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 +1,18 @@
+public enum AlertSeverity { Warning, Critical }
+
+public static class AlertSeverityExtensions
+{
+    public static string ToDbString(this AlertSeverity s) => s switch
+    {
+        AlertSeverity.Warning  => "WARNING",
+        AlertSeverity.Critical => "CRITICAL",
+        _ => throw new ArgumentOutOfRangeException(nameof(s))
+    };
+
+    public static AlertSeverity FromDbString(string v) => v switch
+    {
+        "WARNING"  => AlertSeverity.Warning,
+        "CRITICAL" => AlertSeverity.Critical,
+        _ => throw new ArgumentOutOfRangeException(nameof(v), $"Unknown alert severity: '{v}'")
+    };
+}
@@ -0,0 +1,22 @@
+public enum AlertStatus { Open, Acknowledged, Resolved, Escalated }
+
+public static class AlertStatusExtensions
+{
+    public static string ToDbString(this AlertStatus s) => s switch
+    {
+        AlertStatus.Open         => "OPEN",
+        AlertStatus.Acknowledged => "ACKNOWLEDGED",
+        AlertStatus.Resolved     => "RESOLVED",
+        AlertStatus.Escalated    => "ESCALATED",
+        _ => throw new ArgumentOutOfRangeException(nameof(s))
+    };
+
+    public static AlertStatus FromDbString(string v) => v switch
+    {
+        "OPEN"         => AlertStatus.Open,
+        "ACKNOWLEDGED" => AlertStatus.Acknowledged,
+        "RESOLVED"     => AlertStatus.Resolved,
+        "ESCALATED"    => AlertStatus.Escalated,
+        _ => throw new ArgumentOutOfRangeException(nameof(v), $"Unknown alert status: '{v}'")
+    };
+}
@@ -0,0 +1,225 @@
+public enum AlertType
+{
+    [Obsolete("Legacy — replaced by SOFA_SEPSIS in Phase 27. Retained for historical alert queries.")]
+    SepsisWarning,
+    CriticalHeartRate,
+    CriticalTempC,
+    CriticalPotassiumMeqL,
+    CriticalSpo2,
+    CriticalRespRate,
+    CriticalWbcKUl,
+    CriticalSystolicBp,
+    CriticalDiastolicBp,
+    CriticalLactateMmolL,
+    CriticalAvpu,
+    CriticalGlucoseMgDl,
+
+    // New — warning-level threshold alerts
+    WarningHeartRate,
+    WarningTempC,
+    WarningPotassiumMeqL,
+    WarningSpo2,
+    WarningRespRate,
+    WarningWbcKUl,
+    WarningSystolicBp,
+    WarningDiastolicBp,
+    WarningLactateMmolL,
+    WarningGlucoseMgDl,
+
+    News2Warning,
+    News2Emergency,
+
+    RapidDeterioration,
+
+    [Obsolete("Legacy — replaced by QSOFA_SCREEN in Phase 27. Retained for historical alert queries.")]
+    QsofaWarning,
+
+    QsofaScreen,
+
+    GcsCritical,
+    GcsWarning,
+
+    CriticalPao2MmHg,
+    WarningPao2MmHg,
+    CriticalPlateletKUl,
+    WarningPlateletKUl,
+    CriticalBilirubinMgDl,
+    WarningBilirubinMgDl,
+    CriticalCreatinineMgDl,
+    WarningCreatinineMgDl,
+
+    SofaSepsis,
+    SofaWarning,
+}
+
+public static class AlertTypeExtensions
+{
+#pragma warning disable CS0618 // Legacy alert types retained for historical DB strings
+    public static string ToDbString(this AlertType t) => t switch
+    {
+        AlertType.SepsisWarning         => "SEPSIS_WARNING",
+        AlertType.CriticalHeartRate     => "CRITICAL_HEART_RATE",
+        AlertType.CriticalTempC         => "CRITICAL_TEMP_C",
+        AlertType.CriticalPotassiumMeqL => "CRITICAL_POTASSIUM_MEQ_L",
+        AlertType.CriticalSpo2          => "CRITICAL_SPO2",
+        AlertType.CriticalRespRate      => "CRITICAL_RESP_RATE",
+        AlertType.CriticalWbcKUl        => "CRITICAL_WBC_K_UL",
+        AlertType.CriticalSystolicBp    => "CRITICAL_SYSTOLIC_BP",
+        AlertType.CriticalDiastolicBp   => "CRITICAL_DIASTOLIC_BP",
