Add full Physiotherapy and Maternity specialty clinical suites.

Mirror Eye Care depth with stages, workspace tabs, clinical JSON, stage Move→tab routing, reports/print, demo seeds, and suite feature tests. Co-authored-by: Cursor <cursoragent@cursor.com>
2026-07-19 16:39:22 +00:00
parent 2f724daf49
commit cfa71c2c15
30 changed files with 2794 additions and 24 deletions
@@ -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\Maternity\MaternityAnalyticsService;
+use App\Services\Care\Maternity\MaternityWorkflowService;
+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 MaternityWorkspaceController extends Controller
+{
+    use ScopesToAccount;
+
+    protected function assertMaternityAccess(Request $request, SpecialtyModuleService $modules): void
+    {
+        $organization = $this->organization($request);
+        abort_unless($modules->memberCanAccess($organization, $this->member($request), 'maternity'), 403);
+    }
+
+    protected function assertMaternityManage(Request $request, SpecialtyModuleService $modules): void
+    {
+        $organization = $this->organization($request);
+        abort_unless($modules->memberCanManage($organization, $this->member($request), 'maternity'), 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');
+        $this->assertMaternityManage($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $validated = $request->validate([
+            'stage' => ['required', 'string', 'max:32'],
+        ]);
+
+        try {
+            $stages->setStage(
+                $this->organization($request),
+                $visit,
+                'maternity',
+                $validated['stage'],
+                $this->ownerRef($request),
+                $this->actorRef($request),
+            );
+        } catch (\InvalidArgumentException $e) {
+            return back()->with('error', $e->getMessage());
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', [
+                'module' => 'maternity',
+                'visit' => $visit,
+                'tab' => $shell->workspaceTabForStage('maternity', $validated['stage']),
+            ])
+            ->with('success', 'Visit stage updated.');
+    }
+
+    public function savePostnatal(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        SpecialtyClinicalRecordService $clinical,
+        SpecialtyVisitStageService $stages,
+        MaternityWorkflowService $workflow,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertMaternityManage($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $organization = $this->organization($request);
+        $owner = $this->ownerRef($request);
+
+        $payload = (array) $request->input('payload', []);
+        foreach ($clinical->fieldsFor('maternity', 'postnatal_note') as $field) {
+            if (($field['type'] ?? '') === 'boolean') {
+                $payload[$field['name']] = $request->boolean('payload.'.$field['name']);
+            }
+        }
+        $request->merge(['payload' => $payload, 'tab' => 'postnatal']);
+
+        $validated = $request->validate(array_merge([
+            'tab' => ['required', 'string'],
+        ], $clinical->validationRules('maternity', 'postnatal_note')));
+
+        $record = $clinical->upsert(
+            $organization,
+            $visit,
+            'maternity',
+            'postnatal_note',
+            $clinical->payloadFromRequest($validated),
+            $owner,
+            $owner,
+            MaternityWorkflowService::STAGE_POSTNATAL,
+            SpecialtyClinicalRecord::STATUS_COMPLETED,
+        );
+
+        try {
+            $stages->setStage(
+                $organization,
+                $visit,
+                'maternity',
+                MaternityWorkflowService::STAGE_POSTNATAL,
+                $owner,
+                $owner,
+            );
+        } catch (\InvalidArgumentException) {
+        }
+
+        if ($workflow->shouldCompleteVisit($record->payload ?? [])) {
+            try {
+                $stages->setStage(
+                    $organization,
+                    $visit,
+                    'maternity',
+                    MaternityWorkflowService::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' => 'maternity', 'visit' => $visit, 'tab' => 'postnatal'])
+            ->with('success', 'Delivery / postnatal note saved.');
+    }
+
+    public function reports(
+        Request $request,
+        SpecialtyModuleService $modules,
+        SpecialtyShellService $shell,
+        MaternityAnalyticsService $analytics,
+    ): View {
+        $this->authorizeAbility($request, 'consultations.view');
+        $this->assertMaternityAccess($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.maternity.reports', [
+            'moduleKey' => 'maternity',
+            'definition' => $modules->definition('maternity'),
+            'shellNav' => $shell->navItems('maternity'),
+            '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');
+        $this->assertMaternityAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $visit->loadMissing(['patient', 'appointment.practitioner', 'branch']);
+
+        return view('care.specialty.maternity.print', [
+            'visit' => $visit,
+            'patient' => $visit->patient,
+            'history' => $clinical->findForVisit($visit, 'maternity', 'anc_history'),
+            'exam' => $clinical->findForVisit($visit, 'maternity', 'obstetric_exam'),
+            'fetal' => $clinical->findForVisit($visit, 'maternity', 'fetal_notes'),
+            'investigation' => $clinical->findForVisit($visit, 'maternity', 'mat_investigation'),
+            'plan' => $clinical->findForVisit($visit, 'maternity', 'mat_plan'),
+            'postnatal' => $clinical->findForVisit($visit, 'maternity', 'postnatal_note'),
+        ]);
+    }
+}
@@ -0,0 +1,208 @@
+<?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\Physiotherapy\PhysiotherapyAnalyticsService;
+use App\Services\Care\Physiotherapy\PhysiotherapyWorkflowService;
+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 PhysiotherapyWorkspaceController extends Controller
+{
+    use ScopesToAccount;
+
+    protected function assertPhysiotherapyAccess(Request $request, SpecialtyModuleService $modules): void
+    {
+        $organization = $this->organization($request);
