Add patient-info medication considerations/alerts

src/components/clinical-dashboard/global-search-shell.tsx

@@ -20,6 +20,7 @@ import {
   demoRecentQueryOwnerId,
   loadRecentQueries,
 } from "@/components/clinical-dashboard/recent-query-storage";
+import { PatientProfileProvider } from "@/components/clinical-dashboard/patient-profile-context";
 import { SearchCommandProvider } from "@/components/clinical-dashboard/search-command-context";
 import { SettingsDialog } from "@/components/clinical-dashboard/settings-dialog";
 import {
@@ -134,18 +135,23 @@ function GlobalSearchShellClient(props: GlobalSearchShellProps) {
   const isMedicationDetailRoute = /^\/medications\/[^/]+$/.test(pathname);
   const shouldRenderClinicalDashboard = !isMedicationDetailRoute && (isHomeRoute || shouldRenderDashboardSearch);
 
-  if (shouldRenderClinicalDashboard) {
-    return (
-      <ClinicalDashboard
-        initialSearchMode={resolvedSearchMode}
-        initialQuery={requestedQuery}
-        focusSearch={searchParams.get("focus") === "1"}
-        autoRunSearch={isHomeRoute ? hasSubmittedModeSearch : true}
-      />
-    );
-  }
-
-  return <GlobalStandaloneSearchShellClient {...props} />;
+  // Wrap both render paths so the patient-considerations profile is shared
+  // between the prescribing workspace (ClinicalDashboard) and the medication
+  // detail pages (standalone shell), backed by sessionStorage across navigation.
+  return (
+    <PatientProfileProvider>
+      {shouldRenderClinicalDashboard ? (
+        <ClinicalDashboard
+          initialSearchMode={resolvedSearchMode}
+          initialQuery={requestedQuery}
+          focusSearch={searchParams.get("focus") === "1"}
+          autoRunSearch={isHomeRoute ? hasSubmittedModeSearch : true}
+        />
+      ) : (
+        <GlobalStandaloneSearchShellClient {...props} />
+      )}
+    </PatientProfileProvider>
+  );
 }
 
 function GlobalStandaloneSearchShellClient({

src/components/clinical-dashboard/medication-considerations.tsx

@@ -0,0 +1,96 @@
+"use client";
+
+import { ClipboardList } from "lucide-react";
+import { useMemo } from "react";
+
+import { BadgeCluster, type ClinicalBadgeItem } from "@/components/clinical-dashboard/clinical-badge";
+import { usePatientProfile } from "@/components/clinical-dashboard/patient-profile-context";
+import {
+  evaluatePatientAlerts,
+  noticeToneForSemanticTone,
+  type MedicationConsideration,
+} from "@/lib/medication-patient-alerts";
+import type { MedicationRecord } from "@/lib/medications";
+import type { SemanticTone } from "@/lib/semantic-tone";
+import { cn, InlineNotice } from "@/components/ui-primitives";
+
+/** Badge for a result row summarising how many considerations apply. */
+export function considerationSummaryBadge(count: number, highestTone: SemanticTone | null): ClinicalBadgeItem | null {
+  if (!count || !highestTone) return null;
+  return {
+    id: "patient-alerts",
+    label: `${count} alert${count === 1 ? "" : "s"}`,
+    tone: highestTone,
+  };
+}
+
+function considerationBadges(consideration: MedicationConsideration): ClinicalBadgeItem[] {
+  return [
+    ...consideration.factorLabels.map((label, index) => ({
+      id: `${consideration.id}-factor-${index}`,
+      label,
+      tone: consideration.tone,
+    })),
+    ...consideration.reasons.map((reason, index) => ({
+      id: `${consideration.id}-reason-${index}`,
+      label: reason,
+      tone: "neutral" as const,
+    })),
+  ];
+}
+
+/**
+ * Detail-page block: evaluates the entered profile against a single medication
+ * and renders the applicable considerations, an all-clear when none apply, and a
+ * hint for any contraindication gate the profile did not supply.
+ */
+export function MedicationConsiderations({ record, className }: { record: MedicationRecord; className?: string }) {
+  const { profile, isEmpty } = usePatientProfile();
+  const result = useMemo(() => evaluatePatientAlerts(record, profile), [record, profile]);
+
+  return (
+    <section aria-label="Patient considerations" className={cn("space-y-2", className)}>
+      <div className="flex items-center gap-2">
+        <ClipboardList className="h-4 w-4 text-[color:var(--clinical-accent)]" aria-hidden="true" />
+        <h2 className="text-sm-minus font-semibold text-[color:var(--text-heading)]">
+          Considerations for this patient
+        </h2>
+        {!isEmpty && result.considerations.length > 0 ? (
+          <span className="rounded-full bg-[color:var(--surface-subtle)] px-2 py-0.5 text-2xs font-semibold text-[color:var(--text-muted)]">
+            {result.considerations.length}
+          </span>
+        ) : null}
+      </div>
+
+      {isEmpty ? (
+        <div className="rounded-lg border border-dashed border-[color:var(--border)] bg-[color:var(--surface-subtle)] px-3 py-3 text-sm text-[color:var(--text-muted)]">
+          Enter patient details above to surface dosing, safety, and contraindication considerations for this
+          medication.
+        </div>
+      ) : result.considerations.length === 0 ? (
+        <InlineNotice tone="success">
+          No matching considerations for the entered patient profile. Always confirm against source.
+        </InlineNotice>
+      ) : (
+        <div className="space-y-2">
+          {result.considerations.map((consideration) => (
+            <InlineNotice key={consideration.id} tone={noticeToneForSemanticTone(consideration.tone)}>
+              <div className="min-w-0 space-y-1.5" data-testid={`patient-consideration-${consideration.id}`}>
+                <BadgeCluster items={considerationBadges(consideration)} compact />
+                {consideration.note ? (
+                  <p className="text-xs leading-5 text-[color:var(--text-heading)]">{consideration.note}</p>
+                ) : null}
+              </div>
+            </InlineNotice>
+          ))}
+        </div>
+      )}
+
+      {!isEmpty && result.unassessed.length > 0 ? (
+        <InlineNotice tone="info">
+          Enter {result.unassessed.join(", ")} to fully assess this medication&rsquo;s contraindications.
+        </InlineNotice>
+      ) : null}
+    </section>
+  );
+}

