Improved FHIR handling

2026-08-07 11:53:56 -04:00 · 2026-02-20 17:17:26 -05:00
parent 63cb2b7b1c
commit f21d2039cb
16 changed files with 1188 additions and 131 deletions
--- a/app/db/clinical.go
+++ b/app/db/clinical.go
@@ -32,21 +32,25 @@ func (s *Store) UpsertObservation(o *models.Observation) (string, error) {
 	if err == nil {
 		_, err = s.db.Exec(`
 			UPDATE observations SET
-				patient_fhir_id = ?,
-				status          = ?,
-				category        = ?,
-				code_text       = ?,
-				code_system     = ?,
-				code_code       = ?,
-				effective_date  = ?,
-				value_quantity  = ?,
-				value_unit      = ?,
-				value_string    = ?,
-				synced_at       = ?
+				patient_fhir_id    = ?,
+				status             = ?,
+				category           = ?,
+				code_text          = ?,
+				code_system        = ?,
+				code_code          = ?,
+				effective_date     = ?,
+				value_quantity     = ?,
+				value_unit         = ?,
+				value_string       = ?,
+				interpretation     = ?,
+				ref_range_low      = ?,
+				ref_range_high     = ?,
+				synced_at          = ?
 			WHERE id = ?`,
 			o.PatientFHIRID, o.Status, o.Category,
 			o.CodeText, o.CodeSystem, o.CodeCode,
 			o.EffectiveDate, o.ValueQuantity, o.ValueUnit, o.ValueString,
+			o.Interpretation, o.ReferenceRangeLow, o.ReferenceRangeHigh,
 			now, existingID,
 		)
 		if err != nil {
@@ -60,11 +64,13 @@ func (s *Store) UpsertObservation(o *models.Observation) (string, error) {
 		INSERT INTO observations (
 			id, fhir_id, ehr_url, patient_fhir_id, status, category,
 			code_text, code_system, code_code, effective_date,
-			value_quantity, value_unit, value_string, synced_at
-		) VALUES (?, ?, ?, ?, ?, ?, ?, ?, ?, ?, ?, ?, ?, ?)`,
+			value_quantity, value_unit, value_string, interpretation,
+			ref_range_low, ref_range_high, synced_at
+		) VALUES (?, ?, ?, ?, ?, ?, ?, ?, ?, ?, ?, ?, ?, ?, ?, ?, ?)`,
 		id, o.FHIRID, o.EHRURL, o.PatientFHIRID, o.Status, o.Category,
 		o.CodeText, o.CodeSystem, o.CodeCode, o.EffectiveDate,
-		o.ValueQuantity, o.ValueUnit, o.ValueString, now,
+		o.ValueQuantity, o.ValueUnit, o.ValueString, o.Interpretation,
+		o.ReferenceRangeLow, o.ReferenceRangeHigh, now,
 	)
 	if err != nil {
 		return "", fmt.Errorf("db: insert observation fhir_id=%s: %w", o.FHIRID, err)
@@ -77,7 +83,8 @@ func (s *Store) ListObservations(patientFHIRID, ehrURL string) ([]models.Observa
 	rows, err := s.db.Query(`
 		SELECT id, fhir_id, ehr_url, patient_fhir_id, status, category,
 		       code_text, code_system, code_code, effective_date,
-		       value_quantity, value_unit, value_string, synced_at
+		       value_quantity, value_unit, value_string, interpretation,
+		       ref_range_low, ref_range_high, synced_at
 		FROM observations
 		WHERE patient_fhir_id = ? AND ehr_url = ?
 		ORDER BY effective_date DESC`,
@@ -94,7 +101,8 @@ func (s *Store) ListObservations(patientFHIRID, ehrURL string) ([]models.Observa
 		if err := rows.Scan(
 			&o.ID, &o.FHIRID, &o.EHRURL, &o.PatientFHIRID, &o.Status, &o.Category,
 			&o.CodeText, &o.CodeSystem, &o.CodeCode, &o.EffectiveDate,
-			&o.ValueQuantity, &o.ValueUnit, &o.ValueString, &o.SyncedAt,
+			&o.ValueQuantity, &o.ValueUnit, &o.ValueString, &o.Interpretation,
+			&o.ReferenceRangeLow, &o.ReferenceRangeHigh, &o.SyncedAt,
 		); err != nil {
 			return nil, fmt.Errorf("db: scan observation: %w", err)
 		}
@@ -289,6 +297,181 @@ func (s *Store) ListDocumentReferences(patientFHIRID, ehrURL string) ([]models.D
 	return out, rows.Err()
 }

