feat: persist AI conversation state in DB and fix LangGraph flow bugs

- Replace in-memory Maps in aiHandoffStore with DB-backed async functions using new patient_conversation table (stage + aiHandoff per patient) - Add afterHoursEnabled to ai_settings table (persists across restarts) - Fix runtime crash in reschedule-graph: mon/tue/wed variables were out of scope in the next-week fallback branch (ReferenceError) - Wire rescheduleGreeting and generalFallback chat templates through to LangGraph nodes so user-configured messages take effect - Add otherNode to reminder-graph to handle unclassified patient replies (e.g. "I want another appointment") and route to booking flow - Fetch chatTemplates once per webhook request instead of per stage Co-Authored-By: Claude Sonnet 4.6 <noreply@anthropic.com>
2026-05-09 15:23:55 -04:00
parent e9296c68f9
commit 112529155c
321 changed files with 5096 additions and 446 deletions
--- a/apps/Backend/src/ai/aiHandoffStore.ts
+++ b/apps/Backend/src/ai/aiHandoffStore.ts
@@ -1,93 +1,90 @@
-// In-memory store for per-patient AI handoff toggle, conversation stage,
-// and per-user after-hours handoff toggle.
-// Conversation key: `${userId}:${patientId}`
+import { prisma as db } from "@repo/db/client";

 export type ConversationStage =
-  | "initial"                       // default — no active conversation
-  | "reminder_initial"              // office sent a reminder, waiting for first patient reply
-  | "greeted"                       // reminder intro sent, waiting for yes/no
-  | "done"                          // conversation complete
-  | "new_patient_greeted"           // new-patient greeting sent, waiting for patient intent
-  | "asked_new_or_existing"         // AI asked "new or existing patient?"
-  | "asked_new_patient_insurance"   // AI asked new patient about insurance
-  | "asked_existing_insurance"      // AI asked existing patient about same insurance
-  | "asked_appointment_time"        // AI asked when they'd like to come
-  | "awaiting_masshealth_info"      // AI asked for Member ID + DOB, waiting for reply
-  | "asked_appointment_preference"  // Selenium: ACTIVE — AI asked check-up vs problem
-  | "asked_self_pay"                // Selenium: INACTIVE — AI asked if self-pay exam
-  | "asked_reschedule_confirm"      // AI asked "Would you like to reschedule?"
-  | "asked_reschedule_preference"   // AI asked ASAP vs next week
-  | "asked_reschedule_asap"         // AI asked "Can you come tomorrow?"
-  | "asked_reschedule_next_week"    // AI offered Mon/Tue/Wed next week
-  | "asked_reschedule_time";        // Day confirmed — AI asked morning or afternoon
+  | "initial"
+  | "reminder_initial"
+  | "greeted"
+  | "done"
+  | "new_patient_greeted"
+  | "asked_new_or_existing"
+  | "asked_new_patient_insurance"
+  | "asked_existing_insurance"
+  | "asked_appointment_time"
+  | "awaiting_masshealth_info"
+  | "asked_appointment_preference"
+  | "asked_self_pay"
+  | "asked_reschedule_confirm"
+  | "asked_reschedule_preference"
+  | "asked_reschedule_asap"
+  | "asked_reschedule_next_week"
+  | "asked_reschedule_time";