+        AlertType.CriticalLactateMmolL  => "CRITICAL_LACTATE_MMOL_L",
+        AlertType.CriticalAvpu          => "CRITICAL_AVPU",
+        AlertType.CriticalGlucoseMgDl   => "CRITICAL_GLUCOSE_MG_DL",
+        AlertType.WarningHeartRate      => "WARNING_HEART_RATE",
+        AlertType.WarningTempC          => "WARNING_TEMP_C",
+        AlertType.WarningPotassiumMeqL  => "WARNING_POTASSIUM_MEQ_L",
+        AlertType.WarningSpo2           => "WARNING_SPO2",
+        AlertType.WarningRespRate       => "WARNING_RESP_RATE",
+        AlertType.WarningWbcKUl         => "WARNING_WBC_K_UL",
+        AlertType.WarningSystolicBp     => "WARNING_SYSTOLIC_BP",
+        AlertType.WarningDiastolicBp    => "WARNING_DIASTOLIC_BP",
+        AlertType.WarningLactateMmolL   => "WARNING_LACTATE_MMOL_L",
+        AlertType.WarningGlucoseMgDl    => "WARNING_GLUCOSE_MG_DL",
+        AlertType.News2Warning   => "NEWS2_WARNING",
+        AlertType.News2Emergency => "NEWS2_EMERGENCY",
+        AlertType.RapidDeterioration => "RAPID_DETERIORATION",
+        AlertType.QsofaWarning => "QSOFA_WARNING",
+        AlertType.GcsCritical => "GCS_CRITICAL",
+        AlertType.GcsWarning  => "GCS_WARNING",
+        AlertType.CriticalPao2MmHg       => "CRITICAL_PAO2_MMHG",
+        AlertType.WarningPao2MmHg        => "WARNING_PAO2_MMHG",
+        AlertType.CriticalPlateletKUl    => "CRITICAL_PLATELET_K_UL",
+        AlertType.WarningPlateletKUl     => "WARNING_PLATELET_K_UL",
+        AlertType.CriticalBilirubinMgDl  => "CRITICAL_BILIRUBIN_MG_DL",
+        AlertType.WarningBilirubinMgDl   => "WARNING_BILIRUBIN_MG_DL",
+        AlertType.CriticalCreatinineMgDl => "CRITICAL_CREATININE_MG_DL",
+        AlertType.WarningCreatinineMgDl  => "WARNING_CREATININE_MG_DL",
+        AlertType.SofaSepsis  => "SOFA_SEPSIS",
+        AlertType.SofaWarning => "SOFA_WARNING",
+        AlertType.QsofaScreen => "QSOFA_SCREEN",
+        _ => throw new ArgumentOutOfRangeException(nameof(t))
+    };
+#pragma warning restore CS0618
+
+#pragma warning disable CS0618 // Legacy alert types retained for historical DB strings
+    public static AlertType FromDbString(string v) => v switch
+    {
+        "SEPSIS_WARNING"          => AlertType.SepsisWarning,
+        "CRITICAL_HEART_RATE"     => AlertType.CriticalHeartRate,
+        "CRITICAL_TEMP_C"         => AlertType.CriticalTempC,
+        "CRITICAL_POTASSIUM_MEQ_L"=> AlertType.CriticalPotassiumMeqL,
+        "CRITICAL_SPO2"           => AlertType.CriticalSpo2,
+        "CRITICAL_RESP_RATE"      => AlertType.CriticalRespRate,
+        "CRITICAL_WBC_K_UL"       => AlertType.CriticalWbcKUl,
+        "CRITICAL_SYSTOLIC_BP"    => AlertType.CriticalSystolicBp,
+        "CRITICAL_DIASTOLIC_BP"   => AlertType.CriticalDiastolicBp,
+        "CRITICAL_LACTATE_MMOL_L" => AlertType.CriticalLactateMmolL,
+        "CRITICAL_AVPU"           => AlertType.CriticalAvpu,
+        "CRITICAL_GLUCOSE_MG_DL"  => AlertType.CriticalGlucoseMgDl,
+        "WARNING_HEART_RATE"      => AlertType.WarningHeartRate,
+        "WARNING_TEMP_C"          => AlertType.WarningTempC,
+        "WARNING_POTASSIUM_MEQ_L" => AlertType.WarningPotassiumMeqL,
+        "WARNING_SPO2"            => AlertType.WarningSpo2,
+        "WARNING_RESP_RATE"       => AlertType.WarningRespRate,
+        "WARNING_WBC_K_UL"        => AlertType.WarningWbcKUl,
+        "WARNING_SYSTOLIC_BP"     => AlertType.WarningSystolicBp,
+        "WARNING_DIASTOLIC_BP"    => AlertType.WarningDiastolicBp,
+        "WARNING_LACTATE_MMOL_L"  => AlertType.WarningLactateMmolL,
