feature: Self-Service Clinical Testing Sessions
This commit is contained in:
voltsrage
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using System.Net;
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using System.Net.Http.Json;
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using System.Text.Json;
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using FluentAssertions;
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using Microsoft.EntityFrameworkCore;
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using Microsoft.Extensions.Configuration;
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using Microsoft.Extensions.DependencyInjection;
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using StackExchange.Redis;
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[Collection("Integration")]
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public class SimulationPurgeTests : IAsyncLifetime
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{
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private readonly ApiFixture _fixture;
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private readonly HttpClient _client;
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private ISimulationRunner _runner = null!;
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private TestSimulationClientFactory _clientFactory = null!;
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public SimulationPurgeTests(ApiFixture fixture)
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{
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_fixture = fixture;
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_client = fixture.CreateClient();
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}
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public async Task InitializeAsync()
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{
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using var scope = _fixture.Services.CreateScope();
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var db = scope.ServiceProvider.GetRequiredService<AppDbContext>();
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var redis = scope.ServiceProvider.GetRequiredService<IConnectionMultiplexer>();
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await DbResetHelper.ResetAsync(db);
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await DataSeeder.SeedThresholdsOnlyAsync(db, redis);
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_runner = _fixture.Services.GetRequiredService<ISimulationRunner>();
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_clientFactory = _fixture.SimulationClientFactory;
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_clientFactory.HangOnCreate = false;
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_clientFactory.FailOnCreate = false;
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foreach (var run in _runner.ListRuns())
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_runner.Cancel(run.RunId);
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await WaitForAsync(() => !_runner.HasActiveRuns());
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_runner.ClearRegistry();
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_client.DefaultRequestHeaders.Remove("X-Test-Role");
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_client.DefaultRequestHeaders.Remove("X-Test-User-Id");
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_client.AsNurse();
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}
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public Task DisposeAsync()
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{
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_clientFactory.HangOnCreate = false;
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_clientFactory.FailOnCreate = false;
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return Task.CompletedTask;
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}
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[Fact]
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public async Task Purge_RemovesOnlySimulatedPatients()
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{
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using (var scope = _fixture.Services.CreateScope())
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{
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var db = scope.ServiceProvider.GetRequiredService<AppDbContext>();
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var realPatient = new Patient
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{
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Id = Guid.NewGuid(),
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Mrn = "MRN-REAL-001",
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FirstName = "Real",
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LastName = "Patient",
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DateOfBirth = new DateOnly(1975, 4, 1),
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Gender = "M",
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CreatedAt = DateTimeOffset.UtcNow,
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IsSimulated = false,
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};
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var realEncounter = new Encounter
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{
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Id = Guid.NewGuid(),
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PatientId = realPatient.Id,
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EncounterType = EncounterType.Inpatient,
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Status = EncounterStatus.Active,
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Department = Department.Icu,
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AttendingPhysician = "Dr. Real",
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AdmittedAt = DateTimeOffset.UtcNow,
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CreatedAt = DateTimeOffset.UtcNow,
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};
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var realObs = new Observation
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{
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Id = Guid.NewGuid(),
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EncounterId = realEncounter.Id,
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ObservationCode = "HEART_RATE",
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Value = 70,
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Unit = "bpm",
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Source = ObservationSource.Manual,
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RecordedAt = DateTimeOffset.UtcNow,
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CreatedAt = DateTimeOffset.UtcNow,
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};
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var realAlert = new ClinicalAlert
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{
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Id = Guid.NewGuid(),
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EncounterId = realEncounter.Id,
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PatientId = realPatient.Id,
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AlertType = AlertType.News2Warning,
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Severity = AlertSeverity.Warning,
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Details = "Real patient alert",
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Status = AlertStatus.Acknowledged,
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TriggeredAt = DateTimeOffset.UtcNow.AddMinutes(-10),
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AcknowledgedAt = DateTimeOffset.UtcNow.AddMinutes(-5),
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AcknowledgedBy = "nurse",
