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 +1,75 @@
+using Microsoft.EntityFrameworkCore;
+
+public class LocalWarningEvaluator
+{
+    private readonly GatewayDbContext _db;
+    private readonly ILogger<LocalWarningEvaluator> _logger;
+
+    public LocalWarningEvaluator(GatewayDbContext db, ILogger<LocalWarningEvaluator> logger)
+    {
+        _db = db;
+        _logger = logger;
+    }
+
+    public async Task<bool> TryEvaluateAsync(
+        Guid observationId, Guid encounterId, Guid patientId,
+        string observationCode, decimal value, ThresholdCacheEntry threshold)
+    {
+        if (!IsWarningBreach(value, threshold)) return false;
+        if (IsCriticalBreach(value, threshold)) return false;
+
+        var alertType = AlertTypeExtensions.WarningFor(observationCode);
+        var clientAlertId = Guid.NewGuid();
+        var triggeredAt = DateTimeOffset.UtcNow;
+        var details = BuildWarningDetails(observationCode, value, threshold);
+
+        var exists = await _db.ClinicalAlerts.AnyAsync(a =>
+            a.EncounterId == encounterId
+            && a.AlertType == alertType
+            && (a.Status == AlertStatus.Open || a.Status == AlertStatus.Acknowledged));
+        if (exists) return false;
+
+        var alert = new LocalClinicalAlert
+        {
+            Id = Guid.NewGuid(),
+            ClientAlertId = clientAlertId,
+            EncounterId = encounterId,
+            PatientId = patientId,
+            ObservationId = observationId,
+            AlertType = alertType,
+            Severity = AlertSeverity.Warning,
+            Details = details,
+            Status = AlertStatus.Open,
+            TriggeredAt = triggeredAt
+        };
+        _db.ClinicalAlerts.Add(alert);
+
+        BufferedSyncWriter.Enqueue(_db, BufferedSyncItemType.Alert, new
+        {
+            clientAlertId,
+            encounterId,
+            alertType = alertType.ToDbString(),
+            severity = AlertSeverity.Warning.ToDbString(),
+            details,
+            generatedAt = triggeredAt
+        }, $"alert:{clientAlertId}", encounterId, triggeredAt);
+
+        _logger.LogInformation(
+            "WARNING alert {AlertId} created locally for encounter {EncounterId}",
+            alert.Id, encounterId);
+        return true;
+    }
+
+    private static bool IsWarningBreach(decimal value, ThresholdCacheEntry t) =>
+        (t.WarningHigh.HasValue && value > t.WarningHigh.Value) ||
+        (t.WarningLow.HasValue && value < t.WarningLow.Value);
+
+    private static bool IsCriticalBreach(decimal value, ThresholdCacheEntry t) =>
+        (t.CriticalLow.HasValue && value < t.CriticalLow.Value) ||
+        (t.CriticalHigh.HasValue && value > t.CriticalHigh.Value);
+
+    private static string BuildWarningDetails(string code, decimal value, ThresholdCacheEntry t) =>
+        t.WarningHigh.HasValue && value > t.WarningHigh.Value
+            ? $"{code} value {value} is above warning high of {t.WarningHigh}."
+            : $"{code} value {value} is below warning low of {t.WarningLow}.";
+}