Ship full Emergency specialty suite on the shared shell.

Add ED visit stages, triage-driven routing, vitals, observation, disposition, reports, and print summary so Emergency matches Dentistry’s operational depth without a parallel EHR.

Co-authored-by: Cursor <cursoragent@cursor.com>

app/Http/Controllers/Care/EmergencyWorkspaceController.php

@@ -0,0 +1,234 @@
+<?php
+
+namespace App\Http\Controllers\Care;
+
+use App\Http\Controllers\Care\Concerns\ScopesToAccount;
+use App\Http\Controllers\Controller;
+use App\Models\SpecialtyClinicalRecord;
+use App\Models\Visit;
+use App\Services\Care\Emergency\EmergencyAnalyticsService;
+use App\Services\Care\Emergency\EmergencyVitalsService;
+use App\Services\Care\Emergency\EmergencyWorkflowService;
+use App\Services\Care\SpecialtyClinicalRecordService;
+use App\Services\Care\SpecialtyModuleService;
+use App\Services\Care\SpecialtyShellService;
+use App\Services\Care\SpecialtyVisitStageService;
+use Illuminate\Http\RedirectResponse;
+use Illuminate\Http\Request;
+use Illuminate\View\View;
+
+class EmergencyWorkspaceController extends Controller
+{
+    use ScopesToAccount;
+
+    protected function assertEmergencyAccess(Request $request, SpecialtyModuleService $modules): void
+    {
+        $organization = $this->organization($request);
+        abort_unless($modules->memberCanAccess($organization, $this->member($request), 'emergency'), 403);
+    }
+
+    protected function assertVisit(Request $request, Visit $visit): void
+    {
+        abort_unless($visit->organization_id === $this->organization($request)->id, 404);
+        $this->authorizeBranch($request, (int) $visit->branch_id);
+    }
+
+    public function setStage(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        SpecialtyVisitStageService $stages,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertEmergencyAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $validated = $request->validate([
+            'stage' => ['required', 'string', 'max:32'],
+        ]);
+
+        try {
+            $stages->setStage(
+                $this->organization($request),
+                $visit,
+                'emergency',
+                $validated['stage'],
+                $this->ownerRef($request),
+                $this->actorRef($request),
+            );
+        } catch (\InvalidArgumentException $e) {
+            return back()->with('error', $e->getMessage());
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', ['module' => 'emergency', 'visit' => $visit, 'tab' => 'overview'])
+            ->with('success', 'Visit stage updated.');
+    }
+
+    public function saveVitals(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        EmergencyVitalsService $vitals,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertEmergencyAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $validated = $request->validate([
+            'bp_systolic' => ['nullable', 'integer', 'min:0', 'max:300'],
+            'bp_diastolic' => ['nullable', 'integer', 'min:0', 'max:200'],
+            'pulse' => ['nullable', 'integer', 'min:0', 'max:300'],
+            'temperature' => ['nullable', 'numeric', 'min:30', 'max:45'],
+            'spo2' => ['nullable', 'integer', 'min:0', 'max:100'],
+            'respiratory_rate' => ['nullable', 'integer', 'min:0', 'max:80'],
+            'weight_kg' => ['nullable', 'numeric', 'min:0', 'max:500'],
+            'height_cm' => ['nullable', 'numeric', 'min:0', 'max:300'],
+        ]);
+
+        try {
+            $vitals->record(
+                $this->organization($request),
+                $visit,
+                $this->ownerRef($request),
+                $validated,
+                $this->actorRef($request),
+            );
+        } catch (\InvalidArgumentException $e) {
+            return back()->with('error', $e->getMessage());
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', ['module' => 'emergency', 'visit' => $visit, 'tab' => 'vitals'])
+            ->with('success', 'Vitals recorded.');
+    }
+
+    public function saveDisposition(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        SpecialtyClinicalRecordService $clinical,
+        SpecialtyVisitStageService $stages,
+        EmergencyWorkflowService $workflow,
+    ): RedirectResponse {
+        $this->authorizeAbility($request, 'consultations.manage');
+        $this->assertEmergencyAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $organization = $this->organization($request);
+        $owner = $this->ownerRef($request);
+
+        $payload = (array) $request->input('payload', []);
+        foreach ($clinical->fieldsFor('emergency', 'disposition') as $field) {
+            if (($field['type'] ?? '') === 'boolean') {
+                $payload[$field['name']] = $request->boolean('payload.'.$field['name']);
+            }
+        }
+        $request->merge(['payload' => $payload, 'tab' => 'disposition']);
+
+        $validated = $request->validate(array_merge([
+            'tab' => ['required', 'string'],
+        ], $clinical->validationRules('emergency', 'disposition')));
+
+        $record = $clinical->upsert(
+            $organization,
+            $visit,
+            'emergency',
+            'disposition',
+            $clinical->payloadFromRequest($validated),
+            $owner,
+            $owner,
+            EmergencyWorkflowService::STAGE_DISPOSITION,
+            SpecialtyClinicalRecord::STATUS_COMPLETED,
+        );
+
+        try {
+            $stages->setStage(
+                $organization,
+                $visit,
+                'emergency',
+                EmergencyWorkflowService::STAGE_DISPOSITION,
+                $owner,
+                $owner,
+            );
+        } catch (\InvalidArgumentException) {
+            // Stage already disposition or map empty.
+        }
+
+        if ($workflow->shouldCompleteVisit($record->payload ?? [])) {
+            $visit->refresh();
+            if ($visit->status !== Visit::STATUS_COMPLETED) {
+                $visit->update([
+                    'status' => Visit::STATUS_COMPLETED,
+                    'completed_at' => $visit->completed_at ?? now(),
+                ]);
+            }
+
+            $appointment = $visit->appointment;
+            if ($appointment && $appointment->status !== \App\Models\Appointment::STATUS_COMPLETED) {
+                $appointment->update([
+                    'status' => \App\Models\Appointment::STATUS_COMPLETED,
+                    'completed_at' => $appointment->completed_at ?? now(),
+                ]);
+            }
+        }
+
+        return redirect()
+            ->route('care.specialty.workspace', ['module' => 'emergency', 'visit' => $visit, 'tab' => 'disposition'])
+            ->with('success', 'Disposition saved.');
+    }
+
+    public function reports(
+        Request $request,
+        SpecialtyModuleService $modules,
+        SpecialtyShellService $shell,
+        EmergencyAnalyticsService $analytics,
+    ): View {
+        $this->authorizeAbility($request, 'consultations.view');
+        $this->assertEmergencyAccess($request, $modules);
+
+        $organization = $this->organization($request);
+        $branchScope = app(\App\Services\Care\OrganizationResolver::class)->branchScope($this->member($request));
+
+        $report = $analytics->report(
+            $organization,
+            $this->ownerRef($request),
+            $branchScope,
+            $request->query('from'),
+            $request->query('to'),
+        );
+
+        return view('care.specialty.emergency.reports', [
+            'moduleKey' => 'emergency',
+            'definition' => $modules->definition('emergency'),
+            'shellNav' => $shell->navItems('emergency'),
+            'report' => $report,
+            'currency' => strtoupper((string) config('care.billing.currency', config('care.currency', 'GHS'))),
+        ]);
+    }
+
+    public function printSummary(
+        Request $request,
+        Visit $visit,
+        SpecialtyModuleService $modules,
+        SpecialtyClinicalRecordService $clinical,
+        EmergencyVitalsService $vitals,
+    ): View {
+        $this->authorizeAbility($request, 'consultations.view');
+        $this->assertEmergencyAccess($request, $modules);
+        $this->assertVisit($request, $visit);
+
+        $visit->loadMissing(['patient', 'appointment.practitioner', 'branch']);
+
+        return view('care.specialty.emergency.print', [
+            'visit' => $visit,
+            'patient' => $visit->patient,
+            'triage' => $clinical->findForVisit($visit, 'emergency', 'triage'),
+            'clinicalNote' => $clinical->findForVisit($visit, 'emergency', 'clinical_note'),
+            'observation' => $clinical->findForVisit($visit, 'emergency', 'observation'),
+            'disposition' => $clinical->findForVisit($visit, 'emergency', 'disposition'),
+            'vitals' => $vitals->forVisit($visit),
+            'latestVitals' => $vitals->latestForVisit($visit),
+        ]);
+    }
+}