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};
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var realFeedback = new AlertFeedback
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{
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Id = Guid.NewGuid(),
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AlertId = realAlert.Id,
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UserId = Guid.NewGuid(),
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FeedbackType = AlertFeedbackType.Useful,
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Comment = "Keep me",
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CreatedAt = DateTimeOffset.UtcNow,
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};
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var simPatient = new Patient
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{
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Id = Guid.NewGuid(),
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Mrn = "MRN-SIM-001",
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FirstName = "Sim",
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LastName = "Patient",
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DateOfBirth = new DateOnly(1980, 1, 1),
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Gender = "F",
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CreatedAt = DateTimeOffset.UtcNow,
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IsSimulated = true,
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};
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var simEncounter = new Encounter
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{
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Id = Guid.NewGuid(),
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PatientId = simPatient.Id,
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EncounterType = EncounterType.Inpatient,
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Status = EncounterStatus.Active,
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Department = Department.GeneralMedicine,
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AttendingPhysician = "Dr. Sim",
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AdmittedAt = DateTimeOffset.UtcNow,
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CreatedAt = DateTimeOffset.UtcNow,
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};
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var simObs = new Observation
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{
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Id = Guid.NewGuid(),
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EncounterId = simEncounter.Id,
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ObservationCode = "HEART_RATE",
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Value = 110,
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Unit = "bpm",
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Source = ObservationSource.Manual,
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RecordedAt = DateTimeOffset.UtcNow,
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CreatedAt = DateTimeOffset.UtcNow,
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};
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var simAlert = new ClinicalAlert
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{
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Id = Guid.NewGuid(),
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EncounterId = simEncounter.Id,
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PatientId = simPatient.Id,
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AlertType = AlertType.News2Emergency,
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Severity = AlertSeverity.Critical,
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Details = "Simulated alert",
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Status = AlertStatus.Open,
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TriggeredAt = DateTimeOffset.UtcNow,
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};
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db.Patients.AddRange(realPatient, simPatient);
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db.Encounters.AddRange(realEncounter, simEncounter);
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db.Observations.AddRange(realObs, simObs);
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db.ClinicalAlerts.AddRange(realAlert, simAlert);
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db.AlertFeedbacks.Add(realFeedback);
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await db.SaveChangesAsync();
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}
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var resp = await _client.DeleteAsync("/api/v1/simulation/data");
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resp.StatusCode.Should().Be(HttpStatusCode.OK);
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var body = await resp.Content.ReadFromJsonAsync<JsonElement>();
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var data = body.GetProperty("data");
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data.GetProperty("patientsDeleted").GetInt32().Should().Be(1);
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data.GetProperty("encountersDeleted").GetInt32().Should().Be(1);
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data.GetProperty("alertsDeleted").GetInt32().Should().Be(1);
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using (var scope = _fixture.Services.CreateScope())
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{
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var db = scope.ServiceProvider.GetRequiredService<AppDbContext>();
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(await db.Patients.AnyAsync(p => p.Mrn == "MRN-SIM-001")).Should().BeFalse();
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var real = await db.Patients.SingleAsync(p => p.Mrn == "MRN-REAL-001");
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real.IsSimulated.Should().BeFalse();
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(await db.Observations.CountAsync(o =>
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db.Encounters.Any(e => e.Id == o.EncounterId && e.PatientId == real.Id)))
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.Should().Be(1);
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(await db.ClinicalAlerts.CountAsync(a => a.PatientId == real.Id)).Should().Be(1);
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(await db.AlertFeedbacks.CountAsync()).Should().Be(1);
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(await db.Patients.CountAsync(p => p.IsSimulated)).Should().Be(0);
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}
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}
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[Fact]
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public async Task Purge_CascadesDependentRows()
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{
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Guid simPatientId;
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Guid simEncounterId;
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using (var scope = _fixture.Services.CreateScope())
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{
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var db = scope.ServiceProvider.GetRequiredService<AppDbContext>();
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var simPatient = new Patient
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{
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Id = Guid.NewGuid(),
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Mrn = "MRN-SIM-CASCADE",
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FirstName = "Cascade",
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LastName = "Sim",
