feat: add AI-driven phone calls to patient connection

Adds an "AI Call" option alongside Call/SMS/Chat that places an outbound
call where Lisa converses live with the patient via Twilio speech
gather + TTS, using the same conversational AI as chat. Includes a
separate, user-editable Call Template (Settings > AI Chat/Call Settings)
so the call greeting can be customized independently of SMS templates.

Also fixes the outbound-call webhook URL to always use the fixed public
Twilio hostname (CLOUDFLARE_HOST) instead of deriving it from the
triggering request, since staff-browser requests arrive over the
LAN-only hostname, which Twilio can never reach.

Co-Authored-By: Claude Sonnet 5 <noreply@anthropic.com>

apps/Backend/src/routes/twilio.ts

@@ -3,6 +3,8 @@ import twilio from "twilio";
 import { storage } from "../storage";
 import { prisma as db } from "@repo/db/client";
 import { getHandoff, setHandoff, resetConversation, startNewPatientConversation, startRescheduleConversation, getAfterHoursHandoff, setAfterHoursHandoff } from "../ai/aiHandoffStore";
+import { resolveAiProvider } from "../ai/llm-factory";
+import { getTwilioPublicBaseUrl } from "../utils/publicUrl";
 
 const router = express.Router();
 
@@ -117,6 +119,52 @@ router.post("/send-sms", async (req: Request, res: Response): Promise<any> => {
   }
 });
 
+// POST /api/twilio/make-ai-call
+// Places an outbound call where Lisa (the AI assistant) conducts the whole
+// conversation live over the phone — see /webhook/ai-voice for the loop.
+router.post("/make-ai-call", async (req: Request, res: Response): Promise<any> => {
+  try {
+    const userId = req.user?.id;
+    if (!userId) return res.status(401).json({ message: "Unauthorized" });
+
+    const { to, patientId } = req.body;
+    if (!to || !patientId) return res.status(400).json({ message: "to and patientId are required" });
+
+    const settings = await storage.getTwilioSettings(userId);
+    if (!settings) {
+      return res.status(400).json({ message: "Twilio is not configured. Please add your Twilio credentials in Settings." });
+    }
+
+    const aiSettings = await storage.getAiSettings(userId);
+    if (!resolveAiProvider(aiSettings ?? {})) {
+      return res.status(400).json({ message: "AI is not configured. Please add an AI provider key in Settings before placing an AI call." });
+    }
+
+    const patient = await db.patient.findFirst({ where: { id: Number(patientId), userId } });
+    if (!patient) return res.status(404).json({ message: "Patient not found" });
+
+    let publicBaseUrl: string;
+    try {
+      publicBaseUrl = getTwilioPublicBaseUrl();
+    } catch (err: any) {
+      return res.status(500).json({ message: err.message });
+    }
+    const webhookUrl = `${publicBaseUrl}/api/twilio/webhook/ai-voice?patientId=${patient.id}`;
+
+    const client = getTwilioClient(settings.accountSid, settings.authToken);
+    const call = await client.calls.create({
+      url: webhookUrl,
+      method: "POST",
+      from: settings.phoneNumber,
+      to,
+    });
+
+    return res.status(200).json({ sid: call.sid, status: call.status });
+  } catch (err: any) {
+    return res.status(500).json({ error: err.message || "Failed to place AI call" });
+  }
+});
+
 // POST /api/twilio/send-reminders-batch
 router.post("/send-reminders-batch", async (req: Request, res: Response): Promise<any> => {
   try {