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AI Patient Onboarding — Backend API Documentation

This document provides a comprehensive guide for integrating with the AI Patient Onboarding FastAPI Backend. It covers all REST API endpoints, request/response models, voice integration flows, medical document processing, and EHR integration.

Table of Contents

  1. Architecture & Server Overview
  2. Environment Configuration (.env)
  3. Running the Backend Locally
  4. Voice Onboarding API (/v1/voice-onboarding)
  5. Text Onboarding API (/v1/onboarding)
  6. Medical Document & Vision API (/v1/documents)
  7. System Health Check (/health)
  8. Connecting External Hospital EMR / EHR System
  9. Multi-Language & Clinical Specialties
  10. Client Integration Code Samples

1. Architecture & Server Overview

  • Framework: FastAPI (Python 3.10+) with SQLAlchemy ORM
  • Default Base URL: http://127.0.0.1:8000
  • Interactive Swagger Documentation: http://127.0.0.1:8000/docs
  • OpenAPI JSON Spec: http://127.0.0.1:8000/openapi.json
  • CORS: Pre-configured to allow all origins (*) for easy React web and mobile client integration.
+------------------+         +-------------------------------+         +-----------------------+
|  Client Device   |         |  FastAPI Backend Engine       |         | Hospital EHR / Database|
+------------------+         +-------------------------------+         +-----------------------+
         |                                   |                                     |
         | --- POST /start ----------------> | (Initialize Session + State)        |
         | <-- Greeting Text & Audio URL --- | (Synthesized TTS Audio)             |
         |                                   |                                     |
         | --- POST /turn (Audio / Text) --> | (Sarvam STT -> GPT-4o -> State)     |
         | <-- Next Question & Audio URL --- |                                     |
         |                                   |                                     |
         | --- POST /upload (Prescription) > | (Gemini Vision OCR -> Extract Meds) |
         | <-- Extracted Findings ---------- |                                     |
         |                                   |                                     |
         | --- POST /complete (confirmed) -> | (Extract EHR JSON) ---------------->| POST /patients
         | <-- Final Success Status -------- | <--- 200 OK Record Saved -----------|

2. Environment Configuration (.env)

Create or update the .env file in the ai-patient-onboarding/ directory:

APP_NAME="AI Patient Onboarding"
APP_ENV=development
APP_VERSION=1.0.0

# Database URL
DATABASE_URL="sqlite:///./data/onboarding.db"

# AI Provider API Keys
OPENAI_API_KEY="sk-..."
OPENAI_MODEL="gpt-4o-mini"

ANTHROPIC_API_KEY="sk-ant-..."
ANTHROPIC_MODEL="claude-3-5-sonnet-20241022"

GEMINI_API_KEY="AIzaSy..."
GEMINI_MODEL="gemini-1.5-flash"

SARVAM_API_KEY="your_sarvam_key"

# External Destination Hospital EHR / Patient API (Optional)
PATIENT_API_BASE_URL="https://your-hospital-emr.com/api/v1"
PATIENT_API_TOKEN="your_secure_bearer_token"

3. Running the Backend Locally

# Navigate to the backend directory
cd ai-patient-onboarding

# Activate Python Virtual Environment
# Windows PowerShell:
.\venv\Scripts\Activate.ps1
# Linux / macOS:
# source venv/bin/activate

# Install dependencies if not already installed
pip install -r requirements.txt

# Start FastAPI development server
uvicorn app.main:app --host 0.0.0.0 --port 8000 --reload

4. Voice Onboarding API (/v1/voice-onboarding)

4.1 Start Voice Session

Creates a new voice onboarding session, initializes dynamic state, and returns localized assistant greeting with audio.

