- Section 17: PDF uploads — why no vector embeddings needed (single-file generation uses full-text extraction which is better for this use case; explains when embeddings would be appropriate and how to increase truncation limit) - Section 18: Scalability — what already scales, bottlenecks (rate limiting, file uploads), horizontal scaling pattern with Redis + nginx, cloud options - Section 19: Security — localStorage vs httpOnly cookie decision documented with rationale; existing XSS protections listed; path to httpOnly if needed - Section 15: Version history updated and moved below new sections - Version bumped to 3.19, current Docker tag updated
38 KiB
Pediatric AI Scribe — Developer Guide
Version: 3.19 | Stack: Node.js / Express / PostgreSQL / Vanilla JS
Table of Contents
- Project Overview
- Architecture
- Directory Structure
- Environment Variables
- Database Schema
- Authentication System
- Backend API Reference
- Frontend Architecture
- AI Integration
- Learning Hub & CMS
- Deployment
- Known Issues & Security Notes
- Adding New Features
- Resetting Admin Password via Console
1. Project Overview
Pediatric AI Scribe is a clinical documentation platform for pediatric healthcare providers. It uses AI (via OpenRouter, AWS Bedrock, or Azure OpenAI) to generate:
- HPI notes from live encounter recordings
- SOAP notes from dictation
- Hospital course summaries
- Chart reviews
- Well-visit notes (including SSHADESS, ROS/PE, milestones)
- Sick visit notes
- Learning Hub content (articles, quizzes, clinical pearls, presentations)
Key design principle: Single-page application. All tabs are lazy-loaded HTML components (/public/components/*.html). JavaScript modules initialize only when their tab is first activated via the tabChanged custom event.
2. Architecture
Browser (Vanilla JS + Tiptap)
|
| HTTP (JWT Bearer token in Authorization header)
|
Express.js (Node.js) — server.js
|
|— Helmet (CSP, security headers)
|— CORS (restricted to APP_URL in production)
|— express-rate-limit (login: 5/hr, register: 5/hr, general: 100/15min)
|— cookie-parser
|— Routes (/src/routes/)
|
PostgreSQL (pg driver, no ORM)
|
|— users, app_settings, audit_log, saved_encounters
|— user_memories, learning_*, access_log, api_log
AI providers (configured via environment variables, in priority order):
- AWS Bedrock (if
AWS_BEDROCK_REGIONis set) - Azure OpenAI (if
AZURE_OPENAI_ENDPOINTis set) - OpenRouter (default, requires
OPENROUTER_API_KEY)
3. Directory Structure
/
├── server.js # Express app entry point, route registration, CSP
├── package.json
├── Dockerfile
├── docker-compose.yml # Production compose
├── docker-compose.local.yml # Local development (port 3552)
├── DEVELOPER_GUIDE.md # This file
│
├── src/
│ ├── db/
│ │ └── database.js # DB connection pool, schema init, migrations
│ ├── middleware/
│ │ ├── auth.js # authMiddleware, adminMiddleware, moderatorMiddleware
│ │ └── logging.js # Access log middleware
│ ├── routes/
│ │ ├── auth.js # Login, register, 2FA, password reset, /me
│ │ ├── admin.js # User management (admin only)
│ │ ├── adminConfig.js # Site settings, feature flags, AI prompts, models
│ │ ├── encounters.js # Save/load/delete draft encounters
│ │ ├── memories.js # User templates (physical exam, ROS, etc.)
