Universal Healthcare Data Network

A secure, contract-first foundation for interoperable healthcare data — built as a TypeScript monorepo with a shared validation core, modular Express API, Next.js portal, Expo mobile client, and a ledger-ready integration scaffold.

Overview · Features · Architecture · Getting Started · Deployment · Docs · Contributing

Overview

Universal Healthcare Data Network (UHDN) is an open-source, full-stack foundation for healthcare data interoperability. The codebase is organised so that every layer — API, web, mobile, and shared contracts — evolves against a single source of truth defined in TypeScript and Zod.

The goal is to make it easy to spin up new healthcare workflows (provider directories, patient profiles, payer integrations, longitudinal records, consent dashboards) without re-litigating auth, validation, or data shapes between teams.

UHDN is intentionally a prototype / foundation: it makes the right architectural choices, ships the boring-but-essential primitives (auth, profile management, presigned uploads, slug generation, structured errors, structured logging), and gives the runtime surfaces a clean place to grow into.

Features

Authentication & Identity

Email + password registration and login with bcrypt hashing
JWT-based bearer auth with a requireAuth middleware
Persistent client sessions on web (AuthProvider + localStorage)
Centralised, typed error model (AppError with statusCode + machine-readable code)

Profile Domain

User accounts owned by an email
CreatorProfile with public /api/creators/:slug lookup (display name, bio, avatar, genre, location, verification flag)
FanProfile with genre preferences for tailored experiences
PATCH /api/users/me for self-service profile updates
Presigned S3 avatar upload URLs (5 minute TTL) issued from POST /api/users/me/avatar-upload-url

Cross-Platform Surfaces

API – Express modular monolith with one router per domain (auth, users, creators, …fans)
Web – Next.js (App Router) portal with login, register, public creator pages, profile editing
Mobile – Expo / React Native shell with a CreatorProfileScreen, ProfileImagePicker component, and a reusable useImagePicker hook

Shared Contracts

Zod schemas (loginSchema, registerSchema, updateMeSchema) reused on both sides of the wire (server validation = client validation)
Typed DTOs (AuthResponse, MeResponse, CreatorProfileResponse, FanProfileResponse)
Path-aliased workspace package (@universal-healthcare/shared) consumed directly from TypeScript source — no build step

Developer Experience

pnpm + Turborepo workspace with per-package GitHub Actions
Vitest + Supertest on the API, Vitest + Testing Library on web, Jest + jest-expo on mobile
ESLint flat config, Prettier, TypeScript strict mode enforced everywhere
JSON-structured logger, validated env loader with sensible defaults

Observability & Hardening

Helmet security headers on every response
CORS allowlist driven by CORS_ORIGINS (env-driven; empty list = allow all in dev only)
Per-IP rate limiting on all /api/* routes (RATE_LIMIT_WINDOW_MS / RATE_LIMIT_MAX, no-op in test env)
Request ID (X-Request-Id): trust upstream or generate a UUID, attached to logs and response header
Structured access log with method, path, status, duration, userId, requestId
Prometheus metrics at GET /metrics — request count + duration histogram + in-flight gauge
Liveness / readiness split: /livez (process), /readyz (DB ping with 2s timeout)
Graceful shutdown on SIGTERM / SIGINT — drain connections, disconnect Prisma, force-exit after 25s
Compression (gzip) for all responses ≥ 1KB

Ledger-Ready Scaffold

A separate @universal-healthcare/stellar package that compiles to placeholder types/interfaces ready for a Stellar payment / data-provenance layer (no blockchain logic yet — kept compile-only so future integrations land in one obvious place)

Architecture

UHDN is a pnpm + Turborepo monorepo organised as four runtime apps plus two shared packages.

flowchart LR
  subgraph Clients
    WEB["apps/web<br/>Next.js portal"]
    MOB["apps/mobile<br/>Expo / React Native"]
  end

  subgraph API["apps/api · Express modular monolith"]
    AUTH["modules/auth<br/>register · login"]
    USR["modules/users<br/>me · patch · avatar URL"]
    CRE["modules/creators<br/>/:slug lookup"]
    FAN["modules/fans"]
  end

  subgraph Shared
    S["packages/shared<br/>Zod + DTOs"]
    T["packages/stellar<br/>ledger scaffold"]
  end

  DB[("Prisma<br/>SQLite · Postgres")]
  S3[("AWS S3<br/>avatars")]

  WEB -- "fetch /api/*" --> API
  MOB -- "fetch /api/*" --> API
  WEB -- "imports" --> S
  MOB -- "imports" --> S
  API -- "consumes" --> S
  AUTH --> USR
  USR --> CRE
  USR --> FAN
  API --> DB
  API --> S3

Why this shape?

