HIPAA-Compliant Patient Data Encryption Middleware

Design a Node.js middleware that automatically encrypts and decrypts sensitive patient health information (PHI) using AES-256-GCM encryption. The middleware must seamlessly integrate with Express.js, support dynamic key rotation, and log all encryption/decryption events without exposing raw data. Include robust error handling for decryption failures and implement a secure key management strategy that prevents direct key access.