feature: Self-Service Clinical Testing Sessions
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voltsrage
@@ -0,0 +1,243 @@
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using Microsoft.EntityFrameworkCore;
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public interface ISimulationPurgeService
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{
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Task<SimulationDataSummary> GetSummaryAsync(CancellationToken ct);
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Task<SimulationPurgeResult> PurgeAsync(CancellationToken ct);
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}
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public record SimulationDataSummary(
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int SimulatedPatients,
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int Encounters,
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int Observations,
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int Alerts,
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int ActiveRuns);
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public record SimulationPurgeResult(
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int PatientsDeleted,
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int EncountersDeleted,
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int AlertsDeleted,
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int RunsCleared);
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/// <summary>
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/// Deletes all patients with <c>IsSimulated = true</c> and their dependents.
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/// Never deletes by encounter or date range — only the simulated-patient predicate.
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/// </summary>
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public sealed class SimulationPurgeService : ISimulationPurgeService
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{
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private readonly AppDbContext _db;
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private readonly ISimulationRunner _runner;
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private readonly IAuditService _audit;
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public SimulationPurgeService(
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AppDbContext db,
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ISimulationRunner runner,
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IAuditService audit)
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{
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_db = db;
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_runner = runner;
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_audit = audit;
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}
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public async Task<SimulationDataSummary> GetSummaryAsync(CancellationToken ct)
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{
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var patientIds = await _db.Patients
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.Where(p => p.IsSimulated)
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.Select(p => p.Id)
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.ToListAsync(ct);
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if (patientIds.Count == 0)
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{
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return new SimulationDataSummary(
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0, 0, 0, 0,
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_runner.ListRuns().Count(r =>
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r.Status is SimulationRunStatus.Pending or SimulationRunStatus.Running));
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}
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var encounterIds = await _db.Encounters
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.Where(e => patientIds.Contains(e.PatientId))
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.Select(e => e.Id)
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.ToListAsync(ct);
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var observations = encounterIds.Count == 0
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? 0
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: await _db.Observations.CountAsync(o => encounterIds.Contains(o.EncounterId), ct);
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var alerts = await _db.ClinicalAlerts
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.CountAsync(a => patientIds.Contains(a.PatientId), ct);
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var activeRuns = _runner.ListRuns().Count(r =>
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r.Status is SimulationRunStatus.Pending or SimulationRunStatus.Running);
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return new SimulationDataSummary(
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patientIds.Count,
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encounterIds.Count,
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observations,
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alerts,
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activeRuns);
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}
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public async Task<SimulationPurgeResult> PurgeAsync(CancellationToken ct)
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{
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if (_runner.HasActiveRuns())
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throw new ConflictException(
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"Cannot purge simulated data while runs are Pending or Running. Stop all runs first.",
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"SIMULATION_PURGE_ACTIVE_RUNS");
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await using var tx = await _db.Database.BeginTransactionAsync(ct);
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var patientIds = await _db.Patients
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.Where(p => p.IsSimulated)
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.Select(p => p.Id)
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.ToListAsync(ct);
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if (patientIds.Count == 0)
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{
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var emptyRunsCleared = await ClearSimulationRunsAsync(ct);
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await tx.CommitAsync(ct);
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_runner.ClearRegistry();
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var emptyResult = new SimulationPurgeResult(0, 0, 0, emptyRunsCleared);
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await WriteAuditAsync(emptyResult);
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return emptyResult;
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}
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var encounterIds = await _db.Encounters
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.Where(e => patientIds.Contains(e.PatientId))
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.Select(e => e.Id)
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.ToListAsync(ct);
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var alertIds = await _db.ClinicalAlerts
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.Where(a => patientIds.Contains(a.PatientId))
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.Select(a => a.Id)
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.ToListAsync(ct);
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var alertsDeleted = alertIds.Count;
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var encountersDeleted = encounterIds.Count;
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var patientsDeleted = patientIds.Count;
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// FK order — Restrict relationships require dependents first.
