Add visit-confirmed to extensions

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What it does

VisitConfirmed is an AI scheduling agent that confirms patient appointments over two-way SMS and voice. This plugin forwards Canvas appointment lifecycle events (created, rescheduled, cancelled, no-show) to VisitConfirmed, which then contacts the patient in the practice's name, answers what they ask, and passes only the exceptions back to staff.

One handler, visit_confirmed.handlers.appointment_events:AppointmentEvents, responding to APPOINTMENT_CREATED, APPOINTMENT_CANCELED, and APPOINTMENT_NO_SHOWED. A create linked via appointment_rescheduled_from is reported as a reschedule.

On PHI

The plugin's payload carries resource IDs and scheduling metadata only, no names or contact details, and it logs none either. To be straightforward about the whole picture rather than just the plugin: VisitConfirmed does read patient demographics, over a separate scoped FHIR connection the practice authorizes under a BAA. The README's Privacy section states both channels explicitly rather than leaving the impression that no patient data leaves Canvas.

It is inbound only and never writes appointments back into Canvas.

Configuration

Two sensitive variables, VISIT_CONFIRMED_API_URL and VISIT_CONFIRMED_API_KEY. The handler fails closed if either is unset: it logs an error and makes no outbound call.

Verification

canvas validate-manifest visit_confirmed   valid
canvas validate visit_confirmed            handler loads cleanly in the sandbox
uv run pytest                              6 passed
uv run pytest --cov                        100% branch coverage
uv run mypy visit_confirmed                clean

mypy.ini is copied from extensions/missed-appointment-notifications so local results match review. Structure follows that plugin as well, including docs/ inside the package.

The README screenshot is generated from docs/canvas-appointment-confirmation.source.html, committed beside it so it can be re-rendered rather than being an opaque binary. It is an illustration of the conversation, not a capture of real patient data.

Source repo

https://github.com/VisitConfirmed/canvas-medical-plugin (public, MIT)

One question for reviewers

Happy to move this if a vendor-branded connector belongs somewhere other than the reference-plugin repo. extensions/nabla suggested here is right, but say the word and I will relocate it.

🤖 Generated with Claude Code

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Self-reviewed against this repo's CLAUDE.md plugin checklist after opening, and pushed two fixes.

Retracted appointments were not excluded. The query was a bare Appointment.objects.get(id=...), and Appointment carries a nullable entered_in_error FK. Without the filter, an appointment a clinic had retracted could still have triggered patient outreach, which is the worst failure this plugin is capable of. Now filtered.

Related objects cost a query apiece. The payload reads patient.id and provider.id, so the query now uses select_related("patient", "provider").

Also added a defensive guard for a missing start_time, since arrow.get(None) raises TypeError. start_time is declared non-null on the SDK model, so this is precautionary rather than an observed failure, matching the guard in extensions/missed-appointment-notifications.

Tests now patch the select_related().get() chain, with new cases covering the retraction filter and the missing start time. Still 100% branch coverage, mypy clean, canvas validate clean.

One note in case it looks off against the checklist: the manifest uses variables with sensitive: true rather than the secrets array the CLAUDE.md checklist mentions. canvas_cli/utils/validators/manifest_schema.py marks secrets deprecated in favor of variables, and extensions/missed-appointment-notifications uses variables, so I followed the schema. Happy to switch if you'd rather the checklist win.