+        "WARNING_GLUCOSE_MG_DL"   => AlertType.WarningGlucoseMgDl,
+        "NEWS2_WARNING"   => AlertType.News2Warning,
+        "NEWS2_EMERGENCY" => AlertType.News2Emergency,
+        "RAPID_DETERIORATION" => AlertType.RapidDeterioration,
+        "QSOFA_WARNING" => AlertType.QsofaWarning,
+        "QSOFA_SCREEN" => AlertType.QsofaScreen,
+        "GCS_CRITICAL" => AlertType.GcsCritical,
+        "GCS_WARNING"  => AlertType.GcsWarning,
+        "CRITICAL_PAO2_MMHG"        => AlertType.CriticalPao2MmHg,
+        "WARNING_PAO2_MMHG"         => AlertType.WarningPao2MmHg,
+        "CRITICAL_PLATELET_K_UL"    => AlertType.CriticalPlateletKUl,
+        "WARNING_PLATELET_K_UL"     => AlertType.WarningPlateletKUl,
+        "CRITICAL_BILIRUBIN_MG_DL"  => AlertType.CriticalBilirubinMgDl,
+        "WARNING_BILIRUBIN_MG_DL"   => AlertType.WarningBilirubinMgDl,
+        "CRITICAL_CREATININE_MG_DL" => AlertType.CriticalCreatinineMgDl,
+        "WARNING_CREATININE_MG_DL"  => AlertType.WarningCreatinineMgDl,
+        "SOFA_SEPSIS"  => AlertType.SofaSepsis,
+        "SOFA_WARNING" => AlertType.SofaWarning,
+        _ => throw new ArgumentOutOfRangeException(nameof(v), $"Unknown alert type: '{v}'")
+    };
+#pragma warning restore CS0618
+
+    // Threshold alerts are derived from observation codes in alert_thresholds — not free-form strings.
+    public static AlertType CriticalFor(string observationCode) => observationCode switch
+    {
+        "HEART_RATE"       => AlertType.CriticalHeartRate,
+        "TEMP_C"           => AlertType.CriticalTempC,
+        "POTASSIUM_MEQ_L"  => AlertType.CriticalPotassiumMeqL,
+        "SPO2"             => AlertType.CriticalSpo2,
+        "RESP_RATE"        => AlertType.CriticalRespRate,
+        "WBC_K_UL"         => AlertType.CriticalWbcKUl,
+        "SYSTOLIC_BP"      => AlertType.CriticalSystolicBp,
+        "DIASTOLIC_BP"     => AlertType.CriticalDiastolicBp,
+        "LACTATE_MMOL_L"   => AlertType.CriticalLactateMmolL,
+        "AVPU"             => AlertType.CriticalAvpu,
+        "GLUCOSE_MG_DL"    => AlertType.CriticalGlucoseMgDl,
+        "PAO2_MMHG"        => AlertType.CriticalPao2MmHg,
+        "PLATELET_K_UL"    => AlertType.CriticalPlateletKUl,
+        "BILIRUBIN_MG_DL"  => AlertType.CriticalBilirubinMgDl,
+        "CREATININE_MG_DL" => AlertType.CriticalCreatinineMgDl,
+        _ => throw new ArgumentOutOfRangeException(
+            nameof(observationCode), $"No critical alert type for observation code '{observationCode}'")
+    };
+
+    public static AlertType WarningFor(string observationCode) => observationCode switch
+    {
+        "HEART_RATE"      => AlertType.WarningHeartRate,
+        "TEMP_C"          => AlertType.WarningTempC,
+        "POTASSIUM_MEQ_L" => AlertType.WarningPotassiumMeqL,
+        "SPO2"            => AlertType.WarningSpo2,
+        "RESP_RATE"       => AlertType.WarningRespRate,
+        "WBC_K_UL"        => AlertType.WarningWbcKUl,
+        "SYSTOLIC_BP"     => AlertType.WarningSystolicBp,
+        "DIASTOLIC_BP"    => AlertType.WarningDiastolicBp,
+        "LACTATE_MMOL_L"  => AlertType.WarningLactateMmolL,
+        "GLUCOSE_MG_DL"   => AlertType.WarningGlucoseMgDl,
+        "PAO2_MMHG"        => AlertType.WarningPao2MmHg,
+        "PLATELET_K_UL"    => AlertType.WarningPlateletKUl,
+        "BILIRUBIN_MG_DL"  => AlertType.WarningBilirubinMgDl,
+        "CREATININE_MG_DL" => AlertType.WarningCreatinineMgDl,
+        _ => throw new ArgumentOutOfRangeException(
+            nameof(observationCode), $"No warning alert type for observation code '{observationCode}'")
