Add full Pediatrics, Orthopedics, and ENT specialty clinical suites.

Mirror Cardiology-depth stage flows, workspace tabs, reports/print, clinical
alerts, demo seeds, and PHPUnit coverage for child health, fracture clinic,
and ENT pathways.

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

app/Http/Controllers/Care/EntWorkspaceController.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\Ent\EntAnalyticsService;
+use App\Services\Care\Ent\EntWorkflowService;
+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 EntWorkspaceController extends Controller
+{
+    use ScopesToAccount;
+
+    protected function assertEntAccess(Request $request, SpecialtyModuleService $modules): void
+    {
+        $organization = $this->organization($request);
+        abort_unless($modules->memberCanAccess($organization, $this->member($request), 'ent'), 403);
+    }
+
+    protected function assertEntManage(Request $request, SpecialtyModuleService $modules): void
+    {
+        $organization = $this->organization($request);
+        abort_unless($modules->memberCanManage($organization, $this->member($request), 'ent'), 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');
+        $this->assertEntManage($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $validated = $request->validate([
+            'stage' => ['required', 'string', 'max:32'],
+        ]);
+
+        try {
+            $stages->setStage(
+                $this->organization($request),
+                $visit,
+                'ent',
+                $validated['stage'],
+                $this->ownerRef($request),
+                $this->actorRef($request),
+            );
+        } catch (\InvalidArgumentException $e) {
+            return back()->with('error', $e->getMessage());
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', [
+                'module' => 'ent',
+                'visit' => $visit,
+                'tab' => $shell->workspaceTabForStage('ent', $validated['stage']),
+            ])
+            ->with('success', 'Visit stage updated.');
+    }
+
+    public function saveProcedure(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        SpecialtyClinicalRecordService $clinical,
+        SpecialtyVisitStageService $stages,
+        EntWorkflowService $workflow,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertEntManage($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $organization = $this->organization($request);
+        $owner = $this->ownerRef($request);
+
+        $payload = (array) $request->input('payload', []);
+        foreach ($clinical->fieldsFor('ent', 'ent_procedure') as $field) {
+            if (($field['type'] ?? '') === 'boolean') {
+                $payload[$field['name']] = $request->boolean('payload.'.$field['name']);
+            }
+        }
+        $request->merge(['payload' => $payload, 'tab' => 'procedure']);
+
+        $validated = $request->validate(array_merge([
+            'tab' => ['required', 'string'],
+        ], $clinical->validationRules('ent', 'ent_procedure')));
+
+        $record = $clinical->upsert(
+            $organization,
+            $visit,
+            'ent',
+            'ent_procedure',
+            $clinical->payloadFromRequest($validated),
+            $owner,
+            $owner,
+            EntWorkflowService::STAGE_PROCEDURE,
+            SpecialtyClinicalRecord::STATUS_COMPLETED,
+        );
+
+        try {
+            $stages->setStage(
+                $organization,
+                $visit,
+                'ent',
+                EntWorkflowService::STAGE_PROCEDURE,
+                $owner,
+                $owner,
+            );
+        } catch (\InvalidArgumentException) {
+        }
+
+        if ($workflow->shouldCompleteVisit($record->payload ?? [])) {
+            try {
+                $stages->setStage(
+                    $organization,
+                    $visit,
+                    'ent',
+                    EntWorkflowService::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' => 'ent', 'visit' => $visit, 'tab' => 'procedure'])
+            ->with('success', 'ENT procedure saved.');
+    }
+
+    public function reports(
+        Request $request,
+        SpecialtyModuleService $modules,
+        SpecialtyShellService $shell,
+        EntAnalyticsService $analytics,
+    ): View {
+        $this->authorizeAbility($request, 'consultations.view');
+        $this->assertEntAccess($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.ent.reports', [
+            'moduleKey' => 'ent',
+            'definition' => $modules->definition('ent'),
+            'shellNav' => $shell->navItems('ent'),
+            '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');
+        $this->assertEntAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $visit->loadMissing(['patient', 'appointment.practitioner', 'branch']);
