Files
vigilcare-records/VigilCareRecordsAPI/Services/PromotionService.cs
T

731 lines
28 KiB
C#

using System.Diagnostics;
using System.Text.Json;
using Microsoft.EntityFrameworkCore;
public class PromotionService : IPromotionService
{
private readonly AppDbContext _db;
private readonly IIdempotencyService _idempotency;
private readonly IMrnGenerator _mrnGenerator;
private readonly ILogger<PromotionService> _logger;
public PromotionService(
AppDbContext db,
IIdempotencyService idempotency,
IMrnGenerator mrnGenerator,
ILogger<PromotionService> logger)
{
_db = db;
_idempotency = idempotency;
_mrnGenerator = mrnGenerator;
_logger = logger;
}
public async Task<PromotionResultResponse> ApproveAndPromoteAsync(
Guid batchId, Guid approverUserId, bool enableRetroactiveAlerts, string? idempotencyKey)
{
// --- Idempotency check (before transaction) ---
if (!string.IsNullOrWhiteSpace(idempotencyKey))
{
var existing = await _idempotency.GetExistingAsync(idempotencyKey, "batch_promote");
if (existing is not null)
{
_logger.LogInformation(
"Idempotent replay for batch {BatchId} with key {Key}",
batchId, idempotencyKey);
return JsonSerializer.Deserialize<PromotionResultResponse>(
existing.ResponseBodyJson,
new JsonSerializerOptions { PropertyNameCaseInsensitive = true })!;
}
}
// --- Start timing the promotion ---
var stopwatch = Stopwatch.StartNew();
try
{
// --- Load batch with all draft data ---
var batch = await _db.DigitizationBatches
.Include(b => b.DraftPatient)
.Include(b => b.DraftEncounter)
.Include(b => b.DraftObservations)
.FirstOrDefaultAsync(b => b.Id == batchId);
if (batch is null)
throw new NotFoundException("Batch not found.", "BATCH_NOT_FOUND");
// --- Status validation ---
if (batch.Status != BatchStatus.Verified && batch.Status != BatchStatus.AwaitingClinicalApproval)
throw new ConflictException(
$"Batch must be in 'verified' or 'awaiting_clinical_approval' status to approve. Current status: '{batch.Status.ToDbString()}'.",
"ILLEGAL_STATUS_TRANSITION");
// --- Separation of duties: approver cannot be the entry clerk ---
if (batch.EnteredByUserId == approverUserId)
throw new ConflictException(
"Separation of duties: the entry clerk cannot approve their own batch.",
"SEPARATION_OF_DUTIES_VIOLATION");
// --- Also cannot be the verifier ---
if (batch.VerifiedByUserId == approverUserId)
throw new ConflictException(
"Separation of duties: the verifier cannot also approve the same batch.",
"SEPARATION_OF_DUTIES_VIOLATION");
// --- Validate draft data completeness ---
ValidateDraftDataForPromotion(batch);
// --- Begin atomic transaction ---
await using var transaction = await _db.Database.BeginTransactionAsync();
try
{
var now = DateTimeOffset.UtcNow;
batch.ApprovedByUserId = approverUserId;
var core = await ExecutePromotionCoreAsync(
batch, approverUserId, enableRetroactiveAlerts, now);
// === Store idempotency record (within same transaction) ===
var result = new PromotionResultResponse(
BatchId: batchId,
Status: BatchStatus.Promoted.ToDbString(),
PatientId: core.Patient.Id,
Mrn: core.Patient.Mrn,
EncounterId: core.Encounter.Id,
ObservationIds: core.ObservationIds,
PromotedAt: now,
OutboxEventsWritten: core.OutboxCount
);
if (!string.IsNullOrWhiteSpace(idempotencyKey))
{
await _idempotency.SaveAsync(
idempotencyKey, "batch_promote", batchId,
200, result, TimeSpan.FromHours(24));
}
// === Commit ===
await _db.SaveChangesAsync();
