- 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
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.
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.
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.
After the hybrid auth migration, web users log in but the
setAuthCookie() helper was never actually called in /login or
/register — only in the OIDC callback. Result: local sign-in worked
until the first page reload, then the user appeared logged out. The
Settings page's Active Sessions list came up empty because
/api/sessions received no auth.
Added setAuthCookie(res, token) calls on successful:
- /register (auto-verified first admin path)
- /login (after TOTP / backup code verification)
Mobile is unaffected — it uses Bearer from Keychain and always has.
settings load2FAStatus():
- Explicit credentials: 'same-origin' on the /me fetch (was relying
on fetch defaults, which can behave oddly in some browsers/edges)
- Fall back to window.CURRENT_USER (cached at login) if /me fails,
so local-auth users still see their password/2FA sections after
a transient error. Keeps cache in sync on each successful fetch.
enterApp():
- Cache the logged-in user object on window.CURRENT_USER so modules
that need the canLocalAuth flag don't have to re-fetch /me.
2FA regenerate modal:
- Previous call passed a wrong-shape options object to showConfirm.
Updated to the correct (message, callback, opts) signature with
input:true, inputType:'password', placeholder, required.
OIDC email_verified check:
- Accept boolean true or string 'true' for robustness. Some IdPs
serialize ID-token booleans as strings.
Endpoint guards (defense-in-depth over hidden UI):
- POST /api/auth/change-password: 400 with SSO-aware message if
the caller's stored password is not a real bcrypt/argon2 hash.
Prior behaviour was to fail at passwords.verify() with an
ambiguous "current password is incorrect".
- POST /api/auth/setup-2fa: 400 with same SSO-aware message for
SSO-only accounts. Prior behaviour allowed TOTP setup on an
account where it could never actually trigger (user never logs
in locally).
OIDC account-link safety (src/routes/oidc.js):
- Auto-link to an existing local account now requires the IdP to
assert email_verified=true in the ID token (or userinfo). If
absent/false, the callback redirects with ?error=email_unverified.
Prevents an attacker at a misconfigured IdP from taking over a
local account by claiming an email they don't own.
- If an existing user already has oidc_sub set and the incoming
sub is different, refuse with ?error=sub_mismatch. Prior
behaviour silently did nothing, hiding a potential attack.
- Audit 'oidc_linked' written on first successful link.
Frontend:
- Added user-facing messages for the two new SSO error codes.
Middleware:
- Log to console.warn + audit_log when a session is killed for
inactivity. Shows up in Grafana/Loki so you can see how often
users actually get kicked. Audit action: 'session_idle_timeout'
- last_activity throttle bumped 5 min → 10 min — halves DB writes
per active user. Idle precision slop widens to 24h00-24h10;
still invisible in practice.
Per-user local-auth visibility:
- /api/auth/me now returns user.canLocalAuth: true when the stored
password is a real bcrypt / argon2 hash, false for the random
blob OIDC auto-creates for SSO-only users.
- Settings page hides "Change Password" and "Two-Factor
Authentication" sections when canLocalAuth is false — those UIs
are meaningless for users whose sign-in lives at the IdP.
- Password hash is not leaked in the /me payload.
Mobile (restating existing behaviour for clarity): no idle check,
365-day JWT in Keychain/Keystore, never auto-logs-out. Only logout
triggers are: manual logout, password change, admin revoke, JWT hit
365d, or app uninstall.
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
Shortens both JWT expiresIn and httpOnly cookie maxAge to 24h in
auth.js (local + register + reset flows) and oidc.js (SSO callback).
Rationale: shorter absolute session window for a PHI-adjacent app.
No sliding idle refresh — user re-logs in once a day.
idx_users_email and idx_sessions_token_hash now use byte-order
collation so a future ICU library bump cannot silently corrupt the
indexes the way it did this week. The columns themselves retain
their default collation; only the index comparison is C, which is
safe for these because:
- users.email is lowercased ASCII in practice
- user_sessions.token_hash is SHA-256 hex (pure ASCII)
Both are used for equality lookups only, never ORDER BY. Migration
is idempotent, gated on app_settings.migration.text_indexes_c.