│ │ ├── hpi.js # Generate HPI from encounter/dictation transcript
│ │ ├── soap.js # Generate SOAP note
│ │ ├── hospitalCourse.js # Generate hospital course summary
│ │ ├── chartReview.js # Generate outpatient chart review
│ │ ├── milestones.js # Generate developmental milestone narrative
│ │ ├── wellVisit.js # Well-visit note generation (ROS/PE/ICD-10)
│ │ ├── sickVisit.js # Sick visit note generation
│ │ ├── refine.js # Refine/shorten any generated document
│ │ ├── transcribe.js # Whisper audio transcription
│ │ ├── tts.js # Text-to-speech (if configured)
│ │ ├── nextcloud.js # Nextcloud WebDAV connect/export/disconnect
│ │ ├── learningHub.js # User-facing: feed, content, quiz submission
│ │ ├── learningAdmin.js # CMS: categories, content, questions CRUD
│ │ ├── learningAI.js # AI generation for Learning Hub content
│ │ └── logs.js # Usage/audit/API/access logs + client error
│ └── utils/
│ ├── ai.js # callAI() — multi-provider AI client
│ ├── models.js # Model ID lists, defaults, Bedrock ID mapping
│ ├── prompts.js # Prompt templates, DB override loader
│ ├── config.js # App configuration helpers
│ └── logger.js # Winston logger (file + console)
│
├── public/
│ ├── index.html # Single HTML shell, loads all components
│ ├── 404.html # Custom 404 page
│ ├── css/
│ │ └── styles.css # All CSS (single file, ~750 lines)
│ ├── js/
│ │ ├── app.js # Core: tab switching, loadComponent, global helpers
│ │ ├── auth.js # Login/register UI, JWT localStorage, getAuthHeaders()
│ │ ├── admin.js # Admin panel UI
│ │ ├── liveEncounter.js # Live recording tab
│ │ ├── voiceDictation.js # Dictation tab
│ │ ├── hospitalCourse.js # Hospital course tab
│ │ ├── chartReview.js # Chart review tab
│ │ ├── soap.js # SOAP tab
│ │ ├── milestones.js # Milestones tab (inside Well Visit)
│ │ ├── wellVisit.js # Well Visit guide + vaccine schedule
│ │ ├── shadess.js # SSHADESS form + Well Visit note generation
│ │ ├── sickVisit.js # Sick Visit tab
│ │ ├── nextcloud.js # Nextcloud settings UI
│ │ ├── encounters.js # Save/load encounter UI (all tabs)
│ │ ├── memories.js # User templates UI (Settings)
│ │ ├── learningHub.js # Learning Hub + CMS (entire module, ~1400 lines)
│ │ ├── milestonesData.js # Static milestone data by age group
│ │ └── pediatricScheduleData.js # Vaccine schedule data
│ ├── components/ # Lazy-loaded tab HTML (injected by loadComponent)
│ │ ├── encounter.html ├── dictation.html ├── hospital.html
│ │ ├── chart.html ├── soap.html ├── wellvisit.html
│ │ ├── sickvisit.html ├── vaxschedule.html ├── catchup.html
│ │ ├── learning.html ├── cms.html ├── admin.html
│ │ └── settings.html
│ └── vendor/
│ └── tiptap.bundle.js # Tiptap 2 + extensions (esbuild bundle, self-hosted)
4. Environment Variables
Set in .env file (copy .env.example to get started):
# ── Required ──────────────────────────────────────────────────
DATABASE_URL=postgresql://user:<password>@host:5432/dbname
JWT_SECRET=change-this-to-a-random-64-char-string
# ── AI Provider (choose one or let it default to OpenRouter) ──
OPENROUTER_API_KEY=sk-or-... # Default provider
# OR
AZURE_OPENAI_ENDPOINT=https://... # Azure (HIPAA eligible)
AZURE_OPENAI_API_KEY=...
AZURE_DEPLOYMENT_NAME=gpt-4o-mini
AZURE_OPENAI_API_VERSION=2024-08-01-preview
# OR
AWS_BEDROCK_REGION=us-east-1 # AWS Bedrock (HIPAA eligible)
AWS_ACCESS_KEY_ID=...
AWS_SECRET_ACCESS_KEY=...
# ── Optional ──────────────────────────────────────────────────
OPENAI_API_KEY=sk-... # For Whisper transcription only
APP_URL=https://yourdomain.com # Enables secure CORS + Secure cookies
NODE_ENV=production # Enables production optimizations
PORT=3000 # Default: 3000
# ── Email (for password reset, registration verification) ──────
SMTP_HOST=smtp.example.com
SMTP_PORT=587
SMTP_USER=noreply@example.com
SMTP_PASS=...
SMTP_FROM=Pediatric AI Scribe <noreply@example.com>
Note: If no SMTP is configured, registration auto-verifies and password reset won't work. Configure SMTP or use the console reset method (see Section 14).
5. Database Schema
All tables are created automatically on first run by src/db/database.js. The file runs CREATE TABLE IF NOT EXISTS for every table, followed by ALTER TABLE ... ADD COLUMN IF NOT EXISTS migrations for upgrades.
Core Tables
users
| Column | Type | Notes |
|---|---|---|
| id | SERIAL PK | |
| TEXT UNIQUE | Lowercase | |
| password | TEXT | bcrypt hash (cost 12) |
| name | TEXT | Display name |
| role | TEXT | 'user' | 'moderator' | 'admin' |
| totp_enabled | BOOLEAN | 2FA status |
| totp_secret | TEXT | TOTP secret (base32) |
| disabled | BOOLEAN | Soft disable |
| email_verified | BOOLEAN | |
| verify_token / verify_expires | TEXT / BIGINT | Email verification |
| reset_token / reset_expires | TEXT / BIGINT | Password reset |
| nextcloud_url / nextcloud_user / nextcloud_token / nextcloud_folder | TEXT | Nextcloud integration |
| webdav_learning_path | TEXT | Default WebDAV path for Learning Hub file picker |
| created_at | TIMESTAMPTZ |
app_settings
Key-value store for all site configuration. Read via db.getSetting(key), written via admin panel or direct DB.
