pediatric-ai-scribe-v3/docs/database.md

Database schema

PostgreSQL 16 with pgvector. Image pgvector/pgvector:pg16, data in the pgdata volume. Connection pool: 20 max, 30 s idle timeout, 5 s connect timeout.

Schema is managed in two layers:

1. Baseline init — src/db/database.js. Idempotent CREATE TABLE IF NOT EXISTS + ALTER TABLE ADD COLUMN IF NOT EXISTS. Runs on every boot. Represents everything that predated the migration tool.
2. Versioned migrations — migrations/ via node-pg-migrate. All new schema changes go here. See docs/migrations.md.

Extensions

CREATE EXTENSION IF NOT EXISTS vector;

Tables

users

Core accounts. Local-auth + OIDC federation + per-user preferences.

Column	Type	Notes
id	SERIAL PK
email	TEXT UNIQUE NOT NULL
password	TEXT NOT NULL	argon2id hash (primary) or bcrypt hash (legacy / rehashed on next login). For OIDC-auto-created users: random hex, not verifiable.
name	TEXT
role	TEXT	user / admin / moderator
email_verified	BOOLEAN DEFAULT false
verify_token, verify_expires	TEXT, BIGINT	Email verification
totp_secret, totp_enabled	TEXT, BOOLEAN DEFAULT false	2FA
totp_backup_codes	TEXT	JSON array of bcrypt hashes of 10-character recovery codes. Consumed atomically on login.
oidc_sub	TEXT	IdP subject identifier (when linked)
disabled	BOOLEAN DEFAULT false	Soft disable
nextcloud_url, nextcloud_user, nextcloud_token, nextcloud_folder	TEXT	WebDAV credentials. nextcloud_token stored AES-256-GCM encrypted (prefix enc1:).
reset_token, reset_expires	TEXT, BIGINT	Password reset
stt_model, tts_voice	TEXT	Per-user STT/TTS override
created_at, updated_at	TIMESTAMPTZ DEFAULT NOW()

user_sessions

Authoritative session registry.

Column	Type	Notes
id	TEXT PK (UUID)
user_id	INTEGER FK users.id
token_hash	TEXT NOT NULL	SHA-256 of the JWT. Index idx_sessions_token_hash uses COLLATE "C" for ICU-drift immunity.
ip_address, user_agent	TEXT
device_label	TEXT	Parsed from UA (Chrome on Android, PedScribe (Android), etc.)
created_at, last_activity	TIMESTAMPTZ DEFAULT NOW()	last_activity only updated on POST/PUT/DELETE/PATCH, throttled to once per 10 min

app_settings

Key-value runtime config. 2-minute in-memory cache.

Column	Type	Notes
key	TEXT PK	Also COLLATE "C"
value	TEXT	Plain or JSON
updated_at	TIMESTAMPTZ DEFAULT NOW()
updated_by	INTEGER FK users.id

audit_log

Human-level security and action audit. Writes are batched (1 s flush) by src/utils/auditQueue.js.

Column	Type	Notes
id	SERIAL PK
user_id	INTEGER FK users.id	Null for unknown-user attempts
action	TEXT NOT NULL	e.g. login, login_failed, session_idle_timeout, password_changed, generate_soap, 2fa_backup_code_used
category	TEXT DEFAULT 'general'	auth, clinical, integration, export, documents, phi_access
details	TEXT	Free-form, PHI-redacted via src/utils/redact.js
ip_address, user_agent	TEXT
model_used, tokens_used, duration_ms	TEXT, INT, INT	LLM-call fields (optional)
status	TEXT DEFAULT 'success'
timestamp	TIMESTAMPTZ DEFAULT NOW()

api_log

Per-request AI-call telemetry.

Column	Type	Notes
id	SERIAL PK
user_id	INTEGER FK users.id
endpoint	TEXT	Route path
method	TEXT
status_code	INTEGER
request_size, response_size	INTEGER	Bytes
model_used	TEXT
tokens_input, tokens_output	INTEGER
cost_estimate	NUMERIC	USD estimate (hardcoded rates; OpenRouter uses live pricing)
duration_ms	INTEGER
ip_address, error	TEXT
timestamp	TIMESTAMPTZ DEFAULT NOW()

access_log

Auth-only event stream.

Column	Type	Notes
id	SERIAL PK
user_id	INTEGER FK users.id
action	TEXT	login, logout, failed_login, …
ip_address, user_agent	TEXT
success	BOOLEAN
timestamp	TIMESTAMPTZ DEFAULT NOW()

saved_encounters

Draft/complete encounter workspace. Auto-expires (default 7 d, site.auto_delete_days).

