Emit `AllergyIntolerance` and `FamilyMemberHistory` resources in the
health-record document bundle. Vendor-blind and non-diagnostic, matching the
illness `Condition` stance: the user's own label rides `code.text` (never a
machine-guessed clinical code); only the FHIR-fixed value sets — allergy
category, clinical/verification status, the v3 RoleCode family-member concept —
carry codings. Every resource is marked patient-reported (allergy
`verificationStatus: unconfirmed` plus an explicit "not a clinical diagnosis"
note) so a clinician's viewer never reads it as an adjudicated finding.
The records are loaded owner-scoped in the export route and folded into the
fhir + package bundle formats with their own Composition sections.
One-shot prettier pass so the new format:check gate starts from a clean
baseline. Formatting only — no behaviour change. Generator-owned and
vendored artifacts stay untouched via .prettierignore.
An active illness/condition episode annotates, it never penalises: the
measured number is untouched, only the narrative changes.
- rest-mode.ts: one server-authoritative resolver (module-gated, fail-soft)
for "is the account in Rest Mode + which episodes back it". iOS mirrors the
resolved context, never recomputes the suppression.
- health-score: /api/analytics attaches a value-free Rest Mode annotation;
computeHealthScore stays pure (score never adjusted).
- recovery-score: computeRecoveryScore carries the Rest Mode context as of the
scored day; the persisted blend is unchanged.
- coach-nudge: pause cadence-nudges during an active episode (new
skippedDuringIllness counter, gate sits before the trigger search).
- achievements: bridgeFrozenStreakGaps freezes (does not break) every
day-streak across illness days; never invents a streak, a non-illness gap
still breaks.
- coincident-deviation: reframe a fired flag as illness-explained; vital
numbers untouched. Surfaced as a neutral line on the insights card.
- coach snapshot: illness history + active illness as load-bearing context so
the coach knows about Rest Mode (no decrypted note reaches the prompt).
- FHIR: illness episodes map to Condition (generic disease root, label on
code.text, patient-reported/unconfirmed) + a bounding Encounter.
- doctor-report: module-gated illness section in the aggregator + PDF table
(retrospective, neutral palette); FHIR Condition section in the bundle.
i18n x6 for the report + reframe copy. Tests: score-annotation-not-
penalisation, streak-freeze, coach-nudge pause, FHIR Condition/Encounter
mapping, doctor-report inclusion, Rest Mode resolver. typecheck/lint/test
green, openapi in sync, knip clean.
Promote the reproductive HealthKit category types out of the
Apple-Health-import privacy-hold list and route them into cycle day-logs
instead of measurements, and surface cycle data on the three export
surfaces.
Import promotion:
- A new HealthKit -> cycle mapping module is the single source of truth for
how MenstrualFlow, IntermenstrualBleeding, CervicalMucusQuality,
OvulationTestResult, SexualActivity, PregnancyTestResult,
ProgesteroneTestResult, Contraceptive and the symptom category types fold
into CycleDayLog fields / seeded symptom keys. The XML importer
accumulates same-day reproductive samples and writes one canonical
day-log per day with source APPLE_HEALTH and a synthetic per-day
externalId for idempotent re-import. The fold is gated on cycle tracking
being enabled, so a non-cycle export never provisions cycle rows. A
contraceptive method nudges the profile goal toward avoiding pregnancy
only when the goal is still on its default. Basal body temperature stays
a measurement and mirrors onto the day-log. Pregnancy/Lactation status
and the pregnancy-bleeding types stay deferred; the cycle awareness types
remain server-derived.
Export:
- FHIR emits LMP (LOINC 8665-2), average cycle length (64700-8), period
length (64698-4) and the current phase as opt-in reproductive-health
observations grouped into their own document section.
- The doctor PDF gains an opt-in cycle section (recent cycles, average
length and variability, current phase), privacy-default off like mood.
- The full-backup export, the weekly backup worker and the off-host DR
snapshot include the cycle tables, and the admin restore re-creates them;
the day-log note round-trips as ciphertext and is never decrypted onto a
report surface.
Mapping table documented in docs/api/cycle-healthkit-mapping.md. Adds unit
+ integration coverage for the mapping, the import routing, the FHIR
observations and the backup round-trip. OpenAPI regenerated. Six-locale
strings added.
Co-Authored-By: Claude Opus 4.8 (1M context) <noreply@anthropic.com>
Lift the Observation / MedicationStatement / MedicationAdministration /
Patient / Coverage builders — with their LOINC/ATC/SNOMED/UCUM codings and
the survey-category wellness split — out of build-bundle.ts into a shared
src/lib/fhir/resources.ts. buildFhirDocumentBundle now composes the emitters
so the upcoming FHIR REST search routes reuse the exact same coding logic
instead of a second copy of the mapping.
Pure refactor: the document-bundle output stays byte-identical (the existing
FHIR + export tests pass unchanged). The shared coding constants and option
types re-export from build-bundle so existing import paths keep working.
Expose the server's live id vocabularies (derived-metric ids,
vitals-baseline types, insights layout tile-ids, metric-status ids,
the HealthKit ingest mapping, computed-score types, write allowlist) and
the FHIR coding constants, plus the running contract version, behind
requireAuth (cookie or Bearer, not admin).
Every list is sourced from its canonical server constant / registry, so
the endpoint cannot drift from what the routes actually accept and emit —
retiring the doc-vs-server enum-drift class for the native client. Export
the FHIR ATC/SNOMED URIs and a shared german-ATC default-locale set so the
export route and the discovery surface share one source.
Register the route in the OpenAPI table; drift-guard tests pin
derivedMetricIds to the registry and writeAllowlist to the constant.
