The screener POST hardcoded source=WEB and ignored any client-supplied
externalId, so the native client could not tag provenance and an outbox
replay beyond the 24h idempotency-key window minted duplicate
administrations plus duplicate trend points.
Accept an optional closed source enum (WEB|IOS, default WEB) and an optional
bounded externalId, and persist both. Deduplicate on (userId, externalId)
when present: the route returns the existing administration on replay, and a
partial unique index over (user_id, external_id) WHERE external_id IS NOT
NULL (migration 0221) backstops a concurrent insert race (P2002 resolved to
the winner). The derived *_SCORE measurement keeps its stable per-assessment
externalId, so dedup at the assessment level prevents duplicate trend points.
Item answers stay encrypted and out of AI/MCP/export. Regenerate OpenAPI.
Grip strength, pain (0–10 NRS), waist circumference, and waist-to-height
existed in the measurement enum, signal registry, and FHIR export but had
no web entry, no detail page, single non-sex-aware bands, and a split-brain
MCP exposure. This closes those gaps.
Web capture: the four signals join the manual measurement form, so a
web-only self-hoster can log them (the iOS client and the measurements API
already could).
Detail pages: flip detailPage on for the four signals and mount each on the
shared HealthKit metric template (chart, stat strip, Coach-read strip,
assessment card) via routed sub-pages and tab-strip pills, the same detail
spine every other metric carries.
Sex-aware bands: grip strength (EWGSOP2 men 27 / women 16 kg) and waist
(WHO men 94 / women 80 cm) now classify by the profile sex through the
age/sex norm resolver the assessment already threads; the resolver also
returns a sex-specific, age-independent band when no date of birth is set.
Fix the waist-to-height boundary so the NICE >= 0.5 rule is correct (the
last in-range value is 0.49).
MCP single source of truth: decouple the registry mcp facet from the Coach
snapshot — a signal can be MCP-readable without being on the Coach surface.
Mark the four physical signals mcp:true, derive the MCP rich-reads clinical
set from the registry flag instead of a duplicate allowlist, and relax the
invariant to coachSnapshot implies mcp (not the reverse). PHQ-9 / GAD-7 and
the environmental signals stay mcp:false and unreachable. compare_metric and
detect_changepoints now advertise clinical-signal support to match
get_metric_baseline.
Pin the highest-consequence numbers in the release: every PHQ-9/GAD-7 severity
band edge, the >=10 action threshold, and the item-9 ANY-non-zero safety flag
(true on item9 1/2/3, false on 0 or for GAD-7). Add a POST happy-path test
that would have caught the dead-on-arrival bug — a valid body now parses,
persists server-authoritative scoring, writes the derived score measurement,
and surfaces the crisis set on a positive item 9.
The handler passed the `safeJson` `{ data, error }` wrapper straight into
`safeParse`, so the schema never matched and every POST returned 422 — the
screener was dead on arrival. Destructure the envelope and read an unbounded
body no more: cap the request at 8 KB before validation, matching the sibling
clinical routes.
Add the missing write protections: gate both verbs on the opt-in module
server-side (a valid Bearer token included), wrap the create in idempotency so
a double-tap/retry cannot mint duplicate assessment + score rows, and add a
tight per-user write rate-limit.
The mental-wellbeing screener surface shipped built but unreachable: no nav
entry, no module key, ungated. Add a `mentalHealth` module key (opt-in,
default OFF — a depression/anxiety self-assessment is at least as sensitive
as mood) to the registry, the module-hub icon map, and the exhaustive module
maps. Give the check-in a nav home at /insights/mental-wellbeing, born-gated
on the module so it appears only once the account opts in, and redirect the
page home on a direct hit when the module is off.
Item answers stay encrypted and off the AI Coach / MCP regardless of the
toggle; this only controls whether the surface is visible and reachable.
The inbound-document store encrypts the raw upload
(`inbound_documents.content_encrypted`) because it is sensitive clinical
data, but the per-fact staging columns persisted the same class of data in
the clear: `extracted_facts.data_json` held the transcribed clinical values
(diagnosis text, lab values, medication names, stated codes) and
`provenance_json` held the verbatim source span (up to 2000 chars copied
straight out of the report). The at-rest guarantee was defeated for staged
facts, which persist through PENDING and are retained after the decision.
