feat: Implement SOAP clinical notes management system

- Added ClinicalNotesController to handle CRUD operations for clinical notes.
- Created ClinicalNotesService for business logic related to clinical notes.
- Developed ClinicalNotesRepository for database interactions with clinical notes.
- Introduced clinical notes validation schema using Joi.
- Established routes for clinical notes, including endpoints for creating, updating, retrieving, and deleting notes.
- Enhanced user role authorization for accessing clinical notes based on user roles (doctor, admin, patient).
- Implemented pagination for retrieving clinical notes.
- Added logging for clinical notes operations to track actions and errors.

Author: Dave-code-creater

README.md

@@ -286,17 +286,39 @@ CREATE TABLE appointments (
 -- CLINICAL DOCUMENTATION
 -- ========================================
 
--- Clinical notes
+-- Clinical notes with SOAP format support
+-- SOAP = Subjective, Objective, Assessment, Plan (standard medical documentation format)
 CREATE TABLE clinical_notes (
   id SERIAL PRIMARY KEY,
-  patient_id INT REFERENCES patients(id),
-  appointment_id INT REFERENCES appointments(id),
-  doctor_id INT REFERENCES doctors(id),
-  note_type TEXT DEFAULT 'general',
+  patient_id INT REFERENCES patients(id) ON DELETE CASCADE,
+  appointment_id INT REFERENCES appointments(id) ON DELETE CASCADE,
+  doctor_id INT REFERENCES doctors(id) ON DELETE SET NULL,
+
+  -- SOAP Format Fields (standard medical documentation)
+  subjective TEXT,  -- Patient's complaints, symptoms, and reported history
+  objective TEXT,   -- Doctor's observations, physical findings, test results
+  assessment TEXT,  -- Diagnosis and professional evaluation
+  plan TEXT,        -- Treatment plan, recommendations, next steps
+
+  -- Legacy fields (kept for backward compatibility)
+  note_type TEXT DEFAULT 'soap',
   content TEXT,
   diagnosis TEXT,
   treatment_plan TEXT,
   follow_up_instructions TEXT,
+
+  -- Additional Clinical Details
+  treatment_performed TEXT,  -- Specific treatments performed during this visit
+  techniques_used TEXT[],    -- Array of techniques used (e.g., spinal adjustment, soft tissue therapy)
+  vitals JSONB,              -- Vital signs: {"blood_pressure": "120/80", "pulse": 72, "temperature": 98.6}
+  follow_up_notes TEXT,      -- Internal notes for next visit
+  next_appointment_recommendation TEXT,  -- Recommended time for next visit
+  visit_duration_minutes INTEGER,        -- Length of visit
+
+  -- Privacy and Access Control
+  is_private BOOLEAN DEFAULT TRUE CHECK (is_private = TRUE),  -- Always private from patients
+
+  -- Metadata
   created_at TIMESTAMPTZ DEFAULT NOW(),
   updated_at TIMESTAMPTZ DEFAULT NOW()
 );
@@ -571,6 +593,9 @@ CREATE INDEX idx_appointments_updated_by ON appointments(updated_by);
 -- Clinical data indexes
 CREATE INDEX idx_clinical_notes_patient_id ON clinical_notes(patient_id);
 CREATE INDEX idx_clinical_notes_appointment_id ON clinical_notes(appointment_id);
+CREATE INDEX idx_clinical_notes_doctor_id ON clinical_notes(doctor_id);
+CREATE INDEX idx_clinical_notes_created_at ON clinical_notes(created_at DESC);
+CREATE INDEX idx_clinical_notes_patient_doctor ON clinical_notes(patient_id, doctor_id, created_at DESC);
 CREATE INDEX idx_vitals_patient_id ON vitals(patient_id);
 CREATE INDEX idx_vitals_appointment_id ON vitals(appointment_id);