Clinical Sync Batch Engine: first commit

2026-06-23 03:02:30 +08:00
parent 90b8baa2a1
commit c9994b1ba2
60 changed files with 3547 additions and 31 deletions
@@ -187,6 +187,95 @@ public class ObservationService : IObservationService
        }
    }

+    public async Task ApplySyncedObservationAsync(SyncedObservation obs, CancellationToken ct)
+    {
+        var encounter = await _db.Encounters
+            .Include(e => e.Patient)
+            .FirstOrDefaultAsync(e => e.Id == obs.EncounterId, ct)
+            ?? throw new ValidationException("Encounter not found.", "ENCOUNTER_NOT_FOUND");
+
+        if (encounter.Status != EncounterStatus.Active)
+            throw new ValidationException("Encounter not active.", "ENCOUNTER_NOT_ACTIVE");
+
+        await using var tx = await _db.Database.BeginTransactionAsync(ct);
+        try
+        {
+            var observation = new Observation
+            {
+                Id = obs.ClientRef,
+                EncounterId = obs.EncounterId,
+                ObservationCode = obs.ObservationCode,
+                Value = obs.Value,
+                Unit = obs.Unit ?? "",
+                Source = ObservationSourceExtensions.FromDbString(obs.Source),
+                IdempotencyKey = obs.IdempotencyKey,
+                RecordedAt = obs.RecordedAt,
+                CreatedAt = DateTimeOffset.UtcNow
+            };
+            _db.Observations.Add(observation);
+
+            var threshold = await LoadThresholdAsync(obs.ObservationCode);
+            if (threshold is not null && IsCriticalBreach(obs.Value, threshold))
+            {
+                var hasOpenAlert = await _db.ClinicalAlerts.AnyAsync(a =>
+                    a.EncounterId == obs.EncounterId
+                    && a.ObservationId == observation.Id, ct);
+
+                if (!hasOpenAlert)
+                {
+                    var alert = new ClinicalAlert
+                    {
+                        Id = Guid.NewGuid(),
+                        EncounterId = obs.EncounterId,
+                        PatientId = encounter.PatientId,
+                        ObservationId = observation.Id,
+                        AlertType = AlertTypeExtensions.CriticalFor(obs.ObservationCode),
+                        Severity = AlertSeverity.Critical,
+                        Details = BuildCriticalDetails(
+                            new IngestObservationRequest(obs.ObservationCode, obs.Value, obs.Unit ?? "",
+                                observation.Source, obs.RecordedAt, obs.IdempotencyKey),
+                            threshold),
+                        Status = AlertStatus.Open,
+                        TriggeredAt = obs.RecordedAt
+                    };
+                    _db.ClinicalAlerts.Add(alert);
+                    _db.OutboxEvents.Add(BuildOutboxEvent("alert.generated", new
+                    {
+                        alertId = alert.Id,
+                        encounterId = obs.EncounterId,
+                        patientId = encounter.PatientId,
+                        alertType = alert.AlertType.ToDbString(),
+                        severity = alert.Severity.ToDbString(),
+                        details = alert.Details,
+                        triggeredAt = alert.TriggeredAt,
+                        partitionKey = obs.EncounterId.ToString()
+                    }, obs.EncounterId.ToString()));
+                }
+            }
+
+            _db.OutboxEvents.Add(BuildOutboxEvent("observation.recorded", new
+            {
+                observationId = observation.Id,
+                encounterId = obs.EncounterId,
+                patientId = encounter.PatientId,
+                observationCode = obs.ObservationCode,
+                value = obs.Value,
+                unit = obs.Unit,
+                source = obs.Source,
+                recordedAt = obs.RecordedAt,
+                partitionKey = obs.EncounterId.ToString()
+            }, obs.EncounterId.ToString()));
+
+            await _db.SaveChangesAsync(ct);
+            await tx.CommitAsync(ct);
+        }
+        catch (DbUpdateException ex) when (IsUniqueViolation(ex))
+        {
+            await tx.RollbackAsync(ct);
+            // silent skip — idempotency key already applied
+        }
+    }
+
    private async Task<ThresholdCacheEntry?> LoadThresholdAsync(string observationCode)
    {
        var cache = _redis.GetDatabase();