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/Frontend/src/components/layout/sidebar.tsx

@@ -311,7 +311,7 @@ export function Sidebar() {
             icon: <Bot className="h-4 w-4 text-gray-400" />,
           },
           {
-            name: "AI Chat Settings",
+            name: "AI Chat/Call Settings",
             path: "/settings/aichat",
             icon: <Bot className="h-4 w-4 text-gray-400" />,
           },

apps/Frontend/src/components/settings/ai-chat-settings-card.tsx

@@ -7,7 +7,7 @@ import { Textarea } from "@/components/ui/textarea";
 import { Switch } from "@/components/ui/switch";
 import { useToast } from "@/hooks/use-toast";
 import { apiRequest, queryClient } from "@/lib/queryClient";
-import { Bot, CalendarCheck, UserPlus, MessageCircle, Info, GitFork, MessageSquare, Trash2, Plus, Zap, SlidersHorizontal, BookMarked, ChevronDown, ChevronUp } from "lucide-react";
+import { Bot, CalendarCheck, UserPlus, MessageCircle, Info, GitFork, MessageSquare, Trash2, Plus, Zap, SlidersHorizontal, BookMarked, ChevronDown, ChevronUp, PhoneCall } from "lucide-react";
 import { Tabs, TabsList, TabsTrigger, TabsContent } from "@/components/ui/tabs";
 
 // ─── Types ────────────────────────────────────────────────────────────────────
@@ -18,6 +18,7 @@ type AiChatTemplates = {
   reminderGreeting: string;
   newPatientGreeting: string;
   generalFallback: string;
+  callTemplate: string;
 };
 
 type OfficeContact = {
@@ -36,6 +37,8 @@ const DEFAULTS = {
     "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?",
   generalFallback:
     "Hi! My name is Lisa, the dedicated AI assistant at {officeName}. How can I help you today?",
+  callTemplate:
+    "Hi {firstName}, this is Lisa, the AI assistant at {officeName}. How can I help you today?",
 };
 
 const DEFAULT_SMS_TEMPLATES = [
@@ -1009,6 +1012,7 @@ export function AiChatSettingsCard() {
   const [reminderGreeting,   setReminderGreeting]   = useState(DEFAULTS.reminderGreeting);
   const [newPatientGreeting, setNewPatientGreeting] = useState(DEFAULTS.newPatientGreeting);
   const [generalFallback,    setGeneralFallback]    = useState(DEFAULTS.generalFallback);
+  const [callTemplate,       setCallTemplate]       = useState(DEFAULTS.callTemplate);
   const initialized = useRef(false);
 
   const [openPhoneReply, setOpenPhoneReply] = useState(false);
@@ -1087,6 +1091,7 @@ export function AiChatSettingsCard() {
       setReminderGreeting(templates.reminderGreeting     || DEFAULTS.reminderGreeting);
       setNewPatientGreeting(templates.newPatientGreeting || DEFAULTS.newPatientGreeting);
       setGeneralFallback(templates.generalFallback       || DEFAULTS.generalFallback);
+      setCallTemplate(templates.callTemplate             || DEFAULTS.callTemplate);
     }
   }, [templates]);
 
@@ -1144,6 +1149,7 @@ export function AiChatSettingsCard() {
       reminderGreeting:   reminderGreeting.trim()   || DEFAULTS.reminderGreeting,
       newPatientGreeting: newPatientGreeting.trim()  || DEFAULTS.newPatientGreeting,
       generalFallback:    generalFallback.trim()     || DEFAULTS.generalFallback,
+      callTemplate:       callTemplate.trim()        || DEFAULTS.callTemplate,
     });
   };
 
@@ -1191,6 +1197,15 @@ export function AiChatSettingsCard() {
       onChange: setGeneralFallback,
       placeholder: DEFAULTS.generalFallback,
     },
+    {
+      key: "call",
+      icon: <PhoneCall className="h-4 w-4 text-primary" />,
+      label: "Call Template",
+      description: "Lisa's opening line when placing an AI Call to a patient. Separate from the SMS chat templates above — use {firstName} and {officeName} as placeholders.",
+      value: callTemplate,
+      onChange: setCallTemplate,
+      placeholder: DEFAULTS.callTemplate,
+    },
   ];
 
   return (
@@ -1393,6 +1408,7 @@ export function AiChatSettingsCard() {
                     setReminderGreeting(DEFAULTS.reminderGreeting);
                     setNewPatientGreeting(DEFAULTS.newPatientGreeting);
                     setGeneralFallback(DEFAULTS.generalFallback);
+                    setCallTemplate(DEFAULTS.callTemplate);
                   }}
                 >
                   Reset to defaults

apps/Frontend/src/pages/patient-connection-page.tsx

@@ -24,6 +24,7 @@ import {
   Send,
   X,
   MoonStar,
+  Bot,
 } from "lucide-react";
 import { SmsTemplateDialog } from "@/components/patient-connection/sms-template-diaog";
 import { MessageThread } from "@/components/patient-connection/message-thread";
@@ -103,6 +104,32 @@ export default function PatientConnectionPage() {
     },
   });
 
+  const makeAiCallMutation = useMutation({
+    mutationFn: async ({
+      to,
+      patientId,
+    }: {
+      to: string;
+      patientId: number;
+    }) => {
+      return apiRequest("POST", "/api/twilio/make-ai-call", { to, patientId });
+    },
+    onSuccess: () => {
+      toast({
+        title: "AI Call Started",
+        description: "Lisa is calling the patient now.",
+      });
+    },
+    onError: (error: any) => {
+      toast({
+        title: "AI Call Failed",
+        description:
+          error.message || "Unable to place the AI call. Please try again.",
+        variant: "destructive",
+      });
+    },
+  });
+
   // Fetch all patients from database
   const { data: patients = [], isLoading } = useQuery<Patient[]>({
     queryKey: ["/api/patients"],
@@ -139,6 +166,22 @@ export default function PatientConnectionPage() {
     });
   };
 
+  // Handle AI-driven call via Twilio
+  const handleAiCall = (patient: Patient) => {
+    if (!patient.phone?.trim()) {
+      toast({
+        title: "No Phone Number",
+        description: "This patient does not have a phone number on file.",
+        variant: "destructive",
+      });
+      return;
+    }
+    makeAiCallMutation.mutate({
+      to: patient.phone,
+      patientId: Number(patient.id),
+    });
+  };
+
   // Handle sending SMS
   const handleSMS = (patient: Patient) => {
     setSelectedPatient(patient);
@@ -343,6 +386,15 @@ export default function PatientConnectionPage() {
                           <Phone className="h-4 w-4 mr-1" />
                           Call
                         </Button>
+                        <Button
+                          variant="outline"
+                          size="sm"
+                          onClick={() => handleAiCall(patient)}
+                          data-testid={`button-ai-call-${patient.id}`}
+                        >
+                          <Bot className="h-4 w-4 mr-1" />
+                          AI Call
+                        </Button>
                         <Button
                           variant="outline"
                           size="sm"