Spec:Documentation Index
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specs/ce/specs/CE-29-lead-to-patient-conversion-pipeline.mdStatus: ✅ Evidence Documented
Last Updated: 2026-03-28
1. HIPAA (45 CFR 164.502, 164.312(b))
Controls
| Control | Implementation | Evidence |
|---|---|---|
| PHI in transit | TLS enforced by Supabase platform (default) | Platform infrastructure |
| PHI in event payloads | IDs only — no names, DOB, SSN, or clinical data in publishEvent payloads | src/cores/ce/hooks/useLeadMutations.ts — payload contains lead_id, contact_id, organization_id, correlation_id, converted_by only |
| PHI in logs | No PHI in logger.info/error calls; structured IDs only | supabase/functions/event-consumer/index.ts — logs use correlationId, patientId (UUID), never names |
| PHI in toasts | Static toast messages (“Lead converted successfully”) with no dynamic PHI | src/cores/ce/hooks/useLeadMutations.ts — toast text is static |
| PHI in errors | sanitizeErrorMessage(error) used for all user-facing error display | CE hook error handlers |
| Audit trail | ce_lead_conversions table — INSERT-only, no UPDATE/DELETE policies | Migration + RLS policies |
| Retention | 7-year minimum per HIPAA; enforced by org retention policy alignment (PF-46) | Documented in spec; table has no auto-deletion |
Test Coverage
- RLS tests:
tests/rls/ce-lead-conversions.rls.test.ts— org isolation, immutability - Payload audit: Event payload verified IDs-only in code review
2. 42 CFR Part 2 (SUD Confidentiality)
Controls
| Control | Implementation | Evidence |
|---|---|---|
| SUD data in payloads | Not transmitted — substance_use_history and clinical_flags are NOT included in event payloads | useLeadMutations.ts payload construction — only IDs |
| SUD data in audit | data_mapping JSONB field can store consent references if org configures SUD gating | Schema supports it; no SUD data stored by default |
| Consent verification | Chart-scoped per CL-11 (cl_check_sud_consent(chart_id, ...)) when SUD data is involved | Noted in spec Clarifications; consent gating required when CE-28 wires screening data into conversion flow |
| Re-disclosure prevention | No PHI/SUD data leaves CE core in events; PM subscriber fetches data server-side with service role | event-consumer/index.ts — server-side fetch |
Notes
- CE-29 events carry zero clinical content — they are ID-based pointers only
- The PM subscriber (
handleLeadConvertedToPatient) reads contact data server-side, never exposing it in event payloads - Full Part 2 consent enforcement is deferred to CL-11 integration per spec Clarifications
3. AHCCCS 320-O (Screening Documentation)
Controls
| Control | Implementation | Evidence |
|---|---|---|
| Screening date in audit | custom_fields JSONB on ce_lead_conversions supports screening_date storage | Schema design |
| Screener identification | converted_by UUID identifies the user who triggered conversion | Column in ce_lead_conversions |
| Documentation trail | Immutable audit record links lead → conversion → patient/resident | ce_lead_conversions INSERT-only with correlation_id |
| CE-28 alignment | CE-28 screening disposition triggers CE-29 conversion; screening data flows via data_mapping | Spec integration pattern |
Notes
- AHCCCS 320-O requires 18 assessment elements documented in the clinical record
- CE-29 captures the conversion decision point; full clinical documentation is CL-02/CL-04 responsibility
- The
data_mappingJSONB field provides extensibility for org-specific screening fields
4. Cross-Reference
| Regulation | Spec Section | Task | Status |
|---|---|---|---|
| HIPAA 164.502 | §5 Regulatory | T-COMP-1 | ✅ Complete |
| HIPAA 164.312(b) | §5 Regulatory | T-COMP-1 | ✅ Complete |
| 42 CFR Part 2 | §5 Regulatory | T-COMP-2 | ✅ Complete |
| AHCCCS 320-O | §5 Regulatory | T-COMP-3 | ✅ Complete |
5. References
- Spec:
specs/ce/specs/CE-29-lead-to-patient-conversion-pipeline.md - Tasks:
specs/ce/tasks/CE-29-TASKS.md - Compliance Tracker:
docs/compliance/CE_COMMUNICATIONS_COMPLIANCE_TRACKING.md - Regulatory Tracker:
docs/compliance/REGULATORY_COMPLIANCE_TRACKER.md - RLS Tests:
tests/rls/ce-lead-conversions.rls.test.ts