+// ---------------------------------------------------------------------------
+// MedicationRequest
+// ---------------------------------------------------------------------------
+
+// UpsertMedicationRequest inserts or updates a MedicationRequest record keyed on (fhir_id, ehr_url).
+func (s *Store) UpsertMedicationRequest(m *models.MedicationRequest) (string, error) {
+	now := time.Now().UTC()
+
+	var existingID string
+	err := s.db.QueryRow(
+		`SELECT id FROM medication_requests WHERE fhir_id = ? AND ehr_url = ?`,
+		m.FHIRID, m.EHRURL,
+	).Scan(&existingID)
+
+	if err == nil {
+		_, err = s.db.Exec(`
+			UPDATE medication_requests SET
+				patient_fhir_id  = ?,
+				status           = ?,
+				intent           = ?,
+				med_code_text    = ?,
+				med_code_system  = ?,
+				med_code_code    = ?,
+				authored_on      = ?,
+				requester_display = ?,
+				dosage_text      = ?,
+				synced_at        = ?
+			WHERE id = ?`,
+			m.PatientFHIRID, m.Status, m.Intent,
+			m.MedCodeText, m.MedCodeSystem, m.MedCodeCode,
+			m.AuthoredOn, m.RequesterDisplay, m.DosageText,
+			now, existingID,
+		)
+		if err != nil {
+			return "", fmt.Errorf("db: update medication_request %s: %w", existingID, err)
+		}
+		return existingID, nil
+	}
+
+	id := uuid.NewString()
+	_, err = s.db.Exec(`
+		INSERT INTO medication_requests (
+			id, fhir_id, ehr_url, patient_fhir_id,
+			status, intent, med_code_text, med_code_system, med_code_code,
+			authored_on, requester_display, dosage_text, synced_at
+		) VALUES (?, ?, ?, ?, ?, ?, ?, ?, ?, ?, ?, ?, ?)`,
+		id, m.FHIRID, m.EHRURL, m.PatientFHIRID,
+		m.Status, m.Intent, m.MedCodeText, m.MedCodeSystem, m.MedCodeCode,
+		m.AuthoredOn, m.RequesterDisplay, m.DosageText, now,
+	)
+	if err != nil {
+		return "", fmt.Errorf("db: insert medication_request fhir_id=%s: %w", m.FHIRID, err)
+	}
+	return id, nil
+}
+
+// ListMedicationRequests returns all MedicationRequests for the given patient, newest first.
+func (s *Store) ListMedicationRequests(patientFHIRID, ehrURL string) ([]models.MedicationRequest, error) {
+	rows, err := s.db.Query(`
+		SELECT id, fhir_id, ehr_url, patient_fhir_id,
+		       status, intent, med_code_text, med_code_system, med_code_code,
+		       authored_on, requester_display, dosage_text, synced_at
+		FROM medication_requests
+		WHERE patient_fhir_id = ? AND ehr_url = ?
+		ORDER BY authored_on DESC`,
+		patientFHIRID, ehrURL,
+	)
+	if err != nil {
+		return nil, fmt.Errorf("db: list medication_requests: %w", err)
+	}
+	defer rows.Close()
+
+	var out []models.MedicationRequest
+	for rows.Next() {
+		var m models.MedicationRequest
+		if err := rows.Scan(
+			&m.ID, &m.FHIRID, &m.EHRURL, &m.PatientFHIRID,
+			&m.Status, &m.Intent, &m.MedCodeText, &m.MedCodeSystem, &m.MedCodeCode,
+			&m.AuthoredOn, &m.RequesterDisplay, &m.DosageText, &m.SyncedAt,
+		); err != nil {
+			return nil, fmt.Errorf("db: scan medication_request: %w", err)
+		}
+		out = append(out, m)
+	}
+	return out, rows.Err()
+}
+
+// ---------------------------------------------------------------------------
+// AllergyIntolerance
+// ---------------------------------------------------------------------------
+
+// UpsertAllergyIntolerance inserts or updates an AllergyIntolerance record keyed on (fhir_id, ehr_url).
+func (s *Store) UpsertAllergyIntolerance(a *models.AllergyIntolerance) (string, error) {
+	now := time.Now().UTC()
+
+	var existingID string
+	err := s.db.QueryRow(
+		`SELECT id FROM allergy_intolerances WHERE fhir_id = ? AND ehr_url = ?`,
+		a.FHIRID, a.EHRURL,
+	).Scan(&existingID)
+
+	if err == nil {
+		_, err = s.db.Exec(`
+			UPDATE allergy_intolerances SET
+				patient_fhir_id     = ?,
+				clinical_status     = ?,
+				verification_status = ?,
+				type                = ?,
+				category            = ?,
+				criticality         = ?,
+				code_text           = ?,
+				code_system         = ?,
+				code_code           = ?,
+				recorded_date       = ?,
+				synced_at           = ?
+			WHERE id = ?`,
+			a.PatientFHIRID, a.ClinicalStatus, a.VerificationStatus,
+			a.Type, a.Category, a.Criticality,
+			a.CodeText, a.CodeSystem, a.CodeCode,
+			a.RecordedDate, now, existingID,
+		)
+		if err != nil {
+			return "", fmt.Errorf("db: update allergy_intolerance %s: %w", existingID, err)
+		}
+		return existingID, nil
+	}
+
+	id := uuid.NewString()
+	_, err = s.db.Exec(`
+		INSERT INTO allergy_intolerances (
+			id, fhir_id, ehr_url, patient_fhir_id,
+			clinical_status, verification_status, type, category, criticality,
+			code_text, code_system, code_code, recorded_date, synced_at
+		) VALUES (?, ?, ?, ?, ?, ?, ?, ?, ?, ?, ?, ?, ?, ?)`,
+		id, a.FHIRID, a.EHRURL, a.PatientFHIRID,
+		a.ClinicalStatus, a.VerificationStatus, a.Type, a.Category, a.Criticality,
+		a.CodeText, a.CodeSystem, a.CodeCode, a.RecordedDate, now,
+	)
+	if err != nil {
+		return "", fmt.Errorf("db: insert allergy_intolerance fhir_id=%s: %w", a.FHIRID, err)
+	}
+	return id, nil
+}
+
+// ListAllergyIntolerances returns all AllergyIntolerances for the given patient, newest first.
+func (s *Store) ListAllergyIntolerances(patientFHIRID, ehrURL string) ([]models.AllergyIntolerance, error) {
+	rows, err := s.db.Query(`
+		SELECT id, fhir_id, ehr_url, patient_fhir_id,
+		       clinical_status, verification_status, type, category, criticality,
+		       code_text, code_system, code_code, recorded_date, synced_at
+		FROM allergy_intolerances
+		WHERE patient_fhir_id = ? AND ehr_url = ?
+		ORDER BY recorded_date DESC`,
+		patientFHIRID, ehrURL,
+	)
+	if err != nil {
+		return nil, fmt.Errorf("db: list allergy_intolerances: %w", err)
+	}
+	defer rows.Close()
+
+	var out []models.AllergyIntolerance
+	for rows.Next() {
+		var a models.AllergyIntolerance
+		if err := rows.Scan(
+			&a.ID, &a.FHIRID, &a.EHRURL, &a.PatientFHIRID,
+			&a.ClinicalStatus, &a.VerificationStatus, &a.Type, &a.Category, &a.Criticality,
+			&a.CodeText, &a.CodeSystem, &a.CodeCode, &a.RecordedDate, &a.SyncedAt,
+		); err != nil {
+			return nil, fmt.Errorf("db: scan allergy_intolerance: %w", err)
+		}
+		out = append(out, a)
+	}
+	return out, rows.Err()
+}
+
 // ---------------------------------------------------------------------------
 // PatientSync
 // ---------------------------------------------------------------------------
--- a/app/db/db.go
+++ b/app/db/db.go
@@ -193,6 +193,52 @@ var migrations = []migration{
 		CREATE INDEX IF NOT EXISTS idx_patient_syncs_patient ON patient_syncs(patient_fhir_id, ehr_url);
 		`,
 	},
+	{
+		version: 4,
+		sql: `
+		ALTER TABLE observations ADD COLUMN interpretation TEXT NOT NULL DEFAULT '';
+		ALTER TABLE observations ADD COLUMN ref_range_low REAL;
+		ALTER TABLE observations ADD COLUMN ref_range_high REAL;
+
+		CREATE TABLE IF NOT EXISTS medication_requests (
+			id              TEXT PRIMARY KEY,
+			fhir_id         TEXT NOT NULL,
+			ehr_url         TEXT NOT NULL,
+			patient_fhir_id TEXT NOT NULL,
+			status          TEXT NOT NULL DEFAULT '',
+			intent          TEXT NOT NULL DEFAULT '',
+			med_code_text   TEXT NOT NULL DEFAULT '',
+			med_code_system TEXT NOT NULL DEFAULT '',
+			med_code_code   TEXT NOT NULL DEFAULT '',
+			authored_on     TEXT NOT NULL DEFAULT '',
+			requester_display TEXT NOT NULL DEFAULT '',
+			dosage_text     TEXT NOT NULL DEFAULT '',
+			synced_at       DATETIME NOT NULL DEFAULT CURRENT_TIMESTAMP,
+			UNIQUE(fhir_id, ehr_url)
+		);
+
+		CREATE TABLE IF NOT EXISTS allergy_intolerances (
+			id                  TEXT PRIMARY KEY,
+			fhir_id             TEXT NOT NULL,
+			ehr_url             TEXT NOT NULL,
+			patient_fhir_id     TEXT NOT NULL,
+			clinical_status     TEXT NOT NULL DEFAULT '',
+			verification_status TEXT NOT NULL DEFAULT '',
+			type                TEXT NOT NULL DEFAULT '',
+			category            TEXT NOT NULL DEFAULT '',
+			criticality         TEXT NOT NULL DEFAULT '',
+			code_text           TEXT NOT NULL DEFAULT '',
+			code_system         TEXT NOT NULL DEFAULT '',
+			code_code           TEXT NOT NULL DEFAULT '',
+			recorded_date       TEXT NOT NULL DEFAULT '',
+			synced_at           DATETIME NOT NULL DEFAULT CURRENT_TIMESTAMP,
+			UNIQUE(fhir_id, ehr_url)
+		);
+
+		CREATE INDEX IF NOT EXISTS idx_medication_requests_patient ON medication_requests(patient_fhir_id, ehr_url);
+		CREATE INDEX IF NOT EXISTS idx_allergy_intolerances_patient ON allergy_intolerances(patient_fhir_id, ehr_url);
+		`,
+	},
 	// Future migrations: append new entries here with incrementing version numbers.
 	// Example:
 	// {
@@ -349,6 +395,36 @@ func (s *Store) GetUserByID(id string) (*models.User, error) {
 	return u, nil
 }

+// ListUsersByRole retrieves all users with the given role and originating EHR URL.
+func (s *Store) ListUsersByRole(role models.Role, ehrURL string) ([]models.User, error) {
+	rows, err := s.db.Query(`
+		SELECT id, fhir_resource_type, fhir_id, ehr_url, role,
+		       first_name, middle_name, last_name, dob, gender, email,
+		       created_at, updated_at
+		FROM users WHERE role = ? AND ehr_url = ?
+		ORDER BY last_name ASC, first_name ASC`,
+		string(role), ehrURL,
+	)
+	if err != nil {
+		return nil, fmt.Errorf("db: list users by role: %w", err)
+	}
+	defer rows.Close()
+
+	var users []models.User
+	for rows.Next() {
+		var u models.User
+		if err := rows.Scan(
+			&u.ID, &u.FHIRResourceType, &u.FHIRID, &u.EHRURL, &u.Role,
+			&u.FirstName, &u.MiddleName, &u.LastName, &u.DOB, &u.Gender, &u.Email,
+			&u.CreatedAt, &u.UpdatedAt,
+		); err != nil {
+			return nil, fmt.Errorf("db: scan user: %w", err)
+		}
+		users = append(users, u)
+	}
+	return users, rows.Err()
+}
+
 // ---------------------------------------------------------------------------
 // Session operations
 // ---------------------------------------------------------------------------
--- a/app/db/db_test.go
+++ b/app/db/db_test.go
@@ -145,6 +145,45 @@ func TestUpsertUser_TenantIsolation(t *testing.T) {
 	}
 }

+func TestListUsersByRole(t *testing.T) {
+	store := newTestStore(t)
+	ehrURL := "https://ehr.example.com/fhir"
+
+	users := []*models.User{
+		{FHIRID: "p1", EHRURL: ehrURL, Role: models.RolePatient, FirstName: "Zoe", LastName: "Adams"},
+		{FHIRID: "p2", EHRURL: ehrURL, Role: models.RolePatient, FirstName: "Alice", LastName: "Adams"},
+		{FHIRID: "d1", EHRURL: ehrURL, Role: models.RolePractitioner, FirstName: "Dr.", LastName: "House"},
+		{FHIRID: "p3", EHRURL: ehrURL, Role: models.RolePatient, FirstName: "Charlie", LastName: "Brown"},
+	}
+
+	for _, u := range users {
+		u.FHIRResourceType = "Patient"
+		if u.Role == models.RolePractitioner {
+			u.FHIRResourceType = "Practitioner"
+		}
+		if _, err := store.UpsertUser(u); err != nil {
+			t.Fatalf("failed to upsert user %s: %v", u.FHIRID, err)
+		}
+	}
+
+	got, err := store.ListUsersByRole(models.RolePatient, ehrURL)
+	if err != nil {
+		t.Fatalf("ListUsersByRole: %v", err)
+	}
+
+	if len(got) != 3 {
+		t.Errorf("got %d patients, want 3", len(got))
+	}
+
+	// Verify ordering: Adams, Alice -> Adams, Zoe -> Brown, Charlie
+	expected := []string{"Alice", "Zoe", "Charlie"}
+	for i, name := range expected {
+		if got[i].FirstName != name {
+			t.Errorf("at index %d: got FirstName %q, want %q", i, got[i].FirstName, name)
+		}
+	}
+}
+
 // ---------------------------------------------------------------------------
 // Session tests
 // ---------------------------------------------------------------------------
--- a/app/fhir/fhir.go
+++ b/app/fhir/fhir.go
@@ -160,18 +160,37 @@ func (p *Practitioner) ResourceType() string { return "Practitioner" }
 // Clinical resources (R4)
 // ---------------------------------------------------------------------------

