feature: FHIR R4 Inbound Facade
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voltsrage
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using System.Net;
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using System.Text;
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using FluentAssertions;
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using Hl7.Fhir.Model;
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using Hl7.Fhir.Serialization;
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using Microsoft.Extensions.DependencyInjection;
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using Task = System.Threading.Tasks.Task;
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[Collection("Integration")]
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public class FhirIngestTests : IAsyncLifetime
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{
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private const string ApiKey = "dev-integration-key-change-in-production";
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private readonly ApiFixture _fixture;
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private readonly HttpClient _client;
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private static readonly FhirJsonSerializer Serializer = new();
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public FhirIngestTests(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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await DbResetHelper.ResetAsync(db);
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}
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public Task DisposeAsync() => Task.CompletedTask;
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[Fact]
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public async Task PatientUpsert_IsIdempotent()
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{
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var patient = BuildPatient("MRN-HOSP-001");
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var json = Serializer.SerializeToString(patient);
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var resp1 = await PostFhirAsync("/fhir/R4/Patient", json);
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resp1.StatusCode.Should().Be(HttpStatusCode.Created);
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var resp2 = await PostFhirAsync("/fhir/R4/Patient", json);
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resp2.StatusCode.Should().Be(HttpStatusCode.Created);
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}
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[Fact]
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public async Task Observation_HeartRate_Loinc8867_MapsAndIngests()
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{
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var encounterId = await SeedPatientAndEncounterAsync();
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var obs = new Hl7.Fhir.Model.Observation
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{
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Status = ObservationStatus.Final,
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Category = new List<CodeableConcept>
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{
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new("http://terminology.hl7.org/CodeSystem/observation-category", "vital-signs")
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},
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Code = new CodeableConcept("http://loinc.org", "8867-4", "Heart rate"),
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Subject = new ResourceReference("Patient/test"),
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Encounter = new ResourceReference($"Encounter/{encounterId}"),
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Effective = new FhirDateTime(DateTimeOffset.UtcNow),
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Value = new Quantity(110, "/min", "http://unitsofmeasure.org"),
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Identifier = new List<Identifier>
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{
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new("http://hospital.example/obs", "hr-001")
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}
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};
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var resp = await PostFhirAsync("/fhir/R4/Observation", Serializer.SerializeToString(obs));
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resp.StatusCode.Should().Be(HttpStatusCode.Created);
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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 row = db.Observations.Single(o => o.IdempotencyKey == "hr-001");
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row.ObservationCode.Should().Be("HEART_RATE");
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row.Value.Should().Be(110m);
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}
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[Fact]
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public async Task Observation_UnknownLoinc_Returns422()
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{
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var encounterId = await SeedPatientAndEncounterAsync();
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var obs = new Hl7.Fhir.Model.Observation
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{
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Status = ObservationStatus.Final,
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Code = new CodeableConcept("http://loinc.org", "99999-9"),
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Encounter = new ResourceReference($"Encounter/{encounterId}"),
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Value = new Quantity(1, "1")
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};
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var resp = await PostFhirAsync("/fhir/R4/Observation", Serializer.SerializeToString(obs));
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resp.StatusCode.Should().Be(HttpStatusCode.UnprocessableEntity);
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(await resp.Content.ReadAsStringAsync()).Should().Contain("OperationOutcome");
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}
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[Fact]
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public async Task TransactionBundle_PatientEncounterObservation_Succeeds()
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{
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var bundle = BuildAdmitBundle();
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var resp = await PostFhirAsync("/fhir/R4", Serializer.SerializeToString(bundle));
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resp.StatusCode.Should().Be(HttpStatusCode.OK);
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using var scope = _fixture.Services.CreateScope();
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var db = scope.ServiceProvider.GetRequiredService<AppDbContext>();
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db.Patients.Should().Contain(p => p.Mrn == "MRN-ADT-001");
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db.Encounters.Should().Contain(e => e.Status == EncounterStatus.Active);
