phenoml 17.5.0 → 17.8.0

package/openapi/openapi.json

@@ -2,7 +2,7 @@
   "openapi": "3.0.3",
   "info": {
     "title": "Phenoml API",
-    "version": "64f369254225bd6c2d4c58d87f59165d7e8e8dc9"
+    "version": "0f5e6fc5cd6ac889d00d6733e3b710e4fb90e90e"
   },
   "x-services": [
     {
@@ -19,6 +19,13 @@
       "iconHint": "lang2fhir",
       "status": "ga"
     },
+    {
+      "id": "fhir_artifacts",
+      "name": "FHIR Artifacts",
+      "description": "Manage custom FHIR artifacts on a dedicated instance \u2014 StructureDefinition profiles and the implementation guides that group them \u2014 used by Lang2FHIR extraction and other FHIR capabilities.",
+      "iconHint": "profiles",
+      "status": "alpha"
+    },
     {
       "id": "summary",
       "name": "Summary",
@@ -67,6 +74,13 @@
       "description": "FHIR server operations including resource CRUD, search, and batch operations.",
       "iconHint": "proxy",
       "status": "ga"
+    },
+    {
+      "id": "voice",
+      "name": "Voice",
+      "description": "Transcribe audio recordings into text with speech-to-text. Pair the transcript with Lang2FHIR to turn spoken clinical notes into structured FHIR resources.",
+      "iconHint": "voice",
+      "status": "alpha"
     }
   ],
   "paths": {
@@ -672,6 +686,9 @@
           "404": {
             "description": "Agent or session not found"
           },
+          "409": {
+            "description": "Chat session already has an active request. Retry after the in-flight turn completes."
+          },
           "500": {
             "description": "Server error"
           },
@@ -746,6 +763,9 @@
           "404": {
             "description": "Agent or session not found"
           },
+          "409": {
+            "description": "Chat session already has an active request. Retry after the in-flight turn completes."
+          },
           "500": {
             "description": "Server error"
           },
@@ -1665,7 +1685,7 @@
         ],
         "operationId": "construe_extract",
         "summary": "Extract medical codes from text",
-        "description": "Converts natural language text into structured medical codes.\n\nUsage of CPT is subject to AMA requirements: see PhenoML Terms of Service.\n",
+        "description": "Converts natural language text into structured medical codes.\n\nPass `system.version` to select a specific code system version, for example\n`umls-2026aa` for UMLS 2026AA-backed systems.\n\nUsage of CPT is subject to AMA requirements: see PhenoML Terms of Service.\n",
         "requestBody": {
           "required": true,
           "content": {
@@ -1685,6 +1705,20 @@
                     }
                   }
                 },
+                "icd10cm_umls_2026aa": {
+                  "summary": "ICD-10-CM UMLS 2026AA",
+                  "description": "Select a specific code system version by passing its version ID.",
+                  "value": {
+                    "text": "Patient has type 2 diabetes mellitus with diabetic chronic kidney disease.",
+                    "system": {
+                      "name": "ICD-10-CM",
+                      "version": "umls-2026aa"
+                    },
+                    "config": {
+                      "validation_method": "simple"
+                    }
+                  }
+                },
                 "with_source_citations": {
                   "summary": "With Source Citations",
                   "description": "Enable include_citations and include_rationale to see exactly where each code was found. Notice the highlighted spans in the input text.",
@@ -2018,27 +2052,27 @@
                 "example": {
                   "systems": [
                     {
-                      "name": "ICD-10-CM",
-                      "version": "2025",
-                      "code_count": 97584,
+                      "name": "CPT",
+                      "version": "umls-2026aa",
+                      "code_count": 10298,
                       "builtin": true
                     },
                     {
-                      "name": "SNOMED_CT_US_LITE",
-                      "version": "20240901",
-                      "code_count": 102837,
+                      "name": "CPT",
+                      "version": "2025",
+                      "code_count": 10192,
                       "builtin": true
                     },
                     {
-                      "name": "RXNORM",
-                      "version": "11042024",
-                      "code_count": 257619,
+                      "name": "HCPCS",
+                      "version": "umls-2026aa",
+                      "code_count": 7322,
                       "builtin": true
                     },
                     {
-                      "name": "LOINC",
-                      "version": "2.78",
-                      "code_count": 98123,
+                      "name": "HPO",
+                      "version": "umls-2026aa",
+                      "code_count": 19698,
                       "builtin": true
                     },
                     {
@@ -2048,9 +2082,27 @@
                       "builtin": true
                     },
                     {
-                      "name": "CPT",
+                      "name": "ICD-10",
+                      "version": "umls-2026aa",
+                      "code_count": 12292,
+                      "builtin": true
+                    },
+                    {
+                      "name": "ICD-10-CM",
+                      "version": "umls-2026aa",
+                      "code_count": 98506,
+                      "builtin": true
+                    },
+                    {
+                      "name": "ICD-10-CM",
                       "version": "2025",
-                      "code_count": 10192,
+                      "code_count": 97584,
+                      "builtin": true
+                    },
+                    {
+                      "name": "ICD-10-PCS",
+                      "version": "umls-2026aa",
+                      "code_count": 79232,
                       "builtin": true
                     },
                     {
@@ -2058,6 +2110,48 @@
                       "version": "2025",
                       "code_count": 78717,
                       "builtin": true
+                    },
+                    {
+                      "name": "LOINC",
+                      "version": "umls-2026aa",
+                      "code_count": 99231,
+                      "builtin": true
+                    },
+                    {
+                      "name": "LOINC",
+                      "version": "2.78",
+                      "code_count": 98123,
+                      "builtin": true
+                    },
+                    {
+                      "name": "RXNORM",
+                      "version": "umls-2026aa",
+                      "code_count": 259884,
+                      "builtin": true
+                    },
+                    {
+                      "name": "RXNORM",
+                      "version": "11042024",
+                      "code_count": 257619,
+                      "builtin": true
+                    },
+                    {
+                      "name": "SNOMED_CT_US",
+                      "version": "umls-2026aa",
+                      "code_count": 386110,
+                      "builtin": true
+                    },
+                    {
+                      "name": "SNOMED_CT_US",
+                      "version": "20240901",
+                      "code_count": 371482,
+                      "builtin": true
+                    },
+                    {
+                      "name": "SNOMED_CT_US_LITE",
+                      "version": "20240901",
+                      "code_count": 102837,
+                      "builtin": true
                     }
                   ]
                 }
@@ -2105,7 +2199,7 @@
             "schema": {
               "type": "string"
             },
-            "description": "Specific version of the code system. Required if multiple versions exist.",
+            "description": "Specific version of the code system, such as `umls-2026aa`.",
             "example": "2025"
           }
         ],
@@ -2130,7 +2224,7 @@
             }
           },
           "400": {
-            "description": "Invalid parameters or multiple versions exist without version specified"
+            "description": "Invalid parameters"
           },
           "401": {
             "description": "Unauthorized"
@@ -2174,7 +2268,7 @@
             "schema": {
               "type": "string"
             },
-            "description": "Specific version of the code system. Required if multiple versions exist."
+            "description": "Specific version of the custom code system."
           }
         ],
         "responses": {
@@ -2192,7 +2286,7 @@
             }
           },
           "400": {
-            "description": "Invalid parameters or multiple versions exist without version specified"
+            "description": "Invalid parameters"
           },
           "401": {
             "description": "Unauthorized"
@@ -2241,7 +2335,7 @@
             "schema": {
               "type": "string"
             },
-            "description": "Specific version of the code system. Required if multiple versions exist."
+            "description": "Specific version of the custom code system."
