Mylestech Admin 9c1bf0a285 Central skills catalog: 472 skills + WORKING_SET + AGENTS

2026-07-13 14:05:05 -04:00

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Compliance, Accessibility & Security UI Patterns

Cross-platform reference for HIPAA compliance, WCAG 2.2 AA accessibility, and security UI patterns: Web (Bootstrap 5/Tabler + PHP) and Android (Jetpack Compose + Material 3).

1. HIPAA UI Requirements

1.1 Protected Health Information (PHI) Handling

Never display PHI in:

URLs or query parameters (/patient?ssn=123-45-6789 is a violation)
Browser tab titles or <title> tags (use "Patient Record" not "John Smith - DOB 1985")
Push notification text (use "You have a new message" not "Lab result: HIV positive")
Error messages or stack traces shown to users
Console logs (console.log(patient) must be stripped in production)
Autocomplete suggestions on PHI fields

Mask sensitive identifiers:

Data Type	Display Format	Full Access
SSN	`*--6789`	Behind re-auth click
DOB	`//1985` or age only	Role-dependent
MRN	Full (operational need)	Always visible to clinical
Phone	`(*) *-4321`	Role-dependent
Address	City, State only	Role-dependent

Auto-lock and session timeout:

Lock screen after 15 minutes inactivity (configurable per facility)
Show blurred overlay, not blank screen (preserves context awareness)
Session timeout with state preservation: save draft to server, restore on re-login
Countdown warning at 2 minutes before timeout

Minimum Necessary Rule: Only show PHI needed for the user's current role and task. A receptionist sees demographics, not diagnoses. A lab tech sees orders, not billing.

1.2 Audit Trail Requirements

Log every interaction with patient data:

Event	Fields Logged
Record access	user_id, patient_id, timestamp, IP, device, section_viewed
Data modification	user_id, field, old_value, new_value, reason, timestamp
Export/Print/Download	user_id, patient_id, format, fields_included, timestamp
Failed access attempt	user_id, patient_id, reason_denied, timestamp

UI requirements:

Display "Last accessed by [Name] on [Date]" on sensitive records
Provide audit log viewer for compliance officers (filterable, exportable)
Show access history tab on patient profiles (visible to admin roles)

1.3 Break-the-Glass Access

Emergency override for restricted patient records:

User clicks "Emergency Access" on restricted record
Modal requires: documented reason (dropdown + free text), acknowledgment checkbox
Access granted for limited window (default 4 hours, configurable)
Auto-notify privacy officer immediately
Access logged with elevated audit detail
Banner persists on record: "Emergency access active - expires [time]"

1.4 Platform-Specific HIPAA Controls

Web (PHP):

// Secure session configuration
ini_set('session.cookie_httponly', 1);
ini_set('session.cookie_secure', 1);
ini_set('session.cookie_samesite', 'Strict');
ini_set('session.gc_maxlifetime', 900); // 15 min
header('Content-Security-Policy: default-src \'self\'; script-src \'self\'');
header('X-Content-Type-Options: nosniff');
header('X-Frame-Options: DENY');
header('Referrer-Policy: no-referrer'); // Prevent PHI leaking in referrer

Android (Kotlin):

// Sensitive screen protection
class PatientRecordActivity : ComponentActivity() {
    override fun onCreate(savedInstanceState: Bundle?) {
        super.onCreate(savedInstanceState)
        window.setFlags(
            WindowManager.LayoutParams.FLAG_SECURE,
            WindowManager.LayoutParams.FLAG_SECURE
        )
    }
}

// Encrypted storage for cached PHI
val prefs = EncryptedSharedPreferences.create(
    "phi_cache",
    MasterKeys.getOrCreate(MasterKeys.AES256_GCM_SPEC),
    context,
    EncryptedSharedPreferences.PrefKeyEncryptionScheme.AES256_SIV,
    EncryptedSharedPreferences.PrefValueEncryptionScheme.AES256_GCM
)

2. WCAG 2.2 AA Compliance

2.1 Color Contrast Requirements

Element	Minimum Ratio	Test Tool
Normal text (<18px)	4.5:1	WebAIM Contrast Checker
Large text (18px+ or 14px+ bold)	3:1	Browser DevTools
Non-text (icons, borders, focus rings)	3:1	axe DevTools
Clinical status colors vs background	4.5:1	Test each status color

Critical: Test ALL clinical status colors (critical red, warning amber, success green, info blue) against both light and dark card backgrounds.