+
+        return view('care.specialty.ent.print', [
+            'visit' => $visit,
+            'patient' => $visit->patient,
+            'history' => $clinical->findForVisit($visit, 'ent', 'ent_history'),
+            'exam' => $clinical->findForVisit($visit, 'ent', 'ent_exam'),
+            'investigation' => $clinical->findForVisit($visit, 'ent', 'ent_investigation'),
+            'plan' => $clinical->findForVisit($visit, 'ent', 'ent_plan'),
+            'procedure' => $clinical->findForVisit($visit, 'ent', 'ent_procedure'),
+        ]);
+    }
+}

app/Http/Controllers/Care/OrthopedicsWorkspaceController.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\Orthopedics\OrthopedicsAnalyticsService;
+use App\Services\Care\Orthopedics\OrthopedicsWorkflowService;
+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 OrthopedicsWorkspaceController extends Controller
+{
+    use ScopesToAccount;
+
+    protected function assertOrthopedicsAccess(Request $request, SpecialtyModuleService $modules): void
+    {
+        $organization = $this->organization($request);
+        abort_unless($modules->memberCanAccess($organization, $this->member($request), 'orthopedics'), 403);
+    }
+
+    protected function assertOrthopedicsManage(Request $request, SpecialtyModuleService $modules): void
+    {
+        $organization = $this->organization($request);
+        abort_unless($modules->memberCanManage($organization, $this->member($request), 'orthopedics'), 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');
+        $this->assertOrthopedicsManage($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $validated = $request->validate([
+            'stage' => ['required', 'string', 'max:32'],
+        ]);
+
+        try {
+            $stages->setStage(
+                $this->organization($request),
+                $visit,
+                'orthopedics',
+                $validated['stage'],
+                $this->ownerRef($request),
+                $this->actorRef($request),
+            );
+        } catch (\InvalidArgumentException $e) {
+            return back()->with('error', $e->getMessage());
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', [
+                'module' => 'orthopedics',
+                'visit' => $visit,
+                'tab' => $shell->workspaceTabForStage('orthopedics', $validated['stage']),
+            ])
+            ->with('success', 'Visit stage updated.');
+    }
+
+    public function saveProcedure(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        SpecialtyClinicalRecordService $clinical,
+        SpecialtyVisitStageService $stages,
+        OrthopedicsWorkflowService $workflow,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertOrthopedicsManage($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $organization = $this->organization($request);
+        $owner = $this->ownerRef($request);
+
+        $payload = (array) $request->input('payload', []);
+        foreach ($clinical->fieldsFor('orthopedics', 'ortho_procedure') as $field) {
+            if (($field['type'] ?? '') === 'boolean') {
+                $payload[$field['name']] = $request->boolean('payload.'.$field['name']);
+            }
+        }
+        $request->merge(['payload' => $payload, 'tab' => 'procedure']);
+
+        $validated = $request->validate(array_merge([
+            'tab' => ['required', 'string'],
+        ], $clinical->validationRules('orthopedics', 'ortho_procedure')));
+
+        $record = $clinical->upsert(
+            $organization,
+            $visit,
+            'orthopedics',
+            'ortho_procedure',
+            $clinical->payloadFromRequest($validated),
+            $owner,
+            $owner,
+            OrthopedicsWorkflowService::STAGE_PROCEDURE,
+            SpecialtyClinicalRecord::STATUS_COMPLETED,
+        );
+
+        try {
+            $stages->setStage(
+                $organization,
+                $visit,
+                'orthopedics',
+                OrthopedicsWorkflowService::STAGE_PROCEDURE,
+                $owner,
+                $owner,
+            );
+        } catch (\InvalidArgumentException) {
+        }
+
+        if ($workflow->shouldCompleteVisit($record->payload ?? [])) {
+            try {
+                $stages->setStage(
+                    $organization,
+                    $visit,
+                    'orthopedics',
+                    OrthopedicsWorkflowService::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' => 'orthopedics', 'visit' => $visit, 'tab' => 'procedure'])
+            ->with('success', 'Procedure / cast saved.');
+    }
+
+    public function reports(
+        Request $request,
+        SpecialtyModuleService $modules,
+        SpecialtyShellService $shell,
+        OrthopedicsAnalyticsService $analytics,
+    ): View {
+        $this->authorizeAbility($request, 'consultations.view');
