/** * v1.7.0 — HL7 FHIR R4 document-Bundle builder for the health-record export. * * Pure function: takes the SAME `DoctorReportData` the PDF renderer consumes * (assembled by `collectDoctorReportData`) plus the decrypted patient * identity, and emits a `Bundle` of `type: "document"` — a leading * `Composition` "cover page", the `Patient`, then one `Observation` per * selected vital / glucose context / mood + one `MedicationStatement` per * active medication. * * Because it reuses the PDF aggregator, the FHIR export and the PDF describe * identical numbers by construction (the source-of-truth property the two * PDF endpoints already share). * * No FHIR SDK, no `@types/fhir` — narrow hand-rolled interfaces only * (`./types`), matching the project's "hand-rolled over the documented wire" * convention. The `Composition.text` narrative is escaped plain text, never * user-supplied HTML (no markdown library, no `dangerouslySetInnerHTML`). */ import type { DoctorReportData } from "@/lib/doctor-report-data"; import { resolveGlucoseUnit, convertGlucose } from "@/lib/glucose"; import { LOINC_SYSTEM, UCUM_SYSTEM, MEASUREMENT_LOINC, BP_PANEL_LOINC, BP_SYS_LOINC, BP_DIA_LOINC, BP_UNIT, GLUCOSE_LOINC, MEDICATION_ADHERENCE_LOINC, MOOD_LOINC, type LoincMapping, } from "@/lib/fhir/loinc-map"; import type { FhirBundle, FhirBundleEntry, FhirCodeableConcept, FhirObservation, FhirMedicationStatement, FhirPatient, FhirComposition, FhirDiagnosticReport, FhirReference, FhirResource, } from "@/lib/fhir/types"; /** Patient identity not carried in `DoctorReportData` (KVNR is encrypted). */ export interface FhirPatientIdentity { /** German KVNR (decrypted by the route). */ insuranceNumber: string | null; } /** KVNR identifier namespace per the gematik SID. */ const KVNR_SYSTEM = "http://fhir.de/sid/gkv/kvid-10"; /** Escape the five XML-significant characters for the xhtml narrative. */ function escapeXml(value: string): string { return value .replace(/&/g, "&") .replace(//g, ">") .replace(/"/g, """) .replace(/'/g, "'"); } function codeableFromMapping(m: LoincMapping): FhirCodeableConcept { if (m.loinc) { return { coding: [{ system: LOINC_SYSTEM, code: m.loinc, display: m.display }], text: m.display, }; } // No stable LOINC — local text-only concept (documented fallback). return { text: m.display }; } function categoryConcept(category: string): FhirCodeableConcept { return { coding: [ { system: "http://terminology.hl7.org/CodeSystem/observation-category", code: category, }, ], }; } /** Latest `{ value, measuredAt }` for a type, or null when no rows. */ function latestReading( data: DoctorReportData, type: string, ): { value: number; measuredAt: string } | null { const series = data.measurements[type]; if (!series || series.length === 0) return null; return series[series.length - 1]; } /** * Build a FHIR R4 document Bundle from the aggregated report data. * * `now` is injectable for deterministic tests. */ export function buildFhirDocumentBundle( data: DoctorReportData, identity: FhirPatientIdentity, now: Date = new Date(), ): FhirBundle { const patientId = "patient-1"; const patientRef: FhirReference = { reference: `Patient/${patientId}` }; const entries: FhirBundleEntry[] = []; const observationRefs: FhirReference[] = []; const medicationRefs: FhirReference[] = []; // --- Patient ----------------------------------------------------------- const patient: FhirPatient = { resourceType: "Patient", id: patientId, }; const displayName = data.patient.fullName ?? data.patient.username ?? null; if (displayName) patient.name = [{ text: displayName }]; if (data.patient.gender) { patient.gender = data.patient.gender === "MALE" ? "male" : "female"; } if (data.patient.dateOfBirth) { patient.birthDate = data.patient.dateOfBirth.slice(0, 10); } if (identity.insuranceNumber) { patient.identifier = [ { system: KVNR_SYSTEM, value: identity.insuranceNumber }, ]; } entries.push({ fullUrl: `urn:uuid:${patientId}`, resource: patient }); let obsSeq = 0; const pushObservation = (obs: FhirObservation) => { entries.push({ fullUrl: `urn:uuid:${obs.id}`, resource: obs }); observationRefs.push({ reference: `Observation/${obs.id}` }); }; // --- Vital-sign + activity Observations (one latest reading per type) -- const glucoseUnit = resolveGlucoseUnit(data.glucoseUnit ?? null); for (const [type, mapping] of Object.entries(MEASUREMENT_LOINC)) { // BMI is emitted once by the computed-BMI block below (matching the PDF's // BMI line); skip the stored BODY_MASS_INDEX series here to avoid a // duplicate Observation. if (type === "BODY_MASS_INDEX") continue; const reading = latestReading(data, type); if (!reading) continue; // SLEEP_DURATION is stored in MINUTES; the iOS-locked UCUM unit is `h`, so // emit the value in hours to keep value and unit consistent. The PDF reads // the raw series independently and is unaffected. const value = type === "SLEEP_DURATION" ? Math.round((reading.value / 60) * 100) / 100 : reading.value; obsSeq += 1; pushObservation({ resourceType: "Observation", id: `obs-${obsSeq}`, status: "final", category: [categoryConcept(mapping.category)], code: codeableFromMapping(mapping), subject: patientRef, effectiveDateTime: reading.measuredAt, valueQuantity: { value, unit: mapping.unit, system: UCUM_SYSTEM, code: mapping.unit, }, }); } // --- Blood-pressure panel (sys + dia components) ----------------------- const sys = latestReading(data, "BLOOD_PRESSURE_SYS"); const dia = latestReading(data, "BLOOD_PRESSURE_DIA"); if (sys && dia) { obsSeq += 1; pushObservation({ resourceType: "Observation", id: `obs-${obsSeq}`, status: "final", category: [categoryConcept("vital-signs")], code: { coding: [ { system: LOINC_SYSTEM, code: BP_PANEL_LOINC, display: "Blood pressure panel", }, ], text: "Blood pressure", }, subject: patientRef, // Use the systolic reading's timestamp as the panel effective time. effectiveDateTime: sys.measuredAt, component: [ { code: { coding: [ { system: LOINC_SYSTEM, code: BP_SYS_LOINC, display: "Systolic" }, ], }, valueQuantity: { value: sys.value, unit: BP_UNIT, system: UCUM_SYSTEM, code: BP_UNIT, }, }, { code: { coding: [ { system: LOINC_SYSTEM, code: BP_DIA_LOINC, display: "Diastolic" }, ], }, valueQuantity: { value: dia.value, unit: BP_UNIT, system: UCUM_SYSTEM, code: BP_UNIT, }, }, ], }); } // --- Computed BMI Observation (matches the PDF's BMI line) ------------- if (data.bmi !== null && data.bmi !== undefined) { obsSeq += 1; pushObservation({ resourceType: "Observation", id: `obs-${obsSeq}`, status: "final", category: [categoryConcept("vital-signs")], code: { coding: [ { system: LOINC_SYSTEM, code: "39156-5", display: "Body mass index (BMI) [Ratio]", }, ], text: "Body mass index (BMI) [Ratio]", }, subject: patientRef, effectiveDateTime: data.period.end, valueQuantity: { value: data.bmi, unit: "kg/m2", system: UCUM_SYSTEM, code: "kg/m2", }, }); } // --- Glucose Observations (per context, user display unit) ------------- for (const [ctx, stat] of Object.entries(data.glucoseStats)) { const map = GLUCOSE_LOINC[ctx]; if (!map) continue; obsSeq += 1; pushObservation({ resourceType: "Observation", id: `obs-${obsSeq}`, status: "final", category: [categoryConcept("laboratory")], code: { coding: [{ system: LOINC_SYSTEM, code: map.loinc, display: map.display }], text: map.display, }, subject: patientRef, effectiveDateTime: data.period.end, valueQuantity: { value: convertGlucose(stat.latest, glucoseUnit), unit: glucoseUnit, system: UCUM_SYSTEM, code: glucoseUnit === "mmol/L" ? "mmol/L" : "mg/dL", }, }); } // --- Medication-adherence Observations (one per medication) ------------ for (const [name, comp] of Object.entries(data.compliance)) { if (comp.total <= 0) continue; obsSeq += 1; const rate = Math.round((comp.taken / comp.total) * 1000) / 10; pushObservation({ resourceType: "Observation", id: `obs-${obsSeq}`, status: "final", category: [categoryConcept("activity")], code: { coding: [ { system: LOINC_SYSTEM, code: MEDICATION_ADHERENCE_LOINC, display: "Medication adherence", }, ], text: `Medication adherence — ${name}`, }, subject: patientRef, effectiveDateTime: data.period.end, valueQuantity: { value: rate, unit: "%", system: UCUM_SYSTEM, code: "%" }, }); } // --- Mood Observation (opt-in only; absent when toggle off) ------------ if (data.mood) { obsSeq += 1; pushObservation({ resourceType: "Observation", id: `obs-${obsSeq}`, status: "final", category: [categoryConcept("vital-signs")], code: { coding: [{ system: LOINC_SYSTEM, code: MOOD_LOINC, display: "Mood" }], text: "Mood (average over period)", }, subject: patientRef, effectiveDateTime: data.period.end, valueQuantity: { value: Math.round(data.mood.avg * 10) / 10, unit: "{score}", system: UCUM_SYSTEM, code: "{score}", }, }); } // --- MedicationStatement per active medication ------------------------- let medSeq = 0; for (const med of data.medications) { medSeq += 1; const id = `med-${medSeq}`; const stmt: FhirMedicationStatement = { resourceType: "MedicationStatement", id, status: "active", medicationCodeableConcept: { text: med.name }, subject: patientRef, }; if (med.dose) stmt.dosage = [{ text: med.dose }]; entries.push({ fullUrl: `urn:uuid:${id}`, resource: stmt }); medicationRefs.push({ reference: `MedicationStatement/${id}` }); } // --- Composition (leading "cover" resource) ---------------------------- const narrativeText = [ `Health record for ${escapeXml(displayName ?? "patient")}.`, `Reporting period ${data.period.start.slice(0, 10)} to ${data.period.end.slice(0, 10)}.`, `${observationRefs.length} observation(s), ${medicationRefs.length} medication(s).`, ].join(" "); const composition: FhirComposition = { resourceType: "Composition", id: "composition-1", status: "final", type: { coding: [ { system: LOINC_SYSTEM, code: "11503-0", display: "Medical records", }, ], text: "Health record", }, subject: patientRef, date: now.toISOString(), author: [{ reference: "Device/healthlog", display: "HealthLog" }], title: "Health Record", section: [ { // Vital-signs section carries the narrative + every Observation ref, // matching the iOS Bundle graph ("Vital signs" + "Medications"). title: "Vital signs", text: { status: "generated", div: `
${escapeXml(narrativeText)}
` }, entry: [patientRef, ...observationRefs], }, ...(medicationRefs.length > 0 ? [{ title: "Medications", entry: medicationRefs }] : []), ], }; // --- DiagnosticReport (vital-signs panel; routes all Observations) ----- // Last entry in the Bundle, matching the iOS Bundle graph. `result[]` // references every emitted Observation. const diagnosticReport: FhirDiagnosticReport = { resourceType: "DiagnosticReport", id: "diagnostic-report-1", status: "final", code: { coding: [ { system: LOINC_SYSTEM, code: "85353-1", display: "Vital signs, weight, height, head circumference, oxygen saturation and BMI panel", }, ], text: "Vital signs panel", }, subject: patientRef, effectivePeriod: { start: data.period.start, end: data.period.end }, result: observationRefs, }; // The Composition must be the FIRST entry in a document Bundle; the // DiagnosticReport is the LAST. const orderedEntries: FhirBundleEntry[] = [ { fullUrl: `urn:uuid:${composition.id}`, resource: composition as FhirResource, }, ...entries, { fullUrl: `urn:uuid:${diagnosticReport.id}`, resource: diagnosticReport as FhirResource, }, ]; return { resourceType: "Bundle", type: "document", timestamp: now.toISOString(), entry: orderedEntries, }; }