Clinical Domain Model

CareBridge models a cross-specialty clinic: patients, their charts, the care teams around them, and the clinical flags the AI oversight layer raises. The canonical TypeScript shapes live in @carebridge/shared-types; the persisted schema lives in @carebridge/db-schema (Drizzle ORM).

Key entities

The single source of truth for types is @carebridge/shared-types. Notable exports include Patient, Vital, Medication, LabPanel, LabResult, ClinicalFlag, ClinicalEvent, User, UserRole, FlagSeverity, and FlagStatus.

Database schema

Authentication
  users              id, email, password_hash, name, role, specialty, department
  sessions           id, user_id, token, expires_at

Patients
  patients           id, name, dob, mrn, insurance, primary_provider_id
  diagnoses          id, patient_id, icd10_code, description, status, onset_date
  allergies          id, patient_id, allergen, reaction, severity
  care_team_members  id, patient_id, provider_id, role, specialty

Clinical Data
  vitals             id, patient_id, type, value, unit, recorded_at
  lab_panels         id, patient_id, panel_name, ordered_by, collected_at
  lab_results        id, panel_id, test_name, value, unit, flag, reference_range
  medications        id, patient_id, name, dose, unit, route, frequency, status
  med_logs           id, medication_id, administered_at, administered_by, dose
  procedures         id, patient_id, name, cpt_code, status, performed_at

Documentation
  clinical_notes     id, patient_id, type, content, signed_by, signed_at, version
  note_versions      id, note_id, version_num, content, created_at

AI Oversight
  clinical_flags     id, patient_id, source, severity, category, summary,
                     rationale, suggested_action, status, rule_id,
                     acknowledged_by, resolved_by, dismiss_reason
  review_jobs        id, patient_id, status, rules_fired, flags_generated,
                     prompt_tokens, completion_tokens, elapsed_ms

Notifications
  notifications      id, recipient_id, recipient_type, type, content, status

FHIR
  fhir_resources     id, patient_id, resource_type, resource_id, content, imported_at

The audit_log table (referenced throughout Compliance and Safety) is append-only and tamper-evident at the database level.

Clinical documentation

clinical-notes provides structured documentation with template support: SOAP (Subjective / Objective / Assessment / Plan) and Progress Note. Notes are versioned and become immutable after signing. Saving or signing a note emits note.saved / note.signed events to the clinical-events queue, feeding the oversight layer.

Clinical validation: @carebridge/medical-logic

Validation utilities that the rules engine and forms share:

• VITAL_DANGER_ZONES — per-type min / max / critical ranges (e.g. O2 sat critical below 85%)
• validateVital(type, value) — returns warnings + errors
• isCriticalVital(type, value) — boolean for the rules engine
• validateLabResult(testName, value) — flags out-of-range values
• Trend analysis (rising / falling / stable direction detection)

Interoperability: FHIR R4

CareBridge converts between its own types and standard FHIR R4 resources (Patient, Observation, Medication, DiagnosticReport) via @carebridge/fhir-utils and the fhir-gateway service. CareBridge-minted identifiers use the canonical namespace https://carebridge.dev/fhir/sid, chosen because major EHRs recognise URL-form Identifier.system values. The full namespace convention and a documented legacy MRN namespace are in the FHIR interop doc.

Roles and dev accounts

The clinic spans specialties by design. Development accounts (all password password123):

Email	Role	Specialty
dr.smith@carebridge.dev	Physician	Hematology/Oncology
dr.jones@carebridge.dev	Specialist	Interventional Radiology
nurse.rachel@carebridge.dev	Nurse	Oncology
patient@carebridge.dev	Patient	—

See also: Architecture Overview, AI Oversight Layer, Developer Guide.