A medication taken now and then (#1024) keeps one row and gains course
rows: calendar spans, both ends inclusive, an optional encrypted note, no
schedule or dose of their own. Courses never overlap and every course but
the latest has ended, so the latest course is always the one the
medication's startsOn/endsOn project. src/lib/medications/courses.ts is
the only writer of those two columns for a medication with courses; it
writes under a per-medication advisory lock and re-projects in the same
transaction, so reminders, the next-due line and intakeActionable keep
reading the columns and stay right.
- Migration 0368 adds medication_courses and backfills one course per
medication window (an end-only window starts on the creation day, or
on its end day when that lies earlier); a medication without a window
stays course-less. Idempotent, data-preserving.
- GET/POST /api/medications/{id}/courses and PATCH/DELETE
.../courses/{courseId} (owner-only); create seeds the first course
from a window; the medication PUT edits the latest course and refuses
a window that would break the rules (medications.course.*).
- List, detail, create and update carry courses, courseCount,
previousCourseEndedOn and canStartCourse, resolved on the server.
- Compliance expands over the span of all courses and drops the slots
between them; every compliance read selects the courses. A rolling
cadence is not anchored by an intake from a previous course.
- The card names the last course's end and the running course's number;
the detail Lifecycle group lists the courses with start, edit and
delete. The Coach compliance block, the MCP resource, the doctor
report window and table, the clinician view and FHIR (one
MedicationStatement per course with effectivePeriod and status) read
the courses.
- Backup carries courses per medication and the restore writes them and
re-projects; an older file derives the one course its window
describes. Wipe plan, encrypted columns, rotation and OpenAPI follow.
A type served from day buckets (pulse or glucose past 90 days, and since
the previous change a dense pulse stream on any window) is drawn one point
per day, each the day's mean at the day's start. The summary line counted
those points as measurements, and the FHIR export stamped the last day's
mean as the latest observation: a value and a time nobody measured.
The day-bucket stats now carry when their newest reading was taken
(`latestAt`). `latestReading` returns that reading when it is there, and
the summary line counts each type's readings from its stats. Raw series
are unchanged: their stats count equals their points and their last point
is the newest reading.
A snooze lives on the medication row, and the reminder tick applied it to
every slot of that medication. A Telegram "skip" of the morning dose
snoozes to the end of the day, so the evening dose of the same medication
was neither reminded nor marked missed by the reminder path. A snooze now
holds only slots whose reminder window had opened when it was set, dated by
the row's updatedAt that the snooze write stamps (the same reading the skip
and pin suppression already uses). A later edit to the row can only widen
the hold back to the old behaviour.
The doctor report kept adherence in a map keyed by medication name, so two
medications with the same name (an ended course and a new one, two
strengths) collapsed into one row and the second overwrote the first. The
map is keyed by medication id now and carries the name as the label; the
report's medication list carries the id. The PDF, the FHIR adherence
observations, the MCP visit summary, the clinician view and the GLP-1
section read it that way.
97507-8 is the mean of interstitial glucose in mass/volume. A spot-reading
mean is neither, so it now goes out text-only in the account's unit. A
continuous-stream mean keeps the code and is sent in mg/dL, the unit it is
computed in, whatever unit the account displays.
A run of the HL7 validator against every code the export can emit found
terms that do not exist, are inactive, mean something else, or carry a
display the code system does not publish.
- Body water and bone mass use 101683-1 and 101685-6; the old codes are a
nasogastric fluid output and a calculated body-fat mass.
- Step length, walking speed, walking asymmetry and VO2 max ride their
HealthKit identifiers: LOINC has no fitting term, and two of the old
codes do not exist.
- Mood, estimated A1C, average cycle length and average period length are
text-only. The old codes did not exist or were questionnaire items.
- LDL, vitamin D and eGFR use the method-less and total terms (2089-1,
62292-8, 69405-9) a recorded value can honestly claim.