  • URL: POST /v1/voice-onboarding/start
  • Headers: Content-Type: application/json
  • Request Body:
{
  "patient": {
    "id": "PAT-9842",
    "name": "Arun Kumar",
    "age": 42,
    "gender": "male",
    "abha_id": "91-1234-5678-9012",
    "phone": "+91 98765 43210",
    "insurance_scheme": "PM-JAY",
    "dietary_habits": "Vegetarian"
  },
  "category": {
    "type": "speciality",
    "code": "cardio",
    "name": "Cardiology"
  },
  "language": "en-IN"
}
  • Response (200 OK):
{
  "success": true,
  "session_id": "VOICE-78A1BF2C",
  "patient_id": "PAT-9842",
  "category": {
    "type": "speciality",
    "code": "cardio",
    "name": "Cardiology"
  },
  "language": "en-IN",
  "status": "in_progress",
  "stage": "greeting",
  "greeting_text": "Hello Arun Kumar, welcome to CureSelect Cardiology department. What symptoms or discomfort are you experiencing today?",
  "audio_url": "/v1/voice-onboarding/audio/voice_greeting_89bf1a.wav",
  "response_time_ms": 166.84,
  "response_time_sec": 0.167
}

4.2 Send Voice / Speech Turn

Submits the patient's recorded audio or transcribed speech. The backend runs multi-model Indic speech recognition (Sarvam/Whisper), extracts medical entities, updates conversational state, and generates the next question with audio TTS.

  • URL: POST /v1/voice-onboarding/{session_id}/turn

  • Headers: Content-Type: multipart/form-data

  • Form Data Parameters:

    • audio (Optional File): WebM, WAV, or MP3 recorded audio file from the user's microphone.
    • text_fallback (Optional String): Real-time browser speech recognition transcript fallback.

  • Response (200 OK):

{
  "success": true,
  "session_id": "VOICE-78A1BF2C",
  "patient_transcript": "I have had severe chest pain and breathlessness since yesterday evening.",
  "ai_text": "I understand. Does the chest pain radiate to your left arm or jaw, and are you currently taking any blood pressure or heart medications?",
  "stage": "symptoms_inquiry",
  "completed": false,
  "audio_url": "/v1/voice-onboarding/audio/speech_reply_30ef2.wav",
  "suggested_specialty": {
    "type": "specialist",
    "code": "cardiology",
    "name": "Cardiology / Heart Care"
  },
  "response_time_ms": 1824.12,
  "response_time_sec": 1.824
}

4.3 Fetch Synthesized Voice Audio

Streams audio file generated for assistant responses.

  • URL: GET /v1/voice-onboarding/audio/{audio_id}
  • Response: audio/wav or audio/mpeg binary stream.

4.4 Complete & Confirm Session

Extracts complete structured clinical results. Supports a two-step confirmation workflow (review preview -> permanent submission).

  • URL: POST /v1/voice-onboarding/{session_id}/complete
  • Headers: Content-Type: application/json

Step A: Request Review Preview (confirmed: false)

{
  "confirmed": false
}

Response (200 OK):

{
  "success": true,
  "session_id": "VOICE-78A1BF2C",
  "status": "awaiting_confirmation",
  "result": {
    "patient_id": "PAT-9842",
    "abha_id": "91-1234-5678-9012",
    "phone": "+91 98765 43210",
    "insurance_scheme": "PM-JAY",
    "category": {
      "type": "speciality",
      "code": "cardio",
      "name": "Cardiology"
    },
    "chief_complaint": "Acute onset retrosternal chest pain and dyspnea",
    "symptoms": [
      {
        "name": "Chest tightness",
        "duration": "1 day",
        "severity": "Moderate to Severe",
        "description": "Retrosternal pressure aggravated by exertion"
      }
    ],
    "medical_history": ["Hypertension (5 years)"],
    "medications": ["Amlodipine 5mg OD"],
    "allergies": ["Penicillin"],
    "dietary_habits": "Vegetarian",
    "additional_information": "Non-smoker",
    "language": "en-IN",
    "onboarding_completed": true
  },
  "message": "Please review the collected information and confirm by voice or tap."
}

Step B: Confirm & Submit to EHR (confirmed: true)

{
  "confirmed": true
}

Response (200 OK):

{
  "success": true,
  "session_id": "VOICE-78A1BF2C",
  "status": "submitted_and_cleaned",
  "result": { ... },
  "message": "Voice onboarding successfully saved to patient record."
}

5. Text Onboarding API (/v1/onboarding)

For text chat interfaces or non-voice kiosks.

5.1 Start Text Session

  • URL: POST /v1/onboarding/start
  • Body: Same as Voice Start (patient, category, language).
  • Response: Returns session_id, greeting_message, and initial state.

