The deterministic fact-pattern pass fell back to German when no locale was
passed, the same de-default polarity the narrative surface just lost. Fact
text is model-facing memory, so English is the fallback for every locale
without a reviewed body; German stays for German readers.
Also correct the InsightNarrative.locale doc comment — the column holds any
shipped UI locale, not just de/en. Comment only, no SQL change.
Two additive indexes on medication_intake_events: (user_id, scheduled_for)
for the sibling reads that filter without medication_id, and
(user_id, medication_id, taken_at) for the per-medication last-taken
group-by that scanned the whole intake history on every dashboard load.
Additive migration 0253, no data change, no behaviour change.
The web OIDC flow ends in a session cookie the Bearer-transport native
client cannot consume, so on an OIDC_ONLY instance the iOS app had no
sign-in. Add a native leg: the app opens the login URL with
client=native and its own PKCE S256 challenge inside an in-app browser;
the callback resolves identity exactly as before, then mints a one-time
handoff code and 302s to the fixed compiled-in scheme
healthlog://oidc-callback (or hands back the existing MFA ticket when
the account has a second factor). The app exchanges the code plus its
PKCE verifier at POST /api/auth/oidc/native/token for the standard
native token bundle.
The return address is a compile-time constant — no redirect_uri
parameter and no env allowlist, so the open-redirect / scheme-hijack
class is removed by construction. The native flag and app challenge
travel only inside the AES-256-GCM state blob, so a network attacker or
the IdP cannot flip a web login into a native one. The handoff code is
256-bit CSPRNG, HMAC-hashed at rest, 90-second TTL, single-use via a
guarded consume; a failed PKCE check burns it. A replay of a consumed
code revokes exactly the pair the first exchange issued. The token pair
never rides a URL; only the opaque code or the MFA ticket do. The SSO
login can never satisfy requireFreshMfa step-up — the transport is
Bearer and step-up is cookie-only.
Adds the OidcNativeHandoff model (migration 0252), the token-exchange
route, a daily cleanup sweep, and the OpenAPI entry.
Strava was the second workout integration, after WHOOP, that wrote its
raw vendor sport label ("Run", "Ride", "VirtualRide", ...) straight into
Workout.sportType instead of a canonical bucket. Every Strava row read
as generic, and the read-time picker treats two generic rows as
sport-compatible — a same-source brick session (Strava ride ending
~15:00, Strava run starting 15:03) could cluster into one and silently
drop a leg.
Add mapStravaSportType() (54 documented Strava sport_type values,
mirroring the WHOOP sport-map shape) and apply it at write time in
mapActivity(); the raw label stays in metadata.stravaType for
provenance. Backfill existing Strava rows via a hand-written migration
generated from the same table. Extend the cross-provider sport-map
parity test to cover Strava, and add a picker-level test proving a
back-to-back Ride+Run pair now survives as two rows instead of one.
When the auto-AI-read opt-in is on, a freshly uploaded document is summarised
once in the background and the encrypted summary is stored and shown on the
document detail view.
- A background step runs after upload alongside the existing content-index and
thumbnail steps. It generates a short (3-4 sentence) plain-language summary
only when the user's documentsAutoAiRead opt-in is on (that flag is also the
standing AI-egress consent), skips a document that already has one, and
no-ops when no vision provider is configured. It reuses the same provider
resolution, egress-consent re-assertion, and AI-budget reserve/reconcile
helpers as the on-demand route; a provider error refunds the reservation and
never fails the upload.
- The summary is stored encrypted (summaryEncrypted Bytes) with a
summaryGeneratedAt timestamp on inbound_documents, registered for key
rotation, and returned decrypted in the document detail response.
- The on-demand transient summary route is unchanged.
Gated by the same consent, budget, and module checks.