-const handoffStore     = new Map<string, boolean>();
-const stageStore       = new Map<string, ConversationStage>();
-const afterHoursStore  = new Map<number, boolean>(); // keyed by userId
+// ── Conversation stage + AI handoff per patient (DB-persisted) ────────────────
+
+export async function getStage(userId: number, patientId: number): Promise<ConversationStage> {
+  const row = await db.patientConversation.findUnique({ where: { patientId } });
+  return (row?.stage as ConversationStage) ?? "initial";
+}
+
+export async function setStage(userId: number, patientId: number, stage: ConversationStage): Promise<void> {
+  await db.patientConversation.upsert({
+    where:  { patientId },
+    update: { stage },
+    create: { patientId, userId, stage, aiHandoff: true },
+  });
+}
+
+export async function getHandoff(userId: number, patientId: number): Promise<boolean> {
+  const row = await db.patientConversation.findUnique({ where: { patientId } });
+  return row?.aiHandoff ?? true;
+}
+
+export async function setHandoff(userId: number, patientId: number, enabled: boolean): Promise<void> {
+  await db.patientConversation.upsert({
+    where:  { patientId },
+    update: { aiHandoff: enabled },
+    create: { patientId, userId, aiHandoff: enabled, stage: "initial" },
+  });
+}
+
+// ── After-hours handoff per user (persisted in ai_settings) ──────────────────
+
+export async function getAfterHoursHandoff(userId: number): Promise<boolean> {
+  const row = await db.aiSettings.findUnique({ where: { userId } });
+  return row?.afterHoursEnabled ?? true;
+}
+
+export async function setAfterHoursHandoff(userId: number, enabled: boolean): Promise<void> {
+  await db.aiSettings.update({ where: { userId }, data: { afterHoursEnabled: enabled } });
+}
+
+// ── Conversation starters ─────────────────────────────────────────────────────
+
+export async function resetConversation(userId: number, patientId: number): Promise<void> {
+  await setStage(userId, patientId, "reminder_initial");
+}
+
+export async function startNewPatientConversation(userId: number, patientId: number): Promise<void> {
+  await setStage(userId, patientId, "new_patient_greeted");
+}
+
+export async function startRescheduleConversation(userId: number, patientId: number): Promise<void> {
+  await setStage(userId, patientId, "asked_reschedule_confirm");
+}
+
+// ── Pending reschedule (in-memory — seconds-lived within a single exchange) ───
+
+interface PendingReschedule {
+  newDate:  Date;
+  dayLabel: string;
+}
+
+const pendingRescheduleStore = new Map<string, PendingReschedule>();

 function convKey(userId: number, patientId: number): string {
  return `${userId}:${patientId}`;
 }

-// ── Per-patient handoff toggle (default ON) ───────────────────────────────────
-
-export function getHandoff(userId: number, patientId: number): boolean {
-  const k = convKey(userId, patientId);
-  return handoffStore.has(k) ? handoffStore.get(k)! : true;
-}
-
-export function setHandoff(userId: number, patientId: number, enabled: boolean): void {
-  handoffStore.set(convKey(userId, patientId), enabled);
-}
-
-// ── Per-user after-hours handoff toggle (default ON) ─────────────────────────
-
-export function getAfterHoursHandoff(userId: number): boolean {
-  return afterHoursStore.has(userId) ? afterHoursStore.get(userId)! : true;
-}
-
-export function setAfterHoursHandoff(userId: number, enabled: boolean): void {
-  afterHoursStore.set(userId, enabled);
-}
-
-// ── Conversation stage ────────────────────────────────────────────────────────
-
-export function getStage(userId: number, patientId: number): ConversationStage {
-  return stageStore.get(convKey(userId, patientId)) ?? "initial";
-}
-
-export function setStage(userId: number, patientId: number, stage: ConversationStage): void {
-  stageStore.set(convKey(userId, patientId), stage);
-}
-
-// Called when office sends an outbound reminder — marks next patient reply
-// as the start of a reminder conversation.
-export function resetConversation(userId: number, patientId: number): void {
-  stageStore.set(convKey(userId, patientId), "reminder_initial");
-}
-
-// Called when office sends the new-patient greeting — marks next patient reply
-// as the start of the new-patient conversation flow.
-export function startNewPatientConversation(userId: number, patientId: number): void {
-  stageStore.set(convKey(userId, patientId), "new_patient_greeted");
-}
-
-// Called when office sends a reschedule greeting — patient's next reply enters
-// the reschedule flow.
-export function startRescheduleConversation(userId: number, patientId: number): void {
-  stageStore.set(convKey(userId, patientId), "asked_reschedule_confirm");
-}
-
-// ── Pending reschedule data ───────────────────────────────────────────────────
-// Holds the confirmed new date while AI waits for a time-slot answer.
-
-interface PendingReschedule {
-  newDate:  Date;   // JS Date for the new appointment day (midnight UTC)
-  dayLabel: string; // human-readable, e.g. "Tuesday, May 19"
-}
-
-const pendingRescheduleStore = new Map<string, PendingReschedule>();
-
 export function setPendingReschedule(userId: number, patientId: number, data: PendingReschedule): void {
  pendingRescheduleStore.set(convKey(userId, patientId), data);
 }
--- a/apps/Backend/src/ai/new-patient-graph.ts
+++ b/apps/Backend/src/ai/new-patient-graph.ts
@@ -5,12 +5,13 @@ import type { ConversationStage } from "./aiHandoffStore";
 // ── Graph state ───────────────────────────────────────────────────────────────