await transaction.CommitAsync();
stopwatch.Stop();
DiagnosticsMetrics.PromotionDuration.Observe(stopwatch.Elapsed.TotalSeconds);
_logger.LogInformation(
"Batch {BatchId} promoted in {ElapsedMs}ms: Patient {PatientId} (MRN {Mrn}), " +
"Encounter {EncounterId}, {ObsCount} observations, {OutboxCount} outbox events",
batchId, stopwatch.ElapsedMilliseconds, core.Patient.Id, core.Patient.Mrn,
core.Encounter.Id, core.ObservationIds.Length, core.OutboxCount);
return result;
}
catch
{
await transaction.RollbackAsync();
throw;
}
}
catch
{
stopwatch.Stop();
throw;
}
}
public async Task<PromotionResultResponse> GetPromotionResultAsync(Guid batchId)
{
var batch = await _db.DigitizationBatches
.FirstOrDefaultAsync(b => b.Id == batchId);
if (batch is null)
throw new NotFoundException("Batch not found.", "BATCH_NOT_FOUND");
if (batch.Status != BatchStatus.Promoted)
throw new ConflictException(
$"Batch is not promoted. Current status: '{batch.Status.ToDbString()}'.",
"BATCH_NOT_PROMOTED");
// Retrieve the live patient by looking up the encounter
var encounter = await _db.Encounters
.Include(e => e.Patient)
.FirstOrDefaultAsync(e => e.Id == batch.PromotionEncounterId);
if (encounter is null)
throw new NotFoundException(
"Promotion encounter not found. Data may be inconsistent.",
"PROMOTION_ENCOUNTER_NOT_FOUND");
var observationIds = await _db.Observations
.Where(o => o.SourceBatchId == batchId)
.Select(o => o.Id)
.ToArrayAsync();
return new PromotionResultResponse(
BatchId: batchId,
Status: batch.Status.ToDbString(),
PatientId: encounter.PatientId,
Mrn: encounter.Patient.Mrn,
EncounterId: encounter.Id,
ObservationIds: observationIds,
PromotedAt: batch.PromotedAt!.Value,
OutboxEventsWritten: 0 // Historical count not stored; use event metadata
);
}
// ──────────────────────────────────────────────────
// Private helpers
// ──────────────────────────────────────────────────
private record PromotionCoreResult(
Patient Patient,
Encounter Encounter,
Guid[] ObservationIds,
int OutboxCount,
SupersessionResult? Supersession);
private static void ValidateDraftDataForPromotion(DigitizationBatch batch)
{
if (!batch.SupersedesBatchId.HasValue)
{
if (batch.DraftPatient is null)
throw new ValidationException("Batch has no draft patient data.", "MISSING_DRAFT_PATIENT");
if (string.IsNullOrWhiteSpace(batch.DraftPatient.FullName))
throw new ValidationException("Draft patient must have a full name.", "INVALID_DRAFT_PATIENT");
}
else if (!batch.PatientId.HasValue)
{
throw new ValidationException(
"Correction batch has no linked patient.",
"MISSING_PATIENT");
}
}
private async Task<PromotionCoreResult> ExecutePromotionCoreAsync(
DigitizationBatch batch, Guid actorUserId, bool enableRetroactiveAlerts, DateTimeOffset now)
{
// === Step 1: Create or update Patient ===
Patient patient;
if (batch.SupersedesBatchId.HasValue)
{
patient = await _db.Patients.FirstOrDefaultAsync(p => p.Id == batch.PatientId!.Value)
?? throw new NotFoundException(
$"Patient {batch.PatientId!.Value} not found.",
"PATIENT_NOT_FOUND");
}
else
{
patient = await CreateOrUpdatePatientAsync(batch.DraftPatient!, now);
}
// === Step 2: Create or match Encounter + LiveEncounter ===
var encounter = await ResolveClinicalEncounterAsync(batch, patient.Id, now);
await EnsureLiveEncounterAsync(encounter, now);
// === Step 3: Insert clinical Observations + OutboxEvents ===
var (observationIds, outboxCount) = await PromoteObservationsAsync(
