simplify consent discovery by using chain queries to fetch consents d…

…irectly based on patient identifiers.
mojitoj · Nov 30, 2024 · 26cb659 · 26cb659
1 parent 46d30ee
commit 26cb659
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Showing 7 changed files with 47 additions and 225 deletions.
diff --git a/lib/consent-discovery.js b/lib/consent-discovery.js
@@ -1,4 +1,3 @@
-const _ = require("lodash");
 const superagent = require("superagent");
 const logger = require("../lib/logger");
 const { maybeAddAuth } = require("../lib/auth");
@@ -13,26 +12,33 @@ const addFhirBaseToEntry = (entry, url) => ({
 });
 
 const addFhirBaseToEntries = (entries, url) =>
-  entries.map((entry) => addFhirBaseToEntry(entry, url));
+  entries ? entries.map((entry) => addFhirBaseToEntry(entry, url)) : [];
 
-async function fetchConsents(patientIdentifiers, category) {
+async function fetchConsents(patientIdentifiers) {
   try {
-    const patientFhirIds = await patientIds(patientIdentifiers);
+    const consentSearchQueries = CONSENT_FHIR_SERVERS.map((fhirBase) =>
+      patientIdentifiers.map((patientIdentifier) =>
+        resolveConsents(fhirBase, patientIdentifier)
+      )
+    ).flat();
 
-    const consentSearchQueries = patientFhirIds.map(({ fhirBase, patientId }) =>
-      resolveConsents(fhirBase, patientId, category)
-    );
+    const fhirBasePointers = CONSENT_FHIR_SERVERS.map((fhirBase) =>
+      patientIdentifiers.map(() => fhirBase)
+    ).flat();
 
     const consentSearchResults = await Promise.all(consentSearchQueries);
     const resolvedConsents = consentSearchResults
-      .filter(({ body }) => body?.entry?.length)
       .map(({ body }, index) => ({
         ...body,
-        entry: addFhirBaseToEntries(body.entry, patientFhirIds[index].fhirBase)
+        entry: addFhirBaseToEntries(
+          body.entry,
+          fhirBasePointers[index]
+        )
       }))
+      .filter((body) => body?.entry?.length)
       .map((bundle) => bundle.entry)
       .flat();
-      
+
     return resolvedConsents;
   } catch (e) {
     console.log(e);
@@ -45,11 +51,12 @@ async function fetchConsents(patientIdentifiers, category) {
   }
 }
 
-function resolveConsents(fhirBase, patientId, category) {
+function resolveConsents(fhirBase, patientIdentifier) {
   const patientParam = {
-    patient: `Patient/${patientId}`
+    "patient.identifier": patientIdentifier.system
+      ? `${patientIdentifier.system}|${patientIdentifier.value}`
+      : `|${patientIdentifier.value}`
   };
-  //todo: incorporate categoty into the search parameters
 
   const params = { ...patientParam };
   return maybeAddAuth(
@@ -60,50 +67,6 @@ function resolveConsents(fhirBase, patientId, category) {
   );
 }
 
-async function patientIds(patientIdentifiers) {
-  const patientIdQueries = CONSENT_FHIR_SERVERS.map((fhirBase) =>
-    resolvePatientOnServer(fhirBase, patientIdentifiers)
-  );
-
-  const patientIds = await Promise.all(patientIdQueries);
-
-  return _.zipWith(CONSENT_FHIR_SERVERS, patientIds, (fhirBase, patientId) => ({
-    fhirBase,
-    patientId
-  })).filter(({ patientId }) => patientId);
-}
-
-async function resolvePatientOnServer(fhirBase, patientIdentifiers) {
-  const patientSearchQueries = patientIdentifiers.map((patientIdentifier) =>
-    resolvePatientOnServerByIdentifer(fhirBase, patientIdentifier)
-  );
-  const patientIdSearchResults = await Promise.all(patientSearchQueries);
-
-  const patientIds = patientIdSearchResults
-    .map((patientIdResult) => firstPatientId(patientIdResult))
-    .filter((patientId) => patientId);
-
-  return patientIds?.[0];
-}
-
-function resolvePatientOnServerByIdentifer(fhirBase, patientIdentifier) {
-  const query = {
-    identifier: patientIdentifier.system
-      ? `${patientIdentifier.system}|${patientIdentifier.value}`
-      : `|${patientIdentifier.value}`
-  };
-  return maybeAddAuth(
-    superagent
-      .get(`${fhirBase}/Patient`)
-      .query(query)
-      // .query({ _summary: "true" }) not implemented by some servers.
-      .set({ Accept: "application/json, application/fhir+json" })
-  );
-}
-
-const firstPatientId = (patientSearchResult) =>
-  patientSearchResult.body?.entry?.[0]?.resource?.id;
-
 module.exports = {
   fetchConsents
 };
diff --git a/test/common/setup-mock-consent-servers.js b/test/common/setup-mock-consent-servers.js
@@ -8,38 +8,12 @@ const CONSENT_FHIR_SERVERS = (process.env.CONSENT_FHIR_SERVERS || "")
 const EMPTY_BUNDLE = require("../fixtures/empty-bundle.json");
 const PATIENT = require("../fixtures/patients/patient-boris.json");
 