Surface the server-derived nightly scores (recovery / stress / strain) in the
health-record export without polluting the clinical layer. The aggregator now
emits a wellnessScores summary (latest / avg / min / max / count per score over
the window) built from the already-fetched COMPUTED rows. The PDF renders them
in a clearly-labelled "Wellness summary" section, separate from the clinical
vitals table, with a "descriptive, not a clinical assessment" disclaimer. The
FHIR bundle emits one Observation per score under the survey category with a
text-only concept and the same disclaimer as an Annotation note, so a viewer
never mistakes a band for a diagnosis.
Emit a SNOMED CT coding alongside the existing .text anchor on the
administration dosage. Route maps ORAL to 26643006 (Oral route) and
INJECTION to 34206005 (Subcutaneous route, the form HealthLog injections
take). Site keys on the eight InjectionSite enum values, collapsing to the
three gross body-region concepts (abdomen 818983003, thigh 68367000, upper
arm 40983000); laterality and the abdominal quadrant stay verbatim in the
.text anchor rather than inventing lateralised concepts.
Referencing concept ids in a FHIR instance is not redistributing the
licensed SNOMED distribution, so this is safe to ship. The .text anchor is
unchanged, so a consumer without a SNOMED binding is unaffected.
Reconcile the dose fixture to the real uppercase enum value the live
builder emits (the previous lowercased value never matched production).
The administration set was windowed only to the report period (up to 730
days). A chronic medication dosed several times a day across that window,
multiplied across several medications, can still materialise thousands of
MedicationAdministration resources into a single Bundle — bounded by the
window but unbounded by dose frequency.
Cap the set at the most-recent 1000 acted intakes overall. The omitted
rows are the oldest in the window, so recent adherence is preserved
intact. When the cap trims rows the aggregator records the original and
included counts and the FHIR document narrative discloses the
truncation, so the export is honest about the omitted history rather
than silently dropping it. Cover the cap in the report aggregator and
the narrative note in the bundle builder.
Co-Authored-By: Claude Opus 4.8 (1M context) <noreply@anthropic.com>
(cherry picked from commit c6ce7df2bf6efb5e2c9d948d8f189d95d1289758)
Align the server's `Coverage` emission with the iOS exporter: a
Coverage is now emitted whenever ANY payor signal is present, including
a bare KVNR with no insurer name or IKNR. The KVNR-only case carries the
`subscriberId` with no contained payor Organization; the insurer-known
case is unchanged. A bundle with no payor signal at all still omits
Coverage entirely.
Also add a top-level `Composition.text` narrative (reusing the same
escaped summary the section narrative carries) so a strict
US-Core-style validator sees the document-level narrative it expects.
Co-Authored-By: Claude Opus 4.8 (1M context) <noreply@anthropic.com>
(cherry picked from commit 22c5ed7fbe02993307c3f04cd0498d199c79cf43)
Emit one `MedicationAdministration` per intake the user actually
actioned — `completed` for a taken dose (`effectiveDateTime = takenAt`),
`not-done` for an explicit skip (`effectiveDateTime = scheduledFor`).
Pending / missed slots and soft-deleted tombstones are never exported,
so the record only asserts administrations that happened.
Each administration reuses the statement's ATC/RxNorm + text concept,
so it is self-describing without a cross-resource reference. A `dosage`
is emitted only when a structured dose Quantity is available (resolved
from the dose-change history in effect at the administration instant) —
a dosage carrying only `.text` would violate the R4 dose-or-rate
invariant. Route + injection site ride along as text-only concepts. The
administrations are referenced from the existing Medications section, so
the document's two-section graph is preserved.
`FhirMedicationAdministration` is new; `FhirDosage` gains `dose`,
`route`, and `site`. The source rows come from the same aggregator the
PDF consumes, keeping FHIR and PDF aligned by construction.
Co-Authored-By: Claude Opus 4.8 (1M context) <noreply@anthropic.com>
(cherry picked from commit dd22512f56b7b6dfa42386bbc88d1ced1d71255d)
The health-record export's `MedicationStatement.medicationCodeableConcept`
gains additive `coding[]` entries when the medication carries a stored
code: ATC primary (`http://www.whocc.no/atc`), RxNorm secondary
(`http://www.nlm.nih.gov/research/umls/rxnorm`). The free-text name
stays the `.text` anchor and the concept collapses to exactly the
prior text-only shape when no code is present — the export never
machine-guesses a code, only emits what the user stored.
The aggregator now carries `atcCode` / `rxNormCode` on `medications[]`
and assembles the acted-intake source rows
(`medicationAdministrations`) the administration builder consumes, so
the FHIR export keeps describing the same numbers as the PDF by
construction.
Co-Authored-By: Claude Opus 4.8 (1M context) <noreply@anthropic.com>
(cherry picked from commit 740c86b3a830efa7e76d69b29ae376addeee6811)
The health-record FHIR bundle now carries a Coverage resource right
after the Patient. Coverage.status is active, beneficiary references
the Patient, and subscriberId carries the KVNR when present. The payor
is a contained Organization referenced by a local #-ref: its name is
the insurer name and its identifier carries the IKNR under the
http://fhir.de/sid/arge-ik/iknr system.
When the IKNR is absent the Organization keeps its name only; when
neither insurer name nor IKNR is known the Coverage is omitted rather
than emitting an empty payor. The KVNR continues to ride on
Patient.identifier unchanged — Coverage is purely additive.
Six HealthKit metrics without a published LOINC term were coded under
http://loinc.org, which fails FHIR R4 conformance (a non-LOINC code must
not sit in the LOINC namespace). Route any HKQuantityTypeIdentifier code
onto a shared custom CodeSystem (https://healthlog.dev/fhir/CodeSystem/healthkit),
keeping the raw HealthKit identifier as the code so the export stays
byte-aligned with the native client's exporter.
Marc-André Bombeck