- Resting heart rate and pulse-oximetry SpO2 also carry the heart-rate and
oxygen-saturation codes the R4 vital-signs profiles require.
- Blood pressure, adherence, glucose-panel and injection-site codings carry
the published displays; ATC codings carry none, since the user's
medication name is not the ATC name. The name stays on the text.
- Mood is a survey finding, not a vital sign, so it no longer rides the
vital-signs panel.
Allergy used 106190000, inactive since 2013; it is now 473011001 Allergic
condition. Injury keeps 417163006 with the display SNOMED CT publishes,
Traumatic or non-traumatic injury; the old display was rejected.
A window without a vital sign emitted the panel with result: [], which R4
rejects. The DiagnosticReport now goes out only when it has a result, and
the vital-signs section drops an empty entry list rather than sending one.
The HL7 validator reports 419161000 and 419465000, the left and right
concepts of the R4 bodysite-laterality value set, as inactive. Use the
active qualifier values 7771000 Left and 24028007 Right, with 51440002
Right and left. The side word in bodySite.text stays English, the language
of every other generated text in the Bundle; the builder takes no locale.
Condition.bodySite carries the free-text site as text. The side rides a
contained BodyStructure reached through the core bodySite extension, coded
with the SNOMED CT concepts of the R4 bodysite-laterality value set, and is
repeated in the text so a receiver that ignores extensions still reads it.
New structured leaf SURGICAL_HISTORY in the history group and in the
standard template: every procedure that took place, oldest first, with
its date, what was done (the visit's reason), the body site with its
side and the outcome. Lifetime reference data like the immunization
record, so it ignores the report window. The PDF prints it as a table
and the clinician share page renders it; saved selections do not widen.
The FHIR bundle carries no Procedure resource, on the same terms as
visits: no REST route or capability entry exists for it.
Refs #1025
Both report paths dropped them: the raw path iterated the named contexts,
and the dense path skipped any row without a context outright, so a report
built for a meter that records no meal time carried an empty glucose panel
while the readings sat in the database. The FHIR export dropped them for
the third time, at the LOINC lookup — its own comment already said an
unspecified reading codes as 2339-0, but the table had no entry to hit.
The insights context breakdown names the bucket, and the Coach's glucose
block now resolves through the shared helper rather than its own copy.
Refs #943
`adherenceRatePercent` returns null exactly when nothing was expected, so
callers render a placeholder instead of a misleading 0 or 100. The FHIR
exporter coalesced that null to 0, which would put a clinical claim of zero
adherence into an exported bundle. The guard above it means the branch
cannot be reached today; skipping rather than coalescing keeps it
unreachable if that guard ever moves.
Registering `ko` in the `Locale` union left seven locale-keyed tables
without an entry, so the build could not type-check and the safety
screens, the citation-coverage grader and the reference-range parser
read nothing at all for a Korean reader.
Three failures were not missing keys but wrong assumptions:
- The shared fold decomposes with NFD and strips U+0300-U+036F. Latin
accents become plain letters, but Hangul decomposes into jamo, which
are not in that range and survived — so folded Korean text was a jamo
sequence no precomposed table entry could ever match. It recomposes to
NFC now; every Latin, Polish and German fold is byte-identical.
- `normaliseLabKey` kept `[a-z0-9]`, which reduced every Korean analyte
name to the empty string, so the derived index held none of them and a
Korean cholesterol result reached a FHIR export uncoded.
- The reference-range parser had the hyphen and the dashes but not the
tilde a Korean lab actually prints (`3.5~5.0`).
The Korean safety banks carry no `\b` next to a Hangul token — `\b` is
an ASCII `\w` boundary and Hangul is not `\w`, so `/\b증량/` matches
nothing — and the clause order is the mirror of the Latin banks, since
Korean closes with the verb. The dose patterns require a target-marking
particle for the same reason the Latin banks require "to"/"by": without
it the permitted restatement "7.5mg을 복용 중이고, 체중은 내려가고
있어요" tripped the lowering pattern.
