Add full Oncology, Renal Care, and Surgery specialty clinical suites.

Match Pediatrics/ENT depth with stages, workspace tabs, clinical records, reports/print, demo seed, and suite tests.

Co-authored-by: Cursor <cursoragent@cursor.com>

app/Http/Controllers/Care/OncologyWorkspaceController.php

@@ -0,0 +1,215 @@
+<?php
+
+namespace App\Http\Controllers\Care;
+
+use App\Http\Controllers\Care\Concerns\ScopesToAccount;
+use App\Http\Controllers\Controller;
+use App\Models\SpecialtyClinicalRecord;
+use App\Models\Visit;
+use App\Services\Care\Oncology\OncologyAnalyticsService;
+use App\Services\Care\Oncology\OncologyWorkflowService;
+use App\Services\Care\SpecialtyClinicalRecordService;
+use App\Services\Care\SpecialtyModuleService;
+use App\Services\Care\SpecialtyShellService;
+use App\Services\Care\SpecialtyVisitStageService;
+use Illuminate\Http\RedirectResponse;
+use Illuminate\Http\Request;
+use Illuminate\View\View;
+
+class OncologyWorkspaceController extends Controller
+{
+    use ScopesToAccount;
+
+    protected function assertOncologyAccess(Request $request, SpecialtyModuleService $modules): void
+    {
+        $organization = $this->organization($request);
+        abort_unless($modules->memberCanAccess($organization, $this->member($request), 'oncology'), 403);
+    }
+
+    protected function assertOncologyManage(Request $request, SpecialtyModuleService $modules): void
+    {
+        $organization = $this->organization($request);
+        abort_unless($modules->memberCanManage($organization, $this->member($request), 'oncology'), 403);
+    }
+
+    protected function assertVisit(Request $request, Visit $visit): void
+    {
+        abort_unless($visit->organization_id === $this->organization($request)->id, 404);
+        $this->authorizeBranch($request, (int) $visit->branch_id);
+    }
+
+    public function setStage(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        SpecialtyVisitStageService $stages,
+        SpecialtyShellService $shell,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertOncologyManage($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $validated = $request->validate([
+            'stage' => ['required', 'string', 'max:32'],
+        ]);
+
+        try {
+            $stages->setStage(
+                $this->organization($request),
+                $visit,
+                'oncology',
+                $validated['stage'],
+                $this->ownerRef($request),
+                $this->actorRef($request),
+            );
+        } catch (\InvalidArgumentException $e) {
+            return back()->with('error', $e->getMessage());
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', [
+                'module' => 'oncology',
+                'visit' => $visit,
+                'tab' => $shell->workspaceTabForStage('oncology', $validated['stage']),
+            ])
+            ->with('success', 'Visit stage updated.');
+    }
+
+    public function saveTreatment(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        SpecialtyClinicalRecordService $clinical,
+        SpecialtyVisitStageService $stages,
+        OncologyWorkflowService $workflow,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertOncologyManage($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $organization = $this->organization($request);
+        $owner = $this->ownerRef($request);
+
+        $payload = (array) $request->input('payload', []);
+        foreach ($clinical->fieldsFor('oncology', 'onc_treatment') as $field) {
+            if (($field['type'] ?? '') === 'boolean') {
+                $payload[$field['name']] = $request->boolean('payload.'.$field['name']);
+            }
+        }
+        $request->merge(['payload' => $payload, 'tab' => 'treatment']);
+
+        $validated = $request->validate(array_merge([
+            'tab' => ['required', 'string'],
+        ], $clinical->validationRules('oncology', 'onc_treatment')));
+
+        $record = $clinical->upsert(
+            $organization,
+            $visit,
+            'oncology',
+            'onc_treatment',
+            $clinical->payloadFromRequest($validated),
+            $owner,
+            $owner,
+            OncologyWorkflowService::STAGE_TREATMENT,
+            SpecialtyClinicalRecord::STATUS_COMPLETED,
+        );
+
+        try {
+            $stages->setStage(
+                $organization,
+                $visit,
+                'oncology',
+                OncologyWorkflowService::STAGE_TREATMENT,
+                $owner,
+                $owner,
+            );
+        } catch (\InvalidArgumentException) {
+        }
+
+        if ($workflow->shouldCompleteVisit($record->payload ?? [])) {
+            try {
+                $stages->setStage(
+                    $organization,
+                    $visit,
+                    'oncology',
+                    OncologyWorkflowService::STAGE_COMPLETED,
+                    $owner,
+                    $owner,
+                );
+            } catch (\InvalidArgumentException) {
+            }
+
+            $visit->refresh();
+            if ($visit->status !== Visit::STATUS_COMPLETED) {
+                $visit->update([
+                    'status' => Visit::STATUS_COMPLETED,
+                    'completed_at' => $visit->completed_at ?? now(),
+                ]);
+            }
+
+            $appointment = $visit->appointment;
+            if ($appointment && $appointment->status !== \App\Models\Appointment::STATUS_COMPLETED) {
+                $appointment->update([
+                    'status' => \App\Models\Appointment::STATUS_COMPLETED,
+                    'completed_at' => $appointment->completed_at ?? now(),
+                ]);
+            }
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', ['module' => 'oncology', 'visit' => $visit, 'tab' => 'treatment'])
+            ->with('success', 'Oncology treatment saved.');
+    }
+
+    public function reports(
+        Request $request,
+        SpecialtyModuleService $modules,
+        SpecialtyShellService $shell,
+        OncologyAnalyticsService $analytics,
+    ): View {
+        $this->authorizeAbility($request, 'consultations.view');
+        $this->assertOncologyAccess($request, $modules);
+
+        $organization = $this->organization($request);
+        $branchScope = app(\App\Services\Care\OrganizationResolver::class)->branchScope($this->member($request));
+
+        $report = $analytics->report(
+            $organization,
+            $this->ownerRef($request),
+            $branchScope,
+            $request->query('from'),
+            $request->query('to'),
+        );
+
+        return view('care.specialty.oncology.reports', [
+            'moduleKey' => 'oncology',
+            'definition' => $modules->definition('oncology'),
+            'shellNav' => $shell->navItems('oncology'),
+            'report' => $report,
+            'currency' => strtoupper((string) config('care.billing.currency', config('care.currency', 'GHS'))),
+        ]);
+    }
+
+    public function printSummary(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        SpecialtyClinicalRecordService $clinical,
+    ): View {
+        $this->authorizeAbility($request, 'consultations.view');
+        $this->assertOncologyAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $visit->loadMissing(['patient', 'appointment.practitioner', 'branch']);
+
+        return view('care.specialty.oncology.print', [
+            'visit' => $visit,
+            'patient' => $visit->patient,
+            'history' => $clinical->findForVisit($visit, 'oncology', 'onc_history'),
+            'staging' => $clinical->findForVisit($visit, 'oncology', 'onc_staging'),
+            'investigation' => $clinical->findForVisit($visit, 'oncology', 'onc_investigation'),
+            'plan' => $clinical->findForVisit($visit, 'oncology', 'onc_plan'),
+            'treatment' => $clinical->findForVisit($visit, 'oncology', 'onc_treatment'),
+        ]);
+    }
+}

app/Http/Controllers/Care/RenalWorkspaceController.php

@@ -0,0 +1,214 @@
+<?php
+
+namespace App\Http\Controllers\Care;
+
+use App\Http\Controllers\Care\Concerns\ScopesToAccount;
+use App\Http\Controllers\Controller;
+use App\Models\SpecialtyClinicalRecord;
+use App\Models\Visit;
+use App\Services\Care\Renal\RenalAnalyticsService;
+use App\Services\Care\Renal\RenalWorkflowService;
+use App\Services\Care\SpecialtyClinicalRecordService;
+use App\Services\Care\SpecialtyModuleService;
+use App\Services\Care\SpecialtyShellService;
+use App\Services\Care\SpecialtyVisitStageService;
+use Illuminate\Http\RedirectResponse;
+use Illuminate\Http\Request;
+use Illuminate\View\View;
+
+class RenalWorkspaceController extends Controller
+{
+    use ScopesToAccount;
+
+    protected function assertRenalAccess(Request $request, SpecialtyModuleService $modules): void
+    {
+        $organization = $this->organization($request);
+        abort_unless($modules->memberCanAccess($organization, $this->member($request), 'renal'), 403);
+    }
+
+    protected function assertRenalManage(Request $request, SpecialtyModuleService $modules): void
+    {
+        $organization = $this->organization($request);
+        abort_unless($modules->memberCanManage($organization, $this->member($request), 'renal'), 403);
+    }
+
+    protected function assertVisit(Request $request, Visit $visit): void
+    {
+        abort_unless($visit->organization_id === $this->organization($request)->id, 404);
+        $this->authorizeBranch($request, (int) $visit->branch_id);
+    }
+
+    public function setStage(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        SpecialtyVisitStageService $stages,
+        SpecialtyShellService $shell,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertRenalManage($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $validated = $request->validate([
+            'stage' => ['required', 'string', 'max:32'],
+        ]);
+
+        try {
+            $stages->setStage(
+                $this->organization($request),
+                $visit,
+                'renal',
+                $validated['stage'],
+                $this->ownerRef($request),
+                $this->actorRef($request),
+            );
+        } catch (\InvalidArgumentException $e) {
+            return back()->with('error', $e->getMessage());
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', [
+                'module' => 'renal',
+                'visit' => $visit,
+                'tab' => $shell->workspaceTabForStage('renal', $validated['stage']),
+            ])
+            ->with('success', 'Visit stage updated.');
+    }
+
+    public function savePlan(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        SpecialtyClinicalRecordService $clinical,
+        SpecialtyVisitStageService $stages,
+        RenalWorkflowService $workflow,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertRenalManage($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $organization = $this->organization($request);
+        $owner = $this->ownerRef($request);
+
+        $payload = (array) $request->input('payload', []);
+        foreach ($clinical->fieldsFor('renal', 'renal_plan') as $field) {
+            if (($field['type'] ?? '') === 'boolean') {
+                $payload[$field['name']] = $request->boolean('payload.'.$field['name']);
+            }
+        }
+        $request->merge(['payload' => $payload, 'tab' => 'plan']);
+
+        $validated = $request->validate(array_merge([
+            'tab' => ['required', 'string'],
+        ], $clinical->validationRules('renal', 'renal_plan')));
+
+        $record = $clinical->upsert(
+            $organization,
+            $visit,
+            'renal',
+            'renal_plan',
+            $clinical->payloadFromRequest($validated),
+            $owner,
+            $owner,
+            RenalWorkflowService::STAGE_PLAN,
+            SpecialtyClinicalRecord::STATUS_COMPLETED,
+        );
+
+        try {
+            $stages->setStage(
+                $organization,
+                $visit,
+                'renal',
+                RenalWorkflowService::STAGE_PLAN,
+                $owner,
+                $owner,
+            );
+        } catch (\InvalidArgumentException) {
+        }
+
+        if ($workflow->shouldCompleteVisit($record->payload ?? [])) {
+            try {
+                $stages->setStage(
+                    $organization,
+                    $visit,
+                    'renal',
+                    RenalWorkflowService::STAGE_COMPLETED,
+                    $owner,
+                    $owner,
+                );
+            } catch (\InvalidArgumentException) {
+            }
+
+            $visit->refresh();
+            if ($visit->status !== Visit::STATUS_COMPLETED) {
+                $visit->update([
+                    'status' => Visit::STATUS_COMPLETED,
+                    'completed_at' => $visit->completed_at ?? now(),
+                ]);
+            }
+
+            $appointment = $visit->appointment;
+            if ($appointment && $appointment->status !== \App\Models\Appointment::STATUS_COMPLETED) {
+                $appointment->update([
+                    'status' => \App\Models\Appointment::STATUS_COMPLETED,
+                    'completed_at' => $appointment->completed_at ?? now(),
+                ]);
+            }
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', ['module' => 'renal', 'visit' => $visit, 'tab' => 'plan'])
+            ->with('success', 'Renal care plan saved.');
+    }
+
+    public function reports(
+        Request $request,
+        SpecialtyModuleService $modules,
+        SpecialtyShellService $shell,
+        RenalAnalyticsService $analytics,
+    ): View {
+        $this->authorizeAbility($request, 'consultations.view');
+        $this->assertRenalAccess($request, $modules);
+
+        $organization = $this->organization($request);
+        $branchScope = app(\App\Services\Care\OrganizationResolver::class)->branchScope($this->member($request));
+
+        $report = $analytics->report(
+            $organization,
+            $this->ownerRef($request),
+            $branchScope,
+            $request->query('from'),
+            $request->query('to'),
+        );
+
+        return view('care.specialty.renal.reports', [
+            'moduleKey' => 'renal',
+            'definition' => $modules->definition('renal'),
+            'shellNav' => $shell->navItems('renal'),
+            'report' => $report,
+            'currency' => strtoupper((string) config('care.billing.currency', config('care.currency', 'GHS'))),
+        ]);
+    }
+
+    public function printSummary(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        SpecialtyClinicalRecordService $clinical,
+    ): View {
+        $this->authorizeAbility($request, 'consultations.view');
+        $this->assertRenalAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $visit->loadMissing(['patient', 'appointment.practitioner', 'branch']);
+
+        return view('care.specialty.renal.print', [
+            'visit' => $visit,
+            'patient' => $visit->patient,
+            'history' => $clinical->findForVisit($visit, 'renal', 'renal_history'),
+            'exam' => $clinical->findForVisit($visit, 'renal', 'renal_exam'),
+            'dialysis' => $clinical->findForVisit($visit, 'renal', 'renal_session'),
+            'plan' => $clinical->findForVisit($visit, 'renal', 'renal_plan'),
+        ]);
+    }
+}

app/Http/Controllers/Care/SpecialtyModuleController.php

@@ -162,6 +162,9 @@ class SpecialtyModuleController extends Controller
                 'pediatrics' => 'history',
                 'orthopedics' => 'history',
                 'ent' => 'history',
+                'oncology' => 'history',
+                'renal' => 'history',
+                'surgery' => 'history',
                 default => (collect(array_keys($shellTabs))
                     ->first(fn (string $tab) => $clinical->recordTypeForTab($module, $tab) !== null)
                     ?? 'clinical_notes'),
@@ -242,6 +245,9 @@ class SpecialtyModuleController extends Controller
             'pediatrics' => 'history',
             'orthopedics' => 'history',
             'ent' => 'history',
+            'oncology' => 'history',
+            'renal' => 'history',
+            'surgery' => 'history',
             default => (collect(array_keys($shellTabs))
                 ->first(fn (string $tab) => $clinical->recordTypeForTab($module, $tab) !== null)
                 ?? 'clinical_notes'),
@@ -806,6 +812,109 @@ class SpecialtyModuleController extends Controller
             }
         }
 
+
+        if ($module === 'oncology' && in_array($recordType, ['onc_history', 'onc_staging', 'onc_investigation', 'onc_plan'], true)) {
+            $workflow = app(\App\Services\Care\Oncology\OncologyWorkflowService::class);
+            $stageService = app(\App\Services\Care\SpecialtyVisitStageService::class);
+            $suggested = match ($recordType) {
+                'onc_history' => $workflow->stageFromHistory($record->payload ?? []),
+                'onc_staging' => $workflow->stageFromStaging($record->payload ?? []),
+                'onc_investigation' => $workflow->stageFromInvestigation($record->payload ?? []),
+                'onc_plan' => $workflow->stageFromPlan($record->payload ?? []),
+                default => null,
+            };
+            $current = $visit->specialty_stage;
+            $early = ['check_in', 'waiting', null, ''];
+            $order = [
+                'check_in' => 0,
+                'history' => 1,
+                'staging' => 2,
+                'investigation' => 3,
+                'plan' => 4,
+                'treatment' => 5,
+                'completed' => 6,
+            ];
+            if ($suggested && (! $current || in_array($current, $early, true))) {
+                try {
+                    $stageService->setStage($organization, $visit, 'oncology', $suggested, $this->ownerRef($request), $this->ownerRef($request));
+                } catch (\InvalidArgumentException) {
+                }
+            } elseif ($suggested && $suggested !== $current && ($order[$suggested] ?? 0) > ($order[$current] ?? 0)) {
+                try {
+                    $stageService->setStage($organization, $visit, 'oncology', $suggested, $this->ownerRef($request), $this->ownerRef($request));
+                } catch (\InvalidArgumentException) {
+                }
+            }
+        }
+
+        if ($module === 'renal' && in_array($recordType, ['renal_history', 'renal_exam', 'renal_session'], true)) {
+            $workflow = app(\App\Services\Care\Renal\RenalWorkflowService::class);
+            $stageService = app(\App\Services\Care\SpecialtyVisitStageService::class);
+            $suggested = match ($recordType) {
+                'renal_history' => $workflow->stageFromHistory($record->payload ?? []),
+                'renal_exam' => $workflow->stageFromExam($record->payload ?? []),
+                'renal_session' => $workflow->stageFromDialysis($record->payload ?? []),
+                default => null,
+            };
+            $current = $visit->specialty_stage;
+            $early = ['check_in', 'waiting', null, ''];
+            $order = [
+                'check_in' => 0,
+                'history' => 1,
+                'exam' => 2,
+                'dialysis' => 3,
+                'plan' => 4,
+                'completed' => 5,
+            ];
+            if ($suggested && (! $current || in_array($current, $early, true))) {
+                try {
+                    $stageService->setStage($organization, $visit, 'renal', $suggested, $this->ownerRef($request), $this->ownerRef($request));
+                } catch (\InvalidArgumentException) {
+                }
+            } elseif ($suggested && $suggested !== $current && ($order[$suggested] ?? 0) > ($order[$current] ?? 0)) {
+                try {
+                    $stageService->setStage($organization, $visit, 'renal', $suggested, $this->ownerRef($request), $this->ownerRef($request));
+                } catch (\InvalidArgumentException) {
+                }
+            }
+        }
+
+        if ($module === 'surgery' && in_array($recordType, ['surg_history', 'surg_exam', 'surg_investigation', 'surg_plan', 'surg_procedure'], true)) {
+            $workflow = app(\App\Services\Care\Surgery\SurgeryWorkflowService::class);
+            $stageService = app(\App\Services\Care\SpecialtyVisitStageService::class);
+            $suggested = match ($recordType) {
+                'surg_history' => $workflow->stageFromHistory($record->payload ?? []),
+                'surg_exam' => $workflow->stageFromExam($record->payload ?? []),
+                'surg_investigation' => $workflow->stageFromInvestigation($record->payload ?? []),
+                'surg_plan' => $workflow->stageFromPlan($record->payload ?? []),
+                'surg_procedure' => $workflow->stageFromProcedure($record->payload ?? []),
+                default => null,
+            };
+            $current = $visit->specialty_stage;
+            $early = ['check_in', 'waiting', null, ''];
+            $order = [
+                'check_in' => 0,
+                'history' => 1,
+                'exam' => 2,
+                'investigation' => 3,
+                'plan' => 4,
+                'procedure' => 5,
+                'postop' => 6,
+                'completed' => 7,
+            ];
+            if ($suggested && (! $current || in_array($current, $early, true))) {
+                try {
+                    $stageService->setStage($organization, $visit, 'surgery', $suggested, $this->ownerRef($request), $this->ownerRef($request));
+                } catch (\InvalidArgumentException) {
+                }
+            } elseif ($suggested && $suggested !== $current && ($order[$suggested] ?? 0) > ($order[$current] ?? 0)) {
+                try {
+                    $stageService->setStage($organization, $visit, 'surgery', $suggested, $this->ownerRef($request), $this->ownerRef($request));
+                } catch (\InvalidArgumentException) {
+                }
+            }
+        }
+
         return redirect()
             ->route('care.specialty.workspace', [
                 'module' => $module,
@@ -1262,6 +1371,27 @@ class SpecialtyModuleController extends Controller
         $entProcedure = null;
         $entStageCodes = [];
         $entStageFlow = [];
+        $oncologyHistory = null;
+        $oncologyStaging = null;
+        $oncologyInvestigation = null;
+        $oncologyPlan = null;
+        $oncologyTreatment = null;
+        $oncologyStageCodes = [];
+        $oncologyStageFlow = [];
+        $renalHistory = null;
+        $renalExam = null;
+        $renalDialysis = null;
+        $renalPlan = null;
+        $renalStageCodes = [];
+        $renalStageFlow = [];
+        $surgeryHistory = null;
+        $surgeryExam = null;
+        $surgeryInvestigation = null;
+        $surgeryPlan = null;
+        $surgeryProcedure = null;
+        $surgeryPostop = null;
+        $surgeryStageCodes = [];
+        $surgeryStageFlow = [];
         $activeTab = (string) $request->query('tab', array_key_first($shell->workspaceTabs($module)) ?: 'overview');
         $clinical = app(SpecialtyClinicalRecordService::class);
 
