392 lines
15 KiB
C#
392 lines
15 KiB
C#
using System.Text.Json;
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using Microsoft.EntityFrameworkCore;
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public class PromotionService : IPromotionService
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{
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private readonly AppDbContext _db;
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private readonly IIdempotencyService _idempotency;
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private readonly IMrnGenerator _mrnGenerator;
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private readonly ILogger<PromotionService> _logger;
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public PromotionService(
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AppDbContext db,
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IIdempotencyService idempotency,
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IMrnGenerator mrnGenerator,
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ILogger<PromotionService> logger)
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{
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_db = db;
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_idempotency = idempotency;
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_mrnGenerator = mrnGenerator;
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_logger = logger;
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}
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public async Task<PromotionResultResponse> ApproveAndPromoteAsync(
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Guid batchId, Guid approverUserId, bool enableRetroactiveAlerts, string? idempotencyKey)
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{
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// --- Idempotency check (before transaction) ---
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if (!string.IsNullOrWhiteSpace(idempotencyKey))
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{
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var existing = await _idempotency.GetExistingAsync(idempotencyKey, "batch_promote");
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if (existing is not null)
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{
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_logger.LogInformation(
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"Idempotent replay for batch {BatchId} with key {Key}",
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batchId, idempotencyKey);
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return JsonSerializer.Deserialize<PromotionResultResponse>(
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existing.ResponseBodyJson,
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new JsonSerializerOptions { PropertyNameCaseInsensitive = true })!;
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}
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}
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// --- Load batch with all draft data ---
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var batch = await _db.DigitizationBatches
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.Include(b => b.DraftPatient)
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.Include(b => b.DraftEncounter)
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.Include(b => b.DraftObservations)
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.FirstOrDefaultAsync(b => b.Id == batchId);
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if (batch is null)
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throw new NotFoundException("Batch not found.", "BATCH_NOT_FOUND");
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// --- Status validation ---
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if (batch.Status != BatchStatus.Verified && batch.Status != BatchStatus.AwaitingClinicalApproval)
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throw new ConflictException(
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$"Batch must be in 'verified' or 'awaiting_clinical_approval' status to approve. Current status: '{batch.Status.ToDbString()}'.",
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"ILLEGAL_STATUS_TRANSITION");
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// --- Separation of duties: approver cannot be the entry clerk ---
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if (batch.EnteredByUserId == approverUserId)
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throw new ConflictException(
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"Separation of duties: the entry clerk cannot approve their own batch.",
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"SEPARATION_OF_DUTIES_VIOLATION");
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// --- Also cannot be the verifier ---
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if (batch.VerifiedByUserId == approverUserId)
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throw new ConflictException(
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"Separation of duties: the verifier cannot also approve the same batch.",
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"SEPARATION_OF_DUTIES_VIOLATION");
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// --- Validate draft data completeness ---
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if (batch.DraftPatient is null)
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throw new ValidationException("Batch has no draft patient data.", "MISSING_DRAFT_PATIENT");
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if (string.IsNullOrWhiteSpace(batch.DraftPatient.FullName))
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throw new ValidationException("Draft patient must have a full name.", "INVALID_DRAFT_PATIENT");
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// --- Begin atomic transaction ---
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await using var transaction = await _db.Database.BeginTransactionAsync();
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try
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{
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var now = DateTimeOffset.UtcNow;
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// === Step 1: Create or update Patient ===
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var patient = await CreateOrUpdatePatientAsync(batch.DraftPatient, now);
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// === Step 2: Create or match Encounter ===
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var encounter = await CreateOrMatchEncounterAsync(batch, patient.Id, now);
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// === Step 3: Insert each DraftObservation as live Observation ===
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var (observationIds, outboxCount) = await PromoteObservationsAsync(
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batch, patient.Id, encounter.Id, enableRetroactiveAlerts, now);
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// === Step 4: Update batch status to Promoted ===
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batch.Status = BatchStatus.Promoted;
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batch.ApprovedByUserId = approverUserId;
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batch.PromotedAt = now;
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batch.PromotionEncounterId = encounter.Id;
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batch.EnableRetroactiveAlerts = enableRetroactiveAlerts;
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batch.UpdatedAt = now;
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// === Step 5: Write DigitizationEvent ===
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_db.DigitizationEvents.Add(new DigitizationEvent
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{
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Id = Guid.NewGuid(),
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BatchId = batchId,
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EventType = DigitizationEventType.Promoted,
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ActorUserId = approverUserId,
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OccurredAt = now,
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MetadataJson = JsonSerializer.Serialize(new
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{
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patientId = patient.Id,
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mrn = patient.Mrn,
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encounterId = encounter.Id,
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observationCount = observationIds.Length,
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outboxEventsWritten = outboxCount,
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enableRetroactiveAlerts,
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track = batch.Track.ToDbString()
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})
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});
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// === Step 6: Store idempotency record (within same transaction) ===
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var result = new PromotionResultResponse(