Every healthcare screen must be fully keyboard-operable:

Tab reaches every interactive element in logical order (top-to-bottom, left-to-right)
Focus indicators are always visible: outline: 2px solid var(--clinical-primary); outline-offset: 2px;
Skip-to-content link on every page (first focusable element)
Escape closes all modals, dropdowns, and overlays
Enter/Space activates buttons and toggles
Arrow keys navigate within components (tabs, menus, date pickers)

Web implementation:

<!-- Skip link — first element in <body> -->
<a href="#main-content" class="visually-hidden-focusable">
  Skip to main content
</a>

<!-- Focus indicator — never use outline: none -->
<style>
:focus-visible {
  outline: 2px solid var(--clinical-primary);
  outline-offset: 2px;
  border-radius: var(--radius-sm);
}
</style>

Web ARIA patterns:

<!-- Vital signs with live updates -->
<div role="region" aria-label="Vital Signs Monitor" aria-live="polite">
  <dl>
    <dt>Heart Rate</dt>
    <dd aria-label="Heart rate 72 beats per minute, normal">
      <span class="vital-value">72</span> <span class="vital-unit">bpm</span>
      <span class="badge badge-success">Normal</span>
    </dd>
  </dl>
</div>

<!-- Critical alert — assertive announcement -->
<div role="alert" aria-live="assertive">
  Critical: Blood pressure reading 180/120 — immediate attention required
</div>

<!-- Table with proper scope headers -->
<table aria-label="Patient Medications">
  <thead>
    <tr><th scope="col">Medication</th><th scope="col">Dosage</th><th scope="col">Frequency</th><th scope="col">Status</th></tr>
  </thead>
  <tbody>
    <tr><th scope="row">Metformin</th><td>500mg</td><td>Twice daily</td><td><span aria-label="Active">Active</span></td></tr>
  </tbody>
</table>

<!-- ARIA landmarks -->
<header role="banner">...</header>
<nav role="navigation" aria-label="Main">...</nav>
<main role="main" id="main-content">...</main>
<aside role="complementary" aria-label="Patient summary">...</aside>

Android Compose semantics:

@Composable
fun VitalSignCard(label: String, value: String, unit: String, status: VitalStatus) {
    Card(
        modifier = Modifier.semantics(mergeDescendants = true) {
            contentDescription = "$label $value $unit, ${status.label}"
            stateDescription = status.label
            if (status == VitalStatus.CRITICAL) liveRegion = LiveRegionMode.Assertive
        }
    ) {
        Text(text = label, style = MaterialTheme.typography.labelMedium)
        Text(text = "$value $unit", style = MaterialTheme.typography.headlineMedium)
        StatusBadge(status = status)
    }
}

@Composable
fun CriticalAlert(message: String) {
    Card(
        colors = CardDefaults.cardColors(containerColor = ClinicalColors.CriticalLight),
        modifier = Modifier.semantics {
            liveRegion = LiveRegionMode.Assertive
            contentDescription = "Critical alert: $message"
        }
    ) { Text(text = message, color = ClinicalColors.Critical) }
}

2.4 Touch Target & Form Accessibility

Touch targets:

Context	Web Minimum	Android Minimum	Healthcare Recommended
Standard interactive	44x44px	48x48dp	48px / 48dp
Primary clinical action	48x48px	56x56dp	56px / 56dp
Gap between targets	8px	8dp	8px / 8dp

Forms -- mandatory patterns:

<!-- ALWAYS visible labels, NEVER placeholder-only -->
<div class="mb-3">
  <label for="allergies" class="form-label">
    Known Allergies <span class="text-danger" aria-hidden="true">*</span>
    <span class="visually-hidden">(required)</span>
  </label>
  <textarea id="allergies" class="form-control" required
    aria-describedby="allergies-help allergies-error"></textarea>
  <div id="allergies-help" class="form-text">List all known drug and food allergies</div>
  <div id="allergies-error" class="invalid-feedback" role="alert">Required for patient safety</div>
</div>

