fix: QR wallet pairing broken by multi-clinic routing (v0.8.1)

QR "scan to connect" pairing has no wallet number, so nothing registered the request with the relay and the scanning device's response was rejected ("unknown or expired request"). The backend now pre-registers the pairing request over the relay's new hub:expect event on POST /pair, and re-registers still-pending requests on hub (re)connect so routing survives a relay restart. /pair now requires the clinic to have joined the network (clear 409, surfaced in the import dialog, localized in all five langs). Co-Authored-By: Claude Opus 4.8 <noreply@anthropic.com>
feat: multi-clinic Temetro Network with per-clinic identity (v0.8.0)
2026-07-26 20:08:14 +00:00 · 2026-07-05 19:16:33 +03:00 · 2026-07-05 18:30:19 +03:00 · 2026-07-05 03:04:23 +03:00 · 2026-07-04 01:34:24 +03:00 · 2026-07-04 01:27:32 +03:00
124 changed files with 27244 additions and 389 deletions
@@ -35,6 +35,11 @@ jobs:
        id: meta
        run: echo "version=${GITHUB_REF_NAME#v}" >> "$GITHUB_OUTPUT"

+      # QEMU lets the amd64 runner emulate arm64 so the images below build for
+      # both platforms (Intel + Apple Silicon self-hosters).
+      - name: Set up QEMU
+        uses: docker/setup-qemu-action@v3
+
      - name: Set up Buildx
        uses: docker/setup-buildx-action@v3

@@ -49,6 +54,7 @@ jobs:
        with:
          context: ./backend
          push: true
+          platforms: linux/amd64,linux/arm64
          tags: |
            ${{ env.REGISTRY_NAMESPACE }}/temetro-backend:${{ steps.meta.outputs.version }}
            ${{ env.REGISTRY_NAMESPACE }}/temetro-backend:latest
@@ -58,6 +64,7 @@ jobs:
        with:
          context: ./frontend
          push: true
+          platforms: linux/amd64,linux/arm64
          tags: |
            ${{ env.REGISTRY_NAMESPACE }}/temetro-frontend:${{ steps.meta.outputs.version }}
            ${{ env.REGISTRY_NAMESPACE }}/temetro-frontend:latest
@@ -7,6 +7,166 @@ for how releases are cut and published.

 ## [Unreleased]

+## [0.8.1] — 2026-07-05
+
+### Fixed
+- **QR "scan to connect" pairing** was broken by the multi-clinic relay routing (v0.8.0): pairing
+  has no wallet number, so the clinic never sent a `wallet:send` to register the request, and the
+  relay rejected the scanning device's response as "unknown or expired". The clinic now
+  **pre-registers** the pairing request with the relay (a new `hub:expect { requestId }` event on
+  `POST /api/patients/wallet/pair`), so the device's response routes back correctly. On hub
+  (re)connect the backend re-registers its still-pending requests, so routing also survives a relay
+  restart. `POST /pair` now also requires the clinic to have joined the network (clear 409 instead of
+  a dead QR), surfaced in the import dialog.
+
+### Added
+- **Multi-clinic Temetro Network.** The relay now serves many self-hosted clinics at once. Each
+  clinic authenticates to the `/hub` namespace by **signing a challenge with its own Ed25519 clinic
+  signing key** (`services/signing.ts`) — a per-clinic identity, not a shared password — and the
+  relay routes every device response back to only the clinic that originated the request (keyed by
+  `requestId`), so clinics never see each other's traffic. `wallet:online` is fanned out only to
+  clinics with pending work for that wallet.
+- **"Join Temetro Network" opt-in.** A per-clinic toggle in **Settings → Signing** (backed by
+  `clinic_signing_keys.network_enabled`, `GET`/`PUT /api/signing/network`, owner/admin only). Off by
+  default; enabling opens the clinic's relay connection, disabling tears it down. Wallet
+  import/push endpoints return **409** while a clinic hasn't joined. Localised in all five languages.
+
+### Changed
+- **The backend keeps one authenticated relay connection per network-enabled org**
+  (`services/relay-client.ts` — `connectOrg`/`disconnectOrg`, a `hubs` map keyed by `orgId`), instead
+  of a single shared-token connection. `emitToWallet`/`sendToWallet` now take an `orgId`, and the
+  offline-flush (`pendingUpdatesForWallet`) is org-scoped.
+- **`RELAY_TOKEN` is now optional/legacy.** Clinics authenticate with their signing key, so an open
+  relay needs no shared secret; `RELAY_TOKEN` only gates an optional *private* relay.
+
+## [0.7.0] — 2026-07-05
+
+### Added
+- **Temetro Network** — a standalone, high-performance **relay** (Rust + Axum + socketioxide) that
+  connects the backend to patient wallet apps, in its own repo
+  ([github.com/temetro/temetro-network](https://github.com/temetro/temetro-network)) and deployable
+  on Railway. It replaces the flaky Cloudflare quick-tunnel that used to expose the backend's
+  embedded `/wallet` Socket.io namespace to phones. The relay is a **dumb, stateless pipe**: a
+  `/wallet` namespace for devices (challenge/Ed25519-signature auth, room keyed by wallet number)
+  and a `RELAY_TOKEN`-authenticated `/hub` namespace for the backend. It forwards sealed ciphertext
+  verbatim, keeps no database, and its only crypto is verifying a device's auth signature (proven
+  byte-for-byte compatible with `wallet-crypto.ts`).
+
+### Changed
+- **The backend is now a client of the relay, not the wallet server.** The `/wallet` Socket.io
+  namespace was removed from `src/realtime.ts`; a new `src/services/relay-client.ts` connects to the
+  relay's `/hub` (`emitToWallet` delegates to its `sendToWallet`), handles device responses
+  (`wallet:share-response` / `wallet:update-response` / `wallet:revoke`) and flushes missed updates on
+  `wallet:online` — calling the same `wallet-share` / `wallet-updates` services as before. New
+  `RELAY_URL` + `RELAY_TOKEN` env vars; the wallet-import QR now points at `RELAY_URL`.
+
+## [0.6.0] — 2026-07-04
+
+### Added
+- **Read-only FHIR R4 server** — temetro can now be a FHIR **server**, not just a client.
+  A new endpoint tree at **`/fhir`** (mounted outside `/api`, bearer-only) exposes each
+  clinic's records as FHIR R4: **Patient**, **Observation** (labs + synthesized vital signs),
+  **AllergyIntolerance**, **Condition**, **MedicationRequest**, **Encounter** and
+  **Appointment**, plus an unauthenticated **`GET /fhir/metadata`** CapabilityStatement.
+  Searches return searchset `Bundle`s with `_count`/`_offset` pagination and self/next/prev
+  links. Because temetro stores free-text clinical values, every `CodeableConcept` is
+  **text-only** (no SNOMED/LOINC) and patients carry an **age** extension rather than a
+  `birthDate` — documented in the CapabilityStatement and API docs.
+- **Per-clinic FHIR API keys** — machine-to-machine auth via `Authorization: Bearer tmf_…`.
+  Keys are created/revoked under **Settings → Integrations → FHIR server** (owner/admin),
+  **SHA-256-hashed** at rest, and shown **once** at creation. Every FHIR request is
+  org-scoped (no cross-clinic reads) and written to the activity log with the key name and
+  result count. New `fhir_api_keys` table, `middleware/fhir-auth.ts`, the
+  `services/fhir-server/` mapping module (queries, resources, bundle, capability, keys), the
+  `/fhir` router, and `GET/POST/DELETE /api/integrations/fhir-server/keys`. New `fhirServer`
+  locale namespace across all five languages.
+
+## [0.5.0] — 2026-07-03
+
+### Added
+- **Clinic → wallet record-update push** — a clinician can push an updated record to a
+  **wallet-linked** patient (a permanent, approved share). The record snapshot is **signed**
+  with the clinic's Ed25519 key and **sealed** to the wallet's X25519 key (derived from its
+  Ed25519 wallet number via the birational map — verified byte-for-byte against the wallet's
+  own derivation), stored `pending`, and delivered over the `/wallet` relay live **and** on
+  the wallet's next authenticated connect (so an offline phone catches up). The patient
+  reviews it in a **pending-updates inbox** and approves/denies; the wallet signs its
+  decision, the backend verifies it, and the on-device record is replaced only on approval.
+  The wallet **pins** the clinic key (TOFU) and warns on a key change. New
+  `POST /api/patients/wallet/push`, `GET /api/patients/wallet/{link/:fileNumber,updates,updates/:id}`,
+  `walletRecordUpdates` table + service, `wallet:update-request` / `wallet:update-response`
+  relay events, a "Push to wallet" dialog with live status, and a "Sent updates" list under
+  Settings → Signing. New `walletPush` / `walletUpdatesList` locale namespaces across all five
+  languages. (The wallet app half ships in the sibling `temetro-app` repo.)
+
+## [0.4.0] — 2026-07-03
+
+### Added
+- **Ambient AI visit scribe** — a **Record visit** action on the patient sheet turns a
+  clinician↔patient conversation into a draft **SOAP** encounter note. Record with the
+  microphone (`MediaRecorder`, stored as an auditable patient attachment) or paste a
+  transcript; the backend transcribes via the user's **OpenAI (Whisper)** or **Gemini**
+  key, de-identifies the transcript + patient context through **Veil**, and the model
+  drafts a structured note that the clinician **reviews and edits before saving** — the
+  same write-approval gate as the chat agent. New `POST /api/scribe/{transcribe,draft,save}`
+  (`backend/src/routes/scribe.ts`, `services/ai/transcribe.ts`), a `veil.redactText()`
+  free-text redactor, and an `appendEncounter` service that adds one note without touching
+  the rest of the record. Gated by `patient:write` + the clinic AI policy (reception and
+  disabled-AI accounts don't see it). New `scribe` locale namespace across all five
+  languages. Drafting also works with local Ollama from a pasted transcript.
+
+## [0.3.0] — 2026-07-02
+
+### Added
+- **Three new interface languages** — Somali (`so`), Arabic (`ar`) and German
+  (`de`) join English and French, selectable in Settings → Profile → Language.
+  Each locale carries a full translation of the ~1,660 UI strings, with native
+  names shown in the selector (Soomaali, العربية, Deutsch).
+- **Right-to-left (RTL) support** — selecting Arabic sets `dir="rtl"` on the
+  document (applied before first paint via an inline script, so no flash), flips
+  physical spacing/alignment to logical CSS utilities, mirrors directional icons,
+  and loads an Arabic-capable typeface (IBM Plex Sans Arabic) appended to the
+  font stack for per-character fallback.
+- **Language roams across devices** — the chosen language is persisted to the
+  per-user `user_settings` preferences and re-applied on sign-in, with
+  localStorage remaining the offline source of truth.
+- **`frontend/scripts/check-locales.mjs`** (+ `npm run check-locales`) — a parity
+  check that fails on missing/extra keys or `{{placeholder}}` mismatches across
+  locales and warns when Arabic count-keys lack the full CLDR plural forms.
+
+## [0.2.5] — 2026-07-01
+
+### Fixed
+- **Multi-arch Docker images** — the `release` workflow now builds and publishes
+  `khalidxv/temetro-backend` and `khalidxv/temetro-frontend` for both
+  `linux/amd64` and `linux/arm64`. Previously the images were amd64-only, so
+  `docker compose pull` on Apple Silicon failed with *no matching manifest for
+  linux/arm64/v8* and fell back to building from source.
+
+### Changed
+- **Language switcher** in Settings → Profile is now a **select** that asks for
+  confirmation before switching the interface language, instead of applying the
+  change instantly on a button tap.
+
+## [0.2.4] — 2026-06-29
+
+### Added
+- **Pagination** on the Activity and Invoices pages (10 per page), matching the
+  Patients page, via a shared `ListPagination` component.
+- **French (Français)** interface language, with a language switcher in
+  Settings → Profile. The choice persists on the device.
+- **"Check for updates"** button in Settings → About & updates that forces a
+  fresh check.
+
+### Changed
+- **Update detection** now reads the latest version from **Docker Hub** image
+  tags (the channel clinics actually pull), falling back to the GitHub release
+  if Docker Hub is unreachable. This fixes "About & updates" showing *Up to
+  date* when a newer image was already published.
+- **docker compose** host ports are now configurable (`BACKEND_PORT`,
+  `FRONTEND_PORT`, `ADMINER_PORT`, alongside `POSTGRES_PORT`) so a port clash on
+  `docker compose up -d` can be resolved from `.env` without editing the file.
+
 ## [0.2.3] — 2026-06-29

 ### Fixed
@@ -27,12 +27,13 @@ repository (published as `temetro`).
 > "Patient wallet app" below) and an end-to-end **encrypted share / patient-approval** flow:
 > clinics hold a real **Ed25519 signing key** (Settings → Signing, `backend/src/services/signing.ts`),
 > and "Import from a patient app" on the Patients page relays an encrypted request to the wallet over
-> a **`/wallet` Socket.io namespace**, the patient approves on their phone, and the sealed record is
-> imported (with optional **temporary share + auto-delete**). See `backend/src/routes/{signing,patients-wallet}.ts`.
+> the **Temetro Network** relay (see below), the patient approves on their phone, and the sealed record
+> is imported (with optional **temporary share + auto-delete**). Clinic→wallet **record-update push**
+> and **QR pairing** are built too. See `backend/src/routes/{signing,patients-wallet}.ts`.
 >
-> **Still vision, not built:** clinic→wallet push of signed record updates, in-app record editing,
-> QR pairing, and cryptographic time-boxing of temporary shares. The AI chat is still **mock replies**.
-> Email verification is wired but currently **not enforced** at sign-in (see `backend/CLAUDE.md`).
+> **Still vision, not built:** in-app record editing and cryptographic time-boxing of temporary
+> shares. The AI chat is still **mock replies**. Email verification is wired but currently **not
+> enforced** at sign-in (see `backend/CLAUDE.md`).

 ## Patient wallet app (sibling repo `~/Desktop/temetro-app`)

@@ -47,6 +48,28 @@ here means keys + data live on the patient's device and the relay only ever forw
 is **not** a literal blockchain (records are off-chain, which is also what lets a temporary share be
 deleted). Commit/push that app inside its own repo, separately from this one.

+## Temetro Network (sibling repo/folder `~/Desktop/Temetro-network`)
+
+The **relay** that connects this backend to patient wallet apps. It is its **own git repo** on the
+Desktop (folder `~/Desktop/Temetro-network`, pushed to `github.com/temetro/temetro-network`), **not**
+in this monorepo — a standalone **Rust + Axum + socketioxide** service meant to run always-on (e.g.
+on **Railway**). It replaces the old flaky Cloudflare quick-tunnel that used to expose the backend's
+embedded `/wallet` Socket.io namespace to phones.
+
+It is a **dumb, stateless pipe**: two Socket.io namespaces — `/wallet` for devices
+(challenge/Ed25519-signature auth, room keyed by wallet number) and `/hub` for this backend
+(`RELAY_TOKEN`-authenticated). Devices and the backend both connect to it; it **forwards sealed
+ciphertext verbatim** and never opens bundles or touches a database. Its only crypto is verifying a
+device's auth signature (mirrors `backend/src/lib/wallet-crypto.ts`). The backend connects to it as a
+`/hub` client via `backend/src/services/relay-client.ts` (its `sendToWallet` is what `emitToWallet`
+now calls); configure with `RELAY_URL` + `RELAY_TOKEN`. Commit/push that service inside its own repo,
+separately from this one.
+
+> **Note:** in this sandbox the `~/Desktop/Temetro-network` folder blocks directory enumeration
+> (`ls`/`getcwd`/git inside it return EPERM) though plain file writes work. Develop/build/commit it
+> in an accessible copy and mirror the tree in with `tar`; drive git there via
+> `GIT_DIR`/`GIT_WORK_TREE` from an accessible cwd.
+
 ## Layout

 `frontend/` and `backend/` were previously separate per-folder git repos; they have been **merged
@@ -80,6 +103,11 @@ accurate (e.g. a new backend route needs an `content/docs/api/*.mdx` entry; a UI
 in the matching guide; status changes belong in the roadmap). Commit docs changes inside that
 repo, separately from this one.

+**Every release must also get a dated entry in the docs changelog**
+(`content/docs/changelog.mdx`, newest first) — not just the monorepo `CHANGELOG.md`. When you cut a
+version (see "Always release after pushing"), add a matching, user-facing section to that page in the
+same session so `../temetro/docs` never falls behind the shipped version.
+
 ## Running the stack

 From `backend/`: ensure a `.env` exists (`cp .env.example .env`, then set `BETTER_AUTH_SECRET` via
@@ -73,9 +73,11 @@ missing secrets on first start. Then open:
 Prefer to **build from source** (for development)? Use `docker compose up
 --build` instead. Migrations apply automatically on backend start.

-> **Port conflict?** If another Postgres holds host port `5432`, set
-> `POSTGRES_PORT` (e.g. `5433`) in `backend/.env`. The app still talks to
-> Postgres internally on `db:5432`; only the published host port changes.
+> **Port conflict?** If host ports `5432`, `4000` or `3000` are already in use,
+> set `POSTGRES_PORT`, `BACKEND_PORT` and/or `FRONTEND_PORT` (e.g. `5433` /
+> `4001` / `3001`) in `backend/.env`. The services still talk to each other on
+> their internal ports (`db:5432`, `backend:4000`); only the published host
+> ports change.

 ### Access from other computers (hospital LAN)

@@ -26,17 +26,25 @@ FRONTEND_URL=http://localhost:3000
 PORT=4000
 NODE_ENV=development

-# Host port Postgres is published on by docker compose. Change it if 5432 is
-# already in use on your machine (the app still talks to Postgres internally).
+# Host ports docker compose publishes. Change any that are already in use on
+# this machine (the services still talk to each other on their internal ports).
 POSTGRES_PORT=5432
+BACKEND_PORT=4000
+FRONTEND_PORT=3000

-# --- Patient wallet relay -------------------------------------------------
-# The URL baked into the QR a patient scans to import their record. Their phone
-# must be able to reach it — so localhost will NOT work from a real device. If
-# unset, the backend derives it from the request host (fine when you open the
-# web app over your LAN IP, e.g. http://192.168.1.20:3000). Otherwise set it
-# explicitly to a phone-reachable address: your machine's LAN IP or a public
-# tunnel URL.
+# --- Temetro Network relay ------------------------------------------------
+# The standalone relay (github.com/temetro/temetro-network) that connects this
+# backend to patient phones. Deploy it (e.g. on Railway) and point both this
+# backend and the wallet app at it. RELAY_URL is the relay's public URL (also
+# baked into the QR a patient scans). This clinic authenticates to the relay's
+# /hub with its own Ed25519 signing key, so no shared secret is needed.
+# RELAY_TOKEN is OPTIONAL/LEGACY — set it only for a private relay that also
+# gates on a shared token (then use the SAME value here and on the relay).
+RELAY_URL=http://localhost:8080
+RELAY_TOKEN=
+
+# (Legacy, pre-relay self-hosting.) A phone-reachable URL for the QR when NOT
+# using the Temetro Network relay. RELAY_URL takes precedence over this.
 # PUBLIC_RELAY_URL=http://192.168.1.20:4000

 # --- Email (optional) -----------------------------------------------------
@@ -60,6 +60,18 @@ No test runner is configured. Verify by running the stack (`docker compose up`)
 - **Real-time** lives in **`src/realtime.ts`** — a Socket.io server attached to the same HTTP server
  in `index.ts`; the handshake reuses Better Auth's `getSession`. Other modules push via
  `emitToUser` / `emitToConversation` (no direct socket import, so no circular deps).
+- **Patient-wallet relay** is **no longer hosted here.** Devices connect to the standalone **Temetro
+  Network** service (`~/Desktop/Temetro-network`, see root `CLAUDE.md`), which is **multi-clinic**.
+  This backend connects to it as a `/hub` client in **`src/services/relay-client.ts`**, keeping **one
+  authenticated connection per network-enabled org** (`hubs` map keyed by `orgId`). Each org
+  authenticates by signing the relay's `hub:challenge` with its clinic signing key
+  (`signWithClinicKey`) — no shared `RELAY_TOKEN` needed (it's now optional/legacy, only for a
+  private relay). `emitToWallet(orgId, …)` (realtime.ts) delegates to `sendToWallet(orgId, …)`, and
+  device responses (`wallet:share-response` / `wallet:update-response` / `wallet:revoke`) +
+  `wallet:online` replay are handled per-org there, calling the same `wallet-share` /
+  `wallet-updates` services the old `/wallet` namespace did. A clinic opts in via **"Join Temetro
+  Network"** (Settings → Signing → `PUT /api/signing/network`, `clinic_signing_keys.network_enabled`);
+  `connectOrg`/`disconnectOrg` open/close its connection, and wallet routes 409 when it's off.
 - **`src/lib/email.ts`** — `sendEmail` logs links to the console when SMTP is unset.

 ## Gotchas / conventions
@@ -25,6 +25,12 @@
 #
 # Optional DB browser (Adminer) lives behind a profile:
 #   docker compose --profile tools up adminer   # http://localhost:8080
+#
+# Host ports are configurable to avoid clashing with software already running on
+# this machine. Override any of them in a .env file (or inline), e.g.:
+#   POSTGRES_PORT=5433  BACKEND_PORT=4001  FRONTEND_PORT=3001  docker compose up -d
+# Only the published host port changes; the services still talk to each other on
+# their internal ports (db:5432, backend:4000).

 services:
  db:
@@ -62,6 +68,11 @@ services:
      BETTER_AUTH_URL: http://localhost:4000
      FRONTEND_URL: http://localhost:3000
      PORT: "4000"
+      # Temetro Network relay (github.com/temetro/temetro-network). Set RELAY_URL
+      # to your deployed relay's public URL and RELAY_TOKEN to the shared secret
+      # you configured on it — both are required for patient-wallet import.
+      RELAY_URL: ${RELAY_URL:-}
+      RELAY_TOKEN: ${RELAY_TOKEN:-}
      NODE_ENV: production
      # Uploaded patient/lab files live here, on the temetro_uploads volume.
      UPLOAD_DIR: /var/lib/temetro/uploads
@@ -76,7 +87,8 @@ services:
      # Persists uploaded files across restarts/rebuilds.
      - temetro_uploads:/var/lib/temetro/uploads
    ports:
-      - "4000:4000"
+      # Host port is configurable to avoid clashing with an existing service.
+      - "${BACKEND_PORT:-4000}:4000"

  frontend:
    image: khalidxv/temetro-frontend:${TEMETRO_VERSION:-latest}
@@ -90,7 +102,8 @@ services:
    depends_on:
      - backend
    ports:
-      - "3000:3000"
+      # Host port is configurable to avoid clashing with an existing service.
+      - "${FRONTEND_PORT:-3000}:3000"

  adminer:
    image: adminer:5
@@ -99,7 +112,7 @@ services:
    depends_on:
      - db
    ports:
-      - "8080:8080"
+      - "${ADMINER_PORT:-8080}:8080"

 volumes:
  temetro_pgdata:
@@ -0,0 +1,21 @@
+CREATE TABLE "wallet_record_updates" (
+	"id" uuid PRIMARY KEY DEFAULT gen_random_uuid() NOT NULL,
+	"organization_id" text NOT NULL,
+	"created_by" text NOT NULL,
+	"file_number" text NOT NULL,
+	"wallet_number" text NOT NULL,
+	"status" text DEFAULT 'pending' NOT NULL,
+	"payload_sealed" text NOT NULL,
+	"clinic_signature" text NOT NULL,
+	"clinic_public_key" text NOT NULL,
+	"clinic_fingerprint" text NOT NULL,
+	"changes" jsonb DEFAULT '[]'::jsonb NOT NULL,
+	"created_at" timestamp DEFAULT now() NOT NULL,
+	"delivered_at" timestamp,
+	"resolved_at" timestamp
+);
+--> statement-breakpoint
+ALTER TABLE "wallet_record_updates" ADD CONSTRAINT "wallet_record_updates_organization_id_organization_id_fk" FOREIGN KEY ("organization_id") REFERENCES "public"."organization"("id") ON DELETE cascade ON UPDATE no action;--> statement-breakpoint
+ALTER TABLE "wallet_record_updates" ADD CONSTRAINT "wallet_record_updates_created_by_user_id_fk" FOREIGN KEY ("created_by") REFERENCES "public"."user"("id") ON DELETE cascade ON UPDATE no action;--> statement-breakpoint
+CREATE INDEX "wallet_updates_org_idx" ON "wallet_record_updates" USING btree ("organization_id");--> statement-breakpoint
+CREATE INDEX "wallet_updates_wallet_idx" ON "wallet_record_updates" USING btree ("wallet_number");
@@ -0,0 +1,15 @@
+CREATE TABLE "fhir_api_keys" (
+	"id" uuid PRIMARY KEY DEFAULT gen_random_uuid() NOT NULL,
+	"organization_id" text NOT NULL,
+	"name" text NOT NULL,
+	"key_hash" text NOT NULL,
+	"created_by" text,
+	"created_at" timestamp DEFAULT now() NOT NULL,
+	"last_used_at" timestamp,
+	"revoked_at" timestamp,
+	CONSTRAINT "fhir_api_keys_key_hash_unique" UNIQUE("key_hash")
+);
+--> statement-breakpoint
+ALTER TABLE "fhir_api_keys" ADD CONSTRAINT "fhir_api_keys_organization_id_organization_id_fk" FOREIGN KEY ("organization_id") REFERENCES "public"."organization"("id") ON DELETE cascade ON UPDATE no action;--> statement-breakpoint
+ALTER TABLE "fhir_api_keys" ADD CONSTRAINT "fhir_api_keys_created_by_user_id_fk" FOREIGN KEY ("created_by") REFERENCES "public"."user"("id") ON DELETE set null ON UPDATE no action;--> statement-breakpoint
+CREATE INDEX "fhir_api_keys_org_idx" ON "fhir_api_keys" USING btree ("organization_id");
@@ -0,0 +1 @@
+ALTER TABLE "clinic_signing_keys" ADD COLUMN "network_enabled" boolean DEFAULT false NOT NULL;
@@ -211,6 +211,27 @@
      "when": 1782057030557,
      "tag": "0029_tiny_starhawk",
      "breakpoints": true
+    },
+    {
+      "idx": 30,
+      "version": "7",
+      "when": 1783093188246,
+      "tag": "0030_medical_blur",
+      "breakpoints": true
+    },
+    {
+      "idx": 31,
+      "version": "7",
+      "when": 1783117115021,
+      "tag": "0031_stiff_gateway",
+      "breakpoints": true
+    },
+    {
+      "idx": 32,
+      "version": "7",
+      "when": 1783263738631,
+      "tag": "0032_closed_dakota_north",
+      "breakpoints": true
    }
  ]
 }
@@ -1,12 +1,12 @@
 {
  "name": "temetro-backend",
-  "version": "0.1.0",
+  "version": "0.6.0",
  "lockfileVersion": 3,
  "requires": true,
  "packages": {
    "": {
      "name": "temetro-backend",
-      "version": "0.1.0",
+      "version": "0.6.0",
      "license": "MIT",
      "dependencies": {
        "@ai-sdk/anthropic": "^3.0.84",
@@ -28,6 +28,7 @@
        "nodemailer": "^8.0.10",
        "pg": "^8.21.0",
        "socket.io": "^4.8.3",
+        "socket.io-client": "^4.8.3",
        "zod": "^4.4.3"
      },
      "devDependencies": {
@@ -3339,6 +3340,40 @@
        "node": ">=10.2.0"
      }
    },
+    "node_modules/engine.io-client": {
+      "version": "6.6.6",
+      "resolved": "https://registry.npmjs.org/engine.io-client/-/engine.io-client-6.6.6.tgz",
+      "integrity": "sha512-iY6QdftLQ9pyiPoX082bpf/u1UewnOaJrtJIF9T0++QB34lZrj0uP+Q/bj8AlUsAxqhnkTV2BS8SBZSxOmoV5Q==",
+      "license": "MIT",
+      "dependencies": {
+        "@socket.io/component-emitter": "~3.1.0",
+        "debug": "~4.4.1",
+        "engine.io-parser": "~5.2.1",
+        "ws": "~8.21.0",
+        "xmlhttprequest-ssl": "~2.1.1"
+      }
+    },
+    "node_modules/engine.io-client/node_modules/ws": {
+      "version": "8.21.0",
+      "resolved": "https://registry.npmjs.org/ws/-/ws-8.21.0.tgz",
+      "integrity": "sha512-Vsp28b7DRcimFQvrqu2Wek3z1iYxDCWqHYB8Qsnk/S4RfaCQzPGPyBNuVjJV3cd6UiKtUtp6sNM77gWvzcCH+g==",
+      "license": "MIT",
+      "engines": {
+        "node": ">=10.0.0"
+      },
+      "peerDependencies": {
+        "bufferutil": "^4.0.1",
+        "utf-8-validate": ">=5.0.2"
+      },
+      "peerDependenciesMeta": {
+        "bufferutil": {
+          "optional": true
+        },
+        "utf-8-validate": {
+          "optional": true
+        }
+      }
+    },
    "node_modules/engine.io-parser": {
      "version": "5.2.3",
      "resolved": "https://registry.npmjs.org/engine.io-parser/-/engine.io-parser-5.2.3.tgz",
@@ -4947,6 +4982,21 @@
        "ws": "~8.20.1"
      }
    },
+    "node_modules/socket.io-client": {
+      "version": "4.8.3",
+      "resolved": "https://registry.npmjs.org/socket.io-client/-/socket.io-client-4.8.3.tgz",
+      "integrity": "sha512-uP0bpjWrjQmUt5DTHq9RuoCBdFJF10cdX9X+a368j/Ft0wmaVgxlrjvK3kjvgCODOMMOz9lcaRzxmso0bTWZ/g==",
+      "license": "MIT",
+      "dependencies": {
+        "@socket.io/component-emitter": "~3.1.0",
+        "debug": "~4.4.1",
+        "engine.io-client": "~6.6.1",
+        "socket.io-parser": "~4.2.4"
+      },
+      "engines": {
+        "node": ">=10.0.0"
+      }
+    },
    "node_modules/socket.io-parser": {
      "version": "4.2.6",
      "resolved": "https://registry.npmjs.org/socket.io-parser/-/socket.io-parser-4.2.6.tgz",
@@ -5779,6 +5829,14 @@
        "url": "https://github.com/sponsors/sindresorhus"
      }
    },
+    "node_modules/xmlhttprequest-ssl": {
+      "version": "2.1.2",
+      "resolved": "https://registry.npmjs.org/xmlhttprequest-ssl/-/xmlhttprequest-ssl-2.1.2.tgz",
+      "integrity": "sha512-TEU+nJVUUnA4CYJFLvK5X9AOeH4KvDvhIfm0vV1GaQRtchnG0hgK5p8hw/xjv8cunWYCsiPCSDzObPyhEwq3KQ==",
+      "engines": {
+        "node": ">=0.4.0"
+      }
+    },
    "node_modules/xtend": {
      "version": "4.0.2",
      "resolved": "https://registry.npmjs.org/xtend/-/xtend-4.0.2.tgz",
@@ -1,6 +1,6 @@
 {
  "name": "temetro-backend",
-  "version": "0.2.3",
+  "version": "0.8.1",
  "private": true,
  "type": "module",
  "description": "temetro backend — Express + Postgres API with Better Auth (email/password, organizations) and org-scoped patient records.",
@@ -41,6 +41,7 @@
    "nodemailer": "^8.0.10",
    "pg": "^8.21.0",
    "socket.io": "^4.8.3",
+    "socket.io-client": "^4.8.3",
    "zod": "^4.4.3"
  },
  "devDependencies": {
@@ -0,0 +1,30 @@
+import { index, pgTable, text, timestamp, uuid } from "drizzle-orm/pg-core";
+
+import { organization, user } from "./auth.js";
+
+// Per-organization API keys for the read-only FHIR R4 server (`/fhir`). These
+// are machine-to-machine credentials (no Better Auth session): a caller sends
+// `Authorization: Bearer tmf_<secret>` and every query is scoped to the owning
+// clinic. Only the SHA-256 *hash* of the secret is stored — the plaintext key is
+// shown once at creation and never again. Revoking sets `revokedAt` (kept for
+// audit rather than hard-deleted).
+export const fhirApiKeys = pgTable(
+  "fhir_api_keys",
+  {
+    id: uuid("id").primaryKey().defaultRandom(),
+    organizationId: text("organization_id")
+      .notNull()
+      .references(() => organization.id, { onDelete: "cascade" }),
+    name: text("name").notNull(),
+    // Hex SHA-256 of the full `tmf_…` secret. Unique so a lookup is a single
+    // indexed probe and two keys can never collide.
+    keyHash: text("key_hash").notNull().unique(),
+    createdBy: text("created_by").references(() => user.id, {
+      onDelete: "set null",
+    }),
+    createdAt: timestamp("created_at").defaultNow().notNull(),
+    lastUsedAt: timestamp("last_used_at"),
+    revokedAt: timestamp("revoked_at"),
+  },
+  (t) => [index("fhir_api_keys_org_idx").on(t.organizationId)],
+);
@@ -21,3 +21,5 @@ export * from "./staff-profile.js";
 export * from "./meetings.js";
 export * from "./signing.js";
 export * from "./wallet-share.js";
+export * from "./wallet-updates.js";
+export * from "./fhir-keys.js";
@@ -1,4 +1,4 @@
-import { pgTable, text, timestamp } from "drizzle-orm/pg-core";
+import { boolean, pgTable, text, timestamp } from "drizzle-orm/pg-core";

 import { organization } from "./auth.js";

