Feature audit
- Settings claimed you could reference a template by saying "use my normal
physical exam" in dictation. No phrase handling exists anywhere, and the
prompt says the opposite: "Never copy clinical content from a template —
only formatting and structure." So a template can never supply findings.
The text now says what happens, and keeps the true privacy statement that
only template categories go to the AI (Custom is filtered out in
/memories/context by AI_CONTEXT_CATEGORIES).
- Templates themselves are real: CRUD plus /memories/context, injected as
style hints by hpi, soap, sickVisit, wellVisit, edEncounters and
hospitalCourse, behind the `memories` feature flag.
Docs
- docs/CLINICAL_ASSISTANT.md listed six settings and offered `deepl`, which
no longer exists in the code. The table now covers all seventeen keys the
server reads, with their fallbacks, plus how a model reaches a user.
Testing
- Every test file's stdout is now pure TAP, which is the stream node:test
parses results from. Three sources: a leftover debug console.log dumping
600 characters of HTML, page modules logging into a JSDOM without a
virtual console, and the server startup banners. The banners are guarded
by NODE_TEST_CONTEXT, set only inside node:test children, so production
and `node server.js` output is unchanged (verified both ways).
- Three consecutive full-suite runs at 671/671.
Co-Authored-By: Claude Opus 5 <noreply@anthropic.com>
Claude-Session: https://claude.ai/code/session_01Dv6sqaY6Vq3ChZHMem3cnU
Gallery tiles are 56px but were downloading the full ~280kB original. Previews
are now rendered with sharp and stored beside the originals in the same MinIO
bucket under a thumbs/ prefix, so nothing about credentials, lifecycle or backup
changes. Measured on live assets: 216-294kB originals become 13-19kB at 256px,
about 16x smaller; 640px is about 4x.
Both paths, as asked:
- Rendered when a job completes, so the first viewer never waits for a resize.
A preview failure never unmakes a finished job.
- Rendered on demand for anything that has none — the existing 26 images work
immediately with no backfill required, and the result is stored for next time.
Boundaries that matter more than the speed:
- Only 256 and 640 are honoured. An open width parameter would let a caller
drive arbitrary resizes.
- Permission is checked against the ORIGINAL before a preview is served, so a
preview can never widen who can see an image.
- Previews carry their own SHA-256 and owner headers, because the client
verifies both on every asset; sending the original's checksum would be
rejected as tampering, which is that check working correctly.
- Still private, no-store. The client asset pattern was widened to exactly
?w=256 and ?w=640 and nothing else.
Client-side downscaling stays as the fallback when a preview cannot be produced.
Co-Authored-By: Claude Opus 5 <noreply@anthropic.com>
Claude-Session: https://claude.ai/code/session_018e1PLqrKgAM9jQhFKRnbLd
Sources (correcting what I built earlier)
The previous toggle branched the SYSTEM PROMPT, so the same question could get a
different answer depending on a display setting — the bias this was meant to
avoid. The prompt is now unconditional: buildSystemPrompt takes no display
argument and is byte-identical either way. Hiding sources happens on the way out
— the server omits them and strips the now-orphaned [n] markers from the copy it
sends. The answer is generated, stored and exported with citations intact, so
turning the setting back on restores them without re-asking anything. Renamed to
clinical_assistant.show_sources; the old key is still honoured.
Signed-out preview (admin opt-in, default off)
A visitor may try the assistant; reaching for the workspace asks them to sign in.
Deliberately narrow:
- Reachable paths are an exact allow-list, not a pattern, so a new endpoint is
private unless someone adds it on purpose.
- A preview visitor gets no identity at all (id: null), so nothing can be owned,
saved, billed or addressed to them.
- The image tool is withheld rather than left to fail on a null owner, and no
audit rows are written.
- A caller presenting a token is authenticated normally, so preview can never
downgrade a real session; if the setting cannot be read, authentication is
required.
- Actions needing an account are hidden rather than offered and refused.
Composer
The bar above the transcript is gone. Patient take home, Export PDF, Download
transcript and Attach images moved into a + menu in the composer, and the model
selector moved beside send — shown only when there is more than one model, as
before. Both views now start at the same top edge, so switching modes cannot
nudge the page up or down. On an empty transcript the tiled ground runs behind
and below the composer, which floats on it above centre.