Slug indexes on learning_* tables left at default for now — those
are also ASCII in practice but under lighter load; the startup
drift check + auto-REINDEX covers them.
Root cause of recent "invalid credentials on correct password" was
a silent btree index corruption: pgvector/pgvector:pg16 was pulled
with a different ICU library than the one used to build existing
indexes. Queries returned 0 rows even though matching heap rows
existed. Postgres logged nothing (corrupt index → empty result set
is a "successful" query) and the login path never logged unknown-
user attempts (enumeration protection).
Three defenses:
1. Pin postgres image by digest in docker-compose.yml so a
silent pull can't change ICU under our feet.
2. Startup collation-drift check in src/db/database.js:
compares pg_database.datcollversion to the library's actual
version and, on mismatch, runs REINDEX DATABASE + ALTER
DATABASE REFRESH COLLATION VERSION. Logs "Collation versions:
aligned" on clean boot.
3. Server-side console.warn on login lookup-miss (no email, no
audit row — preserves enumeration protection but gives
Grafana/Loki a signal for unusual miss rates).
Root cause for "invalid credentials" on correct password was a
corrupt btree index (idx_users_email) causing user lookups to miss
existing rows. Fixed by REINDEX DATABASE. Keeping a typed catch
around passwords.verify() so any future verify throw is logged
cleanly instead of bubbling as 500.
- 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.
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.
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)
- Fix: DELETE all other sessions query used empty string fallback when
req.sessionId was undefined, causing id != '' to match ALL rows
(including current session). Now skips deletion if sessionId unknown.
- Fix: Revoke All endpoint returns error if current session not identified
- Fix: var confirm shadowing window.confirm in password change handler
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
- 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
NEW FEATURES:
- Bulk Import button in Admin Panel → Developmental Milestones section
- "Import Default Milestones Data" button appears when database is empty
- "Re-import All" button to clear and re-import all static data
- Visible notice when no milestones exist with one-click import
IMPROVEMENTS:
- Auto-shows empty state notice when database has no milestones
- Backend bulk-import endpoint now supports clearExisting parameter
- Imports ALL age groups from static data (birth to 11 years)
- Better UX - admin doesn't need CLI to populate milestone data
FIXES:
- Makes milestone admin editing feature discoverable and usable
- No need to manually run import script anymore
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
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
Emails: white card, clean typography, dark button, no gradients.
Same minimal aesthetic as Linear/Resend/Notion emails.
Verify page responses also updated to match.
LiteLLM /audio/transcriptions gives 'Unmapped provider' for Vertex AI Chirp.
The correct approach: use /v1/chat/completions with a Gemini model and send
audio as base64 input_audio content block — Gemini natively understands audio.
Set LITELLM_STT_MODEL to your Gemini model name (e.g. gemini-2.5-flash).
- Bug 1: When user selected "Outpatient" review type but had any subspecialty
visit cards filled in, the backend ignored the top-level type and switched to
the subspecialty prompt. Fixed: top-level type dropdown is now definitive.
Per-visit note types only control data formatting/labeling, not prompt selection.
- Bug 2: Labs entered in a visit card were silently dropped for outpatient and
subspecialty visits (only ED visit labs were included). Fixed: per-visit labs
now appear immediately after their visit content, labeled with the visit date.
- Improved lab labeling: visit labs are labeled "Labs from this visit (date)"
and the separate labs section is labeled "ADDITIONAL LABS (not tied to a
specific visit)" so the AI clearly distinguishes them.
- 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)
vertex_ai/chirp does not work via LiteLLM's audio transcription proxy.
Changed default LITELLM_STT_MODEL from vertex_ai/chirp to whisper-1.
Updated .env.example documentation to match.
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.
LiteLLM's atranscription has a routing bug with Vertex AI Chirp proxy.