The Coach and Insights prompts route `ko` down the reviewed English body
plus a Korean reply directive; there is no `safety-contracts.ko.yaml`, so
the native builder has no Korean ground rules to compose from.
Eighteen modules carried a convenience re-export of a symbol defined
elsewhere. In each case the callers the comment describes now import the
concrete module directly, so the line had no importer left. Where the
whole re-export block went, the comment explaining it went with it —
doctor-report-pdf-core, trend-card and medication-extract-prompt each
claimed to be a single import surface that nothing was using.
Definitions are untouched; imports that existed only to feed a removed
re-export go too.
The lab form offers "negative" and "positive" as quick picks and writes the
label it rendered, so the column holds the bundle's own string in the language
the reading was recorded in. The SNOMED mapper matched that string against a
list transcribed in English and German, so "négatif", "negativo", "ujemny",
"positif" and "dodatni" all exported without a code — text-only on the one
document meant to be machine-readable.
The negative and positive arms read `labs.form.qualNegative` and
`labs.form.qualPositive` out of every bundle now. The form writes those exact
keys, so the write side and the read side cannot drift, and a new locale is
coded the day its bundle lands.
The detected / not-detected pair stays hand-written English and German, and
that is the honest limit of this change: the app ships no string for those
terms, they are prose a lab printed and a person copied in, and coding "non
détecté" or "niewykrywalny" would mean inventing clinical vocabulary in four
languages nobody here can check. This module's own rule is that an unverified
code is worse than an honest `.text`. When they need coding they need a quick
pick and a bundle key, which is the route the other two arms took. A test pins
that they stay uncoded rather than leaving it to be discovered.
Borderline stays uncoded as before; a test now pins that the derivation did
not sweep its bundle key up by accident. Comparison folds accents as well as
case, so a result typed without them still resolves.
A biomarker minted from the labs catalog stores `t("labs.catalog.<slug>")` —
the name in the language of whoever minted it — and that stored name is what
reaches the FHIR exporter as free text. The exporter matched it against an
alias table written in English and German. So an account working in French,
Spanish, Italian or Polish exported "Cholestérol total", "Glucosa en ayunas",
"Glicemia a digiuno" and "Cholesterol całkowity" as text-only concepts with no
LOINC code, on the one document whose whole purpose is being read by another
system.
The names are DERIVED from `messages/<locale>.json` now, not transcribed into
this file. Both sides of the new slug map are app-owned identities with no
language in them, which is what makes it the one edit a new locale does not
need: `locales` grows, `messages/xx.json` lands, and the analyte names it
ships resolve the same day. Transcribing four more languages would have fixed
today's six and reopened the hole at the seventh.
The hand-written aliases keep precedence. They cover what the app owns no
string for — clinical abbreviations, the ways a person shortens a name — and
they were verified one at a time over several releases. A derived name landing
on the same key is a harmless duplicate; one landing on a different key would
be a translation typo re-pointing a verified mapping at another analyte, so
the build refuses it and the guard suite asserts the refusal held.
The lookup fold now drops accents before stripping punctuation. Without it a
name carrying diacritics lost them entirely rather than reducing to its base
letters — "Cholestérol total" folded to `cholestroltotal`, and "Hämoglobin" to
`hmoglobin`. That last one means the German umlaut spellings never resolved
either: the hand-written `hamoglobin` and `nuchternglucose` aliases only ever
caught the un-umlauted typing. Every pre-existing alias is ASCII, so the fold
is a widening and what resolved before resolves to the same key.
Two findings from the deferred-audit list, both live since July.
A FHIR lab quantity stamped the UCUM system unconditionally while the
code was only added when the analyte map resolved a symbol for exactly
that unit. A receiver was told the unit came from UCUM and then handed
no UCUM code, which is a coding claim the bundle cannot back. System
and code now travel together, on the value and on both reference-range
bounds.