@@ -1456,6 +1586,36 @@ class SpecialtyModuleController extends Controller
                 $entStageFlow = app(\App\Services\Care\Ent\EntWorkflowService::class)->stageFlow();
             }
 
+            if ($module === 'oncology') {
+                $oncologyHistory = $clinical->findForVisit($workspaceVisit, 'oncology', 'onc_history');
+                $oncologyStaging = $clinical->findForVisit($workspaceVisit, 'oncology', 'onc_staging');
+                $oncologyInvestigation = $clinical->findForVisit($workspaceVisit, 'oncology', 'onc_investigation');
+                $oncologyPlan = $clinical->findForVisit($workspaceVisit, 'oncology', 'onc_plan');
+                $oncologyTreatment = $clinical->findForVisit($workspaceVisit, 'oncology', 'onc_treatment');
+                $oncologyStageCodes = collect($shell->stages('oncology'))->pluck('code')->all();
+                $oncologyStageFlow = app(\App\Services\Care\Oncology\OncologyWorkflowService::class)->stageFlow();
+            }
+
+            if ($module === 'renal') {
+                $renalHistory = $clinical->findForVisit($workspaceVisit, 'renal', 'renal_history');
+                $renalExam = $clinical->findForVisit($workspaceVisit, 'renal', 'renal_exam');
+                $renalDialysis = $clinical->findForVisit($workspaceVisit, 'renal', 'renal_session');
+                $renalPlan = $clinical->findForVisit($workspaceVisit, 'renal', 'renal_plan');
+                $renalStageCodes = collect($shell->stages('renal'))->pluck('code')->all();
+                $renalStageFlow = app(\App\Services\Care\Renal\RenalWorkflowService::class)->stageFlow();
+            }
+
+            if ($module === 'surgery') {
+                $surgeryHistory = $clinical->findForVisit($workspaceVisit, 'surgery', 'surg_history');
+                $surgeryExam = $clinical->findForVisit($workspaceVisit, 'surgery', 'surg_exam');
+                $surgeryInvestigation = $clinical->findForVisit($workspaceVisit, 'surgery', 'surg_investigation');
+                $surgeryPlan = $clinical->findForVisit($workspaceVisit, 'surgery', 'surg_plan');
+                $surgeryProcedure = $clinical->findForVisit($workspaceVisit, 'surgery', 'surg_procedure');
+                $surgeryPostop = $clinical->findForVisit($workspaceVisit, 'surgery', 'surg_postop');
+                $surgeryStageCodes = collect($shell->stages('surgery'))->pluck('code')->all();
+                $surgeryStageFlow = app(\App\Services\Care\Surgery\SurgeryWorkflowService::class)->stageFlow();
+            }
+
             if ($patientHeader !== null) {
                 $patientHeader['clinical_alerts'] = $clinicalAlerts;
             }
@@ -1604,6 +1764,27 @@ class SpecialtyModuleController extends Controller
             'entProcedure' => $entProcedure,
             'entStageCodes' => $entStageCodes,
             'entStageFlow' => $entStageFlow,
+            'oncologyHistory' => $oncologyHistory,
+            'oncologyStaging' => $oncologyStaging,
+            'oncologyInvestigation' => $oncologyInvestigation,
+            'oncologyPlan' => $oncologyPlan,
+            'oncologyTreatment' => $oncologyTreatment,
+            'oncologyStageCodes' => $oncologyStageCodes,
+            'oncologyStageFlow' => $oncologyStageFlow,
+            'renalHistory' => $renalHistory,
+            'renalExam' => $renalExam,
+            'renalDialysis' => $renalDialysis,
+            'renalPlan' => $renalPlan,
+            'renalStageCodes' => $renalStageCodes,
+            'renalStageFlow' => $renalStageFlow,
+            'surgeryHistory' => $surgeryHistory,
+            'surgeryExam' => $surgeryExam,
+            'surgeryInvestigation' => $surgeryInvestigation,
+            'surgeryPlan' => $surgeryPlan,
+            'surgeryProcedure' => $surgeryProcedure,
+            'surgeryPostop' => $surgeryPostop,
+            'surgeryStageCodes' => $surgeryStageCodes,
+            'surgeryStageFlow' => $surgeryStageFlow,
             'queueStubs' => $modules->queueStubsFor($organization, $module),
             'branchId' => $branchId,
             'branchLabel' => $branchLabel,

app/Http/Controllers/Care/SurgeryWorkspaceController.php

@@ -0,0 +1,216 @@
+<?php
+
+namespace App\Http\Controllers\Care;
+
+use App\Http\Controllers\Care\Concerns\ScopesToAccount;
+use App\Http\Controllers\Controller;
+use App\Models\SpecialtyClinicalRecord;
+use App\Models\Visit;
+use App\Services\Care\SpecialtyClinicalRecordService;
+use App\Services\Care\SpecialtyModuleService;
+use App\Services\Care\SpecialtyShellService;
+use App\Services\Care\SpecialtyVisitStageService;
+use App\Services\Care\Surgery\SurgeryAnalyticsService;
+use App\Services\Care\Surgery\SurgeryWorkflowService;
+use Illuminate\Http\RedirectResponse;
+use Illuminate\Http\Request;
+use Illuminate\View\View;
+
+class SurgeryWorkspaceController extends Controller
+{
+    use ScopesToAccount;
+
+    protected function assertSurgeryAccess(Request $request, SpecialtyModuleService $modules): void
+    {
+        $organization = $this->organization($request);
+        abort_unless($modules->memberCanAccess($organization, $this->member($request), 'surgery'), 403);
+    }
+
+    protected function assertSurgeryManage(Request $request, SpecialtyModuleService $modules): void
+    {
+        $organization = $this->organization($request);
+        abort_unless($modules->memberCanManage($organization, $this->member($request), 'surgery'), 403);
+    }
+
+    protected function assertVisit(Request $request, Visit $visit): void
+    {
+        abort_unless($visit->organization_id === $this->organization($request)->id, 404);
+        $this->authorizeBranch($request, (int) $visit->branch_id);
+    }
+
+    public function setStage(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        SpecialtyVisitStageService $stages,
+        SpecialtyShellService $shell,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertSurgeryManage($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $validated = $request->validate([
+            'stage' => ['required', 'string', 'max:32'],
+        ]);
+
+        try {
+            $stages->setStage(
+                $this->organization($request),
+                $visit,
+                'surgery',
+                $validated['stage'],
+                $this->ownerRef($request),
+                $this->actorRef($request),
+            );
+        } catch (\InvalidArgumentException $e) {
+            return back()->with('error', $e->getMessage());
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', [
+                'module' => 'surgery',
+                'visit' => $visit,
+                'tab' => $shell->workspaceTabForStage('surgery', $validated['stage']),
+            ])
+            ->with('success', 'Visit stage updated.');
+    }
+
+    public function savePostop(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        SpecialtyClinicalRecordService $clinical,
+        SpecialtyVisitStageService $stages,
+        SurgeryWorkflowService $workflow,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertSurgeryManage($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $organization = $this->organization($request);
+        $owner = $this->ownerRef($request);
+
+        $payload = (array) $request->input('payload', []);
+        foreach ($clinical->fieldsFor('surgery', 'surg_postop') as $field) {
+            if (($field['type'] ?? '') === 'boolean') {
+                $payload[$field['name']] = $request->boolean('payload.'.$field['name']);
+            }
+        }
+        $request->merge(['payload' => $payload, 'tab' => 'postop']);
+
+        $validated = $request->validate(array_merge([
+            'tab' => ['required', 'string'],
+        ], $clinical->validationRules('surgery', 'surg_postop')));
+
+        $record = $clinical->upsert(
+            $organization,
+            $visit,
+            'surgery',
+            'surg_postop',
+            $clinical->payloadFromRequest($validated),
+            $owner,
+            $owner,
+            SurgeryWorkflowService::STAGE_POSTOP,
+            SpecialtyClinicalRecord::STATUS_COMPLETED,
+        );
+
+        try {
+            $stages->setStage(
+                $organization,
+                $visit,
+                'surgery',
+                SurgeryWorkflowService::STAGE_POSTOP,
+                $owner,
+                $owner,
+            );
+        } catch (\InvalidArgumentException) {
+        }
+
+        if ($workflow->shouldCompleteVisit($record->payload ?? [])) {
+            try {
+                $stages->setStage(
+                    $organization,
+                    $visit,
+                    'surgery',
+                    SurgeryWorkflowService::STAGE_COMPLETED,
+                    $owner,
+                    $owner,
+                );
+            } catch (\InvalidArgumentException) {
+            }
+
+            $visit->refresh();
+            if ($visit->status !== Visit::STATUS_COMPLETED) {
+                $visit->update([
+                    'status' => Visit::STATUS_COMPLETED,
+                    'completed_at' => $visit->completed_at ?? now(),
+                ]);
+            }
+
+            $appointment = $visit->appointment;
+            if ($appointment && $appointment->status !== \App\Models\Appointment::STATUS_COMPLETED) {
+                $appointment->update([
+                    'status' => \App\Models\Appointment::STATUS_COMPLETED,
+                    'completed_at' => $appointment->completed_at ?? now(),
+                ]);
+            }
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', ['module' => 'surgery', 'visit' => $visit, 'tab' => 'postop'])
+            ->with('success', 'Post-op note saved.');
+    }
+
+    public function reports(
+        Request $request,
+        SpecialtyModuleService $modules,
+        SpecialtyShellService $shell,
+        SurgeryAnalyticsService $analytics,
+    ): View {
+        $this->authorizeAbility($request, 'consultations.view');
+        $this->assertSurgeryAccess($request, $modules);
+
+        $organization = $this->organization($request);
+        $branchScope = app(\App\Services\Care\OrganizationResolver::class)->branchScope($this->member($request));
+
+        $report = $analytics->report(
+            $organization,
+            $this->ownerRef($request),
+            $branchScope,
+            $request->query('from'),
+            $request->query('to'),
+        );
+
+        return view('care.specialty.surgery.reports', [
+            'moduleKey' => 'surgery',
+            'definition' => $modules->definition('surgery'),
+            'shellNav' => $shell->navItems('surgery'),
+            'report' => $report,
+            'currency' => strtoupper((string) config('care.billing.currency', config('care.currency', 'GHS'))),
+        ]);
+    }
+
+    public function printSummary(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        SpecialtyClinicalRecordService $clinical,
+    ): View {
+        $this->authorizeAbility($request, 'consultations.view');
+        $this->assertSurgeryAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $visit->loadMissing(['patient', 'appointment.practitioner', 'branch']);
+
+        return view('care.specialty.surgery.print', [
+            'visit' => $visit,
+            'patient' => $visit->patient,
+            'history' => $clinical->findForVisit($visit, 'surgery', 'surg_history'),
+            'exam' => $clinical->findForVisit($visit, 'surgery', 'surg_exam'),
+            'investigation' => $clinical->findForVisit($visit, 'surgery', 'surg_investigation'),
+            'plan' => $clinical->findForVisit($visit, 'surgery', 'surg_plan'),
+            'procedure' => $clinical->findForVisit($visit, 'surgery', 'surg_procedure'),
+            'postop' => $clinical->findForVisit($visit, 'surgery', 'surg_postop'),
+        ]);
+    }
+}

app/Services/Care/DemoTenantSeeder.php

@@ -1023,6 +1023,9 @@ class DemoTenantSeeder
         $this->seedPediatricsClinicalDemo($organization, $ownerRef);
         $this->seedOrthopedicsClinicalDemo($organization, $ownerRef);
         $this->seedEntClinicalDemo($organization, $ownerRef);
+        $this->seedOncologyClinicalDemo($organization, $ownerRef);
+        $this->seedRenalClinicalDemo($organization, $ownerRef);
+        $this->seedSurgeryClinicalDemo($organization, $ownerRef);
 
         return $count;
     }
@@ -2222,6 +2225,226 @@ class DemoTenantSeeder
         }
     }
 
+
+    private function seedOncologyClinicalDemo(Organization $organization, string $ownerRef): void
+    {
+        $branchIds = Branch::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->pluck('id');
+        if ($branchIds->isEmpty()) {
+            return;
+        }
+        $departmentIds = Department::owned($ownerRef)
+            ->whereIn('branch_id', $branchIds)
+            ->where('type', 'oncology')
+            ->where('is_active', true)
+            ->pluck('id');
+        if ($departmentIds->isEmpty()) {
+            return;
+        }
+        $appointments = Appointment::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->whereIn('department_id', $departmentIds)
+            ->whereIn('status', [Appointment::STATUS_WAITING, Appointment::STATUS_CHECKED_IN])
+            ->whereNotNull('visit_id')
+            ->with('visit')
+            ->orderBy('branch_id')
+            ->orderBy('id')
+            ->get();
+        if ($appointments->isEmpty()) {
+            return;
+        }
+        $clinical = app(SpecialtyClinicalRecordService::class);
+        $index = 0;
+        foreach ($appointments as $appointment) {
+            $visit = $appointment->visit;
+            if (! $visit) {
+                continue;
+            }
+            $highRisk = $index === 0;
+            $clinical->upsert($organization, $visit, 'oncology', 'onc_history', [
+                'history' => $highRisk
+                    ? 'New diagnosis work-up; progressive fatigue and weight loss'
+                    : 'On adjuvant regimen; here for cycle review',
+                'cancer_history' => $highRisk ? 'Breast mass biopsied last month' : 'Stage II breast Ca — surgery 4 months ago',
+                'medications' => $highRisk ? 'Analgesia PRN' : 'Current chemo cycle medications',
+                'allergies' => 'NKDA',
+                'comorbidities' => $highRisk ? 'Hypertension' : 'None significant',
+                'social' => 'Family support available',
+            ], $ownerRef, $ownerRef, 'history');
+            $clinical->upsert($organization, $visit, 'oncology', 'onc_staging', [
+                'diagnosis' => $highRisk ? 'Suspected metastatic breast carcinoma' : 'Breast carcinoma — adjuvant',
+                'stage' => $highRisk ? 'cT4 N2 M1' : 'pT2 N1 M0',
+                'histology' => 'Invasive ductal carcinoma',
+                'performance_status' => $highRisk ? '3' : '1',
+                'exam_findings' => $highRisk ? 'Cachexia; axillary nodes; hepatic tenderness' : 'Well; surgical scar healed',
+                'sites' => $highRisk ? 'Breast, axilla, liver' : 'None residual known',
+            ], $ownerRef, $ownerRef, 'staging');
+            if ($highRisk) {
+                $clinical->upsert($organization, $visit, 'oncology', 'onc_plan', [
+                    'diagnosis' => 'Metastatic breast carcinoma',
+                    'plan' => 'Staging imaging; MDT; supportive care; consider palliative systemic therapy',
+                    'intent' => 'Palliative',
+                    'medications' => 'Analgesia; antiemetics PRN',
+                    'treatment_planned' => true,
+                    'follow_up' => 'Chemo day-care after MDT',
+                    'advice' => 'Return if fever or uncontrolled pain',
+                ], $ownerRef, $ownerRef, 'plan');
+            }
+            if (! $visit->specialty_stage) {
+                $visit->update(['specialty_stage' => $highRisk ? 'plan' : 'staging']);
+            }
+            $index++;
+        }
+    }
+
+    private function seedRenalClinicalDemo(Organization $organization, string $ownerRef): void
+    {
+        $branchIds = Branch::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->pluck('id');
+        if ($branchIds->isEmpty()) {
+            return;
+        }
+        $departmentIds = Department::owned($ownerRef)
+            ->whereIn('branch_id', $branchIds)
+            ->where('type', 'renal')
+            ->where('is_active', true)
+            ->pluck('id');
+        if ($departmentIds->isEmpty()) {
+            return;
+        }
+        $appointments = Appointment::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->whereIn('department_id', $departmentIds)
+            ->whereIn('status', [Appointment::STATUS_WAITING, Appointment::STATUS_CHECKED_IN])
+            ->whereNotNull('visit_id')
+            ->with('visit')
+            ->orderBy('branch_id')
+            ->orderBy('id')
+            ->get();
+        if ($appointments->isEmpty()) {
+            return;
+        }
+        $clinical = app(SpecialtyClinicalRecordService::class);
+        $index = 0;
+        foreach ($appointments as $appointment) {
+            $visit = $appointment->visit;
+            if (! $visit) {
+                continue;
+            }
+            $highRisk = $index === 0;
+            $clinical->upsert($organization, $visit, 'renal', 'renal_history', [
+                'history' => $highRisk
+                    ? 'Missed last dialysis; progressive dyspnoea and oedema'
+                    : 'Routine thrice-weekly haemodialysis review',
+                'ckd_stage' => $highRisk ? 'CKD 5D — 2 years on HD' : 'CKD 5D — 8 months on HD',
+                'access_history' => 'Left AV fistula',
+                'medications' => 'EPO; phosphate binders; antihypertensives',
+                'allergies' => 'NKDA',
+                'comorbidities' => $highRisk ? 'Diabetes; heart failure' : 'Hypertension',
+            ], $ownerRef, $ownerRef, 'history');
+            $clinical->upsert($organization, $visit, 'renal', 'renal_exam', [
+                'chief_complaint' => $highRisk ? 'Fluid overload / missed dialysis' : 'Routine dialysis session',
+                'bp' => $highRisk ? '168/98' : '132/78',
+                'weight_kg' => $highRisk ? 78.5 : 65.2,
+                'fluid_status' => $highRisk ? 'Overload' : 'Euvolemic',
+                'access' => 'Left AVF thrills present',
+                'exam_findings' => $highRisk ? 'Bilateral basal crackles; sacral oedema' : 'Chest clear; no oedema',
+                'uremic_symptoms' => $highRisk ? 'Nausea; pruritus' : 'None',
+            ], $ownerRef, $ownerRef, 'exam');
+            if ($highRisk) {
+                $clinical->upsert($organization, $visit, 'renal', 'renal_session', [
+                    'session_type' => 'Hemodialysis',
+                    'pre_weight_kg' => 78.5,
+                    'uf_goal_l' => 3.5,
+                    'access' => 'Left AVF',
+                    'bp_pre' => '168/98',
+                    'labs_summary' => 'K 5.8; Cr elevated; Hb 9.1',
+                    'complications' => 'Hypotension mid-session anticipated',
+                    'notes' => 'Urgent HD for fluid overload after missed session',
+                ], $ownerRef, $ownerRef, 'dialysis');
+            }
+            if (! $visit->specialty_stage) {
+                $visit->update(['specialty_stage' => $highRisk ? 'dialysis' : 'exam']);
+            }
+            $index++;
+        }
+    }
+
+    private function seedSurgeryClinicalDemo(Organization $organization, string $ownerRef): void
+    {
+        $branchIds = Branch::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->pluck('id');
+        if ($branchIds->isEmpty()) {
+            return;
+        }
+        $departmentIds = Department::owned($ownerRef)
+            ->whereIn('branch_id', $branchIds)
+            ->where('type', 'surgery')
+            ->where('is_active', true)
+            ->pluck('id');
+        if ($departmentIds->isEmpty()) {
+            return;
+        }
+        $appointments = Appointment::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->whereIn('department_id', $departmentIds)
+            ->whereIn('status', [Appointment::STATUS_WAITING, Appointment::STATUS_CHECKED_IN])
+            ->whereNotNull('visit_id')
+            ->with('visit')
+            ->orderBy('branch_id')
+            ->orderBy('id')
+            ->get();
+        if ($appointments->isEmpty()) {
+            return;
+        }
+        $clinical = app(SpecialtyClinicalRecordService::class);
+        $index = 0;
+        foreach ($appointments as $appointment) {
+            $visit = $appointment->visit;
+            if (! $visit) {
+                continue;
+            }
+            $highRisk = $index === 0;
+            $clinical->upsert($organization, $visit, 'surgery', 'surg_history', [
+                'history' => $highRisk
+                    ? 'Right inguinal hernia with intermittent pain; electing repair'
+                    : 'Post-appendicectomy wound check',
+                'past_surgical' => $highRisk ? 'None' : 'Laparoscopic appendicectomy 10 days ago',
+                'medications' => $highRisk ? 'None' : 'Analgesia; antibiotics completed',
+                'allergies' => 'NKDA',
+                'comorbidities' => $highRisk ? 'Well-controlled diabetes' : 'None',
+                'anaesthesia_history' => 'No prior issues',
+            ], $ownerRef, $ownerRef, 'history');
+            $clinical->upsert($organization, $visit, 'surgery', 'surg_exam', [
+                'chief_complaint' => $highRisk ? 'Inguinal hernia — pre-op' : 'Wound review',
+                'exam_findings' => $highRisk
+                    ? 'Right reducible inguinal hernia; no strangulation'
+                    : 'Wound clean; mild erythema; no discharge',
+                'asa_class' => $highRisk ? 'II' : 'I',
+                'fitness' => 'Fit for day-case anaesthesia',
+                'site_marking' => $highRisk,
+            ], $ownerRef, $ownerRef, 'exam');
+            if ($highRisk) {
+                $clinical->upsert($organization, $visit, 'surgery', 'surg_plan', [
+                    'diagnosis' => 'Right inguinal hernia',
+                    'proposed_procedure' => 'Open mesh hernia repair',
+                    'plan' => 'Day-case repair; consent discussed including mesh risks',
+                    'consent_obtained' => true,
+                    'procedure_planned' => true,
+                    'follow_up' => 'Wound check 7–10 days',
+                    'advice' => 'NPO from midnight; bring meds list',
+                ], $ownerRef, $ownerRef, 'plan');
+            }
+            if (! $visit->specialty_stage) {
+                $visit->update(['specialty_stage' => $highRisk ? 'plan' : 'exam']);
+            }
+            $index++;
+        }
+    }
+
     private function seedDentistryClinicalDemo(Organization $organization, string $ownerRef): void
     {
         // Specialty departments are provisioned without organization_id; scope via branches.