src/components/clinical-dashboard/medication-prescribing-workspace.tsx

@@ -22,8 +22,12 @@ import { useMemo, useState } from "react";
 
 import { ModeHomeTemplate, ModeHomeVerificationFooter } from "@/components/mode-home-template";
 import { SearchResultsHeaderBand } from "@/components/clinical-dashboard/search-results-header-band";
+import { considerationSummaryBadge } from "@/components/clinical-dashboard/medication-considerations";
+import { usePatientProfile } from "@/components/clinical-dashboard/patient-profile-context";
+import { PatientProfilePanel } from "@/components/clinical-dashboard/patient-profile-panel";
 import { useSearchCommand } from "@/components/clinical-dashboard/search-command-context";
 import { useMedicationCatalog } from "@/components/clinical-dashboard/use-medication-catalog";
+import { evaluatePatientAlerts } from "@/lib/medication-patient-alerts";
 import {
   BadgeCluster,
   ClinicalBadge,
@@ -372,13 +376,21 @@ function MedicationResults({
 >) {
   const command = useSearchCommand();
   const catalog = useMedicationCatalog(query);
+  const { profile, isEmpty: profileEmpty } = usePatientProfile();
   const [activeFilter, setActiveFilter] = useState<MedicationResultFilter>("best");
   const { rows, counts, totalAvailable } = useMemo(() => {
     const governance = catalog.data?.governance;
-    const toRow = (result: MedicationResult, medication?: MedicationRecord): MedicationRow => ({
-      result,
-      badges: medication ? medicationIdentityBadges(medication, governance?.[medication.slug]) : [],
-    });
+    const toRow = (result: MedicationResult, medication?: MedicationRecord): MedicationRow => {
+      const badges = medication ? medicationIdentityBadges(medication, governance?.[medication.slug]) : [];
+      // Prepend a per-patient alert badge so the highest-severity consideration
+      // surfaces first in the row's badge cluster (priority-sorted by tone).
+      if (medication && !profileEmpty) {
+        const alerts = evaluatePatientAlerts(medication, profile);
+        const alertBadge = considerationSummaryBadge(alerts.considerations.length, alerts.highestTone);
+        if (alertBadge) return { result, badges: [alertBadge, ...badges] };
+      }
+      return { result, badges };
+    };
     const sourceRows =
       catalog.data?.matches?.map((match) => toRow(match.result, match.medication)) ??
       (catalog.data?.records ?? []).slice(0, 12).map((record) =>
@@ -413,7 +425,7 @@ function MedicationResults({
       counts: filterCounts,
       totalAvailable: scoped.length,
     };
-  }, [activeFilter, catalog.data, command?.commandScopes]);
+  }, [activeFilter, catalog.data, command?.commandScopes, profile, profileEmpty]);
   const resultCount = rows.length;
   // The match-quality badge only earns its slot when it differentiates: hide it on
   // "Exact clinical fit" rows when every visible row says the same thing.
@@ -437,6 +449,8 @@ function MedicationResults({
         </div>
       </div>
 
