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isaaccladandCursor ac870bcf33
Deploy Ladill Care / deploy (push) Successful in 57s
Implement Care RBAC role→permission→app matrix.
Replace broad doctor/nurse specialty access with granular roles and primary
apps, permission inheritance for lab/BB managers, and cannot-rules for
discharge, lab approve, and cashier vs billing officer.

Co-authored-by: Cursor <cursoragent@cursor.com>
2026-07-20 00:24:09 +00:00

579 lines
20 KiB
PHP

<?php
namespace App\Services\Care;
use App\Models\Assessment;
use App\Models\AssessmentAnswer;
use App\Models\AssessmentQuestion;
use App\Models\AssessmentTemplate;
use App\Models\Consultation;
use App\Models\Member;
use App\Models\Patient;
use App\Models\Visit;
use Illuminate\Contracts\Pagination\LengthAwarePaginator;
use Illuminate\Support\Facades\DB;
use Illuminate\Support\Facades\Validator;
use Illuminate\Validation\ValidationException;
use Symfony\Component\HttpKernel\Exception\HttpException;
class AssessmentService
{
public function __construct(
protected ScoringService $scoring,
) {}
/**
* Start a draft assessment for the current system template by code.
* Idempotent: returns existing draft for the same patient/template/(consultation).
*
* @param array{
* consultation?: ?Consultation,
* visit?: ?Visit,
* patient_pathway?: ?\App\Models\PatientPathway,
* practitioner_id?: ?int,
* actor?: ?string,
* } $context
*/
public function start(
Patient $patient,
string $templateCode,
string $ownerRef,
?Member $member,
array $context = [],
): Assessment {
$template = AssessmentTemplate::currentSystemByCode($templateCode);
if (! $template) {
throw ValidationException::withMessages([
'template_code' => 'Unknown, inactive, or non-current assessment template.',
]);
}
$this->assertCaptureAllowed($member, $template);
$consultation = $context['consultation'] ?? null;
$visit = $context['visit'] ?? $consultation?->visit;
$patientPathway = $context['patient_pathway'] ?? null;
$actor = $context['actor'] ?? null;
return DB::transaction(function () use ($patient, $template, $ownerRef, $consultation, $visit, $patientPathway, $context, $actor) {
$query = Assessment::query()
->where('patient_id', $patient->id)
->where('template_id', $template->id)
->where('status', Assessment::STATUS_DRAFT)
->lockForUpdate();
if ($consultation) {
$query->where('consultation_id', $consultation->id);
} else {
$query->whereNull('consultation_id');
}
$existing = $query->first();
if ($existing) {
if ($patientPathway && ! $existing->patient_pathway_id) {
$existing->update(['patient_pathway_id' => $patientPathway->id]);
}
return $existing->load(['template.questions', 'answers.question', 'patient', 'consultation', 'visit', 'score']);
}
$branchId = $visit?->branch_id ?? $patient->branch_id;
$assessment = Assessment::create([
'owner_ref' => $ownerRef,
'organization_id' => $patient->organization_id,
'branch_id' => $branchId,
'patient_id' => $patient->id,
'template_id' => $template->id,
'consultation_id' => $consultation?->id,
'visit_id' => $visit?->id,
'patient_pathway_id' => $patientPathway?->id,
'practitioner_id' => $context['practitioner_id'] ?? $consultation?->practitioner_id,
'status' => Assessment::STATUS_DRAFT,
'started_by' => $actor,
]);
AuditLogger::record(
$ownerRef,
'assessment.started',
$patient->organization_id,
$actor,
Assessment::class,
$assessment->id,
['template_code' => $template->code, 'template_version' => $template->version],
);
return $assessment->load(['template.questions', 'answers.question', 'patient', 'consultation', 'visit', 'score']);
});
}
/**
* @param array<string, mixed> $answers keyed by question code
*/
public function saveAnswers(
Assessment $assessment,
string $ownerRef,
array $answers,
?Member $member = null,
?string $actorRef = null,
?string $notes = null,
): Assessment {
$this->assertOwner($assessment, $ownerRef);
$this->assertDraft($assessment);
$assessment->loadMissing('template.questions');
$this->assertCaptureAllowed($member, $assessment->template);
DB::transaction(function () use ($assessment, $ownerRef, $answers, $notes) {
foreach ($answers as $code => $raw) {
$question = $assessment->template->questions->firstWhere('code', $code);
if (! $question) {
throw ValidationException::withMessages([
"answers.{$code}" => "Unknown question code [{$code}].",
]);
}
if ($question->answer_type === AssessmentQuestion::TYPE_CALCULATED) {
continue;
}
$normalized = $this->normalizeValue($question, $raw);
AssessmentAnswer::updateOrCreate(
[
'assessment_id' => $assessment->id,
'question_id' => $question->id,
],
array_merge(