5.2 Send Text Message

  • URL: POST /v1/onboarding/{session_id}/message
  • Body:
{
  "message": "I've had knee pain for 3 days after a run."
}
  • Response:
{
  "success": true,
  "session_id": "ONB-84A12B1C",
  "stage": "symptoms_inquiry",
  "message": "Is the knee swollen or locking when you walk?",
  "status": "in_progress"
}

5.3 Complete Text Onboarding

  • URL: POST /v1/onboarding/{session_id}/complete
  • Body: {"confirmed": true}

6. Medical Document & Vision API (/v1/documents)

Uploads patient medical documents (prescriptions, discharge summaries, lab reports) to extract medications, allergies, and diagnoses using Gemini 1.5 Flash Vision, automatically injecting findings into the active session state.

  • URL: POST /v1/documents/{session_id}/upload

  • Headers: Content-Type: multipart/form-data

  • Form Field: file (Binary image or PDF file)

  • Response (200 OK):

{
  "success": true,
  "session_id": "VOICE-78A1BF2C",
  "document_type": "prescription",
  "summary": "Prescription from Cardiologist dated 15-Aug-2024",
  "findings": ["Ejection Fraction 55%", "Normal Sinus Rhythm"],
  "medications_found": ["Atorvastatin 20mg", "Metoprolol 25mg"],
  "allergies_found": ["Sulfa drugs"],
  "message": "Medical document analyzed and integrated into onboarding session."
}

7. System Health Check (/health)

  • URL: GET /health
  • Response (200 OK):
{
  "success": true,
  "service": "AI Patient Onboarding",
  "status": "healthy",
  "models": {
    "speech": "Sarvam AI (Indian Languages) / OpenAI Whisper",
    "conversation": "OpenAI GPT-4o-mini",
    "validation": "Claude 3.5 Sonnet",
    "vision_documents": "Gemini 1.5 Flash"
  }
}

8. Connecting External Hospital EMR / EHR System

When onboarding is finalized, the backend invokes PatientSubmissionService located at: app/services/patient_submission_service.py

Customizing the Destination Forwarding:

import httpx
from app.config import PATIENT_API_BASE_URL, PATIENT_API_TOKEN

class PatientSubmissionService:
    async def submit(self, result: dict) -> dict:
        if not PATIENT_API_BASE_URL:
            # Local fallback mock
            return {
                "success": True,
                "message": "Patient data saved locally.",
                "patient_id": result.get("patient_id"),
            }

        # Forward JSON payload to hospital central server
        async with httpx.AsyncClient(timeout=15.0) as client:
            headers = {
                "Authorization": f"Bearer {PATIENT_API_TOKEN}",
                "Content-Type": "application/json",
            }
            response = await client.post(
                f"{PATIENT_API_BASE_URL}/patients/{result.get('patient_id')}/onboarding",
                json=result,
                headers=headers,
            )

            if response.status_code in [200, 201]:
                return {"success": True, "data": response.json()}
            
            return {
                "success": False,
                "error": f"Hospital API error: {response.text}",
            }

9. Multi-Language & Clinical Specialties

Supported Languages

Code Language Speech Engine
en-IN / en English (Indian accent) Sarvam / OpenAI Whisper
hi-IN / hi Hindi (हिन्दी) Sarvam Bulbul / Whisper
ta-IN / ta Tamil (தமிழ்) Sarvam Bulbul / Whisper
te-IN / te Telugu (తెలుగు) Sarvam Bulbul / Whisper
kn-IN / kn Kannada (ಕನ್ನಡ) Sarvam Bulbul / Whisper
bn-IN / bn Bengali (বাংলা) Sarvam Bulbul / Whisper
ml-IN / ml Malayalam (മലയാളം) Sarvam Bulbul / Whisper
mr-IN / mr Marathi (मराठी) Sarvam Bulbul / Whisper
gu-IN / gu Gujarati (ગુજરાતી) Sarvam Bulbul / Whisper