+        abort_unless($modules->memberCanAccess($organization, $this->member($request), 'physiotherapy'), 403);
+    }
+
+    protected function assertPhysiotherapyManage(Request $request, SpecialtyModuleService $modules): void
+    {
+        $organization = $this->organization($request);
+        abort_unless($modules->memberCanManage($organization, $this->member($request), 'physiotherapy'), 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');
+        $this->assertPhysiotherapyManage($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $validated = $request->validate([
+            'stage' => ['required', 'string', 'max:32'],
+        ]);
+
+        try {
+            $stages->setStage(
+                $this->organization($request),
+                $visit,
+                'physiotherapy',
+                $validated['stage'],
+                $this->ownerRef($request),
+                $this->actorRef($request),
+            );
+        } catch (\InvalidArgumentException $e) {
+            return back()->with('error', $e->getMessage());
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', [
+                'module' => 'physiotherapy',
+                'visit' => $visit,
+                'tab' => $shell->workspaceTabForStage('physiotherapy', $validated['stage']),
+            ])
+            ->with('success', 'Visit stage updated.');
+    }
+
+    public function saveSession(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        SpecialtyClinicalRecordService $clinical,
+        SpecialtyVisitStageService $stages,
+        PhysiotherapyWorkflowService $workflow,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertPhysiotherapyManage($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $organization = $this->organization($request);
+        $owner = $this->ownerRef($request);
+
+        $payload = (array) $request->input('payload', []);
+        foreach ($clinical->fieldsFor('physiotherapy', 'pt_session') as $field) {
+            if (($field['type'] ?? '') === 'boolean') {
+                $payload[$field['name']] = $request->boolean('payload.'.$field['name']);
+            }
+        }
+        $request->merge(['payload' => $payload, 'tab' => 'session']);
+
+        $validated = $request->validate(array_merge([
+            'tab' => ['required', 'string'],
+        ], $clinical->validationRules('physiotherapy', 'pt_session')));
+
+        $record = $clinical->upsert(
+            $organization,
+            $visit,
+            'physiotherapy',
+            'pt_session',
+            $clinical->payloadFromRequest($validated),
+            $owner,
+            $owner,
+            PhysiotherapyWorkflowService::STAGE_SESSION,
+            SpecialtyClinicalRecord::STATUS_COMPLETED,
+        );
+
+        $suggested = $workflow->stageFromSession($record->payload ?? []);
+        try {
+            $stages->setStage($organization, $visit, 'physiotherapy', $suggested, $owner, $owner);
+        } catch (\InvalidArgumentException) {
+        }
+
+        if ($workflow->shouldCompleteVisit($record->payload ?? [])) {
+            try {
+                $stages->setStage(
+                    $organization,
+                    $visit,
+                    'physiotherapy',
+                    PhysiotherapyWorkflowService::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' => 'physiotherapy', 'visit' => $visit, 'tab' => 'session'])
+            ->with('success', 'Therapy session saved.');
+    }
+
+    public function reports(
+        Request $request,
+        SpecialtyModuleService $modules,
+        SpecialtyShellService $shell,
+        PhysiotherapyAnalyticsService $analytics,
+    ): View {
+        $this->authorizeAbility($request, 'consultations.view');
+        $this->assertPhysiotherapyAccess($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.physiotherapy.reports', [
+            'moduleKey' => 'physiotherapy',
+            'definition' => $modules->definition('physiotherapy'),
+            'shellNav' => $shell->navItems('physiotherapy'),
+            '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');
+        $this->assertPhysiotherapyAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $visit->loadMissing(['patient', 'appointment.practitioner', 'branch']);
+
+        return view('care.specialty.physiotherapy.print', [
+            'visit' => $visit,
+            'patient' => $visit->patient,
+            'assessment' => $clinical->findForVisit($visit, 'physiotherapy', 'pt_assessment'),
+            'plan' => $clinical->findForVisit($visit, 'physiotherapy', 'pt_plan'),
+            'session' => $clinical->findForVisit($visit, 'physiotherapy', 'pt_session'),
+            'homeProgram' => $clinical->findForVisit($visit, 'physiotherapy', 'pt_home_program'),
+        ]);
+    }
+}
@@ -154,6 +154,8 @@ class SpecialtyModuleController extends Controller
                'emergency' => 'triage',
                'blood_bank' => 'requests',
                'ophthalmology' => 'refraction',
+                'physiotherapy' => 'assessment',
+                'maternity' => 'history',
                default => (collect(array_keys($shellTabs))
                    ->first(fn (string $tab) => $clinical->recordTypeForTab($module, $tab) !== null)
                    ?? 'clinical_notes'),
@@ -226,6 +228,8 @@ class SpecialtyModuleController extends Controller
            'emergency' => 'triage',
            'blood_bank' => 'requests',
            'ophthalmology' => 'refraction',
+            'physiotherapy' => 'assessment',
+            'maternity' => 'history',
            default => (collect(array_keys($shellTabs))
                ->first(fn (string $tab) => $clinical->recordTypeForTab($module, $tab) !== null)
                ?? 'clinical_notes'),
@@ -409,6 +413,103 @@ class SpecialtyModuleController extends Controller
            }
        }

+
+        if ($module === 'physiotherapy' && in_array($recordType, ['pt_assessment', 'pt_plan', 'pt_session', 'pt_home_program'], true)) {
+            $workflow = app(\App\Services\Care\Physiotherapy\PhysiotherapyWorkflowService::class);
+            $stageService = app(\App\Services\Care\SpecialtyVisitStageService::class);
+            $suggested = match ($recordType) {
+                'pt_assessment' => $workflow->stageFromAssessment($record->payload ?? []),