@@ -16,6 +16,11 @@ export const clinicSigningKeys = pgTable("clinic_signing_keys", {
  fingerprint: text("fingerprint").notNull(),
  // Encrypted (lib/crypto.ts) hex of the Ed25519 private key.
  privateKeyEnc: text("private_key_enc").notNull(),
+  // Whether this clinic has joined the Temetro Network relay ("Join Temetro
+  // Network" in Settings → Signing). Off by default: only when enabled does the
+  // backend open this clinic's relay hub connection and expose wallet features.
+  // The relay identity *is* this signing key, so the flag lives on the same row.
+  networkEnabled: boolean("network_enabled").notNull().default(false),
  createdAt: timestamp("created_at").defaultNow().notNull(),
  rotatedAt: timestamp("rotated_at"),
 });
@@ -0,0 +1,53 @@
+import { index, jsonb, pgTable, text, timestamp, uuid } from "drizzle-orm/pg-core";
+
+import { organization, user } from "./auth.js";
+
+export type WalletUpdateStatus =
+  | "pending"
+  | "delivered"
+  | "approved"
+  | "denied";
+
+// One row per clinic→wallet record-update push. When a clinician edits a
+// wallet-linked patient they can push the updated record to the patient's app;
+// it lands here as `pending`, is sealed to the wallet's (X25519-from-Ed25519)
+// key and signed with the clinic's Ed25519 key. The relay delivers it live if
+// the device is connected, and again on the wallet's next authenticated connect
+// (so an offline phone still receives it). The patient reviews the change,
+// verifies the clinic signature, and approves/denies in-app — only then is the
+// on-device record replaced. The clinic polls `status` for delivery/approval.
+export const walletRecordUpdates = pgTable(
+  "wallet_record_updates",
+  {
+    id: uuid("id").primaryKey().defaultRandom(),
+    organizationId: text("organization_id")
+      .notNull()
+      .references(() => organization.id, { onDelete: "cascade" }),
+    createdBy: text("created_by")
+      .notNull()
+      .references(() => user.id, { onDelete: "cascade" }),
+    fileNumber: text("file_number").notNull(),
+    walletNumber: text("wallet_number").notNull(),
+    status: text("status")
+      .$type<WalletUpdateStatus>()
+      .notNull()
+      .default("pending"),
+    // base64 sealed box of the full updated patient snapshot (sealed to the
+    // wallet's derived X25519 key).
+    payloadSealed: text("payload_sealed").notNull(),
+    // The clinic's Ed25519 signature over the plaintext bundle bytes + its
+    // public key + fingerprint, so the wallet can verify provenance (TOFU pin).
+    clinicSignature: text("clinic_signature").notNull(),
+    clinicPublicKey: text("clinic_public_key").notNull(),
+    clinicFingerprint: text("clinic_fingerprint").notNull(),
+    // Human-readable summary of what changed (shown in the wallet inbox).
+    changes: jsonb("changes").$type<string[]>().notNull().default([]),
+    createdAt: timestamp("created_at").defaultNow().notNull(),
+    deliveredAt: timestamp("delivered_at"),
+    resolvedAt: timestamp("resolved_at"),
+  },
+  (t) => [
+    index("wallet_updates_org_idx").on(t.organizationId),
+    index("wallet_updates_wallet_idx").on(t.walletNumber),
+  ],
+);
@@ -28,6 +28,15 @@ const schema = z.object({
  // Overrides the version reported by GET /api/version. Normally derived from
  // package.json; the release pipeline can pin it explicitly.
  APP_VERSION: z.string().optional(),
+  // Temetro Network relay (github.com/temetro/temetro-network). Both this
+  // backend and patient phones connect to it; it routes the encrypted wallet
+  // messages between them. RELAY_URL is the relay's public URL (also baked into
+  // the QR a patient scans). Each clinic authenticates to the relay's /hub with
+  // its own Ed25519 signing key, so no shared secret is needed. RELAY_TOKEN is
+  // now *optional/legacy* — set it only for a private relay that also gates on a
+  // shared token (must then match the relay's RELAY_TOKEN).
+  RELAY_URL: z.string().min(1).default("http://localhost:8080"),
+  RELAY_TOKEN: z.string().default(""),
  // Public, device-reachable URL of this backend's wallet relay, baked into the
  // QR a patient scans. Optional — when unset we derive it from the request host
  // (so opening the web app over the LAN yields a reachable LAN URL).
@@ -80,6 +89,9 @@ if (env.NODE_ENV === "production") {
    );
    process.exit(1);
  }
+  // RELAY_TOKEN is optional now: clinics authenticate to the relay with their
+  // own Ed25519 signing key, so an unset token is the normal "open relay" case —
+  // no warning needed.
 }

 export const isProd = env.NODE_ENV === "production";
@@ -18,6 +18,7 @@ import { appointmentsRouter } from "./routes/appointments.js";
 import { chatRouter } from "./routes/chat.js";
 import { conversationsRouter } from "./routes/conversations.js";
 import { dispensesRouter } from "./routes/dispenses.js";
+import { fhirRouter } from "./routes/fhir.js";
 import { integrationsRouter } from "./routes/integrations.js";
 import { inventoryRouter } from "./routes/inventory.js";
 import { invoicesRouter } from "./routes/invoices.js";
@@ -28,12 +29,14 @@ import { patientsRouter } from "./routes/patients.js";
 import { patientsWalletRouter } from "./routes/patients-wallet.js";
 import { portalRouter } from "./routes/portal.js";
 import { prescriptionsRouter } from "./routes/prescriptions.js";
+import { scribeRouter } from "./routes/scribe.js";
 import { settingsRouter } from "./routes/settings.js";
 import { signingRouter } from "./routes/signing.js";
 import { staffRouter } from "./routes/staff.js";
 import { networkRouter } from "./routes/network.js";
 import { tasksRouter } from "./routes/tasks.js";
 import { versionRouter } from "./routes/version.js";
+import { initRelayClient } from "./services/relay-client.js";
 import { beginQuickTunnelDiscovery } from "./services/relay-url.js";
 import { sweepExpiredShares } from "./services/wallet-share.js";

@@ -104,10 +107,16 @@ app.use("/api/notifications", notificationsRouter);
 app.use("/api/settings", settingsRouter);
 app.use("/api/ai", aiRouter);
 app.use("/api/chat", chatRouter);
+app.use("/api/scribe", scribeRouter);
 app.use("/api/integrations", integrationsRouter);
 app.use("/api/portal", portalRouter);
 app.use("/api/auth-helpers", authHelpersRouter);

+// Read-only FHIR R4 server, mounted OUTSIDE /api. Bearer-only (per-clinic API
+// keys), no Better Auth session/cookie coupling. Errors are FHIR
+// OperationOutcomes, not our standard error JSON.
+app.use("/fhir", fhirRouter);
+
 app.use(notFound);
 app.use(errorHandler);

@@ -115,6 +124,11 @@ app.use(errorHandler);
 const server = createServer(app);
 initRealtime(server);

+// Connect to the Temetro Network relay (the device-facing hub). Patient phones
+// no longer connect to this backend directly — they connect to the relay, and
+// we push to / receive from them over its /hub namespace.
+initRelayClient();
+
 // Sweep expired temporary patient-wallet shares (auto-delete) every 5 minutes.
 const SHARE_SWEEP_INTERVAL = 5 * 60 * 1000;
 setInterval(() => {
@@ -144,8 +158,9 @@ server.listen(env.PORT, () => {
  console.log(`  • chat:     /api/chat  (LLM agent)`);
  console.log(`  • integr.:  /api/integrations  (FHIR / e-Rx / claims)`);
  console.log(`  • portal:   /api/portal  (public clinic kiosk)`);
+  console.log(`  • fhir:     /fhir  (read-only FHIR R4 server, API-key auth)`);
  console.log(`  • signing:  /api/signing  (Ed25519 clinic key)`);
-  console.log(`  • wallet:   /api/patients/wallet  (+ /wallet socket relay)`);
+  console.log(`  • wallet:   /api/patients/wallet  (via Temetro Network relay: ${env.RELAY_URL})`);
 });

 // Dockerized off-network testing: learn our public Cloudflare quick-tunnel URL
@@ -0,0 +1,49 @@
+import { bytesToHex } from "@noble/hashes/utils.js";
+
+// Convert an Ed25519 public key to the matching X25519 (Montgomery) public key,
+// so the clinic can `seal()` a record update to a wallet that only publishes an
+// Ed25519 identity (its wallet number). The patient wallet derives the matching
+// X25519 *private* key from its Ed25519 seed (SHA-512 clamp) to `open()` it —
+// this file MUST stay byte-for-byte compatible with the wallet app's
+// src/lib/crypto.ts. @noble/curves does not export edwardsToMontgomery in the
+// pinned version, so the birational map u = (1 + y) / (1 - y) mod p is done here
+// with BigInt. Verified: edPubToMontU(A) === x25519.getPublicKey(edClamp(seed)).
+
+const P = 2n ** 255n - 19n;
+
+function modpow(base: bigint, exp: bigint, mod: bigint): bigint {
+  let result = 1n;
+  let b = base % mod;
+  let e = exp;
+  while (e > 0n) {
+    if (e & 1n) result = (result * b) % mod;
+    b = (b * b) % mod;
+    e >>= 1n;
+  }
+  return result;
+}
+
+// Modular inverse via Fermat's little theorem (p is prime).
+function inv(a: bigint): bigint {
+  return modpow(((a % P) + P) % P, P - 2n, P);
+}
+
+// Ed25519 public key (compressed, little-endian y with the x-sign in the high
+// bit) → X25519 u-coordinate, returned as 32-byte little-endian hex.
+export function ed25519PubToX25519Hex(edPub: Uint8Array): string {
+  if (edPub.length !== 32) throw new Error("Ed25519 public key must be 32 bytes.");
+  const bytes = edPub.slice();
+  bytes[31] = (bytes[31] as number) & 0x7f; // clear the x sign bit
+  let y = 0n;
+  for (let i = 31; i >= 0; i--) y = (y << 8n) | BigInt(bytes[i] as number);
+  y %= P;
+  // u = (1 + y) / (1 - y)  (mod p)
+  const u = ((1n + y) * inv((1n - y + P) % P)) % P;
+  const out = new Uint8Array(32);
+  let v = u;
+  for (let i = 0; i < 32; i++) {
+    out[i] = Number(v & 0xffn);
+    v >>= 8n;
+  }
+  return bytesToHex(out);
+}
@@ -0,0 +1,49 @@
+import type { NextFunction, Request, Response } from "express";
+
+import { resolveKey } from "../services/fhir-server/keys.js";
+import {
+  FHIR_CONTENT_TYPE,
+  operationOutcome,
+} from "../services/fhir-server/outcome.js";
+
+// Bearer-token auth for the read-only FHIR server. Unlike the rest of the API
+// (Better Auth session cookies), the `/fhir` endpoints authenticate with a
+// per-clinic API key: `Authorization: Bearer tmf_<secret>`. On success the
+// caller's organization is attached to `req.organizationId` and every downstream
+// query is scoped to it. Failures return a FHIR OperationOutcome, not our
+// standard error JSON.
+export async function requireFhirKey(
+  req: Request,
+  res: Response,
+  next: NextFunction,
+): Promise<void> {
+  const header = req.headers.authorization ?? "";
+  const match = /^Bearer\s+(.+)$/i.exec(header.trim());
+  const secret = match?.[1]?.trim();
+
+  const unauthorized = (diagnostics: string) => {
+    res
+      .status(401)
+      .type(FHIR_CONTENT_TYPE)
+      .set("WWW-Authenticate", "Bearer")
+      .json(operationOutcome("error", "login", diagnostics));
+  };
+
+  if (!secret) {
+    unauthorized("Missing bearer token. Send Authorization: Bearer tmf_…");
+    return;
+  }
+
+  try {
+    const resolved = await resolveKey(secret);
+    if (!resolved) {
+      unauthorized("Invalid or revoked API key.");
+      return;
+    }
+    req.organizationId = resolved.orgId;
+    req.fhirKey = { id: resolved.keyId, name: resolved.keyName };
+    next();
+  } catch (err) {
+    next(err);
+  }
+}
@@ -1,16 +1,14 @@
 import type { Server as HttpServer } from "node:http";

 import { fromNodeHeaders } from "better-auth/node";
-import { bytesToHex, randomBytes, utf8ToBytes } from "@noble/hashes/utils.js";
 import { Server, type Socket } from "socket.io";

 import { auth } from "./auth.js";
 import { env } from "./env.js";
-import { decodeWalletNumber, verifySignature } from "./lib/wallet-crypto.js";
 import * as meetings from "./services/meetings.js";
 import * as messaging from "./services/messaging.js";
 import { createNotification } from "./services/notifications.js";
-import * as walletShare from "./services/wallet-share.js";
+import { sendToWallet } from "./services/relay-client.js";
 import type { MessageAttachment } from "./types/messaging.js";

 let io: Server | null = null;
@@ -19,7 +17,6 @@ const userRoom = (userId: string) => `user:${userId}`;
 const convRoom = (conversationId: string) => `conv:${conversationId}`;
 const callRoom = (roomId: string) => `call:${roomId}`;
 const orgRoom = (orgId: string) => `org:${orgId}`;
-const walletRoom = (walletNumber: string) => `wallet:${walletNumber}`;

 // Mesh WebRTC tops out around four peers (each sends its stream to every other);
 // past that the room is closed to new joiners.
@@ -43,15 +40,18 @@ export function emitToConversation(
  io?.to(convRoom(conversationId)).emit(event, data);
 }

-// Relay an end-to-end-encrypted message to a patient wallet device (the /wallet
-// namespace, room keyed by wallet number). The relay only ever forwards
-// ciphertext — it cannot read the record bundle.
+// Relay an end-to-end-encrypted message to a patient wallet device. Devices no
+// longer connect to this server directly — they connect to the standalone
+// Temetro Network relay, which forwards to the room keyed by wallet number. We
+// push over the relay's /hub namespace (see services/relay-client.ts). The
+// relay only ever forwards ciphertext — it cannot read the record bundle.
 export function emitToWallet(
+  orgId: string,
  walletNumber: string,
  event: string,
  data: unknown,
 ): void {
-  io?.of("/wallet").to(walletRoom(walletNumber)).emit(event, data);
+  sendToWallet(orgId, walletNumber, event, data);
 }

 type Ack = (response: { ok: boolean; [key: string]: unknown }) => void;
@@ -285,106 +285,5 @@ export function initRealtime(httpServer: HttpServer): Server {
    });
  });

-  // --- Patient wallet relay (/wallet namespace) ----------------------------
-  // Devices have no clinic session, so this namespace is NOT cookie-gated.
-  // Instead a device proves control of its wallet keypair: the server issues a
-  // random challenge, the device signs it with its Ed25519 key, and only then
-  // may it join its own wallet room. The relay forwards encrypted share
-  // requests/responses without ever reading the record bundle.
-  const walletNs = io.of("/wallet");
-  walletNs.on("connection", (socket: Socket) => {
-    const challenge = bytesToHex(randomBytes(32));
-    socket.data.challenge = challenge;
-    socket.data.walletNumber = null as string | null;
-    socket.emit("wallet:challenge", { challenge });
-
-    socket.on(
-      "wallet:auth",
-      (payload: { walletNumber?: string; signature?: string }, ack?: Ack) => {
-        try {
-          const walletNumber = String(payload?.walletNumber ?? "");
-          const signature = String(payload?.signature ?? "");
-          const publicKey = decodeWalletNumber(walletNumber);
-          const ok = verifySignature(
-            publicKey,
-            signature,
-            utf8ToBytes(socket.data.challenge as string),
-          );
-          if (!ok) {
-            ack?.({ ok: false });
-            return;
-          }
-          socket.data.walletNumber = walletNumber;
-          socket.join(walletRoom(walletNumber));
-          ack?.({ ok: true });
-        } catch {
-          ack?.({ ok: false });
-        }
-      },
-    );
-
-    // The patient approved/denied a share on their device; the sealed bundle (if
-    // approved) rides along and is decrypted + verified server-side.
-    socket.on(
-      "wallet:share-response",
-      async (
-        payload: {
-          requestId?: string;
-          walletNumber?: string;
-          decision?: "approved" | "denied";
-          sealed?: string;
-          signature?: string;
-        },
-        ack?: Ack,
-      ) => {
-        try {
-          if (
-            !socket.data.walletNumber ||
-            socket.data.walletNumber !== payload?.walletNumber
-          ) {
-            ack?.({ ok: false });
-            return;
-          }
-          const view = await walletShare.applyShareResponse(
-            String(payload?.requestId ?? ""),
-            String(payload?.walletNumber ?? ""),
-            payload?.decision === "approved" ? "approved" : "denied",
-            payload?.sealed,
-            payload?.signature,
-          );
-          ack?.({ ok: !!view });
-        } catch (err) {
-          ack?.({ ok: false, error: (err as Error).message });
-        }
-      },
-    );
-
-    // The patient revoked a previously shared record; delete it from the clinic.
-    socket.on(
-      "wallet:revoke",
-      async (
-        payload: { requestId?: string; walletNumber?: string },
-        ack?: Ack,
-      ) => {
-        try {
-          if (
-            !socket.data.walletNumber ||
-            socket.data.walletNumber !== payload?.walletNumber
-          ) {
-            ack?.({ ok: false });
-            return;
-          }
-          const result = await walletShare.revokeShare(
-            String(payload?.requestId ?? ""),
-            String(payload?.walletNumber ?? ""),
-          );
-          ack?.({ ok: !!result });
-        } catch {
-          ack?.({ ok: false });
-        }
-      },
-    );
-  });
-
  return io;
 }
@@ -41,6 +41,14 @@ const ALLOWED_MIME = new Set([
  "application/vnd.openxmlformats-officedocument.wordprocessingml.document",
  "application/vnd.ms-excel",
  "application/vnd.openxmlformats-officedocument.spreadsheetml.sheet",
+  // Ambient visit-scribe recordings (stored as a patient attachment so they're
+  // auditable). Voice Opus/AAC stays well under the 15 MB cap for a long visit.
+  "audio/webm",
+  "audio/ogg",
+  "audio/mp4",
+  "audio/mpeg",
+  "audio/wav",
+  "audio/x-m4a",
 ]);

 // Disk storage under UPLOAD_DIR/<orgId>/, keyed by a random id so original
@@ -0,0 +1,275 @@
+import { createRequire } from "node:module";
+
+import { Router } from "express";
+import type { Request, Response } from "express";
+import type { ParsedQs } from "qs";
+
+import { env } from "../env.js";
+import { requireFhirKey } from "../middleware/fhir-auth.js";
+import { recordActivity } from "../services/activity.js";
+import {
+  paginate,
+  parseCount,
+  parseOffset,
+  searchsetBundle,
+} from "../services/fhir-server/bundle.js";
+import { capabilityStatement } from "../services/fhir-server/capability.js";
+import {
+  FHIR_CONTENT_TYPE,
+  operationOutcome,
+  type IssueCode,
+  type IssueSeverity,
+} from "../services/fhir-server/outcome.js";
+import * as q from "../services/fhir-server/queries.js";
+import {
+  allergyResource,
+  appointmentResource,
+  conditionResource,
+  encounterResource,
+  labObservation,
+  medicationRequestResource,
+  patientResource,
+  vitalObservations,
+  type FhirResource,
+} from "../services/fhir-server/resources.js";
+
+const require = createRequire(import.meta.url);
+const pkg = require("../../package.json") as { version?: string };
+const VERSION = env.APP_VERSION ?? pkg.version ?? "0.0.0";
+
+export const fhirRouter = Router();
+
+// --- helpers ----------------------------------------------------------------
+
+function baseUrl(req: Request): string {
+  return `${req.protocol}://${req.get("host")}/fhir`;
+}
+
+function sendResource(res: Response, resource: unknown): void {
+  res.type(FHIR_CONTENT_TYPE).json(resource);
+}
+
+function sendOutcome(
+  res: Response,
+  status: number,
+  severity: IssueSeverity,
+  code: IssueCode,
+  diagnostics: string,
+): void {
+  res
+    .status(status)
+    .type(FHIR_CONTENT_TYPE)
+    .json(operationOutcome(severity, code, diagnostics));
+}
+
+function qstr(v: string | ParsedQs | (string | ParsedQs)[] | undefined): string | undefined {
+  if (typeof v === "string") return v.trim() || undefined;
+  if (Array.isArray(v) && typeof v[0] === "string") return v[0].trim() || undefined;
+  return undefined;
+}
+
+// Best-effort audit: every FHIR request is logged with the key name + result
+// count, scoped to the org. Access to PHI over the API must leave a trail.
+function audit(req: Request, resourceType: string, count: number): void {
+  void recordActivity({
+    orgId: req.organizationId!,
+    actor: { name: `FHIR API · ${req.fhirKey?.name ?? "key"}` },
+    action: `Read ${resourceType} via the FHIR API (${count} result${count === 1 ? "" : "s"})`,
+    entityType: "patient",
+  });
+}
+
+// Materialize a page from a full resource array + emit a searchset Bundle.
+function respondSearch(
+  req: Request,
+  res: Response,
+  resourceType: string,
+  all: FhirResource[],
+): void {
+  const count = parseCount(qstr(req.query._count as never));
+  const offset = parseOffset(qstr(req.query._offset as never));
+  const { page, total } = paginate(all, count, offset);
+  const params = new URLSearchParams();
+  for (const [k, v] of Object.entries(req.query)) {
+    if (k === "_count" || k === "_offset") continue;
+    const s = qstr(v as never);
+    if (s !== undefined) params.set(k, s);
+  }
+  audit(req, resourceType, total);
+  sendResource(
+    res,
+    searchsetBundle({ baseUrl: baseUrl(req), resourceType, page, total, count, offset, params }),
+  );
+}
+
+// Resolve the `patient` / `patient.identifier` search parameter to a patient row
+// (org-scoped). Returns undefined when the param is absent or matches nobody.
+async function patientFromQuery(req: Request) {
+  const patientId = qstr(req.query.patient as never);
+  const identifier = qstr(req.query["patient.identifier"] as never);
+  if (!patientId && !identifier) return undefined;
+  return q.resolvePatientRef(req.organizationId!, { patientId, identifier });
+}
+
+// --- CapabilityStatement (unauthenticated, per FHIR convention) -------------
+
+fhirRouter.get("/metadata", (req, res) => {
+  sendResource(res, capabilityStatement(baseUrl(req), VERSION));
+});
+
+// Everything below requires a valid per-clinic API key.
+fhirRouter.use(requireFhirKey);
+
+// --- Patient ----------------------------------------------------------------
+
+fhirRouter.get("/Patient", async (req, res, next) => {
+  try {
+    const count = parseCount(qstr(req.query._count as never));
+    const offset = parseOffset(qstr(req.query._offset as never));
+    const { rows, total } = await q.searchPatients(req.organizationId!, {
+      identifier: qstr(req.query.identifier as never),
+      name: qstr(req.query.name as never),
+      limit: count,
+      offset,
+    });
+    const params = new URLSearchParams();
+    if (qstr(req.query.identifier as never))
+      params.set("identifier", qstr(req.query.identifier as never)!);
+    if (qstr(req.query.name as never)) params.set("name", qstr(req.query.name as never)!);
+    audit(req, "Patient", total);
+    sendResource(
+      res,
+      searchsetBundle({
+        baseUrl: baseUrl(req),
+        resourceType: "Patient",
+        page: rows.map(patientResource),
+        total,
+        count,
+        offset,
+        params,
+      }),
+    );
+  } catch (err) {
+    next(err);
+  }
+});
+
+fhirRouter.get("/Patient/:id", async (req, res, next) => {
+  try {
+    const row = await q.patientById(req.organizationId!, String(req.params.id));
+    if (!row) {
+      sendOutcome(res, 404, "error", "not-found", "Patient not found.");
+      return;
+    }
+    audit(req, "Patient", 1);
+    sendResource(res, patientResource(row));
+  } catch (err) {
+    next(err);
+  }
+});
+
+// --- Observation (labs + vitals) --------------------------------------------
+
+fhirRouter.get("/Observation", async (req, res, next) => {
+  try {
+    const patient = await patientFromQuery(req);
+    if (!patient) {
+      respondSearch(req, res, "Observation", []);
+      return;
+    }
+    const category = qstr(req.query.category as never);
+    const all: FhirResource[] = [];
+    if (category !== "vital-signs") {
+      const rows = await q.labsForPatient(patient.id);
+      all.push(...rows.map((r) => labObservation(r, patient)));
+    }
+    if (category !== "laboratory") {
+      all.push(...vitalObservations(patient));
+    }
+    respondSearch(req, res, "Observation", all);
+  } catch (err) {
+    next(err);
+  }
+});
+
+// --- AllergyIntolerance -----------------------------------------------------
+
+fhirRouter.get("/AllergyIntolerance", async (req, res, next) => {
+  try {
+    const patient = await patientFromQuery(req);
+    if (!patient) return respondSearch(req, res, "AllergyIntolerance", []);
+    const rows = await q.allergiesForPatient(patient.id);
+    respondSearch(req, res, "AllergyIntolerance", rows.map((r) => allergyResource(r, patient)));
+  } catch (err) {
+    next(err);
+  }
+});
+
+// --- Condition --------------------------------------------------------------
+
+fhirRouter.get("/Condition", async (req, res, next) => {
+  try {
+    const patient = await patientFromQuery(req);
+    if (!patient) return respondSearch(req, res, "Condition", []);
+    const rows = await q.problemsForPatient(patient.id);
+    respondSearch(req, res, "Condition", rows.map((r) => conditionResource(r, patient)));
+  } catch (err) {
+    next(err);
+  }
+});
+
+// --- MedicationRequest ------------------------------------------------------
+
+fhirRouter.get("/MedicationRequest", async (req, res, next) => {
+  try {
+    const patient = await patientFromQuery(req);
+    if (!patient) return respondSearch(req, res, "MedicationRequest", []);
+    const rows = await q.prescriptionsForFile(req.organizationId!, patient.fileNumber);
+    respondSearch(
+      req,
+      res,
+      "MedicationRequest",
+      rows.map((r) => medicationRequestResource(r, patient)),
+    );
+  } catch (err) {
+    next(err);
+  }
+});
+
+// --- Encounter --------------------------------------------------------------
+
+fhirRouter.get("/Encounter", async (req, res, next) => {
+  try {
+    const patient = await patientFromQuery(req);
+    if (!patient) return respondSearch(req, res, "Encounter", []);
+    const rows = await q.encountersForPatient(patient.id);
+    respondSearch(req, res, "Encounter", rows.map((r) => encounterResource(r, patient)));
+  } catch (err) {
+    next(err);
+  }
+});
+
+// --- Appointment ------------------------------------------------------------
+
+fhirRouter.get("/Appointment", async (req, res, next) => {
+  try {
+    const patient = await patientFromQuery(req);
+    if (!patient) return respondSearch(req, res, "Appointment", []);
+    const rows = await q.appointmentsForFile(req.organizationId!, patient.fileNumber);
+    respondSearch(req, res, "Appointment", rows.map((r) => appointmentResource(r, patient)));
+  } catch (err) {
+    next(err);
+  }
+});
+
+// --- Unknown resource / path -> OperationOutcome ----------------------------
+
+fhirRouter.use((req, res) => {
+  sendOutcome(
+    res,
+    404,
+    "error",
+    "not-supported",
+    `Unsupported FHIR path or resource: ${req.method} ${req.path}.`,
+  );
+});
@@ -18,6 +18,7 @@ import {
  listConfigs,
  saveConfig,
 } from "../services/integrations/config.js";
+import { createKey, listKeys, revokeKey } from "../services/fhir-server/keys.js";
 import * as eprescribe from "../services/integrations/eprescribe.js";
 import * as fhir from "../services/integrations/fhir.js";

@@ -119,6 +120,75 @@ integrationsRouter.post(
  },
 );