-const PATIENT_RESULTS_BUNDLE = _.set(
-  _.set(_.clone(EMPTY_BUNDLE), "entry[0].resource", PATIENT),
-  "total",
-  1
-);
-
 const MOCK_FHIR_SERVERS = CONSENT_FHIR_SERVERS.map((fhirBase) =>
   nock(fhirBase)
     .defaultReplyHeaders({ "Content-Type": "application/json; charset=utf-8" })
     .replyContentLength()
 );
 
-function setupMockPatient(patientId, index) {
-  const fhirServerIndex = index || 0;
-  const system = patientId.system;
-  const value = patientId.value;
-
-  MOCK_FHIR_SERVERS[fhirServerIndex]
-    .get("/Patient")
-    .query({ identifier: `${system}|${value}` })
-    .reply(200, PATIENT_RESULTS_BUNDLE);
-
-  for (var i = 0; i < MOCK_FHIR_SERVERS.length; i++) {
-    if (i == index) continue;
-
-    MOCK_FHIR_SERVERS[i]
-      .get("/Patient")
-      .query({ identifier: `${system}|${value}` })
-      .reply(200, EMPTY_BUNDLE);
-  }
-}
-
 function setupMockOrganization(url, organizationResource, howManyRequests) {
   const numberOfTimes = howManyRequests || 1;
   MOCK_FHIR_SERVERS[0]
@@ -61,42 +35,12 @@ function setupMockPractitioner(url, practitionerResource, howManyRequests) {
     .reply(200, practitionerResource);
 }
 
-function setupMockConsent(category, consent, index, patientId) {
-  const fhirServerIndex = index || 0;
-  const fhirPatientId = patientId || "Patient/52";
-
-  const CONSENT_RESULTS_BUNDLE = consent
-    ? _.set(
-        _.set(
-          _.set(
-            _.clone(EMPTY_BUNDLE),
-            "entry[0].resource",
-            _.set(consent, "id", "1")
-          ),
-          "entry[0].fullUrl",
-          `${CONSENT_FHIR_SERVERS[0]}/Consent/1`
-        ),
-        "total",
-        1
-      )
-    : EMPTY_BUNDLE;
-
-  MOCK_FHIR_SERVERS[fhirServerIndex]
-    .get(`/Consent?patient=${fhirPatientId}`)
-    .reply(200, CONSENT_RESULTS_BUNDLE);
-
-  for (var i = 0; i < MOCK_FHIR_SERVERS.length; i++) {
-    if (i == index) continue;
-
-    MOCK_FHIR_SERVERS[i]
-      .get(`/Consent?patient=${fhirPatientId}`)
-      .reply(200, EMPTY_BUNDLE);
-  }
-}
-
-function setupMockConsentNoCategory(consent, index, patientId) {
+function setupMockConsent(consent, index, patientIdentifier) {
   const fhirServerIndex = index || 0;
-  const fhirPatientId = patientId || "Patient/52";
+  const { system, value } = patientIdentifier || {
+    system: "http://hl7.org/fhir/sid/us-medicare",
+    value: "0000-000-0000"
+  };
 
   const CONSENT_RESULTS_BUNDLE = consent
     ? _.set(
@@ -115,22 +59,19 @@ function setupMockConsentNoCategory(consent, index, patientId) {
     : EMPTY_BUNDLE;
 
   MOCK_FHIR_SERVERS[fhirServerIndex]
-    .get(`/Consent?patient=${fhirPatientId}`)
+    .get(`/Consent?patient.identifier=${system}|${value}`)
     .reply(200, CONSENT_RESULTS_BUNDLE);
 
   for (var i = 0; i < MOCK_FHIR_SERVERS.length; i++) {
-    if (i == index) continue;
-
+    if (i == fhirServerIndex) continue;
     MOCK_FHIR_SERVERS[i]
-      .get(`/Consent?patient=${fhirPatientId}`)
+      .get(`/Consent?patient.identifier=${system}|${value}`)
       .reply(200, EMPTY_BUNDLE);
   }
 }
 
 module.exports = {
-  setupMockPatient,
   setupMockConsent,
-  setupMockConsentNoCategory,
   setupMockOrganization,
   setupMockPractitioner,
   setupMockAuditEndpoint,

diff --git a/test/controllers/discovery.test.js b/test/controllers/discovery.test.js
diff --git a/test/controllers/patient-consent-consult.test.js b/test/controllers/patient-consent-consult.test.js
@@ -6,7 +6,6 @@ const Ajv = require("ajv");
 const request = require("supertest");
 const { app } = require("../../app");
 const {
-  setupMockPatient,
   setupMockConsent,
   setupMockOrganization,
   setupMockAuditEndpoint
@@ -121,19 +120,13 @@ it("should return 400 on bad content", async () => {
 
 const REQUEST = require("../fixtures/request-samples/patient-consent-consult-hook-request.json");
 