+        $this->assertOrthopedicsAccess($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.orthopedics.reports', [
+            'moduleKey' => 'orthopedics',
+            'definition' => $modules->definition('orthopedics'),
+            'shellNav' => $shell->navItems('orthopedics'),
+            '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');
+        $this->assertOrthopedicsAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $visit->loadMissing(['patient', 'appointment.practitioner', 'branch']);
+
+        return view('care.specialty.orthopedics.print', [
+            'visit' => $visit,
+            'patient' => $visit->patient,
+            'history' => $clinical->findForVisit($visit, 'orthopedics', 'ortho_history'),
+            'exam' => $clinical->findForVisit($visit, 'orthopedics', 'ortho_exam'),
+            'imaging' => $clinical->findForVisit($visit, 'orthopedics', 'ortho_imaging'),
+            'plan' => $clinical->findForVisit($visit, 'orthopedics', 'ortho_plan'),
+            'procedure' => $clinical->findForVisit($visit, 'orthopedics', 'ortho_procedure'),
+        ]);
+    }
+}

app/Http/Controllers/Care/PediatricsWorkspaceController.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\Pediatrics\PediatricsAnalyticsService;
+use App\Services\Care\Pediatrics\PediatricsWorkflowService;
+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 PediatricsWorkspaceController extends Controller
+{
+    use ScopesToAccount;
+
+    protected function assertPediatricsAccess(Request $request, SpecialtyModuleService $modules): void
+    {
+        $organization = $this->organization($request);
+        abort_unless($modules->memberCanAccess($organization, $this->member($request), 'pediatrics'), 403);
+    }
+
+    protected function assertPediatricsManage(Request $request, SpecialtyModuleService $modules): void
+    {
+        $organization = $this->organization($request);
+        abort_unless($modules->memberCanManage($organization, $this->member($request), 'pediatrics'), 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');
+        $this->assertPediatricsManage($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $validated = $request->validate([
+            'stage' => ['required', 'string', 'max:32'],
+        ]);
+
+        try {
+            $stages->setStage(
+                $this->organization($request),
+                $visit,
+                'pediatrics',
+                $validated['stage'],
+                $this->ownerRef($request),
+                $this->actorRef($request),
+            );
+        } catch (\InvalidArgumentException $e) {
+            return back()->with('error', $e->getMessage());
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', [
+                'module' => 'pediatrics',
+                'visit' => $visit,
+                'tab' => $shell->workspaceTabForStage('pediatrics', $validated['stage']),
+            ])
+            ->with('success', 'Visit stage updated.');
+    }
+
+    public function saveTreatment(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        SpecialtyClinicalRecordService $clinical,
+        SpecialtyVisitStageService $stages,
+        PediatricsWorkflowService $workflow,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertPediatricsManage($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $organization = $this->organization($request);
+        $owner = $this->ownerRef($request);
+
+        $payload = (array) $request->input('payload', []);
+        foreach ($clinical->fieldsFor('pediatrics', 'ped_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('pediatrics', 'ped_treatment')));
+
+        $record = $clinical->upsert(
+            $organization,
+            $visit,
+            'pediatrics',
+            'ped_treatment',
+            $clinical->payloadFromRequest($validated),
+            $owner,
+            $owner,
+            PediatricsWorkflowService::STAGE_TREATMENT,
+            SpecialtyClinicalRecord::STATUS_COMPLETED,
+        );
+
+        try {
+            $stages->setStage(
+                $organization,
+                $visit,
+                'pediatrics',
+                PediatricsWorkflowService::STAGE_TREATMENT,
+                $owner,
+                $owner,
+            );
+        } catch (\InvalidArgumentException) {
+        }
+
+        if ($workflow->shouldCompleteVisit($record->payload ?? [])) {
+            try {
+                $stages->setStage(
+                    $organization,
+                    $visit,
+                    'pediatrics',
+                    PediatricsWorkflowService::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' => 'pediatrics', 'visit' => $visit, 'tab' => 'treatment'])
+            ->with('success', 'Treatment / immunization saved.');
+    }
+
+    public function reports(
+        Request $request,