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if (encounterIds.Count > 0)
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{
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await _db.MedicationAdministrations
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.Where(m => encounterIds.Contains(m.EncounterId))
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.ExecuteDeleteAsync(ct);
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var bundleIds = await _db.SepsisBundles
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.Where(b => encounterIds.Contains(b.EncounterId))
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.Select(b => b.Id)
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.ToListAsync(ct);
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if (bundleIds.Count > 0)
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{
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await _db.SepsisBundleElements
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.Where(e => bundleIds.Contains(e.BundleId))
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.ExecuteDeleteAsync(ct);
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await _db.SepsisBundles
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.Where(b => bundleIds.Contains(b.Id))
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.ExecuteDeleteAsync(ct);
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}
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await _db.Orders
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.Where(o => encounterIds.Contains(o.EncounterId))
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.ExecuteDeleteAsync(ct);
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await _db.ReconciliationAlerts
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.Where(r => r.EncounterId != null && encounterIds.Contains(r.EncounterId.Value))
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.ExecuteDeleteAsync(ct);
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var encounterKeys = encounterIds.Select(id => id.ToString()).ToList();
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await _db.OutboxEvents
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.Where(o => o.PartitionKey != null && encounterKeys.Contains(o.PartitionKey))
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.ExecuteDeleteAsync(ct);
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await _db.Observations
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.Where(o => encounterIds.Contains(o.EncounterId))
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.ExecuteDeleteAsync(ct);
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await _db.News2Scores
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.Where(s => encounterIds.Contains(s.EncounterId))
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.ExecuteDeleteAsync(ct);
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await _db.SofaScores
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.Where(s => encounterIds.Contains(s.EncounterId))
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.ExecuteDeleteAsync(ct);
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await _db.GcsScores
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.Where(s => encounterIds.Contains(s.EncounterId))
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.ExecuteDeleteAsync(ct);
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await _db.QsofaEvaluations
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.Where(s => encounterIds.Contains(s.EncounterId))
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.ExecuteDeleteAsync(ct);
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}
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if (alertIds.Count > 0)
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{
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// AlertFeedback cascades with alert, but delete explicitly for clarity.
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await _db.AlertFeedbacks
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.Where(f => alertIds.Contains(f.AlertId))
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.ExecuteDeleteAsync(ct);
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await _db.ClinicalAlerts
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.Where(a => alertIds.Contains(a.Id))
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.ExecuteDeleteAsync(ct);
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}
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// Window aggregates are not patient-scoped; clear them so the next tester
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// starts with a clean quality dashboard after a ward reset.
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await _db.AlertQualityMetrics.ExecuteDeleteAsync(ct);
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await _db.PhiAccessLogs
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.Where(l => l.PatientId != null && patientIds.Contains(l.PatientId.Value))
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.ExecuteDeleteAsync(ct);
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var resourceIds = patientIds.Concat(encounterIds).ToList();
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if (resourceIds.Count > 0)
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{
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await _db.ExternalResourceIdentifiers
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.Where(x => resourceIds.Contains(x.InternalId))
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.ExecuteDeleteAsync(ct);
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}
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if (encounterIds.Count > 0)
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{
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await _db.Encounters
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.Where(e => encounterIds.Contains(e.Id))
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.ExecuteDeleteAsync(ct);
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}
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await _db.Patients
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.Where(p => patientIds.Contains(p.Id))
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.ExecuteDeleteAsync(ct);
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var runsCleared = await ClearSimulationRunsAsync(ct);
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await tx.CommitAsync(ct);
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_runner.ClearRegistry();
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var result = new SimulationPurgeResult(
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patientsDeleted, encountersDeleted, alertsDeleted, runsCleared);
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await WriteAuditAsync(result);
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return result;
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}
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private async Task<int> ClearSimulationRunsAsync(CancellationToken ct)
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{
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var count = await _db.SimulationRuns.CountAsync(ct);
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if (count > 0)
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await _db.SimulationRuns.ExecuteDeleteAsync(ct);
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return count;
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}
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private async Task WriteAuditAsync(SimulationPurgeResult result)
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{
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await _audit.WriteAsync(
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AuditAction.SimulationDataPurged,
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"SimulationData",
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Guid.NewGuid(),
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newValue: new
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{
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result.PatientsDeleted,
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result.EncountersDeleted,
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result.AlertsDeleted,
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result.RunsCleared,
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});
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}
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}
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