// MedLink · Visite-Tour-Modus (5-Phasen-Workflow nach deutscher Pflegeheim-Praxis) // Öffnet per CustomEvent 'medlink:startVisite' — Detail: { visitId?, bewohnerIds? }. // Echte Web Speech API (de-DE) in der Gesprächs-Phase. // Real-Life-Orientierung: Briefing → Sichtung → Gespräch → Entscheidung → Protokoll. (function () { const { useState, useEffect, useRef, useMemo, useCallback } = React; // ---------------- Speech Recognition helpers ---------------- const getSR = () => window.SpeechRecognition || window.webkitSpeechRecognition; const speechSupported = typeof window !== "undefined" && !!getSR(); // ---------------- Voice commands ---------------- const COMMANDS = [ { re: /(?:n(?:ä|ae)ch(?:ster?|es)\s*patient(?:in)?|weiter(?:\s*bitte)?|vor\s*weiter)/i, type: "next", label: "Nächste:r" }, { re: /(?:zur(?:ü|ue)ck|vorherige[rn]?\s*patient)/i, type: "prev", label: "Zurück" }, { re: /(?:(?:patient)?\s*(?:ü|ue)berspringen|skip)/i, type: "skip", label: "Übersprungen" }, { re: /(?:visite\s*beenden|visite\s*ende|ende\s*der\s*visite|abschlie(?:ß|ss)en|fertig)/i, type: "end", label: "Visite beendet" }, { re: /(?:freigeben|medikament\s*freigeben|verordnen|rezept\s*aus)/i, type: "approve", label: "Freigegeben" }, { re: /blutdruck\s+(\d{2,3})\s*(?:zu|\/|\s)\s*(\d{2,3})/i, type: "vital", key: "bp", label: "Blutdruck" }, { re: /puls(?:frequenz)?\s+(\d{2,3})/i, type: "vital", key: "pulse", label: "Puls" }, { re: /temperatur\s+(\d{2}(?:[\.,]\d)?)/i, type: "vital", key: "temp", label: "Temperatur" }, { re: /(?:sauerstoff[-\s]?)?s(?:ä|ae)ttigung\s+(\d{2,3})/i, type: "vital", key: "spo2", label: "SpO₂" }, { re: /(?:diktat\s+)?(?:stopp|stop|ende\s+diktat)/i, type: "stopMic", label: "Diktat pausiert" }, { re: /(?:objektiv|befund)/i, type: "soap", section: "O", label: "Objektiv" }, { re: /(?:beurteilung|assessment|diagnose)/i, type: "soap", section: "A", label: "Beurteilung" }, { re: /(?:plan|therapie|verordnung|n(?:ä|ae)chste\s+schritte)/i, type: "soap", section: "P", label: "Plan" }, ]; const parseCommand = (text) => { const trimmed = text.trim().toLowerCase(); for (const cmd of COMMANDS) { const m = trimmed.match(cmd.re); if (m) return { ...cmd, match: m }; } return null; }; // ---------------- Helpers ---------------- const fmtTime = (ms) => { const s = Math.max(0, Math.floor(ms / 1000)); const m = Math.floor(s / 60); const r = s % 60; return `${String(m).padStart(2, "0")}:${String(r).padStart(2, "0")}`; }; const firstInitial = (name) => (name || "?").split(",")[0].trim()[0] || "?"; const lastName = (name) => (name || "").split(",")[0].trim(); const bewById = (id) => (window.BEWOHNER || []).find((b) => b.id === id); const heimName = (id) => (window.HEIMS || []).find((h) => h.id === id)?.name || id; const lastOf = (v) => Array.isArray(v) ? v[v.length - 1] : v; const ensureVitals = (bid) => { const existing = (window.VITALS || {})[bid]; if (existing) { const lastBP = lastOf(existing.bp); return { bp: Array.isArray(lastBP) ? `${lastBP[0]}/${lastBP[1]}` : (lastBP ? String(lastBP) : ""), pulse: lastOf(existing.puls) != null ? String(lastOf(existing.puls)) : "", temp: lastOf(existing.temp) != null ? String(lastOf(existing.temp)) : "", spo2: lastOf(existing.spo2) != null ? String(lastOf(existing.spo2)) : "", }; } return { bp: "", pulse: "", temp: "", spo2: "" }; }; // Schätzt Visite-Dauer pro Bewohner (in Minuten) — realistisch: PG + offene Anfragen zählen. const estimateMinutes = (b) => { if (!b) return 8; let base = 