Imported from jeremylongshore/tons-of-skills-marketplace (plugins/saas-packs/abridge-pack/skills/abridge-common-errors/SKILL.md). Install upstream with npx skills add jeremylongshore/tons-of-skills-marketplace --skill abridge-common-errors. Copyright stays with the author (MIT).

Abridge Common Errors

Overview

Comprehensive troubleshooting guide for Abridge clinical documentation integration. Covers authentication failures, EHR connectivity, audio streaming, note generation, and FHIR push errors.

Prerequisites

Collect a timestamp, sanitized request or session ID, the affected sandbox or production environment, and the relevant HTTP status before investigation. Use a permitted support environment and redact patient names, MRNs, dates of birth, transcripts, and authorization values from every log or ticket.

Instructions

Start with the error code or symptom table, then reproduce only with synthetic data where possible. Check credentials and the FHIR endpoint before retrying a session; validate audio format before changing transcription logic. Run the diagnostic script with secrets supplied by the environment, preserve only its status codes and request identifiers, and escalate with the smallest redacted reproduction when the targeted fix does not resolve the fault.

Error Reference

Authentication & Authorization Errors

Session & Encounter Errors

Audio & Transcription Errors

// Common audio streaming diagnostics
async function diagnoseAudioIssues(wsUrl: string): Promise<string[]> {
  const issues: string[] = [];

  // Check WebSocket connectivity
  try {
    const ws = new WebSocket(wsUrl);
    await new Promise((resolve, reject) => {
      ws.onopen = resolve;
      ws.onerror = reject;
      setTimeout(() => reject(new Error('Connection timeout')), 5000);
    });
    ws.close();
  } catch {
    issues.push('WebSocket connection failed — check firewall allows wss:// on port 443');
  }

  // Check audio format requirements
  // Abridge requires: 16kHz, mono, 16-bit PCM little-endian
  const requiredFormat = { sampleRate: 16000, channels: 1, encoding: 'pcm_s16le' };
  issues.push(`Verify audio format: ${JSON.stringify(requiredFormat)}`);

  return issues;
}

Note Generation Errors

// Note generation failure handler
async function handleNoteFailure(sessionId: string, error: any): Promise<void> {
  const status = error.response?.status;
  const code = error.response?.data?.error_code;

  switch (code) {
    case 'INSUFFICIENT_CONTENT':
      console.error('Transcript too short — need at least 30 seconds of clinical conversation');
      break;
    case 'UNSUPPORTED_LANGUAGE':
      console.error('Language not in Abridge supported set (28+ languages)');
      break;
    case 'TEMPLATE_NOT_FOUND':
      console.error('Note template not available — use: soap, hp, progress, procedure');
      break;
    case 'GENERATION_TIMEOUT':
      console.error('Note generation exceeded 120s — complex encounter, retry once');
      break;
    default:
      console.error(`Unknown note error: ${status} ${code}`);
  }
}

FHIR Integration Errors

HIPAA Compliance Errors

// PHI leak detection in error logs
function auditErrorLog(error: any): void {
  const serialized = JSON.stringify(error);

  // Check for accidental PHI in error output
  const phiPatterns = [
    /\b\d{3}-\d{2}-\d{4}\b/,        // SSN
    /\b\d{10}\b/,                     // MRN (10-digit)
    /\b[A-Z][a-z]+\s[A-Z][a-z]+\b/,  // Patient names (heuristic)
    /\b\d{1,2}\/\d{1,2}\/\d{4}\b/,   // DOB
  ];

  for (const pattern of phiPatterns) {
    if (pattern.test(serialized)) {
      console.error('WARNING: Possible PHI detected in error log — redact before logging');
      return;
    }
  }
}

Diagnostic Script

#!/bin/bash
# abridge-diagnostic.sh — Run before opening a support ticket

echo "=== Abridge Integration Diagnostics ==="

# 1. Check credentials
echo "Checking credentials..."
curl -s -o /dev/null -w "%{http_code}" \
  -H "Authorization: Bearer $ABRIDGE_CLIENT_SECRET" \
  -H "X-Org-Id: $ABRIDGE_ORG_ID" \
  "${ABRIDGE_BASE_URL}/health"

# 2. Check FHIR server
echo "Checking FHIR connectivity..."
curl -s -o /dev/null -w "%{http_code}" \
  "${EPIC_FHIR_BASE_URL}/metadata"

# 3. Check WebSocket
echo "Checking WebSocket..."
curl -s -o /dev/null -w "%{http_code}" \
  --header "Upgrade: websocket" \
  "${ABRIDGE_BASE_URL/http/ws}/ws/health"

echo "=== Diagnostics Complete ==="

Output

• Identified root cause from error code lookup
• Applied targeted fix for the specific error
• HIPAA-safe error logging verified

Error Handling

Stop and rotate credentials if a secret appears in logs. Do not replay a live patient encounter to investigate an audio or note-generation failure; use a synthetic session and record the resulting request ID. Treat repeated 5xx responses, corrupted sessions, and persistent FHIR authorization failures as support escalations with redacted diagnostics rather than blind retries.

Examples

If a sandbox encounter returns 422 INVALID_SPECIALTY, compare the submitted specialty to the /specialties response, correct the code, and retry the synthetic session once. If a WebSocket disconnects, confirm 16 kHz mono PCM input and network access to port 443; attach the redacted timestamp and request ID to the support ticket, never the clinical transcript.

Resources

• Abridge Platform
• FHIR R4 Operation Outcomes
• HIPAA Breach Notification Rule

Next Steps

For collecting debug evidence for support tickets, see abridge-debug-bundle.