batch, patient.Id, encounter.Id, enableRetroactiveAlerts, now);
// === Step 4: Mirror to LiveObservations ===
PromoteLiveObservationsAsync(batch, patient.Id, encounter.Id, now);
// === Step 5: Handle supersession for correction batches ===
SupersessionResult? supersessionResult = null;
if (batch.SupersedesBatchId.HasValue)
{
supersessionResult = await SupersedeOriginalBatchAsync(
batch.SupersedesBatchId.Value, batch.Id, actorUserId, now);
}
// === Step 6: Update batch status to Promoted ===
batch.Status = BatchStatus.Promoted;
batch.PatientId = patient.Id;
batch.PromotedAt = now;
batch.PromotionEncounterId = encounter.Id;
batch.EnableRetroactiveAlerts = enableRetroactiveAlerts;
batch.UpdatedAt = now;
// === Step 7: Write DigitizationEvent ===
var promotionMetadata = new Dictionary<string, object>
{
["patientId"] = patient.Id,
["mrn"] = patient.Mrn,
["encounterId"] = encounter.Id,
["observationCount"] = observationIds.Length,
["outboxEventsWritten"] = outboxCount,
["enableRetroactiveAlerts"] = enableRetroactiveAlerts,
["track"] = batch.Track.ToDbString(),
["isCorrection"] = batch.SupersedesBatchId.HasValue
};
if (supersessionResult is not null)
{
promotionMetadata["supersession"] = new
{
originalBatchId = supersessionResult.OriginalBatchId,
observationsSuperseded = supersessionResult.ObservationsSuperseded,
observationsReplaced = supersessionResult.ObservationsReplaced
};
}
_db.DigitizationEvents.Add(new DigitizationEvent
{
Id = Guid.NewGuid(),
BatchId = batch.Id,
EventType = batch.SupersedesBatchId.HasValue
? DigitizationEventType.CorrectionPromoted
: DigitizationEventType.Promoted,
ActorUserId = actorUserId,
OccurredAt = now,
MetadataJson = JsonSerializer.Serialize(promotionMetadata)
});
return new PromotionCoreResult(patient, encounter, observationIds, outboxCount, supersessionResult);
}
private static string NormalizePatientName(string name) =>
string.Join(" ", name.Trim().Split((char[]?)null, StringSplitOptions.RemoveEmptyEntries))
.ToUpperInvariant();
private async Task<Patient> CreateOrUpdatePatientAsync(DraftPatient draft, DateTimeOffset now)
{
var normalizedName = NormalizePatientName(draft.FullName!);
Patient? existing = null;
if (draft.DateOfBirth.HasValue)
{
existing = await _db.Patients
.FirstOrDefaultAsync(p =>
EF.Functions.ILike(p.FullName, normalizedName) &&
p.DateOfBirth == draft.DateOfBirth);
}
if (existing is not null)
{
existing.Sex = draft.Sex ?? existing.Sex;
existing.BloodType = draft.BloodType ?? existing.BloodType;
existing.EmergencyContact = draft.EmergencyContact ?? existing.EmergencyContact;
existing.AllergiesJson = draft.AllergiesJson ?? existing.AllergiesJson;
existing.NoKnownAllergies = draft.NoKnownAllergies || existing.NoKnownAllergies;
existing.UpdatedAt = now;
_logger.LogInformation(
"Matched existing patient {PatientId} (MRN {Mrn}) by normalized name + DOB",
existing.Id, existing.Mrn);
return existing;
}
// No exact normalized match — check for fuzzy near-misses on same DOB
if (draft.DateOfBirth.HasValue)
{
var sameDobPatients = await _db.Patients
.Where(p => p.DateOfBirth == draft.DateOfBirth)
.Select(p => new { p.Id, p.Mrn, p.FullName })
.ToListAsync();
foreach (var candidate in sameDobPatients)
{
var distance = LevenshteinDistance(
normalizedName, NormalizePatientName(candidate.FullName));
if (distance > 0 && distance <= 3)
{
_logger.LogWarning(
"Fuzzy patient match: new name '{NewName}' is {Distance} edits from " +