The doctor-report export accepted a selection that admits nothing. The
panel disables its own submit in that state, so only a hand-built
request reached it, and it rendered an empty artefact while spending a
rate-limit slot. This route has no documents-only mode that would make
an empty leaf list a legitimate scope, so it refuses with 422. The
share-link route, which does have that mode, is untouched.
Four small debts from the audit tail. The FHIR bundle's missing
Immunization resource gets the same written-decision paragraph the visits
exclusion carries — deliberate follow-up, not oversight. The service
worker's offline allowlist gains /api/daily/digest (both copies, policy
module and sw.js, plus the test) so the Today rail renders on an offline
reopen. The two Telegram plumbing tables that link to an account by a
bare userId string are frozen as a closed NO_FK_BY_DESIGN set in the wipe
guard — a third such table now fails the test instead of passing rule 1
silently. And deploy.md documents the manual digest-pin bump end to end:
imagetools inspect, the env update, and the three-probe /api/version
verification with the too-fast-deploy warning.
The VISITS leaf ships in the release that made a visit possible, because a
selectable checkbox that produces nothing is worse than no checkbox. Leaf,
collector and PDF renderer land together, and the leaf carries no LEAF_MODULE
entry — like ALLERGIES beside it — because a visit is core and the whole report
is already gated by doctorReport. The absence is commented at the map so a
later reader does not read it as an oversight.
The rows print the date, the practice with its specialty, the kind, the reason,
the outcome and the conditions the visit was filed against. The two encrypted
columns decrypt at render, fail-soft, and never enter the stored selection. A
condition the person has since deleted is not named: the link row survives a
soft delete, and printing a label they withdrew would put it in front of a
doctor.
No FHIR resource type is added. That deferral is already written at the
Encounter model, and the bundle builder now says so at the point a reader would
look for the missing section: FHIR splits the future from the past across
Appointment and Encounter, which is a serialisation question this release does
not answer.
Two properties are free and worth stating: a stored selection never grows
(unknown ids drop) and a clinician share link's sections are frozen write-once,
so no existing report and no already-shared link gains a section.
The panel also offers a booked visit as the report's reason — one query, one
prefilled window end, one dismissible offer that names its own source and never
applies itself. A window control that moves on its own is what makes an export
panel untrustworthy.
A lab runs its own method on its own device, so the window a physician
evaluates a value against is the one printed next to it on that report,
not a catalog band averaged over every lab. Reading a report pulled the
value and dropped that range: the extraction asked for it, the commit
handed it to the biomarker resolver, and the resolver only uses it when
it mints a NEW marker. For every analyte the user already had — the
normal case after a first panel — the printed range was read and then
thrown away.
Add `sourceReferenceLow` / `sourceReferenceHigh` / `sourceReferenceText`
to `LabResult` and carry the range from the report to the reading. The
text is stored whether or not numbers can be read out of it, because
"bis 5,0" and "negativ" state a window too; a range that could not be
parsed is kept verbatim, never replaced with invented bounds.
`resolveEffectiveReferenceRange` is the one place the precedence lives:
the source window wins for that single reading, and the catalog stays
the net for readings without one. A printed string with no derivable
bound does not displace the catalog. Every surface that judges a
reading routes through it — the API verdict, the doctor report, the
insights blocks and per-marker assessment, the coach snapshot, the MCP
read and the FHIR `referenceRange` — so a value cannot read in range on
one surface and out on another.
The API keeps `referenceLow` / `referenceHigh` as the window in force,
so a client that reads only those two renders the right range and the
right verdict with no change of its own; the catalog band, the source
window, its origin and a divergence flag ride alongside for clients
that want to show both.
Read side: the chart draws the source window as a second, visually
distinct band with the reading it came from named beneath it, the
reading rows name the printed range and the catalog band where the two
disagree, and the doctor-report PDF prints the report's own string with
a footnote naming the saved range. Entry side: one optional field on
the lab form, folded away until asked for, and the printed range is
editable on the scan review screen.
