feature: Medication Tracking & Vital Sign Correlation

2026-06-19 10:47:55 +08:00
parent e2d40331b7
commit 5c7e37471b
29 changed files with 2512 additions and 4 deletions
@@ -0,0 +1,102 @@
+using Microsoft.EntityFrameworkCore;
+using Microsoft.Extensions.Options;
+
+public class MedicationService : IMedicationService
+{
+    private readonly AppDbContext _db;
+    private readonly MedicationCorrelationOptions _correlationOptions;
+
+    public MedicationService(
+        AppDbContext db,
+        IOptions<MedicationCorrelationOptions> correlationOptions)
+    {
+        _db = db;
+        _correlationOptions = correlationOptions.Value;
+    }
+
+    public async Task<MedicationAdministration> CreateAsync(
+        Guid encounterId, CreateMedicationAdministrationRequest req)
+    {
+        var encounter = await _db.Encounters.FindAsync(encounterId);
+        if (encounter is null)
+            throw new NotFoundException("Encounter not found.", "ENCOUNTER_NOT_FOUND");
+
+        if (encounter.Status != EncounterStatus.Active)
+            throw new ConflictException(
+                "Cannot record medications for a non-active encounter.",
+                "ENCOUNTER_NOT_ACTIVE");
+
+        var med = new MedicationAdministration
+        {
+            Id = Guid.NewGuid(),
+            EncounterId = encounterId,
+            DrugName = req.DrugName.Trim(),
+            Dose = req.Dose,
+            DoseUnit = req.DoseUnit.Trim(),
+            Route = req.Route.Trim(),
+            AdministeredAt = req.AdministeredAt ?? DateTimeOffset.UtcNow,
+            AdministeredBy = req.AdministeredBy.Trim()
+        };
+
+        _db.MedicationAdministrations.Add(med);
+        await _db.SaveChangesAsync();
+        return med;
+    }
+
+    public async Task<MedicationAdministration> GetByIdAsync(Guid id)
+    {
+        var med = await _db.MedicationAdministrations
+            .AsNoTracking()
+            .Include(m => m.Encounter)
+            .FirstOrDefaultAsync(m => m.Id == id);
+
+        if (med is null)
+            throw new NotFoundException("Medication administration not found.", "MEDICATION_NOT_FOUND");
+
+        return med;
+    }
+
+    public async Task<IReadOnlyList<MedicationAdministration>> GetRecentForEncounterAsync(
+        Guid encounterId, string observationCode, int windowMinutes)
+    {
+        var cutoff = DateTimeOffset.UtcNow.AddMinutes(-windowMinutes);
+        var mappings = _correlationOptions.DrugVitalMappings;
+
+        // Find drugs that affect this observation code
+        var relevantDrugs = mappings
+            .Where(kv => kv.Value.Contains(observationCode, StringComparer.OrdinalIgnoreCase))
+            .Select(kv => kv.Key)
+            .ToHashSet(StringComparer.OrdinalIgnoreCase);
+
+        if (relevantDrugs.Count == 0)
+            return Array.Empty<MedicationAdministration>();
+
+        return await _db.MedicationAdministrations
+            .AsNoTracking()
+            .Where(m => m.EncounterId == encounterId
+                     && m.AdministeredAt >= cutoff
+                     && relevantDrugs.Contains(m.DrugName.ToLower()))
+            .OrderByDescending(m => m.AdministeredAt)
+            .ToListAsync();
+    }
+
+    public async Task<PagedResult<MedicationAdministration>> ListByEncounterAsync(
+        Guid encounterId, DateTimeOffset? since, int page, int pageSize)
+    {
+        var query = _db.MedicationAdministrations
+            .AsNoTracking()
+            .Where(m => m.EncounterId == encounterId);
+
+        if (since.HasValue)
+            query = query.Where(m => m.AdministeredAt >= since.Value);
+
+        var total = await query.CountAsync();
+        var items = await query
+            .OrderByDescending(m => m.AdministeredAt)
+            .Skip((page - 1) * pageSize)
+            .Take(pageSize)
+            .ToListAsync();
+
+        return new PagedResult<MedicationAdministration>(items, page, pageSize, total);
+    }
+}