feat: per-patient record history + summary PDF export

Add GET /api/activity/patient/:fileNumber (every audited change on one chart,
newest first, readable by any clinic member) and surface it as a Record
history timeline in the patient detail sheet. Add a Download summary action
that builds a clean, printable one-page clinical summary in the browser
(Save as PDF) — no PDF dependency, nothing leaves the server.

Co-Authored-By: Claude Opus 4.8 <noreply@anthropic.com>

backend/src/routes/activity.ts

@@ -25,3 +25,18 @@ activityRouter.get("/", async (req, res, next) => {
     next(err);
   }
 });
+
+// A single patient's record history (who added/changed what, when). Any clinic
+// member can read it — it's the audit trail for that chart.
+activityRouter.get("/patient/:fileNumber", async (req, res, next) => {
+  try {
+    res.json(
+      await service.listPatientActivity(
+        req.organizationId!,
+        req.params.fileNumber as string,
+      ),
+    );
+  } catch (err) {
+    next(err);
+  }
+});

backend/src/services/activity.ts

@@ -54,6 +54,28 @@ export async function recordActivity(params: {
   }
 }
 
+// Lists every audit entry tied to a single patient (by file number), newest
+// first. Unlike the clinic feed this is NOT scoped to one actor: a patient's
+// record history should show every clinician who added or changed data on it.
+export async function listPatientActivity(
+  orgId: string,
+  fileNumber: string,
+  limit = 100,
+): Promise<ActivityEntry[]> {
+  const rows = await db
+    .select()
+    .from(activityLog)
+    .where(
+      and(
+        eq(activityLog.organizationId, orgId),
+        eq(activityLog.patientFileNumber, fileNumber),
+      ),
+    )
+    .orderBy(desc(activityLog.createdAt))
+    .limit(limit);
+  return rows.map(toEntry);
+}
+
 // Lists the clinic's audit feed. When `actorId` is given, only that user's own
 // actions are returned (each employee sees their own activity); admins/owners
 // call without it to see the whole clinic.

frontend/components/patients/patient-detail.tsx

@@ -1,12 +1,14 @@
 "use client";
 
-import { ArrowLeftRight, Network, Pencil, Trash2 } from "lucide-react";
+import { ArrowLeftRight, FileDown, Network, Pencil, Trash2 } from "lucide-react";
 import { type ReactNode, useEffect, useState } from "react";
 import { useTranslation } from "react-i18next";
 
 import { Sparkline } from "@/components/chat/sparkline";
 import { AttachmentsSection } from "@/components/patients/patient-files";
 import { Avatar, AvatarFallback } from "@/components/ui/avatar";
+import { type ActivityEntry, listPatientActivity } from "@/lib/activity";
+import { printPatientSummary } from "@/lib/patient-pdf";
 import { Badge } from "@/components/ui/badge";
 import { Button } from "@/components/ui/button";
 import {
@@ -39,7 +41,14 @@ type RecordFile = {
   rows: { label: string; value: string }[];
 };
 
-type BadgeVariant = "default" | "secondary" | "destructive" | "outline";
+type BadgeVariant =
+  | "default"
+  | "secondary"
+  | "destructive"
+  | "outline"
+  | "success"
+  | "info"
+  | "warning";
 
 const severityVariant: Record<AllergySeverity, BadgeVariant> = {
   mild: "outline",
@@ -53,8 +62,8 @@ const labFlagVariant: Record<LabFlag, BadgeVariant> = {
   critical: "destructive",
 };
 const statusVariant: Record<Patient["status"], BadgeVariant> = {
-  active: "secondary",
-  inpatient: "destructive",
+  active: "success",
+  inpatient: "info",
   discharged: "outline",
 };
 
