Medplum

// SPDX-FileCopyrightText: Copyright Orangebot, Inc. and Medplum contributors // SPDX-License-Identifier: Apache-2.0 import { indexSearchParameterBundle, indexStructureDefinitionBundle, RXNORM } from '@medplum/core'; import { readJson, SEARCH_PARAMETER_BUNDLE_FILES } from '@medplum/definitions'; import type { Bundle, Patient, Practitioner, Reference, SearchParameter } from '@medplum/fhirtypes'; import { MockClient } from '@medplum/mock'; import { vi } from 'vitest'; import type { PhotonPatient, PhotonPatientAllergy, PhotonPrescription, PhotonProvider } from '../photon-types'; import { NEUTRON_HEALTH, NEUTRON_HEALTH_PATIENTS } from './constants'; import { createAllergies, createPatientResource, createPrescriptions, getExistingPatient, getPrescriber, getStatusFromPhotonState, handler, } from './sync-patient-from-photon'; describe('Sync patients from Photon', 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>); } }); describe('handler', async () => { test('Executes a batch of resources', async () => { const medplum = new MockClient(); const executeBatchSpy = vi.spyOn(medplum, 'executeBatch').mockResolvedValue({ resourceType: 'Bundle', type: 'batch-response', entry: [], }); // Mock the photon GraphQL fetch vi.mock('./utils.ts', async () => { const actual = await vi.importActual('./utils.ts'); return { ...actual, handlePhotonAuth: vi.fn().mockImplementation(() => 'example-auth-token'), photonGraphqlFetch: vi.fn().mockImplementation(() => { return { data: { patients: [ { id: '123', externalId: undefined, name: { first: 'John', last: 'Doe', full: 'Jane Doe' }, sex: 'MALE', dateOfBirth: '1990-01-01', phone: '555-1234', allergies: [], prescriptions: [], }, ], }, }; }), }; }); const mockEvent = { secrets: { PHOTON_CLIENT_ID: { valueString: 'test-id' }, PHOTON_CLIENT_SECRET: { valueString: 'test-secret' }, }, }; await handler(medplum, mockEvent as any); // Verify executeBatch was called with a non-empty bundle expect(executeBatchSpy).toHaveBeenCalledWith( expect.objectContaining({ resourceType: 'Bundle', type: 'batch', entry: expect.arrayContaining([ expect.objectContaining({ resource: expect.objectContaining({ resourceType: 'Patient', }), }), ]), }) ); executeBatchSpy.mockRestore(); }); }); describe('getExistingPatient', async () => { test('Get a patient with no external id', async () => { const medplum = new MockClient(); const photonPatient: PhotonPatient = { id: 'example-id', dateOfBirth: '1984-11-20', sex: 'FEMALE', name: { first: 'Homer', last: 'Simpson', full: 'Homer Simpson', }, phone: '9085552432', }; const result = await getExistingPatient(photonPatient, medplum); expect(result).toBeUndefined(); }); test('Get patient with external id not in Medplum', async () => { const medplum = new MockClient(); const photonPatient = { externalId: 'exterenalId' } as PhotonPatient; const result = await getExistingPatient(photonPatient, medplum); expect(result).toBeUndefined(); }); test('Get an existing patient', async () => { const medplum = new MockClient(); const patient: Patient = await medplum.createResource({ resourceType: 'Patient', }); const photonPatient = { externalId: patient.id as string } as PhotonPatient; const result = await getExistingPatient(photonPatient, medplum); expect(result).toStrictEqual(patient); }); test('Get patient by Photon ID', async () => { const medplum = new MockClient(); const patient = await medplum.createResource({ resourceType: 'Patient', identifier: [{ system: NEUTRON_HEALTH_PATIENTS, value: 'example-photon-id' }], }); const photonPatient = { id: 'example-photon-id' } as PhotonPatient; const result = await getExistingPatient(photonPatient, medplum); expect(result).toStrictEqual(patient); }); }); describe('createPatientResource', async () => { test('Create a patient with full resource details', async () => { const photonPatient = { id: '123', name: { first: 'John', last: 'Doe' }, sex: 'MALE', dateOfBirth: '1990-01-01', phone: '555-1234', email: 'john@example.com', address: { street1: '123 Main St', city: 'Springfield', state: 'IL', postalCode: '12345', country: 'US', }, } as PhotonPatient; const patient = await createPatientResource(photonPatient); expect(patient).toEqual( expect.objectContaining({ resourceType: 'Patient', name: [{ family: 'Doe', given: ['John'] }], gender: 'male', birthDate: '1990-01-01', telecom: [ { system: 'phone', value: '555-1234' }, { system: 'email', value: 'john@example.com' }, ], address: [ expect.objectContaining({ line: ['123 Main St'], city: 'Springfield', state: 'IL', postalCode: '12345', country: 'US', }), ], }) ); }); }); describe('createAllergies', async () => { const patientReference: Reference<Patient> = { reference: 'Patient/123', display: 'Homer Simpson' }; test('Correctly handles allergies', async () => { const photonAllergies: PhotonPatientAllergy[] = [ { allergen: { id: 'photon-id', rxcui: '12345', name: 'Penicillin' }, comment: 'Severe reaction', onset: '2022-01-01', }, { allergen: { id: 'photon-id', rxcui: undefined, name: 'Unknown' }, // Should be skipped }, ]; const allergies = createAllergies(patientReference, photonAllergies); expect(allergies?.length).toBe(1); expect(allergies?.