public InteractController()
{
string fhirserver = CloudConfigurationManager.GetSetting("FHIRServerAddress");
string fhirtenant = CloudConfigurationManager.GetSetting("FHIRAADTenant");
string fhirclientid = CloudConfigurationManager.GetSetting("FHIRClientId");
string fhirclientsecret = CloudConfigurationManager.GetSetting("FHIRClientSecret");
_client = new FHIRClient(fhirserver, fhirtenant, fhirclientid, fhirclientsecret);
}
public async Task <ProxyProcessResult> Process(FHIRResponse response, HttpRequest req, ILogger log, ClaimsPrincipal principal, string res, string id, string hist, string vid)
{
if (!req.Method.Equals("GET") || response.StatusCode != HttpStatusCode.OK || response.Content == null)
{
return(new ProxyProcessResult(true, "", "", response));
}
List <JToken> ss = null;
if (DATE_SORT_RESOURCES_SUPPORTED.Contains(res) && req.Query.ContainsKey("_sort") && req.Query["_sort"].First().Contains("date"))
{
var fhirresp = JObject.Parse(response.Content.ToString());
if (fhirresp.IsNullOrEmpty() || !((string)fhirresp["resourceType"]).Equals("Bundle") || !((string)fhirresp["type"]).Equals("searchset"))
{
return(new ProxyProcessResult(true, "", "", response));
}
ss = new List <JToken>();
addEntries((JArray)fhirresp["entry"], ss, log);
//Process Next Pages until out or max array
bool nextlink = !fhirresp["link"].IsNullOrEmpty() && ((string)fhirresp["link"].getFirstField()["relation"]).Equals("next");
while (nextlink && ss.Count < MAX_ARRAY_SIZE)
{
string nextpage = (string)fhirresp["link"].getFirstField()["url"];
FHIRClient fhirClient = FHIRClientFactory.getClient(log);
var nextresult = await fhirClient.LoadResource(nextpage);
fhirresp = JObject.Parse(nextresult.Content.ToString());
if (fhirresp.IsNullOrEmpty() || !fhirresp.FHIRResourceType().Equals("Bundle") || !((string)fhirresp["type"]).Equals("searchset"))
{
return(new ProxyProcessResult(false, "Next Page not Returned or server error", "", nextresult));
}
addEntries((JArray)fhirresp["entry"], ss, log);
nextlink = !fhirresp["link"].IsNullOrEmpty() && ((string)fhirresp["link"].getFirstField()["relation"]).Equals("next");
}
ss.Sort(new DateSortedIndexComparar(req.Query["_sort"].First().Contains("-date")));
fhirresp["entry"] = new JArray(ss.ToArray());
fhirresp["link"] = new JArray();
response.Content = fhirresp.ToString();
}
var retVal = new ProxyProcessResult();
if (ss != null && ss.Count >= MAX_ARRAY_SIZE)
{
retVal.ErrorMsg = "Warning: _Sort exceeed or met MAX_ARRAY_SIZE results may not be accurate!";
log.LogWarning("_Sort exceeed or met MAX_ARRAY_SIZE results may not be accurate!");
}
retVal.Response = response;
return(retVal);
}
public async Task <ProxyProcessResult> Process(string requestBody, HttpRequest req, ILogger log, ClaimsPrincipal principal, string res, string id, string hist, string vid)
{
if (req.Method.Equals("GET") && res.SafeEquals("Patient") && !string.IsNullOrEmpty(id) && hist.SafeEquals("$everything"))
{
ConcurrentBag <JToken> ss = new ConcurrentBag <JToken>();
FHIRClient fhirClient = FHIRClientFactory.getClient(log);
var nextresult = await fhirClient.LoadResource("Patient", "_id=" + id);
var fhirresp = JObject.Parse(nextresult.Content.ToString());
if (fhirresp.IsNullOrEmpty() || !fhirresp.FHIRResourceType().Equals("Bundle") || !((string)fhirresp["type"]).Equals("searchset"))
{
return(new ProxyProcessResult(false, "Patient not found", "", nextresult));
}
addEntries((JArray)fhirresp["entry"], ss, log, "Patient");
CountdownEvent countdown = new CountdownEvent(everyresource.Length);
foreach (string rt in everyresource)
{
ThreadPool.QueueUserWorkItem(async delegate
{
try
{
FHIRClient fhirClient1 = FHIRClientFactory.getClient(log);
string[] s = rt.Split(":");
log.LogInformation($"Loading {s[0]} resources for patient {id}");
var rslt = await fhirClient1.LoadResource(s[0], s[1].Replace("{id}", id) + "&_count=100");
var resp = JObject.Parse(rslt.Content.ToString());
if (!resp.IsNullOrEmpty() && resp.FHIRResourceType().Equals("Bundle") && ((string)resp["type"]).Equals("searchset"))
{
addEntries((JArray)resp["entry"], ss, log, s[0]);
}
countdown.Signal();
}
catch (Exception e)
{
log.LogError($"Error fetching {rt} resources for patient {id}:{e.Message}");
countdown.Signal();
}
});
}
countdown.Wait();
fhirresp["entry"] = new JArray(ss.ToArray());
fhirresp["link"] = new JArray();
nextresult.Content = fhirresp;