The range parser covers the notations German and English reports
actually print — two-sided, one-sided, comma or dot decimals, thousands
separators, trailing units — reads units without ever converting them,
and refuses to guess on anything ambiguous.
Five layers, because the defect had five places to hide.
The catalogue guard checks what the compiler cannot state: every leaf resolves
a label a human can read, every group resolves one, the fenced tier stays last,
and the shipped template intersects the fence at nothing.
The selection guard pins the three minting functions against each other. A
stored blob this build cannot read resolves to the empty selection, never to a
default set — that is what makes the revoked legacy links revocable rather than
silently re-scoped. A request naming an id the server does not know is refused
by name rather than dropped, because dropping it would narrow a scope the
caller did express.
The egress guard freezes the set of aggregator callers with the source of each
one's selection written down. The required brand-typed parameter already stops
a new path compiling without an answer; this stops one being added without a
human writing the answer down, which is the moment a reviewer asks the
question.
The behavioural sweep aggregates every leaf in and out against a fixture that
carries a row for each, and asserts the payload differs. It is parametrised
over the catalogue, so a leaf added later is covered the day it is added. Its
positive control asserts the all-on payload is genuinely populated first, so a
"no difference" result means the gate is inert and not that the account is
empty. Beside it: an unmapped measurement type is excluded rather than passed
through, no table behind an unchosen leaf is queried at all, and an empty
selection produces an empty record.
The artefact layer runs the real route and reads what comes out — the FHIR
bundle, the PDF text and the zip's contents — with a positive control beside
every exclusion.
Mutation-checked: making the gate admit everything reddens the sweep for every
leaf; passing an unmapped type through reddens the fail-closed case; dropping
the mood query's condition reddens the zero-read case; returning the BMI
unconditionally reddens the sweep naming BODY_MASS_INDEX; adding a fenced leaf
to the template reddens the purity guard; removing the panel's seeding block
reddens the first-run and repeat-run cases; dropping the insurance refusal
reddens the share-link case; adding a caller outside the frozen list reddens
the egress guard naming the file.
The panel suite grew past the practice name it was written for and is renamed
for what it now covers: the three states, the fenced tier having no group
control, and the scope line naming its sensitive inclusions.
Integration coverage moves to the leaf model, including the case this release
exists for: an account with data in every domain and a caller that named
nothing gets an empty record.
The OpenAPI contract catches up with the routes — the required selection, the
refused keys, the share summary's new fields, the moved `Patient/$everything`,
the Coverage search and the five typed reads.
/api/fhir/* serves the same whole-record aggregate as
/api/export/health-record -- right down to the decrypted insurance number
on the Patient resource -- but never consulted the module gate. The
export refuses with a 403 module.disabled envelope when the account turns
the doctor-report module off; the FHIR face happily returned the full
Bundle to the same token.
Gate all five data routes (Patient, Observation, MedicationStatement,
MedicationAdministration, $everything). Refuse rather than omit: a
whole-record export has no truthful partial answer, and unlike the sync
delta feed no background client depends on it draining to stay
consistent. The refusal reuses the shared module.disabled envelope so the
errorCode clients already branch on stays the same.
loadFhirContext gains a fail-closed assertion as a second layer. It is
the one door to the aggregate, so it refuses outright instead of trusting
that every future caller remembers its gate; reaching it means a route is
missing one, which is a bug to surface rather than a flow to serve.
The static CapabilityStatement at /api/fhir/metadata stays open -- server
metadata, no user data.
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.
Add the clinical-signals wave's new measurement types and wire them through
the signal registry so FHIR, correlation eligibility, ingestion, and the
measurement-list surfaces derive from one definition each:
- MeasurementType: PHQ9_SCORE, GAD7_SCORE, GRIP_STRENGTH, PAIN_NRS,
WAIST_CIRCUMFERENCE, WAIST_TO_HEIGHT (+ AssessmentInstrument enum and the
MentalHealthAssessment model that backs the screener scores).