           }
         ],
         "responses": {
@@ -2279,7 +2373,7 @@
             }
           },
           "400": {
-            "description": "Invalid parameters or multiple versions exist without version specified"
+            "description": "Invalid parameters"
           },
           "401": {
             "description": "Unauthorized"
@@ -2343,7 +2437,7 @@
             "schema": {
               "type": "string"
             },
-            "description": "Specific version of the code system. Required if multiple versions exist.",
+            "description": "Specific version of the code system, such as `umls-2026aa`.",
             "examples": {
               "browse_icd10cm": {
                 "summary": "Browse ICD-10-CM",
@@ -2467,7 +2561,7 @@
             }
           },
           "400": {
-            "description": "Invalid parameters or multiple versions exist without version specified"
+            "description": "Invalid parameters"
           },
           "401": {
             "description": "Unauthorized"
@@ -2541,7 +2635,7 @@
             "schema": {
               "type": "string"
             },
-            "description": "Specific version of the code system"
+            "description": "Specific version of the code system, such as `umls-2026aa`."
           }
         ],
         "responses": {
@@ -2657,7 +2751,7 @@
             "schema": {
               "type": "string"
             },
-            "description": "Specific version of the code system"
+            "description": "Specific version of the code system, such as `umls-2026aa`."
           },
           {
             "name": "limit",
@@ -2906,7 +3000,7 @@
             "schema": {
               "type": "string"
             },
-            "description": "Specific version of the code system"
+            "description": "Specific version of the code system, such as `umls-2026aa`."
           },
           {
             "name": "limit",
@@ -3021,7 +3115,7 @@
       "post": {
         "operationId": "fhir2omop_create",
         "summary": "Map FHIR resources to OMOP CDM v5.4",
-        "description": "Maps a FHIR R4 resource or Bundle into OMOP Common Data Model v5.4 rows\n(person, visit_occurrence, condition_occurrence, drug_exposure,\nprocedure_occurrence, measurement, observation).\n\nEach resource's primary clinical coding is resolved to a standard OMOP\n`concept_id`. Alongside the OMOP rows grouped by table (`tables`), the\nresponse carries `mappings` (how each source coding resolved, linked back\nto the row it produced), `dropped` (resources that could not be shaped\ninto a row), `vocab_version` (the OMOP vocabulary release codes were\nresolved against), and a small `summary` of the resolution outcomes.\n\nA `concept_id` of `0` is reported, not omitted (OMOP \"no matching\nconcept\" semantics): it covers both a coding with no standard match\n(`UNMAPPED`) and an unverified suggestion for a text-only resource\n(`UNCHECKED`). Only the primary clinical coding is resolved, so\n`gender`/`race`/`ethnicity`/`visit`/`value`/`unit` `concept_id`s are\nalways `0`; the one populated non-resolved concept is measurement\n`operator_concept_id`, set from a value comparator (`<`, `<=`, `>`, `>=`)\nrather than the resolver. Each `*_source_value` carries the verbatim FHIR\ncoding (`system#code`), and `*_type_concept_id` is set to `32817` (EHR).\n\nMedication codes are resolved whether they appear inline\n(`medicationCodeableConcept`) or via a `medicationReference` to a contained,\nrelative (`Type/id`), or bundle-entry (`urn:uuid`) `Medication` resource.\nResources that cannot be shaped into a row \u2014 a medication with no usable\ncode, resolvable reference, or display, or any clinical resource whose\nsubject/patient reference cannot be tied to a person \u2014 are reported under\n`dropped` rather than emitted as blank rows. The\nbundle must contain at least one Patient resource.\n",
+        "description": "Maps a FHIR R4 resource or Bundle into OMOP Common Data Model v5.4 rows\n(person, visit_occurrence, condition_occurrence, drug_exposure,\nprocedure_occurrence, measurement, observation).\n\nResource support is intentionally limited to the OMOP tables returned by\nthis endpoint:\n- `Patient` -> `person`\n- `Encounter` -> `visit_occurrence`\n- `Condition` -> `condition_occurrence`\n- `Procedure` -> `procedure_occurrence`\n- `MedicationRequest`, `MedicationStatement`, and\n  `MedicationAdministration` -> `drug_exposure`\n- `Immunization` -> `drug_exposure`\n- `Observation` with a numeric `valueQuantity`, `valueInteger`, or\n  numeric-looking `valueString` (for example `\"<2\"`) -> `measurement`\n- non-numeric `Observation` -> `observation`\n- `AllergyIntolerance` -> `observation`\n\n`Medication` is supported only as reference data for medication\nresources; it is not emitted as its own row because OMOP CDM has no\nMedication table. Other reference/admin resources such as `Practitioner`,\n`Organization`, `Location`, `Coverage`, and `Claim`, and clinical\nworkflow/document resources such as `DiagnosticReport`, `ServiceRequest`,\n`CarePlan`, `DocumentReference`, `Composition`, `Specimen`, and\n`DeviceUseStatement`, are currently accepted in a Bundle but are not\nshaped into OMOP rows. Unsupported resource types are ignored rather than\nlisted under `dropped`; `dropped` is reserved for supported resource types\nthat were missing the subject/patient, code, or medication reference data\nneeded to produce a valid row.\n\nEach resource's primary clinical coding is resolved to a standard OMOP\n`concept_id`. Alongside the OMOP rows grouped by table (`tables`), the\nresponse carries `mappings` (how each source coding resolved, linked back\nto the row it produced), `dropped` (resources that could not be shaped\ninto a row), `vocab_version` (the OMOP vocabulary release codes were\nresolved against), and a small `summary` of the resolution outcomes.\n\nA `concept_id` of `0` is reported, not omitted (OMOP \"no matching\nconcept\" semantics): it covers both a coding with no standard match\n(`UNMAPPED`) and an unverified suggestion for a text-only resource\n(`UNCHECKED`). Only the primary clinical coding is resolved, so\n`gender`/`race`/`ethnicity`/`visit`/`value`/`unit` `concept_id`s are\nalways `0`; the one populated non-resolved concept is measurement\n`operator_concept_id`, set from a value comparator (`<`, `<=`, `>`, `>=`)\nrather than the resolver. Each `*_source_value` carries the verbatim FHIR\ncoding (`system#code`), and `*_type_concept_id` is set to `32817` (EHR).\n\nMedication codes are resolved whether they appear inline\n(`medicationCodeableConcept`) or via a `medicationReference` to a contained,\nrelative (`Type/id`), or bundle-entry (`urn:uuid`) `Medication` resource.\nResources that cannot be shaped into a row \u2014 a medication with no usable\ncode, resolvable reference, or display, or any clinical resource whose\nsubject/patient reference cannot be tied to a person \u2014 are reported under\n`dropped` rather than emitted as blank rows. The\nbundle must contain at least one Patient resource.\n",
         "requestBody": {
           "required": true,
           "content": {
@@ -4733,8 +4827,9 @@
     "/lang2fhir/profile/upload": {
       "post": {
         "operationId": "lang2fhir_uploadProfile",
-        "summary": "Upload custom FHIR profile",
-        "description": "Upload a custom FHIR StructureDefinition profile for use with the lang2fhir service.\n\nAll metadata is derived from the StructureDefinition JSON itself. The lowercase `id` field\nfrom the StructureDefinition is used as the profile's unique identifier and lookup key.\nTo use the uploaded profile with `/lang2fhir/create`, pass this id as the `resource` parameter.\n\nUploads will be rejected if:\n- A built-in US Core or R4 base profile already exists with the same id\n- A custom profile with the same id has already been uploaded\n- A custom profile with the same url has already been uploaded\n",
+        "deprecated": true,
+        "summary": "Upload custom FHIR profile (deprecated)",
+        "description": "**Deprecated \u2014 use `POST /fhir/profiles` instead.** This route continues to work\nand operates on the same custom profiles, so no migration is required; it\nwill be removed in a future release. Note that `POST /fhir/profiles` does not\naccept `profile_context`; set implementation-guide context with\n`PUT /fhir/implementation-guides/{name}`.\n\nUpload a custom FHIR StructureDefinition profile for use with the lang2fhir service.\n\nAll metadata is derived from the StructureDefinition JSON itself. The lowercase `id` field\nfrom the StructureDefinition is used as the profile's unique identifier and lookup key.\nTo use the uploaded profile with `/lang2fhir/create`, pass this id as the `resource` parameter.\n\nUploads will be rejected if:\n- A built-in US Core or R4 base profile already exists with the same id\n- A custom profile with the same id has already been uploaded\n- A custom profile with the same url has already been uploaded\n",
         "requestBody": {
           "required": true,
           "content": {
@@ -4981,19 +5076,28 @@
                       "tempId": "urn:uuid:patient-001",
                       "resourceType": "Patient",
                       "description": "John Doe, born 1979-03-15",
-                      "originalText": "John Doe, DOB 1979-03-15"
+                      "originalText": "John Doe, DOB 1979-03-15",
+                      "sourcePages": [
+                        1
+                      ]
                     },
                     {
                       "tempId": "urn:uuid:condition-001",
                       "resourceType": "Condition",
                       "description": "Type 2 Diabetes Mellitus diagnosis",
-                      "originalText": "diagnosed with Type 2 Diabetes"