@@ -105,6 +114,60 @@ function TrendBlock({ trend }: { trend: Trend }) {
   );
 }
 
+// The patient's record history: every audited add/change on this chart, newest
+// first. Reuses the clinic activity log scoped to this file number.
+function RecordHistory({ fileNumber }: { fileNumber: string }) {
+  const { t } = useTranslation();
+  const [entries, setEntries] = useState<ActivityEntry[] | null>(null);
+  const [error, setError] = useState(false);
+
+  useEffect(() => {
+    let active = true;
+    listPatientActivity(fileNumber)
+      .then((e) => active && setEntries(e))
+      .catch(() => active && setError(true));
+    return () => {
+      active = false;
+    };
+  }, [fileNumber]);
+
+  return (
+    <Section title={t("patientCard.history.title")}>
+      {error ? (
+        <p className="text-muted-foreground text-sm">
+          {t("patientCard.history.loadError")}
+        </p>
+      ) : entries === null ? (
+        <p className="text-muted-foreground text-sm">{t("patients.loading")}</p>
+      ) : entries.length === 0 ? (
+        <p className="text-muted-foreground text-sm">
+          {t("patientCard.history.empty")}
+        </p>
+      ) : (
+        <ol className="flex flex-col gap-3">
+          {entries.map((e) => (
+            <li className="flex items-start gap-3" key={e.id}>
+              <Avatar className="mt-0.5 size-7 shrink-0">
+                <AvatarFallback className="text-[11px]">
+                  {e.actorInitials}
+                </AvatarFallback>
+              </Avatar>
+              <div className="flex min-w-0 flex-1 flex-col">
+                <span className="text-foreground text-sm">
+                  <span className="font-medium">{e.actorName}</span> {e.action}
+                </span>
+                <span className="text-muted-foreground text-xs">
+                  {new Date(e.createdAt).toLocaleString()}
+                </span>
+              </div>
+            </li>
+          ))}
+        </ol>
+      )}
+    </Section>
+  );
+}
+
 // Full patient record laid out vertically for the side Sheet — plain full-width
 // sections (no fixed-width cards, no nested click-to-expand dialogs).
 export function PatientDetail({
@@ -200,6 +263,15 @@ export function PatientDetail({
           )}
         </div>
         <div className="flex shrink-0 items-center gap-2">
+          <Button
+            onClick={() => printPatientSummary(patient, t)}
+            size="sm"
+            type="button"
+            variant="outline"
+          >
+            <FileDown className="size-4" />
+            {t("patientCard.exportPdf")}
+          </Button>
           {onTransfer && (
             <Button
               onClick={onTransfer}
@@ -533,6 +605,8 @@ export function PatientDetail({
         </Section>
       )}
 
+      <RecordHistory fileNumber={patient.fileNumber} />
+
       <Dialog
         onOpenChange={(o) => {
           if (!o) setOpenFile(null);

frontend/lib/activity.ts

@@ -25,3 +25,12 @@ export type ActivityEntry = {
 export function listActivity(): Promise<ActivityEntry[]> {
   return apiFetch<ActivityEntry[]>("/api/activity");
 }
+
+// A single patient's record history (every clinician's adds/changes on it).
+export function listPatientActivity(
+  fileNumber: string,
+): Promise<ActivityEntry[]> {
+  return apiFetch<ActivityEntry[]>(
+    `/api/activity/patient/${encodeURIComponent(fileNumber)}`,
+  );
+}

