Every staged fact carried a sourceText the model echoed back, stored verbatim
as 'the exact verbatim span of the document the fact came from'. Nothing
checked that the span existed. A paraphrase, a normalised rendering, or an
outright invention was persisted and shown to the reviewer as a transcription
of their own clinical record — an anchor pointing at nothing, or at a span the
document never contained.
Treat the echo as a lookup key instead. anchorSourceText resolves it against
the extracted text (exact, then whitespace-collapsed and case-folded to absorb
OCR reflow) and stores the span the document actually carries, with its offset.
A quote that matches nothing is dropped and the fact is flagged unanchored;
vision mode has no extracted text at all, so its facts are unanchored by
construction. Rows written before this resolve to unanchored on read — their
quote is preserved but never presented as checked.
Ingest an uploaded doctor report / discharge letter through the existing
dedicated OCR/vision provider rails (the v1.22 document-scan provider/key,
reused — no new provider) and transcribe structured facts into staging.
The safety line is extract, never interpret: the prompt frames the document
as untrusted data to reproduce verbatim. Diagnoses map to Condition,
measured values to Observation, medications to MedicationStatement — with
STATED status only. A code survives only when the document writes it and its
system matches the resource (SNOMED/ICD-10 for a diagnosis, LOINC for a
value, RxNorm/ATC for a medication); nothing is inferred, no value is
range-flagged, no condition is linked to a medication. Every fact carries
per-field provenance and a confidence score; a fact below the confidence
floor fails closed — it cannot be approved until the user edits it.
Routes (apiHandler + Zod + session-narrowed userId, opt-in module-gated):
- POST/GET /api/documents/inbound — upload+extract (vision or local-OCR
text), and list. The raw document is stored encrypted at rest.
- GET/DELETE /api/documents/inbound/[id] — review detail; soft-delete.
- PATCH .../facts/[factId] — correct a staged fact before approval.
- POST .../confirm — the only write path: approved facts flow into the
labs / conditions / medications stores through their normal create paths;
rejected facts are discarded; low-confidence facts are refused.
Marc-André Bombeck