-const MOCK_PATIENT_ID = {
-  system: "http://hl7.org/fhir/sid/us-medicare",
-  value: "0000-000-0000"
-};
-
 const ORGANIZATION = require("../fixtures/organizations/org-good-health.json");
 
 it("should return 200 and an array including a consent permit card with an OPTIN consent", async () => {
   expect.assertions(2);
 
   setupMockAuditEndpoint();
-  setupMockPatient(MOCK_PATIENT_ID);
-  setupMockConsent("patient-privacy", CONSENT_OPTIN);
+  setupMockConsent(CONSENT_OPTIN);
   setupMockOrganization(
     `/${_.get(
       CONSENT_OPTIN,
@@ -165,8 +158,7 @@ it("should return 200 and an array including a consent deny card with an OPTIN c
   expect.assertions(2);
 
   setupMockAuditEndpoint();
-  setupMockPatient(MOCK_PATIENT_ID);
-  setupMockConsent("patient-privacy", CONSENT_OPTIN);
+  setupMockConsent(CONSENT_OPTIN);
   setupMockOrganization(
     `/${_.get(
       CONSENT_OPTIN,
@@ -204,8 +196,7 @@ it("should return 200 and an array including a consent deny card with an OPTOUT
   expect.assertions(2);
 
   setupMockAuditEndpoint();
-  setupMockPatient(MOCK_PATIENT_ID);
-  setupMockConsent("patient-privacy", CONSENT_OPTOUT);
+  setupMockConsent(CONSENT_OPTOUT);
   setupMockOrganization(
     `/${_.get(
       CONSENT_OPTOUT,
@@ -240,11 +231,7 @@ it("should return 200 and an array including a consent permit card with obligati
 
   const ACTIVE_PRIVACY_CONSENT_WITH_SEC_LABEL_PROVISION = require("../fixtures/consents/r4/consent-boris-deny-restricted-label.json");
 
-  setupMockPatient(MOCK_PATIENT_ID);
-  setupMockConsent(
-    "patient-privacy",
-    ACTIVE_PRIVACY_CONSENT_WITH_SEC_LABEL_PROVISION
-  );
+  setupMockConsent(ACTIVE_PRIVACY_CONSENT_WITH_SEC_LABEL_PROVISION);
   setupMockOrganization(
     `/${_.get(
       ACTIVE_PRIVACY_CONSENT_WITH_SEC_LABEL_PROVISION,
@@ -315,8 +302,7 @@ it("should return 200 and an array including a consent permit card with obligati
 it("should return 200 and an array including a NO_CONSENT card when no consent exists", async () => {
   expect.assertions(2);
 
-  setupMockPatient(MOCK_PATIENT_ID);
-  setupMockConsent("patient-privacy", null);
+  setupMockConsent(null);
 
   const res = await request(app)
     .post(HOOK_ENDPOINT)

diff --git a/test/controllers/xacml-schema.test.js b/test/controllers/xacml-schema.test.js
@@ -4,7 +4,6 @@ const nock = require("nock");
 const request = require("supertest");
 const { app } = require("../../app");
 const {
-  setupMockPatient,
   setupMockConsent,
   setupMockOrganization,
   setupMockAuditEndpoint
@@ -237,21 +236,13 @@ it("should return 400 on missing required attribtues", async () => {
 
 it("should return a response compliant with the response schema", async () => {
   const REQUEST = require("../fixtures/request-samples/xacml-request.json");
-  const MOCK_PATIENT_ID = {
-    system: "http://hl7.org/fhir/sid/us-medicare",
-    value: "0000-000-0000"
-  };
   const ORGANIZATION = require("../fixtures/organizations/org-good-health.json");
   const ACTIVE_PRIVACY_CONSENT_WITH_SEC_LABEL_PROVISION = require("../fixtures/consents/r4/consent-boris-deny-restricted-label.json");
 
   expect.assertions(1);
 
   setupMockAuditEndpoint();
-  setupMockPatient(MOCK_PATIENT_ID);
-  setupMockConsent(
-    "patient-privacy",
-    ACTIVE_PRIVACY_CONSENT_WITH_SEC_LABEL_PROVISION
-  );
+  setupMockConsent(ACTIVE_PRIVACY_CONSENT_WITH_SEC_LABEL_PROVISION);
   setupMockOrganization(
     `/${_.get(
       ACTIVE_PRIVACY_CONSENT_WITH_SEC_LABEL_PROVISION,