ladill-care/tests/Feature/CarePathwayTest.php

<?php

namespace Tests\Feature;

use App\Http\Middleware\EnsurePlatformSession;
use App\Models\Assessment;
use App\Models\AssessmentQuestion;
use App\Models\AssessmentTemplate;
use App\Models\Branch;
use App\Models\ClinicalPathway;
use App\Models\Consultation;
use App\Models\Diagnosis;
use App\Models\Member;
use App\Models\Organization;
use App\Models\Patient;
use App\Models\PatientPathway;
use App\Models\User;
use App\Models\Visit;
use App\Services\Care\CareFeatures;
use App\Services\Care\PathwayMatcher;
use App\Services\Care\PathwayService;
use Database\Seeders\ClinicalPathwaySeeder;
use Illuminate\Foundation\Testing\RefreshDatabase;
use Illuminate\Support\Str;
use Tests\TestCase;

class CarePathwayTest extends TestCase
{
    use RefreshDatabase;

    protected User $user;

    protected Organization $organization;

    protected Branch $branch;

    protected Patient $patient;

    protected Member $member;

    protected function setUp(): void
    {
        parent::setUp();
        $this->withoutMiddleware(EnsurePlatformSession::class);

        $this->user = User::create([
            'public_id' => 'pathway-user',
            'name' => 'Pathway User',
            'email' => 'pathway@example.com',
        ]);

        $this->organization = Organization::create([
            'owner_ref' => $this->user->public_id,
            'name' => 'Pathway Clinic',
            'slug' => 'pathway-clinic',
            'timezone' => 'UTC',
            'settings' => [
                'onboarded' => true,
                'rollout' => [CareFeatures::ASSESSMENTS_ENGINE => true],
            ],
        ]);

        $this->member = Member::create([
            'owner_ref' => $this->user->public_id,
            'organization_id' => $this->organization->id,
            'user_ref' => $this->user->public_id,
            'role' => 'doctor',
        ]);

        $this->branch = Branch::create([
            'owner_ref' => $this->user->public_id,
            'organization_id' => $this->organization->id,
            'name' => 'Main',
            'is_active' => true,
        ]);

        $this->patient = Patient::create([
            'uuid' => (string) Str::uuid(),
            'owner_ref' => $this->user->public_id,
            'organization_id' => $this->organization->id,
            'branch_id' => $this->branch->id,
            'patient_number' => 'LC-PATH-001',
            'first_name' => 'Kojo',
            'last_name' => 'Stroke',
        ]);
    }

    public function test_clinical_pathway_seeder_loads_stroke(): void
    {
        $this->seed(ClinicalPathwaySeeder::class);

        $pathway = ClinicalPathway::findByCode('stroke');
        $this->assertNotNull($pathway);
        $this->assertTrue($pathway->is_active);
        $this->assertContains('I63', $pathway->match_rules['icd_prefixes'] ?? []);
        $this->assertGreaterThanOrEqual(2, $pathway->templates()->count());
        $this->assertTrue($pathway->templates->contains('template_code', 'nihss'));
        $this->assertTrue($pathway->templates->contains('template_code', 'mrs'));
        $required = $pathway->templates()->where('is_required_on_activation', true)->pluck('template_code')->all();
        $this->assertEqualsCanonicalizing(['nihss', 'mrs'], $required);
    }

    public function test_matcher_icd_keyword_exclude_and_no_match(): void
    {
        $this->seed(ClinicalPathwaySeeder::class);
        $matcher = app(PathwayMatcher::class);

        $icd = $matcher->match([['code' => 'I63.9', 'description' => '']]);
        $this->assertCount(1, $icd);
        $this->assertSame('stroke', $icd[0]['pathway_code']);
        $this->assertSame(100, $icd[0]['rank']);
        $this->assertStringStartsWith('icd_prefix:', $icd[0]['match_reason']);

        $kw = $matcher->match([['code' => '', 'description' => 'Ischaemic stroke']]);
        $this->assertCount(1, $kw);
        $this->assertSame(50, $kw[0]['rank']);
        $this->assertStringContainsString('keyword:', $kw[0]['match_reason']);

