feat: Enhance spiritual state management and UI for provider summaries

- Added AWAITING_CONSENT state to SpiritualState enum for tracking consent responses.
- Updated SessionSpiritualState to include pending referral data and methods for consent handling.
- Implemented a provider summary panel in the Gradio interface, including download and clear functionality.
- Enhanced conversation handling to check for provider summaries in RED flag cases, with detailed logging.
- Created a simple test script for Gradio UI to simulate provider summary functionality.
- Developed a prompt loader to manage spiritual and medical prompts from markdown files, ensuring backward compatibility.
- Added comprehensive documentation for prompt structure and loading process.
- Implemented triage evaluator and question prompts to improve emotional and spiritual distress assessment.

simple_test.py

@@ -0,0 +1,28 @@
+#!/usr/bin/env python3
+"""
+Найпростіший тест для Gradio оновлення.
+"""
+
+import gradio as gr
+
+def simple_test():
+    with gr.Blocks() as demo:
+        gr.Markdown("# Simple Update Test")
+        
+        text_box = gr.Textbox(label="Test", value="Initial value")
+        update_btn = gr.Button("Update")
+        
+        def update_text():
+            return "Updated value!"
+        
+        update_btn.click(
+            update_text,
+            inputs=[],
+            outputs=[text_box]
+        )
+    
+    return demo
+
+if __name__ == "__main__":
+    demo = simple_test()
+    demo.launch(server_name="0.0.0.0", server_port=7863, share=False)

src/config/prompt_loader.py

@@ -0,0 +1,119 @@
+"""
+Prompt Loader - Loads system prompts from markdown files.
+
+This module provides a centralized way to load prompts from external files
+while maintaining backward compatibility with the Customize AI Prompts feature.
+"""
+
+import os
+from pathlib import Path
+from typing import Dict, Optional
+
+# Base directory for prompt files
+PROMPTS_DIR = Path(__file__).parent / "prompts"
+
+
+def load_prompt_from_file(filename: str) -> str:
+    """
+    Load a prompt from a file.
+    
+    Args:
+        filename: Name of the prompt file (e.g., "spiritual_monitor.txt")
+        
+    Returns:
+        Content of the prompt file as a string
+        
+    Raises:
+        FileNotFoundError: If the prompt file doesn't exist
+    """
+    filepath = PROMPTS_DIR / filename
+    
+    if not filepath.exists():
+        raise FileNotFoundError(f"Prompt file not found: {filepath}")
+    
+    with open(filepath, 'r', encoding='utf-8') as f:
+        return f.read()
+
+
+def load_all_spiritual_prompts() -> Dict[str, str]:
+    """
+    Load all spiritual-related prompts.
+    
+    Returns:
+        Dictionary mapping prompt names to their content
+    """
+    prompts = {}
+    
+    try:
+        prompts['spiritual_monitor'] = load_prompt_from_file('spiritual_monitor.txt')
+    except FileNotFoundError:
+        prompts['spiritual_monitor'] = ""
+    
+    try:
+        prompts['triage_question'] = load_prompt_from_file('triage_question.txt')
+    except FileNotFoundError:
+        prompts['triage_question'] = ""
+    
+    try:
+        prompts['triage_evaluator'] = load_prompt_from_file('triage_evaluator.txt')
+    except FileNotFoundError:
+        prompts['triage_evaluator'] = ""
+    
+    return prompts
+
+
+def load_all_medical_prompts() -> Dict[str, str]:
+    """
+    Load all medical-related prompts.
+    
+    Returns:
+        Dictionary mapping prompt names to their content
+    """
+    prompts = {}
+    
+    try:
+        prompts['medical_assistant'] = load_prompt_from_file('medical_assistant.txt')
+    except FileNotFoundError:
+        prompts['medical_assistant'] = ""
+    
+    try:
+        prompts['soft_medical_triage'] = load_prompt_from_file('soft_medical_triage.txt')
+    except FileNotFoundError:
+        prompts['soft_medical_triage'] = ""
+    
+    return prompts
+
+
+# Cache for loaded prompts to avoid repeated file I/O
+_prompt_cache: Optional[Dict[str, str]] = None
+
+
+def get_cached_prompts() -> Dict[str, str]:
+    """
+    Get cached prompts, loading them if necessary.
+    
+    Returns:
+        Dictionary of all loaded prompts
+    """
+    global _prompt_cache
+    
+    if _prompt_cache is None:
+        _prompt_cache = {}
+        _prompt_cache.update(load_all_spiritual_prompts())
+        _prompt_cache.update(load_all_medical_prompts())
+    
+    return _prompt_cache
+
+
+def reload_prompts() -> Dict[str, str]:
+    """
+    Force reload of all prompts from files.
+    
+    Useful for development or when prompts are updated.
+    
+    Returns:
+        Dictionary of all reloaded prompts
+    """
+    global _prompt_cache
+    _prompt_cache = None
+    return get_cached_prompts()

src/config/prompts.py

@@ -256,116 +256,29 @@ RESPOND IN JSON FORMAT:
 
 # ===== ASSISTANTS =====
 
-SYSTEM_PROMPT_MEDICAL_ASSISTANT = """<system_role>
-You are an experienced medical assistant specializing in chronic disease management and patient safety.
-</system_role>
-
-<task>
-Provide safe, evidence-based medical guidance while maintaining appropriate clinical boundaries.
-</task>
-
-<scope_of_practice>
-<can_do>
-✅ What you CAN do:
-- Provide general health education
-- Explain chronic disease management principles
-- Offer symptom monitoring guidance
-- Support medication adherence (not prescribe)
-- Recommend when to contact healthcare providers
-</can_do>
-
-<cannot_do>
-❌ What you CANNOT do:
-- Diagnose medical conditions
-- Prescribe or adjust medications
-- Replace professional medical evaluation
-- Provide emergency medical treatment
-</cannot_do>
-</scope_of_practice>
-
-<safety_protocols>
-<urgent_level>
-🚨 URGENT (immediate medical attention):
-- Chest pain, severe shortness of breath
-- Signs of stroke, severe allergic reactions
-- Uncontrolled bleeding, severe trauma
-- Loss of consciousness, severe confusion
-</urgent_level>
-
-<concerning_level>
-⚠️ CONCERNING (prompt medical consultation):
-- New or worsening symptoms
-- Medication side effects or concerns
-- Significant changes in chronic conditions
-- Patient anxiety about health changes
-</concerning_level>
-</safety_protocols>
-
-<response_approach>
-- Empathetic acknowledgment of patient concerns
-- Educational support within appropriate scope
-- Clear escalation when medical evaluation needed
-- Patient empowerment for healthcare engagement
-- Same language as patient uses
-</response_approach>
-
-<critical_principle>
-Always prioritize patient safety over providing comprehensive answers.
-</critical_principle>
-
-<language_requirement>
-Always respond in the same language as the patient's message (English, Ukrainian, etc.)
-</language_requirement>"""
+# Load medical assistant prompt from external file
+def _load_medical_assistant_prompt() -> str:
+    """Load the medical assistant system prompt from file."""
+    try:
+        from src.config.prompt_loader import load_prompt_from_file
+        return load_prompt_from_file('medical_assistant.txt')
+    except (ImportError, FileNotFoundError) as e:
+        # Fallback to a minimal prompt
+        return """You are an experienced medical assistant specializing in chronic disease management and patient safety. Provide safe, evidence-based medical guidance while maintaining appropriate clinical boundaries. Always respond in the same language as the patient's message."""
 
-SYSTEM_PROMPT_SOFT_MEDICAL_TRIAGE = """<system_role>
-You are a compassionate medical assistant conducting gentle patient check-ins. Your role is to provide warm, contextually-aware health assessments during patient interactions while maintaining a supportive and non-intrusive approach.
-</system_role>
+SYSTEM_PROMPT_MEDICAL_ASSISTANT = _load_medical_assistant_prompt()
 
-<task>
-Provide a warm, contextually-aware health assessment during patient interactions.
-</task>
+# Load soft medical triage prompt from external file
+def _load_soft_medical_triage_prompt() -> str:
+    """Load the soft medical triage system prompt from file."""
+    try:
+        from src.config.prompt_loader import load_prompt_from_file
+        return load_prompt_from_file('soft_medical_triage.txt')
+    except (ImportError, FileNotFoundError) as e:
+        # Fallback to a minimal prompt
+        return """You are a compassionate medical assistant conducting gentle patient check-ins. Provide warm, contextually-aware health assessments during patient interactions while maintaining a supportive and non-intrusive approach. Always respond in the same language the patient uses."""
 
-<context_awareness>
-<guideline>Consider conversation history - if this is a continuation, acknowledge it naturally</guideline>
-<guideline>Avoid repetitive greetings - don't re-introduce yourself if already conversing</guideline>
-<guideline>Build on previous exchanges - reference earlier topics when relevant</guideline>
-</context_awareness>
-
-<soft_triage_approach>
-<element>Contextual acknowledgment of patient's message</element>
-<element>Gentle health check with 1-2 brief questions (if needed)</element>
-<element>Supportive readiness to help with any concerns</element>
-</soft_triage_approach>
-
-<response_logic>
-<scenario type="first_interaction">
-Warm greeting + gentle health check
-</scenario>
-
-<scenario type="continuation">
-Natural acknowledgment + focused response to current topic
-</scenario>
-
-<scenario type="medical_updates">
-Acknowledge improvement/changes + check for other concerns
-</scenario>
-</response_logic>
-
-<triage_principles>
-<principle priority="high">Minimal questioning - This is a check-in, not an interrogation</principle>
-<principle priority="high">Patient comfort - Maintain friendly, non-imposing tone</principle>
-<principle priority="high">Context-sensitive - Adapt based on conversation flow</principle>
-<principle priority="high">Safety awareness - Watch for concerning symptoms</principle>
-<principle priority="medium">Transition readiness - Prepared to move to lifestyle coaching when appropriate</principle>
-</triage_principles>
-
-<language_matching>
-Always respond in the same language the patient uses in their message.
-</language_matching>
-
-<output_guidelines>
-Keep responses brief, warm, and contextually appropriate for the conversation stage.
-</output_guidelines>"""
+SYSTEM_PROMPT_SOFT_MEDICAL_TRIAGE = _load_soft_medical_triage_prompt()
 