+    };
+
+#pragma warning disable CS0618 // Legacy alert types retained for historical DB strings
+    public static bool IsSuppressible(this AlertType t) => t switch
+    {
+        AlertType.SepsisWarning or AlertType.News2Emergency => false,
+        AlertType.CriticalHeartRate or AlertType.CriticalTempC or AlertType.CriticalPotassiumMeqL
+            or AlertType.CriticalSpo2 or AlertType.CriticalRespRate or AlertType.CriticalWbcKUl
+            or AlertType.CriticalSystolicBp or AlertType.CriticalDiastolicBp
+            or AlertType.CriticalLactateMmolL or AlertType.CriticalAvpu
+            or AlertType.CriticalGlucoseMgDl => false,
+        AlertType.RapidDeterioration => false, 
+        AlertType.GcsCritical => false, // trajectory alerts are never suppressed
+        AlertType.SofaSepsis => false,
+        _ => true  // all Warning* types, News2Warning, QsofaScreen, SofaWarning, GcsWarning
+    };
+#pragma warning restore CS0618
+
+    public static string? ObservationCodeForWarning(this AlertType t) => t switch
+    {
+        AlertType.WarningHeartRate      => "HEART_RATE",
+        AlertType.WarningTempC          => "TEMP_C",
+        AlertType.WarningPotassiumMeqL  => "POTASSIUM_MEQ_L",
+        AlertType.WarningSpo2           => "SPO2",
+        AlertType.WarningRespRate       => "RESP_RATE",
+        AlertType.WarningWbcKUl         => "WBC_K_UL",
+        AlertType.WarningSystolicBp     => "SYSTOLIC_BP",
+        AlertType.WarningDiastolicBp    => "DIASTOLIC_BP",
+        AlertType.WarningLactateMmolL   => "LACTATE_MMOL_L",
+        AlertType.WarningGlucoseMgDl    => "GLUCOSE_MG_DL",
+        AlertType.WarningPao2MmHg        => "PAO2_MMHG",
+        AlertType.WarningPlateletKUl     => "PLATELET_K_UL",
+        AlertType.WarningBilirubinMgDl   => "BILIRUBIN_MG_DL",
+        AlertType.WarningCreatinineMgDl  => "CREATININE_MG_DL",
+        _ => null
+    };
+}
@@ -0,0 +1,22 @@
+public enum BufferedSyncItemType { Observation, Alert, Ack, Resolve }
+
+public static class BufferedSyncItemTypeExtensions
+{
+    public static string ToDbString(this BufferedSyncItemType t) => t switch
+    {
+        BufferedSyncItemType.Observation => "OBSERVATION",
+        BufferedSyncItemType.Alert       => "ALERT",
+        BufferedSyncItemType.Ack         => "ACK",
+        BufferedSyncItemType.Resolve     => "RESOLVE",
+        _ => throw new ArgumentOutOfRangeException(nameof(t))
+    };
+
+    public static BufferedSyncItemType FromDbString(string v) => v switch
+    {
+        "OBSERVATION" => BufferedSyncItemType.Observation,
+        "ALERT"       => BufferedSyncItemType.Alert,
+        "ACK"         => BufferedSyncItemType.Ack,
+        "RESOLVE"     => BufferedSyncItemType.Resolve,
+        _ => throw new ArgumentOutOfRangeException(nameof(v), $"Unknown buffered sync item type: '{v}'")
+    };
+}
@@ -0,0 +1,34 @@
+public enum Department
+{
+    Icu,
+    GeneralMedicine,
+    Emergency,
+    Cardiology,
+    Surgery,
+    Pediatrics
+}
+
+public static class DepartmentExtensions
+{
+    public static string ToDbString(this Department d) => d switch
+    {
+        Department.Icu             => "ICU",
+        Department.GeneralMedicine => "GENERAL_MEDICINE",
+        Department.Emergency       => "EMERGENCY",
+        Department.Cardiology      => "CARDIOLOGY",
+        Department.Surgery         => "SURGERY",
+        Department.Pediatrics      => "PEDIATRICS",
+        _ => throw new ArgumentOutOfRangeException(nameof(d))
+    };
+