- Registry: the six measurement/score signals plus the longevity lab panel as
kind:"biomarker" entries; the FHIR golden fixture is regenerated in lockstep.
Grip-strength and waist-to-height carry a null LOINC (NEEDS-VERIFY) and emit a
local text concept until a stable code is confirmed.
- FHIR: add the survey observation category for the screener / pain signals.
- Labs: extend the biomarker catalogue with ApoB, Lp(a), fasting insulin, and
the omega-3 index; add LOINC codes for those plus GGT and hs-CRP; add a
computed HOMA-IR helper.
- Exhaustive maps updated to keep the enum coverage, category, list-meta, and
personal-record drift guards green.
Replace the hand-maintained MEASUREMENT_LOINC literal and the BUCKETED_TYPES
correlation list with signal-registry projections. Both reads are byte-identical
to the previous tables (guarded by the registry-invariant test), so there is no
behaviour change — only one source of truth for each.
Add first-class qualitative lab findings (positive / negative / borderline
serology) alongside the existing numeric path. A LabResult is now EITHER a
numeric reading (value + unit, optional reference bounds) OR a qualitative one
(valueText, e.g. "negativ"), never both, never neither.
- schema: make `value` nullable, add `value_text`; migration 0181 is additive
(DROP NOT NULL + ADD COLUMN), every existing numeric row is untouched.
- validation: numeric-XOR-qualitative refine on create + update; unit/bounds
apply to the numeric path only; valueText capped at 120 chars. The single
resource PUT rejects a cross-type edit.
- serialise: carry valueText through both DTOs; a qualitative row reports the
neutral `unknown` range verdict (no number to classify).
- FHIR: a qualitative result emits valueCodeableConcept — SNOMED qualifier
value for confidently-known terms (Negative 260385009, Positive 10828004,
Not detected 260415000, Detected 260373001), text-only for borderline /
grenzwertig and any unrecognised term. The raw text always rides .text.
- UI: a numeric/qualitative toggle in the lab form; list, history, detail,
chart, sparkline, and the doctor-report PDF all render qualitative readings
as their text and never plot or divide on a null value.
- i18n: new labs.form keys across all six locales.
- openapi: response carries a nullable value + valueText; regenerated.
Close the three FHIR R4 coding gaps in the health-record export. Both are
export-layer only — no schema column, no migration, no contract change.
Illness Conditions now carry a broad SNOMED CT category concept per
IllnessType (infectious disease, allergy, injury, mental disorder, autoimmune
disease, chronic disease, with the generic Disease root as the fallback for an
unknown type) instead of the single generic placeholder. The user's own label
stays on code.text, the class on category.text, and the unconfirmed +
patient-reported guard rails are unchanged — the export still asserts no
specific diagnosis.
Lab Observations resolve a curated analyte to a real LOINC coding alongside the
user's code.text for the common biomarkers (HbA1c, lipid panel, ferritin, TSH,
vitamin D, creatinine, eGFR, ALT, AST, CRP, fasting glucose, hemoglobin), with
analyte-key and EN/DE alias normalisation. The canonical UCUM code is stamped
on the value only when the recorded unit matches the mapped canonical symbol;
an unmapped analyte or a non-matching unit keeps the honest text-only code and
display-only unit, never a fabricated code. The resolver takes an optional
canonical-name argument so a future Biomarker-catalog link can take precedence
over the free-text analyte without a further change here.
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.
Surface actual workout sessions and a per-analyte lab trend in the doctor
report PDF + FHIR bundle (gated on their modules), carry the user's stored
conditions/allergies through to the report and FHIR Condition/AllergyIntolerance,
and round medication adherence to the app's integer convention so the PDF, FHIR
and in-app numbers agree.
