex,
  OpenAI), Set as Default writes embeddings.model+dimensions to DB,
  embeddings.js respects DB override
- Add record-and-transcribe STT test (browser MediaRecorder)
- Add TTS synthesize-and-play test (returns base64 audio)
- Add embedding generate test (shows dims + vector sample)
- Expand PUT /config/:key(*) whitelist to include tts., stt., embeddings.
- Add @aws-sdk/client-bedrock as optional dependency for live Bedrock discovery
2026-04-03 19:55:11 +00:00
ifedan-ed
d86625c7e6 v4: Fix milestones display + add OpenID auth + 100MB PDF support
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FIXES:
- Milestones now show correctly on encounter page (use static fallback if DB empty)
- Static data preserved as MILESTONES_DATA_STATIC for compatibility
- Database-driven milestones still work (admin can edit via CMS)

NEW FEATURES:
- OpenID Connect (OIDC) authentication support (PocketID, Keycloak, Azure AD, etc.)
- Comprehensive setup guide: OPENID_SETUP.md
- Auto-linking existing users by email on SSO login
- Multiple PDF upload support in Learning Hub (up to 10 files)
- 100 MB per file limit (was 20 MB)
- Full PDF content used for AI generation
- Embeddings use first ~8K chars for semantic search

IMPROVEMENTS:
- Updated UI to show multiple file selection with list
- Drag-and-drop supports multiple files
- Better file upload validation and error handling
- Added clarifying comments about embedding truncation
2026-04-01 17:59:51 +00:00
ifedan-ed
ef0f986c2f Add per-user voice preferences (STT model + TTS voice selection)
- NEW: User preferences for STT model and TTS voice
- Database: stt_model and tts_voice columns in users table
- UI: Voice Preferences section in Settings with dropdowns
- API: /api/user/preferences (GET/POST) + /preferences/options
- Transcribe: Respects user's STT model (Google, LiteLLM)
- TTS: Respects user's TTS voice (Google, LiteLLM, OpenAI, ElevenLabs)
- Preview: Test TTS voice before saving
- Available models/voices auto-detected from provider config
2026-03-31 14:47:00 +00:00
ifedan-ed
106e4baf17 Add Vertex AI embeddings + semantic search for Learning Hub
- New: Vector search with pgvector extension (cosine similarity)
- Embeddings: Vertex AI text-embedding-005 (768 dims, HIPAA-eligible)
- 3 search modes: keyword, semantic, hybrid (best of both)
- Auto-generate embeddings on content create/update
- Admin endpoints: /api/admin/learning/embeddings/generate (backfill), /status
- User endpoints: /api/learning/search/semantic, /search/hybrid
- Falls back to OpenAI embeddings if Vertex not configured
- Supports LiteLLM proxy routing

Models tested:
- vertex_ai/text-embedding-005 (768 dims, English+code) 
- vertex_ai/gemini-embedding-001 (3072 dims, multilingual) 
- vertex_ai/text-multilingual-embedding-002 (768 dims) 
2026-03-31 14:36:49 +00:00
Daniel Onyejesi
4808d08aa7 Fix STT/TTS properly per LiteLLM docs
STT: Vertex AI Chirp not supported via LiteLLM proxy (confirmed by docs).
     Now uses Gemini directly (transcribeGoogle.js) — auto-detected when
     GOOGLE_VERTEX_PROJECT is set, fallback to AWS then OpenAI.