+// --- FHIR server API keys (owner/admin only) --------------------------------
+// These credential the read-only /fhir server. The plaintext secret is returned
+// exactly once (on creation) and only its hash is stored.
+
+integrationsRouter.get(
+  "/fhir-server/keys",
+  requireAuth,
+  requireOrg,
+  async (req, res, next) => {
+    try {
+      assertAdmin(req.memberRole);
+      res.json(await listKeys(req.organizationId!));
+    } catch (err) {
+      next(err);
+    }
+  },
+);
+
+const createKeySchema = z.object({ name: z.string().trim().min(1).max(120) });
+
+integrationsRouter.post(
+  "/fhir-server/keys",
+  requireAuth,
+  requireOrg,
+  async (req, res, next) => {
+    try {
+      assertAdmin(req.memberRole);
+      const { name } = createKeySchema.parse(req.body);
+      const { secret, key } = await createKey(
+        req.organizationId!,
+        name,
+        req.user!.id,
+      );
+      void recordActivity({
+        orgId: req.organizationId!,
+        actor: { id: req.user!.id, name: req.user!.name },
+        action: `Created a FHIR API key ("${key.name}")`,
+        entityType: "settings",
+      });
+      // `secret` is present only in this response — the client must show it now.
+      res.status(201).json({ ...key, secret });
+    } catch (err) {
+      next(err);
+    }
+  },
+);
+
+integrationsRouter.delete(
+  "/fhir-server/keys/:id",
+  requireAuth,
+  requireOrg,
+  async (req, res, next) => {
+    try {
+      assertAdmin(req.memberRole);
+      const revoked = await revokeKey(req.organizationId!, String(req.params.id));
+      if (!revoked) throw new HttpError(404, "API key not found.");
+      void recordActivity({
+        orgId: req.organizationId!,
+        actor: { id: req.user!.id, name: req.user!.name },
+        action: "Revoked a FHIR API key",
+        entityType: "settings",
+      });
+      res.json({ revoked: true });
+    } catch (err) {
+      next(err);
+    }
+  },
+);
+
 // --- Actions ----------------------------------------------------------------

 const syncSchema = z.object({ fileNumber: z.string().trim().min(1) });
@@ -17,18 +17,36 @@ import {
 } from "../middleware/auth.js";
 import { emitToWallet } from "../realtime.js";
 import { recordActivity } from "../services/activity.js";
+import { expectResponse } from "../services/relay-client.js";
 import * as patientService from "../services/patients.js";
 import { awaitQuickTunnelUrl } from "../services/relay-url.js";
+import { getNetworkEnabled } from "../services/signing.js";
 import * as walletShare from "../services/wallet-share.js";
+import * as walletUpdates from "../services/wallet-updates.js";

 export const patientsWalletRouter = Router();

 patientsWalletRouter.use(requireAuth, requireOrg);

+// Wallet sharing rides the Temetro Network relay, which a clinic must opt into
+// ("Join Temetro Network" in Settings → Signing). Guard the actions that need a
+// live relay connection so a disabled clinic gets a clear message, not silence.
+async function requireNetwork(orgId: string): Promise<void> {
+  if (!(await getNetworkEnabled(orgId))) {
+    throw new HttpError(
+      409,
+      "This clinic hasn't joined the Temetro Network. Enable it in Settings → Signing to share with patient wallets.",
+    );
+  }
+}
+
 // The device-reachable URL the patient's app should connect to (baked into the
-// QR). Prefer an explicit PUBLIC_RELAY_URL; otherwise derive it from the request
-// host so that opening the web app over the LAN yields a reachable LAN URL.
+// QR). Devices connect to the standalone Temetro Network relay — the same relay
+// this backend is hubbed to — so RELAY_URL is the canonical answer. The legacy
+// PUBLIC_RELAY_URL / cloudflared / request-host fallbacks remain for pre-relay
+// self-hosting.
 async function resolveRelayUrl(req: Request): Promise<string> {
+  if (env.RELAY_URL) return env.RELAY_URL;
  if (env.PUBLIC_RELAY_URL) return env.PUBLIC_RELAY_URL;
  // A cloudflared quick tunnel (`npm run docker:tunnel`). Wait briefly for it to
  // become reachable so the QR never carries a not-yet-live URL.
@@ -67,6 +85,7 @@ patientsWalletRouter.post(
  requirePermission({ patient: ["write"] }),
  async (req, res, next) => {
    try {
+      await requireNetwork(req.organizationId!);
      const input = pairSchema.parse(req.body);
      const { view, ephemeralPubKey } = await walletShare.createPairingRequest(
        req.organizationId!,
@@ -74,6 +93,9 @@ patientsWalletRouter.post(
        input.mode,
        input.durationHours,
      );
+      // No wallet number to `wallet:send` to yet, so pre-register the request id
+      // with the relay so the scanning device's response routes back to us.
+      expectResponse(req.organizationId!, view.id);
      res.status(201).json({
        ...view,
        ephemeralPubKey,
@@ -93,6 +115,7 @@ patientsWalletRouter.post(
  requirePermission({ patient: ["write"] }),
  async (req, res, next) => {
    try {
+      await requireNetwork(req.organizationId!);
      const input = requestSchema.parse(req.body);
      const { view, ephemeralPubKey } = await walletShare.createShareRequest(
        req.organizationId!,
@@ -105,7 +128,7 @@ patientsWalletRouter.post(
        .select({ name: organization.name })
        .from(organization)
        .where(eq(organization.id, req.organizationId!));
-      emitToWallet(input.walletNumber, "wallet:share-request", {
+      emitToWallet(req.organizationId!, input.walletNumber, "wallet:share-request", {
        requestId: view.id,
        clinicName: org?.name ?? "A clinic",
        requestedBy: req.user!.name,
@@ -138,6 +161,95 @@ patientsWalletRouter.get(
  },
 );

+// --- Clinic → wallet record-update push ------------------------------------
+
+// Whether a patient is linked to a wallet (drives the "Push update" button).
+// Returns the wallet number when linked, 404 otherwise.
+patientsWalletRouter.get(
+  "/link/:fileNumber",
+  requirePermission({ patient: ["read"] }),
+  async (req, res, next) => {
+    try {
+      const walletNumber = await walletUpdates.walletNumberForPatient(
+        req.organizationId!,
+        req.params.fileNumber as string,
+      );
+      if (!walletNumber) throw new HttpError(404, "Not wallet-linked.");
+      res.json({ walletNumber });
+    } catch (err) {
+      next(err);
+    }
+  },
+);
+
+const pushSchema = z.object({
+  fileNumber: z.string().trim().min(1),
+  changes: z.array(z.string().trim().min(1)).min(1).max(50),
+});
+
+// Push the current record snapshot to the linked wallet. Seals + signs it,
+// stores it pending, and delivers live if the device is connected (it is also
+// re-sent on the wallet's next connect). The patient must approve in-app.
+patientsWalletRouter.post(
+  "/push",
+  requirePermission({ patient: ["write"] }),
+  async (req, res, next) => {
+    try {
+      await requireNetwork(req.organizationId!);
+      const input = pushSchema.parse(req.body);
+      const row = await walletUpdates.createRecordUpdate(
+        req.organizationId!,
+        req.user!.id,
+        input.fileNumber,
+        input.changes,
+      );
+      const event = await walletUpdates.toEvent(row);
+      emitToWallet(req.organizationId!, row.walletNumber, "wallet:update-request", event);
+      await recordActivity({
+        orgId: req.organizationId!,
+        actor: { id: req.user!.id, name: req.user!.name },
+        action: `Pushed a record update to a patient wallet (#${row.fileNumber})`,
+        entityType: "patient",
+        entityId: row.fileNumber,
+        patientFileNumber: row.fileNumber,
+      });
+      res.status(201).json(walletUpdates.viewOf(row));
+    } catch (err) {
+      next(err);
+    }
+  },
+);
+
+// The clinic's recent update pushes (Signing panel + status polling).
+patientsWalletRouter.get(
+  "/updates",
+  requirePermission({ patient: ["read"] }),
+  async (req, res, next) => {
+    try {
+      res.json(await walletUpdates.listUpdates(req.organizationId!));
+    } catch (err) {
+      next(err);
+    }
+  },
+);
+
+patientsWalletRouter.get(
+  "/updates/:id",
+  requirePermission({ patient: ["read"] }),
+  async (req, res, next) => {
+    try {
+      const view = await walletUpdates.getUpdate(
+        req.organizationId!,
+        req.params.id as string,
+      );
+      if (!view) throw new HttpError(404, "Update not found.");
+      res.json(view);
+    } catch (err) {
+      next(err);
+    }
+  },
+);
+
 // Commit the (possibly clinician-edited) draft into a real patient record. The
 // temporary-share metadata (origin + auto-delete deadline) is taken from the
 // request server-side, so the clinic can't quietly keep a temporary record.
@@ -0,0 +1,240 @@
+import { readFile } from "node:fs/promises";
+
+import { generateText } from "ai";
+import { Router } from "express";
+import { z } from "zod";
+
+import { HttpError } from "../lib/http-error.js";
+import { isReceptionOnly, providerScope } from "../lib/role-scope.js";
+import {
+  requireAuth,
+  requireOrg,
+  requirePermission,
+} from "../middleware/auth.js";
+import { recordActivity } from "../services/activity.js";
+import { getAiSettings } from "../services/ai/config.js";
+import { aiAllowedFor, getPolicy } from "../services/ai/policy.js";
+import { resolveModel } from "../services/ai/provider.js";
+import { transcribeAudio } from "../services/ai/transcribe.js";
+import { createVeil } from "../services/ai/veil.js";
+import { absolutePath, getAttachmentRow } from "../services/attachments.js";
+import { appendEncounter, getPatient } from "../services/patients.js";
+import type { Encounter } from "../types/patient.js";
+
+export const scribeRouter = Router();
+
+// The ambient scribe drafts and saves a clinical encounter note, so it needs
+// full clinical write access — never reception (demographics only).
+scribeRouter.use(
+  requireAuth,
+  requireOrg,
+  requirePermission({ patient: ["write"] }),
+);
+
+// Guard shared by every scribe route: the clinic AI kill-switch must allow this
+// member, and reception (demographics-only) can never draft clinical notes.
+async function ensureScribeAllowed(req: {
+  organizationId?: string;
+  memberRole?: string;
+}): Promise<void> {
+  if (isReceptionOnly(req.memberRole)) {
+    throw new HttpError(403, "The visit scribe is not available for your role.");
+  }
+  const policy = await getPolicy(req.organizationId!);
+  if (!aiAllowedFor(policy, req.memberRole)) {
+    throw new HttpError(403, "The AI assistant is disabled for your account.");
+  }
+}
+
+const transcribeSchema = z.object({
+  attachmentId: z.string().trim().min(1),
+});
+
+// POST /api/scribe/transcribe — turn a stored audio attachment into a raw
+// transcript via the user's speech provider (OpenAI/Gemini). The audio does NOT
+// pass through Veil or the chat loop.
+scribeRouter.post("/transcribe", async (req, res, next) => {
+  try {
+    await ensureScribeAllowed(req);
+    const { attachmentId } = transcribeSchema.parse(req.body);
+    const row = await getAttachmentRow(req.organizationId!, attachmentId);
+    if (!row) throw new HttpError(404, "Recording not found.");
+    if (!row.mimeType.startsWith("audio/")) {
+      throw new HttpError(400, "That attachment is not an audio recording.");
+    }
+
+    const settings = await getAiSettings(req.user!.id);
+    const buffer = await readFile(absolutePath(row.storagePath));
+    const { transcript, provider } = await transcribeAudio(settings, {
+      buffer,
+      mimeType: row.mimeType,
+      filename: row.filename,
+    });
+
+    void recordActivity({
+      orgId: req.organizationId!,
+      actor: { id: req.user!.id, name: req.user!.name },
+      action: `Transcribed a visit recording (${provider})`,
+      entityType: "patient",
+      patientFileNumber: row.fileNumber,
+    });
+
+    res.json({ transcript });
+  } catch (err) {
+    next(err);
+  }
+});
+
+const draftSchema = z.object({
+  fileNumber: z.string().trim().min(1),
+  transcript: z.string().trim().min(1).max(100_000),
+  visitType: z.string().trim().max(120).optional(),
+  date: z.string().trim().max(40).optional(),
+});
+
+// Strip ```json fences and parse; returns null if the text isn't JSON.
+function parseDraftJson(text: string): { type?: string; summary?: string } | null {
+  const cleaned = text
+    .replace(/^\s*```(?:json)?/i, "")
+    .replace(/```\s*$/i, "")
+    .trim();
+  try {
+    const parsed = JSON.parse(cleaned);
+    return typeof parsed === "object" && parsed ? parsed : null;
+  } catch {
+    return null;
+  }
+}
+
+const DRAFT_SYSTEM = [
+  "You are a clinical scribe. From a visit transcript, write a concise, structured",
+  "encounter note in SOAP format (Subjective, Objective, Assessment, Plan).",
+  "Rules:",
+  "- Use ONLY what the transcript supports. Never invent vitals, doses, or findings.",
+  "- If a SOAP section has nothing to report, write \"Not discussed.\" under it.",
+  "- Identifiers may appear as tokens like [PATIENT_1] or [PROVIDER_1]; keep them",
+  "  verbatim — do not guess real names.",
+  "Respond with a JSON object ONLY (no prose, no code fences):",
+  '{ "type": "<short visit type, e.g. Follow-up / New patient / Telehealth>",',
+  '  "summary": "<the SOAP note as markdown with **Subjective** / **Objective** /',
+  '  **Assessment** / **Plan** headings>" }',
+].join("\n");
+
+// POST /api/scribe/draft — draft an encounter note from a transcript. The
+// transcript + patient context are Veil-redacted before any external call and
+// the output is rehydrated. Nothing is written — the clinician reviews and
+// approves via POST /save (the same write-approval gate as the chat agent).
+scribeRouter.post("/draft", async (req, res, next) => {
+  try {
+    await ensureScribeAllowed(req);
+    const { fileNumber, transcript, visitType, date } = draftSchema.parse(
+      req.body,
+    );
+
+    const patient = await getPatient(
+      req.organizationId!,
+      fileNumber,
+      false,
+      providerScope(req.memberRole, req.user!.id),
+    );
+    if (!patient) throw new HttpError(404, "Patient not found.");
+
+    const settings = await getAiSettings(req.user!.id);
+    const resolved = resolveModel(settings, settings.defaultModel);
+    const veil = createVeil(settings.veilLevel, resolved.isExternal);
+
+    // Seed Veil's token maps with this patient's identifiers, then redact the
+    // free-text transcript against them before it leaves the clinic.
+    const redactedPatient = veil.redactPatient(patient);
+    const redactedTranscript = veil.redactText(transcript);
+
+    const context = [
+      `Patient: ${redactedPatient.name} (MRN ${redactedPatient.fileNumber}), ${patient.age}y ${patient.sex}.`,
+      patient.problems.length
+        ? `Known problems: ${patient.problems.map((p) => p.label).join(", ")}.`
+        : "",
+      patient.medications.length
+        ? `Current medications: ${patient.medications
+            .map((m) => `${m.name} ${m.dose}`)
+            .join(", ")}.`
+        : "",
+      visitType ? `Visit type hint: ${visitType}.` : "",
+      "",
+      "Transcript:",
+      redactedTranscript,
+    ]
+      .filter(Boolean)
+      .join("\n");
+
+    const result = await generateText({
+      model: resolved.model,
+      system: DRAFT_SYSTEM,
+      prompt: context,
+    });
+
+    const parsed = parseDraftJson(result.text);
+    const summary = veil.rehydrate(
+      (parsed?.summary ?? result.text ?? "").trim(),
+    );
+    const type = (parsed?.type ?? visitType ?? "Visit").trim() || "Visit";
+
+    const draft: Encounter = {
+      date: date || new Date().toISOString().slice(0, 10),
+      type,
+      // The responsible clinician is the signed-in user, not the model's guess.
+      provider: req.user!.name ?? "",
+      summary,
+    };
+
+    res.json({
+      draft,
+      veil: {
+        active: veil.active,
+        level: veil.level,
+        classes: veil.usedClasses(),
+        provider: resolved.providerLabel,
+      },
+    });
+  } catch (err) {
+    next(err);
+  }
+});
+
+const saveSchema = z.object({
+  fileNumber: z.string().trim().min(1),
+  encounter: z.object({
+    date: z.string().trim().min(1),
+    type: z.string().trim().min(1),
+    provider: z.string().trim().default(""),
+    summary: z.string().trim().min(1),
+  }),
+});
+
+// POST /api/scribe/save — the approval step: append the reviewed encounter note
+// to the patient record. Re-validates server-side and audits like any add.
+scribeRouter.post("/save", async (req, res, next) => {
+  try {
+    await ensureScribeAllowed(req);
+    const { fileNumber, encounter } = saveSchema.parse(req.body);
+    const updated = await appendEncounter(
+      req.organizationId!,
+      fileNumber,
+      encounter,
+    );
+    if (!updated) throw new HttpError(404, "Patient not found.");
+
+    void recordActivity({
+      orgId: req.organizationId!,
+      actor: { id: req.user!.id, name: req.user!.name },
+      action: `Added a scribe visit note for ${updated.name}`,
+      entityType: "patient",
+      entityId: updated.fileNumber,
+      patientName: updated.name,
+      patientFileNumber: updated.fileNumber,
+    });
+
+    res.status(201).json(updated);
+  } catch (err) {
+    next(err);
+  }
+});
@@ -1,4 +1,5 @@
 import { Router } from "express";
+import { z } from "zod";

 import {
  requireAuth,
@@ -6,6 +7,7 @@ import {
  requirePermission,
 } from "../middleware/auth.js";
 import { recordActivity } from "../services/activity.js";
+import { connectOrg, disconnectOrg } from "../services/relay-client.js";
 import * as signing from "../services/signing.js";
 import * as walletShare from "../services/wallet-share.js";

@@ -48,6 +50,52 @@ signingRouter.post(
  },
 );

+// Whether this clinic has joined the Temetro Network relay. Readable by any
+// clinician (the panel shows the toggle state + connection status).
+signingRouter.get(
+  "/network",
+  requirePermission({ patient: ["read"] }),
+  async (req, res, next) => {
+    try {
+      res.json({ enabled: await signing.getNetworkEnabled(req.organizationId!) });
+    } catch (err) {
+      next(err);
+    }
+  },
+);
+
+// Join / leave the Temetro Network — owner/admin only (same gate as key
+// rotation). Enabling opens this clinic's relay hub connection; disabling tears
+// it down.
+const networkSchema = z.object({ enabled: z.boolean() });
+
+signingRouter.put(
+  "/network",
+  requirePermission({ organization: ["update"] }),
+  async (req, res, next) => {
+    try {
+      const { enabled } = networkSchema.parse(req.body);
+      await signing.setNetworkEnabled(req.organizationId!, enabled);
+      if (enabled) {
+        await connectOrg(req.organizationId!);
+      } else {
+        disconnectOrg(req.organizationId!);
+      }
+      await recordActivity({
+        orgId: req.organizationId!,
+        actor: { id: req.user!.id, name: req.user!.name },
+        action: enabled
+          ? "Joined the Temetro Network"
+          : "Left the Temetro Network",
+        entityType: "settings",
+      });
+      res.json({ enabled });
+    } catch (err) {
+      next(err);
+    }
+  },
+);
+
 // Recent records shared from patient wallets — feeds the panel's shared-records
 // list.
 signingRouter.get(
@@ -1,6 +1,8 @@
-// GET /api/version — reports the running version and whether a newer release
-// exists on GitHub. Public (no PHI); the frontend uses it for the Settings
-// "About & Updates" panel and the optional update banner.
+// GET /api/version — reports the running version and whether a newer image is
+// available. The latest version is read from Docker Hub (the actual update
+// channel: clinics run `docker compose pull`), falling back to the GitHub
+// release if Docker Hub's API is unreachable. Public (no PHI); the frontend uses
+// it for the Settings "About & Updates" panel and the optional update banner.
 import { createRequire } from "node:module";

 import { Router } from "express";
@@ -13,16 +15,24 @@ const require = createRequire(import.meta.url);
 const pkg = require("../../package.json") as { version?: string };
 const CURRENT = env.APP_VERSION ?? pkg.version ?? "0.0.0";

-const LATEST_RELEASE_URL =
+// The published image whose tags reflect what `docker compose pull` would fetch.
+const DOCKERHUB_TAGS_URL =
+  "https://hub.docker.com/v2/repositories/khalidxv/temetro-backend/tags?page_size=100";
+// GitHub release of a given version — used for the human-readable "what's new"
+// link, and as a fallback source for the latest version.
+const GITHUB_LATEST_RELEASE_URL =
  "https://api.github.com/repos/temetro/temetro/releases/latest";
-const CACHE_TTL = 6 * 60 * 60 * 1000; // 6h — releases are infrequent.
+const releaseUrlFor = (version: string) =>
+  `https://github.com/temetro/temetro/releases/tag/v${version}`;
+
+const CACHE_TTL = 60 * 60 * 1000; // 1h — surface a new release reasonably fast.
 const ERROR_TTL = 10 * 60 * 1000; // back off ~10m after a failed lookup.

 type LatestInfo = { latest: string | null; releaseUrl: string | null };
 let cache: { at: number; ttl: number; info: LatestInfo } | null = null;

 function parseSemver(v: string): [number, number, number] | null {
-  const m = v.trim().replace(/^v/, "").match(/^(\d+)\.(\d+)\.(\d+)/);
+  const m = v.trim().replace(/^v/, "").match(/^(\d+)\.(\d+)\.(\d+)$/);
  return m ? [Number(m[1]), Number(m[2]), Number(m[3])] : null;
 }

@@ -38,18 +48,52 @@ function isNewer(latest: string, current: string): boolean {
  return false;
 }

-async function fetchLatest(): Promise<LatestInfo> {
-  if (cache && Date.now() - cache.at < cache.ttl) return cache.info;
+// Highest strict X.Y.Z tag in the list (ignores `latest` and any non-semver).
+function maxSemver(versions: string[]): string | null {
+  let best: string | null = null;
+  for (const v of versions) {
+    if (parseSemver(v) && (best === null || isNewer(v, best))) best = v;
+  }
+  return best;
+}
+
+// Primary source: the published Docker Hub image tags.
+async function fetchFromDockerHub(): Promise<string | null> {
+  const res = await fetch(DOCKERHUB_TAGS_URL, {
+    headers: { Accept: "application/json", "User-Agent": "temetro" },
+    signal: AbortSignal.timeout(5000),
+  });
+  if (!res.ok) throw new Error(`Docker Hub responded ${res.status}`);
+  const body = (await res.json()) as { results?: Array<{ name?: string }> };
+  const names = (body.results ?? [])
+    .map((r) => r.name)
+    .filter((n): n is string => typeof n === "string");
+  return maxSemver(names);
+}
+
+// Fallback source: the latest GitHub release tag (used if Docker Hub is blocked).
+async function fetchFromGitHub(): Promise<string | null> {
+  const res = await fetch(GITHUB_LATEST_RELEASE_URL, {
+    headers: { Accept: "application/vnd.github+json", "User-Agent": "temetro" },
+    signal: AbortSignal.timeout(5000),
+  });
+  if (!res.ok) throw new Error(`GitHub responded ${res.status}`);
+  const body = (await res.json()) as { tag_name?: string };
+  return body.tag_name ? body.tag_name.replace(/^v/, "") : null;
+}
+
+async function fetchLatest(force = false): Promise<LatestInfo> {
+  if (!force && cache && Date.now() - cache.at < cache.ttl) return cache.info;
  try {
-    const res = await fetch(LATEST_RELEASE_URL, {
-      headers: { Accept: "application/vnd.github+json", "User-Agent": "temetro" },
-      signal: AbortSignal.timeout(5000),
-    });
-    if (!res.ok) throw new Error(`GitHub responded ${res.status}`);
-    const body = (await res.json()) as { tag_name?: string; html_url?: string };
+    let latest: string | null = null;
+    try {
+      latest = await fetchFromDockerHub();
+    } catch {
+      latest = await fetchFromGitHub();
+    }
    const info: LatestInfo = {
-      latest: body.tag_name ? body.tag_name.replace(/^v/, "") : null,
-      releaseUrl: body.html_url ?? null,
+      latest,
+      releaseUrl: latest ? releaseUrlFor(latest) : null,
    };
    cache = { at: Date.now(), ttl: CACHE_TTL, info };
    return info;
@@ -63,8 +107,10 @@ async function fetchLatest(): Promise<LatestInfo> {

 const router = Router();

-router.get("/", async (_req, res) => {
-  const { latest, releaseUrl } = await fetchLatest();
+router.get("/", async (req, res) => {
+  // `?refresh=1` powers the "Check for updates" button — bypass the cache.
+  const force = req.query.refresh === "1" || req.query.refresh === "true";
+  const { latest, releaseUrl } = await fetchLatest(force);
  res.json({
    current: CURRENT,
    latest,
@@ -0,0 +1,132 @@
+import { HttpError } from "../../lib/http-error.js";
+import type { userAiSettings } from "../../db/schema/ai.js";
+import { getApiKey } from "./config.js";
+
+type AiSettingsRow = typeof userAiSettings.$inferSelect;
+
+export type AudioInput = {
+  buffer: Buffer;
+  mimeType: string;
+  filename: string;
+};
+
+// Which transcription backend a user's AI settings can reach. Anthropic has no
+// speech-to-text API, so an Anthropic-only user must paste a transcript instead.
+export type TranscribeProvider = "openai" | "gemini";
+
+export function transcribeProviderFor(
+  settings: AiSettingsRow,
+): TranscribeProvider | null {
+  if (getApiKey(settings, "openai")) return "openai";
+  if (getApiKey(settings, "gemini")) return "gemini";
+  return null;
+}
+
+const OPENAI_MODEL = "whisper-1";
+const GEMINI_MODEL = "gemini-2.5-flash";
+
+const TRANSCRIBE_PROMPT =
+  "Transcribe this clinical visit recording verbatim. Return only the spoken words as plain text, with no commentary, headings, or timestamps.";
+
+async function transcribeWithOpenAI(
+  apiKey: string,
+  audio: AudioInput,
+): Promise<string> {
+  const form = new FormData();
+  form.append(
+    "file",
+    new Blob([new Uint8Array(audio.buffer)], { type: audio.mimeType }),
+    audio.filename,
+  );
+  form.append("model", OPENAI_MODEL);
+  form.append("response_format", "json");
+
+  const res = await fetch("https://api.openai.com/v1/audio/transcriptions", {
+    method: "POST",
+    headers: { Authorization: `Bearer ${apiKey}` },
+    body: form,
+  });
+  if (!res.ok) {
+    const detail = await res.text().catch(() => "");
+    throw new HttpError(
+      502,
+      `Transcription failed (OpenAI ${res.status}). ${detail.slice(0, 300)}`,
+    );
+  }
+  const json = (await res.json()) as { text?: string };
+  return (json.text ?? "").trim();
+}
+
+async function transcribeWithGemini(
+  apiKey: string,
+  audio: AudioInput,
+): Promise<string> {
+  const url = `https://generativelanguage.googleapis.com/v1beta/models/${GEMINI_MODEL}:generateContent?key=${encodeURIComponent(
+    apiKey,
+  )}`;
+  const res = await fetch(url, {
+    method: "POST",
+    headers: { "Content-Type": "application/json" },
+    body: JSON.stringify({
+      contents: [
+        {
+          parts: [
+            {
+              inline_data: {
+                mime_type: audio.mimeType,
+                data: audio.buffer.toString("base64"),
+              },
+            },
+            { text: TRANSCRIBE_PROMPT },
+          ],
+        },
+      ],
+    }),
+  });
+  if (!res.ok) {
+    const detail = await res.text().catch(() => "");
+    throw new HttpError(
+      502,
+      `Transcription failed (Gemini ${res.status}). ${detail.slice(0, 300)}`,
+    );
+  }
+  const json = (await res.json()) as {
+    candidates?: { content?: { parts?: { text?: string }[] } }[];
+  };
+  const text =
+    json.candidates?.[0]?.content?.parts
+      ?.map((p) => p.text ?? "")
+      .join("")
+      .trim() ?? "";
+  return text;
+}
+
+// Send an audio recording to the user's transcription provider and return the
+// raw transcript. The audio never passes through the chat loop or Veil — Veil
+// cannot redact speech, so the caller must warn the clinician that audio leaves
+// the clinic when an external provider is used (only the DRAFTING step is
+// Veil-protected). Throws a 400 when no speech-capable provider is configured.
+export async function transcribeAudio(
+  settings: AiSettingsRow,
+  audio: AudioInput,
+): Promise<{ transcript: string; provider: TranscribeProvider }> {
+  const provider = transcribeProviderFor(settings);
+  if (!provider) {
+    throw new HttpError(
+      400,
+      "Transcription needs an OpenAI or Gemini API key. Add one in Settings → AI, or paste the visit transcript instead.",
+    );
+  }
+  const apiKey = getApiKey(settings, provider)!;
+  const transcript =
+    provider === "openai"
+      ? await transcribeWithOpenAI(apiKey, audio)
+      : await transcribeWithGemini(apiKey, audio);
+  if (!transcript) {
+    throw new HttpError(
+      502,
+      "The transcription came back empty — try again or paste the transcript.",
+    );
+  }
+  return { transcript, provider };
+}
@@ -26,6 +26,15 @@ export type Veil = {
  redactPatient: (patient: Patient) => Patient;
  /** Map a possibly-tokenized file number from a tool call back to the real one. */
  resolveFileNumber: (input: string) => string;
+  /**
+   * De-identify free text (e.g. a visit transcript) by swapping any KNOWN
+   * identifiers — the patient name, MRN and provider names already seen via
+   * redactPatient — for their tokens. Seed the token maps by calling
+   * redactPatient(patient) first. Note: this only catches identifiers we know
+   * about; free-text PHI spoken aloud (addresses, relatives' names) is not
+   * covered — see the ambient-scribe consent notice.
+   */
+  redactText: (text: string) => string;
  /** Swap any tokens in model output back to real identifiers. */
  rehydrate: (text: string) => string;
  /** Token classes actually emitted — for the audit log. */
@@ -81,6 +90,21 @@ export function createVeil(level: VeilLevel, active: boolean): Veil {
    return mrnByToken.get(input.trim()) ?? input;
  }