NutrientIntakeDay's composite primary key gains `source` (migration
0249_nutrient_intake_day_source): a manual water entry and the
Apple-synced day total now live as two rows instead of the manual
write being silently clobbered by the next Apple last-writer-wins
sync. Every existing row already defaults to source=APPLE_HEALTH, so
the migration is a pure PK-constraint change with no data rewrite.
- POST /api/nutrients/batch keeps writing the APPLE_HEALTH row,
byte-identical upsert semantics against the wider key.
- GET /api/nutrients sums amounts within (nutrient, day) across
sources before folding into the window summary.
- POST /api/nutrients/water (new): manual water quick-add, add/set
modes against the MANUAL row only, module-gated, rate-limited,
idempotency-key aware, hard-evicts the dashboard snapshot cache.
- GET /api/nutrients/daily (new): dense per-day series for one
nutrient (summed across sources) plus the EFSA reference resolved
against the caller's profile sex — omitted when sex is unknown.
- catalog.ts gains resolveNutrientReference(), the sex-resolution
helper both new routes and the insights cards share.
docs/api/openapi.yaml regenerated for the two new routes.
The worth-a-look rail mixed actionable items (an overdue dose, a broken
sync) with observational ones (a milestone, a new ECG pointer, a tension
window) that have nothing to act on beyond "seen it" — there was no way
to clear them short of them expiring on their own.
Add server-side dismissal scoped to the three observational kinds only:
a new DismissedPriorityItem table (userId + itemKey, composite-unique),
a POST /api/daily/digest/dismiss route, and a deterministic itemKey the
digest builder stamps per kind (metric + reach day for a milestone, the
recording's own timestamp for an ECG, the local day + part of day for a
tension window) so a dismissal never bleeds into a later day's instance.
The actionable kinds never carry an itemKey, so the dismiss affordance
and the endpoint are both structurally unreachable for them — an
itemKey not namespaced under a dismissible kind 422s before any lookup.
Existing WHOOP Workout rows still carry whatever the pre-fix write path
stored — a whoop_sport_<id> placeholder or WHOOP's raw sport_name — so
the sport-map fix only corrects new syncs. This one-shot UPDATE
re-derives every existing WHOOP row's sport_type from the same table
sport-map.ts uses, generated directly from that table so the historical
data and the live mapper can't drift apart. Unmatched values default to
"other", matching the mapper's fallback. Idempotent: the WHERE clause
skips rows already on a canonical value, so a re-run touches zero rows.
Replace the scalar document_id discriminator on a coach conversation with a
CoachConversationDocument join table and a sticky documentScoped flag, so a
conversation can be grounded on several stored documents at once while the
prompt-injection fence stays intact across the data-model change.
The fence is re-established at both enforcement points, fail-closed:
- Client: resolveCoachSendTarget routes any turn on a fenced conversation (or a
fresh chat with staged attachments) to the new /api/insights/chat/fenced
endpoint; the fenced body is strict and never carries scope, guided-question,
or prefill hints.
- Server: the tool route fetches with documentScoped:false AND 404s when the
fetched row still carries an attachment (flag/join drift), emitting a
fence_drift audit alarm. Document text now enters an LLM prompt in exactly one
code path — the fenced pipeline — with no tools and no health snapshot; a
module-graph test pins that the tool loop is unreachable from it.
The fenced turn fences each document separately with a server-built, scrubbed
header line (title and filename are untrusted text), runs a per-document egress
consent check on the single picked provider, and grounds numerically over the
live attachment union only. Attachments are capped at five documents and 192 KB
of combined text with honest truncation.
Attach and detach ride dedicated endpoints: attaching validates the document is
owned, live, indexed, and within cap, then flips the conversation fenced (the
one legal, privilege-reducing transition, audit-logged); detaching removes the
document but never clears the flag. The document-sheet chat keeps its public
wire contract and shares the same fenced pipeline over the join.
Migration 0245 adds the join table and the flag, backfills every legacy
single-document chat into a one-attachment fenced conversation, and drops the
scalar column in the same transaction — no dual-truth window.