+                'pt_plan' => $workflow->stageFromPlan($record->payload ?? []),
+                'pt_session' => $workflow->stageFromSession($record->payload ?? []),
+                'pt_home_program' => $workflow->stageFromHomeProgram($record->payload ?? []),
+                default => null,
+            };
+            $current = $visit->specialty_stage;
+            $early = ['check_in', 'waiting', null, ''];
+            $order = [
+                'check_in' => 0,
+                'assessment' => 1,
+                'treatment_plan' => 2,
+                'session' => 3,
+                'progress' => 4,
+                'completed' => 5,
+            ];
+            if ($suggested && (! $current || in_array($current, $early, true))) {
+                try {
+                    $stageService->setStage(
+                        $organization,
+                        $visit,
+                        'physiotherapy',
+                        $suggested,
+                        $this->ownerRef($request),
+                        $this->ownerRef($request),
+                    );
+                } catch (\InvalidArgumentException) {
+                }
+            } elseif ($suggested && $suggested !== $current && ($order[$suggested] ?? 0) > ($order[$current] ?? 0)) {
+                try {
+                    $stageService->setStage(
+                        $organization,
+                        $visit,
+                        'physiotherapy',
+                        $suggested,
+                        $this->ownerRef($request),
+                        $this->ownerRef($request),
+                    );
+                } catch (\InvalidArgumentException) {
+                }
+            }
+        }
+
+        if ($module === 'maternity' && in_array($recordType, ['anc_history', 'obstetric_exam', 'fetal_notes', 'mat_investigation', 'mat_plan'], true)) {
+            $workflow = app(\App\Services\Care\Maternity\MaternityWorkflowService::class);
+            $stageService = app(\App\Services\Care\SpecialtyVisitStageService::class);
+            $suggested = match ($recordType) {
+                'anc_history' => $workflow->stageFromHistory($record->payload ?? []),
+                'obstetric_exam' => $workflow->stageFromExam($record->payload ?? []),
+                'fetal_notes' => $workflow->stageFromFetal($record->payload ?? []),
+                'mat_investigation' => \App\Services\Care\Maternity\MaternityWorkflowService::STAGE_INVESTIGATION,
+                'mat_plan' => $workflow->stageFromPlan($record->payload ?? []),
+                default => null,
+            };
+            $current = $visit->specialty_stage;
+            $early = ['check_in', 'waiting', null, ''];
+            $order = [
+                'check_in' => 0,
+                'history' => 1,
+                'exam' => 2,
+                'investigation' => 3,
+                'plan' => 4,
+                'postnatal' => 5,
+                'completed' => 6,
+            ];
+            if ($suggested && (! $current || in_array($current, $early, true))) {
+                try {
+                    $stageService->setStage(
+                        $organization,
+                        $visit,
+                        'maternity',
+                        $suggested,
+                        $this->ownerRef($request),
+                        $this->ownerRef($request),
+                    );
+                } catch (\InvalidArgumentException) {
+                }
+            } elseif ($suggested && $suggested !== $current && ($order[$suggested] ?? 0) > ($order[$current] ?? 0)) {
+                try {
+                    $stageService->setStage(
+                        $organization,
+                        $visit,
+                        'maternity',
+                        $suggested,
+                        $this->ownerRef($request),
+                        $this->ownerRef($request),
+                    );
+                } catch (\InvalidArgumentException) {
+                }
+            }
+        }
+
        return redirect()
            ->route('care.specialty.workspace', [
                'module' => $module,
@@ -809,6 +910,20 @@ class SpecialtyModuleController extends Controller
        $ophthalmologyProcedure = null;
        $ophthalmologyStageCodes = [];
        $ophthalmologyStageFlow = [];
+        $physiotherapyAssessment = null;
+        $physiotherapyPlan = null;
+        $physiotherapySession = null;
+        $physiotherapyHomeProgram = null;
+        $physiotherapyStageCodes = [];
+        $physiotherapyStageFlow = [];
+        $maternityHistory = null;
+        $maternityExam = null;
+        $maternityFetal = null;
+        $maternityInvestigation = null;
+        $maternityPlan = null;
+        $maternityPostnatal = null;
+        $maternityStageCodes = [];
+        $maternityStageFlow = [];
        $activeTab = (string) $request->query('tab', array_key_first($shell->workspaceTabs($module)) ?: 'overview');
        $clinical = app(SpecialtyClinicalRecordService::class);

@@ -925,6 +1040,26 @@ class SpecialtyModuleController extends Controller
                $ophthalmologyStageFlow = app(\App\Services\Care\Ophthalmology\OphthalmologyWorkflowService::class)->stageFlow();
            }

+            if ($module === 'physiotherapy') {
+                $physiotherapyAssessment = $clinical->findForVisit($workspaceVisit, 'physiotherapy', 'pt_assessment');
+                $physiotherapyPlan = $clinical->findForVisit($workspaceVisit, 'physiotherapy', 'pt_plan');
+                $physiotherapySession = $clinical->findForVisit($workspaceVisit, 'physiotherapy', 'pt_session');
+                $physiotherapyHomeProgram = $clinical->findForVisit($workspaceVisit, 'physiotherapy', 'pt_home_program');
+                $physiotherapyStageCodes = collect($shell->stages('physiotherapy'))->pluck('code')->all();
+                $physiotherapyStageFlow = app(\App\Services\Care\Physiotherapy\PhysiotherapyWorkflowService::class)->stageFlow();
+            }
+
+            if ($module === 'maternity') {
+                $maternityHistory = $clinical->findForVisit($workspaceVisit, 'maternity', 'anc_history');
+                $maternityExam = $clinical->findForVisit($workspaceVisit, 'maternity', 'obstetric_exam');