[0]).toEqual( expect.objectContaining({ resourceType: 'AllergyIntolerance', patient: patientReference, code: { coding: [ { system: 'http://www.nlm.nih.gov/research/umls/rxnorm', code: '12345', display: 'Penicillin', }, ], }, onsetDateTime: '2022-01-01', note: [{ text: 'Severe reaction' }], }) ); }); test('No allergies', async () => { const result = createAllergies(patientReference, []); expect(result).toBeUndefined(); }); }); describe('createPrescriptions', async () => { const patientReference: Reference<Patient> = { reference: 'Patient/123', display: 'Homer Simpson' }; test('No prescriptions', async () => { const medplum = new MockClient(); const result = await createPrescriptions(patientReference, medplum, []); expect(result).toBeUndefined(); }); test('Creates a prescription', async () => { const medplum = new MockClient(); const photonPrescriptions: PhotonPrescription[] = [ { id: 'rx-123', state: 'ACTIVE', treatment: { id: 'example-id', codes: { rxcui: '12345' }, name: 'Test Medication', }, prescriber: { id: 'provider-123', name: { first: 'Alice', last: 'Smith', title: 'Dr.', full: 'Dr. Alice Smith', }, email: 'dralicesmith@example.com', phone: '6105558932', address: { street1: '123 Main Street', city: 'Anytown', state: 'IN', country: 'USA', postalCode: '09328', }, } as PhotonProvider, dispenseQuantity: 30, dispenseUnit: 'tablets', refillsAllowed: 3, daysSupply: 30, effectiveDate: '2023-01-01', expirationDate: '2023-12-31', dispenseAsWritten: false, instructions: 'Take one tablet daily', writtenAt: '2023-01-01T00:00:00Z', notes: 'Additional notes', } as PhotonPrescription, ]; const result = await createPrescriptions(patientReference, medplum, photonPrescriptions); expect(result).toHaveLength(1); const prescription = result?.[0]; expect(prescription).toEqual( expect.objectContaining({ resourceType: 'MedicationRequest', status: 'active', intent: 'order', subject: patientReference, identifier: [{ system: NEUTRON_HEALTH, value: 'rx-123' }], dispenseRequest: { quantity: { value: 30, unit: 'tablets', }, numberOfRepeatsAllowed: 3, expectedSupplyDuration: { value: 30, unit: 'days' }, validityPeriod: { start: '2023-01-01', end: '2023-12-31', }, }, substitution: { allowedBoolean: true }, dosageInstruction: [{ patientInstruction: 'Take one tablet daily' }], authoredOn: '2023-01-01T00:00:00Z', medicationCodeableConcept: { coding: [{ system: RXNORM, code: '12345', display: 'Test Medication' }], }, note: [{ text: 'Additional notes' }], }) ); }); }); describe('Prescriber functions', async () => { test('Get prescriber by medplum ID', async () => { const medplum = new MockClient(); const practitioner: Practitioner = await medplum.createResource({ resourceType: 'Practitioner', }); const photonProvider = { id: 'example-id', externalId: practitioner.id } as PhotonProvider; const result = await getPrescriber(medplum, photonProvider); expect(result).toStrictEqual(practitioner); }); test('Get prescriber by Photon identifier', async () => { const medplum = new MockClient(); const practitioner: Practitioner = await medplum.createResource({ resourceType: 'Practitioner', identifier: [{ system: NEUTRON_HEALTH, value: 'example-id' }], }); const photonProvider = { id: 'example-id' } as PhotonProvider; const result = await getPrescriber(medplum, photonProvider); expect(result).toStrictEqual(practitioner); }); test('Create practitioner reference if none exists', async () => { const medplum = new MockClient(); const photonProvider: PhotonProvider = { id: 'example-id', name: { first: 'Alice', last: 'Smith', title: 'Dr.', full: 'Dr. Alice Smith', }, email: 'dralicesmith@aol.com', phone: '9085556392', address: { street1: '85 Willow Lane', street2: 'Apt B', city: 'Youngstown', state: 'OH', country: 'US', postalCode: '44405', }, organizations: [], }; const result = await getPrescriber(medplum, photonProvider); expect(result).toBeUndefined(); }); }); describe('getStatusFromPhotonState', async () => { test('Map Photon states to FHIR statuses', async () => { const testCases = [ { input: 'ACTIVE', expected: 'active' }, { input: 'CANCELED', expected: 'cancelled' }, { input: 'DEPLETED', expected: 'completed' }, { input: 'EXPIRED', expected: 'stopped' }, ]; testCases.forEach(({ input, expected }) => { const result = getStatusFromPhotonState(input as PhotonPrescription['state']); expect(result).toBe(expected); }); }); test('Invalid state', async () => { expect(() => getStatusFromPhotonState('invalid-state' as PhotonPrescription['state'])).toThrow( 'Invalid state provided' ); }); }); });