New top-level tab positioned after Physical Exam Guide. Per-user
directory of hospital phone extensions and pagers — grouped by location
then type, searchable, soft-deleted.
Data:
- New table user_phone_extensions (id, user_id, location, name, number,
type CHECK (extension|pager), notes, trashed_at, timestamps).
Partial indexes on active vs trashed rows for fast filtering.
- Not PHI — hospital internal phone directory. Plaintext.
API (all user-scoped, all params validated):
- GET /api/extensions?trash=1&q=text — list active or trash, optional search
- POST /api/extensions — create
- PUT /api/extensions/:id — update (requires all three core fields)
- DELETE /api/extensions/:id — soft-delete (sets trashed_at)
- POST /api/extensions/:id/restore — un-trash
- DELETE /api/extensions/:id/purge — hard-delete (only if trashed)
All :id params parsed + validated (positive integer) before query.
All queries parameterized, every WHERE includes user_id scoping.
UI (public/js/extensions.js + components/extensions.html):
- Search bar with 200ms debounce, server-side LIKE on location/name/number/notes
- Add button expands inline form — location (with datalist of existing
locations for autocomplete), name/dept, number, type, optional notes
- Each entry renders as a card: big monospace number, dept, type badge,
edit + delete inline
- Grouped by location → type (Extensions / Pagers subheaders)
- Trash view: toggle shows trashed items with Restore + Purge actions
- Trash count badge on the Trash button updates after every delete/restore
- Delete requires confirm() dialog, then soft-delete (easy to undo)
- Purge from trash requires a second confirm() ("cannot be undone")
- Esc closes the form; form resets between Add and Edit
New top-level tab (positioned after Catch-Up Schedule) combining two
functions:
1. Study reference — for each (age group, system) shows OSCE-style
components with technique, expected normal finding, and abnormal-
feature watch-list.
2. Documentation generator — physician marks each component
Normal / Abnormal (with free-text detail) / Skip; AI produces a
two-section report (Technique + Findings), narrative or structured
list format.
Scope v1: MSK + Neuro × 6 age groups (newborn, infant, toddler,
preschool, school-age, adolescent). More systems can be added to the
embedded PE_DATA in peGuide.js without route changes.
Files:
- src/routes/peGuide.js — POST /api/generate-pe-narrative (mirrors
milestone-narrative pattern: AppRole-level
injection guard, clinical audit category,
PHI redaction upstream already in place)
- src/utils/prompts.js — peGuideNarrative + peGuideList prompts,
structured two-section output
- public/components/pe-guide.html — demographics bar + sub-pills + cards
- public/js/peGuide.js — embedded PE_DATA (all clinical content),
render + state + AI call
- public/index.html — tab button, section, script include
- server.js — mount route at /api
No schema change. No PHI stored — findings live in memory only, exported
via existing copy/read-aloud/Nextcloud actions.
Split the Bedside clinical reference section out of calculators.js
(~1220 lines) into 20 focused ES modules under public/js/bedside/.
Each module owns one clinical topic (cardiac, seizure, sepsis, burns,
etc.) and exports an init() wired up by bedside/index.js. Shared
helpers live in shared.js and also set window._EM for back-compat
with the 4 remaining call sites in calculators.js.
Load order: classic defer calculators.js first, then module script
bedside/index.js. Handlers bind at DOM-ready; runtime _EM lookups
resolve after both are evaluated.
Makes bedside content editable per-section, shrinks calculators.js
from 4111 to 2891 lines, and keeps the existing Playwright smoke
suite (e2e/tests/bedside-smoke.spec.js) as the behavioral contract.
Calculators:
- Bedside tab consolidating emergency protocols (Neonatal+Apgar+NRP, Airway/RSI,
Cardiac Arrest/PALS, Respiratory, O2 & Ventilation, Status Epilepticus,
Sepsis & Fever with PECARN/Aronson/Rochester/Step-by-Step, Anaphylaxis,
Procedural Sedation, Agitation, Antiemetics, Antimicrobials, Burns with
Lund-Browder body-parts TBSA + Parkland, Toxicology, Trauma).
