begin: PHI Column Encryption

.gitignore

@@ -92,6 +92,7 @@ packages/
 node_modules/
 dist/
 build/
+data-protection-keys/
 
 # =========================
 # Docker

VigilCareClinicalAPI/Configuration/PhiEncryptionOptions.cs

@@ -0,0 +1,18 @@
+public class PhiEncryptionOptions
+{
+    public const string Section = "PhiEncryption";
+
+    /// <summary>
+    /// Purpose string for IDataProtector. Rotate by changing purpose and re-encrypting.
+    /// </summary>
+    public string ProtectorPurpose { get; set; } = "VigilCare.PatientPhi.v1";
+
+    /// <summary>
+    /// HMAC key for name search tokens (base64). Separate from encryption key.
+    /// In production: store in Key Vault, not appsettings.
+    /// </summary>
+    public string SearchTokenKey { get; set; } = null!;
+
+    /// <summary>When true, logs PHI access for list/search operations as aggregate events.</summary>
+    public bool LogListAccess { get; set; } = true;
+}

VigilCareClinicalAPI/Data/AppDbContext.cs

@@ -2,7 +2,14 @@ using Microsoft.EntityFrameworkCore;
 
 public class AppDbContext : DbContext
 {
-    public AppDbContext(DbContextOptions<AppDbContext> options) : base(options) { }
+    private readonly IPhiEncryptionService? _phiCrypto;
+
+    public AppDbContext(
+        DbContextOptions<AppDbContext> options,
+        IPhiEncryptionService? phiCrypto = null) : base(options)
+    {
+        _phiCrypto = phiCrypto;
+    }
 
     public DbSet<Patient> Patients => Set<Patient>();
     public DbSet<Encounter> Encounters => Set<Encounter>();
@@ -21,9 +28,13 @@ public class AppDbContext : DbContext
     public DbSet<ExternalResourceIdentifier> ExternalResourceIdentifiers => Set<ExternalResourceIdentifier>();
     public DbSet<ClinicalUser> ClinicalUsers => Set<ClinicalUser>();
     public DbSet<ClinicalAuditLog> ClinicalAuditLogs => Set<ClinicalAuditLog>();
+    public DbSet<PhiAccessLog> PhiAccessLogs => Set<PhiAccessLog>();
 
     protected override void OnModelCreating(ModelBuilder modelBuilder)
     {
         modelBuilder.ApplyConfigurationsFromAssembly(typeof(AppDbContext).Assembly);
+
+        if (_phiCrypto is not null)
+            modelBuilder.ConfigurePhiConverters(_phiCrypto);
     }
 }

VigilCareClinicalAPI/Data/Configurations/PatientConfiguration.cs

@@ -21,6 +21,9 @@ public class PatientConfiguration : IEntityTypeConfiguration<Patient>
         builder.Property(p => p.Allergies).HasColumnName("allergies");
         builder.Property(p => p.EmergencyContactName).HasColumnName("emergency_contact_name").HasMaxLength(200);
         builder.Property(p => p.EmergencyContactPhone).HasColumnName("emergency_contact_phone").HasMaxLength(20);
+        builder.Property(p => p.NameSearchToken)
+            .HasColumnName("name_search_token")
+            .HasMaxLength(64);
         builder.Property(p => p.CreatedAt).HasColumnName("created_at").HasDefaultValueSql("NOW()");
 
         // MRN uses exact-match unique index — MRN lookups are always equality checks,
@@ -29,5 +32,6 @@ public class PatientConfiguration : IEntityTypeConfiguration<Patient>
         // equality match — so no index here; full ILIKE is intentionally unindexed
         // at this scale (pg_trgm GIN would be warranted at >500k patients).
         builder.HasIndex(p => p.Mrn).IsUnique();
+        builder.HasIndex(p => p.NameSearchToken);
     }
 }