+  function redactText(text: string): string {
+    if (!isActive || fromToken.size === 0) return text;
+    let out = text;
+    // Longest real values first so a provider name containing the patient name
+    // (or similar overlap) is replaced whole before its substrings.
+    const byLength = [...fromToken.entries()]
+      .filter(([, real]) => real.trim().length > 0)
+      .sort((a, b) => b[1].length - a[1].length);
+    for (const [token, real] of byLength) {
+      const escaped = real.replace(/[.*+?^${}()|[\]\\]/g, "\\$&");
+      out = out.replace(new RegExp(escaped, "gi"), token);
+    }
+    return out;
+  }
+
  function rehydrate(text: string): string {
    if (!isActive || fromToken.size === 0) return text;
    let out = text;
@@ -101,6 +125,7 @@ export function createVeil(level: VeilLevel, active: boolean): Veil {
    level,
    redactPatient,
    resolveFileNumber,
+    redactText,
    rehydrate,
    usedClasses,
  };
@@ -0,0 +1,77 @@
+import type { FhirResource } from "./resources.js";
+
+// searchset Bundle assembly + offset/limit pagination for the FHIR server.
+
+export const DEFAULT_COUNT = 50;
+export const MAX_COUNT = 200;
+
+// Clamp a client-supplied `_count` into [1, MAX_COUNT], defaulting when absent.
+export function parseCount(raw: string | undefined): number {
+  const n = Number(raw);
+  if (!Number.isFinite(n) || n <= 0) return DEFAULT_COUNT;
+  return Math.min(Math.floor(n), MAX_COUNT);
+}
+
+export function parseOffset(raw: string | undefined): number {
+  const n = Number(raw);
+  if (!Number.isFinite(n) || n < 0) return 0;
+  return Math.floor(n);
+}
+
+// Slice an already-materialized resource array to the requested page.
+export function paginate<T>(
+  all: T[],
+  count: number,
+  offset: number,
+): { page: T[]; total: number } {
+  return { page: all.slice(offset, offset + count), total: all.length };
+}
+
+export type SearchsetBundle = {
+  resourceType: "Bundle";
+  type: "searchset";
+  total: number;
+  link: { relation: string; url: string }[];
+  entry: { fullUrl: string; resource: FhirResource; search: { mode: "match" } }[];
+};
+
+// Build a FHIR searchset Bundle. `page` is the current slice; `total` the full
+// match count; `params` the effective query (already carrying `_count`/`_offset`)
+// used to derive self/next/prev links.
+export function searchsetBundle(opts: {
+  baseUrl: string; // e.g. https://host/fhir
+  resourceType: string;
+  page: FhirResource[];
+  total: number;
+  count: number;
+  offset: number;
+  params: URLSearchParams;
+}): SearchsetBundle {
+  const { baseUrl, resourceType, page, total, count, offset, params } = opts;
+
+  const linkFor = (nextOffset: number): string => {
+    const q = new URLSearchParams(params);
+    q.set("_count", String(count));
+    q.set("_offset", String(nextOffset));
+    return `${baseUrl}/${resourceType}?${q.toString()}`;
+  };
+
+  const link: { relation: string; url: string }[] = [
+    { relation: "self", url: linkFor(offset) },
+  ];
+  if (offset + count < total) link.push({ relation: "next", url: linkFor(offset + count) });
+  if (offset > 0)
+    link.push({ relation: "previous", url: linkFor(Math.max(0, offset - count)) });
+
+  return {
+    resourceType: "Bundle",
+    type: "searchset",
+    total,
+    link,
+    entry: page.map((resource) => ({
+      fullUrl: `${baseUrl}/${resource.resourceType}/${resource.id}`,
+      resource,
+      search: { mode: "match" },
+    })),
+  };
+}
@@ -0,0 +1,114 @@
+// A static CapabilityStatement describing exactly what this read-only FHIR R4
+// server supports. It is intentionally honest: only the resources and search
+// params implemented below are listed, everything is `read`/`search-type` only,
+// and clinical concepts are text-only (no SNOMED/LOINC coding).
+
+type ResourceCapability = {
+  type: string;
+  interaction: { code: "read" | "search-type" }[];
+  searchParam?: { name: string; type: "token" | "string" | "reference" }[];
+};
+
+const RESOURCES: ResourceCapability[] = [
+  {
+    type: "Patient",
+    interaction: [{ code: "read" }, { code: "search-type" }],
+    searchParam: [
+      { name: "identifier", type: "token" },
+      { name: "name", type: "string" },
+    ],
+  },
+  {
+    type: "Observation",
+    interaction: [{ code: "read" }, { code: "search-type" }],
+    searchParam: [
+      { name: "patient", type: "reference" },
+      { name: "patient.identifier", type: "token" },
+      { name: "category", type: "token" },
+    ],
+  },
+  {
+    type: "AllergyIntolerance",
+    interaction: [{ code: "read" }, { code: "search-type" }],
+    searchParam: [
+      { name: "patient", type: "reference" },
+      { name: "patient.identifier", type: "token" },
+    ],
+  },
+  {
+    type: "Condition",
+    interaction: [{ code: "read" }, { code: "search-type" }],
+    searchParam: [
+      { name: "patient", type: "reference" },
+      { name: "patient.identifier", type: "token" },
+    ],
+  },
+  {
+    type: "MedicationRequest",
+    interaction: [{ code: "read" }, { code: "search-type" }],
+    searchParam: [
+      { name: "patient", type: "reference" },
+      { name: "patient.identifier", type: "token" },
+    ],
+  },
+  {
+    type: "Encounter",
+    interaction: [{ code: "read" }, { code: "search-type" }],
+    searchParam: [
+      { name: "patient", type: "reference" },
+      { name: "patient.identifier", type: "token" },
+    ],
+  },
+  {
+    type: "Appointment",
+    interaction: [{ code: "read" }, { code: "search-type" }],
+    searchParam: [
+      { name: "patient", type: "reference" },
+      { name: "patient.identifier", type: "token" },
+    ],
+  },
+];
+
+export function capabilityStatement(
+  baseUrl: string,
+  version: string,
+): Record<string, unknown> {
+  return {
+    resourceType: "CapabilityStatement",
+    status: "active",
+    date: new Date().toISOString(),
+    publisher: "temetro",
+    kind: "instance",
+    implementation: { description: "temetro FHIR server", url: baseUrl },
+    software: { name: "temetro", version },
+    fhirVersion: "4.0.1",
+    format: ["application/fhir+json", "json"],
+    rest: [
+      {
+        mode: "server",
+        documentation:
+          "Read-only FHIR R4 server. Authenticate with a per-clinic API key: " +
+          "Authorization: Bearer tmf_…. Clinical values are text-only " +
+          "CodeableConcepts (no SNOMED/LOINC). Patients expose age (extension), " +
+          "not birthDate. Pagination via _count (default 50, max 200) and _offset.",
+        security: {
+          description: "Bearer token (per-organization API key, tmf_ prefix).",
+          service: [
+            {
+              coding: [
+                {
+                  system:
+                    "http://terminology.hl7.org/CodeSystem/restful-security-service",
+                  code: "OAuth",
+                  display: "OAuth",
+                },
+              ],
+              text: "API key bearer token",
+            },
+          ],
+        },
+        resource: RESOURCES,
+      },
+    ],
+  };
+}
@@ -0,0 +1,110 @@
+import { createHash, randomBytes } from "node:crypto";
+
+import { and, desc, eq, isNull } from "drizzle-orm";
+
+import { db } from "../../db/index.js";
+import { fhirApiKeys } from "../../db/schema/fhir-keys.js";
+
+// FHIR-server API keys. The secret is `tmf_` + 32 random bytes (base64url); we
+// persist only its SHA-256 hash, so a leaked database never yields usable keys
+// and the plaintext is returned exactly once (at creation).
+
+const PREFIX = "tmf_";
+
+export type FhirKeyView = {
+  id: string;
+  name: string;
+  createdAt: string;
+  lastUsedAt: string | null;
+  revoked: boolean;
+};
+
+function hashKey(secret: string): string {
+  return createHash("sha256").update(secret).digest("hex");
+}
+
+function toView(row: typeof fhirApiKeys.$inferSelect): FhirKeyView {
+  return {
+    id: row.id,
+    name: row.name,
+    createdAt: row.createdAt.toISOString(),
+    lastUsedAt: row.lastUsedAt ? row.lastUsedAt.toISOString() : null,
+    revoked: row.revokedAt !== null,
+  };
+}
+
+// List a clinic's keys (active first, then revoked), newest first. Never
+// exposes the hash.
+export async function listKeys(orgId: string): Promise<FhirKeyView[]> {
+  const rows = await db
+    .select()
+    .from(fhirApiKeys)
+    .where(eq(fhirApiKeys.organizationId, orgId))
+    .orderBy(desc(fhirApiKeys.createdAt));
+  return rows.map(toView);
+}
+
+// Mint a new key. Returns the one-time plaintext secret alongside the stored
+// view — the caller must surface the secret to the user immediately; it is not
+// recoverable afterwards.
+export async function createKey(
+  orgId: string,
+  name: string,
+  createdBy: string,
+): Promise<{ secret: string; key: FhirKeyView }> {
+  const secret = PREFIX + randomBytes(32).toString("base64url");
+  const [row] = await db
+    .insert(fhirApiKeys)
+    .values({
+      organizationId: orgId,
+      name: name.trim() || "FHIR key",
+      keyHash: hashKey(secret),
+      createdBy,
+    })
+    .returning();
+  return { secret, key: toView(row!) };
+}
+
+// Revoke a key (idempotent). Scoped to the org so one clinic can't revoke
+// another's. Returns false if no such active key exists.
+export async function revokeKey(orgId: string, id: string): Promise<boolean> {
+  const result = await db
+    .update(fhirApiKeys)
+    .set({ revokedAt: new Date() })
+    .where(
+      and(
+        eq(fhirApiKeys.id, id),
+        eq(fhirApiKeys.organizationId, orgId),
+        isNull(fhirApiKeys.revokedAt),
+      ),
+    )
+    .returning({ id: fhirApiKeys.id });
+  return result.length > 0;
+}
+
+export type ResolvedKey = { orgId: string; keyId: string; keyName: string };
+
+// Resolve a presented bearer secret to its owning organization (plus the key's
+// identity, for the audit log), or null when it is unknown or revoked. Bumps
+// `lastUsedAt` (throttled to once a minute) so the key list can show recent
+// activity without a write on every request.
+export async function resolveKey(secret: string): Promise<ResolvedKey | null> {
+  if (!secret.startsWith(PREFIX)) return null;
+  const [row] = await db
+    .select()
+    .from(fhirApiKeys)
+    .where(eq(fhirApiKeys.keyHash, hashKey(secret)))
+    .limit(1);
+  if (!row || row.revokedAt) return null;
+
+  const now = Date.now();
+  const last = row.lastUsedAt?.getTime() ?? 0;
+  if (now - last > 60_000) {
+    void db
+      .update(fhirApiKeys)
+      .set({ lastUsedAt: new Date() })
+      .where(eq(fhirApiKeys.id, row.id))
+      .catch(() => {});
+  }
+  return { orgId: row.organizationId, keyId: row.id, keyName: row.name };
+}
@@ -0,0 +1,36 @@
+// FHIR OperationOutcome helpers. Errors on a FHIR endpoint are returned as an
+// OperationOutcome resource (not our usual `{ error }` JSON), with the
+// `application/fhir+json` content type, so conformant clients can parse them.
+
+export const FHIR_CONTENT_TYPE = "application/fhir+json";
+
+export type IssueSeverity = "fatal" | "error" | "warning" | "information";
+export type IssueCode =
+  | "not-found"
+  | "not-supported"
+  | "security"
+  | "login"
+  | "forbidden"
+  | "invalid"
+  | "processing"
+  | "exception";
+
+export type OperationOutcome = {
+  resourceType: "OperationOutcome";
+  issue: {
+    severity: IssueSeverity;
+    code: IssueCode;
+    diagnostics?: string;
+  }[];
+};
+
+export function operationOutcome(
+  severity: IssueSeverity,
+  code: IssueCode,
+  diagnostics: string,
+): OperationOutcome {
+  return {
+    resourceType: "OperationOutcome",
+    issue: [{ severity, code, diagnostics }],
+  };
+}
@@ -0,0 +1,168 @@
+import { and, asc, count, eq, ilike, sql } from "drizzle-orm";
+import type { SQL } from "drizzle-orm";
+
+import { db } from "../../db/index.js";
+import { appointments } from "../../db/schema/appointments.js";
+import {
+  allergies,
+  encounters,
+  labs,
+  medications,
+  patients,
+  problems,
+} from "../../db/schema/patients.js";
+import { prescriptions } from "../../db/schema/prescriptions.js";
+
+// Narrow, org-scoped reads for the FHIR server. Deliberately separate from the
+// app's `services/patients.ts` (which returns the reshaped canonical Patient and
+// applies role redaction): the FHIR layer needs raw rows *with their UUIDs* to
+// mint stable resource ids, and offset/limit pagination the app service doesn't
+// expose. Every function is scoped to a single organization.
+
+export type PatientRow = typeof patients.$inferSelect;
+export type LabRow = typeof labs.$inferSelect;
+export type AllergyRow = typeof allergies.$inferSelect;
+export type ProblemRow = typeof problems.$inferSelect;
+export type EncounterRow = typeof encounters.$inferSelect;
+export type PrescriptionRow = typeof prescriptions.$inferSelect;
+export type AppointmentRow = typeof appointments.$inferSelect;
+
+// --- Patient ----------------------------------------------------------------
+
+// Paginated Patient search. `identifier` matches the MRN (file number) exactly;
+// `name` is a case-insensitive substring. Returns the page plus the full total
+// for the searchset Bundle.
+export async function searchPatients(
+  orgId: string,
+  opts: { identifier?: string; name?: string; limit: number; offset: number },
+): Promise<{ rows: PatientRow[]; total: number }> {
+  const filters: SQL[] = [eq(patients.organizationId, orgId)];
+  if (opts.identifier) filters.push(eq(patients.fileNumber, opts.identifier));
+  if (opts.name) filters.push(ilike(patients.name, `%${opts.name}%`));
+  const where = and(...filters);
+
+  const [rows, [totalRow]] = await Promise.all([
+    db
+      .select()
+      .from(patients)
+      .where(where)
+      .orderBy(asc(patients.fileNumber))
+      .limit(opts.limit)
+      .offset(opts.offset),
+    db.select({ value: count() }).from(patients).where(where),
+  ]);
+
+  return { rows, total: totalRow?.value ?? 0 };
+}
+
+// A single patient by FHIR logical id (the row UUID), scoped to the org.
+export async function patientById(
+  orgId: string,
+  id: string,
+): Promise<PatientRow | undefined> {
+  // Guard against a non-UUID id: Postgres would otherwise error on the cast.
+  if (!/^[0-9a-f-]{36}$/i.test(id)) return undefined;
+  const [row] = await db
+    .select()
+    .from(patients)
+    .where(and(eq(patients.organizationId, orgId), eq(patients.id, id)))
+    .limit(1);
+  return row;
+}
+
+// Resolve a `patient` search parameter to a patient row. Accepts either the FHIR
+// logical id (`patient=<uuid>`) or the MRN (`patient.identifier=<file#>`).
+export async function resolvePatientRef(
+  orgId: string,
+  ref: { patientId?: string; identifier?: string },
+): Promise<PatientRow | undefined> {
+  if (ref.patientId) {
+    // A reference may arrive as "Patient/<id>" or a bare id.
+    const id = ref.patientId.replace(/^Patient\//, "");
+    return patientById(orgId, id);
+  }
+  if (ref.identifier) {
+    const [row] = await db
+      .select()
+      .from(patients)
+      .where(
+        and(
+          eq(patients.organizationId, orgId),
+          eq(patients.fileNumber, ref.identifier),
+        ),
+      )
+      .limit(1);
+    return row;
+  }
+  return undefined;
+}
+
+// --- Clinical child rows (by patient UUID) ----------------------------------
+
+export function labsForPatient(patientId: string): Promise<LabRow[]> {
+  return db
+    .select()
+    .from(labs)
+    .where(eq(labs.patientId, patientId))
+    .orderBy(asc(labs.position));
+}
+
+export function allergiesForPatient(patientId: string): Promise<AllergyRow[]> {
+  return db
+    .select()
+    .from(allergies)
+    .where(eq(allergies.patientId, patientId))
+    .orderBy(asc(allergies.position));
+}
+
+export function problemsForPatient(patientId: string): Promise<ProblemRow[]> {
+  return db
+    .select()
+    .from(problems)
+    .where(eq(problems.patientId, patientId))
+    .orderBy(asc(problems.position));
+}
+
+export function encountersForPatient(
+  patientId: string,
+): Promise<EncounterRow[]> {
+  return db
+    .select()
+    .from(encounters)
+    .where(eq(encounters.patientId, patientId))
+    .orderBy(asc(encounters.position));
+}
+
+// --- Denormalized resources (linked to the patient by MRN / file number) ----
+
+export function prescriptionsForFile(
+  orgId: string,
+  fileNumber: string,
+): Promise<PrescriptionRow[]> {
+  return db
+    .select()
+    .from(prescriptions)
+    .where(
+      and(
+        eq(prescriptions.organizationId, orgId),
+        eq(prescriptions.patientFileNumber, fileNumber),
+      ),
+    )
+    .orderBy(sql`${prescriptions.prescribedAt} desc`);
+}
+
+export function appointmentsForFile(
+  orgId: string,
+  fileNumber: string,
+): Promise<AppointmentRow[]> {
+  return db
+    .select()
+    .from(appointments)
+    .where(
+      and(
+        eq(appointments.organizationId, orgId),
+        eq(appointments.patientFileNumber, fileNumber),
+      ),
+    )
+    .orderBy(sql`${appointments.date} desc, ${appointments.time} desc`);
+}
@@ -0,0 +1,317 @@
+import type { LabFlag } from "../../types/patient.js";
+import type {
+  AllergyRow,
+  AppointmentRow,
+  EncounterRow,
+  LabRow,
+  PatientRow,
+  PrescriptionRow,
+  ProblemRow,
+} from "./queries.js";
+
+// Pure mappers from temetro rows to FHIR R4 JSON. temetro stores clinical values
+// as **free text** (no SNOMED/LOINC coding), so every CodeableConcept here is
+// `text`-only — valid FHIR, deliberately un-coded (documented in the
+// CapabilityStatement and API docs). Resource ids are the rows' own UUIDs so
+// they are stable; synthesized vital-sign Observations derive their id from the
+// patient UUID.
+
+export type FhirResource = {
+  resourceType: string;
+  id?: string;
+  [key: string]: unknown;
+};
+
+// System URIs.
+const MRN_SYSTEM = "urn:temetro:mrn";
+const INTERPRETATION_SYSTEM =
+  "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation";
+const OBS_CATEGORY_SYSTEM =
+  "http://terminology.hl7.org/CodeSystem/observation-category";
+const AGE_EXTENSION =
+  "https://temetro.app/fhir/StructureDefinition/patient-age-years";
+
+// A FHIR dateTime from our stored strings. Passes date-only values (`YYYY-MM-DD`)
+// through unchanged (valid FHIR dateTime), otherwise parses display strings like
+// "Jun 28, 2025" to a full instant. Returns undefined when unparseable.
+function fhirDateTime(value: string | null | undefined): string | undefined {
+  if (!value) return undefined;
+  const trimmed = value.trim();
+  if (!trimmed) return undefined;
+  if (/^\d{4}-\d{2}-\d{2}$/.test(trimmed)) return trimmed;
+  const parsed = new Date(trimmed);
+  return Number.isNaN(parsed.getTime()) ? undefined : parsed.toISOString();
+}
+
+function humanName(full: string): Record<string, unknown>[] {
+  const parts = full.trim().split(/\s+/).filter(Boolean);
+  if (parts.length < 2) return [{ text: full }];
+  return [{ text: full, family: parts.at(-1), given: parts.slice(0, -1) }];
+}
+
+function subjectRef(patient: PatientRow) {
+  return { reference: `Patient/${patient.id}`, display: patient.name };
+}
+
+// --- Patient ----------------------------------------------------------------
+
+export function patientResource(row: PatientRow): FhirResource {
+  return {
+    resourceType: "Patient",
+    id: row.id,
+    identifier: [{ system: MRN_SYSTEM, value: row.fileNumber }],
+    active: row.status !== "discharged",
+    name: humanName(row.name),
+    gender: row.sex === "M" ? "male" : "female",
+    // temetro records age, not date of birth; expose it as an extension rather
+    // than fabricate a birthDate.
+    extension: [{ url: AGE_EXTENSION, valueInteger: row.age }],
+  };
+}
+
+// --- Observation ------------------------------------------------------------
+
+function interpretation(flag: LabFlag) {
+  const map: Record<LabFlag, { code: string; display: string }> = {
+    normal: { code: "N", display: "Normal" },
+    high: { code: "H", display: "High" },
+    low: { code: "L", display: "Low" },
+    critical: { code: "HH", display: "Critical high" },
+  };
+  const { code, display } = map[flag];
+  return [{ coding: [{ system: INTERPRETATION_SYSTEM, code, display }] }];
+}
+
+export function labObservation(row: LabRow, patient: PatientRow): FhirResource {
+  const effective = fhirDateTime(row.takenAt);
+  return {
+    resourceType: "Observation",
+    id: row.id,
+    status: "final",
+    category: [
+      {
+        coding: [
+          {
+            system: OBS_CATEGORY_SYSTEM,
+            code: "laboratory",
+            display: "Laboratory",
+          },
+        ],
+      },
+    ],
+    code: { text: row.name },
+    subject: subjectRef(patient),
+    ...(effective ? { effectiveDateTime: effective } : {}),
+    valueString: row.value,
+    interpretation: interpretation(row.flag),
+  };
+}
+
+// Synthesize vital-sign Observations from the denormalized columns on the
+// patient row. Returns an empty array when vitals are blank (e.g. a
+// reception-registered patient with clinical fields stripped).
+export function vitalObservations(patient: PatientRow): FhirResource[] {
+  const effective = fhirDateTime(patient.vitalsTakenAt);
+  const base = (idSuffix: string, text: string) => ({
+    resourceType: "Observation" as const,
+    id: `${patient.id}-vital-${idSuffix}`,
+    status: "final",
+    category: [
+      {
+        coding: [
+          {
+            system: OBS_CATEGORY_SYSTEM,
+            code: "vital-signs",
+            display: "Vital Signs",
+          },
+        ],
+      },
+    ],
+    code: { text },
+    subject: subjectRef(patient),
+    ...(effective ? { effectiveDateTime: effective } : {}),
+  });
+
+  const out: FhirResource[] = [];
+
+  if (patient.vitalsBp) {
+    const bp = base("bp", "Blood pressure");
+    const m = /^(\d+)\s*\/\s*(\d+)/.exec(patient.vitalsBp.trim());
+    if (m) {
+      out.push({
+        ...bp,
+        component: [
+          {
+            code: { text: "Systolic blood pressure" },
+            valueQuantity: { value: Number(m[1]), unit: "mmHg" },
+          },
+          {
+            code: { text: "Diastolic blood pressure" },
+            valueQuantity: { value: Number(m[2]), unit: "mmHg" },
+          },
+        ],
+      });
+    } else {
+      out.push({ ...bp, valueString: patient.vitalsBp });
+    }
+  }
+  if (patient.vitalsHr)
+    out.push({ ...base("hr", "Heart rate"), valueString: patient.vitalsHr });
+  if (patient.vitalsTemp)
+    out.push({
+      ...base("temp", "Body temperature"),
+      valueString: patient.vitalsTemp,
+    });
+  if (patient.vitalsSpo2)
+    out.push({
+      ...base("spo2", "Oxygen saturation"),
+      valueString: patient.vitalsSpo2,
+    });
+
+  return out;
+}
+
+// --- AllergyIntolerance -----------------------------------------------------
+
+export function allergyResource(
+  row: AllergyRow,
+  patient: PatientRow,
+): FhirResource {
+  return {
+    resourceType: "AllergyIntolerance",
+    id: row.id,
+    clinicalStatus: {
+      coding: [
+        {
+          system:
+            "http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical",
+          code: "active",
+        },
+      ],
+    },
+    code: { text: row.substance },
+    patient: subjectRef(patient),
+    criticality: row.severity === "severe" ? "high" : "low",
+    reaction: [
+      { manifestation: [{ text: row.reaction }], severity: row.severity },
+    ],
+  };
+}
+
+// --- Condition --------------------------------------------------------------
+
+export function conditionResource(
+  row: ProblemRow,
+  patient: PatientRow,
+): FhirResource {
+  return {
+    resourceType: "Condition",
+    id: row.id,
+    clinicalStatus: {
+      coding: [
+        {
+          system: "http://terminology.hl7.org/CodeSystem/condition-clinical",
+          code: "active",
+        },
+      ],
+    },
+    code: { text: row.label },
+    subject: subjectRef(patient),
+    ...(row.since ? { onsetString: row.since } : {}),
+  };
+}
+
+// --- MedicationRequest ------------------------------------------------------
+
+export function medicationRequestResource(
+  row: PrescriptionRow,
+  patient: PatientRow,
+): FhirResource {
+  const status =
+    row.status === "completed"
+      ? "completed"
+      : row.status === "expired"
+        ? "stopped"
+        : "active";
+  const dosageText = [row.dose, row.frequency].filter(Boolean).join(" ").trim();
+  return {
+    resourceType: "MedicationRequest",
+    id: row.id,
+    status,
+    intent: "order",
+    medicationCodeableConcept: { text: row.medication },
+    subject: subjectRef(patient),
+    ...(row.prescribedAt ? { authoredOn: row.prescribedAt } : {}),
+    requester: { display: row.prescriber },
+    ...(dosageText ? { dosageInstruction: [{ text: dosageText }] } : {}),
+  };
+}
+
+// --- Encounter --------------------------------------------------------------
+
+function narrative(text: string): Record<string, unknown> {
+  const escaped = text
+    .replace(/&/g, "&amp;")
+    .replace(/</g, "&lt;")
+    .replace(/>/g, "&gt;");
+  return {
+    status: "generated",
+    div: `<div xmlns="http://www.w3.org/1999/xhtml">${escaped}</div>`,
+  };
+}
+
+export function encounterResource(
+  row: EncounterRow,
+  patient: PatientRow,
+): FhirResource {
+  const start = fhirDateTime(row.date);
+  return {
+    resourceType: "Encounter",
+    id: row.id,
+    ...(row.summary ? { text: narrative(row.summary) } : {}),
+    status: "finished",
+    class: {
+      system: "http://terminology.hl7.org/CodeSystem/v3-ActCode",
+      code: "AMB",
+      display: "ambulatory",
+    },
+    type: [{ text: row.type }],
+    subject: subjectRef(patient),
+    ...(start ? { period: { start } } : {}),
+    participant: [{ individual: { display: row.provider } }],
+  };
+}
+
+// --- Appointment ------------------------------------------------------------
+
+export function appointmentResource(
+  row: AppointmentRow,
+  patient: PatientRow,
+): FhirResource {
+  const statusMap: Record<string, string> = {
+    confirmed: "booked",
+    "checked-in": "arrived",
+    completed: "fulfilled",
+    cancelled: "cancelled",
+  };
+  // Combine local date + time into an instant; omit when unparseable.
+  const startDate =
+    row.date && row.time ? new Date(`${row.date}T${row.time}:00`) : null;
+  const start =
+    startDate && !Number.isNaN(startDate.getTime())
+      ? startDate.toISOString()
+      : undefined;
+  return {
+    resourceType: "Appointment",
+    id: row.id,
+    status: statusMap[row.status] ?? "booked",
+    description: row.type,
+    ...(start ? { start } : {}),
+    participant: [
+      { actor: subjectRef(patient), status: "accepted" },
+      ...(row.provider
+        ? [{ actor: { display: row.provider }, status: "accepted" }]
+        : []),
+    ],
+  };
+}
@@ -570,6 +570,46 @@ export async function appendLabs(
  return getPatient(orgId, fileNumber);
 }