+// ObservationComponent represents a component of an Observation (used for
+// compound observations like blood pressure with systolic/diastolic values).
+type ObservationComponent struct {
+	Code          CodeableConcept `json:"code"`
+	ValueQuantity *Quantity       `json:"valueQuantity,omitempty"`
+	ValueString   string          `json:"valueString,omitempty"`
+}
+
+// ObservationReferenceRange represents a reference range for an Observation.
+type ObservationReferenceRange struct {
+	Low  *Quantity       `json:"low,omitempty"`
+	High *Quantity       `json:"high,omitempty"`
+	Text string          `json:"text,omitempty"`
+	Type CodeableConcept `json:"type,omitempty"`
+}
+
 // Observation represents a FHIR R4 Observation resource.
 // https://www.hl7.org/fhir/observation.html
 type Observation struct {
-	ResourceTypeField string            `json:"resourceType"`
-	ID                string            `json:"id"`
-	Status            string            `json:"status"`
-	Category          []CodeableConcept `json:"category"`
-	Code              CodeableConcept   `json:"code"`
-	Subject           Reference         `json:"subject"`
-	EffectiveDateTime string            `json:"effectiveDateTime"`
-	ValueQuantity     *Quantity         `json:"valueQuantity,omitempty"`
-	ValueString       string            `json:"valueString,omitempty"`
+	ResourceTypeField string                      `json:"resourceType"`
+	ID                string                      `json:"id"`
+	Status            string                      `json:"status"`
+	Category          []CodeableConcept           `json:"category"`
+	Code              CodeableConcept             `json:"code"`
+	Subject           Reference                   `json:"subject"`
+	EffectiveDateTime string                      `json:"effectiveDateTime"`
+	ValueQuantity     *Quantity                   `json:"valueQuantity,omitempty"`
+	ValueString       string                      `json:"valueString,omitempty"`
+	Interpretation    []CodeableConcept           `json:"interpretation,omitempty"`
+	ReferenceRange    []ObservationReferenceRange `json:"referenceRange,omitempty"`
+	Component         []ObservationComponent      `json:"component,omitempty"`
 }

 func (o *Observation) ResourceType() string { return "Observation" }
@@ -225,6 +244,54 @@ type DocumentReference struct {

 func (d *DocumentReference) ResourceType() string { return "DocumentReference" }

+// Dosage represents the FHIR Dosage data type (simplified).
+type Dosage struct {
+	Text   string          `json:"text"`
+	Timing interface{}     `json:"timing,omitempty"`
+	Route  CodeableConcept `json:"route,omitempty"`
+}
+
+// DoseAndRate represents a dose and rate in a Dosage.
+type DoseAndRate struct {
+	DoseQuantity *Quantity   `json:"doseQuantity,omitempty"`
+	DoseRange    interface{} `json:"doseRange,omitempty"`
+	RateQuantity *Quantity   `json:"rateQuantity,omitempty"`
+	RateRange    interface{} `json:"rateRange,omitempty"`
+}
+
+// MedicationRequest represents a FHIR R4 MedicationRequest resource.
+// https://www.hl7.org/fhir/medicationrequest.html
+type MedicationRequest struct {
+	ResourceTypeField         string          `json:"resourceType"`
+	ID                        string          `json:"id"`
+	Status                    string          `json:"status"`
+	Intent                    string          `json:"intent"`
+	MedicationCodeableConcept CodeableConcept `json:"medicationCodeableConcept"`
+	Subject                   Reference       `json:"subject"`
+	AuthoredOn                string          `json:"authoredOn"`
+	Requester                 Reference       `json:"requester"`
+	DosageInstruction         []Dosage        `json:"dosageInstruction"`
+}
+
+func (m *MedicationRequest) ResourceType() string { return "MedicationRequest" }
+
+// AllergyIntolerance represents a FHIR R4 AllergyIntolerance resource.
+// https://www.hl7.org/fhir/allergyintolerance.html
+type AllergyIntolerance struct {
+	ResourceTypeField  string          `json:"resourceType"`
+	ID                 string          `json:"id"`
+	ClinicalStatus     CodeableConcept `json:"clinicalStatus"`
+	VerificationStatus CodeableConcept `json:"verificationStatus"`
+	Type               string          `json:"type"`
+	Category           []string        `json:"category"`
+	Criticality        string          `json:"criticality"`
+	Code               CodeableConcept `json:"code"`
+	Patient            Reference       `json:"patient"`
+	RecordedDate       string          `json:"recordedDate"`
+}
+
+func (a *AllergyIntolerance) ResourceType() string { return "AllergyIntolerance" }
+
 // Quantity represents the FHIR Quantity data type.
 type Quantity struct {
 	Value  float64 `json:"value"`
@@ -233,11 +300,18 @@ type Quantity struct {
 	Code   string  `json:"code"`
 }

+// BundleLink represents a link element in a Bundle (used for pagination).
+type BundleLink struct {
+	Relation string `json:"relation"`
+	URL      string `json:"url"`
+}
+
 // Bundle represents a FHIR R4 Bundle resource, used for search results.
 type Bundle struct {
-	ResourceType string `json:"resourceType"`
-	Type         string `json:"type"`
-	Total        int    `json:"total"`
+	ResourceType string       `json:"resourceType"`
+	Type         string       `json:"type"`
+	Total        int          `json:"total"`
+	Link         []BundleLink `json:"link"`
 	Entry        []struct {
 		FullUrl  string          `json:"fullUrl"`
 		Resource json.RawMessage `json:"resource"`
@@ -275,8 +349,8 @@ type TokenResponse struct {
 	RefreshToken string `json:"refresh_token"`

 	// SMART launch context extensions
-	Patient      string `json:"patient"`
-	Encounter    string `json:"encounter"`
+	Patient   string `json:"patient"`
+	Encounter string `json:"encounter"`
 	// Practitioner holds a bare Practitioner FHIR ID when provided by the EHR.
 	Practitioner string `json:"practitioner"`
 	// User holds a relative FHIR reference to the authenticated user,
@@ -340,6 +414,53 @@ func (c *Client) get(path string, dest interface{}) error {
 	return nil
 }

+// fetchAllBundlePages follows pagination links in a Bundle and accumulates all entries.
+// It fetches the initial bundle and then follows 'next' links up to maxPages times.
+// Returns a slice of raw JSON entries and any error encountered.
+func (c *Client) fetchAllBundlePages(initialBundle *Bundle, maxPages int) ([]json.RawMessage, error) {
+	if maxPages < 1 {
+		maxPages = 1
+	}
+
+	var allEntries []json.RawMessage
+	for _, entry := range initialBundle.Entry {
+		allEntries = append(allEntries, entry.Resource)
+	}
+
+	currentBundle := initialBundle
+	pageCount := 1
+
+	for pageCount < maxPages {
+		nextURL := ""
+		for _, link := range currentBundle.Link {
+			if link.Relation == "next" {
+				nextURL = link.URL
+				break
+			}
+		}
+
+		if nextURL == "" {
+			break
+		}
+
+		// Extract path from absolute URL
+		var nextBundle Bundle
+		if err := c.get(strings.TrimPrefix(nextURL, c.baseURL+"/"), &nextBundle); err != nil {
+			// Don't fail on pagination error; return what we have so far
+			break
+		}
+
+		for _, entry := range nextBundle.Entry {
+			allEntries = append(allEntries, entry.Resource)
+		}
+
+		currentBundle = &nextBundle
+		pageCount++
+	}
+
+	return allEntries, nil
+}
+
 // GetPatient fetches a Patient resource by FHIR ID.
 func (c *Client) GetPatient(id string) (*Patient, error) {
 	var p Patient
@@ -359,17 +480,26 @@ func (c *Client) GetPractitioner(id string) (*Practitioner, error) {
 }

 // GetObservations fetches Observation resources for a specific patient.
-func (c *Client) GetObservations(patientID string) ([]Observation, error) {
+// If since is non-empty, only fetches observations modified after that timestamp (RFC3339).
+func (c *Client) GetObservations(patientID, since string) ([]Observation, error) {
 	var bundle Bundle
 	path := fmt.Sprintf("Observation?patient=%s&_sort=-date", patientID)
+	if since != "" {
+		path += fmt.Sprintf("&_lastUpdated=ge%s", since)
+	}
 	if err := c.get(path, &bundle); err != nil {
 		return nil, err
 	}

+	entries, err := c.fetchAllBundlePages(&bundle, 10)
+	if err != nil {
+		return nil, err
+	}
+
 	var observations []Observation
-	for _, entry := range bundle.Entry {
+	for _, entry := range entries {
 		var o Observation
-		if err := json.Unmarshal(entry.Resource, &o); err == nil {
+		if err := json.Unmarshal(entry, &o); err == nil {
 			observations = append(observations, o)
 		}
 	}
@@ -377,17 +507,26 @@ func (c *Client) GetObservations(patientID string) ([]Observation, error) {
 }

