FirstIn

FirstIn is a Next.js emergency room pre-triage app. Patients can check in through a text form or a voice intake flow, then staff can review a live queue sorted by Emergency Severity Index (ESI) priority.

The app was built for HackaBull and uses Supabase for patient data/auth, Gemini for clinical parsing and scoring, ElevenLabs for voice intake and audio, and Resend for confirmation emails.

Features

• Patient-facing landing page and check-in flow
• Text intake form for demographics, symptoms, chief complaint, pain level, and language
• Voice intake flow powered by ElevenLabs Conversational AI
• Gemini transcript parsing, SOAP note generation, and ESI scoring
• Rule-based ESI fallback when AI scoring is unavailable
• Staff-only dashboard protected by Supabase Auth and an email allowlist
• Live queue updates through Supabase Realtime, with fallback polling
• Patient dashboard/status pages
• Confirmation emails through Resend
• Supabase schema for patients, triage cases, staff, and case notes
• Vitest coverage for triage and queue behavior

Tech Stack

• Next.js 16 App Router
• React 19
• Tailwind CSS 4
• Supabase Postgres, Auth, SSR, and Realtime
• Google Gemini API
• ElevenLabs Conversational AI and text-to-speech
• Resend
• Vitest

Project Structure

src/app/                  Next.js routes and API routes
src/app/api/intake        Text intake endpoint
src/app/api/voice         Voice token/finalization endpoints
src/app/api/queue         Staff queue endpoint
src/app/staff             Protected staff dashboard
src/app/patient           Patient login, dashboard, and status pages
src/lib                   Supabase, Gemini, ElevenLabs, triage, and validation helpers
src/components            Shared UI components
supabase/schema.sql       Database schema and RLS policies
tests                     Vitest tests

Getting Started

Prerequisites

• Node.js 20 or newer
• A Supabase project
• A Gemini API key
• An ElevenLabs API key and Conversational AI agent
• A Resend API key

Install

npm install
cp .env.example .env.local
npm run dev

Open http://localhost:3000.

Database

Run supabase/schema.sql in the Supabase SQL editor before using the app. The schema creates:

• patients
• triage_cases
• staff
• case_notes

It also enables row-level security (RLS) and adds policies for patient and staff access.

Environment Variables

Copy .env.example to .env.local and fill in the values:

NEXT_PUBLIC_SUPABASE_URL=your_supabase_url_here
NEXT_PUBLIC_SUPABASE_ANON_KEY=your_supabase_anon_key_here
SUPABASE_SERVICE_ROLE_KEY=your_service_role_key_here
GEMINI_API_KEY=your_gemini_api_key_here
ELEVENLABS_API_KEY=your_elevenlabs_api_key_here
ELEVENLABS_AGENT_ID=your_agent_id_here
NEXT_PUBLIC_ELEVENLABS_AGENT_ID=your_agent_id_here
RESEND_API_KEY=your_resend_api_key_here
EMAIL_FROM=triage@firstin.local
STAFF_ALLOWED_EMAILS=

Useful optional variables used by the code:

NEXT_PUBLIC_APP_URL=http://localhost:3000
GEMINI_MODEL=gemini-2.5-flash
ELEVENLABS_MOCK_MODE=true

STAFF_ALLOWED_EMAILS should be a comma-separated list of staff emails allowed to access /staff.

Scripts

npm run dev          # Start the development server
npm run build        # Build for production
npm run start        # Start the production server
npm run lint         # Run ESLint
npm run test         # Run Vitest once
npm run test:watch   # Run Vitest in watch mode

Main Flows

1. A patient starts at / and clicks check in.
2. The patient chooses voice intake or typed intake at /intake.
3. The app validates the intake, scores acuity, and inserts a patient row in Supabase.
4. /api/queue returns patients ordered by esi_score and arrival_time.
5. Staff access /staff, sign in with Supabase Auth, and manage patient status from the dashboard.
6. Patients can use the patient pages to view their status and dashboard.

Testing

Run the test suite with:

npm run test

Current tests cover intake validation, rule-based ESI scoring, queue reads, and patient status updates.