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pediatric-ai-scribe-v3/docs/speech.md
Daniel a08524d95f harden logging and observability
2026-05-08 19:08:19 +02:00

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Speech: STT, TTS, Audio Backup

Transcription

POST /api/transcribe accepts multipart/form-data with one audio file up to 25 MB. The provider is selected by TRANSCRIBE_PROVIDER, or auto-detected from available credentials.

Provider priority in auto mode is Google/Gemini, AWS Transcribe, LiteLLM, then OpenAI Whisper when configured.

Provider Notes HIPAA posture
Google/Gemini Uses the configured Vertex/Gemini STT model. Eligible with the correct Google Cloud agreement.
AWS Transcribe Supports standard and Medical mode. Eligible with the correct AWS agreement.
LiteLLM Sends audio through the configured LiteLLM /audio/transcriptions backend. Depends on the selected upstream.
OpenAI Whisper Uses whisper-1 directly when OPENAI_API_KEY is configured. Not HIPAA eligible unless your own agreement says otherwise.

Browser Whisper and browser-local Whisper workers are not part of the runtime. Do not add browser model downloads or Transformers.js STT back into the public app.

Web Speech Preview

Browser-native Web Speech can show interim text when the user explicitly enables it. It is browser/vendor dependent, may send audio to browser-provider cloud services, and should not be treated as the final clinical transcript.

Text To Speech

POST /api/text-to-speech returns audio/mpeg. The X-TTS-Provider response header identifies the provider used. Requests are limited to 5000 characters.

Provider Notes
Google Cloud TTS Uses Google Cloud voices when configured.
LiteLLM Uses LITELLM_TTS_MODEL and LITELLM_TTS_VOICE.
ElevenLabs Available when configured; not HIPAA eligible by default.

Audio Backup

Failed transcription submissions can be stored for retry instead of being silently lost.

  • Audio backups are compressed and encrypted before storage.
  • Backups expire automatically.
  • The Settings audio backup UI can retry or delete saved items.
  • Browser fallback storage is used only when the server cannot save the failed audio.

Treat audio backups as sensitive clinical data even when encrypted.