+    public static Department FromDbString(string v) => v switch
+    {
+        "ICU"              => Department.Icu,
+        "GENERAL_MEDICINE" => Department.GeneralMedicine,
+        "EMERGENCY"        => Department.Emergency,
+        "CARDIOLOGY"       => Department.Cardiology,
+        "SURGERY"          => Department.Surgery,
+        "PEDIATRICS"       => Department.Pediatrics,
+        _ => throw new ArgumentOutOfRangeException(nameof(v), $"Unknown department: '{v}'")
+    };
+}
@@ -0,0 +1,22 @@
+public enum EncounterStatus { Scheduled, Active, Discharged, Cancelled }
+
+public static class EncounterStatusExtensions
+{
+    public static string ToDbString(this EncounterStatus s) => s switch
+    {
+        EncounterStatus.Scheduled  => "SCHEDULED",
+        EncounterStatus.Active     => "ACTIVE",
+        EncounterStatus.Discharged => "DISCHARGED",
+        EncounterStatus.Cancelled  => "CANCELLED",
+        _ => throw new ArgumentOutOfRangeException(nameof(s))
+    };
+
+    public static EncounterStatus FromDbString(string v) => v switch
+    {
+        "SCHEDULED"  => EncounterStatus.Scheduled,
+        "ACTIVE"     => EncounterStatus.Active,
+        "DISCHARGED" => EncounterStatus.Discharged,
+        "CANCELLED"  => EncounterStatus.Cancelled,
+        _ => throw new ArgumentOutOfRangeException(nameof(v), $"Unknown encounter status: '{v}'")
+    };
+}
@@ -0,0 +1,20 @@
+public enum EncounterType { Inpatient, Outpatient, Emergency }
+
+public static class EncounterTypeExtensions
+{
+    public static string ToDbString(this EncounterType t) => t switch
+    {
+        EncounterType.Inpatient  => "INPATIENT",
+        EncounterType.Outpatient => "OUTPATIENT",
+        EncounterType.Emergency  => "EMERGENCY",
+        _ => throw new ArgumentOutOfRangeException(nameof(t))
+    };
+
+    public static EncounterType FromDbString(string v) => v switch
+    {
+        "INPATIENT"  => EncounterType.Inpatient,
+        "OUTPATIENT" => EncounterType.Outpatient,
+        "EMERGENCY"  => EncounterType.Emergency,
+        _ => throw new ArgumentOutOfRangeException(nameof(v), $"Unknown encounter type: '{v}'")
+    };
+}
@@ -0,0 +1,20 @@
+public enum ObservationSource { Manual, Device, Lab }
+
+public static class ObservationSourceExtensions
+{
+    public static string ToDbString(this ObservationSource s) => s switch
+    {
+        ObservationSource.Manual => "MANUAL",
+        ObservationSource.Device => "DEVICE",
+        ObservationSource.Lab    => "LAB",
+        _ => throw new ArgumentOutOfRangeException(nameof(s))
+    };
+
+    public static ObservationSource FromDbString(string v) => v switch
+    {
+        "MANUAL" => ObservationSource.Manual,
+        "DEVICE" => ObservationSource.Device,
+        "LAB"    => ObservationSource.Lab,
+        _ => throw new ArgumentOutOfRangeException(nameof(v), $"Unknown observation source: '{v}'")
+    };
+}
@@ -0,0 +1,18 @@
+public enum SyncOutboxStatus { Pending, Submitted }
+
+public static class SyncOutboxStatusExtensions
+{
+    public static string ToDbString(this SyncOutboxStatus s) => s switch
+    {
+        SyncOutboxStatus.Pending   => "PENDING",
+        SyncOutboxStatus.Submitted => "SUBMITTED",
+        _ => throw new ArgumentOutOfRangeException(nameof(s))
+    };
+
+    public static SyncOutboxStatus FromDbString(string v) => v switch
+    {
+        "PENDING"   => SyncOutboxStatus.Pending,
+        "SUBMITTED" => SyncOutboxStatus.Submitted,
+        _ => throw new ArgumentOutOfRangeException(nameof(v), $"Unknown sync outbox status: '{v}'")
+    };
+}