"existing patient {PatientId} (MRN {Mrn}, name '{ExistingName}') with same DOB. " +
"Creating new patient — consider merging if these are the same person",
normalizedName, distance, candidate.Id, candidate.Mrn, candidate.FullName);
}
}
}
var mrn = await _mrnGenerator.GenerateNextMrnAsync();
var patient = new Patient
{
Id = Guid.NewGuid(),
Mrn = mrn,
FullName = normalizedName,
DateOfBirth = draft.DateOfBirth,
Sex = draft.Sex,
BloodType = draft.BloodType,
EmergencyContact = draft.EmergencyContact,
AllergiesJson = draft.AllergiesJson,
NoKnownAllergies = draft.NoKnownAllergies,
CreatedAt = now,
UpdatedAt = now
};
_db.Patients.Add(patient);
_logger.LogInformation(
"Created new patient {PatientId} with MRN {Mrn}",
patient.Id, mrn);
return patient;
}
private static int LevenshteinDistance(string a, string b)
{
if (a.Length == 0) return b.Length;
if (b.Length == 0) return a.Length;
var prev = new int[b.Length + 1];
var curr = new int[b.Length + 1];
for (var j = 0; j <= b.Length; j++)
prev[j] = j;
for (var i = 1; i <= a.Length; i++)
{
curr[0] = i;
for (var j = 1; j <= b.Length; j++)
{
var cost = a[i - 1] == b[j - 1] ? 0 : 1;
curr[j] = Math.Min(
Math.Min(curr[j - 1] + 1, prev[j] + 1),
prev[j - 1] + cost);
}
(prev, curr) = (curr, prev);
}
return prev[b.Length];
}
private async Task<Encounter> ResolveClinicalEncounterAsync(
DigitizationBatch batch, Guid patientId, DateTimeOffset now)
{
if (batch.SupersedesBatchId.HasValue)
{
var originalBatch = await _db.DigitizationBatches
.AsNoTracking()
.FirstOrDefaultAsync(b => b.Id == batch.SupersedesBatchId.Value);
if (originalBatch?.PromotionEncounterId is not Guid encounterId)
throw new ValidationException(
"Original batch has no promotion encounter for correction reuse.",
"MISSING_ORIGINAL_ENCOUNTER");
var encounter = await _db.Encounters.FirstOrDefaultAsync(e => e.Id == encounterId);
if (encounter is null)
throw new NotFoundException(
"Original promotion encounter not found.",
"PROMOTION_ENCOUNTER_NOT_FOUND");
_logger.LogInformation(
"Correction batch {CorrectionBatchId} reusing clinical encounter {EncounterId} " +
"from original batch {OriginalBatchId}",
batch.Id, encounter.Id, originalBatch.Id);
return encounter;
}
return await CreateOrMatchEncounterAsync(batch, patientId, now);
}
private async Task EnsureLiveEncounterAsync(Encounter encounter, DateTimeOffset now)
{
if (await _db.LiveEncounters.AnyAsync(e => e.Id == encounter.Id))
return;
_db.LiveEncounters.Add(new LiveEncounter
{
Id = encounter.Id,
PatientId = encounter.PatientId,
AdmissionDate = encounter.AdmissionDate ?? now,
Department = encounter.Department,
RoomBed = encounter.RoomBed,
AdmissionReason = encounter.AdmissionReason,
DischargeDiagnosis = encounter.DischargeDiagnosis,
Status = encounter.Status,
CreatedAt = now
});
}
private void PromoteLiveObservationsAsync(
DigitizationBatch batch, Guid patientId, Guid encounterId, DateTimeOffset now)
{
foreach (var draft in batch.DraftObservations)
{
_db.LiveObservations.Add(new LiveObservation
{
Id = Guid.NewGuid(),
EncounterId = encounterId,
PatientId = patientId,
SourceBatchId = batch.Id,
ObservationCode = draft.ObservationCode,
Value = draft.Value,
Unit = draft.Unit,
RecordedAt = draft.RecordedAt,
Note = draft.Note,
CreatedAt = now,
IsSuperseded = false,
SupersededByBatchId = null,
SupersededAt = null
});
}
}
private async Task<Encounter> CreateOrMatchEncounterAsync(