 const GraphState = Annotation.Root({
-  message:   Annotation<string>(),
-  stage:     Annotation<string>(),
-  intent:    Annotation<string>(),
-  reply:     Annotation<string>(),
-  language:  Annotation<string>(),
-  nextStage: Annotation<string>(),
+  message:         Annotation<string>(),
+  stage:           Annotation<string>(),
+  intent:          Annotation<string>(),
+  reply:           Annotation<string>(),
+  language:        Annotation<string>(),
+  nextStage:       Annotation<string>(),
+  generalFallback: Annotation<string>(),
 });

 type GraphStateType = typeof GraphState.State;
@@ -377,7 +378,7 @@ async function handleSelfPayNode(state: GraphStateType, config: any) {

 function transferNode(state: GraphStateType) {
  const lang = state.language || "English";
-  return { reply: transferMsg(lang), nextStage: "done" };
+  return { reply: state.generalFallback || transferMsg(lang), nextStage: "done" };
 }

 // ── Graph assembly ────────────────────────────────────────────────────────────
@@ -419,13 +420,14 @@ const graph = new StateGraph(GraphState)
 // ── Public API ────────────────────────────────────────────────────────────────

 export async function runNewPatientStep(
-  message:  string,
-  stage:    ConversationStage,
-  language: string,
-  apiKey:   string
+  message:         string,
+  stage:           ConversationStage,
+  language:        string,
+  apiKey:          string,
+  generalFallback  = ""
 ): Promise<{ reply: string; nextStage: ConversationStage }> {
  const result = await graph.invoke(
-    { message, stage, intent: "", reply: "", language, nextStage: "" },
+    { message, stage, intent: "", reply: "", language, nextStage: "", generalFallback },
    { configurable: { apiKey } }
  );
  return {
--- a/apps/Backend/src/ai/reminder-graph.ts
+++ b/apps/Backend/src/ai/reminder-graph.ts
@@ -7,6 +7,8 @@ const GraphState = Annotation.Root({
  reply:               Annotation<string>(),
  language:            Annotation<string>(),
  appointmentDatetime: Annotation<string>(),
+  rescheduleGreeting:  Annotation<string>(),
+  generalFallback:     Annotation<string>(),
 });

 type GraphStateType = typeof GraphState.State;
@@ -27,7 +29,7 @@ function classifyNode(state: GraphStateType) {
 function routeByIntent(state: GraphStateType): string {
  if (state.intent === "yes") return "confirm";
  if (state.intent === "no")  return "reschedule";
-  return END;
+  return "other";
 }

 // ── Confirmation fallbacks (with appointment datetime) ────────────────────────
@@ -58,6 +60,30 @@ const RESCHEDULE_FALLBACKS: Record<string, string> = {
  "Haitian Creole": "Nou konprann! Èske ou ta renmen repwograme randevou ou?",
 };

