Files
temetro/backend/src/routes/attachments.ts
T
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

211 lines
6.0 KiB
TypeScript

import path from "node:path";
import { Router } from "express";
import multer from "multer";
import { nanoid } from "nanoid";
import { z } from "zod";
import { HttpError } from "../lib/http-error.js";
import {
requireAnyPermission,
requireAuth,
requireOrg,
} from "../middleware/auth.js";
import { recordActivity } from "../services/activity.js";
import {
createAttachment,
deleteAttachment,
ensureUploadDir,
getAttachmentRow,
listAttachments,
openAttachmentStream,
} from "../services/attachments.js";
export const attachmentsRouter = Router();
const MAX_BYTES = 15 * 1024 * 1024; // 15 MB
// Clinical documents only — block scripts/executables.
const ALLOWED_MIME = new Set([
"application/pdf",
"image/png",
"image/jpeg",
"image/gif",
"image/webp",
"image/tiff",
"image/heic",
"text/plain",
"text/csv",
"application/dicom",
"application/msword",
"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
// names never collide or escape the directory. Runs after requireOrg, so
// req.organizationId is set.
const storage = multer.diskStorage({
destination: (req, _file, cb) => {
ensureUploadDir(req.organizationId!)
.then((dir) => cb(null, dir))
.catch((err) => cb(err as Error, ""));
},
filename: (_req, file, cb) => {
cb(null, `${nanoid()}${path.extname(file.originalname).toLowerCase()}`);
},
});
const upload = multer({
storage,
limits: { fileSize: MAX_BYTES, files: 1 },
fileFilter: (_req, file, cb) => {
if (ALLOWED_MIME.has(file.mimetype)) cb(null, true);
else cb(new HttpError(400, `Unsupported file type: ${file.mimetype}`));
},
});
// Wrap multer so its errors (size/type) surface as clean 400s.
function uploadSingle(req: never, res: never, next: (err?: unknown) => void) {
upload.single("file")(req, res, (err: unknown) => {
if (!err) return next();
if (err instanceof multer.MulterError) {
next(
new HttpError(
400,
err.code === "LIMIT_FILE_SIZE"
? "File is too large (max 15 MB)."
: err.message,
),
);
return;
}
next(err);
});
}
const linkSchema = z.object({
fileNumber: z.string().trim().min(1),
labKey: z.string().trim().min(1).optional(),
});
// POST /api/attachments — upload one file linked to a patient (and optionally a
// specific lab result). Allowed for clinicians (patient:write) or lab staff
// (lab:write).
attachmentsRouter.post(
"/",
requireAuth,
requireOrg,
requireAnyPermission({ patient: ["write"] }, { lab: ["write"] }),
uploadSingle as never,
async (req, res, next) => {
try {
const file = req.file;
if (!file) throw new HttpError(400, "No file uploaded.");
const parsed = linkSchema.safeParse(req.body);
if (!parsed.success) throw new HttpError(400, "A fileNumber is required.");
const orgId = req.organizationId!;
const attachment = await createAttachment({
organizationId: orgId,
fileNumber: parsed.data.fileNumber,
labKey: parsed.data.labKey ?? null,
filename: file.originalname,
mimeType: file.mimetype,
sizeBytes: file.size,
storagePath: path.join(orgId, file.filename),
uploadedByUserId: req.user?.id ?? null,
});
await recordActivity({
orgId,
actor: { id: req.user?.id, name: req.user?.name },
action: "attachment.upload",
entityType: "patient",
entityId: attachment.id,
patientFileNumber: parsed.data.fileNumber,
}).catch(() => {});
res.status(201).json(attachment);
} catch (err) {
next(err);
}
},
);
// GET /api/attachments?fileNumber=… — list a patient's files.
attachmentsRouter.get(
"/",
requireAuth,
requireOrg,
requireAnyPermission({ patient: ["read"] }, { lab: ["read"] }),
async (req, res, next) => {
try {
const fileNumber = String(req.query.fileNumber ?? "").trim();
if (!fileNumber) throw new HttpError(400, "A fileNumber is required.");
res.json(await listAttachments(req.organizationId!, fileNumber));
} catch (err) {
next(err);
}
},
);
// GET /api/attachments/:id — stream/download a file. Images and PDFs are sent
// inline so the client can preview them in a dialog.
attachmentsRouter.get(
"/:id",
requireAuth,
requireOrg,
requireAnyPermission({ patient: ["read"] }, { lab: ["read"] }),
async (req, res, next) => {
try {
const row = await getAttachmentRow(
req.organizationId!,
String(req.params.id),
);
if (!row) throw new HttpError(404, "File not found.");
const inline =
row.mimeType.startsWith("image/") || row.mimeType === "application/pdf";
res.setHeader("Content-Type", row.mimeType);
res.setHeader(
"Content-Disposition",
`${inline ? "inline" : "attachment"}; filename="${encodeURIComponent(
row.filename,
)}"`,
);
const stream = openAttachmentStream(row.storagePath);
stream.on("error", () => next(new HttpError(404, "File not found.")));
stream.pipe(res);
} catch (err) {
next(err);
}
},
);
// DELETE /api/attachments/:id — remove a file (row + bytes).
attachmentsRouter.delete(
"/:id",
requireAuth,
requireOrg,
requireAnyPermission({ patient: ["write"] }, { lab: ["write"] }),
async (req, res, next) => {
try {
const row = await getAttachmentRow(
req.organizationId!,
String(req.params.id),
);
if (!row) throw new HttpError(404, "File not found.");
await deleteAttachment(req.organizationId!, row);
res.status(204).end();
} catch (err) {
next(err);
}
},
);