AWS Transcribe is already configured and working. Auto-detect now prefers
AWS over LiteLLM. Use TRANSCRIBE_PROVIDER=litellm to force LiteLLM.
- TTS: switch to axios, drop voice param (configured in LiteLLM per model)
- STT: log full LiteLLM error body so 500s are diagnosable in logs
- TTS: same error detail logging
- Fix 'ElevenLabs unavailable' toast to generic 'TTS unavailable'
- Add red Stop button to encounter recording UI
- TTS: switch from OpenAI SDK to axios (same fix as STT), drop voice
param since it's configured inside LiteLLM per model
- Fix 'ElevenLabs unavailable' toast shown even when provider is LiteLLM
- Add dedicated red Stop button to encounter recording UI
Vertex AI Chirp via LiteLLM rejects/hangs when 'prompt' and
'response_format' are included — these are OpenAI Whisper-only params.
Send only file + model for LiteLLM/Chirp.
Having LITELLM_API_BASE for AI text was auto-routing audio transcription
through LiteLLM even when the proxy has no Whisper model configured,
causing silent hangs. Now LiteLLM STT only activates when LITELLM_STT_MODEL
is explicitly set. Falls back correctly to AWS Transcribe when configured.
OpenAI SDK's audio.transcriptions.create() hangs with LiteLLM
(no timeout, SDK-level incompatibility with multipart handling).
Use axios + form-data directly with 120s timeout — same approach
as ElevenLabs TTS. Handles both {text:"..."} and plain string responses.
- 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
- 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
- Root cause: PUT /config/:key(*) wildcard was registered before
/config/models/toggle and /config/models/default, intercepting them
and returning "value is required" (body had modelId not value)
- Fix: move all model-specific PUT routes before the wildcard
- LiteLLM: return empty built-in list with discovery hint (hardcoded
models don't match user's proxy — must use Search API)
- After adding a discovered model: auto-select it in the default dropdown
- GET /config/models now returns defaultModel so dropdown pre-selects it
- 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
- Add GET /api/transcribe/status endpoint — returns whether any server
transcription provider (Whisper/AWS/Local) is configured
- Frontend checks status on login via checkTranscribeStatus()
- When no provider configured: recording stops instantly, keeps live
Web Speech API text, shows friendly toast — no error, no upload wait
- Works in encounter, dictation, and SOAP tabs
- App now works fully out-of-the-box with just an AI provider key
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.
- 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
- 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
- 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
- OIDC callback now passes only ?sso=ok flag, token stays in
httpOnly cookie (prevents token leaking to logs/referrer/history)
- Frontend auth.js uses cookie-based auth for SSO flow
- Add [PHYSICIAN TEMPLATES] boundary markers around physicianMemories
in all 5 generation routes to mitigate prompt injection
- Consistent boundary format across wellVisit, sickVisit, hpi, soap,
hospitalCourse
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
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.
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.
- Add try-catch to /nextcloud/disconnect route (was crashing on DB errors)
- Update docker-compose.yml image tag from v7 to v8
- Remove unused SESSION_SECRET from .env.example
Previously only well-visit and sick-visit used saved physician
templates. Now HPI encounter, HPI dictation, SOAP, and hospital
course all fetch getUserMemoryContext() and pass physicianMemories
to the backend so the AI learns from saved templates/preferences.
- 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
- 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
- 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
Sonnet 4.6 outputs literal newline characters inside JSON string
values (e.g. in HTML body field) instead of \n escape sequences.
Added sanitizeJsonString that walks the string character by character
and escapes unescaped control chars inside quoted values.
- ALL models that need inference profiles now use us. prefix IDs:
Anthropic (all 8), Nova (3), Meta Llama (3), DeepSeek R1, Writer
- Models with low max output tokens (Cohere 4096, Jamba 4096) now
have maxOut field; callBedrock clamps maxTokens automatically
- Removed Qwen3 235B (no us-east-1 support, no inference profile)
- Added better debug logging for response block structure
Opus 4.6, Opus 4.5, Sonnet 4.6, Haiku 4.5 do NOT support direct
on-demand invocation — they require cross-region inference profile IDs
(us.anthropic.* prefix). Updated all affected bedrockIds. Also fixed
isAnthropic check to handle us.anthropic.* prefix.