        $tia = $matcher->match([['code' => 'G45.9', 'description' => 'TIA']]);
        $this->assertCount(1, $tia);
        $this->assertSame('stroke', $tia[0]['pathway_code']);

        $none = $matcher->match([['code' => '', 'description' => 'History unclear']]);
        $this->assertCount(0, $none);

        $excluded = $matcher->match([['code' => '', 'description' => 'Family history of stroke']]);
        $this->assertCount(0, $excluded);
    }

    public function test_activate_is_idempotent_and_creates_required_drafts(): void
    {
        $this->seed(ClinicalPathwaySeeder::class);

        // Minimal current templates so activation can draft them.
        foreach (['nihss' => 'NIHSS', 'mrs' => 'mRS'] as $code => $name) {
            $t = AssessmentTemplate::create([
                'code' => $code,
                'name' => $name,
                'category' => AssessmentTemplate::CATEGORY_DISEASE,
                'version' => 1,
                'is_current' => true,
                'scoring_strategy' => $code === 'mrs' ? 'single_value' : 'sum_items',
                'meta' => ['capture_roles' => ['doctor']],
            ]);
            AssessmentQuestion::create([
                'template_id' => $t->id,
                'code' => 'item',
                'label' => 'Item',
                'answer_type' => AssessmentQuestion::TYPE_SCORE_ITEM,
                'options' => ['choices' => [['code' => '1', 'label' => '1', 'score' => 1]], 'max' => 1],
                'is_required' => true,
                'sort_order' => 1,
            ]);
        }

        $visit = Visit::create([
            'owner_ref' => $this->user->public_id,
            'organization_id' => $this->organization->id,
            'branch_id' => $this->branch->id,
            'patient_id' => $this->patient->id,
            'status' => Visit::STATUS_OPEN,
            'checked_in_at' => now(),
        ]);

        $consultation = Consultation::create([
            'owner_ref' => $this->user->public_id,
            'visit_id' => $visit->id,
            'patient_id' => $this->patient->id,
            'status' => Consultation::STATUS_DRAFT,
            'started_at' => now(),
        ]);

        Diagnosis::create([
            'owner_ref' => $this->user->public_id,
            'consultation_id' => $consultation->id,
            'code' => 'I63.9',
            'description' => 'Cerebral infarction',
            'is_primary' => true,
        ]);

        $this->actingAs($this->user)
            ->post(route('care.pathways.store', $this->patient), [
                'pathway_code' => 'stroke',
                'consultation_uuid' => $consultation->uuid,
            ])
            ->assertRedirect(route('care.pathways.index', $this->patient));

        $this->assertSame(1, PatientPathway::where('status', PatientPathway::STATUS_ACTIVE)->count());
        $pp = PatientPathway::first();
        $this->assertStringContainsString('I63.9', (string) $pp->activation_diagnosis_text);
        $this->assertSame($consultation->id, $pp->activation_consultation_id);
        $this->assertSame(2, Assessment::where('status', Assessment::STATUS_DRAFT)->count());
        $this->assertTrue(Assessment::where('patient_pathway_id', $pp->id)->exists());
        $this->assertDatabaseHas('care_audit_logs', ['action' => 'pathway.activated']);

        // Idempotent re-activate
        $this->actingAs($this->user)
            ->post(route('care.pathways.store', $this->patient), [
                'pathway_code' => 'stroke',
                'consultation_uuid' => $consultation->uuid,
            ])
            ->assertRedirect();

        $this->assertSame(1, PatientPathway::where('status', PatientPathway::STATUS_ACTIVE)->count());
        $this->assertSame(2, Assessment::where('status', Assessment::STATUS_DRAFT)->count());
    }

    public function test_suggestions_use_persisted_diagnoses_only(): void
    {
        $this->seed(ClinicalPathwaySeeder::class);

        $visit = Visit::create([
            'owner_ref' => $this->user->public_id,
            'organization_id' => $this->organization->id,
            'branch_id' => $this->branch->id,
            'patient_id' => $this->patient->id,
            'status' => Visit::STATUS_OPEN,
            'checked_in_at' => now(),
        ]);