app/Services/Care/Oncology/OncologyAnalyticsService.php

@@ -0,0 +1,163 @@
+<?php
+
+namespace App\Services\Care\Oncology;
+
+use App\Models\Appointment;
+use App\Models\Bill;
+use App\Models\BillLineItem;
+use App\Models\Organization;
+use App\Models\SpecialtyClinicalRecord;
+use App\Models\Visit;
+use App\Services\Care\SpecialtyShellService;
+use Carbon\Carbon;
+use Illuminate\Support\Collection;
+
+class OncologyAnalyticsService
+{
+    public function __construct(
+        protected SpecialtyShellService $shell,
+    ) {}
+
+    /**
+     * @return array{
+     *     arrivals_today: int,
+     *     completed_today: int,
+     *     chemo_open: int,
+     *     diagnosis_breakdown: Collection,
+     *     regimen_breakdown: Collection,
+     *     avg_los_minutes: ?float,
+     *     revenue_by_service: Collection,
+     *     from: string,
+     *     to: string
+     * }
+     */
+    public function report(
+        Organization $organization,
+        string $ownerRef,
+        ?int $branchId = null,
+        ?string $from = null,
+        ?string $to = null,
+    ): array {
+        $todayStart = now()->startOfDay();
+        $rangeFrom = $from ? Carbon::parse($from)->startOfDay() : now()->startOfMonth();
+        $rangeTo = $to ? Carbon::parse($to)->endOfDay() : now()->endOfDay();
+
+        $departmentIds = $this->shell->departmentIds($organization, 'oncology', $ownerRef, $branchId);
+
+        $appointmentBase = Appointment::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->when($departmentIds !== [], fn ($q) => $q->whereIn('department_id', $departmentIds))
+            ->when($departmentIds === [], fn ($q) => $q->whereRaw('1 = 0'))
+            ->when($branchId, fn ($q) => $q->where('branch_id', $branchId));
+
+        $arrivalsToday = (clone $appointmentBase)
+            ->where('checked_in_at', '>=', $todayStart)
+            ->count();
+
+        $completedToday = (clone $appointmentBase)
+            ->where('status', Appointment::STATUS_COMPLETED)
+            ->where('completed_at', '>=', $todayStart)
+            ->count();
+
+        $visitIds = (clone $appointmentBase)->whereNotNull('visit_id')->pluck('visit_id');
+
+        $openVisitIds = Visit::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->whereIn('id', $visitIds->isEmpty() ? [0] : $visitIds)
+            ->whereIn('status', [Visit::STATUS_OPEN, Visit::STATUS_IN_PROGRESS])
+            ->pluck('id');
+
+        $chemoOpen = SpecialtyClinicalRecord::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->where('module_key', 'oncology')
+            ->where('record_type', 'onc_treatment')
+            ->whereIn('visit_id', $openVisitIds->isEmpty() ? [0] : $openVisitIds)
+            ->where('status', '!=', SpecialtyClinicalRecord::STATUS_COMPLETED)
+            ->count();
+
+        $stagingRecords = SpecialtyClinicalRecord::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->where('module_key', 'oncology')
+            ->where('record_type', 'onc_staging')
+            ->when($branchId, fn ($q) => $q->where('branch_id', $branchId))
+            ->whereBetween('recorded_at', [$rangeFrom, $rangeTo])
+            ->get();
+
+        $diagnosisBreakdown = $stagingRecords
+            ->groupBy(fn (SpecialtyClinicalRecord $r) => (string) ($r->payload['diagnosis'] ?? 'Unknown'))
+            ->map(fn (Collection $rows, string $diagnosis) => [
+                'diagnosis' => $diagnosis,
+                'total' => $rows->count(),
+            ])
+            ->values()
+            ->sortByDesc('total')
+            ->values();
+
+        $treatmentRecords = SpecialtyClinicalRecord::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->where('module_key', 'oncology')
+            ->where('record_type', 'onc_treatment')
+            ->when($branchId, fn ($q) => $q->where('branch_id', $branchId))
+            ->whereBetween('recorded_at', [$rangeFrom, $rangeTo])
+            ->get();
+
+        $regimenBreakdown = $treatmentRecords
+            ->groupBy(fn (SpecialtyClinicalRecord $r) => (string) ($r->payload['regimen'] ?? ($r->payload['treatment'] ?? 'Unknown')))
+            ->map(fn (Collection $rows, string $regimen) => [
+                'regimen' => $regimen,
+                'total' => $rows->count(),
+            ])
+            ->values()
+            ->sortByDesc('total')
+            ->values();
+
+        $completedVisits = Visit::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->whereIn('id', $visitIds->isEmpty() ? [0] : $visitIds)
+            ->where('status', Visit::STATUS_COMPLETED)
+            ->whereBetween('completed_at', [$rangeFrom, $rangeTo])
+            ->whereNotNull('checked_in_at')
+            ->whereNotNull('completed_at')
+            ->get();
+
+        $avgLos = null;
+        if ($completedVisits->isNotEmpty()) {
+            $avgLos = round($completedVisits->avg(function (Visit $visit) {
+                return $visit->checked_in_at->diffInMinutes($visit->completed_at);
+            }), 1);
+        }
+
+        $serviceLabels = collect($this->shell->provisionedServices($organization, 'oncology'))
+            ->pluck('label')
+            ->filter()
+            ->values()
+            ->all();
+
+        $revenueByService = BillLineItem::query()
+            ->where('owner_ref', $ownerRef)
+            ->where('source_type', 'specialty_service')
+            ->whereIn('description', $serviceLabels ?: ['__none__'])
+            ->whereBetween('created_at', [$rangeFrom, $rangeTo])
+            ->whereHas('bill', function ($q) use ($organization, $visitIds) {
+                $q->where('organization_id', $organization->id)
+                    ->whereIn('visit_id', $visitIds->isEmpty() ? [0] : $visitIds)
+                    ->whereNotIn('status', [Bill::STATUS_VOID]);
+            })
+            ->selectRaw('description, count(*) as total, sum(total_minor) as amount_minor')
+            ->groupBy('description')
+            ->orderByDesc('amount_minor')
+            ->get();
+
+        return [
+            'arrivals_today' => $arrivalsToday,
+            'completed_today' => $completedToday,
+            'chemo_open' => $chemoOpen,
+            'diagnosis_breakdown' => $diagnosisBreakdown,
+            'regimen_breakdown' => $regimenBreakdown,
+            'avg_los_minutes' => $avgLos,
+            'revenue_by_service' => $revenueByService,
+            'from' => $rangeFrom->toDateString(),
+            'to' => $rangeTo->toDateString(),
+        ];
+    }
+}

app/Services/Care/Oncology/OncologyWorkflowService.php

@@ -0,0 +1,106 @@
+<?php
+
+namespace App\Services\Care\Oncology;
+
+/**
+ * Map oncology clinical progress onto visit stages.
+ */
+class OncologyWorkflowService
+{
+    public const STAGE_CHECK_IN = 'check_in';
+
+    public const STAGE_HISTORY = 'history';
+
+    public const STAGE_STAGING = 'staging';
+
+    public const STAGE_INVESTIGATION = 'investigation';
+
+    public const STAGE_PLAN = 'plan';
+
+    public const STAGE_TREATMENT = 'treatment';
+
+    public const STAGE_COMPLETED = 'completed';
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromHistory(array $payload): string
+    {
+        $history = trim((string) ($payload['history'] ?? ''));
+        if ($history !== '') {
+            return self::STAGE_HISTORY;
+        }
+
+        return self::STAGE_CHECK_IN;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromStaging(array $payload): string
+    {
+        if (! empty($payload['diagnosis'])
+            || ! empty($payload['stage'])
+            || ! empty($payload['exam_findings'])) {
+            return self::STAGE_STAGING;
+        }
+
+        return self::STAGE_HISTORY;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromInvestigation(array $payload): string
+    {
+        $findings = trim((string) ($payload['findings'] ?? ''));
+        if ($findings !== '') {
+            return self::STAGE_INVESTIGATION;
+        }
+
+        return self::STAGE_STAGING;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromPlan(array $payload): string
+    {
+        if (! empty($payload['treatment_planned'])) {
+            return self::STAGE_TREATMENT;
+        }
+
+        $plan = trim((string) ($payload['plan'] ?? ''));
+        if ($plan !== '') {
+            return self::STAGE_PLAN;
+        }
+
+        return self::STAGE_INVESTIGATION;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function shouldCompleteVisit(array $payload): bool
+    {
+        $outcome = strtolower((string) ($payload['outcome'] ?? ''));
+
+        return str_contains($outcome, 'completed');
+    }
+
+    /**
+     * @return array<string, array{next: string, label: string}>
+     */
+    public function stageFlow(): array
+    {
+        return [
+            self::STAGE_CHECK_IN => ['next' => self::STAGE_HISTORY, 'label' => 'Start history'],
+            self::STAGE_HISTORY => ['next' => self::STAGE_STAGING, 'label' => 'Move to staging / exam'],
+            self::STAGE_STAGING => ['next' => self::STAGE_INVESTIGATION, 'label' => 'Move to investigations'],
+            self::STAGE_INVESTIGATION => ['next' => self::STAGE_PLAN, 'label' => 'Move to diagnosis & plan'],
+            self::STAGE_PLAN => ['next' => self::STAGE_TREATMENT, 'label' => 'Move to treatment'],
+            self::STAGE_TREATMENT => ['next' => self::STAGE_COMPLETED, 'label' => 'Complete visit'],
+            self::STAGE_COMPLETED => ['next' => self::STAGE_COMPLETED, 'label' => 'Completed'],
+        ];
+    }
+}

app/Services/Care/Renal/RenalAnalyticsService.php

@@ -0,0 +1,161 @@
+<?php
+
+namespace App\Services\Care\Renal;
+
+use App\Models\Appointment;
+use App\Models\Bill;
+use App\Models\BillLineItem;
+use App\Models\Organization;
+use App\Models\SpecialtyClinicalRecord;
+use App\Models\Visit;
+use App\Services\Care\SpecialtyShellService;
+use Carbon\Carbon;
+use Illuminate\Support\Collection;
+
+class RenalAnalyticsService
+{
+    public function __construct(
+        protected SpecialtyShellService $shell,
+    ) {}
+
+    /**
+     * @return array{
+     *     arrivals_today: int,
+     *     completed_today: int,
+     *     dialysis_open: int,
+     *     session_breakdown: Collection,
+     *     diagnosis_breakdown: Collection,
+     *     avg_los_minutes: ?float,
+     *     revenue_by_service: Collection,
+     *     from: string,
+     *     to: string
+     * }
+     */
+    public function report(
+        Organization $organization,
+        string $ownerRef,
+        ?int $branchId = null,
+        ?string $from = null,
+        ?string $to = null,
+    ): array {
+        $todayStart = now()->startOfDay();
+        $rangeFrom = $from ? Carbon::parse($from)->startOfDay() : now()->startOfMonth();
+        $rangeTo = $to ? Carbon::parse($to)->endOfDay() : now()->endOfDay();
+
+        $departmentIds = $this->shell->departmentIds($organization, 'renal', $ownerRef, $branchId);
+
+        $appointmentBase = Appointment::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->when($departmentIds !== [], fn ($q) => $q->whereIn('department_id', $departmentIds))
+            ->when($departmentIds === [], fn ($q) => $q->whereRaw('1 = 0'))
+            ->when($branchId, fn ($q) => $q->where('branch_id', $branchId));
+
+        $arrivalsToday = (clone $appointmentBase)
+            ->where('checked_in_at', '>=', $todayStart)
+            ->count();
+
+        $completedToday = (clone $appointmentBase)
+            ->where('status', Appointment::STATUS_COMPLETED)
+            ->where('completed_at', '>=', $todayStart)
+            ->count();
+
+        $visitIds = (clone $appointmentBase)->whereNotNull('visit_id')->pluck('visit_id');
+
+        $openVisitIds = Visit::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->whereIn('id', $visitIds->isEmpty() ? [0] : $visitIds)
+            ->whereIn('status', [Visit::STATUS_OPEN, Visit::STATUS_IN_PROGRESS])
+            ->pluck('id');
+
+        $dialysisOpen = Visit::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->whereIn('id', $openVisitIds->isEmpty() ? [0] : $openVisitIds)
+            ->where('specialty_stage', 'dialysis')
+            ->count();
+
+        $sessionRecords = SpecialtyClinicalRecord::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->where('module_key', 'renal')
+            ->where('record_type', 'renal_session')
+            ->when($branchId, fn ($q) => $q->where('branch_id', $branchId))
+            ->whereBetween('recorded_at', [$rangeFrom, $rangeTo])
+            ->get();
+
+        $sessionBreakdown = $sessionRecords
+            ->groupBy(fn (SpecialtyClinicalRecord $r) => (string) ($r->payload['session_type'] ?? 'Unknown'))
+            ->map(fn (Collection $rows, string $type) => [
+                'session_type' => $type,
+                'total' => $rows->count(),
+            ])
+            ->values()
+            ->sortByDesc('total')
+            ->values();
+
+        $planRecords = SpecialtyClinicalRecord::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->where('module_key', 'renal')
+            ->where('record_type', 'renal_plan')
+            ->when($branchId, fn ($q) => $q->where('branch_id', $branchId))
+            ->whereBetween('recorded_at', [$rangeFrom, $rangeTo])
+            ->get();
+
+        $diagnosisBreakdown = $planRecords
+            ->groupBy(fn (SpecialtyClinicalRecord $r) => (string) ($r->payload['diagnosis'] ?? 'Unknown'))
+            ->map(fn (Collection $rows, string $diagnosis) => [
+                'diagnosis' => $diagnosis,
+                'total' => $rows->count(),
+            ])
+            ->values()
+            ->sortByDesc('total')
+            ->values();
+
+        $completedVisits = Visit::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->whereIn('id', $visitIds->isEmpty() ? [0] : $visitIds)
+            ->where('status', Visit::STATUS_COMPLETED)
+            ->whereBetween('completed_at', [$rangeFrom, $rangeTo])
+            ->whereNotNull('checked_in_at')
+            ->whereNotNull('completed_at')
+            ->get();
+
+        $avgLos = null;
+        if ($completedVisits->isNotEmpty()) {
+            $avgLos = round($completedVisits->avg(function (Visit $visit) {
+                return $visit->checked_in_at->diffInMinutes($visit->completed_at);
+            }), 1);
+        }
+
+        $serviceLabels = collect($this->shell->provisionedServices($organization, 'renal'))
+            ->pluck('label')
+            ->filter()
+            ->values()
+            ->all();
+
+        $revenueByService = BillLineItem::query()
+            ->where('owner_ref', $ownerRef)
+            ->where('source_type', 'specialty_service')
+            ->whereIn('description', $serviceLabels ?: ['__none__'])
+            ->whereBetween('created_at', [$rangeFrom, $rangeTo])
+            ->whereHas('bill', function ($q) use ($organization, $visitIds) {
+                $q->where('organization_id', $organization->id)
+                    ->whereIn('visit_id', $visitIds->isEmpty() ? [0] : $visitIds)
+                    ->whereNotIn('status', [Bill::STATUS_VOID]);
+            })
+            ->selectRaw('description, count(*) as total, sum(total_minor) as amount_minor')
+            ->groupBy('description')
+            ->orderByDesc('amount_minor')
+            ->get();
+
+        return [
+            'arrivals_today' => $arrivalsToday,
+            'completed_today' => $completedToday,
+            'dialysis_open' => $dialysisOpen,
+            'session_breakdown' => $sessionBreakdown,
+            'diagnosis_breakdown' => $diagnosisBreakdown,
+            'avg_los_minutes' => $avgLos,
+            'revenue_by_service' => $revenueByService,
+            'from' => $rangeFrom->toDateString(),
+            'to' => $rangeTo->toDateString(),
+        ];
+    }
+}

app/Services/Care/Renal/RenalWorkflowService.php

@@ -0,0 +1,98 @@
+<?php
+
+namespace App\Services\Care\Renal;
+
+/**
+ * Map renal / nephrology clinical progress onto visit stages.
+ */
+class RenalWorkflowService
+{
+    public const STAGE_CHECK_IN = 'check_in';
+
+    public const STAGE_HISTORY = 'history';
+
+    public const STAGE_EXAM = 'exam';
+
+    public const STAGE_DIALYSIS = 'dialysis';
+
+    public const STAGE_PLAN = 'plan';
+
+    public const STAGE_COMPLETED = 'completed';
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromHistory(array $payload): string
+    {
+        $history = trim((string) ($payload['history'] ?? ''));
+        if ($history !== '') {
+            return self::STAGE_HISTORY;
+        }
+
+        return self::STAGE_CHECK_IN;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromExam(array $payload): string
+    {
+        if (! empty($payload['chief_complaint'])
+            || ! empty($payload['exam_findings'])
+            || ! empty($payload['fluid_status'])) {
+            return self::STAGE_EXAM;
+        }
+
+        return self::STAGE_HISTORY;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromDialysis(array $payload): string
+    {
+        if (! empty($payload['session_type']) || ! empty($payload['notes'])) {
+            return self::STAGE_DIALYSIS;
+        }
+
+        return self::STAGE_EXAM;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromPlan(array $payload): string
+    {
+        $plan = trim((string) ($payload['plan'] ?? ''));
+        if ($plan !== '') {
+            return self::STAGE_PLAN;
+        }
+
+        return self::STAGE_DIALYSIS;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function shouldCompleteVisit(array $payload): bool
+    {
+        $outcome = strtolower((string) ($payload['outcome'] ?? ''));
+
+        return str_contains($outcome, 'completed') || str_contains($outcome, 'discharged');
+    }
+
+    /**
+     * @return array<string, array{next: string, label: string}>
+     */
+    public function stageFlow(): array
+    {
+        return [
+            self::STAGE_CHECK_IN => ['next' => self::STAGE_HISTORY, 'label' => 'Start history'],
+            self::STAGE_HISTORY => ['next' => self::STAGE_EXAM, 'label' => 'Move to exam'],
+            self::STAGE_EXAM => ['next' => self::STAGE_DIALYSIS, 'label' => 'Move to dialysis / labs'],
+            self::STAGE_DIALYSIS => ['next' => self::STAGE_PLAN, 'label' => 'Move to care plan'],
+            self::STAGE_PLAN => ['next' => self::STAGE_COMPLETED, 'label' => 'Complete visit'],
+            self::STAGE_COMPLETED => ['next' => self::STAGE_COMPLETED, 'label' => 'Completed'],
+        ];
+    }
+}

app/Services/Care/SpecialtyClinicalRecordService.php

@@ -471,6 +471,39 @@ class SpecialtyClinicalRecordService
             }
         }
 
+
+        if ($moduleKey === 'oncology' && $recordType === 'onc_staging') {
+            $ecog = (string) ($payload['performance_status'] ?? '');
+            if (in_array($ecog, ['3', '4'], true)) {
+                $alerts[] = [
+                    'code' => 'onc.ecog_high',
+                    'severity' => 'warning',
+                    'message' => 'High ECOG performance status ('.$ecog.') — review treatment fitness.',
+                ];
+            }
+        }
+
+        if ($moduleKey === 'renal' && $recordType === 'renal_exam') {
+            $fluid = strtolower((string) ($payload['fluid_status'] ?? ''));
+            if (str_contains($fluid, 'overload')) {
+                $alerts[] = [
+                    'code' => 'ren.fluid_overload',
+                    'severity' => 'warning',
+                    'message' => 'Fluid overload recorded on renal exam.',
+                ];
+            }
+        }
+
+        if ($moduleKey === 'surgery' && $recordType === 'surg_plan') {
+            if (empty($payload['consent_obtained']) && ! empty($payload['procedure_planned'])) {
+                $alerts[] = [
+                    'code' => 'sur.consent_missing',
+                    'severity' => 'critical',
+                    'message' => 'Procedure planned without documented consent.',
+                ];
+            }
+        }
+
         if ($moduleKey === 'psychiatry' && $recordType === 'risk_assessment') {
             $level = strtolower((string) ($payload['overall_risk'] ?? ''));
             if (str_contains($level, 'imminent')) {

app/Services/Care/SpecialtyShellService.php

@@ -20,6 +20,9 @@ use App\Services\Care\Psychiatry\PsychiatryWorkflowService;
 use App\Services\Care\Pediatrics\PediatricsWorkflowService;
 use App\Services\Care\Orthopedics\OrthopedicsWorkflowService;
 use App\Services\Care\Ent\EntWorkflowService;
+use App\Services\Care\Oncology\OncologyWorkflowService;
+use App\Services\Care\Renal\RenalWorkflowService;
+use App\Services\Care\Surgery\SurgeryWorkflowService;
 use Illuminate\Support\Collection;
 
