Medplum

// SPDX-FileCopyrightText: Copyright Orangebot, Inc. and Medplum contributors // SPDX-License-Identifier: Apache-2.0 import { getCodeBySystem, getReferenceString, indexSearchParameterBundle, indexStructureDefinitionBundle, } from '@medplum/core'; import { readJson, SEARCH_PARAMETER_BUNDLE_FILES } from '@medplum/definitions'; import type { Bot, Bundle, BundleEntry, List, ListEntry, MedicationKnowledge, Patient, Reference, SearchParameter, } from '@medplum/fhirtypes'; import { MockClient } from '@medplum/mock'; import { vi } from 'vitest'; import { NEUTRON_HEALTH, NEUTRON_HEALTH_TREATMENTS } from './constants'; import { addPhotonIdToMedicationKnowledge, handler } from './sync-formulary'; describe('Sync formulary', async () => { beforeAll(() => { indexStructureDefinitionBundle(readJson('fhir/r4/profiles-types.json') as Bundle); indexStructureDefinitionBundle(readJson('fhir/r4/profiles-resources.json') as Bundle); indexStructureDefinitionBundle(readJson('fhir/r4/profiles-medplum.json') as Bundle); for (const filename of SEARCH_PARAMETER_BUNDLE_FILES) { indexSearchParameterBundle(readJson(filename) as Bundle<SearchParameter>); } }); vi.mock('./utils.ts', async () => { const actualModule = await vi.importActual('./utils.ts'); return { ...actualModule, handlePhotonAuth: vi.fn().mockImplementation(() => 'example-auth-token'), }; }); const bot: Reference<Bot> = { reference: 'Bot/123' }; const contentType = 'application/json'; const baseList: List = { resourceType: 'List', status: 'current', mode: 'working', }; const secrets = { PHOTON_CLIENT_ID: { name: 'Photon Client ID', valueString: 'client-id' }, PHOTON_CLIENT_SECRET: { name: 'Photon Client Secret', valueString: 'client-secret' }, }; test.skip('No medications to sync', async () => { const medplum = new MockClient(); await expect(() => handler(medplum, { bot, contentType, input: baseList, secrets })).rejects.toThrow( 'No medications to sync' ); }); test.skip('No catalog in Photon', async () => { const medplum = new MockClient(); const medicationKnowledge = await medplum.createResource(knowledge); const list: List = { ...baseList, entry: [{ item: { reference: getReferenceString(medicationKnowledge) } }], }; await expect(() => handler(medplum, { bot, contentType, input: list, secrets, }) ).rejects.toThrow('No catalog found in Photon Health'); }, 10000); test.skip('List includes resource that is not a MedicationKnowledge', async () => { const medplum = new MockClient(); const patient: Patient = await medplum.createResource({ resourceType: 'Patient', }); const list: List = { ...baseList, entry: [{ item: { reference: getReferenceString(patient) } }], }; await expect(() => handler(medplum, { bot, contentType, input: list, secrets, }) ).rejects.toThrow('Invalid resource type in formulary'); }); test.skip('All medications in formulary synced to photon', async () => { const medplum = new MockClient(); await medplum.executeBatch({ resourceType: 'Bundle', type: 'transaction', entry: medicationKnowledgeBundleEntries, }); const medicationKnowledges = await medplum.searchResources('MedicationKnowledge'); const listEntry: ListEntry[] = medicationKnowledges.map((knowledge) => { return { item: { reference: getReferenceString(knowledge) } }; }); const list: List = await medplum.createResource({ ...baseList, entry: listEntry, }); const result = await handler(medplum, { bot, contentType, input: list, secrets, }); expect(result.length).toBe(0); }, 20000); test.skip('Skip already synced medications', async () => { const medplum = new MockClient(); await medplum.executeBatch({ resourceType: 'Bundle', type: 'transaction', entry: medicationKnowledgeBundleEntries, }); const medicationKnowledges = await medplum.searchResources('MedicationKnowledge'); const listEntry: ListEntry[] = medicationKnowledges.map((knowledge) => { return { item: { reference: getReferenceString(knowledge) }, flag: { coding: [{ system: NEUTRON_HEALTH, code: 'synced' }] }, }; }); const list: List = await medplum.createResource({ ...baseList, entry: listEntry, }); await expect(() => handler(medplum, { bot, contentType, secrets, input: list })).rejects.toThrow( 'No medications to sync' ); }); test.skip('Sync a medication that is not in Photon', async () => { const medplum = new MockClient(); const medicationKnowledge = await medplum.createResource({ resourceType: 'MedicationKnowledge', code: { coding: [ { system: 'http://www.nlm.nih.gov/research/umls/rxnorm', code: '1546038', display: 'tetracycline hydrochloride 2.2 MG/ML Topical Solution', }, ], }, }); const