// src/llm/mapToFHIR.ts
import axios from "axios";
import { jsonrepair } from "jsonrepair";
import dotenv from "dotenv";
dotenv.config();
// -----------------------------
// Type Definitions
// -----------------------------
interface ConfidenceMetrics {
overallConfidence: "high" | "medium" | "low";
confidenceScore: number; // 0–100
flaggedFields: string[];
ocrQualityScore: number;
parsingIssues: string[];
missingCriticalFields: string[];
}
interface FHIRWithConfidence {
fhirBundle: any;
confidence: ConfidenceMetrics;
needsReview: boolean;
reviewComments: string[];
}
interface ClaudeAPIResponse {
content: { text: string }[];
}
// -----------------------------
// OCR Quality Analysis
// -----------------------------
function analyzeOCRQuality(ocrText: string): { score: number; issues: string[] } {
const issues: string[] = [];
let score = 100;
const ocrProblems = [
{ pattern: /[|\\\/]{3,}/, issue: "Multiple vertical lines detected", penalty: 15 },
{ pattern: /\s{5,}/, issue: "Excessive whitespace", penalty: 10 },
{ pattern: /[0O]{3,}|[Il]{3,}/, issue: "Character confusion (0/O, I/l)", penalty: 20 },
{ pattern: /[^\w\s\-.,()/@:]/g, issue: "Special characters", penalty: 5 },
{ pattern: /^\s*$/, issue: "Empty or whitespace-only text", penalty: 100 },
];
ocrProblems.forEach(({ pattern, issue, penalty }) => {
if (pattern.test(ocrText)) {
issues.push(issue);
score -= penalty;
}
});
if (ocrText.length < 100) {
issues.push("Very short text - possible incomplete OCR");
score -= 25;
}
if (!/patient|name|date|doctor|physician/i.test(ocrText)) {
issues.push("No recognizable medical form structure");
score -= 30;
}
return { score: Math.max(0, score), issues };
}
// -----------------------------
// Critical Field Checker
// -----------------------------
function identifyMissingFields(ocrText: string): string[] {
const criticalFields = [
{ field: "Patient Name", patterns: [/patient.*name/i, /first.*name/i, /last.*name/i] },
{ field: "Date of Birth", patterns: [/date.*birth/i, /dob/i, /born/i] },
{ field: "Medical Record Number", patterns: [/medical.*record/i, /mrn/i, /patient.*id/i] },
{ field: "Referring Physician", patterns: [/referring.*physician/i, /doctor/i, /md/i] },
{ field: "Chief Complaint", patterns: [/chief.*complaint/i, /symptoms/i, /diagnosis/i] },
];
return criticalFields
.filter(({ patterns }) => !patterns.some((p) => p.test(ocrText)))
.map(({ field }) => field);
}
// -----------------------------
// Main Mapping Function
// -----------------------------
export async function mapToFHIR(ocrText: string): Promise<FHIRWithConfidence> {
try {
console.log("Calling Claude API for FHIR mapping...");
const ocrAnalysis = analyzeOCRQuality(ocrText);
const missingFields = identifyMissingFields(ocrText);
const claudeRes = await axios.post<ClaudeAPIResponse>(
"https://api.anthropic.com/v1/messages",
{
model: "claude-3-5-haiku-20241022",
max_tokens: 3000,
messages: [
{
role: "user",
content: `Convert the following medical referral form text into FHIR-compliant JSON. IMPORTANT: You must also provide a confidence assessment.
OCR Text:
${ocrText}
Please return a JSON response with this exact structure:
{
"fhirBundle": { ... },
"confidence": {
"overallConfidence": "high|medium|low",
"confidenceScore": 0-100,
"flaggedFields": [],
"parsingIssues": [],
"reasoning": "..."
