pediatric-ai-scribe-v3/src/routes/memories.js
Daniel 6dc7870a1b feat(security): AES-256-GCM at-rest encryption for encounters and memories
Extends the existing crypto helper (already used for audio backups and the
Nextcloud token) to cover every column that can hold PHI:

- saved_encounters.transcript, .generated_note, .partial_data
- user_memories.content (templates + Dragon-style corrections)
- user_memories.name (auto-derived from original snippet on corrections,
  so effectively PHI)

Reads decrypt transparently. Legacy plaintext rows continue to work —
decryptString passes non-enc1: values through unchanged — so no migration
is required; rows re-encrypt on their next save.

The encounters list query previously used LEFT(transcript, 200) for a
preview. With ciphertext that slice is meaningless, so the route now
fetches the full columns, decrypts in Node, then slices. At 7-day auto-
delete the row count is bounded and the cost is a handful of GCM
decrypts per list call.

user_memories ORDER BY moved from (category, name) to (category, id)
since SQL can no longer order on encrypted names.

Closes the HHS breach-notification safe-harbor gap on at-rest PHI.
2026-04-22 01:01:00 +02:00

181 lines
8.4 KiB
JavaScript

// ============================================================
// MEMORIES ROUTES — User template/memory storage
// ============================================================
var express = require('express');
var router = express.Router();
var db = require('../db/database');
var { authMiddleware } = require('../middleware/auth');
var logger = require('../utils/logger');
var cryptoUtil = require('../utils/crypto');
router.use(authMiddleware);
// Decrypt a row's user-facing fields. Safe against legacy plaintext rows —
// cryptoUtil.decryptString passes through values without the "enc1:" prefix.
function decryptMemory(row) {
if (!row) return row;
try { row.name = cryptoUtil.decryptString(row.name); } catch (e) {}
try { row.content = cryptoUtil.decryptString(row.content); } catch (e) {}
return row;
}
var VALID_CATEGORIES = [
'physical_exam', 'ros', 'encounter_format', 'family_history', 'assessment_plan', 'custom',
'template_soap', 'template_hpi', 'template_wellvisit', 'template_sickvisit',
'correction_soap', 'correction_hpi', 'correction_encounter', 'correction_wellvisit', 'correction_sickvisit'
];
// ── GET all memories for current user ───────────────────────────────────
router.get('/memories', async function(req, res) {
try {
// Cannot ORDER BY encrypted `name`; order by id as a stable proxy after
// per-category sort. Frontend can re-sort alphabetically client-side.
var rows = await db.all(
'SELECT id, category, name, content, created_at, updated_at FROM user_memories WHERE user_id = $1 ORDER BY category, id',
[req.user.id]
);
rows.forEach(decryptMemory);
res.json({ success: true, memories: rows });
} catch (e) { logger.error('GET /memories', e.message); res.status(500).json({ error: 'Request failed' }); }
});
// ── POST create memory ───────────────────────────────────────────────────
router.post('/memories', async function(req, res) {
try {
var { name, category, content } = req.body;
if (!name || !name.trim()) return res.status(400).json({ error: 'Name required' });
if (!content || !content.trim()) return res.status(400).json({ error: 'Content required' });
var cat = VALID_CATEGORIES.includes(category) ? category : 'custom';
// Limit per user
var count = await db.get('SELECT COUNT(*) as cnt FROM user_memories WHERE user_id = $1', [req.user.id]);
if (count && parseInt(count.cnt) >= 200) return res.status(400).json({ error: 'Maximum 200 memories per user' });
var result = await db.run(
'INSERT INTO user_memories (user_id, category, name, content) VALUES ($1,$2,$3,$4)',
[
req.user.id,
cat,
cryptoUtil.encryptString(name.trim().substring(0, 100)),
cryptoUtil.encryptString(content.trim().substring(0, 5000))
]
);
res.json({ success: true, id: result.lastInsertRowid });
} catch (e) { logger.error('POST /memories', e.message); res.status(500).json({ error: 'Request failed' }); }
});
// ── PUT update memory ────────────────────────────────────────────────────
router.put('/memories/:id', async function(req, res) {
try {
var { name, category, content } = req.body;
var cat = VALID_CATEGORIES.includes(category) ? category : 'custom';
await db.run(