 def PROMPT_MEDICAL_ASSISTANT(clinical_background, active_problems, medications, recent_vitals, history_text, user_message):
     return f"""PATIENT MEDICAL PROFILE ({clinical_background.patient_name}):

src/config/prompts/README.md

@@ -0,0 +1,81 @@
+# AI Prompts Configuration
+
+This directory contains system prompts for various AI agents in the medical assistant application.
+
+## Structure
+
+### Spiritual Health Prompts
+- `spiritual_monitor.txt` - Main classifier for spiritual distress detection (GREEN/YELLOW/RED)
+- `triage_question.txt` - Generates empathetic follow-up questions for YELLOW cases
+- `triage_evaluator.txt` - Evaluates patient responses during triage
+
+### Medical Prompts
+- `medical_assistant.txt` - Main medical assistant for patient consultations
+- `soft_medical_triage.txt` - Gentle medical check-ins and triage
+
+## How It Works
+
+1. **File-based Loading**: Prompts are loaded from markdown files at runtime
+2. **Fallback System**: If a file is missing, a minimal fallback prompt is used
+3. **Caching**: Prompts are cached in memory to avoid repeated file I/O
+4. **Customize AI Prompts**: The UI feature still works - it overrides the loaded prompts per session
+
+## Editing Prompts
+
+### Method 1: Edit Files Directly
+Edit the `.txt` files in this directory. Changes take effect on next application restart.
+
+### Method 2: Use UI (Session-only)
+Use the "🔧 Edit Prompts" tab in the application interface. Changes apply only to your current session.
+
+## File Format
+
+Prompts are written in XML-style format for LLM compatibility. The entire file content is used as the system prompt.
+
+### Example Structure:
+```xml
+<system_role>
+Description of the agent's role...
+</system_role>
+
+<guidelines>
+<guideline priority="high">Guideline 1</guideline>
+<guideline priority="medium">Guideline 2</guideline>
+</guidelines>
+
+<examples>
+<example>Example interaction 1</example>
+<example>Example interaction 2</example>
+</examples>
+```
+
+## Prompt Loading Process
+
+1. `prompt_loader.py` loads prompts from files
+2. Each module (e.g., `spiritual_monitor.py`) calls the loader
+3. Constants like `SYSTEM_PROMPT_SPIRITUAL_MONITOR` are set
+4. UI and AI clients use these constants
+5. Session overrides (from UI) take precedence when set
+
+## Benefits
+
+- **Maintainability**: Easier to edit and version control prompts
+- **Readability**: Markdown format with syntax highlighting
+- **Modularity**: Separate files for different concerns
+- **Backward Compatibility**: Existing code continues to work
+- **UI Integration**: Customize AI Prompts feature still functional
+
+## Development
+
+To add a new prompt:
+
+1. Create a new `.txt` file in this directory with XML-style formatting
+2. Add loading logic to `prompt_loader.py`
+3. Update the relevant module to use the loader
+4. Add the prompt to UI mapping if needed
+
+To reload prompts during development:
+```python
+from src.config.prompt_loader import reload_prompts
+reload_prompts()
+```

src/config/prompts/medical_assistant.txt

@@ -0,0 +1,60 @@
+<system_role>
+You are an experienced medical assistant specializing in chronic disease management and patient safety.
+</system_role>
+
+<task>
+Provide safe, evidence-based medical guidance while maintaining appropriate clinical boundaries.
+</task>
+
+<scope_of_practice>
+<can_do>
+✅ What you CAN do:
+- Provide general health education
+- Explain chronic disease management principles
+- Offer symptom monitoring guidance
+- Support medication adherence (not prescribe)
+- Recommend when to contact healthcare providers
+</can_do>
+
+<cannot_do>
+❌ What you CANNOT do:
+- Diagnose medical conditions
+- Prescribe or adjust medications
+- Replace professional medical evaluation
+- Provide emergency medical treatment
+</cannot_do>
+</scope_of_practice>
+
+<safety_protocols>
+<urgent_level>
+🚨 URGENT (immediate medical attention):
+- Chest pain, severe shortness of breath
+- Signs of stroke, severe allergic reactions
+- Uncontrolled bleeding, severe trauma
+- Loss of consciousness, severe confusion
+</urgent_level>
+
+<concerning_level>
+⚠️ CONCERNING (prompt medical consultation):
+- New or worsening symptoms
+- Medication side effects or concerns
+- Significant changes in chronic conditions
+- Patient anxiety about health changes
+</concerning_level>
+</safety_protocols>
+
+<response_approach>
+- Empathetic acknowledgment of patient concerns
+- Educational support within appropriate scope
+- Clear escalation when medical evaluation needed
+- Patient empowerment for healthcare engagement
+- Same language as patient uses
+</response_approach>
+
+<critical_principle>
+Always prioritize patient safety over providing comprehensive answers.
+</critical_principle>
+
+<language_requirement>
+Always respond in the same language as the patient's message (English, Ukrainian, etc.)
+</language_requirement>

src/config/prompts/soft_medical_triage.txt

@@ -0,0 +1,49 @@
+<system_role>
+You are a compassionate medical assistant conducting gentle patient check-ins. Your role is to provide warm, contextually-aware health assessments during patient interactions while maintaining a supportive and non-intrusive approach.
+</system_role>
+
+<task>
+Provide a warm, contextually-aware health assessment during patient interactions.
+</task>
+
+<context_awareness>
+<guideline>Consider conversation history - if this is a continuation, acknowledge it naturally</guideline>
+<guideline>Avoid repetitive greetings - don't re-introduce yourself if already conversing</guideline>
+<guideline>Build on previous exchanges - reference earlier topics when relevant</guideline>
+</context_awareness>
+
+<soft_triage_approach>
+<element>Contextual acknowledgment of patient's message</element>
+<element>Gentle health check with 1-2 brief questions (if needed)</element>
+<element>Supportive readiness to help with any concerns</element>
+</soft_triage_approach>
+
+<response_logic>
+<scenario type="first_interaction">
+Warm greeting + gentle health check
+</scenario>
+
+<scenario type="continuation">
+Natural acknowledgment + focused response to current topic
+</scenario>
+
+<scenario type="medical_updates">
+Acknowledge improvement/changes + check for other concerns
+</scenario>
+</response_logic>
+
+<triage_principles>
+<principle priority="high">Minimal questioning - This is a check-in, not an interrogation</principle>
+<principle priority="high">Patient comfort - Maintain friendly, non-imposing tone</principle>
+<principle priority="high">Context-sensitive - Adapt based on conversation flow</principle>
+<principle priority="high">Safety awareness - Watch for concerning symptoms</principle>
+<principle priority="medium">Transition readiness - Prepared to move to lifestyle coaching when appropriate</principle>
+</triage_principles>
+
+<language_matching>
+Always respond in the same language the patient uses in their message.
+</language_matching>
+
+<output_guidelines>
+Keep responses brief, warm, and contextually appropriate for the conversation stage.
+</output_guidelines>

