feature: Schema, Migrations, Core CRUD, and Redis Threshold Cache

2026-06-16 17:59:16 +08:00
commit 882d4af3e6
63 changed files with 3923 additions and 0 deletions
@@ -0,0 +1,22 @@
+using Microsoft.EntityFrameworkCore;
+using Microsoft.EntityFrameworkCore.Metadata.Builders;
+
+public class AlertThresholdConfiguration : IEntityTypeConfiguration<AlertThreshold>
+{
+    public void Configure(EntityTypeBuilder<AlertThreshold> builder)
+    {
+        builder.ToTable("alert_thresholds");
+        builder.HasKey(t => t.Id);
+        builder.Property(t => t.Id).HasColumnName("id").HasDefaultValueSql("gen_random_uuid()");
+        builder.Property(t => t.ObservationCode).HasColumnName("observation_code").HasMaxLength(50).IsRequired();
+        builder.Property(t => t.DisplayName).HasColumnName("display_name").HasMaxLength(200).IsRequired();
+        builder.Property(t => t.Unit).HasColumnName("unit").HasMaxLength(20).IsRequired();
+        builder.Property(t => t.CriticalLow).HasColumnName("critical_low").HasColumnType("decimal(10,3)");
+        builder.Property(t => t.WarningLow).HasColumnName("warning_low").HasColumnType("decimal(10,3)");
+        builder.Property(t => t.WarningHigh).HasColumnName("warning_high").HasColumnType("decimal(10,3)");
+        builder.Property(t => t.CriticalHigh).HasColumnName("critical_high").HasColumnType("decimal(10,3)");
+        builder.Property(t => t.CreatedAt).HasColumnName("created_at").HasDefaultValueSql("NOW()");
+
+        builder.HasIndex(t => t.ObservationCode).IsUnique();
+    }
+}
@@ -0,0 +1,61 @@
+using Microsoft.EntityFrameworkCore;
+using Microsoft.EntityFrameworkCore.Metadata.Builders;
+
+public class ClinicalAlertConfiguration : IEntityTypeConfiguration<ClinicalAlert>
+{
+    public void Configure(EntityTypeBuilder<ClinicalAlert> builder)
+    {
+        builder.ToTable("clinical_alerts", t =>
+        {
+            t.HasCheckConstraint("chk_clinical_alerts_severity",
+                "severity IN ('WARNING', 'CRITICAL')");
+            t.HasCheckConstraint("chk_clinical_alerts_status",
+                "status IN ('OPEN', 'ACKNOWLEDGED', 'RESOLVED', 'ESCALATED')");
+            t.HasCheckConstraint("chk_clinical_alerts_alert_type",
+                "alert_type IN ('SEPSIS_WARNING', 'CRITICAL_HEART_RATE', 'CRITICAL_TEMP_C', " +
+                "'CRITICAL_POTASSIUM_MEQ_L', 'CRITICAL_SPO2', 'CRITICAL_RESP_RATE', 'CRITICAL_WBC_K_UL')");
+        });
+        builder.HasKey(a => a.Id);
+        builder.Property(a => a.Id).HasColumnName("id").HasDefaultValueSql("gen_random_uuid()");
+        builder.Property(a => a.EncounterId).HasColumnName("encounter_id");
+        builder.Property(a => a.PatientId).HasColumnName("patient_id");
+        builder.Property(a => a.ObservationId).HasColumnName("observation_id");
+        builder.Property(a => a.AlertType)
+            .HasColumnName("alert_type")
+            .HasMaxLength(50)
+            .HasConversion(
+                v => v.ToDbString(),
+                v => AlertTypeExtensions.FromDbString(v))
+            .IsRequired();
+        builder.Property(a => a.Severity)
+            .HasColumnName("severity")
+            .HasMaxLength(20)
+            .HasConversion(
+                v => v.ToDbString(),
+                v => AlertSeverityExtensions.FromDbString(v))
+            .IsRequired();
+        builder.Property(a => a.Details).HasColumnName("details").IsRequired();
+        builder.Property(a => a.Status)
+            .HasColumnName("status")
+            .HasMaxLength(20)
+            .HasConversion(
+                v => v.ToDbString(),
+                v => AlertStatusExtensions.FromDbString(v))
+            .HasDefaultValueSql("'OPEN'")
+            .HasSentinel((AlertStatus)(-1));