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BatchId: batchId,
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Status: BatchStatus.Promoted.ToDbString(),
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PatientId: patient.Id,
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Mrn: patient.Mrn,
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EncounterId: encounter.Id,
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ObservationIds: observationIds,
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PromotedAt: now,
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OutboxEventsWritten: outboxCount
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);
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if (!string.IsNullOrWhiteSpace(idempotencyKey))
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{
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await _idempotency.SaveAsync(
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idempotencyKey, "batch_promote", batchId,
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200, result, TimeSpan.FromHours(24));
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}
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// === Step 7: Commit ===
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await _db.SaveChangesAsync();
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await transaction.CommitAsync();
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_logger.LogInformation(
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"Batch {BatchId} promoted: Patient {PatientId} (MRN {Mrn}), " +
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"Encounter {EncounterId}, {ObsCount} observations, {OutboxCount} outbox events",
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batchId, patient.Id, patient.Mrn, encounter.Id,
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observationIds.Length, outboxCount);
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return result;
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}
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catch
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{
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await transaction.RollbackAsync();
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throw;
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}
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}
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public async Task<PromotionResultResponse> GetPromotionResultAsync(Guid batchId)
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{
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var batch = await _db.DigitizationBatches
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.FirstOrDefaultAsync(b => b.Id == batchId);
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if (batch is null)
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throw new NotFoundException("Batch not found.", "BATCH_NOT_FOUND");
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if (batch.Status != BatchStatus.Promoted)
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throw new ConflictException(
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$"Batch is not promoted. Current status: '{batch.Status.ToDbString()}'.",
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"BATCH_NOT_PROMOTED");
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// Retrieve the live patient by looking up the encounter
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var encounter = await _db.Encounters
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.Include(e => e.Patient)
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.FirstOrDefaultAsync(e => e.Id == batch.PromotionEncounterId);
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if (encounter is null)
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throw new NotFoundException(
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"Promotion encounter not found. Data may be inconsistent.",
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"PROMOTION_ENCOUNTER_NOT_FOUND");
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var observationIds = await _db.Observations
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.Where(o => o.SourceBatchId == batchId)
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.Select(o => o.Id)
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.ToArrayAsync();
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return new PromotionResultResponse(
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BatchId: batchId,
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Status: batch.Status.ToDbString(),
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PatientId: encounter.PatientId,
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Mrn: encounter.Patient.Mrn,
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EncounterId: encounter.Id,
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ObservationIds: observationIds,
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PromotedAt: batch.PromotedAt!.Value,
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OutboxEventsWritten: 0 // Historical count not stored; use event metadata
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);
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}
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// ──────────────────────────────────────────────────
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// Private helpers
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// ──────────────────────────────────────────────────
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private async Task<Patient> CreateOrUpdatePatientAsync(DraftPatient draft, DateTimeOffset now)
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{
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// Attempt to match existing patient by name + DOB (simple dedup)
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Patient? existing = null;
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if (draft.DateOfBirth.HasValue)
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{
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existing = await _db.Patients
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.FirstOrDefaultAsync(p =>
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p.FullName == draft.FullName &&
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p.DateOfBirth == draft.DateOfBirth);
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}
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if (existing is not null)
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{
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// Update fields that may have new information
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existing.Sex = draft.Sex ?? existing.Sex;
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existing.BloodType = draft.BloodType ?? existing.BloodType;
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existing.EmergencyContact = draft.EmergencyContact ?? existing.EmergencyContact;
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existing.AllergiesJson = draft.AllergiesJson ?? existing.AllergiesJson;
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existing.NoKnownAllergies = draft.NoKnownAllergies || existing.NoKnownAllergies;
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existing.UpdatedAt = now;
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_logger.LogInformation(
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"Matched existing patient {PatientId} (MRN {Mrn}) by name + DOB",
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existing.Id, existing.Mrn);
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return existing;
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}
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// Create new patient with generated MRN
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var mrn = await _mrnGenerator.GenerateNextMrnAsync();
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var patient = new Patient
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{
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Id = Guid.NewGuid(),
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Mrn = mrn,
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FullName = draft.FullName!,
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DateOfBirth = draft.DateOfBirth,
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Sex = draft.Sex,
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BloodType = draft.BloodType,
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EmergencyContact = draft.EmergencyContact,
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AllergiesJson = draft.AllergiesJson,
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NoKnownAllergies = draft.NoKnownAllergies,
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CreatedAt = now,
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UpdatedAt = now
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};
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_db.Patients.Add(patient);
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_logger.LogInformation(
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"Created new patient {PatientId} with MRN {Mrn}",
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patient.Id, mrn);
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return patient;