Convert both columns to the AES-256-GCM `*_encrypted` BYTEA convention shared
with the note columns, going through the same Bytes codec. The upload and
fact-edit paths encrypt on write; the confirm path decrypts at commit time to
write into the normal structured stores, so the review-then-confirm flow is
unchanged. Reads are fail-closed (a bad key id throws).
Register both columns in the encrypted-columns registry and the key-rotation
script so a dropped legacy key cannot strand them (the guard test enforces
both). Migration 0220 swaps the plaintext JSONB columns for the encrypted
BYTEA columns; pre-confirm staged rows are ephemeral and cannot be
re-encrypted in SQL, so any left by a pre-release build are dropped rather
than retained as plaintext (their parent document keeps its encrypted
original).
Introduce one canonical "what this is / is not, not a medical device"
statement plus a layered, calm disclaimer set, and apply it on the
surfaces that earn a context note.
- New shared `MedicalDisclaimer` component renders the copy as plain
React text (no markdown renderer, per the XSS posture). Variants:
intendedPurpose, coach, insights, labs, medications, emergency,
dataPosture.
- New `selfDescription` i18n namespace across all six locales: the
intended-purpose line, the per-surface notes, the emergency note, and
an explicit data-posture statement (self-hosted, data stays on your
instance, encrypted at rest, BYOK / local model, no third-party
analytics).
- Apply once per surface, layered not plastered: a calm standing line on
the Coach new-chat hero, one framing line in the Insights layout shell
(covers the briefing and trends), a labs note (ranges vary, only a
clinician interprets), a neutral medications note, and the data-posture
line where the provider key is configured. Mental-wellbeing keeps its
existing crisis copy; records keep their existing note.
- Extend the Coach system prompt (EN + DE) with a self-description ground
rule so the Coach answers "what are you / where does my data go"
honestly and stays non-diagnostic.
App-authored copy was already observational; the few diagnose/treat
tokens are negations, idioms, or framed as the user's own self-reported
statement, so no softening was required.
Rework the per-day location resolution so it can no longer fabricate weather for
days before the home was set. Precedence, first hit wins:
1. an explicit dated location period (a trip, or a corrected stretch of
history) covering the day;
2. DEVICE — a reserved slot for a future client-supplied coarse per-day
location (ranks between the period and home; not produced server-side yet);
3. the home location, but only for days on/after its effective-from date;
4. otherwise the day is skipped.
The home route stamps `homeSince` whenever the home is set/updated and returns
it. The overview exposes it. Backfill bounds are now optional and default to the
conservative `[homeSince .. today]` span instead of a fixed reach onto the
current home; days before `homeSince` still resolve to a skip in the worker, so
even a wider explicit start cannot back-fill weather for the pre-home past. To
reach further back a user adds an explicit location period for that range.
Add unit coverage for the precedence (including the effective-from boundary and
the skip-not-guess rule) and the default backfill range.
Add the opt-in Environment module (default off), its Settings surface (home
location search, travel overrides, backfill, with Open-Meteo attribution), the
gated API routes (overview, home, geocode, travel CRUD, backfill), the nightly
pg-boss fetch job with a lookback window plus on-demand backfill, the query
keys, six-locale strings, and the regenerated OpenAPI. The module performs an
outbound weather fetch tied to a coarse location, so it ships dark and the user
turns it on deliberately; off means no job, no row, no egress.
Register the seven environmental-exposure signals through the signal registry
as a new "environment" kind (correlation-eligible; off Coach/MCP/FHIR in v1),
and fold their daily series into the correlation engine as lagged behaviour
channels. Weather/daylight now pair against mood, sleep, and vitals through
the existing FDR / effect-size / shrinkage gates, so a thin series degrades to
absent rather than a spurious link. All env channels share one ENVIRONMENT
family so two same-day fields never lag-correlate against each other.
Add the opt-in inboundDocuments module (off by default, like the MCP
endpoint): ingesting a clinical document egresses it to the OCR/vision
provider, so the surface ships dark and the user turns it on from the
Modules hub. The born-gated /documents page carries the prominent
non-diagnostic disclaimer (we read, we don't interpret; nothing is saved
until you approve it; only your clinician can interpret these results),
uploads a document, and walks each extracted fact: source provenance and
confidence are shown, low-confidence facts are blocked from approval until
edited, and the confirm step commits the approved facts.
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.