return(new ProxyProcessResult(false, "", requestBody, nextresult));
}
return(new ProxyProcessResult(true, "", requestBody, null));
}
public async Task <ProxyProcessResult> Process(string requestBody, HttpRequest req, ILogger log, ClaimsPrincipal principal, string res, string id, string hist, string vid)
{
if (req.Method.Equals("GET") && res.SafeEquals("Patient") && !string.IsNullOrEmpty(id) && hist.SafeEquals("$everything"))
{
ConcurrentBag <JToken> ss = new ConcurrentBag <JToken>();
FHIRClient fhirClient = FHIRClientFactory.getClient(log);
var nextresult = await fhirClient.LoadResource("Patient", "_id=" + id);
var fhirresp = JObject.Parse(nextresult.Content.ToString());
if (fhirresp.IsNullOrEmpty() || fhirresp["entry"].IsNullOrEmpty())
{
return(new ProxyProcessResult(false, "Patient not found or server error", "", null));
}
addEntries((JArray)fhirresp["entry"], ss, log);
nextresult = await fhirClient.LoadResource($"Patient/{id}/*", "_count=100");
fhirresp = JObject.Parse(nextresult.Content.ToString());
if (!fhirresp.IsNullOrEmpty() && !fhirresp["entry"].IsNullOrEmpty())
{
addEntries((JArray)fhirresp["entry"], ss, log);
bool nextlink = !fhirresp["link"].IsNullOrEmpty() && ((string)fhirresp["link"].getFirstField()["relation"]).Equals("next");
while (nextlink && ss.Count < MAX_ARRAY_SIZE)
{
string nextpage = (string)fhirresp["link"].getFirstField()["url"];
FHIRClient fhirClient1 = FHIRClientFactory.getClient(log);
nextresult = await fhirClient1.LoadResource(nextpage);
fhirresp = JObject.Parse(nextresult.Content.ToString());
if (fhirresp.IsNullOrEmpty() || !fhirresp.FHIRResourceType().Equals("Bundle") || !((string)fhirresp["type"]).Equals("searchset"))
{
return(new ProxyProcessResult(false, "Next Page not Returned or server error", "", null));
}
addEntries((JArray)fhirresp["entry"], ss, log);
nextlink = !fhirresp["link"].IsNullOrEmpty() && ((string)fhirresp["link"].getFirstField()["relation"]).Equals("next");
}
}
fhirresp["entry"] = new JArray(ss.ToArray());
fhirresp["link"] = new JArray();
nextresult.Content = fhirresp;
return(new ProxyProcessResult(false, "", requestBody, nextresult));
}
return(new ProxyProcessResult(true, "", requestBody, null));
}
private async Task MessageReceivedAsync(IDialogContext context, IAwaitable <object> result)
{
var activity = await result as Activity;
string msg = activity.Text.ToLower().Trim();
if (msg == "start over" || msg == "exit" || msg == "quit" || msg == "done" || msg == "start again" || msg == "restart" || msg == "leave" || msg == "reset" || msg == "bye" || msg == "goodbye")
{
context.Done("end");
}
else
{
if (isSessionTimedOut(context))
{
context.Fail(new SessionTimedOutException("Your session has timedout or is invalid."));
}
else
{
string fhirserver = null;
context.PrivateConversationData.TryGetValue <string>("fhirserver", out fhirserver);
string token = null;
context.PrivateConversationData.TryGetValue <string>("bearertoken", out token);
string patid = null;
context.PrivateConversationData.TryGetValue <string>("id", out patid);
//Initialize FHIR Client
FHIRClient client = new FHIRClient(fhirserver, token);
//Determine Intent/Entities from LUIS
var luisresp = await LUISClient.RequestAsync <LUISResponse>(activity.Text);
var intent = luisresp.topScoringIntent;
//Nothing over 50% confidence bail
if (intent == null)
{
await context.PostAsync($"Sorry, I didn't understand {activity.Text}...");
}
if (intent.intent == "FindPractitioner")
{
if (luisresp.entities == null || luisresp.entities.Count() == 0)
{
await context.PostAsync($"Sorry, I think you want to find a practioner but I can't determine the location you want");
}
//Handle Geography
var geo = luisresp.entities.FirstOrDefault();
//Call FHIR Server
string parm = geo.entity.ToLower().StartsWith("anywhere") ? "" : $"city={geo.entity}";
var bundle = (Hl7.Fhir.Model.Bundle)client.LoadResource("Practitioner", parm);
if (bundle.Entry.Count == 0)
{
await context.PostAsync($"Sorry, I couldn't find providers in {geo.entity}...");
}
else
{
StringBuilder sb = new StringBuilder();
sb.Append($"Got {bundle.Entry.Count()} practioners in {geo.entity}\n\n");
foreach (var entry in bundle.Entry)
{
Hl7.Fhir.Model.Practitioner p = (Hl7.Fhir.Model.Practitioner)entry.Resource;
var address = (p.Address.Count > 0 ? p.Address[0] : null);
var tel = (p.Telecom.Count > 0 ? p.Telecom[0] : null);