+        SpecialtyModuleService $modules,
+        SpecialtyShellService $shell,
+        PediatricsAnalyticsService $analytics,
+    ): View {
+        $this->authorizeAbility($request, 'consultations.view');
+        $this->assertPediatricsAccess($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.pediatrics.reports', [
+            'moduleKey' => 'pediatrics',
+            'definition' => $modules->definition('pediatrics'),
+            'shellNav' => $shell->navItems('pediatrics'),
+            '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');
+        $this->assertPediatricsAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $visit->loadMissing(['patient', 'appointment.practitioner', 'branch']);
+
+        return view('care.specialty.pediatrics.print', [
+            'visit' => $visit,
+            'patient' => $visit->patient,
+            'history' => $clinical->findForVisit($visit, 'pediatrics', 'ped_history'),
+            'exam' => $clinical->findForVisit($visit, 'pediatrics', 'pediatric_exam'),
+            'investigation' => $clinical->findForVisit($visit, 'pediatrics', 'ped_investigation'),
+            'plan' => $clinical->findForVisit($visit, 'pediatrics', 'ped_plan'),
+            'treatment' => $clinical->findForVisit($visit, 'pediatrics', 'ped_treatment'),
+        ]);
+    }
+}

app/Http/Controllers/Care/SpecialtyModuleController.php

@@ -159,6 +159,9 @@ class SpecialtyModuleController extends Controller
                 'radiology' => 'protocol',
                 'cardiology' => 'history',
                 'psychiatry' => 'history',
+                'pediatrics' => 'history',
+                'orthopedics' => 'history',
+                'ent' => 'history',
                 default => (collect(array_keys($shellTabs))
                     ->first(fn (string $tab) => $clinical->recordTypeForTab($module, $tab) !== null)
                     ?? 'clinical_notes'),
@@ -236,6 +239,9 @@ class SpecialtyModuleController extends Controller
             'radiology' => 'protocol',
             'cardiology' => 'history',
             'psychiatry' => 'history',
+            'pediatrics' => 'history',
+            'orthopedics' => 'history',
+            'ent' => 'history',
             default => (collect(array_keys($shellTabs))
                 ->first(fn (string $tab) => $clinical->recordTypeForTab($module, $tab) !== null)
                 ?? 'clinical_notes'),
@@ -656,6 +662,150 @@ class SpecialtyModuleController extends Controller
             }
         }
 
+        if ($module === 'pediatrics' && in_array($recordType, ['ped_history', 'pediatric_exam', 'ped_investigation', 'ped_plan'], true)) {
+            $workflow = app(\App\Services\Care\Pediatrics\PediatricsWorkflowService::class);
+            $stageService = app(\App\Services\Care\SpecialtyVisitStageService::class);
+            $suggested = match ($recordType) {
+                'ped_history' => $workflow->stageFromHistory($record->payload ?? []),
+                'pediatric_exam' => $workflow->stageFromExam($record->payload ?? []),
+                'ped_investigation' => $workflow->stageFromInvestigation($record->payload ?? []),
+                'ped_plan' => $workflow->stageFromPlan($record->payload ?? []),
+                default => null,
+            };
+            $current = $visit->specialty_stage;
+            $early = ['check_in', 'waiting', null, ''];
+            $order = [
+                'check_in' => 0,
+                'history' => 1,
+                'exam' => 2,
+                'investigation' => 3,
+                'plan' => 4,
+                'treatment' => 5,
+                'completed' => 6,
+            ];
+            if ($suggested && (! $current || in_array($current, $early, true))) {
+                try {
+                    $stageService->setStage(
+                        $organization,
+                        $visit,
+                        'pediatrics',
+                        $suggested,
+                        $this->ownerRef($request),
+                        $this->ownerRef($request),
+                    );
+                } catch (\InvalidArgumentException) {
+                }
+            } elseif ($suggested && $suggested !== $current && ($order[$suggested] ?? 0) > ($order[$current] ?? 0)) {
+                try {
+                    $stageService->setStage(
+                        $organization,
+                        $visit,
+                        'pediatrics',
+                        $suggested,
+                        $this->ownerRef($request),
+                        $this->ownerRef($request),
+                    );
+                } catch (\InvalidArgumentException) {
+                }
+            }
+        }
+
+        if ($module === 'orthopedics' && in_array($recordType, ['ortho_history', 'ortho_exam', 'ortho_imaging', 'ortho_plan'], true)) {