+                $maternityFetal = $clinical->findForVisit($workspaceVisit, 'maternity', 'fetal_notes');
+                $maternityInvestigation = $clinical->findForVisit($workspaceVisit, 'maternity', 'mat_investigation');
+                $maternityPlan = $clinical->findForVisit($workspaceVisit, 'maternity', 'mat_plan');
+                $maternityPostnatal = $clinical->findForVisit($workspaceVisit, 'maternity', 'postnatal_note');
+                $maternityStageCodes = collect($shell->stages('maternity'))->pluck('code')->all();
+                $maternityStageFlow = app(\App\Services\Care\Maternity\MaternityWorkflowService::class)->stageFlow();
+            }
+
            if ($patientHeader !== null) {
                $patientHeader['clinical_alerts'] = $clinicalAlerts;
            }
@@ -1019,6 +1154,20 @@ class SpecialtyModuleController extends Controller
            'ophthalmologyProcedure' => $ophthalmologyProcedure,
            'ophthalmologyStageCodes' => $ophthalmologyStageCodes,
            'ophthalmologyStageFlow' => $ophthalmologyStageFlow,
+            'physiotherapyAssessment' => $physiotherapyAssessment,
+            'physiotherapyPlan' => $physiotherapyPlan,
+            'physiotherapySession' => $physiotherapySession,
+            'physiotherapyHomeProgram' => $physiotherapyHomeProgram,
+            'physiotherapyStageCodes' => $physiotherapyStageCodes,
+            'physiotherapyStageFlow' => $physiotherapyStageFlow,
+            'maternityHistory' => $maternityHistory,
+            'maternityExam' => $maternityExam,
+            'maternityFetal' => $maternityFetal,
+            'maternityInvestigation' => $maternityInvestigation,
+            'maternityPlan' => $maternityPlan,
+            'maternityPostnatal' => $maternityPostnatal,
+            'maternityStageCodes' => $maternityStageCodes,
+            'maternityStageFlow' => $maternityStageFlow,
            'queueStubs' => $modules->queueStubsFor($organization, $module),
            'branchId' => $branchId,
            'branchLabel' => $branchLabel,
@@ -1015,6 +1015,8 @@ class DemoTenantSeeder
        $this->seedDentistryClinicalDemo($organization, $ownerRef);
        $this->seedBloodBankInventoryDemo($organization, $ownerRef);
        $this->seedOphthalmologyClinicalDemo($organization, $ownerRef);
+        $this->seedPhysiotherapyClinicalDemo($organization, $ownerRef);
+        $this->seedMaternityClinicalDemo($organization, $ownerRef);

        return $count;
    }
@@ -1242,6 +1244,269 @@ class DemoTenantSeeder
        }
    }

+
+    /**
+     * Seed assessment + plan (+ optional session) on open physiotherapy visits.
+     */
+    private function seedPhysiotherapyClinicalDemo(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', $branchIds)
+            ->where('type', 'physiotherapy')
+            ->where('is_active', true)
+            ->pluck('id');
+
+        if ($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;
+            }
+
+            $highPain = $index === 0;
+            $clinical->upsert(
+                $organization,
+                $visit,
+                'physiotherapy',
+                'pt_assessment',
+                [
+                    'chief_complaint' => $highPain ? 'Severe low back pain after lifting' : 'Knee stiffness post-injury',
+                    'onset' => $highPain ? 'Acute — 3 days ago' : 'Subacute — 3 weeks',
+                    'pain_score' => $highPain ? 9 : 4,
+                    'body_region' => $highPain ? 'Back / lumbar' : 'Knee',
+                    'rom' => $highPain ? 'Lumbar flexion limited, guarded' : 'Knee flexion 90°, extension -5°',
+                    'strength' => $highPain ? 'Core activation poor' : 'Quadriceps 4/5',
+                    'special_tests' => $highPain ? 'SLR positive right' : 'McMurray negative',
+                    'red_flags' => $highPain ? 'Night pain; no saddle anaesthesia' : '',
+                    'goals' => $highPain ? 'Reduce pain and restore safe lifting' : 'Restore full ROM and return to sport',
+                ],
+                $ownerRef,
+                $ownerRef,
+                'assessment',
+            );
+
+            $clinical->upsert(
+                $organization,
+                $visit,
+                'physiotherapy',
+                'pt_plan',
+                [
+                    'diagnosis' => $highPain ? 'Acute lumbar strain' : 'Post-traumatic knee stiffness',
+                    'frequency' => '2–3× / week',
+                    'duration_weeks' => $highPain ? 4 : 6,
+                    'interventions' => $highPain
+                        ? 'Manual therapy, core activation, graded activity'
+                        : 'ROM drills, strengthening, proprioception',
+                    'precautions' => $highPain ? 'Avoid heavy flexion under load' : 'No pivoting until week 4',
+                    'goals' => 'Pain <3/10 and functional mobility',
+                    'outcome_measures' => 'VAS, Oswestry / LEFS',
+                ],
+                $ownerRef,
+                $ownerRef,
+                'treatment_plan',
+            );
+
+            if ($highPain) {
+                $clinical->upsert(
+                    $organization,
+                    $visit,
+                    'physiotherapy',
+                    'pt_session',
+                    [
+                        'session_number' => 1,
+                        'modalities' => 'Heat, soft-tissue mobilisation',
+                        'exercises' => 'Pelvic tilts, bird-dog, walking',
+                        'pain_before' => 9,
+                        'pain_after' => 6,
+                        'response' => 'Tolerated well; pain eased post-session',
+                        'outcome' => 'Completed — continue plan',
+                        'next_review' => '2 days',
+                        'notes' => 'Demo physio session.',
+                    ],
+                    $ownerRef,
+                    $ownerRef,
+                    'session',
+                );
+            }
+
+            if (! $visit->specialty_stage) {
+                $visit->update(['specialty_stage' => $highPain ? 'session' : 'treatment_plan']);
+            }
+
+            $index++;
+        }
+    }
+
+    /**
+     * Seed ANC history + exam (+ optional plan) on open maternity visits.