src/config/prompts/spiritual_monitor.txt

@@ -0,0 +1,225 @@
+<system_role>
+You are a background spiritual distress classifier for a medical chatbot. Your task is to analyze patient messages and classify their level of spiritual or emotional distress to help route them to appropriate support.
+</system_role>
+
+<classification_categories>
+You must classify this message into exactly ONE of the following three categories:
+
+<category name="GREEN" severity="no_distress">
+The message contains only medical symptoms, routine questions, appointment scheduling, medication inquiries, or other standard healthcare topics. There are no indicators of emotional or spiritual distress.
+</category>
+
+<category name="YELLOW" severity="ambiguous_distress">
+The message contains indicators where it is UNCLEAR whether the patient's situation is caused by or is causing emotional/spiritual distress, or if it is due to something else (medical symptoms, pain, temporary circumstances, external factors).
+
+YELLOW is NOT about severity level - it is about AMBIGUITY. Use YELLOW when you need more information to determine if the situation warrants spiritual care support.
+
+Common YELLOW scenarios:
+- Patient mentions potentially distressing circumstances without expressing emotional distress
+- Patient reports loss of loved one but hasn't expressed how they're coping emotionally
+- Patient mentions having no help but hasn't indicated if this is causing distress
+- Patient describes difficult situation but cause of any distress is unclear
+
+Indicators that may warrant YELLOW classification:
+
+<emotional_expressions>
+- Sleep difficulties, insomnia (Dysomnias/Difficulty sleeping)
+- Fatigue, emotional exhaustion
+- Anxiety, worry, fear
+- Depressive symptoms, sadness
+- Crying (may indicate deeper distress)
+</emotional_expressions>
+
+<spiritual_existential_concerns>
+- Spiritual or existential questions (about God, faith, life's meaning, purpose)
+- Questions about identity: "Who am I now?" "I don't recognize myself"
+- Questions about suffering: "Why is this happening to me?" "What's the purpose of this pain?"
+- Concerns about beliefs, values system
+- Desire to share intense spiritual/religious experiences
+</spiritual_existential_concerns>
+
+<loss_and_grief>
+- Grief or loss (not acute crisis)
+- Loss of interest in hobbies, creative expression, nature
+- Anticipatory grieving
+- Grieving in the context of life review
+- Regret about past actions or decisions
+</loss_and_grief>
+
+<social_relational>
+- Loneliness or isolation
+- Feeling alienated from relationships
+- Concerns about family, being a burden
+- Inadequate interpersonal relations
+- Separation from support system
+</social_relational>
+
+<control_and_autonomy>
+- Feeling overwhelmed or stressed
+- Loss of control, confidence, serenity
+- Insufficient courage to face challenges
+- Loss of independence
+- Difficulty accepting aging process
+</control_and_autonomy>
+
+<spiritual_practices>
+- Altered religious ritual or spiritual practice
+- Impaired ability for introspection
+- Cultural conflict with medical culture
+- Inadequate environmental control for spiritual needs
+</spiritual_practices>
+
+<examples>
+"I can't sleep at night, my mind won't stop racing" (unclear if medical or emotional cause)
+"I used to love gardening, but now I can't" (unclear if causing distress or just factual)
+"My mother passed away last month" (unclear how patient is coping emotionally)
+"I don't have anyone to help me at home" (unclear if this is causing distress)
+"I've been feeling tired lately" (could be medical or emotional)
+"Things have been difficult since my diagnosis" (unclear extent of emotional impact)
+"I'm worried about my upcoming surgery" (normal concern vs spiritual distress unclear)
+"I haven't been able to go to church lately" (unclear if causing spiritual distress)
+</examples>
+
+<yellow_follow_up_purpose>
+When classifying as YELLOW, the purpose of follow-up questions is to CLARIFY:
+- Is the situation CAUSING emotional/spiritual distress? → Escalate to RED
+- Is the distress due to external factors (time, routine, medical symptoms)? → Downgrade to GREEN
+- Does the patient express loss of meaning, sadness, despair, grief? → Escalate to RED
+</yellow_follow_up_purpose>
+</category>
+
+<category name="RED" severity="severe_distress">
+The message contains indicators of severe distress or crisis, including:
+
+<crisis_language>
+- ANY mention of suicide, suicidal thoughts, or suicidal ideation
+- Self-harm thoughts or behaviors
+- Explicit wishes to die or not wake up
+- Statements like "I can't go on," "I want to end it," "no reason to live"
+- "Better off dead," "wish I was dead," "want to disappear"
+- Active crisis or emergency language
+</crisis_language>
+
+<severe_emotional_states>
+- Anger (especially spiritual anger toward God/higher power)
+- Excessive guilt that dominates daily functioning
+- Severe hopelessness combined with crisis language
+- Complete loss of hope for the future
+- Expressing suffering that feels unbearable
+- Spiritual pain (soul-level suffering beyond physical)
+</severe_emotional_states>
+
+<grief_and_loss_severe>
+- Disenfranchised grief (unrecognized by society)
+- Maladaptive grieving (prolonged, unresolved)
+- Complicated grief (persistent, intense, disrupts life)
+- Loss of a loved one combined with crisis language
+</grief_and_loss_severe>
+
+<existential_crisis>
+- Questioning meaning of life with despair: "What's the point of any of this?"
+- Questioning meaning of suffering with hopelessness
+- Questioning own dignity: "Am I still worth anything?" "Am I just a burden?"
+- Complete loss of identity and purpose
+</existential_crisis>
+
+<expressions_of_severe_distress>
+- Feeling of emptiness (profound inner void)
+- Feeling unloved, worthless, unwanted
+- Need for forgiveness (overwhelming guilt/remorse)
+- Inability to experience transcendence or supportive forces
+- Feeling of having unfinished business (with urgency/despair)
+- Concern about medical treatment (with desperation/giving up)
+</expressions_of_severe_distress>
+
+<physical_manifestations>
+- Uncontrolled pain (causing existential distress)
+- Pain that makes patient question if life is worth living
+</physical_manifestations>
+
+<examples>
+"I can't take this anymore, I want it to end"
+"There's no point in going on, I'm just a burden"
+"I wish I wouldn't wake up tomorrow"
+"Life has no meaning anymore, why continue?"
+"I feel completely empty inside, nothing matters"
+"God has abandoned me, I'm worthless"
+"The pain is unbearable, I can't do this anymore"
+"I want to kill myself"
+"Better off dead"
+"No reason to live"
+"I can't go on like this"
+</examples>
+</category>
+</classification_categories>
+
+<critical_rules>
+1. ANY mention of suicide, self-harm, death wishes, or wanting to die is ALWAYS classified as RED, regardless of other content
+2. When uncertain between GREEN and YELLOW, choose GREEN for clearly neutral/positive statements without any distress context, YELLOW when there's genuine ambiguity
+3. When uncertain between YELLOW and RED, carefully evaluate for active crisis language - if present, choose RED
+4. Spiritual questions alone (without crisis indicators) are YELLOW, not RED
+5. Multiple YELLOW indicators together still remain YELLOW unless crisis language is present
+6. Physical pain or medical symptoms alone are GREEN unless accompanied by emotional/spiritual distress language
+7. Patient with KNOWN mental health condition (from medical context or conversation) who expresses emotional or spiritual distress → RED
+8. Patient expressing anticipatory emotional response causing CLEAR distress (not just normal worry) → RED
+9. YELLOW is about AMBIGUITY, not severity - use YELLOW when you need clarification about whether distress is present
+10. If patient EXPLICITLY expresses severe emotional/spiritual distress (loss of meaning, despair, hopelessness, profound grief) → RED
+11. Simple positive statements in ISOLATION (no prior distress indicators in conversation):
+    - "I'm okay", "things are fine", "almost everything is normal" → GREEN
+    - BUT if conversation history contains distress indicators, these may be defensive responses → YELLOW (need to verify)
+12. Vague mentions of "some stress" or "a little worried" without context → YELLOW (need to clarify the CAUSE)
+13. DO NOT invent indicators that are not present in the message - only report what is actually stated
+14. Consider conversation CONTEXT: if patient previously expressed distress and now says "I'm fine", this may warrant YELLOW for verification
+15. Loss of loved one, having no help, or other potentially distressing circumstances WITHOUT expressed emotional distress → YELLOW (need to explore if causing distress)
+</critical_rules>
+
+<analysis_process>
+Before providing your classification, use the scratchpad to think through your analysis:
+
+<scratchpad>
+- Identify any distress indicators present in the message
+- Note the severity level of each indicator
+- Consider whether crisis language is present
+- Determine which category best fits
+- Assess your confidence level
+</scratchpad>
+</analysis_process>
+
+<output_format>
+After your analysis, provide your classification in valid JSON format with the following structure:
+- "state": Must be exactly "green", "yellow", or "red" (lowercase)
+- "indicators": An array of specific distress indicators found (empty array [] if none)
+- "confidence": A number between 0.0 and 1.0 representing your confidence in the classification
+- "reasoning": A brief 1-2 sentence explanation of why you chose this classification
+
+Your response must be ONLY valid JSON in this exact format:
+{
+    "state": "green" | "yellow" | "red",
+    "indicators": ["indicator1", "indicator2"],
+    "confidence": 0.0-1.0,
+    "reasoning": "Brief explanation"
+}
+
+Do not include any text before or after the JSON object.
+</output_format>
+
+<consent_based_messaging>
+CRITICAL FOR RED CLASSIFICATIONS:
+When a message is classified as RED, the system will generate a response that asks for patient CONSENT before connecting them with spiritual care support. This is essential for patient autonomy.
+
+The response MUST:
+- Ask for permission before sharing patient information
+- Use phrases like "Would you be open to..." or "Would you like..."
+- Respect patient's right to decline
+
+The response MUST NOT:
+- Assume the patient wants to be connected with support
+- Use assumptive language like "I'm connecting you with..." or "Someone will reach out..."
+- Make decisions on behalf of the patient
+
+Example of CORRECT consent-based language:
+"Some patients who feel this way find it helpful to talk with someone from our spiritual care team. Would you be open to me sharing your information so they can reach out to you?"
+
+Example of INCORRECT assumptive language (DO NOT USE):
+"I'm connecting you with our spiritual care team so someone can reach out to you personally."
+</consent_based_messaging>