        $consultation = Consultation::create([
            'owner_ref' => $this->user->public_id,
            'visit_id' => $visit->id,
            'patient_id' => $this->patient->id,
            'status' => Consultation::STATUS_DRAFT,
            'started_at' => now(),
        ]);

        $this->actingAs($this->user)
            ->getJson(route('care.consultations.pathway-suggestions', $consultation))
            ->assertOk()
            ->assertJsonPath('data', []);

        Diagnosis::create([
            'owner_ref' => $this->user->public_id,
            'consultation_id' => $consultation->id,
            'code' => null,
            'description' => 'Ischaemic stroke',
            'is_primary' => true,
        ]);

        $this->actingAs($this->user)
            ->getJson(route('care.consultations.pathway-suggestions', $consultation))
            ->assertOk()
            ->assertJsonPath('data.0.pathway_code', 'stroke')
            ->assertJsonPath('data.0.already_active', false);

        $this->actingAs($this->user)
            ->get(route('care.consultations.show', $consultation))
            ->assertOk()
            ->assertSee('Condition pathways')
            ->assertSee('Stroke')
            ->assertSee('keyword:');
    }

    public function test_deactivate_pathway(): void
    {
        $this->seed(ClinicalPathwaySeeder::class);
        $pathway = ClinicalPathway::findByCode('stroke');

        $pp = app(PathwayService::class)->activate(
            $this->patient,
            $pathway,
            $this->user->public_id,
            $this->member,
            ['actor' => $this->user->public_id, 'activation_diagnosis_text' => 'stroke'],
        );

        $this->actingAs($this->user)
            ->post(route('care.pathways.deactivate', [$this->patient, $pp]))
            ->assertRedirect();

        $this->assertSame(PatientPathway::STATUS_INACTIVE, $pp->fresh()->status);
        $this->assertDatabaseHas('care_audit_logs', ['action' => 'pathway.deactivated']);
    }

    public function test_nurse_cannot_activate_pathway(): void
    {
        $this->seed(ClinicalPathwaySeeder::class);
        $this->member->update(['role' => 'nurse']);

        $this->actingAs($this->user)
            ->post(route('care.pathways.store', $this->patient), [
                'pathway_code' => 'stroke',
            ])
            ->assertForbidden();
    }

    public function test_template_version_bump_still_resolves_pathway_binding(): void
    {
        $this->seed(ClinicalPathwaySeeder::class);

        AssessmentTemplate::create([
            'code' => 'nihss',
            'name' => 'NIHSS v1',
            'category' => AssessmentTemplate::CATEGORY_DISEASE,
            'version' => 1,
            'is_current' => false,
            'meta' => ['capture_roles' => ['doctor']],
        ]);

        $v2 = AssessmentTemplate::create([
            'code' => 'nihss',
            'name' => 'NIHSS v2',
            'category' => AssessmentTemplate::CATEGORY_DISEASE,
            'version' => 2,
            'is_current' => true,
            'meta' => ['capture_roles' => ['doctor']],
        ]);

        AssessmentQuestion::create([
            'template_id' => $v2->id,
            'code' => 'item',
            'label' => 'Item',
            'answer_type' => AssessmentQuestion::TYPE_SCORE_ITEM,
            'options' => ['choices' => [['code' => '1', 'label' => '1', 'score' => 1]]],
            'is_required' => true,
            'sort_order' => 1,
        ]);

        // Only nihss required for this test — remove mrs binding temporarily via pathway seed already has both.
        // Activate stroke; mrs missing is skipped; nihss v2 should draft.
        $pathway = ClinicalPathway::findByCode('stroke');
        $pp = app(PathwayService::class)->activate(
            $this->patient,
            $pathway,
            $this->user->public_id,
            $this->member,
            ['actor' => $this->user->public_id],
        );

        $draft = Assessment::where('patient_pathway_id', $pp->id)->where('template_id', $v2->id)->first();
        $this->assertNotNull($draft);
        $this->assertSame(2, $draft->template->version);
    }
}