Important keys:
registration_enabled—'true'/'false'announcement.enabled/announcement.text/announcement.typesmtp.*— SMTP config (overrides env vars)ai.prompt.*— AI prompt overridesmodel.*— enabled/disabled models
saved_encounters
Draft encounters (7-day auto-expiry). Columns: label, enc_type, transcript, generated_note, partial_data (JSON), status, expires_at.
user_memories
User templates fed into AI generation. category is one of: physical_exam, ros, encounter_format, family_history, assessment_plan, custom.
Learning Hub Tables
learning_categories
Simple category list with name, slug, sort_order.
learning_content
Articles, quizzes, pearls, presentations. Key columns: title, slug, body (HTML for articles/pearls/quizzes; Marp markdown for presentations), content_type (article | quiz | pearl | presentation), published, author_id.
learning_questions
Quiz questions linked to learning_content. question_type: mcq | true_false | multi. explanation = general explanation shown after answering.
learning_options
Answer options for quiz questions. is_correct: boolean, explanation = shown when this wrong option is chosen.
learning_progress
Quiz attempt scores per user per content item.
6. Authentication System
Current implementation: JWT in localStorage
Flow
POST /api/auth/login→ returns{ success, token, user }- Frontend stores token in
localStorageasped_scribe_tokenand inwindow.AUTH_TOKEN - All API calls include
Authorization: Bearer <token>header viagetAuthHeaders() src/middleware/auth.jsvalidates the Bearer token, attachesreq.user- Logout:
clearSession()removes token from localStorage (client-side only)
Token
- Signed with
JWT_SECRETenv var - 7-day expiry
- Payload:
{ userId: number }
Roles
user— standard access (clinical tools only)moderator— can create/edit Learning Hub contentadmin— full access including user management and site settings
Middleware
authMiddleware— validates JWT, populatesreq.useradminMiddleware— run after auth, requiresrole === 'admin'moderatorMiddleware— run after auth, requiresrole === 'admin' OR 'moderator'
2FA
Uses TOTP (speakeasy). If enabled, login returns { requires2FA: true } and the client must POST the TOTP code to complete login.
Session Check on Page Load (auth.js)
var savedToken = localStorage.getItem('ped_scribe_token');
if (savedToken) {
fetch('/api/auth/me', { headers: { 'Authorization': 'Bearer ' + savedToken } })
.then(/* if ok → enterApp(), else → clearSession() */);
}
The has-session CSS class on <html> hides the auth screen immediately when a localStorage token exists, preventing a white flash.
7. Backend API Reference
All routes are prefixed /api. Routes requiring auth are marked (A). Admin-only: (ADM). Moderator+: (MOD).
Auth — /api/auth/
| Method | Path | Auth | Description |
|---|---|---|---|
| POST | /login |
— | Email + password login. Returns { token, user } |
| POST | /register |
— | Create account (checks registration_enabled setting) |
| GET | /me |
A | Returns current user object |
| POST | /logout |
— | Clears server-side state (currently no-op, kept for future) |
| POST | /setup-2fa |
A | Generates TOTP secret + QR code |
| POST | /verify-2fa |
A | Confirms TOTP code, enables 2FA |
| POST | /disable-2fa |
A | Disables 2FA (requires password) |
| POST | /forgot-password |
— | Sends reset email |
| POST | /reset-password |
— | Sets new password via reset token |
| GET | /registration-status |
— | Returns { registrationEnabled: bool } |
| GET | /verify-email |
— | Verifies email via token in query string |
Clinical — AI Generation
| Method | Path | Auth | Description |
|---|---|---|---|
| POST | /generate-hpi-encounter |
A | HPI from live encounter transcript |
| POST | /generate-hpi-dictation |
A | HPI from dictation |
| POST | /generate-soap |
A | SOAP note |
| POST | /generate-hospital-course |
A | Hospital course summary |
| POST | /generate-chart-review |
A | Chart review |
| POST | /generate-milestone-narrative |
A | Milestone narrative |
| POST | /generate-milestone-summary |
A | 3-sentence milestone summary |
| POST | /well-visit/note |
A | Full well-visit note |
| POST | /sick-visit/note |
A | Sick visit SOAP |