The shared package is the single source of truth for every request/response shape. When it changes, TypeScript checks and Zod parses catch the mismatch on both sides immediately.
The API is a modular monolith — the routes, services, repositories, validators, types, and tests for each domain live side by side. Add a new module by copying the template (auth is the most complete one) and you get lint, typecheck, and test wiring for free.
The web app transpiles @universal-healthcare/shared so the workspace package works transparently in Next.js without a build step.
The mobile app talks to the same API and reuses the same client shape as the web app, so feature parity is enforced by the typechecker.

For deeper architectural notes (how to add a new module, how modules depend on each other, how shared types flow end-to-end), see docs/architecture.md.

Repository Layout

universal-healthcare-data-network/
├── apps/
│   ├── api/        # @universal-healthcare/api     – Express modular monolith
│   ├── web/        # @universal-healthcare/web     – Next.js web portal
│   └── mobile/     # @universal-healthcare/mobile  – Expo / React Native client
│
├── packages/
│   ├── shared/     # @universal-healthcare/shared  – Zod schemas, DTOs, validators
│   └── stellar/    # @universal-healthcare/stellar – ledger integration scaffold
│
├── docs/           # architecture · contributing · environment · testing
├── .github/        # per-package CI workflows
├── tools/          # developer tooling (publish-backlog, etc.)
└── README.md

Tech Stack

Layer	Stack
Backend	Express · Prisma (SQLite in dev, swap to Postgres for prod) · TypeScript
Web	Next.js 15 (App Router) · React 19 · TypeScript
Mobile	Expo · React Native · expo-image-picker
Shared	pnpm workspace · Turborepo · Zod
Auth	JWT (`jsonwebtoken`) · bcryptjs
Storage	AWS S3 for avatars via presigned URLs
Testing	Vitest + Supertest (api, web, shared) · Jest + jest-expo (mobile)
Quality	TypeScript strict · ESLint flat config · Prettier
CI	GitHub Actions · one workflow per package, scoped via Turbo
Future	Stellar integration scaffold for data provenance / payment flows

Getting Started

Prerequisites

Node.js ≥ 20 (.github/workflows/* pin Node 20)
pnpm 10 (the repo root package.json declares pnpm@10.6.5)
A POSIX shell (bash/zsh) — workflows target ubuntu-latest

1. Install

pnpm install

Turbo caches the result. To force a clean install: pnpm install --frozen-lockfile=false.

2. Configure environment

Copy the example files for the apps you intend to run:

cp apps/api/.env.example      apps/api/.env
cp apps/web/.env.example      apps/web/.env.local
cp apps/mobile/.env.example   apps/mobile/.env

Fill in your values (see docs/environment.md for the full list).

3. Set up the database

The API uses Prisma. Generate the client and push the schema for a local SQLite database:

pnpm --filter @universal-healthcare/api exec prisma generate
pnpm --filter @universal-healthcare/api exec prisma db push

4. Run the apps

# all three at once
pnpm dev

# individually
pnpm dev:api      # http://localhost:4000
pnpm dev:web      # http://localhost:3000
pnpm dev:mobile   # Expo Dev Tools (press i for iOS simulator, a for Android)

5. Verify

pnpm check        # lint + typecheck + test across the workspace

Application Quickstarts

`apps/api` – Express backend

pnpm dev:api      # tsx watch with .env loaded
pnpm --filter @universal-healthcare/api test     # vitest + supertest (sqlite)
pnpm --filter @universal-healthcare/api build   # prisma generate + tsc

The current surface is:

Method	Path	Auth	Description
GET	`/health`	–	Simple liveness probe (200)
GET	`/livez`	–	Kubernetes-style liveness (process up)
GET	`/readyz`	–	Readiness probe (pings the DB; 503 on failure)
GET	`/metrics`	–	Prometheus text-format metrics
POST	`/api/auth/register`	–	Create account, returns user + JWT
POST	`/api/auth/login`	–	Verify credentials, returns user + JWT
GET	`/api/users/me`	Bearer	Current user + creator / fan profile
PATCH	`/api/users/me`	Bearer	Update own profile (display name, bio, etc.)
POST	`/api/users/me/avatar-upload-url`	Bearer	Issue a presigned S3 `PUT` URL (5 min TTL)
GET	`/api/creators/:slug`	–	Public creator profile lookup
GET	`/api/fans/me`	Bearer	Current fan profile
PUT	`/api/fans/me`	Bearer	Create or replace own fan profile
PATCH	`/api/fans/me`	Bearer	Partial update of own fan profile
PUT	`/api/fans/me/genre-prefs`	Bearer	Replace the genre-preferences array

All /api/* routes are subject to per-IP rate limiting. Configure via RATE_LIMIT_WINDOW_MS and RATE_LIMIT_MAX (no-op in NODE_ENV=test).