<!-- Group related fields with fieldset/legend -->
<fieldset>
  <legend>Emergency Contact</legend>
  <label for="ec-name" class="form-label">Full Name</label>
  <input type="text" id="ec-name" class="form-control mb-3">
  <label for="ec-phone" class="form-label">Phone Number</label>
  <input type="tel" id="ec-phone" class="form-control">
</fieldset>

3. Color-Blind Safe Design

Rule: Never use color alone to convey clinical meaning.

Every color indicator must be paired with at least one of: icon, text label, pattern, or shape.

3.1 Status Indicator Pattern

Status	Color	Icon	Text Label	All Three Together
Critical	`#DC2626`	Warning triangle	"Critical"	Red triangle + "Critical" text
Warning	`#D97706`	Exclamation circle	"Warning"	Amber circle + "Warning" text
Normal	`#059669`	Checkmark	"Normal"	Green check + "Normal" text
Info	`#0284C7`	Info circle	"Pending"	Blue info + "Pending" text

3.2 Chart Accessibility

For clinical charts (vitals over time, lab trends):

Use different line patterns: solid, dashed, dotted, dash-dot
Add distinct markers: circle, square, triangle, diamond
Include data labels at key points
Provide tabular data alternative

3.3 Safe Color Pairs

Instead of red/green (indistinguishable for 8% of males):

Use Case	Recommended Pair	Avoid
Good/Bad	Blue `#2563EB` + Orange `#D97706`	Red + Green
High contrast	Dark blue `#1E40AF` + Yellow `#CA8A04`	Red + Green
Status range	Blue/Amber/Dark gray	Red/Yellow/Green alone

Test all palettes with Deuteranopia, Protanopia, and Tritanopia simulators (Chrome DevTools > Rendering > Emulate vision deficiencies).

4. Role-Based Access Control UI

4.1 UI Visibility Rules

Strategy	When to Use
Hide nav items/menu entries	User's role has zero access to the feature
Disable (gray out) buttons/actions	User can see but needs higher permission to act
Show explanation on unauthorized attempt	User clicks disabled action or navigates via URL

Never rely on UI hiding alone for security. Server-side permission checks are mandatory.

4.2 Healthcare Role Hierarchy

Role	Scope	Typical Access
Super Admin	System-wide	Full platform configuration
Facility Admin	Facility	User management, facility settings, reports
Physician	Assigned patients	Records, orders, prescriptions, referrals
Nurse	Assigned ward/unit	Vitals, medication admin, notes, assessments
Lab Technician	Lab module	Lab orders, results entry, specimen tracking
Pharmacist	Pharmacy module	Medication orders, dispensing, interactions
Receptionist	Front desk	Scheduling, check-in, demographics, billing
Patient	Own records	View records, appointments, messages, payments

4.3 Platform Integration

Web: Use dual-auth-rbac skill for server-side checks + UI filtering:

// Server-side: always check before rendering
if ($auth->hasPermission('view_patient_records')) {
    include 'partials/patient-records-nav.php';
}
// Client-side disabled state for visible but restricted actions
<button class="btn btn-primary" <?= !$auth->hasPermission('prescribe') ? 'disabled aria-disabled="true" title="Requires physician role"' : '' ?>>
  Write Prescription
</button>

Android: Use mobile-rbac skill PermissionGate composable:

PermissionGate(permission = "view_patient_records") {
    PatientRecordsScreen()
}

// Disabled button for visible but restricted actions
PermissionButton(
    permission = "prescribe",
    onClick = { navController.navigate("prescribe/$patientId") },
    disabledMessage = "Requires physician role"
) {
    Text("Write Prescription")
}

5. Data Privacy UI Patterns

Provide granular, revocable consent toggles:

Consent Settings
-------------------------------------------------
[ON]  Share records with my care team
[OFF] Share anonymized data with research
[OFF] Share records with insurance provider
[ON]  Receive appointment reminders via SMS
[OFF] Allow third-party health app access
-------------------------------------------------
Last updated: Feb 15, 2026 | Version 3
[View full consent agreement] [Download my consent history]

Requirements:

Each toggle has a plain-language explanation (not legal jargon)
Revocable at any time from patient settings
All consent changes are version-tracked with timestamps
Consent state is checked server-side before any data sharing

5.2 Data Portability

Export my health data -- FHIR R4 format (JSON) or human-readable PDF
Request data deletion -- with clear notice of legal retention periods (e.g., "Records retained 7 years per state law")
Data sharing dashboard -- shows who has access to what, with revoke option

5.3 Privacy Notices

Layered notice: short summary visible, full policy one click away (plain language, 6th grade reading level)
Web: cookie/tracking consent banner (GDPR/state law) | Android: privacy policy in settings, consent at onboarding

6. Security UI Patterns

6.1 Authentication

MFA required for all clinical users (password + OTP or biometric)
Session indicator: lock icon + "Secure Session" in header
Failed login handling: lockout after 5 consecutive failures, CAPTCHA after 3
Password strength: minimum 12 characters, complexity indicator, healthcare-grade policy

6.2 Sensitive Action Verification

Re-authenticate before high-risk actions:

Action	Verification Method
Prescribing medication	Password or biometric re-entry
Accessing restricted record	Break-the-glass flow (Section 1.3)
Exporting patient data	Password + reason documentation
Overriding a block	Supervisor PIN entry
Digital signature	Credentials + displayed signer identity

6.3 Copy/Paste and Screen Capture

Web:

<!-- Warn on copy of PHI fields -->
<input type="text" id="ssn-field" class="phi-field"
  oncopy="logPhiCopy('ssn', userId); showCopyWarning();"
  style="user-select: none;" readonly>

<script>
function showCopyWarning() {
  Swal.fire({
    icon: 'warning',
    title: 'PHI Copy Detected',
    text: 'Copying protected health information has been logged.',
    confirmButtonColor: 'var(--clinical-primary)'
  });
}
</script>

Android:

// Prevent screenshots on sensitive screens
window.setFlags(
    WindowManager.LayoutParams.FLAG_SECURE,
    WindowManager.LayoutParams.FLAG_SECURE
)

// Disable copy on PHI text fields
TextField(
    value = maskedSsn,
    onValueChange = {},
    readOnly = true,
    modifier = Modifier.semantics {
        // Announce that copy is restricted
        contentDescription = "Social Security Number, last four digits, copy restricted"
    },
    visualTransformation = SsnMaskTransformation()
)

7. Per-Screen Compliance Checklist

Use this checklist for every healthcare screen built:

Accessibility

Color contrast verified: 4.5:1 for text, 3:1 for non-text elements
All color indicators paired with text labels and/or icons
Keyboard navigation works completely (Tab, Enter, Escape, arrows)
Visible focus indicators on all interactive elements
Screen reader announces all content correctly (test with NVDA/TalkBack)
Touch targets meet minimum 48dp (Android) / 44px (web)
Forms have visible labels, not placeholder-only
Error messages programmatically associated with fields (aria-describedby)
Loading states announced via aria-live regions
Skip-to-content link present (web)

HIPAA & Privacy

PHI not exposed in URLs, page titles, or browser tabs
PHI not logged to console or included in error messages
Sensitive identifiers masked (SSN, DOB per role)
Session timeout implemented with state preservation
Audit logging for all data access and modifications
"Last accessed by" displayed on sensitive records
Minimum Necessary Rule applied (role-scoped data)

Security

Role-based visibility applied (hide/disable per permission)
Server-side permission check backs up every UI gate
Re-authentication required for sensitive actions
FLAG_SECURE set on sensitive Android screens
CSP headers and secure cookies configured (web)
Copy/paste restrictions on PHI fields with logging
Break-the-glass flow available for emergency access

Cross-references: dual-auth-rbac for auth patterns | mobile-rbac for Android permissions | vibe-security-skill for general web security | design-tokens.md for clinical color values

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