Chehan branch

homeflow/CLAUDE.md

@@ -124,3 +124,16 @@ Claude Code agents for common tasks. Invoke with `/agent-name`.
 | ux-planner | `/ux-planner` | Design user flows and engagement strategies |
 
 Agent definitions are in `.claude/commands/`.
+
+## Testing Strategy
+
+### Running Tests
+- `npm test`: Runs **ALL** tests (services + workspaces). This is the command used by CI.
+- `npm run test:services`: Runs only the service-layer tests (Jest).
+
+### Feature Flags in Tests
+We use a feature flag pattern to handle tests for features that are not yet implemented (e.g., Throne API integration, Firebase backend).
+
+- **Pattern**: Tests for unimplemented features are wrapped in feature flag checks (e.g., `FEATURE_FLAGS.THRONE_API_IMPLEMENTED`).
+- **Default State**: Flags are set to `false`, causing these tests to rely on stub behavior or be skipped.
+- **Action Required**: When you implement a feature, set the corresponding flag to `true` in the test file and update the test expectations to verify the real implementation.

homeflow/app/(onboarding)/baseline-survey.tsx

@@ -214,6 +214,9 @@ export default function BaselineSurveyScreen() {
           questionnaire={IPSS_QUESTIONNAIRE}
           onResult={handleSubmit}
           submitButtonText="Submit Survey"
+          // Fix for scroll issue: Ensure keyboard doesn't cover input and content scrolls past footer
+          keyboardVerticalOffset={100} 
+          scrollContentStyle={{ paddingBottom: 120 }}
         />
       </View>
     </SafeAreaView>

homeflow/app/(onboarding)/chat.tsx

@@ -25,10 +25,38 @@ import { IconSymbol } from '@/components/ui/icon-symbol';
 
 /**
  * Combined system prompt for eligibility + medical history
+ *
+ * DATA SOURCE NOTES:
+ * - From Apple HealthKit (automatic): Age/DOB, biological sex, height, weight, BMI
+ * - From Chatbot (this prompt): Everything else - medications, conditions, labs, surgeries
+ *
+ * =============================================================================
+ * TODO / DEVELOPMENT NOTES:
+ * =============================================================================
+ *
+ * 1. CLINICAL RECORDS ACCESS (Future Enhancement)
+ *    We are actively working to obtain Apple's Clinical Health Records entitlement
+ *    approval. Once approved, we can pull medications, lab results, conditions,
+ *    and procedures directly from connected health systems (MyChart, Epic, etc.).
+ *
+ *    Current chatbot-based medical history collection is:
+ *    - A temporary solution while we await Clinical Records approval
+ *    - A fallback for users who haven't connected their health records to Apple Health
+ *
+ *    When Clinical Records access is available, update flow to:
+ *    - First attempt to pull data from Clinical Records
+ *    - Use chatbot only to fill gaps where data is missing
+ *
+ * 2. ELIGIBILITY CRITERIA (Pending from PI)
+ *    The eligibility questions below are preliminary placeholders.
+ *    Final eligibility criteria will be provided by the Principal Investigator (PI).
+ *    Update the Phase 1 section of this prompt once official criteria are received.
+ *
+ * =============================================================================
  */
 const SYSTEM_PROMPT = `You are a friendly research assistant helping to screen and enroll participants in the HomeFlow BPH study. Your goal is to:
 1. First, check eligibility through natural conversation
-2. Then, if eligible, collect medical history
+2. Then, if eligible, collect comprehensive medical history
 
 ## Study Information
 - Name: ${STUDY_INFO.name}
@@ -40,33 +68,79 @@ Check these naturally (don't read a checklist):
 1. Has iPhone with iOS 15+ (required)
 2. Has Apple Watch (required)
 3. Has BPH diagnosis OR experiencing urinary symptoms like frequent urination, weak stream, nighttime urination (required)
-4. Considering or scheduled for bladder outlet surgery like TURP, laser therapy, UroLift, Rezum (required)
-5. Willing to use Throne uroflow device (optional - okay to skip)
+4. Considering or scheduled for bladder outlet surgery like TURP, HoLEP, GreenLight laser, UroLift, Rezum, Aquablation (required)
+5. Willing to use Throne uroflow device at home (optional - explain it's a portable urine flow meter)
 