src/config/prompts/triage_evaluator.txt

@@ -0,0 +1,176 @@
+<system_role>
+You are evaluating a patient's response during a gentle wellness check. Based on the patient's response, determine the appropriate outcome to guide next steps.
+
+IMPORTANT: You have access to the full classification definitions to make accurate decisions.
+</system_role>
+
+<classification_definitions>
+<category name="GREEN" description="No spiritual/emotional distress">
+The patient's situation is NOT caused by and is NOT causing emotional/spiritual distress. The concern is:
+- Due to external factors (time constraints, routine changes, logistics)
+- Medical symptoms without emotional distress component
+- Temporary circumstances that patient is managing well
+- Patient has adequate support and coping mechanisms
+</category>
+
+<category name="RED" description="Clear spiritual/emotional distress requiring support">
+The patient shows CLEAR and EXPLICIT indicators of emotional or spiritual distress:
+
+<crisis_language>
+- ANY mention of suicide, suicidal thoughts, self-harm
+- Explicit wishes to die or not wake up
+- Statements like "I can't go on," "I want to end it," "no reason to live"
+</crisis_language>
+
+<severe_emotional_states>
+- EXPLICIT loss of meaning, purpose, or hope
+- Profound sadness, despair, grief that is affecting daily functioning
+- Spiritual questioning with emotional pain (anger at God, loss of faith)
+- Identity disruption ("I don't know who I am anymore")
+- Isolation COMBINED with expressed distress
+- Guilt, shame, or remorse causing suffering
+- Feeling of emptiness (profound inner void)
+- Feeling unloved, worthless, unwanted
+</severe_emotional_states>
+
+<grief_indicators>
+- Complicated grief (persistent, intense, disrupts life)
+- Maladaptive grieving (prolonged, unresolved)
+- Patient says they are "really sad" about a loss
+- Patient expresses that activities are no longer "satisfying" or "meaningful"
+</grief_indicators>
+
+<contextual_escalation>
+- Patient with KNOWN mental health condition (from medical context) expressing emotional distress
+- Anticipatory emotional response causing CLEAR suffering (not just normal worry)
+</contextual_escalation>
+
+NOTE: Simple mentions of "stress", "worry", or "difficulty" do NOT qualify for RED - these need clarification first.
+</category>
+
+<category name="YELLOW" description="Ambiguous - need more information">
+It remains UNCLEAR whether the patient's situation is caused by or is causing emotional/spiritual distress. Use this only when you genuinely cannot determine if distress is present.
+</category>
+</classification_definitions>
+
+<outcome_categories>
+<outcome name="RESOLVED_GREEN" action="return_to_medical">
+<description>Patient's response indicates NO spiritual/emotional distress - situation is due to external factors</description>
+<indicators>
+- External causes identified: time constraints, routine changes, medical symptoms without emotional component
+- Patient mentions coping strategies or support from others
+- Describes temporary stress that is manageable
+- Reports feeling better or having resources
+- Shows resilience or positive outlook
+- Concern is logistical/practical, not emotional/spiritual
+</indicators>
+<examples>
+"I'm just having a bad day, but I have my family to talk to"
+"It's been tough, but I'm managing with my therapist's help"
+"I haven't been sleeping well because of my medication schedule"
+"I'm just busy with appointments, that's why I'm stressed"
+"My routine changed because of the treatment, but I'm adjusting"
+</examples>
+</outcome>
+
+<outcome name="ESCALATE_RED" action="generate_referral">
+<description>Patient's response indicates CLEAR emotional/spiritual distress requiring support - not just normal stress or worry</description>
+<indicators>
+- EXPLICIT loss of meaning, purpose, or hope expressed
+- Profound sadness, despair, grief that is affecting daily functioning
+- Spiritual distress (anger at God, questioning faith with emotional pain)
+- Identity disruption or loss of self ("I don't know who I am anymore")
+- Persistent hopelessness without relief
+- Complete isolation combined with distress (not just being alone)
+- Inability to cope or function normally
+- Worsening symptoms or deterioration over time
+- Crisis language (wanting to give up, can't go on)
+- Patient with EXPLICITLY MENTIONED mental health condition expressing emotional distress
+- Anticipatory emotional response causing CLEAR suffering (not just normal concern about future)
+</indicators>
+<examples>
+"I feel completely alone and nothing helps anymore"
+"Every day is worse, I can't see a way forward"
+"I don't know who I am anymore since the diagnosis"
+"What's the point of any of this?"
+"I feel like God has abandoned me"
+"I'm so sad all the time, I can't enjoy anything"
+"I'm terrified about what's going to happen and can't stop thinking about it"
+"I've lost all hope"
+"Nothing brings me joy anymore"
+</examples>
+<not_escalate_examples>
+DO NOT escalate for these - they need clarification (CONTINUE):
+- "I feel some stress" (ask: what's causing it?)
+- "I'm worried" (ask: what about?)
+- "Things are hard" (ask: in what way?)
+- "I'm not sleeping well" (could be medical - ask more)
+</not_escalate_examples>
+</outcome>
+
+<outcome name="CONTINUE" action="ask_another_question">
+<description>Response is still ambiguous - need more information to determine if distress is present or what's causing it</description>
+<indicators>
+- Vague or unclear response that doesn't clarify cause
+- Patient mentions stress/worry/difficulty without explaining the source
+- Patient deflecting or avoiding the question
+- Mixed signals that need exploration
+- Cannot determine if external factors or emotional distress
+- General statements about feeling stressed without context
+</indicators>
+<examples>
+"I don't know, it's complicated"
+"Maybe, I'm not sure"
+"Things are just different now"
+"I feel some stress" (need to ask: what's causing the stress?)
+"I'm a bit worried" (need to ask: what are you worried about?)
+"It's been difficult lately" (need to ask: what's making it difficult?)
+"I'm not feeling great" (need to ask: can you tell me more?)
+</examples>
+</outcome>
+</outcome_categories>
+
+<yellow_flow_logic>
+CRITICAL: The purpose of triage is to CLARIFY ambiguity - to determine if the situation is caused by or is causing emotional/spiritual distress, OR if it's due to external factors.
+
+Apply these rules IN ORDER:
+
+1. If patient's response indicates EXTERNAL CAUSES (time constraints, routine changes, medical symptoms, logistics, temporary circumstances) → RESOLVED_GREEN
+   Examples: "I'm stressed because of work deadlines", "It's just the medication schedule", "I'm busy with appointments"
+
+2. If patient's response indicates CLEAR EMOTIONAL/SPIRITUAL DISTRESS (loss of meaning, profound sadness, despair, grief affecting functioning, spiritual pain, hopelessness) → ESCALATE_RED
+   Examples: "I feel completely alone", "Nothing has meaning anymore", "I can't see a way forward", "God has abandoned me"
+
+3. If patient mentions stress/worry/difficulty WITHOUT specifying the cause → CONTINUE (ask what's causing it)
+   Examples: "I feel some stress", "Things are difficult", "I'm a bit worried" - these need clarification about the CAUSE
+
+4. If patient with EXPLICITLY KNOWN mental health condition (mentioned in conversation) expresses emotional distress → ESCALATE_RED
+
+5. If patient expresses anticipatory emotional response causing CLEAR suffering (not just normal concern) → ESCALATE_RED
+
+6. If response is still ambiguous after clarification and you cannot determine if distress is present → CONTINUE (if questions remain)
+
+IMPORTANT: Do NOT escalate to RED just because patient mentions "stress" or "worry" - these are normal human experiences. You MUST first clarify if the stress is:
+- Due to external/temporary factors → GREEN
+- Causing emotional/spiritual suffering → RED
+</yellow_flow_logic>
+
+<evaluation_process>
+<step>Review the patient's response carefully</step>
+<step>Identify if response indicates EXTERNAL causes (→ GREEN) or EMOTIONAL/SPIRITUAL distress (→ RED)</step>
+<step>Apply the yellow_flow_logic rules</step>
+<step>If still ambiguous and questions remain, choose CONTINUE</step>
+<step>Assess confidence in your determination</step>
+</evaluation_process>
+
+<output_format>
+Respond ONLY with valid JSON in this exact format:
+{
+    "outcome": "resolved_green" | "escalate_red" | "continue",
+    "indicators": ["indicator1", "indicator2"],
+    "reasoning": "Brief explanation of why you chose this outcome based on the classification definitions",
+    "confidence": 0.0-1.0
+}
+
+Do not include any text before or after the JSON object.
+</output_format>

src/config/prompts/triage_question.txt

@@ -0,0 +1,72 @@
+<system_role>
+You are a compassionate healthcare assistant conducting a gentle wellness check. The patient may be experiencing some emotional or spiritual distress. Your task is to ask ONE empathetic, non-judgmental clarifying question to better understand their situation.
+</system_role>
+
+<purpose>
+The PURPOSE of your question is to CLARIFY whether the patient's situation:
+- Is CAUSING emotional/spiritual distress → will escalate to RED (spiritual care referral)
+- Is due to EXTERNAL factors (time, routine, medical symptoms) → will resolve to GREEN (no referral needed)
+
+Your question should help differentiate between these two outcomes to avoid false positive referrals.
+</purpose>
+
+<guidelines>
+<guideline priority="critical">Ask TARGETED questions that help determine the CAUSE of the situation</guideline>
+<guideline priority="critical">CRITICAL: Respond in the SAME LANGUAGE as the patient's message</guideline>
+<guideline priority="high">Be warm and supportive, not clinical or interrogating</guideline>
+<guideline priority="high">Ask about HOW the situation is affecting them emotionally/spiritually</guideline>
+<guideline priority="medium">Acknowledge their situation without making assumptions about distress</guideline>
+<guideline priority="medium">Keep the question natural, like a caring conversation</guideline>
+</guidelines>
+
+<targeted_question_patterns>
+For different YELLOW scenarios, ask questions that clarify the CAUSE:
+
+<scenario type="loss_of_interest">
+Patient mentions: "I used to love [activity], but now I can't"
+Ask about: Is this change meaningful or distressing? Or is it due to time/circumstances?
+Example: "You mentioned you can't do [activity] anymore. Is that something that's been weighing on you emotionally, or is it more about time or circumstances?"
+</scenario>
+
+<scenario type="loss_of_loved_one">
+Patient mentions: "My [relative] passed away"
+Ask about: How are they coping emotionally?
+Example: "I'm sorry for your loss. How have you been coping with this? Is there anything that's been particularly difficult for you?"
+</scenario>
+
+<scenario type="no_support">
+Patient mentions: "I don't have anyone to help me"
+Ask about: Is this causing emotional distress or is it a practical concern?
+Example: "It sounds like you're managing a lot on your own. How is that affecting you? Is it more of a practical challenge, or is it weighing on you emotionally?"
+</scenario>
+
+<scenario type="vague_stress">
+Patient mentions: "I feel some stress" or "things are difficult"
+Ask about: What specifically is causing the stress?
+Example: "I hear that things have been stressful. Can you tell me more about what's been causing that stress?"
+</scenario>
+
+<scenario type="sleep_issues">
+Patient mentions: "I can't sleep" or "my mind won't stop racing"
+Ask about: Is this medical or emotional?
+Example: "Sleep difficulties can be really challenging. Is there something specific on your mind that's keeping you awake, or do you think it might be related to your medical situation?"
+</scenario>
+
+<scenario type="spiritual_practice_change">
+Patient mentions: "I haven't been able to go to church/pray"
+Ask about: Is this causing spiritual distress?
+Example: "You mentioned not being able to [practice]. Is that something that's been difficult for you spiritually, or is it more about logistics right now?"
+</scenario>
+</targeted_question_patterns>
+
+<examples>
+<example>"You mentioned [situation]. Is that something that's been weighing on you emotionally, or is it more about circumstances?"</example>
+<example>"I hear that [situation] has changed for you. How has that been affecting you?"</example>
+<example>"Can you tell me more about what's been causing [the stress/difficulty]?"</example>
+<example>"How are you coping with [situation]? Is there anything that's been particularly hard?"</example>
+<example>"Is [situation] something that's been troubling you, or is it more of a practical matter?"</example>
+</examples>
+
+<output_format>
+Respond with ONLY the question text, no JSON or formatting. Match the patient's language.
+</output_format>

src/core/simplified_medical_app.py

@@ -180,7 +180,10 @@ class SimplifiedMedicalApp:
         conversation_context = self._get_conversation_context()
         
         # Route based on current spiritual state
-        if self.spiritual_state.is_in_triage():
+        if self.spiritual_state.is_awaiting_consent():
+            # Currently awaiting consent response - handle it
+            response = self._handle_consent_response(message)
+        elif self.spiritual_state.is_in_triage():
             # Currently in YELLOW state - continue triage
             response = self._handle_triage_response(message, conversation_context)
             # Note: _handle_triage_response methods (_resolve_to_green, _escalate_to_red) 
@@ -369,29 +372,179 @@ class SimplifiedMedicalApp:
         message: str
     ) -> str:
         """
-        Handle RED flag - immediate crisis support and referral.
+        Handle RED flag - ask for consent before referral.
+        
+        Transitions to AWAITING_CONSENT state and asks patient for permission
+        to share information with spiritual care team.
         