['owner_ref' => $ownerRef],
$normalized,
),
);
}
if ($notes !== null) {
$assessment->update(['notes' => $notes]);
}
});
AuditLogger::record(
$ownerRef,
'assessment.updated',
$assessment->organization_id,
$actorRef,
Assessment::class,
$assessment->id,
['template_code' => $assessment->template->code, 'answer_keys' => array_keys($answers)],
);
return $assessment->fresh(['template.questions', 'answers.question', 'patient', 'consultation', 'visit']);
}
public function complete(
Assessment $assessment,
string $ownerRef,
?Member $member = null,
?string $actorRef = null,
): Assessment {
$this->assertOwner($assessment, $ownerRef);
$this->assertDraft($assessment);
$assessment->loadMissing(['template.questions', 'answers']);
$this->assertCaptureAllowed($member, $assessment->template);
$this->validateRequiredAnswers($assessment);
return DB::transaction(function () use ($assessment, $ownerRef, $actorRef) {
// Score first so complete fails cleanly without marking completed if scoring 422s.
$scoreMeta = [];
if ($this->scoring->requiresScore($assessment)) {
$score = $this->scoring->materialize($assessment);
$scoreMeta = [
'total_score' => $score->total_score,
'max_score' => $score->max_score,
];
}
$assessment->update([
'status' => Assessment::STATUS_COMPLETED,
'completed_at' => now(),
'completed_by' => $actorRef,
'assessed_at' => $assessment->assessed_at ?? now(),
]);
AuditLogger::record(
$ownerRef,
'assessment.completed',
$assessment->organization_id,
$actorRef,
Assessment::class,
$assessment->id,
array_merge(['template_code' => $assessment->template->code], $scoreMeta),
);
return $assessment->fresh(['template.questions', 'answers.question', 'patient', 'consultation', 'visit', 'score']);
});
}
public function cancel(
Assessment $assessment,
string $ownerRef,
?Member $member = null,
?string $actorRef = null,
): Assessment {
$this->assertOwner($assessment, $ownerRef);
$this->assertDraft($assessment);
$assessment->loadMissing('template');
$this->assertCaptureAllowed($member, $assessment->template);
$assessment->update([
'status' => Assessment::STATUS_CANCELLED,
]);
AuditLogger::record(
$ownerRef,
'assessment.cancelled',
$assessment->organization_id,
$actorRef,
Assessment::class,
$assessment->id,
['template_code' => $assessment->template->code],
);
return $assessment->fresh(['template', 'patient']);
}
/**
* @param array<string, mixed> $filters
*/
public function listForPatient(
Patient $patient,
string $ownerRef,
array $filters = [],
?int $branchScope = null,
): LengthAwarePaginator {
$query = Assessment::query()
->owned($ownerRef)
->where('patient_id', $patient->id)
->with(['template', 'consultation', 'visit', 'practitioner'])
->orderByDesc('assessed_at')
->orderByDesc('created_at');
if ($branchScope !== null) {
$query->where('branch_id', $branchScope);
}
if (! empty($filters['status'])) {
$query->where('status', $filters['status']);
}
if (! empty($filters['template_code'])) {
$query->whereHas('template', fn ($q) => $q->where('code', $filters['template_code']));
}
if (! empty($filters['category'])) {
$query->whereHas('template', fn ($q) => $q->where('category', $filters['category']));
}
if (! empty($filters['from'])) {
$query->whereDate('assessed_at', '>=', $filters['from']);
}
if (! empty($filters['to'])) {
$query->whereDate('assessed_at', '<=', $filters['to']);
}
$perPage = min(max((int) ($filters['per_page'] ?? 20), 1), 100);
return $query->paginate($perPage);
}
public function assertCaptureAllowed(?Member $member, AssessmentTemplate $template): void
{
if ($member === null) {
throw new HttpException(403, 'Not authorized to capture assessments.');
}
if (in_array($member->role, ['hospital_admin', 'super_admin'], true)) {
return;
}
$roles = $template->meta['capture_roles']
?? $this->defaultCaptureRoles($template->category);
if (! in_array($member->role, $roles, true)) {
throw new HttpException(403, 'Your role cannot capture this assessment template.');
}
}
/**
* @return list<string>
*/
public function defaultCaptureRoles(string $category): array
{
return match ($category) {
AssessmentTemplate::CATEGORY_DISEASE => [
'doctor', 'general_physician', 'emergency_physician', 'surgeon',
'pediatrician', 'oncologist', 'psychiatrist', 'dentist', 'pathologist',
],
default => [
'doctor', 'general_physician', 'emergency_physician', 'surgeon',
'pediatrician', 'oncologist', 'psychiatrist', 'dentist', 'pathologist',
'nurse', 'ed_nurse', 'theatre_nurse', 'dialysis_nurse', 'midwife',
'physiotherapist', 'ambulance_staff', 'radiographer',
],
};
}
/**
* Normalize a raw answer into typed columns (exactly one authoritative column set).