+// Append a single encounter (visit note) without touching the rest of the
+// record — used by the ambient AI scribe, which drafts one note at a time and
+// must not go through updatePatient's wholesale child replacement. Position
+// continues after the current max so the new note sorts last.
+export async function appendEncounter(
+  orgId: string,
+  fileNumber: string,
+  entry: Encounter,
+): Promise<Patient | null> {
+  const inserted = await db.transaction(async (tx) => {
+    const [existing] = await tx
+      .select({ id: patients.id })
+      .from(patients)
+      .where(
+        and(
+          eq(patients.organizationId, orgId),
+          eq(patients.fileNumber, fileNumber),
+        ),
+      );
+    if (!existing) return false;
+
+    const [pos] = await tx
+      .select({ max: sql<number>`coalesce(max(${encounters.position}), -1)` })
+      .from(encounters)
+      .where(eq(encounters.patientId, existing.id));
+    await tx.insert(encounters).values({
+      patientId: existing.id,
+      position: (pos?.max ?? -1) + 1,
+      ...entry,
+    });
+    await tx
+      .update(patients)
+      .set({ updatedAt: new Date() })
+      .where(eq(patients.id, existing.id));
+    return true;
+  });
+  if (!inserted) return null;
+  return getPatient(orgId, fileNumber);
+}
+
 // Remove a single lab result from a patient, identified by its
 // name/value/takenAt (the frontend has no row id). Scoped to the org via the
 // owning patient. Returns the reloaded patient, or null when the chart is gone.
@@ -0,0 +1,217 @@
+// Client connection to the Temetro Network relay
+// (github.com/temetro/temetro-network), a standalone Rust service that routes
+// encrypted wallet messages between this backend and patient phones.
+//
+// This backend was previously the device-facing Socket.io server itself (the
+// `/wallet` namespace in realtime.ts). Now it is a *client* of the relay's
+// `/hub` namespace: it pushes messages to devices via `sendToWallet` and handles
+// their responses here, calling the same wallet service functions the old socket
+// handlers did. Sealed bundles are decrypted here (we hold the ephemeral key);
+// the relay only ever forwards ciphertext.
+//
+// The relay is **multi-clinic**: each clinic (organization) authenticates to
+// `/hub` with its own Ed25519 signing key (a per-clinic identity, not a shared
+// password), and the relay routes each device response back only to the clinic
+// that originated the request. So this backend keeps **one hub connection per
+// network-enabled org**, opened when the org joins the network ("Join Temetro
+// Network" in Settings → Signing) and torn down when it leaves.
+
+import { io as connect, type Socket } from "socket.io-client";
+
+import { env } from "../env.js";
+import { networkEnabledOrgs, signWithClinicKey } from "./signing.js";
+import * as walletShare from "./wallet-share.js";
+import * as walletUpdates from "./wallet-updates.js";
+
+// One authenticated hub connection per network-enabled organization.
+const hubs = new Map<string, Socket>();
+
+type Ack = (response: { ok: boolean; [key: string]: unknown }) => void;
+
+// Push an end-to-end-encrypted message to a patient wallet device via the given
+// clinic's relay connection (the relay forwards it to the room keyed by wallet
+// number). A no-op if the clinic isn't on the network / not connected yet — the
+// device replays anything it missed on its next connect (see `wallet:online`).
+export function sendToWallet(
+  orgId: string,
+  walletNumber: string,
+  event: string,
+  data: unknown,
+): void {
+  hubs.get(orgId)?.emit("wallet:send", { walletNumber, event, data });
+}
+
+// Tell the relay to expect a device response for `requestId` and route it back
+// to this clinic — used by **QR pairing**, where there's no wallet number to
+// `wallet:send` to yet, so nothing would otherwise register the request.
+export function expectResponse(orgId: string, requestId: string): void {
+  hubs.get(orgId)?.emit("hub:expect", { requestId });
+}
+
+// Open (and authenticate) a hub connection for a clinic, if not already open.
+// Idempotent — safe to call on startup and again when an org joins the network.
+export async function connectOrg(orgId: string): Promise<void> {
+  if (hubs.has(orgId)) return;
+
+  const hub = connect(`${env.RELAY_URL}/hub`, {
+    transports: ["websocket"],
+    reconnection: true,
+    reconnectionDelayMax: 10_000,
+  });
+  hubs.set(orgId, hub);
+  registerHubHandlers(orgId, hub);
+}
+
+// Leave the network for a clinic: close and forget its hub connection.
+export function disconnectOrg(orgId: string): void {
+  const hub = hubs.get(orgId);
+  if (!hub) return;
+  hub.disconnect();
+  hubs.delete(orgId);
+}
+
+// Open a hub connection for every clinic already on the network. Called once at
+// startup; runtime joins/leaves go through connectOrg/disconnectOrg.
+export async function initRelayClient(): Promise<void> {
+  try {
+    const orgs = await networkEnabledOrgs();
+    await Promise.all(orgs.map((orgId) => connectOrg(orgId)));
+  } catch (err) {
+    console.warn(`Temetro Network: failed to open hub connections: ${(err as Error).message}`);
+  }
+}
+
+// Wire up auth + device-response handlers for one clinic's hub socket.
+function registerHubHandlers(orgId: string, hub: Socket): void {
+  // Authenticate by signing the relay's challenge with this clinic's signing
+  // key. `clinicId` is that key's public half (hex), which is how the relay
+  // identifies and routes to this clinic.
+  hub.on("hub:challenge", async (payload: { challenge?: string }) => {
+    const challenge = String(payload?.challenge ?? "");
+    if (!challenge) return;
+    try {
+      const { signature, publicKey } = await signWithClinicKey(
+        orgId,
+        new TextEncoder().encode(challenge),
+      );
+      hub.emit(
+        "hub:auth",
+        // `token` is only meaningful for a private relay (optional shared gate);
+        // an empty value is ignored by an open relay.
+        { clinicId: publicKey, signature, token: env.RELAY_TOKEN || undefined },
+        async (ack: { ok?: boolean } | undefined) => {
+          if (!ack?.ok) {
+            console.warn(`Temetro Network: relay rejected clinic ${orgId}`);
+            return;
+          }
+          console.log(`Temetro Network: clinic ${orgId} authenticated on the relay`);
+          // The relay keeps routing state in memory, so re-register this clinic's
+          // still-pending requests — restores QR-pairing / share routing after a
+          // relay restart or a reconnect.
+          try {
+            for (const requestId of await walletShare.pendingRequestIds(orgId)) {
+              expectResponse(orgId, requestId);
+            }
+          } catch {
+            /* best-effort */
+          }
+        },
+      );
+    } catch (err) {
+      console.warn(`Temetro Network: failed to sign relay challenge for ${orgId}: ${(err as Error).message}`);
+    }
+  });
+
+  hub.on("connect_error", (err) => {
+    console.warn(`Temetro Network relay unreachable (${env.RELAY_URL}) for ${orgId}: ${err.message}`);
+  });
+
+  // A device authenticated on the relay — flush any record updates it missed
+  // while offline (scoped to this clinic; the relay only delivers this to
+  // clinics with pending work for the wallet).
+  hub.on("wallet:online", async (payload: { walletNumber?: string }) => {
+    const walletNumber = String(payload?.walletNumber ?? "");
+    if (!walletNumber) return;
+    try {
+      const rows = await walletUpdates.pendingUpdatesForWallet(orgId, walletNumber);
+      for (const row of rows) {
+        sendToWallet(orgId, walletNumber, "wallet:update-request", await walletUpdates.toEvent(row));
+        await walletUpdates.markDelivered(row.id);
+      }
+    } catch {
+      /* best-effort */
+    }
+  });
+
+  // The patient approved/denied a clinic→wallet record update. Verify the
+  // wallet's signature over the decision and resolve the row.
+  hub.on(
+    "wallet:update-response",
+    async (
+      payload: {
+        requestId?: string;
+        walletNumber?: string;
+        decision?: "approved" | "denied";
+        signature?: string;
+      },
+      ack?: Ack,
+    ) => {
+      try {
+        const view = await walletUpdates.applyUpdateResponse(
+          String(payload?.requestId ?? ""),
+          String(payload?.walletNumber ?? ""),
+          payload?.decision === "approved" ? "approved" : "denied",
+          payload?.signature,
+        );
+        ack?.({ ok: !!view });
+      } catch (err) {
+        ack?.({ ok: false, error: (err as Error).message });
+      }
+    },
+  );
+
+  // The patient approved/denied a share; the sealed bundle (if approved) rides
+  // along and is decrypted + verified here.
+  hub.on(
+    "wallet:share-response",
+    async (
+      payload: {
+        requestId?: string;
+        walletNumber?: string;
+        decision?: "approved" | "denied";
+        sealed?: string;
+        signature?: string;
+      },
+      ack?: Ack,
+    ) => {
+      try {
+        const view = await walletShare.applyShareResponse(
+          String(payload?.requestId ?? ""),
+          String(payload?.walletNumber ?? ""),
+          payload?.decision === "approved" ? "approved" : "denied",
+          payload?.sealed,
+          payload?.signature,
+        );
+        ack?.({ ok: !!view });
+      } catch (err) {
+        ack?.({ ok: false, error: (err as Error).message });
+      }
+    },
+  );
+
+  // The patient revoked a previously shared record; delete it from the clinic.
+  hub.on(
+    "wallet:revoke",
+    async (payload: { requestId?: string; walletNumber?: string }, ack?: Ack) => {
+      try {
+        const result = await walletShare.revokeShare(
+          String(payload?.requestId ?? ""),
+          String(payload?.walletNumber ?? ""),
+        );
+        ack?.({ ok: !!result });
+      } catch {
+        ack?.({ ok: false });
+      }
+    },
+  );
+}
@@ -74,6 +74,40 @@ export async function rotateKey(orgId: string): Promise<SigningKeyView> {
  return mintKey(orgId, true);
 }

+// Whether this clinic has joined the Temetro Network relay. Defaults to `false`
+// when the clinic has no signing key yet (it hasn't opted in).
+export async function getNetworkEnabled(orgId: string): Promise<boolean> {
+  const [row] = await db
+    .select({ networkEnabled: clinicSigningKeys.networkEnabled })
+    .from(clinicSigningKeys)
+    .where(eq(clinicSigningKeys.organizationId, orgId));
+  return row?.networkEnabled ?? false;
+}
+
+// Org ids of every clinic currently on the network — used at startup to open a
+// relay hub connection for each.
+export async function networkEnabledOrgs(): Promise<string[]> {
+  const rows = await db
+    .select({ organizationId: clinicSigningKeys.organizationId })
+    .from(clinicSigningKeys)
+    .where(eq(clinicSigningKeys.networkEnabled, true));
+  return rows.map((r) => r.organizationId);
+}
+
+// Join or leave the Temetro Network. Ensures the clinic has a signing key first
+// (the relay authenticates with it), then flips the flag. Returns the new state.
+export async function setNetworkEnabled(
+  orgId: string,
+  enabled: boolean,
+): Promise<boolean> {
+  await getOrCreateKey(orgId);
+  await db
+    .update(clinicSigningKeys)
+    .set({ networkEnabled: enabled })
+    .where(eq(clinicSigningKeys.organizationId, orgId));
+  return enabled;
+}
+
 // Sign a message with the clinic's signing key (creating one if needed). Returns
 // the signature + public key so a verifier can check provenance.
 export async function signWithClinicKey(
@@ -137,6 +137,22 @@ export async function listShareRequests(
  return rows.map(toView);
 }

+// Ids of this clinic's still-pending share/pairing requests. Used to re-register
+// them with the relay when the clinic's hub (re)connects (the relay keeps
+// routing state in memory, so it's lost on a relay restart / redeploy).
+export async function pendingRequestIds(orgId: string): Promise<string[]> {
+  const rows = await db
+    .select({ id: walletShareRequests.id })
+    .from(walletShareRequests)
+    .where(
+      and(
+        eq(walletShareRequests.organizationId, orgId),
+        eq(walletShareRequests.status, "pending"),
+      ),
+    );
+  return rows.map((r) => r.id);
+}
+
 // Apply a response relayed back from the patient's device. On approval we
 // decrypt the sealed bundle with the request's ephemeral private key and verify
 // the wallet's Ed25519 signature over it (provenance: it really came from that
@@ -0,0 +1,239 @@
+import { hexToBytes, utf8ToBytes } from "@noble/hashes/utils.js";
+import { and, desc, eq, isNotNull, isNull } from "drizzle-orm";
+
+import { db } from "../db/index.js";
+import { organization } from "../db/schema/auth.js";
+import { walletRecordUpdates } from "../db/schema/wallet-updates.js";
+import { walletShareRequests } from "../db/schema/wallet-share.js";
+import { HttpError } from "../lib/http-error.js";
+import {
+  decodeWalletNumber,
+  fingerprint,
+  seal,
+  verifySignature,
+} from "../lib/wallet-crypto.js";
+import { ed25519PubToX25519Hex } from "../lib/wallet-x25519.js";
+import { getPatient } from "./patients.js";
+import { signWithClinicKey } from "./signing.js";
+
+type UpdateRow = typeof walletRecordUpdates.$inferSelect;
+
+// The payload the relay pushes to a wallet. `sealed` is the encrypted patient
+// snapshot; `signature`/`clinicPublicKey`/`fingerprint` let the wallet verify
+// provenance (TOFU pin) before applying.
+export type WalletUpdateEvent = {
+  requestId: string;
+  clinicName: string;
+  sealed: string;
+  signature: string;
+  clinicPublicKey: string;
+  fingerprint: string;
+  changes: string[];
+  createdAt: string;
+};
+
+// The clinic-facing view (no ciphertext) for the "Sent updates" list + polling.
+export type WalletUpdateView = {
+  id: string;
+  fileNumber: string;
+  walletNumber: string;
+  status: UpdateRow["status"];
+  changes: string[];
+  createdAt: string;
+  deliveredAt: string | null;
+  resolvedAt: string | null;
+};
+
+export function viewOf(row: UpdateRow): WalletUpdateView {
+  return toView(row);
+}
+
+function toView(row: UpdateRow): WalletUpdateView {
+  return {
+    id: row.id,
+    fileNumber: row.fileNumber,
+    walletNumber: row.walletNumber,
+    status: row.status,
+    changes: row.changes,
+    createdAt: row.createdAt.toISOString(),
+    deliveredAt: row.deliveredAt ? row.deliveredAt.toISOString() : null,
+    resolvedAt: row.resolvedAt ? row.resolvedAt.toISOString() : null,
+  };
+}
+
+// The wallet number a patient's record is linked to, or null when it isn't
+// wallet-backed. Only *permanent, approved, committed* shares qualify —
+// temporary shares auto-delete, so pushing an update to them is meaningless.
+export async function walletNumberForPatient(
+  orgId: string,
+  fileNumber: string,
+): Promise<string | null> {
+  const [row] = await db
+    .select({ walletNumber: walletShareRequests.walletNumber })
+    .from(walletShareRequests)
+    .where(
+      and(
+        eq(walletShareRequests.organizationId, orgId),
+        eq(walletShareRequests.committedFileNumber, fileNumber),
+        eq(walletShareRequests.status, "approved"),
+        eq(walletShareRequests.shareMode, "permanent"),
+        isNotNull(walletShareRequests.walletNumber),
+      ),
+    )
+    .limit(1);
+  return row?.walletNumber ?? null;
+}
+
+// Compose, seal and sign a record-update push, and store it as pending. Loads
+// the current patient snapshot, seals it to the wallet's derived X25519 key, and
+// signs the plaintext bundle with the clinic's Ed25519 key. Returns the row.
+export async function createRecordUpdate(
+  orgId: string,
+  userId: string,
+  fileNumber: string,
+  changes: string[],
+): Promise<UpdateRow> {
+  const walletNumber = await walletNumberForPatient(orgId, fileNumber);
+  if (!walletNumber) {
+    throw new HttpError(409, "This patient is not linked to a wallet.");
+  }
+  const patient = await getPatient(orgId, fileNumber);
+  if (!patient) throw new HttpError(404, "Patient not found.");
+
+  // The wallet opens this, verifies the signature over the same bytes, then
+  // replaces its on-device record with `patient`.
+  const bundle = utf8ToBytes(JSON.stringify({ patient, changes }));
+  const { signature, publicKey } = await signWithClinicKey(orgId, bundle);
+  const x25519Hex = ed25519PubToX25519Hex(decodeWalletNumber(walletNumber));
+  const sealed = seal(x25519Hex, bundle);
+
+  const [row] = await db
+    .insert(walletRecordUpdates)
+    .values({
+      organizationId: orgId,
+      createdBy: userId,
+      fileNumber,
+      walletNumber,
+      payloadSealed: sealed,
+      clinicSignature: signature,
+      clinicPublicKey: publicKey,
+      clinicFingerprint: fingerprint(hexToBytes(publicKey)),
+      changes,
+    })
+    .returning();
+  return row!;
+}
+
+// Build the wire event for a stored update row (joins the clinic name).
+export async function toEvent(row: UpdateRow): Promise<WalletUpdateEvent> {
+  const [org] = await db
+    .select({ name: organization.name })
+    .from(organization)
+    .where(eq(organization.id, row.organizationId));
+  return {
+    requestId: row.id,
+    clinicName: org?.name ?? "A clinic",
+    sealed: row.payloadSealed,
+    signature: row.clinicSignature,
+    clinicPublicKey: row.clinicPublicKey,
+    fingerprint: row.clinicFingerprint,
+    changes: row.changes,
+    createdAt: row.createdAt.toISOString(),
+  };
+}
+
+// Every unresolved update for a wallet — re-sent on each authenticated connect
+// so an offline device eventually receives what it missed.
+// Pending updates a wallet missed, scoped to one clinic — the relay delivers a
+// `wallet:online` over that clinic's own hub connection, so a clinic only ever
+// re-sends its *own* updates (never another clinic's).
+export async function pendingUpdatesForWallet(
+  orgId: string,
+  walletNumber: string,
+): Promise<UpdateRow[]> {
+  return db
+    .select()
+    .from(walletRecordUpdates)
+    .where(
+      and(
+        eq(walletRecordUpdates.organizationId, orgId),
+        eq(walletRecordUpdates.walletNumber, walletNumber),
+        isNull(walletRecordUpdates.resolvedAt),
+      ),
+    )
+    .orderBy(walletRecordUpdates.createdAt);
+}
+
+// Mark a pending update delivered (best-effort; only advances from pending).
+export async function markDelivered(id: string): Promise<void> {
+  await db
+    .update(walletRecordUpdates)
+    .set({ status: "delivered", deliveredAt: new Date() })
+    .where(
+      and(
+        eq(walletRecordUpdates.id, id),
+        eq(walletRecordUpdates.status, "pending"),
+      ),
+    );
+}
+
+// Apply the patient's decision relayed back from the wallet. Verifies the
+// wallet's Ed25519 signature over `${decision}:${requestId}` (provenance) before
+// resolving. Returns the resolved view, or null when unknown/already resolved.
+export async function applyUpdateResponse(
+  requestId: string,
+  walletNumber: string,
+  decision: "approved" | "denied",
+  signatureHex?: string,
+): Promise<WalletUpdateView | null> {
+  const [row] = await db
+    .select()
+    .from(walletRecordUpdates)
+    .where(eq(walletRecordUpdates.id, requestId));
+  if (!row || row.resolvedAt) return null;
+  if (row.walletNumber !== walletNumber.trim()) return null;
+  if (!signatureHex) return null;
+
+  const publicKey = decodeWalletNumber(walletNumber);
+  const message = utf8ToBytes(`${decision}:${requestId}`);
+  if (!verifySignature(publicKey, signatureHex, message)) {
+    throw new HttpError(400, "Response signature did not match the wallet.");
+  }
+
+  const [updated] = await db
+    .update(walletRecordUpdates)
+    .set({ status: decision, resolvedAt: new Date() })
+    .where(eq(walletRecordUpdates.id, requestId))
+    .returning();
+  return updated ? toView(updated) : null;
+}
+
+// Recent update pushes for the clinic (Signing panel "Sent updates" list).
+export async function listUpdates(
+  orgId: string,
+  limit = 30,
+): Promise<WalletUpdateView[]> {
+  const rows = await db
+    .select()
+    .from(walletRecordUpdates)
+    .where(eq(walletRecordUpdates.organizationId, orgId))
+    .orderBy(desc(walletRecordUpdates.createdAt))
+    .limit(limit);
+  return rows.map(toView);
+}
+
+export async function getUpdate(
+  orgId: string,
+  id: string,
+): Promise<WalletUpdateView | null> {
+  const [row] = await db
+    .select()
+    .from(walletRecordUpdates)
+    .where(
+      and(
+        eq(walletRecordUpdates.id, id),
+        eq(walletRecordUpdates.organizationId, orgId),
+      ),
+    );
+  return row ? toView(row) : null;
+}
@@ -15,6 +15,9 @@ declare global {
      };
      organizationId?: string;
      memberRole?: string;
+      // Set by the FHIR bearer-auth middleware (machine-to-machine API key)
+      // instead of a Better Auth session; used for org scoping + audit.
+      fhirKey?: { id: string; name: string };
    }
  }
 }
@@ -7,9 +7,11 @@
@theme inline {
  --color-background: var(--background);
  --color-foreground: var(--foreground);
-  --font-sans: var(--font-sans);
+  /* Append the Arabic face so Arabic codepoints fall through per-character even
+     in LTR locales; Latin text still renders in Inter. See app/layout.tsx. */
+  --font-sans: var(--font-sans), var(--font-arabic);
  --font-mono: var(--font-mono);
-  --font-heading: var(--font-heading);
+  --font-heading: var(--font-heading), var(--font-arabic);
  --color-sidebar-ring: var(--sidebar-ring);
  --color-sidebar-border: var(--sidebar-border);
  --color-sidebar-accent-foreground: var(--sidebar-accent-foreground);
@@ -1,5 +1,5 @@
 import type { Metadata } from "next";
-import { Geist_Mono, Inter } from "next/font/google";
+import { Geist_Mono, IBM_Plex_Sans_Arabic, Inter } from "next/font/google";
 import "./globals.css";
 import { cn } from "@/lib/utils";
 import { ThemeProvider } from "@/components/theme-provider";
@@ -10,6 +10,27 @@ import { ToastProvider } from "@/components/ui/toast";
 const inter = Inter({ subsets: ["latin"], variable: "--font-sans" });
 const interHeading = Inter({ subsets: ["latin"], variable: "--font-heading" });
 const geistMono = Geist_Mono({ subsets: ["latin"], variable: "--font-mono" });
+// Arabic-capable fallback: Inter has no Arabic glyphs, so we append this to the
+// sans/heading stacks (see globals.css) for per-character fallback in every
+// locale, and rely on it fully when dir="rtl". Not a variable font — pin weights.
+const plexArabic = IBM_Plex_Sans_Arabic({
+  subsets: ["arabic"],
+  weight: ["400", "500", "600", "700"],
+  variable: "--font-arabic",
+});
+
+// Runs before first paint: mirror lib/i18n/config.ts `dirFor` so an Arabic user
+// gets dir="rtl" immediately instead of a flash of LTR. Detection order matches
+// i18next-browser-languagedetector (localStorage key "i18nextLng", then the
+// browser language). suppressHydrationWarning on <html> ignores the attr diff.
+const setInitialDir = `
+(function(){try{
+  var l=localStorage.getItem("i18nextLng")||navigator.language||"en";
+  var e=document.documentElement;
+  e.lang=l;
+  e.dir=l.indexOf("ar")===0?"rtl":"ltr";
+}catch(_){}})();
+`;

 export const metadata: Metadata = {
  title: "temetro — AI assistant for clinicians",
@@ -33,17 +54,22 @@ export default function RootLayout({
        inter.variable,
        interHeading.variable,
        geistMono.variable,
+        plexArabic.variable,
        "font-sans"
      )}
    >
      {/* suppressHydrationWarning: next-themes sets the theme class on <html>
-          before hydration, and browser extensions (e.g. ColorZilla's
-          cz-shortcut-listen) mutate <body>. Only ignores attribute diffs on
-          those elements, not their children. */}
+          before hydration, the dir script below sets lang/dir, and browser
+          extensions (e.g. ColorZilla's cz-shortcut-listen) mutate <body>. Only
+          ignores attribute diffs on those elements, not their children. */}
      <body
        className="h-dvh overflow-hidden flex flex-col"
        suppressHydrationWarning
      >
+        <script
+          // Sets <html dir/lang> before paint; see setInitialDir above.
+          dangerouslySetInnerHTML={{ __html: setInitialDir }}
+        />
        <ThemeProvider
          attribute="class"
          defaultTheme="dark"
@@ -28,6 +28,7 @@ import {
  DialogTitle,
 } from "@/components/ui/dialog";
 import { Button } from "@/components/ui/button";
+import { ListPagination } from "@/components/ui/list-pagination";
 import {
  type ActivityEntityType,
  type ActivityEntry,
@@ -103,15 +104,19 @@ function DetailRow({ label, value }: { label: string; value: string }) {
  return (
    <div className="flex items-baseline justify-between gap-3">
      <span className="shrink-0 text-muted-foreground text-xs">{label}</span>
-      <span className="text-right text-foreground text-sm">{value}</span>
+      <span className="text-end text-foreground text-sm">{value}</span>
    </div>
  );
 }

+// Entries shown per page in the activity feed before paginating.
+const PAGE_SIZE = 10;
+
 export function ActivityView() {
  const { t } = useTranslation();
  const [entries, setEntries] = useState<ActivityEntry[]>([]);
  const [selected, setSelected] = useState<ActivityEntry | null>(null);
+  const [page, setPage] = useState(1);

  useEffect(() => {
    let active = true;
@@ -153,6 +158,15 @@ export function ActivityView() {
    ];
  }, [entries, t]);

+  // Client-side pagination over the feed (10/page). `page` is clamped at render
+  // so a shrinking feed never leaves us past the last page.
+  const totalPages = Math.max(1, Math.ceil(entries.length / PAGE_SIZE));
+  const safePage = Math.min(page, totalPages);
+  const pageRows = entries.slice(
+    (safePage - 1) * PAGE_SIZE,
+    safePage * PAGE_SIZE,
+  );
+
  return (
    <div className="mx-auto flex w-full max-w-3xl flex-col gap-10 px-6 py-10">
      <div>
@@ -173,10 +187,11 @@ export function ActivityView() {
          {t("activity.empty")}
        </div>
      ) : (
+        <div>
        <ol className="flex flex-col">
-          {entries.map((entry, i) => {
+          {pageRows.map((entry, i) => {
            const Icon = entityIcon[entry.entityType] ?? FileText;
-            const isLast = i === entries.length - 1;
+            const isLast = i === pageRows.length - 1;
            const context = [
              entry.actorName,
              entry.patientName &&
@@ -197,7 +212,7 @@ export function ActivityView() {

                <button
                  className={cn(
-                    "-mx-2 flex-1 rounded-lg px-2 py-1 text-left transition-colors hover:bg-accent/40",
+                    "-mx-2 flex-1 rounded-lg px-2 py-1 text-start transition-colors hover:bg-accent/40",
                    isLast ? "pb-1" : "mb-5",
                  )}
                  onClick={() => setSelected(entry)}
@@ -226,6 +241,13 @@ export function ActivityView() {
            );
          })}
        </ol>
+        <ListPagination
+          onPageChange={setPage}
+          page={safePage}
+          pageSize={PAGE_SIZE}
+          total={entries.length}
+        />
+        </div>
      )}

      <Dialog
@@ -37,7 +37,7 @@ export function TrendCard({
  return (
    <>
      <button
-        className="w-full text-left"
+        className="w-full text-start"
        disabled={!hasData}
        onClick={() => setOpen(true)}
        type="button"
@@ -314,9 +314,9 @@ export function AppointmentsView() {
        </div>
        <div className="flex items-center gap-2">
          <div className="relative">
-            <Search className="-translate-y-1/2 absolute top-1/2 left-3 size-4 text-muted-foreground" />
+            <Search className="-translate-y-1/2 absolute top-1/2 start-3 size-4 text-muted-foreground" />
            <Input
-              className="w-full pl-9 sm:w-64"
+              className="w-full ps-9 sm:w-64"
              onChange={(event) => setQuery(event.target.value)}
              placeholder={t("appointments.searchPlaceholder")}
              value={query}
@@ -145,7 +145,7 @@ export function CalendarDialog({
                type="button"
                variant="ghost"
              >
-                <ChevronLeft />
+                <ChevronLeft className="rtl:rotate-180" />
              </Button>
              <Button
                aria-label="Next month"
@@ -154,7 +154,7 @@ export function CalendarDialog({
                type="button"
                variant="ghost"
              >
-                <ChevronRight />
+                <ChevronRight className="rtl:rotate-180" />
              </Button>
            </div>
          </div>
@@ -182,7 +182,7 @@ export function CalendarDialog({
                return (
                  <button
                    className={cn(
-                      "flex min-h-22 flex-col gap-1 rounded-lg border p-1.5 text-left align-top transition-colors hover:bg-accent/50",
+                      "flex min-h-22 flex-col gap-1 rounded-lg border p-1.5 text-start align-top transition-colors hover:bg-accent/50",
                      inMonth
                        ? "bg-card/30"
                        : "bg-transparent text-muted-foreground/40",
@@ -5,6 +5,7 @@ import { type ReactNode, useEffect, useRef } from "react";

 import { useAiAccess } from "@/lib/ai-policy";
 import { authClient } from "@/lib/auth-client";
+import { applyStoredLanguage } from "@/lib/language";
 import { canAccessRoute, defaultLandingFor, useActiveRole } from "@/lib/roles";

 // Authoritative client-side gate for the app shell. Requires a session and an
@@ -24,6 +25,16 @@ export function AppAuthGuard({ children }: { children: ReactNode }) {
  const hasUser = Boolean(session?.user);
  const activeOrgId = session?.session?.activeOrganizationId ?? null;

+  // Adopt the language saved on the backend once signed in, so the UI language
+  // roams across devices. Best-effort and one-shot; localStorage stays the
+  // offline source of truth.
+  const languageSynced = useRef(false);
+  useEffect(() => {
+    if (!hasUser || languageSynced.current) return;
+    languageSynced.current = true;
+    void applyStoredLanguage();
+  }, [hasUser]);
+
  useEffect(() => {
    if (isPending) return;
    if (!hasUser) {
@@ -269,7 +269,7 @@ export function ActionPreviewCard({
        </span>
        {editable ? (
          <Button
-            className="ml-auto"
+            className="ms-auto"
            onClick={() => setEditOpen(true)}
            size="sm"
            variant="ghost"
@@ -60,7 +60,7 @@ export function AiSetupNotice() {
      </div>
      <button
        aria-label={t("chat.setupNotice.dismiss")}
-        className="-mr-1 shrink-0 rounded-md p-1 text-muted-foreground transition-colors hover:bg-accent hover:text-foreground"
+        className="-me-1 shrink-0 rounded-md p-1 text-muted-foreground transition-colors hover:bg-accent hover:text-foreground"
        onClick={() => setDismissed(true)}
        type="button"
      >
@@ -115,7 +115,7 @@ export function BatchActionPreviewCard({
        <span className="font-medium text-sm">
          {t("chat.actionCard.batch.title", { count: items.length })}
        </span>
-        <Badge className="ml-auto gap-1" variant="secondary">
+        <Badge className="ms-auto gap-1" variant="secondary">
          <Sparkles className="size-3" />
          AI
        </Badge>
@@ -104,9 +104,9 @@ export function ChatHistoryPanel() {
              {t("chat.history.startNew")}
            </Button>
            <div className="relative">
-              <Search className="-translate-y-1/2 absolute top-1/2 left-2.5 size-4 text-muted-foreground" />
+              <Search className="-translate-y-1/2 absolute top-1/2 start-2.5 size-4 text-muted-foreground" />
              <Input
-                className="pl-8"
+                className="ps-8"
                onChange={(e) => setQuery(e.target.value)}
                placeholder={t("chat.history.search")}
                value={query}
@@ -123,7 +123,7 @@ export function ChatHistoryPanel() {
                  return (
                    <button
                      className={cn(
-                        "group flex items-center gap-2 rounded-md px-2 py-2 text-left text-sm transition-colors hover:bg-accent",
+                        "group flex items-center gap-2 rounded-md px-2 py-2 text-start text-sm transition-colors hover:bg-accent",
                        active
                          ? "bg-accent text-foreground"
                          : "text-muted-foreground",
@@ -242,7 +242,7 @@ export function ChatInput({
              />
            </label>
            <button
-              className={cn(contextPill, "ml-0.5")}
+              className={cn(contextPill, "ms-0.5")}
              onClick={() => {
                setAddKey((k) => k + 1);
                setAddOpen(true);
@@ -258,7 +258,7 @@ export function ChatInput({
            <ModePicker
              mode={mode}
              onModeChange={onModeChange}
-              triggerClassName={cn(pillButton, "mr-1")}
+              triggerClassName={cn(pillButton, "me-1")}
            />
            <button
              aria-label={
@@ -421,7 +421,7 @@ export function ChatPanel() {
        </div>
        <button
          aria-label={t("chat.error.dismiss")}
-          className="-mr-1 shrink-0 rounded-md p-1 text-destructive-foreground/70 transition-colors hover:bg-destructive/10 hover:text-destructive-foreground"
+          className="-me-1 shrink-0 rounded-md p-1 text-destructive-foreground/70 transition-colors hover:bg-destructive/10 hover:text-destructive-foreground"
          onClick={() => setErrorDismissed(true)}
          type="button"
        >
@@ -196,7 +196,7 @@ export function ImportPreviewCard({
        <span className="text-sm font-medium">{t("chat.importCard.title")}</span>
        {status === "pending" && records.length > 0 ? (
          <Button
-            className="ml-auto"
+            className="ms-auto"
            onClick={() => setReviewOpen(true)}
            size="sm"
            variant="ghost"
@@ -289,7 +289,7 @@ export function ImportPreviewCard({
                t("chat.importCard.unnamed");
              return (
                <button
-                  className="flex items-start gap-2 rounded-xl border bg-card/30 p-3 text-left transition-colors hover:bg-accent"
+                  className="flex items-start gap-2 rounded-xl border bg-card/30 p-3 text-start transition-colors hover:bg-accent"
                  key={index}
                  onClick={() => setEditingIndex(index)}
                  type="button"
@@ -16,7 +16,7 @@ export function InventoryListCard({ items }: { items: InventoryItem[] }) {
      <div className="flex items-center gap-2 border-b px-4 py-3">
        <Boxes className="size-4 text-muted-foreground" />
        <span className="font-medium text-sm">{t("chat.lists.inventory")}</span>
-        <Badge className="ml-auto" variant="secondary">
+        <Badge className="ms-auto" variant="secondary">
          {items.length}
        </Badge>
      </div>
@@ -71,11 +71,11 @@ const statusVariant: Record<Patient["status"], BadgeVariant> = {
 // plus a subtle clickable affordance (they open a detail dialog). Compact cards
 // size to their own (short) content — see `items-start` in PatientResult.
 const rowCard =
-  "w-72 shrink-0 cursor-pointer gap-0 text-left outline-none transition hover:bg-accent/30 hover:ring-foreground/20 focus-visible:ring-2 focus-visible:ring-ring";
+  "w-72 shrink-0 cursor-pointer gap-0 text-start outline-none transition hover:bg-accent/30 hover:ring-foreground/20 focus-visible:ring-2 focus-visible:ring-ring";

 // Same footprint as `rowCard` but with no clickable affordance — used when a
 // card has nothing extra to reveal, so it shouldn't promise "Click for more".
-const rowCardStatic = "w-72 shrink-0 gap-0 text-left";
+const rowCardStatic = "w-72 shrink-0 gap-0 text-start";

