factory = new FhirGeneratorFactory(); } public function testDocumentBuilderRemovesExactPlaceholderValues(): void { $bundle = (new FhirDocumentBuilder()) ->buildBundleMeta('placeholder-test', '2026-08-24T10:00:00+05:30') ->buildComposition([ 'resourceType' => 'Composition', 'id' => 'placeholder-composition', 'status' => 'final', 'title' => 'NA', 'subject' => ['display' => 'N/A'], 'note' => 'Nasal congestion', ]) ->toBundle(); $composition = $bundle['entry'][0]['resource']; $this->assertArrayNotHasKey('title', $composition); $this->assertArrayNotHasKey('subject', $composition); $this->assertSame('Nasal congestion', $composition['note']); } public function testLegacyBuilderRemovesExactPlaceholderValues(): void { $bundle = (new FhirR4Builder())->buildClaimBundle( ['id' => 'patient-1', 'name' => 'NA', 'gender' => 'female', 'birthDate' => '1990-01-01'], ['id' => 'encounter-1'], ['id' => 'claim-1', 'provider' => 'N/A'] ); $this->assertStringNotContainsString('"NA"', (string) json_encode($bundle)); $this->assertStringNotContainsString('"N/A"', (string) json_encode($bundle)); } public function testImmunizationCareContextReferenceIsStableAcrossClinicalDateChanges(): void { $method = new ReflectionMethod(AbdmGateway::class, 'resolveImmunizationCareContextReference'); $first = $method->invoke(null, [[ 'id' => 47, 'given_date' => '2026-08-10 09:00:00', 'abdm_care_context_reference' => null, ]], 47, 12); $retry = $method->invoke(null, [[ 'id' => 47, 'given_date' => '2026-08-15 11:30:00', 'abdm_care_context_reference' => null, ]], 47, 12); $this->assertSame('IMM-47', $first); $this->assertSame($first, $retry); $this->assertSame('LEGACY-IMM-47', $method->invoke(null, [[ 'id' => 47, 'abdm_care_context_reference' => 'LEGACY-IMM-47', ]], 47, 12)); } public function testOpdGeneratorHappyPath(): void { $src = [ 'record_id' => 101, 'session_id' => 1, 'visit_date' => '2026-06-27', 'completed_at' => '2026-06-27T10:00:00+05:30', 'patient' => ['id' => 12, 'name' => 'Devender Singh', 'gender' => 'male', 'dob' => '1979-03-28', 'abha_id' => '1234-5678-9012'], 'encounter' => ['id' => 'E101', 'start' => '2026-06-27T09:30:00+05:30', 'end' => '2026-06-27T10:00:00+05:30'], 'doctor' => ['id' => 'D9', 'name' => 'Dr. R K Sundriyal'], 'organization' => ['id' => 'H1', 'name' => 'Chamunda Hospital'], 'diagnoses' => [['text' => 'Acute upper respiratory infection']], 'medications' => [['name' => 'Eltroxin 50', 'dosage' => '1-0-0 for 5 days']], 'vitals' => [['display' => 'Heart Rate', 'code' => '8867-4', 'value' => 82, 'unit' => 'beats/min']], ]; $out = $this->factory->opd()->generate($src); $this->assertSame('OPConsultRecord', $out['hi_type']); $this->assertSame('Bundle', $out['fhir_bundle']['resourceType']); $this->assertSame('document', $out['fhir_bundle']['type']); $this->assertSame('Composition', $out['fhir_bundle']['entry'][0]['resource']['resourceType']); $this->assertTrue((bool) ($out['validation']['valid'] ?? false)); } public function testLabGeneratorLargeObservationSet(): void { $obs = []; for ($i = 0; $i < 120; $i++) { $obs[] = ['name' => 'Glucose', 'code' => 'GLUCOSE', 'value' => 90 + $i, 'unit' => 'mg/dL', 'interpretation' => 'NORMAL']; } $src = [ 'record_id' => 4001, 'session_id' => 9, 'visit_date' => '2026-06-26', 'completed_at' => '2026-06-26T18:10:00+05:30', 'patient' => ['id' => 12, 'name' => 'Devender Singh', 'gender' => 'male', 'dob' => '1979-03-28'], 'encounter' => ['id' => 'L4001', 'start' => '2026-06-26T16:00:00+05:30'], 'panel_name' => 'Biochemistry', 'panel_code' => 'GLUCOSE', 'observations' => $obs, ]; $out = $this->factory->lab()->generate($src); $this->assertSame('DiagnosticReportRecord', $out['hi_type']); $this->assertTrue((bool) ($out['validation']['valid'] ?? false)); $this->assertGreaterThan(90, count($out['fhir_bundle']['entry'])); } public function testDeterministicCareContextForSameInput(): void { $src = [ 'record_id' => 7001, 'session_id' => 3, 'visit_date' => '2026-06-25', 'completed_at' => '2026-06-25T10:00:00+05:30', 'patient' => ['id' => 1, 'name' => 'Test Patient', 'gender' => 'male', 'dob' => '1990-01-01'], ]; $o1 = $this->factory->invoice()->generate($src); $o2 = $this->factory->invoice()->generate($src); $this->assertSame($o1['care_context_reference'], $o2['care_context_reference']); $this->assertSame($o1['hi_type'], $o2['hi_type']); } public function testDischargeDocumentHasValidStructureAndResolvableReferences(): void { $src = [ 'record_id' => 4, 'bundle_identifier' => 'discharge-A26080000004', 'session_id' => 4, 'visit_date' => '2026-08-15', 'completed_at' => '2026-08-15T12:00:00+05:30', 'patient' => ['id' => 11, 'name' => 'Test Patient', 'gender' => 'male', 'dob' => '1979-03-28'], 'encounter' => ['id' => 'A26080000004', 'class_code' => 'IMP', 'start' => '2026-08-14T09:00:00+05:30', 'end' => '2026-08-15T12:00:00+05:30'], 'doctor' => ['id' => 9, 'name' => 'Test Doctor'], 'organization' => ['id' => 'H1', 'name' => 'Test Hospital'], 'chief_complaints' => [['text' => 'Fever and body ache']], 'diagnoses' => [['text' => 'Viral fever']], 'procedures' => [['text' => 'Supportive care']], 'medications' => [['name' => 'Paracetamol', 'dosage' => 'As directed']], 'investigations' => [['text' => 'Haemoglobin: 11', 'loinc_code' => '718-7']], 'care_plans' => [['title' => 'Advice', 'description' => 'Review after three days']], 'documents' => [[ 'title' => 'Discharge Summary PDF', 'content_type' => 'application/pdf', 'data' => base64_encode('%PDF-test'), 'created_at' => '2026-08-15T12:00:00+05:30', ]], ]; $bundle = $this->factory->discharge()->generate($src)['fhir_bundle']; $composition = $bundle['entry'][0]['resource']; $this->assertSame('discharge-A26080000004', $bundle['identifier']['value'] ?? null); $this->assertSame('Discharge Summary', $composition['title'] ?? null); $this->assertContains('https://nrces.in/ndhm/fhir/r4/StructureDefinition/DocumentBundle', $bundle['meta']['profile'] ?? []); $this->assertContains('https://nrces.in/ndhm/fhir/r4/StructureDefinition/DischargeSummaryRecord', $composition['meta']['profile'] ?? []); $this->assertSame('http://snomed.info/sct', $composition['type']['coding'][0]['system'] ?? null); $this->assertSame('373942005', $composition['type']['coding'][0]['code'] ?? null); $this->assertNotEmpty($composition['author'] ?? []); $this->assertNotEmpty($composition['custodian'] ?? []); $this->assertNotEmpty($composition['section'] ?? []); $this->assertNotEmpty($composition['section'][0]['title'] ?? ''); $fullUrls = array_column($bundle['entry'], 'fullUrl'); foreach ($fullUrls as $fullUrl) { $this->assertMatchesRegularExpression('/^urn:uuid:[0-9a-f]{8}-[0-9a-f]{4}-4[0-9a-f]{3}-a[0-9a-f]{3}-[0-9a-f]{12}$/', $fullUrl); } $encounters = array_values(array_filter($bundle['entry'], static fn (array $entry): bool => ($entry['resource']['resourceType'] ?? '') === 'Encounter')); $patients = array_values(array_filter($bundle['entry'], static fn (array $entry): bool => ($entry['resource']['resourceType'] ?? '') === 'Patient')); $this->assertContains('https://nrces.in/ndhm/fhir/r4/StructureDefinition/Patient', $patients[0]['resource']['meta']['profile'] ?? []); $this->assertSame('IMP', $encounters[0]['resource']['class']['code'] ?? null); $this->assertSame('A26080000004', $encounters[0]['resource']['identifier'][0]['value'] ?? null); $documents = array_values(array_filter($bundle['entry'], static fn (array $entry): bool => ($entry['resource']['resourceType'] ?? '') === 'DocumentReference')); $this->assertCount(1, $documents); $this->assertSame('%PDF-test', base64_decode((string) ($documents[0]['resource']['content'][0]['attachment']['data'] ?? ''), true)); $this->assertSame('final', $documents[0]['resource']['docStatus'] ?? null); $this->assertSame('373942005', $documents[0]['resource']['type']['coding'][0]['code'] ?? null); $sectionCodes = array_column(array_map(static fn (array $section): array => (array) ($section['code']['coding'][0] ?? []), $composition['section']), 'code'); $this->assertSame(['422843007', '1003642006', '1003640003', '1003606003', '721981007', '734163000', '373942005'], $sectionCodes); $reports = array_values(array_filter($bundle['entry'], static fn (array $entry): bool => ($entry['resource']['resourceType'] ?? '') === 'DiagnosticReport')); $this->assertCount(1, $reports); $this->assertContains('https://nrces.in/ndhm/fhir/r4/StructureDefinition/DiagnosticReportLab', $reports[0]['resource']['meta']['profile'] ?? []); $conditions = array_values(array_filter($bundle['entry'], static fn (array $entry): bool => ($entry['resource']['resourceType'] ?? '') === 'Condition')); $this->assertNotEmpty($conditions[0]['resource']['recordedDate'] ?? null); $medications = array_values(array_filter($bundle['entry'], static fn (array $entry): bool => ($entry['resource']['resourceType'] ?? '') === 'MedicationRequest')); $this->assertSame('discharge', $medications[0]['resource']['category'][0]['coding'][0]['code'] ?? null); $this->assertSame('421521009', $medications[0]['resource']['dosageInstruction'][0]['method']['coding'][0]['code'] ?? null); $encoded = json_encode($bundle, JSON_UNESCAPED_SLASHES); preg_match_all('/"reference":"(urn:uuid:[^"]+)"/', (string) $encoded, $matches); foreach ($matches[1] as $reference) { $this->assertContains($reference, $fullUrls, 'Unresolved document reference: ' . $reference); } $this->assertStringNotContainsString('UNMAPPED', (string) $encoded); } public function testDischargeRecordWithDualVitalsAdviceAndMultiplePdfs(): void { $src = [ 'record_id' => 3208, 'bundle_identifier' => 'discharge-A26090003208', 'session_id' => 3208, 'visit_date' => '2026-09-04', 'completed_at' => '2026-09-04T04:58:00+05:30', 'patient' => [ 'id' => 15355, 'uhid' => 'P26091015355', 'name' => 'JANVI BISHT', 'gender' => 'female', 'dob' => '2013-05-10', 'abha_id' => '91407564383062', 'abha_address' => 'janvibisht@sbx', ], 'encounter' => [ 'id' => 'A26090003208', 'class_code' => 'IMP', 'start' => '2026-09-01T04:53:00+05:30', 'end' => '2026-09-04T04:58:00+05:30', 'location_display' => 'Ward: General Ward, Bed: GW-05', 'ward' => 'General Ward', 'bed' => 'GW-05', ], 'doctor' => ['id' => 9, 'name' => 'Dr. Sanjay Kumar', 'registration_number' => 'DOC12345'], 'organization' => ['id' => 'IN0510000000', 'name' => 'DevSoft Tech'], 'chief_complaints' => [ ['text' => 'Abdominal Pain'], ['text' => 'Breathlessness'], ['text' => 'Cough'], ['text' => 'Fever'], ], 'diagnoses' => [['text' => 'VIRAL FEVER']], 'procedures' => [['text' => 'Biphosphonate prophylaxis', 'performed_at' => '2026-09-03T00:00:00+05:30']], 'medications' => [ [ 'name' => 'TAB PANTAKOOL DSR', 'dosage' => 'BF (BEFORE FOOD) | OD | भोजन से पहले | दिन में एक बार (OD)', ], [ 'name' => 'TAB AZIK-500', 'dosage' => 'AF (AFTER FOOD) | BD | भोजन के बाद | दिन में दो बार (BD)', ], ], 'observations' => [ ['text' => 'Pulse /min', 'value' => '30/min', 'category' => 'Condition on Admission Time', 'effective_at' => '2026-09-01T04:53:00+05:30'], ['text' => 'Respiration /min', 'value' => '120/min', 'category' => 'Condition on Admission Time', 'effective_at' => '2026-09-01T04:53:00+05:30'], ['text' => 'BP mmHg', 'value' => '80mmHg', 'category' => 'Condition on Admission Time', 'effective_at' => '2026-09-01T04:53:00+05:30'], ['text' => 'Pallor', 'value' => 'Negative', 'category' => 'Condition on Admission Time', 'effective_at' => '2026-09-01T04:53:00+05:30'], ['text' => 'SPO2', 'value' => '95', 'unit' => '%', 'category' => 'Condition on Admission Time', 'effective_at' => '2026-09-01T04:53:00+05:30'], ['text' => 'RBS', 'value' => '95', 'unit' => 'mg/dL', 'category' => 'Condition on Admission Time', 'effective_at' => '2026-09-01T04:53:00+05:30'], ['text' => 'Temp F', 'value' => '99', 'unit' => 'degF', 'category' => 'Condition on Admission Time', 'effective_at' => '2026-09-01T04:53:00+05:30'], ['text' => 'Pulse /min', 'value' => '30/min', 'category' => 'Condition on Discharge Time', 'effective_at' => '2026-09-04T04:58:00+05:30'], ['text' => 'Respiration /min', 'value' => '110/min', 'category' => 'Condition on Discharge Time', 'effective_at' => '2026-09-04T04:58:00+05:30'], ['text' => 'BP mmHg', 'value' => '90mmHg', 'category' => 'Condition on Discharge Time', 'effective_at' => '2026-09-04T04:58:00+05:30'], ['text' => 'Pallor', 'value' => 'Negative', 'category' => 'Condition on Discharge Time', 'effective_at' => '2026-09-04T04:58:00+05:30'], ['text' => 'SPO2', 'value' => '95', 'unit' => '%', 'category' => 'Condition on Discharge Time', 'effective_at' => '2026-09-04T04:58:00+05:30'], ['text' => 'RBS', 'value' => '105', 'unit' => 'mg/dL', 'category' => 'Condition on Discharge Time', 'effective_at' => '2026-09-04T04:58:00+05:30'], ['text' => 'Temp F', 'value' => '97', 'unit' => 'degF', 'category' => 'Condition on Discharge Time', 'effective_at' => '2026-09-04T04:58:00+05:30'], ], 'investigations' => [ ['text' => 'Hb %: 11', 'loinc_code' => '718-7'], ], 'care_plans' => [ ['title' => 'Discharge Advice', 'description' => 'To Continue the other medication if any systmic condition like hypertension , diabetic etc, as per adivised by treating physician'], ['title' => 'Dietary Advice', 'description' => "1. Eat Nutritious diet,Stay away from smoking and alcohol altogether.