feature: Ward Gateway Service (Local-First Clinical Path)

2026-06-23 16:45:38 +08:00
parent d8e142fffe
commit 1bf8359097
100 changed files with 5474 additions and 4 deletions
@@ -0,0 +1,37 @@
+using Microsoft.EntityFrameworkCore;
+using Microsoft.EntityFrameworkCore.Metadata.Builders;
+
+public class BufferedSyncItemConfiguration : IEntityTypeConfiguration<BufferedSyncItem>
+{
+    public void Configure(EntityTypeBuilder<BufferedSyncItem> builder)
+    {
+        builder.ToTable("buffered_sync_items", t =>
+        {
+            t.HasCheckConstraint("chk_buffered_sync_items_item_type",
+                "item_type IN ('OBSERVATION', 'ALERT', 'ACK', 'RESOLVE')");
+        });
+        builder.HasKey(b => b.Id);
+        builder.Property(b => b.Id).HasColumnName("id").HasDefaultValueSql("gen_random_uuid()");
+        builder.Property(b => b.ItemType)
+            .HasColumnName("item_type")
+            .HasMaxLength(32)
+            .HasConversion(
+                v => v.ToDbString(),
+                v => BufferedSyncItemTypeExtensions.FromDbString(v))
+            .IsRequired();
+        builder.Property(b => b.Payload).HasColumnName("payload").HasColumnType("jsonb").IsRequired();
+        builder.Property(b => b.IdempotencyKey).HasColumnName("idempotency_key").HasMaxLength(200).IsRequired();
+        builder.Property(b => b.EncounterId).HasColumnName("encounter_id");
+        builder.Property(b => b.RecordedAt).HasColumnName("recorded_at");
+        builder.Property(b => b.Synced).HasColumnName("synced").HasDefaultValue(false);
+        builder.Property(b => b.SyncedAt).HasColumnName("synced_at");
+        builder.Property(b => b.CreatedAt).HasColumnName("created_at").HasDefaultValueSql("NOW()");
+
+        builder.HasIndex(b => b.IdempotencyKey)
+            .IsUnique()
+            .HasFilter("NOT synced");
+
+        builder.HasIndex(b => b.CreatedAt)
+            .HasFilter("NOT synced");
+    }
+}
@@ -0,0 +1,16 @@
+using Microsoft.EntityFrameworkCore;
+using Microsoft.EntityFrameworkCore.Metadata.Builders;
+
+public class GatewaySyncStateConfiguration : IEntityTypeConfiguration<GatewaySyncState>
+{
+    public void Configure(EntityTypeBuilder<GatewaySyncState> builder)
+    {
+        builder.ToTable("gateway_sync_state");
+        builder.HasKey(s => s.Id);
+        builder.Property(s => s.Id).HasColumnName("id").HasDefaultValueSql("gen_random_uuid()");
+        builder.Property(s => s.LastEncounterSyncAt).HasColumnName("last_encounter_sync_at");
+        builder.Property(s => s.InitialSyncCompleted)
+            .HasColumnName("initial_sync_completed")
+            .HasDefaultValue(false);
+    }
+}
@@ -0,0 +1,82 @@
+using Microsoft.EntityFrameworkCore;
+using Microsoft.EntityFrameworkCore.Metadata.Builders;
+
+public class LocalClinicalAlertConfiguration : IEntityTypeConfiguration<LocalClinicalAlert>
+{
+    public void Configure(EntityTypeBuilder<LocalClinicalAlert> builder)
+    {
+        builder.ToTable("clinical_alerts", t =>
+        {
+            t.HasCheckConstraint("chk_clinical_alerts_severity",
+                "severity IN ('WARNING', 'CRITICAL')");
+            t.HasCheckConstraint("chk_clinical_alerts_status",
+                "status IN ('OPEN', 'ACKNOWLEDGED', 'RESOLVED', 'ESCALATED')");