TTS: LiteLLM Vertex TTS DOES work but requires the model_list ALIAS
     (tts-1) not the underlying path (vertex_ai/text-to-speech).
     Also pass voice param — LiteLLM supports Google Cloud voice names.
     Auto-detected when LITELLM_API_BASE is set.
2026-03-30 07:28:47 -04:00
Daniel Onyejesi
58c8f1c549 Fix model management: empty LiteLLM list, always reload panel, clear-all
- LITELLM_MODELS = [] — no hardcoded models, global selector now only
  shows what admin has actually added via Search API
- getAvailableModelsWithOverrides: for LiteLLM returns only custom list
- Remove toggle safety check — admin can disable any/all models freely
- Admin panel always reloads on tab open (was cached, showing stale data)
- Add 'Clear all models' button for LiteLLM to wipe and start fresh
- Add POST /config/models/clear-all endpoint
2026-03-29 19:32:09 -04:00
Daniel Onyejesi
9ec4cbf6b1 v9.1: Add Google Vertex AI + LiteLLM support, admin model management panel
- 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
2026-03-29 10:32:45 -04:00
ifedan-ed
72e91e940c Revert chunk size to 8KB — larger sizes cause AWS deserialization errors
Keep 8KB CHUNK_SIZE (proven stable) but replace 10ms setTimeout delay
with a microtask break every 16 chunks. This avoids the AWS SDK
"Deserialization error: inspect {error}.\$response" while still
eliminating the ~1.25s/MB artificial delay from the old 10ms sleep.
2026-03-29 01:21:43 +00:00
ifedan-ed
35f03ac0ba Optimize transcription speed: remove artificial delays, add timing
- AWS Transcribe: remove 10ms delay between chunks (was adding ~1.25s/MB),
  increase chunk size from 8KB to 32KB (AWS max per frame)
- Add detailed timing logs (ffmpeg, streaming, total) for diagnostics
- OpenAI Whisper: use response_format='text' for faster response parsing
- Frontend: show transcription time in toast, request 16kHz sample rate,
  increase bitrate to 32kbps Opus (better quality, still small files)
- Return duration in API response for all providers
2026-03-29 00:59:30 +00:00
Daniel Onyejesi
044c809ff3 v10: Local Whisper transcription, bigger text areas, flexible AI memory
- Add local Whisper (whisper.cpp / faster-whisper) as transcription provider
  Set TRANSCRIBE_PROVIDER=local with configurable model size and binary path
- Upgrade all refine/instruction inputs to resizable textareas across
  encounter, dictation, hospital course, chart review, well visit, sick visit
- Make AI memory injection flexible: physician preferences and corrections
  are now actively applied (not just "formatting reference"), while still
  overridable by current prompt instructions
2026-03-28 22:00:30 +00:00
Daniel Onyejesi
25c462bfd6 Fix AWS Transcribe: reduce chunk size from 32KB to 8KB
AWS Transcribe rejects audio event frames over ~16KB with a
cryptic "Deserialization error" / "Your stream is too big" message
hidden inside the SDK error object. Reducing to 8KB per chunk
fixes both Standard and Medical Transcribe streaming.
2026-03-25 18:41:05 -04:00
Daniel Onyejesi
6d1c2e5422 Improve Transcribe error diagnostics, add minimum audio check
- Log $response status/headers/body on deserialization errors
- Add 10ms delay between audio chunks to prevent stream overload
- Skip transcription if audio < 0.5s (too short for recognition)
- Cleaner error logging with dedicated logTranscribeError helper
2026-03-25 18:29:48 -04:00
Daniel Onyejesi
a53124a747 Add detailed error logging for Transcribe Medical failures
Log error name, AWS metadata, and root cause to diagnose
the "non-retryable streaming request" error.
2026-03-25 18:24:37 -04:00
Daniel Onyejesi
1f66b7c0e1 Add Medical→Standard fallback and better error logging for AWS Transcribe
When Medical Transcribe fails (wrong IAM permissions, region not
supported), automatically falls back to Standard Transcribe instead
of returning an error. Logs the specific failure reason.
2026-03-25 18:10:21 -04:00
Daniel Onyejesi
9eaec4f2de Add ffmpeg audio conversion fallback for AWS Transcribe
- transcribeAWS.js: convert browser WebM/Opus → PCM 16kHz mono via
  ffmpeg before sending to AWS Transcribe — PCM is unambiguous and
  most reliable; gracefully falls back to ogg-opus if ffmpeg absent
- Dockerfile: install ffmpeg (apk add ffmpeg) so Docker image works
  out of the box with AWS Transcribe
- README: document Amazon Transcribe setup, ffmpeg requirement,
  Transcribe Medical specialty options, and env vars reference
2026-03-25 20:35:24 +00:00
Daniel Onyejesi
b997d6d388 Add Amazon Transcribe streaming (no S3) with Medical specialty support
- New src/utils/transcribeAWS.js: streams audio directly to AWS
  Transcribe without requiring an S3 bucket
- Supports AWS_TRANSCRIBE_MEDICAL=true for Transcribe Medical
  (better clinical accuracy: drug names, diagnoses, procedures)
- AWS_TRANSCRIBE_SPECIALTY configures specialty (default PRIMARYCARE)
- transcribe.js auto-selects AWS when AWS_BEDROCK_REGION is set,
  or can be forced with TRANSCRIBE_PROVIDER=aws|openai
- Falls back to OpenAI Whisper when AWS is not configured
- Add @aws-sdk/client-transcribe-streaming as optional dependency
- Update .env.example with transcription configuration docs
2026-03-25 20:26:10 +00:00
Daniel Onyejesi
feb47b5e79 Re-add vendor model Opus 4.6, update DEVELOPER_GUIDE with logs/Bedrock docs
- Re-added Opus 4.6 (JSON sanitizer now handles its output)
- Added Logs & Debugging section with docker logs commands and prefixes
- Added Bedrock Model Notes (inference profiles, maxTokens, JSON sanitization)
- Updated version history through v5.8
- Updated rate limiting docs, build/push process, current image tag
2026-03-24 19:14:00 -04:00
Daniel Onyejesi
4b62d073f7 Remove vendor model Opus 4.6 (returns invalid JSON via Bedrock) 2026-03-24 18:43:28 -04:00
Daniel Onyejesi
993e3a112f Re-add Qwen3 235B (works in us-east-1 despite docs) 2026-03-24 18:35:51 -04:00