VigilCareClinicalAPI/Data/Configurations/PhiAccessLogConfiguration.cs

@@ -0,0 +1,27 @@
+using Microsoft.EntityFrameworkCore;
+using Microsoft.EntityFrameworkCore.Metadata.Builders;
+
+public class PhiAccessLogConfiguration : IEntityTypeConfiguration<PhiAccessLog>
+{
+    public void Configure(EntityTypeBuilder<PhiAccessLog> builder)
+    {
+        builder.ToTable("phi_access_logs");
+        builder.HasKey(p => p.Id);
+        builder.Property(p => p.Id).HasColumnName("id").HasDefaultValueSql("gen_random_uuid()");
+        builder.Property(p => p.AccessType).HasColumnName("access_type").HasMaxLength(20).IsRequired()
+            .HasConversion(v => v.ToDbString(), v => PhiAccessTypeExtensions.FromDbString(v));
+        builder.Property(p => p.PatientId).HasColumnName("patient_id");
+        builder.Property(p => p.UserId).HasColumnName("user_id").IsRequired();
+        builder.Property(p => p.UserDisplayName).HasColumnName("user_display_name").HasMaxLength(200).IsRequired();
+        builder.Property(p => p.ResourcePath).HasColumnName("resource_path").HasMaxLength(500).IsRequired();
+        builder.Property(p => p.SearchQueryHash).HasColumnName("search_query_hash").HasMaxLength(64);
+        builder.Property(p => p.ResultCount).HasColumnName("result_count");
+        builder.Property(p => p.IpAddress).HasColumnName("ip_address").HasMaxLength(45);
+        builder.Property(p => p.CorrelationId).HasColumnName("correlation_id").HasMaxLength(100);
+        builder.Property(p => p.AccessedAt).HasColumnName("accessed_at").HasDefaultValueSql("NOW()");
+
+        builder.HasIndex(p => p.PatientId);
+        builder.HasIndex(p => p.UserId);
+        builder.HasIndex(p => p.AccessedAt);
+    }
+}

VigilCareClinicalAPI/Data/PatientPhiConverterConfigurator.cs

@@ -0,0 +1,42 @@
+using Microsoft.EntityFrameworkCore;
+
+public static class PatientPhiConverterConfigurator
+{
+    public static void ConfigurePhiConverters(
+        this ModelBuilder modelBuilder,
+        IPhiEncryptionService crypto)
+    {
+        var entity = modelBuilder.Entity<Patient>();
+
+        entity.Property(p => p.FirstName)
+            .HasConversion(
+                v => crypto.Encrypt(v),
+                v => crypto.Decrypt(v));
+
+        entity.Property(p => p.LastName)
+            .HasConversion(
+                v => crypto.Encrypt(v),
+                v => crypto.Decrypt(v));
+
+        entity.Property(p => p.Allergies)
+            .HasConversion(
+                v => v == null ? null! : crypto.Encrypt(v),
+                v => v == null ? null : crypto.Decrypt(v));
+
+        entity.Property(p => p.EmergencyContactName)
+            .HasConversion(
+                v => v == null ? null! : crypto.Encrypt(v),
+                v => v == null ? null : crypto.Decrypt(v));
+
+        entity.Property(p => p.EmergencyContactPhone)
+            .HasConversion(
+                v => v == null ? null! : crypto.Encrypt(v),
+                v => v == null ? null : crypto.Decrypt(v));
+
+        // DateOfBirth stored as encrypted ISO string
+        entity.Property(p => p.DateOfBirth)
+            .HasConversion(
+                v => crypto.Encrypt(v.ToString("yyyy-MM-dd")),
+                v => DateOnly.Parse(crypto.Decrypt(v)));
+    }
+}

VigilCareClinicalAPI/Domains/Entities/Patient.cs

@@ -10,6 +10,9 @@ public class Patient
     public string? Allergies { get; set; }
     public string? EmergencyContactName { get; set; }
     public string? EmergencyContactPhone { get; set; }
+    
+    /// <summary>HMAC token for name search. Not PHI — enables lookup without decrypting all rows.</summary>
+    public string? NameSearchToken { get; set; }
     public string Status { get; set; } = "active";
     public DateTimeOffset CreatedAt { get; set; }
 