The nightly insight pre-pass runs ~04:30, before last night's sleep has
synced, so the morning digest and health score reference the day without
the current sleep. Close the gap the event-driven way instead of an
on-mount generation.
A day's digest is now provisional until the sleep-dependent output has
been regenerated with last night's sleep, and final after. The lifecycle
is driven by a real marker (User.morningDigestRefreshedOn, the user-local
date the refresh completed), not a heuristic: it flips the instant the
refresh runs, ahead of the snapshot cache that feeds the sleep last-seen
fallback. A day with no sleep device stays honestly provisional and keeps
the sleep-pending note rather than showing a stale final score.
When a completed sleep segment for last night lands from any of the three
sleep transports — Withings sync-sleep, the WHOOP sync, the Apple-Health
measurement batch — a debounced morning-digest-refresh job is enqueued.
"Last night" is judged in the user's profile timezone, so a full-history
re-sync never re-triggers for an old night. The queue singletonKey plus
the marker collapse the many samples of one night, across all sources,
into one refresh per user per local morning; the job re-runs the same
comprehensive pipeline the nightly cron uses (forced, so the content-hash
gate turns a no-change regen into a cheap no-op) and stamps the marker. A
hard generation failure leaves the day provisional and hands recovery to
the existing 45-minute briefing-retry machinery.
Deferred perf fixes from the campaign's verified perf-correctness audit,
correctness-first (each with an output-equivalence test):
- comprehensive-generate fan-out: replaced per-type 400d findMany+JS-average
with DB prisma.aggregate(_avg) over the exact half-open windows the JS
reducer used (current 30d, lastMonth (60d,30d], lastYear (395d,365d]), same
rounding + null-on-empty, pLimit(4). SLEEP_DURATION stays on the raw path
(per-night reconstruction dedup). Byte-equality test vs the old algorithm.
- boot-discovery: replaced Prisma in-memory distinct with DB SELECT DISTINCT
in the 4 backfill discovery scans + migration 0243 (7 additive
partial indexes matching each predicate). Integration test asserts identical
discovered set against real Postgres.
- ChatBubble wrapped in React.memo with a comparator (onRegenerate compared by
presence — the thread rebuilds it each render), so only the streaming bubble
re-renders per token.
- doctor-report mood read narrowed to {score, tags} (the only fields the
collector uses); the 730d main measurement read left as-is — a blind bound
would corrupt clinical stats (documented deferred follow-up).
Migration 0243 additive-only.
The v1.28.33 rollup + staging fixes were correct but never reached the
reporter's case: the upload dedup keys on the content SHA-256 and the
lookup matched a previously FAILED job too, so re-uploading the same
export.zip returned the dead job's id and replayed its stale
failureReason without ever staging or sending again. The dedup now
excludes failed rows (short-circuits only on queued/unpacking/parsing/
upserting/done); the same bytes retry cleanly. A redundant staged upload
is unlinked on a dedup hit instead of leaking in the staging dir.
reconcileOrphanImportJobs no longer unconditionally fails every
non-terminal ImportJob at boot: it now checks pg-boss job state plus a
progress heartbeat (new import_jobs.updated_at, migration 0242), so a
split or multi-worker deployment cannot kill an import running in
another worker. The missing-staging message names the separate-container
cause explicitly, with a matching note in docs/self-hosting/scaling.md.
Supplement-style intake written to Apple Health by nutrition apps —
vitamins, minerals, water, caffeine — can now sync as daily totals into a
dedicated NutrientIntakeDay store (migration 0241): composite (user, day,
nutrient) identity, re-post replaces, no soft delete, no rollup coupling.
A code-side catalog carries the 26 nutrient codes with canonical units,
plausibility caps, and EFSA dietary reference values (direction-aware;
chromium cites NIH ODS where EFSA declined a DRV).