+     */
+    private function seedMaternityClinicalDemo(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', $branchIds)
+            ->where('type', 'maternity')
+            ->where('is_active', true)
+            ->pluck('id');
+
+        if ($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,
+                'maternity',
+                'anc_history',
+                [
+                    'gravida' => $highRisk ? 3 : 1,
+                    'para' => $highRisk ? 1 : 0,
+                    'lmp' => '12 Jan 2026',
+                    'edd' => '19 Oct 2026',
+                    'gestational_age_weeks' => $highRisk ? 34 : 22,
+                    'anc_visit_number' => $highRisk ? 6 : 3,
+                    'obstetric_history' => $highRisk ? 'Previous CS; one miscarriage' : 'Primigravida',
+                    'medical_history' => $highRisk ? 'Hypertension in pregnancy' : 'None significant',
+                    'allergies' => 'None known',
+                    'medications' => 'IFAS, calcium',
+                    'social_history' => 'Lives with partner; support available',
+                ],
+                $ownerRef,
+                $ownerRef,
+                'history',
+            );
+
+            $clinical->upsert(
+                $organization,
+                $visit,
+                'maternity',
+                'obstetric_exam',
+                [
+                    'bp' => $highRisk ? '158/102' : '118/74',
+                    'pulse' => $highRisk ? 92 : 78,
+                    'weight_kg' => 72,
+                    'fundal_height' => $highRisk ? 33 : 22,
+                    'presentation' => 'Cephalic',
+                    'lie' => 'Longitudinal',
+                    'engagement' => $highRisk ? '3/5' : 'Free',
+                    'oedema' => $highRisk ? 'Moderate' : 'None',
+                    'urine' => $highRisk ? 'Protein +1' : 'NAD',
+                    'danger_signs' => $highRisk ? 'Headache; visual spots' : '',
+                    'findings' => $highRisk
+                        ? 'Hypertension with oedema — escalate high-risk ANC'
+                        : 'Normal ANC examination',
+                ],
+                $ownerRef,
+                $ownerRef,
+                'exam',
+            );
+
+            $clinical->upsert(
+                $organization,
+                $visit,
+                'maternity',
+                'fetal_notes',
+                [
+                    'fetal_heart_rate' => $highRisk ? 168 : 142,
+                    'fetal_movements' => $highRisk ? 'Reduced' : 'Normal',
+                    'presentation' => 'Cephalic',
+                    'liquor' => 'Adequate clinically',
+                    'ctg_summary' => $highRisk ? 'Baseline raised; observe' : 'Not indicated',
+                    'notes' => 'Demo fetal notes for maternity suite.',
+                ],
+                $ownerRef,
+                $ownerRef,
+                'exam',
+            );
+
+            if ($highRisk) {
+                $clinical->upsert(
+                    $organization,
+                    $visit,
+                    'maternity',
+                    'mat_plan',
+                    [
+                        'risk_category' => 'High risk',
+                        'plan' => 'Urgent senior review; BP control; fetal monitoring; consider admission.',
+                        'medications' => 'Continue antihypertensives as prescribed',
+                        'education' => 'Return immediately if headache, bleeding, or reduced movements',
+                        'postnatal_needed' => false,
+                        'follow_up' => 'Same day review',
+                        'referral' => 'Obstetric high-risk clinic',
+                    ],
+                    $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.
@@ -0,0 +1,168 @@
+<?php
+
+namespace App\Services\Care\Maternity;
+
+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 MaternityAnalyticsService
+{
+    public function __construct(
+        protected SpecialtyShellService $shell,
+    ) {}
+
+    /**
+     * @return array{
+     *     arrivals_today: int,
+     *     completed_today: int,
+     *     high_risk_open: int,
+     *     risk_breakdown: Collection,
+     *     postnatal_outcomes: 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, 'maternity', $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');
+
+        $highRiskOpen = SpecialtyClinicalRecord::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->where('module_key', 'maternity')
+            ->where('record_type', 'mat_plan')
+            ->whereIn('visit_id', $openVisitIds->isEmpty() ? [0] : $openVisitIds)
+            ->get()
+            ->filter(function (SpecialtyClinicalRecord $r) {
+                $risk = strtolower((string) ($r->payload['risk_category'] ?? ''));
+
+                return str_contains($risk, 'high');
+            })
+            ->count();
+
+        $planRecords = SpecialtyClinicalRecord::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->where('module_key', 'maternity')
+            ->where('record_type', 'mat_plan')
+            ->when($branchId, fn ($q) => $q->where('branch_id', $branchId))
+            ->whereBetween('recorded_at', [$rangeFrom, $rangeTo])
+            ->get();
+
+        $riskBreakdown = $planRecords
+            ->groupBy(fn (SpecialtyClinicalRecord $r) => (string) ($r->payload['risk_category'] ?? 'Unknown'))
+            ->map(fn (Collection $rows, string $risk) => [
+                'risk' => $risk,
+                'total' => $rows->count(),
+            ])
+            ->values()
+            ->sortByDesc('total')
+            ->values();
+
+        $postnatalRecords = SpecialtyClinicalRecord::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->where('module_key', 'maternity')
+            ->where('record_type', 'postnatal_note')
+            ->when($branchId, fn ($q) => $q->where('branch_id', $branchId))
+            ->whereBetween('recorded_at', [$rangeFrom, $rangeTo])
+            ->get();
+
+        $postnatalOutcomes = $postnatalRecords
+            ->groupBy(fn (SpecialtyClinicalRecord $r) => (string) ($r->payload['outcome'] ?? 'Unknown'))
+            ->map(fn (Collection $rows, string $outcome) => [
+                'outcome' => $outcome,
+                '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, 'maternity'))
+            ->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,
+            'high_risk_open' => $highRiskOpen,
+            'risk_breakdown' => $riskBreakdown,
+            'postnatal_outcomes' => $postnatalOutcomes,
+            'avg_los_minutes' => $avgLos,
+            'revenue_by_service' => $revenueByService,
+            'from' => $rangeFrom->toDateString(),
+            'to' => $rangeTo->toDateString(),
+        ];
+    }
+}
@@ -0,0 +1,106 @@
+<?php
+
+namespace App\Services\Care\Maternity;
+
+/**
+ * Map maternity / ANC clinical progress onto visit stages.