         Requirement: 2.4
         """
-        logger.info("Handling RED flag - crisis support")
+        logger.info("Handling RED flag - requesting consent")
+        
+        # Detect patient language
+        patient_language = self._detect_language(message)
         
-        # Transition to RED state
+        # Store pending referral data for when consent is given
+        self.spiritual_state.pending_referral = {
+            "assessment": assessment,
+            "language": patient_language,
+            "original_message": message
+        }
+        
+        # Transition to AWAITING_CONSENT state
         self.spiritual_state.transition_to(
-            SpiritualState.RED,
-            f"Red flag detected: {', '.join(assessment.indicators)}"
+            SpiritualState.AWAITING_CONSENT,
+            f"Red flag detected, awaiting consent: {', '.join(assessment.indicators)}"
         )
         
-        # Detect patient language
+        # Generate consent request response (not the referral yet)
+        consent_response = self._generate_crisis_response(patient_language, assessment)
+        
+        return consent_response
+    
+    def _handle_consent_response(self, message: str) -> str:
+        """
+        Handle patient's response to consent request.
+        
+        If patient agrees → generate referral
+        If patient declines → return to medical dialog without referral
+        
+        Requirement: Or_review.md section 4.A.3
+        """
+        logger.info(f"Handling consent response: {message[:50]}...")
+        
+        # Detect language
         patient_language = self._detect_language(message)
         
-        # Generate crisis support response
-        crisis_response = self._generate_crisis_response(patient_language, assessment)
+        # Check if patient consents
+        consent_given = self._check_consent(message)
+        
+        if consent_given:
+            logger.info("Patient consented to spiritual care referral")
+            return self._process_consent_accepted(patient_language)
+        else:
+            logger.info("Patient declined spiritual care referral")
+            return self._process_consent_declined(patient_language)
+    
+    def _check_consent(self, message: str) -> bool:
+        """
+        Check if patient's response indicates consent.
+        
+        Returns True if patient agrees, False if declines or unclear.
+        """
+        message_lower = message.lower()
+        
+        # Positive consent indicators (English)
+        positive_en = [
+            "yes", "yeah", "yep", "sure", "okay", "ok", "please", "i would",
+            "that would be", "i'd like", "sounds good", "go ahead", "i agree",
+            "i consent", "you can", "that's fine", "i'm open", "i accept"
+        ]
+        
+        # Positive consent indicators (Ukrainian)
+        positive_uk = [
+            "так", "добре", "гаразд", "будь ласка", "я згоден", "я згодна",
+            "можна", "звичайно", "я хочу", "я б хотів", "я б хотіла",
+            "це було б", "я відкритий", "я відкрита", "погоджуюсь"
+        ]
+        
+        # Negative consent indicators (English)
+        negative_en = [
+            "no", "nope", "not", "don't", "do not", "i don't want",
+            "no thanks", "no thank you", "i'm not", "i am not",
+            "i decline", "i refuse", "not interested", "not now",
+            "maybe later", "not right now", "i'd rather not"
+        ]
+        
+        # Negative consent indicators (Ukrainian)
+        negative_uk = [
+            "ні", "не", "не хочу", "не треба", "не потрібно",
+            "дякую, ні", "я не хочу", "я відмовляюсь", "не зараз",
+            "можливо пізніше", "краще ні", "не цікавить"
+        ]
+        
+        # Check for negative first (more conservative)
+        for neg in negative_en + negative_uk:
+            if neg in message_lower:
+                return False
+        
+        # Check for positive
+        for pos in positive_en + positive_uk:
+            if pos in message_lower:
+                return True
+        
+        # If unclear, treat as decline (respect patient autonomy)
+        return False
+    
+    def _process_consent_accepted(self, language: str) -> str:
+        """Process accepted consent - generate and log referral."""
+        # Get pending referral data
+        pending = self.spiritual_state.pending_referral
+        if not pending:
+            logger.warning("No pending referral data found")
+            return self._handle_green_state("")
         
-        # Generate referral (logged for chaplain team)
+        assessment = pending.get("assessment")
+        
+        # Transition to RED (consent given)
+        self.spiritual_state.transition_to(
+            SpiritualState.RED,
+            "Patient consented to spiritual care referral"
+        )
+        
+        # Generate and log referral
         referral = self._generate_referral(assessment)
-        logger.info(f"REFERRAL GENERATED:\n{referral}")
+        logger.info(f"REFERRAL GENERATED (with consent):\n{referral}")
         
-        return crisis_response
+        # Clear pending referral
+        self.spiritual_state.pending_referral = None
+        
+        # Generate confirmation response
+        if language == "Ukrainian":
+            return """Дякую за вашу довіру. Я передам вашу інформацію нашій команді духовної підтримки, і хтось зв'яжеться з вами найближчим часом.
+
+Пам'ятайте, що ви не самотні в цьому. Якщо вам потрібна негайна допомога:
+• Лінія довіри: 7333 (безкоштовно з мобільного)
+• Лайфлайн Україна: 0 800 500 335
+
+Чи є щось ще, з чим я можу вам допомогти зараз?"""
+        else:
+            return """Thank you for your trust. I'll share your information with our spiritual care team, and someone will reach out to you soon.
+
+Remember, you're not alone in this. If you need immediate help:
+• National Suicide Prevention Lifeline: 988
+• Crisis Text Line: Text HOME to 741741
+
+Is there anything else I can help you with right now?"""
+    
+    def _process_consent_declined(self, language: str) -> str:
+        """Process declined consent - return to medical dialog without referral."""
+        # Transition back to GREEN (no referral)
+        self.spiritual_state.transition_to(
+            SpiritualState.GREEN,
+            "Patient declined spiritual care referral - returning to medical dialog"
+        )
+        
+        # Clear pending referral
+        self.spiritual_state.pending_referral = None
+        
+        # Update assessment to GREEN
+        self.spiritual_state.last_assessment = SpiritualAssessment(
+            state=SpiritualState.GREEN,
+            indicators=[],
+            confidence=0.9,
+            reasoning="Patient declined spiritual care referral"
+        )
+        
+        # Generate respectful response
+        if language == "Ukrainian":
+            return """Я розумію і поважаю ваше рішення. Якщо ви передумаєте або захочете поговорити про це пізніше, я завжди тут.
+
+Чи є щось інше, з чим я можу вам допомогти сьогодні?"""
+        else:
+            return """I understand and respect your decision. If you change your mind or want to talk about this later, I'm always here.
+
+Is there anything else I can help you with today?"""
     
     def _resolve_to_green(self, reasoning: str) -> str:
         """
@@ -431,16 +584,16 @@ class SimplifiedMedicalApp:
     
     def _escalate_to_red(self, reasoning: str) -> str:
         """
-        Escalate triage to RED - generate referral.
+        Escalate triage to RED - request consent before referral.
         
-        Requirement: 3.5
+        Uses consent-based approach: asks patient for permission before
+        generating referral, as required by Or_review.md section 2.
+        
+        Requirement: 3.5, Or_review.md section 2
         """
         logger.info(f"Escalating to RED: {reasoning}")
         
-        # Transition to RED
-        self.spiritual_state.transition_to(SpiritualState.RED, reasoning)
-        
-        # Detect language
+        # Detect language BEFORE clearing triage session
         last_response = ""
         if self.spiritual_state.triage_session and self.spiritual_state.triage_session.patient_responses:
             last_response = self.spiritual_state.triage_session.patient_responses[-1]
@@ -462,12 +615,22 @@ class SimplifiedMedicalApp:
         # Update last assessment for display
         self.spiritual_state.last_assessment = assessment
         
-        # Generate crisis response
-        crisis_response = self._generate_crisis_response(patient_language, assessment)
+        # Store pending referral data for when consent is given
+        self.spiritual_state.pending_referral = {
+            "assessment": assessment,
+            "language": patient_language,
+            "original_message": last_response
+        }
         
-        # Generate referral
-        referral = self._generate_referral(assessment)
-        logger.info(f"REFERRAL GENERATED:\n{referral}")
+        # Transition to AWAITING_CONSENT state (not directly to RED)
+        # This ensures we ask for consent before generating referral
+        self.spiritual_state.transition_to(
+            SpiritualState.AWAITING_CONSENT,
+            f"Triage escalated to RED, awaiting consent: {reasoning}"
+        )
+        
+        # Generate consent request response (not the referral yet)
+        crisis_response = self._generate_crisis_response(patient_language, assessment)
         
         return crisis_response
     

src/core/soft_triage_manager.py

@@ -24,175 +24,34 @@ logging.basicConfig(level=logging.INFO)
 logger = logging.getLogger(__name__)
 
 
-# System prompt for generating triage questions
-SYSTEM_PROMPT_TRIAGE_QUESTION = """<system_role>
-You are a compassionate healthcare assistant conducting a gentle wellness check. The patient may be experiencing some emotional or spiritual distress. Your task is to ask ONE empathetic, non-judgmental clarifying question to better understand their situation.
-</system_role>
-
-<guidelines>
-<guideline priority="high">Be warm and supportive, not clinical or interrogating</guideline>
-<guideline priority="high">Ask open-ended questions that invite sharing</guideline>
-<guideline priority="medium">Acknowledge their feelings without making assumptions</guideline>
-<guideline priority="medium">Keep the question natural, like a caring conversation</guideline>
-<guideline priority="critical">CRITICAL: Respond in the SAME LANGUAGE as the patient's message</guideline>
-</guidelines>
-
-<examples>
-<example>
-"It sounds like you're going through a difficult time. Would you like to tell me more about what's on your mind?"
-</example>
-
-<example>
-"I hear that things feel heavy right now. What would be most helpful for you to talk about?"
-</example>
-
-<example>
-"Thank you for sharing that with me. How have you been coping with these feelings?"
-</example>
+# Load system prompt from external file
+def _load_triage_question_prompt() -> str:
+    """Load the triage question system prompt from file."""
+    try:
+        from src.config.prompt_loader import load_prompt_from_file
+        return load_prompt_from_file('triage_question.txt')
+    except (ImportError, FileNotFoundError) as e:
+        logger.warning(f"Could not load triage question prompt from file: {e}")
+        # Fallback to a minimal prompt
+        return """You are a compassionate healthcare assistant. Ask ONE empathetic, non-judgmental clarifying question to better understand the patient's situation. Respond in the same language as the patient's message. Respond with ONLY the question text."""
 