+// ── New-appointment fallbacks (other intent, appointment keywords detected) ───
+
+const NEW_APPT_FALLBACKS: Record<string, string> = {
+  English:          "Of course! Are you a new patient or an existing patient?",
+  Spanish:          "¡Por supuesto! ¿Es usted un paciente nuevo o ya ha visitado nuestra clínica?",
+  Portuguese:       "Claro! Você é um paciente novo ou já veio ao nosso consultório antes?",
+  Mandarin:         "当然！您是新患者还是我们的现有患者？",
+  Cantonese:        "當然！您係新病人定係我們的舊病人？",
+  Arabic:           "بالطبع! هل أنت مريض جديد أم مريض حالي؟",
+  "Haitian Creole": "Byensèten! Èske ou se yon nouvo pasyan oswa yon pasyan egzistan?",
+};
+
+// ── General-other fallbacks ───────────────────────────────────────────────────
+
+const GENERAL_FALLBACKS: Record<string, string> = {
+  English:          "Thank you for your message! Our office staff will be happy to assist you shortly.",
+  Spanish:          "¡Gracias por su mensaje! El personal de nuestra oficina estará encantado de ayudarle en breve.",
+  Portuguese:       "Obrigado pela sua mensagem! Nossa equipe terá prazer em ajudá-lo em breve.",
+  Mandarin:         "感谢您的留言！我们的办公室工作人员将很快为您提供帮助。",
+  Cantonese:        "感謝您的留言！我們的辦公室工作人員將很快為您提供幫助。",
+  Arabic:           "شكراً على رسالتك! سيسعد فريق مكتبنا بمساعدتك قريباً.",
+  "Haitian Creole": "Mèsi pou mesaj ou! Ekip biwo nou an pral kontan ede ou byento.",
+};
+
 // ── LangGraph nodes ───────────────────────────────────────────────────────────

 async function confirmNode(state: GraphStateType, config: any) {
@@ -88,7 +114,7 @@ async function confirmNode(state: GraphStateType, config: any) {
 async function rescheduleNode(state: GraphStateType, config: any) {
  const apiKey: string | undefined = config?.configurable?.apiKey;
  const lang    = state.language || "English";
-  const fallback = RESCHEDULE_FALLBACKS[lang] ?? RESCHEDULE_FALLBACKS["English"]!;
+  const fallback = state.rescheduleGreeting || (RESCHEDULE_FALLBACKS[lang] ?? RESCHEDULE_FALLBACKS["English"]!);

  if (!apiKey) return { reply: fallback };

@@ -108,30 +134,76 @@ async function rescheduleNode(state: GraphStateType, config: any) {
  }
 }

+async function otherNode(state: GraphStateType, config: any) {
+  const apiKey: string | undefined = config?.configurable?.apiKey;
+  const lang = state.language || "English";
+  const text = state.message.toLowerCase();
+
+  const isAppointmentRequest = /appointment|schedule|book|come in|visit|check.?up|cleaning|tooth|teeth|pain|dental|another|new appt/i.test(text);
+
+  if (isAppointmentRequest) {
+    const fallback = NEW_APPT_FALLBACKS[lang] ?? NEW_APPT_FALLBACKS["English"]!;
+    if (!apiKey) return { reply: fallback, intent: "wants_appointment" };
+    try {
+      const llm = new ChatGoogleGenerativeAI({ model: "gemini-1.5-flash", apiKey });
+      const response = await llm.invoke([
+        {
+          role: "system",
+          content: `You are a friendly dental office AI assistant named Lisa. The patient wants to schedule an appointment. Ask them in ${lang} whether they are a new patient or an existing patient. One sentence, no formatting.`,
+        },
+        { role: "user", content: `Patient said: "${state.message}"` },
+      ]);
+      return { reply: String(response.content) || fallback, intent: "wants_appointment" };
+    } catch {
+      return { reply: fallback, intent: "wants_appointment" };
+    }
+  }
+
+  const fallback = state.generalFallback || (GENERAL_FALLBACKS[lang] ?? GENERAL_FALLBACKS["English"]!);
+  if (!apiKey) return { reply: fallback };
+  try {
+    const llm = new ChatGoogleGenerativeAI({ model: "gemini-1.5-flash", apiKey });
+    const response = await llm.invoke([
+      {
+        role: "system",
+        content: `You are a friendly dental office AI assistant named Lisa. Respond helpfully to the patient's message in ${lang}. Keep it to 1-2 sentences, no formatting. For non-dental questions, let them know our office staff can assist.`,
+      },
+      { role: "user", content: `Patient said: "${state.message}"` },
+    ]);
+    return { reply: String(response.content) || fallback };
+  } catch {
+    return { reply: fallback };
+  }
+}
+
 // ── Graph ─────────────────────────────────────────────────────────────────────