sb.Append($"{p.Name[0].Text} is accepting new patients.");
if (address != null)
{
sb.Append($"Located at " + address.LineElement[0] + " " + address.City);
}
if (tel != null)
{
sb.Append($" Phone:" + tel.Value);
}
sb.Append("\n\n");
}
await context.PostAsync(sb.ToString());
}
}
else if (intent.intent == "ChartHeartRate")
{
var entity = luisresp.FindEntityByType("builtin.number");
if (entity != null)
{
var hr = Convert.ToDecimal(new String(entity.entity.Where(Char.IsDigit).ToArray()));
Hl7.Fhir.Model.Observation rv = new Hl7.Fhir.Model.Observation();
rv.Status = Hl7.Fhir.Model.ObservationStatus.Final;
rv.Category = new List <Hl7.Fhir.Model.CodeableConcept>();
Hl7.Fhir.Model.CodeableConcept cc = new Hl7.Fhir.Model.CodeableConcept("http://hl7.org/fhir/observation-category", "vital-signs", "Vital Signs");
rv.Category.Add(cc);
rv.Code = new Hl7.Fhir.Model.CodeableConcept("http://loinc.org", "8867-4", "Heart rate");
rv.Subject = new Hl7.Fhir.Model.ResourceReference("patient/" + patid);
rv.Effective = Hl7.Fhir.Model.FhirDateTime.Now();
rv.Value = new Hl7.Fhir.Model.Quantity(hr, "beats/minute");
var rslt = client.SaveResource(rv);
if (rslt)
{
await context.PostAsync($"Thanks, I recorded your heart rate of {entity.entity} in your medical record");
}
else
{
await context.PostAsync($"Sorry I had a problem posting your heartrate...try again later.");
}
}
else
{
await context.PostAsync($"Sorry, I think you want to record your heartrate vital but I can't understand the value you provided.");
}
}
else if (intent.intent == "ChartWeight")
{
string entity_weight = null;
var entity = luisresp.FindEntityByType("weight");
if (entity == null)
{
entity = luisresp.FindEntityByType("builtin.number");
if (entity != null)
{
entity_weight = entity.entity;
var wt = luisresp.FindEntityByType("builtin.dimension");
if (wt != null)
{
if (wt.entity.ToLower().EndsWith("kilograms") || wt.entity.ToLower().EndsWith("kg"))
{
entity_weight = entity_weight + "kg";
}
else
{
entity_weight = entity_weight + "lbs";
}
}
}
}
else
{
entity_weight = entity.entity;
}
if (entity_weight != null)
{
var weight = Convert.ToDecimal(new String(entity_weight.Where(Char.IsDigit).ToArray()));
//Determine pounds or kg
if (entity_weight.ToLower().EndsWith("kg"))
{
weight = weight * (decimal)2.20462;
}
Hl7.Fhir.Model.Observation rv = new Hl7.Fhir.Model.Observation();
rv.Status = Hl7.Fhir.Model.ObservationStatus.Final;
rv.Category = new List <Hl7.Fhir.Model.CodeableConcept>();
Hl7.Fhir.Model.CodeableConcept cc = new Hl7.Fhir.Model.CodeableConcept("http://hl7.org/fhir/observation-category", "vital-signs", "Vital Signs");
rv.Category.Add(cc);
rv.Code = new Hl7.Fhir.Model.CodeableConcept("http://loinc.org", "29463-7", "Body Weight");
rv.Code.Coding.Add(new Hl7.Fhir.Model.Coding("http://snomed.info/sct", "27113001", "Body Weight"));
rv.Subject = new Hl7.Fhir.Model.ResourceReference("patient/" + patid);
rv.Effective = Hl7.Fhir.Model.FhirDateTime.Now();
rv.Value = new Hl7.Fhir.Model.Quantity(weight, "lbs");
((Hl7.Fhir.Model.Quantity)rv.Value).Code = "[lb_av]";
var rslt = client.SaveResource(rv);
if (rslt)
{
string weightmsg = "";
string parm = $"patient={patid}";
var bundle = (Hl7.Fhir.Model.Bundle)client.LoadResource("Observation", parm);
List <Hl7.Fhir.Model.Observation> weights = new List <Hl7.Fhir.Model.Observation>();
foreach (Hl7.Fhir.Model.Bundle.EntryComponent entry in bundle.Entry)
{
Hl7.Fhir.Model.Observation o = (Hl7.Fhir.Model.Observation)entry.Resource;
if (FHIRUtils.isCodeMatch(o.Code.Coding, "http://loinc.org", "29463-7"))
{
weights.Add(o);
}
}
if (weights.Count > 1)
{
Hl7.Fhir.Model.Observation[] sorted = weights.OrderBy(o => Convert.ToDateTime(o.Effective.ToString())).ToArray();
decimal prevw = ((Hl7.Fhir.Model.SimpleQuantity)sorted[sorted.Length - 2].Value).Value.Value;
decimal curw = ((Hl7.Fhir.Model.SimpleQuantity)sorted[sorted.Length - 1].Value).Value.Value;
decimal dif = prevw - curw;
if (dif < 0)
{
weightmsg = "Looks like you gained around " + Math.Round(Math.Abs(dif), 1) + " lbs.";
}
else if (dif > 0)
{
weightmsg = "Looks like you loss around " + Math.Round(Math.Abs(dif), 1) + " lbs. Keep it up!!";
}
else
{
weightmsg = "Your weight is holding steady";
}
}
await context.PostAsync($"Thanks, I recorded your weight of {weight} lbs in your medical record\n\n{weightmsg}");
}
else
{