- Global age→weight estimator at top of Calculators tab (APLS + Best Guess).
- Pressure-time waveform SVG teaching graphic for Ventilation.
- Algorithm image lightbox (fullscreen, Esc/tap-to-close).
- Every weight-based dose shows mg/kg inline for clinician verification.
- Drug tables wrapped in overflow-x:auto for mobile.
Infrastructure:
- Pure dose math extracted to public/js/calc-math.js (dual-export Node+browser).
- 36 unit tests in test/calc-math.test.js via node:test (zero new deps).
- "npm test" added to package.json.
The "Download Android app (APK)" link on the login page is pointless
when the user is already inside the Capacitor app. Wrapped the link
in id="apk-download-link" and added a native-app-only hide pass in
auth.js that runs against a short array of web-only element IDs.
Add more entries to that array as other web-only UI appears, so the
mobile wrapper can diverge cleanly from the web UI without branching
the HTML.
The server-side revoke was always working — it deletes user_sessions
rows, and middleware correctly returned 401 on the revoked device's
next /api/* request. The bug was entirely client-side: individual
fetch handlers swallowed the 401 (rendering "no sessions found" or
empty data) and nothing redirected to the login screen. So the
revoked device looked like it stayed signed in.
Added public/js/authFetch.js: a global fetch interceptor that
watches every /api/* response. On 401 from a non-auth endpoint
(i.e. not /login, /register, /logout, /me, etc.), it clears any
cached token/user state and reloads the page. The reload's boot
flow lands on /api/auth/me → 401 → login screen as usual.
Guarded against false positives: only triggers when the app believes
the user is currently logged in (AUTH_TOKEN set or main-app visible)
so a pre-login 401 doesn't accidentally flash the screen.
Loaded before auth.js in index.html.
- 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.
Web still uses localStorage; Capacitor native app now routes
token/user/session-id through capacitor-secure-storage-plugin
(iOS Keychain, Android EncryptedSharedPreferences / Keystore).
A thin SecureStorage wrapper detects Capacitor at runtime and
falls back to localStorage elsewhere, keeping a single auth.js
codebase for both targets.
To activate on mobile: cd mobile && npm install && npx cap sync android
New feature: after generating any clinical note, the app automatically
suggests relevant billing codes displayed as clickable chips below the output.
Backend (src/routes/billing.js):
- POST /api/suggest-codes endpoint analyzes note text
- Extracts diagnoses from Assessment section via regex
- Looks up ICD-10 codes: local common pediatric map (40+ conditions)
first, then NLM Clinical Tables API for unknown terms
- Suggests CPT E/M codes based on note type, visit complexity,
ROS/PE system counts, and MDM level estimation
- Supports: outpatient (new/established), well visit (age-based),
ED, inpatient (admit/subsequent/discharge)
Frontend (public/js/app.js):
- suggestBillingCodes() renders collapsible card with ICD-10 and CPT chips
- Click any chip to copy the code to clipboard
- Shows E/M level assessment (diagnosis count, ROS, PE, MDM complexity)
- Disclaimer: "Suggestions only. Always verify codes."