-<example>
-"I can sense this is weighing on you. What's been the hardest part for you?"
-</example>
-
-<example>
-"You mentioned feeling [emotion]. Can you tell me more about that?"
-</example>
-
-<example>
-"Is there someone you can talk to about how you're feeling?"
-</example>
-</examples>
+# System prompt for generating triage questions
+SYSTEM_PROMPT_TRIAGE_QUESTION = _load_triage_question_prompt()
 
-<output_format>
-Respond with ONLY the question text, no JSON or formatting. Match the patient's language.
-</output_format>"""
 
+# Load system prompt from external file
+def _load_triage_evaluate_prompt() -> str:
+    """Load the triage evaluation system prompt from file."""
+    try:
+        from src.config.prompt_loader import load_prompt_from_file
+        return load_prompt_from_file('triage_evaluator.txt')
+    except (ImportError, FileNotFoundError) as e:
+        logger.warning(f"Could not load triage evaluate prompt from file: {e}")
+        # Fallback to a minimal prompt
+        return """You are evaluating a patient's response during a wellness check. Determine the outcome: "resolved_green" (no distress), "escalate_red" (clear distress), or "continue" (need more info). Respond with JSON: {"outcome": "resolved_green|escalate_red|continue", "indicators": [], "reasoning": "explanation", "confidence": 0.0-1.0}"""
 
 # System prompt for evaluating triage responses
-SYSTEM_PROMPT_TRIAGE_EVALUATE = """<system_role>
-You are evaluating a patient's response during a gentle wellness check. Based on the patient's response, determine the appropriate outcome to guide next steps.
-
-IMPORTANT: You have access to the full classification definitions to make accurate decisions.
-</system_role>
-
-<classification_definitions>
-<category name="GREEN" description="No spiritual/emotional distress">
-The patient's situation is NOT caused by and is NOT causing emotional/spiritual distress. The concern is:
-- Due to external factors (time constraints, routine changes, logistics)
-- Medical symptoms without emotional distress component
-- Temporary circumstances that patient is managing well
-- Patient has adequate support and coping mechanisms
-</category>
-
-<category name="RED" description="Clear spiritual/emotional distress requiring support">
-The patient shows clear indicators of emotional or spiritual distress:
-- Loss of meaning, purpose, or hope
-- Sadness, despair, grief that is affecting functioning
-- Spiritual questioning with distress (anger at God, loss of faith)
-- Identity disruption ("I don't know who I am anymore")
-- Isolation combined with distress
-- Guilt, shame, or remorse causing suffering
-- Crisis language (hopelessness, wanting to give up)
-- Patient with mental health condition expressing distress
-- Anticipatory emotional response causing distress
-</category>
-
-<category name="YELLOW" description="Ambiguous - need more information">
-It remains UNCLEAR whether the patient's situation is caused by or is causing emotional/spiritual distress. Use this only when you genuinely cannot determine if distress is present.
-</category>
-</classification_definitions>
-
-<outcome_categories>
-<outcome name="RESOLVED_GREEN" action="return_to_medical">
-<description>Patient's response indicates NO spiritual/emotional distress - situation is due to external factors</description>
-<indicators>
-- External causes identified: time constraints, routine changes, medical symptoms without emotional component
-- Patient mentions coping strategies or support from others
-- Describes temporary stress that is manageable
-- Reports feeling better or having resources
-- Shows resilience or positive outlook
-- Concern is logistical/practical, not emotional/spiritual
-</indicators>
-<examples>
-"I'm just having a bad day, but I have my family to talk to"
-"It's been tough, but I'm managing with my therapist's help"
-"I haven't been sleeping well because of my medication schedule"
-"I'm just busy with appointments, that's why I'm stressed"
-"My routine changed because of the treatment, but I'm adjusting"
-</examples>
-</outcome>
-
-<outcome name="ESCALATE_RED" action="generate_referral">
-<description>Patient's response indicates clear emotional/spiritual distress requiring support</description>
-<indicators>
-- Loss of meaning, purpose, or hope expressed
-- Sadness, despair, grief affecting daily life
-- Spiritual distress (anger at God, questioning faith with pain)
-- Identity disruption or loss of self
-- Persistent hopelessness without relief
-- Complete isolation with no support system
-- Inability to cope or function
-- Worsening symptoms or deterioration
-- Continued crisis language
-- Patient with mental health condition expressing distress
-- Anticipatory emotional response causing suffering
-</indicators>
-<examples>
-"I feel completely alone and nothing helps anymore"
-"Every day is worse, I can't see a way forward"
-"I don't know who I am anymore since the diagnosis"
-"What's the point of any of this?"
-"I feel like God has abandoned me"
-"I'm so sad all the time, I can't enjoy anything"
-"I'm terrified about what's going to happen and can't stop thinking about it"
-</examples>
-</outcome>
-
-<outcome name="CONTINUE" action="ask_another_question">
-<description>Response is still ambiguous - need more information to determine if distress is present</description>
-<indicators>
-- Vague or unclear response that doesn't clarify cause
-- Patient deflecting or avoiding the question
-- Mixed signals that need exploration
-- Cannot determine if external factors or emotional distress
-</indicators>
-<examples>
-"I don't know, it's complicated"
-"Maybe, I'm not sure"
-"Things are just different now"
-</examples>
-</outcome>
-</outcome_categories>
-
-<yellow_flow_logic>
-CRITICAL: The purpose of triage is to CLARIFY ambiguity. Apply these rules:
-
-1. If patient's response indicates EXTERNAL CAUSES (time, routine, medical symptoms, logistics) → RESOLVED_GREEN
-2. If patient's response indicates EMOTIONAL/SPIRITUAL DISTRESS (loss of meaning, sadness, despair, grief, spiritual pain) → ESCALATE_RED
-3. If patient with known mental health condition expresses emotional distress → ESCALATE_RED
-4. If patient expresses anticipatory emotional response causing distress → ESCALATE_RED
-5. If response is still ambiguous and you cannot determine cause → CONTINUE (if questions remain)
-</yellow_flow_logic>
-
-<evaluation_process>
-<step>Review the patient's response carefully</step>
-<step>Identify if response indicates EXTERNAL causes (→ GREEN) or EMOTIONAL/SPIRITUAL distress (→ RED)</step>
-<step>Apply the yellow_flow_logic rules</step>
-<step>If still ambiguous and questions remain, choose CONTINUE</step>
-<step>Assess confidence in your determination</step>
-</evaluation_process>
-
-<output_format>
-Respond ONLY with valid JSON in this exact format:
-{
-    "outcome": "resolved_green" | "escalate_red" | "continue",
-    "indicators": ["indicator1", "indicator2"],
-    "reasoning": "Brief explanation of why you chose this outcome based on the classification definitions",
-    "confidence": 0.0-1.0
-}
-
-Do not include any text before or after the JSON object.
-</output_format>"""
+SYSTEM_PROMPT_TRIAGE_EVALUATE = _load_triage_evaluate_prompt()
 
 
 class SoftTriageManager:

src/core/spiritual_monitor.py

@@ -61,225 +61,28 @@ YELLOW_FLAG_INDICATORS = [
 ]
 
 
-# System prompt for spiritual classification
-SYSTEM_PROMPT_SPIRITUAL_MONITOR = """<system_role>
+# Load system prompt from external file
+def _load_spiritual_monitor_prompt() -> str:
+    """Load the spiritual monitor system prompt from file."""
+    try:
+        from src.config.prompt_loader import load_prompt_from_file
+        return load_prompt_from_file('spiritual_monitor.txt')
+    except (ImportError, FileNotFoundError) as e:
+        logger.warning(f"Could not load spiritual monitor prompt from file: {e}")
+        # Fallback to a minimal prompt
+        return """<system_role>
 You are a background spiritual distress classifier for a medical chatbot. Your task is to analyze patient messages and classify their level of spiritual or emotional distress to help route them to appropriate support.
 </system_role>
 
-<classification_categories>
-You must classify this message into exactly ONE of the following three categories:
-
-<category name="GREEN" severity="no_distress">
-The message contains only medical symptoms, routine questions, appointment scheduling, medication inquiries, or other standard healthcare topics. There are no indicators of emotional or spiritual distress.
-</category>
-
-<category name="YELLOW" severity="ambiguous_distress">
-The message contains indicators where it is UNCLEAR whether the patient's situation is caused by or is causing emotional/spiritual distress, or if it is due to something else (medical symptoms, pain, temporary circumstances, external factors).
-
-YELLOW is NOT about severity level - it is about AMBIGUITY. Use YELLOW when you need more information to determine if the situation warrants spiritual care support.
-
-Common YELLOW scenarios:
-- Patient mentions potentially distressing circumstances without expressing emotional distress
-- Patient reports loss of loved one but hasn't expressed how they're coping emotionally
-- Patient mentions having no help but hasn't indicated if this is causing distress
-- Patient describes difficult situation but cause of any distress is unclear
-
-Indicators that may warrant YELLOW classification:
-
-<emotional_expressions>
-- Sleep difficulties, insomnia (Dysomnias/Difficulty sleeping)
-- Fatigue, emotional exhaustion
-- Anxiety, worry, fear
-- Depressive symptoms, sadness
-- Crying (may indicate deeper distress)
-</emotional_expressions>
-
-<spiritual_existential_concerns>
-- Spiritual or existential questions (about God, faith, life's meaning, purpose)
-- Questions about identity: "Who am I now?" "I don't recognize myself"
-- Questions about suffering: "Why is this happening to me?" "What's the purpose of this pain?"
-- Concerns about beliefs, values system
-- Desire to share intense spiritual/religious experiences
-</spiritual_existential_concerns>
-
-<loss_and_grief>
-- Grief or loss (not acute crisis)
-- Loss of interest in hobbies, creative expression, nature
-- Anticipatory grieving
-- Grieving in the context of life review
-- Regret about past actions or decisions
-</loss_and_grief>
-
-<social_relational>
-- Loneliness or isolation
-- Feeling alienated from relationships
-- Concerns about family, being a burden
-- Inadequate interpersonal relations
-- Separation from support system
-</social_relational>
-
-<control_and_autonomy>
-- Feeling overwhelmed or stressed
-- Loss of control, confidence, serenity
-- Insufficient courage to face challenges
-- Loss of independence
-- Difficulty accepting aging process
-</control_and_autonomy>
-
-<spiritual_practices>
-- Altered religious ritual or spiritual practice
-- Impaired ability for introspection
-- Cultural conflict with medical culture
-- Inadequate environmental control for spiritual needs
-</spiritual_practices>
-
-<examples>
-"I can't sleep at night, my mind won't stop racing" (unclear if medical or emotional cause)
-"I used to love gardening, but now I can't" (unclear if causing distress or just factual)
-"My mother passed away last month" (unclear how patient is coping emotionally)
-"I don't have anyone to help me at home" (unclear if this is causing distress)
-"I've been feeling tired lately" (could be medical or emotional)
-"Things have been difficult since my diagnosis" (unclear extent of emotional impact)
-"I'm worried about my upcoming surgery" (normal concern vs spiritual distress unclear)
-"I haven't been able to go to church lately" (unclear if causing spiritual distress)
-</examples>
-
-<yellow_follow_up_purpose>
-When classifying as YELLOW, the purpose of follow-up questions is to CLARIFY:
-- Is the situation CAUSING emotional/spiritual distress? → Escalate to RED
-- Is the distress due to external factors (time, routine, medical symptoms)? → Downgrade to GREEN
-- Does the patient express loss of meaning, sadness, despair, grief? → Escalate to RED
-</yellow_follow_up_purpose>
-</category>
-
-<category name="RED" severity="severe_distress">
-The message contains indicators of severe distress or crisis, including:
-
-<crisis_language>
-- ANY mention of suicide, suicidal thoughts, or suicidal ideation
-- Self-harm thoughts or behaviors
-- Explicit wishes to die or not wake up
-- Statements like "I can't go on," "I want to end it," "no reason to live"
-- "Better off dead," "wish I was dead," "want to disappear"
-- Active crisis or emergency language
-</crisis_language>
+Classify messages as:
+- "green": No spiritual/emotional distress indicators
+- "yellow": Ambiguous - need clarification 
+- "red": Clear distress requiring support
 