DigitizationBatch batch, Guid patientId, DateTimeOffset now)
{
// If the batch has a draft encounter, try to match an active encounter
// for the same patient in the same department
if (batch.DraftEncounter is not null)
{
var existingEncounter = await _db.Encounters
.FirstOrDefaultAsync(e =>
e.PatientId == patientId &&
e.Department == batch.DraftEncounter.Department &&
e.Status == "active" &&
e.SourceBatchId != batch.Id);
if (existingEncounter is not null)
{
_logger.LogInformation(
"Matched existing active encounter {EncounterId} for patient {PatientId}",
existingEncounter.Id, patientId);
return existingEncounter;
}
}
// Determine encounter status from draft
var encounterStatus = batch.DraftEncounter?.Status ?? "active";
if (batch.DraftEncounter?.DischargeDiagnosis is not null)
{
encounterStatus = "discharged";
}
var encounter = new Encounter
{
Id = Guid.NewGuid(),
PatientId = patientId,
AdmissionDate = batch.DraftEncounter?.AdmissionDate,
Department = batch.DraftEncounter?.Department,
RoomBed = batch.DraftEncounter?.RoomBed,
AdmissionReason = batch.DraftEncounter?.AdmissionReason,
DischargeDiagnosis = batch.DraftEncounter?.DischargeDiagnosis,
Status = encounterStatus,
SourceBatchId = batch.Id,
CreatedAt = now,
UpdatedAt = now
};
_db.Encounters.Add(encounter);
_logger.LogInformation(
"Created encounter {EncounterId} for patient {PatientId} with status '{Status}'",
encounter.Id, patientId, encounterStatus);
return encounter;
}
private async Task<(Guid[] observationIds, int outboxCount)> PromoteObservationsAsync(
DigitizationBatch batch, Guid patientId, Guid encounterId,
bool enableRetroactiveAlerts, DateTimeOffset now)
{
var observationIds = new List<Guid>();
var outboxCount = 0;
// Determine the source label based on batch track
var source = batch.Track == BatchTrack.LiveCapture
? "live_capture"
: "digitization_backfill";
// Determine whether outbox events should be written for this batch
var shouldAlert = batch.Track == BatchTrack.LiveCapture || enableRetroactiveAlerts;
foreach (var draft in batch.DraftObservations)
{
var observationId = Guid.NewGuid();
var observation = new Observation
{
Id = observationId,
EncounterId = encounterId,
PatientId = patientId,
ObservationCode = draft.ObservationCode,
Value = draft.Value,
Unit = draft.Unit,
RecordedAt = draft.RecordedAt,
Note = draft.Note,
Source = source,
SourceDraftObservationId = draft.Id,
SourceBatchId = batch.Id,
CreatedAt = now
};
_db.Observations.Add(observation);
observationIds.Add(observationId);
// Write outbox event only if alerting is enabled for this batch
if (shouldAlert)
{
_db.OutboxEvents.Add(new OutboxEvent
{
Id = Guid.NewGuid(),
EventType = "observation.created",
AggregateType = "Observation",
AggregateId = observationId,
PayloadJson = JsonSerializer.Serialize(new
{
observationId,
encounterId,
patientId,
observationCode = draft.ObservationCode,
value = draft.Value,
unit = draft.Unit,
recordedAt = draft.RecordedAt,
source,
batchId = batch.Id,
track = batch.Track.ToDbString()
}),
CreatedAt = now,
ProcessedAt = null,
RetryCount = 0
});
outboxCount++;
}
}
_logger.LogInformation(
"Promoted {Count} observations for batch {BatchId}, " +
"{OutboxCount} outbox events (shouldAlert={ShouldAlert}, track={Track})",
observationIds.Count, batch.Id, outboxCount, shouldAlert, batch.Track.ToDbString());
return (observationIds.ToArray(), outboxCount);
}
public async Task<PromotionResult> PromoteAsync(Guid batchId, Guid actorUserId)