Integration: called after note generation in all 6 tabs
(encounter, SOAP, sick visit, well visit, hospital course, chart review)
Calculators tab with 7 tools:
- BP Percentile (AAP 2017) with age/sex/height classification
- BMI Percentile (CDC 2000) with extended obesity classification
(Class 1/2/3 using % of 95th percentile per CDC 2022)
- Growth Charts: weight-for-age, length-for-age, head circumference,
weight-for-length (WHO/CDC LMS), Fenton preterm (22-50 weeks)
- Bilirubin: AAP 2022 phototherapy threshold + Bhutani nomogram
with Nelson Table 137.1 risk factors for severe hyperbilirubinemia
- Vital Signs by Age (Harriet Lane) with quick reference formulas
(estimated weight, min SBP, ETT size, maintenance fluids 4-2-1)
- Body Surface Area (Mosteller formula)
- Weight-Based Dosing with max cap and volume calculation
Fix growth chart sub-tab navigation (pills scoped separately from
top-level nav to prevent panel disappearing)
- Replace browser prompt() with inline UI for: 2FA disable (password field),
admin password reset (inline input), admin test email (inline input)
- Remove all password breach warning UI (login, register, settings)
Backend HIBP check endpoint remains but is no longer called from frontend
- Remove model cost display from dropdown and header badge
- Hide empty cost-badge element in header
- Fix model dropdown to flat list (no category grouping)
- Add FAQ tab with accordion sections: Getting Started, AI & Models,
Voice & Transcription, Saving & Export, Privacy & Security,
Well Visit & Sick Visit, Learning Hub, Troubleshooting
- Documents how AI learns from physician edits (correction tracker)
- Fix FAQ accordion (CSP was blocking inline script, moved to app.js)
- Patch all 5 npm vulnerabilities: nodemailer 8.0.5, xmldom, basic-ftp,
path-to-regexp (npm audit now reports 0 vulnerabilities)
- Remove model category grouping from dropdown (flat list, no optgroups)
- Fix model dropdown dark background on options (white bg, dark text)
- Update FAQ model guidance to reflect admin-managed model selection
Security:
- Add session management: users can view/revoke active sessions in Settings
- Add password change in Settings (requires current password, HIBP check)
- Force logout all sessions on password reset
- Fix logout to destroy server-side session (was only clearing cookie)
- Add trust proxy for correct client IP in rate limiting and audit logs
- Add CORS support for multiple domains (CORS_ORIGINS env var)
- Add HIBP breach check endpoint and inline warnings on password fields
Audit logging:
- Add audit logging to all 24 PHI-handling endpoints across 13 route files
- Covers: generation, transcription, TTS, refine, encounters, documents, Nextcloud
- All fire-and-forget (no response delay)
AI improvements:
- Refine now includes original source material (transcript, notes, labs)
so AI can reference the full input when modifying output
- Add correction tracking (trackAIOutput) to sick visit and well visit tabs
- Fix sickvisit missing from encounter save noteIdMap
UI fixes:
- Non-blocking busy bar for transcription and AI generation (replaces full-screen overlay)
- Fix encounter recording: hide record button during recording (was showing two stop buttons)
- Fix ROS/PE "All WNL" stacking duplicate event handlers; add Clear buttons
- Enlarge AI instructions textarea in Learning Hub CMS
Domain:
- Primary domain now app.pedshub.com, with scribe.pedshub.com and peds.danvics.com as CORS origins
- Add Cloudflare Turnstile to login, register, and password reset forms
- Switch AI provider to LiteLLM, transcription to OpenAI Whisper
- Change domain to scribe.pedshub.com
- Fix PPTX export: add tables, bold/italic, numbered lists, code blocks, blockquotes
- Fix announcement banner close button (CSP was blocking inline onclick)
- Fix auth middleware: empty Bearer token now falls through to cookie auth
- Fix audio backups: only save on transcription failure, stop auto-deleting on success
- Soften AI correction injection to prevent model hallucination from correction history
- Fix LiteLLM TTS model name handling (no incorrect openai/ prefix)
- Expand AI instructions textarea in Learning Hub CMS
- Update README for v6 with all features and providers
- Add comprehensive docs/: architecture, API reference, database schema,
authentication, AI providers, speech, learning hub, configuration, deployment
Provides two transcription options:
1. Browser Whisper (Offline, Batch) - RECOMMENDED
- 100% offline, zero network calls
- HIPAA-compliant, audio never leaves device
- Highest accuracy (Whisper)
- Processes after recording (batch mode)
- Models self-hosted, bundled in v2
2. Web Speech API (Real-time, Streaming) - EXPERIMENTAL
- Real-time transcription (see words as you speak)
- Uses browser's built-in speech recognition
- ⚠️ Sends audio to cloud (Chrome/Edge → Google)
- ⚠️ NOT HIPAA-compliant
- Requires user consent with clear warnings
Features:
- Settings UI for both options
- Clear privacy warnings for Web Speech
- Mutual exclusion (only one active at a time)
- Browser detection shows which provider is used
- Confirmation dialog before enabling Web Speech
Use Cases:
- Clinical/HIPAA: Use Browser Whisper only
- Personal/Non-clinical: Can use Web Speech for real-time feedback
- Maximum privacy: Browser Whisper (offline)
- Maximum speed: Web Speech (if privacy not required)
Implementation:
- speechRecognition.js: Web Speech API wrapper
- transcriptionSettings.js: Settings UI handler
- Privacy info displayed per browser
User can choose based on their privacy vs. speed preference.
