The insights alert cards computed medication compliance with the naive
`schedules.length × days` denominator, so a fully-adherent weekly
injectable read ~14% and fired a false low-compliance alert (and a paused
medication mis-fired the same way). Route the alert path through the
canonical `calculateCompliance` engine like every other compliance
surface — pause eras, schedule revisions and dose windows honoured.
Document confirm: committing a numeric observation against an existing
biomarker silently replaced the stated unit with the catalog's, with no
conversion — a stated "6.1 mmol/L" against a mg/dL marker committed
"6.1 mg/dL". Reject on a unit mismatch (fail closed) so the user
reconciles on the review screen, the same posture as the unit-required
guard.
Wire grip strength, waist (with waist-to-height) and pain into the
briefing feature set and the grounding allow-set so the clinical-depth
signals reach the daily narrative; the mental-health screeners stay
excluded by construction.
Biomarker detail: fall back to a generic description for catalog-less
markers, and keep the heading + description with a retry on the error
state. Collapse the medication External-API and Lifecycle groups by
default. Re-enable the insights scroll-to-top regression and assert the
shipped main-content reset.
Align the EN haemoglobin/haematocrit display names to British spelling.
Drop the redundant `(userId, deletedAt)` index on inbound documents — a
strict prefix of the new three-column index. Trim the dead
MedicalDisclaimer variants to the one live `dataPosture`. Move the
crisis-resources card off the retired amber tint to a calm
destructive-subtle border. Add a registry invariant asserting every
biomarker signal key resolves to a real catalog slug.
Default documentDate at store time. A store-only upload no longer lands
with a NULL filing date: when the client omits one, default it to the
upload day so the column is always set on a stored row. The library list
sorts, groups, and range-filters on the same effective date the UI shows,
so undated uploads no longer mis-sort under nulls-last, break date-group
headers, or fall through the range filter. The date stays user-editable
and may be cleared back to NULL via PATCH.
Block re-extraction once any fact is APPROVED. A partially-confirmed
document stays EXTRACTED, which the CONFIRMED guard does not catch;
re-extracting would delete the approved facts (severing the committed
record's provenance) and re-stage them as PENDING, letting a second
approval duplicate the committed lab / condition / medication. The
extract route now refuses with 409 (documents.inbound.alreadyPartlyConfirmed)
when approved facts exist; the user must finish reviewing or discard first.
RFC 5987-encode the original-download filename. The Content-Disposition
now carries both an ASCII filename= fallback and a filename*=UTF-8'' value
so a non-ASCII name survives intact; the stored set is inline-safe by
construction, so the dead attachment branch is removed.
Add a light per-user rate-limit backstop to the original-read, PATCH, and
DELETE routes (generous; self-DoS only — the routes are owner-scoped).
Lean the list counts: tally facts for the whole page in one grouped count
instead of materialising fact-id rows, and exclude REJECTED facts from
factCount. Extend the documentDate index with deleted_at to cover the
list scan. Document the deliberate plaintext-title PHI tradeoff at the
column and the store site.
Invert the inbound-documents surface from an OCR inbox into a document
library: a file can be stored without any AI provider, and extraction
becomes an opt-in action on top.
- Migration 0222: add `title` + `document_date` columns, a
`(user_id, document_date)` index, the richer kind taxonomy
(lab/imaging/prescription/insurance/vaccination), and a STORED status
made the column default. The status enum is recreated so the new value
can be set as the default within the migration transaction; kind values
use ADD VALUE. Nullable columns, no backfill.
- POST /api/documents/inbound is now store-only: bounded multipart read,
magic-byte MIME sniff, AES-256-GCM at rest, persisted as STORED with no
provider/consent/budget call and no egress.
- POST /api/documents/inbound/[id]/extract carries the relocated
extraction gauntlet (resolve provider, consent, rate-limit, budget, run,
reconcile, stage facts) against an already-stored row; absent a provider
it 422s the enhancement only and leaves the stored document intact.
- PATCH /api/documents/inbound/[id] edits title/kind/documentDate
field-by-field, owner-scoped by session userId.
- GET /api/documents/inbound gains search, kind filter, documentDate
range, sort, and keyset pagination via the parameter-bound query builder.
- Extend the validation schemas + DTO, regenerate the OpenAPI contract,
and add route tests for the store/extract/edit/list paths.
The inbound-document store keeps the uploaded doctor letter encrypted at
rest (InboundDocument.contentEncrypted, AES-256-GCM), but there was no way
to read the original back — the decrypt helper had been dropped as unused.
- Restore decryptDocumentFromBytes in the document store, fail-closed on a
bad / missing key id.
- Add GET /api/documents/inbound/[id]/original: owner-scoped (userId-narrowed
query), module-gated, returns the decrypted bytes with the stored MIME
type. A PDF / image is served inline so the browser can render it; other
types download as an attachment. The filename is sanitised before it
reaches the Content-Disposition header. The bytes are PHI — never logged,
never served cross-user, and a decrypt error fails closed (500) rather than
returning ciphertext. Cache-Control is private, no-store.
- Surface a 'View original' action in the document review screen.
- Document the route in the OpenAPI registry and regenerate the spec.
- Cover the route with a test: owner-scoped success, attachment fallback,
404 for another user's document, and fail-closed on decrypt error.
i18n: viewOriginal across all six locales.
- Reword two LOINC verification comments in the signals registry so they
no longer trip the forbidden-marker grep, keeping the meaning intact.
- Resolve the dead-code gate: gate the seeded-question opener on the
per-user ambient-suggestions opt-out (wiring the previously orphaned
resolveCoachAmbientSuggestionsEnabled, server-authoritative), drop the
unread decryptDocumentFromBytes helper and its now-unused import, and
remove the unused SignalKind type alias.
- Delegate undici's fetch to the global stub in the provider-chain
integration test so the egress-pinned client HTTP is mocked again.
- Defer the JSON example-download cleanup a tick so revoking the blob URL
no longer races the browser download start (stabilises the e2e).
- Sync the service-worker version fallback to v1.25.0.
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).
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