+                      "originalText": "diagnosed with Type 2 Diabetes",
+                      "sourcePages": [
+                        1
+                      ]
                     },
                     {
                       "tempId": "urn:uuid:medication-001",
                       "resourceType": "MedicationRequest",
                       "description": "Metformin 500mg prescription",
-                      "originalText": "Prescribed Metformin 500mg"
+                      "originalText": "Prescribed Metformin 500mg",
+                      "sourcePages": [
+                        2
+                      ]
                     }
                   ]
                 }
@@ -5568,101 +5672,30 @@
         "x-service": "summary"
       }
     },
-    "/tools/lang2fhir-and-create": {
-      "post": {
-        "operationId": "tools_createFhirResource",
-        "summary": "Create FHIR resource from text and store it",
-        "description": "Converts natural language to FHIR resource and optionally stores it in a FHIR server",
-        "parameters": [
-          {
-            "$ref": "#/components/parameters/tools_OnBehalfOfHeader"
-          },
-          {
-            "$ref": "#/components/parameters/tools_FhirProviderHeader"
-          }
+    "/fhir/implementation-guides": {
+      "get": {
+        "operationId": "implementation-guides_list",
+        "tags": [
+          "FHIR Artifacts / Implementation Guides"
         ],
-        "requestBody": {
-          "required": true,
-          "content": {
-            "application/json": {
-              "schema": {
-                "$ref": "#/components/schemas/tools_Lang2FhirAndCreateRequest"
-              },
-              "example": {
-                "resource": "condition-encounter-diagnosis",
-                "text": "Patient has severe persistent asthma with acute exacerbation",
-                "provider": "550e8400-e29b-41d4-a716-446655440000"
-              }
-            }
-          }
-        },
+        "summary": "List implementation guides",
+        "description": "Returns every implementation guide on this instance \u2014 both guides that\nhave stored metadata (a profile_context) and guides referenced by at\nleast one custom profile \u2014 with the number of profiles in each.\n",
         "responses": {
           "200": {
-            "description": "Successfully created FHIR resource",
+            "description": "List of implementation guides",
             "content": {
               "application/json": {
                 "schema": {
-                  "$ref": "#/components/schemas/tools_Lang2FhirAndCreateResponse"
-                },
-                "example": {
-                  "success": true,
-                  "message": "FHIR resource created successfully",
-                  "fhir_id": "condition-123",
-                  "fhir_resource": {
-                    "resourceType": "Condition",
-                    "id": "condition-123",
-                    "clinicalStatus": {
-                      "coding": [
-                        {
-                          "system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
-                          "code": "active"
-                        }
-                      ]
-                    },
-                    "verificationStatus": {
-                      "coding": [
-                        {
-                          "system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
-                          "code": "confirmed"
-                        }
-                      ]
-                    },
-                    "category": [
-                      {
-                        "coding": [
-                          {
-                            "system": "http://terminology.hl7.org/CodeSystem/condition-category",
-                            "code": "encounter-diagnosis"
-                          }
-                        ]
-                      }
-                    ],
-                    "code": {
-                      "coding": [
-                        {
-                          "system": "http://snomed.info/sct",
-                          "code": "195967001",
-                          "display": "Asthma"
-                        }
-                      ],
-                      "text": "Severe persistent asthma with acute exacerbation"
-                    },
-                    "subject": {
-                      "reference": "Patient/patient-123"
-                    }
-                  }
+                  "$ref": "#/components/schemas/implementation-guides_ImplementationGuideListResponse"
                 }
               }
             }
           },
-          "400": {
-            "description": "Invalid request"
-          },
           "401": {
             "description": "Unauthorized"
           },
           "403": {
-            "description": "Forbidden - access denied to the requested resource"
+            "description": "Forbidden - custom profiles are only available on dedicated instances"
           },
           "500": {
             "description": "Server error"
@@ -5673,101 +5706,51 @@
             "bearerAuth": []
           }
         ],
-        "x-service": "tools"
+        "x-service": "fhir_artifacts"
       }
     },
-    "/tools/lang2fhir-and-create-multi": {
-      "post": {
-        "operationId": "tools_createFhirResourcesMulti",
-        "summary": "Extract and store multiple FHIR resources",
-        "description": "Extracts multiple FHIR resources from natural language text and stores them in a FHIR server.\nAutomatically detects Patient, Condition, MedicationRequest, Observation, and other resource types.\nResources are linked with proper references and submitted as a transaction bundle.\nFor FHIR servers that don't auto-resolve urn:uuid references, this endpoint will automatically\nresolve them via PUT requests after the initial bundle creation.\n",
-        "parameters": [
-          {
-            "$ref": "#/components/parameters/tools_OnBehalfOfHeader"
+    "/fhir/implementation-guides/{name}": {
+      "parameters": [
+        {
+          "name": "name",
+          "in": "path",
+          "required": true,
+          "description": "The implementation guide name.",
+          "schema": {
+            "type": "string"
           },
-          {
-            "$ref": "#/components/parameters/tools_FhirProviderHeader"
-          }
+          "example": "acme-cardiology"
+        }
+      ],
+      "get": {
+        "operationId": "implementation-guides_get",
+        "tags": [
+          "FHIR Artifacts / Implementation Guides"
         ],
-        "requestBody": {
-          "required": true,
-          "content": {
-            "application/json": {
-              "schema": {
-                "$ref": "#/components/schemas/tools_Lang2FhirAndCreateMultiRequest"
-              },
-              "example": {
-                "text": "John Smith, 45-year-old male, diagnosed with Type 2 Diabetes. Prescribed Metformin 500mg twice daily.",
-                "version": "R4",
-                "provider": "medplum"
-              }
-            }
-          }
-        },
+        "summary": "Get an implementation guide",
+        "description": "Returns a single implementation guide, including its profile_context and\nthe ids of the profiles that belong to it.\n",
         "responses": {
           "200": {
-            "description": "Successfully created FHIR resources",
+            "description": "The requested implementation guide",
             "content": {
               "application/json": {
                 "schema": {
-                  "$ref": "#/components/schemas/tools_Lang2FhirAndCreateMultiResponse"
-                },
-                "example": {
-                  "success": true,
-                  "message": "Created 3 resources",
-                  "response_bundle": {
-                    "resourceType": "Bundle",
-                    "type": "transaction-response",
-                    "entry": [
-                      {
-                        "response": {
-                          "status": "201 Created",
-                          "location": "Patient/patient-001"
-                        }
-                      },
-                      {
-                        "response": {
-                          "status": "201 Created",
-                          "location": "Condition/condition-001"
-                        }
-                      },
-                      {
-                        "response": {
-                          "status": "201 Created",
-                          "location": "MedicationRequest/medication-001"
-                        }
-                      }
-                    ]
-                  },
-                  "resource_info": [
-                    {
-                      "tempId": "urn:uuid:patient-abc123",
-                      "resourceType": "Patient",
-                      "description": "John Smith, 45-year-old male"
-                    },
-                    {
-                      "tempId": "urn:uuid:condition-abc123",
-                      "resourceType": "Condition",
-                      "description": "Type 2 Diabetes diagnosis"
-                    },
-                    {
-                      "tempId": "urn:uuid:medication-abc123",
-                      "resourceType": "MedicationRequest",
-                      "description": "Metformin 500mg twice daily"
-                    }
-                  ]
+                  "$ref": "#/components/schemas/implementation-guides_ImplementationGuideDetail"
                 }
               }
             }
           },
           "400": {
-            "description": "Invalid request"
+            "description": "The name is reserved or malformed"
           },
           "401": {