+        builder.Property(a => a.AcknowledgedAt).HasColumnName("acknowledged_at");
+        builder.Property(a => a.AcknowledgedBy).HasColumnName("acknowledged_by").HasMaxLength(200);
+        builder.Property(a => a.ResolvedAt).HasColumnName("resolved_at");
+        builder.Property(a => a.TriggeredAt).HasColumnName("triggered_at").HasDefaultValueSql("NOW()");
+
+        builder.HasOne(a => a.Encounter)
+            .WithMany(e => e.Alerts)
+            .HasForeignKey(a => a.EncounterId)
+            .OnDelete(DeleteBehavior.Restrict);
+
+        builder.HasIndex(a => new { a.EncounterId, a.TriggeredAt });
+        builder.HasIndex(a => new { a.PatientId, a.TriggeredAt });
+        builder.HasIndex(a => new { a.Severity, a.TriggeredAt })
+            .HasFilter("status = 'OPEN'");
+    }
+}
@@ -0,0 +1,48 @@
+using Microsoft.EntityFrameworkCore;
+using Microsoft.EntityFrameworkCore.Metadata.Builders;
+
+public class EncounterConfiguration : IEntityTypeConfiguration<Encounter>
+{
+    public void Configure(EntityTypeBuilder<Encounter> builder)
+    {
+        builder.ToTable("encounters", t =>
+        {
+            t.HasCheckConstraint("chk_encounters_encounter_type",
+                "encounter_type IN ('INPATIENT', 'OUTPATIENT', 'EMERGENCY')");
+            t.HasCheckConstraint("chk_encounters_status",
+                "status IN ('SCHEDULED', 'ACTIVE', 'DISCHARGED', 'CANCELLED')");
+        });
+        builder.HasKey(e => e.Id);
+        builder.Property(e => e.Id).HasColumnName("id").HasDefaultValueSql("gen_random_uuid()");
+        builder.Property(e => e.PatientId).HasColumnName("patient_id");
+        builder.Property(e => e.EncounterType)
+            .HasColumnName("encounter_type")
+            .HasMaxLength(20)
+            .HasConversion(
+                v => v.ToDbString(),
+                v => EncounterTypeExtensions.FromDbString(v))
+            .IsRequired();
+        builder.Property(e => e.Status)
+            .HasColumnName("status")
+            .HasMaxLength(20)
+            .HasConversion(
+                v => v.ToDbString(),
+                v => EncounterStatusExtensions.FromDbString(v))
+            .HasDefaultValueSql("'SCHEDULED'")
+            .HasSentinel((EncounterStatus)(-1));
+        builder.Property(e => e.Department).HasColumnName("department").HasMaxLength(100).IsRequired();
+        builder.Property(e => e.AttendingPhysician).HasColumnName("attending_physician").HasMaxLength(200).IsRequired();
+        builder.Property(e => e.AdmittedAt).HasColumnName("admitted_at").HasDefaultValueSql("NOW()");
+        builder.Property(e => e.DischargedAt).HasColumnName("discharged_at");
+        builder.Property(e => e.CreatedAt).HasColumnName("created_at").HasDefaultValueSql("NOW()");
+
+        builder.HasOne(e => e.Patient)
+            .WithMany(p => p.Encounters)
+            .HasForeignKey(e => e.PatientId)
+            .OnDelete(DeleteBehavior.Restrict);
+
+        builder.HasIndex(e => new { e.PatientId, e.AdmittedAt });
+        builder.HasIndex(e => new { e.Status, e.AdmittedAt })
+            .HasFilter("status = 'ACTIVE'");
+    }
+}
@@ -0,0 +1,44 @@
+using Microsoft.EntityFrameworkCore;
+using Microsoft.EntityFrameworkCore.Metadata.Builders;
+
+public class ObservationConfiguration : IEntityTypeConfiguration<Observation>
+{
+    public void Configure(EntityTypeBuilder<Observation> builder)
+    {
+        builder.ToTable("observations", t =>
+        {
+            t.HasCheckConstraint("chk_observations_source",
+                "source IN ('MANUAL', 'DEVICE', 'LAB')");
+        });
+        builder.HasKey(o => o.Id);
+        builder.Property(o => o.Id).HasColumnName("id").HasDefaultValueSql("gen_random_uuid()");