VigilCareClinicalAPI/Domains/Entities/PhiAccessLog.cs

@@ -0,0 +1,14 @@
+public class PhiAccessLog
+{
+    public Guid Id { get; set; }
+    public PhiAccessType AccessType { get; set; }
+    public Guid? PatientId { get; set; }
+    public Guid UserId { get; set; }
+    public string UserDisplayName { get; set; } = null!;
+    public string ResourcePath { get; set; } = null!;
+    public string? SearchQueryHash { get; set; }
+    public int? ResultCount { get; set; }
+    public string? IpAddress { get; set; }
+    public string? CorrelationId { get; set; }
+    public DateTimeOffset AccessedAt { get; set; }
+}

VigilCareClinicalAPI/Domains/Enums/PhiAccessType.cs

@@ -0,0 +1,31 @@
+public enum PhiAccessType
+{
+    View,
+    List,
+    Search,
+    Create,
+    Update
+}
+
+public static class PhiAccessTypeExtensions
+{
+    public static string ToDbString(this PhiAccessType t) => t switch
+    {
+        PhiAccessType.View   => "VIEW",
+        PhiAccessType.List   => "LIST",
+        PhiAccessType.Search => "SEARCH",
+        PhiAccessType.Create => "CREATE",
+        PhiAccessType.Update => "UPDATE",
+        _ => throw new ArgumentOutOfRangeException(nameof(t))
+    };
+
+    public static PhiAccessType FromDbString(string v) => v switch
+    {
+        "VIEW"   => PhiAccessType.View,
+        "LIST"   => PhiAccessType.List,
+        "SEARCH" => PhiAccessType.Search,
+        "CREATE" => PhiAccessType.Create,
+        "UPDATE" => PhiAccessType.Update,
+        _ => throw new ArgumentOutOfRangeException(nameof(v))
+    };
+}

VigilCareClinicalAPI/Migrations/20260622130402_AddPatientNameSearchToken.cs

@@ -0,0 +1,55 @@
+using System;
+using Microsoft.EntityFrameworkCore.Migrations;
+
+#nullable disable
+
+namespace VigilCareClinicalAPI.Migrations
+{
+    /// <inheritdoc />
+    public partial class AddPatientNameSearchToken : Migration
+    {
+        /// <inheritdoc />
+        protected override void Up(MigrationBuilder migrationBuilder)
+        {
+            migrationBuilder.AlterColumn<string>(
+                name: "date_of_birth",
+                table: "patients",
+                type: "text",
+                nullable: false,
+                oldClrType: typeof(DateOnly),
+                oldType: "date");
+
+            migrationBuilder.AddColumn<string>(
+                name: "name_search_token",
+                table: "patients",
+                type: "character varying(64)",
+                maxLength: 64,
+                nullable: true);
+
+            migrationBuilder.CreateIndex(
+                name: "IX_patients_name_search_token",
+                table: "patients",
+                column: "name_search_token");
+        }
+
+        /// <inheritdoc />
+        protected override void Down(MigrationBuilder migrationBuilder)
+        {
+            migrationBuilder.DropIndex(
+                name: "IX_patients_name_search_token",
+                table: "patients");
+
+            migrationBuilder.DropColumn(
+                name: "name_search_token",
+                table: "patients");
+
+            migrationBuilder.AlterColumn<DateOnly>(
+                name: "date_of_birth",
+                table: "patients",
+                type: "date",
+                nullable: false,
+                oldClrType: typeof(string),
+                oldType: "text");
+        }
+    }
+}