+            $workflow = app(\App\Services\Care\Orthopedics\OrthopedicsWorkflowService::class);
+            $stageService = app(\App\Services\Care\SpecialtyVisitStageService::class);
+            $suggested = match ($recordType) {
+                'ortho_history' => $workflow->stageFromHistory($record->payload ?? []),
+                'ortho_exam' => $workflow->stageFromExam($record->payload ?? []),
+                'ortho_imaging' => $workflow->stageFromImaging($record->payload ?? []),
+                'ortho_plan' => $workflow->stageFromPlan($record->payload ?? []),
+                default => null,
+            };
+            $current = $visit->specialty_stage;
+            $early = ['check_in', 'waiting', null, ''];
+            $order = [
+                'check_in' => 0,
+                'history' => 1,
+                'exam' => 2,
+                'imaging' => 3,
+                'plan' => 4,
+                'procedure' => 5,
+                'completed' => 6,
+            ];
+            if ($suggested && (! $current || in_array($current, $early, true))) {
+                try {
+                    $stageService->setStage(
+                        $organization,
+                        $visit,
+                        'orthopedics',
+                        $suggested,
+                        $this->ownerRef($request),
+                        $this->ownerRef($request),
+                    );
+                } catch (\InvalidArgumentException) {
+                }
+            } elseif ($suggested && $suggested !== $current && ($order[$suggested] ?? 0) > ($order[$current] ?? 0)) {
+                try {
+                    $stageService->setStage(
+                        $organization,
+                        $visit,
+                        'orthopedics',
+                        $suggested,
+                        $this->ownerRef($request),
+                        $this->ownerRef($request),
+                    );
+                } catch (\InvalidArgumentException) {
+                }
+            }
+        }
+
+        if ($module === 'ent' && in_array($recordType, ['ent_history', 'ent_exam', 'ent_investigation', 'ent_plan'], true)) {
+            $workflow = app(\App\Services\Care\Ent\EntWorkflowService::class);
+            $stageService = app(\App\Services\Care\SpecialtyVisitStageService::class);
+            $suggested = match ($recordType) {
+                'ent_history' => $workflow->stageFromHistory($record->payload ?? []),
+                'ent_exam' => $workflow->stageFromExam($record->payload ?? []),
+                'ent_investigation' => $workflow->stageFromInvestigation($record->payload ?? []),
+                'ent_plan' => $workflow->stageFromPlan($record->payload ?? []),
+                default => null,
+            };
+            $current = $visit->specialty_stage;
+            $early = ['check_in', 'waiting', null, ''];
+            $order = [
+                'check_in' => 0,
+                'history' => 1,
+                'exam' => 2,
+                'investigation' => 3,
+                'plan' => 4,
+                'procedure' => 5,
+                'completed' => 6,
+            ];
+            if ($suggested && (! $current || in_array($current, $early, true))) {
+                try {
+                    $stageService->setStage(
+                        $organization,
+                        $visit,
+                        'ent',
+                        $suggested,
+                        $this->ownerRef($request),
+                        $this->ownerRef($request),
+                    );
+                } catch (\InvalidArgumentException) {
+                }
+            } elseif ($suggested && $suggested !== $current && ($order[$suggested] ?? 0) > ($order[$current] ?? 0)) {
+                try {
+                    $stageService->setStage(
+                        $organization,
+                        $visit,
+                        'ent',
+                        $suggested,
+                        $this->ownerRef($request),
+                        $this->ownerRef($request),
+                    );
+                } catch (\InvalidArgumentException) {
+                }
+            }
+        }
+
         return redirect()
             ->route('care.specialty.workspace', [
                 'module' => $module,
@@ -1091,6 +1241,27 @@ class SpecialtyModuleController extends Controller
         $psychiatryFollowup = null;
         $psychiatryStageCodes = [];
         $psychiatryStageFlow = [];
+        $pediatricsHistory = null;
+        $pediatricsExam = null;
+        $pediatricsInvestigation = null;
+        $pediatricsPlan = null;
+        $pediatricsTreatment = null;
+        $pediatricsStageCodes = [];
+        $pediatricsStageFlow = [];
+        $orthopedicsHistory = null;
+        $orthopedicsExam = null;
