175 lines
6.9 KiB
C#
175 lines
6.9 KiB
C#
using System.Text.Json;
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using Microsoft.EntityFrameworkCore;
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using StackExchange.Redis;
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public class LocalObservationService : ILocalObservationService
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{
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private readonly GatewayDbContext _db;
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private readonly IConnectionMultiplexer _redis;
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private readonly LocalWarningEvaluator _warnings;
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private readonly LocalPagingPublisher _paging;
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private readonly ILogger<LocalObservationService> _logger;
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public LocalObservationService(
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GatewayDbContext db,
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IConnectionMultiplexer redis,
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LocalWarningEvaluator warnings,
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LocalPagingPublisher paging,
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ILogger<LocalObservationService> logger)
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{
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_db = db;
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_redis = redis;
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_warnings = warnings;
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_paging = paging;
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_logger = logger;
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}
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public async Task<LocalIngestResult> IngestAsync(Guid encounterId, IngestObservationRequest req)
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{
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var encounter = await _db.Encounters
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.AsNoTracking()
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.FirstOrDefaultAsync(e => e.Id == encounterId);
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if (encounter is null)
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throw new NotFoundException("Encounter not found.", "ENCOUNTER_NOT_FOUND");
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if (encounter.Status != EncounterStatus.Active)
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throw new ConflictException("Encounter is not active.", "ENCOUNTER_NOT_ACTIVE");
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if (!string.IsNullOrEmpty(req.IdempotencyKey))
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{
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var existing = await _db.Observations.AsNoTracking()
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.FirstOrDefaultAsync(o => o.IdempotencyKey == req.IdempotencyKey);
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if (existing is not null)
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return LocalIngestResult.Duplicate(existing);
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}
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if (!PlausibilityValidator.IsPlausible(req.ObservationCode, req.Value, out var reason))
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throw new ValidationException(reason!, "OBSERVATION_OUT_OF_PLAUSIBLE_RANGE");
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await using var tx = await _db.Database.BeginTransactionAsync();
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try
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{
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var observation = new LocalObservation
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{
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Id = Guid.NewGuid(),
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EncounterId = encounterId,
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ObservationCode = req.ObservationCode,
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Value = req.Value,
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Unit = req.Unit,
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Source = req.Source,
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IdempotencyKey = req.IdempotencyKey,
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RecordedAt = req.RecordedAt,
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CreatedAt = DateTimeOffset.UtcNow
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};
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_db.Observations.Add(observation);
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var threshold = await LoadThresholdAsync(req.ObservationCode);
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if (threshold is null)
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throw new ValidationException("Unknown observation code.", "UNKNOWN_OBSERVATION_CODE");
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LocalClinicalAlert? alert = null;
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if (IsCriticalBreach(req.Value, threshold))
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{
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var triggeredAt = DateTimeOffset.UtcNow;
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alert = new LocalClinicalAlert
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{
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Id = Guid.NewGuid(),
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ClientAlertId = Guid.NewGuid(),
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EncounterId = encounterId,
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PatientId = encounter.PatientId,
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ObservationId = observation.Id,
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AlertType = AlertTypeExtensions.CriticalFor(req.ObservationCode),
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Severity = AlertSeverity.Critical,
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Details = BuildCriticalDetails(req, threshold),
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Status = AlertStatus.Open,
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TriggeredAt = triggeredAt
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};
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_db.ClinicalAlerts.Add(alert);
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BufferedSyncWriter.Enqueue(_db, BufferedSyncItemType.Alert, new
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{
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alert.ClientAlertId,
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alert.EncounterId,
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alertType = alert.AlertType.ToDbString(),
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severity = alert.Severity.ToDbString(),
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alert.Details,
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generatedAt = triggeredAt
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}, $"alert:{alert.ClientAlertId}", encounterId, triggeredAt);
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await _paging.PublishCriticalAsync(alert, encounter);
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}
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if (alert is null)
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await _warnings.TryEvaluateAsync(
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observation.Id, encounterId, encounter.PatientId,
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req.ObservationCode, req.Value, threshold);
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BufferedSyncWriter.Enqueue(_db, BufferedSyncItemType.Observation, new
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{
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clientRef = observation.Id,
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req.IdempotencyKey,
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encounterId,
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req.ObservationCode,
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req.Value,
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req.Unit,
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source = req.Source.ToDbString(),
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req.RecordedAt
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}, req.IdempotencyKey ?? $"obs:{observation.Id}", encounterId, req.RecordedAt);
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await _db.SaveChangesAsync();
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await tx.CommitAsync();
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return LocalIngestResult.Created(observation, alert);
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}
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catch (DbUpdateException ex) when (IsUniqueViolation(ex))
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{
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await tx.RollbackAsync();
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var existing = await _db.Observations.AsNoTracking()
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.FirstOrDefaultAsync(o => o.IdempotencyKey == req.IdempotencyKey);
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if (existing is not null) return LocalIngestResult.Duplicate(existing);
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throw;
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}
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}
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private async Task<ThresholdCacheEntry?> LoadThresholdAsync(string observationCode)
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{
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var cache = _redis.GetDatabase();
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var cacheKey = $"threshold:{observationCode}";
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var cached = await cache.StringGetAsync(cacheKey);
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if (cached.HasValue)
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return JsonSerializer.Deserialize<ThresholdCacheEntry>(cached!);
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var threshold = await _db.AlertThresholds
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.AsNoTracking()
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.FirstOrDefaultAsync(t => t.ObservationCode == observationCode);
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if (threshold is null) return null;
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var entry = new ThresholdCacheEntry(
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threshold.ObservationCode,
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threshold.CriticalLow,
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threshold.WarningLow,
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threshold.WarningHigh,
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threshold.CriticalHigh);
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await cache.StringSetAsync(cacheKey, JsonSerializer.Serialize(entry));
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_logger.LogDebug("Cache miss for threshold {Code} — loaded from PostgreSQL", observationCode);
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return entry;
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}
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private static bool IsCriticalBreach(decimal value, ThresholdCacheEntry t) =>
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(t.CriticalLow.HasValue && value < t.CriticalLow.Value) ||
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(t.CriticalHigh.HasValue && value > t.CriticalHigh.Value);
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private static string BuildCriticalDetails(IngestObservationRequest req, ThresholdCacheEntry t)
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{
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if (t.CriticalLow.HasValue && req.Value < t.CriticalLow.Value)
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return $"{req.ObservationCode} value {req.Value} {req.Unit} is below critical low of {t.CriticalLow} {req.Unit}.";
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return $"{req.ObservationCode} value {req.Value} {req.Unit} is above critical high of {t.CriticalHigh} {req.Unit}.";
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}
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private static bool IsUniqueViolation(DbUpdateException ex) =>
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ex.InnerException is Npgsql.PostgresException pg && pg.SqlState == "23505";
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}
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