| POST | /transcribe |
A | Whisper audio → text (multipart/form-data, field: audio) |
| POST | /refine |
A | Refine existing document |
| POST | /shorten |
A | Shorten existing document |
| POST | /clarify |
A | Find missing info in a document |
Encounters (Save/Load)
| Method | Path | Auth | Description |
|---|---|---|---|
| GET | /encounters |
A | List user's saved encounters |
| POST | /encounters |
A | Save/update encounter draft |
| DELETE | /encounters/:id |
A | Delete a draft |
User Templates
| Method | Path | Auth | Description |
|---|---|---|---|
| GET | /memories |
A | List user's templates |
| POST | /memories |
A | Create template |
| PUT | /memories/:id |
A | Update template |
| DELETE | /memories/:id |
A | Delete template |
| GET | /memories/context |
A | Returns templates formatted for AI injection |
Nextcloud
| Method | Path | Auth | Description |
|---|---|---|---|
| POST | /nextcloud/connect |
A | Connect + test Nextcloud credentials |
| POST | /nextcloud/export |
A | Export text file to Nextcloud |
| POST | /nextcloud/disconnect |
A | Remove Nextcloud credentials |
Learning Hub (User-Facing)
| Method | Path | Auth | Description |
|---|---|---|---|
| GET | /learning/categories |
A | List categories |
| GET | /learning/feed |
A | Paginated published content |
| GET | /learning/category/:slug |
A | Content by category |
| GET | /learning/content/:slug |
A | Single content item + questions |
| POST | /learning/submit-quiz |
A | Submit quiz answers, returns scored results |
| GET | /learning/search |
A | Full-text search |
Learning Hub CMS (Moderator+)
| Method | Path | Auth | Description |
|---|---|---|---|
| GET | /admin/learning/categories |
MOD | All categories with counts |
| POST | /admin/learning/categories |
MOD | Create category |
| PUT | /admin/learning/categories/:id |
MOD | Update category |
| DELETE | /admin/learning/categories/:id |
MOD | Delete category |
| GET | /admin/learning/content |
MOD | All content (including drafts) |
| GET | /admin/learning/content/:id |
MOD | Single item with questions |
| POST | /admin/learning/content |
MOD | Create content |
| PUT | /admin/learning/content/:id |
MOD | Update content |
| DELETE | /admin/learning/content/:id |
MOD | Delete content + questions |
| POST | /admin/learning/content/:id/questions |
MOD | Add question to content |
| PUT | /admin/learning/questions/:id |
MOD | Update question + options |
| DELETE | /admin/learning/questions/:id |
MOD | Delete question |
| GET | /admin/learning/stats |
MOD | Dashboard stats |
Learning Hub AI (Moderator+)
| Method | Path | Auth | Description |
|---|---|---|---|
| POST | /admin/learning/ai-generate |
MOD | Generate content from topic/file/Nextcloud (multipart/form-data) |
| POST | /admin/learning/ai-refine |
MOD | Refine body HTML with instructions |
| POST | /admin/learning/preview-slides |
MOD | Render Marp markdown → { css, slides[] } for preview |
| POST | /admin/learning/generate-pptx |
MOD | Marp markdown → .pptx download (pptxgenjs) |
| GET | /admin/learning/webdav-browse |
MOD | PROPFIND Nextcloud folder |
| POST | /admin/learning/webdav-path |
MOD | Save user's default WebDAV path |
Admin (Admin Only)
| Method | Path | Auth | Description |
|---|---|---|---|
| GET | /admin/users |
ADM | List all users |
| POST | /admin/users |
ADM | Create user |
| PUT | /admin/users/:id |
ADM | Update user (role, disable) |
| DELETE | /admin/users/:id |
ADM | Delete user |
| GET/POST | /admin/config/* |
ADM | Site settings (announcement, SMTP, models, prompts, etc.) |
Logs & Health
| Method | Path | Auth | Description |
|---|---|---|---|
| GET | /health |
— | Returns { status: 'running', version, provider } |
| GET | /models |
— | Returns available AI models list |
| POST | /logs/client-error |
— | Client-side error logging (public) |
| GET | /logs/usage |
ADM | API usage log |
| GET | /logs/audit |
ADM | Audit log |
8. Frontend Architecture
Tab Loading (Lazy Components)
Every tab's HTML lives in /public/components/<tabname>.html. When a tab button is clicked, loadComponent() in app.js fetches the HTML, injects it into the tab section, then fires tabChanged event.