*
* @return array{
* value_text: ?string,
* value_number: ?string|null,
* value_boolean: ?bool,
* value_date: ?string,
* value_json: mixed
* }
*/
public function normalizeValue(AssessmentQuestion $question, mixed $raw): array
{
$empty = [
'value_text' => null,
'value_number' => null,
'value_boolean' => null,
'value_date' => null,
'value_json' => null,
];
if ($raw === null || $raw === '') {
return $empty;
}
$type = $question->answer_type;
$options = $question->options ?? [];
$validation = $question->validation ?? [];
return match ($type) {
AssessmentQuestion::TYPE_TEXT,
AssessmentQuestion::TYPE_TEXTAREA => array_merge($empty, [
'value_text' => $this->validatedString($raw, $question->code, $validation),
]),
AssessmentQuestion::TYPE_SINGLE_CHOICE => array_merge($empty, [
'value_text' => $this->validatedChoiceCode($raw, $question->code, $options),
]),
AssessmentQuestion::TYPE_NUMBER,
AssessmentQuestion::TYPE_INTEGER,
AssessmentQuestion::TYPE_SCALE => array_merge($empty, [
'value_number' => $this->validatedNumber($raw, $question->code, $options, $validation, $type === AssessmentQuestion::TYPE_INTEGER),
]),
AssessmentQuestion::TYPE_SCORE_ITEM => array_merge($empty, [
'value_number' => $this->validatedScoreItem($raw, $question->code, $options),
]),
AssessmentQuestion::TYPE_BOOLEAN => array_merge($empty, [
'value_boolean' => filter_var($raw, FILTER_VALIDATE_BOOLEAN, FILTER_NULL_ON_FAILURE) ?? (bool) $raw,
]),
AssessmentQuestion::TYPE_DATE => array_merge($empty, [
'value_date' => $this->validatedDate($raw, $question->code, false),
]),
AssessmentQuestion::TYPE_DATETIME => array_merge($empty, [
'value_date' => $this->validatedDate($raw, $question->code, true),
]),
AssessmentQuestion::TYPE_MULTI_CHOICE => array_merge($empty, [
'value_json' => $this->validatedMultiChoice($raw, $question->code, $options),
]),
AssessmentQuestion::TYPE_CALCULATED => $empty,
default => throw ValidationException::withMessages([
"answers.{$question->code}" => "Unsupported answer type [{$type}].",
]),
};
}
protected function assertOwner(Assessment $assessment, string $ownerRef): void
{
if ($assessment->owner_ref !== $ownerRef) {
throw new HttpException(404, 'Assessment not found.');
}
}
protected function assertDraft(Assessment $assessment): void
{
if ($assessment->status !== Assessment::STATUS_DRAFT) {
throw ValidationException::withMessages([
'status' => 'Only draft assessments can be modified. Completed assessments are immutable.',
]);
}
}
protected function validateRequiredAnswers(Assessment $assessment): void
{
$answersByQuestion = $assessment->answers->keyBy('question_id');
$errors = [];
foreach ($assessment->template->questions as $question) {
if ($question->answer_type === AssessmentQuestion::TYPE_CALCULATED) {
continue;
}
if (! $question->is_required) {
continue;
}
$answer = $answersByQuestion->get($question->id);
if (! $answer || $this->isEmptyAuthoritative($answer, $question->answer_type)) {
$errors["answers.{$question->code}"] = "{$question->label} is required.";
}
}
if ($errors !== []) {
throw ValidationException::withMessages($errors);
}
}
protected function isEmptyAuthoritative(AssessmentAnswer $answer, string $type): bool
{
$value = $answer->authoritativeValue($type);
if ($value === null || $value === '') {
return true;
}
if (is_array($value) && $value === []) {
return true;
}
return false;
}