Deliberately not a nutrition feature: no diary, no calories, no dashboard
surface. POST /api/nutrients/batch is gated behind the new opt-in
nutrients module (default off — with the module off the server refuses
ingest entirely), rate-limited, idempotency-wrapped, with per-entry
unit-mismatch and out-of-range skips. GET /api/nutrients serves a
catalog-ordered summary; the only visible surface is a read-only card
under Settings → Sources. Coach/correlation access is a later slice; the
iOS reading side is coordinated in the companion-app tracker.
An OIDC login now resolves the account by the durable (issuer, sub)
pair instead of the email claim. First contact stamps the pair — by
auto-provision or a one-time link against an existing account matched
by verified email — and every later login matches on it alone, so an
IdP-side email change refreshes the display email but can never
re-point the login at a different account. An email that matches an
account already bound to a different identity is rejected and audited
(auth.oidc.link_conflict), never silently re-bound.
The email gate tightens with it: linking and provisioning now require
an explicit email_verified: true — an absent claim is a reject
(oidc_email_unverified) rather than a benefit of the doubt, since an
IdP that does not assert verification cannot anchor the account match.
Provisioned accounts get a lowercased email and the same server-default
timezone resolution the register route uses.
Migration 0240 adds the nullable users.oidc_issuer / users.oidc_sub
columns with a composite unique index.
The sleep source-discrepancy annotation now reaches the surfaces: SleepNight
carries the MAIN session's annotation (naps never cross-compare), the analytics
slim slice / dashboard snapshot / iOS summary thread it additively, and the
dashboard sleep tile renders the shared discreet marker (extracted from the
sleep panel — one implementation, two surfaces). Served totals unchanged,
pinned by tests.
Apple Health medications groundwork (server side of the medication-import
request): IntakeSource gains APPLE_HEALTH; medications accept an external
mirror identity (source-exclusive by policy) and dose imports carry the HK
dose-event UUID — both idempotent per stable key, with the concurrent-create
race resolved to the winner. Migration 0239, additive only. Entries without
the new fields behave byte-identically.
Hardening: doctor-report aggregation + PDF charts compute ranges with loops
instead of spread calls — a report over a sample-dense year cannot overflow
the call stack (the class fixed for the Google Health full sync).
A one-time background pass re-reads each connected account's Google Health
sleep history so nights stored twice before the sleep fix collapse to their
true total (new sleep_repaired_at marker, migration 0238; watermark-safe,
enqueued once at boot per un-repaired connection).
The sleep night read reports when two writers disagree about the same night —
the served total is unchanged, the disagreement rides along as an annotation
(sourceDiscrepancy on the night DTO) so clients can mark the number instead of
silently picking a side.
A GLP-1 medication whose weight has plateaued on the current dose says so next
to the estimated drug level (efficacy tab + insights) — a factual note from the
existing detector, association only, verb-guard covered.
Google Health diagnostics: the sync log now separates a daily-totals read that
returned nothing from one the importer could not parse
(googleHealth.rollup.emptyResponse vs droppedAll), and the connection test's
structure probe reports the raw response envelope key names when a rollup type
parses to zero — a per-account naming drift becomes visible from one report.
A share link created to carry only documents now records an explicit,
frozen document_only flag, and the shared view gates on that flag directly
instead of inferring documents-only from "are all report sections off?".
The inference would have re-opened an existing documents-only link the day
a new report section was added — the link's frozen settings never mention
the new section, so it would default on and begin serving that data. The
flag closes that path; the derived check stays only as the fallback for
links created before the column.
Migration 0237 adds the column and freezes it on for every existing link
whose sections are entirely off (checked at any nesting depth), leaving
full-record shares untouched.
Document vault shows a per-file thumbnail: a server-rendered preview,
downscaled and re-encoded so location and camera metadata are dropped,
served only to the file's owner over an authenticated request. Files that
cannot be previewed keep their type icon. Generation is bounded — a header
sniff refuses an over-large source before decode, so a crafted image cannot
exhaust the preview worker.