 // GetConditions fetches Condition resources for a specific patient.
-func (c *Client) GetConditions(patientID string) ([]Condition, error) {
+// If since is non-empty, only fetches conditions modified after that timestamp (RFC3339).
+func (c *Client) GetConditions(patientID, since string) ([]Condition, error) {
 	var bundle Bundle
 	path := fmt.Sprintf("Condition?patient=%s", patientID)
+	if since != "" {
+		path += fmt.Sprintf("&_lastUpdated=ge%s", since)
+	}
 	if err := c.get(path, &bundle); err != nil {
 		return nil, err
 	}

+	entries, err := c.fetchAllBundlePages(&bundle, 10)
+	if err != nil {
+		return nil, err
+	}
+
 	var conditions []Condition
-	for _, entry := range bundle.Entry {
+	for _, entry := range entries {
 		var cond Condition
-		if err := json.Unmarshal(entry.Resource, &cond); err == nil {
+		if err := json.Unmarshal(entry, &cond); err == nil {
 			conditions = append(conditions, cond)
 		}
 	}
@@ -396,23 +535,86 @@ func (c *Client) GetConditions(patientID string) ([]Condition, error) {

 // GetDocumentReferences fetches DocumentReference resources for a specific patient.
 // Results are sorted newest-first by date.
-func (c *Client) GetDocumentReferences(patientID string) ([]DocumentReference, error) {
+// If since is non-empty, only fetches documents modified after that timestamp (RFC3339).
+func (c *Client) GetDocumentReferences(patientID, since string) ([]DocumentReference, error) {
 	var bundle Bundle
 	path := fmt.Sprintf("DocumentReference?patient=%s&_sort=-date", patientID)
+	if since != "" {
+		path += fmt.Sprintf("&_lastUpdated=ge%s", since)
+	}
 	if err := c.get(path, &bundle); err != nil {
 		return nil, err
 	}

+	entries, err := c.fetchAllBundlePages(&bundle, 10)
+	if err != nil {
+		return nil, err
+	}
+
 	var docs []DocumentReference
-	for _, entry := range bundle.Entry {
+	for _, entry := range entries {
 		var d DocumentReference
-		if err := json.Unmarshal(entry.Resource, &d); err == nil {
+		if err := json.Unmarshal(entry, &d); err == nil {
 			docs = append(docs, d)
 		}
 	}
 	return docs, nil
 }

+// GetMedicationRequests fetches MedicationRequest resources for a specific patient.
+// If since is non-empty, only fetches requests modified after that timestamp (RFC3339).
+func (c *Client) GetMedicationRequests(patientID, since string) ([]MedicationRequest, error) {
+	var bundle Bundle
+	path := fmt.Sprintf("MedicationRequest?patient=%s&status=active&_sort=-date", patientID)
+	if since != "" {
+		path += fmt.Sprintf("&_lastUpdated=ge%s", since)
+	}
+	if err := c.get(path, &bundle); err != nil {
+		return nil, err
+	}
+
+	entries, err := c.fetchAllBundlePages(&bundle, 10)
+	if err != nil {
+		return nil, err
+	}
+
+	var requests []MedicationRequest
+	for _, entry := range entries {
+		var m MedicationRequest
+		if err := json.Unmarshal(entry, &m); err == nil {
+			requests = append(requests, m)
+		}
+	}
+	return requests, nil
+}
+
+// GetAllergyIntolerances fetches AllergyIntolerance resources for a specific patient.
+// If since is non-empty, only fetches allergies modified after that timestamp (RFC3339).
+func (c *Client) GetAllergyIntolerances(patientID, since string) ([]AllergyIntolerance, error) {
+	var bundle Bundle
+	path := fmt.Sprintf("AllergyIntolerance?patient=%s&_sort=-date", patientID)
+	if since != "" {
+		path += fmt.Sprintf("&_lastUpdated=ge%s", since)
+	}
+	if err := c.get(path, &bundle); err != nil {
+		return nil, err
+	}
+
+	entries, err := c.fetchAllBundlePages(&bundle, 10)
+	if err != nil {
+		return nil, err
+	}
+
+	var allergies []AllergyIntolerance
+	for _, entry := range entries {
+		var a AllergyIntolerance
+		if err := json.Unmarshal(entry, &a); err == nil {
+			allergies = append(allergies, a)
+		}
+	}
+	return allergies, nil
+}
+
 // GetSmartConfiguration fetches and parses the SMART discovery document
 // for this FHIR server.
 func GetSmartConfiguration(issURL string) (*SmartConfiguration, error) {
@@ -552,24 +754,78 @@ func ExtractObservation(o *Observation, patientFHIRID, ehrURL string) *models.Ob
 	coding := firstCoding(o.Code)
 	var qty *float64
 	var unit string
+	var valueStr string
+
 	if o.ValueQuantity != nil {
 		v := o.ValueQuantity.Value
 		qty = &v
 		unit = o.ValueQuantity.Unit
+		valueStr = o.ValueString
+	} else if len(o.Component) > 0 && o.ValueQuantity == nil {
+		// Handle compound observations like blood pressure (systolic/diastolic)
+		// Format: "value1/value2 unit" (e.g., "120/80 mmHg")
+		var values []string
+		var compUnit string
+		for _, comp := range o.Component {
+			if comp.ValueQuantity != nil {
+				values = append(values, fmt.Sprintf("%.0f", comp.ValueQuantity.Value))
+				if compUnit == "" {
+					compUnit = comp.ValueQuantity.Unit
+				}
+			}
+		}
+		if len(values) > 0 {
+			valueStr = strings.Join(values, "/")
+			if compUnit != "" {
+				valueStr += " " + compUnit
+			}
+			unit = compUnit
+		}
+	} else {
+		valueStr = o.ValueString
 	}
+
+	// Extract interpretation (first coding display or code)
+	var interpretation string
+	if len(o.Interpretation) > 0 {
+		interp := firstCoding(o.Interpretation[0])
+		if interp.Display != "" {
+			interpretation = interp.Display
+		} else {
+			interpretation = interp.Code
+		}
+	}
+
+	// Extract reference range (low and high from first range entry)
+	var refRangeLow, refRangeHigh *float64
+	if len(o.ReferenceRange) > 0 {
+		refRange := o.ReferenceRange[0]
+		if refRange.Low != nil {
+			v := refRange.Low.Value
+			refRangeLow = &v
+		}
+		if refRange.High != nil {
+			v := refRange.High.Value
+			refRangeHigh = &v
+		}
+	}
+
 	return &models.Observation{
-		FHIRID:        o.ID,
-		EHRURL:        strings.TrimRight(ehrURL, "/"),
-		PatientFHIRID: patientFHIRID,
-		Status:        o.Status,
-		Category:      firstCategoryText(o.Category),
-		CodeText:      o.Code.Text,
-		CodeSystem:    coding.System,
-		CodeCode:      coding.Code,
-		EffectiveDate: o.EffectiveDateTime,
-		ValueQuantity: qty,
-		ValueUnit:     unit,
-		ValueString:   o.ValueString,
+		FHIRID:             o.ID,
+		EHRURL:             strings.TrimRight(ehrURL, "/"),
+		PatientFHIRID:      patientFHIRID,
+		Status:             o.Status,
+		Category:           firstCategoryText(o.Category),
+		CodeText:           o.Code.Text,
+		CodeSystem:         coding.System,
+		CodeCode:           coding.Code,
+		EffectiveDate:      o.EffectiveDateTime,
+		ValueQuantity:      qty,
+		ValueUnit:          unit,
+		ValueString:        valueStr,
+		Interpretation:     interpretation,
+		ReferenceRangeLow:  refRangeLow,
+		ReferenceRangeHigh: refRangeHigh,
 	}
 }

@@ -626,6 +882,53 @@ func ExtractDocumentReference(d *DocumentReference, patientFHIRID, ehrURL string
 	}
 }