protected function validatedString(mixed $raw, string $code, array $validation): string
{
$value = is_scalar($raw) ? (string) $raw : '';
$max = (int) ($validation['max'] ?? 10000);
if (mb_strlen($value) > $max) {
throw ValidationException::withMessages([
"answers.{$code}" => "Must be at most {$max} characters.",
]);
}
return $value;
}
protected function validatedChoiceCode(mixed $raw, string $code, array $options): string
{
$value = is_scalar($raw) ? (string) $raw : '';
$choices = collect($options['choices'] ?? [])->pluck('code')->map(fn ($c) => (string) $c)->all();
if ($choices !== [] && ! in_array($value, $choices, true)) {
throw ValidationException::withMessages([
"answers.{$code}" => 'Invalid choice.',
]);
}
return $value;
}
protected function validatedNumber(mixed $raw, string $code, array $options, array $validation, bool $integerOnly): string
{
if (! is_numeric($raw)) {
throw ValidationException::withMessages([
"answers.{$code}" => 'Must be a number.',
]);
}
if ($integerOnly && (float) $raw != (int) $raw) {
throw ValidationException::withMessages([
"answers.{$code}" => 'Must be an integer.',
]);
}
$number = (float) $raw;
$min = $validation['min'] ?? $options['min'] ?? null;
$max = $validation['max'] ?? $options['max'] ?? null;
if ($min !== null && $number < (float) $min) {
throw ValidationException::withMessages([
"answers.{$code}" => "Must be at least {$min}.",
]);
}
if ($max !== null && $number > (float) $max) {
throw ValidationException::withMessages([
"answers.{$code}" => "Must be at most {$max}.",
]);
}
return (string) $number;
}
protected function validatedScoreItem(mixed $raw, string $code, array $options): string
{
$choices = $options['choices'] ?? [];
if (is_array($choices) && $choices !== []) {
// Accept choice code or numeric score.
if (is_string($raw) || is_int($raw)) {
$asString = (string) $raw;
foreach ($choices as $choice) {
if ((string) ($choice['code'] ?? '') === $asString) {
if (! array_key_exists('score', $choice)) {
throw ValidationException::withMessages([
"answers.{$code}" => 'Choice has no score.',
]);
}
return (string) $choice['score'];
}
}
}
}
return $this->validatedNumber($raw, $code, $options, [], false);
}
protected function validatedDate(mixed $raw, string $code, bool $withTime): string
{
$format = $withTime ? 'Y-m-d H:i:s' : 'Y-m-d';
$rules = [$withTime ? 'date' : 'date_format:Y-m-d'];
$validator = Validator::make(
['v' => $raw],
['v' => $rules],
);
if ($validator->fails()) {
throw ValidationException::withMessages([
"answers.{$code}" => 'Invalid date.',
]);
}
try {
$dt = \Carbon\Carbon::parse($raw);
return $withTime ? $dt->format('Y-m-d H:i:s') : $dt->format('Y-m-d').' 00:00:00';
} catch (\Throwable) {
throw ValidationException::withMessages([
"answers.{$code}" => 'Invalid date.',
]);
}
}
/**
* @return list<string>
*/
protected function validatedMultiChoice(mixed $raw, string $code, array $options): array
{
if (! is_array($raw)) {
throw ValidationException::withMessages([
"answers.{$code}" => 'Must be a list of choices.',
]);
}
$allowed = collect($options['choices'] ?? [])->pluck('code')->map(fn ($c) => (string) $c)->all();
$values = array_values(array_map(fn ($v) => (string) $v, $raw));
foreach ($values as $value) {
if ($allowed !== [] && ! in_array($value, $allowed, true)) {
throw ValidationException::withMessages([
"answers.{$code}" => "Invalid choice [{$value}].",
]);
}
}
return $values;
}
}