Sonnet 4.5, Sonnet 4, 3.5 Haiku also updated to use profiles for
consistency (profiles work everywhere, direct IDs are limited).
- Opus 4.6 returns multiple content blocks (thinking + text); was only
reading content[0] which was the thinking block (just '{')
- Now iterates all blocks and extracts only type:'text' blocks
- Added debug logging for Bedrock response structure
- Re-added Nova Pro, Nova Lite, Nova Micro with correct region metadata
Opus 4.6 and other large models add preamble/thinking text before
JSON output. Fix: add system message enforcing JSON-only, strip
leading text before first {, trim trailing text after last }, and
log raw output on parse failure for debugging.
- Removed Amazon Nova models (not available for on-demand invocation)
- Replaced DeepSeek V3 with V3.2 (correct model ID)
- Removed Mistral Large 24.07 (us-west-2 only), added Magistral Small
- Added vendor model Opus 4.1, Writer Palmyra X5, Qwen3, Command R
- Each model now has region metadata; getAvailableModels() filters
to only show models available in the configured AWS_BEDROCK_REGION
- Fixes "on-demand throughput not allowed" and region mismatch errors
- New GET /api/learning/content/:slug/slides (authMiddleware only)
Renders Marp markdown via marp-core, returns {css, slides[]} for
any authenticated user — no moderator access required
- showViewer: when content_type === 'presentation', hides the body card
and shows a presentation card with title, slide count, and View Slides button
Auto-opens the slide modal immediately on load; button allows re-opening
- openSlidesFromSlug(): fetches slides from user-accessible endpoint
then opens the existing slide preview modal (arrow keys, swipe, dots)
- Viewer already correctly hides feed/categories/search when viewing content;
"Back to Feed" button returns to the main list
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
Delete confirmation:
- Replaced browser confirm() popup with inline red warning bar in editor
- Shows content title, Cancel and Delete buttons inline in the editor header
- Category delete uses double-click pattern with toast feedback
Login screen:
- Changed from dark blue/purple gradient to light gray background (var(--g50))
- Card now matches 404 page style: white, subtle blue shadow, indigo border
Presentation content type:
- New 'Presentation' button in CMS toolbar (green style)
- Marp markdown textarea editor (dark code editor style) shown when type=presentation
- Body/Tiptap editor hidden; Marp section shown (toggleEditorMode)
- Preview button: renders Marp HTML via @marp-team/marp-core, opens in new tab
- Download PPTX: pure-JS pptxgenjs (no Chromium), parses slides, exports .pptx
- AI generate: returns Marp markdown directly when contentType=presentation
- Body column stores Marp markdown for presentations
Backend:
- POST /api/admin/learning/generate-pptx — pptxgenjs PPTX from Marp markdown
- POST /api/admin/learning/preview-slides — Marp HTML preview
GitHub repo set to private via API.