             "description": "Unauthorized"
           },
           "403": {
-            "description": "Forbidden - access denied to the requested resource"
+            "description": "Forbidden - custom profiles are only available on dedicated instances"
+          },
+          "404": {
+            "description": "Implementation guide not found"
           },
           "500": {
             "description": "Server error"
@@ -5778,9 +5761,541 @@
             "bearerAuth": []
           }
         ],
-        "x-service": "tools"
-      }
-    },
+        "x-service": "fhir_artifacts"
+      },
+      "put": {
+        "operationId": "implementation-guides_update",
+        "tags": [
+          "FHIR Artifacts / Implementation Guides"
+        ],
+        "summary": "Set an implementation guide's profile context",
+        "description": "Sets (or clears, with an empty value) the natural-language profile_context\nfor an implementation guide. The context is injected into the LLM during\nresource detection to help select the right profiles from this guide.\nIt applies to every profile in the guide.\n",
+        "requestBody": {
+          "required": true,
+          "content": {
+            "application/json": {
+              "schema": {
+                "$ref": "#/components/schemas/implementation-guides_UpdateImplementationGuideRequest"
+              }
+            }
+          }
+        },
+        "responses": {
+          "200": {
+            "description": "Implementation guide successfully updated",
+            "content": {
+              "application/json": {
+                "schema": {
+                  "$ref": "#/components/schemas/implementation-guides_ImplementationGuideSummary"
+                }
+              }
+            }
+          },
+          "400": {
+            "description": "Invalid implementation guide name or profile_context too long"
+          },
+          "401": {
+            "description": "Unauthorized"
+          },
+          "403": {
+            "description": "Forbidden - custom profiles are only available on dedicated instances"
+          },
+          "500": {
+            "description": "Server error"
+          }
+        },
+        "security": [
+          {
+            "bearerAuth": []
+          }
+        ],
+        "x-service": "fhir_artifacts"
+      },
+      "delete": {
+        "operationId": "implementation-guides_delete",
+        "tags": [
+          "FHIR Artifacts / Implementation Guides"
+        ],
+        "summary": "Delete an implementation guide's metadata",
+        "description": "Deletes the stored metadata for an implementation guide \u2014 its\nprofile_context and timestamps. Member profiles keep their\nimplementation_guide assignment, so a guide still referenced by at least\none profile continues to appear in listings, just without context or\ntimestamps.\n",
+        "responses": {
+          "204": {
+            "description": "Implementation guide metadata successfully deleted"
+          },
+          "400": {
+            "description": "The name is reserved or malformed"
+          },
+          "401": {
+            "description": "Unauthorized"
+          },
+          "403": {
+            "description": "Forbidden - custom profiles are only available on dedicated instances"
+          },
+          "404": {
+            "description": "No implementation guide metadata exists for this name"
+          },
+          "500": {
+            "description": "Server error"
+          }
+        },
+        "security": [
+          {
+            "bearerAuth": []
+          }
+        ],
+        "x-service": "fhir_artifacts"
+      }
+    },
+    "/fhir/profiles": {
+      "get": {
+        "operationId": "profiles_list",
+        "tags": [
+          "FHIR Artifacts / Profiles"
+        ],
+        "summary": "List custom FHIR profiles",
+        "description": "Returns metadata for every custom (uploaded) FHIR profile on this\ninstance, across all implementation guides. The full StructureDefinition\nJSON is omitted from each entry; fetch a single profile by id to retrieve it.\n\nThe `url` query parameter filters by canonical URL. The canonical URL is the\nstable key other platform features use to reference a profile (FHIR's\n`meta.profile`, `baseDefinition`), since StructureDefinition ids are only\nunique within a package. A non-matching filter returns an empty list, not a 404.\n",
+        "parameters": [
+          {
+            "name": "url",
+            "in": "query",
+            "required": false,
+            "description": "Filter by canonical URL. Accepts the FHIR pinned form `url|version` (split on the last `|`); the bare form matches the current version.\n",
+            "schema": {
+              "type": "string"
+            },
+            "example": "http://phenoml.com/fhir/StructureDefinition/custom-patient|1.0.0"
+          }
+        ],
+        "responses": {
+          "200": {
+            "description": "List of uploaded profiles",
+            "content": {
+              "application/json": {
+                "schema": {
+                  "$ref": "#/components/schemas/profiles_ProfileListResponse"
+                }
+              }
+            }
+          },
+          "401": {
+            "description": "Unauthorized"
+          },
+          "403": {
+            "description": "Forbidden - custom profiles are only available on dedicated instances"
+          },
+          "500": {
+            "description": "Server error"
+          }
+        },
+        "security": [
+          {
+            "bearerAuth": []
+          }
+        ],
+        "x-service": "fhir_artifacts"
+      },
+      "post": {
+        "operationId": "profiles_create",
+        "tags": [
+          "FHIR Artifacts / Profiles"
+        ],
+        "summary": "Upload a custom FHIR profile",
+        "description": "Creates a custom profile from a FHIR StructureDefinition supplied as a JSON\nobject. All metadata (version, resource type, id, url) is derived from the\nStructureDefinition; the lowercase StructureDefinition id becomes the\nprofile's lookup key. Code system configuration is auto-extracted from the\nsnapshot. Optionally group the profile under a named implementation guide.\n",
+        "requestBody": {
+          "required": true,
+          "content": {
+            "application/json": {
+              "schema": {
+                "$ref": "#/components/schemas/profiles_ProfileUploadRequest"
+              }
+            }
+          }
+        },
+        "responses": {
+          "201": {
+            "description": "Profile successfully created",
+            "content": {
+              "application/json": {
+                "schema": {
+                  "$ref": "#/components/schemas/profiles_ProfileSummary"
+                }
+              }
+            }
+          },
+          "400": {
+            "description": "Invalid request or profile validation failed. Possible reasons:\n- Missing or invalid StructureDefinition JSON\n- The id collides with a built-in US Core or R4 base profile\n- A custom profile with the same id or url already exists\n"
+          },
+          "401": {
+            "description": "Unauthorized"
+          },
+          "403": {
+            "description": "Forbidden - custom profiles are only available on dedicated instances"
+          },
+          "500": {
+            "description": "Server error"
+          }
+        },
+        "security": [
+          {
+            "bearerAuth": []
+          }
+        ],
+        "x-service": "fhir_artifacts"
+      }
+    },
+    "/fhir/profiles/{id}": {
+      "parameters": [
+        {
+          "name": "id",
+          "in": "path",
+          "required": true,
+          "description": "The lowercase StructureDefinition id of the custom profile.",
+          "schema": {
+            "type": "string"
+          },
+          "example": "custom-patient"
+        }
+      ],
+      "get": {
+        "operationId": "profiles_get",
+        "tags": [
+          "FHIR Artifacts / Profiles"
+        ],
+        "summary": "Get a custom FHIR profile",
+        "description": "Returns a single custom profile by id, including its full StructureDefinition JSON.\n",
+        "responses": {
+          "200": {
+            "description": "The requested profile",
+            "content": {
+              "application/json": {
+                "schema": {
+                  "$ref": "#/components/schemas/profiles_ProfileGetResponse"
+                }
+              }
+            }
+          },
+          "400": {
+            "description": "The id is not a valid profile id"
+          },
+          "401": {
+            "description": "Unauthorized"
+          },
+          "403": {
+            "description": "Forbidden - custom profiles are only available on dedicated instances"
+          },
+          "404": {
+            "description": "Profile not found"
+          },
+          "500": {
+            "description": "Server error"
+          }
+        },
+        "security": [
+          {
+            "bearerAuth": []
+          }
+        ],
+        "x-service": "fhir_artifacts"
+      },
+      "put": {
+        "operationId": "profiles_update",
+        "tags": [
+          "FHIR Artifacts / Profiles"
+        ],
+        "summary": "Update a custom FHIR profile",
+        "description": "Replaces an existing custom profile with a new StructureDefinition. The\n`id` path parameter is authoritative: if the StructureDefinition includes\nan `id` it must match the path parameter, and if it omits one the path\nparameter is used. The FHIR resource type of the profile cannot change.\nCode system configuration is\nre-derived from the new StructureDefinition. When `implementation_guide` is\nomitted, the profile keeps its existing implementation guide. The instance\nstores a single version per canonical URL, so this replaces it in place.\n",