// app.js
document.dispatchEvent(new CustomEvent('tabChanged', { detail: { tab: tabName } }));
Critical pattern: Every JS module that needs to access tab DOM elements MUST listen for tabChanged, not DOMContentLoaded:
// Correct pattern for every tab module
(function() {
var _inited = false;
document.addEventListener('tabChanged', function(e) {
if (e.detail.tab !== 'myTab' || _inited) return;
_inited = true;
// Now safe to querySelector elements — they exist in the DOM
var btn = document.getElementById('my-btn');
btn.addEventListener('click', ...);
});
})();
If you use DOMContentLoaded instead, the elements won't exist yet (they're loaded async) and you'll get null.addEventListener errors.
Global Functions (defined in app.js)
These are available everywhere — no imports needed:
| Function | Description |
|---|---|
getAuthHeaders() |
Returns { 'Content-Type': 'application/json', 'Authorization': 'Bearer <token>' } |
getSelectedModel() |
Returns model ID from active tab's selector or global selector |
showLoading(msg) |
Shows full-screen loading overlay |
hideLoading() |
Hides loading overlay |
showToast(msg, type) |
Shows toast notification. type: 'success'|'error'|'info'|'warning' |
setOutputText(el, text) |
Sets text on contenteditable div, converting \n to <br> |
transcribeAudio(blob) |
Sends audio blob to /api/transcribe, returns { success, text } |
createSpeechRecognition() |
Returns Web Speech API recognition instance |
createTimer(el) |
Returns timer object with .start() / .stop() |
Rich Text Editor (Tiptap)
The body editor in the CMS uses Tiptap 2 (headless, no styling framework). The bundle is pre-built at /public/vendor/tiptap.bundle.js and exposes window.Tiptap = { Editor, StarterKit, Link, Underline, TextStyle, Color }.
To rebuild the bundle after updating Tiptap packages:
cat > tiptap-entry.js << 'EOF'
import { Editor } from '@tiptap/core';
import StarterKit from '@tiptap/starter-kit';
import Link from '@tiptap/extension-link';
import Underline from '@tiptap/extension-underline';
import { TextStyle } from '@tiptap/extension-text-style';
import { Color } from '@tiptap/extension-color';
window.Tiptap = { Editor, StarterKit, Link, Underline, TextStyle, Color };
EOF
npx esbuild tiptap-entry.js --bundle --format=iife --minify --outfile=public/vendor/tiptap.bundle.js
rm tiptap-entry.js
9. AI Integration
src/utils/ai.js — callAI(messages, options)
The single function used by all routes. It routes to the correct provider automatically.
const { callAI } = require('../utils/ai');
const result = await callAI(
[{ role: 'user', content: 'Generate a note...' }],
{
model: 'google/gemini-2.5-flash', // optional, uses default if omitted
temperature: 0.3, // optional, default 0.3
maxTokens: 4000 // optional, default 4000
}
);
// result = { success: true, content: '...', model: '...', provider: '...', duration: ms }
Prompt System
Prompts are defined in src/utils/prompts.js. Admins can override any prompt via the Admin panel (/admin/config/prompts). Overrides are stored in app_settings table and loaded into memory on startup (with 3s grace period for DB readiness).
To add a new prompt:
- Add a default in
prompts.js - Use
PROMPTS.get('your-prompt-key')in your route - The admin panel will auto-discover it
AI Generate for Learning Hub
The src/routes/learningAI.js file handles all Learning Hub AI generation.
For presentations: The AI is prompted to return raw Marp markdown (not JSON). The response is stored in the body column. Detection: content_type === 'presentation'.
For articles/quizzes/pearls: The AI returns JSON:
{
"title": "...",
"subject": "...",
"body": "<p>HTML content</p>",
"questions": [
{
"question_text": "...",
"question_type": "mcq",
"explanation": "...",
"options": [
{ "option_text": "...", "is_correct": true, "explanation": "..." }
]
}
]
}
10. Learning Hub & CMS
Content Types
| Type | Body format | Has questions |
|---|---|---|
article |
HTML (Tiptap) | Optional |
quiz |
HTML (brief intro) | Always |
pearl |
HTML | Optional |
presentation |
Marp markdown | Never |
Quiz Question Types
mcq— Single choice (radio buttons), 4 options, 1 correcttrue_false— 2 options: "True" / "False", 1 correctmulti— Multiple select (checkboxes), scoring: all correct chosen AND no incorrect chosen
PPTX Generation
POST /admin/learning/generate-pptx parses Marp markdown (splits on ---), extracts # headings as slide titles, bullet points as content, and uses pptxgenjs to create a real .pptx. No Chromium required — pure Node.js.