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DateOfBirth = new DateOnly(1982, 2, 2),
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Gender = "M",
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CreatedAt = DateTimeOffset.UtcNow,
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IsSimulated = true,
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};
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var simEncounter = new Encounter
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{
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Id = Guid.NewGuid(),
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PatientId = simPatient.Id,
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EncounterType = EncounterType.Inpatient,
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Status = EncounterStatus.Active,
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Department = Department.Icu,
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AttendingPhysician = "Dr. Cascade",
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AdmittedAt = DateTimeOffset.UtcNow,
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CreatedAt = DateTimeOffset.UtcNow,
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};
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simPatientId = simPatient.Id;
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simEncounterId = simEncounter.Id;
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db.Patients.Add(simPatient);
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db.Encounters.Add(simEncounter);
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db.Observations.Add(new Observation
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{
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Id = Guid.NewGuid(),
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EncounterId = simEncounter.Id,
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ObservationCode = "HEART_RATE",
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Value = 120,
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Unit = "bpm",
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Source = ObservationSource.Manual,
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RecordedAt = DateTimeOffset.UtcNow,
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CreatedAt = DateTimeOffset.UtcNow,
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});
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db.News2Scores.Add(new News2Score
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{
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Id = Guid.NewGuid(),
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EncounterId = simEncounter.Id,
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PatientId = simPatient.Id,
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TotalScore = 5,
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RiskLevel = "MEDIUM",
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CalculatedAt = DateTimeOffset.UtcNow,
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});
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db.GcsScores.Add(new GcsScore
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{
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Id = Guid.NewGuid(),
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EncounterId = simEncounter.Id,
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PatientId = simPatient.Id,
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EyeScore = 4,
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VerbalScore = 5,
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MotorScore = 6,
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TotalScore = 15,
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Classification = "MILD",
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CalculatedAt = DateTimeOffset.UtcNow,
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CreatedAt = DateTimeOffset.UtcNow,
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});
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db.SofaScores.Add(new SofaScore
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{
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Id = Guid.NewGuid(),
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EncounterId = simEncounter.Id,
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PatientId = simPatient.Id,
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TotalScore = 2,
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CalculatedAt = DateTimeOffset.UtcNow,
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CreatedAt = DateTimeOffset.UtcNow,
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});
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db.QsofaEvaluations.Add(new QsofaEvaluation
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{
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Id = Guid.NewGuid(),
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EncounterId = simEncounter.Id,
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PatientId = simPatient.Id,
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ActiveCriteria = 1,
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EvaluatedAt = DateTimeOffset.UtcNow,
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CreatedAt = DateTimeOffset.UtcNow,
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});
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var alert = new ClinicalAlert
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{
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Id = Guid.NewGuid(),
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EncounterId = simEncounter.Id,
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PatientId = simPatient.Id,
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AlertType = AlertType.News2Warning,
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Severity = AlertSeverity.Warning,
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Details = "Cascade alert",
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Status = AlertStatus.Acknowledged,
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TriggeredAt = DateTimeOffset.UtcNow,
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AcknowledgedAt = DateTimeOffset.UtcNow,
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AcknowledgedBy = "nurse",
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};
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db.ClinicalAlerts.Add(alert);
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db.AlertFeedbacks.Add(new AlertFeedback
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{
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Id = Guid.NewGuid(),
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AlertId = alert.Id,
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UserId = Guid.NewGuid(),
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FeedbackType = AlertFeedbackType.Useful,
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CreatedAt = DateTimeOffset.UtcNow,
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});
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db.PhiAccessLogs.Add(new PhiAccessLog
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{
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Id = Guid.NewGuid(),
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PatientId = simPatient.Id,
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AccessType = PhiAccessType.View,
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AccessedAt = DateTimeOffset.UtcNow,
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UserId = Guid.NewGuid(),
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UserDisplayName = "nurse",
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ResourcePath = "/api/v1/patients/" + simPatient.Id,
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});
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await db.SaveChangesAsync();