Also folds in admin-managed central AI access — an administrator connects
one access on the server and each user opts in or keeps their own provider,
off until an admin turns it on — and trims the redundant documents-search
caption and per-file searchable/read badges.
Render a small JPEG preview for each stored document and show it at the
card's leading edge, falling back to the kind icon when none exists.
- Generate previews in the background on upload (new document-thumbnail
pg-boss queue) plus a boot-time corpus backfill for existing documents;
upload never blocks on or fails because of it. Images are downscaled via
@napi-rs/canvas, a PDF's first page is rasterised then downscaled, every
other type is skipped. Generation never throws.
- Store the preview encrypted at rest in a 1:1 DocumentThumbnail side table
(migration 0236) so the list/detail queries that omit the original blob
never drag the preview either. Same AES-256-GCM string codec + fail-closed
decrypt as the content index; wired into the key-rotation walk.
- Serve it through an owner-scoped GET /api/documents/inbound/[id]/thumbnail
(auth + module gate + userId-scoped query + fail-closed decrypt), always
image/jpeg + nosniff + private, no-store; 404 on miss. The card renders an
authed lazy <img>, onError falls back to the icon.
- Add hasThumbnail to the document DTO so the card only fetches a preview
that exists.
Also drop the "search looks inside your documents" caption from the overview
(the index-all prompt stays) and the per-card searchable marker; both were
noise. Remove the now-unused i18n keys across all six locales.
Introduce an operator-level ChatGPT-subscription (Codex) credential that the
operator connects once and shares server-wide, plus a per-user switch to route
AI egress through it.
- Schema (migration 0235): three encrypted columns on AppSettings for the
operator's central Codex access/refresh tokens and the ChatGPT-Account-ID
claim, plus expiry/connected-at/status; a per-user useCentralCodex flag
(default false). Register the new encrypted columns in the rotation registry
and script.
- Resolution: add the admin-codex chain type; append it to a user's resolved
chain only when they opted in AND the operator connected it. Tokens refresh
server-side against the singleton row (CAS-style), same primitives as the
per-user Codex path.
- Budget: bill an admin-codex primary against the operator cost cap, not the
user plan — it drains the operator's account.
- Consent: admin-codex is server-managed external egress, gated by the existing
consent machinery (self-snapshot and document surfaces alike). No existing
consent path is weakened.
- Document order: rank admin-codex with the subscription tier (last), so the
document class stays local-first.
- UI: admin device-code connect/disconnect card (cookie-only admin routes) with
honest copy on account pooling, shared rate limits, and training-by-default;
a per-user opt-in switch shown only once the operator has connected it, off by
default, behind a one-time honesty confirm.
- i18n across all six locales; unit tests for the chain type, budget cap,
consent gate, vision capability, and document order; a mocked e2e for both
the admin connect surface and the per-user switch.
The central credential's tokens are encrypted at rest and never returned to a
non-admin API; the opt-in only takes effect once the operator has connected the
shared account.
Lab-report OCR now rasterizes a PDF to page images for any non-Anthropic
vision provider, exactly as the document vault already does — Anthropic keeps
its native PDF block, every other vision provider (codex/OAuth, OpenAI, local)
reads the rendered pages. The capability probe reports `pdfSupported` whenever
the picked provider reads PDFs natively or the server-side rasterizer is
available, so the "scan a PDF" affordance shows for a codex provider too.
Drop the dedicated document-scan (Lab-OCR) provider: labs OCR always uses the
main configured provider chain. Removes the settings card, the `aiOcr*`
resolution branch, the GET/PATCH handler fields, the OpenAPI schema fields, the
i18n keys across all locales, and the five backing `User` columns (migration
0234). The on-device tesseract fallback is untouched.