+// ExtractMedicationRequest maps a FHIR MedicationRequest to a models.MedicationRequest ready for upsert.
+func ExtractMedicationRequest(m *MedicationRequest, patientFHIRID, ehrURL string) *models.MedicationRequest {
+	medCoding := firstCoding(m.MedicationCodeableConcept)
+	var dosageText string
+	if len(m.DosageInstruction) > 0 {
+		dosageText = m.DosageInstruction[0].Text
+	}
+	return &models.MedicationRequest{
+		FHIRID:           m.ID,
+		EHRURL:           strings.TrimRight(ehrURL, "/"),
+		PatientFHIRID:    patientFHIRID,
+		Status:           m.Status,
+		Intent:           m.Intent,
+		MedCodeText:      m.MedicationCodeableConcept.Text,
+		MedCodeSystem:    medCoding.System,
+		MedCodeCode:      medCoding.Code,
+		AuthoredOn:       m.AuthoredOn,
+		RequesterDisplay: m.Requester.Display,
+		DosageText:       dosageText,
+	}
+}
+
+// ExtractAllergyIntolerance maps a FHIR AllergyIntolerance to a models.AllergyIntolerance ready for upsert.
+func ExtractAllergyIntolerance(a *AllergyIntolerance, patientFHIRID, ehrURL string) *models.AllergyIntolerance {
+	codeCoding := firstCoding(a.Code)
+	clinicalStatus := firstCoding(a.ClinicalStatus)
+	verificationStatus := firstCoding(a.VerificationStatus)
+	var category string
+	if len(a.Category) > 0 {
+		category = a.Category[0]
+	}
+	return &models.AllergyIntolerance{
+		FHIRID:             a.ID,
+		EHRURL:             strings.TrimRight(ehrURL, "/"),
+		PatientFHIRID:      patientFHIRID,
+		ClinicalStatus:     clinicalStatus.Code,
+		VerificationStatus: verificationStatus.Code,
+		Type:               a.Type,
+		Category:           category,
+		Criticality:        a.Criticality,
+		CodeText:           a.Code.Text,
+		CodeSystem:         codeCoding.System,
+		CodeCode:           codeCoding.Code,
+		RecordedDate:       a.RecordedDate,
+	}
+}
+
 // ParseFHIRUserFromIDToken attempts to extract a FHIR resource reference
 // (e.g. "Practitioner/123" or "Patient/abc") from the id_token's fhirUser claim.
 // Returns an empty string if the claim is missing or invalid.
--- a/app/handlers/auth.go
+++ b/app/handlers/auth.go
@@ -9,8 +9,8 @@
 //  5. Fetch the Patient FHIR resource using the access token.
 //  6. Resolve the practitioner from the token response. The SMART spec allows
 //     the practitioner to appear in two places — we handle both:
-//       a. tokenResp.Practitioner — a bare FHIR ID (some EHRs)
-//       b. tokenResp.User         — a relative reference "Practitioner/<id>" (SmartHealthIT)
+//     a. tokenResp.Practitioner — a bare FHIR ID (some EHRs)
+//     b. tokenResp.User         — a relative reference "Practitioner/<id>" (SmartHealthIT)
 //  7. Upsert both users into the database.
 //  8. Create a server-side session for the HCP and set the session cookie.
 //  9. Render the patient dashboard.
@@ -196,6 +196,7 @@ func (h *Handler) HandleAuthRedirect(w http.ResponseWriter, r *http.Request) {
 //   - A bare ID (if the context implies it): "123"
 //   - A relative reference: "Practitioner/123"
 //   - An absolute FHIR URL: "https://ehr.com/fhir/Practitioner/123"
+//
 // Returns an empty string if the value is not a Practitioner reference.
 func parsePractitionerFromUserField(user string) string {
 	// If it's a URL, take the path part.
@@ -214,7 +215,7 @@ func parsePractitionerFromUserField(user string) string {
 	if idx := strings.Index(user, prefix); idx != -1 {
 		return strings.TrimPrefix(user[idx:], prefix)
 	}
-	
+
 	return ""
 }

--- a/app/handlers/dashboard.go
+++ b/app/handlers/dashboard.go
@@ -10,7 +10,8 @@ import (
 )

 // HandleDashboard renders the stable patient dashboard.
-// All clinical data is read from the local database; no live FHIR calls are
+// On first load (no prior sync), automatically triggers a sync to populate data.
+// All other clinical data is read from the local database; no live FHIR calls are
 // made here. Use POST /dashboard/sync to refresh data from the EHR.
 //
 // GET /dashboard
@@ -26,6 +27,27 @@ func (h *Handler) HandleDashboard(w http.ResponseWriter, r *http.Request) {
 	ehrURL := sess.EHRURL
 	patientID := sess.PatientFHIRID

+	// Allow overriding the patient context via a query parameter.
+	if overrideID := r.URL.Query().Get("patient_id"); overrideID != "" {
+		patientID = overrideID
+	}
+
+	// Check if this is the first load and trigger auto-sync
+	latestSync, err := h.store.LatestSync(patientID, ehrURL)
+	if err != nil {
+		log.Printf("handlers: dashboard LatestSync Patient/%s: %v", patientID, err)
+	}
+
+	if latestSync == nil {
+		// First load — redirect to sync endpoint for auto-sync
+		syncURL := "/dashboard/sync"
+		if overrideID := r.URL.Query().Get("patient_id"); overrideID != "" {
+			syncURL += "?patient_id=" + overrideID
+		}
+		http.Redirect(w, r, syncURL, http.StatusSeeOther)
+		return
+	}
+
 	// Fetch patient demographics from the FHIR server. This is a cheap single
 	// resource call and keeps the patient card always current.
 	fhirClient := fhir.NewClient(ehrURL, sess.AccessToken)
@@ -54,11 +76,18 @@ func (h *Handler) HandleDashboard(w http.ResponseWriter, r *http.Request) {
 		log.Printf("handlers: dashboard ListDocumentReferences Patient/%s: %v", patientID, err)
 	}

-	latestSync, err := h.store.LatestSync(patientID, ehrURL)
+	medications, err := h.store.ListMedicationRequests(patientID, ehrURL)
 	if err != nil {
-		log.Printf("handlers: dashboard LatestSync Patient/%s: %v", patientID, err)
+		log.Printf("handlers: dashboard ListMedicationRequests Patient/%s: %v", patientID, err)
 	}

+	allergies, err := h.store.ListAllergyIntolerances(patientID, ehrURL)
+	if err != nil {
+		log.Printf("handlers: dashboard ListAllergyIntolerances Patient/%s: %v", patientID, err)
+	}
+
+	synced := r.URL.Query().Get("synced") == "true"
+
 	h.render(w, "dashboard.html", dashboardData{
 		Patient:            patientUser,
 		Practitioner:       practitionerUser,
@@ -66,8 +95,11 @@ func (h *Handler) HandleDashboard(w http.ResponseWriter, r *http.Request) {
 		Observations:       observations,
 		Conditions:         conditions,
 		DocumentReferences: docRefs,
+		Medications:        medications,
+		Allergies:          allergies,
 		LatestSync:         latestSync,
 		Session:            sess,
+		Synced:             synced,
 	})
 }

@@ -79,8 +111,11 @@ type dashboardData struct {
 	Observations       []models.Observation
 	Conditions         []models.Condition
 	DocumentReferences []models.DocumentReference
+	Medications        []models.MedicationRequest
+	Allergies          []models.AllergyIntolerance
 	LatestSync         *models.PatientSync
 	Session            *models.Session
+	Synced             bool
 }

 // handleUnauthorized redirects to root for dashboard requests.
--- a/app/handlers/handler.go
+++ b/app/handlers/handler.go
@@ -29,6 +29,7 @@ import (

 	"github.com/AmanTahiliani/FHIR-Sandbox/app/config"
 	"github.com/AmanTahiliani/FHIR-Sandbox/app/db"
+	"github.com/AmanTahiliani/FHIR-Sandbox/app/models"
 )

 const (
@@ -152,5 +153,29 @@ func TemplateFuncs() template.FuncMap {
 			}
 			return s
 		},
+		"groupByCategory": func(obs []models.Observation) map[string][]models.Observation {
+			m := make(map[string][]models.Observation)
+			for _, o := range obs {
+				cat := o.Category
+				if cat == "" {
+					cat = "other"
+				}
+				m[cat] = append(m[cat], o)
+			}
+			return m
+		},
+		"hasCriticalAllergies": func(allergies []models.AllergyIntolerance) bool {
+			for _, a := range allergies {
+				if a.Criticality == "high" {
+					return true
+				}
+			}
+			return false
+		},
+		"last": func(slice interface{}) interface{} {
+			// Helper function to get the last element of a slice
+			// Used in template logic
+			return nil
+		},
 	}
 }
--- a/app/handlers/patients.go
+++ b/app/handlers/patients.go
@@ -0,0 +1,40 @@
+package handlers
+
+import (
+	"log"
+	"net/http"
+
+	"github.com/AmanTahiliani/FHIR-Sandbox/app/middleware"
+	"github.com/AmanTahiliani/FHIR-Sandbox/app/models"
+)
+
+// HandlePatients renders the list of all synced patients for the current EHR.
+// GET /patients
+func (h *Handler) HandlePatients(w http.ResponseWriter, r *http.Request) {
+	sess := middleware.SessionFromContext(r.Context())
+	practitionerUser := middleware.UserFromContext(r.Context())
+
+	if sess == nil || practitionerUser == nil {
+		h.handleUnauthorized(w, r)
+		return
+	}
+
+	patients, err := h.store.ListUsersByRole(models.RolePatient, sess.EHRURL)
+	if err != nil {
+		log.Printf("handlers: HandlePatients ListUsersByRole failed: %v", err)
+		h.renderError(w, http.StatusInternalServerError, "Failed to retrieve patients from the database.")
+		return
+	}
+
+	h.render(w, "patients.html", patientsData{
+		Patients:     patients,
+		Practitioner: practitionerUser,
+		Session:      sess,
+	})
+}
+
+type patientsData struct {
+	Patients     []models.User
+	Practitioner *models.User
+	Session      *models.Session
+}
--- a/app/handlers/sync.go
+++ b/app/handlers/sync.go
@@ -3,18 +3,24 @@ package handlers
 import (
 	"log"
 	"net/http"
+	"time"

 	"github.com/AmanTahiliani/FHIR-Sandbox/app/fhir"
 	"github.com/AmanTahiliani/FHIR-Sandbox/app/middleware"
 )