list: List = await medplum.createResource({ ...baseList, entry: [{ item: { reference: getReferenceString(medicationKnowledge) } }], }); const result = await handler(medplum, { bot, contentType, input: list, secrets, }); expect(result.length).toBe(1); }); test.skip('Formulary is updated on successful sync', async () => { const medplum = new MockClient(); const medKnowledge: MedicationKnowledge = await medplum.createResource({ resourceType: 'MedicationKnowledge', code: { coding: [ { system: 'http://www.nlm.nih.gov/research/umls/rxnorm', code: '1869699', display: 'Linzess 72 MCG Oral Capsule', }, ], }, }); const formulary: List = await medplum.createResource({ ...baseList, entry: [{ item: { reference: getReferenceString(medKnowledge) } }], }); const result = await handler(medplum, { bot, contentType, secrets, input: formulary }); const updatedFormulary = await medplum.readResource('List', formulary.id as string); const medicationsUpdated = updatedFormulary.entry?.map((entry) => entry.flag); expect(medicationsUpdated?.length).toBe(1); expect(medicationsUpdated?.[0]?.coding?.[0]).toStrictEqual({ system: 'https://neutron.health', code: 'synced' }); expect(result.length).toBe(0); }, 10000); test('Add photon ID to MedicationKnowledge', async () => { const medplum = new MockClient(); const knowledge: MedicationKnowledge = await medplum.createResource({ resourceType: 'MedicationKnowledge', code: { coding: [{ system: 'http://www.nlm.nih.gov/research/umls/rxnorm', code: '310430' }] }, }); await addPhotonIdToMedicationKnowledge('example-id', knowledge, medplum); const updatedKnowledge = await medplum.searchOne('MedicationKnowledge'); const codes = updatedKnowledge?.code; expect(codes).toBeDefined(); expect(codes?.coding?.length).toBe(2); if (codes) { expect(getCodeBySystem(codes, NEUTRON_HEALTH_TREATMENTS)).toBe('example-id'); } }); }); const medicationKnowledgeBundleEntries: BundleEntry[] = [ { request: { method: 'POST', url: 'MedicationKnowledge' }, resource: { resourceType: 'MedicationKnowledge', code: { coding: [ { system: 'http://www.nlm.nih.gov/research/umls/rxnorm', code: '351993', display: 'GONAL-f 600 UNT/ML Injectable Solution', }, ], }, }, }, { request: { method: 'POST', url: 'MedicationKnowledge' }, resource: { resourceType: 'MedicationKnowledge', code: { coding: [ { system: 'http://www.nlm.nih.gov/research/umls/rxnorm', code: '1020118', display: 'triclosan 1.5 MG/ML Medicated Liquid Soap', }, ], }, }, }, { request: { method: 'POST', url: 'MedicationKnowledge' }, resource: { resourceType: 'MedicationKnowledge', code: { coding: [ { system: 'http://www.nlm.nih.gov/research/umls/rxnorm', code: '1869699', display: 'Linzess 72 MCG Oral Capsule', }, ], }, }, }, ]; const knowledge: MedicationKnowledge = { resourceType: 'MedicationKnowledge', status: 'active', code: { coding: [ { system: 'http://www.nlm.nih.gov/research/umls/rxnorm', code: '861007', display: 'metFORMIN hydrochloride 500 MG Oral Tablet', }, ], }, manufacturer: { reference: 'Organization/acme-pharma', display: 'Acme Pharmaceuticals', }, doseForm: { coding: [{ system: 'http://snomed.info/sct', code: '385055001', display: 'Tablet' }] }, amount: { unit: 'tablets', value: 100, system: 'http://terminology.hl7.org/ValueSet/v3-UnitsOfMeasureCaseSensitive', code: '{tbl}', }, synonym: ['metFORMIN'], ingredient: [ { isActive: true, itemCodeableConcept: { coding: [{ system: 'http://www.nlm.nih.gov/research/umls/rxnorm', code: '6809', display: 'metFORMIN' }], }, strength: { numerator: { value: 500, unit: 'mg', system: 'http://unitofmeasure.com', code: 'mg', }, denominator: { value: 1, unit: 'tablet', system: 'http://terminology.hl7.org/ValueSet/v3-UnitsOfMeasureCaseSensitive', code: '{tbl}', }, }, }, ], packaging: { type: { coding: [ { system: 'http://terminology.hl7.org/CodeSystem/medicationknowledge-package-type', code: 'bot', display: 'Bottle', }, ], }, quantity: { value: 100, unit: 'tablets', system: 'http://terminology.hl7.org/ValueSet/v3-UnitsOfMeasureCaseSensitive', code: '{tbl}', }, }, intendedRoute: [ { text: 'oral', coding: [ { display: 'Oral use', code: '26643006', system: 'http://snomed.info/sct', }, ], }, ], drugCharacteristic: [ { type: { coding: [ { system: 'http://terminology.hl7.org/CodeSystem/medicationknowledge-characteristic', code: 'color', display: 'Color', }, ], }, valueString: 'White', }, { type: { coding: [ { system: 'http://terminology.hl7.org/CodeSystem/medicationknowledge-characteristic', code: 'shape', display: 'Shape', }, ], }, valueString: 'Oval', }, ], };