VigilCareClinicalAPI/Migrations/20260622130927_AddPhiAccessLogs.cs

@@ -0,0 +1,58 @@
+using System;
+using Microsoft.EntityFrameworkCore.Migrations;
+
+#nullable disable
+
+namespace VigilCareClinicalAPI.Migrations
+{
+    /// <inheritdoc />
+    public partial class AddPhiAccessLogs : Migration
+    {
+        /// <inheritdoc />
+        protected override void Up(MigrationBuilder migrationBuilder)
+        {
+            migrationBuilder.CreateTable(
+                name: "phi_access_logs",
+                columns: table => new
+                {
+                    id = table.Column<Guid>(type: "uuid", nullable: false, defaultValueSql: "gen_random_uuid()"),
+                    access_type = table.Column<string>(type: "character varying(20)", maxLength: 20, nullable: false),
+                    patient_id = table.Column<Guid>(type: "uuid", nullable: true),
+                    user_id = table.Column<Guid>(type: "uuid", nullable: false),
+                    user_display_name = table.Column<string>(type: "character varying(200)", maxLength: 200, nullable: false),
+                    resource_path = table.Column<string>(type: "character varying(500)", maxLength: 500, nullable: false),
+                    search_query_hash = table.Column<string>(type: "character varying(64)", maxLength: 64, nullable: true),
+                    result_count = table.Column<int>(type: "integer", nullable: true),
+                    ip_address = table.Column<string>(type: "character varying(45)", maxLength: 45, nullable: true),
+                    correlation_id = table.Column<string>(type: "character varying(100)", maxLength: 100, nullable: true),
+                    accessed_at = table.Column<DateTimeOffset>(type: "timestamp with time zone", nullable: false, defaultValueSql: "NOW()")
+                },
+                constraints: table =>
+                {
+                    table.PrimaryKey("PK_phi_access_logs", x => x.id);
+                });
+
+            migrationBuilder.CreateIndex(
+                name: "IX_phi_access_logs_accessed_at",
+                table: "phi_access_logs",
+                column: "accessed_at");
+
+            migrationBuilder.CreateIndex(
+                name: "IX_phi_access_logs_patient_id",
+                table: "phi_access_logs",
+                column: "patient_id");
+
+            migrationBuilder.CreateIndex(
+                name: "IX_phi_access_logs_user_id",
+                table: "phi_access_logs",
+                column: "user_id");
+        }
+
+        /// <inheritdoc />
+        protected override void Down(MigrationBuilder migrationBuilder)
+        {
+            migrationBuilder.DropTable(
+                name: "phi_access_logs");
+        }
+    }
+}

VigilCareClinicalAPI/Migrations/AppDbContextModelSnapshot.cs

@@ -828,8 +828,9 @@ namespace VigilCareClinicalAPI.Migrations
                         .HasColumnName("created_at")
                         .HasDefaultValueSql("NOW()");
 
-                    b.Property<DateOnly>("DateOfBirth")
+                    b.Property<string>("DateOfBirth")
-                        .HasColumnType("date")
+                        .IsRequired()
+                        .HasColumnType("text")
                         .HasColumnName("date_of_birth");
 
                     b.Property<string>("EmergencyContactName")
@@ -866,6 +867,11 @@ namespace VigilCareClinicalAPI.Migrations
                         .HasColumnType("character varying(20)")
                         .HasColumnName("mrn");
 
+                    b.Property<string>("NameSearchToken")
+                        .HasMaxLength(64)
+                        .HasColumnType("character varying(64)")
+                        .HasColumnName("name_search_token");
+
                     b.Property<string>("Status")
                         .IsRequired()
                         .ValueGeneratedOnAdd()
@@ -879,9 +885,81 @@ namespace VigilCareClinicalAPI.Migrations
                     b.HasIndex("Mrn")
                         .IsUnique();
 
+                    b.HasIndex("NameSearchToken");
+
                     b.ToTable("patients", (string)null);
                 });
 