\n2. Balanced Meals\n3. Fruits and Vegetables\n4. Avoid Processed Foods"], ['title' => 'Follow Up', 'description' => 'Review After: 5 Days (09-09-2026) / as and when required'], ], 'documents' => [ [ 'title' => 'IPD Discharge Summary', 'content_type' => 'application/pdf', 'data' => base64_encode('%PDF-discharge-summary'), 'snomed_code' => '373942005', 'loinc_code' => '18842-5', 'created_at' => '2026-09-04T04:58:00+05:30', ], [ 'title' => 'IPD Bill / Invoice', 'content_type' => 'application/pdf', 'data' => base64_encode('%PDF-ipd-bill'), 'snomed_code' => '823651000000106', 'loinc_code' => '75490-3', 'created_at' => '2026-09-04T04:58:00+05:30', ], ], ]; $output = $this->factory->discharge()->generate($src); $bundle = $output['fhir_bundle']; $composition = $bundle['entry'][0]['resource']; // Verify sections $sectionTitles = array_column($composition['section'], 'title'); $this->assertContains('Care Plan', $sectionTitles); $this->assertContains('Document Reference', $sectionTitles); $medRequests = array_values(array_filter($bundle['entry'], static fn (array $e): bool => ($e['resource']['resourceType'] ?? '') === 'MedicationRequest')); $this->assertCount(2, $medRequests); $this->assertSame('Take 1 Tablet Once daily before food / empty stomach for 5 days', $medRequests[0]['resource']['dosageInstruction'][0]['text']); $this->assertSame('Take 1 Tablet Twice daily after food for 5 days', $medRequests[1]['resource']['dosageInstruction'][0]['text']); // Verify CarePlans $carePlans = array_values(array_filter($bundle['entry'], static fn (array $e): bool => ($e['resource']['resourceType'] ?? '') === 'CarePlan')); $this->assertNotEmpty($carePlans); $carePlanTitles = array_column(array_column($carePlans, 'resource'), 'title'); $this->assertContains('Follow Up', $carePlanTitles); // Verify DocumentReferences (both Discharge Summary and Invoice) $docRefs = array_values(array_filter($bundle['entry'], static fn (array $e): bool => ($e['resource']['resourceType'] ?? '') === 'DocumentReference')); $this->assertCount(2, $docRefs); $this->assertSame('IPD Discharge Summary', $docRefs[0]['resource']['description']); $this->assertSame('IPD Bill / Invoice', $docRefs[1]['resource']['description']); $this->assertSame('823651000000106', $docRefs[1]['resource']['type']['coding'][0]['code']); // Verify Encounter period $encounters = array_values(array_filter($bundle['entry'], static fn (array $e): bool => ($e['resource']['resourceType'] ?? '') === 'Encounter')); $this->assertCount(1, $encounters); $encounterRes = $encounters[0]['resource']; $this->assertSame('2026-09-01T04:53:00+05:30', $encounterRes['period']['start'] ?? null); $this->assertSame('2026-09-04T04:58:00+05:30', $encounterRes['period']['end'] ?? null); // Verify Composition narrative text, language, and confidentiality $this->assertSame('en-IN', $composition['language'] ?? null); $this->assertStringContainsString('xmlns="http://www.w3.org/1999/xhtml"', $composition['text']['div'] ?? ''); $this->assertStringContainsString('DevSoft Tech', $composition['text']['div'] ?? ''); $patients = array_values(array_filter($bundle['entry'], static fn (array $e): bool => ($e['resource']['resourceType'] ?? '') === 'Patient')); $this->assertSame('JANVI BISHT', $patients[0]['resource']['name'][0]['text'] ?? ''); // Verify all references resolve $fullUrls = array_column($bundle['entry'], 'fullUrl'); $encoded = json_encode($bundle, JSON_UNESCAPED_SLASHES); preg_match_all('/"reference":"(urn:uuid:[^"]+)"/', (string) $encoded, $matches); foreach ($matches[1] as $reference) { $this->assertContains($reference, $fullUrls, 'Unresolved reference: ' . $reference); } } public function testInvoiceRecordHasNrcesProfilesAndResolvableReferences(): void { $controller = new AbdmGateway(); $method = new ReflectionMethod($controller, 'buildSimpleInvoiceBundle'); $bundle = $method->invoke($controller, [ 'resourceType' => 'Patient', 'id' => 'patient-11', 'identifier' => [[ 'system' => 'https://healthid.ndhm.gov.in/abha-address', 'value' => 'testpatient@sbx', ]], 'name' => [['text' => 'Test Patient']], 'gender' => 'male', 'birthDate' => '1990-01-01', ], [ 'id' => 19, 'invoice_code' => 'OPD-19', 'invoice_type_code' => '03', 'invoice_type_display' => 'OPD', 'encounter_class' => 'AMB', 'practitioner_id' => 7, 'practitioner_name' => 'Dr Test', 'encounter_start' => '2026-08-14', 'inv_date' => '2026-08-15', 'net_amount' => 300, 'total_amount' => 350, ], [[ 'item_name' => 'OPD Consultation Fee', 'item_qty' => 1, 'item_rate' => 300, 'item_amount' => 300, ]]); $this->assertSame('document', $bundle['type'] ?? null); $this->assertContains('https://nrces.in/ndhm/fhir/r4/StructureDefinition/DocumentBundle', $bundle['meta']['profile'] ?? []); $this->assertSame('OPD-19', $bundle['identifier']['value'] ?? null); $this->assertSame('Composition', $bundle['entry'][0]['resource']['resourceType'] ?? null); $resources = []; $resourcesByType = []; $fullUrlByResourceType = []; foreach ($bundle['entry'] as $entry) { $fullUrl = (string) ($entry['fullUrl'] ?? ''); $this->assertMatchesRegularExpression('/^urn:uuid:[0-9a-f]{8}-[0-9a-f]{4}-4[0-9a-f]{3}-a[0-9a-f]{3}-[0-9a-f]{12}$/', $fullUrl); $resourceType = (string) ($entry['resource']['resourceType'] ?? ''); $resources[$resourceType] = $entry['resource']; $resourcesByType[$resourceType][] = $entry['resource']; $fullUrlByResourceType[$resourceType][] = $fullUrl; } $composition = $resources['Composition']; $invoice = $resources['Invoice']; $patient = $resources['Patient']; $organization = $resources['Organization']; $encounter = $resources['Encounter']; $practitioner = $resources['Practitioner']; $documentReference = $resources['DocumentReference']; $this->assertContains('https://nrces.in/ndhm/fhir/r4/StructureDefinition/InvoiceRecord', $composition['meta']['profile'] ?? []); $this->assertSame('Invoice Record', $composition['type']['text'] ?? null); $this->assertSame('34775-2', $composition['type']['coding'][0]['code'] ?? null); $this->assertSame('Patient/patient-11', $composition['subject']['reference'] ?? null); $this->assertSame('Organization/organization-invoice-issuer', $composition['author'][0]['reference'] ?? null); $this->assertSame( 'Invoice', $composition['section'][0]['entry'][0]['type'] ?? null, 'NRCeS InvoiceRecord 6.5.0 requires Reference.type to be Invoice' ); $this->assertCount(1, $composition['section'][0]['entry'] ?? []); $this->assertNotEmpty($composition['author'][0]['reference'] ?? ''); $this->assertNotEmpty($composition['custodian']['reference'] ?? ''); $this->assertContains('https://nrces.in/ndhm/fhir/r4/StructureDefinition/Patient', $patient['meta']['profile'] ?? []); $this->assertContains('https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization', $organization['meta']['profile'] ?? []); $this->assertContains('https://nrces.in/ndhm/fhir/r4/StructureDefinition/Encounter', $encounter['meta']['profile'] ?? []); $this->assertSame('2026-08-14', $encounter['period']['start'] ?? null); $this->assertNotEmpty($encounter['serviceProvider']['reference'] ?? ''); $this->assertContains('https://nrces.in/ndhm/fhir/r4/StructureDefinition/Practitioner', $practitioner['meta']['profile'] ?? []); $this->assertSame('MD', $practitioner['identifier'][0]['type']['coding'][0]['code'] ?? null); $this->assertSame('7', $practitioner['identifier'][0]['value'] ?? null); $this->assertSame('Dr Test', $practitioner['name'][0]['text'] ?? null); $this->assertContains('https://nrces.in/ndhm/fhir/r4/StructureDefinition/Invoice', $invoice['meta']['profile'] ?? []); $this->assertSame('Dr Test', $invoice['participant'][0]['actor']['display'] ?? null); $this->assertSame('03', $invoice['type']['coding'][0]['code'] ?? null); $this->assertSame('01', $invoice['lineItem'][0]['priceComponent'][0]['code']['coding'][0]['code'] ?? null); $this->assertArrayHasKey('chargeItemReference', $invoice['lineItem'][0]); $chargeItems = array_values(array_filter( $bundle['entry'], static fn (array $entry): bool => ($entry['resource']['resourceType'] ?? '') === 'ChargeItem' )); $this->assertCount(1, $chargeItems); $this->assertContains('https://nrces.in/ndhm/fhir/r4/StructureDefinition/ChargeItem', $chargeItems[0]['resource']['meta']['profile'] ?? []); $this->assertSame('OPD Consultation Fee', $chargeItems[0]['resource']['code']['text'] ?? null); $this->assertSame('OPD Consultation Fee', $chargeItems[0]['resource']['productCodeableConcept']['text'] ?? null); $this->assertSame(1.0, $chargeItems[0]['resource']['quantity']['value'] ?? null); $this->assertSame('unit', $chargeItems[0]['resource']['quantity']['unit'] ?? null); $this->assertSame(300.0, $invoice['totalNet']['value'] ?? null, 'NRCeS Invoice requires totalNet'); $this->assertSame(350.0, $invoice['totalGross']['value'] ?? null, 'NRCeS Invoice requires totalGross'); $this->assertSame(300.0, $invoice['totalPriceComponent'][0]['amount']['value'] ?? null); $this->assertContains( 'https://nrces.in/ndhm/fhir/r4/StructureDefinition/DocumentReference', $documentReference['meta']['profile'] ?? [] ); $attachment = $documentReference['content'][0]['attachment'] ?? []; $pdfBytes = base64_decode((string) ($attachment['data'] ?? ''), true); $this->assertIsString($pdfBytes); $this->assertSame('application/pdf', $attachment['contentType'] ?? null); $this->assertArrayNotHasKey('url', $attachment); $this->assertStringStartsWith('%PDF-', $pdfBytes); $this->assertStringNotContainsString('table.items{', $pdfBytes); $this->assertSame(strlen($pdfBytes), $attachment['size'] ?? null); $this->assertSame(base64_encode(sha1($pdfBytes, true)), $attachment['hash'] ?? null); $this->assertSame( $composition['section'][0]['entry'][0]['reference'] ?? null, $documentReference['context']['related'][0]['reference'] ?? null ); $this->assertSame('DocumentReference', $composition['section'][1]['entry'][0]['type'] ?? null); $this->assertSame($fullUrlByResourceType['DocumentReference'][0] ?? null, $composition['section'][1]['entry'][0]['reference'] ?? null, 'Document Reference section must point to the DocumentReference'); $this->assertSame('725458005', $documentReference['type']['coding'][0]['code'] ?? null); $this->assertSame('Receipt', $documentReference['type']['coding'][0]['display'] ?? null); $this->assertSame('725458005', $composition['section'][1]['code']['coding'][0]['code'] ?? null); $this->assertSame('Receipt', $composition['section'][1]['code']['coding'][0]['display'] ?? null); $binaries = array_values(array_filter( $bundle['entry'], static fn (array $entry): bool => ($entry['resource']['resourceType'] ?? '') === 'Binary' )); $this->assertCount(1, $binaries); $this->assertSame('Binary', $composition['section'][2]['entry'][0]['type'] ?? null); $this->assertSame('Binary/invoice-19-pdf-content', $composition['section'][2]['entry'][0]['reference'] ?? null); $this->assertSame('application/pdf', $binaries[0]['resource']['contentType'] ?? null); $this->assertSame($attachment['data'] ?? null, $binaries[0]['resource']['data'] ?? null); $fullUrls = array_column($bundle['entry'], 'fullUrl'); $encoded = json_encode($bundle, JSON_UNESCAPED_SLASHES); preg_match_all('/"reference":"(urn:uuid:[^"]+)"/', (string) $encoded, $matches); foreach ($matches[1] as $reference) { $this->assertContains($reference, $fullUrls, 'Unresolved invoice reference: ' . $reference); } } public function testImmunizationRecordHasM2DocumentStructureAndResolvableReferences(): void { $bundle = (new FhirR4Builder())->buildImmunizationRecordBundle([ 'id' => '91', 'name' => 'Test Patient', 'gender' => 'female', 'birthDate' => '2020-01-10', 'abhaAddress' => 'testpatient@sbx', ], [[ 'id' => '17', 'vaccine_name' => 'BCG Vaccine', 'vaccine_code_system' => 'https://hms.local/immunization/uip', 'vaccine_code' => 'UIP-BCG', 'given_date' => '2026-08-15', 'status' => 'completed', 'lot_number' => 'LOT-42', 'dose_number' => '1', 'series_name' => 'Infant Immunization Schedule', 'target_disease_code' => '56717001', 'target_disease_name' => 'Tuberculosis', ]], [ 'care_context_reference' => 