+        "requestBody": {
+          "required": true,
+          "content": {
+            "application/json": {
+              "schema": {
+                "$ref": "#/components/schemas/profiles_ProfileUploadRequest"
+              }
+            }
+          }
+        },
+        "responses": {
+          "200": {
+            "description": "Profile successfully updated",
+            "content": {
+              "application/json": {
+                "schema": {
+                  "$ref": "#/components/schemas/profiles_ProfileSummary"
+                }
+              }
+            }
+          },
+          "400": {
+            "description": "Invalid request or profile validation failed. Possible reasons:\n- Missing or invalid StructureDefinition JSON\n- The StructureDefinition id does not match the id path parameter\n- The resource type differs from the existing profile\n- The url collides with a built-in profile or another custom profile\n"
+          },
+          "401": {
+            "description": "Unauthorized"
+          },
+          "403": {
+            "description": "Forbidden - custom profiles are only available on dedicated instances"
+          },
+          "404": {
+            "description": "Profile not found"
+          },
+          "500": {
+            "description": "Server error"
+          }
+        },
+        "security": [
+          {
+            "bearerAuth": []
+          }
+        ],
+        "x-service": "fhir_artifacts"
+      },
+      "delete": {
+        "operationId": "profiles_delete",
+        "tags": [
+          "FHIR Artifacts / Profiles"
+        ],
+        "summary": "Delete a custom FHIR profile",
+        "description": "Permanently deletes a custom profile by id.\n",
+        "responses": {
+          "204": {
+            "description": "Profile successfully deleted"
+          },
+          "400": {
+            "description": "The id is not a valid profile id"
+          },
+          "401": {
+            "description": "Unauthorized"
+          },
+          "403": {
+            "description": "Forbidden - custom profiles are only available on dedicated instances"
+          },
+          "404": {
+            "description": "Profile not found"
+          },
+          "500": {
+            "description": "Server error"
+          }
+        },
+        "security": [
+          {
+            "bearerAuth": []
+          }
+        ],
+        "x-service": "fhir_artifacts"
+      }
+    },
+    "/tools/lang2fhir-and-create": {
+      "post": {
+        "operationId": "tools_createFhirResource",
+        "summary": "Create FHIR resource from text and store it",
+        "description": "Converts natural language to FHIR resource and optionally stores it in a FHIR server",
+        "parameters": [
+          {
+            "$ref": "#/components/parameters/tools_OnBehalfOfHeader"
+          },
+          {
+            "$ref": "#/components/parameters/tools_FhirProviderHeader"
+          }
+        ],
+        "requestBody": {
+          "required": true,
+          "content": {
+            "application/json": {
+              "schema": {
+                "$ref": "#/components/schemas/tools_Lang2FhirAndCreateRequest"
+              },
+              "example": {
+                "resource": "condition-encounter-diagnosis",
+                "text": "Patient has severe persistent asthma with acute exacerbation",
+                "provider": "550e8400-e29b-41d4-a716-446655440000"
+              }
+            }
+          }
+        },
+        "responses": {
+          "200": {
+            "description": "Successfully created FHIR resource",
+            "content": {
+              "application/json": {
+                "schema": {
+                  "$ref": "#/components/schemas/tools_Lang2FhirAndCreateResponse"
+                },
+                "example": {
+                  "success": true,
+                  "message": "FHIR resource created successfully",
+                  "fhir_id": "condition-123",
+                  "fhir_resource": {
+                    "resourceType": "Condition",
+                    "id": "condition-123",
+                    "clinicalStatus": {
+                      "coding": [
+                        {
+                          "system": "http://terminology.hl7.org/CodeSystem/condition-clinical",
+                          "code": "active"
+                        }
+                      ]
+                    },
+                    "verificationStatus": {
+                      "coding": [
+                        {
+                          "system": "http://terminology.hl7.org/CodeSystem/condition-ver-status",
+                          "code": "confirmed"
+                        }
+                      ]
+                    },
+                    "category": [
+                      {
+                        "coding": [
+                          {
+                            "system": "http://terminology.hl7.org/CodeSystem/condition-category",
+                            "code": "encounter-diagnosis"
+                          }
+                        ]
+                      }
+                    ],
+                    "code": {
+                      "coding": [
+                        {
+                          "system": "http://snomed.info/sct",
+                          "code": "195967001",
+                          "display": "Asthma"
+                        }
+                      ],
+                      "text": "Severe persistent asthma with acute exacerbation"
+                    },
+                    "subject": {
+                      "reference": "Patient/patient-123"
+                    }
+                  }
+                }
+              }
+            }
+          },
+          "400": {
+            "description": "Invalid request"
+          },
+          "401": {
+            "description": "Unauthorized"
+          },
+          "403": {
+            "description": "Forbidden - access denied to the requested resource"
+          },
+          "500": {
+            "description": "Server error"
+          }
+        },
+        "security": [
+          {
+            "bearerAuth": []
+          }
+        ],
+        "x-service": "tools"
+      }
+    },
+    "/tools/lang2fhir-and-create-multi": {
+      "post": {
+        "operationId": "tools_createFhirResourcesMulti",
+        "summary": "Extract and store multiple FHIR resources",
+        "description": "Extracts multiple FHIR resources from natural language text and stores them in a FHIR server.\nAutomatically detects Patient, Condition, MedicationRequest, Observation, and other resource types.\nResources are linked with proper references and submitted as a transaction bundle.\nFor FHIR servers that don't auto-resolve urn:uuid references, this endpoint will automatically\nresolve them via PUT requests after the initial bundle creation.\n",
+        "parameters": [
+          {
+            "$ref": "#/components/parameters/tools_OnBehalfOfHeader"
+          },
+          {
+            "$ref": "#/components/parameters/tools_FhirProviderHeader"
+          }
+        ],
+        "requestBody": {
+          "required": true,
+          "content": {
+            "application/json": {
+              "schema": {
+                "$ref": "#/components/schemas/tools_Lang2FhirAndCreateMultiRequest"
+              },
+              "example": {
+                "text": "John Smith, 45-year-old male, diagnosed with Type 2 Diabetes. Prescribed Metformin 500mg twice daily.",
+                "version": "R4",
+                "provider": "medplum"
+              }
+            }
+          }
+        },
+        "responses": {
+          "200": {
+            "description": "Successfully created FHIR resources",
+            "content": {
+              "application/json": {
+                "schema": {
+                  "$ref": "#/components/schemas/tools_Lang2FhirAndCreateMultiResponse"
+                },
+                "example": {
+                  "success": true,
+                  "message": "Created 3 resources",
+                  "response_bundle": {
+                    "resourceType": "Bundle",
+                    "type": "transaction-response",
+                    "entry": [
+                      {
+                        "response": {
+                          "status": "201 Created",
+                          "location": "Patient/patient-001"
+                        }
+                      },
+                      {
+                        "response": {
+                          "status": "201 Created",
+                          "location": "Condition/condition-001"
+                        }
+                      },
+                      {
+                        "response": {
+                          "status": "201 Created",
+                          "location": "MedicationRequest/medication-001"
+                        }
+                      }
+                    ]
+                  },
+                  "resource_info": [
+                    {
+                      "tempId": "urn:uuid:patient-abc123",
+                      "resourceType": "Patient",
+                      "description": "John Smith, 45-year-old male"
+                    },
+                    {
+                      "tempId": "urn:uuid:condition-abc123",
+                      "resourceType": "Condition",
+                      "description": "Type 2 Diabetes diagnosis"
+                    },
+                    {
+                      "tempId": "urn:uuid:medication-abc123",
+                      "resourceType": "MedicationRequest",
+                      "description": "Metformin 500mg twice daily"