+            t.HasCheckConstraint("chk_clinical_alerts_alert_type",
+                "alert_type IN (" +
+                "'SEPSIS_WARNING', " +
+                "'CRITICAL_HEART_RATE', 'CRITICAL_TEMP_C', 'CRITICAL_POTASSIUM_MEQ_L', " +
+                "'CRITICAL_SPO2', 'CRITICAL_RESP_RATE', 'CRITICAL_WBC_K_UL', " +
+                "'CRITICAL_SYSTOLIC_BP', 'CRITICAL_DIASTOLIC_BP', 'CRITICAL_LACTATE_MMOL_L', " +
+                "'CRITICAL_AVPU', 'CRITICAL_GLUCOSE_MG_DL', " +
+                "'CRITICAL_PAO2_MMHG', 'CRITICAL_PLATELET_K_UL', " +
+                "'CRITICAL_BILIRUBIN_MG_DL', 'CRITICAL_CREATININE_MG_DL', " +
+                "'WARNING_HEART_RATE', 'WARNING_TEMP_C', 'WARNING_POTASSIUM_MEQ_L', " +
+                "'WARNING_SPO2', 'WARNING_RESP_RATE', 'WARNING_WBC_K_UL', " +
+                "'WARNING_SYSTOLIC_BP', 'WARNING_DIASTOLIC_BP', 'WARNING_LACTATE_MMOL_L', " +
+                "'WARNING_GLUCOSE_MG_DL', " +
+                "'WARNING_PAO2_MMHG', 'WARNING_PLATELET_K_UL', " +
+                "'WARNING_BILIRUBIN_MG_DL', 'WARNING_CREATININE_MG_DL', " +
+                "'NEWS2_WARNING', 'NEWS2_EMERGENCY', " +
+                "'RAPID_DETERIORATION', 'QSOFA_WARNING', 'QSOFA_SCREEN', " +
+                "'GCS_CRITICAL', 'GCS_WARNING', " +
+                "'SOFA_SEPSIS', 'SOFA_WARNING')");
+        });
+        builder.HasKey(a => a.Id);
+        builder.Property(a => a.Id).HasColumnName("id").HasDefaultValueSql("gen_random_uuid()");
+        builder.Property(a => a.EncounterId).HasColumnName("encounter_id");
+        builder.Property(a => a.PatientId).HasColumnName("patient_id");
+        builder.Property(a => a.ObservationId).HasColumnName("observation_id");
+        builder.Property(a => a.AlertType)
+            .HasColumnName("alert_type")
+            .HasMaxLength(50)
+            .HasConversion(
+                v => v.ToDbString(),
+                v => AlertTypeExtensions.FromDbString(v))
+            .IsRequired();
+        builder.Property(a => a.Severity)
+            .HasColumnName("severity")
+            .HasMaxLength(20)
+            .HasConversion(
+                v => v.ToDbString(),
+                v => AlertSeverityExtensions.FromDbString(v))
+            .IsRequired();
+        builder.Property(a => a.Details).HasColumnName("details").IsRequired();
+        builder.Property(a => a.ObservationCode).HasColumnName("observation_code").HasMaxLength(50);
+        builder.Property(a => a.Status)
+            .HasColumnName("status")
+            .HasMaxLength(20)
+            .HasConversion(
+                v => v.ToDbString(),
+                v => AlertStatusExtensions.FromDbString(v))
+            .HasDefaultValueSql("'OPEN'")
+            .HasSentinel((AlertStatus)(-1));
+        builder.Property(a => a.AcknowledgedAt).HasColumnName("acknowledged_at");
+        builder.Property(a => a.AcknowledgedBy).HasColumnName("acknowledged_by").HasMaxLength(200);
+        builder.Property(a => a.ResolvedAt).HasColumnName("resolved_at");
+        builder.Property(a => a.ClientAlertId).HasColumnName("client_alert_id").IsRequired();
+        builder.Property(a => a.TriggeredAt).HasColumnName("triggered_at").HasDefaultValueSql("NOW()");
+
+        builder.HasOne(a => a.Encounter)
+            .WithMany(e => e.Alerts)