 const graph = new StateGraph(GraphState)
  .addNode("classify",   classifyNode)
  .addNode("confirm",    confirmNode)
  .addNode("reschedule", rescheduleNode)
+  .addNode("other",      otherNode)
  .addEdge(START, "classify")
  .addConditionalEdges("classify", routeByIntent, {
    confirm:    "confirm",
    reschedule: "reschedule",
-    [END]:      END,
+    other:      "other",
  })
  .addEdge("confirm",    END)
  .addEdge("reschedule", END)
+  .addEdge("other",      END)
  .compile();

 export async function runReminderGraph(
  patientMessage:      string,
  apiKey:              string,
  language            = "English",
-  appointmentDatetime = ""
+  appointmentDatetime = "",
+  rescheduleGreeting  = "",
+  generalFallback     = ""
 ): Promise<{ reply: string | null; intent: string | null }> {
  const result = await graph.invoke(
-    { message: patientMessage, intent: "", reply: "", language, appointmentDatetime },
+    { message: patientMessage, intent: "", reply: "", language, appointmentDatetime, rescheduleGreeting, generalFallback },
    { configurable: { apiKey } }
  );
  return {
--- a/apps/Backend/src/ai/reschedule-graph.ts
+++ b/apps/Backend/src/ai/reschedule-graph.ts
@@ -387,6 +387,7 @@ export async function runRescheduleStep(
    }

    // Day not clearly detected — ask again with the specific options
+    const { mon, tue, wed } = getNextWeekDays();
    const fallbacks: Record<string, string> = {
      English:          `Which day works best — ${mon}, ${tue}, or ${wed}?`,
      Spanish:          `¿Qué día le viene mejor — el ${mon}, ${tue} o el ${wed}?`,
--- a/apps/Backend/src/routes/twilio-webhooks.ts
+++ b/apps/Backend/src/routes/twilio-webhooks.ts
@@ -208,7 +208,7 @@ async function runMassHealthCheckAndNotify(

    // Persist and advance stage
    await saveOutbound(patient.id, resultText);
-    setStage(patient.userId, patient.id, nextStage);
+    await setStage(patient.userId, patient.id, nextStage);

  } catch {
    // Silent — don't crash the main request
@@ -241,7 +241,7 @@ router.post("/webhook/sms", async (req: Request, res: Response): Promise<any> =>
    });

    // Per-patient handoff toggle must be ON
-    if (!getHandoff(patient.userId, patient.id)) {
+    if (!await getHandoff(patient.userId, patient.id)) {
      res.set("Content-Type", "text/xml");
      return res.send(empty());
    }
@@ -252,23 +252,22 @@ router.post("/webhook/sms", async (req: Request, res: Response): Promise<any> =>
      return res.send(empty());
    }