+                    }
+                  ]
+                }
+              }
+            }
+          },
+          "400": {
+            "description": "Invalid request"
+          },
+          "401": {
+            "description": "Unauthorized"
+          },
+          "403": {
+            "description": "Forbidden - access denied to the requested resource"
+          },
+          "500": {
+            "description": "Server error"
+          }
+        },
+        "security": [
+          {
+            "bearerAuth": []
+          }
+        ],
+        "x-service": "tools"
+      }
+    },
     "/tools/lang2fhir-and-search": {
       "post": {
         "operationId": "tools_searchFhirResources",
@@ -6403,6 +6918,80 @@
         "x-service": "tools"
       }
     },
+    "/transcribe": {
+      "post": {
+        "tags": [
+          "Voice / Voice"
+        ],
+        "operationId": "voice_transcribe",
+        "summary": "Transcribe audio",
+        "description": "Transcribes an uploaded audio recording and returns the transcript.\nSend the raw audio bytes as the request body; the audio format is\ndetected automatically (WAV, FLAC, MP3, OGG/WebM Opus).\n\nSupports up to ~5 minutes of audio per request. This limit is on audio\nduration regardless of file size or format, so a compressed recording\nwithin the size limit can still be rejected for being too long. Pair the\ntranscript with a downstream text step (e.g. `POST /lang2fhir/create`)\nto turn it into a FHIR resource.\n",
+        "parameters": [
+          {
+            "name": "language",
+            "in": "query",
+            "description": "BCP-47 language tag, repeatable for up to 4 candidate languages. Defaults to `en-US`.",
+            "schema": {
+              "type": "array",
+              "items": {
+                "type": "string"
+              }
+            }
+          }
+        ],
+        "requestBody": {
+          "required": true,
+          "description": "Raw audio bytes (WAV, FLAC, MP3, or OGG/WebM Opus).",
+          "content": {
+            "application/octet-stream": {
+              "schema": {
+                "type": "string",
+                "format": "binary"
+              }
+            }
+          }
+        },
+        "responses": {
+          "200": {
+            "description": "Transcription succeeded.",
+            "content": {
+              "application/json": {
+                "schema": {
+                  "$ref": "#/components/schemas/voice_TranscribeResponse"
+                }
+              }
+            }
+          },
+          "400": {
+            "description": "Invalid request (empty body, too many languages, no transcript produced, or audio that is too long or in an unsupported format)"
+          },
+          "401": {
+            "description": "Unauthorized"
+          },
+          "402": {
+            "description": "Payment required (credits exhausted or subscription inactive)"
+          },
+          "413": {
+            "description": "Audio exceeds the maximum size"
+          },
+          "502": {
+            "description": "Speech recognition failed"
+          },
+          "503": {
+            "description": "Transcription temporarily unavailable"
+          },
+          "504": {
+            "description": "Transcription timed out"
+          }
+        },
+        "security": [
+          {
+            "bearerAuth": []
+          }
+        ],
+        "x-service": "voice"
+      }
+    },
     "/workflows": {
       "get": {
         "operationId": "workflows_list",
@@ -7345,7 +7934,7 @@
           },
           "session_id": {
             "type": "string",
-            "description": "Optional session ID for conversation continuity",
+            "description": "Optional session ID for conversation continuity. Only one request may be active for a session at a time; overlapping turns for the same session return 409 Conflict.",
             "example": "session-abc123"
           },
           "agent_id": {
@@ -7381,7 +7970,7 @@
           },
           "session_id": {
             "type": "string",
-            "description": "Optional session ID for conversation continuity",
+            "description": "Optional session ID for conversation continuity. Only one request may be active for a session at a time; overlapping turns for the same session return 409 Conflict.",
             "example": "session-abc123"
           },
           "agent_id": {
@@ -7884,13 +8473,13 @@
         "properties": {
           "name": {
             "type": "string",
-            "description": "Code system name. Can be a built-in system or a custom system name.\n\nBuilt-in systems:\n* SNOMED_CT_US_LITE - version 20240901\n* RXNORM - version 11042024\n* ICD-10-CM - version 2025\n* ICD-10-PCS - version 2025\n* LOINC - version 2.78\n* HPO - version 2025\n* CPT - version 2025\n\nCustom systems:\n* Any valid system name uploaded via /construe/upload. Requires a paid plan.\n\nUsage of CPT is subject to AMA requirements: see PhenoML Terms of Service.\n",
+            "description": "Code system name. Can be a built-in system or a custom system name.\n\nBuilt-in systems:\n* CPT\n* HCPCS\n* HPO\n* ICD-10\n* ICD-10-CM\n* ICD-10-PCS\n* LOINC\n* RXNORM\n* SNOMED_CT_US\n* SNOMED_CT_US_LITE\n\nCustom systems:\n* Any valid system name uploaded via /construe/upload. Requires a paid plan.\n\nUsage of CPT is subject to AMA requirements: see PhenoML Terms of Service.\n",
             "example": "SNOMED_CT_US_LITE"
           },
           "version": {
             "type": "string",
-            "description": "Code system version. Must match the version available in your environment.",
-            "example": "20240901"
+            "description": "Specific code system version.",
+            "example": "umls-2026aa"
           }
         }
       },
@@ -8121,7 +8710,7 @@
           "version": {
             "type": "string",
             "description": "Code system version",
-            "example": "2025"
+            "example": "umls-2026aa"
           }
         }
       },
@@ -8142,7 +8731,7 @@
           "version": {
             "type": "string",
             "description": "Code system version",
-            "example": "2025"
+            "example": "umls-2026aa"
           },
           "code_count": {
             "type": "integer",
@@ -8414,7 +9003,7 @@
           "version": {
             "type": "string",
             "description": "Code system version",
-            "example": "2025"
+            "example": "umls-2026aa"
           },
           "code_count": {
             "type": "integer",
@@ -8544,7 +9133,7 @@
           "fhir_resources": {
             "type": "object",
             "additionalProperties": true,
-            "description": "FHIR resources (single resource or Bundle). Must contain at least one\nPatient resource. Resources are mapped to OMOP rows; standalone\nMedication resources are consumed by medication references rather than\nmapped to their own table.\n"
+            "description": "FHIR resources (single resource or Bundle). Must contain at least one\nPatient resource. Supported row-producing resources are Patient,\nEncounter, Condition, Procedure, MedicationRequest,\nMedicationStatement, MedicationAdministration, Immunization,\nObservation, and AllergyIntolerance. Standalone Medication resources\nare consumed by medication references rather than mapped to their own\ntable. Other resource types are accepted but ignored.\n"
           }
         }
       },
@@ -8569,7 +9158,7 @@
           },
           "dropped": {
             "type": "array",
-            "description": "Resources that could not be shaped into an OMOP row (rather than emitted as blank rows).",
+            "description": "Supported resource instances that could not be shaped into an OMOP\nrow because required subject/patient, code, or medication reference\ndata was missing. Unsupported resource types are ignored and do not\nappear here.\n",
             "items": {
               "$ref": "#/components/schemas/fhir2omop_DroppedResource"
             }
@@ -8587,47 +9176,198 @@
         "type": "object",
         "description": "OMOP CDM v5.4 rows grouped by destination table.",
         "properties": {
+          "location": {
+            "type": "array",
+            "items": {
+              "$ref": "#/components/schemas/fhir2omop_LocationRow"
+            }
+          },
+          "care_site": {
+            "type": "array",
+            "items": {
+              "$ref": "#/components/schemas/fhir2omop_CareSiteRow"
+            }
+          },
+          "provider": {
+            "type": "array",
+            "items": {
+              "$ref": "#/components/schemas/fhir2omop_ProviderRow"
+            }
+          },
           "person": {
             "type": "array",
             "items": {
               "$ref": "#/components/schemas/fhir2omop_PersonRow"
             }
           },
+          "death": {
+            "type": "array",
+            "items": {
+              "$ref": "#/components/schemas/fhir2omop_DeathRow"
+            }
+          },
+          "observation_period": {
+            "type": "array",
+            "items": {
+              "$ref": "#/components/schemas/fhir2omop_ObservationPeriodRow"
+            }
+          },
           "visit_occurrence": {
             "type": "array",
             "items": {
               "$ref": "#/components/schemas/fhir2omop_VisitOccurrenceRow"
             }
           },
-          "condition_occurrence": {
-            "type": "array",
-            "items": {
-              "$ref": "#/components/schemas/fhir2omop_ConditionOccurrenceRow"
-            }
+          "condition_occurrence": {
+            "type": "array",
+            "items": {
+              "$ref": "#/components/schemas/fhir2omop_ConditionOccurrenceRow"