+            .HasForeignKey(a => a.EncounterId)
+            .OnDelete(DeleteBehavior.Restrict);
+
+        builder.HasIndex(a => new { a.EncounterId, a.TriggeredAt });
+        builder.HasIndex(a => new { a.PatientId, a.TriggeredAt });
+        builder.HasIndex(a => new { a.Severity, a.TriggeredAt })
+            .HasFilter("status = 'OPEN'");
+        builder.HasIndex(a => new { a.EncounterId, a.AlertType, a.ObservationCode })
+            .HasFilter("status IN ('OPEN', 'ESCALATED')");
+        builder.HasIndex(a => a.ClientAlertId).IsUnique();
+    }
+}
@@ -0,0 +1,42 @@
+using Microsoft.EntityFrameworkCore;
+using Microsoft.EntityFrameworkCore.Metadata.Builders;
+
+public class LocalObservationConfiguration : IEntityTypeConfiguration<LocalObservation>
+{
+    public void Configure(EntityTypeBuilder<LocalObservation> builder)
+    {
+        builder.ToTable("observations", t =>
+        {
+            t.HasCheckConstraint("chk_observations_source",
+                "source IN ('MANUAL', 'DEVICE', 'LAB')");
+        });
+        builder.HasKey(o => o.Id);
+        builder.Property(o => o.Id).HasColumnName("id").HasDefaultValueSql("gen_random_uuid()");
+        builder.Property(o => o.EncounterId).HasColumnName("encounter_id");
+        builder.Property(o => o.ObservationCode).HasColumnName("observation_code").HasMaxLength(50).IsRequired();
+        builder.Property(o => o.Value).HasColumnName("value").HasColumnType("decimal(10,3)").IsRequired();
+        builder.Property(o => o.Unit).HasColumnName("unit").HasMaxLength(20).IsRequired();
+        builder.Property(o => o.Source)
+            .HasColumnName("source")
+            .HasMaxLength(20)
+            .HasConversion(
+                v => v.ToDbString(),
+                v => ObservationSourceExtensions.FromDbString(v))
+            .HasDefaultValueSql("'MANUAL'")
+            .HasSentinel((ObservationSource)(-1));
+        builder.Property(o => o.IdempotencyKey).HasColumnName("idempotency_key").HasMaxLength(100);
+        builder.Property(o => o.RecordedAt).HasColumnName("recorded_at");
+        builder.Property(o => o.CreatedAt).HasColumnName("created_at").HasDefaultValueSql("NOW()");
+
+        builder.HasOne(o => o.Encounter)
+            .WithMany(e => e.Observations)
+            .HasForeignKey(o => o.EncounterId)
+            .OnDelete(DeleteBehavior.Restrict);
+
+        builder.HasIndex(o => o.IdempotencyKey)
+            .IsUnique()
+            .HasFilter("idempotency_key IS NOT NULL");
+
+        builder.HasIndex(o => new { o.EncounterId, o.ObservationCode, o.RecordedAt });
+    }
+}
@@ -0,0 +1,23 @@
+using Microsoft.EntityFrameworkCore;
+using Microsoft.EntityFrameworkCore.Metadata.Builders;
+
+public class ReplicaAlertThresholdConfiguration : IEntityTypeConfiguration<ReplicaAlertThreshold>
+{
+    public void Configure(EntityTypeBuilder<ReplicaAlertThreshold> builder)
+    {
+        builder.ToTable("alert_thresholds");
+        builder.HasKey(t => t.Id);
+        builder.Property(t => t.Id).HasColumnName("id").HasDefaultValueSql("gen_random_uuid()");
+        builder.Property(t => t.ObservationCode).HasColumnName("observation_code").HasMaxLength(50).IsRequired();
+        builder.Property(t => t.DisplayName).HasColumnName("display_name").HasMaxLength(200).IsRequired();