`apps/web` – Next.js portal

pnpm dev:web
pnpm --filter @universal-healthcare/web test     # vitest + @testing-library/react
pnpm --filter @universal-healthcare/web build   # next build

Existing routes:

/ – landing + login state
/register – new account
/login – existing account
/profile/edit – update your own profile (creator or fan)
/creators/[slug] – public creator profile page

`apps/mobile` – Expo / React Native client

pnpm dev:mobile
pnpm --filter @universal-healthcare/mobile test   # jest + @testing-library/react-native
pnpm --filter @universal-healthcare/mobile ios   # iOS simulator
pnpm --filter @universal-healthcare/mobile android

Existing screens / components:

src/screens/CreatorProfileScreen.tsx – fetch + render a creator by slug
src/components/ProfileImagePicker.tsx – tap-to-pick avatar with permission handling
src/hooks/useImagePicker.ts – reusable image picker hook (permission, editing, quality)

The mobile app currently renders a single Expo placeholder from App.tsx while the rest of the surface is brought online. Hooks, services, and screen components are scaffolded so feature work drops in cleanly.

Shared Packages

`packages/shared`

The contract layer. Source is consumed directly by both apps/api and apps/web (no build step). Exports:

Types – AuthUser, AuthResponse, MeResponse, CreatorProfileResponse, FanProfileResponse
Validation – loginSchema, registerSchema, updateMeSchema
Utilities – profileCompleteness helper

Change a schema here and every consumer breaks loudly — exactly what you want for shared contracts.

`packages/stellar`

A compile-only scaffold for a future Stellar-based payment or data-provenance layer. It exports placeholder types (StellarAccountReference, StellarNetworkConfig) and a StellarPaymentClient interface — no blockchain, no network calls. When the integration becomes real, this is the one entry point to update.

Environment Variables

Every app keeps a committed .env.example. See docs/environment.md for the full table. The minimum to run locally:

App	Required	Optional
`api`	`DATABASE_URL`, `JWT_SECRET`	`PORT`, `NODE_ENV`, `JWT_EXPIRES_IN`, AWS creds for S3, `CORS_ORIGINS`, `RATE_LIMIT_*`, `TRUST_PROXY`, `LOG_LEVEL`
`web`	–	`NEXT_PUBLIC_API_URL` (default `http://localhost:4000`)
`mobile`	–	`EXPO_PUBLIC_API_URL` (default `http://localhost:4000`)

apps/api/.env.test is checked in with safe, test-only values.

Testing & CI

The repo uses Turbo's task graph, so tests and lint are scoped to the package you changed and any package that depends on it. Run them manually:

pnpm test         # all packages
pnpm typecheck    # all packages
pnpm lint         # all packages
pnpm check        # lint + typecheck + test, in that order

CI mirrors that. Each package has its own workflow under .github/workflows/:

api.yml – lint · test · build
web.yml – lint · test · build
mobile.yml – lint · test
shared.yml – lint · build
stellar.yml – lint · build
docs.yml – markdownlint + markdown-link-check
deploy-api.yml – docker build + push GHCR + trigger Render deploy

PRs only need to pass the workflows for the packages they touch (plus their downstream consumers via Turbo). See docs/testing.md for runner specifics and coverage notes.

Verify CI locally before pushing

Run the full CI-equivalent suite with one command — mirrors every step the 7 workflows actually execute (install + per-package turbo + docs lints + docker build):

tools/ci-local.sh                # full suite (api, web, shared, stellar,
                                  # mobile, docs, docker build) — ~3 min
tools/ci-local.sh --quick        # api + web + shared only — ~1 min
tools/ci-local.sh --no-docker    # everything except the docker build
tools/ci-local.sh --no-color     # plain output, for log files

The script uses set -o pipefail so docker/pnpm exit codes are captured correctly (this was the bug that hid a broken COPY line in the Dockerfile for a day), colors each step green/red, prints per-step timings, and exits with the number of failed steps.

Deployment

UHDN is platform-agnostic at the API layer and ships with the build pipelines each framework expects.