+            }
+          },
+          "drug_exposure": {
+            "type": "array",
+            "items": {
+              "$ref": "#/components/schemas/fhir2omop_DrugExposureRow"
+            }
+          },
+          "procedure_occurrence": {
+            "type": "array",
+            "items": {
+              "$ref": "#/components/schemas/fhir2omop_ProcedureOccurrenceRow"
+            }
+          },
+          "measurement": {
+            "type": "array",
+            "items": {
+              "$ref": "#/components/schemas/fhir2omop_MeasurementRow"
+            }
+          },
+          "observation": {
+            "type": "array",
+            "items": {
+              "$ref": "#/components/schemas/fhir2omop_ObservationRow"
+            }
+          }
+        }
+      },
+      "fhir2omop_LocationRow": {
+        "type": "object",
+        "properties": {
+          "location_id": {
+            "type": "integer",
+            "format": "int64"
+          },
+          "address_1": {
+            "type": "string"
+          },
+          "address_2": {
+            "type": "string"
+          },
+          "city": {
+            "type": "string"
+          },
+          "state": {
+            "type": "string"
+          },
+          "zip": {
+            "type": "string"
+          },
+          "county": {
+            "type": "string"
+          },
+          "location_source_value": {
+            "type": "string"
+          },
+          "country_concept_id": {
+            "type": "integer",
+            "format": "int64"
+          },
+          "country_source_value": {
+            "type": "string"
+          },
+          "latitude": {
+            "type": "number",
+            "format": "double"
+          },
+          "longitude": {
+            "type": "number",
+            "format": "double"
+          }
+        }
+      },
+      "fhir2omop_CareSiteRow": {
+        "type": "object",
+        "properties": {
+          "care_site_id": {
+            "type": "integer",
+            "format": "int64"
+          },
+          "care_site_name": {
+            "type": "string"
+          },
+          "place_of_service_concept_id": {
+            "type": "integer",
+            "format": "int64"
+          },
+          "location_id": {
+            "type": "integer",
+            "format": "int64"
+          },
+          "care_site_source_value": {
+            "type": "string"
+          },
+          "place_of_service_source_value": {
+            "type": "string"
+          }
+        }
+      },
+      "fhir2omop_ProviderRow": {
+        "type": "object",
+        "properties": {
+          "provider_id": {
+            "type": "integer",
+            "format": "int64"
+          },
+          "provider_name": {
+            "type": "string"
+          },
+          "npi": {
+            "type": "string"
+          },
+          "dea": {
+            "type": "string"
+          },
+          "specialty_concept_id": {
+            "type": "integer",
+            "format": "int64"
+          },
+          "care_site_id": {
+            "type": "integer",
+            "format": "int64"
+          },
+          "year_of_birth": {
+            "type": "integer"
+          },
+          "gender_concept_id": {
+            "type": "integer",
+            "format": "int64"
+          },
+          "provider_source_value": {
+            "type": "string"
           },
-          "drug_exposure": {
-            "type": "array",
-            "items": {
-              "$ref": "#/components/schemas/fhir2omop_DrugExposureRow"
-            }
+          "specialty_source_value": {
+            "type": "string"
           },
-          "procedure_occurrence": {
-            "type": "array",
-            "items": {
-              "$ref": "#/components/schemas/fhir2omop_ProcedureOccurrenceRow"
-            }
+          "specialty_source_concept_id": {
+            "type": "integer",
+            "format": "int64"
           },
-          "measurement": {
-            "type": "array",
-            "items": {
-              "$ref": "#/components/schemas/fhir2omop_MeasurementRow"
-            }
+          "gender_source_value": {
+            "type": "string"
           },
-          "observation": {
-            "type": "array",
-            "items": {
-              "$ref": "#/components/schemas/fhir2omop_ObservationRow"
-            }
+          "gender_source_concept_id": {
+            "type": "integer",
+            "format": "int64"
           }
         }
       },
@@ -8662,6 +9402,10 @@
             "type": "integer",
             "format": "int64"
           },
+          "location_id": {
+            "type": "integer",
+            "format": "int64"
+          },
           "person_source_value": {
             "type": "string"
           },
@@ -8676,6 +9420,59 @@
           }
         }
       },
+      "fhir2omop_DeathRow": {
+        "type": "object",
+        "properties": {
+          "person_id": {
+            "type": "integer",
+            "format": "int64"
+          },
+          "death_date": {
+            "type": "string"
+          },
+          "death_datetime": {
+            "type": "string"
+          },
+          "death_type_concept_id": {
+            "type": "integer",
+            "format": "int64"
+          },
+          "cause_concept_id": {
+            "type": "integer",
+            "format": "int64"
+          },
+          "cause_source_value": {
+            "type": "string"
+          },
+          "cause_source_concept_id": {
+            "type": "integer",
+            "format": "int64"
+          }
+        }
+      },
+      "fhir2omop_ObservationPeriodRow": {
+        "type": "object",
+        "properties": {
+          "observation_period_id": {
+            "type": "integer",
+            "format": "int64"
+          },
+          "person_id": {
+            "type": "integer",
+            "format": "int64"
+          },
+          "observation_period_start_date": {
+            "type": "string"
+          },
+          "observation_period_end_date": {
+            "type": "string"
+          },
+          "period_type_concept_id": {
+            "type": "integer",
+            "format": "int64"
+          }
+        }
+      },
       "fhir2omop_VisitOccurrenceRow": {
         "type": "object",
         "properties": {
@@ -8707,6 +9504,14 @@
             "type": "integer",
             "format": "int64"
           },
+          "provider_id": {
+            "type": "integer",
+            "format": "int64"
+          },
+          "care_site_id": {
+            "type": "integer",
+            "format": "int64"
+          },
           "visit_source_value": {
             "type": "string"
           }
@@ -8744,6 +9549,10 @@
             "type": "integer",
             "format": "int64"
           },
+          "provider_id": {
+            "type": "integer",
+            "format": "int64"
+          },
           "condition_source_value": {
             "type": "string"
           },
@@ -8794,6 +9603,10 @@
             "type": "integer",
             "format": "int64"
           },
+          "provider_id": {
+            "type": "integer",
+            "format": "int64"
+          },
           "drug_source_value": {
             "type": "string"
           },
@@ -8832,6 +9645,10 @@
             "type": "integer",
             "format": "int64"
           },
+          "provider_id": {
+            "type": "integer",
+            "format": "int64"
+          },
           "procedure_source_value": {
             "type": "string"
           },
@@ -8895,6 +9712,10 @@
             "type": "integer",
             "format": "int64"
           },
+          "provider_id": {
+            "type": "integer",
+            "format": "int64"
+          },
           "measurement_source_value": {
             "type": "string"
           },
@@ -8954,6 +9775,10 @@
             "type": "integer",
             "format": "int64"
           },
+          "provider_id": {
+            "type": "integer",
+            "format": "int64"
+          },
           "observation_source_value": {
             "type": "string"
           },
@@ -10133,6 +10958,16 @@
                   "type": "string",
                   "description": "Verbatim text excerpt from the original clinical document",
                   "example": "diagnosed with Type 2 Diabetes"
+                },
+                "sourcePages": {
+                  "type": "array",
+                  "items": {
+                    "type": "integer"
+                  },
+                  "description": "1-indexed source document page number(s) this resource was extracted from. Populated only by the /lang2fhir/document/multi endpoint; omitted when the source page could not be determined (e.g. raw-text create/multi, or a resource with no verbatim source text).\n",
+                  "example": [
+                    2
+                  ]
                 }
               }
             }
@@ -10551,6 +11386,219 @@
           }
         }
       },
+      "implementation-guides_ImplementationGuideSummary": {
+        "type": "object",
+        "description": "Metadata for an implementation guide. This is an instance-local grouping record, not a complete FHIR ImplementationGuide resource.\n",
+        "properties": {
+          "name": {
+            "type": "string",
+            "description": "The instance-local implementation guide name (the stable key).",
+            "example": "acme-cardiology"
+          },
+          "profile_context": {
+            "type": "string",
+            "description": "Natural-language context injected into the LLM during resource detection.",
+            "example": "When the text mentions phenotypic features, prefer the hpo-observation profile over Condition."