'IMM-17-91-20260815', 'practitioner' => [ 'id' => '7', 'name' => 'Dr Test', 'registration_number' => 'MED-7', ], 'organization' => ['name' => 'Test Hospital', 'hfr_id' => 'IN0000000001'], 'encounter' => [ 'id' => 'IMM-17', 'status' => 'finished', 'class_code' => 'AMB', 'period_start' => '2026-08-15 19:33:00', ], ]); $this->assertSame('document', $bundle['type'] ?? null); $this->assertSame('IMM-17-91-20260815', $bundle['identifier']['value'] ?? null); $this->assertContains('https://nrces.in/ndhm/fhir/r4/StructureDefinition/DocumentBundle', $bundle['meta']['profile'] ?? []); $resources = []; $fullUrls = array_column($bundle['entry'], 'fullUrl'); foreach ($bundle['entry'] as $entry) { $resource = $entry['resource'] ?? []; $resources[(string) ($resource['resourceType'] ?? '')] = $resource; } $composition = $resources['Composition']; $immunization = $resources['Immunization']; $this->assertContains('https://nrces.in/ndhm/fhir/r4/StructureDefinition/ImmunizationRecord', $composition['meta']['profile'] ?? []); $this->assertSame('Immunization record', $composition['title'] ?? null); $this->assertSame('Test Patient', $composition['subject']['display'] ?? null); $this->assertSame('41000179103', $composition['type']['coding'][0]['code'] ?? null); $this->assertSame('Dr Test', $composition['author'][0]['display'] ?? null); $this->assertSame('Test Hospital', $composition['custodian']['display'] ?? null); $this->assertSame('Immunization', $composition['section'][0]['entry'][0]['type'] ?? null); $this->assertSame('BCG Vaccine', $immunization['vaccineCode']['text'] ?? null); $this->assertSame('http://hl7.org/fhir/sid/cvx', $immunization['vaccineCode']['coding'][0]['system'] ?? null); $this->assertSame('19', $immunization['vaccineCode']['coding'][0]['code'] ?? null); $this->assertSame('2026-08-15T00:00:00+05:30', $immunization['occurrenceDateTime'] ?? null); $this->assertNotEmpty($immunization['performer'][0]['actor']['reference'] ?? ''); $this->assertNotEmpty($composition['encounter']['reference'] ?? ''); $this->assertSame('Encounter', $composition['encounter']['display'] ?? null); $this->assertSame($composition['encounter']['reference'], $immunization['encounter']['reference'] ?? null); $this->assertArrayNotHasKey('location', $immunization); $encounter = $resources['Encounter']; $this->assertContains('https://nrces.in/ndhm/fhir/r4/StructureDefinition/Encounter', $encounter['meta']['profile'] ?? []); $this->assertSame('AMB', $encounter['class']['code'] ?? null); $this->assertSame('ambulatory', $encounter['class']['display'] ?? null); $this->assertSame('finished', $encounter['status'] ?? null); $this->assertSame('2026-08-15T19:33:00+05:30', $encounter['period']['start'] ?? null); $this->assertSame('Infant Immunization Schedule', $immunization['protocolApplied'][0]['series'] ?? null); $this->assertSame(1, $immunization['protocolApplied'][0]['doseNumberPositiveInt'] ?? null); $this->assertSame('56717001', $immunization['protocolApplied'][0]['targetDisease'][0]['coding'][0]['code'] ?? null); // Canonical NRCES entry order: Composition, Practitioner, Organization, Patient, Encounter, Immunization $actualTypes = array_map(fn($e) => $e['resource']['resourceType'], $bundle['entry']); $this->assertSame(['Composition', 'Practitioner', 'Organization', 'Patient', 'Encounter', 'Immunization'], $actualTypes); $encoded = json_encode($bundle, JSON_UNESCAPED_SLASHES); preg_match_all('/"reference":"(urn:uuid:[^"]+)"/', (string) $encoded, $matches); foreach ($matches[1] as $reference) { $this->assertContains($reference, $fullUrls, 'Unresolved ImmunizationRecord reference: ' . $reference); } } public function testImmunizationBuilderFallbackReferenceIsStableOnRetry(): void { $builder = new FhirR4Builder(); $patient = ['id' => '91', 'name' => 'Test Patient']; $first = $builder->buildImmunizationRecordBundle($patient, [[ 'id' => '17', 'vaccine_name' => 'BCG Vaccine', 'given_date' => '2026-08-10', 'status' => 'completed', ]]); $retry = $builder->buildImmunizationRecordBundle($patient, [[ 'id' => '17', 'vaccine_name' => 'BCG Vaccine', 'given_date' => '2026-08-15', 'status' => 'completed', ]]); $this->assertSame('IMM-17', $first['identifier']['value'] ?? null); $this->assertSame($first['identifier']['value'] ?? null, $retry['identifier']['value'] ?? null); } public function testImmunizationRecordBundleIncludesPractitionerAuthorAndRecommendation(): void { $builder = new FhirR4Builder(); $patient = [ 'id' => '11', 'name' => 'DEVENDER SINGH', 'gender' => 'male', 'birthDate' => '1979-03-28', 'abhaAddress' => 'devender@sbx', ]; $immunizations = [[ 'id' => '10', 'vaccine_name' => 'Fractional IPV', 'vaccine_code' => 'UIP-FIPV', 'vaccine_code_system' => 'https://hms.local/immunization/uip', 'status' => 'completed', 'given_date' => '2026-08-15T19:33:00+05:30', 'manufacturer' => 'Cipla', 'lot_number' => '0002145', 'expiry_date' => '2026-08-29', 'dose_number' => '1', 'series_doses' => '2', 'series_name' => 'Fractional IPV', 'site_name' => 'Right Upper Arm', 'route_name' => 'Intradermal', 'notes' => 'Fractional dose 0.1 ml intradermal', ]]; $context = [ 'care_context_reference' => 'IMM-10-R12345', 'practitioner' => [ 'id' => '4', 'name' => 'Dr. R.K. Sundriyal', 'registration_number' => 'MCI-12345', ], 'organization' => [ 'name' => 'E-Atria Hospital', 'hfr_id' => 'IN0510000871', 'address' => 'Avas Vikas, Kashipur -244713, Uttarakhand', 'address_1' => 'Avas Vikas', 'address_2' => 'Kashipur -244713, Uttarakhand', 'phone' => '90125 12505', ], 'encounter' => [ 'id' => 'IMM-10', 'status' => 'finished', 'period_start' => '2026-08-15T19:33:00+05:30', ], 'recommendations' => [ [ 'vaccine_name' => 'Fractional IPV', 'vaccine_code' => 'UIP-FIPV', 'vaccine_code_system' => 'https://hms.local/immunization/uip', 'dose_number' => 2, 'series_doses' => 2, 'due_date' => '1979-07-04', ], [ 'vaccine_name' => 'Pentavalent', 'vaccine_code' => 'UIP-PENTA', 'vaccine_code_system' => 'https://hms.local/immunization/uip', 'dose_number' => 1, 'series_doses' => 3, 'due_date' => '1979-05-09', ], ], ]; $bundle = $builder->buildImmunizationRecordBundle($patient, $immunizations, $context); $this->assertSame('Bundle', $bundle['resourceType'] ?? null); $this->assertSame('document', $bundle['type'] ?? null); $resourcesByType = []; $fullUrls = array_column($bundle['entry'], 