 /**
@@ -72,6 +75,9 @@ class SpecialtyShellService
             'pediatrics' => 'care.specialty.pediatrics.stage',
             'orthopedics' => 'care.specialty.orthopedics.stage',
             'ent' => 'care.specialty.ent.stage',
+            'oncology' => 'care.specialty.oncology.stage',
+            'renal' => 'care.specialty.renal.stage',
+            'surgery' => 'care.specialty.surgery.stage',
             default => null,
         };
     }
@@ -95,6 +101,9 @@ class SpecialtyShellService
             'pediatrics' => app(PediatricsWorkflowService::class)->stageFlow(),
             'orthopedics' => app(OrthopedicsWorkflowService::class)->stageFlow(),
             'ent' => app(EntWorkflowService::class)->stageFlow(),
+            'oncology' => app(OncologyWorkflowService::class)->stageFlow(),
+            'renal' => app(RenalWorkflowService::class)->stageFlow(),
+            'surgery' => app(SurgeryWorkflowService::class)->stageFlow(),
             'dentistry' => [
                 'waiting' => ['next' => 'chair', 'label' => 'Seat at chair'],
                 'chair' => ['next' => 'procedure', 'label' => 'Start procedure'],
@@ -394,7 +403,7 @@ class SpecialtyShellService
         ) {
             $code = (string) ($stage['code'] ?? '');
 
-            if (in_array($moduleKey, ['dentistry', 'emergency', 'blood_bank', 'ophthalmology', 'physiotherapy', 'maternity', 'radiology', 'cardiology', 'psychiatry', 'pediatrics', 'orthopedics', 'ent'], true) && $visitIds->isNotEmpty()) {
+            if (in_array($moduleKey, ['dentistry', 'emergency', 'blood_bank', 'ophthalmology', 'physiotherapy', 'maternity', 'radiology', 'cardiology', 'psychiatry', 'pediatrics', 'orthopedics', 'ent', 'oncology', 'renal', 'surgery'], true) && $visitIds->isNotEmpty()) {
                 $count = Visit::owned($ownerRef)
                     ->where('organization_id', $organization->id)
                     ->whereIn('id', $visitIds)
@@ -433,6 +442,9 @@ class SpecialtyShellService
             'pediatrics' => $clinical->countOpenByType($organization, 'pediatrics', 'pediatric_exam', $branchScope),
             'orthopedics' => $clinical->countOpenByType($organization, 'orthopedics', 'ortho_exam', $branchScope),
             'ent' => $clinical->countOpenByType($organization, 'ent', 'ent_exam', $branchScope),
+            'oncology' => $clinical->countOpenByType($organization, 'oncology', 'onc_staging', $branchScope),
+            'renal' => $clinical->countOpenByType($organization, 'renal', 'renal_exam', $branchScope),
+            'surgery' => $clinical->countOpenByType($organization, 'surgery', 'surg_exam', $branchScope),
             'dentistry' => \App\Models\DentalPlanItem::query()
                 ->whereHas('plan', function ($q) use ($organization, $ownerRef) {
                     $q->owned($ownerRef)

app/Services/Care/Surgery/SurgeryAnalyticsService.php

@@ -0,0 +1,161 @@
+<?php
+
+namespace App\Services\Care\Surgery;
+
+use App\Models\Appointment;
+use App\Models\Bill;
+use App\Models\BillLineItem;
+use App\Models\Organization;
+use App\Models\SpecialtyClinicalRecord;
+use App\Models\Visit;
+use App\Services\Care\SpecialtyShellService;
+use Carbon\Carbon;
+use Illuminate\Support\Collection;
+
+class SurgeryAnalyticsService
+{
+    public function __construct(
+        protected SpecialtyShellService $shell,
+    ) {}
+
+    /**
+     * @return array{
+     *     arrivals_today: int,
+     *     completed_today: int,
+     *     preop_open: int,
+     *     diagnosis_breakdown: Collection,
+     *     procedure_breakdown: Collection,
+     *     avg_los_minutes: ?float,
+     *     revenue_by_service: Collection,
+     *     from: string,
+     *     to: string
+     * }
+     */
+    public function report(
+        Organization $organization,
+        string $ownerRef,
+        ?int $branchId = null,
+        ?string $from = null,
+        ?string $to = null,
+    ): array {
+        $todayStart = now()->startOfDay();
+        $rangeFrom = $from ? Carbon::parse($from)->startOfDay() : now()->startOfMonth();
+        $rangeTo = $to ? Carbon::parse($to)->endOfDay() : now()->endOfDay();
+
+        $departmentIds = $this->shell->departmentIds($organization, 'surgery', $ownerRef, $branchId);
+
+        $appointmentBase = Appointment::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->when($departmentIds !== [], fn ($q) => $q->whereIn('department_id', $departmentIds))
+            ->when($departmentIds === [], fn ($q) => $q->whereRaw('1 = 0'))
+            ->when($branchId, fn ($q) => $q->where('branch_id', $branchId));
+
+        $arrivalsToday = (clone $appointmentBase)
+            ->where('checked_in_at', '>=', $todayStart)
+            ->count();
+
+        $completedToday = (clone $appointmentBase)
+            ->where('status', Appointment::STATUS_COMPLETED)
+            ->where('completed_at', '>=', $todayStart)
+            ->count();
+
+        $visitIds = (clone $appointmentBase)->whereNotNull('visit_id')->pluck('visit_id');
+
+        $openVisitIds = Visit::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->whereIn('id', $visitIds->isEmpty() ? [0] : $visitIds)
+            ->whereIn('status', [Visit::STATUS_OPEN, Visit::STATUS_IN_PROGRESS])
+            ->pluck('id');
+
+        $preopOpen = Visit::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->whereIn('id', $openVisitIds->isEmpty() ? [0] : $openVisitIds)
+            ->whereIn('specialty_stage', ['history', 'exam', 'investigation', 'plan'])
+            ->count();
+
+        $planRecords = SpecialtyClinicalRecord::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->where('module_key', 'surgery')
+            ->where('record_type', 'surg_plan')
+            ->when($branchId, fn ($q) => $q->where('branch_id', $branchId))
+            ->whereBetween('recorded_at', [$rangeFrom, $rangeTo])
+            ->get();
+
+        $diagnosisBreakdown = $planRecords
+            ->groupBy(fn (SpecialtyClinicalRecord $r) => (string) ($r->payload['diagnosis'] ?? 'Unknown'))
+            ->map(fn (Collection $rows, string $diagnosis) => [
+                'diagnosis' => $diagnosis,
+                'total' => $rows->count(),
+            ])
+            ->values()
+            ->sortByDesc('total')
+            ->values();
+
+        $procedureRecords = SpecialtyClinicalRecord::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->where('module_key', 'surgery')
+            ->where('record_type', 'surg_procedure')
+            ->when($branchId, fn ($q) => $q->where('branch_id', $branchId))
+            ->whereBetween('recorded_at', [$rangeFrom, $rangeTo])
+            ->get();
+
+        $procedureBreakdown = $procedureRecords
+            ->groupBy(fn (SpecialtyClinicalRecord $r) => (string) ($r->payload['procedure'] ?? 'Unknown'))
+            ->map(fn (Collection $rows, string $procedure) => [
+                'procedure' => $procedure,
+                'total' => $rows->count(),
+            ])
+            ->values()
+            ->sortByDesc('total')
+            ->values();
+
+        $completedVisits = Visit::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->whereIn('id', $visitIds->isEmpty() ? [0] : $visitIds)
+            ->where('status', Visit::STATUS_COMPLETED)
+            ->whereBetween('completed_at', [$rangeFrom, $rangeTo])
+            ->whereNotNull('checked_in_at')
+            ->whereNotNull('completed_at')
+            ->get();
+
+        $avgLos = null;
+        if ($completedVisits->isNotEmpty()) {
+            $avgLos = round($completedVisits->avg(function (Visit $visit) {
+                return $visit->checked_in_at->diffInMinutes($visit->completed_at);
+            }), 1);
+        }
+
+        $serviceLabels = collect($this->shell->provisionedServices($organization, 'surgery'))
+            ->pluck('label')
+            ->filter()
+            ->values()
+            ->all();
+
+        $revenueByService = BillLineItem::query()
+            ->where('owner_ref', $ownerRef)
+            ->where('source_type', 'specialty_service')
+            ->whereIn('description', $serviceLabels ?: ['__none__'])
+            ->whereBetween('created_at', [$rangeFrom, $rangeTo])
+            ->whereHas('bill', function ($q) use ($organization, $visitIds) {
+                $q->where('organization_id', $organization->id)
+                    ->whereIn('visit_id', $visitIds->isEmpty() ? [0] : $visitIds)
+                    ->whereNotIn('status', [Bill::STATUS_VOID]);
+            })
+            ->selectRaw('description, count(*) as total, sum(total_minor) as amount_minor')
+            ->groupBy('description')
+            ->orderByDesc('amount_minor')
+            ->get();
+
+        return [
+            'arrivals_today' => $arrivalsToday,
+            'completed_today' => $completedToday,
+            'preop_open' => $preopOpen,
+            'diagnosis_breakdown' => $diagnosisBreakdown,
+            'procedure_breakdown' => $procedureBreakdown,
+            'avg_los_minutes' => $avgLos,
+            'revenue_by_service' => $revenueByService,
+            'from' => $rangeFrom->toDateString(),
+            'to' => $rangeTo->toDateString(),
+        ];
+    }
+}

app/Services/Care/Surgery/SurgeryWorkflowService.php

@@ -0,0 +1,119 @@
+<?php
+
+namespace App\Services\Care\Surgery;
+
+/**
+ * Map surgical OPD / pre-op clinic progress onto visit stages.
+ */
+class SurgeryWorkflowService
+{
+    public const STAGE_CHECK_IN = 'check_in';
+
+    public const STAGE_HISTORY = 'history';
+
+    public const STAGE_EXAM = 'exam';
+
+    public const STAGE_INVESTIGATION = 'investigation';
+
+    public const STAGE_PLAN = 'plan';
+
+    public const STAGE_PROCEDURE = 'procedure';
+
+    public const STAGE_POSTOP = 'postop';
+
+    public const STAGE_COMPLETED = 'completed';
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromHistory(array $payload): string
+    {
+        $history = trim((string) ($payload['history'] ?? ''));
+        if ($history !== '') {
+            return self::STAGE_HISTORY;
+        }
+
+        return self::STAGE_CHECK_IN;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromExam(array $payload): string
+    {
+        if (! empty($payload['chief_complaint']) || ! empty($payload['exam_findings'])) {
+            return self::STAGE_EXAM;
+        }
+
+        return self::STAGE_HISTORY;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromInvestigation(array $payload): string
+    {
+        $findings = trim((string) ($payload['findings'] ?? ''));
+        if ($findings !== '') {
+            return self::STAGE_INVESTIGATION;
+        }
+
+        return self::STAGE_EXAM;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromPlan(array $payload): string
+    {
+        if (! empty($payload['procedure_planned'])) {
+            return self::STAGE_PROCEDURE;
+        }
+
+        $plan = trim((string) ($payload['plan'] ?? ''));
+        if ($plan !== '') {
+            return self::STAGE_PLAN;
+        }
+
+        return self::STAGE_INVESTIGATION;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromProcedure(array $payload): string
+    {
+        if (! empty($payload['procedure']) || ! empty($payload['outcome'])) {
+            return self::STAGE_PROCEDURE;
+        }
+
+        return self::STAGE_PLAN;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function shouldCompleteVisit(array $payload): bool
+    {
+        $outcome = strtolower((string) ($payload['outcome'] ?? ''));
+
+        return str_contains($outcome, 'completed') || str_contains($outcome, 'discharged');
+    }
+
+    /**
+     * @return array<string, array{next: string, label: string}>
+     */
+    public function stageFlow(): array
+    {
+        return [
+            self::STAGE_CHECK_IN => ['next' => self::STAGE_HISTORY, 'label' => 'Start pre-op history'],
+            self::STAGE_HISTORY => ['next' => self::STAGE_EXAM, 'label' => 'Move to exam'],
+            self::STAGE_EXAM => ['next' => self::STAGE_INVESTIGATION, 'label' => 'Move to investigations'],
+            self::STAGE_INVESTIGATION => ['next' => self::STAGE_PLAN, 'label' => 'Move to consent / plan'],
+            self::STAGE_PLAN => ['next' => self::STAGE_PROCEDURE, 'label' => 'Move to procedure'],
+            self::STAGE_PROCEDURE => ['next' => self::STAGE_POSTOP, 'label' => 'Move to post-op'],
+            self::STAGE_POSTOP => ['next' => self::STAGE_COMPLETED, 'label' => 'Complete visit'],
+            self::STAGE_COMPLETED => ['next' => self::STAGE_COMPLETED, 'label' => 'Completed'],
+        ];
+    }
+}

