Feature Specifications (F01-F18)

This page documents all 18 Med-SEAL features, organised into three tiers by priority. Each feature specifies its assigned agent(s), input sources, processing logic, output destinations, and current implementation status.

Implementation Status Summary

Feature

Name

Status

Patient App

AI Service

FHIR

F01

Chat Interface

Live

chat.tsx (64KB)

/chat, /chat/stream

AuditEvent

F02

Medication Management

Live

medications.tsx (25KB)

FHIR read

MedicationRequest, MedicationAdministration

F03

Smart Nudge Engine

Built

index.tsx nudge cards

Mock engine

–

F04

Conversational PROs

Live

checkin.tsx (15KB)

FHIR write

QuestionnaireResponse

F05

Wearable Data

Live

watch.tsx (23KB), health.tsx

HealthKit bridge

Observation (vitals)

F06

Pre-Visit Summary

Live

insights.tsx (31KB)

/patients/:id/previsit-summary

Composition, 11-section FHIR aggregation

F07

Dietary/Lifestyle

Live

lifestyle.tsx (39KB)

AI diet plan + fallback

NutritionOrder, Goal

F08

Outcome Measurement

Built

analytics.tsx (12KB)

Dashboard metrics

Observation, MeasureReport

F09

Analytics Dashboard

Built

analytics.tsx

getDashboardMetrics()

Observation (vitals + labs)

F10

Escalation Pathways

Live

escalations.tsx (8KB)

FHIR read

Flag

F11

Behavioral Anticipation

Built

analytics.tsx badges

Mock risk model

–

F12

Appointment Orchestrator

Live

appointments.tsx (53KB)

/api/appointments/writeback

Appointment, Encounter, DocumentReference

F13

Caregiver Mode

Built

caregiver.tsx (33KB)

FHIR read (consent-gated)

Consent, filtered vitals

F14

Health Education

Built

education.tsx (38KB)

Context-triggered cards

–

F15

Data Fusion Timeline

Built

timeline.tsx (8KB)

Multi-source aggregation

–

F16

Readmission Risk

Built

analytics.tsx

Mock risk scoring

RiskAssessment

F17

A/B Evaluation

Planned

–

Synthea scripts exist

MeasureReport

F18

Patient Satisfaction

Built

satisfaction.tsx (11KB)

Mock NPS tracking

–

Status definitions:

  • Live – End-to-end working: UI + AI Service API + FHIR data (or real HealthKit bridge)

  • Built – UI screen is complete and functional; uses mock/fallback data when backend API is unavailable

  • Planned – Designed and specified; not yet implemented in code

Tier 1: Must Be Functional in Prototype

F01 - MERaLiON / SEA-LION Chat Interface

Agent: A1 (Companion) | Status: Live

The primary conversational interface supporting English, Chinese, Malay, and Tamil. The Companion Agent handles casual and general health queries directly, delegates medical queries to A2 (Clinical Reasoning) and dietary queries to A4 (Lifestyle), then rephrases responses empathetically via MERaLiON.

Implementation:

  • Patient app: chat.tsx (64KB) – full-featured chat UI with streaming responses, voice input, language picker, and suggested prompts

  • AI Service: POST /chat and POST /chat/stream endpoints in index.ts

  • LLM: Connected to med-r1 via llm.ts with system prompts from prompts.ts

  • FHIR: Patient context built from live Patient, Condition, AllergyIntolerance, MedicationRequest resources

Key outputs: Chat responses, suggested follow-up actions, FHIR Communication + AuditEvent records.

F02 - Medication Management + Adherence Tracking

Agent: A2 (Clinical Reasoning) + A3 (Nudge) + A1 (Companion) | Status: Live

Reads active MedicationRequests from Medplum, generates daily medication schedules, tracks dose confirmations as MedicationAdministration resources, checks drug interactions via RxNorm, and computes weekly PDC (proportion of days covered) adherence metrics.

Implementation:

  • Patient app: medications.tsx (25KB) – daily schedule view with timing inference, dose logging UI, refill tracking

  • Services: medication-service.ts (17KB) – FHIR MedicationRequest read, MedicationAdministration write, adherence computation

  • FHIR integration: Full read/write – MedicationRequest (active meds), MedicationAdministration (dose logs)

  • Mock fallback: 4 medications (Metformin, Lisinopril, Atorvastatin, Vitamin D3) when FHIR unavailable

Key outputs: Daily schedule, interaction warnings, MedicationAdministration, adherence Observation.