app/Http/Controllers/Care/SpecialtyModuleController.php

@@ -156,11 +156,13 @@ class SpecialtyModuleController extends Controller
         if ($openConsultation && $openConsultation->status !== \App\Models\Consultation::STATUS_COMPLETED) {
             $clinical = app(SpecialtyClinicalRecordService::class);
             $shellTabs = app(SpecialtyShellService::class)->workspaceTabs($module);
-            $preferredTab = $module === 'dentistry'
-                ? 'odontogram'
-                : (collect(array_keys($shellTabs))
+            $preferredTab = match ($module) {
+                'dentistry' => 'odontogram',
+                'emergency' => 'triage',
+                default => (collect(array_keys($shellTabs))
                     ->first(fn (string $tab) => $clinical->recordTypeForTab($module, $tab) !== null)
-                    ?? 'clinical_notes');
+                    ?? 'clinical_notes'),
+            };
 
             return redirect()
                 ->route('care.specialty.workspace', [
@@ -214,7 +216,7 @@ class SpecialtyModuleController extends Controller
                 } catch (\InvalidArgumentException) {
                     // Stage map may be empty for some modules.
                 }
-            } elseif ($nextStage && $visit->specialty_stage === 'waiting') {
+            } elseif ($nextStage && in_array($visit->specialty_stage, ['waiting', 'arrival'], true)) {
                 try {
                     $stageService->setStage($organization, $visit, $module, $nextStage, $owner, $owner);
                     $visit = $visit->fresh();
@@ -224,11 +226,13 @@ class SpecialtyModuleController extends Controller
         }
         $clinical = app(SpecialtyClinicalRecordService::class);
         $shellTabs = app(SpecialtyShellService::class)->workspaceTabs($module);
-        $preferredTab = $module === 'dentistry'
-            ? 'odontogram'
-            : (collect(array_keys($shellTabs))
+        $preferredTab = match ($module) {
+            'dentistry' => 'odontogram',
+            'emergency' => 'triage',
+            default => (collect(array_keys($shellTabs))
                 ->first(fn (string $tab) => $clinical->recordTypeForTab($module, $tab) !== null)
-                ?? 'clinical_notes');
+                ?? 'clinical_notes'),
+        };
 