+        $orthopedicsImaging = null;
+        $orthopedicsPlan = null;
+        $orthopedicsProcedure = null;
+        $orthopedicsStageCodes = [];
+        $orthopedicsStageFlow = [];
+        $entHistory = null;
+        $entExam = null;
+        $entInvestigation = null;
+        $entPlan = null;
+        $entProcedure = null;
+        $entStageCodes = [];
+        $entStageFlow = [];
         $activeTab = (string) $request->query('tab', array_key_first($shell->workspaceTabs($module)) ?: 'overview');
         $clinical = app(SpecialtyClinicalRecordService::class);
 
@@ -1255,6 +1426,36 @@ class SpecialtyModuleController extends Controller
                 $psychiatryStageFlow = app(\App\Services\Care\Psychiatry\PsychiatryWorkflowService::class)->stageFlow();
             }
 
+            if ($module === 'pediatrics') {
+                $pediatricsHistory = $clinical->findForVisit($workspaceVisit, 'pediatrics', 'ped_history');
+                $pediatricsExam = $clinical->findForVisit($workspaceVisit, 'pediatrics', 'pediatric_exam');
+                $pediatricsInvestigation = $clinical->findForVisit($workspaceVisit, 'pediatrics', 'ped_investigation');
+                $pediatricsPlan = $clinical->findForVisit($workspaceVisit, 'pediatrics', 'ped_plan');
+                $pediatricsTreatment = $clinical->findForVisit($workspaceVisit, 'pediatrics', 'ped_treatment');
+                $pediatricsStageCodes = collect($shell->stages('pediatrics'))->pluck('code')->all();
+                $pediatricsStageFlow = app(\App\Services\Care\Pediatrics\PediatricsWorkflowService::class)->stageFlow();
+            }
+
+            if ($module === 'orthopedics') {
+                $orthopedicsHistory = $clinical->findForVisit($workspaceVisit, 'orthopedics', 'ortho_history');
+                $orthopedicsExam = $clinical->findForVisit($workspaceVisit, 'orthopedics', 'ortho_exam');
+                $orthopedicsImaging = $clinical->findForVisit($workspaceVisit, 'orthopedics', 'ortho_imaging');
+                $orthopedicsPlan = $clinical->findForVisit($workspaceVisit, 'orthopedics', 'ortho_plan');
+                $orthopedicsProcedure = $clinical->findForVisit($workspaceVisit, 'orthopedics', 'ortho_procedure');
+                $orthopedicsStageCodes = collect($shell->stages('orthopedics'))->pluck('code')->all();
+                $orthopedicsStageFlow = app(\App\Services\Care\Orthopedics\OrthopedicsWorkflowService::class)->stageFlow();
+            }
+
+            if ($module === 'ent') {
+                $entHistory = $clinical->findForVisit($workspaceVisit, 'ent', 'ent_history');
+                $entExam = $clinical->findForVisit($workspaceVisit, 'ent', 'ent_exam');
+                $entInvestigation = $clinical->findForVisit($workspaceVisit, 'ent', 'ent_investigation');
+                $entPlan = $clinical->findForVisit($workspaceVisit, 'ent', 'ent_plan');
+                $entProcedure = $clinical->findForVisit($workspaceVisit, 'ent', 'ent_procedure');
+                $entStageCodes = collect($shell->stages('ent'))->pluck('code')->all();
+                $entStageFlow = app(\App\Services\Care\Ent\EntWorkflowService::class)->stageFlow();
+            }
+
             if ($patientHeader !== null) {
                 $patientHeader['clinical_alerts'] = $clinicalAlerts;
             }
@@ -1382,6 +1583,27 @@ class SpecialtyModuleController extends Controller
             'psychiatryFollowup' => $psychiatryFollowup,
             'psychiatryStageCodes' => $psychiatryStageCodes,
             'psychiatryStageFlow' => $psychiatryStageFlow,
+            'pediatricsHistory' => $pediatricsHistory,
+            'pediatricsExam' => $pediatricsExam,
+            'pediatricsInvestigation' => $pediatricsInvestigation,
+            'pediatricsPlan' => $pediatricsPlan,
+            'pediatricsTreatment' => $pediatricsTreatment,
+            'pediatricsStageCodes' => $pediatricsStageCodes,
+            'pediatricsStageFlow' => $pediatricsStageFlow,
+            'orthopedicsHistory' => $orthopedicsHistory,
+            'orthopedicsExam' => $orthopedicsExam,
+            'orthopedicsImaging' => $orthopedicsImaging,
+            'orthopedicsPlan' => $orthopedicsPlan,
+            'orthopedicsProcedure' => $orthopedicsProcedure,
+            'orthopedicsStageCodes' => $orthopedicsStageCodes,
+            'orthopedicsStageFlow' => $orthopedicsStageFlow,
+            'entHistory' => $entHistory,
+            'entExam' => $entExam,
+            'entInvestigation' => $entInvestigation,
+            'entPlan' => $entPlan,
+            'entProcedure' => $entProcedure,
+            'entStageCodes' => $entStageCodes,
+            'entStageFlow' => $entStageFlow,
             'queueStubs' => $modules->queueStubsFor($organization, $module),
             'branchId' => $branchId,
             'branchLabel' => $branchLabel,