+ */
+class MaternityWorkflowService
+{
+    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_POSTNATAL = 'postnatal';
+
+    public const STAGE_COMPLETED = 'completed';
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromHistory(array $payload): string
+    {
+        if (isset($payload['gravida']) || isset($payload['gestational_age_weeks'])) {
+            return self::STAGE_HISTORY;
+        }
+
+        return self::STAGE_CHECK_IN;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromExam(array $payload): string
+    {
+        $findings = trim((string) ($payload['findings'] ?? ''));
+        $danger = strtolower((string) ($payload['danger_signs'] ?? ''));
+
+        if ($findings !== '' || $danger !== '') {
+            return self::STAGE_EXAM;
+        }
+
+        return self::STAGE_HISTORY;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromFetal(array $payload): string
+    {
+        if (isset($payload['fetal_heart_rate']) && $payload['fetal_heart_rate'] !== '') {
+            return self::STAGE_EXAM;
+        }
+
+        return self::STAGE_EXAM;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromPlan(array $payload): string
+    {
+        if (! empty($payload['postnatal_needed'])) {
+            return self::STAGE_POSTNATAL;
+        }
+
+        $plan = trim((string) ($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($outcome, 'discharged')
+            || str_contains($outcome, 'continue anc');
+    }
+
+    /**
+     * @return array<string, array{next: string, label: string}>
+     */
+    public function stageFlow(): array
+    {
+        return [
+            self::STAGE_CHECK_IN => ['next' => self::STAGE_HISTORY, 'label' => 'Start ANC history'],
+            self::STAGE_HISTORY => ['next' => self::STAGE_EXAM, 'label' => 'Move to exam / vitals'],
+            self::STAGE_EXAM => ['next' => self::STAGE_INVESTIGATION, 'label' => 'Move to investigations'],
+            self::STAGE_INVESTIGATION => ['next' => self::STAGE_PLAN, 'label' => 'Move to care plan'],
+            self::STAGE_PLAN => ['next' => self::STAGE_POSTNATAL, 'label' => 'Move to delivery / postnatal'],
+            self::STAGE_POSTNATAL => ['next' => self::STAGE_COMPLETED, 'label' => 'Complete visit'],
+            self::STAGE_COMPLETED => ['next' => self::STAGE_COMPLETED, 'label' => 'Completed'],
+        ];
+    }
+}
@@ -0,0 +1,164 @@
+<?php
+
+namespace App\Services\Care\Physiotherapy;
+
+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 PhysiotherapyAnalyticsService
+{
+    public function __construct(
+        protected SpecialtyShellService $shell,
+    ) {}
+
+    /**
+     * @return array{
+     *     arrivals_today: int,
+     *     completed_today: int,
+     *     high_pain_open: int,
+     *     diagnosis_breakdown: Collection,
+     *     session_outcomes: 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, 'physiotherapy', $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');
+
+        $highPainOpen = SpecialtyClinicalRecord::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->where('module_key', 'physiotherapy')
+            ->where('record_type', 'pt_assessment')
+            ->whereIn('visit_id', $openVisitIds->isEmpty() ? [0] : $openVisitIds)
+            ->get()
+            ->filter(fn (SpecialtyClinicalRecord $r) => (int) ($r->payload['pain_score'] ?? 0) >= 8)
+            ->count();
+
+        $planRecords = SpecialtyClinicalRecord::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->where('module_key', 'physiotherapy')
+            ->where('record_type', 'pt_plan')
+            ->when($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();
+
+        $sessionRecords = SpecialtyClinicalRecord::owned($ownerRef)
+            ->where('organization_id', $organization->id)
+            ->where('module_key', 'physiotherapy')
+            ->where('record_type', 'pt_session')
+            ->when($branchId, fn ($q) => $q->where('branch_id', $branchId))
+            ->whereBetween('recorded_at', [$rangeFrom, $rangeTo])
+            ->get();
+
+        $sessionOutcomes = $sessionRecords
+            ->groupBy(fn (SpecialtyClinicalRecord $r) => (string) ($r->payload['outcome'] ?? 'Unknown'))
+            ->map(fn (Collection $rows, string $outcome) => [
+                'outcome' => $outcome,
+                '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, 'physiotherapy'))
+            ->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,
+            'high_pain_open' => $highPainOpen,
+            'diagnosis_breakdown' => $diagnosisBreakdown,
+            'session_outcomes' => $sessionOutcomes,
+            'avg_los_minutes' => $avgLos,
+            'revenue_by_service' => $revenueByService,
+            'from' => $rangeFrom->toDateString(),
+            'to' => $rangeTo->toDateString(),
+        ];
+    }
+}
@@ -0,0 +1,113 @@
+<?php
+
+namespace App\Services\Care\Physiotherapy;
+
+/**
+ * Map physiotherapy clinical progress onto visit stages.