-    const language = patient.preferredLanguage || "English";
-    const stage    = getStage(patient.userId, patient.id);
+    const language     = patient.preferredLanguage || "English";
+    const stage        = await getStage(patient.userId, patient.id);
+    const chatTemplates = await storage.getAiChatTemplates(patient.userId);
+    const officeContact = await storage.getOfficeContact(patient.userId);
+    const officeName    = (officeContact as any)?.officeName?.trim() || "";

    // ── Helper: send reply + set stage ─────────────────────────────────────
    const reply = async (text: string, nextStage: ConversationStage) => {
      await saveOutbound(patient.id, text);
-      setStage(patient.userId, patient.id, nextStage);
+      await setStage(patient.userId, patient.id, nextStage);
      res.set("Content-Type", "text/xml");
      return res.send(twimlReply(text));
    };

    // ── Stage: reminder_initial → send reminder greeting ─────────────────
    if (stage === "reminder_initial") {
-      const chatTemplates = await storage.getAiChatTemplates(patient.userId);
-      const officeContact = await storage.getOfficeContact(patient.userId);
-      const officeName    = (officeContact as any)?.officeName?.trim() || "";
-
      const rawGreeting = chatTemplates.reminderGreeting ||
        `Hi! My name is Lisa, the dedicated AI assistant at {officeName}. I can confirm or reschedule your appointment and answer general questions 24/7. I will reply your message at any time you need.`;

@@ -278,10 +277,15 @@ router.post("/webhook/sms", async (req: Request, res: Response): Promise<any> =>
    // ── Stage: greeted → classify yes/no for appointment reminder ────────
    if (stage === "greeted") {
      const apptDatetime = await getAppointmentDatetime(patient.id);
-      const { reply: aiReply, intent } = await runReminderGraph(Body, aiSettings.apiKey, language, apptDatetime);
+      const { reply: aiReply, intent } = await runReminderGraph(
+        Body, aiSettings.apiKey, language, apptDatetime,
+        chatTemplates.rescheduleGreeting, chatTemplates.generalFallback
+      );
      if (aiReply) {
-        // YES → done; NO → start rescheduling flow
-        const nextStage: ConversationStage = intent === "no" ? "asked_reschedule_confirm" : "done";
+        let nextStage: ConversationStage;
+        if (intent === "no")               nextStage = "asked_reschedule_confirm";
+        else if (intent === "wants_appointment") nextStage = "asked_new_or_existing";
+        else                               nextStage = "done";
        return reply(aiReply, nextStage);
      }
    }
@@ -332,7 +336,7 @@ router.post("/webhook/sms", async (req: Request, res: Response): Promise<any> =>

      // Reply now — Selenium runs in the background
      await saveOutbound(patient.id, checkingMsg);
-      setStage(patient.userId, patient.id, "done");
+      await setStage(patient.userId, patient.id, "done");
      res.set("Content-Type", "text/xml");
      res.send(twimlReply(checkingMsg));

@@ -380,7 +384,7 @@ router.post("/webhook/sms", async (req: Request, res: Response): Promise<any> =>
          const checkingMsg = checkingMessages[language] ?? checkingMessages["English"]!;

          await saveOutbound(patient.id, checkingMsg);
-          setStage(patient.userId, patient.id, "done");
+          await setStage(patient.userId, patient.id, "done");
          res.set("Content-Type", "text/xml");
          res.send(twimlReply(checkingMsg));

@@ -403,7 +407,7 @@ router.post("/webhook/sms", async (req: Request, res: Response): Promise<any> =>
    ];
    if (newPatientStages.includes(stage)) {
      const { reply: aiReply, nextStage } = await runNewPatientStep(
-        Body, stage, language, aiSettings.apiKey
+        Body, stage, language, aiSettings.apiKey, chatTemplates.generalFallback
      );
      return reply(aiReply, nextStage);
    }
@@ -411,14 +415,10 @@ router.post("/webhook/sms", async (req: Request, res: Response): Promise<any> =>
    // ── Stage: initial (no active conversation) ───────────────────────────
    // Check after-hours: if enabled and currently outside office hours → start new-patient flow
    if (stage === "initial" || stage === "done") {
-      const afterHoursEnabled = getAfterHoursHandoff(patient.userId);
+      const afterHoursEnabled = await getAfterHoursHandoff(patient.userId);
      const outsideHours      = await isAfterHours(patient.userId);