Dashboard hero: stack the overdue-dose action directly beneath the verdict
text (tight gap, left-aligned) on every viewport instead of pushing it to the
far container edge on desktop.
Add Strava as a per-user BYO-OAuth workout source, mirroring the shipped
WHOOP/Oura/Polar pattern. Strava caps every new app at single-player mode, so
each self-hoster registers their own app and pastes the client id/secret into
Settings (falling back to a shared env app). Strava is a workout source only —
it exposes no daily metrics and no training-depth analytics are derived.
- Schema (migration 0233): per-user encrypted client id/secret + access/refresh
tokens, plaintext athlete id, incremental cursor, and backfill marker on
`User`; `STRAVA` added to `MeasurementSource`.
- Token model follows Oura's reactive-refresh-on-401 with a compare-and-set on
the stored refresh ciphertext, because Strava rotates its refresh token on
every refresh.
- Client over safeFetch: authorization-code + refresh, activity list + budget-
aware per-activity detail (for calories/HR), honouring the 200/15min cap; each
activity maps to one `Workout` row. Activity name/description stay in metadata
as data, never surfaced or interpolated.
- Dedup reuses the existing source-agnostic two-layer picker: `STRAVA` slots
into the workout ladder below the device-native wearables and above
MANUAL/IMPORT, so an Apple-Watch + Strava twin collapses to one canonical row.
- Poll-cohort hourly sync (:17) + self-converging boot backfill, wired into the
integration-sync registrar. Webhook deferred.
- OAuth routes (connect/callback/credentials/disconnect/status/test) with signed
state, cross-account re-auth rejection, and a surgical `www.strava.com`
connect-src gated to the Strava surfaces.
- Settings card + consolidated status envelope entry; env + compose whitelist;
i18n across all six locales.
- Garmin: no direct connector is possible (business-partner-only). Add
docs/integrations/garmin.md documenting the Apple Health / Google Health
Connect path and Garmin's withheld proprietary scores, cross-linked from both
platform docs, plus a non-connector info note in the Connections panel.
Regenerate docs/api/openapi.yaml for the new `STRAVA` MeasurementSource value.
Add the migration (0232), Prisma model MedicationEfficacyTarget (persists ONLY
the user's explicit target override; everything else derives each read), and
the server builder buildMedicationEfficacy that composes the target's series,
a before/after-start comparison, the cadence-aware adherence lane (never
recomputed), an optional conservative level-shift note, honest data-floor
states and the retarget options into one strictly-descriptive DTO — no
verdict/score field by construction. Expose GET /api/medications/[id]/efficacy
and PUT /api/medications/[id]/efficacy/target, regenerate the OpenAPI contract.
Add the documentsAutoAiRead per-user Boolean (migration 0231, default
false) that authorises ambient AI reading of uploaded vault documents.
OFF by default keeps the vault local-first for every self-hoster.
- schema column + migration 0231_documents_auto_ai_read
- documentAutoReadEnabled(userId) read helper
- GET/PATCH /api/auth/me/documents-auto-ai-read toggle route; the ON
write mints an ai_full consent receipt for the audit trail
- the document consent gate short-circuits an external pick when the
toggle is ON; a local pick stays ungated and OFF still requires a
receipt for any external egress
Index a document for content search automatically the moment it is stored,
instead of requiring a manual index action. A fire-and-forget per-document
job runs an AI-first decision tree: when a vision-capable provider is
configured and consented, transcribe the stored original (rich, handles
scanned PDFs and images), budget-reserved exactly like the interactive index
route; otherwise fall back to server-side text-layer extraction via pdf-parse
(no provider, no egress, milliseconds) so content search works at a baseline
even with no AI. Budget exhaustion, a provider that cannot read the file
(a text-layer PDF on a non-Anthropic account), and provider errors all fall
through to the free local path rather than leave a document unsearchable.
