HIPAA-Compliant Patient Data Encryption Middleware

Design a Node.js middleware that automatically encrypts and decrypts sensitive patient health information using AES-256-GCM encryption. Implement robust key management with automatic key rotation every 30 days, and create a comprehensive logging system that tracks all encryption/decryption events without storing the actual sensitive data. Include error handling for potential cryptographic failures and ensure the middleware is compatible with Express.js REST APIs used in electronic health record systems.