F03 - Smart Nudge Engine

Agent: A3 (Nudge) | Status: Built

Proactive engagement system triggered by: missed doses, high biometric readings, daily engagement checks, and appointment reminders. Nudges are delivered in the patient’s language via MERaLiON. Tiered escalation:

  • Low – Patient nudge only (e.g., gentle medication reminder)

  • Medium – Patient nudge + next-day clinician flag

  • High – Immediate clinician alert (e.g., BP >180/120, suicidal ideation)

Implementation:

  • Patient app: index.tsx home screen displays nudge cards with severity colours and action buttons

  • Services: nudge-service.ts (3KB) – nudge display and dismissal

  • Backend: Nudge generation uses mock data; rule engine not yet wired to live triggers

  • Note: UI fully functional; backend rule engine for automated trigger evaluation is planned

F04 - Conversational PROs (Patient-Reported Outcomes)

Agent: A1 (Companion) | Status: Live

Delivers standardised questionnaires (PHQ-9, DDS-17) conversationally rather than as forms. The Companion Agent maps free-text patient responses to structured answers, computes derived scores, and triggers escalation when thresholds are exceeded.

Implementation:

  • Patient app: checkin.tsx (15KB) – conversational wellness check-in with emoji-based scales

  • Services: pro-service.ts (7KB) – PRO questionnaire delivery and scoring

  • FHIR write: Completed check-ins are saved as QuestionnaireResponse resources

  • Scoring guide: Built-in threshold detection (low/moderate/high distress)

Key outputs: FHIR QuestionnaireResponse, derived score Observations, threshold breach alerts.

F05 - Wearable Data Ingestion

Agent: A6 (Measurement) + A3 (Nudge) | Status: Live

Ingests vitals from Apple Health, Google Health Connect, Bluetooth devices, and manual entry. Maps readings to FHIR Observations with LOINC codes (BP: 8480-6/8462-4, glucose: 2345-7, heart rate: 8867-4, steps: 55423-8, weight: 29463-7). Batch uploaded as FHIR transaction Bundles.

Implementation:

  • Patient app: watch.tsx (23KB) – wearable device management, sync status, data visualization; health.tsx (15KB) – consolidated health dashboard

  • Services: health-kit-service.ts (7KB) – Apple HealthKit bridge for iOS; vitals-service.ts (8KB) – FHIR Observation read/write

  • FHIR integration: Reads Observation (vital-signs category) for heart rate, BP, glucose; writes new readings

  • Mock fallback: 3 devices (Apple Watch, Accu-Chek glucometer, Omron BP monitor) and 7-day trend data when no FHIR data available

Key outputs: FHIR Observations, computed 7/30-day averages, threshold breach events, trend visualisation data.

F06 - Patient Insight Summary for Clinician

Agent: A5 (Insight Synthesis) | Status: Live

Generates a pre-visit brief as a FHIR Composition with 11 sections: active conditions, latest biometrics, lab results, current medications, medication adherence, allergies, upcoming appointments, recent encounters, health goals, escalation flags, and clinical summary. Triggered via API or 24h before appointments.

Implementation:

  • Patient app: insights.tsx (31KB) – enterprise-grade summary viewer with collapsible sections, data cards, and loading states

  • Services: feature-services.ts – fetchPreVisitFromAgent() calls POST /patients/:id/previsit-summary; getPreVisitSummary() provides local FHIR aggregation fallback

  • AI Service: Dedicated endpoint with 11-section structured response

  • FHIR integration: Full – reads Condition, Observation, MedicationRequest, MedicationAdministration, AllergyIntolerance, Appointment, Encounter, Goal, Flag

  • Auto-generation: Pre-visit summaries are automatically generated when a new appointment is booked (fire-and-forget) and saved as DocumentReference

Tier 2: Strengthens Personalisation + Impact

F07 - Dietary + Lifestyle Engine (SEA-Culturally Aware)

Agent: A4 (Lifestyle) | Status: Live

Culturally-aware dietary recommendations grounded in Southeast Asian food context (hawker dishes, festive foods). Checks drug-food interactions and generates FHIR NutritionOrders with specific, actionable advice.