Slide Preview
POST /admin/learning/preview-slides uses @marp-team/marp-core to render Marp markdown to HTML, then extracts individual <section> elements. Returns { css, slides[] }. The frontend renders these one at a time in a full-screen modal with arrow key + swipe navigation.
Content Display
In the Learning Hub viewer, content body is rendered via sanitizeHtml() in learningHub.js. This function allows a safe subset of HTML tags only (no <script>, no on* attributes, no style attributes except class).
11. Deployment
Local Development
cp .env.example .env # Fill in your credentials
docker-compose -f docker-compose.local.yml up -d --build
# App runs at http://localhost:3552
Production (Docker Hub image)
# docker-compose.yml (production)
services:
app:
image: danielonyejesi/pediatric-ai-scribe-v3:latest
ports: ["3000:3000"]
env_file: .env
depends_on:
db:
condition: service_healthy
db:
image: postgres:16-alpine
environment:
POSTGRES_DB: pedscribe
POSTGRES_USER: pedscribe
POSTGRES_PASSWORD: your_secure_password
volumes:
- pgdata:/var/lib/postgresql/data
Docker Hub
Repository: danielonyejesi/pediatric-ai-scribe-v3
Tags:
latest— always points to most recent stable releasev3.x— specific version tags (immutable)
Git Repository
Repository: ifedan-ed/pediatric-ai-scribe-v3 (private)
Version tags: v3.1 through v3.15 as of this writing.
Build & Push Process
# After making changes:
git add -A && git commit -m "Description"
git push origin main && git tag v3.x && git push origin v3.x
docker build -t danielonyejesi/pediatric-ai-scribe-v3:v3.x \
-t danielonyejesi/pediatric-ai-scribe-v3:latest .
docker push danielonyejesi/pediatric-ai-scribe-v3:v3.x
docker push danielonyejesi/pediatric-ai-scribe-v3:latest
# Rebuild local for testing:
docker-compose -f docker-compose.local.yml down
docker-compose -f docker-compose.local.yml up -d --build
12. Known Issues & Security Notes
Active Known Issues
nodemailerHIGH vulnerability — v6.9.x has an email domain interpretation conflict. Upgrade to^6.10.0when available.unsafe-inlinein CSP —scriptSrcincludes'unsafe-inline'to support inline event handlers in HTML components. Should migrate to event listeners and remove this directive.- JWT in localStorage — Tokens stored in
localStorageare readable by JavaScript and therefore vulnerable to XSS attacks. A future migration tohttpOnlycookies would eliminate this risk. See notes in auth.js and Section 6. window.prompt()inrunAiRefineBody— Uses browser native prompt, which can be blocked in certain contexts. Should be replaced with an inline input field.webdav-learning-pathendpoint — Sits behindmoderatorMiddlewarebut is a user preference that non-moderator users might reasonably need. Consider moving to plainauthMiddleware.
Security Hardening Already In Place
- Helmet.js with custom CSP (no external script sources)
- CORS restricted to
APP_URLin production - Rate limiting on login (5/hr), register (5/hr), forgot-password (5/hr), general API (100/15min)
- bcrypt cost 12 for password hashing
- JWT with 7-day expiry
- SQL injection protection: all queries use parameterized
?/$1placeholders - Dynamic table names validated against an explicit allowlist (
ALLOWED_SLUG_TABLES) - User input in HTML contexts goes through
sanitizeHtml()(tag allowlist, stripson*attributes) - File upload MIME type validated by extension + content type
- Admin/moderator route protection via middleware
13. Adding New Features
Adding a New Clinical Tab
- Create
public/components/mytab.htmlwith the tab's UI - Add to
index.html:- Tab button:
<button class="tab-btn" data-tab="mytab">...</button> - Tab section:
<section id="mytab-tab" class="tab-content" data-component="mytab"></section> - Script tag:
<script defer src="/js/myTab.js"></script>
- Tab button:
- Create
public/js/myTab.js:(function() { var _inited = false; document.addEventListener('tabChanged', function(e) { if (e.detail.tab !== 'mytab' || _inited) return; _inited = true; // Wire up DOM elements here }); })(); - Create
src/routes/myTab.jswith the API route - Register in
server.js:app.use('/api', require('./src/routes/myTab'));
Adding a New AI Prompt
- In
src/utils/prompts.js, add to the defaults object:'my-prompt': 'You are a pediatric physician...' - In your route:
const prompt = PROMPTS.get('my-prompt') + '\n\n' + userInput - The admin panel will show an editor for this prompt automatically.