+        builder.Property(t => t.Unit).HasColumnName("unit").HasMaxLength(20).IsRequired();
+        builder.Property(t => t.CriticalLow).HasColumnName("critical_low").HasColumnType("decimal(10,3)");
+        builder.Property(t => t.WarningLow).HasColumnName("warning_low").HasColumnType("decimal(10,3)");
+        builder.Property(t => t.WarningHigh).HasColumnName("warning_high").HasColumnType("decimal(10,3)");
+        builder.Property(t => t.CriticalHigh).HasColumnName("critical_high").HasColumnType("decimal(10,3)");
+        builder.Property(t => t.SuppressionWindowMinutes).HasColumnName("suppression_window_minutes");
+        builder.Property(t => t.SyncedAt).HasColumnName("synced_at");
+
+        builder.HasIndex(t => t.ObservationCode).IsUnique();
+    }
+}
@@ -0,0 +1,56 @@
+using Microsoft.EntityFrameworkCore;
+using Microsoft.EntityFrameworkCore.Metadata.Builders;
+
+public class ReplicaEncounterConfiguration : IEntityTypeConfiguration<ReplicaEncounter>
+{
+    public void Configure(EntityTypeBuilder<ReplicaEncounter> builder)
+    {
+        builder.ToTable("encounters", t =>
+        {
+            t.HasCheckConstraint("chk_encounters_encounter_type",
+                "encounter_type IN ('INPATIENT', 'OUTPATIENT', 'EMERGENCY')");
+            t.HasCheckConstraint("chk_encounters_status",
+                "status IN ('SCHEDULED', 'ACTIVE', 'DISCHARGED', 'CANCELLED')");
+            t.HasCheckConstraint("chk_encounters_department",
+                "department IN ('ICU', 'GENERAL_MEDICINE', 'EMERGENCY', 'CARDIOLOGY', 'SURGERY', 'PEDIATRICS')");
+        });
+        builder.HasKey(e => e.Id);
+        builder.Property(e => e.Id).HasColumnName("id").HasDefaultValueSql("gen_random_uuid()");
+        builder.Property(e => e.PatientId).HasColumnName("patient_id");
+        builder.Property(e => e.EncounterType)
+            .HasColumnName("encounter_type")
+            .HasMaxLength(20)
+            .HasConversion(
+                v => v.ToDbString(),
+                v => EncounterTypeExtensions.FromDbString(v))
+            .IsRequired();
+        builder.Property(e => e.Status)
+            .HasColumnName("status")
+            .HasMaxLength(20)
+            .HasConversion(
+                v => v.ToDbString(),
+                v => EncounterStatusExtensions.FromDbString(v))
+            .HasDefaultValueSql("'SCHEDULED'")
+            .HasSentinel((EncounterStatus)(-1));
+        builder.Property(e => e.Department)
+            .HasColumnName("department")
+            .HasMaxLength(100)
+            .HasConversion(
+                v => v.ToDbString(),
+                v => DepartmentExtensions.FromDbString(v))
+            .IsRequired();
+        builder.Property(e => e.RoomBed).HasColumnName("room_bed").HasMaxLength(20);
+        builder.Property(e => e.AttendingPhysician).HasColumnName("attending_physician").HasMaxLength(200).IsRequired();
+        builder.Property(e => e.AdmittedAt).HasColumnName("admitted_at").HasDefaultValueSql("NOW()");
+        builder.Property(e => e.SyncedAt).HasColumnName("synced_at");
+
+        builder.HasOne(e => e.Patient)
+            .WithMany(p => p.Encounters)
+            .HasForeignKey(e => e.PatientId)
+            .OnDelete(DeleteBehavior.Restrict);