await context.PostAsync($"Sorry I had a problem posting your weight...try again later.");
}
}
}
else if (intent.intent == "ChartGlucose")
{
var entity = luisresp.FindEntityByType("builtin.number");
if (entity != null)
{
var glucose = Convert.ToDecimal(new String(entity.entity.Where(Char.IsDigit).ToArray()));
var unit = "mg/dL";
Hl7.Fhir.Model.CodeableConcept loinc = new Hl7.Fhir.Model.CodeableConcept("http://loinc.org", "2345-7", "Glucose [Mass/volume] in Serum or Plasma");
//convert mg/DL if mmol/l
if (glucose < 20)
{
glucose = glucose * 18;
}
Hl7.Fhir.Model.Observation rv = new Hl7.Fhir.Model.Observation();
rv.Status = Hl7.Fhir.Model.ObservationStatus.Final;
rv.Category = new List <Hl7.Fhir.Model.CodeableConcept>();
Hl7.Fhir.Model.CodeableConcept cc = new Hl7.Fhir.Model.CodeableConcept("http://hl7.org/fhir/observation-category", "laboratory", "Laboratory");
rv.Category.Add(cc);
rv.Code = loinc;
rv.Subject = new Hl7.Fhir.Model.ResourceReference("patient/" + patid);
rv.Effective = Hl7.Fhir.Model.FhirDateTime.Now();
rv.Issued = DateTimeOffset.UtcNow;
rv.ReferenceRange = new List <Hl7.Fhir.Model.Observation.ReferenceRangeComponent>();
Hl7.Fhir.Model.Observation.ReferenceRangeComponent rrc = new Hl7.Fhir.Model.Observation.ReferenceRangeComponent();
rrc.High = new Hl7.Fhir.Model.SimpleQuantity();
rrc.High.Unit = "mg/dL";
rrc.High.Code = rrc.High.Unit;
rrc.High.System = "http://unitsofmeasure.org";
rrc.High.Value = 140;
rrc.Low = new Hl7.Fhir.Model.SimpleQuantity();
rrc.Low.Unit = "mg/dL";
rrc.Low.Code = rrc.Low.Unit;
rrc.Low.System = "http://unitsofmeasure.org";
rrc.Low.Value = 70;
rv.ReferenceRange.Add(rrc);
rv.Value = new Hl7.Fhir.Model.Quantity(glucose, unit);
((Hl7.Fhir.Model.Quantity)rv.Value).Code = unit;
var rslt = client.SaveResource(rv);
if (rslt)
{
int numglucose = 0;
string parm = $"patient={patid}";
var bundle = (Hl7.Fhir.Model.Bundle)client.LoadResource("Observation", parm);
decimal bga = 0;
foreach (Hl7.Fhir.Model.Bundle.EntryComponent entry in bundle.Entry)
{
Hl7.Fhir.Model.Observation o = (Hl7.Fhir.Model.Observation)entry.Resource;
if (FHIRUtils.isCodeMatch(o.Code.Coding, "http://loinc.org", "2345-7"))
{
bga = bga + ((Hl7.Fhir.Model.SimpleQuantity)o.Value).Value.Value;
numglucose++;
}
}
bga = Math.Round(bga / numglucose, 1);
decimal a1c = ((Convert.ToDecimal(46.7) + bga) / Convert.ToDecimal(28.7));
string bgmsg = $"Your blood glucose is averaging {bga} mg/dL " + (bga > 140 ? "looks like it's running high" : (bga < 70 ? "looks like it's running low" : ""));
bgmsg = bgmsg + "\n\nYour estimated A1C is " + Convert.ToString(Math.Round(a1c, 1));
await context.PostAsync($"Thanks, I recorded your blood glucose of {glucose} mg/dL in your medical record\n\n{bgmsg}");
}
else
{
await context.PostAsync($"Sorry I had a problem posting your blood glucose...you can try again later.");
}
}
else
{
await context.PostAsync($"Sorry, I couldnt determine your blood glucose value...try again");
}
}
else if (intent.intent == "DisplayGlucose")
{
int numglucose = 0;
string parm = $"patient={patid}";
var bundle = (Hl7.Fhir.Model.Bundle)client.LoadResource("Observation", parm);
decimal bga = 0;
decimal la1c = 0;
decimal ea1c = 0;
DateTime?dta1c = null;
foreach (Hl7.Fhir.Model.Bundle.EntryComponent entry in bundle.Entry)
{
Hl7.Fhir.Model.Observation o = (Hl7.Fhir.Model.Observation)entry.Resource;
if (FHIRUtils.isCodeMatch(o.Code.Coding, "http://loinc.org", "2345-7"))
{
bga = bga + ((Hl7.Fhir.Model.SimpleQuantity)o.Value).Value.Value;
numglucose++;
}
else if (FHIRUtils.isCodeMatch(o.Code.Coding, "http://loinc.org", "4548-4"))
{
la1c = ((Hl7.Fhir.Model.SimpleQuantity)o.Value).Value.Value;
dta1c = Convert.ToDateTime(o.Effective.ToString());
}
}
if (numglucose > 0)
{
bga = Math.Round(bga / numglucose, 1);
ea1c = ((Convert.ToDecimal(46.7) + bga) / Convert.ToDecimal(28.7));
}
string a1cmsg = "I don't see any A1C tests on file for you.";
string bgmsg = "I don't see any blood glucose tests on file for you.";
if (la1c > 0)
{
a1cmsg = $"Your last A1C test was on " + String.Format("{0:MM/dd/yyyy}", dta1c.Value) + " the result was " + Convert.ToString(la1c) + "% " + (la1c > 6 ? "thats high" : "");
}
if (bga > 0)
{
bgmsg = $"Your blood glucose is averaging {bga} mg/dL " + (bga > 140 ? "looks like it's running high" : (bga < 70 ? "looks like it's running low" : ""));