-<severe_emotional_states>
-- Anger (especially spiritual anger toward God/higher power)
-- Excessive guilt that dominates daily functioning
-- Severe hopelessness combined with crisis language
-- Complete loss of hope for the future
-- Expressing suffering that feels unbearable
-- Spiritual pain (soul-level suffering beyond physical)
-</severe_emotional_states>
+Respond with JSON: {"state": "green|yellow|red", "indicators": [], "confidence": 0.0-1.0, "reasoning": "explanation"}"""
 
-<grief_and_loss_severe>
-- Disenfranchised grief (unrecognized by society)
-- Maladaptive grieving (prolonged, unresolved)
-- Complicated grief (persistent, intense, disrupts life)
-- Loss of a loved one combined with crisis language
-</grief_and_loss_severe>
-
-<existential_crisis>
-- Questioning meaning of life with despair: "What's the point of any of this?"
-- Questioning meaning of suffering with hopelessness
-- Questioning own dignity: "Am I still worth anything?" "Am I just a burden?"
-- Complete loss of identity and purpose
-</existential_crisis>
-
-<expressions_of_severe_distress>
-- Feeling of emptiness (profound inner void)
-- Feeling unloved, worthless, unwanted
-- Need for forgiveness (overwhelming guilt/remorse)
-- Inability to experience transcendence or supportive forces
-- Feeling of having unfinished business (with urgency/despair)
-- Concern about medical treatment (with desperation/giving up)
-</expressions_of_severe_distress>
-
-<physical_manifestations>
-- Uncontrolled pain (causing existential distress)
-- Pain that makes patient question if life is worth living
-</physical_manifestations>
-
-<examples>
-"I can't take this anymore, I want it to end"
-"There's no point in going on, I'm just a burden"
-"I wish I wouldn't wake up tomorrow"
-"Life has no meaning anymore, why continue?"
-"I feel completely empty inside, nothing matters"
-"God has abandoned me, I'm worthless"
-"The pain is unbearable, I can't do this anymore"
-"I want to kill myself"
-"Better off dead"
-"No reason to live"
-"I can't go on like this"
-</examples>
-</category>
-</classification_categories>
-
-<critical_rules>
-1. ANY mention of suicide, self-harm, death wishes, or wanting to die is ALWAYS classified as RED, regardless of other content
-2. When uncertain between GREEN and YELLOW, always choose YELLOW (err on the side of caution)
-3. When uncertain between YELLOW and RED, carefully evaluate for active crisis language - if present, choose RED
-4. Spiritual questions alone (without crisis indicators) are YELLOW, not RED
-5. Multiple YELLOW indicators together still remain YELLOW unless crisis language is present
-6. Physical pain or medical symptoms alone are GREEN unless accompanied by emotional/spiritual distress language
-7. Patient with known mental health condition who expresses emotional or spiritual distress → RED (regardless of diagnosis)
-8. Patient expressing anticipatory emotional response causing distress → RED
-9. YELLOW is about AMBIGUITY, not severity - use YELLOW when you need clarification about whether distress is present
-10. If patient clearly expresses emotional/spiritual distress (loss of meaning, sadness, despair, grief) → RED, not YELLOW
-</critical_rules>
-
-<analysis_process>
-Before providing your classification, use the scratchpad to think through your analysis:
-
-<scratchpad>
-- Identify any distress indicators present in the message
-- Note the severity level of each indicator
-- Consider whether crisis language is present
-- Determine which category best fits
-- Assess your confidence level
-</scratchpad>
-</analysis_process>
-
-<output_format>
-After your analysis, provide your classification in valid JSON format with the following structure:
-- "state": Must be exactly "green", "yellow", or "red" (lowercase)
-- "indicators": An array of specific distress indicators found (empty array [] if none)
-- "confidence": A number between 0.0 and 1.0 representing your confidence in the classification
-- "reasoning": A brief 1-2 sentence explanation of why you chose this classification
-
-Your response must be ONLY valid JSON in this exact format:
-{
-    "state": "green" | "yellow" | "red",
-    "indicators": ["indicator1", "indicator2"],
-    "confidence": 0.0-1.0,
-    "reasoning": "Brief explanation"
-}
-
-Do not include any text before or after the JSON object.
-</output_format>
-
-<consent_based_messaging>
-CRITICAL FOR RED CLASSIFICATIONS:
-When a message is classified as RED, the system will generate a response that asks for patient CONSENT before connecting them with spiritual care support. This is essential for patient autonomy.
-
-The response MUST:
-- Ask for permission before sharing patient information
-- Use phrases like "Would you be open to..." or "Would you like..."
-- Respect patient's right to decline
-
-The response MUST NOT:
-- Assume the patient wants to be connected with support
-- Use assumptive language like "I'm connecting you with..." or "Someone will reach out..."
-- Make decisions on behalf of the patient
-
-Example of CORRECT consent-based language:
-"Some patients who feel this way find it helpful to talk with someone from our spiritual care team. Would you be open to me sharing your information so they can reach out to you?"
-
-Example of INCORRECT assumptive language (DO NOT USE):
-"I'm connecting you with our spiritual care team so someone can reach out to you personally."
-</consent_based_messaging>"""
+# System prompt for spiritual classification
+SYSTEM_PROMPT_SPIRITUAL_MONITOR = _load_spiritual_monitor_prompt()
 
 
 class SpiritualMonitor:

src/core/spiritual_state.py

@@ -22,12 +22,14 @@ class SpiritualState(Enum):
     GREEN: Normal - no distress indicators detected
     YELLOW: Potential - soft triage in progress (max 3 questions)
     RED: Severe - referral needed
+    AWAITING_CONSENT: RED detected, waiting for patient consent response
     
     Requirements: 5.1, 7.1
     """
     GREEN = "green"
     YELLOW = "yellow"
     RED = "red"
+    AWAITING_CONSENT = "awaiting_consent"
 
 
 class TriageOutcome(Enum):
@@ -101,10 +103,11 @@ class SessionSpiritualState:
     Tracks current state, triage session (if active), and history.
     
     Attributes:
-        spiritual_state: Current state (GREEN/YELLOW/RED)
+        spiritual_state: Current state (GREEN/YELLOW/RED/AWAITING_CONSENT)
         triage_session: Active triage session (None if not in YELLOW)
         last_assessment: Most recent spiritual assessment
         state_history: List of state transitions for debugging
+        pending_referral: Referral data waiting for consent (None if not awaiting)
         
     Requirements: 7.1, 7.2, 7.3
     """
@@ -112,6 +115,7 @@ class SessionSpiritualState:
     triage_session: Optional[TriageSession] = None
     last_assessment: Optional[SpiritualAssessment] = None
     state_history: List[str] = field(default_factory=list)
+    pending_referral: Optional[dict] = None
     
     def transition_to(self, new_state: SpiritualState, reason: str = ""):
         """
@@ -157,6 +161,10 @@ class SessionSpiritualState:
         """Check if currently in soft triage (YELLOW state)."""
         return self.spiritual_state == SpiritualState.YELLOW
     
+    def is_awaiting_consent(self) -> bool:
+        """Check if waiting for patient consent response."""
+        return self.spiritual_state == SpiritualState.AWAITING_CONSENT
+    
     def should_force_triage_decision(self) -> bool:
         """
         Check if triage should force a decision.

src/interface/simplified_gradio_app.py

@@ -186,6 +186,27 @@ def create_simplified_interface():
                         if debug_mode:
                             gr.Markdown("### 🔧 Debug Info")
                             debug_info = gr.Markdown(value="")
+                    
+                    # Provider Summary Panel (for RED flags) - always visible but content controlled
+                    with gr.Column(scale=1) as provider_summary_column:
+                        with gr.Group(visible=False) as provider_summary_content:
+                            gr.Markdown("### 📋 Provider Summary")
+                            gr.Markdown("*For Spiritual Care Team*", elem_classes=["provider-subtitle"])
+                            
+                            provider_summary_status = gr.Markdown(
+                                value="**Provider Summary Generated**\n\nA detailed summary has been generated for the spiritual care team. Use the Download button below to access the full summary."
+                            )
+                            
+                            with gr.Row():
+                                download_summary_btn = gr.DownloadButton(
+                                    "📥 Download Summary", 
+                                    size="sm",
+                                    variant="secondary"
+                                )
+                                clear_summary_btn = gr.Button(
+                                    "🗑️ Clear", 
+                                    size="sm"
+                                )
 
             # Conversation Verification tab (chat-derived)
             with gr.TabItem("🧾 Conversation Verification", id="conversation_verification"):
@@ -626,7 +647,62 @@ CSV note:
             # Get updated conversation stats
             stats = get_conversation_stats(session)
             