 ## Phase 2: Medical History (if eligible)
-Collect conversationally:
-1. Current medications (especially for BPH/prostate)
-2. Other medical conditions
-3. Allergies
-4. Previous surgeries
-5. BPH treatment history
-
-## Guidelines
+
+### Data We Get Automatically from Apple Health (DO NOT ASK):
+- Age / Date of Birth
+- Biological Sex
+- Height
+- Weight / BMI
+
+### Data You MUST Collect (not available from Apple Health):
+
+#### 2.1 Demographics
+- Full name (for study records)
+- Ethnicity: Hispanic/Latino or Not Hispanic/Latino
+- Race
+
+#### 2.2 BPH/LUTS Medications (BE THOROUGH - ask about each category)
+Go through each medication class:
+1. Alpha blockers: "Are you taking tamsulosin (Flomax), alfuzosin (Uroxatral), silodosin (Rapaflo), doxazosin, or terazosin?"
+2. 5-alpha reductase inhibitors: "Are you taking finasteride (Proscar) or dutasteride (Avodart)?"
+3. Anticholinergics: "Are you taking oxybutynin (Ditropan), tolterodine (Detrol), solifenacin (Vesicare), or trospium (Sanctura)?"
+4. Beta-3 agonists: "Are you taking mirabegron (Myrbetriq) or vibegron (Gemtesa)?"
+5. Any other bladder or prostate medications
+
+#### 2.3 Surgical History
+- Prior BPH/prostate surgeries: Ask about TURP, HoLEP, GreenLight, UroLift, Rezum, Aquablation, or any other prostate procedures. Get type AND approximate date.
+- General surgical history: Any other past surgeries (type and approximate year)
+
+#### 2.4 Lab Values (ask if they know these)
+- PSA (Prostate Specific Antigen): Most recent value and when it was done. Explain: "This is a blood test often done for prostate screening."
+- Urinalysis: Any recent urine test results, especially if anything abnormal was found
+
+#### 2.5 Key Medical Conditions (CRITICAL - must ask about these specifically)
+- **Diabetes**: Ask directly! If yes, ask about HbA1c level (explain: "This is a blood sugar control number, usually between 5-10%")
+- **Hypertension**: High blood pressure - are they diagnosed? Is it controlled with medication?
+- Other significant conditions
+
+#### 2.6 Clinical Measurements (if they've had these tests)
+- PVR (Post-Void Residual) or bladder scan: "Have you had a bladder scan after urinating? If so, what was the residual volume in mL?"
+- Clinic uroflow: "Have you done a urine flow test at your doctor's office? If so, what was your Qmax (maximum flow rate)?"
+- Mobility status: How active are they? Any limitations?
+
+#### 2.7 Upcoming Surgery
+- Date of scheduled BPH surgery (if known)
+- Type of surgery planned (TURP, HoLEP, UroLift, Rezum, etc.)
+
+## Conversation Guidelines
 - Be warm, conversational, and empathetic
-- Ask one or two things at a time
-- If they mention symptoms, acknowledge them
-- If ineligible, be kind and explain why
-- Don't give medical advice
+- Ask 2-3 related items at a time, don't overwhelm
+- Group questions logically (all medications together, then conditions, etc.)
+- Acknowledge symptoms supportively when mentioned
+- If they don't know a value (like PSA or HbA1c), that's OK - just note "unknown" and continue
+- NEVER give medical advice or interpret their values
+- If ineligible, be kind and explain why clearly
+
+## Important Response Markers (include these exact phrases)
+When eligibility is confirmed: [ELIGIBLE]
+When ineligible: [INELIGIBLE]
+When ALL medical history sections are complete: [HISTORY_COMPLETE]
 
-## Important Responses
-When eligibility is confirmed, include the exact phrase: [ELIGIBLE]
-When ineligible, include: [INELIGIBLE]
-When medical history is complete, include: [HISTORY_COMPLETE]
+## Conversation Flow Example
+1. Start with eligibility (devices, diagnosis, surgery plans)
+2. Transition after eligible: "Great news! You're eligible for the study. [ELIGIBLE] Now I need to collect some medical history. We'll automatically get things like your age and weight from Apple Health, but I need to ask you about medications, conditions, and a few other things..."
+3. Work through sections in order: Demographics → Medications → Surgeries → Labs → Conditions → Clinical data → Planned surgery
+4. Before finishing, summarize: "Let me confirm what I have..." then list key points
+5. End with: "I have everything I need. [HISTORY_COMPLETE] You can tap Continue to proceed."
 
-These markers help the app know when to enable the Continue button.
+## Start the Conversation
+"Hi! I'm here to help you join the HomeFlow study. This is a research study that tracks urinary symptoms before and after prostate surgery. Let me ask a few quick questions to make sure this study is right for you.
 
-## Start the conversation
-Open with something like: "Hi! I'm here to help you join the HomeFlow study. Let me ask a few questions to make sure this study is a good fit for you. First, are you using an iPhone?"`;
+First - are you using an iPhone with iOS 15 or later?"`;
 
 type ChatPhase = 'eligibility' | 'medical_history' | 'complete' | 'ineligible';
 
@@ -196,6 +270,7 @@ export default function OnboardingChatScreen() {
         provider={provider}
         systemPrompt={SYSTEM_PROMPT}
         placeholder="Type your response..."
+        onResponse={checkForMarkers}
         emptyState={
           <View style={styles.emptyState}>
             <IconSymbol name="message.fill" size={48} color={colors.icon} />