config/care_specialty_clinical.php

@@ -87,16 +87,25 @@ return [
             'procedure' => 'ent_procedure',
         ],
         'oncology' => [
-            'review' => 'oncology_review',
+            'history' => 'onc_history',
-            'clinical_notes' => 'clinical_note',
+            'staging' => 'onc_staging',
+            'investigations' => 'onc_investigation',
+            'plan' => 'onc_plan',
+            'treatment' => 'onc_treatment',
         ],
         'renal' => [
-            'session' => 'renal_session',
+            'history' => 'renal_history',
-            'clinical_notes' => 'clinical_note',
+            'exam' => 'renal_exam',
+            'dialysis' => 'renal_session',
+            'plan' => 'renal_plan',
         ],
         'surgery' => [
-            'preop' => 'preop',
+            'history' => 'surg_history',
-            'clinical_notes' => 'clinical_note',
+            'exam' => 'surg_exam',
+            'investigations' => 'surg_investigation',
+            'plan' => 'surg_plan',
+            'procedure' => 'surg_procedure',
+            'postop' => 'surg_postop',
         ],
         'vaccination' => [
             'screening' => 'vax_screening',
@@ -620,58 +629,133 @@ return [
             ],
         ],
         'oncology' => [
-            'oncology_review' => [
+            'onc_history' => [
+                ['name' => 'history', 'label' => 'History of present illness', 'type' => 'textarea', 'required' => true, 'rows' => 4],
+                ['name' => 'cancer_history', 'label' => 'Cancer / treatment history', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'medications', 'label' => 'Medications', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'allergies', 'label' => 'Allergies', 'type' => 'text'],
+                ['name' => 'comorbidities', 'label' => 'Comorbidities', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'social', 'label' => 'Social / support context', 'type' => 'textarea', 'rows' => 2],
+            ],
+            'onc_staging' => [
                 ['name' => 'diagnosis', 'label' => 'Oncology diagnosis', 'type' => 'text', 'required' => true],
-                ['name' => 'stage', 'label' => 'Stage', 'type' => 'text'],
+                ['name' => 'stage', 'label' => 'Stage / TNM', 'type' => 'text'],
+                ['name' => 'histology', 'label' => 'Histology', 'type' => 'text'],
                 ['name' => 'performance_status', 'label' => 'Performance status (ECOG)', 'type' => 'select', 'options' => ['0', '1', '2', '3', '4']],
-                ['name' => 'current_regimen', 'label' => 'Current regimen', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'exam_findings', 'label' => 'Exam findings', 'type' => 'textarea', 'rows' => 3],
+                ['name' => 'sites', 'label' => 'Disease sites', 'type' => 'textarea', 'rows' => 2],
+            ],
+            'onc_investigation' => [
+                ['name' => 'investigation', 'label' => 'Investigation', 'type' => 'text', 'required' => true],
+                ['name' => 'findings', 'label' => 'Findings', 'type' => 'textarea', 'required' => true, 'rows' => 3],
+                ['name' => 'impression', 'label' => 'Impression', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'notes', 'label' => 'Notes', 'type' => 'textarea', 'rows' => 2],
+            ],
+            'onc_plan' => [
+                ['name' => 'diagnosis', 'label' => 'Diagnosis', 'type' => 'text', 'required' => true],
+                ['name' => 'plan', 'label' => 'Plan', 'type' => 'textarea', 'required' => true, 'rows' => 3],
+                ['name' => 'intent', 'label' => 'Treatment intent', 'type' => 'select', 'options' => ['Curative', 'Adjuvant', 'Neoadjuvant', 'Palliative', 'Supportive']],
+                ['name' => 'medications', 'label' => 'Medications', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'treatment_planned', 'label' => 'Treatment / chemo planned', 'type' => 'boolean'],
+                ['name' => 'follow_up', 'label' => 'Follow-up', 'type' => 'text'],
+                ['name' => 'advice', 'label' => 'Patient advice', 'type' => 'textarea', 'rows' => 2],
+            ],
+            'onc_treatment' => [
+                ['name' => 'treatment', 'label' => 'Treatment / chemo note', 'type' => 'text', 'required' => true],
+                ['name' => 'regimen', 'label' => 'Regimen', 'type' => 'text'],
                 ['name' => 'cycle', 'label' => 'Cycle / day', 'type' => 'text'],
                 ['name' => 'toxicity', 'label' => 'Toxicity / side effects', 'type' => 'textarea', 'rows' => 2],
-                ['name' => 'response', 'label' => 'Treatment response', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'outcome', 'label' => 'Outcome', 'type' => 'select', 'required' => true, 'options' => ['Completed uneventfully', 'Completed with complications', 'Deferred', 'Aborted']],
-                ['name' => 'plan', 'label' => 'Plan', 'type' => 'textarea', 'required' => true, 'rows' => 2],
+                ['name' => 'post_treatment_plan', 'label' => 'Post-treatment plan', 'type' => 'textarea', 'rows' => 2],
-            ],
+                ['name' => 'notes', 'label' => 'Notes', 'type' => 'textarea', 'rows' => 2],
-            'clinical_note' => [
-                ['name' => 'history', 'label' => 'History of present illness', 'type' => 'textarea', 'required' => true, 'rows' => 4],
-                ['name' => 'examination', 'label' => 'Examination', 'type' => 'textarea', 'rows' => 3],
-                ['name' => 'working_diagnosis', 'label' => 'Working diagnosis', 'type' => 'text'],
-                ['name' => 'plan', 'label' => 'Plan', 'type' => 'textarea', 'rows' => 3],
             ],
         ],
         'renal' => [
+            'renal_history' => [
+                ['name' => 'history', 'label' => 'History of present illness', 'type' => 'textarea', 'required' => true, 'rows' => 4],
+                ['name' => 'ckd_stage', 'label' => 'CKD stage / dialysis vintage', 'type' => 'text'],
+                ['name' => 'access_history', 'label' => 'Access history', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'medications', 'label' => 'Medications', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'allergies', 'label' => 'Allergies', 'type' => 'text'],
+                ['name' => 'comorbidities', 'label' => 'Comorbidities', 'type' => 'textarea', 'rows' => 2],
+            ],
+            'renal_exam' => [
+                ['name' => 'chief_complaint', 'label' => 'Chief complaint', 'type' => 'text', 'required' => true],
+                ['name' => 'bp', 'label' => 'Blood pressure', 'type' => 'text'],
+                ['name' => 'weight_kg', 'label' => 'Weight (kg)', 'type' => 'number'],
+                ['name' => 'fluid_status', 'label' => 'Fluid status', 'type' => 'select', 'options' => ['Euvolemic', 'Overload', 'Dehydrated', 'Not assessed']],
+                ['name' => 'access', 'label' => 'Access assessment', 'type' => 'text'],
+                ['name' => 'exam_findings', 'label' => 'Exam findings', 'type' => 'textarea', 'rows' => 3],
+                ['name' => 'uremic_symptoms', 'label' => 'Uremic symptoms', 'type' => 'textarea', 'rows' => 2],
+            ],
             'renal_session' => [
-                ['name' => 'session_type', 'label' => 'Session type', 'type' => 'select', 'required' => true, 'options' => ['Hemodialysis', 'Peritoneal dialysis', 'Clinic review', 'Other']],
+                ['name' => 'session_type', 'label' => 'Session / labs type', 'type' => 'select', 'required' => true, 'options' => ['Hemodialysis', 'Peritoneal dialysis', 'Clinic labs review', 'Other']],
                 ['name' => 'pre_weight_kg', 'label' => 'Pre-weight (kg)', 'type' => 'number'],
                 ['name' => 'post_weight_kg', 'label' => 'Post-weight (kg)', 'type' => 'number'],
                 ['name' => 'uf_goal_l', 'label' => 'UF goal (L)', 'type' => 'number'],
                 ['name' => 'access', 'label' => 'Access', 'type' => 'text'],
                 ['name' => 'bp_pre', 'label' => 'BP pre', 'type' => 'text'],
                 ['name' => 'bp_post', 'label' => 'BP post', 'type' => 'text'],
+                ['name' => 'labs_summary', 'label' => 'Labs summary', 'type' => 'textarea', 'rows' => 2],
                 ['name' => 'complications', 'label' => 'Complications', 'type' => 'textarea', 'rows' => 2],
-                ['name' => 'notes', 'label' => 'Session notes', 'type' => 'textarea', 'required' => true, 'rows' => 3],
+                ['name' => 'notes', 'label' => 'Session / labs notes', 'type' => 'textarea', 'required' => true, 'rows' => 3],
             ],
-            'clinical_note' => [
+            'renal_plan' => [
-                ['name' => 'history', 'label' => 'History of present illness', 'type' => 'textarea', 'required' => true, 'rows' => 4],
+                ['name' => 'diagnosis', 'label' => 'Diagnosis', 'type' => 'text', 'required' => true],
-                ['name' => 'examination', 'label' => 'Examination', 'type' => 'textarea', 'rows' => 3],
+                ['name' => 'plan', 'label' => 'Care plan', 'type' => 'textarea', 'required' => true, 'rows' => 3],
-                ['name' => 'working_diagnosis', 'label' => 'Working diagnosis', 'type' => 'text'],
+                ['name' => 'dialysis_prescription', 'label' => 'Dialysis prescription notes', 'type' => 'textarea', 'rows' => 2],
-                ['name' => 'plan', 'label' => 'Plan', 'type' => 'textarea', 'rows' => 3],
+                ['name' => 'medications', 'label' => 'Medications', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'follow_up', 'label' => 'Follow-up', 'type' => 'text'],
+                ['name' => 'outcome', 'label' => 'Visit outcome', 'type' => 'select', 'required' => true, 'options' => ['In progress', 'Completed — continue plan', 'Completed — discharged', 'Referred', 'Admitted']],
+                ['name' => 'advice', 'label' => 'Patient advice', 'type' => 'textarea', 'rows' => 2],
             ],
         ],
         'surgery' => [
-            'preop' => [
+            'surg_history' => [
-                ['name' => 'proposed_procedure', 'label' => 'Proposed procedure', 'type' => 'text', 'required' => true],
-                ['name' => 'indication', 'label' => 'Indication', 'type' => 'textarea', 'required' => true, 'rows' => 2],
-                ['name' => 'asa_class', 'label' => 'ASA class', 'type' => 'select', 'options' => ['I', 'II', 'III', 'IV', 'V', 'E']],
-                ['name' => 'allergies_reviewed', 'label' => 'Allergies reviewed', 'type' => 'boolean'],
-                ['name' => 'consent_obtained', 'label' => 'Consent obtained', 'type' => 'boolean'],
-                ['name' => 'fitness', 'label' => 'Fitness for anaesthesia', 'type' => 'textarea', 'rows' => 2],
-                ['name' => 'investigations', 'label' => 'Relevant investigations', 'type' => 'textarea', 'rows' => 2],
-                ['name' => 'plan', 'label' => 'Peri-op plan', 'type' => 'textarea', 'required' => true, 'rows' => 2],
-            ],
-            'clinical_note' => [
                 ['name' => 'history', 'label' => 'History of present illness', 'type' => 'textarea', 'required' => true, 'rows' => 4],
-                ['name' => 'examination', 'label' => 'Examination', 'type' => 'textarea', 'rows' => 3],
+                ['name' => 'past_surgical', 'label' => 'Past surgical history', 'type' => 'textarea', 'rows' => 2],
-                ['name' => 'working_diagnosis', 'label' => 'Working diagnosis', 'type' => 'text'],
+                ['name' => 'medications', 'label' => 'Medications', 'type' => 'textarea', 'rows' => 2],
-                ['name' => 'plan', 'label' => 'Plan', 'type' => 'textarea', 'rows' => 3],
+                ['name' => 'allergies', 'label' => 'Allergies', 'type' => 'text'],
+                ['name' => 'comorbidities', 'label' => 'Comorbidities', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'anaesthesia_history', 'label' => 'Anaesthesia history', 'type' => 'textarea', 'rows' => 2],
+            ],
+            'surg_exam' => [
+                ['name' => 'chief_complaint', 'label' => 'Chief complaint', 'type' => 'text', 'required' => true],
+                ['name' => 'exam_findings', 'label' => 'Examination findings', 'type' => 'textarea', 'required' => true, 'rows' => 3],
+                ['name' => 'asa_class', 'label' => 'ASA class', 'type' => 'select', 'options' => ['I', 'II', 'III', 'IV', 'V', 'E']],
+                ['name' => 'fitness', 'label' => 'Fitness notes', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'site_marking', 'label' => 'Site marking reviewed', 'type' => 'boolean'],
+            ],
+            'surg_investigation' => [
+                ['name' => 'investigation', 'label' => 'Investigation', 'type' => 'text', 'required' => true],
+                ['name' => 'findings', 'label' => 'Findings', 'type' => 'textarea', 'required' => true, 'rows' => 3],
+                ['name' => 'impression', 'label' => 'Impression', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'notes', 'label' => 'Notes', 'type' => 'textarea', 'rows' => 2],
+            ],
+            'surg_plan' => [
+                ['name' => 'diagnosis', 'label' => 'Diagnosis', 'type' => 'text', 'required' => true],
+                ['name' => 'proposed_procedure', 'label' => 'Proposed procedure', 'type' => 'text'],
+                ['name' => 'plan', 'label' => 'Consent / peri-op plan', 'type' => 'textarea', 'required' => true, 'rows' => 3],
+                ['name' => 'consent_obtained', 'label' => 'Consent obtained', 'type' => 'boolean'],
+                ['name' => 'procedure_planned', 'label' => 'Procedure planned today', 'type' => 'boolean'],
+                ['name' => 'follow_up', 'label' => 'Follow-up', 'type' => 'text'],
+                ['name' => 'advice', 'label' => 'Patient advice', 'type' => 'textarea', 'rows' => 2],
+            ],
+            'surg_procedure' => [
+                ['name' => 'procedure', 'label' => 'Procedure', 'type' => 'text', 'required' => true],
+                ['name' => 'indication', 'label' => 'Indication', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'technique', 'label' => 'Technique / findings', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'outcome', 'label' => 'Outcome', 'type' => 'select', 'required' => true, 'options' => ['Completed uneventfully', 'Completed with complications', 'Deferred', 'Aborted']],
+                ['name' => 'complications', 'label' => 'Complications', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'notes', 'label' => 'Notes', 'type' => 'textarea', 'rows' => 2],
+            ],
+            'surg_postop' => [
+                ['name' => 'review_type', 'label' => 'Review type', 'type' => 'select', 'required' => true, 'options' => ['Immediate post-op', 'Clinic wound check', 'Follow-up review', 'Discharge review']],
+                ['name' => 'progress', 'label' => 'Progress / wound status', 'type' => 'textarea', 'required' => true, 'rows' => 3],
+                ['name' => 'pain_score', 'label' => 'Pain score (0–10)', 'type' => 'number'],
+                ['name' => 'outcome', 'label' => 'Outcome', 'type' => 'select', 'required' => true, 'options' => ['In progress', 'Completed — continue plan', 'Completed — discharged', 'Referred', 'Admitted']],
+                ['name' => 'next_steps', 'label' => 'Next steps', 'type' => 'textarea', 'rows' => 2],
+                ['name' => 'notes', 'label' => 'Notes', 'type' => 'textarea', 'rows' => 2],
             ],
         ],
         'vaccination' => [

config/care_specialty_shell.php

@@ -513,62 +513,114 @@ return [
         ],
         'oncology' => [
             'stages' => [
-                ['code' => 'waiting', 'label' => 'Waiting', 'queue_point' => 'waiting'],
+                ['code' => 'check_in', 'label' => 'Check-in', 'queue_point' => 'waiting'],
-                ['code' => 'review', 'label' => 'Oncology review', 'queue_point' => 'chair'],
+                ['code' => 'history', 'label' => 'History', 'queue_point' => 'waiting'],
-                ['code' => 'treatment', 'label' => 'Treatment', 'queue_point' => 'chair'],
+                ['code' => 'staging', 'label' => 'Staging / exam', 'queue_point' => 'chair'],
+                ['code' => 'investigation', 'label' => 'Investigations', 'queue_point' => 'chair'],
+                ['code' => 'plan', 'label' => 'Diagnosis & plan', 'queue_point' => 'chair'],
+                ['code' => 'treatment', 'label' => 'Treatment / chemo', 'queue_point' => 'chair'],
                 ['code' => 'completed', 'label' => 'Completed', 'queue_point' => null],
             ],
             'services' => [
                 ['code' => 'onc.consult', 'label' => 'Oncology consultation', 'amount_minor' => 10000, 'type' => 'consultation'],
+                ['code' => 'onc.staging', 'label' => 'Staging assessment', 'amount_minor' => 8000, 'type' => 'consultation'],
                 ['code' => 'onc.chemo', 'label' => 'Chemo day-care session', 'amount_minor' => 50000, 'type' => 'procedure'],
+                ['code' => 'onc.supportive', 'label' => 'Supportive care visit', 'amount_minor' => 6000, 'type' => 'consultation'],
             ],
             'workspace_tabs' => [
                 'overview' => 'Overview',
-                'review' => 'Oncology review',
+                'history' => 'History',
-                'clinical_notes' => 'Clinical notes',
+                'staging' => 'Staging / exam',
+                'investigations' => 'Investigations',
+                'plan' => 'Diagnosis & plan',
+                'treatment' => 'Treatment',
                 'orders' => 'Orders',
                 'billing' => 'Billing',
                 'documents' => 'Documents',
             ],
+            'stage_tabs' => [
+                'check_in' => 'overview',
+                'history' => 'history',
+                'staging' => 'staging',
+                'investigation' => 'investigations',
+                'plan' => 'plan',
+                'treatment' => 'treatment',
+                'completed' => 'overview',
+            ],
         ],
         'renal' => [
             'stages' => [
-                ['code' => 'waiting', 'label' => 'Waiting', 'queue_point' => 'waiting'],
+                ['code' => 'check_in', 'label' => 'Check-in', 'queue_point' => 'waiting'],
-                ['code' => 'dialysis', 'label' => 'Dialysis / clinic', 'queue_point' => 'chair'],
+                ['code' => 'history', 'label' => 'History', 'queue_point' => 'waiting'],
+                ['code' => 'exam', 'label' => 'Exam', 'queue_point' => 'chair'],
+                ['code' => 'dialysis', 'label' => 'Dialysis / labs', 'queue_point' => 'chair'],
+                ['code' => 'plan', 'label' => 'Care plan', 'queue_point' => 'chair'],
                 ['code' => 'completed', 'label' => 'Completed', 'queue_point' => null],
             ],
             'services' => [
                 ['code' => 'ren.consult', 'label' => 'Nephrology consultation', 'amount_minor' => 8000, 'type' => 'consultation'],
                 ['code' => 'ren.dialysis', 'label' => 'Dialysis session', 'amount_minor' => 35000, 'type' => 'procedure'],
+                ['code' => 'ren.labs', 'label' => 'Renal labs panel', 'amount_minor' => 6000, 'type' => 'lab'],
+                ['code' => 'ren.review', 'label' => 'Clinic review', 'amount_minor' => 5000, 'type' => 'consultation'],
             ],
             'workspace_tabs' => [
                 'overview' => 'Overview',
-                'session' => 'Renal session',
+                'history' => 'History',
-                'clinical_notes' => 'Clinical notes',
+                'exam' => 'Exam',
+                'dialysis' => 'Dialysis / labs',
+                'plan' => 'Care plan',
                 'orders' => 'Orders',
                 'billing' => 'Billing',
                 'documents' => 'Documents',
             ],
+            'stage_tabs' => [
+                'check_in' => 'overview',
+                'history' => 'history',
+                'exam' => 'exam',
+                'dialysis' => 'dialysis',
+                'plan' => 'plan',
+                'completed' => 'overview',
+            ],
         ],
         'surgery' => [
             'stages' => [
-                ['code' => 'waiting', 'label' => 'Waiting', 'queue_point' => 'waiting'],
+                ['code' => 'check_in', 'label' => 'Check-in', 'queue_point' => 'waiting'],
-                ['code' => 'preop', 'label' => 'Pre-op assessment', 'queue_point' => 'chair'],
+                ['code' => 'history', 'label' => 'Pre-op history', 'queue_point' => 'waiting'],
-                ['code' => 'postop', 'label' => 'Post-op review', 'queue_point' => 'chair'],
+                ['code' => 'exam', 'label' => 'Exam', 'queue_point' => 'chair'],
+                ['code' => 'investigation', 'label' => 'Investigations', 'queue_point' => 'chair'],
+                ['code' => 'plan', 'label' => 'Consent / plan', 'queue_point' => 'chair'],
+                ['code' => 'procedure', 'label' => 'Procedure', 'queue_point' => 'chair'],
+                ['code' => 'postop', 'label' => 'Post-op', 'queue_point' => 'chair'],
                 ['code' => 'completed', 'label' => 'Completed', 'queue_point' => null],
             ],
             'services' => [
                 ['code' => 'sur.consult', 'label' => 'Surgical consultation', 'amount_minor' => 8000, 'type' => 'consultation'],
                 ['code' => 'sur.preop', 'label' => 'Pre-op assessment', 'amount_minor' => 5000, 'type' => 'consultation'],
+                ['code' => 'sur.procedure', 'label' => 'Minor procedure / clinic', 'amount_minor' => 25000, 'type' => 'procedure'],
+                ['code' => 'sur.postop', 'label' => 'Post-op review', 'amount_minor' => 4500, 'type' => 'consultation'],
             ],
             'workspace_tabs' => [
                 'overview' => 'Overview',
-                'preop' => 'Pre-op',
+                'history' => 'History',
-                'clinical_notes' => 'Clinical notes',
+                'exam' => 'Exam',
+                'investigations' => 'Investigations',
+                'plan' => 'Consent / plan',
+                'procedure' => 'Procedure',
+                'postop' => 'Post-op',
                 'orders' => 'Orders',
                 'billing' => 'Billing',
                 'documents' => 'Documents',
             ],
+            'stage_tabs' => [
+                'check_in' => 'overview',
+                'history' => 'history',
+                'exam' => 'exam',
+                'investigation' => 'investigations',
+                'plan' => 'plan',
+                'procedure' => 'procedure',
+                'postop' => 'postop',
+                'completed' => 'overview',
+            ],
         ],
         'vaccination' => [
             'stages' => [

resources/views/care/specialty/oncology/print.blade.php

@@ -0,0 +1,33 @@
+<!DOCTYPE html>
+<html lang="en">
+<head>
+    <meta charset="utf-8">
+    <title>Oncology summary · {{ $patient->fullName() }}</title>
+    <style>
+        body { font-family: system-ui, sans-serif; color: #0f172a; margin: 2rem; }
+        h1 { font-size: 1.25rem; margin: 0 0 .25rem; }
+        h2 { font-size: .95rem; margin: 1.25rem 0 .5rem; border-bottom: 1px solid #e2e8f0; padding-bottom: .25rem; }
+        .meta { color: #64748b; font-size: .875rem; }
+        dl { display: grid; grid-template-columns: 10rem 1fr; gap: .35rem .75rem; font-size: .875rem; }
+        dt { color: #64748b; }
+        dd { margin: 0; font-weight: 500; }
+        @media print { .no-print { display: none; } }
+    </style>
+</head>
+<body>
+    <p class="no-print"><a href="{{ route('care.specialty.workspace', ['module' => 'oncology', 'visit' => $visit]) }}">Back</a></p>
+    <h1>{{ $patient->fullName() }}</h1>
+    <p class="meta">{{ $patient->patient_number }} · Visit #{{ $visit->id }} · Stage {{ $visit->specialty_stage ?? '—' }}</p>
+    <h2>History</h2>
+    @if ($history)<dl><dt>HPI</dt><dd>{{ $history->payload['history'] ?? '—' }}</dd><dt>Cancer history</dt><dd>{{ $history->payload['cancer_history'] ?? '—' }}</dd></dl>@else<p class="meta">No history recorded.</p>@endif
+    <h2>Staging / exam</h2>
+    @if ($staging)<dl><dt>Diagnosis</dt><dd>{{ $staging->payload['diagnosis'] ?? '—' }}</dd><dt>Stage</dt><dd>{{ $staging->payload['stage'] ?? '—' }}</dd><dt>ECOG</dt><dd>{{ $staging->payload['performance_status'] ?? '—' }}</dd></dl>@else<p class="meta">No staging recorded.</p>@endif
+    <h2>Investigations</h2>
+    @if ($investigation)<dl><dt>Investigation</dt><dd>{{ $investigation->payload['investigation'] ?? '—' }}</dd><dt>Findings</dt><dd>{{ $investigation->payload['findings'] ?? '—' }}</dd></dl>@else<p class="meta">No investigation recorded.</p>@endif
+    <h2>Plan</h2>
+    @if ($plan)<dl><dt>Diagnosis</dt><dd>{{ $plan->payload['diagnosis'] ?? '—' }}</dd><dt>Plan</dt><dd>{{ $plan->payload['plan'] ?? '—' }}</dd></dl>@else<p class="meta">No plan recorded.</p>@endif
+    <h2>Treatment</h2>
+    @if ($treatment)<dl><dt>Treatment</dt><dd>{{ $treatment->payload['treatment'] ?? '—' }}</dd><dt>Outcome</dt><dd>{{ $treatment->payload['outcome'] ?? '—' }}</dd></dl>@else<p class="meta">No treatment recorded.</p>@endif
+    <script>window.print();</script>
+</body>
+</html>

resources/views/care/specialty/oncology/reports.blade.php

@@ -0,0 +1,87 @@
+<x-app-layout title="Oncology reports">
+    <div class="space-y-6">
+        <div class="flex flex-wrap items-center justify-between gap-3">
+            <div>
+                <h1 class="text-xl font-semibold text-slate-900">Oncology reports</h1>
+                <p class="mt-1 text-sm text-slate-500">Arrivals, open chemo notes, diagnoses, regimens, length of stay, and oncology revenue.</p>
+            </div>
+            <a href="{{ route('care.specialty.show', 'oncology') }}" class="text-sm font-medium text-indigo-600">← Specialty home</a>
+        </div>
+
+        <form method="GET" class="flex flex-wrap items-end gap-3 rounded-2xl border border-slate-200 bg-white p-4">
+            <div>
+                <label class="block text-xs font-medium text-slate-600">From</label>
+                <input type="date" name="from" value="{{ $report['from'] ?? '' }}" class="mt-1 rounded-xl border border-slate-200 px-3 py-2 text-sm">
+            </div>
+            <div>
+                <label class="block text-xs font-medium text-slate-600">To</label>
+                <input type="date" name="to" value="{{ $report['to'] ?? '' }}" class="mt-1 rounded-xl border border-slate-200 px-3 py-2 text-sm">
+            </div>
+            <button type="submit" class="rounded-xl bg-indigo-600 px-4 py-2 text-sm font-semibold text-white">Apply</button>
+        </form>
+
+        <div class="grid gap-4 sm:grid-cols-4">
+            <div class="rounded-2xl border border-slate-200 bg-white p-4">
+                <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Arrivals today</p>
+                <p class="mt-2 text-2xl font-semibold tabular-nums text-slate-900">{{ number_format($report['arrivals_today']) }}</p>
+            </div>
+            <div class="rounded-2xl border border-slate-200 bg-white p-4">
+                <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Completed today</p>
+                <p class="mt-2 text-2xl font-semibold tabular-nums text-slate-900">{{ number_format($report['completed_today']) }}</p>
+            </div>
+            <div class="rounded-2xl border border-slate-200 bg-white p-4">
+                <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Chemo notes open</p>
+                <p class="mt-2 text-2xl font-semibold tabular-nums text-rose-700">{{ number_format($report['chemo_open']) }}</p>
+            </div>
+            <div class="rounded-2xl border border-slate-200 bg-white p-4">
+                <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Avg LOS (range)</p>
+                <p class="mt-2 text-2xl font-semibold tabular-nums text-slate-900">
+                    {{ $report['avg_los_minutes'] !== null ? $report['avg_los_minutes'].' min' : '—' }}
+                </p>
+            </div>
+        </div>
+
+        <div class="grid gap-4 lg:grid-cols-2">
+            <section class="rounded-2xl border border-slate-200 bg-white p-5">
+                <h2 class="text-sm font-semibold text-slate-900">Diagnoses</h2>
+                <ul class="mt-3 space-y-2 text-sm">
+                    @forelse ($report['diagnosis_breakdown'] as $row)
+                        <li class="flex justify-between gap-3">
+                            <span>{{ $row['diagnosis'] }}</span>
+                            <span class="tabular-nums text-slate-600">{{ $row['total'] }}</span>
+                        </li>
+                    @empty
+                        <li class="text-slate-500">No staging records in range.</li>
+                    @endforelse
+                </ul>
+            </section>
+            <section class="rounded-2xl border border-slate-200 bg-white p-5">
+                <h2 class="text-sm font-semibold text-slate-900">Regimens / treatments</h2>
+                <ul class="mt-3 space-y-2 text-sm">
+                    @forelse ($report['regimen_breakdown'] as $row)
+                        <li class="flex justify-between gap-3">
+                            <span>{{ $row['regimen'] }}</span>
+                            <span class="tabular-nums text-slate-600">{{ $row['total'] }}</span>
+                        </li>
+                    @empty
+                        <li class="text-slate-500">No treatments in range.</li>
+                    @endforelse
+                </ul>
+            </section>
+        </div>
+
+        <section class="rounded-2xl border border-slate-200 bg-white p-5">
+            <h2 class="text-sm font-semibold text-slate-900">Oncology service revenue</h2>
+            <ul class="mt-3 space-y-2 text-sm">
+                @forelse ($report['revenue_by_service'] as $row)
+                    <li class="flex justify-between gap-3">
+                        <span>{{ $row->description }} <span class="text-slate-400">×{{ $row->total }}</span></span>
+                        <span class="tabular-nums">{{ $currency }} {{ number_format($row->amount_minor / 100, 2) }}</span>
+                    </li>
+                @empty
+                    <li class="text-slate-500">No billed oncology services in range.</li>
+                @endforelse
+            </ul>
+        </section>
+    </div>
+</x-app-layout>