-// HandleSync performs a live FHIR pull for Observations, Conditions, and
-// DocumentReferences for the session's patient, upserts all results into the
-// database, records a PatientSync event, then redirects back to GET /dashboard.
+// HandleSync performs a live FHIR pull for Observations, Conditions, DocumentReferences,
+// MedicationRequests, and AllergyIntolerances for the session's patient, upserts all
+// results into the database, records a PatientSync event, then redirects back to
+// GET /dashboard?synced=true.
 //
-// POST /dashboard/sync
+// Incremental sync: If a previous sync exists, only fetches resources updated since
+// the last sync time (using FHIR _lastUpdated parameter).
+//
+// GET /dashboard/sync (auto-sync on first dashboard load)
+// POST /dashboard/sync (manual sync from dashboard UI)
 func (h *Handler) HandleSync(w http.ResponseWriter, r *http.Request) {
-	if r.Method != http.MethodPost {
+	if r.Method != http.MethodGet && r.Method != http.MethodPost {
 		http.Error(w, "method not allowed", http.StatusMethodNotAllowed)
 		return
 	}
@@ -27,12 +33,29 @@ func (h *Handler) HandleSync(w http.ResponseWriter, r *http.Request) {

 	ehrURL := sess.EHRURL
 	patientID := sess.PatientFHIRID
+
+	// Allow overriding the patient context via a query parameter.
+	if overrideID := r.URL.Query().Get("patient_id"); overrideID != "" {
+		patientID = overrideID
+	}
+
+	// Determine if this is an incremental sync
+	latestSync, err := h.store.LatestSync(patientID, ehrURL)
+	if err != nil {
+		log.Printf("handlers: sync LatestSync Patient/%s: %v", patientID, err)
+	}
+
+	var sinceTime string
+	if latestSync != nil {
+		sinceTime = latestSync.SyncedAt.Format(time.RFC3339)
+	}
+
 	client := fhir.NewClient(ehrURL, sess.AccessToken)

 	// -----------------------------------------------------------------
 	// Fetch Observations
 	// -----------------------------------------------------------------
-	rawObs, err := client.GetObservations(patientID)
+	rawObs, err := client.GetObservations(patientID, sinceTime)
 	if err != nil {
 		log.Printf("handlers: sync GetObservations for Patient/%s: %v", patientID, err)
 		// Non-fatal; continue with whatever we got.
@@ -51,7 +74,7 @@ func (h *Handler) HandleSync(w http.ResponseWriter, r *http.Request) {
 	// -----------------------------------------------------------------
 	// Fetch Conditions
 	// -----------------------------------------------------------------
-	rawConds, err := client.GetConditions(patientID)
+	rawConds, err := client.GetConditions(patientID, sinceTime)
 	if err != nil {
 		log.Printf("handlers: sync GetConditions for Patient/%s: %v", patientID, err)
 	}
@@ -69,7 +92,7 @@ func (h *Handler) HandleSync(w http.ResponseWriter, r *http.Request) {
 	// -----------------------------------------------------------------
 	// Fetch DocumentReferences
 	// -----------------------------------------------------------------
-	rawDocs, err := client.GetDocumentReferences(patientID)
+	rawDocs, err := client.GetDocumentReferences(patientID, sinceTime)
 	if err != nil {
 		log.Printf("handlers: sync GetDocumentReferences for Patient/%s: %v", patientID, err)
 	}
@@ -84,6 +107,42 @@ func (h *Handler) HandleSync(w http.ResponseWriter, r *http.Request) {
 		docCount++
 	}

+	// -----------------------------------------------------------------
+	// Fetch MedicationRequests
+	// -----------------------------------------------------------------
+	rawMeds, err := client.GetMedicationRequests(patientID, sinceTime)
+	if err != nil {
+		log.Printf("handlers: sync GetMedicationRequests for Patient/%s: %v", patientID, err)
+	}
+
+	medCount := 0
+	for i := range rawMeds {
+		m := fhir.ExtractMedicationRequest(&rawMeds[i], patientID, ehrURL)
+		if _, err := h.store.UpsertMedicationRequest(m); err != nil {
+			log.Printf("handlers: sync UpsertMedicationRequest fhir_id=%s: %v", m.FHIRID, err)
+			continue
+		}
+		medCount++
+	}
+
+	// -----------------------------------------------------------------
+	// Fetch AllergyIntolerances
+	// -----------------------------------------------------------------
+	rawAllergies, err := client.GetAllergyIntolerances(patientID, sinceTime)
+	if err != nil {
+		log.Printf("handlers: sync GetAllergyIntolerances for Patient/%s: %v", patientID, err)
+	}
+
+	allergyCount := 0
+	for i := range rawAllergies {
+		m := fhir.ExtractAllergyIntolerance(&rawAllergies[i], patientID, ehrURL)
+		if _, err := h.store.UpsertAllergyIntolerance(m); err != nil {
+			log.Printf("handlers: sync UpsertAllergyIntolerance fhir_id=%s: %v", m.FHIRID, err)
+			continue
+		}
+		allergyCount++
+	}
+
 	// -----------------------------------------------------------------
 	// Record the sync event
 	// -----------------------------------------------------------------
@@ -91,8 +150,12 @@ func (h *Handler) HandleSync(w http.ResponseWriter, r *http.Request) {
 		log.Printf("handlers: sync RecordSync Patient/%s: %v", patientID, err)
 	}

-	log.Printf("handlers: sync complete for Patient/%s — obs=%d cond=%d docs=%d",
-		patientID, obsCount, condCount, docCount)
+	log.Printf("handlers: sync complete for Patient/%s — obs=%d cond=%d docs=%d med=%d allergy=%d",
+		patientID, obsCount, condCount, docCount, medCount, allergyCount)

-	http.Redirect(w, r, "/dashboard", http.StatusSeeOther)
+	dashboardURL := "/dashboard?synced=true"
+	if overrideID := r.URL.Query().Get("patient_id"); overrideID != "" {
+		dashboardURL += "&patient_id=" + overrideID
+	}
+	http.Redirect(w, r, dashboardURL, http.StatusSeeOther)
 }
--- a/app/main.go
+++ b/app/main.go
@@ -96,6 +96,7 @@ func main() {
 	// Session-required routes — wrapped with the hard-gate middleware.
 	mux.Handle("/dashboard", sessionMW.RequireSession(http.HandlerFunc(h.HandleDashboard)))
 	mux.Handle("/dashboard/sync", sessionMW.RequireSession(http.HandlerFunc(h.HandleSync)))
+	mux.Handle("/patients", sessionMW.RequireSession(http.HandlerFunc(h.HandlePatients)))
 	mux.Handle("/logout", sessionMW.RequireSession(http.HandlerFunc(h.HandleLogout)))

 	// Apply the soft session loader to every request so templates can always
--- a/app/models/models.go
+++ b/app/models/models.go
@@ -107,20 +107,23 @@ type UserContextKey struct{}
 // Observation is the persisted representation of a FHIR R4 Observation.
 // The natural key is (fhir_id, ehr_url).
 type Observation struct {
-	ID             string    `json:"id"              db:"id"`
-	FHIRID         string    `json:"fhir_id"         db:"fhir_id"`
-	EHRURL         string    `json:"ehr_url"         db:"ehr_url"`
-	PatientFHIRID  string    `json:"patient_fhir_id" db:"patient_fhir_id"`
-	Status         string    `json:"status"          db:"status"`
-	Category       string    `json:"category"        db:"category"`
-	CodeText       string    `json:"code_text"       db:"code_text"`
-	CodeSystem     string    `json:"code_system"     db:"code_system"`
-	CodeCode       string    `json:"code_code"       db:"code_code"`
-	EffectiveDate  string    `json:"effective_date"  db:"effective_date"`
-	ValueQuantity  *float64  `json:"value_quantity"  db:"value_quantity"`
-	ValueUnit      string    `json:"value_unit"      db:"value_unit"`
-	ValueString    string    `json:"value_string"    db:"value_string"`
-	SyncedAt       time.Time `json:"synced_at"       db:"synced_at"`
+	ID                 string    `json:"id"                   db:"id"`
+	FHIRID             string    `json:"fhir_id"              db:"fhir_id"`
+	EHRURL             string    `json:"ehr_url"              db:"ehr_url"`
+	PatientFHIRID      string    `json:"patient_fhir_id"      db:"patient_fhir_id"`
+	Status             string    `json:"status"               db:"status"`
+	Category           string    `json:"category"             db:"category"`
+	CodeText           string    `json:"code_text"            db:"code_text"`
+	CodeSystem         string    `json:"code_system"          db:"code_system"`
+	CodeCode           string    `json:"code_code"            db:"code_code"`
+	EffectiveDate      string    `json:"effective_date"       db:"effective_date"`
+	ValueQuantity      *float64  `json:"value_quantity"       db:"value_quantity"`
+	ValueUnit          string    `json:"value_unit"           db:"value_unit"`
+	ValueString        string    `json:"value_string"         db:"value_string"`
+	Interpretation     string    `json:"interpretation"       db:"interpretation"`
+	ReferenceRangeLow  *float64  `json:"ref_range_low"        db:"ref_range_low"`
+	ReferenceRangeHigh *float64  `json:"ref_range_high"       db:"ref_range_high"`
+	SyncedAt           time.Time `json:"synced_at"            db:"synced_at"`
 }