 // COSS Card has no `size` variant; recreate the old compact ("sm") density by
 // tightening the inner section padding from p-6 → p-4 via data-slot selectors.
@@ -196,7 +196,7 @@ function ExpandableCard({
        {children}
        <div className="flex items-center gap-1 px-4 pt-2 pb-3 text-muted-foreground text-xs">
          {t("patientCard.clickForMore")}
-          <ArrowRight className="size-3" />
+          <ArrowRight className="size-3 rtl:rotate-180" />
        </div>
      </DialogTrigger>
      <DialogPopup className="max-h-[80dvh] sm:max-w-lg">
@@ -724,7 +724,7 @@ export function PatientFormDialog({

          <DialogFooter className="flex-col items-stretch gap-2 sm:flex-row sm:items-center">
            {error && (
-              <p className="text-sm text-destructive sm:mr-auto">{error}</p>
+              <p className="text-sm text-destructive sm:me-auto">{error}</p>
            )}
            <DialogClose render={<Button type="button" variant="outline" />}>
              {t("patientForm.cancel")}
@@ -31,7 +31,7 @@ function Shell({
      <div className="flex items-center gap-2 border-b px-4 py-3">
        <Icon className="size-4 text-muted-foreground" />
        <span className="font-medium text-sm">{title}</span>
-        <Badge className="ml-auto" variant="secondary">
+        <Badge className="ms-auto" variant="secondary">
          {rows.length}
        </Badge>
      </div>
@@ -123,7 +123,7 @@ export function AppointmentListCard({
        {range ? (
          <span className="text-muted-foreground text-xs">{range}</span>
        ) : null}
-        <Badge className="ml-auto" variant="secondary">
+        <Badge className="ms-auto" variant="secondary">
          {appointments.length}
        </Badge>
      </div>
@@ -157,7 +157,7 @@ export function AppointmentListCard({
        </span>
        <Button render={<Link href={href} />} size="sm" variant="ghost">
          {t("chat.lists.viewInCalendar")}
-          <ChevronRight className="size-4" />
+          <ChevronRight className="size-4 rtl:rotate-180" />
        </Button>
      </div>
    </Card>
@@ -1,10 +1,27 @@
 "use client";

+import { useEffect } from "react";
 import type * as React from "react";
 import { I18nextProvider } from "react-i18next";

-import i18n from "@/lib/i18n/config";
+import i18n, { dirFor } from "@/lib/i18n/config";

 export function I18nProvider({ children }: { children: React.ReactNode }) {
+  // Keep <html lang/dir> in sync with the active language. The inline script in
+  // app/layout.tsx sets these before first paint (avoiding an RTL flash); this
+  // effect keeps them correct after hydration and on every language switch.
+  useEffect(() => {
+    const apply = (lng: string) => {
+      const root = document.documentElement;
+      root.lang = lng;
+      root.dir = dirFor(lng);
+    };
+    apply(i18n.resolvedLanguage ?? i18n.language);
+    i18n.on("languageChanged", apply);
+    return () => {
+      i18n.off("languageChanged", apply);
+    };
+  }, []);
+
  return <I18nextProvider i18n={i18n}>{children}</I18nextProvider>;
 }
@@ -171,7 +171,7 @@ export function InvoiceDetailSheet({
          <SheetTitle className="flex items-center gap-2">
            {invoice.number}
            <AiBadge source={invoice.source} />
-            <Badge className="ml-auto" variant={statusVariant[invoice.status]}>
+            <Badge className="ms-auto" variant={statusVariant[invoice.status]}>
              {t(`invoices.status.${invoice.status}`)}
            </Badge>
          </SheetTitle>
@@ -222,7 +222,7 @@ export function InvoiceDetailSheet({
                    <span className="shrink-0 text-muted-foreground text-xs tabular-nums">
                      {li.quantity} × {formatMoney(li.unitPrice)}
                    </span>
-                    <span className="w-20 shrink-0 text-right font-medium text-foreground tabular-nums">
+                    <span className="w-20 shrink-0 text-end font-medium text-foreground tabular-nums">
                      {formatMoney(li.quantity * li.unitPrice)}
                    </span>
                  </div>
@@ -11,6 +11,7 @@ import { Badge } from "@/components/ui/badge";
 import { Button } from "@/components/ui/button";
 import { Card } from "@/components/ui/card";
 import { Input } from "@/components/ui/input";
+import { ListPagination } from "@/components/ui/list-pagination";
 import {
  formatInvoiceDate,
  formatMoney,
@@ -30,10 +31,14 @@ const statusVariant: Record<
  void: "destructive",
 };

+// Invoices shown per page before paginating.
+const PAGE_SIZE = 10;
+
 export function InvoicesView() {
  const { t } = useTranslation();
  const [list, setList] = useState<Invoice[]>([]);
  const [query, setQuery] = useState("");
+  const [page, setPage] = useState(1);
  const [loadError, setLoadError] = useState<string | null>(null);

  const [selected, setSelected] = useState<Invoice | null>(null);
@@ -70,6 +75,15 @@ export function InvoicesView() {
    );
  }, [list, search]);

+  // Client-side pagination over the filtered list (10/page); clamp at render so a
+  // shrinking list never leaves us past the last page.
+  const totalPages = Math.max(1, Math.ceil(filtered.length / PAGE_SIZE));
+  const safePage = Math.min(page, totalPages);
+  const pageRows = filtered.slice(
+    (safePage - 1) * PAGE_SIZE,
+    safePage * PAGE_SIZE,
+  );
+
  const kpis = useMemo(() => {
    const unpaid = list
      .filter((i) => i.status === "draft" || i.status === "sent")
@@ -121,10 +135,13 @@ export function InvoicesView() {
        </div>
        <div className="flex flex-col gap-2 sm:flex-row sm:items-center">
          <div className="relative">
-            <Search className="-translate-y-1/2 absolute top-1/2 left-3 size-4 text-muted-foreground" />
+            <Search className="-translate-y-1/2 absolute top-1/2 start-3 size-4 text-muted-foreground" />
            <Input
-              className="w-full pl-9 sm:w-64"
-              onChange={(event) => setQuery(event.target.value)}
+              className="w-full ps-9 sm:w-64"
+              onChange={(event) => {
+                setQuery(event.target.value);
+                setPage(1);
+              }}
              placeholder={t("invoices.searchPlaceholder")}
              value={query}
            />
@@ -161,9 +178,9 @@ export function InvoicesView() {
      </div>

      <div className="divide-y divide-border overflow-hidden rounded-2xl border bg-card/30">
-        {filtered.map((inv) => (
+        {pageRows.map((inv) => (
          <button
-            className="flex w-full items-center gap-3 px-4 py-3 text-left transition-colors hover:bg-accent/50"
+            className="flex w-full items-center gap-3 px-4 py-3 text-start transition-colors hover:bg-accent/50"
            key={inv.id}
            onClick={() => openInvoice(inv)}
            type="button"
@@ -199,6 +216,13 @@ export function InvoicesView() {
        )}
      </div>

+      <ListPagination
+        onPageChange={setPage}
+        page={safePage}
+        pageSize={PAGE_SIZE}
+        total={filtered.length}
+      />
+
      <InvoiceFormDialog
        invoice={editing ?? undefined}
        mode={formMode}
@@ -92,7 +92,7 @@ export function LabIntegrationCard({
          {t("integrations.fhir.cardTitle")}
        </h2>
        <Badge
-          className="ml-auto"
+          className="ms-auto"
          variant={
            config.status === "connected"
              ? "secondary"
@@ -141,9 +141,9 @@ export function LabIntegrationCard({
      ) : (
        <div className="flex flex-col gap-1.5">
          <div className="relative">
-            <Search className="-translate-y-1/2 absolute top-1/2 left-3 size-4 text-muted-foreground" />
+            <Search className="-translate-y-1/2 absolute top-1/2 start-3 size-4 text-muted-foreground" />
            <Input
-              className="pl-9"
+              className="ps-9"
              onChange={(e) => setQuery(e.target.value)}
              placeholder={t("integrations.fhir.searchPlaceholder")}
              value={query}
@@ -153,7 +153,7 @@ export function LabIntegrationCard({
            <div className="flex flex-col gap-1">
              {matches.map((p) => (
                <button
-                  className="flex items-center gap-3 rounded-lg px-2 py-2 text-left transition-colors hover:bg-accent"
+                  className="flex items-center gap-3 rounded-lg px-2 py-2 text-start transition-colors hover:bg-accent"
                  key={p.fileNumber}
                  onClick={() => setSelected(p)}
                  type="button"
@@ -336,7 +336,7 @@ function AddResultDialog({
                  {t("lab.addResult.patient")}
                </span>
                <div className="relative">
-                  <Search className="-translate-y-1/2 absolute top-1/2 left-3 size-4 text-muted-foreground" />
+                  <Search className="-translate-y-1/2 absolute top-1/2 start-3 size-4 text-muted-foreground" />
                  <Input
                    aria-activedescendant={
                      matches[activeIndex]
@@ -344,7 +344,7 @@ function AddResultDialog({
                        : undefined
                    }
                    autoFocus
-                    className="pl-9"
+                    className="ps-9"
                    onChange={(event) => {
                      setPatientQuery(event.target.value);
                      setActiveIndex(0);
@@ -359,7 +359,7 @@ function AddResultDialog({
                    {matches.map((p, index) => (
                      <button
                        className={cn(
-                          "flex items-center gap-3 rounded-lg px-2 py-2 text-left transition-colors",
+                          "flex items-center gap-3 rounded-lg px-2 py-2 text-start transition-colors",
                          index === activeIndex
                            ? "bg-accent"
                            : "hover:bg-accent",
@@ -650,7 +650,7 @@ export function LabView() {
                    }
                    onClick={() => toggle(task.id)}
                  />
-                  <CollapsibleTrigger className="group flex min-w-0 flex-1 items-center gap-3 text-left">
+                  <CollapsibleTrigger className="group flex min-w-0 flex-1 items-center gap-3 text-start">
                    <div className="flex min-w-0 flex-1 flex-col">
                      <span
                        className={cn(
@@ -679,7 +679,7 @@ export function LabView() {
                  </CollapsibleTrigger>
                </div>
                <CollapsibleContent>
-                  <div className="space-y-3 px-4 pb-4 pl-12 text-sm">
+                  <div className="space-y-3 px-4 pb-4 ps-12 text-sm">
                    <p
                      className={cn(
                        "whitespace-pre-wrap",
@@ -124,7 +124,7 @@ export function LoginForm({
                    {t("auth.login.passwordLabel")}
                  </FieldLabel>
                  <Link
-                    className="ml-auto inline-block text-sm underline-offset-4 hover:underline"
+                    className="ms-auto inline-block text-sm underline-offset-4 hover:underline"
                    href="/forgot-password"
                  >
                    {t("auth.login.forgotPassword")}
@@ -285,10 +285,10 @@ export function MeetingRoom({
          </DialogHeader>
          <DialogPanel className="flex flex-col gap-2">
            <div className="relative">
-              <Search className="-translate-y-1/2 absolute top-1/2 left-3 size-4 text-muted-foreground" />
+              <Search className="-translate-y-1/2 absolute top-1/2 start-3 size-4 text-muted-foreground" />
              <Input
                aria-label={t("meetings.invite.search")}
-                className="pl-9"
+                className="ps-9"
                onChange={(e) => setMemberQuery(e.target.value)}
                placeholder={t("meetings.invite.search")}
                size="sm"
@@ -246,13 +246,13 @@ export function MeetingsView() {
                  return (
                    <div
                      className={cn(
-                        "group flex w-full items-center gap-1 rounded-lg pr-1 transition-colors hover:bg-accent/50",
+                        "group flex w-full items-center gap-1 rounded-lg pe-1 transition-colors hover:bg-accent/50",
                        activeRoom?.id === room.id && "bg-accent hover:bg-accent",
                      )}
                      key={room.id}
                    >
                      <button
-                        className="flex min-w-0 flex-1 items-center gap-2.5 rounded-lg px-2 py-2 text-left"
+                        className="flex min-w-0 flex-1 items-center gap-2.5 rounded-lg px-2 py-2 text-start"
                        onClick={() => setActiveRoom(room)}
                        type="button"
                      >
@@ -352,7 +352,7 @@ export function MeetingsView() {
                <div className="flex flex-col gap-1">
                  {upcoming.map((e) => (
                    <button
-                      className="flex flex-col gap-0.5 rounded-xl border bg-card px-2.5 py-2 text-left transition-colors hover:bg-accent/50"
+                      className="flex flex-col gap-0.5 rounded-xl border bg-card px-2.5 py-2 text-start transition-colors hover:bg-accent/50"
                      key={e.id}
                      onClick={() => setSelectedDay(new Date(`${e.date}T00:00:00`))}
                      type="button"
@@ -159,7 +159,7 @@ export function ScheduleMeetingDialog({
                      return (
                        <button
                          className={cn(
-                            "flex items-center gap-3 rounded-lg px-2 py-1.5 text-left transition-colors hover:bg-accent/50",
+                            "flex items-center gap-3 rounded-lg px-2 py-1.5 text-start transition-colors hover:bg-accent/50",
                            on && "bg-accent",
                          )}
                          key={m.id}
@@ -28,7 +28,7 @@ function Row({ label, value }: { label: string; value: ReactNode }) {
  return (
    <div className="flex items-baseline justify-between gap-3">
      <dt className="text-muted-foreground text-sm">{label}</dt>
-      <dd className="text-right text-foreground text-sm">{value}</dd>
+      <dd className="text-end text-foreground text-sm">{value}</dd>
    </div>
  );
 }
@@ -152,7 +152,7 @@ function SentAttachment({ att }: { att: MessageAttachment }) {
        <AttachmentContent>
          <AttachmentTitle>{att.fileName}</AttachmentTitle>
        </AttachmentContent>
-        <AttachmentActions className="pr-1.5">
+        <AttachmentActions className="pe-1.5">
          <AttachmentAction
            aria-label={t("messages.attach.download")}
            onClick={() => {
@@ -491,10 +491,10 @@ export function MessagesView() {
        </div>
        <div className="border-border border-b px-3 py-2">
          <div className="relative">
-            <Search className="-translate-y-1/2 absolute top-1/2 left-3 size-4 text-muted-foreground" />
+            <Search className="-translate-y-1/2 absolute top-1/2 start-3 size-4 text-muted-foreground" />
            <Input
              aria-label={t("messages.searchPlaceholder")}
-              className="pl-9"
+              className="ps-9"
              onChange={(e) => setInboxQuery(e.target.value)}
              placeholder={t("messages.searchPlaceholder")}
              size="sm"
@@ -520,7 +520,7 @@ export function MessagesView() {
              return (
                <div
                  className={cn(
-                    "flex w-full items-center gap-1 rounded-lg pr-2 transition-colors hover:bg-accent/50",
+                    "flex w-full items-center gap-1 rounded-lg pe-2 transition-colors hover:bg-accent/50",
                    selected?.id === c.id && "bg-accent hover:bg-accent",
                  )}
                  key={c.id}
@@ -544,7 +544,7 @@ export function MessagesView() {
                    </button>
                  )}
                  <button
-                    className="flex min-w-0 flex-1 items-center gap-3 rounded-lg py-2 pr-1 text-left"
+                    className="flex min-w-0 flex-1 items-center gap-3 rounded-lg py-2 pe-1 text-start"
                    onClick={() => open(c.id)}
                    type="button"
                  >
@@ -880,10 +880,10 @@ export function MessagesView() {
          </DialogHeader>
          <DialogPanel className="flex flex-col gap-2">
            <div className="relative">
-              <Search className="-translate-y-1/2 absolute top-1/2 left-3 size-4 text-muted-foreground" />
+              <Search className="-translate-y-1/2 absolute top-1/2 start-3 size-4 text-muted-foreground" />
              <Input
                aria-label={t("messages.compose.searchPlaceholder")}
-                className="pl-9"
+                className="ps-9"
                onChange={(e) => setMemberQuery(e.target.value)}
                placeholder={t("messages.compose.searchPlaceholder")}
                size="sm"
@@ -902,7 +902,7 @@ export function MessagesView() {
              ) : (
                visibleMembers.map((m) => (
                  <button
-                    className="flex w-full items-center gap-3 rounded-lg px-2 py-2 text-left transition-colors hover:bg-accent"
+                    className="flex w-full items-center gap-3 rounded-lg px-2 py-2 text-start transition-colors hover:bg-accent"
                    key={m.id}
                    onClick={() => startConversation(m.id)}
                    type="button"
@@ -932,10 +932,10 @@ export function MessagesView() {
          </DialogHeader>
          <DialogPanel className="flex flex-col gap-2">
            <div className="relative">
-              <Search className="-translate-y-1/2 absolute top-1/2 left-3 size-4 text-muted-foreground" />
+              <Search className="-translate-y-1/2 absolute top-1/2 start-3 size-4 text-muted-foreground" />
              <Input
                aria-label={t("messages.attach.apptSearchPlaceholder")}
-                className="pl-9"
+                className="ps-9"
                onChange={(e) => setApptQuery(e.target.value)}
                placeholder={t("messages.attach.apptSearchPlaceholder")}
                size="sm"
@@ -954,7 +954,7 @@ export function MessagesView() {
              ) : (
                visibleAppts.map((a) => (
                  <button
-                    className="flex w-full flex-col gap-0.5 rounded-lg px-2 py-2 text-left transition-colors hover:bg-accent"
+                    className="flex w-full flex-col gap-0.5 rounded-lg px-2 py-2 text-start transition-colors hover:bg-accent"
                    key={a.id}
                    onClick={() => attachAppointment(a)}
                    type="button"
@@ -153,7 +153,7 @@ export function NotesView() {
        <div className="divide-y divide-border overflow-hidden rounded-2xl border bg-card/30">
          {notes.map((n) => (
            <button
-              className="flex w-full flex-col items-start gap-0.5 px-4 py-3 text-left transition-colors hover:bg-accent/50"
+              className="flex w-full flex-col items-start gap-0.5 px-4 py-3 text-start transition-colors hover:bg-accent/50"
              key={n.id}
              onClick={() => openNote(n)}
              type="button"
@@ -141,6 +141,8 @@ export function ImportFromWalletDialog({
    } catch (err) {
      if (err instanceof ApiError && err.status === 400) {
        setError(t("patients.importApp.invalidWallet"));
+      } else if (err instanceof ApiError && err.status === 409) {
+        setError(t("patients.importApp.networkOff"));
      } else {
        setError(t("patients.importApp.error"));
      }
@@ -171,8 +173,12 @@ export function ImportFromWalletDialog({
      setPairUri(`temetro-pair:?${params.toString()}`);
      setRequest(pairing);
      setPhase("waiting");
-    } catch {
-      setError(t("patients.importApp.error"));
+    } catch (err) {
+      if (err instanceof ApiError && err.status === 409) {
+        setError(t("patients.importApp.networkOff"));
+      } else {
+        setError(t("patients.importApp.error"));
+      }
      setPhase("error");
    }
  };
@@ -7,7 +7,9 @@ import { AiBadge } from "@/components/ai-badge";
 import { PatientFormDialog } from "@/components/chat/patient-form-dialog";
 import { RecordGraph } from "@/components/graph/record-graph";
 import { PatientDetail } from "@/components/patients/patient-detail";
+import { ScribeDialog } from "@/components/patients/scribe-dialog";
 import { TransferPatientDialog } from "@/components/patients/transfer-patient-dialog";
+import { WalletPushDialog } from "@/components/patients/wallet-push-dialog";
 import { ConfirmDialog } from "@/components/ui/confirm-dialog";
 import {
  Dialog,
@@ -28,8 +30,10 @@ import { type Appointment, listAppointments } from "@/lib/appointments";
 import { type Invoice, listInvoices } from "@/lib/invoices";
 import { deletePatient, getPatient, type Patient } from "@/lib/patients";
 import { listPrescriptions, type Prescription } from "@/lib/prescriptions";
+import { useAiAccess } from "@/lib/ai-policy";
 import { hasClinicalAccess, useActiveRole } from "@/lib/roles";
 import { notify } from "@/lib/toast";
+import { getWalletLink } from "@/lib/wallet-updates";

 type Status = "loading" | "ready" | "not-found";

@@ -76,9 +80,17 @@ export function PatientDetailSheet({
  // Deleting a chart is destructive — only offer it once we know the role is
  // a full clinician (patient:delete), never optimistically.
  const canDelete = role != null && hasClinicalAccess(role);
+  // The ambient scribe writes a clinical note, so it needs full clinical write
+  // access AND the clinic's AI must be enabled for this member.
+  const { allowed: aiAllowed } = useAiAccess();
+  const canScribe = role != null && hasClinicalAccess(role) && aiAllowed;
  const [patient, setPatient] = useState<Patient | null>(null);
  const [status, setStatus] = useState<Status>("loading");
  const [editOpen, setEditOpen] = useState(false);
+  const [scribeOpen, setScribeOpen] = useState(false);
+  const [walletPushOpen, setWalletPushOpen] = useState(false);
+  // Set once we confirm this patient is linked to a wallet (permanent share).
+  const [walletLinked, setWalletLinked] = useState(false);
  const [transferOpen, setTransferOpen] = useState(false);
  const [confirmOpen, setConfirmOpen] = useState(false);
  // Graph popped out of the sheet into its own dialog (the sheet closes first).
@@ -124,6 +136,21 @@ export function PatientDetailSheet({
    };
  }, [open, fileNumber]);

+  // Whether this patient is wallet-linked (drives the "Push update" button).
+  // Separate from the main load so it re-checks once the role resolves without
+  // refetching the record. Only clinicians can push.
+  useEffect(() => {
+    setWalletLinked(false);
+    if (!open || !fileNumber || !hasClinicalAccess(role)) return;
+    let active = true;
+    getWalletLink(fileNumber)
+      .then(() => active && setWalletLinked(true))
+      .catch(() => {});
+    return () => {
+      active = false;
+    };
+  }, [open, fileNumber, role]);
+
  const remove = async () => {
    if (!patient) return;
    try {
@@ -171,6 +198,10 @@ export function PatientDetailSheet({
                  setEditKey((k) => k + 1);
                  setEditOpen(true);
                }}
+                onScribe={canScribe ? () => setScribeOpen(true) : undefined}
+                onWalletPush={
+                  walletLinked ? () => setWalletPushOpen(true) : undefined
+                }
                onOpenGraph={() => {
                  onOpenChange(false);
                  setGraphOpen(true);
@@ -197,6 +228,23 @@ export function PatientDetailSheet({
        />
      )}

+      {patient && (
+        <ScribeDialog
+          onOpenChange={setScribeOpen}
+          onSaved={(updated) => setPatient(updated)}
+          open={scribeOpen}
+          patient={patient}
+        />
+      )}
+
+      {patient && (
+        <WalletPushDialog
+          onOpenChange={setWalletPushOpen}
+          open={walletPushOpen}
+          patient={patient}
+        />
+      )}
+
      {patient && (
        <TransferPatientDialog
          onOpenChange={setTransferOpen}
@@ -1,6 +1,14 @@
 "use client";

-import { ArrowLeftRight, FileDown, Network, Pencil, Trash2 } from "lucide-react";
+import {
+  ArrowLeftRight,
+  FileDown,
+  Mic,
+  Network,
+  Pencil,
+  Send,
+  Trash2,
+} from "lucide-react";
 import { type ReactNode, useEffect, useState } from "react";
 import { useTranslation } from "react-i18next";

@@ -173,6 +181,8 @@ function RecordHistory({ fileNumber }: { fileNumber: string }) {
 export function PatientDetail({
  patient,
  onEdit,
+  onScribe,
+  onWalletPush,
  onTransfer,
  onDelete,
  onOpenGraph,
@@ -182,6 +192,10 @@ export function PatientDetail({
 }: {
  patient: Patient;
  onEdit?: () => void;
+  // Opens the ambient AI visit scribe (record/transcribe → draft note).
+  onScribe?: () => void;
+  // Pushes the record to the patient's wallet (only when wallet-linked).
+  onWalletPush?: () => void;
  onTransfer?: () => void;
  onDelete?: () => void;
  // Pops the record graph out into its own dialog (closing this sheet).
@@ -287,16 +301,33 @@ export function PatientDetail({
              {t("patients.transfer.action")}
            </Button>
          )}
+          {onScribe && (
+            <Button onClick={onScribe} size="sm" type="button" variant="outline">
+              <Mic className="size-4" />
+              {t("scribe.recordVisit")}
+            </Button>
+          )}
          {onEdit && (
            <Button onClick={onEdit} size="sm" type="button" variant="outline">
              <Pencil className="size-4" />
              {t("patientCard.edit")}
            </Button>
          )}
+          {onWalletPush && (
+            <Button
+              onClick={onWalletPush}
+              size="sm"
+              type="button"
+              variant="outline"
+            >
+              <Send className="size-4" />
+              {t("walletPush.action")}
+            </Button>
+          )}
          {onDelete && (
            <Button
              aria-label={t("patients.delete.action")}
-              className="ml-auto"
+              className="ms-auto"
              onClick={onDelete}
              size="sm"
              type="button"
@@ -358,7 +389,7 @@ export function PatientDetail({
            <div className="divide-y divide-border overflow-hidden rounded-xl border bg-card/30">
              {files.map((file) => (
                <button
-                  className="flex w-full items-center gap-2.5 px-3 py-2 text-left transition-colors hover:bg-accent"
+                  className="flex w-full items-center gap-2.5 px-3 py-2 text-start transition-colors hover:bg-accent"
                  key={file.id}
                  onClick={() => setOpenFile(file)}
                  type="button"
@@ -210,7 +210,7 @@ export function AttachmentsSection({
              key={attachment.id}
            >
              <button
-                className="flex min-w-0 flex-1 items-center gap-2.5 text-left"
+                className="flex min-w-0 flex-1 items-center gap-2.5 text-start"
                onClick={() => setPreview(attachment)}
                type="button"
              >
@@ -1,6 +1,6 @@
 "use client";

-import { ChevronLeft, ChevronRight, Plus, Search, Smartphone } from "lucide-react";
+import { Plus, Search, Smartphone } from "lucide-react";
 import { useSearchParams } from "next/navigation";
 import { useEffect, useRef, useState } from "react";
 import { useTranslation } from "react-i18next";
@@ -12,34 +12,12 @@ import { PatientDetailSheet } from "@/components/patients/patient-detail-sheet";
 import { Badge } from "@/components/ui/badge";
 import { Button } from "@/components/ui/button";
 import { Input } from "@/components/ui/input";
-import {
-  Pagination,
-  PaginationContent,
-  PaginationEllipsis,
-  PaginationItem,
-} from "@/components/ui/pagination";
+import { ListPagination } from "@/components/ui/list-pagination";
 import { listPatients, type Patient } from "@/lib/patients";

 // Rows shown per page on the patients table before paginating.
 const PAGE_SIZE = 10;

-// Page numbers to render, with `null` marking an ellipsis gap. Keeps the first,
-// last, and a small window around the current page so the control stays compact
-// even with many pages.
-function pageWindow(current: number, total: number): (number | null)[] {
-  if (total <= 7) {
-    return Array.from({ length: total }, (_, i) => i + 1);
-  }
-  const pages: (number | null)[] = [1];
-  const start = Math.max(2, current - 1);
-  const end = Math.min(total - 1, current + 1);
-  if (start > 2) pages.push(null);
-  for (let p = start; p <= end; p++) pages.push(p);
-  if (end < total - 1) pages.push(null);
-  pages.push(total);
-  return pages;
-}
-
 type BadgeVariant = "success" | "info" | "outline";

 // Colour the status for at-a-glance scanning: active patients read as success
@@ -137,9 +115,9 @@ export function PatientsView() {
        </h1>
        <div className="flex items-center gap-2">
          <div className="relative">
-            <Search className="-translate-y-1/2 absolute top-1/2 left-3 size-4 text-muted-foreground" />
+            <Search className="-translate-y-1/2 absolute top-1/2 start-3 size-4 text-muted-foreground" />
            <Input
-              className="w-full pl-9 sm:w-64"
+              className="w-full ps-9 sm:w-64"
              onChange={(event) => {
                setQuery(event.target.value);
                setPage(1);
@@ -181,7 +159,7 @@ export function PatientsView() {
      <div className="mt-8 overflow-hidden rounded-2xl border border-border bg-card/30">
        <table className="w-full text-sm">
          <thead>
-            <tr className="border-border border-b text-left text-xs text-muted-foreground uppercase">
+            <tr className="border-border border-b text-start text-xs text-muted-foreground uppercase">
              <th className="px-4 py-3 font-medium">{t("patients.columns.name")}</th>
              <th className="px-4 py-3 font-medium">{t("patients.columns.mrn")}</th>
              <th className="px-4 py-3 font-medium">
@@ -273,75 +251,13 @@ export function PatientsView() {
        </table>
      </div>

-      {!loading && !loadError && patients.length > PAGE_SIZE ? (
-        <div className="mt-4 flex flex-col items-center justify-between gap-3 sm:flex-row">
-          <p className="text-xs text-muted-foreground">
-            {t("patients.pagination.summary", {
-              from: (safePage - 1) * PAGE_SIZE + 1,
-              to: Math.min(safePage * PAGE_SIZE, patients.length),
-              total: patients.length,
-            })}
-          </p>
-          <Pagination
-            aria-label={t("patients.pagination.label")}
-            className="mx-0 w-auto justify-end"
-          >
-            <PaginationContent>
-              <PaginationItem>
-                <Button
-                  aria-label={t("patients.pagination.previous")}
-                  className="gap-1"
-                  disabled={safePage === 1}
-                  onClick={() => setPage(Math.max(1, safePage - 1))}
-                  size="sm"
-                  type="button"
-                  variant="ghost"
-                >
-                  <ChevronLeft className="size-4" />
-                  <span className="max-sm:hidden">
-                    {t("patients.pagination.previous")}
-                  </span>
-                </Button>
-              </PaginationItem>
-              {pageWindow(safePage, totalPages).map((p, i) =>
-                p === null ? (
-                  <PaginationItem key={`ellipsis-${i}`}>
-                    <PaginationEllipsis />
-                  </PaginationItem>
-                ) : (
-                  <PaginationItem key={p}>
-                    <Button
-                      aria-current={p === safePage ? "page" : undefined}
-                      aria-label={t("patients.pagination.page", { page: p })}
-                      onClick={() => setPage(p)}
-                      size="icon-sm"
-                      type="button"
-                      variant={p === safePage ? "outline" : "ghost"}
-                    >
-                      {p}
-                    </Button>
-                  </PaginationItem>
-                )
-              )}
-              <PaginationItem>
-                <Button
-                  aria-label={t("patients.pagination.next")}
-                  className="gap-1"
-                  disabled={safePage === totalPages}
-                  onClick={() => setPage(Math.min(totalPages, safePage + 1))}
-                  size="sm"
-                  type="button"
-                  variant="ghost"
-                >
-                  <span className="max-sm:hidden">
-                    {t("patients.pagination.next")}
-                  </span>
-                  <ChevronRight className="size-4" />
-                </Button>
-              </PaginationItem>
-            </PaginationContent>
-          </Pagination>
-        </div>
+      {!loading && !loadError ? (
+        <ListPagination
+          onPageChange={setPage}
+          page={safePage}
+          pageSize={PAGE_SIZE}
+          total={patients.length}
+        />
      ) : null}