resources/views/care/specialty/oncology/workspace-overview.blade.php

@@ -0,0 +1,60 @@
+@php
+    $hist = $oncologyHistory?->payload ?? [];
+    $staging = $oncologyStaging?->payload ?? [];
+    $plan = $oncologyPlan?->payload ?? [];
+@endphp
+
+<section class="rounded-2xl border border-slate-200 bg-white p-5">
+    <div class="flex flex-wrap items-start justify-between gap-3">
+        <div>
+            <h3 class="text-sm font-semibold text-slate-900">Oncology overview</h3>
+            <p class="mt-0.5 text-xs text-slate-500">History, staging, investigations, plan, and treatment for this episode.</p>
+        </div>
+        <div class="flex flex-wrap gap-3 text-sm">
+            <a href="{{ route('care.specialty.oncology.print', $workspaceVisit) }}" target="_blank" class="font-medium text-indigo-600">Print summary</a>
+            <a href="{{ route('care.specialty.oncology.reports') }}" class="font-medium text-indigo-600">Oncology reports</a>
+        </div>
+    </div>
+
+    <div class="mt-4 grid gap-3 sm:grid-cols-3">
+        <div class="rounded-xl border border-slate-100 bg-slate-50 px-3 py-3">
+            <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Diagnosis</p>
+            <p class="mt-1 text-sm font-semibold text-slate-900">{{ $staging['diagnosis'] ?? ($plan['diagnosis'] ?? '—') }}</p>
+            <p class="mt-1 text-xs text-slate-500">Stage {{ $staging['stage'] ?? '—' }}</p>
+        </div>
+        <div class="rounded-xl border border-slate-100 bg-slate-50 px-3 py-3">
+            <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">ECOG</p>
+            <p class="mt-1 text-sm font-semibold text-slate-900">{{ $staging['performance_status'] ?? '—' }}</p>
+            <p class="mt-1 text-xs text-slate-500">{{ $plan['intent'] ?? '—' }}</p>
+        </div>
+        <div class="rounded-xl border border-slate-100 bg-slate-50 px-3 py-3">
+            <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Plan</p>
+            <p class="mt-1 text-sm font-semibold text-slate-900">{{ \Illuminate\Support\Str::limit($plan['plan'] ?? 'Not set', 40) }}</p>
+            <p class="mt-1 text-xs text-slate-500">{{ $plan['follow_up'] ?? '—' }}</p>
+        </div>
+    </div>
+
+    <dl class="mt-4 grid gap-3 text-sm sm:grid-cols-2">
+        <div>
+            <dt class="text-slate-500">History</dt>
+            <dd class="font-medium text-slate-900">{{ $hist['history'] ?? '—' }}</dd>
+        </div>
+        <div>
+            <dt class="text-slate-500">Queue</dt>
+            <dd class="font-medium text-slate-900">
+                {{ $workspaceVisit->appointment?->queue_ticket_number ?? '—' }}
+            </dd>
+        </div>
+    </dl>
+
+    @if (! empty($clinicalAlerts))
+        <div class="mt-4 space-y-1.5 border-t border-slate-100 pt-4">
+            <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Alerts</p>
+            @foreach ($clinicalAlerts as $alert)
+                <p class="text-sm {{ ($alert['severity'] ?? '') === 'critical' ? 'text-rose-700' : 'text-amber-800' }}">
+                    {{ $alert['message'] ?? '' }}
+                </p>
+            @endforeach
+        </div>
+    @endif
+</section>

resources/views/care/specialty/oncology/workspace-treatment.blade.php

@@ -0,0 +1,70 @@
+@php
+    $record = $oncologyTreatment;
+    $payload = $record?->payload ?? [];
+    $canManage = $canManageClinical ?? $canConsult ?? false;
+@endphp
+
+<section class="rounded-2xl border border-slate-200 bg-white p-5">
+    <div class="flex flex-wrap items-start justify-between gap-3">
+        <div>
+            <h3 class="text-sm font-semibold text-slate-900">Treatment / chemo</h3>
+            <p class="mt-0.5 text-xs text-slate-500">Completed treatments can close the oncology visit.</p>
+        </div>
+        <a href="{{ route('care.specialty.oncology.print', $workspaceVisit) }}" target="_blank" class="text-sm font-medium text-indigo-600">Print summary</a>
+    </div>
+
+    @if ($canManage)
+        <form method="POST" action="{{ route('care.specialty.oncology.treatment', $workspaceVisit) }}" class="mt-4 space-y-4">
+            @csrf
+            <input type="hidden" name="tab" value="treatment">
+            <div class="grid gap-3 sm:grid-cols-2">
+                @foreach ($clinicalFields ?? [] as $field)
+                    @php
+                        $name = $field['name'];
+                        $value = old('payload.'.$name, $payload[$name] ?? '');
+                        $type = $field['type'] ?? 'text';
+                    @endphp
+                    <div @class(['sm:col-span-2' => in_array($type, ['textarea'], true)])>
+                        <label class="block text-xs font-medium text-slate-600">
+                            {{ $field['label'] }}
+                            @if (! empty($field['required'])) <span class="text-rose-600">*</span> @endif
+                        </label>
+                        @if ($type === 'textarea')
+                            <textarea name="payload[{{ $name }}]" rows="{{ $field['rows'] ?? 3 }}" @required(! empty($field['required']))
+                                class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">{{ $value }}</textarea>
+                        @elseif ($type === 'select')
+                            <select name="payload[{{ $name }}]" @required(! empty($field['required']))
+                                class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+                                <option value="">Select…</option>
+                                @foreach ($field['options'] ?? [] as $option)
+                                    <option value="{{ $option }}" @selected((string) $value === (string) $option)>{{ $option }}</option>
+                                @endforeach
+                            </select>
+                        @elseif ($type === 'boolean')
+                            <label class="mt-2 inline-flex items-center gap-2 text-sm text-slate-700">
+                                <input type="checkbox" name="payload[{{ $name }}]" value="1" @checked(old('payload.'.$name, ! empty($payload[$name])))>
+                                Yes
+                            </label>
+                        @else
+                            <input type="{{ $type === 'number' ? 'number' : 'text' }}" name="payload[{{ $name }}]" value="{{ $value }}"
+                                @required(! empty($field['required']))
+                                class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+                        @endif
+                    </div>
+                @endforeach
+            </div>
+            <button type="submit" class="btn-primary">Save treatment</button>
+        </form>
+    @elseif ($record)
+        <dl class="mt-4 grid gap-3 text-sm sm:grid-cols-2">
+            @foreach ($clinicalFields ?? [] as $field)
+                <div>
+                    <dt class="text-slate-500">{{ $field['label'] }}</dt>
+                    <dd class="font-medium text-slate-900">{{ $payload[$field['name']] ?? '—' }}</dd>
+                </div>
+            @endforeach
+        </dl>
+    @else
+        <p class="mt-4 text-sm text-slate-500">No treatment recorded yet.</p>
+    @endif
+</section>

resources/views/care/specialty/renal/print.blade.php

@@ -0,0 +1,12 @@
+<!DOCTYPE html>
+<html lang="en"><head><meta charset="utf-8"><title>Renal summary · {{ $patient->fullName() }}</title>
+<style>body{font-family:system-ui,sans-serif;color:#0f172a;margin:2rem}h1{font-size:1.25rem}h2{font-size:.95rem;margin:1.25rem 0 .5rem;border-bottom:1px solid #e2e8f0;padding-bottom:.25rem}.meta{color:#64748b;font-size:.875rem}dl{display:grid;grid-template-columns:10rem 1fr;gap:.35rem .75rem;font-size:.875rem}dt{color:#64748b}dd{margin:0;font-weight:500}@media print{.no-print{display:none}}</style></head>
+<body>
+<p class="no-print"><a href="{{ route('care.specialty.workspace', ['module' => 'renal', 'visit' => $visit]) }}">Back</a></p>
+<h1>{{ $patient->fullName() }}</h1>
+<p class="meta">{{ $patient->patient_number }} · Visit #{{ $visit->id }} · Stage {{ $visit->specialty_stage ?? '—' }}</p>
+<h2>History</h2>@if($history)<dl><dt>HPI</dt><dd>{{ $history->payload['history'] ?? '—' }}</dd><dt>CKD</dt><dd>{{ $history->payload['ckd_stage'] ?? '—' }}</dd></dl>@else<p class="meta">No history.</p>@endif
+<h2>Exam</h2>@if($exam)<dl><dt>Complaint</dt><dd>{{ $exam->payload['chief_complaint'] ?? '—' }}</dd><dt>Fluid</dt><dd>{{ $exam->payload['fluid_status'] ?? '—' }}</dd></dl>@else<p class="meta">No exam.</p>@endif
+<h2>Dialysis / labs</h2>@if($dialysis)<dl><dt>Type</dt><dd>{{ $dialysis->payload['session_type'] ?? '—' }}</dd><dt>Notes</dt><dd>{{ $dialysis->payload['notes'] ?? '—' }}</dd></dl>@else<p class="meta">No session.</p>@endif
+<h2>Plan</h2>@if($plan)<dl><dt>Diagnosis</dt><dd>{{ $plan->payload['diagnosis'] ?? '—' }}</dd><dt>Plan</dt><dd>{{ $plan->payload['plan'] ?? '—' }}</dd><dt>Outcome</dt><dd>{{ $plan->payload['outcome'] ?? '—' }}</dd></dl>@else<p class="meta">No plan.</p>@endif
+<script>window.print();</script></body></html>

resources/views/care/specialty/renal/reports.blade.php

@@ -0,0 +1,48 @@
+<x-app-layout title="Renal Care reports">
+    <div class="space-y-6">
+        <div class="flex flex-wrap items-center justify-between gap-3">
+            <div>
+                <h1 class="text-xl font-semibold text-slate-900">Renal Care reports</h1>
+                <p class="mt-1 text-sm text-slate-500">Arrivals, dialysis sessions, diagnoses, length of stay, and renal revenue.</p>
+            </div>
+            <a href="{{ route('care.specialty.show', 'renal') }}" class="text-sm font-medium text-indigo-600">← Specialty home</a>
+        </div>
+        <form method="GET" class="flex flex-wrap items-end gap-3 rounded-2xl border border-slate-200 bg-white p-4">
+            <div><label class="block text-xs font-medium text-slate-600">From</label><input type="date" name="from" value="{{ $report['from'] ?? '' }}" class="mt-1 rounded-xl border border-slate-200 px-3 py-2 text-sm"></div>
+            <div><label class="block text-xs font-medium text-slate-600">To</label><input type="date" name="to" value="{{ $report['to'] ?? '' }}" class="mt-1 rounded-xl border border-slate-200 px-3 py-2 text-sm"></div>
+            <button type="submit" class="rounded-xl bg-indigo-600 px-4 py-2 text-sm font-semibold text-white">Apply</button>
+        </form>
+        <div class="grid gap-4 sm:grid-cols-4">
+            <div class="rounded-2xl border border-slate-200 bg-white p-4"><p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Arrivals today</p><p class="mt-2 text-2xl font-semibold tabular-nums text-slate-900">{{ number_format($report['arrivals_today']) }}</p></div>
+            <div class="rounded-2xl border border-slate-200 bg-white p-4"><p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Completed today</p><p class="mt-2 text-2xl font-semibold tabular-nums text-slate-900">{{ number_format($report['completed_today']) }}</p></div>
+            <div class="rounded-2xl border border-slate-200 bg-white p-4"><p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Dialysis stage open</p><p class="mt-2 text-2xl font-semibold tabular-nums text-rose-700">{{ number_format($report['dialysis_open']) }}</p></div>
+            <div class="rounded-2xl border border-slate-200 bg-white p-4"><p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Avg LOS</p><p class="mt-2 text-2xl font-semibold tabular-nums text-slate-900">{{ $report['avg_los_minutes'] !== null ? $report['avg_los_minutes'].' min' : '—' }}</p></div>
+        </div>
+        <div class="grid gap-4 lg:grid-cols-2">
+            <section class="rounded-2xl border border-slate-200 bg-white p-5">
+                <h2 class="text-sm font-semibold text-slate-900">Session types</h2>
+                <ul class="mt-3 space-y-2 text-sm">
+                    @forelse ($report['session_breakdown'] as $row)
+                        <li class="flex justify-between gap-3"><span>{{ $row['session_type'] }}</span><span class="tabular-nums text-slate-600">{{ $row['total'] }}</span></li>
+                    @empty<li class="text-slate-500">No sessions in range.</li>@endforelse
+                </ul>
+            </section>
+            <section class="rounded-2xl border border-slate-200 bg-white p-5">
+                <h2 class="text-sm font-semibold text-slate-900">Diagnoses</h2>
+                <ul class="mt-3 space-y-2 text-sm">
+                    @forelse ($report['diagnosis_breakdown'] as $row)
+                        <li class="flex justify-between gap-3"><span>{{ $row['diagnosis'] }}</span><span class="tabular-nums text-slate-600">{{ $row['total'] }}</span></li>
+                    @empty<li class="text-slate-500">No care plans in range.</li>@endforelse
+                </ul>
+            </section>
+        </div>
+        <section class="rounded-2xl border border-slate-200 bg-white p-5">
+            <h2 class="text-sm font-semibold text-slate-900">Renal service revenue</h2>
+            <ul class="mt-3 space-y-2 text-sm">
+                @forelse ($report['revenue_by_service'] as $row)
+                    <li class="flex justify-between gap-3"><span>{{ $row->description }} <span class="text-slate-400">×{{ $row->total }}</span></span><span class="tabular-nums">{{ $currency }} {{ number_format($row->amount_minor / 100, 2) }}</span></li>
+                @empty<li class="text-slate-500">No billed renal services in range.</li>@endforelse
+            </ul>
+        </section>
+    </div>
+</x-app-layout>

resources/views/care/specialty/renal/workspace-overview.blade.php

@@ -0,0 +1,46 @@
+@php
+    $hist = $renalHistory?->payload ?? [];
+    $exam = $renalExam?->payload ?? [];
+    $plan = $renalPlan?->payload ?? [];
+@endphp
+<section class="rounded-2xl border border-slate-200 bg-white p-5">
+    <div class="flex flex-wrap items-start justify-between gap-3">
+        <div>
+            <h3 class="text-sm font-semibold text-slate-900">Renal Care overview</h3>
+            <p class="mt-0.5 text-xs text-slate-500">History, exam, dialysis/labs, and care plan for this episode.</p>
+        </div>
+        <div class="flex flex-wrap gap-3 text-sm">
+            <a href="{{ route('care.specialty.renal.print', $workspaceVisit) }}" target="_blank" class="font-medium text-indigo-600">Print summary</a>
+            <a href="{{ route('care.specialty.renal.reports') }}" class="font-medium text-indigo-600">Renal reports</a>
+        </div>
+    </div>
+    <div class="mt-4 grid gap-3 sm:grid-cols-3">
+        <div class="rounded-xl border border-slate-100 bg-slate-50 px-3 py-3">
+            <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Complaint</p>
+            <p class="mt-1 text-sm font-semibold text-slate-900">{{ $exam['chief_complaint'] ?? '—' }}</p>
+            <p class="mt-1 text-xs text-slate-500">Fluid {{ $exam['fluid_status'] ?? '—' }}</p>
+        </div>
+        <div class="rounded-xl border border-slate-100 bg-slate-50 px-3 py-3">
+            <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">CKD / access</p>
+            <p class="mt-1 text-sm font-semibold text-slate-900">{{ $hist['ckd_stage'] ?? '—' }}</p>
+            <p class="mt-1 text-xs text-slate-500">{{ $exam['access'] ?? '—' }}</p>
+        </div>
+        <div class="rounded-xl border border-slate-100 bg-slate-50 px-3 py-3">
+            <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Diagnosis / plan</p>
+            <p class="mt-1 text-sm font-semibold text-slate-900">{{ $plan['diagnosis'] ?? 'Not set' }}</p>
+            <p class="mt-1 text-xs text-slate-500">{{ $plan['follow_up'] ?? '—' }}</p>
+        </div>
+    </div>
+    <dl class="mt-4 grid gap-3 text-sm sm:grid-cols-2">
+        <div><dt class="text-slate-500">History</dt><dd class="font-medium text-slate-900">{{ $hist['history'] ?? '—' }}</dd></div>
+        <div><dt class="text-slate-500">Plan</dt><dd class="font-medium text-slate-900">{{ $plan['plan'] ?? '—' }}</dd></div>
+    </dl>
+    @if (! empty($clinicalAlerts))
+        <div class="mt-4 space-y-1.5 border-t border-slate-100 pt-4">
+            <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Alerts</p>
+            @foreach ($clinicalAlerts as $alert)
+                <p class="text-sm {{ ($alert['severity'] ?? '') === 'critical' ? 'text-rose-700' : 'text-amber-800' }}">{{ $alert['message'] ?? '' }}</p>
+            @endforeach
+        </div>
+    @endif
+</section>

resources/views/care/specialty/renal/workspace-plan.blade.php

@@ -0,0 +1,67 @@
+@php
+    $record = $renalPlan;
+    $payload = $record?->payload ?? [];
+    $canManage = $canManageClinical ?? $canConsult ?? false;
+@endphp
+<section class="rounded-2xl border border-slate-200 bg-white p-5">
+    <div class="flex flex-wrap items-start justify-between gap-3">
+        <div>
+            <h3 class="text-sm font-semibold text-slate-900">Care plan</h3>
+            <p class="mt-0.5 text-xs text-slate-500">Completed / discharged outcomes can close the renal visit.</p>
+        </div>
+        <a href="{{ route('care.specialty.renal.print', $workspaceVisit) }}" target="_blank" class="text-sm font-medium text-indigo-600">Print summary</a>
+    </div>
+    @if ($canManage)
+        <form method="POST" action="{{ route('care.specialty.renal.plan', $workspaceVisit) }}" class="mt-4 space-y-4">
+            @csrf
+            <input type="hidden" name="tab" value="plan">
+
+            <div class="grid gap-3 sm:grid-cols-2">
+                @foreach ($clinicalFields ?? [] as $field)
+                    @php
+                        $name = $field['name'];
+                        $value = old('payload.'.$name, $payload[$name] ?? '');
+                        $type = $field['type'] ?? 'text';
+                    @endphp
+                    <div @class(['sm:col-span-2' => in_array($type, ['textarea'], true)])>
+                        <label class="block text-xs font-medium text-slate-600">
+                            {{ $field['label'] }}
+                            @if (! empty($field['required'])) <span class="text-rose-600">*</span> @endif
+                        </label>
+                        @if ($type === 'textarea')
+                            <textarea name="payload[{{ $name }}]" rows="{{ $field['rows'] ?? 3 }}" @required(! empty($field['required']))
+                                class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">{{ $value }}</textarea>
+                        @elseif ($type === 'select')
+                            <select name="payload[{{ $name }}]" @required(! empty($field['required']))
+                                class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+                                <option value="">Select…</option>
+                                @foreach ($field['options'] ?? [] as $option)
+                                    <option value="{{ $option }}" @selected((string) $value === (string) $option)>{{ $option }}</option>
+                                @endforeach
+                            </select>
+                        @elseif ($type === 'boolean')
+                            <label class="mt-2 inline-flex items-center gap-2 text-sm text-slate-700">
+                                <input type="checkbox" name="payload[{{ $name }}]" value="1" @checked(old('payload.'.$name, ! empty($payload[$name])))>
+                                Yes
+                            </label>
+                        @else
+                            <input type="{{ $type === 'number' ? 'number' : 'text' }}" name="payload[{{ $name }}]" value="{{ $value }}"
+                                @required(! empty($field['required']))
+                                class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+                        @endif
+                    </div>
+                @endforeach
+            </div>
+
+            <button type="submit" class="btn-primary">Save care plan</button>
+        </form>
+    @elseif ($record)
+        <dl class="mt-4 grid gap-3 text-sm sm:grid-cols-2">
+            @foreach ($clinicalFields ?? [] as $field)
+                <div><dt class="text-slate-500">{{ $field['label'] }}</dt><dd class="font-medium text-slate-900">{{ $payload[$field['name']] ?? '—' }}</dd></div>
+            @endforeach
+        </dl>
+    @else
+        <p class="mt-4 text-sm text-slate-500">No care plan recorded yet.</p>
+    @endif
+</section>