Column	Type	Notes
id	SERIAL PK
user_id	INTEGER FK users.id ON DELETE CASCADE
label	TEXT NOT NULL DEFAULT 'Untitled'	Unique-per-user within active rows
enc_type	TEXT NOT NULL DEFAULT 'encounter'	encounter, dictation, soap, sickvisit, wellvisit, hospital, chart, milestones
transcript	TEXT
generated_note	TEXT
partial_data	TEXT	JSON of in-progress form state
status	TEXT DEFAULT 'active'
version	INTEGER NOT NULL DEFAULT 1	Optimistic lock. POST with expected_version mismatch returns 409.
idempotency_key	TEXT	Prevents duplicate creates from double-submit
created_at, updated_at	TIMESTAMPTZ DEFAULT NOW()
expires_at	TIMESTAMPTZ	Default NOW() + 7 days

user_memories

Per-user template and preference rows. Only selected categories are injected into AI generation through /api/memories/context; custom rows are stored for the user but not included in prompt context.

Column	Type	Notes
id	SERIAL PK
user_id	INTEGER FK users.id ON DELETE CASCADE
category	TEXT NOT NULL DEFAULT 'custom'	Valid categories: physical_exam, ros, encounter_format, family_history, assessment_plan, custom, template_soap, template_hpi, template_wellvisit, template_sickvisit, template_ed. Legacy correction_* rows may exist but are filtered out.
name	TEXT NOT NULL	Encrypted with enc1: for new rows
content	TEXT NOT NULL	Encrypted with enc1: for new rows
created_at, updated_at	TIMESTAMPTZ DEFAULT NOW()

audio_backups

Optional 24-hour encrypted recovery store for recordings when transcription fails, so users can retry without re-recording.

Column	Type	Notes
id	SERIAL PK
user_id	INTEGER FK users.id
module	TEXT	encounter, dictation, etc.
mime_type	TEXT
size_bytes, compressed_bytes	INTEGER
audio_data	BYTEA	Gzip → AES-256-GCM (0x01 version prefix). Legacy rows (prefix 0x1F = raw gzip) pass through.
created_at, expires_at	TIMESTAMPTZ	24 h default

user_documents

Metadata for files in S3-compatible object storage. File bytes stay in S3.

Column	Type	Notes
id	SERIAL PK
user_id	INTEGER FK users.id
s3_key	TEXT	Object storage key (prefixed with user id)
filename, mime_type	TEXT
size_bytes	INTEGER
description	TEXT
created_at	TIMESTAMPTZ DEFAULT NOW()

developmental_milestones

AAP-aligned pediatric milestone reference data. Age group + domain keyed.

Column	Type	Notes
id	SERIAL PK
age_group	TEXT	2 months, 4 months, 1 year, …
domain	TEXT	motor, language, social, cognitive
milestone_text	TEXT
sort_order	INTEGER
created_at, updated_at	TIMESTAMPTZ DEFAULT NOW()

user_resources

My Resources: a user's own teaching material. deck is the typed deck the renderers read; markdown is the flattened form used for display and for the markdown export. Export always renders from deck when it is present, so a modification that edits only markdown will not change the exported file.

Column	Type	Notes
id	SERIAL PK
user_id	INTEGER NOT NULL
title, topic	TEXT NOT NULL
kind	TEXT NOT NULL	deck or document
markdown	TEXT NOT NULL	Flattened form
deck	JSONB	The typed deck; NULL for documents
image_ids	JSONB NOT NULL	Generated figures belonging to this resource
grounded_count	INTEGER NOT NULL	How many sources the generation was grounded in
created_at, updated_at	TIMESTAMPTZ NOT NULL

personal_notes

Personal notes, with a trash lifecycle: deleted_at set means trashed, and restore clears it. Emptying the trash is what actually deletes rows.

Column	Type	Notes
id	SERIAL PK
user_id	INTEGER NOT NULL
title, body	TEXT NOT NULL
created_at, updated_at	TIMESTAMPTZ NOT NULL
deleted_at	TIMESTAMPTZ	NULL = live, set = in trash

clinical_assistant_chats

Saved Clinical Assistant conversations, one row per chat. payload holds the serialized turns. Answers themselves are never cached for reuse — this is the user's own history, not an answer cache.

Column	Type	Notes
id	SERIAL PK
user_id	INTEGER NOT NULL
title	TEXT NOT NULL
payload	TEXT NOT NULL	Serialized conversation
created_at, updated_at	TIMESTAMPTZ NOT NULL

clinical_prompt_pool_snapshots

Point-in-time copies of the generated example-prompt pool, so a regeneration that produces a worse pool can be rolled back from the Admin panel.

Column	Type	Notes
id	SERIAL PK
payload	JSONB NOT NULL	The pool itself
generated_at	TIMESTAMPTZ
target, count	INTEGER	Requested size and actual size
restored_from	INTEGER	The snapshot this one was restored from, if any
created_by	INTEGER	Admin user id
created_at	TIMESTAMPTZ

citation_audit

Records how well an answer's citations matched its retrieved sources, so citation quality can be watched over time rather than sampled by hand. Rows expire.