+            modelBuilder.Entity("PhiAccessLog", b =>
+                {
+                    b.Property<Guid>("Id")
+                        .ValueGeneratedOnAdd()
+                        .HasColumnType("uuid")
+                        .HasColumnName("id")
+                        .HasDefaultValueSql("gen_random_uuid()");
+
+                    b.Property<string>("AccessType")
+                        .IsRequired()
+                        .HasMaxLength(20)
+                        .HasColumnType("character varying(20)")
+                        .HasColumnName("access_type");
+
+                    b.Property<DateTimeOffset>("AccessedAt")
+                        .ValueGeneratedOnAdd()
+                        .HasColumnType("timestamp with time zone")
+                        .HasColumnName("accessed_at")
+                        .HasDefaultValueSql("NOW()");
+
+                    b.Property<string>("CorrelationId")
+                        .HasMaxLength(100)
+                        .HasColumnType("character varying(100)")
+                        .HasColumnName("correlation_id");
+
+                    b.Property<string>("IpAddress")
+                        .HasMaxLength(45)
+                        .HasColumnType("character varying(45)")
+                        .HasColumnName("ip_address");
+
+                    b.Property<Guid?>("PatientId")
+                        .HasColumnType("uuid")
+                        .HasColumnName("patient_id");
+
+                    b.Property<string>("ResourcePath")
+                        .IsRequired()
+                        .HasMaxLength(500)
+                        .HasColumnType("character varying(500)")
+                        .HasColumnName("resource_path");
+
+                    b.Property<int?>("ResultCount")
+                        .HasColumnType("integer")
+                        .HasColumnName("result_count");
+
+                    b.Property<string>("SearchQueryHash")
+                        .HasMaxLength(64)
+                        .HasColumnType("character varying(64)")
+                        .HasColumnName("search_query_hash");
+
+                    b.Property<string>("UserDisplayName")
+                        .IsRequired()
+                        .HasMaxLength(200)
+                        .HasColumnType("character varying(200)")
+                        .HasColumnName("user_display_name");
+
+                    b.Property<Guid>("UserId")
+                        .HasColumnType("uuid")
+                        .HasColumnName("user_id");
+
+                    b.HasKey("Id");
+
+                    b.HasIndex("AccessedAt");
+
+                    b.HasIndex("PatientId");
+
+                    b.HasIndex("UserId");
+
+                    b.ToTable("phi_access_logs", (string)null);
+                });
+
             modelBuilder.Entity("ReconciliationAlert", b =>
                 {
                     b.Property<Guid>("Id")

VigilCareClinicalAPI/Program.cs

@@ -14,6 +14,7 @@ using Microsoft.IdentityModel.Tokens;
 using Microsoft.AspNetCore.Authorization;
 using System.Text;
 using Microsoft.OpenApi;
+using Microsoft.AspNetCore.DataProtection;
 
 Log.Logger = new LoggerConfiguration()
     .WriteTo.Console()
@@ -72,8 +73,10 @@ try
                   .Enrich.WithThreadId());
     }
 
-    builder.Services.AddDbContext<AppDbContext>(opts =>
+    builder.Services.AddDbContext<AppDbContext>((sp, opts) =>
-        opts.UseNpgsql(builder.Configuration.GetConnectionString("DefaultConnection")));
+    {
+        opts.UseNpgsql(builder.Configuration.GetConnectionString("DefaultConnection"));
+    });
 
     builder.Services.AddSingleton<IConnectionMultiplexer>(sp =>
         ConnectionMultiplexer.Connect(sp.GetRequiredService<IConfiguration>()["Redis:ConnectionString"]!));
@@ -129,6 +132,14 @@ try
     builder.Services.Configure<PatientOptions>(
         builder.Configuration.GetSection(PatientOptions.Section));
 
+    builder.Services.AddDataProtection()
+    .PersistKeysToFileSystem(new DirectoryInfo(
+        builder.Configuration["DataProtection:KeyPath"] ?? "./data-protection-keys"))
+    .SetApplicationName("VigilCareClinical");
+
+    builder.Services.Configure<PhiEncryptionOptions>(
+    builder.Configuration.GetSection(PhiEncryptionOptions.Section));
+
     builder.Services.AddCors(options =>
     {
         options.AddPolicy("Dashboard", policy =>
@@ -180,6 +191,8 @@ try
     builder.Services.AddScoped<ICurrentUserService, CurrentUserService>();
     builder.Services.AddScoped<IAuthService, AuthService>();
     builder.Services.AddScoped<IAuditService, AuditService>();
+    builder.Services.AddSingleton<IPhiEncryptionService, PhiEncryptionService>();
+    builder.Services.AddScoped<IPhiAccessLogService, PhiAccessLogService>();
     
     builder.Services.AddHostedService<ThresholdCacheLoader>();
     builder.Services.AddHostedService<KafkaTopicProvisioner>();

VigilCareClinicalAPI/Services/Interfaces/IPhiAccessLogService.cs

@@ -0,0 +1,7 @@
+public interface IPhiAccessLogService
+{
+    Task LogViewAsync(Guid patientId, string resourcePath);
+    Task LogListAsync(string resourcePath, int resultCount, string? searchQuery = null);
+    Task LogCreateAsync(Guid patientId, string resourcePath);
+    Task LogUpdateAsync(Guid patientId, string resourcePath);
+}