bgmsg = bgmsg + "\n\nYour current estimated A1C is " + Convert.ToString(Math.Round(ea1c, 1)) + (ea1c < 6 ? " great control!" : (ea1c <= 7 ? " doing good for a diabetic!" : " need to work at lowering!"));
}
await context.PostAsync($"{a1cmsg}\n\n{bgmsg}");
}
else if (intent.intent == "DisplayCareplan")
{
//Call FHIR Server
string parm = $"patient={patid}";
var bundle = (Hl7.Fhir.Model.Bundle)client.LoadResource("CarePlan", parm);
if (bundle.Entry.Count == 0)
{
await context.PostAsync($"Sorry, I couldn't find a plan of care for you in the database...");
}
else
{
StringBuilder sb = new StringBuilder();
sb.Append("Your current plan of care addresses the following conditions:\n\n");
Hl7.Fhir.Model.CarePlan cp = (Hl7.Fhir.Model.CarePlan)bundle.Entry[0].Resource;
int x = 1;
foreach (var cond in cp.Addresses)
{
sb.Append(x++ + ". " + cond.Display + "\n\n");
}
sb.Append("\n\nYou have the following goals:\n\n");
x = 1;
foreach (var goal in cp.Goal)
{
sb.Append(x++ + ". " + goal.Display + "\n\n");
}
sb.Append("\n\nYou should:\n\n");
x = 1;
foreach (var act in cp.Activity)
{
if (act.Detail != null)
{
sb.Append(x++ + ". " + act.Detail.Description + "\n\n");
}
else
{
if (act.Reference != null && act.Reference.Reference.StartsWith("MedicationRequest"))
{
sb.Append(x++ + ". Take " + act.Reference.Display + " as directed.\n\n");
}
}
}
await context.PostAsync(sb.ToString());
}
}
else
{
await context.PostAsync($"Sorry, I didn't understand {activity.Text}...");
}
}
context.Wait(MessageReceivedAsync);
}
}
/* Opt-out: Default is for health information of patients to be included automatically, but the patient can opt out completely.
* Note: This is an access only policy, it does not prevent updates to the medical record as these could be valid */
public async Task <ProxyProcessResult> Process(FHIRResponse response, HttpRequest req, ILogger log, ClaimsPrincipal principal, string res, string id, string hist, string vid)
{
FHIRResponse fr = response;
if (!req.Method.Equals("GET"))
{
return(new ProxyProcessResult(true, "", "", fr));
}
//Load the consent category code from settings
string consent_category = System.Environment.GetEnvironmentVariable("FP-MOD-CONSENT-OPTOUT-CATEGORY");
if (string.IsNullOrEmpty(consent_category))
{
log.LogWarning("ConsentOptOutFilter: No value for FP-MOD-CONSENT-OPTOUT-CATEGORY in settings...Filter will not execute");
return(new ProxyProcessResult(true, "", "", fr));
}
if (fr == null || fr.Content == null || string.IsNullOrEmpty(fr.Content.ToString()))
{
log.LogInformation("ConsentOptOutFilter: No FHIR Response found in context...Nothing to filter");
return(new ProxyProcessResult(true, "", "", fr));
}
JObject result = JObject.Parse(fr.ToString());
//Administrator is allowed access
if (Utils.inServerAccessRole(req, "A"))
{
return(new ProxyProcessResult(true, "", "", fr));
}
ClaimsIdentity ci = (ClaimsIdentity)principal.Identity;
string aadten = ci.Tenant();
string name = principal.Identity.Name;
//We'll need FHIRClient to check server
FHIRClient fhirClient = FHIRClientFactory.getClient(log);
var cache = Utils.RedisConnection.GetDatabase();
List <string> associations = ((string)cache.StringGet($"{ASSOCIATION_CACHE_PREFIX}{aadten}-{name}")).DeSerializeList <string>();
if (associations == null)
{
//Load Associations if not in cache
associations = new List <string>();
var table = Utils.getTable();
//Practioner
var practitioner = Utils.getLinkEntity(table, "Practitioner", aadten + "-" + name);
if (practitioner != null)
{
associations.Add(practitioner.PartitionKey + "/" + practitioner.LinkedResourceId);
//Load organization from PractionerRoles
var prs = await fhirClient.LoadResource("PractitionerRole", "practitioner=" + practitioner.LinkedResourceId, true, req.Headers);
var ro = (JObject)prs.Content;
if (ro.FHIRResourceType().Equals("Bundle"))
{
JArray entries = (JArray)ro["entry"];
if (!entries.IsNullOrEmpty())
{
foreach (JToken tok in entries)
{
associations.Add(tok["resource"].FHIRReferenceId());
if (!tok["resource"]["organization"].IsNullOrEmpty() && !tok["resource"]["organization"]["reference"].IsNullOrEmpty())
{
associations.Add((string)tok["resource"]["organization"]["reference"]);
}
}
}
}
}
//RealtedPerson
var related = Utils.getLinkEntity(table, "RelatedPerson", aadten + "-" + name);
if (related != null)
{
associations.Add(related.PartitionKey + "/" + related.LinkedResourceId);
}