}
}
Confidence Guidelines:
- HIGH (80-100): Clear text, all critical fields present, no ambiguity
- MEDIUM (50-79): Some unclear text or missing non-critical fields
- LOW (0-49): Poor text quality, missing critical fields, or high uncertainty
Be conservative with confidence scores for medical data. Flag any field where you had to guess or interpret unclear text.`,
},
],
},
{
headers: {
"x-api-key": process.env.CLAUDE_API_KEY!,
"anthropic-version": "2023-06-01",
"Content-Type": "application/json",
},
}
);
const content = claudeRes.data?.content?.[0]?.text;
if (!content) {
throw new Error("No valid response content from Claude API");
}
const jsonMatch = content.match(/```(?:json)?\s*([\s\S]*?)\s*```/) || content.match(/\{[\s\S]*\}/);
if (!jsonMatch) throw new Error("Claude returned invalid JSON format");
const rawJson = jsonMatch[1] || jsonMatch[0];
const parsed = JSON.parse(jsonrepair(rawJson));
const combinedConfidence: ConfidenceMetrics = {
overallConfidence: parsed.confidence?.overallConfidence || "low",
confidenceScore: Math.min(parsed.confidence?.confidenceScore || 50, ocrAnalysis.score),
flaggedFields: [...(parsed.confidence?.flaggedFields || []), ...missingFields],
ocrQualityScore: ocrAnalysis.score,
parsingIssues: [...(parsed.confidence?.parsingIssues || []), ...ocrAnalysis.issues],
missingCriticalFields: missingFields,
};
const needsReview =
combinedConfidence.confidenceScore < 70 ||
combinedConfidence.overallConfidence === "low" ||
missingFields.length > 2 ||
ocrAnalysis.score < 60;
const reviewComments: string[] = [];
if (ocrAnalysis.score < 60) reviewComments.push("Poor OCR quality - verify data.");
if (missingFields.length > 0) reviewComments.push(`Missing fields: ${missingFields.join(", ")}`);
if (combinedConfidence.flaggedFields.length > 0)
reviewComments.push(`Uncertain fields: ${combinedConfidence.flaggedFields.join(", ")}`);
if (parsed.confidence?.reasoning) reviewComments.push(`Claude: ${parsed.confidence.reasoning}`);
const enhancedBundle = {
...parsed.fhirBundle,
meta: {
...parsed.fhirBundle?.meta,
tag: [
...(parsed.fhirBundle?.meta?.tag || []),
{
system: "http://terminology.hl7.org/CodeSystem/v3-ObservationValue",
code: combinedConfidence.overallConfidence,
display: `Confidence: ${combinedConfidence.overallConfidence.toUpperCase()}`,
},
],
extension: [
{
url: "http://example.com/fhir/StructureDefinition/confidence-score",
valueInteger: combinedConfidence.confidenceScore,
},
{
url: "http://example.com/fhir/StructureDefinition/needs-review",
valueBoolean: needsReview,
},
],
},
};
return {
fhirBundle: enhancedBundle,
confidence: combinedConfidence,
needsReview,
reviewComments,
};
} catch (error: any) {
console.error("❌ Claude FHIR Mapping Error:", error.response?.data || error.message);
return {
fhirBundle: {
resourceType: "Bundle",
id: "error-bundle",
type: "collection",
timestamp: new Date().toISOString(),
meta: {
tag: [
{
system: "http://terminology.hl7.org/CodeSystem/v3-ObservationValue",
code: "low",
display: "Confidence: LOW",
},
],
},
entry: [
{
resource: {
resourceType: "OperationOutcome",
id: "mapping-error",
issue: [
{
severity: "error",
code: "processing",
details: {
text: `Failed to map OCR text to FHIR: ${error.message}`,
},
},
],
},
},
],
},
confidence: {
overallConfidence: "low",
confidenceScore: 0,
flaggedFields: ["all"],
ocrQualityScore: 0,
parsingIssues: [error.message],
missingCriticalFields: ["all"],
},
needsReview: true,
reviewComments: ["Complete failure – manual entry required"],
};
}
}