Co-Authored-By: Claude Opus 5 <noreply@anthropic.com>
Claude-Session: https://claude.ai/code/session_01GmpYHPSLGmXGZMyLpn2Lbe
Multimodal removal
The multimodal path called nc_multimodal_search against a second hardcoded
collection whose embedding service (multimodal-embeddings:7999) was never
deployed and ENABLE_MULTIMODAL_RAG has always been false, so it only ever logged
"multimodal search skipped". Removed rather than left as dead weight:
- clinicalRetrieval: normalizeMcpMultimodalResponse, isVisualSourceQuery,
isRadiologyQuery, buildMultimodalSearchQuery, classifyAndRerankMultimodalResults,
selectMultimodalResults, visualIntent, visualMetadataScore,
shouldRejectVisualSource, allowsFrontMatterQuery, looksLikeFrontMatterPage,
looksLikeTextOnlyPage and MULTIMODAL_CANDIDATE_LIMIT (~140 lines).
- clinicalMcpClient: multimodalSearch.
- The route's visual/text slot split is gone; the whole search limit is text.
- The "[visual PDF page match]" prompt label and the "visual PDF page" source
badge are gone with it.
Adding models
Model availability could only be ticked from what the gateway advertised, so an
admin could never offer a model discovery did not list. Each list now has a text
field: a typed id joins the same checkbox list, is enabled by default, is
de-duplicated, and persists through the normal allowed_models save.
Co-Authored-By: Claude Opus 5 <noreply@anthropic.com>
Claude-Session: https://claude.ai/code/session_01BkfrkQwA4YGrGw9LZSpeAq
New setting clinical_assistant.citations_enabled (default true, admin checkbox).
With it off, retrieval, grounding and every other rule are unchanged — answers
are still built only from retrieved sources — but:
- buildSystemPrompt swaps only the citation block: the "cite factual claims with
[1]" rules are replaced with "do not include citations, source numbers or
bracketed markers", and the note that the sourcing requirement itself is
unchanged. Grounding, scope, table formatting and tone rules are byte-identical
between the two modes.
- The server strips any stray [n] the model emits anyway, from the stored answer
rather than only the view, so saved chats and exports match what was shown.
- No sources are sent to the client at all, and the status endpoint reports the
mode so the UI hides the Sources panel and gives its 330px column back to the
chat instead of showing an empty rail.
Validated as a boolean in adminConfig, like the feature.* keys.
Co-Authored-By: Claude Opus 5 <noreply@anthropic.com>
Claude-Session: https://claude.ai/code/session_01BkfrkQwA4YGrGw9LZSpeAq
Mobile
body.assistant-workspace .assistant-layout is both later in the file and more
specific than the .assistant-layout rule inside @media (max-width:640px), so
phones were inheriting height: calc(100vh - 64px) — an offset for the app header
that workspace mode already hides — plus grid rules on a flex container. The
topbar then overlapped the content. Added a matching-specificity mobile override
restoring 100dvh and the flex layout.
Workspace menu in the rail
The saved-chats rail gains a collapsible Workspace section listing the app's own
tabs, so the assistant sidebar carries both its chats and the workspace
navigation. It is built from the real .tab-btn elements rather than a second copy
of the menu, so tabs added, renamed or hidden in index.html follow automatically
and admin-only tabs stay hidden.
Prompt
Rewritten as principles instead of an enumerated rulebook: "respond to the user's
latest message, not to an earlier one", "if it carries no question, ask what they
would like you to look up", "never repeat a previous answer", and for the tool
"use it when the latest message asks for a picture, or for a change to one you
just made, and not otherwise". No example words in any language remain — the
model reads the message as written. 1032 -> 788 characters.
Co-Authored-By: Claude Opus 5 <noreply@anthropic.com>
Claude-Session: https://claude.ai/code/session_01BkfrkQwA4YGrGw9LZSpeAq
The previous fix put a hand-maintained multilingual word list in the route. That
does not generalise — the bug report itself was "Окей", and the next one would be
a language not on the list. The model already has the tool, the system prompt and
the whole conversation, so the policy belongs where it reads it.
Removed from src/routes/clinicalAssistant.js:
- GREETING_RE and its short-circuit (an ASCII keyword list that decided, before
the model ever saw the message, that a greeting deserved a canned reply).
- The IMAGE_NOUN / IMAGE_REPEAT vocabulary lists and the answer-repetition
backstop added earlier today.
