Longitudinal Health Record (LHR) — patient app

Note (2026-05-11): This doc captures the original LHR feature spec for the patient app. The live implementation has shipped; the API Requirements and Mock Data Structure sections below predate it and are kept for historical context only.

Up-to-date references:

• CMS LHR developer guide — backend transformers + CMS frontend
• LHR product overview — what users see, scope, principles
• LHR QA guide — test plan
• Patient-app code: patient/src/features/health-records/

OverviewCopy Anchor Link

The Longitudinal Health Record provides a comprehensive, timeline-based view of a patient's complete health journey, with contextual information and trends visualization, including symptom tracking and health data entry capabilities.

User StoriesCopy Anchor Link

• As a patient, I want to view my complete health history in chronological order
• As a patient, I want to see trends in my vital signs over time
• As a patient, I want to track my ongoing health conditions and treatments
• As a patient, I want to understand how my health has changed over time
• As a patient, I want to log and track my symptoms over time
• As a patient, I want to see patterns and triggers for my symptoms
• As a patient, I want to share my symptom history with my healthcare provider
• As a patient, I want to correlate symptoms with medications and treatments
• As a patient, I want to manually enter my vital signs and health data

Information ArchitectureCopy Anchor Link

• Patient Timeline
• Vital Signs Trends
  • Manual Vital Entry
  • Trend Visualization
• Problem List Management
• Medication History
• Lab Results Summary
• Clinical Encounters
• Health Events
• Symptom Diary
  • Add Symptom Entry
  • Symptom Timeline
  • Symptom Trends Analysis
  • Quick Symptom Logger
• Symptom-Medication Correlation
• Symptom Pattern Detection

Component SpecificationsCopy Anchor Link

Health Data Entry ComponentsCopy Anchor Link

Add Vital Signs DialogCopy Anchor Link

• Date and time selection
• Blood pressure, heart rate, temperature inputs
• Weight and blood glucose tracking
• Oxygen saturation monitoring
• Notes field for additional context
• Organized in tabs for different vital categories

Symptom Tracking ComponentsCopy Anchor Link

Add Symptom DialogCopy Anchor Link

• Symptom Selection

  • Searchable dropdown with common symptoms
  • Auto-complete from previous entries
  • Option to add custom symptoms

• Severity Assessment

  • Visual severity scale (1-5)
  • 1 = Mild, 2 = Moderate, 3 = Significant, 4 = Severe, 5 = Critical
  • Color-coded indicators for quick recognition

• Duration Tracking

  • How long symptom has been present
  • Options: Minutes, Hours, Days, Weeks
  • Start/end time selection

• Trigger Identification

  • Common triggers checklist (food, stress, activity, weather, medication)
  • Custom trigger input field
  • Multiple trigger selection

• Relief Factors

  • What helps alleviate the symptom
  • Pre-defined options (medication, rest, position change, heat/cold)
  • Custom relief method input

• Associated Symptoms

  • Multi-select for related symptoms
  • Shows potential correlations
  • Links to other logged symptoms

• Impact Assessment

  • How it affects daily activities
  • Scale: None / Mild / Moderate / Severe impact
  • Specific activity limitations

Symptom List ViewCopy Anchor Link

• Chronological symptom history display
• Filter options:
  • Date range selector
  • Severity level filter
  • Symptom type/category
  • Body system grouping
• Color-coded severity indicators
• Expandable cards for detailed view
• Quick actions (edit, delete, duplicate)

Symptom Trends VisualizationCopy Anchor Link

• Severity Trends Chart

  • Line chart showing severity over time
  • Multiple symptom comparison
  • Adjustable time ranges

• Frequency Heat Map

  • Calendar view with intensity colors
  • Daily symptom frequency
  • Pattern identification

• Common Symptoms Chart

  • Bar chart of most frequent symptoms
  • Percentage breakdown
  • Time period selection

• Trigger Correlation Analysis

  • Visual correlation between triggers and symptoms
  • Statistical significance indicators
  • Actionable insights

Quick Symptom LoggerCopy Anchor Link

• One-click logging for frequent symptoms
• Recent symptoms list for quick selection
• Pre-filled with last entry details
• "Same as yesterday" quick option
• Minimal fields for rapid entry
• Voice input support (future enhancement)

API RequirementsCopy Anchor Link

Vital Signs EndpointsCopy Anchor Link

• POST /api/vitals - Create new vital sign entry
• GET /api/vitals - Retrieve vital signs history
• PUT /api/vitals/:id - Update vital sign entry
• DELETE /api/vitals/:id - Delete vital sign entry
• GET /api/vitals/trends - Get vital sign trends and analytics

Symptom Tracking EndpointsCopy Anchor Link

• POST /api/symptoms - Create new symptom entry
• GET /api/symptoms - Retrieve symptom history with filtering
• PUT /api/symptoms/:id - Update symptom entry
• DELETE /api/symptoms/:id - Delete symptom entry
• GET /api/symptoms/trends - Get symptom analytics and patterns
• GET /api/symptoms/correlations - Get symptom-medication correlations
• GET /api/symptoms/triggers - Analyze trigger patterns
• GET /api/symptoms/common - Get list of common symptoms by body system

Mock Data StructureCopy Anchor Link

Vital EntryCopy Anchor Link

interface VitalEntry {
  id?: string;
  date: Date;
  time?: string;
  bloodPressure?: {
    systolic: number;
    diastolic: number;
  };
  heartRate?: number;
  temperature?: number;
  weight?: number;
  bloodGlucose?: {
    value: number;
    type: 'fasting' | 'postprandial' | 'random';
  };
  oxygenSaturation?: number;
  notes?: string;
  source: 'manual' | 'device' | 'provider';
  createdAt?: Date;
  updatedAt?: Date;
}

Symptom EntryCopy Anchor Link

interface SymptomEntry {
  id?: string;
  date: Date;
  symptom: string;
  severity: 1 | 2 | 3 | 4 | 5; // 1-5 scale
  duration: string;
  triggers?: string[];
  relievingFactors?: string[];
  associatedSymptoms?: string[];
  impact: 'none' | 'mild' | 'moderate' | 'severe';
  notes?: string;
  createdAt?: Date;
  updatedAt?: Date;
}

Implementation ChecklistCopy Anchor Link

Core LHR ComponentsCopy Anchor Link

• Create timeline component
• Implement vital signs charts
• Build problem list interface
• Add medication history view
• Create lab results display
• Implement encounter history
• Add filtering and search
• Enable data export functionality

Health Data EntryCopy Anchor Link

• Define health data types (VitalEntry, SymptomEntry)
• Create add vital signs dialog component
• Implement vital signs API integration
• Add data validation and error handling

Symptom TrackingCopy Anchor Link

• Define symptom data types
• Create add symptom dialog component
• Implement symptom list view
• Build symptom trends visualization
• Add quick symptom logger
• Create symptom-medication correlation
• Implement symptom pattern detection
• Add symptom export functionality
• Create common symptoms database
• Implement trigger analysis
• Add symptom sharing with providers