API – Node service

Build – pnpm --filter @universal-healthcare/api build (runs prisma generate then tsc)
Start – node dist/server.js (after build)
Recommended hosts – Render, Railway, Fly.io, Fly Machines, AWS ECS/Fargate, or any Node 20+ host
Production data – swap SQLite for Postgres by changing the Prisma datasource provider and the DATABASE_URL
Secrets – inject via the host's env manager; never commit .env

Web – Next.js

Build – pnpm --filter @universal-healthcare/web build
Recommended host – Vercel (zero-config for Next.js App Router); Netlify or any Node host also work
Env vars – set NEXT_PUBLIC_API_URL to your deployed API origin

Mobile – Expo

Run locally – pnpm dev:mobile (Expo Dev Tools)
Build for stores – configure EAS Build and run eas build --platform ios|android
Env vars – set EXPO_PUBLIC_API_URL in eas.json per environment

Storage – S3

Avatars are uploaded via presigned URLs returned by POST /api/users/me/avatar-upload-url. The client PUTs the file directly to S3 and persists the returned URL on the profile. For local development, you can stub the S3 URLs in tests or point the bucket at minio + a .env.test override.

Documentation

Doc	What's in it
`docs/architecture.md`	Monorepo layout, modular monolith convention, how to add a module, client / shared integration notes
`docs/contributing.md`	Coding standards, dev workflow, contribution expectations
`docs/testing.md`	How to run tests, what each runner covers, what CI runs
`docs/environment.md`	Every env var, every `.env.example`, secrets handling

Contributing

Contributions are welcome — please read docs/contributing.md before opening a PR. The short version:

pnpm install and copy the .env.example you need.
Make scoped, focused changes — extend existing modules / packages rather than introducing new top-level layers.
Run pnpm check before pushing (lint + typecheck + test).
Open a PR against main. CI will only run workflows for the packages you touched (plus their downstream consumers).

Don't commit .env, secrets, or generated artifacts (dist/, .next/, .expo/, *.db).

Roadmap

UHDN ships production-grade auth (register, login, refresh-token rotation, password reset, email verification, role-based activation) and profile management. The next priorities — each pre-scaffolded and building on the existing primitives:

Real Stellar integration – flesh out packages/stellar with a Horizon client and reconciliation flows for data provenance.
Patient / provider / payer scopes – additional tables and DTOs sharing the existing module pattern.
OAuth / SSO – Google, Apple, Microsoft Entra for clinician identity.
Distributed tracing – OpenTelemetry across API → Prisma → S3, with W3C traceparent propagation.
Audit log – append-only record of every privileged write (login, profile change, role change).
Mobile feature parity – login / profile edit screens in Expo wired to the same API.

Have an idea? See the contributing guide and open an issue or PR.

License

Acknowledgements

UHDN is built on the shoulders of excellent open source:

Express · Next.js · React · Expo · Prisma · Zod · Turborepo · pnpm · Vitest · Jest · jsonwebtoken · AWS SDK for S3

Built with care for everyone building the future of healthcare data.

Name		Name	Last commit message	Last commit date
Latest commit History 147 Commits
.github		.github
apps		apps
docs		docs
packages		packages
tools		tools
.env.example		.env.example
.gitignore		.gitignore
.markdown-link-check.json		.markdown-link-check.json
.markdownlint.jsonc		.markdownlint.jsonc
.npmrc		.npmrc
.prettierrc.json		.prettierrc.json
CHANGELOG.md		CHANGELOG.md
LICENSE		LICENSE
README.md		README.md
docker-compose.yml		docker-compose.yml
eslint.config.mjs		eslint.config.mjs
lefthook.yml		lefthook.yml
package.json		package.json
pnpm-lock.yaml		pnpm-lock.yaml
pnpm-workspace.yaml		pnpm-workspace.yaml
tsconfig.base.json		tsconfig.base.json
tsconfig.json		tsconfig.json
turbo.json		turbo.json

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Universal Healthcare Data Network

Overview

Features

Authentication & Identity

Profile Domain

Cross-Platform Surfaces

Shared Contracts

Developer Experience

Observability & Hardening

Ledger-Ready Scaffold

Architecture

Repository Layout

Tech Stack

Getting Started

Prerequisites

1. Install

2. Configure environment

3. Set up the database

4. Run the apps

5. Verify

Application Quickstarts

apps/api – Express backend

apps/web – Next.js portal

apps/mobile – Expo / React Native client

Shared Packages

packages/shared

packages/stellar

Environment Variables

Testing & CI

Verify CI locally before pushing

Deployment

API – Node service

Web – Next.js

Mobile – Expo

Storage – S3

Documentation

Contributing

Roadmap

License

Acknowledgements

About

Resources

License

Contributing

Security policy

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`apps/api` – Express backend

`apps/web` – Next.js portal

`apps/mobile` – Expo / React Native client

`packages/shared`

`packages/stellar`

Packages