{
var stopwatch = Stopwatch.StartNew();
try
{
await using var transaction = await _db.Database.BeginTransactionAsync();
try
{
var batch = await _db.DigitizationBatches
.Include(b => b.DraftPatient)
.Include(b => b.DraftEncounter)
.Include(b => b.DraftObservations)
.FirstOrDefaultAsync(b => b.Id == batchId);
if (batch is null)
throw new NotFoundException("Batch not found.", "BATCH_NOT_FOUND");
if (batch.Status != BatchStatus.Approved)
throw new ConflictException(
$"Only approved batches can be promoted. Batch is in '{batch.Status.ToDbString()}' status.",
"ILLEGAL_STATUS_TRANSITION");
ValidateDraftDataForPromotion(batch);
var now = DateTimeOffset.UtcNow;
var enableRetroactiveAlerts = batch.EnableRetroactiveAlerts;
var core = await ExecutePromotionCoreAsync(
batch, actorUserId, enableRetroactiveAlerts, now);
await _db.SaveChangesAsync();
await transaction.CommitAsync();
stopwatch.Stop();
DiagnosticsMetrics.PromotionDuration.Observe(stopwatch.Elapsed.TotalSeconds);
_logger.LogInformation(
"Batch {BatchId} promoted via retry in {ElapsedMs}ms: Patient {PatientId} (MRN {Mrn}), " +
"Encounter {EncounterId}, {ObsCount} observations, {OutboxCount} outbox events",
batchId, stopwatch.ElapsedMilliseconds, core.Patient.Id, core.Patient.Mrn,
core.Encounter.Id, core.ObservationIds.Length, core.OutboxCount);
return new PromotionResult(
batch.Id,
core.Patient.Id,
core.Patient.Mrn,
core.Encounter.Id,
core.ObservationIds,
core.ObservationIds.Length,
core.OutboxCount,
batch.SupersedesBatchId.HasValue,
core.Supersession);
}
catch
{
await transaction.RollbackAsync();
throw;
}
}
catch
{
stopwatch.Stop();
throw;
}
}
/// <summary>
/// Marks all live observations sourced from the original batch as superseded.
/// Records an audit event on the original batch documenting the supersession.
/// </summary>
private async Task<SupersessionResult> SupersedeOriginalBatchAsync(
Guid originalBatchId, Guid correctionBatchId, Guid actorUserId, DateTimeOffset now)
{
// Load all live observations that came from the original erroneous batch
var originalObservations = await _db.LiveObservations
.Where(o => o.SourceBatchId == originalBatchId && !o.IsSuperseded)
.ToListAsync();
if (originalObservations.Count == 0)
{
_logger.LogWarning(
"Supersession: no active live observations found for original batch {OriginalBatchId}",
originalBatchId);
}
// Mark each observation as superseded — never delete
foreach (var obs in originalObservations)
{
obs.IsSuperseded = true;
obs.SupersededByBatchId = correctionBatchId;
obs.SupersededAt = now;
}
// Count the correction batch's draft observations for the replacement count
var replacementCount = await _db.DigitizationBatches
.Where(b => b.Id == correctionBatchId)
.SelectMany(b => b.DraftObservations)
.CountAsync();
// Record supersession event on the original batch's audit trail
_db.DigitizationEvents.Add(new DigitizationEvent
{
Id = Guid.NewGuid(),
BatchId = originalBatchId,
EventType = DigitizationEventType.Superseded,
ActorUserId = actorUserId,
OccurredAt = now,
MetadataJson = JsonSerializer.Serialize(new
{
supersededByBatchId = correctionBatchId,
observationsSuperseded = originalObservations.Count,
replacementObservations = replacementCount,
reason = "Correction batch promoted — original observations marked superseded"
})
});
return new SupersessionResult(
originalBatchId,
originalObservations.Count,
replacementCount,
now);
}
}