Rework the proactive Coach nudge so it reads like one human checking in on
another instead of a terse English alert.
Copy: the title is a name-led greeting that rotates day to day ("Guten
Morgen, …" / "Hey …"; the 05:15 frame makes a morning opener safe) and the
body is one calm observation plus a gentle invite — never an imperative.
Drop the verbatim quoting of the user's decrypted self-context sentence:
the focus is referenced only by presence, abstractly, and is no longer
decrypted at all. Remove the 80-char mid-word clamp; each channel composes
to a length budget instead.
Cadence: suppress the nudge when the user already talked to the Coach in
the last ~24 h. With the existing rolling frequency cap (never two in a
window) and the no-trigger-no-nudge rule, the surface stays anti-nag.
AI enrichment (opt-in via the coach prefs blob, default off): when a
provider is healthy the body is composed through the model under hard
guards — a per-user budget gate, a tight per-call timeout, a per-tick
ceiling so the sequential tick can't stall across the user base, and the
outbound safety screen on the output. Any error, timeout, budget refusal
or unsafe reply falls silently back to the deterministic template, which is
always the default and the fail-closed fallback.
Localized greetings, per-trigger bodies and the focus note across all six
locales; the prefs opt-in is surfaced in the notification settings.
The language switcher wrote the choice to localStorage, the
`healthlog-locale` cookie and `<html lang>` only — never to the user row.
Server-side background work (the proactive Coach nudge, the Telegram test
message) has no request cookie to read and falls back to `User.locale`;
with the column left null those messages went out in English regardless of
the language the user reads the app in.
Add `PUT /api/auth/me/locale` (idempotent, validated against the supported
locales) and have the i18n provider mirror the active locale onto the row —
on every switch and once on mount, so the column is backfilled for users
who set their language before this landed. Fire-and-forget: a 401 on a
public page or an offline blip never blocks the UI flip; the cookie stays
the first-paint source of truth.
DELETE /api/measurements/by-external-ids now only tombstones rows the iOS
client minted through its HealthKit ingestion path (source APPLE_HEALTH).
An externalId the app never minted — an integration- or manually-sourced
row that happens to collide on externalUUID — falls outside the predicate
and is a no-op rather than a delete. Defence-in-depth so a foreign
HealthKit sample with a colliding UUID cannot be tombstoned by the
periodic reconciliation. The delete stays user-scoped as before.
Add a route test proving a foreign-origin externalId is not deleted, and
regenerate the OpenAPI spec for the narrowed contract.
The structured lab-create path (POST /api/labs) now accepts an optional
`source` marker ("MANUAL" | "OCR"). The on-device-OCR ingestion path posts
"OCR" so a reading captured from a phone-camera lab photo records its
provenance; the raw image never touches the server on this path. Omitting
the field reads as "MANUAL", so the existing hand-entry contract is
unchanged. The value is narrowed by a closed Zod enum and assigned
field-by-field, never spread from the body. Mirrors the "OCR" source the
server-side /api/labs/ocr/commit path already stamps.
Regenerate the OpenAPI spec for the widened request body.
Add the opt-in PHQ-9 / GAD-7 questionnaire surface at /insights/mental-wellbeing:
instrument picker, 0–3 item scale, server-scored result with the validated
severity band, the verbatim Pfizer/PHQ attribution, the screening-not-diagnosis
disclaimer, and a calm crisis-resource card on a positive item-9. The surface
deliberately does NOT mount the shared Coach-launch card — mental-health item
content stays out of the AI.
- i18n: full mentalHealth block plus the six new measurement-type labels and the
longevity-marker catalogue names/descriptions across all six locales
(de/en/es/fr/it/pl). Instrument item wording uses the validated German text and
the canonical English elsewhere (re-wording invalidates the score).
- OpenAPI: regenerate the contract for /api/mental-health/assessments (response
excludes raw item answers by construction).
- Exclude the new manual / instrument types from the HealthKit-counterpart guard.
Add a per-user toggle that turns off the proactive ambient example suggestions
(the daily seeded opener on the Coach hero). The flag rides the existing coach
notification-prefs blob (coach.ambientSuggestions, default on) — no schema
change — and a shared hook makes it the single source every ambient suggestion
surface consults, so the seeded opener and its fetch both stand down when off.