cache.StringSet($"{ASSOCIATION_CACHE_PREFIX}{aadten}-{name}", associations.Distinct().ToList().SerializeList(), TimeSpan.FromMinutes(Utils.GetIntEnvironmentVariable("CONSENT_CACHE_TTL_MINUTES", "60")));
}
//Loop through results load any consent records and validate no opt-out default is to allow
if (result.FHIRResourceType().Equals("Bundle"))
{
JArray entries = (JArray)result["entry"];
if (!entries.IsNullOrEmpty())
{
foreach (JToken tok in entries)
{
if (await denyAccess(tok["resource"], fhirClient, cache, associations, consent_category, req.Headers))
{
JObject denyObj = new JObject();
denyObj["resourceType"] = tok["resource"].FHIRResourceType();
denyObj["id"] = tok["resource"].FHIRResourceId();
denyObj["text"] = new JObject();
denyObj["text"]["status"] = "generated";
denyObj["text"]["div"] = "<div xmlns =\"http://www.w3.org/1999/xhtml\"><p>Patient has withheld access to this resource</p></div>";
tok["resource"] = denyObj;
}
}
}
}
else if (!result.FHIRResourceType().Equals("OperationalOutcome"))
{
if (await denyAccess(result, fhirClient, cache, associations, consent_category, req.Headers))
{
fr.Content = Utils.genOOErrResponse("access-denied", $"The patient has withheld access to this resource: {res + (id == null ? "" : "/" + id)}");
fr.StatusCode = System.Net.HttpStatusCode.Unauthorized;
return(new ProxyProcessResult(false, "access-denied", "", fr));
}
}
fr.Content = result.ToString();
return(new ProxyProcessResult(true, "", "", fr));
}
private async Task <bool> denyAccess(JToken resource, FHIRClient fhirclient, IDatabase cache, List <string> associations, string consentcat, IHeaderDictionary headers)
{
string patientId = null;
string rt = resource.FHIRResourceType();
//Check for Patient resource or load patient resource id from subject/patient member
if (rt.Equals("Patient"))
{
patientId = rt + "/" + (string)resource["id"];
}
if (patientId == null)
{
patientId = (string)resource?["subject"]?["reference"];
if (string.IsNullOrEmpty(patientId) || !patientId.StartsWith("Patient"))
{
patientId = (string)resource?["patient"]?["reference"];
}
}
//If no patient id present assume not tied to patient do not filter;
if (string.IsNullOrEmpty(patientId))
{
return(false);
}
//Load Cache if needed
List <string> denyactors = ((string)cache.StringGet($"{PATIENT_DENY_ACTORS_PREFIX}{patientId}")).DeSerializeList <string>();
if (denyactors == null)
{
//Fetch and Cache Deny access Consent Information
var pid = patientId.Split("/")[1];
var consentrecs = await fhirclient.LoadResource("Consent", "patient=" + pid + "&category=" + consentcat, true, headers);
var result = (JObject)consentrecs.Content;
if (result.FHIRResourceType().Equals("Bundle"))
{
JArray entries = (JArray)result["entry"];
if (!entries.IsNullOrEmpty())
{
denyactors = new List <string>();
foreach (JToken tok in entries)
{
var r = tok["resource"];
if (!r["provision"].IsNullOrEmpty())
{
//Check enforceemnt period
if (isEnforced(r["provision"]["period"]))
{
string type = (string)r["provision"]["type"];
//Load deny provisions only
if (type != null && type.Equals("deny"))
{
//Load actor references to deny
JArray actors = (JArray)r["provision"]["actors"];
if (!actors.IsNullOrEmpty())
{
foreach (JToken actor in actors)
{
denyactors.Add((string)actor["reference"]);
}
}
else
{
//Nobody specified so everybody is denied access this trumps all opt out advise
denyactors.Clear();
denyactors.Add("*");
break;
}
}
}
}
}
}
else
{
denyactors = new List <string>();
}
cache.StringSet($"{PATIENT_DENY_ACTORS_PREFIX}{patientId}", denyactors.Distinct().ToList().SerializeList(), TimeSpan.FromHours(Utils.GetIntEnvironmentVariable("CONSENT_CACHE_TTL_MINUTES", "60")));
}
}
//If there is an empty actor array that means there is no deny provision specified so return false to allow access
if (denyactors.Count == 0)
{
return(false);
}
//It there is a wildcard in first entry then everyone is denied return true
if (denyactors.First().Equals("*"))
{
return(true);
}
//Check for intersection of denied actors and associations of current user if found access will be denied
return(associations.Select(x => x)
.Intersect(denyactors)
.Any());
}
public async Task <ProxyProcessResult> Process(FHIRResponse response, HttpRequest req, ILogger log, ClaimsPrincipal principal, string res, string id, string hist, string vid)
{
FHIRResponse fr = response;
if (!req.Method.Equals("GET"))
{