+
+        builder.HasIndex(e => new { e.PatientId, e.AdmittedAt });
+        builder.HasIndex(e => new { e.Status, e.AdmittedAt })
+            .HasFilter("status = 'ACTIVE'");
+    }
+}
@@ -0,0 +1,20 @@
+using Microsoft.EntityFrameworkCore;
+using Microsoft.EntityFrameworkCore.Metadata.Builders;
+
+public class ReplicaPatientConfiguration : IEntityTypeConfiguration<ReplicaPatient>
+{
+    public void Configure(EntityTypeBuilder<ReplicaPatient> builder)
+    {
+        builder.ToTable("patients");
+        builder.HasKey(p => p.Id);
+        builder.Property(p => p.Id).HasColumnName("id").HasDefaultValueSql("gen_random_uuid()");
+        builder.Property(p => p.Mrn).HasColumnName("mrn").HasMaxLength(20).IsRequired();
+        builder.Property(p => p.FirstName).HasColumnName("first_name").HasMaxLength(100).IsRequired();
+        builder.Property(p => p.LastName).HasColumnName("last_name").HasMaxLength(100).IsRequired();
+        builder.Property(p => p.DateOfBirth).HasColumnName("date_of_birth");
+        builder.Property(p => p.Gender).HasColumnName("gender").HasMaxLength(10).IsRequired();
+        builder.Property(p => p.SyncedAt).HasColumnName("synced_at");
+
+        builder.HasIndex(p => p.Mrn).IsUnique();
+    }
+}
@@ -0,0 +1,23 @@
+using Microsoft.EntityFrameworkCore;
+using Microsoft.EntityFrameworkCore.Metadata.Builders;
+
+public class SyncOutboxEntryConfiguration : IEntityTypeConfiguration<SyncOutboxEntry>
+{
+    public void Configure(EntityTypeBuilder<SyncOutboxEntry> builder)
+    {
+        builder.ToTable("sync_outbox");
+        builder.HasKey(e => e.Id);
+        builder.Property(e => e.Id).HasColumnName("id").HasDefaultValueSql("gen_random_uuid()");
+        builder.Property(e => e.BatchId).HasColumnName("batch_id");
+        builder.Property(e => e.Status)
+            .HasColumnName("status")
+            .HasMaxLength(16)
+            .HasConversion(
+                v => v.ToDbString(),
+                v => SyncOutboxStatusExtensions.FromDbString(v))
+            .HasDefaultValueSql("'PENDING'")
+            .HasSentinel((SyncOutboxStatus)(-1));
+        builder.Property(e => e.CreatedAt).HasColumnName("created_at").HasDefaultValueSql("NOW()");
+        builder.Property(e => e.SubmittedAt).HasColumnName("submitted_at");
+    }
+}
@@ -0,0 +1,18 @@
+using Microsoft.EntityFrameworkCore;
+
+public class GatewayDbContext : DbContext
+{
+    public GatewayDbContext(DbContextOptions<GatewayDbContext> opts) : base(opts) { }
+
+    public DbSet<ReplicaPatient> Patients => Set<ReplicaPatient>();
+    public DbSet<ReplicaEncounter> Encounters => Set<ReplicaEncounter>();
+    public DbSet<ReplicaAlertThreshold> AlertThresholds => Set<ReplicaAlertThreshold>();
+    public DbSet<LocalObservation> Observations => Set<LocalObservation>();
+    public DbSet<LocalClinicalAlert> ClinicalAlerts => Set<LocalClinicalAlert>();
+    public DbSet<BufferedSyncItem> BufferedSyncItems => Set<BufferedSyncItem>();
+    public DbSet<SyncOutboxEntry> SyncOutbox => Set<SyncOutboxEntry>();
+    public DbSet<GatewaySyncState> SyncState => Set<GatewaySyncState>();
+
+    protected override void OnModelCreating(ModelBuilder modelBuilder) =>
+        modelBuilder.ApplyConfigurationsFromAssembly(typeof(GatewayDbContext).Assembly);
+}