      <PatientFormDialog
@@ -0,0 +1,436 @@
+"use client";
+
+import { Mic, Square, Sparkles, Trash2 } from "lucide-react";
+import { useEffect, useRef, useState } from "react";
+import { useTranslation } from "react-i18next";
+
+import { Button } from "@/components/ui/button";
+import {
+  Dialog,
+  DialogDescription,
+  DialogFooter,
+  DialogHeader,
+  DialogPanel,
+  DialogPopup,
+  DialogTitle,
+} from "@/components/ui/dialog";
+import { Input } from "@/components/ui/input";
+import { Label } from "@/components/ui/label";
+import { Spinner } from "@/components/ui/spinner";
+import {
+  Tabs,
+  TabsList,
+  TabsPanel,
+  TabsTab,
+} from "@/components/ui/tabs";
+import { Textarea } from "@/components/ui/textarea";
+import { uploadAttachment } from "@/lib/attachments";
+import type { Encounter, Patient } from "@/lib/patients";
+import { draftNote, saveNote, transcribeRecording } from "@/lib/scribe";
+import { notify } from "@/lib/toast";
+import { ApiError } from "@/lib/api-client";
+
+type Phase = "input" | "processing" | "review";
+type InputTab = "record" | "paste";
+type RecState = "idle" | "recording" | "recorded";
+
+// Pick a supported audio mime for MediaRecorder (Opus in WebM/OGG is tiny for
+// speech; Safari falls back to mp4). Returns "" to let the browser choose.
+function pickAudioMime(): string {
+  if (typeof MediaRecorder === "undefined") return "";
+  const candidates = [
+    "audio/webm;codecs=opus",
+    "audio/webm",
+    "audio/ogg;codecs=opus",
+    "audio/mp4",
+  ];
+  return candidates.find((m) => MediaRecorder.isTypeSupported(m)) ?? "";
+}
+
+function fmtElapsed(sec: number): string {
+  const m = Math.floor(sec / 60);
+  const s = sec % 60;
+  return `${m}:${String(s).padStart(2, "0")}`;
+}
+
+// The ambient AI scribe: record or paste a visit conversation, draft a SOAP
+// encounter note, review it, and append it to the patient record.
+export function ScribeDialog({
+  patient,
+  open,
+  onOpenChange,
+  onSaved,
+}: {
+  patient: Patient;
+  open: boolean;
+  onOpenChange: (open: boolean) => void;
+  onSaved: (updated: Patient) => void;
+}) {
+  const { t } = useTranslation();
+  const [phase, setPhase] = useState<Phase>("input");
+  const [tab, setTab] = useState<InputTab>("record");
+  const [recState, setRecState] = useState<RecState>("idle");
+  const [elapsed, setElapsed] = useState(0);
+  const [transcript, setTranscript] = useState("");
+  const [visitType, setVisitType] = useState("");
+  const [draft, setDraft] = useState<Encounter | null>(null);
+  const [veilNote, setVeilNote] = useState<string | null>(null);
+  const [error, setError] = useState<string | null>(null);
+
+  const mediaRef = useRef<MediaRecorder | null>(null);
+  const chunksRef = useRef<Blob[]>([]);
+  const blobRef = useRef<Blob | null>(null);
+  const timerRef = useRef<ReturnType<typeof setInterval> | null>(null);
+
+  // Tear down any live recording + object state when the dialog closes.
+  const stopTracks = () => {
+    mediaRef.current?.stream.getTracks().forEach((track) => track.stop());
+    mediaRef.current = null;
+    if (timerRef.current) clearInterval(timerRef.current);
+    timerRef.current = null;
+  };
+
+  // Stop tracks on unmount.
+  useEffect(() => () => stopTracks(), []);
+
+  // Reset all state for the next open. Called on every close (the parent only
+  // ever closes this dialog through our onOpenChange), so no reset-in-effect.
+  const reset = () => {
+    setPhase("input");
+    setTab("record");
+    setRecState("idle");
+    setElapsed(0);
+    setTranscript("");
+    setVisitType("");
+    setDraft(null);
+    setVeilNote(null);
+    setError(null);
+    chunksRef.current = [];
+    blobRef.current = null;
+  };
+
+  const handleOpenChange = (next: boolean) => {
+    if (!next) {
+      stopTracks();
+      reset();
+    }
+    onOpenChange(next);
+  };
+
+  const startRecording = async () => {
+    setError(null);
+    try {
+      const stream = await navigator.mediaDevices.getUserMedia({ audio: true });
+      const mime = pickAudioMime();
+      const recorder = new MediaRecorder(
+        stream,
+        mime ? { mimeType: mime } : undefined,
+      );
+      chunksRef.current = [];
+      recorder.ondataavailable = (e) => {
+        if (e.data.size > 0) chunksRef.current.push(e.data);
+      };
+      recorder.onstop = () => {
+        blobRef.current = new Blob(chunksRef.current, {
+          type: recorder.mimeType || "audio/webm",
+        });
+        setRecState("recorded");
+      };
+      recorder.start();
+      mediaRef.current = recorder;
+      setRecState("recording");
+      setElapsed(0);
+      timerRef.current = setInterval(() => setElapsed((s) => s + 1), 1000);
+    } catch {
+      setError(t("scribe.errors.mic"));
+    }
+  };
+
+  const stopRecording = () => {
+    mediaRef.current?.stop();
+    mediaRef.current?.stream.getTracks().forEach((track) => track.stop());
+    if (timerRef.current) clearInterval(timerRef.current);
+    timerRef.current = null;
+  };
+
+  const discardRecording = () => {
+    blobRef.current = null;
+    chunksRef.current = [];
+    setRecState("idle");
+    setElapsed(0);
+  };
+
+  const filenameFor = (blob: Blob): string => {
+    const ext = blob.type.includes("mp4")
+      ? "m4a"
+      : blob.type.includes("ogg")
+        ? "ogg"
+        : "webm";
+    return `visit-${patient.fileNumber}-${Date.now()}.${ext}`;
+  };
+
+  const generate = async () => {
+    setError(null);
+    setPhase("processing");
+    try {
+      let text = transcript.trim();
+      if (tab === "record") {
+        const blob = blobRef.current;
+        if (!blob) {
+          setError(t("scribe.errors.noRecording"));
+          setPhase("input");
+          return;
+        }
+        // Store the recording as a patient attachment (auditable), then
+        // transcribe it server-side.
+        const file = new File([blob], filenameFor(blob), { type: blob.type });
+        const attachment = await uploadAttachment({
+          file,
+          fileNumber: patient.fileNumber,
+          labKey: "scribe",
+        });
+        const res = await transcribeRecording(attachment.id);
+        text = res.transcript.trim();
+        setTranscript(text);
+      }
+      if (!text) {
+        setError(t("scribe.errors.empty"));
+        setPhase("input");
+        return;
+      }
+      const { draft: note, veil } = await draftNote({
+        fileNumber: patient.fileNumber,
+        transcript: text,
+        visitType: visitType.trim() || undefined,
+      });
+      setDraft(note);
+      setVeilNote(
+        veil.active ? t("scribe.review.veil", { provider: veil.provider }) : null,
+      );
+      setPhase("review");
+    } catch (err) {
+      setError(
+        err instanceof ApiError ? err.message : t("scribe.errors.generic"),
+      );
+      setPhase("input");
+    }
+  };
+
+  const save = async () => {
+    if (!draft) return;
+    setPhase("processing");
+    try {
+      const updated = await saveNote(patient.fileNumber, draft);
+      notify.success(t("scribe.saved.title"), patient.name);
+      onSaved(updated);
+      handleOpenChange(false);
+    } catch (err) {
+      setError(
+        err instanceof ApiError ? err.message : t("scribe.errors.generic"),
+      );
+      setPhase("review");
+    }
+  };
+
+  const busy = phase === "processing";
+
+  return (
+    <Dialog onOpenChange={handleOpenChange} open={open}>
+      <DialogPopup className="flex max-h-[85dvh] flex-col sm:max-w-lg">
+        <DialogHeader>
+          <DialogTitle className="flex items-center gap-2">
+            <Sparkles className="size-4 text-primary" />
+            {t("scribe.title")}
+          </DialogTitle>
+          <DialogDescription>
+            {t("scribe.subtitle", { name: patient.name })}
+          </DialogDescription>
+        </DialogHeader>
+
+        <DialogPanel className="min-h-0 flex-1 overflow-y-auto">
+          {phase === "review" && draft ? (
+            <div className="flex flex-col gap-4">
+              <div className="grid grid-cols-2 gap-3">
+                <div className="flex flex-col gap-1.5">
+                  <Label htmlFor="scribe-type">{t("scribe.review.type")}</Label>
+                  <Input
+                    id="scribe-type"
+                    onChange={(e) =>
+                      setDraft({ ...draft, type: e.target.value })
+                    }
+                    value={draft.type}
+                  />
+                </div>
+                <div className="flex flex-col gap-1.5">
+                  <Label htmlFor="scribe-date">{t("scribe.review.date")}</Label>
+                  <Input
+                    id="scribe-date"
+                    onChange={(e) =>
+                      setDraft({ ...draft, date: e.target.value })
+                    }
+                    type="date"
+                    value={draft.date}
+                  />
+                </div>
+              </div>
+              <div className="flex flex-col gap-1.5">
+                <Label htmlFor="scribe-summary">
+                  {t("scribe.review.summary")}
+                </Label>
+                <Textarea
+                  className="min-h-56"
+                  id="scribe-summary"
+                  onChange={(e) =>
+                    setDraft({ ...draft, summary: e.target.value })
+                  }
+                  value={draft.summary}
+                />
+              </div>
+              <p className="text-muted-foreground text-xs">
+                {t("scribe.review.provider", { provider: draft.provider })}
+              </p>
+              {veilNote && (
+                <p className="rounded-lg bg-muted px-3 py-2 text-muted-foreground text-xs">
+                  {veilNote}
+                </p>
+              )}
+            </div>
+          ) : (
+            <Tabs
+              onValueChange={(v) => setTab(v as InputTab)}
+              value={tab}
+            >
+              <TabsList className="w-full">
+                <TabsTab value="record">
+                  <Mic className="size-4" />
+                  {t("scribe.tabs.record")}
+                </TabsTab>
+                <TabsTab value="paste">{t("scribe.tabs.paste")}</TabsTab>
+              </TabsList>
+
+              <TabsPanel className="pt-3" value="record">
+                <div className="flex flex-col items-center gap-4 py-4">
+                  {recState === "recording" ? (
+                    <>
+                      <div className="flex items-center gap-2 text-destructive">
+                        <span className="size-2.5 animate-pulse rounded-full bg-destructive" />
+                        <span className="font-mono text-lg tabular-nums">
+                          {fmtElapsed(elapsed)}
+                        </span>
+                      </div>
+                      <Button
+                        onClick={stopRecording}
+                        type="button"
+                        variant="destructive"
+                      >
+                        <Square className="size-4" />
+                        {t("scribe.record.stop")}
+                      </Button>
+                    </>
+                  ) : recState === "recorded" ? (
+                    <>
+                      <p className="text-foreground text-sm">
+                        {t("scribe.record.ready", {
+                          duration: fmtElapsed(elapsed),
+                        })}
+                      </p>
+                      <Button
+                        onClick={discardRecording}
+                        size="sm"
+                        type="button"
+                        variant="outline"
+                      >
+                        <Trash2 className="size-4" />
+                        {t("scribe.record.discard")}
+                      </Button>
+                    </>
+                  ) : (
+                    <Button onClick={startRecording} type="button">
+                      <Mic className="size-4" />
+                      {t("scribe.record.start")}
+                    </Button>
+                  )}
+                </div>
+              </TabsPanel>
+
+              <TabsPanel className="pt-3" value="paste">
+                <Textarea
+                  className="min-h-40"
+                  onChange={(e) => setTranscript(e.target.value)}
+                  placeholder={t("scribe.paste.placeholder")}
+                  value={transcript}
+                />
+              </TabsPanel>
+
+              <div className="mt-4 flex flex-col gap-3">
+                <div className="flex flex-col gap-1.5">
+                  <Label htmlFor="scribe-visit-type">
+                    {t("scribe.visitType.label")}
+                  </Label>
+                  <Input
+                    id="scribe-visit-type"
+                    onChange={(e) => setVisitType(e.target.value)}
+                    placeholder={t("scribe.visitType.placeholder")}
+                    value={visitType}
+                  />
+                </div>
+                <p className="rounded-lg bg-muted px-3 py-2 text-muted-foreground text-xs">
+                  {t("scribe.consent")}
+                </p>
+              </div>
+            </Tabs>
+          )}
+
+          {error && (
+            <p className="mt-3 text-destructive text-sm" role="alert">
+              {error}
+            </p>
+          )}
+        </DialogPanel>
+
+        <DialogFooter>
+          {phase === "review" ? (
+            <>
+              <Button
+                disabled={busy}
+                onClick={() => setPhase("input")}
+                type="button"
+                variant="outline"
+              >
+                {t("scribe.review.back")}
+              </Button>
+              <Button disabled={busy} onClick={save} type="button">
+                {busy && <Spinner className="size-4" />}
+                {t("scribe.review.save")}
+              </Button>
+            </>
+          ) : (
+            <>
+              <Button
+                disabled={busy}
+                onClick={() => handleOpenChange(false)}
+                type="button"
+                variant="outline"
+              >
+                {t("scribe.cancel")}
+              </Button>
+              <Button
+                disabled={
+                  busy ||
+                  (tab === "record"
+                    ? recState !== "recorded"
+                    : transcript.trim().length === 0)
+                }
+                onClick={generate}
+                type="button"
+              >
+                {busy && <Spinner className="size-4" />}
+                {busy ? t("scribe.processing") : t("scribe.generate")}
+              </Button>
+            </>
+          )}
+        </DialogFooter>
+      </DialogPopup>
+    </Dialog>
+  );
+}
@@ -0,0 +1,242 @@
+"use client";
+
+import { Check, Loader2, Send, X } from "lucide-react";
+import { useEffect, useState } from "react";
+import { useTranslation } from "react-i18next";
+
+import { Button } from "@/components/ui/button";
+import {
+  Dialog,
+  DialogDescription,
+  DialogFooter,
+  DialogHeader,
+  DialogPanel,
+  DialogPopup,
+  DialogTitle,
+} from "@/components/ui/dialog";
+import { Label } from "@/components/ui/label";
+import { Spinner } from "@/components/ui/spinner";
+import { Textarea } from "@/components/ui/textarea";
+import { ApiError } from "@/lib/api-client";
+import type { Patient } from "@/lib/patients";
+import { cn } from "@/lib/utils";
+import {
+  getWalletUpdate,
+  pushWalletUpdate,
+  type WalletUpdate,
+} from "@/lib/wallet-updates";
+
+// The record sections a clinician can flag as changed. The labels double as the
+// human-readable change summary the patient sees when approving.
+const SECTION_KEYS = [
+  "demographics",
+  "problems",
+  "medications",
+  "allergies",
+  "labs",
+  "vitals",
+  "visits",
+] as const;
+
+type Phase = "compose" | "sent";
+
+// Push the current record to a wallet-linked patient's app. The patient must
+// approve it on their phone before their on-device record is replaced.
+export function WalletPushDialog({
+  patient,
+  open,
+  onOpenChange,
+}: {
+  patient: Patient;
+  open: boolean;
+  onOpenChange: (open: boolean) => void;
+}) {
+  const { t } = useTranslation();
+  const [phase, setPhase] = useState<Phase>("compose");
+  const [selected, setSelected] = useState<Set<string>>(new Set());
+  const [note, setNote] = useState("");
+  const [update, setUpdate] = useState<WalletUpdate | null>(null);
+  const [busy, setBusy] = useState(false);
+  const [error, setError] = useState<string | null>(null);
+
+  const reset = () => {
+    setPhase("compose");
+    setSelected(new Set());
+    setNote("");
+    setUpdate(null);
+    setBusy(false);
+    setError(null);
+  };
+
+  const handleOpenChange = (next: boolean) => {
+    if (!next) reset();
+    onOpenChange(next);
+  };
+
+  // Poll the update's status until the patient approves/denies (or the dialog
+  // closes). Live pushes usually resolve within seconds.
+  useEffect(() => {
+    if (phase !== "sent" || !update || update.resolvedAt) return;
+    let active = true;
+    const timer = setInterval(async () => {
+      try {
+        const fresh = await getWalletUpdate(update.id);
+        if (!active) return;
+        setUpdate(fresh);
+        if (fresh.resolvedAt) clearInterval(timer);
+      } catch {
+        /* keep polling */
+      }
+    }, 3000);
+    return () => {
+      active = false;
+      clearInterval(timer);
+    };
+  }, [phase, update]);
+
+  const toggle = (key: string) => {
+    setSelected((prev) => {
+      const next = new Set(prev);
+      if (next.has(key)) next.delete(key);
+      else next.add(key);
+      return next;
+    });
+  };
+
+  const push = async () => {
+    setBusy(true);
+    setError(null);
+    try {
+      const changes = [
+        ...[...selected].map((k) => t(`walletPush.sections.${k}`)),
+        ...(note.trim() ? [note.trim()] : []),
+      ];
+      const created = await pushWalletUpdate({
+        fileNumber: patient.fileNumber,
+        changes,
+      });
+      setUpdate(created);
+      setPhase("sent");
+    } catch (err) {
+      setError(
+        err instanceof ApiError ? err.message : t("walletPush.errors.generic"),
+      );
+    } finally {
+      setBusy(false);
+    }
+  };
+
+  const canPush = selected.size > 0 || note.trim().length > 0;
+  const status = update?.status ?? "pending";
+
+  return (
+    <Dialog onOpenChange={handleOpenChange} open={open}>
+      <DialogPopup className="flex max-h-[85dvh] flex-col sm:max-w-md">
+        <DialogHeader>
+          <DialogTitle className="flex items-center gap-2">
+            <Send className="size-4 text-primary" />
+            {t("walletPush.title")}
+          </DialogTitle>
+          <DialogDescription>
+            {t("walletPush.subtitle", { name: patient.name })}
+          </DialogDescription>
+        </DialogHeader>
+
+        <DialogPanel className="min-h-0 flex-1 overflow-y-auto">
+          {phase === "compose" ? (
+            <div className="flex flex-col gap-4">
+              <div className="flex flex-col gap-2">
+                <Label>{t("walletPush.sectionsLabel")}</Label>
+                <div className="flex flex-wrap gap-2">
+                  {SECTION_KEYS.map((key) => {
+                    const on = selected.has(key);
+                    return (
+                      <button
+                        className={cn(
+                          "rounded-full border px-3 py-1 text-sm transition-colors",
+                          on
+                            ? "border-primary bg-primary/10 text-foreground"
+                            : "border-border text-muted-foreground hover:bg-accent",
+                        )}
+                        key={key}
+                        onClick={() => toggle(key)}
+                        type="button"
+                      >
+                        {t(`walletPush.sections.${key}`)}
+                      </button>
+                    );
+                  })}
+                </div>
+              </div>
+              <div className="flex flex-col gap-1.5">
+                <Label htmlFor="wallet-push-note">
+                  {t("walletPush.noteLabel")}
+                </Label>
+                <Textarea
+                  className="min-h-20"
+                  id="wallet-push-note"
+                  onChange={(e) => setNote(e.target.value)}
+                  placeholder={t("walletPush.notePlaceholder")}
+                  value={note}
+                />
+              </div>
+              <p className="rounded-lg bg-muted px-3 py-2 text-muted-foreground text-xs">
+                {t("walletPush.notice")}
+              </p>
+            </div>
+          ) : (
+            <div className="flex flex-col items-center gap-4 py-6 text-center">
+              {status === "approved" ? (
+                <div className="flex size-12 items-center justify-center rounded-full bg-success/15 text-success">
+                  <Check className="size-6" />
+                </div>
+              ) : status === "denied" ? (
+                <div className="flex size-12 items-center justify-center rounded-full bg-destructive/15 text-destructive">
+                  <X className="size-6" />
+                </div>
+              ) : (
+                <Loader2 className="size-8 animate-spin text-muted-foreground" />
+              )}
+              <div className="flex flex-col gap-1">
+                <p className="font-medium text-foreground text-sm">
+                  {t(`walletPush.status.${status}.title`)}
+                </p>
+                <p className="text-muted-foreground text-sm">
+                  {t(`walletPush.status.${status}.body`)}
+                </p>
+              </div>
+            </div>
+          )}
+
+          {error && (
+            <p className="mt-3 text-destructive text-sm" role="alert">
+              {error}
+            </p>
+          )}
+        </DialogPanel>
+
+        <DialogFooter>
+          {phase === "compose" ? (
+            <>
+              <Button
+                onClick={() => handleOpenChange(false)}
+                type="button"
+                variant="outline"
+              >
+                {t("walletPush.cancel")}
+              </Button>
+              <Button disabled={busy || !canPush} onClick={push} type="button">
+                {busy && <Spinner className="size-4" />}
+                {t("walletPush.send")}
+              </Button>
+            </>
+          ) : (
+            <Button onClick={() => handleOpenChange(false)} type="button">
+              {t("walletPush.done")}
+            </Button>
+          )}
+        </DialogFooter>
+      </DialogPopup>
+    </Dialog>
+  );
+}
@@ -35,7 +35,7 @@ function Row({ label, value }: { label: string; value: ReactNode }) {
  return (
    <div className="flex items-center justify-between gap-4 py-2">
      <span className="text-muted-foreground text-sm">{label}</span>
-      <span className="text-right text-foreground text-sm">{value}</span>
+      <span className="text-end text-foreground text-sm">{value}</span>
    </div>
  );
 }
@@ -68,7 +68,7 @@ export function InventoryDetailDialog({
            </span>
            <span className="min-w-0 truncate">{item.name}</span>
            <Badge
-              className="ml-auto shrink-0"
+              className="ms-auto shrink-0"
              variant={availabilityVariant[availability]}
            >
              {t(`inventory.availability.${availability}`)}
@@ -67,7 +67,7 @@ function ItemRow({
  const descriptor = [item.strength, item.form].filter(Boolean).join(" · ");
  return (
    <div
-      className="flex w-full cursor-pointer items-center gap-3 px-4 py-3 text-left transition-colors hover:bg-accent/50"
+      className="flex w-full cursor-pointer items-center gap-3 px-4 py-3 text-start transition-colors hover:bg-accent/50"
      onClick={onOpen}
      onKeyDown={(event) => {
        if (event.key === "Enter" || event.key === " ") {
@@ -205,9 +205,9 @@ export function InventoryView() {
        </div>
        <div className="flex items-center gap-2">
          <div className="relative">
-            <Search className="-translate-y-1/2 absolute top-1/2 left-3 size-4 text-muted-foreground" />
+            <Search className="-translate-y-1/2 absolute top-1/2 start-3 size-4 text-muted-foreground" />
            <Input
-              className="w-full pl-9 sm:w-64"
+              className="w-full ps-9 sm:w-64"
              onChange={(event) => setQuery(event.target.value)}
              placeholder={t("inventory.searchPlaceholder")}
              value={query}
@@ -330,9 +330,9 @@ export function PharmacyView() {
          <p className="text-muted-foreground text-sm">{t("pharmacy.subtitle")}</p>
        </div>
        <div className="relative">
-          <Search className="-translate-y-1/2 absolute top-1/2 left-3 size-4 text-muted-foreground" />
+          <Search className="-translate-y-1/2 absolute top-1/2 start-3 size-4 text-muted-foreground" />
          <Input
-            className="w-full pl-9 sm:w-64"
+            className="w-full ps-9 sm:w-64"
            onChange={(event) => setQuery(event.target.value)}
            placeholder={t("pharmacy.searchPlaceholder")}
            value={query}
@@ -43,7 +43,7 @@ function Field({
  children: React.ReactNode;
 }) {
  return (
-    <label className="flex flex-col gap-1.5 text-left">
+    <label className="flex flex-col gap-1.5 text-start">
      <span className="font-medium text-foreground text-sm">{label}</span>
      {children}
    </label>
@@ -122,7 +122,7 @@ function ChooseStep({ onPick }: { onPick: (step: Step) => void }) {
    <div className="grid w-full gap-4 sm:grid-cols-2">
      {cards.map((c) => (
        <button
-          className="group flex flex-col items-start gap-4 rounded-3xl border bg-card/40 p-6 text-left transition-colors hover:border-primary/50 hover:bg-accent/40 focus-visible:outline-none focus-visible:ring-2 focus-visible:ring-ring"
+          className="group flex flex-col items-start gap-4 rounded-3xl border bg-card/40 p-6 text-start transition-colors hover:border-primary/50 hover:bg-accent/40 focus-visible:outline-none focus-visible:ring-2 focus-visible:ring-ring"
          key={c.step}
          onClick={() => onPick(c.step)}
          type="button"
@@ -133,7 +133,7 @@ function ChooseStep({ onPick }: { onPick: (step: Step) => void }) {
          <span className="flex flex-col gap-1">
            <span className="flex items-center gap-1 font-semibold text-lg text-foreground">
              {c.title}
-              <ChevronRight className="size-4 text-muted-foreground transition-transform group-hover:translate-x-0.5" />
+              <ChevronRight className="size-4 text-muted-foreground transition-transform group-hover:translate-x-0.5 rtl:rotate-180" />
            </span>
            <span className="text-muted-foreground text-sm">{c.desc}</span>
          </span>
@@ -151,7 +151,7 @@ function BackButton({ onBack }: { onBack: () => void }) {
      onClick={onBack}
      type="button"
    >
-      <ArrowLeft className="size-4" />
+      <ArrowLeft className="size-4 rtl:rotate-180" />
      {t("portal.back")}
    </button>
  );
@@ -378,11 +378,11 @@ export function AddPrescriptionDialog({
              ) : (
                <div className="flex flex-col gap-1.5">
                  <div className="relative">
-                    <Search className="-translate-y-1/2 absolute top-1/2 left-3 size-4 text-muted-foreground" />
+                    <Search className="-translate-y-1/2 absolute top-1/2 start-3 size-4 text-muted-foreground" />
                    <Input
                      aria-autocomplete="list"
                      autoFocus
-                      className="pl-9"
+                      className="ps-9"
                      onChange={(event) => setQuery(event.target.value)}
                      onKeyDown={onPatientKeyDown}
                      placeholder={t("prescriptions.dialog.searchPlaceholder")}
@@ -399,7 +399,7 @@ export function AddPrescriptionDialog({
                        matches.map((p, i) => (
                          <button
                            className={cn(
-                              "flex w-full items-center justify-between gap-2 rounded-lg px-2 py-1.5 text-left transition-colors",
+                              "flex w-full items-center justify-between gap-2 rounded-lg px-2 py-1.5 text-start transition-colors",
                              i === activeIndex
                                ? "bg-accent"
                                : "hover:bg-accent",
@@ -442,7 +442,7 @@ export function AddPrescriptionDialog({
                      return (
                        <button
                          className={cn(
-                            "flex w-full items-center justify-between gap-2 rounded-lg px-2 py-1.5 text-left transition-colors",
+                            "flex w-full items-center justify-between gap-2 rounded-lg px-2 py-1.5 text-start transition-colors",
                            i === medIndex ? "bg-accent" : "hover:bg-accent",
                          )}
                          // Use onMouseDown so the pick fires before the input's
@@ -147,7 +147,7 @@ export function PrescriptionDetailSheet({
          <SheetFooter>
            {onDelete && (
              <Button
-                className="sm:mr-auto"
+                className="sm:me-auto"
                onClick={onDelete}
                type="button"
                variant="destructive"
@@ -244,9 +244,9 @@ export function PrescriptionsView() {
        </div>
        <div className="flex flex-col gap-2 sm:flex-row sm:items-center">
          <div className="relative">
-            <Search className="-translate-y-1/2 absolute top-1/2 left-3 size-4 text-muted-foreground" />
+            <Search className="-translate-y-1/2 absolute top-1/2 start-3 size-4 text-muted-foreground" />
            <Input
-              className="w-full pl-9 sm:w-64"
+              className="w-full ps-9 sm:w-64"
              onChange={(event) => setQuery(event.target.value)}
              placeholder={t("prescriptions.searchPlaceholder")}
              value={query}
@@ -422,7 +422,7 @@ export function EmployeeDetailDialog({
        <DialogFooter>
          {editable && member && (
            <Button
-              className="sm:mr-auto"
+              className="sm:me-auto"
              onClick={() => onRemove(member)}
              type="button"
              variant="destructive"
@@ -6,6 +6,7 @@ import { useTranslation } from "react-i18next";
 import { cn } from "@/lib/utils";
 import { Badge } from "@/components/ui/badge";
 import { Button } from "@/components/ui/button";
+import { Switch } from "@/components/ui/switch";
 import {
  CopyField,
  SettingsCard,
@@ -13,12 +14,15 @@ import {
  whiteButton,
 } from "@/components/settings/settings-parts";
 import {
+  getNetworkEnabled,
  getSigningKey,
  listSignedRecords,
  rotateSigningKey,
+  setNetworkEnabled,
  type SharedRecord,
  type SigningKey,
 } from "@/lib/signing";
+import { listWalletUpdates, type WalletUpdate } from "@/lib/wallet-updates";
 import { notify } from "@/lib/toast";

 function formatDate(iso: string): string {
@@ -33,17 +37,27 @@ export function SigningPanel() {
  const { t } = useTranslation();
  const [key, setKey] = useState<SigningKey | null>(null);
  const [records, setRecords] = useState<SharedRecord[]>([]);
+  const [updates, setUpdates] = useState<WalletUpdate[]>([]);
  const [loading, setLoading] = useState(true);
  const [error, setError] = useState<string | null>(null);
  const [rotating, setRotating] = useState(false);
+  const [networkOn, setNetworkOn] = useState(false);
+  const [networkSaving, setNetworkSaving] = useState(false);

  useEffect(() => {
    let active = true;
-    Promise.all([getSigningKey(), listSignedRecords().catch(() => [])])
-      .then(([k, r]) => {
+    Promise.all([
+      getSigningKey(),
+      listSignedRecords().catch(() => []),
+      listWalletUpdates().catch(() => []),
+      getNetworkEnabled().catch(() => false),
+    ])
+      .then(([k, r, u, n]) => {
        if (!active) return;
        setKey(k);
        setRecords(r);
+        setUpdates(u);
+        setNetworkOn(n);
        setError(null);
      })
      .catch(() => {
@@ -76,6 +90,32 @@ export function SigningPanel() {
    }
  };

+  const toggleNetwork = async (next: boolean) => {
+    setNetworkSaving(true);
+    // Optimistic — revert on failure.
+    setNetworkOn(next);
+    try {
+      const saved = await setNetworkEnabled(next);
+      setNetworkOn(saved);
+      notify.success(
+        next
+          ? t("settings.network.joinedTitle")
+          : t("settings.network.leftTitle"),
+        next
+          ? t("settings.network.joinedBody")
+          : t("settings.network.leftBody"),
+      );
+    } catch {
+      setNetworkOn(!next);
+      notify.error(
+        t("settings.network.errorTitle"),
+        t("settings.network.error"),
+      );
+    } finally {
+      setNetworkSaving(false);
+    }
+  };
+
  const recordStatusLabel = (status: SharedRecord["status"]): string =>
    t(
      `settings.signing.records.status${
@@ -109,7 +149,7 @@ export function SigningPanel() {
              : t("settings.signing.rotateKey")}
          </Button>
        </div>
-        <div className="sm:text-right">
+        <div className="sm:text-end">
          <p className="text-3xl font-semibold tracking-tight">Ed25519</p>
          <p className="text-sm text-muted-foreground">
            {key
@@ -130,6 +170,41 @@ export function SigningPanel() {
        </div>
      </SettingsCard>