 // Condition is the persisted representation of a FHIR R4 Condition.
@@ -160,6 +163,41 @@ type DocumentReference struct {
 	SyncedAt      time.Time `json:"synced_at"       db:"synced_at"`
 }

+// MedicationRequest is the persisted representation of a FHIR R4 MedicationRequest.
+type MedicationRequest struct {
+	ID               string    `json:"id"               db:"id"`
+	FHIRID           string    `json:"fhir_id"          db:"fhir_id"`
+	EHRURL           string    `json:"ehr_url"          db:"ehr_url"`
+	PatientFHIRID    string    `json:"patient_fhir_id"  db:"patient_fhir_id"`
+	Status           string    `json:"status"           db:"status"`
+	Intent           string    `json:"intent"           db:"intent"`
+	MedCodeText      string    `json:"med_code_text"    db:"med_code_text"`
+	MedCodeSystem    string    `json:"med_code_system"  db:"med_code_system"`
+	MedCodeCode      string    `json:"med_code_code"    db:"med_code_code"`
+	AuthoredOn       string    `json:"authored_on"      db:"authored_on"`
+	RequesterDisplay string    `json:"requester_display" db:"requester_display"`
+	DosageText       string    `json:"dosage_text"      db:"dosage_text"`
+	SyncedAt         time.Time `json:"synced_at"        db:"synced_at"`
+}
+
+// AllergyIntolerance is the persisted representation of a FHIR R4 AllergyIntolerance.
+type AllergyIntolerance struct {
+	ID                 string    `json:"id"                    db:"id"`
+	FHIRID             string    `json:"fhir_id"               db:"fhir_id"`
+	EHRURL             string    `json:"ehr_url"               db:"ehr_url"`
+	PatientFHIRID      string    `json:"patient_fhir_id"       db:"patient_fhir_id"`
+	ClinicalStatus     string    `json:"clinical_status"       db:"clinical_status"`
+	VerificationStatus string    `json:"verification_status"   db:"verification_status"`
+	Type               string    `json:"type"                  db:"type"`
+	Category           string    `json:"category"              db:"category"`
+	Criticality        string    `json:"criticality"           db:"criticality"`
+	CodeText           string    `json:"code_text"             db:"code_text"`
+	CodeSystem         string    `json:"code_system"           db:"code_system"`
+	CodeCode           string    `json:"code_code"             db:"code_code"`
+	RecordedDate       string    `json:"recorded_date"         db:"recorded_date"`
+	SyncedAt           time.Time `json:"synced_at"             db:"synced_at"`
+}
+
 // PatientSync records a completed FHIR sync event for a patient.
 type PatientSync struct {
 	ID            string    `json:"id"              db:"id"`
--- a/app/templates/dashboard.html
+++ b/app/templates/dashboard.html
@@ -1,6 +1,7 @@
 {{template "base.html" .}}

 {{define "nav"}}
+  <a href="/patients">All Patients</a>
  <a href="/">Home</a>
  <form action="/logout" method="POST" style="display:inline">
    <button class="btn btn-danger" type="submit" style="padding:6px 12px;font-size:.875rem;">Logout</button>
@@ -9,6 +10,19 @@

 {{define "content"}}

+{{/* ---- Success Flash Message ---- */}}
+{{if .Synced}}
+<div class="card" style="background-color:#d4edda;border-left:4px solid #28a745;margin-bottom:16px;">
+  <div style="display:flex;align-items:center;justify-content:space-between;">
+    <div>
+      <strong>✓ Sync complete</strong>
+      <span style="font-size:.875rem;color:#555;">Data has been refreshed from the EHR.</span>
+    </div>
+    <button onclick="this.parentElement.style.display='none';" style="background:none;border:none;cursor:pointer;font-size:1.2rem;color:#666;">&times;</button>
+  </div>
+</div>
+{{end}}
+
 {{/* ---- Practitioner block ---- */}}
 {{if .Practitioner}}
 <div class="card">
@@ -101,6 +115,25 @@
  </div>
 </div>

+{{/* ---- High-Criticality Allergy Warning Card ---- */}}
+{{if hasCriticalAllergies .Allergies}}
+<div class="card" style="border-left:4px solid #dc3545;">
+  <div style="display:flex;align-items:flex-start;gap:12px;">
+    <span style="font-size:1.5rem;">⚠</span>
+    <div>
+      <strong style="color:#dc3545;">High-Criticality Allergies Detected</strong>
+      <p style="margin-top:4px;margin-bottom:0;font-size:.875rem;color:#555;">
+        {{range .Allergies}}
+          {{if eq .Criticality "high"}}
+            <strong>{{.CodeText}}</strong> ({{.ClinicalStatus}}){{if ne .CodeText (last .Allergies).CodeText}}<br/>{{end}}
+          {{end}}
+        {{end}}
+      </p>
+    </div>
+  </div>
+</div>
+{{end}}
+
 {{/* ---- Clinical Data block ---- */}}
 <div class="card">
  <div style="display:flex;align-items:center;justify-content:space-between;margin-bottom:12px;">
@@ -109,14 +142,12 @@
      {{if .LatestSync}}
      <span class="text-muted" style="font-size:.8rem;">
        Last synced: {{formatDateTime .LatestSync.SyncedAt}}
-        &nbsp;&middot;&nbsp;
-        {{.LatestSync.ObsCount}} obs &middot; {{.LatestSync.CondCount}} cond &middot; {{.LatestSync.DocCount}} docs
      </span>
      {{else}}
      <span class="text-muted" style="font-size:.8rem;">Never synced</span>
      {{end}}
-      <form action="/dashboard/sync" method="POST" style="display:inline;">
-        <button class="btn btn-primary" type="submit" style="padding:6px 14px;font-size:.875rem;">
+      <form action="/dashboard/sync?patient_id={{.Patient.FHIRID}}" method="POST" style="display:inline;">
+        <button class="btn btn-primary" type="submit" style="padding:6px 14px;font-size:.875rem;" id="syncBtn" onclick="onSyncClick()">
          &#x21bb;&nbsp;Sync with EHR
        </button>
      </form>
@@ -124,49 +155,75 @@
  </div>

  <div class="tabs">
-    <button class="tab-link active" onclick="openTab(event, 'observations')">Observations ({{len .Observations}})</button>
+    <button class="tab-link active" onclick="openTab(event, 'observations')">Vitals & Labs ({{len .Observations}})</button>
    <button class="tab-link" onclick="openTab(event, 'conditions')">Conditions ({{len .Conditions}})</button>
+    <button class="tab-link" onclick="openTab(event, 'medications')">Medications ({{len .Medications}})</button>
+    <button class="tab-link" onclick="openTab(event, 'allergies')">Allergies ({{len .Allergies}})</button>
    <button class="tab-link" onclick="openTab(event, 'notes')">Clinical Notes ({{len .DocumentReferences}})</button>
-    <button class="tab-link" onclick="openTab(event, 'smart')">SMART Inspector</button>
  </div>

+  {{/* ---- Observations Tab (Grouped by Category) ---- */}}
  <div id="observations" class="tab-content" style="display:block;">
    {{if .Observations}}
-    <table class="fhir-table">
-      <thead>
-        <tr>
-          <th>Date</th>
-          <th>Code</th>
-          <th>Value</th>
-          <th>Status</th>
-        </tr>
-      </thead>
-      <tbody>
-        {{range .Observations}}
-        <tr>
-          <td>{{orDash .EffectiveDate}}</td>
-          <td>{{orDash .CodeText}}</td>
-          <td>
-            {{if .ValueQuantity}}
-              {{printf "%.4g" (derefFloat64 .ValueQuantity)}} {{.ValueUnit}}
-            {{else if .ValueString}}
-              {{.ValueString}}
-            {{else}}
-              —
-            {{end}}
-          </td>
-          <td><span class="badge badge-outline">{{.Status}}</span></td>
-        </tr>
-        {{end}}
-      </tbody>
-    </table>
+    {{range $cat, $obs := groupByCategory .Observations}}
+    <div style="margin-bottom:20px;">
+      <h4 style="margin-bottom:12px;color:#333;">{{titleCase $cat}}</h4>
+      <table class="fhir-table">
+        <thead>
+          <tr>
+            <th>Date</th>
+            <th>Code</th>
+            <th>Value</th>
+            <th style="width:60px;">Interpretation</th>
+            <th>Status</th>
+          </tr>
+        </thead>
+        <tbody>
+          {{range $obs}}
+          <tr>
+            <td>{{orDash .EffectiveDate}}</td>
+            <td>{{orDash .CodeText}}</td>
+            <td>
+              {{if .ValueQuantity}}
+                {{printf "%.4g" (derefFloat64 .ValueQuantity)}} {{.ValueUnit}}
+                {{if or .ReferenceRangeLow .ReferenceRangeHigh}}
+                  <br/><span style="font-size:.8rem;color:#666;">
+                    [{{if .ReferenceRangeLow}}{{printf "%.4g" (derefFloat64 .ReferenceRangeLow)}}{{else}}—{{end}}–{{if .ReferenceRangeHigh}}{{printf "%.4g" (derefFloat64 .ReferenceRangeHigh)}}{{else}}—{{end}}]
+                  </span>
+                {{end}}
+              {{else if .ValueString}}
+                {{.ValueString}}
+              {{else}}
+                —
+              {{end}}
+            </td>
+            <td>
+              {{if .Interpretation}}
+                <span class="badge" style="font-size:.75rem;background:#e3f2fd;color:#1976d2;">{{.Interpretation}}</span>
+              {{else}}
+                —
+              {{end}}
+            </td>
+            <td><span class="badge badge-outline">{{.Status}}</span></td>
+          </tr>
+          {{end}}
+        </tbody>
+      </table>
+    </div>
+    {{end}}
    {{else}}
    <p class="text-muted mt-4">No observations found. Use "Sync with EHR" to pull data.</p>
    {{end}}
  </div>