Column	Type	Notes
id	SERIAL PK
user_id	INTEGER
question	TEXT NOT NULL
cited_count, source_count	INTEGER NOT NULL
unverifiable	TEXT[] NOT NULL	Citations that matched no retrieved source
source_titles	TEXT[] NOT NULL
created_at, expires_at	TIMESTAMPTZ NOT NULL

generated_image_jobs, generated_image_links

Image generation jobs and their output. The prompt is stored encrypted (prompt_cipher), and bytes are staged on the row until the job is claimed. lease_token + lease_until are the worker lease, so a crashed worker's job becomes claimable again instead of being stuck.

Column	Type	Notes
id	UUID PK
owner_id	INTEGER NOT NULL	Ownership is checked on every read
workflow	TEXT NOT NULL	Which feature asked, e.g. clinical_assistant
idempotency_key, input_hash	TEXT NOT NULL	Repeat submissions return the same job
prompt_cipher	TEXT NOT NULL	Encrypted prompt
model	TEXT NOT NULL
prompt_revision, budget, prompt_units	INTEGER NOT NULL
stage	TEXT NOT NULL	Job state
lease_token	UUID	Worker lease
lease_until	TIMESTAMPTZ	Lease expiry
staged_bytes	BYTEA	Image bytes
mime, checksum	TEXT
byte_length	INTEGER
error_code	TEXT
context_included, context_total	INTEGER	How much context the prompt could carry
created_at, updated_at	TIMESTAMPTZ NOT NULL

mermaid_diagrams

Saved diagrams: the Mermaid source plus the user's own notes.

Column	Type	Notes
id	SERIAL PK
user_id	INTEGER NOT NULL
title, source, notes	TEXT NOT NULL
created_at, updated_at	TIMESTAMPTZ NOT NULL

user_phone_extensions

Phone extensions and pagers, with a trash lifecycle (trashed_at).

Column	Type	Notes
id	SERIAL PK
user_id	INTEGER
location, name, number, type	TEXT	type distinguishes extension from pager
notes	TEXT
trashed_at	TIMESTAMPTZ	NULL = live
created_at, updated_at	TIMESTAMPTZ

prompt_revisions

History for admin prompt overrides, so a prompt edit can be reviewed and rolled back. was_default records whether the value replaced the built-in.

Column	Type	Notes
id	SERIAL PK
prompt_key	TEXT NOT NULL
value	TEXT NOT NULL
was_default	BOOLEAN NOT NULL
created_by	INTEGER
restored_from	INTEGER	The revision this one was restored from
created_at	TIMESTAMPTZ NOT NULL

pgmigrations

Created and managed by node-pg-migrate. Records applied migration filenames

• run time. Never edit by hand.

Indexes

Core btree indexes — see database.js for the full list.

• users(email) — COLLATE "C" (lookup-critical auth path)
• user_sessions(token_hash) — COLLATE "C"
• audit_log(user_id), audit_log(timestamp), audit_log(action), audit_log(category)
• api_log(user_id), api_log(timestamp), api_log(endpoint)
• access_log(user_id), access_log(timestamp)
• saved_encounters(user_id), saved_encounters(expires_at), saved_encounters(idempotency_key)
• user_memories(user_id, category)
• audio_backups(user_id), audio_backups(expires_at)
• user_documents(user_id)
• developmental_milestones(age_group, domain)

The COLLATE "C" indexes are immune to ICU library version changes between Postgres image upgrades — silent index corruption from libc / ICU drift cannot affect auth lookups.

Collation drift handling

On startup, src/db/database.js compares pg_database.datcollversion with pg_database_collation_actual_version(). On mismatch it runs REINDEX DATABASE + ALTER DATABASE … REFRESH COLLATION VERSION and logs the event. npm run maint:reindex runs the same operation manually.

Auto-cleanup

Hourly job (plus 10 s after startup):

DELETE FROM saved_encounters WHERE expires_at < NOW();
DELETE FROM audio_backups    WHERE expires_at < NOW();
DELETE FROM user_sessions    WHERE last_activity < NOW() - INTERVAL '30 days';

(The session cleanup is optional safety — the idle middleware deletes stale rows eagerly.)

PHI at rest

Column	Protection
users.nextcloud_token	AES-256-GCM via src/utils/crypto.js, prefix enc1:
audio_backups.audio_data	Gzip → AES-256-GCM, 0x01 version prefix
audit_log.details	Redacted (SSN, phone, email, DoB regex; 500-char cap; note-body heuristic truncation)
Error responses	Generic 'Request failed' on 500s; full detail stays in logger.error / Loki