+      <SettingsSection
+        description={t("settings.network.description")}
+        title={t("settings.network.title")}
+      >
+        <SettingsCard className="flex items-center justify-between gap-4 p-5">
+          <div className="min-w-0 space-y-0.5">
+            <div className="flex items-center gap-2">
+              <p className="text-sm font-medium">
+                {t("settings.network.toggleLabel")}
+              </p>
+              <Badge
+                className={cn(
+                  networkOn
+                    ? "bg-emerald-500/15 text-emerald-400"
+                    : "bg-muted text-muted-foreground",
+                )}
+              >
+                {networkOn
+                  ? t("settings.network.statusConnected")
+                  : t("settings.network.statusOff")}
+              </Badge>
+            </div>
+            <p className="text-sm text-muted-foreground">
+              {t("settings.network.toggleDesc")}
+            </p>
+          </div>
+          <Switch
+            aria-label={t("settings.network.toggleLabel")}
+            checked={networkOn}
+            disabled={loading || networkSaving}
+            onCheckedChange={toggleNetwork}
+          />
+        </SettingsCard>
+      </SettingsSection>
+
      <SettingsSection
        description={t("settings.signing.identityDescription")}
        title={t("settings.signing.identityTitle")}
@@ -223,6 +298,40 @@ export function SigningPanel() {
          </SettingsCard>
        )}
      </SettingsSection>
+
+      <SettingsSection
+        description={t("walletUpdatesList.description")}
+        title={t("walletUpdatesList.title")}
+      >
+        {updates.length === 0 ? (
+          <SettingsCard className="flex items-center justify-center p-12">
+            <p className="text-sm text-muted-foreground">
+              {t("walletUpdatesList.none")}
+            </p>
+          </SettingsCard>
+        ) : (
+          <SettingsCard className="divide-y divide-border">
+            {updates.map((update) => (
+              <div
+                className="flex items-center justify-between gap-3 px-4 py-3.5"
+                key={update.id}
+              >
+                <div className="min-w-0 space-y-0.5">
+                  <p className="truncate text-sm">
+                    {update.changes.join(" · ") || `#${update.fileNumber}`}
+                  </p>
+                  <p className="truncate font-mono text-xs text-muted-foreground">
+                    #{update.fileNumber} · {formatDate(update.createdAt)}
+                  </p>
+                </div>
+                <Badge variant="secondary">
+                  {t(`walletPush.status.${update.status}.title`)}
+                </Badge>
+              </div>
+            ))}
+          </SettingsCard>
+        )}
+      </SettingsSection>
    </>
  );
 }
@@ -164,11 +164,11 @@ export function CareTeamPanel({
                    {initials(m.name, m.email)}
                  </AvatarFallback>
                </Avatar>
-                <div className="min-w-0 flex-1 text-left">
+                <div className="min-w-0 flex-1 text-start">
                  <p className="truncate text-sm font-medium">
                    {m.name || m.email || m.userId}
                    {isSelf && (
-                      <span className="ml-1 text-xs text-muted-foreground">
+                      <span className="ms-1 text-xs text-muted-foreground">
                        {t("settings.careTeam.you")}
                      </span>
                    )}
@@ -1,6 +1,6 @@
 "use client";

-import { CheckCircle2, CircleDashed, XCircle } from "lucide-react";
+import { CheckCircle2, CircleDashed, Copy, KeyRound, Trash2, XCircle } from "lucide-react";
 import { useEffect, useState } from "react";
 import { useTranslation } from "react-i18next";

@@ -13,10 +13,15 @@ import { Badge } from "@/components/ui/badge";
 import { Button } from "@/components/ui/button";
 import { Input } from "@/components/ui/input";
 import { Switch } from "@/components/ui/switch";
+import { API_BASE_URL } from "@/lib/api-client";
 import {
+  createFhirKey,
+  type FhirApiKey,
  type IntegrationConfig,
  type IntegrationType,
+  listFhirKeys,
  listIntegrations,
+  revokeFhirKey,
  saveIntegration,
  testIntegration,
 } from "@/lib/integrations";
@@ -179,7 +184,7 @@ function IntegrationCard({
              : t("settings.integrations.test")}
          </Button>
          {config.lastSyncAt ? (
-            <span className="ml-auto text-xs text-muted-foreground">
+            <span className="ms-auto text-xs text-muted-foreground">
              {t("settings.integrations.lastSync", {
                when: new Date(config.lastSyncAt).toLocaleString(),
              })}
@@ -191,6 +196,216 @@ function IntegrationCard({
  );
 }

+// The read-only FHIR R4 server. Unlike the integration cards above (which make
+// temetro a FHIR *client*), this exposes temetro's own records over `/fhir` to
+// external systems, authenticated with per-clinic API keys. Owner/admin only:
+// the component self-gates by hiding when the keys fetch is forbidden.
+function FhirServerCard() {
+  const { t } = useTranslation();
+  const [keys, setKeys] = useState<FhirApiKey[] | null>(null);
+  const [allowed, setAllowed] = useState(true);
+  const [name, setName] = useState("");
+  const [creating, setCreating] = useState(false);
+  const [freshSecret, setFreshSecret] = useState<string | null>(null);
+  const [confirmRevoke, setConfirmRevoke] = useState<string | null>(null);
+
+  const baseUrl = `${API_BASE_URL}/fhir`;
+
+  useEffect(() => {
+    let active = true;
+    listFhirKeys()
+      .then((rows) => active && setKeys(rows))
+      .catch(() => {
+        if (active) {
+          setAllowed(false);
+          setKeys([]);
+        }
+      });
+    return () => {
+      active = false;
+    };
+  }, []);
+
+  const create = async () => {
+    if (!name.trim() || creating) return;
+    setCreating(true);
+    try {
+      const created = await createFhirKey(name.trim());
+      setFreshSecret(created.secret);
+      setKeys((prev) => [created, ...(prev ?? [])]);
+      setName("");
+    } catch {
+      notify.error(
+        t("settings.integrations.fhirServer.createFailed"),
+        t("settings.integrations.fhirServer.createFailedBody"),
+      );
+    } finally {
+      setCreating(false);
+    }
+  };
+
+  const revoke = async (id: string) => {
+    try {
+      await revokeFhirKey(id);
+      setKeys((prev) =>
+        (prev ?? []).map((k) => (k.id === id ? { ...k, revoked: true } : k)),
+      );
+    } catch {
+      notify.error(
+        t("settings.integrations.fhirServer.revokeFailed"),
+        t("settings.integrations.fhirServer.revokeFailedBody"),
+      );
+    } finally {
+      setConfirmRevoke(null);
+    }
+  };
+
+  const copy = async (text: string, label: string) => {
+    try {
+      await navigator.clipboard.writeText(text);
+      notify.success(label, "");
+    } catch {
+      // Clipboard blocked — no-op; the value is visible for manual copy.
+    }
+  };
+
+  if (!allowed) return null;
+
+  return (
+    <SettingsSection
+      description={t("settings.integrations.fhirServer.description")}
+      title={t("settings.integrations.fhirServer.title")}
+    >
+      <SettingsCard className="space-y-5 p-5">
+        <div className="space-y-1.5">
+          <FieldLabel>{t("settings.integrations.fhirServer.baseUrl")}</FieldLabel>
+          <div className="flex items-center gap-2">
+            <Input readOnly value={baseUrl} />
+            <Button
+              onClick={() =>
+                copy(baseUrl, t("settings.integrations.fhirServer.copiedUrl"))
+              }
+              size="icon"
+              variant="outline"
+            >
+              <Copy className="size-4" />
+            </Button>
+          </div>
+          <p className="text-xs text-muted-foreground">
+            {t("settings.integrations.fhirServer.baseUrlHint")}
+          </p>
+        </div>
+
+        {freshSecret ? (
+          <div className="space-y-2 rounded-2xl border border-primary/40 bg-primary/5 p-4">
+            <p className="text-sm font-medium">
+              {t("settings.integrations.fhirServer.secretTitle")}
+            </p>
+            <p className="text-xs text-muted-foreground">
+              {t("settings.integrations.fhirServer.secretHint")}
+            </p>
+            <div className="flex items-center gap-2">
+              <code className="min-w-0 flex-1 truncate rounded-lg bg-muted px-3 py-2 font-mono text-xs">
+                {freshSecret}
+              </code>
+              <Button
+                onClick={() =>
+                  copy(
+                    freshSecret,
+                    t("settings.integrations.fhirServer.copiedSecret"),
+                  )
+                }
+                size="icon"
+                variant="outline"
+              >
+                <Copy className="size-4" />
+              </Button>
+            </div>
+            <Button onClick={() => setFreshSecret(null)} size="sm" variant="ghost">
+              {t("settings.integrations.fhirServer.dismissSecret")}
+            </Button>
+          </div>
+        ) : null}
+
+        <div className="space-y-1.5">
+          <FieldLabel>{t("settings.integrations.fhirServer.newKey")}</FieldLabel>
+          <div className="flex items-center gap-2">
+            <Input
+              onChange={(e) => setName(e.target.value)}
+              onKeyDown={(e) => e.key === "Enter" && create()}
+              placeholder={t("settings.integrations.fhirServer.newKeyPlaceholder")}
+              value={name}
+            />
+            <Button disabled={creating || !name.trim()} onClick={create} size="sm">
+              <KeyRound className="size-4" />
+              {creating
+                ? t("settings.integrations.fhirServer.creating")
+                : t("settings.integrations.fhirServer.create")}
+            </Button>
+          </div>
+        </div>
+
+        {keys && keys.length > 0 ? (
+          <ul className="divide-y rounded-2xl border">
+            {keys.map((k) => (
+              <li
+                key={k.id}
+                className="flex items-center justify-between gap-3 px-4 py-3"
+              >
+                <div className="min-w-0">
+                  <p className="truncate text-sm font-medium">{k.name}</p>
+                  <p className="text-xs text-muted-foreground">
+                    {k.lastUsedAt
+                      ? t("settings.integrations.fhirServer.lastUsed", {
+                          when: new Date(k.lastUsedAt).toLocaleString(),
+                        })
+                      : t("settings.integrations.fhirServer.neverUsed")}
+                  </p>
+                </div>
+                {k.revoked ? (
+                  <Badge variant="outline">
+                    {t("settings.integrations.fhirServer.revoked")}
+                  </Badge>
+                ) : confirmRevoke === k.id ? (
+                  <div className="flex items-center gap-2">
+                    <Button
+                      onClick={() => revoke(k.id)}
+                      size="sm"
+                      variant="destructive"
+                    >
+                      {t("settings.integrations.fhirServer.confirmRevoke")}
+                    </Button>
+                    <Button
+                      onClick={() => setConfirmRevoke(null)}
+                      size="sm"
+                      variant="ghost"
+                    >
+                      {t("settings.integrations.fhirServer.cancel")}
+                    </Button>
+                  </div>
+                ) : (
+                  <Button
+                    onClick={() => setConfirmRevoke(k.id)}
+                    size="sm"
+                    variant="outline"
+                  >
+                    <Trash2 className="size-4" />
+                    {t("settings.integrations.fhirServer.revoke")}
+                  </Button>
+                )}
+              </li>
+            ))}
+          </ul>
+        ) : (
+          <p className="text-xs text-muted-foreground">
+            {t("settings.integrations.fhirServer.noKeys")}
+          </p>
+        )}
+      </SettingsCard>
+    </SettingsSection>
+  );
+}
+
 export function IntegrationsPanel() {
  const { t } = useTranslation();
  const [configs, setConfigs] = useState<IntegrationConfig[] | null>(null);
@@ -231,6 +446,7 @@ export function IntegrationsPanel() {
          } satisfies IntegrationConfig);
        return <IntegrationCard initial={initial} key={type} type={type} />;
      })}
+      <FhirServerCard />
    </div>
  );
 }
@@ -108,7 +108,7 @@ export function CopyField({
          <p className="text-xs text-muted-foreground">{description}</p>
        ) : null}
      </div>
-      <div className="flex h-9 w-full items-center gap-2 rounded-3xl bg-input/50 pr-1 pl-3 sm:w-80">
+      <div className="flex h-9 w-full items-center gap-2 rounded-3xl bg-input/50 pe-1 ps-3 sm:w-80">
        <span className="flex-1 truncate text-sm text-muted-foreground">
          {value}
        </span>
@@ -6,7 +6,15 @@ import { useTranslation } from "react-i18next";

 import { Avatar, AvatarFallback } from "@/components/ui/avatar";
 import { Button } from "@/components/ui/button";
+import { ConfirmDialog } from "@/components/ui/confirm-dialog";
 import { Input } from "@/components/ui/input";
+import {
+  Select,
+  SelectItem,
+  SelectPopup,
+  SelectTrigger,
+  SelectValue,
+} from "@/components/ui/select";
 import { DeleteAccountDialog } from "@/components/settings/delete-account-dialog";
 import {
  CopyField,
@@ -16,6 +24,8 @@ import {
  ToggleRow,
 } from "@/components/settings/settings-parts";
 import { authClient } from "@/lib/auth-client";
+import { supportedLanguages } from "@/lib/i18n/config";
+import { persistLanguage } from "@/lib/language";
 import {
  getSettings,
  saveSettings,
@@ -53,16 +63,24 @@ const DEFAULT_PREFS: UserPreferences = {
 };

 export function ProfilePanel() {
-  const { t } = useTranslation();
+  const { t, i18n } = useTranslation();
  const { data: session } = authClient.useSession();
  const user = session?.user;

+  // The active UI language — `i18n.changeLanguage` persists the choice to
+  // localStorage (the detector's cache), so it survives reloads.
+  const activeLang = i18n.resolvedLanguage ?? i18n.language;
+
  const [prefs, setPrefs] = useState<UserPreferences>(DEFAULT_PREFS);
  const [baseline, setBaseline] = useState<UserPreferences>(DEFAULT_PREFS);
  const [name, setName] = useState("");
  const [baselineName, setBaselineName] = useState("");
  const [saving, setSaving] = useState(false);
  const [deleteOpen, setDeleteOpen] = useState(false);
+  // A language picked in the Select but not yet applied — its presence opens the
+  // confirmation dialog. The Select stays bound to `activeLang`, so cancelling
+  // (clearing this) automatically reverts the shown selection.
+  const [pendingLang, setPendingLang] = useState<string | null>(null);

  useEffect(() => {
    let cancelled = false;
@@ -211,6 +229,32 @@ export function ProfilePanel() {
        </SettingsCard>
      </SettingsSection>

+      <SettingsSection
+        description={t("settings.profile.language.description")}
+        title={t("settings.profile.language.title")}
+      >
+        <SettingsCard className="space-y-1.5 p-5">
+          <FieldLabel>{t("settings.profile.language.label")}</FieldLabel>
+          <Select
+            onValueChange={(value) => {
+              if (value !== activeLang) setPendingLang(value);
+            }}
+            value={activeLang}
+          >
+            <SelectTrigger>
+              <SelectValue />
+            </SelectTrigger>
+            <SelectPopup>
+              {supportedLanguages.map((lng) => (
+                <SelectItem key={lng} value={lng}>
+                  {t(`settings.profile.language.${lng}`)}
+                </SelectItem>
+              ))}
+            </SelectPopup>
+          </Select>
+        </SettingsCard>
+      </SettingsSection>
+
      <SettingsSection
        description={t("settings.profile.patientNotificationsDescription")}
        title={t("settings.profile.patientNotifications")}
@@ -287,6 +331,30 @@ export function ProfilePanel() {

      <DeleteAccountDialog onOpenChange={setDeleteOpen} open={deleteOpen} />

+      <ConfirmDialog
+        cancelLabel={t("settings.profile.language.cancel")}
+        confirmLabel={t("settings.profile.language.confirmCta")}
+        description={
+          pendingLang
+            ? t("settings.profile.language.confirmBody", {
+                language: t(`settings.profile.language.${pendingLang}`),
+              })
+            : undefined
+        }
+        onConfirm={() => {
+          if (pendingLang) {
+            void i18n.changeLanguage(pendingLang);
+            void persistLanguage(pendingLang);
+          }
+        }}
+        onOpenChange={(open) => {
+          if (!open) setPendingLang(null);
+        }}
+        open={pendingLang !== null}
+        title={t("settings.profile.language.confirmTitle")}
+        variant="default"
+      />
+
      {dirty ? (
        <div className="sticky bottom-4 z-10">
          <div className="flex items-center justify-between gap-4 rounded-2xl border border-border bg-background/95 px-4 py-3 shadow-lg backdrop-blur">
@@ -1,5 +1,6 @@
 "use client";

+import { RefreshCw } from "lucide-react";
 import { useEffect, useMemo, useState } from "react";
 import { useTranslation } from "react-i18next";

@@ -8,6 +9,7 @@ import {
  SettingsCard,
  SettingsSection,
 } from "@/components/settings/settings-parts";
+import { Button } from "@/components/ui/button";
 import { getNetworkInfo, getVersionInfo, type VersionInfo } from "@/lib/version";
 import { cn } from "@/lib/utils";

@@ -45,6 +47,7 @@ export function VersionPanel() {
  const { t } = useTranslation();
  const [info, setInfo] = useState<VersionInfo | null>(null);
  const [loading, setLoading] = useState(true);
+  const [checking, setChecking] = useState(false);
  const [networkUrls, setNetworkUrls] = useState<string[]>([]);

  useEffect(() => {
@@ -54,6 +57,17 @@ export function VersionPanel() {
      .finally(() => setLoading(false));
  }, []);

+  // "Check for updates" — force a fresh, cache-bypassing lookup on the backend.
+  const checkForUpdates = () => {
+    setChecking(true);
+    getVersionInfo(true)
+      .then(setInfo)
+      .catch(() => {
+        /* keep the last known info on a failed manual check */
+      })
+      .finally(() => setChecking(false));
+  };
+
  // The most reliable shareable URL is the one the browser is already using —
  // unless that's localhost, in which case we fall back to the backend's
  // detected LAN addresses (accurate when not running in Docker's bridge net).
@@ -72,7 +86,7 @@ export function VersionPanel() {
      .catch(() => setNetworkUrls([]));
  }, [localShareUrl]);

-  const statusBadge = loading ? (
+  const statusBadge = loading || checking ? (
    <Badge tone="muted">{t("settings.version.checking")}</Badge>
  ) : !info || info.latest === null ? (
    <Badge tone="muted">{t("settings.version.offline")}</Badge>
@@ -122,6 +136,20 @@ export function VersionPanel() {
              </a>
            ) : null}
          </div>
+          <div className="flex justify-end border-t border-border pt-4">
+            <Button
+              disabled={loading || checking}
+              onClick={checkForUpdates}
+              size="sm"
+              type="button"
+              variant="outline"
+            >
+              <RefreshCw className={cn("size-4", checking && "animate-spin")} />
+              {checking
+                ? t("settings.version.checking")
+                : t("settings.version.checkNow")}
+            </Button>
+          </div>
        </SettingsCard>
      </SettingsSection>

@@ -21,7 +21,7 @@ export function MobileSidebarTrigger() {
  return (
    <Button
      aria-label={t("nav.openSidebar")}
-      className="fixed top-3 right-3 z-50 size-9 rounded-full bg-background/80 shadow-sm backdrop-blur md:hidden"
+      className="fixed top-3 end-3 z-50 size-9 rounded-full bg-background/80 shadow-sm backdrop-blur md:hidden"
      onClick={toggleSidebar}
      size="icon"
      variant="outline"
@@ -66,7 +66,7 @@ export default function DashboardNavigation({ routes }: { routes: Route[] }) {
            >
              {route.icon}
              {!isCollapsed && (
-                <span className="ml-2 flex-1 truncate font-medium text-sm">
+                <span className="ms-2 flex-1 truncate font-medium text-sm">
                  {route.title}
                </span>
              )}
@@ -53,7 +53,7 @@ export function NotificationsPopover() {
      >
        <BellIcon className="size-5" />
        {unread > 0 && (
-          <span className="-top-0.5 -right-0.5 absolute flex min-w-4 items-center justify-center rounded-full bg-primary px-1 font-medium text-[10px] text-primary-foreground leading-4">
+          <span className="-top-0.5 -end-0.5 absolute flex min-w-4 items-center justify-center rounded-full bg-primary px-1 font-medium text-[10px] text-primary-foreground leading-4">
            {unread > 9 ? "9+" : unread}
          </span>
        )}
--- a/Show More
+++ b/Show More
Author	SHA1	Message	Date
Khalid Abdi	233ce9f854	fix: QR wallet pairing broken by multi-clinic routing (v0.8.1) QR "scan to connect" pairing has no wallet number, so nothing registered the request with the relay and the scanning device's response was rejected ("unknown or expired request"). The backend now pre-registers the pairing request over the relay's new hub:expect event on POST /pair, and re-registers still-pending requests on hub (re)connect so routing survives a relay restart. /pair now requires the clinic to have joined the network (clear 409, surfaced in the import dialog, localized in all five langs). Co-Authored-By: Claude Opus 4.8 <noreply@anthropic.com>	2026-07-05 19:16:33 +03:00
Khalid Abdi	99aa534e88	feat: multi-clinic Temetro Network with per-clinic identity (v0.8.0) The relay is now multi-clinic. Each clinic authenticates to the /hub namespace by signing a challenge with its own Ed25519 clinic signing key (a per-clinic identity, not a shared RELAY_TOKEN), and the relay routes every device response back to only the clinic that originated the request (keyed by requestId) — so clinics never see each other's traffic. Backend: - clinic_signing_keys.network_enabled + GET/PUT /api/signing/network (owner/admin) to join/leave the network. - relay-client keeps one authenticated hub connection per network-enabled org (connectOrg/disconnectOrg, hubs map keyed by orgId); emitToWallet/ sendToWallet take orgId; offline flush is org-scoped. - Wallet import/push return 409 until a clinic joins. - RELAY_TOKEN is now optional/legacy (open relay needs no shared secret). Frontend: - "Join Temetro Network" toggle in Settings → Signing, localized in all five languages (en, fr, de, so, ar). Co-Authored-By: Claude Opus 4.8 <noreply@anthropic.com>	2026-07-05 18:30:19 +03:00
Khalid Abdi	ef76afc3ca	feat: route wallet traffic through the Temetro Network relay (v0.7.0) Devices no longer connect to the backend directly. The /wallet Socket.io namespace is removed from realtime.ts; a new services/relay-client.ts connects to the standalone Temetro Network relay's /hub namespace (RELAY_TOKEN-auth), emitToWallet delegates to its sendToWallet, and device responses + wallet:online replay are handled there via the same wallet-share/wallet-updates services. - Add RELAY_URL + RELAY_TOKEN env (env.ts, .env.example, docker-compose.yml); the wallet-import QR (resolveRelayUrl) now points at RELAY_URL. - Add socket.io-client dependency. - Document the Temetro Network folder/service in root + backend CLAUDE.md. - Bump root/backend/frontend to 0.7.0; CHANGELOG entry. The relay service itself lives in github.com/temetro/temetro-network. Co-Authored-By: Claude Opus 4.8 <noreply@anthropic.com>	2026-07-05 03:04:23 +03:00
Khalid Abdi	d79f7f7c06	chore(release): v0.6.0 Read-only FHIR R4 server at /fhir with per-clinic API keys. Co-Authored-By: Claude Opus 4.8 <noreply@anthropic.com>	2026-07-04 01:34:24 +03:00
Khalid Abdi	0d2494d67a	feat: read-only FHIR R4 server (share records over /fhir) Expose temetro's own records as a read-only FHIR R4 server at /fhir, authenticated with per-clinic API keys (tmf_… bearer tokens, SHA-256 hashed, shown once). Serves Patient, Observation (labs + vitals), AllergyIntolerance, Condition, MedicationRequest, Encounter and Appointment as text-only CodeableConcepts (temetro stores free-text clinical values); CapabilityStatement at /fhir/metadata (unauth). Searchset Bundles with _count/_offset pagination and self/next/prev links; every request is org-scoped and written to the activity log. Keys are created/revoked under Settings → Integrations (owner/admin). Co-Authored-By: Claude Opus 4.8 <noreply@anthropic.com>	2026-07-04 01:27:32 +03:00
Khalid Abdi	bb536ba6da	feat: clinic→wallet record-update push A clinician can push an updated record to a wallet-linked patient (permanent share). The snapshot is signed with the clinic Ed25519 key and sealed to the wallet's X25519 key — derived from its Ed25519 wallet number via the birational map, verified byte-for-byte against the wallet's own derivation. Stored pending, delivered over the /wallet relay live and on the wallet's next authenticated connect (offline catch-up). The patient approves/denies in-app; the wallet signs its decision, the backend verifies it, and the record is replaced only on approval. Wallet pins the clinic key (TOFU) and warns on change. Backend: walletRecordUpdates table + service, ed25519PubToX25519Hex helper, POST /api/patients/wallet/push, GET .../link/:fileNumber\|updates\|updates/:id, wallet:update-request / wallet:update-response relay events. Frontend: "Push to wallet" dialog with live status, wallet-link gating on the patient sheet, "Sent updates" list under Settings → Signing, walletPush / walletUpdatesList locale namespaces across all five languages. Bumps to v0.5.0. Co-Authored-By: Claude Opus 4.8 <noreply@anthropic.com>	2026-07-03 18:57:38 +03:00
Khalid Abdi	b29fdff1cb	feat: ambient AI visit scribe (record/paste → reviewed SOAP note) Record a clinician↔patient visit (or paste a transcript) on the patient sheet; the backend transcribes it (OpenAI Whisper / Gemini), de-identifies the transcript + context through Veil, and drafts a structured SOAP note the clinician reviews and edits before saving — the same write-approval gate as the chat agent. Backend: POST /api/scribe/{transcribe,draft,save} (routes/scribe.ts, services/ai/transcribe.ts), veil.redactText() free-text redactor, appendEncounter service, audio MIME types on attachments. Gated by patient:write + the clinic AI policy (reception/disabled-AI excluded). Frontend: ScribeDialog + lib/scribe.ts, "Record visit" on the patient detail, gated by clinical access + AI availability. New `scribe` locale namespace across all five languages. Bumps to v0.4.0. Co-Authored-By: Claude Opus 4.8 <noreply@anthropic.com>	2026-07-03 18:33:30 +03:00
Khalid Abdi	d237504af9	frontend: add Somali, Arabic (RTL) & German languages Add three UI locales (so/ar/de) with full ~1,660-key translations alongside en/fr, selectable in Settings → Profile. Arabic gets full right-to-left support: - config.ts registers the locales and exports a `dirFor` helper; an inline <head> script in layout.tsx sets <html dir/lang> before first paint (no RTL flash), and i18n-provider keeps them in sync on language change. - ~160 physical direction utilities converted to logical (ms/me/ps/pe/ start/end/text-start/text-end); directional chevrons/arrows get rtl:rotate-180; chat-bubble align variants fixed to logical. - IBM Plex Sans Arabic appended to the sans/heading font stacks for per-character Arabic fallback. - Language persists to the backend user_settings and re-applies on sign-in so it roams across devices (localStorage stays the offline source of truth). - New scripts/check-locales.mjs (npm run check-locales) enforces key/placeholder parity and Arabic CLDR plural completeness. Bump to 0.3.0. Co-Authored-By: Claude Fable 5 <noreply@anthropic.com>	2026-07-02 23:03:13 +03:00
Khalid Abdi	46c32b432c	chore(release): v0.2.5 Co-Authored-By: Claude Opus 4.8 <noreply@anthropic.com>	2026-07-01 21:54:47 +03:00
Khalid Abdi	5bbfe551fc	release workflow: publish multi-arch images; settings: confirm language switch - release.yml: add QEMU + platforms: linux/amd64,linux/arm64 to both build-push steps so the published images work on Apple Silicon (fixes 'no matching manifest for linux/arm64/v8' on docker compose pull). - Settings -> Profile language picker is now a select that opens a confirmation dialog before applying, instead of switching instantly. - CLAUDE.md: require a dated docs changelog entry for every release. Co-Authored-By: Claude Opus 4.8 <noreply@anthropic.com>	2026-07-01 21:54:47 +03:00
Khalid Abdi	7838dd68a5	chore(release): v0.2.4 Co-Authored-By: Claude Opus 4.8 <noreply@anthropic.com>	2026-06-29 21:00:52 +03:00
Khalid Abdi	06810f861e	backend: make docker compose host ports configurable Mirror the existing POSTGRES_PORT override for the backend, frontend and adminer host ports (BACKEND_PORT / FRONTEND_PORT / ADMINER_PORT) so a port clash on `docker compose up -d` can be fixed via .env without editing the compose file. Documented in .env.example and the README. Co-Authored-By: Claude Opus 4.8 <noreply@anthropic.com>	2026-06-29 21:00:18 +03:00
Khalid Abdi	2bb03633ff	backend: detect updates from Docker Hub + add a Check for updates button GET /api/version now reads the latest version from Docker Hub image tags (the actual update channel clinics pull), falling back to the GitHub release if Docker Hub is unreachable, with a shorter 1h cache and a `?refresh=1` bypass. Settings → About & updates gains a "Check for updates" button that forces a fresh, cache-bypassing lookup. Co-Authored-By: Claude Opus 4.8 <noreply@anthropic.com>	2026-06-29 21:00:18 +03:00
Khalid Abdi	dc5f55f87d	frontend: paginate the Activity and Invoices pages Extract the Patients pagination into a reusable ListPagination component (components/ui/list-pagination.tsx, carrying the pageWindow helper) and use it on the Activity feed and the Invoices list (10/page, search resets to page 1). Patients is refactored onto the same component, removing the duplicated block. Co-Authored-By: Claude Opus 4.8 <noreply@anthropic.com>	2026-06-29 21:00:18 +03:00
Khalid Abdi	a4970df334	frontend: add a language switcher to Profile settings A Language section in the Profile panel offers English / Français, wired to i18n.changeLanguage (persisted to localStorage via the detector cache). Co-Authored-By: Claude Opus 4.8 <noreply@anthropic.com>	2026-06-29 21:00:01 +03:00
Khalid Abdi	6c074b54f3	frontend: add French translation and language i18n keys Register `fr` in the i18n config (resources + supportedLngs) and add a full French translation (locales/fr/translation.json) with exact key parity to English (1661 keys; placeholders and plural suffixes preserved). Also adds the shared `common.pagination.` keys, `settings.version.checkNow`, and `settings.profile.language.`, and drops the now-unused `patients.pagination.*`. Co-Authored-By: Claude Opus 4.8 <noreply@anthropic.com>	2026-06-29 21:00:01 +03:00
				`@@ -0,0 +1 @@`
				`ALTER TABLE "clinic_signing_keys" ADD COLUMN "network_enabled" boolean DEFAULT false NOT NULL;`