+ */
+class PhysiotherapyWorkflowService
+{
+    public const STAGE_CHECK_IN = 'check_in';
+
+    public const STAGE_ASSESSMENT = 'assessment';
+
+    public const STAGE_TREATMENT_PLAN = 'treatment_plan';
+
+    public const STAGE_SESSION = 'session';
+
+    public const STAGE_PROGRESS = 'progress';
+
+    public const STAGE_COMPLETED = 'completed';
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromAssessment(array $payload): string
+    {
+        $complaint = trim((string) ($payload['chief_complaint'] ?? ''));
+        $goals = trim((string) ($payload['goals'] ?? ''));
+
+        if ($complaint !== '' || $goals !== '') {
+            return self::STAGE_ASSESSMENT;
+        }
+
+        return self::STAGE_CHECK_IN;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromPlan(array $payload): string
+    {
+        $diagnosis = trim((string) ($payload['diagnosis'] ?? ''));
+        $interventions = trim((string) ($payload['interventions'] ?? ''));
+
+        if ($diagnosis !== '' || $interventions !== '') {
+            return self::STAGE_TREATMENT_PLAN;
+        }
+
+        return self::STAGE_ASSESSMENT;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromSession(array $payload): string
+    {
+        $outcome = strtolower((string) ($payload['outcome'] ?? ''));
+
+        if (str_contains($outcome, 'progress review') || str_contains($outcome, 'discharge')) {
+            return self::STAGE_PROGRESS;
+        }
+
+        if (str_contains($outcome, 'completed') || trim((string) ($payload['modalities'] ?? '')) !== '') {
+            return self::STAGE_SESSION;
+        }
+
+        return self::STAGE_TREATMENT_PLAN;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function stageFromHomeProgram(array $payload): string
+    {
+        $outcome = strtolower((string) ($payload['outcome'] ?? ''));
+
+        if (str_contains($outcome, 'discharge') || str_contains($outcome, 'goals met')) {
+            return self::STAGE_PROGRESS;
+        }
+
+        if (trim((string) ($payload['exercises'] ?? '')) !== ''
+            || trim((string) ($payload['progress_notes'] ?? '')) !== '') {
+            return self::STAGE_PROGRESS;
+        }
+
+        return self::STAGE_SESSION;
+    }
+
+    /**
+     * @param  array<string, mixed>  $payload
+     */
+    public function shouldCompleteVisit(array $payload): bool
+    {
+        $outcome = strtolower((string) ($payload['outcome'] ?? ''));
+
+        return str_contains($outcome, 'discharge');
+    }
+
+    /**
+     * @return array<string, array{next: string, label: string}>
+     */
+    public function stageFlow(): array
+    {
+        return [
+            self::STAGE_CHECK_IN => ['next' => self::STAGE_ASSESSMENT, 'label' => 'Start assessment'],
+            self::STAGE_ASSESSMENT => ['next' => self::STAGE_TREATMENT_PLAN, 'label' => 'Move to treatment plan'],
+            self::STAGE_TREATMENT_PLAN => ['next' => self::STAGE_SESSION, 'label' => 'Move to therapy session'],
+            self::STAGE_SESSION => ['next' => self::STAGE_PROGRESS, 'label' => 'Move to progress review'],
+            self::STAGE_PROGRESS => ['next' => self::STAGE_COMPLETED, 'label' => 'Complete visit'],
+            self::STAGE_COMPLETED => ['next' => self::STAGE_COMPLETED, 'label' => 'Completed'],
+        ];
+    }
+}
@@ -295,6 +295,84 @@ class SpecialtyClinicalRecordService
            }
        }

+        if ($moduleKey === 'physiotherapy' && $recordType === 'pt_assessment') {
+            $pain = (int) ($payload['pain_score'] ?? 0);
+            if ($pain >= 8) {
+                $alerts[] = [
+                    'code' => 'pt.severe_pain',
+                    'severity' => 'warning',
+                    'message' => 'Severe pain score (≥8) on physio assessment.',
+                ];
+            }
+            $red = trim((string) ($payload['red_flags'] ?? ''));
+            if ($red !== '') {
+                $alerts[] = [
+                    'code' => 'pt.red_flags',
+                    'severity' => 'critical',
+                    'message' => 'Physio red flags recorded — review urgently.',
+                ];
+            }
+        }
+
+        if ($moduleKey === 'maternity' && $recordType === 'obstetric_exam') {
+            $danger = trim((string) ($payload['danger_signs'] ?? ''));
+            if ($danger !== '') {
+                $alerts[] = [
+                    'code' => 'mat.danger_signs',
+                    'severity' => 'critical',
+                    'message' => 'Maternity danger signs flagged.',
+                ];
+            }
+            $bp = (string) ($payload['bp'] ?? '');
+            if (preg_match('/(\d{2,3})\s*[\/]\s*(\d{2,3})/', $bp, $m)) {
+                $sys = (int) $m[1];
+                $dia = (int) $m[2];
+                if ($sys >= 160 || $dia >= 110) {
+                    $alerts[] = [
+                        'code' => 'mat.severe_hypertension',
+                        'severity' => 'critical',
+                        'message' => 'Severe hypertension on obstetric exam.',
+                    ];
+                } elseif ($sys >= 140 || $dia >= 90) {
+                    $alerts[] = [
+                        'code' => 'mat.hypertension',
+                        'severity' => 'warning',
+                        'message' => 'Elevated BP on obstetric exam.',
+                    ];