Features:
- Admin can add, edit, and delete developmental milestones via dashboard
- Milestones stored in PostgreSQL (developmental_milestones table)
- Client-side loads milestones from API instead of static file
- Import script to migrate existing static data to database
- Organized by age group and domain
- Supports sorting and filtering
Admin UI:
- New section in Admin panel for milestone management
- Filter by age group
- Add/Edit modal with validation
- Delete with confirmation
- Auto-complete for age groups and domains
API Endpoints:
- GET /api/milestones-data - Public endpoint for authenticated users
- GET /api/admin/milestones - List all milestones (admin only)
- GET /api/admin/milestones/meta - Get age groups and domains
- POST /api/admin/milestones - Create milestone
- PUT /api/admin/milestones/:id - Update milestone
- DELETE /api/admin/milestones/:id - Delete milestone
- POST /api/admin/milestones/bulk-import - Bulk import
Usage:
1. Run import script: node scripts/import-milestones.js
2. Access Admin dashboard → Developmental Milestones section
3. Add/Edit/Delete milestones as needed
OIDC/SSO:
- New /api/auth/oidc route with PKCE for secure authorization
- Supports Azure AD, Okta, Keycloak, PocketID, Google, any OIDC provider
- Admin configurable: issuer, client ID/secret, button label
- Option to disable local auth (force SSO only)
- Auto-creates users on first SSO login, links existing by email
- SSO button on login page, hidden until admin enables OIDC
Firefox:
- Show info toast on first recording that live preview requires
Chrome/Edge; server-side transcription still works in all browsers
Login flash:
- Auth screen now hidden by CSS default (#auth-screen{display:none !important})
- auth.js shows it only when there is no valid token or token is expired
- No more flash of login page on refresh for logged-in users
Presentation quiz option (AI Generate panel):
- Presentation type now shows optional quiz question toggle (same as article)
- Backend: when questionCount>0, returns JSON {marpMarkdown, questions[]}
instead of plain Marp markdown
- applyAiContent fills both the Marp textarea and question blocks for presentations
Viewer revert:
- Removed the viewer presentation card change (user wants markdown as-is)
- Removed dangling viewer button wiring
Feed/CMS list:
- Presentation type shows correct icon (fa-presentation-screen) and
label "Slides" in the CMS content list
REVERT: httpOnly cookie auth removed — reverts to JWT in localStorage.
The cookie implementation broke the login page (always-hidden auth screen).
localStorage token approach is restored fully:
- Login/register return token in JSON body
- getAuthHeaders() sends Authorization: Bearer header
- Session check reads localStorage token on load
- clearSession() removes localStorage token
Fix: slide preview padding — section elements now have 40px 48px padding
so text is not flush against the frame edges.
Kept from v3.14: AI panel context-aware options (word count, slide count,
quiz question toggle), delete confirmation wording per content type.