+        builder.Property(o => o.EncounterId).HasColumnName("encounter_id");
+        builder.Property(o => o.ObservationCode).HasColumnName("observation_code").HasMaxLength(50).IsRequired();
+        builder.Property(o => o.Value).HasColumnName("value").HasColumnType("decimal(10,3)").IsRequired();
+        builder.Property(o => o.Unit).HasColumnName("unit").HasMaxLength(20).IsRequired();
+        builder.Property(o => o.Source)
+            .HasColumnName("source")
+            .HasMaxLength(20)
+            .HasConversion(
+                v => v.ToDbString(),
+                v => ObservationSourceExtensions.FromDbString(v))
+            .HasDefaultValueSql("'MANUAL'")
+            .HasSentinel((ObservationSource)(-1));
+        builder.Property(o => o.IdempotencyKey).HasColumnName("idempotency_key").HasMaxLength(100);
+        builder.Property(o => o.RecordedAt).HasColumnName("recorded_at");
+        builder.Property(o => o.CreatedAt).HasColumnName("created_at").HasDefaultValueSql("NOW()");
+
+        builder.HasOne(o => o.Encounter)
+            .WithMany(e => e.Observations)
+            .HasForeignKey(o => o.EncounterId)
+            .OnDelete(DeleteBehavior.Restrict);
+
+        // Partial unique index — only non-null idempotency keys are checked for uniqueness.
+        // Devices that do not send a key are not subject to deduplication.
+        builder.HasIndex(o => o.IdempotencyKey)
+            .IsUnique()
+            .HasFilter("idempotency_key IS NOT NULL");
+
+        builder.HasIndex(o => new { o.EncounterId, o.ObservationCode, o.RecordedAt });
+    }
+}
@@ -0,0 +1,38 @@
+using Microsoft.EntityFrameworkCore;
+using Microsoft.EntityFrameworkCore.Metadata.Builders;
+
+public class OrderConfiguration : IEntityTypeConfiguration<Order>
+{
+    public void Configure(EntityTypeBuilder<Order> builder)
+    {
+        builder.ToTable("orders", t =>
+        {
+            t.HasCheckConstraint("chk_orders_order_type",
+                "order_type IN ('LAB', 'IMAGING', 'MEDICATION', 'PROCEDURE')");
+        });
+        builder.HasKey(o => o.Id);
+        builder.Property(o => o.Id).HasColumnName("id").HasDefaultValueSql("gen_random_uuid()");
+        builder.Property(o => o.EncounterId).HasColumnName("encounter_id");
+        builder.Property(o => o.OrderType)
+            .HasColumnName("order_type")
+            .HasMaxLength(20)
+            .HasConversion(
+                v => v.ToDbString(),
+                v => OrderTypeExtensions.FromDbString(v))
+            .IsRequired();
+        builder.Property(o => o.Description).HasColumnName("description").IsRequired();
+        builder.Property(o => o.OrderedBy).HasColumnName("ordered_by").HasMaxLength(200).IsRequired();
+        builder.Property(o => o.Status).HasColumnName("status").HasMaxLength(20).HasDefaultValue("pending");
+        builder.Property(o => o.OrderedAt).HasColumnName("ordered_at").HasDefaultValueSql("NOW()");
+        builder.Property(o => o.ResultedAt).HasColumnName("resulted_at");
+
+        builder.HasOne(o => o.Encounter)
+            .WithMany(e => e.Orders)
+            .HasForeignKey(o => o.EncounterId)
+            .OnDelete(DeleteBehavior.Restrict);
+
+        builder.HasIndex(o => new { o.EncounterId, o.OrderedAt });
+        builder.HasIndex(o => new { o.Status, o.OrderedAt })
+            .HasFilter("status IN ('pending', 'in_progress')");
+    }
+}
@@ -0,0 +1,19 @@
+using Microsoft.EntityFrameworkCore;
+using Microsoft.EntityFrameworkCore.Metadata.Builders;
+
+public class OutboxEventConfiguration : IEntityTypeConfiguration<OutboxEvent>
+{
+    public void Configure(EntityTypeBuilder<OutboxEvent> builder)
+    {
+        builder.ToTable("outbox_events");