return(new ProxyProcessResult(true, "", "", fr));
}
JObject result = (fr == null ? null : JObject.Parse(fr.ToString()));
if (fr == null)
{
log.LogInformation("ParticipantFilter: No FHIR Response found in context");
return(new ProxyProcessResult());
}
//Needed Variables
ClaimsIdentity ci = (ClaimsIdentity)principal.Identity;
string aadten = ci.Tenant();
string name = principal.Identity.Name;
bool admin = Utils.inServerAccessRole(req, "A");
List <string> resourceidentities = new List <string>();
List <string> inroles = ci.Roles();
List <string> fhirresourceroles = new List <string>();
fhirresourceroles.AddRange(Environment.GetEnvironmentVariable("FP-PARTICIPANT-ACCESS-ROLES").Split(","));
fhirresourceroles.AddRange(Environment.GetEnvironmentVariable("FP-PATIENT-ACCESS-ROLES").Split(","));
Dictionary <string, bool> porcache = new Dictionary <string, bool>();
FHIRClient fhirClient = FHIRClientFactory.getClient(log);
var table = Utils.getTable();
//Load linked Resource Identifiers from linkentities table for each known role the user is in
foreach (string r in inroles)
{
if (fhirresourceroles.Any(r.Equals))
{
var entity = Utils.getLinkEntity(table, r, aadten + "-" + name);
if (entity != null)
{
resourceidentities.Add(r + "/" + entity.LinkedResourceId);
}
}
}
if (!admin && !ci.IsInFHIRRole(Environment.GetEnvironmentVariable("FP-GLOBAL-ACCESS-ROLES")))
{
if (((string)result["resourceType"]).Equals("Bundle"))
{
JArray entries = (JArray)result["entry"];
if (!entries.IsNullOrEmpty())
{
foreach (JToken entry in entries)
{
if (!await IsAParticipantOrPatient(entry["resource"], fhirClient, resourceidentities, porcache, req.Headers))
{
JObject denyObj = new JObject();
denyObj["resourceType"] = entry["resource"].FHIRResourceType();
denyObj["id"] = entry["resource"].FHIRResourceId();
denyObj["text"] = new JObject();
denyObj["text"]["status"] = "generated";
denyObj["text"]["div"] = "<div xmlns =\"http://www.w3.org/1999/xhtml\"><p>You do not have access to data contained in this resource</p></div>";
entry["resource"] = denyObj;
}
}
}
}
else if (!((string)result["resourceType"]).Equals("OperationalOutcome"))
{
if (!await IsAParticipantOrPatient(result, fhirClient, resourceidentities, porcache, req.Headers))
{
fr.Content = Utils.genOOErrResponse("access-denied", $"You are not an authorized Paticipant in care and cannot access this resource: {res + (id == null ? "" : "/" + id)}");
fr.StatusCode = System.Net.HttpStatusCode.Unauthorized;
return(new ProxyProcessResult(false, "access-denied", "", fr));
}
}
}
fr.Content = result.ToString();
return(new ProxyProcessResult(true, "", "", fr));
}
private static async Task <bool> IsAParticipantOrPatient(JToken resource, FHIRClient fhirClient, IEnumerable <string> knownresourceIdentities, Dictionary <string, bool> porcache, IHeaderDictionary auditheaders)
{
string patientId = null;
string encounterId = null;
JToken patient = null;
JToken encounter = null;
string rt = (string)resource["resourceType"];
//Check for Patient resource or load patient resource from subject member
if (rt.Equals("Patient"))
{
patient = resource;
patientId = rt + "/" + (string)resource["id"];
}
if (patient == null)
{
patientId = (string)resource?["subject"]?["reference"];
if (string.IsNullOrEmpty(patientId))
{
patientId = (string)resource?["patient"]?["reference"];
}
}
if (rt.Equals("Encounter"))
{
encounter = resource;
encounterId = rt + "/" + (string)resource["id"];
patientId = (string)resource?["subject"]?["reference"];
}
if (encounter == null)
{
encounterId = (string)resource?["encounter"]?["reference"];
}
//If no patient or encounter records present assume not tied to patient do not filter;
if (patientId == null && encounterId == null)
{
return(true);
}
//See if patientId is in POR Cache
if (!string.IsNullOrEmpty(patientId) && porcache.ContainsKey(patientId))
{
return(porcache[patientId]);
}
if (!string.IsNullOrEmpty(encounterId) && porcache.ContainsKey(encounterId))
{
return(porcache[encounterId]);
}
//Load the patient if needed
if (patient == null)
{
if (!string.IsNullOrEmpty(patientId))
{
var pat = await fhirClient.LoadResource(patientId, null, false, auditheaders);
JObject temp = JObject.Parse((string)pat.Content);
if (temp != null && ((string)temp["resourceType"]).Equals("Patient"))
{
patient = temp;
}
else
{
porcache[patientId] = false;
return(false);
}
}