VigilCareClinicalAPI/Services/Interfaces/IPhiEncryptionService.cs

@@ -0,0 +1,7 @@
+public interface IPhiEncryptionService
+{
+    string Encrypt(string plaintext);
+    string Decrypt(string ciphertext);
+    string ComputeNameSearchToken(string firstName, string lastName);
+    bool IsEncrypted(string value);
+}

VigilCareClinicalAPI/Services/PatientService.cs

@@ -8,17 +8,26 @@ public class PatientService : IPatientService
     private readonly IExternalIdentifierService _identifiers;
     private readonly IAuditService _audit;
     private readonly PatientOptions _options;
+    private readonly IPhiEncryptionService _crypto;
+    private readonly IPhiAccessLogService _phiAccess;
+    private readonly IHttpContextAccessor _http;
 
     public PatientService(
         AppDbContext db,
         IExternalIdentifierService identifiers,
         IAuditService audit,
-        IOptions<PatientOptions> options)
+        IOptions<PatientOptions> options,
+        IPhiEncryptionService crypto,
+        IPhiAccessLogService phiAccess,
+        IHttpContextAccessor http)
     {
         _db = db;
         _identifiers = identifiers;
         _audit = audit;
         _options = options.Value;
+        _crypto = crypto;
+        _phiAccess = phiAccess;
+        _http = http;
     }
 
     public async Task<Patient> RegisterAsync(RegisterPatientRequest req)
@@ -37,6 +46,7 @@ public class PatientService : IPatientService
             EmergencyContactPhone = req.EmergencyContactPhone,
             CreatedAt = DateTimeOffset.UtcNow
         };
+        SetNameSearchToken(patient);
         _db.Patients.Add(patient);
 
         try
@@ -260,4 +270,10 @@ public class PatientService : IPatientService
             .SingleAsync();
         return $"{_options.MrnPrefix}-{seq.ToString($"D{_options.MrnDigits}")}";
     }
+
+    private void SetNameSearchToken(Patient patient)
+    {
+        patient.NameSearchToken = _crypto.ComputeNameSearchToken(
+            patient.FirstName, patient.LastName);
+    }
 }

VigilCareClinicalAPI/Services/PhiAccessLogService.cs

@@ -0,0 +1,78 @@
+using System.Security.Cryptography;
+using System.Text;
+using Microsoft.Extensions.Options;
+
+public class PhiAccessLogService : IPhiAccessLogService
+{
+    private readonly AppDbContext _db;
+    private readonly ICurrentUserService _currentUser;
+    private readonly IHttpContextAccessor _http;
+    private readonly PhiEncryptionOptions _options;
+
+    public PhiAccessLogService(
+        AppDbContext db,
+        ICurrentUserService currentUser,
+        IHttpContextAccessor http,
+        IOptions<PhiEncryptionOptions> options)
+    {
+        _db = db;
+        _currentUser = currentUser;
+        _http = http;
+        _options = options.Value;
+    }
+
+    public async Task LogViewAsync(Guid patientId, string resourcePath) =>
+        await WriteAsync(PhiAccessType.View, patientId, resourcePath);
+
+    public async Task LogCreateAsync(Guid patientId, string resourcePath) =>
+        await WriteAsync(PhiAccessType.Create, patientId, resourcePath);
+
+    public async Task LogUpdateAsync(Guid patientId, string resourcePath) =>
+        await WriteAsync(PhiAccessType.Update, patientId, resourcePath);
+
+    public async Task LogListAsync(string resourcePath, int resultCount, string? searchQuery = null)
+    {
+        if (!_options.LogListAccess)
+            return;
+
+        var accessType = string.IsNullOrWhiteSpace(searchQuery)
+            ? PhiAccessType.List
+            : PhiAccessType.Search;
+
+        await WriteAsync(accessType, null, resourcePath, resultCount, searchQuery);
+    }
+
+    private async Task WriteAsync(
+        PhiAccessType accessType,
+        Guid? patientId,
+        string resourcePath,
+        int? resultCount = null,
+        string? searchQuery = null)
+    {
+        if (!_currentUser.IsAuthenticated || _currentUser.UserId is null)
+            return; // machine/integration paths may skip — Phase 31 Integration role should still auth
+
+        _db.PhiAccessLogs.Add(new PhiAccessLog
+        {
+            Id = Guid.NewGuid(),
+            AccessType = accessType,
+            PatientId = patientId,
+            UserId = _currentUser.UserId.Value,
+            UserDisplayName = _currentUser.DisplayName ?? _currentUser.Username ?? "Unknown",
+            ResourcePath = resourcePath,
+            SearchQueryHash = searchQuery is null ? null : HashQuery(searchQuery),
+            ResultCount = resultCount,
+            IpAddress = _currentUser.IpAddress,
+            CorrelationId = _http.HttpContext?.Items["CorrelationId"]?.ToString(),
+            AccessedAt = DateTimeOffset.UtcNow
+        });
+
+        await _db.SaveChangesAsync();
+    }
+
+    private static string HashQuery(string query)
+    {
+        var hash = SHA256.HashData(Encoding.UTF8.GetBytes(query.Trim().ToLowerInvariant()));
+        return Convert.ToHexString(hash).ToLowerInvariant();
+    }
+}