The short-horizon trajectory tile read as a wall of text with no clear value
on the metric pages. Drop it from the weight page and the shared HealthKit
metric page (the opt-in forecast slot is removed entirely, not left dead), and
delete the now-orphaned tile + fan components. The trajectory engine stays for
the Coach narrative; only the metric-page surfacing is removed.
Add a new "Medical history" (Anamnese) Settings section that hosts the two
structured-record managers — allergies and family history — each a
list + add/edit sheet + delete-with-confirm built on the shared query-key
factory and the ResponsiveSheet pattern. It sits between the illness journal
and the preventive-care reminders and is always shown (not module-gated, like
Vorsorge), since these are foundational health-profile records.
The section carries a plain non-diagnostic note ("your own records, not a
medical diagnosis"). Full i18n across all six locales (de/en/es/fr/it/pl).
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 `/api/allergies` and `/api/family-history` endpoints (list / create /
read / update / soft-delete), each wrapped in `apiHandler` with Zod
`safeParse` + `returnAllZodIssues`. `userId` is always narrowed from the
session/Bearer — never a body field — and the Prisma `data` is built
field-by-field (no mass assignment). Creates wrap in `withIdempotency`. The
free-text reaction/note are encrypted before write and decrypted fail-soft on
read via the server-authoritative DTOs.
Register the query-key factory entries and the OpenAPI route tables (new
`Records` tag); regenerate `docs/api/openapi.yaml`.
Add the validated mental-health self-assessment surface, beside mood tracking
(never replacing it) and off by default:
- MentalHealthAssessment stores per-item answers in a single AES-256-GCM Bytes
blob (registered for key rotation); only the server-authoritative total,
severity band, and item-9 flag are denormalised. The total projects to a
PHQ9_SCORE / GAD7_SCORE measurement row so the trend rides existing infra
without ever exposing item content.
- Item-9 safety: any non-zero PHQ-9 self-harm answer surfaces a calm,
locale-aware crisis-resource set (DE: TelefonSeelsorge 0800 111 0 111 / 112;
international fallback) and stamps crisisShownAt. No clinical interpretation,
no AI ingestion of item content, no third-party alerting.
- API + OpenAPI: POST/GET /api/mental-health/assessments; the response excludes
raw item answers by construction. Required Pfizer/PHQ attribution lives in the
instrument module, rendered verbatim.
The screener scores are kept off the Coach snapshot and MCP surfaces, and out of
exports by default — item content never reaches the AI pipeline.
The requirePublicHost egress paths now dispatch through undici's own
fetch, so the existing global fetch stubs in the AI, GeoIP, moodlog,
send, and ntfy suites no longer intercept them. Delegate undici's fetch
back to the installed global stub so each suite keeps asserting its
request shape and canned responses without exercising the network.
CIMD client resolution swallowed every fetch failure as ssrf_blocked and
/authorize logged a bare invalid event, so an unreachable metadata host
was indistinguishable from a genuine SSRF block and the consent flow
returned invalid_client with no diagnosable cause.
Split the resolution failure into ssrf_blocked (a real private-host
refusal) and fetch_failed (timeout / connect error), carrying the
concrete SafeFetchError kind and cause as a short non-secret detail.
Thread the resolution reason and detail into the authorize.invalid
annotation behind a pinned meta shape, and cache a resolved CIMD
document for up to 24h so the consent flow does not re-fetch on every
hit.
The sleep page rendered an assessment under the duration/architecture charts
and a second one under the sleep-quality scores. The quality assessment mostly
never generated — most accounts carry no wearable sleep score — so it sat at the
foot of the page as a duplicate empty card or a redundant connect-a-provider
prompt.
Drop the quality-block assessment so the duration card is the page's single
assessment; the quality block keeps its score tiles. Remove the now-unused
grounded-note fallback and its deterministic grading helper, and the orphaned
quality-assessment message keys across every locale.
The per-metric assessment card carried the Coach hand-off as a bottom-right
text button, present on only some pages. Pin it to the card header's top-right
as a single icon button (no text label) with an accessible name and a tooltip,
and wire every assessment surface to it: the bespoke slug pages
(weight, BMI, pulse, blood pressure, mood), the generic metric scaffold, the
medication-compliance card, and the biomarker detail page already on the shared
card. Each opens the Coach with a localised, auto-sent opener narrowed to that
metric's snapshot source.