The server already computes the clinical glucose panel (TIR / GMI / estimated
A1C / mean / CV%) by the one literature-locked engine the insights panel and
coach consume, but nothing surfaced it in the export. Render it as a dedicated
PDF table after the vitals section and emit it as FHIR Observations
(LOINC-coded where a term exists; CV% under a survey text-only concept). Both
gate on the panel carrying readings, which the aggregator already zeroes when
the glucose module is off — so a disabled module emits no glucose panel. The
spot-reading caveat rides along when the readings are sparse. Adds clinical
glucose-panel keys across all locales and PDF + FHIR tests.
Add a Lab results section to the report aggregator (latest reading per
analyte over the window), a new labs section toggle (ON by default, the
same stance as BP and weight since the user recorded these to share with
a clinician), a PDF table with a quiet non-colour in/out-of-range marker,
and one laboratory Observation per result in the FHIR bundle carrying the
lab's reported referenceRange. Everything stays server-authoritative.
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>
Add a single canonical FHIR_REST_RESOURCE_TYPES catalogue (plus the
$everything operation and honoured search params) to fhir/rest.ts; the
metadata CapabilityStatement and the share-link resource-type enum now
derive from it so the advertised set can never drift from what is routed.
Extend GET /api/meta/capabilities with the FHIR REST descriptor
(restBaseUrl, readScope, resourceTypes, operations, searchParams) and a
clinician-share descriptor (supported, maxDays, resourceTypes, scopeable
sections) — every list sourced from its canonical registry, guarded by
the existing drift assertions. Grow the OpenAPI CapabilitiesResponse to
match.
Fill the clinician test-matrix gap: assert the clinician view never
requests a KVNR / identifier opt-in from the aggregator (default-OFF by
construction) and resolves a rolling window without reaching data older
than the frozen start.
GET /api/fhir/{metadata,Patient,Observation,MedicationStatement,
MedicationAdministration} and $everything, returning type:"searchset"
Bundles (total + self/next links, offset paging via _count clamped to 200)
as application/fhir+json, with an OperationOutcome on error. The per-resource
emitters are reused from src/lib/fhir/resources.ts so the document export and
the REST face share one coding source and can never drift. Auth is a narrow
fhir:read scope via requireAuth (cookie sessions also pass); userId is
narrowed from auth. Read-only — no write handlers. Rate-limited per user.
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).
Wire seven previously-deferred HealthKit quantity identifiers through
the full pipeline — enum, mapping, plausibility range, category, list-UI
metadata, FHIR coding, and the generic metric-status assessment:
CARDIO_RECOVERY heartRateRecoveryOneMinute bpm
WRIST_TEMPERATURE appleSleepingWristTemperature celsius
FALL_COUNT numberOfTimesFallen count
SIX_MINUTE_WALK_DISTANCE sixMinuteWalkTestDistance m
STAIR_ASCENT_SPEED stairAscentSpeed m/s
STAIR_DESCENT_SPEED stairDescentSpeed m/s
BREATHING_DISTURBANCES appleSleepingBreathingDisturbances count
Each value rides raw on the wire (identity conversion). Fall count is
cumulative (daily SUM); the stair speeds drain to a daily mean; the rest
store as latest per-workout / per-night spot readings. Wrist temperature
and breathing disturbances are flagged privacy-sensitive. The category
sleep-apnea and walking-steadiness EVENT identifiers stay deferred — they
are events, not quantities.
Each new metric gains an Insights sub-page on the shared scaffold with the
generic assessment card, localised across all six locales. Cardio fitness
(VO2 max) — ingested since v1.4.23 but assessment-less — gains its own
/insights/cardio-fitness page so it picks up the assessment instead of
riding as a bare chart-row on the pulse page.
Normal-range anchors are cited where defensible (six-minute walk 400-700 m,
ATS guideline + population reference); the rest defer to the user's own
baseline rather than fabricate a band.
Migration 0104 appends the enum values additively (IF NOT EXISTS, forward-only).
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)
Marc-André Bombeck