AI Generate panel:
- Content type synced from editor on open
- Article/Pearl: optional word count field
- Presentation: optional slide count field
- Questions row: checkbox toggle for article/pearl (optional), always on for quiz,
hidden for presentation; count input shown only when enabled
- Backend: passes wordCount/slideCount to prompt; questionCount=0 skips questions
Delete confirmation:
- Wording built dynamically from content type
- Presentation: no mention of questions
- Quiz: "All quiz questions will be permanently removed"
- Article/pearl: "Any quiz questions attached will also be removed"
Auth refactor — JWT → httpOnly cookie:
- Backend: setAuthCookie() sets ped_auth as httpOnly, Secure, SameSite=Lax, 7d
- Backend: clearAuthCookie() on POST /api/auth/logout (new endpoint)
- Backend: auth middleware reads ped_auth cookie first, falls back to Bearer header
- Login/register: no longer return token in JSON body; cookie is the session
- Frontend: getAuthHeaders() returns only Content-Type (no Authorization header)
- Frontend: session check uses /api/auth/me via cookie (no localStorage token)
- Frontend: clearSession() calls /api/auth/logout to clear cookie server-side
- Frontend: no token in localStorage; window.AUTH_TOKEN removed
- All FormData fetches use credentials:'same-origin' (cookie sent automatically)
- index.html: optimistic auth-screen hide (removed localStorage token check)
Tested: login, logout, /api/auth/me, admin routes, FormData uploads, cookie httpOnly
flag, 401 without cookie, cookie cleared on logout.
Delete bar bug:
- Root cause: .lh-delete-confirm-bar{display:flex} defined after .hidden{display:none}
so flex overrode hidden (no !important on global .hidden rule)
- Fix: remove display:flex from base rule, use .lh-delete-confirm-bar:not(.hidden){display:flex}
so hidden class always wins regardless of CSS order
Slide preview (replace window.open + document.write approach):
- Backend /preview-slides now returns JSON: {css, slides[]} (individual <section> HTML)
- In-page full-screen modal with dark overlay, white slide frame
- Prev/Next arrow buttons, dot indicators, slide counter
- Keyboard navigation (arrow keys, Escape to close)
- Touch/swipe support for mobile
- Overlay click closes modal
- No popups required, works in all browsers
Marp textarea:
- Placeholder updated to guide users: "Click AI Generate above to create slides"
- Makes it clear AI is the primary authoring path; textarea for review/edits
- Bundle Tiptap 2 (StarterKit, Link, Underline) with esbuild into
public/vendor/tiptap.bundle.js — fully self-hosted, no CDN needed
- Remove Quill (quill.min.js, quill.snow.css, patchQuillTooltip hack)
- Headless Tiptap editor: custom toolbar (bold/italic/underline/strike,
headings, lists, blockquote, code, link) with active-state highlighting
- Link insertion: inline link bar below toolbar (no popup, no tooltip)
— type URL, press Apply or Enter; Remove button to unset
- Mini editor for question text and option text (same toggle UX)
- ProseMirror content styles: headings, lists, blockquote, code, links
Quill tooltip: move tooltip element to document.body via patchQuillTooltip()
so overflow:hidden on .cms-main cannot clip it. Recalculates position from
container-relative to viewport (fixed) coordinates with viewport clamping.
Removes overflow:hidden from quill wrappers; applies border-radius to toolbar/container.
Registration: hide #show-register by default in HTML; reveal only after
registration-status fetch confirms enabled=true. Endpoint already returns 403
when disabled — no backend change needed.
- wellVisit.js now handles tabChanged for vaxschedule and catchup tabs
so renderFullSchedule() and renderCatchUp() fire when those tabs open
- Replace Quill CDN with local /vendor/quill.min.js + quill.snow.css
(CDN was unreachable in local/offline environments)
- Replace textarea+toolbar with Quill.js (free, MIT) for body editor
- Full WYSIWYG: headings, bold/italic, lists, blockquote, code, link (inline, no popup)
- Rich Text toggle button on each question text field and option text field
- Plain textarea by default; toggle activates mini Quill editor per field
- New 'Multiple Select' question type: checkboxes, all correct must be chosen
- Backend scoring: allCorrectChosen && noWrongChosen
- Results show all correct options highlighted, wrong selections flagged
- quiz display uses sanitizeHtml for question/option text (supports formatted HTML)
- sanitizeHtml allows Quill class attrs (ql-indent, etc.)