The button self-gates on the Coach triple (provider mounted, operator flag,
per-user opt-out) and the card only mounts it on the populated branch, so it
never advertises a control that cannot work. The auto-sent opener now
interpolates the localised measurement name rather than a raw token.
Add coverage for the new biomarker-assessment seam and the marker detail
surface:
- the generator serves today's cache, re-stamps unchanged readings without an
LLM call, and regenerates only when the latest-reading fingerprint changes
- the read-only endpoint returns the envelope, 422s a missing id, and honours
the auth + insightStatus gates
- the detail page paints the stat strip, the chart placeholder, and the
assessment card
- the biomarker resource route drops the marker with its readings in one
userId-narrowed transaction and rejects an inverted target range
Hold the input gate independent of the worker's forced run so an idle marker
re-stamps cached text instead of regenerating, and list the new route on the
non-Coach gate allowlist.
Give each biomarker a detail page that matches the metric sub-pages: a
numbers-first Min/Max/Median/Mean strip over the numeric readings and a
data-grounded AI assessment card.
The assessment is served by a new read-only endpoint
GET /api/insights/biomarker-assessment?biomarkerId=&locale=, returning the
same envelope as /api/insights/metric-status so InsightStatusCard consumes
it unchanged. A new generator reads the marker's LabResult history and
reuses the shared provider runner, the stale-while-revalidate read-only
path, and the persist helper. Regeneration is gated on a fingerprint of the
latest reading, so the assessment is rebuilt only when a new reading lands;
an idle marker re-stamps the cached text without an LLM call. The
biomarker: scope rides the existing on-demand status queue.
The stat strip and the assessment card both self-gate on numeric data, so a
qualitative-only or brand-new marker paints neither.
Deleting a biomarker now removes its recorded values in the same
userId-narrowed transaction instead of unlinking them via the SetNull
FK. Removing a marker is a deliberate "drop this and its history"
action, so leaving orphaned, unlinked readings behind was surprising.
Update the delete-confirmation copy in all six locales to state that
the values are removed too.
Thread an autoSend flag through the coach-launch flow so a card's
"ask the coach about this" hand-off dispatches its seeded prompt as
the conversation's first turn instead of only seeding the composer.
The flag rides the launch context, the layout mount, the drawer, and
the shared conversation surface, where a ref-guarded mount effect fires
the send exactly once for a fresh thread.
Localize the previously hardcoded English assessment opener in the
metric status card behind insights.coach.assessmentPrompt with a
{metric} placeholder, and localize the resting-pulse coach prefill.
Both keys land in all six locales.
Surface the generation-failure signal in the daily briefing card. When a
held briefing is shown but the last refresh failed, the footer states it
plainly and offers a retry that runs the existing explicit regenerate —
no warm-on-mount. When there is no briefing to fall back on, the empty
state reads "couldn't generate" with the same retry instead of the
generic "no briefing yet". The hint is suppressed when no AI provider is
configured, where that hint already owns the surface and a retry is
futile. New copy lands in all six locales.
The daily briefing and the per-metric status assessments ignored the
per-user response-timeout setting: they hardcoded their per-surface
AI_BUDGETS default, so raising the timeout for a slow self-hosted or
local backend had no effect and the surfaces still aborted early. Only
the coach threaded the setting through.
Resolve the effective timeout from User.aiResponseTimeoutSeconds in one
shared helper and thread it onto every non-coach generation call:
- runStatusCompletion is the single chokepoint every status / reference
surface funnels through (per-metric cards, the batched assessment, the
derived assessments, the period narratives), so resolving it there
applies the setting to all of them at once — on both the upstream
call's own timeout and the outer wall-clock cap that previously clipped
a raised value at 60 s.
- The comprehensive briefing generator and the user-initiated regenerate
route thread it onto the main generation, the JSON retry, the grounding
retry, and the paragraph re-roll.
On a failed generation the briefing keeps its last good text — no cache
row is written, so the previous payload stays intact — and records a
dated, append-only failure marker (no migration; reuses the audit-log
JSON pattern). The read path compares the marker against the last
successful generation so it can tell a held briefing from a current one.
A render failure on `/c/<token>` previously fell through to the full-app
error screen, which carries app chrome the public share view never wants.
Add a route-scoped, chrome-free error boundary that shows a localised,
stack-free message and a single retry. Add the matching copy across all
six locales.
Marc-André Bombeck