resources/views/care/specialty/sections/workspace.blade.php

@@ -79,6 +79,12 @@
             @include('care.specialty.orthopedics.workspace-'.$activeTab)
         @elseif ($moduleKey === 'ent' && in_array($activeTab, ['overview', 'procedure'], true))
             @include('care.specialty.ent.workspace-'.$activeTab)
+        @elseif ($moduleKey === 'oncology' && in_array($activeTab, ['overview', 'treatment'], true))
+            @include('care.specialty.oncology.workspace-'.$activeTab)
+        @elseif ($moduleKey === 'renal' && in_array($activeTab, ['overview', 'plan'], true))
+            @include('care.specialty.renal.workspace-'.$activeTab)
+        @elseif ($moduleKey === 'surgery' && in_array($activeTab, ['overview', 'postop'], true))
+            @include('care.specialty.surgery.workspace-'.$activeTab)
         @elseif ($activeTab === 'billing')
             <section class="rounded-2xl border border-slate-200 bg-white p-5">
                 <h3 class="text-sm font-semibold text-slate-900">

resources/views/care/specialty/shell.blade.php

@@ -61,6 +61,15 @@
                     @if ($moduleKey === 'ent')
                         <a href="{{ route('care.specialty.ent.reports') }}" class="text-slate-600 hover:text-slate-900">Reports</a>
                     @endif
+                    @if ($moduleKey === 'oncology')
+                        <a href="{{ route('care.specialty.oncology.reports') }}" class="text-slate-600 hover:text-slate-900">Reports</a>
+                    @endif
+                    @if ($moduleKey === 'renal')
+                        <a href="{{ route('care.specialty.renal.reports') }}" class="text-slate-600 hover:text-slate-900">Reports</a>
+                    @endif
+                    @if ($moduleKey === 'surgery')
+                        <a href="{{ route('care.specialty.surgery.reports') }}" class="text-slate-600 hover:text-slate-900">Reports</a>
+                    @endif
                     <a href="{{ route('care.specialty.history', $moduleKey) }}" class="text-slate-600 hover:text-slate-900">History</a>
                     @if ($canManageClinical ?? $canManageSpecialty ?? true)
                         <a href="{{ route('care.specialty.billing', $moduleKey) }}" class="text-slate-600 hover:text-slate-900">Billing</a>

resources/views/care/specialty/surgery/print.blade.php

@@ -0,0 +1,14 @@
+<!DOCTYPE html>
+<html lang="en"><head><meta charset="utf-8"><title>Surgery summary · {{ $patient->fullName() }}</title>
+<style>body{font-family:system-ui,sans-serif;color:#0f172a;margin:2rem}h1{font-size:1.25rem}h2{font-size:.95rem;margin:1.25rem 0 .5rem;border-bottom:1px solid #e2e8f0;padding-bottom:.25rem}.meta{color:#64748b;font-size:.875rem}dl{display:grid;grid-template-columns:10rem 1fr;gap:.35rem .75rem;font-size:.875rem}dt{color:#64748b}dd{margin:0;font-weight:500}@media print{.no-print{display:none}}</style></head>
+<body>
+<p class="no-print"><a href="{{ route('care.specialty.workspace', ['module' => 'surgery', 'visit' => $visit]) }}">Back</a></p>
+<h1>{{ $patient->fullName() }}</h1>
+<p class="meta">{{ $patient->patient_number }} · Visit #{{ $visit->id }} · Stage {{ $visit->specialty_stage ?? '—' }}</p>
+<h2>History</h2>@if($history)<dl><dt>HPI</dt><dd>{{ $history->payload['history'] ?? '—' }}</dd></dl>@else<p class="meta">No history.</p>@endif
+<h2>Exam</h2>@if($exam)<dl><dt>Complaint</dt><dd>{{ $exam->payload['chief_complaint'] ?? '—' }}</dd><dt>ASA</dt><dd>{{ $exam->payload['asa_class'] ?? '—' }}</dd></dl>@else<p class="meta">No exam.</p>@endif
+<h2>Investigations</h2>@if($investigation)<dl><dt>Investigation</dt><dd>{{ $investigation->payload['investigation'] ?? '—' }}</dd><dt>Findings</dt><dd>{{ $investigation->payload['findings'] ?? '—' }}</dd></dl>@else<p class="meta">No investigation.</p>@endif
+<h2>Consent / plan</h2>@if($plan)<dl><dt>Diagnosis</dt><dd>{{ $plan->payload['diagnosis'] ?? '—' }}</dd><dt>Procedure</dt><dd>{{ $plan->payload['proposed_procedure'] ?? '—' }}</dd><dt>Consent</dt><dd>{{ !empty($plan->payload['consent_obtained']) ? 'Yes' : 'No' }}</dd></dl>@else<p class="meta">No plan.</p>@endif
+<h2>Procedure</h2>@if($procedure)<dl><dt>Procedure</dt><dd>{{ $procedure->payload['procedure'] ?? '—' }}</dd><dt>Outcome</dt><dd>{{ $procedure->payload['outcome'] ?? '—' }}</dd></dl>@else<p class="meta">No procedure.</p>@endif
+<h2>Post-op</h2>@if($postop)<dl><dt>Progress</dt><dd>{{ $postop->payload['progress'] ?? '—' }}</dd><dt>Outcome</dt><dd>{{ $postop->payload['outcome'] ?? '—' }}</dd></dl>@else<p class="meta">No post-op.</p>@endif
+<script>window.print();</script></body></html>

resources/views/care/specialty/surgery/reports.blade.php

@@ -0,0 +1,33 @@
+<x-app-layout title="Surgery reports">
+    <div class="space-y-6">
+        <div class="flex flex-wrap items-center justify-between gap-3">
+            <div>
+                <h1 class="text-xl font-semibold text-slate-900">Surgery reports</h1>
+                <p class="mt-1 text-sm text-slate-500">Arrivals, pre-op pipeline, diagnoses, procedures, length of stay, and surgery revenue.</p>
+            </div>
+            <a href="{{ route('care.specialty.show', 'surgery') }}" class="text-sm font-medium text-indigo-600">← Specialty home</a>
+        </div>
+        <form method="GET" class="flex flex-wrap items-end gap-3 rounded-2xl border border-slate-200 bg-white p-4">
+            <div><label class="block text-xs font-medium text-slate-600">From</label><input type="date" name="from" value="{{ $report['from'] ?? '' }}" class="mt-1 rounded-xl border border-slate-200 px-3 py-2 text-sm"></div>
+            <div><label class="block text-xs font-medium text-slate-600">To</label><input type="date" name="to" value="{{ $report['to'] ?? '' }}" class="mt-1 rounded-xl border border-slate-200 px-3 py-2 text-sm"></div>
+            <button type="submit" class="rounded-xl bg-indigo-600 px-4 py-2 text-sm font-semibold text-white">Apply</button>
+        </form>
+        <div class="grid gap-4 sm:grid-cols-4">
+            <div class="rounded-2xl border border-slate-200 bg-white p-4"><p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Arrivals today</p><p class="mt-2 text-2xl font-semibold tabular-nums text-slate-900">{{ number_format($report['arrivals_today']) }}</p></div>
+            <div class="rounded-2xl border border-slate-200 bg-white p-4"><p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Completed today</p><p class="mt-2 text-2xl font-semibold tabular-nums text-slate-900">{{ number_format($report['completed_today']) }}</p></div>
+            <div class="rounded-2xl border border-slate-200 bg-white p-4"><p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Pre-op pipeline</p><p class="mt-2 text-2xl font-semibold tabular-nums text-rose-700">{{ number_format($report['preop_open']) }}</p></div>
+            <div class="rounded-2xl border border-slate-200 bg-white p-4"><p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Avg LOS</p><p class="mt-2 text-2xl font-semibold tabular-nums text-slate-900">{{ $report['avg_los_minutes'] !== null ? $report['avg_los_minutes'].' min' : '—' }}</p></div>
+        </div>
+        <div class="grid gap-4 lg:grid-cols-2">
+            <section class="rounded-2xl border border-slate-200 bg-white p-5"><h2 class="text-sm font-semibold text-slate-900">Diagnoses</h2>
+                <ul class="mt-3 space-y-2 text-sm">@forelse ($report['diagnosis_breakdown'] as $row)<li class="flex justify-between gap-3"><span>{{ $row['diagnosis'] }}</span><span class="tabular-nums text-slate-600">{{ $row['total'] }}</span></li>@empty<li class="text-slate-500">No plans in range.</li>@endforelse</ul>
+            </section>
+            <section class="rounded-2xl border border-slate-200 bg-white p-5"><h2 class="text-sm font-semibold text-slate-900">Procedures</h2>
+                <ul class="mt-3 space-y-2 text-sm">@forelse ($report['procedure_breakdown'] as $row)<li class="flex justify-between gap-3"><span>{{ $row['procedure'] }}</span><span class="tabular-nums text-slate-600">{{ $row['total'] }}</span></li>@empty<li class="text-slate-500">No procedures in range.</li>@endforelse</ul>
+            </section>
+        </div>
+        <section class="rounded-2xl border border-slate-200 bg-white p-5"><h2 class="text-sm font-semibold text-slate-900">Surgery service revenue</h2>
+            <ul class="mt-3 space-y-2 text-sm">@forelse ($report['revenue_by_service'] as $row)<li class="flex justify-between gap-3"><span>{{ $row->description }} <span class="text-slate-400">×{{ $row->total }}</span></span><span class="tabular-nums">{{ $currency }} {{ number_format($row->amount_minor / 100, 2) }}</span></li>@empty<li class="text-slate-500">No billed surgery services in range.</li>@endforelse</ul>
+        </section>
+    </div>
+</x-app-layout>

resources/views/care/specialty/surgery/workspace-overview.blade.php

@@ -0,0 +1,46 @@
+@php
+    $hist = $surgeryHistory?->payload ?? [];
+    $exam = $surgeryExam?->payload ?? [];
+    $plan = $surgeryPlan?->payload ?? [];
+@endphp
+<section class="rounded-2xl border border-slate-200 bg-white p-5">
+    <div class="flex flex-wrap items-start justify-between gap-3">
+        <div>
+            <h3 class="text-sm font-semibold text-slate-900">Surgery overview</h3>
+            <p class="mt-0.5 text-xs text-slate-500">Pre-op history, exam, investigations, consent/plan, procedure, and post-op.</p>
+        </div>
+        <div class="flex flex-wrap gap-3 text-sm">
+            <a href="{{ route('care.specialty.surgery.print', $workspaceVisit) }}" target="_blank" class="font-medium text-indigo-600">Print summary</a>
+            <a href="{{ route('care.specialty.surgery.reports') }}" class="font-medium text-indigo-600">Surgery reports</a>
+        </div>
+    </div>
+    <div class="mt-4 grid gap-3 sm:grid-cols-3">
+        <div class="rounded-xl border border-slate-100 bg-slate-50 px-3 py-3">
+            <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Complaint</p>
+            <p class="mt-1 text-sm font-semibold text-slate-900">{{ $exam['chief_complaint'] ?? '—' }}</p>
+            <p class="mt-1 text-xs text-slate-500">ASA {{ $exam['asa_class'] ?? '—' }}</p>
+        </div>
+        <div class="rounded-xl border border-slate-100 bg-slate-50 px-3 py-3">
+            <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Proposed procedure</p>
+            <p class="mt-1 text-sm font-semibold text-slate-900">{{ $plan['proposed_procedure'] ?? '—' }}</p>
+            <p class="mt-1 text-xs text-slate-500">{{ ! empty($plan['consent_obtained']) ? 'Consent obtained' : 'Consent pending' }}</p>
+        </div>
+        <div class="rounded-xl border border-slate-100 bg-slate-50 px-3 py-3">
+            <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Diagnosis / plan</p>
+            <p class="mt-1 text-sm font-semibold text-slate-900">{{ $plan['diagnosis'] ?? 'Not set' }}</p>
+            <p class="mt-1 text-xs text-slate-500">{{ $plan['follow_up'] ?? '—' }}</p>
+        </div>
+    </div>
+    <dl class="mt-4 grid gap-3 text-sm sm:grid-cols-2">
+        <div><dt class="text-slate-500">History</dt><dd class="font-medium text-slate-900">{{ $hist['history'] ?? '—' }}</dd></div>
+        <div><dt class="text-slate-500">Plan</dt><dd class="font-medium text-slate-900">{{ $plan['plan'] ?? '—' }}</dd></div>
+    </dl>
+    @if (! empty($clinicalAlerts))
+        <div class="mt-4 space-y-1.5 border-t border-slate-100 pt-4">
+            <p class="text-xs font-semibold uppercase tracking-wide text-slate-500">Alerts</p>
+            @foreach ($clinicalAlerts as $alert)
+                <p class="text-sm {{ ($alert['severity'] ?? '') === 'critical' ? 'text-rose-700' : 'text-amber-800' }}">{{ $alert['message'] ?? '' }}</p>
+            @endforeach
+        </div>
+    @endif
+</section>

resources/views/care/specialty/surgery/workspace-postop.blade.php

@@ -0,0 +1,67 @@
+@php
+    $record = $surgeryPostop;
+    $payload = $record?->payload ?? [];
+    $canManage = $canManageClinical ?? $canConsult ?? false;
+@endphp
+<section class="rounded-2xl border border-slate-200 bg-white p-5">
+    <div class="flex flex-wrap items-start justify-between gap-3">
+        <div>
+            <h3 class="text-sm font-semibold text-slate-900">Post-op</h3>
+            <p class="mt-0.5 text-xs text-slate-500">Completed / discharged outcomes can close the surgery visit.</p>
+        </div>
+        <a href="{{ route('care.specialty.surgery.print', $workspaceVisit) }}" target="_blank" class="text-sm font-medium text-indigo-600">Print summary</a>
+    </div>
+    @if ($canManage)
+        <form method="POST" action="{{ route('care.specialty.surgery.postop', $workspaceVisit) }}" class="mt-4 space-y-4">
+            @csrf
+            <input type="hidden" name="tab" value="postop">
+
+            <div class="grid gap-3 sm:grid-cols-2">
+                @foreach ($clinicalFields ?? [] as $field)
+                    @php
+                        $name = $field['name'];
+                        $value = old('payload.'.$name, $payload[$name] ?? '');
+                        $type = $field['type'] ?? 'text';
+                    @endphp
+                    <div @class(['sm:col-span-2' => in_array($type, ['textarea'], true)])>
+                        <label class="block text-xs font-medium text-slate-600">
+                            {{ $field['label'] }}
+                            @if (! empty($field['required'])) <span class="text-rose-600">*</span> @endif
+                        </label>
+                        @if ($type === 'textarea')
+                            <textarea name="payload[{{ $name }}]" rows="{{ $field['rows'] ?? 3 }}" @required(! empty($field['required']))
+                                class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">{{ $value }}</textarea>
+                        @elseif ($type === 'select')
+                            <select name="payload[{{ $name }}]" @required(! empty($field['required']))
+                                class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+                                <option value="">Select…</option>
+                                @foreach ($field['options'] ?? [] as $option)
+                                    <option value="{{ $option }}" @selected((string) $value === (string) $option)>{{ $option }}</option>
+                                @endforeach
+                            </select>
+                        @elseif ($type === 'boolean')
+                            <label class="mt-2 inline-flex items-center gap-2 text-sm text-slate-700">
+                                <input type="checkbox" name="payload[{{ $name }}]" value="1" @checked(old('payload.'.$name, ! empty($payload[$name])))>
+                                Yes
+                            </label>
+                        @else
+                            <input type="{{ $type === 'number' ? 'number' : 'text' }}" name="payload[{{ $name }}]" value="{{ $value }}"
+                                @required(! empty($field['required']))
+                                class="mt-1 w-full rounded-xl border border-slate-200 px-3 py-2 text-sm">
+                        @endif
+                    </div>
+                @endforeach
+            </div>
+
+            <button type="submit" class="btn-primary">Save post-op</button>
+        </form>
+    @elseif ($record)
+        <dl class="mt-4 grid gap-3 text-sm sm:grid-cols-2">
+            @foreach ($clinicalFields ?? [] as $field)
+                <div><dt class="text-slate-500">{{ $field['label'] }}</dt><dd class="font-medium text-slate-900">{{ $payload[$field['name']] ?? '—' }}</dd></div>
+            @endforeach
+        </dl>
+    @else
+        <p class="mt-4 text-sm text-slate-500">No post-op note recorded yet.</p>
+    @endif
+</section>

routes/web.php

@@ -50,6 +50,9 @@ use App\Http\Controllers\Care\PsychiatryWorkspaceController;
 use App\Http\Controllers\Care\PediatricsWorkspaceController;
 use App\Http\Controllers\Care\OrthopedicsWorkspaceController;
 use App\Http\Controllers\Care\EntWorkspaceController;
+use App\Http\Controllers\Care\OncologyWorkspaceController;
+use App\Http\Controllers\Care\RenalWorkspaceController;
+use App\Http\Controllers\Care\SurgeryWorkspaceController;
 use App\Http\Controllers\Care\SpecialtyModuleController;
 use App\Http\Controllers\Care\VisitWorkflowController;
 use App\Http\Controllers\NotificationController;
@@ -141,6 +144,9 @@ Route::middleware(['auth', 'platform.session'])->group(function () {
             Route::get('/specialty/pediatrics/reports', [PediatricsWorkspaceController::class, 'reports'])->name('care.specialty.pediatrics.reports');
             Route::get('/specialty/orthopedics/reports', [OrthopedicsWorkspaceController::class, 'reports'])->name('care.specialty.orthopedics.reports');
             Route::get('/specialty/ent/reports', [EntWorkspaceController::class, 'reports'])->name('care.specialty.ent.reports');
+            Route::get('/specialty/oncology/reports', [OncologyWorkspaceController::class, 'reports'])->name('care.specialty.oncology.reports');
+            Route::get('/specialty/renal/reports', [RenalWorkspaceController::class, 'reports'])->name('care.specialty.renal.reports');
+            Route::get('/specialty/surgery/reports', [SurgeryWorkspaceController::class, 'reports'])->name('care.specialty.surgery.reports');
             Route::get('/specialty/{module}/workspace/{visit?}', [SpecialtyModuleController::class, 'workspace'])->name('care.specialty.workspace');
             Route::post('/specialty/{module}/workspace/{visit}/clinical', [SpecialtyModuleController::class, 'saveClinical'])->name('care.specialty.clinical.save');
             Route::post('/specialty/{module}/workspace/{visit}/documents', [SpecialtyModuleController::class, 'uploadDocument'])->name('care.specialty.documents.upload');
@@ -201,6 +207,15 @@ Route::middleware(['auth', 'platform.session'])->group(function () {
             Route::post('/specialty/ent/workspace/{visit}/stage', [EntWorkspaceController::class, 'setStage'])->name('care.specialty.ent.stage');
             Route::post('/specialty/ent/workspace/{visit}/procedure', [EntWorkspaceController::class, 'saveProcedure'])->name('care.specialty.ent.procedure');
             Route::get('/specialty/ent/workspace/{visit}/print', [EntWorkspaceController::class, 'printSummary'])->name('care.specialty.ent.print');
+            Route::post('/specialty/oncology/workspace/{visit}/stage', [OncologyWorkspaceController::class, 'setStage'])->name('care.specialty.oncology.stage');
+            Route::post('/specialty/oncology/workspace/{visit}/treatment', [OncologyWorkspaceController::class, 'saveTreatment'])->name('care.specialty.oncology.treatment');
+            Route::get('/specialty/oncology/workspace/{visit}/print', [OncologyWorkspaceController::class, 'printSummary'])->name('care.specialty.oncology.print');
+            Route::post('/specialty/renal/workspace/{visit}/stage', [RenalWorkspaceController::class, 'setStage'])->name('care.specialty.renal.stage');
+            Route::post('/specialty/renal/workspace/{visit}/plan', [RenalWorkspaceController::class, 'savePlan'])->name('care.specialty.renal.plan');
+            Route::get('/specialty/renal/workspace/{visit}/print', [RenalWorkspaceController::class, 'printSummary'])->name('care.specialty.renal.print');
+            Route::post('/specialty/surgery/workspace/{visit}/stage', [SurgeryWorkspaceController::class, 'setStage'])->name('care.specialty.surgery.stage');
+            Route::post('/specialty/surgery/workspace/{visit}/postop', [SurgeryWorkspaceController::class, 'savePostop'])->name('care.specialty.surgery.postop');
+            Route::get('/specialty/surgery/workspace/{visit}/print', [SurgeryWorkspaceController::class, 'printSummary'])->name('care.specialty.surgery.print');
             Route::get('/specialty/{module}', [SpecialtyModuleController::class, 'show'])->name('care.specialty.show');
             Route::post('/specialty/{module}/call-next', [SpecialtyModuleController::class, 'callNext'])->name('care.specialty.call-next');
             Route::post('/specialty/{module}/refer', [SpecialtyModuleController::class, 'refer'])->name('care.specialty.refer');