- New dedicated Content Manager tab (WordPress-like layout) with:
- Stats dashboard (published, drafts, categories, quizzes, attempts)
- Sidebar with category tree and filter controls (status, category)
- Table-style content list with search
- Full-page editor with title bar, meta fields, body editor, quiz builder
- Content Manager visible only for admin and moderator roles in sidebar
- Removed CMS from admin panel (admin panel is admin-only again)
- Email templates: fully responsive with max-width, proper mobile breakpoints,
table-based layout for Outlook/Gmail compatibility, no overflow
- Security: escape all user data in emails with escHtml(), escape APP_URL
in verify-email HTML, replace raw err.message with generic errors in auth
- Security: email body from admin settings now HTML-escaped before rendering
- New Learning Hub under Pediatric menu with content feed, category browsing,
search, content viewer, and interactive quizzes (MCQ, true/false)
- Quiz system with per-option wrong-answer explanations and general explanations
- Admin CMS for creating/editing categories, content (articles, pearls, quizzes),
and inline question builder with answer options
- 3-role system: admin (full access), moderator (can manage Learning Hub content),
user (all clinical features + learning hub read access)
- 5 new database tables: learning_categories, learning_content, learning_questions,
learning_options, learning_progress
- User progress tracking with score history per quiz
- Moderators see "Content Manager" tab instead of full Admin panel
- Bedrock: Add 14 non-vendor model models (Amazon Nova, Meta Llama 4, DeepSeek R1/V3,
Mistral Large 3, Cohere Command R+, AI21 Jamba) with verified AWS model IDs
- Bedrock: Implement Converse API for non-Anthropic models (unified cross-model API),
keep native Messages API for vendor model models (best performance)
- Milestones: Add Newborn / 1 month developmental milestones (Gross Motor, Fine Motor,
Language, Social/Emotional, Cognitive) — previously started at 2 months
- Bump version to 3.0.0, docker-compose tag to v3.0
- Copy to Note button now switches to Well Visit → Visit Note subtab
automatically so user sees the result immediately
- Add complete AAP/Nelson developmental milestones for ages 6, 7, 8, 9,
10, and 11 years (Gross Motor, Fine Motor, Language, Social/Emotional,
Cognitive domains each)
- Add corresponding age options to ms-age-group select
- Fix 2FA status stuck at "Loading...": export load2FAStatus globally so
app.js tabChanged handler can call it when navigating via sidebar
- Fix admin models silent failure: add error message + retry button on catch
- Fix save encounter doubles: persist _savedEncId_* to sessionStorage so
page refresh reuses existing record instead of inserting a duplicate;
add _savingInProgress guard to prevent race-condition double-saves
- Desktop sidebar collapsible: add collapse/expand buttons (not collapsed
by default), state saved to localStorage; hidden on mobile
- Copy to Visit Note now also copies SSHADESS assessment to wv-shadess-text
- Store selected visit age in window._wellVisitAge + sessionStorage so
other tabs can read the patient's age
- Bigger screening/vaccine boxes: min-height on wv-vax-list, wv-screen-list,
wv-visit-detail; slightly more padding on vaccine items
- Wire New Patient (clearTab) buttons to document click handler
- Replace horizontal tab-nav with collapsible left sidebar (sticky desktop, slide-in mobile with hamburger toggle)
- Fix tab persistence: use localStorage instead of URL hash; restore last tab after login in enterApp()
- Fix admin CMS models loading: move autoDeleteDays read inside .then() callback (was ReferenceError), switch admin loading from click-only to tabChanged event
- Add Save/Load bars to Hospital Course and Chart Review tabs with popover support
- Add wv (well visit) save handler in encounters.js
- Register load handlers for hospital and chart tabs
- Expand popover prefix list to include hosp and chart
- Wrap save-bar + popover in .save-bar-wrap (position:relative) so the
absolute-positioned popover anchors correctly below the Load button
(previously popovers were outside the save-bar, so had no positioned
ancestor and appeared at the wrong place on screen)
- Remove confirm() dialog from deleteEncounter — encounter disappears
immediately from the popover list after deletion
- ICD-10 diagnoses: replace static-only lookup with live NLM Clinical
Tables API search (clinicaltables.nlm.nih.gov) with 280ms debounce;
results appear in a dropdown below the search input; Enter/click selects
- Add clinicaltables.nlm.nih.gov to CSP connect-src
- Drop unused position:relative from .save-bar (now on .save-bar-wrap)