Clinical Specialties Supported

  • general_medicine - General Medicine / Primary Care
  • cardio - Cardiology
  • ortho - Orthopedics
  • peds - Pediatrics
  • derma - Dermatology
  • neuro - Neurology
  • gastro - Gastroenterology
  • ent - ENT / Otorhinolaryngology
  • gyn - Obstetrics & Gynecology

10. Client Integration Code Samples

10.1 Python Client (httpx)

import httpx
import asyncio

API_BASE = "http://127.0.0.1:8000"

async def main():
    async with httpx.AsyncClient() as client:
        # 1. Start Session
        start_res = await client.post(f"{API_BASE}/v1/voice-onboarding/start", json={
            "patient": {"id": "P-1001", "name": "Deepak Sharma", "age": 45, "gender": "male"},
            "category": {"type": "speciality", "code": "cardio", "name": "Cardiology"},
            "language": "hi-IN"
        })
        session = start_res.json()
        session_id = session["session_id"]
        print(f"Session started: {session_id}")
        print(f"Greeting: {session['greeting_text']}")

        # 2. Send Turn
        turn_res = await client.post(
            f"{API_BASE}/v1/voice-onboarding/{session_id}/turn",
            data={"text_fallback": "मुझे सीने में भारीपन महसूस हो रहा है"}
        )
        turn_data = turn_res.json()
        print(f"AI Response: {turn_data['ai_text']}")

        # 3. Finalize & Submit
        complete_res = await client.post(
            f"{API_BASE}/v1/voice-onboarding/{session_id}/complete",
            json={"confirmed": True}
        )
        print(f"EHR Saved: {complete_res.json()}")

if __name__ == "__main__":
    asyncio.run(main())

10.2 JavaScript / TypeScript (fetch)

const API_BASE = "http://127.0.0.1:8000";

// Start voice onboarding
export async function startVoiceOnboarding(patient: any, category: any, language = "en-IN") {
  const res = await fetch(`${API_BASE}/v1/voice-onboarding/start`, {
    method: "POST",
    headers: { "Content-Type": "application/json" },
    body: JSON.stringify({ patient, category, language })
  });
  return res.json();
}

// Send audio turn
export async function sendVoiceTurn(sessionId: string, audioBlob?: Blob, textFallback?: string) {
  const formData = new FormData();
  if (audioBlob) formData.append("audio", audioBlob, "speech.webm");
  if (textFallback) formData.append("text_fallback", textFallback);

  const res = await fetch(`${API_BASE}/v1/voice-onboarding/${sessionId}/turn`, {
    method: "POST",
    body: formData
  });
  return res.json();
}

// Upload medical report
export async function uploadPrescription(sessionId: string, file: File) {
  const formData = new FormData();
  formData.append("file", file);

  const res = await fetch(`${API_BASE}/v1/documents/${sessionId}/upload`, {
    method: "POST",
    body: formData
  });
  return res.json();
}

// Complete onboarding
export async function completeOnboarding(sessionId: string, confirmed: boolean) {
  const res = await fetch(`${API_BASE}/v1/voice-onboarding/${sessionId}/complete`, {
    method: "POST",
    headers: { "Content-Type": "application/json" },
    body: JSON.stringify({ confirmed })
  });
  return res.json();
}

10.3 cURL Commands

Start Session:

curl -X POST "http://127.0.0.1:8000/v1/voice-onboarding/start" \
  -H "Content-Type: application/json" \
  -d '{
    "patient": {"id": "P-101", "name": "Arun Kumar", "age": 40, "gender": "male"},
    "category": {"type": "general", "code": "general_medicine", "name": "General Medicine"},
    "language": "en-IN"
  }'

Send Voice Turn (with text fallback):

curl -X POST "http://127.0.0.1:8000/v1/voice-onboarding/VOICE-XXXXX/turn" \
  -F "text_fallback=I have had high fever and sore throat since yesterday"

Upload Prescription:

curl -X POST "http://127.0.0.1:8000/v1/documents/VOICE-XXXXX/upload" \
  -F "file=@/path/to/prescription.pdf"

Confirm & Submit:

curl -X POST "http://127.0.0.1:8000/v1/voice-onboarding/VOICE-XXXXX/complete" \
  -H "Content-Type: application/json" \
  -d '{"confirmed": true}'
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