'fullUrl'); foreach ($bundle['entry'] as $entry) { $r = $entry['resource'] ?? []; $resourcesByType[(string) ($r['resourceType'] ?? '')][] = $r; } // Must include Composition, Practitioner, Organization, Patient, Encounter, Immunization, ImmunizationRecommendation $this->assertArrayHasKey('Composition', $resourcesByType); $this->assertArrayHasKey('Practitioner', $resourcesByType); $this->assertArrayHasKey('Organization', $resourcesByType); $this->assertArrayHasKey('Patient', $resourcesByType); $this->assertArrayHasKey('Encounter', $resourcesByType); $this->assertArrayHasKey('Immunization', $resourcesByType); $this->assertArrayHasKey('ImmunizationRecommendation', $resourcesByType); // Canonical NRCES entry order: Composition, Practitioner, Organization, Patient, Encounter, Immunization, ImmunizationRecommendation $actualTypes = array_map(fn($e) => $e['resource']['resourceType'], $bundle['entry']); $this->assertSame(['Composition', 'Practitioner', 'Organization', 'Patient', 'Encounter', 'Immunization', 'ImmunizationRecommendation'], $actualTypes); $composition = $resourcesByType['Composition'][0]; $practitioner = $resourcesByType['Practitioner'][0]; $encounter = $resourcesByType['Encounter'][0]; $immunization = $resourcesByType['Immunization'][0]; $recommendation = $resourcesByType['ImmunizationRecommendation'][0]; $this->assertSame('Immunization record', $composition['title'] ?? null); $this->assertSame('DEVENDER SINGH', $composition['subject']['display'] ?? null); $this->assertNotEmpty($composition['encounter']['reference'] ?? ''); $this->assertSame('Encounter', $composition['encounter']['display'] ?? null); $this->assertSame($composition['encounter']['reference'], $immunization['encounter']['reference'] ?? null); $this->assertArrayNotHasKey('location', $immunization); // Encounter has ambulatory class (eliminates NA below hospital name in PHR app) $this->assertSame('AMB', $encounter['class']['code'] ?? null); $this->assertSame('ambulatory', $encounter['class']['display'] ?? null); $this->assertSame('finished', $encounter['status'] ?? null); // Author MUST be Practitioner (eliminates NA in PHR app) $this->assertSame('Dr. R.K. Sundriyal', $practitioner['name'][0]['text'] ?? null); $this->assertSame('Dr. R.K. Sundriyal', $composition['author'][0]['display'] ?? null); $this->assertStringStartsWith('urn:uuid:', $composition['author'][0]['reference'] ?? ''); // Custodian is Organization $this->assertSame('E-Atria Hospital', $composition['custodian']['display'] ?? null); // Organization resource has MustSupport address and telecom (eliminates NA below hospital name in PHR app) $organization = $resourcesByType['Organization'][0]; $this->assertSame('E-Atria Hospital', $organization['name'] ?? null); $this->assertNotEmpty($organization['address'] ?? []); $this->assertSame('Avas Vikas, Kashipur -244713, Uttarakhand', $organization['address'][0]['text'] ?? null); $this->assertSame(['Avas Vikas'], $organization['address'][0]['line'] ?? []); $this->assertSame('Kashipur', $organization['address'][0]['city'] ?? null); $this->assertSame('Uttarakhand', $organization['address'][0]['state'] ?? null); $this->assertSame('244713', $organization['address'][0]['postalCode'] ?? null); $this->assertSame('90125 12505', $organization['telecom'][0]['value'] ?? null); // Section entries contains both Immunization and ImmunizationRecommendation $this->assertCount(2, $composition['section'][0]['entry'] ?? []); $this->assertSame('Immunization', $composition['section'][0]['entry'][0]['type'] ?? null); $this->assertSame('ImmunizationRecommendation', $composition['section'][0]['entry'][1]['type'] ?? null); // Immunization resource has site, route, target disease $this->assertSame('368209003', $immunization['site']['coding'][0]['code'] ?? null); $this->assertSame('372464004', $immunization['route']['coding'][0]['code'] ?? null); $this->assertSame('398102009', $immunization['protocolApplied'][0]['targetDisease'][0]['coding'][0]['code'] ?? null); $this->assertSame('10', $immunization['vaccineCode']['coding'][0]['code'] ?? null); // Performer references Practitioner $this->assertSame('Dr. R.K. Sundriyal', $immunization['performer'][0]['actor']['display'] ?? null); // ImmunizationRecommendation forecast status and dose $this->assertCount(2, $recommendation['recommendation']); $this->assertSame('due', $recommendation['recommendation'][0]['forecastStatus']['coding'][0]['code'] ?? null); $this->assertSame(2, $recommendation['recommendation'][0]['doseNumberPositiveInt'] ?? null); $this->assertNotEmpty($recommendation['recommendation'][0]['supportingImmunization'][0]['reference'] ?? ''); // Second recommendation item is Pentavalent with CVX 198 $this->assertSame('198', $recommendation['recommendation'][1]['vaccineCode'][0]['coding'][0]['code'] ?? null); $this->assertSame('Pentavalent', $recommendation['recommendation'][1]['vaccineCode'][0]['coding'][0]['display'] ?? null); $this->assertSame(1, $recommendation['recommendation'][1]['doseNumberPositiveInt'] ?? null); // Verify all references resolve $encoded = json_encode($bundle, JSON_UNESCAPED_SLASHES); preg_match_all('/"reference":"(urn:uuid:[^"]+)"/', (string) $encoded, $matches); foreach ($matches[1] as $ref) { $this->assertContains($ref, $fullUrls, 'Unresolved reference: ' . $ref); } } public function testLegacyNumericGenderMapsToFhirGender(): void { $controller = new AbdmGateway(); $method = new ReflectionMethod($controller, 'normalizeFhirGender'); $this->assertSame('male', $method->invoke($controller, '1')); $this->assertSame('female', $method->invoke($controller, '2')); $this->assertSame('other', $method->invoke($controller, '3')); } public function testBlankDischargeTemplateUsesDefaultHospitalHeader(): void { $controller = new Ipd_discharge(); $blankMethod = new ReflectionMethod($controller, 'isDischargeHeaderBlank'); $headerMethod = new ReflectionMethod($controller, 'buildDefaultDischargeHeader'); $this->assertTrue($blankMethod->invoke($controller, '
Fit to resume work