+                }
+            }
+        }
+
+        if ($moduleKey === 'maternity' && $recordType === 'fetal_notes') {
+            $fhr = isset($payload['fetal_heart_rate']) ? (int) $payload['fetal_heart_rate'] : null;
+            if ($fhr !== null && ($fhr < 110 || $fhr > 160)) {
+                $alerts[] = [
+                    'code' => 'mat.abnormal_fhr',
+                    'severity' => 'critical',
+                    'message' => 'Fetal heart rate outside 110–160 bpm.',
+                ];
+            }
+            $movements = strtolower((string) ($payload['fetal_movements'] ?? ''));
+            if (str_contains($movements, 'reduced') || str_contains($movements, 'absent')) {
+                $alerts[] = [
+                    'code' => 'mat.reduced_movements',
+                    'severity' => 'critical',
+                    'message' => 'Reduced or absent fetal movements.',
+                ];
+            }
+        }
+
+        if ($moduleKey === 'maternity' && $recordType === 'mat_plan') {
+            $risk = strtolower((string) ($payload['risk_category'] ?? ''));
+            if (str_contains($risk, 'high')) {
+                $alerts[] = [
+                    'code' => 'mat.high_risk',
+                    'severity' => 'warning',
+                    'message' => 'High-risk maternity care plan.',
+                ];
+            }
+        }
+
        return $alerts;
    }

@@ -12,6 +12,8 @@ use App\Models\Visit;
 use App\Services\Care\BloodBank\BloodBankWorkflowService;
 use App\Services\Care\Emergency\EmergencyWorkflowService;
 use App\Services\Care\Ophthalmology\OphthalmologyWorkflowService;
+use App\Services\Care\Physiotherapy\PhysiotherapyWorkflowService;
+use App\Services\Care\Maternity\MaternityWorkflowService;
 use Illuminate\Support\Collection;

 /**
@@ -56,6 +58,8 @@ class SpecialtyShellService
            'emergency' => 'care.specialty.emergency.stage',
            'blood_bank' => 'care.specialty.blood-bank.stage',
            'ophthalmology' => 'care.specialty.ophthalmology.stage',
+            'physiotherapy' => 'care.specialty.physiotherapy.stage',
+            'maternity' => 'care.specialty.maternity.stage',
            default => null,
        };
    }
@@ -71,6 +75,8 @@ class SpecialtyShellService
            'emergency' => app(EmergencyWorkflowService::class)->stageFlow(),
            'blood_bank' => app(BloodBankWorkflowService::class)->stageFlow(),
            'ophthalmology' => app(OphthalmologyWorkflowService::class)->stageFlow(),
+            'physiotherapy' => app(PhysiotherapyWorkflowService::class)->stageFlow(),
+            'maternity' => app(MaternityWorkflowService::class)->stageFlow(),
            'dentistry' => [
                'waiting' => ['next' => 'chair', 'label' => 'Seat at chair'],
                'chair' => ['next' => 'procedure', 'label' => 'Start procedure'],
@@ -370,7 +376,7 @@ class SpecialtyShellService
        ) {
            $code = (string) ($stage['code'] ?? '');

-            if (in_array($moduleKey, ['dentistry', 'emergency', 'blood_bank', 'ophthalmology'], true) && $visitIds->isNotEmpty()) {
+            if (in_array($moduleKey, ['dentistry', 'emergency', 'blood_bank', 'ophthalmology', 'physiotherapy', 'maternity'], true) && $visitIds->isNotEmpty()) {
                $count = Visit::owned($ownerRef)
                    ->where('organization_id', $organization->id)
                    ->whereIn('id', $visitIds)
@@ -401,6 +407,8 @@ class SpecialtyShellService
            'emergency' => $clinical->countOpenByType($organization, 'emergency', 'triage', $branchScope),
            'blood_bank' => $clinical->countOpenByType($organization, 'blood_bank', 'blood_request', $branchScope),
            'ophthalmology' => $clinical->countOpenByType($organization, 'ophthalmology', 'eye_exam', $branchScope),
+            'physiotherapy' => $clinical->countOpenByType($organization, 'physiotherapy', 'pt_assessment', $branchScope),
+            'maternity' => $clinical->countOpenByType($organization, 'maternity', 'anc_history', $branchScope),
            'dentistry' => \App\Models\DentalPlanItem::query()
                ->whereHas('plan', function ($q) use ($organization, $ownerRef) {
                    $q->owned($ownerRef)
@@ -104,6 +104,22 @@ class SpecialtyVisitStageService
                : ($stages[1] ?? ($stages[0] ?? null));
        }

+        if ($moduleKey === 'physiotherapy') {
+            $stages = $this->allowedStages($moduleKey);
+
+            return in_array(\App\Services\Care\Physiotherapy\PhysiotherapyWorkflowService::STAGE_ASSESSMENT, $stages, true)
+                ? \App\Services\Care\Physiotherapy\PhysiotherapyWorkflowService::STAGE_ASSESSMENT
+                : ($stages[1] ?? ($stages[0] ?? null));
+        }
+
+        if ($moduleKey === 'maternity') {
+            $stages = $this->allowedStages($moduleKey);
+
+            return in_array(\App\Services\Care\Maternity\MaternityWorkflowService::STAGE_HISTORY, $stages, true)
+                ? \App\Services\Care\Maternity\MaternityWorkflowService::STAGE_HISTORY
+                : ($stages[1] ?? ($stages[0] ?? null));
+        }
+
        $stages = $this->allowedStages($moduleKey);
        foreach (['chair', 'in_care', 'exam', 'assessment', 'treatment'] as $preferred) {
            if (in_array($preferred, $stages, true)) {