+          },
+          "profile_count": {
+            "type": "integer",
+            "description": "The number of custom profiles in this implementation guide.",
+            "example": 3
+          },
+          "created_at": {
+            "type": "string",
+            "format": "date-time",
+            "description": "Present only for guides that have stored metadata (a profile_context has been set). Omitted for guides that exist solely because a profile references them.\n"
+          },
+          "updated_at": {
+            "type": "string",
+            "format": "date-time",
+            "description": "Present only for guides that have stored metadata. Omitted for guides that exist solely because a profile references them.\n"
+          }
+        }
+      },
+      "implementation-guides_ImplementationGuideListResponse": {
+        "type": "object",
+        "properties": {
+          "implementation_guides": {
+            "type": "array",
+            "items": {
+              "$ref": "#/components/schemas/implementation-guides_ImplementationGuideSummary"
+            }
+          }
+        }
+      },
+      "implementation-guides_ImplementationGuideDetail": {
+        "allOf": [
+          {
+            "$ref": "#/components/schemas/implementation-guides_ImplementationGuideSummary"
+          },
+          {
+            "type": "object",
+            "properties": {
+              "profiles": {
+                "type": "array",
+                "description": "The ids of the profiles that belong to this implementation guide.",
+                "items": {
+                  "type": "string"
+                },
+                "example": [
+                  "custom-patient",
+                  "acme-vital-signs"
+                ]
+              }
+            }
+          }
+        ]
+      },
+      "implementation-guides_UpdateImplementationGuideRequest": {
+        "type": "object",
+        "properties": {
+          "profile_context": {
+            "type": "string",
+            "maxLength": 2000,
+            "description": "Natural-language context that helps the LLM select the right profiles from this implementation guide during resource detection. An empty value clears the context. Max 2000 characters.\n",
+            "example": "When clinical text describes phenotypic features, use the hpo-phenotype-observation profile instead of Condition."
+          }
+        }
+      },
+      "profiles_ProfileUploadRequest": {
+        "type": "object",
+        "required": [
+          "structure_definition"
+        ],
+        "properties": {
+          "structure_definition": {
+            "allOf": [
+              {
+                "$ref": "#/components/schemas/profiles_FHIRResource"
+              }
+            ],
+            "description": "A FHIR StructureDefinition as a JSON object. Must include url, type, and a snapshot with elements. All metadata (version, resource type, id) is derived from the StructureDefinition itself. The lowercase id becomes the profile's lookup key; when omitted, it is derived from the final path segment of the canonical url.\n",
+            "example": {
+              "resourceType": "StructureDefinition",
+              "id": "custom-patient",
+              "url": "http://phenoml.com/fhir/StructureDefinition/custom-patient",
+              "name": "CustomPatient",
+              "status": "active",
+              "fhirVersion": "4.0.1",
+              "kind": "resource",
+              "abstract": false,
+              "type": "Patient",
+              "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Patient",
+              "derivation": "constraint",
+              "snapshot": {
+                "element": [
+                  {
+                    "id": "Patient",
+                    "path": "Patient",
+                    "min": 0,
+                    "max": "*"
+                  },
+                  {
+                    "id": "Patient.name",
+                    "path": "Patient.name",
+                    "min": 1,
+                    "max": "*"
+                  }
+                ]
+              }
+            }
+          },
+          "implementation_guide": {
+            "type": "string",
+            "description": "Implementation Guide name to group this profile under. On create, defaults to \"custom\" if omitted; on update, omitting it preserves the profile's current guide. Cannot be \"us_core\" (reserved). Use this to organize custom profiles into named IGs that can be referenced when calling create/multi or document/multi endpoints.\n",
+            "example": "acme-cardiology"
+          }
+        }
+      },
+      "profiles_ProfileSummary": {
+        "type": "object",
+        "properties": {
+          "id": {
+            "type": "string",
+            "description": "The lowercase StructureDefinition id, used as the profile's lookup key.",
+            "example": "custom-patient"
+          },
+          "source": {
+            "type": "string",
+            "enum": [
+              "custom",
+              "builtin"
+            ],
+            "description": "The profile's origin. Listings currently return only custom (uploaded) profiles, so this is always \"custom\" today; built-in (US Core / R4 base) profiles would be surfaced via an opt-in parameter in a future release, not by changing the default behavior.\n",
+            "example": "custom"
+          },
+          "resource_type": {
+            "type": "string",
+            "description": "The FHIR resource type from the StructureDefinition.",
+            "example": "Patient"
+          },
+          "url": {
+            "type": "string",
+            "description": "The canonical URL from the StructureDefinition.",
+            "example": "http://phenoml.com/fhir/StructureDefinition/custom-patient"
+          },
+          "version": {
+            "type": "string",
+            "description": "The version from the StructureDefinition.version field.",
+            "example": "1.0.0"
+          },
+          "fhir_version": {
+            "type": "string",
+            "description": "The base FHIR version the StructureDefinition targets.",
+            "example": "4.0.1"
+          },
+          "implementation_guide": {
+            "type": "string",
+            "description": "The implementation guide the profile belongs to.",
+            "example": "acme-cardiology"
+          },
+          "created_at": {
+            "type": "string",
+            "format": "date-time"
+          },
+          "updated_at": {
+            "type": "string",
+            "format": "date-time"
+          }
+        }
+      },
+      "profiles_ProfileListResponse": {
+        "type": "object",
+        "properties": {
+          "profiles": {
+            "type": "array",
+            "items": {
+              "$ref": "#/components/schemas/profiles_ProfileSummary"
+            }
+          }
+        }
+      },
+      "profiles_ProfileGetResponse": {
+        "allOf": [
+          {
+            "$ref": "#/components/schemas/profiles_ProfileSummary"
+          },
+          {
+            "type": "object",
+            "properties": {
+              "structure_definition": {
+                "allOf": [
+                  {
+                    "$ref": "#/components/schemas/profiles_FHIRResource"
+                  }
+                ],
+                "description": "The full FHIR StructureDefinition JSON."
+              }
+            }
+          }
+        ]
+      },
+      "profiles_FHIRResource": {
+        "type": "object",
+        "description": "A FHIR resource (schema depends on resource type)"
+      },
       "tools_Lang2FhirAndCreateRequest": {
         "type": "object",
         "required": [
@@ -11038,6 +12086,18 @@
           }
         }
       },
+      "voice_TranscribeResponse": {
+        "type": "object",
+        "required": [
+          "transcript"
+        ],
+        "properties": {
+          "transcript": {
+            "type": "string",
+            "description": "The full transcript of the audio."
+          }
+        }
+      },
       "workflows_CreateWorkflowRequest": {
         "type": "object",
         "required": [
@@ -11819,6 +12879,14 @@
       "name": "Summary / Templates",
       "description": "Reusable summary templates that drive FHIR-to-text generation."
     },
+    {
+      "name": "FHIR Artifacts / Implementation Guides",
+      "description": "Manage implementation guides that group custom FHIR profiles."
+    },
+    {
+      "name": "FHIR Artifacts / Profiles",
+      "description": "Manage custom FHIR profiles (StructureDefinitions) as instance-level FHIR artifacts."
+    },
     {
       "name": "Tools / MCP Servers",
       "description": "Register and manage MCP servers exposed as agent tools."
@@ -11826,6 +12894,10 @@
     {
       "name": "Tools / MCP Tools",
       "description": "List and manage individual tools exposed by an MCP server."
+    },
+    {
+      "name": "Voice / Voice",
+      "description": "Speech-to-text transcription of audio recordings."
     }
   ]
 }