Backend (src/routes/learningAI.js):
- POST /api/admin/learning/ai-generate
* Accepts: topic text, uploaded file (PDF/TXT/MD/HTML), or Nextcloud WebDAV path
* Extracts text from PDFs via pdf-parse; plain text read directly
* Fetches WebDAV files using stored Nextcloud credentials
* Prompts AI to return structured JSON: title, subject, body (HTML), questions[]
* Strips code fences, falls back to regex JSON extraction if needed
- POST /api/admin/learning/ai-refine — refine existing body with instructions
- GET /api/admin/learning/webdav-browse — PROPFIND-based Nextcloud file browser
- POST /api/admin/learning/webdav-path — save user's default browse path
Frontend:
- AI Generate button in CMS editor header (gradient purple→blue)
- Panel with 3 source tabs: By Topic / Upload File / Nextcloud
- Drag-and-drop file dropzone with DataTransfer API support
- WebDAV file browser: navigate folders, select files, breadcrumb path
- Options: question count, content type (article/quiz/pearl), model selector, instructions
- Refine Current Body: prompt-driven AI rewrite of existing content
- Generated content auto-fills title, subject, type, Tiptap body, quiz questions
Settings:
- Nextcloud section: "Learning Hub Default Browse Path" field (shown when connected)
- Saves to webdav_learning_path column via /api/admin/learning/webdav-path
DB: ALTER TABLE users ADD COLUMN IF NOT EXISTS webdav_learning_path TEXT
- 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
- WNL/Normal systems now expand to 1-3 specific pertinent negatives instead of
just "WNL" — varies each time, relates to chief complaint and differential
(e.g., Skin: "no rash, no petechiae, no bruising" instead of "WNL")
- Abnormal systems: AI expands physician's brief note into clinical description
favoring most common presentation, adds only 1-2 related pertinent negatives
(e.g., "pimples on face" → "inflammatory papules on bilateral cheeks...")
- Format function now passes system domain details for context
- Rules applied to well visit (full + short) and sick visit prompts
- Growth reference data by age (newborn through 21y): expected weight/length/HC
gains per day/month/year, puberty growth spurt details
- Feeding/nutrition guidance by age: formula amounts, breastfeeding frequency,
solid food introduction timeline, juice limits, milk transitions, calorie needs
- BMI/obesity classification per AAP 2023 CPG + CDC Extended BMI:
Underweight, Healthy, Overweight, Obesity Class I/II/III with action items
(≥120% and ≥140% of 95th percentile thresholds)
- Weight-for-length guidance for children <2 years
- "By Visit" panel now shows growth reference + feeding guidance + BMI table
- Well visit AI prompt updated to include growth assessment, BMI classification,
and feeding counseling in generated notes
- Backend injects age-appropriate growth/nutrition data into AI context
- 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
- Source: docs.aws.amazon.com/bedrock/latest/userguide/models-supported.html
- Added: vendor model Opus 4.6 (anthropic.agent-config-opus-4-6-v1)
- Added: vendor model Opus 4.5 (anthropic.agent-config-opus-4-5-20251101-v1:0)
- Added: vendor model Sonnet 4.6 (anthropic.agent-config-sonnet-4-6) — new default
- Added: vendor model Sonnet 4.5 (anthropic.agent-config-sonnet-4-5-20250929-v1:0)
- Kept: vendor model Sonnet 4, Haiku 4.5, vendor model 3.5 Haiku
- Fallback updated to vendor model Haiku 4.5
- Bump version to 2.9.0
- resetChartReview() clears all pasted notes, visit cards, labs, demographics, and output on New
- clearTab('chart') in encounters.js now calls resetChartReview() for complete reset
- chartReview route injects today's date so AI understands time-relative terms
- Bedrock models updated to vendor model-only with verified 2025 IDs (Sonnet 4, 3.7 Sonnet, 3.5 Sonnet v2, 3.5 Haiku)
- Removed Llama/Mistral/Titan from Bedrock; fixed incorrect vendor-model-4.6 Bedrock IDs
- Bump version to 2.8.0
Replace checkmark/X symbol format with plain numbered sentences:
achieved → 'Can walk independently'
not achieved → 'Cannot walk' / 'Does not yet use 2-word sentences'
- CSP connectSrc was blocking service worker re-fetches to cdnjs.cloudflare.com
causing Font Awesome icons to go blank (settings, logout, nextcloud buttons)
- Add cdnjs, googleapis, gstatic, google to connectSrc to fix icon rendering
and Chrome Web Speech API (which connects to Google servers for TTS voices)
- Add vendor model Opus 4.6 and vendor model Sonnet 4.6 to all three provider lists
(OpenRouter, Bedrock, Azure-compatible); Sonnet 4.6 now default for Bedrock