frontend/lib/patient-pdf.ts

@@ -0,0 +1,156 @@
+import type { TFunction } from "i18next";
+
+import type { Patient } from "@/lib/patients";
+
+// Build and print a clean, one-page clinical summary for a patient. We render an
+// isolated HTML document in a new window and trigger the browser's print dialog
+// (where the user picks "Save as PDF") — no PDF library needed, and the output
+// follows the user's locale via the passed `t`.
+
+function esc(value: unknown): string {
+  return String(value ?? "")
+    .replace(/&/g, "&")
+    .replace(/</g, "&lt;")
+    .replace(/>/g, "&gt;");
+}
+
+function rows(items: { label: string; value: string }[]): string {
+  return items
+    .filter((r) => r.value)
+    .map(
+      (r) =>
+        `<tr><td class="l">${esc(r.label)}</td><td class="v">${esc(r.value)}</td></tr>`,
+    )
+    .join("");
+}
+
+export function printPatientSummary(patient: Patient, t: TFunction): void {
+  const sexLabel = t(`patientCard.sex.${patient.sex}`);
+  const generated = new Date().toLocaleString();
+
+  const section = (title: string, body: string, empty: string): string =>
+    `<section><h2>${esc(title)}</h2>${body || `<p class="empty">${esc(empty)}</p>`}</section>`;
+
+  const list = (items: string[]): string =>
+    items.length
+      ? `<ul>${items.map((i) => `<li>${esc(i)}</li>`).join("")}</ul>`
+      : "";
+
+  const html = `<!doctype html>
+<html>
+<head>
+<meta charset="utf-8" />
+<title>${esc(patient.name)} — ${esc(t("patientCard.pdf.title"))}</title>
+<style>
+  * { box-sizing: border-box; }
+  body { font-family: -apple-system, Segoe UI, Roboto, Helvetica, Arial, sans-serif;
+    color: #111; margin: 32px; font-size: 12px; line-height: 1.5; }
+  header { border-bottom: 2px solid #111; padding-bottom: 12px; margin-bottom: 16px; }
+  h1 { font-size: 20px; margin: 0 0 4px; }
+  .sub { color: #555; font-size: 12px; }
+  .gen { color: #888; font-size: 10px; margin-top: 6px; }
+  section { margin-bottom: 16px; break-inside: avoid; }
+  h2 { font-size: 13px; text-transform: uppercase; letter-spacing: .04em;
+    border-bottom: 1px solid #ddd; padding-bottom: 4px; margin: 0 0 8px; }
+  table { width: 100%; border-collapse: collapse; }
+  td { padding: 2px 0; vertical-align: top; }
+  td.l { color: #555; width: 38%; padding-right: 12px; }
+  td.v { color: #111; }
+  ul { margin: 0; padding-left: 18px; }
+  li { margin: 1px 0; }
+  .empty { color: #999; font-style: italic; margin: 0; }
+  @media print { body { margin: 16px; } }
+</style>
+</head>
+<body>
+  <header>
+    <h1>${esc(patient.name)}</h1>
+    <div class="sub">${esc(`${patient.age} · ${sexLabel} · ${t("patientCard.summary.mrn")} ${patient.fileNumber}`)}</div>
+    <div class="gen">${esc(t("patientCard.pdf.generated", { date: generated }))}</div>
+  </header>
+
+  ${section(
+    t("patientCard.overview"),
+    `<table>${rows([
+      { label: t("patientCard.summary.primaryCare"), value: patient.pcp },
+      { label: t("patientCard.summary.lastSeen"), value: patient.encounters[0]?.date ?? "" },
+      { label: t("patientCard.summary.status"), value: t(`patients.status.${patient.status}`) },
+    ])}</table>`,
+    "",
+  )}
+
+  ${section(
+    t("patientCard.allergies.title"),
+    list(
+      patient.allergies.map((a) =>
+        [a.substance, a.reaction, t(`patientCard.severity.${a.severity}`)]
+          .filter(Boolean)
+          .join(" — "),
+      ),
+    ),
+    t("patientCard.allergies.none"),
+  )}
+
+  ${section(
+    t("patientCard.problems.title"),
+    list(
+      patient.problems.map((p) =>
+        p.since ? `${p.label} (${p.since})` : p.label,
+      ),
+    ),
+    t("patientCard.problems.empty"),
+  )}
+
+  ${section(
+    t("patientCard.medications.title"),
+    list(
+      patient.medications.map((m) =>
+        [m.name, m.dose, m.frequency].filter(Boolean).join(" · "),
+      ),
+    ),
+    t("patientCard.medications.empty"),
+  )}
+
+  ${section(
+    t("patientCard.vitals.title"),
+    `<table>${rows([
+      { label: t("patientCard.vitals.bp"), value: patient.vitals.bp },
+      { label: t("patientCard.vitals.hr"), value: patient.vitals.hr },
+      { label: t("patientCard.vitals.temp"), value: patient.vitals.temp },
+      { label: t("patientCard.vitals.spo2"), value: patient.vitals.spo2 },
+    ])}</table>`,
+    "",
+  )}
+
+  ${section(
+    t("patientCard.labs.title"),
+    list(
+      patient.labs.map((l) =>
+        `${l.name}: ${l.value} (${t(`patientCard.labFlag.${l.flag}`)})`,
+      ),
+    ),
+    t("patientCard.labs.empty"),
+  )}
+
+  ${section(
+    t("patientCard.visits.title"),
+    patient.encounters
+      .map(
+        (e) =>
+          `<div style="margin-bottom:6px"><strong>${esc(e.type)}</strong> <span style="color:#888">${esc(e.date)} ${esc(e.provider)}</span><br/>${esc(e.summary)}</div>`,
+      )
+      .join(""),
+    t("patientCard.visits.empty"),
+  )}
+</body>
+</html>`;
+
+  const win = window.open("", "_blank", "width=820,height=1000");
+  if (!win) return;
+  win.document.open();
+  win.document.write(html);
+  win.document.close();
+  win.focus();
+  // Let layout settle before invoking print.
+  win.setTimeout(() => win.print(), 250);
+}