+        builder.HasKey(o => o.Id);
+        builder.Property(o => o.Id).HasColumnName("id").HasDefaultValueSql("gen_random_uuid()");
+        builder.Property(o => o.Topic).HasColumnName("topic").HasMaxLength(200).IsRequired();
+        builder.Property(o => o.Payload).HasColumnName("payload").HasColumnType("jsonb").IsRequired();
+        builder.Property(o => o.CreatedAt).HasColumnName("created_at").HasDefaultValueSql("NOW()");
+        builder.Property(o => o.ProcessedAt).HasColumnName("processed_at");
+
+        builder.HasIndex(o => o.CreatedAt)
+            .HasFilter("processed_at IS NULL");
+    }
+}
@@ -0,0 +1,26 @@
+using Microsoft.EntityFrameworkCore;
+using Microsoft.EntityFrameworkCore.Metadata.Builders;
+
+public class PatientConfiguration : IEntityTypeConfiguration<Patient>
+{
+    public void Configure(EntityTypeBuilder<Patient> builder)
+    {
+        builder.ToTable("patients");
+        builder.HasKey(p => p.Id);
+        builder.Property(p => p.Id).HasColumnName("id").HasDefaultValueSql("gen_random_uuid()");
+        builder.Property(p => p.Mrn).HasColumnName("mrn").HasMaxLength(20).IsRequired();
+        builder.Property(p => p.FirstName).HasColumnName("first_name").HasMaxLength(100).IsRequired();
+        builder.Property(p => p.LastName).HasColumnName("last_name").HasMaxLength(100).IsRequired();
+        builder.Property(p => p.DateOfBirth).HasColumnName("date_of_birth");
+        builder.Property(p => p.Gender).HasColumnName("gender").HasMaxLength(10).IsRequired();
+        builder.Property(p => p.Status).HasColumnName("status").HasMaxLength(20).HasDefaultValue("active");
+        builder.Property(p => p.CreatedAt).HasColumnName("created_at").HasDefaultValueSql("NOW()");
+
+        // MRN uses exact-match unique index — MRN lookups are always equality checks,
+        // never LIKE/ILIKE. A B-tree unique index satisfies O(log n) point lookup.
+        // Name search uses ILIKE on first_name/last_name — a prefix scan, not an
+        // equality match — so no index here; full ILIKE is intentionally unindexed
+        // at this scale (pg_trgm GIN would be warranted at >500k patients).
+        builder.HasIndex(p => p.Mrn).IsUnique();
+    }
+}
@@ -0,0 +1,31 @@
+using Microsoft.EntityFrameworkCore;
+using Microsoft.EntityFrameworkCore.Metadata.Builders;
+
+public class ReconciliationAlertConfiguration : IEntityTypeConfiguration<ReconciliationAlert>
+{
+    public void Configure(EntityTypeBuilder<ReconciliationAlert> builder)
+    {
+        builder.ToTable("reconciliation_alerts", t =>
+        {
+            t.HasCheckConstraint("chk_reconciliation_alerts_check_type",
+                "check_type IN ('UNACKNOWLEDGED_CRITICAL_ALERT', 'PENDING_ORDER_NO_RESULT', 'ACTIVE_INPATIENT_NO_OBSERVATION')");
+        });
+        builder.HasKey(r => r.Id);
+        builder.Property(r => r.Id).HasColumnName("id").HasDefaultValueSql("gen_random_uuid()");
+        builder.Property(r => r.CheckType)
+            .HasColumnName("check_type")
+            .HasMaxLength(50)
+            .HasConversion(
+                v => v.ToDbString(),
+                v => ReconciliationCheckTypeExtensions.FromDbString(v))
+            .IsRequired();
+        builder.Property(r => r.EncounterId).HasColumnName("encounter_id");
+        builder.Property(r => r.PatientId).HasColumnName("patient_id");
+        builder.Property(r => r.Details).HasColumnName("details").IsRequired();
+        builder.Property(r => r.ResolvedAt).HasColumnName("resolved_at");
+        builder.Property(r => r.CreatedAt).HasColumnName("created_at").HasDefaultValueSql("NOW()");
+
+        builder.HasIndex(r => new { r.CheckType, r.EncounterId })
+            .HasFilter("resolved_at IS NULL");
+    }
+}