      if (afterHoursEnabled && outsideHours) {
-        const chatTemplates = await storage.getAiChatTemplates(patient.userId);
-        const officeContact = await storage.getOfficeContact(patient.userId);
-        const officeName    = (officeContact as any)?.officeName?.trim() || "";
-
        const rawGreeting = chatTemplates.newPatientGreeting ||
          `Hi! My name is Lisa, the dedicated AI assistant at {officeName}. I can help you schedule an appointment, check your insurance, and answer general questions 24/7. How can I help you today?`;

--- a/apps/Backend/src/routes/twilio.ts
+++ b/apps/Backend/src/routes/twilio.ts
@@ -94,11 +94,11 @@ router.post("/send-sms", async (req: Request, res: Response): Promise<any> => {
      });
      // Set conversation stage based on which flow was started
      if (startFlow === "new_patient") {
-        startNewPatientConversation(userId, pid);
+        await startNewPatientConversation(userId, pid);
      } else if (startFlow === "reschedule") {
-        startRescheduleConversation(userId, pid);
+        await startRescheduleConversation(userId, pid);
      } else {
-        resetConversation(userId, pid);
+        await resetConversation(userId, pid);
      }
    }

@@ -140,7 +140,7 @@ router.get("/after-hours-handoff", async (req: Request, res: Response): Promise<
  try {
    const userId = req.user?.id;
    if (!userId) return res.status(401).json({ message: "Unauthorized" });
-    return res.status(200).json({ enabled: getAfterHoursHandoff(userId) });
+    return res.status(200).json({ enabled: await getAfterHoursHandoff(userId) });
  } catch (err) {
    return res.status(500).json({ error: "Failed to get after-hours handoff state" });
  }
@@ -153,7 +153,7 @@ router.put("/after-hours-handoff", async (req: Request, res: Response): Promise<
    if (!userId) return res.status(401).json({ message: "Unauthorized" });
    const { enabled } = req.body;
    if (typeof enabled !== "boolean") return res.status(400).json({ message: "enabled must be a boolean" });
-    setAfterHoursHandoff(userId, enabled);
+    await setAfterHoursHandoff(userId, enabled);
    return res.status(200).json({ enabled });
  } catch (err) {
    return res.status(500).json({ error: "Failed to set after-hours handoff state" });
@@ -167,7 +167,7 @@ router.get("/ai-handoff/:patientId", async (req: Request, res: Response): Promis
    if (!userId) return res.status(401).json({ message: "Unauthorized" });
    const patientId = parseInt(req.params.patientId);
    if (isNaN(patientId)) return res.status(400).json({ message: "Invalid patientId" });
-    return res.status(200).json({ enabled: getHandoff(userId, patientId) });
+    return res.status(200).json({ enabled: await getHandoff(userId, patientId) });
  } catch (err) {
    return res.status(500).json({ error: "Failed to get AI handoff state" });
  }
@@ -182,7 +182,7 @@ router.put("/ai-handoff/:patientId", async (req: Request, res: Response): Promis
    if (isNaN(patientId)) return res.status(400).json({ message: "Invalid patientId" });
    const { enabled } = req.body;
    if (typeof enabled !== "boolean") return res.status(400).json({ message: "enabled must be a boolean" });
-    setHandoff(userId, patientId, enabled);
+    await setHandoff(userId, patientId, enabled);
    return res.status(200).json({ enabled });
  } catch (err) {
    return res.status(500).json({ error: "Failed to set AI handoff state" });