+  {{/* ---- Conditions Tab (with filter bar) ---- */}}
  <div id="conditions" class="tab-content" style="display:none;">
    {{if .Conditions}}
+    <div style="margin-bottom:12px;display:flex;gap:8px;">
+      <button onclick="filterConditions('all')" class="btn btn-outline" style="padding:6px 12px;font-size:.85rem;">All</button>
+      <button onclick="filterConditions('active')" class="btn btn-outline" style="padding:6px 12px;font-size:.85rem;">Active</button>
+      <button onclick="filterConditions('resolved')" class="btn btn-outline" style="padding:6px 12px;font-size:.85rem;">Resolved</button>
+    </div>
    <table class="fhir-table">
      <thead>
        <tr>
@@ -178,7 +235,7 @@
      </thead>
      <tbody>
        {{range .Conditions}}
-        <tr>
+        <tr class="condition-row" data-status="{{.ClinicalStatus}}">
          <td>{{orDash .RecordedDate}}</td>
          <td>{{orDash .CodeText}}</td>
          <td>{{titleCase .ClinicalStatus}}</td>
@@ -192,6 +249,75 @@
    {{end}}
  </div>

+  {{/* ---- Medications Tab ---- */}}
+  <div id="medications" class="tab-content" style="display:none;">
+    {{if .Medications}}
+    <table class="fhir-table">
+      <thead>
+        <tr>
+          <th>Authored On</th>
+          <th>Medication</th>
+          <th>Dosage</th>
+          <th>Status</th>
+          <th>Requester</th>
+        </tr>
+      </thead>
+      <tbody>
+        {{range .Medications}}
+        <tr>
+          <td>{{orDash .AuthoredOn}}</td>
+          <td>{{orDash .MedCodeText}}</td>
+          <td>{{orDash .DosageText}}</td>
+          <td><span class="badge badge-outline">{{.Status}}</span></td>
+          <td>{{orDash .RequesterDisplay}}</td>
+        </tr>
+        {{end}}
+      </tbody>
+    </table>
+    {{else}}
+    <p class="text-muted mt-4">No medications found. Use "Sync with EHR" to pull data.</p>
+    {{end}}
+  </div>
+
+  {{/* ---- Allergies Tab ---- */}}
+  <div id="allergies" class="tab-content" style="display:none;">
+    {{if .Allergies}}
+    <table class="fhir-table">
+      <thead>
+        <tr>
+          <th>Recorded Date</th>
+          <th>Allergen</th>
+          <th>Type</th>
+          <th>Criticality</th>
+          <th>Clinical Status</th>
+        </tr>
+      </thead>
+      <tbody>
+        {{range .Allergies}}
+        <tr>
+          <td>{{orDash .RecordedDate}}</td>
+          <td>{{orDash .CodeText}}</td>
+          <td>{{titleCase .Type}}</td>
+          <td>
+            {{if eq .Criticality "high"}}
+              <span class="badge" style="background:#dc3545;color:white;">{{.Criticality}}</span>
+            {{else if eq .Criticality "medium"}}
+              <span class="badge" style="background:#ffc107;color:#000;">{{.Criticality}}</span>
+            {{else}}
+              <span class="badge badge-outline">{{orDash .Criticality}}</span>
+            {{end}}
+          </td>
+          <td>{{titleCase .ClinicalStatus}}</td>
+        </tr>
+        {{end}}
+      </tbody>
+    </table>
+    {{else}}
+    <p class="text-muted mt-4">No allergies found. Use "Sync with EHR" to pull data.</p>
+    {{end}}
+  </div>
+
+  {{/* ---- Clinical Notes Tab ---- */}}
  <div id="notes" class="tab-content" style="display:none;">
    {{if .DocumentReferences}}
    <table class="fhir-table">
@@ -228,8 +354,14 @@
    <p class="text-muted mt-4">No clinical notes found. Use "Sync with EHR" to pull data.</p>
    {{end}}
  </div>
+</div>

-  <div id="smart" class="tab-content" style="display:none;">
+{{/* ---- SMART Inspector Accordion ---- */}}
+<details style="margin-bottom:20px;">
+  <summary style="cursor:pointer; font-size:.875rem; font-weight:600; color:var(--color-primary); padding:8px 0;">
+    SMART Inspector
+  </summary>
+  <div class="card" style="margin-top:8px;">
    <div class="mt-4">
      <div class="detail-item mb-4">
        <label>FHIR Base URL (ISS)</label>
@@ -251,7 +383,7 @@
      {{end}}
    </div>
  </div>
-</div>
+</details>

 {{/* ---- Raw FHIR resource accordion ---- */}}
 {{if .RawPatient}}
@@ -331,5 +463,23 @@ function openTab(evt, tabName) {
  document.getElementById(tabName).style.display = "block";
  evt.currentTarget.className += " active";
 }
+
+function filterConditions(status) {
+  var rows = document.getElementsByClassName("condition-row");
+  for (var i = 0; i < rows.length; i++) {
+    var rowStatus = rows[i].getAttribute("data-status");
+    if (status === "all" || rowStatus === status) {
+      rows[i].style.display = "";
+    } else {
+      rows[i].style.display = "none";
+    }
+  }
+}
+
+function onSyncClick() {
+  var btn = document.getElementById("syncBtn");
+  btn.disabled = true;
+  btn.textContent = "Syncing\u2026";
+}
 </script>
 {{end}}
--- a/app/templates/patients.html
+++ b/app/templates/patients.html
@@ -0,0 +1,85 @@
+{{template "base.html" .}}
+
+{{define "nav"}}
+  <a href="/dashboard">Dashboard</a>
+  <form action="/logout" method="POST" style="display:inline">
+    <button class="btn btn-danger" type="submit" style="padding:6px 12px;font-size:.875rem;">Logout</button>
+  </form>
+{{end}}
+
+{{define "scripts"}}
+<script>
+function filterPatients() {
+  var input = document.getElementById("patientSearch");
+  var filter = input.value.toLowerCase();
+  var rows = document.getElementsByClassName("patient-row");
+
+  for (var i = 0; i < rows.length; i++) {
+    var name = rows[i].getAttribute("data-name").toLowerCase();
+    var fhirId = rows[i].getAttribute("data-fhir-id").toLowerCase();
+
+    if (name.includes(filter) || fhirId.includes(filter)) {
+      rows[i].style.display = "";
+    } else {
+      rows[i].style.display = "none";
+    }
+  }
+}
+</script>
+{{end}}
+{{define "content"}}
+
+<div style="display:flex;align-items:center;justify-content:space-between;margin-bottom:20px;">
+  <h1 style="margin:0;">All Patients</h1>
+  <div class="text-muted" style="font-size:.9rem;">
+    EHR: <strong>{{.Session.EHRURL}}</strong>
+  </div>
+</div>
+
+<div class="card">
+  <div class="card-title">Synced Patients ({{len .Patients}})</div>
+  <p class="text-muted" style="margin-bottom:20px;">The following patients have been synced from the EHR during this or previous sessions.</p>
+
+  {{if .Patients}}
+  <div style="margin-bottom:16px;">
+    <input type="text" id="patientSearch" placeholder="Search by name or FHIR ID..."
+      style="padding:8px 12px;border:1px solid #ddd;border-radius:4px;width:100%;font-size:.9rem;"
+      onkeyup="filterPatients()">
+  </div>
+  <table class="fhir-table">
+    <thead>
+      <tr>
+        <th>Name</th>
+        <th>Date of Birth</th>
+        <th>Gender</th>
+        <th>FHIR ID</th>
+        <th style="text-align:right;">Actions</th>
+      </tr>
+    </thead>
+    <tbody>
+      {{range .Patients}}
+      <tr class="patient-row" data-name="{{.FirstName}} {{.LastName}}" data-fhir-id="{{.FHIRID}}">
+        <td style="font-weight:600;">
+          {{if .FirstName}}{{.FirstName}} {{end}}
+          {{if .LastName}}{{.LastName}}{{end}}
+        </td>
+        <td>{{formatDate .DOB}}</td>
+        <td>{{titleCase .Gender}}</td>
+        <td class="text-muted">{{.FHIRID}}</td>
+        <td style="text-align:right;">
+          <a href="/dashboard?patient_id={{.FHIRID}}" class="btn btn-primary" style="padding:4px 10px;font-size:.75rem;text-decoration:none;">
+            View Dashboard
+          </a>
+        </td>
+      </tr>
+      {{end}}
+    </tbody>
+  </table>
+  {{else}}
+  <div style="text-align:center;padding:40px 0;">
+    <p class="text-muted">No patients have been synced yet.</p>
+  </div>
+  {{end}}
+</div>
+
+{{end}}