Implementation:

  • Patient app: lifestyle.tsx (39KB) – meal logging, dietary recommendations, AI diet plan generation, exercise recommendations, festive food alerts (e.g., Hari Raya)

  • Services: feature-services.ts – logMeal() (FHIR NutritionOrder write), getDietaryRecommendations() (AI agent with fallback), generateAIDietPlan() (condition-aware + medication interaction), getHealthGoals() (FHIR Goal read), getMealHistory() (FHIR NutritionOrder read)

  • FHIR integration: Full read/write – NutritionOrder, Goal

  • Notable: Localised recommendations for Singaporean food (nasi lemak, chicken rice, teh tarik alternatives, hawker centre tips)

F08 - Outcome Measurement Framework

Agent: A6 (Measurement) | Status: Built

Computes population-level clinical metrics: medication adherence PDC, biometric improvement deltas, PRO score changes, engagement frequency, readmission rates, and time-to-intervention. Produces FHIR MeasureReports (individual + summary).

Implementation:

  • Patient app: analytics.tsx (12KB) – metrics dashboard with trend charts and intervention period markers

  • Services: feature-services.ts – getDashboardMetrics() reads FHIR Observation (vital-signs + laboratory) for BP, glucose, heart rate, HbA1c

  • FHIR integration: Reads Observation for real metrics; time-series and population views use mock data

  • Note: Individual metrics are live from FHIR; population-level aggregation uses mock data

F09 - Adherence + Biometric Analytics Dashboard

Agent: A6 (Measurement) | Status: Built

Provides three view modes:

  • Patient – 90-day time-series with goal lines and intervention markers

  • Clinician – per-patient panel sortable by risk level

  • Population – cohort-level aggregated trends

Implementation:

  • Patient app: analytics.tsx – combined with F08 dashboard; chart data from getChartData() which calls vitals-service.ts for FHIR trend data

  • FHIR integration: Reads vital trend data from Observation resources

  • Note: Patient view is live; clinician and population views are planned

F10 - Escalation Pathways (Tiered Clinician Alerts)

Agent: A3 (Nudge) + A5 (Insight Synthesis) | Status: Live

Structured clinical alerts with three severity tiers. High-priority alerts (severe symptoms, suicidal ideation) generate immediate FHIR Flags + CommunicationRequests. Clinicians receive one-click actions: Review, Call, Adjust Medication, Dismiss.

Implementation:

  • Patient app: escalations.tsx (8KB) – alert list with severity badges, clinician escalation status

  • Services: feature-services.ts – getEscalationFlags() reads FHIR Flag resources with severity parsing

  • FHIR integration: Full read – Flag (active alerts by patient)

F11 - Behavioral Anticipation Model

Agent: A3 (Nudge) | Status: Built

Predictive model computing: disengagement risk, non-adherence risk, and clinical deterioration risk. Uses logistic model / rule-based thresholds over 30-day adherence, engagement, and biometric patterns. Produces FHIR RiskAssessments.

Implementation:

  • Patient app: analytics.tsx – engagement badges and streak tracking

  • Services: api.ts – getMockEngagementData() with risk level, streaks, badges, weekly activity

  • Note: UI complete with gamification elements (badges, streaks); predictive model uses mock risk scores

Tier 3: Polish + Differentiation

F12 - Appointment Orchestrator (Pre/Post Visit)

Agent: A1 (Companion) + A5 (Insight Synthesis) | Status: Live

Pre-visit: preparation prompts (what to bring, questions to ask). Post-visit: plain-language summaries of medication changes, care plan updates, and follow-up tasks.