7; base += (b.offen || 0) * 2; base += Math.max(0, (b.pflegegrad || 0) - 2) * 1.5; if ((b.allergien || []).length > 0) base += 1; if ((b.diagnosen || []).length > 2) base += 2; return Math.round(base); }; // Prophylaxen-Flags anhand der Diagnosen + Pflegegrad. const prophylaxenFor = (b) => { if (!b) return []; const flags = []; const has = (sub) => (b.diagnosen || []).some((d) => d.toLowerCase().includes(sub)); if ((b.pflegegrad || 0) >= 4) flags.push({ t: "sturz", l: "Sturzrisiko" }); if (has("demenz") || has("parkinson")) flags.push({ t: "sturz", l: "Sturzrisiko" }); if (has("copd") || has("schlaf")) flags.push({ t: "pneumo", l: "Pneumonie-Prophylaxe" }); if ((b.pflegegrad || 0) >= 4) flags.push({ t: "dekubitus", l: "Dekubitus-Check" }); if (has("diabetes")) flags.push({ t: "bz", l: "BZ-Kontrolle" }); return flags.slice(0, 3); // max 3, sonst zu unübersichtlich }; // Generiert SBAR-Briefing aus Daten — als wäre es von der Pflegekraft vorbereitet. const generateBriefing = (b) => { if (!b) return null; const pending = (window.ANFRAGEN || []).filter((a) => a.bewohner === b.id && a.status === "offen"); const lastA = pending[0]; const age = b.alter; const name = b.name.split(",")[0].trim(); const diags = (b.diagnosen || []).slice(0, 2).join(", "); const pg = b.pflegegrad; const allergies = (b.allergien || []).length ? `Allergie: ${b.allergien.join(", ")}. ` : ""; // Situation — was ist akut? const situations = [ lastA?.notiz ? lastA.notiz : null, `${name} ist heute wach und zugewandt, Nahrungsaufnahme stabil.`, `${name} wirkt heute etwas ruhiger als gestern, kein Fieber.`, ].filter(Boolean); const situation = situations[0]; // Background — Vorgeschichte const background = `${age} Jahre · ${diags}. Pflegegrad ${pg}. ${allergies}${pending.length > 0 ? `${pending.length} offene Arzt-Anfrage${pending.length > 1 ? "n" : ""}.` : "Stabiler Dauer-Verlauf."}`; // Assessment — Einschätzung const vitals = ensureVitals(b.id); const vitalStr = vitals.bp ? `RR ${vitals.bp}, Puls ${vitals.pulse || "—"}. ` : ""; const mobility = pg >= 4 ? "Mobilität stark eingeschränkt" : (pg >= 3 ? "teilmobilisiert, mit Hilfestellung" : "eigenständig mobil"); const assessment = `${vitalStr}${mobility}. Medikation regelmäßig eingenommen. ${lastA?.prio === "H" || lastA?.prio === "U" ? "Priorität erhöht." : ""}`; // Recommendation — was braucht der Arzt? const recommendation = lastA ? `Bitte prüfen: ${lastA.med}${lastA.dosis ? ` (${lastA.dosis})` : ""} — ${lastA.typ}. ${lastA.notiz ? "Kontext siehe oben." : ""}` : "Routine-Kontrolle. Kein akuter Handlungsbedarf von unserer Seite."; return { pflegekraft: "Maria Lehmann", schicht: "Frühdienst", zeit: new Date().toLocaleTimeString("de-DE", { hour: "2-digit", minute: "2-digit" }), situation, background, assessment, recommendation, }; }; // ---------------- Specialty-specific configuration ---------------- // Each Fachrichtung hat eigene Sichtung-Checkliste, Vital-/Assessment-Felder, // Medikations-Fokus, Protokoll-Pflichtpunkte. Hausarzt ist der Default. const SPECIALTY_CONFIG = { Hausarzt: { label: "Hausarzt", short: "H", tone: "teal", tagline: "Allgemeinmedizinische Regelvisite", focus: [ "Dauermedikation (Polypharmazie-Check)", "RR- und BZ-Verlauf · Gewicht", "Wunden · Haut · Ödeme", "Impfstatus · Labor-Bedarf", ], sichtung: [ { key: "haut", label: "Haut", hint: "Farbe, Feuchtigkeit, Turgor" }, { key: "dekubitus", label: "Dekubitus-Check", hint: "Ferse, Steiß, Ellbogen" }, { key: "wunden", label: "Wunden & Narben", hint: "Heilungsverlauf, Sekretion" }, { key: "katheter", label: "Katheter / Sonde", hint: "Lage, Ausfluss, Wechseldatum" }, { key: "oedeme", label: "Ödeme", hint: "Beine, Knöchel, Lidödeme" }, { key: "ernaehrung", label: "Ernährung & Flüssigkeit", hint: "Gewichtsverlauf, Trinkmenge" }, { key: "sturz", label: "Sturz-Risiko", hint: "Mobilität, Orientierung, Sturz-Tag-Intervall" }, ], vitals: [ { key: "bp", label: "Blutdruck", unit: "mmHg", hint: "RR syst/diast" }, { key: "pulse", label: "Puls", unit: "/min" }, { key: "temp", label: "Temp.", unit: "°C" }, { key: "spo2", label: "SpO₂", unit: "%" }, ], assessments: [], protokollChecks: ["Medikation besprochen", "Labor bei Bedarf angefordert"], }, Nervenarzt: { label: "Nervenarzt", short: "N", tone: "violet", tagline: "Konsiliar · Demenz · BPSD · Parkinson · alle 6 Wochen", focus: [ "BPSD-Symptome (Unruhe, Wahn, Aggression, Schlaf)", "Antipsychotika-Indikation prüfen (Leitlinie S3)", "Deprescribing · Dosis reduzieren wenn möglich", "Motorik: Rigor · Tremor · Bradykinese · Gang", "Kognition · Orientierung · Affekt", ], sichtung: [ { key: "orientierung", label: "Orientierung", hint: "Zeit · Ort · Person · Situation" }, { key: "affekt", label: "Affekt & Stimmung", hint: "GDS · niedergeschlagen · apathisch · labil" }, { key: "bpsd", label: "BPSD-Verhalten", hint: "Unruhe · Aggression · Wahn · Halluzinationen · Wandern" }, { key: "schlaf", label: "Schlafprofil", hint: "Einschlaf · Durchschlafen · Nacht-Unruhe" }, { key: "motorik", label: "Motorik (Parkinsonoid)", hint: "Rigor · Tremor · Bradykinese · posturale Instabilität" }, { key: "gang", label: "Gang & Sturz", hint: "Gangbild · Freezing · letzte Stürze" }, { key: "neuroleptika", label: "Neuroleptika-Review", hint: "Dauer · Nebenwirkung · Indikation noch gegeben?" }, ], vitals: [ { key: "mmse", label: "MMSE", unit: "/30", hint: "letzter Wert + Datum" }, { key: "gds", label: "GDS", unit: "/15", hint: "Depression-Skala" }, { key: "bp", label: "Blutdruck", unit: "mmHg" }, { key: "pulse", label: "Puls", unit: "/min" }, ], assessments: [ { key: "bpsd_aggr", label: "Aggressiv", type: "toggle" }, { key: "bpsd_wahn", label: "Wahn/Halluz.", type: "toggle" }, { key: "bpsd_unruhe", label: "Motor. Unruhe", type: "toggle" }, { key: "bpsd_apathie", label: "Apathie", type: "toggle" }, { key: "sleep_quality", label: "Schlafqualität", type: "scale", min: 1, max: 10 }, ], medCategories: ["Neuroleptika", "Antidementiva", "Parkinson-Therapie", "Benzodiazepine", "SSRI/Antidepressiva"], medHighlightRe: /(Melperon|Quetiapin|Risperidon|Haloperidol|Olanzapin|Pipamperon|Donepezil|Memantin|Rivastigmin|Madopar|Rasagilin|Levodopa|Pramipexol|Zopiclon|Diazepam|Lorazepam|Sertralin|Citalopram|Mirtazapin)/i, protokollChecks: [ "Antipsychotika-Indikation dokumentiert", "Reduktionsversuch geprüft", "BPSD-Verhaltensbeobachtung eingeleitet", "Nächster Konsil-Termin (6 Wo)", ], }, Internist: { label: "Internist", short: "I", tone: "amber", tagline: "Konsiliar · Herz-Kreislauf · Lunge · Stoffwechsel", focus: [ "Herzinsuffizienz-Zeichen (NYHA · Ödeme · Gewicht)", "Vorhofflimmern · Antikoagulation (CHA₂DS₂-VASc)", "COPD · Asthma · Inhalations-Technik", "BZ-Einstellung · HbA1c-Verlauf", "Elektrolyte · Nierenfunktion", ], sichtung: [ { key: "auskult", label: "Auskultation", hint: "Herztöne · Rasselgeräusche · Atem" }, { key: "oedeme", label: "Ödeme & Stauung", hint: "Beine · Halsvenen · Gewicht +/−" }, { key: "atmung", label: "Atmung", hint: "Ruhe · Belastung · Atemfrequenz · SpO₂" }, { key: "rr_verlauf", label: "RR-Verlauf", hint: "14-Tage-Trend · Morgenspitzen" }, { key: "bz_verlauf", label: "BZ-Verlauf", hint: "Nüchtern · postprandial · HbA1c" }, { key: "inhalation", label: "Inhalations-Technik", hint: "Hub · Koordination · Spacer?" }, ], vitals: [ { key: "bp", label: "Blutdruck", unit: "mmHg" }, { key: "pulse", label: "Puls", unit: "/min" }, { key: "spo2", label: "SpO₂", unit: "%" }, { key: "weight", label: "Gewicht", unit: "kg" }, { key: "resp", label: "Atemfreq.", unit: "/min" }, { key: "glucose", label: "BZ", unit: "mg/dl" }, ], assessments: [ { key: "nyha", label: "NYHA-Stadium", type: "select", options: ["I","II","III","IV"] }, { key: "ekg", label: "EKG nötig", type: "toggle" }, ], medCategories: ["Antihypertonika", "Antikoagulantien", "Diuretika", "Insulin/OAD", "Inhalativa"], medHighlightRe: /(Ramipril|Bisoprolol|Candesartan|Amlodipin|Apixaban|Rivaroxaban|Marcumar|Torasemid|Furosemid|Metformin|Insulin|Formoterol|Budesonid|Salbutamol)/i, protokollChecks: [ "Herzinsuffizienz-Status dokumentiert", "Antikoag.-Indikation geprüft", "Labor-Verordnung (Elyte, Krea, NT-proBNP)", ], }, Geriater: { label: "Geriater", short: "G", tone: "teal", tagline: "Ganzheitliches Assessment · Multimorbidität", focus: [ "Mobilität · Sturz-Risiko · Timed-Up-&-Go", "Kognition · Polypharmazie · FORTA-Liste", "Ernährung · Trinkmenge · MNA", "Kontinenz · Dekubitus · Hautpflege", ], sichtung: [ { key: "mobil", label: "Mobilität & Transfer", hint: "Timed-Up-&-Go · Rollator · Hilfebedarf" }, { key: "kognitiv", label: "Kognitiv-Screen", hint: "MMSE · Uhrentest · Orientierung" }, { key: "ernaehrung", label: "Ernährung (MNA)", hint: "Gewicht · BMI · Trinkmenge · Schluckstörung" }, { key: "haut_wunden", label: "Haut & Wunden", hint: "Dekubitus · Intertrigo · Pergamenthaut" }, { key: "kontinenz", label: "Kontinenz", hint: "Urin/Stuhl · Inkontinenz-Versorgung" }, { key: "polypharm", label: "Polypharmazie", hint: "≥5 Wirkstoffe · FORTA-Check · Interaktionen" }, ], vitals: [ { key: "bp", label: "Blutdruck", unit: "mmHg" }, { key: "pulse", label: "Puls", unit: "/min" }, { key: "weight", label: "Gewicht", unit: "kg" }, { key: "tug", label: "Timed-Up-&-Go", unit: "Sek.", hint: ">14 s = Sturzgefahr" }, ], assessments: [ { key: "mmse", label: "MMSE", type: "number", suffix: "/30" }, { key: "barthel", label: "Barthel-Index", type: "number", suffix: "/100" }, ], medCategories: ["FORTA-A", "FORTA-B", "FORTA-C", "FORTA-D"], protokollChecks: [ "Timed-Up-&-Go dokumentiert", "Polypharmazie-Review durchgeführt", "Assessment-Termin (nächstes Quartal)", ], }, Palliativ: { label: "Palliativ", short: "P", tone: "rose", tagline: "Symptomkontrolle · End-of-Life-Care", focus: [ "Schmerz · NRS / ECPA bei kognitiver Einschränkung", "Dyspnoe · Atemnot-Score", "Übelkeit · Obstipation · Mundpflege", "Patientenverfügung · Angehörigen-Gespräch", "BTM-Dosisanpassung · Rescue-Medikation", ], sichtung: [ { key: "schmerz", label: "Schmerz-Assessment", hint: "NRS 0–10 · bei Demenz: ECPA · Grimassieren" }, { key: "dyspnoe", label: "Dyspnoe", hint: "Ruhe / Belastung · RR · Atemfrequenz" }, { key: "uebelkeit", label: "Übelkeit / Erbrechen", hint: "Appetit · Nahrungsaufnahme" }, { key: "obstipation", label: "Obstipation", hint: "Letzter Stuhlgang · Laxans-Regime" }, { key: "mund", label: "Mundpflege & Xerostomie", hint: "Soor · Speichel · Lippenpflege" }, { key: "hautzehn", label: "Haut & Dekubitus", hint: "Druckstellen · feuchtwarm · Feuchtigkeit" }, { key: "angst", label: "Angst / Unruhe", hint: "Nachts · Wahn · Lorazepam b.B.?" }, ], vitals: [ { key: "nrs", label: "NRS", unit: "/10", hint: "Schmerz-Selbstrating" }, { key: "ecpa", label: "ECPA", unit: "/32", hint: "Fremdrating bei Demenz" }, { key: "resp", label: "Atemfreq.", unit: "/min" }, { key: "bp", label: "Blutdruck", unit: "mmHg" }, ], assessments: [ { key: "dyspnoe_scale", label: "Dyspnoe (NRS)", type: "scale", min: 0, max: 10 }, { key: "sedation", label: "RASS-Sedierung", type: "select", options: ["+2","+1","0","−1","−2","−3"] }, { key: "pv", label: "Patientenverfügung", type: "toggle", label_on: "vorhanden" }, ], medCategories: ["Analgetika-Stufe-I", "Opioide", "Koanalgetika", "Antiemetika", "Laxantien", "Sedativa"], medHighlightRe: /(Morphin|MST|Targin|Fentanyl|Oxycodon|Buprenorphin|Novalgin|Metamizol|Paracetamol|Tramadol|Gabapentin|Pregabalin|MCP|Haloperidol|Lorazepam|Midazolam|Movicol|Laxoberal)/i, protokollChecks: [ "Schmerzstärke (NRS/ECPA) dokumentiert", "Rescue-Medikation verfügbar", "Angehörigen-Kontakt informiert", "Patientenverfügung geprüft", ], }, Urologe: { label: "Urologe", short: "U", tone: "indigo", tagline: "Konsiliar · Harnwege · Kontinenz", focus: [ "Katheter-Lage, Wechsel-Intervall, Urin-Aspekt", "Restharn · Blasenentleerung", "Harnwegsinfekt-Zeichen", "Inkontinenz-Versorgung", ], sichtung: [ { key: "katheter", label: "Katheter", hint: "DK/suprapubisch · Wechseldatum · Sekret · Urin klar?" }, { key: "restharn", label: "Restharn-Sonografie", hint: "Ziel <100 ml nach Miktion" }, { key: "hwi", label: "HWI-Zeichen", hint: "Dysurie · CRP · Fieber · Trübung" }, { key: "genital", label: "Genital-Region", hint: "Rötung · Ekzem · Skrotum · Vagina" }, { key: "kontinenz", label: "Kontinenz", hint: "Tag/Nacht · Vorlagen-Verbrauch" }, ], vitals: [ { key: "restharn_ml", label: "Restharn", unit: "ml" }, { key: "urin_ph", label: "Urin-pH", unit: "" }, { key: "temp", label: "Temp.", unit: "°C" }, ], assessments: [ { key: "urinaspekt", label: "Urin-Aspekt", type: "select", options: ["klar","trüb","blutig","bernsteinfarben"] }, ], medCategories: ["Antibiotika (Harnwege)", "Anticholinergika"], medHighlightRe: /(Ciprofloxacin|Nitrofurantoin|Fosfomycin|Tamsulosin|Solifenacin|Oxybutynin|Mirabegron)/i, protokollChecks: [ "Katheter-Wechsel dokumentiert", "Urin-Status (Stix/Kultur) veranlasst", ], }, }; // Kompatibilitäts-Fallback: altes SICHTUNG_ITEMS verweist jetzt auf Hausarzt. const SICHTUNG_ITEMS = SPECIALTY_CONFIG.Hausarzt.sichtung; // Spezialität aus Visit/Arzt ermitteln const specFromDoctor = (arztId) => { const d = (window.DOCTORS || []).find((x) => x.id === arztId); const raw = d?.spec || "Hausarzt"; return SPECIALTY_CONFIG[raw] ? raw : "Hausarzt"; }; const PHASES = [ { key: "briefing", label: "Briefing", icon: "clipboard", min: 2 }, { key: "sichtung", label: "Sichtung", icon: "eye", min: 5 }, { key: "gespraech", label: "Gespräch", icon: "mic", min: 8 }, { key: "entscheidung", label: "Entscheidung", icon: "check", min: 3 }, { key: "protokoll", label: "Protokoll", icon: "file", min: 2 }, ]; const PHASE_ORDER = PHASES.map((p) => p.key); // ---------------- Root component ---------------- const VisiteMode = () => { if (window.useStoreVersion) window.useStoreVersion(); const [open, setOpen] = useState(false); const [patients, setPatients] = useState([]); const [currentIdx, setCurrentIdx] = useState(0); const [mainPhase, setMainPhase] = useState("start"); // "start" | "patient" | "end" const [startedAt, setStartedAt] = useState(null); const [elapsed, setElapsed] = useState(0); const [specialty, setSpecialty] = useState("Hausarzt"); const [visitArzt, setVisitArzt] = useState(null); const [visitAnlass, setVisitAnlass] = useState(""); const spec = SPECIALTY_CONFIG[specialty] || SPECIALTY_CONFIG.Hausarzt; // Speech state const [listening, setListening] = useState(false); const [interim, setInterim] = useState(""); const [cmdChip, setCmdChip] = useState(""); const recognitionRef = useRef(null); const listeningRef = useRef(false); // ---------- Open / close ---------- useEffect(() => { const onStart = (e) => { const detail = e.detail || {}; let bewohnerIds = detail.bewohnerIds; let nextVisit = null; if (!bewohnerIds && detail.visitId) { nextVisit = (window.VISITEN || []).find((x) => x.id === detail.visitId); if (nextVisit) bewohnerIds = nextVisit.bewohner; } // Spezialität aus Visite oder aktuellem Portal-Arzt let nextSpec = "Hausarzt"; let nextArzt = null; if (detail.arztId) nextArzt = detail.arztId; else if (nextVisit?.arzt) nextArzt = nextVisit.arzt; if (nextArzt) nextSpec = specFromDoctor(nextArzt); setSpecialty(nextSpec); setVisitArzt(nextArzt); setVisitAnlass(nextVisit?.anlass || ""); const sc = SPECIALTY_CONFIG[nextSpec] || SPECIALTY_CONFIG.Hausarzt; if (!bewohnerIds || bewohnerIds.length === 0) { let state = {}; try { state = JSON.parse(localStorage.getItem("medlink.state.v2") || "{}"); } catch {} const heim = state.heim || "ros"; bewohnerIds = (window.BEWOHNER || []) .filter((b) => b.heim === heim) .slice(0, 6) .map((b) => b.id); } const initialPatients = bewohnerIds .map((id) => bewById(id)) .filter(Boolean) .map((b, i) => ({ id: b.id, status: i === 0 ? "current" : "pending", phase: "briefing", briefing: generateBriefing(b), briefingAcknowledged: false, sichtung: sc.sichtung.reduce((acc, it) => ({ ...acc, [it.key]: { status: "", note: "" } }), {}), soap: { S: "", O: "", A: "", P: "", active: "S" }, note: "", vitals: ensureVitals(b.id), assessments: {}, // role-specific scores (MMSE, NRS, ...) medActions: {}, // { medName: "approve" | "modify" | "stop" | "new" } anfrageActions: {}, // { anfrageId: "approve" | "reject" } labOrdered: false, followUpDays: null, nurseRequested: false, signedByNurse: false, signedByDoctor: false, protokollChecks: sc.protokollChecks.reduce((a, k) => ({ ...a, [k]: false }), {}), })); setPatients(initialPatients); setCurrentIdx(0); setMainPhase("start"); setStartedAt(null); setElapsed(0); setOpen(true); }; window.addEventListener("medlink:startVisite", onStart); return () => window.removeEventListener("medlink:startVisite", onStart); }, []); const close = useCallback(() => { stopListening(); setOpen(false); setMainPhase("start"); setListening(false); setInterim(""); }, []); // Escape + Shortcuts useEffect(() => { if (!open) return; const onKey = (e) => { if (e.key === "Escape") close(); if (mainPhase === "start" && e.key === "Enter" && !["INPUT","TEXTAREA"].includes(e.target.tagName)) { e.preventDefault(); if (patients.length > 0) startTour(); } if (mainPhase === "patient") { if (e.key === "ArrowRight" && e.shiftKey) nextPatient(); if (e.key === "ArrowLeft" && e.shiftKey) prevPatient(); if (e.key === " " && e.target.tagName !== "TEXTAREA" && e.target.tagName !