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db.Observations.Should().Contain(o => o.ObservationCode == "HEART_RATE");
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}
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private async Task<HttpResponseMessage> PostFhirAsync(string path, string json)
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{
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var req = new HttpRequestMessage(HttpMethod.Post, path)
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{
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Content = new StringContent(json, Encoding.UTF8, "application/fhir+json")
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};
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req.Headers.Add("X-Api-Key", ApiKey);
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return await _client.SendAsync(req);
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}
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private static Hl7.Fhir.Model.Patient BuildPatient(string mrn) => new()
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{
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Identifier = new List<Identifier>
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{
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new("http://hospital.example/mrn", mrn)
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{
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Type = new CodeableConcept("http://terminology.hl7.org/CodeSystem/v2-0203", "MR")
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}
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},
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Name = new List<HumanName> { new() { Given = new[] { "Jane" }, Family = "Doe" } },
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BirthDate = "1980-01-15",
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Gender = AdministrativeGender.Female
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};
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private async Task<Guid> SeedPatientAndEncounterAsync()
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{
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using var scope = _fixture.Services.CreateScope();
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var patients = scope.ServiceProvider.GetRequiredService<IPatientService>();
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var patient = await patients.RegisterOrUpdateByIdentifierAsync(new FhirPatientUpsertRequest(
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"http://hospital.example/mrn", "MRN-TEST-001",
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"Test", "Patient", new DateOnly(1990, 1, 1), "female"));
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var encounters = scope.ServiceProvider.GetRequiredService<IEncounterService>();
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var encounter = await encounters.OpenOrUpdateByIdentifierAsync(new FhirEncounterUpsertRequest(
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"http://hospital.example/visit", "VISIT-001",
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patient.Id, EncounterType.Inpatient, Department.Icu,
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"Dr. Smith", EncounterStatus.Active));
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return encounter.Id;
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}
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private static Bundle BuildAdmitBundle()
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{
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var patient = BuildPatient("MRN-ADT-001");
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var encounter = new Hl7.Fhir.Model.Encounter
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{
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Status = Hl7.Fhir.Model.Encounter.EncounterStatus.InProgress,
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Class = new Coding("http://terminology.hl7.org/CodeSystem/v3-ActCode", "IMP"),
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Identifier = new List<Identifier> { new("http://hospital.example/visit", "VISIT-ADT-001") },
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Subject = new ResourceReference
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{
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Identifier = new Identifier("http://hospital.example/mrn", "MRN-ADT-001")
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},
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Participant = new List<Hl7.Fhir.Model.Encounter.ParticipantComponent>
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{
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new()
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{
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Type = new List<CodeableConcept>
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{
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new("http://terminology.hl7.org/CodeSystem/v3-ParticipationType", "ATND")
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},
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Individual = new ResourceReference { Display = "Dr. Admit" }
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}
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}
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};
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var obs = new Hl7.Fhir.Model.Observation
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{
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Status = ObservationStatus.Final,
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Code = new CodeableConcept("http://loinc.org", "8867-4"),
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Encounter = new ResourceReference
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{
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Identifier = new Identifier("http://hospital.example/visit", "VISIT-ADT-001")
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},
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Value = new Quantity(88, "/min"),
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Identifier = new List<Identifier> { new("http://hospital.example/obs", "adt-hr-1") }
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};
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return new Bundle
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{
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Type = Bundle.BundleType.Transaction,
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Entry = new List<Bundle.EntryComponent>
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{
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new() { Resource = patient, Request = new Bundle.RequestComponent { Method = Bundle.HTTPVerb.POST, Url = "Patient" } },
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new() { Resource = encounter, Request = new Bundle.RequestComponent { Method = Bundle.HTTPVerb.POST, Url = "Encounter" } },
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new() { Resource = obs, Request = new Bundle.RequestComponent { Method = Bundle.HTTPVerb.POST, Url = "Observation" } }
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}
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};
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}
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}
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