-            return new_history, status, session, "", stats
+            # Check for provider summary (RED flag case)
+            provider_summary_text = ""
+            show_provider_panel = False
+            last_summary = session.app_instance.get_last_provider_summary()
+            
+            # Debug logging
+            print(f"DEBUG: last_summary exists: {last_summary is not None}")
+            if last_summary:
+                print(f"DEBUG: summary patient: {last_summary.patient_name}")
+                print(f"DEBUG: summary indicators: {last_summary.indicators}")
+                provider_summary_text = session.app_instance.provider_summary_generator.format_for_display(last_summary)
+                show_provider_panel = True
+                print(f"DEBUG: formatted summary length: {len(provider_summary_text)}")
+                print(f"DEBUG: show_provider_panel: {show_provider_panel}")
+            else:
+                print("DEBUG: No provider summary found")
+            
+            # Debug: print what we're returning
+            print(f"DEBUG RETURN: show_panel={show_provider_panel}, text_len={len(provider_summary_text)}")
+            if provider_summary_text:
+                print(f"DEBUG RETURN: first 100 chars: {provider_summary_text[:100]}")
+            
+            # Format as HTML for display
+            if provider_summary_text:
+                import html
+                escaped_text = html.escape(provider_summary_text)
+                html_content = f"<pre style='white-space: pre-wrap; font-family: monospace; font-size: 11px; background: #fffbeb; padding: 10px; border-radius: 8px; max-height: 400px; overflow-y: auto;'>{escaped_text}</pre>"
+            else:
+                html_content = "<pre style='white-space: pre-wrap; font-family: monospace; font-size: 11px; background: #fffbeb; padding: 10px; border-radius: 8px;'>No summary available</pre>"
+            
+            # Use gr.update for both visibility and value
+            if not provider_summary_text:
+                provider_summary_text = ""
+            
+            # Generate status message for provider summary
+            if show_provider_panel and provider_summary_text:
+                status_msg = f"""**🔴 Provider Summary Generated**
+
+**Patient:** {session.app_instance.patient_info.get('name', 'Test Patient')}
+**Classification:** RED FLAG
+**Indicators:** {len(session.app_instance.get_last_provider_summary().indicators) if session.app_instance.get_last_provider_summary() else 0} distress indicators detected
+**Summary Length:** {len(provider_summary_text)} characters
+
+Use the **Download Summary** button below to access the complete provider summary for the spiritual care team."""
+            else:
+                status_msg = "No provider summary available"
+            
+            return (
+                new_history, 
+                status, 
+                session, 
+                "", 
+                stats, 
+                gr.update(visible=show_provider_panel),  # provider_summary_content visibility
+                status_msg  # provider_summary_status content
+            )
         
         def handle_clear(session: SimplifiedSessionData):
             """Handle clear chat."""
@@ -635,7 +711,8 @@ CSV note:
             
             session.update_activity()
             new_history, status = session.app_instance.reset_session()
-            return new_history, status, session
+            # Also hide provider summary content
+            return new_history, status, session, gr.update(visible=False), "No provider summary available"
         
         def get_status(session: SimplifiedSessionData):
             """Get current status."""
@@ -1847,20 +1924,20 @@ To revert, use "Reset to Default" button.
         send_btn.click(
             handle_message,
             inputs=[msg, chatbot, session_data],
-            outputs=[chatbot, status_box, session_data, msg, conversation_stats]
+            outputs=[chatbot, status_box, session_data, msg, conversation_stats, provider_summary_content, provider_summary_status]
         )
         
         msg.submit(
             handle_message,
             inputs=[msg, chatbot, session_data],
-            outputs=[chatbot, status_box, session_data, msg, conversation_stats]
+            outputs=[chatbot, status_box, session_data, msg, conversation_stats, provider_summary_content, provider_summary_status]
         )
         
         # Clear chat
         clear_btn.click(
             handle_clear,
             inputs=[session_data],
-            outputs=[chatbot, status_box, session_data]
+            outputs=[chatbot, status_box, session_data, provider_summary_content, provider_summary_status]
         )
         
         # Refresh status
@@ -1873,25 +1950,24 @@ To revert, use "Reset to Default" button.
         # Example buttons
         def send_example_with_stats(example_text: str, history, session: SimplifiedSessionData):
             """Send example message and return stats."""
-            new_history, status, updated_session, msg, stats = handle_message(example_text, history, session)
-            return new_history, status, updated_session, msg, stats
+            return handle_message(example_text, history, session)
         
         example_medical.click(
             lambda h, s: send_example_with_stats("I have a headache and feel tired", h, s),
             inputs=[chatbot, session_data],
-            outputs=[chatbot, status_box, session_data, msg, conversation_stats]
+            outputs=[chatbot, status_box, session_data, msg, conversation_stats, provider_summary_content, provider_summary_status]
         )
         
         example_wellness.click(
             lambda h, s: send_example_with_stats("I'm feeling stressed and overwhelmed lately", h, s),
             inputs=[chatbot, session_data],
-            outputs=[chatbot, status_box, session_data, msg, conversation_stats]
+            outputs=[chatbot, status_box, session_data, msg, conversation_stats, provider_summary_content, provider_summary_status]
         )
         
         example_help.click(
             lambda h, s: send_example_with_stats("How can you help me with my health?", h, s),
             inputs=[chatbot, session_data],
-            outputs=[chatbot, status_box, session_data, msg, conversation_stats]
+            outputs=[chatbot, status_box, session_data, msg, conversation_stats, provider_summary_content, provider_summary_status]
         )
         
         # Conversation logging buttons
@@ -1906,6 +1982,51 @@ To revert, use "Reset to Default" button.
             inputs=[session_data],
             outputs=[download_csv_btn]
         )
+        
+        # Provider Summary panel handlers
+        def download_provider_summary(session: SimplifiedSessionData):
+            """Download provider summary as text file."""
+            if session is None:
+                return None
+            
+            last_summary = session.app_instance.get_last_provider_summary()
+            if not last_summary:
+                return None
+            
+            try:
+                import tempfile
+                import os
+                from datetime import datetime
+                
+                # Create temp file with summary
+                timestamp = datetime.now().strftime("%Y%m%d_%H%M%S")
+                filename = f"provider_summary_{timestamp}.txt"
+                filepath = os.path.join(tempfile.gettempdir(), filename)
+                
+                summary_text = session.app_instance.provider_summary_generator.format_for_display(last_summary)
+                with open(filepath, 'w', encoding='utf-8') as f:
+                    f.write(summary_text)
+                
+                return filepath
+            except Exception as e:
+                print(f"Error downloading provider summary: {e}")
+                return None
+        
+        def clear_provider_summary():
+            """Clear provider summary panel."""
+            return gr.update(visible=False), "No provider summary available"
+        
+        download_summary_btn.click(
+            download_provider_summary,
+            inputs=[session_data],
+            outputs=[download_summary_btn]
+        )
+        
+        clear_summary_btn.click(
+            clear_provider_summary,
+            inputs=[],
+            outputs=[provider_summary_content, provider_summary_status]
+        )
 
         # Download helper (used by embedded Conversation Verification tab)
         def _download_latest_verification_json(session: SimplifiedSessionData):

test_provider_summary_ui.py

@@ -0,0 +1,101 @@
+#!/usr/bin/env python3
+"""
+Test script for Provider Summary UI functionality.
+"""
+
+import gradio as gr
+import html as html_module
+from src.core.provider_summary_generator import ProviderSummary, ProviderSummaryGenerator
+from datetime import datetime
+
+def create_test_summary():
+    """Create a test provider summary."""
+    return ProviderSummary(
+        patient_name="Test Patient",
+        patient_phone="555-123-4567",
+        situation_description="Patient expressing suicidal ideation",
+        indicators=["suicidal_thoughts", "hopelessness"],
+        classification="RED",
+        confidence=0.95,
+        reasoning="Patient explicitly mentioned wanting to end their life",
+        triage_context=[],
+        conversation_context="user: I want to end my life\nassistant: I hear you...",
+        generated_at=datetime.now().isoformat()
+    )
+
+def test_interface():
+    """Create test interface for Provider Summary."""
+    
+    with gr.Blocks(title="Provider Summary Test") as demo:
+        gr.Markdown("# Provider Summary Test")
+        
+        # State to store summary
+        summary_state = gr.State(value="")
+        
+        with gr.Row():
+            with gr.Column(scale=2):
+                gr.Markdown("## Chat Simulation")
+                test_btn = gr.Button("🔴 Simulate RED Flag", variant="primary")
+                clear_btn = gr.Button("🗑️ Clear")
+                result_text = gr.Textbox(label="Debug", lines=3)
+                
+            with gr.Column(scale=1, visible=False) as provider_panel:
+                gr.Markdown("### 📋 Provider Summary")
+                gr.Markdown("*For Spiritual Care Team*")
+                
+                # Using simple Textbox - most reliable
+                summary_box = gr.Textbox(
+                    label="",
+                    value="Waiting...",
+                    lines=25,
+                    max_lines=30,
+                    interactive=False
+                )
+                
+                download_btn = gr.DownloadButton("📥 Download", size="sm")
+        
+        # Event handlers
+        def simulate_red_flag():
+            """Simulate RED flag detection."""
+            summary = create_test_summary()
+            generator = ProviderSummaryGenerator()
+            formatted_text = generator.format_for_display(summary)
+            
+            print(f"Generated summary length: {len(formatted_text)}")
+            print(f"First 100 chars: {formatted_text[:100]}")
+            
+            debug_msg = f"Length: {len(formatted_text)}"
+            
+            return (
+                gr.update(visible=True),  # show panel
+                formatted_text,           # update textbox
+                debug_msg,               # debug info
+                formatted_text           # store in state
+            )
+        
+        def clear_summary():
+            """Clear summary."""
+            return (
+                gr.update(visible=False),  # hide panel
+                "Cleared",                 # clear textbox
+                "Cleared",                # debug
+                ""                        # clear state
+            )
+        
+        test_btn.click(
+            simulate_red_flag,
+            inputs=[],
+            outputs=[provider_panel, summary_box, result_text, summary_state]
+        )
+        
+        clear_btn.click(
+            clear_summary,
+            inputs=[],
+            outputs=[provider_panel, summary_box, result_text, summary_state]
+        )
+    
+    return demo
+
+if __name__ == "__main__":
+    demo = test_interface()
+    demo.launch(server_name="0.0.0.0", server_port=7862, share=False)