Moved into the prompt and the tool definition:
- DEFAULT_BEHAVIOR now says that a greeting, acknowledgement or thanks in ANY
language gets a one-sentence request for a clinical question, and that a
previous turn's answer must never be repeated to justify a second image.
- The generate_image description says to call it ONLY when the user's latest
message asks for a picture or a change to one just made, and that an
acknowledgement of an existing image is not such a request.
Both are admin-editable (clinical_assistant.system_behavior), so this can now be
tuned without a deploy.
dispatchImageRequestFallback and IMAGE_REQUEST_PATTERN stay: that is the
compatibility path for a serving model that writes the image prompt as text
instead of calling the tool. It reads the USER's message only, never the model's
answer, so it cannot replay a previous turn — it was not the cause of this bug.
The DEFAULT_BEHAVIOR byte-hash lock in prompt-administration.test.js is updated
deliberately, which is what that guard is for.
Co-Authored-By: Claude Opus 5 <noreply@anthropic.com>
Claude-Session: https://claude.ai/code/session_01BkfrkQwA4YGrGw9LZSpeAq
Translation
- Stop scrubbing markdown before sending it to LibreTranslate. The scrub
deleted ordered-list numbering ("1. Give amoxicillin" -> "Give amoxicillin"),
flattened tables into ambiguous whitespace and ate underscores inside
identifiers. Raw markdown now goes to the translator unchanged.
- Render the translation through the same markdown pipeline as the original
bubble, with the message's own sources, so [n] markers come back as the usual
clickable .assistant-cite chips instead of escaped literal text. Headings,
lists and tables survive with them.
- When the translator drops citation markers, surface the affected sources in a
recovery block rather than letting the evidence disappear.
- Image cards are live nodes: they are now re-attached on every path out of a
translation (success, failure and Show original), so a failed translation no
longer silently removes a generating image from the message.
Patient take home
- Add a language selector to the take-home modal, reusing the existing
/translate endpoint and offering only what the local LibreTranslate reports.
- Copy, Export and Email carry what the caregiver is actually reading; the
original stays canonical behind "Original".
Conversation budget
- The admin field no longer prefills with the environment value, which turned
the next Save into an accidental override and made the documented "leave
empty to use the environment" path unreachable. The effective limit is shown
as a placeholder instead.
- Report source 'default' honestly instead of naming an unset env var.
- The load-failure notice now lands on the <p> instead of an <input>'s
textContent, where it rendered nothing.
- One validator for the budget everywhere: conversationLimit() replaces a
parseInt that accepted "120000abc".
Other
- /assistant is addressed by its URL, not by ped_last_tab, so "/" no longer
reopens the assistant; the URL follows tab changes and Back leaves it.
- Remove the dead DeepL path (it referenced an undefined DEEPL_BASES) and stop
offering admins a provider the server silently ignores.
Co-Authored-By: Claude Opus 5 <noreply@anthropic.com>
Claude-Session: https://claude.ai/code/session_01BkfrkQwA4YGrGw9LZSpeAq
The MCP server builds a Nextcloud client per session and closes it only
when the session ends. The clinical assistant replaced its cached session
every time the ten-minute TTL lapsed but never ended the old one, so each
abandoned client held its Nextcloud connections open. The production MCP
container was holding 708 sockets in CLOSE-WAIT against a 1024 descriptor
ceiling, roughly 300 from the point where every clinical search fails.
Expired and server-rejected sessions are now deleted. Session reuse is
unchanged: a live session is still shared across calls, since closing one
still in use would force a re-initialize on every search.
Co-Authored-By: Claude Opus 5 <noreply@anthropic.com>
Voice lists were a single flat set from LITELLM_TTS_VOICES, so picking a
model could leave an incompatible voice selected and the request would
fail at the gateway. Voices are now resolved per model family (Kokoro,
Kitten, Supertonic, Groq Orpheus EN/AR), with a compatibility check that
falls back through user → admin → env → first valid voice. Groq Orpheus
requests also pin response_format to wav.
Also refreshes the cardiac/respiratory auscultation samples, extends the
well-visit component, and fixes the Android launch theme background
(@null → colorPrimary) so the splash does not flash through.
NOTE: this is in-progress work that was already sitting uncommitted in
the working tree; it is committed here as-is so the tree was clean for
the release bump.