VigilCareClinicalAPI/Services/PhiEncryptionService.cs

@@ -0,0 +1,48 @@
+using System.Security.Cryptography;
+using System.Text;
+using Microsoft.AspNetCore.DataProtection;
+using Microsoft.Extensions.Options;
+
+public class PhiEncryptionService : IPhiEncryptionService
+{
+    private readonly IDataProtector _protector;
+    private readonly byte[] _searchKey;
+
+    public PhiEncryptionService(
+        IDataProtectionProvider provider,
+        IOptions<PhiEncryptionOptions> options)
+    {
+        var opts = options.Value;
+        _protector = provider.CreateProtector(opts.ProtectorPurpose);
+        _searchKey = Convert.FromBase64String(
+            Convert.ToBase64String(Encoding.UTF8.GetBytes(opts.SearchTokenKey))[..44]); // normalize dev key
+    }
+
+    public string Encrypt(string plaintext)
+    {
+        if (string.IsNullOrEmpty(plaintext))
+            return plaintext;
+        return _protector.Protect(plaintext);
+    }
+
+    public string Decrypt(string ciphertext)
+    {
+        if (string.IsNullOrEmpty(ciphertext))
+            return ciphertext;
+        if (!IsEncrypted(ciphertext))
+            return ciphertext; // migration transition: plaintext rows still readable
+        return _protector.Unprotect(ciphertext);
+    }
+
+    public bool IsEncrypted(string value) =>
+        value.StartsWith("CfDJ8", StringComparison.Ordinal) || // DataProtection prefix
+        value.Length > 50; // heuristic for protected payloads
+
+    public string ComputeNameSearchToken(string firstName, string lastName)
+    {
+        var normalized = $"{firstName.Trim().ToLowerInvariant()}|{lastName.Trim().ToLowerInvariant()}";
+        using var hmac = new HMACSHA256(_searchKey);
+        var hash = hmac.ComputeHash(Encoding.UTF8.GetBytes(normalized));
+        return Convert.ToHexString(hash).ToLowerInvariant();
+    }
+}

VigilCareClinicalAPI/appsettings.json

@@ -196,5 +196,13 @@
     "Audience": "VigilCareClinical.Dashboard",
     "SigningKey": "DEV-ONLY-REPLACE-WITH-256-BIT-SECRET-IN-PRODUCTION-abc123xyz",
     "ExpirationMinutes": 480
+  },
+  "PhiEncryption": {
+    "ProtectorPurpose": "VigilCare.PatientPhi.v1",
+    "SearchTokenKey": "DEV-ONLY-HMAC-KEY-REPLACE-IN-PRODUCTION-32bytes!!",
+    "LogListAccess": true
+  },
+  "DataProtection": {
+    "KeyPath": "./data-protection-keys"
   }
 }