HIPAA-Compliant Real-Time Patient Vitals Streaming API

Design a secure WebSocket-based API for streaming patient vital signs from IoT medical devices using Node.js, ensuring end-to-end encryption and HIPAA compliance. Create middleware that automatically sanitizes and validates incoming medical data streams, with built-in error handling for irregular heart rates or sensor malfunctions. Implement rate limiting and secure token-based authentication that automatically expires after 30 minutes. Include comprehensive logging mechanisms that capture all data transmissions without storing personally identifiable information.