tests/Feature/CareOncologySuiteTest.php

@@ -0,0 +1,233 @@
+<?php
+
+namespace Tests\Feature;
+
+use App\Http\Middleware\EnsurePlatformSession;
+use App\Models\Appointment;
+use App\Models\Branch;
+use App\Models\Department;
+use App\Models\Member;
+use App\Models\Organization;
+use App\Models\Patient;
+use App\Models\SpecialtyClinicalRecord;
+use App\Models\User;
+use App\Models\Visit;
+use App\Services\Care\SpecialtyModuleService;
+use Illuminate\Foundation\Testing\RefreshDatabase;
+use Tests\TestCase;
+
+class CareOncologySuiteTest extends TestCase
+{
+    use RefreshDatabase;
+
+    protected User $owner;
+
+    protected Organization $organization;
+
+    protected Branch $branch;
+
+    protected Patient $patient;
+
+    protected Visit $visit;
+
+    protected function setUp(): void
+    {
+        parent::setUp();
+        $this->withoutMiddleware(EnsurePlatformSession::class);
+
+        $this->owner = User::create([
+            'public_id' => 'onc-owner',
+            'name' => 'Owner',
+            'email' => 'onc-owner@example.com',
+        ]);
+
+        $this->organization = Organization::create([
+            'owner_ref' => $this->owner->public_id,
+            'name' => 'Oncology Clinic',
+            'slug' => 'onc-owner-clinic',
+            'settings' => [
+                'onboarded' => true,
+                'facility_type' => 'clinic',
+                'plan' => 'pro',
+                'plan_expires_at' => now()->addMonth()->toIso8601String(),
+                'queue_integration_enabled' => true,
+            ],
+        ]);
+
+        Member::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'user_ref' => $this->owner->public_id,
+            'role' => 'hospital_admin',
+            'branch_id' => null,
+        ]);
+
+        $this->branch = Branch::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'name' => 'Main',
+            'is_active' => true,
+        ]);
+
+        app(SpecialtyModuleService::class)->activate(
+            $this->organization,
+            $this->owner->public_id,
+            'oncology',
+        );
+
+        $department = Department::query()
+            ->where('branch_id', $this->branch->id)
+            ->where('type', 'oncology')
+            ->firstOrFail();
+
+        $this->patient = Patient::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'branch_id' => $this->branch->id,
+            'patient_number' => 'P-ONC-SUITE',
+            'first_name' => 'Ama',
+            'last_name' => 'Cancer',
+            'gender' => 'female',
+            'date_of_birth' => '1988-09-02',
+        ]);
+
+        $this->visit = Visit::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'branch_id' => $this->branch->id,
+            'patient_id' => $this->patient->id,
+            'status' => Visit::STATUS_IN_PROGRESS,
+            'checked_in_at' => now(),
+            'specialty_stage' => 'check_in',
+        ]);
+
+        Appointment::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'branch_id' => $this->branch->id,
+            'patient_id' => $this->patient->id,
+            'department_id' => $department->id,
+            'visit_id' => $this->visit->id,
+            'type' => Appointment::TYPE_WALK_IN,
+            'status' => Appointment::STATUS_IN_CONSULTATION,
+            'scheduled_at' => now(),
+            'waiting_at' => now(),
+            'checked_in_at' => now(),
+            'started_at' => now(),
+        ]);
+    }
+
+    public function test_overview_and_clinical_tabs_render(): void
+    {
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.workspace', [
+                'module' => 'oncology',
+                'visit' => $this->visit,
+                'tab' => 'overview',
+            ]))
+            ->assertOk()
+            ->assertSee('Oncology overview')
+            ->assertSee('data-care-stage-bar', false)
+            ->assertSee('Start history')
+            ->assertSee('Oncology reports');
+
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.workspace', [
+                'module' => 'oncology',
+                'visit' => $this->visit,
+                'tab' => 'staging',
+            ]))
+            ->assertOk()
+            ->assertSee('Oncology diagnosis');
+    }
+
+    public function test_clinical_save_sets_stage_and_alerts(): void
+    {
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.clinical.save', [
+                'module' => 'oncology',
+                'visit' => $this->visit,
+            ]), [
+                'tab' => 'staging',
+                'payload' => [
+                    'diagnosis' => 'Breast carcinoma',
+                    'stage' => 'IIA',
+                    'performance_status' => '3',
+                    'exam_findings' => 'Palpable mass',
+                ],
+            ])
+            ->assertRedirect();
+
+        $this->assertSame('staging', $this->visit->fresh()->specialty_stage);
+
+        $record = SpecialtyClinicalRecord::query()
+            ->where('visit_id', $this->visit->id)
+            ->firstOrFail();
+
+        $codes = collect($record->alerts)->pluck('code')->all();
+        $this->assertContains('onc.ecog_high', $codes);
+
+    }
+
+    public function test_stage_advance_and_terminal_completes_visit(): void
+    {
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.oncology.stage', $this->visit), [
+                'stage' => 'treatment',
+            ])
+            ->assertRedirect(route('care.specialty.workspace', [
+                'module' => 'oncology',
+                'visit' => $this->visit,
+                'tab' => 'treatment',
+            ]));
+
+        $this->assertSame('treatment', $this->visit->fresh()->specialty_stage);
+
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.oncology.treatment', $this->visit), [
+                'tab' => 'treatment',
+                'payload' => [
+                    'treatment' => 'AC cycle 1 day 1',
+                    'regimen' => 'AC',
+                    'cycle' => '1/4',
+                    'outcome' => 'Completed uneventfully',
+                    'post_treatment_plan' => 'Return cycle 2 in 21 days',
+                ],
+            ])
+            ->assertRedirect(route('care.specialty.workspace', [
+                'module' => 'oncology',
+                'visit' => $this->visit,
+                'tab' => 'treatment',
+            ]));
+
+        $this->assertSame('completed', $this->visit->fresh()->specialty_stage);
+        $this->assertSame(Visit::STATUS_COMPLETED, $this->visit->fresh()->status);
+        $this->assertDatabaseHas('care_specialty_clinical_records', [
+            'visit_id' => $this->visit->id,
+            'record_type' => 'onc_treatment',
+            'status' => SpecialtyClinicalRecord::STATUS_COMPLETED,
+        ]);
+    }
+
+    public function test_reports_and_print(): void
+    {
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.oncology.reports'))
+            ->assertOk()
+            ->assertSee('Oncology reports')
+            ->assertSee('Arrivals today');
+
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.oncology.print', $this->visit))
+            ->assertOk()
+            ->assertSee($this->patient->fullName());
+    }
+
+    public function test_list_index_does_not_auto_open_patient(): void
+    {
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.show', 'oncology'))
+            ->assertOk()
+            ->assertDontSee('Oncology overview');
+    }
+}

tests/Feature/CareRenalSuiteTest.php

@@ -0,0 +1,231 @@
+<?php
+
+namespace Tests\Feature;
+
+use App\Http\Middleware\EnsurePlatformSession;
+use App\Models\Appointment;
+use App\Models\Branch;
+use App\Models\Department;
+use App\Models\Member;
+use App\Models\Organization;
+use App\Models\Patient;
+use App\Models\SpecialtyClinicalRecord;
+use App\Models\User;
+use App\Models\Visit;
+use App\Services\Care\SpecialtyModuleService;
+use Illuminate\Foundation\Testing\RefreshDatabase;
+use Tests\TestCase;
+
+class CareRenalSuiteTest extends TestCase
+{
+    use RefreshDatabase;
+
+    protected User $owner;
+
+    protected Organization $organization;
+
+    protected Branch $branch;
+
+    protected Patient $patient;
+
+    protected Visit $visit;
+
+    protected function setUp(): void
+    {
+        parent::setUp();
+        $this->withoutMiddleware(EnsurePlatformSession::class);
+
+        $this->owner = User::create([
+            'public_id' => 'renal-owner',
+            'name' => 'Owner',
+            'email' => 'renal-owner@example.com',
+        ]);
+
+        $this->organization = Organization::create([
+            'owner_ref' => $this->owner->public_id,
+            'name' => 'Renal Clinic',
+            'slug' => 'renal-owner-clinic',
+            'settings' => [
+                'onboarded' => true,
+                'facility_type' => 'clinic',
+                'plan' => 'pro',
+                'plan_expires_at' => now()->addMonth()->toIso8601String(),
+                'queue_integration_enabled' => true,
+            ],
+        ]);
+
+        Member::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'user_ref' => $this->owner->public_id,
+            'role' => 'hospital_admin',
+            'branch_id' => null,
+        ]);
+
+        $this->branch = Branch::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'name' => 'Main',
+            'is_active' => true,
+        ]);
+
+        app(SpecialtyModuleService::class)->activate(
+            $this->organization,
+            $this->owner->public_id,
+            'renal',
+        );
+
+        $department = Department::query()
+            ->where('branch_id', $this->branch->id)
+            ->where('type', 'renal')
+            ->firstOrFail();
+
+        $this->patient = Patient::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'branch_id' => $this->branch->id,
+            'patient_number' => 'P-REN-SUITE',
+            'first_name' => 'Kojo',
+            'last_name' => 'Kidney',
+            'gender' => 'female',
+            'date_of_birth' => '1988-09-02',
+        ]);
+
+        $this->visit = Visit::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'branch_id' => $this->branch->id,
+            'patient_id' => $this->patient->id,
+            'status' => Visit::STATUS_IN_PROGRESS,
+            'checked_in_at' => now(),
+            'specialty_stage' => 'check_in',
+        ]);
+
+        Appointment::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'branch_id' => $this->branch->id,
+            'patient_id' => $this->patient->id,
+            'department_id' => $department->id,
+            'visit_id' => $this->visit->id,
+            'type' => Appointment::TYPE_WALK_IN,
+            'status' => Appointment::STATUS_IN_CONSULTATION,
+            'scheduled_at' => now(),
+            'waiting_at' => now(),
+            'checked_in_at' => now(),
+            'started_at' => now(),
+        ]);
+    }
+
+    public function test_overview_and_clinical_tabs_render(): void
+    {
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.workspace', [
+                'module' => 'renal',
+                'visit' => $this->visit,
+                'tab' => 'overview',
+            ]))
+            ->assertOk()
+            ->assertSee('Renal Care overview')
+            ->assertSee('data-care-stage-bar', false)
+            ->assertSee('Start history')
+            ->assertSee('Renal reports');
+
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.workspace', [
+                'module' => 'renal',
+                'visit' => $this->visit,
+                'tab' => 'exam',
+            ]))
+            ->assertOk()
+            ->assertSee('Chief complaint', false);
+    }
+
+    public function test_clinical_save_sets_stage_and_alerts(): void
+    {
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.clinical.save', [
+                'module' => 'renal',
+                'visit' => $this->visit,
+            ]), [
+                'tab' => 'exam',
+                'payload' => [
+                    'chief_complaint' => 'Missed dialysis with oedema',
+                    'fluid_status' => 'Overload',
+                    'exam_findings' => 'Bilateral crackles',
+                ],
+            ])
+            ->assertRedirect();
+
+        $this->assertSame('exam', $this->visit->fresh()->specialty_stage);
+
+        $record = SpecialtyClinicalRecord::query()
+            ->where('visit_id', $this->visit->id)
+            ->firstOrFail();
+
+        $codes = collect($record->alerts)->pluck('code')->all();
+        $this->assertContains('ren.fluid_overload', $codes);
+
+    }
+
+    public function test_stage_advance_and_terminal_completes_visit(): void
+    {
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.renal.stage', $this->visit), [
+                'stage' => 'plan',
+            ])
+            ->assertRedirect(route('care.specialty.workspace', [
+                'module' => 'renal',
+                'visit' => $this->visit,
+                'tab' => 'plan',
+            ]));
+
+        $this->assertSame('plan', $this->visit->fresh()->specialty_stage);
+
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.renal.plan', $this->visit), [
+                'tab' => 'plan',
+                'payload' => [
+                    'diagnosis' => 'CKD 5D with fluid overload',
+                    'plan' => 'Urgent HD; adjust dry weight',
+                    'outcome' => 'Completed — discharged',
+                    'follow_up' => 'Next HD in 2 days',
+                ],
+            ])
+            ->assertRedirect(route('care.specialty.workspace', [
+                'module' => 'renal',
+                'visit' => $this->visit,
+                'tab' => 'plan',
+            ]));
+
+        $this->assertSame('completed', $this->visit->fresh()->specialty_stage);
+        $this->assertSame(Visit::STATUS_COMPLETED, $this->visit->fresh()->status);
+        $this->assertDatabaseHas('care_specialty_clinical_records', [
+            'visit_id' => $this->visit->id,
+            'record_type' => 'renal_plan',
+            'status' => SpecialtyClinicalRecord::STATUS_COMPLETED,
+        ]);
+    }
+
+    public function test_reports_and_print(): void
+    {
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.renal.reports'))
+            ->assertOk()
+            ->assertSee('Renal Care reports')
+            ->assertSee('Arrivals today');
+
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.renal.print', $this->visit))
+            ->assertOk()
+            ->assertSee($this->patient->fullName());
+    }
+
+    public function test_list_index_does_not_auto_open_patient(): void
+    {
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.show', 'renal'))
+            ->assertOk()
+            ->assertDontSee('Renal Care overview');
+    }
+}

tests/Feature/CareSurgerySuiteTest.php

@@ -0,0 +1,224 @@
+<?php
+
+namespace Tests\Feature;
+
+use App\Http\Middleware\EnsurePlatformSession;
+use App\Models\Appointment;
+use App\Models\Branch;
+use App\Models\Department;
+use App\Models\Member;
+use App\Models\Organization;
+use App\Models\Patient;
+use App\Models\SpecialtyClinicalRecord;
+use App\Models\User;
+use App\Models\Visit;
+use App\Services\Care\SpecialtyModuleService;
+use Illuminate\Foundation\Testing\RefreshDatabase;
+use Tests\TestCase;
+
+class CareSurgerySuiteTest extends TestCase
+{
+    use RefreshDatabase;
+
+    protected User $owner;
+
+    protected Organization $organization;
+
+    protected Branch $branch;
+
+    protected Patient $patient;
+
+    protected Visit $visit;
+
+    protected function setUp(): void
+    {
+        parent::setUp();
+        $this->withoutMiddleware(EnsurePlatformSession::class);
+
+        $this->owner = User::create([
+            'public_id' => 'surg-owner',
+            'name' => 'Owner',
+            'email' => 'surg-owner@example.com',
+        ]);
+
+        $this->organization = Organization::create([
+            'owner_ref' => $this->owner->public_id,
+            'name' => 'Surgery Clinic',
+            'slug' => 'surg-owner-clinic',
+            'settings' => [
+                'onboarded' => true,
+                'facility_type' => 'clinic',
+                'plan' => 'pro',
+                'plan_expires_at' => now()->addMonth()->toIso8601String(),
+                'queue_integration_enabled' => true,
+            ],
+        ]);
+
+        Member::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'user_ref' => $this->owner->public_id,
+            'role' => 'hospital_admin',
+            'branch_id' => null,
+        ]);
+
+        $this->branch = Branch::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'name' => 'Main',
+            'is_active' => true,
+        ]);
+
+        app(SpecialtyModuleService::class)->activate(
+            $this->organization,
+            $this->owner->public_id,
+            'surgery',
+        );
+
+        $department = Department::query()
+            ->where('branch_id', $this->branch->id)
+            ->where('type', 'surgery')
+            ->firstOrFail();
+
+        $this->patient = Patient::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'branch_id' => $this->branch->id,
+            'patient_number' => 'P-SUR-SUITE',
+            'first_name' => 'Efua',
+            'last_name' => 'Hernia',
+            'gender' => 'female',
+            'date_of_birth' => '1988-09-02',
+        ]);
+
+        $this->visit = Visit::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'branch_id' => $this->branch->id,
+            'patient_id' => $this->patient->id,
+            'status' => Visit::STATUS_IN_PROGRESS,
+            'checked_in_at' => now(),
+            'specialty_stage' => 'check_in',
+        ]);
+
+        Appointment::create([
+            'owner_ref' => $this->owner->public_id,
+            'organization_id' => $this->organization->id,
+            'branch_id' => $this->branch->id,
+            'patient_id' => $this->patient->id,
+            'department_id' => $department->id,
+            'visit_id' => $this->visit->id,
+            'type' => Appointment::TYPE_WALK_IN,
+            'status' => Appointment::STATUS_IN_CONSULTATION,
+            'scheduled_at' => now(),
+            'waiting_at' => now(),
+            'checked_in_at' => now(),
+            'started_at' => now(),
+        ]);
+    }
+
+    public function test_overview_and_clinical_tabs_render(): void
+    {
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.workspace', [
+                'module' => 'surgery',
+                'visit' => $this->visit,
+                'tab' => 'overview',
+            ]))
+            ->assertOk()
+            ->assertSee('Surgery overview')
+            ->assertSee('data-care-stage-bar', false)
+            ->assertSee('Start pre-op history')
+            ->assertSee('Surgery reports');
+
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.workspace', [
+                'module' => 'surgery',
+                'visit' => $this->visit,
+                'tab' => 'exam',
+            ]))
+            ->assertOk()
+            ->assertSee('Chief complaint', false);
+    }
+
+    public function test_clinical_save_sets_stage_and_alerts(): void
+    {
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.clinical.save', [
+                'module' => 'surgery',
+                'visit' => $this->visit,
+            ]), [
+                'tab' => 'exam',
+                'payload' => [
+                    'chief_complaint' => 'Right inguinal hernia',
+                    'exam_findings' => 'Reducible hernia',
+                    'asa_class' => 'II',
+                ],
+            ])
+            ->assertRedirect();
+
+        $this->assertSame('exam', $this->visit->fresh()->specialty_stage);
+
+    }
+
+    public function test_stage_advance_and_terminal_completes_visit(): void
+    {
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.surgery.stage', $this->visit), [
+                'stage' => 'postop',
+            ])
+            ->assertRedirect(route('care.specialty.workspace', [
+                'module' => 'surgery',
+                'visit' => $this->visit,
+                'tab' => 'postop',
+            ]));
+
+        $this->assertSame('postop', $this->visit->fresh()->specialty_stage);
+
+        $this->actingAs($this->owner)
+            ->post(route('care.specialty.surgery.postop', $this->visit), [
+                'tab' => 'postop',
+                'payload' => [
+                    'review_type' => 'Immediate post-op',
+                    'progress' => 'Stable; wound dry',
+                    'outcome' => 'Completed — discharged',
+                    'next_steps' => 'Wound check in 7 days',
+                ],
+            ])
+            ->assertRedirect(route('care.specialty.workspace', [
+                'module' => 'surgery',
+                'visit' => $this->visit,
+                'tab' => 'postop',
+            ]));
+
+        $this->assertSame('completed', $this->visit->fresh()->specialty_stage);
+        $this->assertSame(Visit::STATUS_COMPLETED, $this->visit->fresh()->status);
+        $this->assertDatabaseHas('care_specialty_clinical_records', [
+            'visit_id' => $this->visit->id,
+            'record_type' => 'surg_postop',
+            'status' => SpecialtyClinicalRecord::STATUS_COMPLETED,
+        ]);
+    }
+
+    public function test_reports_and_print(): void
+    {
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.surgery.reports'))
+            ->assertOk()
+            ->assertSee('Surgery reports')
+            ->assertSee('Arrivals today');
+
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.surgery.print', $this->visit))
+            ->assertOk()
+            ->assertSee($this->patient->fullName());
+    }
+
+    public function test_list_index_does_not_auto_open_patient(): void
+    {
+        $this->actingAs($this->owner)
+            ->get(route('care.specialty.show', 'surgery'))
+            ->assertOk()
+            ->assertDontSee('Surgery overview');
+    }
+}