', 'patient' => [ 'id' => '11', 'uhid' => 'P26061000011', 'name' => 'Test Patient', 'gender' => 'male', 'dob' => '1990-01-01', 'abha_id' => '91510165305101', ], 'organization' => [ 'id' => 'IN0100000001', 'name' => 'Test Hospital', ], ]); $this->assertSame('HealthDocumentRecord', $output['hi_type']); $this->assertStringStartsWith('DOC-4-2026-08-26', $output['care_context_reference']); $this->assertTrue($output['validation']['valid']); $this->assertSame(100, $output['validation']['score']); $bundle = $output['fhir_bundle']; $resourceTypes = array_column(array_column($bundle['entry'], 'resource'), 'resourceType'); $this->assertContains('Composition', $resourceTypes); $this->assertContains('Patient', $resourceTypes); $this->assertContains('DocumentReference', $resourceTypes); } public function testHealthDocumentGeneratorSupportsCustomContentType(): void { $generator = $this->factory->healthDocument(); $output = $generator->generate([ 'record_id' => '5', 'visit_date' => '2026-08-31', 'document_title' => 'Scanned X-Ray', 'document_data_base64' => base64_encode('fake image data'), 'content_type' => 'image/png', 'patient' => [ 'id' => '11', 'name' => 'DEVENDER SINGH', 'abha_id' => '91510165305101', ], ]); $this->assertSame('HealthDocumentRecord', $output['hi_type']); $bundle = $output['fhir_bundle']; $this->assertSame('Bundle', $bundle['resourceType']); $docRef = null; foreach ($bundle['entry'] as $entry) { if (($entry['resource']['resourceType'] ?? '') === 'DocumentReference') { $docRef = $entry['resource']; break; } } $this->assertNotNull($docRef); $this->assertSame('application/pdf', $docRef['content'][0]['attachment']['contentType']); } public function testWellnessRecordGeneratorCreatesFullSections(): void { $generator = $this->factory->wellness(); $output = $generator->generate([ 'record_id' => '101', 'session_id' => '2', 'visit_date' => '2026-09-01', 'completed_at' => date(DATE_ATOM), 'vitals' => [ ['loinc_code' => '8480-6', 'display' => 'Systolic blood pressure', 'value' => 120, 'unit' => 'mmHg', 'ucum_code' => 'mm[Hg]'], ['loinc_code' => '8462-4', 'display' => 'Diastolic blood pressure', 'value' => 80, 'unit' => 'mmHg', 'ucum_code' => 'mm[Hg]'], ['loinc_code' => '8867-4', 'display' => 'Heart rate', 'value' => 72, 'unit' => '/min', 'ucum_code' => '/min'], ['loinc_code' => '8310-5', 'display' => 'Body temperature', 'value' => 36.666666666666664, 'unit' => 'Cel', 'ucum_code' => 'Cel'], ['loinc_code' => '59408-5', 'display' => 'Oxygen saturation', 'value' => 98, 'unit' => '%', 'ucum_code' => '%'], ], 'physical_examination' => [ 'Complaints: Mild headache for 2 days', 'Diagnosis: Essential hypertension (mild)', ], 'women_wellness' => [ 'lmp' => '2026-08-15', 'gravida' => '2', 'para' => '1', ], 'advice' => [ 'Smoking status: No', 'Diet & Lifestyle Advice: Low salt diet, 30 min daily walk', ], 'patient' => [ 'id' => '11', 'name' => 'SUNITA DEVI', 'abha_id' => '91510165305101', 'gender' => 'female', ], ]); $this->assertSame('WellnessRecord', $output['hi_type']); $bundle = $output['fhir_bundle']; $this->assertSame('Bundle', $bundle['resourceType']); $resourceTypes = array_column(array_column($bundle['entry'], 'resource'), 'resourceType'); $this->assertContains('Composition', $resourceTypes); $this->assertContains('Patient', $resourceTypes); $this->assertContains('Observation', $resourceTypes); $composition = $bundle['entry'][0]['resource']; $this->assertSame('https://nrces.in/ndhm/fhir/r4/StructureDefinition/WellnessRecord', $composition['meta']['profile'][0]); $this->assertSame('Wellness Record', $composition['type']['coding'][0]['display'] ?? ''); $this->assertNotEmpty($composition['encounter']['reference'] ?? ''); $this->assertContains('Encounter', $resourceTypes); $encounterEntries = array_values(array_filter($bundle['entry'], static fn ($e) => ($e['resource']['resourceType'] ?? '') === 'Encounter')); $this->assertNotEmpty($encounterEntries); $encResource = $encounterEntries[0]['resource']; $this->assertSame('AMB', $encResource['class']['code'] ?? ''); $this->assertSame('ambulatory', $encResource['class']['display'] ?? ''); $this->assertArrayNotHasKey('hospitalization', $encResource); $this->assertGreaterThanOrEqual(1, count($composition['section'])); $this->assertNotEmpty($composition['section'][0]['entry']); $tempObsEntries = array_values(array_filter($bundle['entry'], static function ($e) { $r = $e['resource'] ?? []; return ($r['resourceType'] ?? '') === 'Observation' && (($r['code']['coding'][0]['code'] ?? '') === '8310-5'); })); $this->assertNotEmpty($tempObsEntries); $this->assertSame(36.7, $tempObsEntries[0]['resource']['valueQuantity']['value']); } public function testDischargeSummaryGeneratorCreatesFullSectionsAndComponents(): void { $generator = $this->factory->discharge(); $output = $generator->generate([ 'record_id' => '3209', 'encounter' => [ 'id' => 'A26090003209', 'start' => '2026-09-01T18:57:00+05:30', 'end' => '2026-09-04T19:00:00+05:30', 'ward' => 'General Ward', 'bed' => 'GW-05', ], 'patient' => [ 'id' => '15355', 'name' => 'JANVI BISHT', 'gender' => 'female', 'dob' => '2013-06-25', 'abha_id' => '91407564383062', ], 'doctor_name' => 'Dr. Sanjay Kumar', 'chief_complaints' => [ ['name' => 'Fever'], ['name' => 'Cough'], ['name' => 'Breathlessness'], ['name' => 'Vomiting'], ], 'diagnoses' => [ ['name' => 'VIRAL FEVER'], ], 'medications' => [ ['name' => 'DOZPANTA DSR', 'dosage' => 'BF | OD | for 5 Days'], ['name' => 'WANAPOL', 'dosage' => 'AF | BD | for 2 Days'], ], 'observations' => [ ['text' => 'Pulse', 'value' => '40', 'unit' => '/min', 'category' => 'Condition on Admission Time'], ['text' => 'BP', 'value' => '120/80', 'unit' => 'mmHg', 'category' => 'Condition on Admission Time'], ['text' => 'Pulse', 'value' => '25', 'unit' => '/min', 'category' => 'Condition on Discharge Time'], ['text' => 'BP', 'value' => '110/70', 'unit' => 'mmHg', 'category' => 'Condition on Discharge Time'], ], 'investigations' => [ ['text' => 'HB', 'value' => '11', 'unit' => 'g/dL', 'loinc_code' => '718-7'], ], 'care_plans' => [ ['title' => 'Dietary Advice', 'description' => 'Hydration: 8-10 glasses of water daily.'], ], ]); $this->assertSame('DischargeSummaryRecord', $output['hi_type']); $bundle = $output['fhir_bundle']; $this->assertSame('Bundle', $bundle['resourceType']); $resourceTypes = array_column(array_column($bundle['entry'], 'resource'), 'resourceType'); $this->assertContains('Composition', $resourceTypes); $this->assertContains('Patient', $resourceTypes); $this->assertContains('Encounter', $resourceTypes); $this->assertContains('Condition', $resourceTypes); $this->assertContains('MedicationRequest', $resourceTypes); $this->assertContains('DiagnosticReport', $resourceTypes); $this->assertContains('CarePlan', $resourceTypes); // Verify