Both paths write the same blind, encrypted content index (AES-256-GCM text +
opaque HMAC token tags) — nothing readable at rest. The local path adds the
'local-pdf' / 'local-ocr' source values (free String column, no migration).
Server-side OCR for scanned images and scanned PDFs is left as a documented
seam. Pin pdf-parse + pdfjs-dist into the standalone trace so the wasm text
extractor ships in the runtime image.
P3-1-T1. Introduce ClinicianShareLinkDocument, the write-once join binding a
stored document to a clinician share link. The document set a share exposes is
a relation, not a mutable column, so it inherits the link's frozen-scope
discipline. Both foreign keys cascade so a deleted link or document takes its
membership with it.
P2-1-T1. Migration 0228 adds the 1:1 document_content_index sibling of
inbound_documents: AES-256-GCM ciphertext of the extracted text plus a
deduped HMAC-SHA256 token array (search_tokens) with a GIN index for the
array-overlap match the list search will union with title/filename ILIKE.
Both foreign keys cascade. Nothing readable sits at rest; the index subkey
is HKDF-derived at runtime, so tokens are opaque without the server key.
REFERRAL joins the document-kind enum (Überweisung — LOINC 57133-1 / ePA
ANF). inbound_documents gains content_sha256 (plaintext hash for same-user
duplicate detection; pre-existing rows stay NULL) and content_codec
(base64v1 legacy string codec | binary2 binary codec, explicit column —
never header-sniffed), plus a partial unique index that allows at most one
LIVE row per (user_id, content_sha256) so a tombstoned document never
blocks a re-upload.
document_condition_links is the m:n join between a document and an
illness/condition episode (a discharge letter legitimately touches two
conditions); both sides cascade. app_settings carries the two admin-tunable
limits (per-file cap, default 25 MiB; per-user quota, default 1 GiB) and
users the nullable per-user quota override.
Task: W1-T1.
Two new self-report instruments join the mental-wellbeing engine on the
existing PHQ-9 / GAD-7 infrastructure:
- WHO-5 Well-Being Index: 5 items on the 6-point 5..0 scale over the last
two weeks; the reported total is raw-sum x 4 (0-100) per the official
WHO scoring (WHO/UCN/MSD/MHE/2024.1, CC BY-NC-SA 3.0 IGO). A total of
50 or below follows the WHO comment (below 50 = indication for further
assessment).
- Sleep Condition Indicator: 8 DSM-5-aligned items, 0-4 each with
item-specific anchors, total 0-32, higher = better sleep; a total of
16 or below maps to the probable-insomnia range of the source
publication (Espie et al., BMJ Open 2014;4:e004183, CC BY-NC,
(c) Sleepio Limited).
The instrument registry generalises rather than forking: per-item answer
ceilings, option order/label schemes, recall-stem captions, a reported-
score multiplier, score direction (higher-is-better inverts the follow-up
threshold), per-instrument attribution lines, and the validated-item
locale set are now instrument properties. Scoring stays server-
authoritative; the create route validates the per-instrument answer
ceiling and projects the total onto a COMPUTED WHO5_SCORE / SCI_SCORE
measurement row (never client-attributable), which also auto-satisfies a
planned screening reminder. Migration 0226 adds the enum values
(additive, idempotent). OpenAPI regenerated.
Neither instrument carries a self-harm item; the PHQ-9 item-9 crisis
routing is unchanged.
Each completed PHQ-9 / GAD-7 administration already projects its total
onto a PHQ9_SCORE / GAD7_SCORE measurement row (unit score, linked via
externalId assessment:<id>). Those rows were attributed MANUAL — a
client-writable source. The projection is a server-derived value, so it
now writes source COMPUTED, the same server-owned source RECOVERY_SCORE
uses: no client write surface can attribute COMPUTED, so a forged score
trend point cannot enter through the measurement POST. Migration 0225
re-attributes the existing assessment-linked projection rows; a score a
user typed into the generic measurement form keeps MANUAL. OpenAPI
description updated and the spec regenerated.
