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 +1,154 @@
+using FluentAssertions;
+using Microsoft.EntityFrameworkCore;
+using Microsoft.Extensions.DependencyInjection;
+
+[Collection("Integration")]
+public class MedicationServiceTests : IAsyncLifetime
+{
+    private readonly ApiFixture _fixture;
+    private Guid _patientId;
+    private Guid _activeEncounterId;
+    private Guid _dischargedEncounterId;
+
+    public MedicationServiceTests(ApiFixture fixture) => _fixture = fixture;
+
+    public async Task InitializeAsync() => await ResetAndSeedAsync();
+
+    public Task DisposeAsync() => Task.CompletedTask;
+
+    private async Task ResetAndSeedAsync()
+    {
+        using var scope = _fixture.Services.CreateScope();
+        var db = scope.ServiceProvider.GetRequiredService<AppDbContext>();
+        await DbResetHelper.ResetAsync(db);
+
+        var patient = new Patient
+        {
+            Id = Guid.NewGuid(), Mrn = "MRN-MED-001", FirstName = "Med", LastName = "Test",
+            DateOfBirth = new DateOnly(1980, 3, 15), Gender = "F", CreatedAt = DateTimeOffset.UtcNow
+        };
+        var activeEncounter = new Encounter
+        {
+            Id = Guid.NewGuid(), PatientId = patient.Id, EncounterType = EncounterType.Inpatient,
+            Status = EncounterStatus.Active, Department = Department.Icu,
+            AttendingPhysician = "Dr. Medication", AdmittedAt = DateTimeOffset.UtcNow,
+            CreatedAt = DateTimeOffset.UtcNow
+        };
+        var dischargedEncounter = new Encounter
+        {
+            Id = Guid.NewGuid(), PatientId = patient.Id, EncounterType = EncounterType.Inpatient,
+            Status = EncounterStatus.Discharged, Department = Department.Icu,
+            AttendingPhysician = "Dr. Medication", AdmittedAt = DateTimeOffset.UtcNow.AddDays(-3),
+            DischargedAt = DateTimeOffset.UtcNow.AddHours(-1),
+            CreatedAt = DateTimeOffset.UtcNow
+        };
+        db.Patients.Add(patient);
+        db.Encounters.Add(activeEncounter);
+        db.Encounters.Add(dischargedEncounter);
+        await db.SaveChangesAsync();
+
+        _patientId = patient.Id;
+        _activeEncounterId = activeEncounter.Id;
+        _dischargedEncounterId = dischargedEncounter.Id;
+    }
+
+    [Fact]
+    public async Task Create_OnActiveEncounter_Succeeds()
+    {
+        await ResetAndSeedAsync();
+
+        using var scope = _fixture.Services.CreateScope();
+        var service = scope.ServiceProvider.GetRequiredService<IMedicationService>();
+
+        var med = await service.CreateAsync(_activeEncounterId,
+            new CreateMedicationAdministrationRequest(
+                "metoprolol", 25m, "mg", "PO", null, "nurse-1"));
+
+        med.Should().NotBeNull();
+        med.DrugName.Should().Be("metoprolol");
+        med.Dose.Should().Be(25m);
+        med.DoseUnit.Should().Be("mg");
+        med.Route.Should().Be("PO");
+        med.EncounterId.Should().Be(_activeEncounterId);
+
+        var db = scope.ServiceProvider.GetRequiredService<AppDbContext>();
+        var persisted = await db.MedicationAdministrations.FindAsync(med.Id);
+        persisted.Should().NotBeNull();
+    }
+
+    [Fact]
+    public async Task Create_OnDischargedEncounter_ThrowsConflict()
+    {
+        await ResetAndSeedAsync();
+
+        using var scope = _fixture.Services.CreateScope();
+        var service = scope.ServiceProvider.GetRequiredService<IMedicationService>();
+
+        var act = () => service.CreateAsync(_dischargedEncounterId,
+            new CreateMedicationAdministrationRequest(
+                "metoprolol", 25m, "mg", "PO", null, "nurse-1"));
+
+        await act.Should().ThrowAsync<ConflictException>();
+    }
+
+    [Fact]
+    public async Task ListByEncounter_ReturnsPaginated()
+    {
+        await ResetAndSeedAsync();
+
+        using var scope = _fixture.Services.CreateScope();
+        var service = scope.ServiceProvider.GetRequiredService<IMedicationService>();
+
+        await service.CreateAsync(_activeEncounterId,
+            new CreateMedicationAdministrationRequest(
+                "metoprolol", 25m, "mg", "PO", null, "nurse-1"));
+        await service.CreateAsync(_activeEncounterId,
+            new CreateMedicationAdministrationRequest(
+                "morphine", 4m, "mg", "IV", null, "nurse-2"));
+        await service.CreateAsync(_activeEncounterId,
+            new CreateMedicationAdministrationRequest(
+                "insulin", 10m, "units", "SubQ", null, "nurse-1"));
+
+        var result = await service.ListByEncounterAsync(_activeEncounterId, null, 1, 2);
+
+        result.TotalCount.Should().Be(3);
+        result.Items.Should().HaveCount(2);
+        result.TotalPages.Should().Be(2);
+    }
+
+    [Fact]
+    public async Task GetRecentForEncounter_FiltersByWindow()
+    {
+        await ResetAndSeedAsync();
+
+        using var scope = _fixture.Services.CreateScope();
+        var service = scope.ServiceProvider.GetRequiredService<IMedicationService>();
+        var db = scope.ServiceProvider.GetRequiredService<AppDbContext>();
+
+        // Recent metoprolol — within 90-min window
+        await service.CreateAsync(_activeEncounterId,
+            new CreateMedicationAdministrationRequest(
+                "metoprolol", 25m, "mg", "PO",
+                DateTimeOffset.UtcNow.AddMinutes(-30), "nurse-1"));
+
+        // Old metoprolol — outside 90-min window
+        db.MedicationAdministrations.Add(new MedicationAdministration
+        {
+            Id = Guid.NewGuid(),
+            EncounterId = _activeEncounterId,
+            DrugName = "metoprolol",
+            Dose = 50m,
+            DoseUnit = "mg",
+            Route = "PO",
+            AdministeredAt = DateTimeOffset.UtcNow.AddMinutes(-120),
+            AdministeredBy = "nurse-2"
+        });
+        await db.SaveChangesAsync();
+
+        var recent = await service.GetRecentForEncounterAsync(
+            _activeEncounterId, "SYSTOLIC_BP", 90);
+
+        recent.Should().HaveCount(1);
+        recent[0].Dose.Should().Be(25m);
+    }
+}