composition sections $composition = $bundle['entry'][0]['resource']; $sectionTitles = array_column($composition['section'], 'title'); $this->assertContains('Chief complaints', $sectionTitles); $this->assertContains('Medications', $sectionTitles); $this->assertContains('Care Plan', $sectionTitles); } public function testDischargeMandatoryFieldsPatientEncounterDiagnosisAndOutcome(): void { $src = [ 'record_id' => 9901, 'bundle_identifier' => 'discharge-A26090009901', 'session_id' => 9901, 'visit_date' => '2026-09-04', 'completed_at' => '2026-09-04T10:00:00+05:30', 'discharge_status' => 'LAMA', 'patient' => [ 'id' => 1234, 'uhid' => 'P26091001234', 'name' => 'ANITA SHARMA', 'gender' => 'female', 'dob' => '1985-07-20', 'mobile' => '9876543210', 'address' => '123 Main Street, Civil Lines', 'city' => 'Haridwar', 'district' => 'Haridwar', 'state' => 'Uttarakhand', 'pin' => '249401', 'abha_id' => '91407564383099', 'abha_address' => 'anitasharma@sbx', ], 'encounter' => [ 'id' => 'A26090009901', 'class_code' => 'IMP', 'start' => '2026-09-01T09:00:00+05:30', 'end' => '2026-09-04T10:00:00+05:30', 'discharge_disposition' => 'LAMA', 'ward' => 'ICU', 'bed' => 'ICU-02', ], 'doctor' => ['id' => 10, 'name' => 'Dr. R K Sundriyal'], 'organization' => ['id' => 'IN0510000000', 'name' => 'DevSoft Hospital'], 'chief_complaints' => [['text' => 'High grade fever with chills']], 'diagnoses' => [['text' => 'Enteric Fever / Typhoid']], 'procedures' => [['text' => 'Intravenous cannulation and fluid hydration']], 'medications' => [['name' => 'INJ CEFTRIAXONE 1GM', 'dosage' => 'IV | BD | for 5 Days']], 'ui_course_treatment' => [ 'Patient admitted with high grade fever. Started on IV antibiotics and fluids. Vitals stabilized on Day 2. Patient requested LAMA on Day 4.', ], 'care_plans' => [ ['title' => 'Follow Up Advice', 'description' => 'Consult local physician after 3 days.'], ], ]; $output = $this->factory->discharge()->generate($src); $bundle = $output['fhir_bundle']; $composition = $bundle['entry'][0]['resource']; // 1. Patient Telecom and Address verification $patients = array_values(array_filter($bundle['entry'], static fn (array $e): bool => ($e['resource']['resourceType'] ?? '') === 'Patient')); $this->assertCount(1, $patients); $patient = $patients[0]['resource']; $this->assertSame('+919876543210', $patient['telecom'][0]['value'] ?? null); $this->assertSame('phone', $patient['telecom'][0]['system'] ?? null); $this->assertSame('mobile', $patient['telecom'][0]['use'] ?? null); $this->assertSame('123 Main Street, Civil Lines', $patient['address'][0]['line'][0] ?? null); $this->assertSame('Haridwar', $patient['address'][0]['city'] ?? null); $this->assertSame('Uttarakhand', $patient['address'][0]['state'] ?? null); $this->assertSame('249401', $patient['address'][0]['postalCode'] ?? null); $this->assertSame('IND', $patient['address'][0]['country'] ?? null); // ABHA address identifier $patientIdSystems = array_column($patient['identifier'], 'system'); $this->assertContains('https://healthid.ndhm.gov.in', $patientIdSystems); // 2. Encounter: Start/End period, hospitalization and discharge disposition $encounters = array_values(array_filter($bundle['entry'], static fn (array $e): bool => ($e['resource']['resourceType'] ?? '') === 'Encounter')); $this->assertCount(1, $encounters); $encounter = $encounters[0]['resource']; $this->assertSame('2026-09-01T09:00:00+05:30', $encounter['period']['start'] ?? null); $this->assertSame('2026-09-04T10:00:00+05:30', $encounter['period']['end'] ?? null); $this->assertSame('aadvice', $encounter['hospitalization']['dischargeDisposition']['coding'][0]['code'] ?? null); $this->assertSame('Left against medical advice', $encounter['hospitalization']['dischargeDisposition']['coding'][0]['display'] ?? null); // 3. Encounter.diagnosis linking to Final Diagnosis Condition $this->assertNotEmpty($encounter['diagnosis'] ?? []); $this->assertSame('DD', $encounter['diagnosis'][0]['use']['coding'][0]['code'] ?? null); $diagRef = $encounter['diagnosis'][0]['condition']['reference'] ?? ''; $this->assertStringStartsWith('urn:uuid:', $diagRef); // Verify that diagRef points to the final diagnosis Condition $conditionUrls = array_column(array_filter($bundle['entry'], static fn (array $e): bool => ($e['resource']['resourceType'] ?? '') === 'Condition'), 'fullUrl'); $this->assertContains($diagRef, $conditionUrls); // 4. CarePlan for Course of Treatment $carePlans = array_values(array_filter($bundle['entry'], static fn (array $e): bool => ($e['resource']['resourceType'] ?? '') === 'CarePlan')); $carePlanTitles = array_column(array_column($carePlans, 'resource'), 'title'); $this->assertContains('Course of Treatment in Hospital', $carePlanTitles); // 5. Composition narrative XHTML checks $narrative = $composition['text']['div'] ?? ''; $this->assertStringContainsString('ANITA SHARMA', $narrative); $this->assertStringContainsString('9876543210', $narrative); $this->assertStringContainsString('Enteric Fever / Typhoid', $narrative); $this->assertStringContainsString('Left Against Medical Advice', $narrative); $this->assertStringContainsString('01-Sep-2026', $narrative); $this->assertStringContainsString('04-Sep-2026', $narrative); // Assert NO standalone placeholder "NA" or "N/A" $this->assertDoesNotMatchRegularExpression('/>\s*(NA|N\/A|null)\s*factory->discharge()->generate($srcCured); $encCured = array_values(array_filter($outCured['fhir_bundle']['entry'], static fn (array $e): bool => ($e['resource']['resourceType'] ?? '') === 'Encounter'))[0]['resource']; $this->assertSame('home', $encCured['hospitalization']['dischargeDisposition']['coding'][0]['code']); $srcExp = $src; $srcExp['discharge_status'] = 'Expired'; unset($srcExp['encounter']['discharge_disposition']); $outExp = $this->factory->discharge()->generate($srcExp); $encExp = array_values(array_filter($outExp['fhir_bundle']['entry'], static fn (array $e): bool => ($e['resource']['resourceType'] ?? '') === 'Encounter'))[0]['resource']; $this->assertSame('exp', $encExp['hospitalization']['dischargeDisposition']['coding'][0]['code']); } }