Introduce the data model behind a Google Health provider that reads
Fitbit, Pixel Watch, and Fitbit Air data through a user's Google account.
- GoogleHealthConnection: 1:1 with the user, encrypted access/refresh
tokens, token expiry, external Google user id, sync high-water-mark,
and a needsReauth flag for the periodic re-consent that Google's
Testing-mode clients require.
- GoogleHealthOAuthState: the connect-flow nonce ledger with the PKCE
verifier.
- Two encrypted BYO-client columns on User for the operator's own Google
OAuth client id and secret.
- GOOGLE_HEALTH added to the measurement_source enum.
Migration 0224 mirrors the existing integration shape: a standalone
enum-add, guarded CREATE TABLE / ADD COLUMN, forward-only and idempotent.
Renumber the custom-metrics migration to 0223 (the next free slot on the
trunk) and cut the release: version bump, regenerated OpenAPI contract,
service-worker stamp, and CHANGELOG entry.
Add a user-defined custom-metric store alongside the built-in measurements
on the Measurements surface. A user defines an arbitrary metric (name, unit,
optional target window, decimals, description), logs values, and charts them.
The store is a separate generic catalog + values pair, isolated from the
closed measurement-type system: not synced, not in FHIR, not in insights —
log and chart only. Names and units are plaintext, mirroring the biomarker
catalog. The inline list lives beneath the measurement list (no new nav
entry); tapping a metric opens a detail page with the trend chart, target
band, stat strip, and an editable value history.
Migration 0224 adds custom_metrics and custom_metric_entries.
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 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.
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).
Add `User.homeSince` (nullable effective-from instant) and a `DEVICE` value to
the location-source enum (migration 0219). `homeSince` records when the home
location became effective so day resolution can attribute a past day to the
home only on/after that instant, rather than to the current home for every past
day. Existing accounts with a home get `homeSince` stamped to the migration
instant; their deep past is filled by explicit location periods instead.
`DEVICE` is reserved for a future client-supplied coarse per-day location: the
enum value and the wire contract accept it now so the resolver can rank it
later without rework. Nothing writes it server-side yet.
Add the opt-in environmental-context store: per-day EnvironmentContext
observations (temperature, daylight, sunshine, precipitation, pressure,
humidity, cloud, weather code) keyed by user + day and location, plus the
manual EnvironmentTravelLocation overrides and the coarse home-location
columns on the user. Location is city-level by design; the weather model
needs no finer than ~10-25 km and no GPS track is ever stored.
Store an uploaded doctor report / discharge letter and stage extracted
structured facts for review. Two models:
- InboundDocument: the uploaded document, raw bytes encrypted at rest via
the shared AES-256-GCM Bytes codec (content_encrypted), with queryable
metadata (kind, mime, size, status, report date).
- ExtractedFact: the review-then-confirm staging row — fact type, status,
per-field provenance, a confidence score, and a needs-review gate, plus
the FHIR-staged payload (stated codes/status only) as JSONB.
Wire content_encrypted into the encryption-key rotation registry and the
rotation script so a key drop never strands a stored document.
Introduce two structured health-record tables, kept as reference records
(not time-series signals):
- `allergies` — AllergyIntolerance-style: substance + category + type +
severity + status + optional onset. The substance label stays queryable
plaintext; the free-text reaction and note are AES-256-GCM encrypted
(`reaction_encrypted` / `notes_encrypted` BYTEA).
- `family_history_entries` — one condition per relative: relationship +
condition label + optional age-at-onset; the free-text note is encrypted.
Both are owner-scoped and soft-deleted. Migrations 0215/0216 are additive
and idempotent. The three new encrypted columns are registered in
ENCRYPTED_COLUMNS and wired into the key-rotation script, so a key drop can
never silently strand them undecryptable.
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.
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.
Marc-André Bombeck