+      <PatientProfilePanel variant="compact" />
+
       <FilterStrip activeFilter={activeFilter} counts={counts} onFilterChange={setActiveFilter} />
 
       {catalog.loading ? (

src/components/clinical-dashboard/medication-record-page.tsx

@@ -19,6 +19,8 @@ import Link from "next/link";
 import { useMemo, useState } from "react";
 
 import { BadgeCluster, clinicalBadgeToneClass } from "@/components/clinical-dashboard/clinical-badge";
+import { MedicationConsiderations } from "@/components/clinical-dashboard/medication-considerations";
+import { PatientProfilePanel } from "@/components/clinical-dashboard/patient-profile-panel";
 import { useMedicationDetail } from "@/components/clinical-dashboard/use-medication-catalog";
 import {
   medicationAccessBadges,
@@ -215,6 +217,11 @@ function MedicationRecordDetail({
             ))}
           </section>
 
+          <section className="space-y-2.5">
+            <PatientProfilePanel />
+            <MedicationConsiderations record={record} />
+          </section>
+
           <div className="flex flex-wrap gap-2">
             {(
               [

src/components/clinical-dashboard/patient-profile-context.tsx

@@ -0,0 +1,62 @@
+"use client";
+
+import { createContext, useCallback, useContext, useMemo, useSyncExternalStore } from "react";
+
+import { isProfileEmpty, type AllergyClass, type PatientProfile } from "@/lib/medication-patient-alerts";
+import {
+  EMPTY_PATIENT_PROFILE,
+  getPatientProfileSnapshot,
+  getServerPatientProfileSnapshot,
+  subscribePatientProfile,
+  writePatientProfile,
+} from "@/lib/patient-profile-storage";
+
+export type PatientProfileContextValue = {
+  profile: PatientProfile;
+  updateField: <K extends keyof PatientProfile>(key: K, value: PatientProfile[K]) => void;
+  toggleAllergy: (allergy: AllergyClass) => void;
+  clear: () => void;
+  isEmpty: boolean;
+};
+
+const PatientProfileContext = createContext<PatientProfileContextValue | null>(null);
+
+export function PatientProfileProvider({ children }: { children: React.ReactNode }) {
+  // Read from the sessionStorage-backed external store so the profile is shared
+  // across the prescribing workspace and detail pages with no hydration mismatch.
+  const profile = useSyncExternalStore(
+    subscribePatientProfile,
+    getPatientProfileSnapshot,
+    getServerPatientProfileSnapshot,
+  );
+
+  const updateField = useCallback<PatientProfileContextValue["updateField"]>((key, value) => {
+    writePatientProfile({ ...getPatientProfileSnapshot(), [key]: value });
+  }, []);
+
+  const toggleAllergy = useCallback((allergy: AllergyClass) => {
+    const current = getPatientProfileSnapshot();
+    const allergies = current.allergies ?? [];
+    const next = allergies.includes(allergy) ? allergies.filter((item) => item !== allergy) : [...allergies, allergy];
+    writePatientProfile({ ...current, allergies: next });
+  }, []);
+
+  const clear = useCallback(() => {
+    writePatientProfile({ ...EMPTY_PATIENT_PROFILE });
+  }, []);
+
+  const value = useMemo<PatientProfileContextValue>(
+    () => ({ profile, updateField, toggleAllergy, clear, isEmpty: isProfileEmpty(profile) }),
+    [profile, updateField, toggleAllergy, clear],
+  );
+
+  return <PatientProfileContext.Provider value={value}>{children}</PatientProfileContext.Provider>;
+}
+
+export function usePatientProfile(): PatientProfileContextValue {
+  const value = useContext(PatientProfileContext);
+  if (!value) {
+    throw new Error("usePatientProfile must be used within a PatientProfileProvider");
+  }
+  return value;
+}