Implementation:

  • Patient app: appointments.tsx (53KB) – the largest screen; full appointment management with booking, cancellation, doctor/specialty selection, available slots, SOAP note viewing

  • Services: feature-services.ts – getAppointments() (FHIR Appointment + Encounter merge), bookAppointment() (FHIR Appointment write + OpenEMR writeback + auto pre-visit summary)

  • AI Service: POST /api/appointments/writeback syncs to OpenEMR; POST /api/admin/sync-appointments for bulk sync

  • FHIR integration: Full read/write – Appointment, Encounter, DocumentReference (SOAP notes), Practitioner (doctor names)

  • Post-visit: Extracts and displays SOAP note summaries from DocumentReference base64-encoded attachments

F14 - Adaptive Health Education (Teachable Moments)

Agent: A1 (Companion) + A4 (Lifestyle) | Status: Built

Event-triggered educational content (e.g., high glucose reading -> diabetes management tips). Adapted to patient health literacy level and preferred language.

Implementation:

  • Patient app: education.tsx (38KB) – educational content cards with categories (medication, nutrition, exercise, condition, lab), read time estimates, save/bookmark functionality

  • Services: api.ts – getMockEducationContent() with 6 contextual articles (HbA1c explained, Metformin mechanism, glucose spikes, walking benefits, BP basics, Hari Raya food guide)

  • Note: UI complete with context triggers shown; content is currently static mock data

F15 - Multi-Source Data Fusion Timeline

Agent: A6 (Measurement) | Status: Built

Unified chronological timeline merging vitals, medications, encounters, nudges, goals, and escalation events. Available in both patient and clinician views.

Implementation:

  • Patient app: timeline.tsx (8KB) – chronological event list with type-based icons and colour coding

  • Services: api.ts – getMockTimeline() with 10 sample events from EHR, wearable, PRO, lifestyle, and flag sources

  • Note: UI complete; data aggregation pipeline uses mock data

F16 - Readmission Risk + Event Tracking

Agent: A6 (Measurement) + A3 (Nudge) | Status: Built

Readmission risk scoring using encounter history, adherence, biometric trends, PRO scores, and condition complexity. High-risk patients receive increased monitoring frequency.

Implementation:

  • Patient app: analytics.tsx – risk score visualization with contributing factors

  • Services: api.ts – getMockReadmissionRisk() with 6 risk factors (adherence, BP trend, HbA1c, PHQ-9, engagement, ED visits)

  • Note: UI complete with factor breakdown; risk algorithm uses mock scoring

F17 - A/B Evaluation Framework (Synthetic Cohorts)

Agent: A6 (Measurement) | Status: Planned

Compares Med-SEAL intervention cohort against Synthea-generated control cohort. Produces comparative FHIR MeasureReports with effect sizes and p-values for impact demonstration.

Implementation:

  • Scripts: Synthea patient generation scripts exist in scripts/ for control cohort creation

  • Note: Framework designed; backend analysis and reporting not yet implemented

F18 - Patient Satisfaction + NPS Tracking

Agent: A1 (Companion) + A6 (Measurement) | Status: Built

Monthly NPS + CSAT surveys delivered conversationally (via F04 pattern). Computes promoter/detractor ratios and satisfaction trends over time.

Implementation:

  • Patient app: satisfaction.tsx (11KB) – NPS score display, history trends, weekly pulse, recent feedback, message helpfulness ratio

  • Services: api.ts – getMockSatisfactionData() with NPS history, weekly pulse, feedback, and message helpfulness metrics

  • Note: UI fully functional; data collection uses mock source

Code Map

App

Directory

Key Files

Patient Portal Native

apps/patient-portal-native/

app/(tabs)/chat.tsx, app/(tabs)/medications.tsx, app/(tabs)/health.tsx, app/(tabs)/index.tsx, app/(tabs)/more.tsx

app/appointments.tsx, app/lifestyle.tsx, app/education.tsx, app/caregiver.tsx, app/analytics.tsx, app/timeline.tsx, app/satisfaction.tsx, app/escalations.tsx, app/checkin.tsx, app/watch.tsx, app/insights.tsx, app/records.tsx, app/profile.tsx

AI Service

apps/ai-service/src/

index.ts (API routes), llm.ts (LLM client), prompts.ts (system prompts), db.ts (SSO DB), openemr-db.ts (OpenEMR sync)

AI Frontend

apps/ai-frontend/src/

App.tsx (SPA), services.ts (auth), pages/ (admin UI), components/

Services

apps/patient-portal-native/lib/services/

chat-service.ts, feature-services.ts, health-kit-service.ts, medication-service.ts, nudge-service.ts, pro-service.ts, records-service.ts, vitals-service.ts