         return redirect()
             ->route('care.specialty.workspace', [
@@ -285,6 +289,41 @@ class SpecialtyModuleController extends Controller
             $validated['status'] ?? \App\Models\SpecialtyClinicalRecord::STATUS_ACTIVE,
         );
 
+        if ($module === 'emergency' && $recordType === 'triage') {
+            $workflow = app(\App\Services\Care\Emergency\EmergencyWorkflowService::class);
+            $stageService = app(\App\Services\Care\SpecialtyVisitStageService::class);
+            $suggested = $workflow->stageFromTriage($record->payload ?? []);
+            $current = $visit->specialty_stage;
+            if (! $current || in_array($current, ['arrival', 'waiting'], true)) {
+                try {
+                    $stageService->setStage(
+                        $organization,
+                        $visit,
+                        'emergency',
+                        $suggested,
+                        $this->ownerRef($request),
+                        $this->ownerRef($request),
+                    );
+                } catch (\InvalidArgumentException) {
+                }
+            }
+        }
+
+        if ($module === 'emergency' && $recordType === 'observation') {
+            $stageService = app(\App\Services\Care\SpecialtyVisitStageService::class);
+            try {
+                $stageService->setStage(
+                    $organization,
+                    $visit,
+                    'emergency',
+                    \App\Services\Care\Emergency\EmergencyWorkflowService::STAGE_OBSERVATION,
+                    $this->ownerRef($request),
+                    $this->ownerRef($request),
+                );
+            } catch (\InvalidArgumentException) {
+            }
+        }
+
         return redirect()
             ->route('care.specialty.workspace', [
                 'module' => $module,
@@ -555,6 +594,14 @@ class SpecialtyModuleController extends Controller
         $dentalLabCaseStatuses = [];
         $dentalRecalls = collect();
         $dentalStageCodes = [];
+        $emergencyTriage = null;
+        $emergencyClinicalNote = null;
+        $emergencyObservation = null;
+        $emergencyDisposition = null;
+        $emergencyVitals = collect();
+        $emergencyLatestVitals = null;
+        $emergencyStageCodes = [];
+        $emergencyStageFlow = [];
         $activeTab = (string) $request->query('tab', array_key_first($shell->workspaceTabs($module)) ?: 'overview');
         $clinical = app(SpecialtyClinicalRecordService::class);
 
@@ -659,6 +706,18 @@ class SpecialtyModuleController extends Controller
                 );
             }
 
+            if ($module === 'emergency') {
+                $emergencyTriage = $clinical->findForVisit($workspaceVisit, 'emergency', 'triage');
+                $emergencyClinicalNote = $clinical->findForVisit($workspaceVisit, 'emergency', 'clinical_note');
+                $emergencyObservation = $clinical->findForVisit($workspaceVisit, 'emergency', 'observation');
+                $emergencyDisposition = $clinical->findForVisit($workspaceVisit, 'emergency', 'disposition');
+                $vitalsService = app(\App\Services\Care\Emergency\EmergencyVitalsService::class);
+                $emergencyVitals = $vitalsService->forVisit($workspaceVisit);
+                $emergencyLatestVitals = $vitalsService->latestForVisit($workspaceVisit);
+                $emergencyStageCodes = collect($shell->stages('emergency'))->pluck('code')->all();
+                $emergencyStageFlow = app(\App\Services\Care\Emergency\EmergencyWorkflowService::class)->stageFlow();
+            }
+
             if ($patientHeader !== null) {
                 $patientHeader['clinical_alerts'] = $clinicalAlerts;
             }
@@ -729,6 +788,14 @@ class SpecialtyModuleController extends Controller
             'dentalLabCaseStatuses' => $dentalLabCaseStatuses,
             'dentalRecalls' => $dentalRecalls,
             'dentalStageCodes' => $dentalStageCodes,
+            'emergencyTriage' => $emergencyTriage,
+            'emergencyClinicalNote' => $emergencyClinicalNote,
+            'emergencyObservation' => $emergencyObservation,
+            'emergencyDisposition' => $emergencyDisposition,
+            'emergencyVitals' => $emergencyVitals,
+            'emergencyLatestVitals' => $emergencyLatestVitals,
+            'emergencyStageCodes' => $emergencyStageCodes,
+            'emergencyStageFlow' => $emergencyStageFlow,
             'queueStubs' => $modules->queueStubsFor($organization, $module),
             'branchId' => $branchId,
             'branchLabel' => $branchLabel,