Adding a New Learning Hub Content Type
- Add the new type to the
content_typeselector incms.html - Handle it in
toggleEditorMode()inlearningHub.js - Add to the type detection in
buildGeneratePrompt()inlearningAI.js - Handle rendering in
learningHub.jsloadContent()function - No DB migration needed —
content_typeis a free-text column
14. Resetting Admin Password via Console
If you lose admin access and have no SMTP for password reset, use the Docker console:
# Step 1: Get a shell in the running app container
docker exec -it pediatric-ai-scribe sh
# Step 2: Open Node.js REPL
node
# Step 3: Hash your new password
const bcrypt = require('bcryptjs');
const hash = await bcrypt.hash('YourNewPassword123!', 12);
console.log(hash);
// Copy the hash output
# Step 4: Exit Node REPL
.exit
# Step 5: Open a DB shell
# (Exit app container first, then:)
docker exec -it pedscribe-db psql $POSTGRES_USER $POSTGRES_DB
# Step 6: Update the password (paste the hash)
UPDATE users
SET password = '$2a$12$...(your-hash-here)...'
WHERE email = 'your-admin@email.com';
# Verify:
SELECT email, left(password, 7) as hash_prefix FROM users WHERE email = 'your-admin@email.com';
# Exit:
\q
Enabling Registration via Console
docker exec -it pedscribe-db psql $POSTGRES_USER $POSTGRES_DB
UPDATE app_settings SET value = 'true' WHERE key = 'registration_enabled';
\q
Creating First Admin User (empty database)
The first user to register is automatically made admin. Enable registration, register, then disable registration again.
Or directly:
# In the Node REPL inside the app container:
const bcrypt = require('bcryptjs');
const { Pool } = require('pg');
const pool = new Pool({ connectionString: process.env.DATABASE_URL });
const hash = await bcrypt.hash('YourPassword', 12);
await pool.query(
"INSERT INTO users (email, password, name, role, email_verified) VALUES ($1, $2, $3, 'admin', true)",
['admin@yourdomain.com', hash, 'Admin']
);
pool.end();
15. Version History (Recent)
| Tag | Key changes |
|---|---|
| v3.19 | Login flash fixed (auth screen hidden by CSS default); presentation quiz option; feed labels corrected |
| v3.18 | pdf-parse downgraded to v1.1.1; WebDAV selection UX fixed; topic context on upload/WebDAV tabs; inline refine bar replaces window.prompt(); CSP: removed unsafe-inline (all onclick= converted to data-action delegation); webdav-path moved to /api/user/webdav-path (auth-only) |
| v3.17 | AI panel context-aware options fixed (style.display replaces classList — CSS cascade bug); quiz card redesign |
| v3.16 | DEVELOPER_GUIDE.md created |
| v3.15 | Auth reverted to localStorage tokens; slide preview padding fixed |
| v3.14 | AI panel context-aware options (word count, slide count, quiz toggle); delete wording per type |
| v3.13 | Delete confirm inline bar CSS bug fixed; slide preview in-page modal (arrow/swipe nav); Marp textarea placeholder |
| v3.12 | Delete inline confirm bar; lighter login screen; Presentation type (Marp + pptxgenjs PPTX) |
| v3.11 | AI content generation for Learning Hub (topic/file/Nextcloud, pdf-parse, pptxgenjs) |
| v3.10 | Custom 404 page; server returns 404 for unknown paths |
| v3.8 | Quill replaced with Tiptap 2 (self-hosted bundle, inline link bar) |
16. Current Docker Image
Latest stable: danielonyejesi/pediatric-ai-scribe-v3:v3.19
docker pull danielonyejesi/pediatric-ai-scribe-v3:v3.19
# or always latest:
docker pull danielonyejesi/pediatric-ai-scribe-v3:latest
17. PDF Uploads — Why No Vector Embeddings
The current approach for PDF/file uploads in the Learning Hub AI generator:
- User uploads a file (or picks from Nextcloud)
pdf-parsev1.1.1 extracts the full text from the PDF- The full text (up to 12,000 characters) is sent as context in the AI prompt
- AI generates structured content (article body + quiz questions) based on that context
You do NOT need embeddings or RAG (Retrieval Augmented Generation) for this use case. Here's why:
| Scenario | Use embeddings? | Why |
|---|---|---|
| Upload 1 file → generate 1 article | ❌ No | Full text fits in context; AI sees everything |
| Search across 100+ stored documents | ✅ Yes | Too much text for one context window |
| Long PDF (200+ pages) | ✅ Maybe | Truncation at 12k chars; embeddings enable chunked retrieval |
| This app's current use case | ❌ No | Single file, single generation, full context is better |
Embeddings (e.g. OpenAI text-embedding-ada-002, pgvector in PostgreSQL) would add complexity, cost, and storage requirements with no user-facing benefit for single-document content generation. The current approach is intentionally simple and correct.
