Abridge Webhooks & Events

Overview

Handle Abridge webhook events for clinical documentation lifecycle: note completion, encounter status changes, quality alerts, and provider enrollment notifications. All webhook payloads are HIPAA-scoped (contain session IDs but no PHI).

Abridge Event Types

Event	Trigger	Use Case
encounter.session.completed	Note generation finished	Push note to EHR
encounter.session.failed	Note generation failed	Alert clinical team
encounter.note.reviewed	Clinician reviewed/edited note	Update EHR with final version
encounter.note.signed	Clinician signed the note	Lock note in EHR
patient.summary.ready	Patient summary generated	Push to patient portal
provider.enrolled	Provider onboarded	Update provider roster
quality.alert	Low confidence or missing content	Flag for clinical review

Instructions

Step 1: Webhook Endpoint with Signature Verification

// src/webhooks/abridge-webhook-handler.ts
import express from 'express';
import crypto from 'crypto';

const router = express.Router();

// CRITICAL: Use raw body for signature verification
router.post('/webhooks/abridge',
  express.raw({ type: 'application/json' }),
  async (req, res) => {
    const signature = req.headers['x-abridge-signature'] as string;
    const timestamp = req.headers['x-abridge-timestamp'] as string;

    if (!verifySignature(req.body, signature, timestamp)) {
      return res.status(401).json({ error: 'Invalid signature' });
    }

    const event = JSON.parse(req.body.toString());

    // Idempotency check
    if (await isProcessed(event.event_id)) {
      return res.status(200).json({ status: 'already_processed' });
    }

    // Process asynchronously — respond immediately
    processEvent(event).catch(err =>
      console.error(`Event processing failed: ${event.event_id}`, err)
    );

    res.status(200).json({ received: true });
  }
);

function verifySignature(payload: Buffer, signature: string, timestamp: string): boolean {
  const secret = process.env.ABRIDGE_WEBHOOK_SECRET!;
  const maxAge = 300000; // 5 minutes

  if (Date.now() - parseInt(timestamp) * 1000 > maxAge) {
    console.error('Webhook timestamp expired');
    return false;
  }

  const expected = crypto
    .createHmac('sha256', secret)
    .update(`${timestamp}.${payload.toString()}`)
    .digest('hex');

  return crypto.timingSafeEqual(Buffer.from(signature), Buffer.from(expected));
}

Step 2: Event Router

// src/webhooks/event-router.ts
interface AbridgeEvent {
  event_id: string;
  type: string;
  timestamp: string;
  data: {
    session_id?: string;
    note_id?: string;
    provider_id?: string;
    status?: string;
    quality_score?: number;
  };
}

type EventHandler = (data: AbridgeEvent['data']) => Promise<void>;

const handlers: Record<string, EventHandler> = {
  'encounter.session.completed': async (data) => {
    console.log(`Note ready for session ${data.session_id}`);
    // Fetch note and push to EHR
    await fetchAndPushNote(data.session_id!);
  },

  'encounter.session.failed': async (data) => {
    console.error(`Note generation failed: ${data.session_id} — ${data.status}`);
    // Alert clinical operations team
    await sendClinicalAlert(data.session_id!, 'Note generation failed');
  },

  'encounter.note.signed': async (data) => {
    console.log(`Note signed: ${data.note_id}`);
    // Lock note in EHR — no further edits
    await lockNoteInEhr(data.note_id!);
  },

  'patient.summary.ready': async (data) => {
    console.log(`Patient summary ready: ${data.session_id}`);
    // Push to patient portal
    await pushSummaryToPortal(data.session_id!);
  },

  'quality.alert': async (data) => {
    console.warn(`Quality alert: session ${data.session_id}, score ${data.quality_score}`);
    // Flag for clinical review if score < 0.7
    if ((data.quality_score || 0) < 0.7) {
      await flagForReview(data.session_id!);
    }
  },
};

async function processEvent(event: AbridgeEvent): Promise<void> {
  const handler = handlers[event.type];
  if (!handler) {
    console.log(`Unhandled event: ${event.type}`);
    return;
  }
  await handler(event.data);
  await markProcessed(event.event_id);
}

Step 3: Idempotency Store

// src/webhooks/idempotency.ts
// Use Redis or database for production — in-memory for dev

const processedEvents = new Map<string, number>();

async function isProcessed(eventId: string): Promise<boolean> {
  return processedEvents.has(eventId);
}

async function markProcessed(eventId: string): Promise<void> {
  processedEvents.set(eventId, Date.now());
  // Clean up events older than 7 days
  const cutoff = Date.now() - 7 * 24 * 60 * 60 * 1000;
  for (const [id, ts] of processedEvents) {
    if (ts < cutoff) processedEvents.delete(id);
  }
}

Step 4: Webhook Registration

# Register webhook endpoint with Abridge
curl -X POST "${ABRIDGE_BASE_URL}/webhooks" \
  -H "Authorization: Bearer ${ABRIDGE_CLIENT_SECRET}" \
  -H "X-Org-Id: ${ABRIDGE_ORG_ID}" \
  -H "Content-Type: application/json" \
  -d '{
    "url": "https://your-service.run.app/webhooks/abridge",
    "events": [
      "encounter.session.completed",
      "encounter.session.failed",
      "encounter.note.signed",
      "patient.summary.ready",
      "quality.alert"
    ],
    "secret": "your-webhook-secret"
  }'

Output

• Secure webhook endpoint with HMAC signature verification
• Event router with handlers for all clinical documentation events
• Idempotency store preventing duplicate processing
• Webhook registration via Abridge API

Error Handling

Issue	Cause	Solution
Invalid signature	Wrong webhook secret	Verify secret matches Abridge config
Timestamp expired	Clock drift > 5 min	Sync server clock via NTP
Duplicate processing	Missing idempotency	Implement event ID tracking
Handler timeout	Slow EHR push	Process async; respond 200 immediately

Resources

• Abridge Platform
• HMAC Signature Verification

Next Steps

For performance optimization, see abridge-performance-tuning.