else if (!string.IsNullOrEmpty(encounterId) && patient == null)
{
var enc = await fhirClient.LoadResource(encounterId, null, false, auditheaders);
if (enc != null)
{
JObject temp = JObject.Parse((string)enc.Content);
if (temp != null && ((string)temp["resourceType"]).Equals("Encounter") && (string)temp["subject"]?["reference"] != null)
{
patientId = (string)temp["subject"]?["reference"];
var pat = await fhirClient.LoadResource(patientId, null, false, auditheaders);
JObject temp1 = JObject.Parse((string)pat.Content);
if (temp1 != null && ((string)temp1["resourceType"]).Equals("Patient"))
{
patient = temp1;
}
else
{
porcache[patientId] = false;
return(false);
}
}
else
{
porcache[encounterId] = false;
return(false);
}
}
}
else
{
//Cannot Determine/Find a Patient or Encounter reference assume it's not a patient reference
return(true);
}
}
foreach (string rid in knownresourceIdentities)
{
if (rid.StartsWith("Patient"))
{
string pid = rid;
if (pid.Equals(patientId))
{
porcache[patientId] = true;
if (!string.IsNullOrEmpty(encounterId))
{
porcache[encounterId] = true;
}
return(true);
}
}
else if (rid.StartsWith("Practitioner"))
{
if (patient["generalPractitioner"] != null)
{
var gp_s = from gp in patient["generalPractitioner"]
where (string)gp["reference"] == rid
select(string) gp["reference"];
if (gp_s != null && gp_s.Count() > 0)
{
porcache[patientId] = true;
if (!string.IsNullOrEmpty(encounterId))
{
porcache[encounterId] = true;
}
return(true);
}
}
string pid = rid.Split("/")[1];
string patid = (string)patient["id"];
var porencs = await fhirClient.LoadResource("Encounter", $"patient={patid}&participant={pid}", false, auditheaders);
if (porencs != null)
{
JObject temp2 = JObject.Parse((string)porencs.Content);
if (temp2 != null && ((string)temp2["resourceType"]).Equals("Bundle"))
{
JArray entries = (JArray)temp2["entry"];
if (entries != null && entries.Count > 0)
{
porcache[patientId] = true;
if (!string.IsNullOrEmpty(encounterId))
{
porcache[encounterId] = true;
}
return(true);
}
}
}
}
}
porcache[patientId] = false;
if (!string.IsNullOrEmpty(encounterId))
{
porcache[encounterId] = false;
}
return(false);
}
private async Task MessageReceivedAsync(IDialogContext context, IAwaitable <object> result)
{
var activity = await result as Activity;
string msg = activity.Text.Trim().ToLower();
if (msg == "start over" || msg == "exit" || msg == "quit" || msg == "done" || msg == "start again" || msg == "restart" || msg == "leave" || msg == "reset" || msg == "bye" || msg == "goodbye")
{
context.PrivateConversationData.Clear();
await context.PostAsync($"Ending your session...Dont' forget to delete your conversation for privacy!");
context.Done("");
}
else
{
model.Patient pat = null;
// Within the code body set your variable
string fhirserver = CloudConfigurationManager.GetSetting("FHIRServerAddress");
string fhirtenant = CloudConfigurationManager.GetSetting("FHIRAADTenant");
string fhirclientid = CloudConfigurationManager.GetSetting("FHIRClientId");
string fhirclientsecret = CloudConfigurationManager.GetSetting("FHIRClientSecret");
FHIRClient fhirclient = new FHIRClient(fhirserver, fhirtenant, fhirclientid, fhirclientsecret);
var rslt = (model.Bundle)fhirclient.LoadResource("Patient", "identifier=http://fhirbot.org|" + activity.Text.Trim());
if (rslt != null && rslt.Entry != null && rslt.Entry.Count > 0)
{
pat = (model.Patient)rslt.Entry.FirstOrDefault().Resource;
if (pat != null)
{
var fbid = pat.Identifier.Single(ident => ident.System == "http://fhirbot.org");
if (fbid != null)
{
var period = fbid.Period;
var now = model.FhirDateTime.Now();
if (period != null && (now > period.EndElement))
{
//Use Period Expired remove the token from the patient and update db
pat.Identifier.Remove(fbid);
fhirclient.SaveResource(pat);
pat = null;
context.PrivateConversationData.Clear();
}
}
}
}
if (pat != null)
{
// Set BotUserData
context.PrivateConversationData.SetValue <string>(
"id", pat.Id);
context.PrivateConversationData.SetValue <string>(
"name", pat.Name[0].Text);
context.PrivateConversationData.SetValue <DateTime?>(
"sessionstart", DateTime.Now);
context.PrivateConversationData.SetValue <string>("bearertoken", fhirclient.BearerToken);
context.PrivateConversationData.SetValue <string>("fhirserver", fhirserver);
context.Done(pat.Name[0].Text);
}
else
{
context.Fail(new InvalidPINException("Not a valid PIN Code"));
}
}
}