'UPDATE user_memories SET name=$1, category=$2, content=$3, updated_at=NOW() WHERE id=$4 AND user_id=$5',
[
cryptoUtil.encryptString((name || '').trim().substring(0, 100)),
cat,
cryptoUtil.encryptString((content || '').trim().substring(0, 5000)),
req.params.id,
req.user.id
]
);
res.json({ success: true });
} catch (e) { logger.error('PUT /memories/:id', e.message); res.status(500).json({ error: 'Request failed' }); }
});
// ── DELETE memory ────────────────────────────────────────────────────────
router.delete('/memories/:id', async function(req, res) {
try {
await db.run('DELETE FROM user_memories WHERE id = $1 AND user_id = $2', [req.params.id, req.user.id]);
res.json({ success: true });
} catch (e) { logger.error('DELETE /memories/:id', e.message); res.status(500).json({ error: 'Request failed' }); }
});
// ── GET memories as prompt context (for AI generation) ──────────────────
router.get('/memories/context', async function(req, res) {
try {
var rows = await db.all(
'SELECT category, name, content FROM user_memories WHERE user_id = $1 ORDER BY category',
[req.user.id]
);
if (rows.length === 0) return res.json({ success: true, context: '' });
rows.forEach(decryptMemory);
var templates = [];
var corrections = [];
rows.forEach(function(r) {
if (r.category.startsWith('correction_')) corrections.push(r);
else templates.push(r);
});
var context = '';
if (templates.length > 0) {
context += '\n\nPHYSICIAN TEMPLATES AND PREFERENCES:\n';
templates.forEach(function(r) {
context += '--- ' + r.category.toUpperCase().replace(/_/g, ' ') + ': ' + r.name + ' ---\n' + r.content + '\n\n';
});
}
if (corrections.length > 0) {
context += '\n\nSTYLE CORRECTIONS (these are examples of past edits — use only the writing style, never the clinical content):\n';
corrections.slice(-10).forEach(function(r) {
// Trim to just the key style difference, not full encounter text
var lines = r.content.split('\n').filter(function(l) { return l.trim(); });
var orig = '', corr = '';
var inCorrected = false;
lines.forEach(function(l) {
if (l.startsWith('CORRECTED TO:')) { inCorrected = true; corr = l.replace('CORRECTED TO:', '').trim(); }
else if (l.startsWith('ORIGINAL:')) { orig = l.replace('ORIGINAL:', '').trim(); }
else if (inCorrected) { corr += ' ' + l.trim(); }
else { orig += ' ' + l.trim(); }
});
// Keep only first 200 chars of each to avoid flooding the prompt
orig = orig.substring(0, 200);
corr = corr.substring(0, 200);
if (orig && corr) {
context += '- Before: "' + orig + '..."\n After: "' + corr + '..."\n';
}
});
}
res.json({ success: true, context: context.trim() });
} catch (e) { logger.error('GET /memories/context', e.message); res.status(500).json({ error: 'Request failed' }); }
});
// ── POST auto-save correction (Dragon-like learning) ──────────────────
router.post('/memories/correction', async function(req, res) {
try {
var { section, original_snippet, corrected_snippet } = req.body;
if (!section || !original_snippet || !corrected_snippet) {
return res.status(400).json({ error: 'section, original_snippet, and corrected_snippet required' });
}
if (original_snippet.trim() === corrected_snippet.trim()) {
return res.json({ success: true, skipped: true });
}
var cat = 'correction_' + section;
if (!VALID_CATEGORIES.includes(cat)) cat = 'correction_encounter';
// Limit corrections per category: keep only latest 20
var existing = await db.all(
'SELECT id FROM user_memories WHERE user_id = $1 AND category = $2 ORDER BY created_at ASC',
[req.user.id, cat]
);
if (existing.length >= 20) {
// Delete oldest to make room
var toDelete = existing.slice(0, existing.length - 19);
for (var i = 0; i < toDelete.length; i++) {
await db.run('DELETE FROM user_memories WHERE id = $1 AND user_id = $2', [toDelete[i].id, req.user.id]);
}
}
var name = original_snippet.substring(0, 60).replace(/\n/g, ' ') + '...';
var content = 'ORIGINAL: ' + original_snippet.substring(0, 2000) + '\nCORRECTED TO: ' + corrected_snippet.substring(0, 2000);
await db.run(
'INSERT INTO user_memories (user_id, category, name, content) VALUES ($1,$2,$3,$4)',
[req.user.id, cat, cryptoUtil.encryptString(name), cryptoUtil.encryptString(content)]
);
res.json({ success: true });
} catch (e) { logger.error('POST /memories/correction', e.message); res.status(500).json({ error: 'Request failed' }); }
});
module.exports = router;