GET /api/fhir/Observation keeps its snapshot answer when no date is
sent. A date range (FHIR prefixes eq/gt/ge/lt/le, UTC when no offset)
switches it to the time series: every reading in the range plus
workouts, newest first, paged in the database through one UNION id
query and a count, so a page costs what it holds. Series ids are the
row's own (m-<id>, w-<id>) and read back through /Observation/{id}.
The series replays the same saved report selection as the snapshot,
pairs systolic and diastolic recorded at one instant into the
blood-pressure panel, leaves sleep stage segments out, and reads an
hourly heart-rate bucket as a mean over its hour. A code parameter
narrows either answer; a malformed date is a 400 OperationOutcome.
A workout is an activity Observation after the Physical Activity IG:
LOINC 73985-4 with the sport as its value and duration (55411-3) and
energy (41981-2) as components. RMSSD gets its own registry coding,
text-only because LOINC has no RMSSD term, so it never borrows the SDNN
code. The capability statement lists the two new parameters.
Room climate from a home automation system gets three types of its own:
INDOOR_CO2 (ppm), INDOOR_TEMPERATURE (celsius, shown in Fahrenheit for
imperial readers) and INDOOR_HUMIDITY (percent). They arrive through the
existing ingest token (measurements:write, source EXTERNAL), sit in the
environment cluster beside daylight, and the daily rollup carries their
mean, low and high like any spot reading. They never mix with the body
temperatures or with the outdoor environment channels.
The Home Assistant page documents the three types, a rest_command that
sends a room as one request, a single-room automation, and an
importable blueprint (docs/integrations/blueprints) that skips sensors
reporting unknown or non-numeric states, converts Fahrenheit, and
stamps readings to the minute so a retried push is refused rather than
written twice.
Six Apple Health signals leave the deferred list and ride
POST /api/measurements/batch and the export.zip import end to end:
EXERCISE_MINUTES, STAND_MINUTES and STAND_HOURS (the exercise and stand
rings), MINDFUL_MINUTES, STATE_OF_MIND_VALENCE (iOS 18 State of Mind,
-1..1) and AFIB_BURDEN (AFib History, percent of the week). The ring
types and mindful minutes are cumulative, so the daily rollup is their
sum; AFib burden is scaled strictly from Apple's fraction and a value
above 1 is refused rather than guessed at. The archive import takes
mindful minutes from the session's dates and skips idle stand hours.
Every registry carries them: units, ranges, labels in all locales,
categories, chart tokens, report catalogue (mindful minutes and the
valence fenced as sensitive), signal registry with FHIR codings, and
MCP exposure for the three ring types only.
Workout GPS tracks are now an opt-in, off by default
(PATCH /api/auth/me/workout-routes, a switch on Data & Privacy). While
it is off, the workout batch route and the export import keep every
workout and drop its track with the same per-entry status. With it on,
the import reads the referenced GPX files from the archive one bounded
member at a time, thins each to the point cap and stores it sealed.
The climb a track carries is written to Workout.elevationM at write
time, so the workout insight no longer opens the track, and the AI
egress guard now freezes the set of files that read route geometry.
Land every file the v1.42 work shares before any of it is built, so the
parts built side by side never edit the same file.
Schema and migrations 0379-0386: the HEALTH_CONNECT measurement source,
ImportJob.kind, the air-quality columns and the per-user switch on the
environment tables, sealed environment locations with nullable plaintext,
managed-profile handover links, the per-type HealthKit arrival ledger, lab
unit-conversion provenance, and user-defined vaccines. Every new column is
annotated for the column-reader sweep.
HEALTH_CONNECT reaches every exhaustive list: the source labels, the
read enum (not the write allowlist), the source-priority ladder cap, now
the number of sources rather than a fixed eight, and the write-path smoke
test. RMSSD gets its own priority class and a 300 ms ceiling. The batch
syncTrigger gains `manual`, with its label on the Apple Health card.
Queues for the Health Connect import, the compaction-tombstone purge and
the measurement-table maintenance are registered with stub handlers;
host-metric sampling moves to every five minutes. Environment and work_mem
variables reach the compose whitelist, the production example and the
manifest. The proxy admits the handover link and redirects it at the edge,
and the Health Connect upload bypasses the proxy body limit.
The new routes answer 501 behind their final authentication and are
published in the contract; backup, wipe and key rotation classify the new
models and columns; the seven message bundles carry the base copy. Guards
that list release-pending keys and columns fail once an entry is wired, so
those lists empty themselves before the tag.
Also re-anchor a login-throttle fixture to the wall clock, where its
expiry is compared, and re-base the aggregate bundle cap on a measured
12 KB of new locale strings.
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.
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.
Wire the two new screening totals through the read surfaces on the
PHQ-9 / GAD-7 precedent: signal-registry entries (higher-better
direction, off the Coach snapshot and MCP by construction, no FHIR
coding attached — neither total has a verified LOINC, and the export
skips uncoded signals rather than shipping an invented code), the
scores category cluster, list labels/icons/colours, the generic
insight-chart tokens, a null PR direction (screeners are never
gamified), and the module-gated mental-health section of the doctor
report. The vitals-table exclusion rationale is documented alongside
the existing screener entries.
Reference-band fills, classification tones, and the trend-chart palette
carried hardcoded hex that rendered identically in both themes and
glared on the light surface. Route them through the semantic and chart
CSS variables, which already hold per-theme values, so the light theme
gets the muted set and the dark theme stays byte-identical.
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.
- 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.
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.
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 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 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.
Introduce one declarative table describing each health signal across the
surfaces it touches — DB measurement type, detail page, correlation engine,
Coach snapshot, MCP read tool, and FHIR coding — discriminated on kind
(measurement / biomarker / score). Promote the proto-registry in
metric-status-registry.ts to the canonical definition and add thin adapters
that derive the per-surface tables from it.
The registry coexists with the enum-driven code: the DB enum stays the source
of truth for persistence and the registry sits above it. An invariant test
pins every derived table byte-for-byte to the values the hand-maintained
tables carry today, so cross-surface drift fails CI.
Marc-André Bombeck