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}
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var resp = await _client.DeleteAsync("/api/v1/simulation/data");
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resp.StatusCode.Should().Be(HttpStatusCode.OK);
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using (var scope = _fixture.Services.CreateScope())
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{
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var db = scope.ServiceProvider.GetRequiredService<AppDbContext>();
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(await db.Patients.AnyAsync(p => p.Id == simPatientId)).Should().BeFalse();
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(await db.Encounters.AnyAsync(e => e.Id == simEncounterId)).Should().BeFalse();
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(await db.Observations.AnyAsync(o => o.EncounterId == simEncounterId)).Should().BeFalse();
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(await db.News2Scores.AnyAsync(s => s.EncounterId == simEncounterId)).Should().BeFalse();
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(await db.GcsScores.AnyAsync(s => s.EncounterId == simEncounterId)).Should().BeFalse();
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(await db.SofaScores.AnyAsync(s => s.EncounterId == simEncounterId)).Should().BeFalse();
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(await db.QsofaEvaluations.AnyAsync(s => s.EncounterId == simEncounterId)).Should().BeFalse();
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(await db.ClinicalAlerts.AnyAsync(a => a.PatientId == simPatientId)).Should().BeFalse();
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(await db.AlertFeedbacks.CountAsync()).Should().Be(0);
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(await db.PhiAccessLogs.AnyAsync(l => l.PatientId == simPatientId)).Should().BeFalse();
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}
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}
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[Fact]
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public async Task Purge_WithActiveRun_Returns409()
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{
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_clientFactory.HangOnCreate = true;
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var state = await _runner.StartAsync("minimal-sim-01", 60, "tester", CancellationToken.None);
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var resp = await _client.DeleteAsync("/api/v1/simulation/data");
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resp.StatusCode.Should().Be(HttpStatusCode.Conflict);
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var body = await resp.Content.ReadFromJsonAsync<JsonElement>();
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body.GetProperty("error").GetProperty("code").GetString()
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.Should().Be("SIMULATION_PURGE_ACTIVE_RUNS");
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_runner.Cancel(state.RunId);
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await WaitForAsync(() => !_runner.HasActiveRuns());
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}
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[Fact]
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public async Task Purge_WritesAuditLog()
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{
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using (var scope = _fixture.Services.CreateScope())
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{
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var db = scope.ServiceProvider.GetRequiredService<AppDbContext>();
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db.Patients.Add(new Patient
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{
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Id = Guid.NewGuid(),
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Mrn = "MRN-SIM-AUDIT",
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FirstName = "Sim",
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LastName = "Audit",
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DateOfBirth = new DateOnly(1990, 1, 1),
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Gender = "M",
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CreatedAt = DateTimeOffset.UtcNow,
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IsSimulated = true,
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});
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await db.SaveChangesAsync();
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}
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var resp = await _client.DeleteAsync("/api/v1/simulation/data");
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resp.StatusCode.Should().Be(HttpStatusCode.OK);
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using (var scope = _fixture.Services.CreateScope())
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{
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var db = scope.ServiceProvider.GetRequiredService<AppDbContext>();
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var audit = await db.ClinicalAuditLogs
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.SingleAsync(l => l.Action == AuditAction.SimulationDataPurged);
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audit.NewValueJson.Should().Contain("PatientsDeleted");
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}
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}
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[Fact]
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public async Task Purge_WhenDisabled_Returns404()
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{
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using var factory = _fixture.WithWebHostBuilder(builder =>
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{
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builder.ConfigureAppConfiguration((_, config) =>
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{
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config.AddInMemoryCollection(new Dictionary<string, string?>
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{
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["Simulation:Enabled"] = "false",
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});
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});
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});
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var client = factory.CreateClient();
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client.AsNurse();
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var resp = await client.DeleteAsync("/api/v1/simulation/data");
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resp.StatusCode.Should().Be(HttpStatusCode.NotFound);
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}
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private static async Task WaitForAsync(Func<bool> condition, TimeSpan? timeout = null)
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{
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var deadline = DateTimeOffset.UtcNow + (timeout ?? TimeSpan.FromSeconds(15));
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while (DateTimeOffset.UtcNow < deadline)
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{
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if (condition())
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return;
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await Task.Delay(25);
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}
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throw new TimeoutException("Condition was not met within the timeout.");
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}
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}
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