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}
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private async Task<Encounter> CreateOrMatchEncounterAsync(
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DigitizationBatch batch, Guid patientId, DateTimeOffset now)
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{
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// If the batch has a draft encounter, try to match an active encounter
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// for the same patient in the same department
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if (batch.DraftEncounter is not null)
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{
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var existingEncounter = await _db.Encounters
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.FirstOrDefaultAsync(e =>
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e.PatientId == patientId &&
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e.Department == batch.DraftEncounter.Department &&
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e.Status == "active" &&
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e.SourceBatchId != batch.Id);
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if (existingEncounter is not null)
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{
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_logger.LogInformation(
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"Matched existing active encounter {EncounterId} for patient {PatientId}",
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existingEncounter.Id, patientId);
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return existingEncounter;
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}
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}
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// Determine encounter status from draft
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var encounterStatus = batch.DraftEncounter?.Status ?? "active";
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if (batch.DraftEncounter?.DischargeDiagnosis is not null)
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{
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encounterStatus = "discharged";
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}
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var encounter = new Encounter
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{
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Id = Guid.NewGuid(),
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PatientId = patientId,
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AdmissionDate = batch.DraftEncounter?.AdmissionDate,
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Department = batch.DraftEncounter?.Department,
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RoomBed = batch.DraftEncounter?.RoomBed,
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AdmissionReason = batch.DraftEncounter?.AdmissionReason,
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DischargeDiagnosis = batch.DraftEncounter?.DischargeDiagnosis,
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Status = encounterStatus,
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SourceBatchId = batch.Id,
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CreatedAt = now,
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UpdatedAt = now
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};
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_db.Encounters.Add(encounter);
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_logger.LogInformation(
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"Created encounter {EncounterId} for patient {PatientId} with status '{Status}'",
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encounter.Id, patientId, encounterStatus);
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return encounter;
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}
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private async Task<(Guid[] observationIds, int outboxCount)> PromoteObservationsAsync(
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DigitizationBatch batch, Guid patientId, Guid encounterId,
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bool enableRetroactiveAlerts, DateTimeOffset now)
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{
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var observationIds = new List<Guid>();
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var outboxCount = 0;
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// Determine the source label based on batch track
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var source = batch.Track == BatchTrack.LiveCapture
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? "live_capture"
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: "digitization_backfill";
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// Determine whether outbox events should be written for this batch
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var shouldAlert = batch.Track == BatchTrack.LiveCapture || enableRetroactiveAlerts;
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foreach (var draft in batch.DraftObservations)
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{
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var observationId = Guid.NewGuid();
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var observation = new Observation
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{
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Id = observationId,
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EncounterId = encounterId,
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PatientId = patientId,
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ObservationCode = draft.ObservationCode,
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Value = draft.Value,
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Unit = draft.Unit,
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RecordedAt = draft.RecordedAt,
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Note = draft.Note,
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Source = source,
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SourceDraftObservationId = draft.Id,
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SourceBatchId = batch.Id,
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CreatedAt = now
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};
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_db.Observations.Add(observation);
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observationIds.Add(observationId);
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// Write outbox event only if alerting is enabled for this batch
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if (shouldAlert)
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{
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_db.OutboxEvents.Add(new OutboxEvent
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{
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Id = Guid.NewGuid(),
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EventType = "observation.created",
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AggregateType = "Observation",
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AggregateId = observationId,
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PayloadJson = JsonSerializer.Serialize(new
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{
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observationId,
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encounterId,
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patientId,
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observationCode = draft.ObservationCode,
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value = draft.Value,
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unit = draft.Unit,
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recordedAt = draft.RecordedAt,
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source,
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batchId = batch.Id,
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track = batch.Track.ToDbString()
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}),
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CreatedAt = now,
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ProcessedAt = null,
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RetryCount = 0
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});
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outboxCount++;
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}
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}
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_logger.LogInformation(
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"Promoted {Count} observations for batch {BatchId}, " +
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"{OutboxCount} outbox events (shouldAlert={ShouldAlert}, track={Track})",
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observationIds.Count, batch.Id, outboxCount, shouldAlert, batch.Track.ToDbString());
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return (observationIds.ToArray(), outboxCount);
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}
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} |