== "INPUT") { e.preventDefault(); toggleListening(); } } }; window.addEventListener("keydown", onKey); return () => window.removeEventListener("keydown", onKey); }, [open, mainPhase, currentIdx]); // Timer useEffect(() => { if (!open || mainPhase !== "patient" || !startedAt) return; const t = setInterval(() => setElapsed(Date.now() - startedAt), 1000); return () => clearInterval(t); }, [open, mainPhase, startedAt]); // ---------- Patient-Navigation ---------- const updateCurrent = (patcher) => { setPatients((ps) => { const next = ps.slice(); if (next[currentIdx]) next[currentIdx] = { ...next[currentIdx], ...patcher(next[currentIdx]) }; return next; }); }; const setPhase = (phaseKey) => { updateCurrent(() => ({ phase: phaseKey })); }; const nextPatient = () => { stopListening(); setPatients((ps) => { const next = ps.slice(); if (next[currentIdx]) next[currentIdx] = { ...next[currentIdx], status: "done" }; if (next[currentIdx + 1]) next[currentIdx + 1] = { ...next[currentIdx + 1], status: "current" }; return next; }); setInterim(""); if (currentIdx + 1 < patients.length) setCurrentIdx((i) => i + 1); else finishTour(); }; const prevPatient = () => { stopListening(); if (currentIdx > 0) { setPatients((ps) => { const next = ps.slice(); if (next[currentIdx]) next[currentIdx] = { ...next[currentIdx], status: "pending" }; if (next[currentIdx - 1]) next[currentIdx - 1] = { ...next[currentIdx - 1], status: "current" }; return next; }); setCurrentIdx((i) => i - 1); setInterim(""); } }; const skipPatient = () => { stopListening(); setPatients((ps) => { const next = ps.slice(); if (next[currentIdx]) next[currentIdx] = { ...next[currentIdx], status: "skip" }; if (next[currentIdx + 1]) next[currentIdx + 1] = { ...next[currentIdx + 1], status: "current" }; return next; }); setInterim(""); if (currentIdx + 1 < patients.length) setCurrentIdx((i) => i + 1); else finishTour(); }; const jumpTo = (idx) => { if (idx === currentIdx || idx < 0 || idx >= patients.length) return; stopListening(); setPatients((ps) => { const next = ps.slice(); if (next[currentIdx]?.status === "current") next[currentIdx] = { ...next[currentIdx], status: "pending" }; if (next[idx]) next[idx] = { ...next[idx], status: "current" }; return next; }); setCurrentIdx(idx); setInterim(""); }; const startTour = () => { setStartedAt(Date.now()); setMainPhase("patient"); }; const finishTour = () => { stopListening(); setMainPhase("end"); }; // ---------- Speech Recognition ---------- const handleFinalTranscript = useCallback((text) => { if (!text || !text.trim()) return; const cmd = parseCommand(text); if (cmd) { setCmdChip(cmd.label); setTimeout(() => setCmdChip(""), 1800); if (cmd.type === "next") nextPatient(); else if (cmd.type === "prev") prevPatient(); else if (cmd.type === "skip") skipPatient(); else if (cmd.type === "end") finishTour(); else if (cmd.type === "approve") { window.dispatchEvent(new CustomEvent("medlink:toast", { detail: "Medikation freigegeben" })); try { window.STORE?.bump?.(); } catch {} } else if (cmd.type === "stopMic") stopListening(); else if (cmd.type === "soap") { updateCurrent((p) => ({ soap: { ...p.soap, active: cmd.section } })); } else if (cmd.type === "vital") { const m = cmd.match; let value = ""; if (cmd.key === "bp") value = `${m[1]}/${m[2]}`; else if (cmd.key === "temp") value = m[1].replace(",", "."); else value = m[1]; updateCurrent((p) => ({ vitals: { ...p.vitals, [cmd.key]: value } })); } return; } updateCurrent((p) => { const section = p.soap.active || "S"; const prev = p.soap[section] || ""; const joined = prev ? `${prev} ${text.trim()}` : text.trim(); return { soap: { ...p.soap, [section]: joined }, note: `${p.note}${p.note ? " " : ""}${text.trim()}`.trim() }; }); }, [currentIdx, patients.length]); const startListening = useCallback(() => { const SR = getSR(); if (!SR) { window.dispatchEvent(new CustomEvent("medlink:toast", { detail: "Spracherkennung nicht verfügbar" })); return; } if (listeningRef.current) return; try { const rec = new SR(); rec.lang = "de-DE"; rec.continuous = true; rec.interimResults = true; rec.maxAlternatives = 1; rec.onresult = (event) => { let interimStr = ""; let finalStr = ""; for (let i = event.resultIndex; i < event.results.length; i++) { const r = event.results[i]; if (r.isFinal) finalStr += r[0].transcript; else interimStr += r[0].transcript; } if (finalStr) { handleFinalTranscript(finalStr); setInterim(""); } else setInterim(interimStr); }; rec.onerror = (e) => { if (e.error === "not-allowed" || e.error === "service-not-allowed") { window.dispatchEvent(new CustomEvent("medlink:toast", { detail: "Mikrofon-Zugriff abgelehnt" })); } }; rec.onend = () => { if (listeningRef.current) { try { rec.start(); } catch { listeningRef.current = false; setListening(false); } } }; rec.start(); recognitionRef.current = rec; listeningRef.current = true; setListening(true); } catch (err) { window.dispatchEvent(new CustomEvent("medlink:toast", { detail: "Diktat konnte nicht gestartet werden" })); } }, [handleFinalTranscript]); const stopListening = useCallback(() => { listeningRef.current = false; setListening(false); setInterim(""); const rec = recognitionRef.current; if (rec) { try { rec.stop(); } catch {} } recognitionRef.current = null; }, []); const toggleListening = () => { if (listeningRef.current) stopListening(); else startListening(); }; useEffect(() => () => { stopListening(); }, [currentIdx]); useEffect(() => { if (!open) stopListening(); }, [open]); // Scroll-Detection für kompakten Patient-Header const stageRef = useRef(null); const [scrolled, setScrolled] = useState(false); const currentPhase = patients[currentIdx]?.phase; useEffect(() => { const el = stageRef.current; if (!el) return; el.scrollTop = 0; setScrolled(false); const onScroll = () => setScrolled(el.scrollTop > 60); el.addEventListener("scroll", onScroll, { passive: true }); return () => el.removeEventListener("scroll", onScroll); }, [currentIdx, mainPhase, currentPhase]); // Progress-Ribbon: kumuliert über alle Phasen × alle Patient:innen. // WICHTIG: useMemo MUSS vor jedem `return` stehen (Rules of Hooks). const progress = useMemo(() => { if (mainPhase === "start" || patients.length === 0) return 0; if (mainPhase === "end") return 100; const totalSteps = patients.length * PHASE_ORDER.length; let done = 0; patients.forEach((p, i) => { if (i < currentIdx) done += PHASE_ORDER.length; else if (i === currentIdx) { done += PHASE_ORDER.filter((ph) => isPhaseDone(p, ph)).length; } }); return Math.min(100, (done / totalSteps) * 100); }, [patients, currentIdx, mainPhase]); if (!open) return null; const current = patients[currentIdx]; const currentBew = current ? bewById(current.id) : null; const doneCount = patients.filter((p) => p.status === "done").length; // Patient-Header kompakt wenn: Briefing abgeschlossen ODER gescrollt const headerCompact = mainPhase === "patient" && current && ( !!current.briefingAcknowledged || scrolled ); return ( <>
{/* Progress-Ribbon — 3px sticky oben mit continuous shimmer */} {mainPhase === "patient" && (