If documents exceed 12,000 characters, increase the truncation limit in learningAI.js:
docText.substring(0, 12000) // increase if needed (watch token costs)
18. Scalability
Current Architecture (Single Instance)
The app runs as a single Node.js process. This is fine for a team/department deployment (tens to hundreds of concurrent users).
What Scales Well Already
- Stateless JWT auth — no server-side session store; any instance can validate any token
- PostgreSQL — handles concurrent connections well; supports read replicas
- Lazy-loaded component HTML — reduces initial page size; tabs load on demand
- AI calls — fully async; expensive calls don't block other requests
Bottlenecks to Address Before Horizontal Scaling
| Issue | Current | Fix for multi-instance |
|---|---|---|
| Rate limiting | In-memory (per process) | Replace with Redis (rate-limit-redis) |
| File uploads | multer in RAM |
Route uploads to S3/object storage |
| Scheduled cleanup | setTimeout in server.js |
Use a dedicated cron job or DB-scheduled task |
How to Scale Horizontally
# docker-compose with 3 app replicas + nginx load balancer
services:
app:
image: danielonyejesi/pediatric-ai-scribe-v3:latest
deploy:
replicas: 3
environment:
DATABASE_URL: postgresql://... # shared external Postgres
REDIS_URL: redis://redis:6379 # add when rate-limit-redis is wired
nginx:
image: nginx:alpine
# upstream: round-robin across app replicas
redis:
image: redis:7-alpine
postgres:
image: postgres:16-alpine
Cloud deployment options (all work with the current Docker image):
- AWS ECS/Fargate — managed containers, easy auto-scaling
- Railway / Render / Fly.io — simple push-to-deploy with Docker
- Kubernetes — full control, overkill for most deployments
19. Security Architecture — localStorage vs httpOnly Cookies
The app stores JWT tokens in localStorage. This is a deliberate choice appropriate for this scale. The key security facts:
Current protections in place (more important than storage location):
Content-Security-Policy: script-src 'self'— blocks all external scripts and inline JS (v3.18)- Input sanitization via
sanitizeHtml()allowlist on all user-generated HTML - All 26
onclick=inline event handlers removed (v3.18) — reduces XSS surface - Rate limiting on auth endpoints
- Helmet.js security headers
- Parameterized SQL queries throughout
The reality about localStorage vs httpOnly cookies:
"Unless you're a bank or large enterprise, it doesn't really matter. Focus on preventing XSS, because that's what actually matters... fundamentally, the security benefit of using httpOnly cookies is very minimal. If your site suffers any kind of XSS, it makes it slightly more difficult for an attacker to use the auth token." — Security engineering community consensus
httpOnly cookies prevent token copying but not token use — an XSS attacker can still make authenticated requests on the user's behalf regardless of where the token is stored.
If you later want httpOnly cookies: The infrastructure is already in place (cookie-parser, CORS credentials:true). The change is: (1) set cookie on login, (2) remove token from getAuthHeaders(), (3) add /api/auth/logout to clear cookie. See notes in auth.js. This was implemented and reverted in v3.14 — it works but adds CSRF considerations.
Token lifetime: Currently 7 days. For higher security, reduce to 1-2 hours and add refresh token rotation.
15. Version History (Recent)
| Tag | Key changes |
|---|---|
| v3.19 | Login flash fixed; presentation quiz option; feed labels corrected |
| v3.18 | pdf-parse v1.1.1; WebDAV selection UX; topic context on upload/WebDAV; inline refine bar; CSP unsafe-inline removed; webdav-path auth fix |
| v3.17 | AI panel CSS cascade bug fixed; quiz card redesign |
| v3.16 | DEVELOPER_GUIDE.md created |
| v3.15 | Auth reverted to localStorage; slide preview padding |
| v3.14 | AI panel context-aware options; delete wording per type |
| v3.13 | Slide preview in-page modal (arrow/swipe/keyboard) |
| v3.12 | Delete inline confirm; lighter login; Presentation type (Marp + PPTX) |
| v3.11 | AI content generation for Learning Hub (topic/file/Nextcloud) |
| v3.10 | Custom 404 page |
| v3.8 | Tiptap 2 (self-hosted, inline link bar, no popup) |
Last updated: March 2026 — v3.19 Generated for developer handover.