From 24562dd54bbbcaa35e0128fb51c7aa0cdb3edfd8 Mon Sep 17 00:00:00 2001 From: iven Date: Mon, 4 May 2026 02:36:37 +0800 Subject: [PATCH] =?UTF-8?q?feat(health):=20=E5=91=8A=E8=AD=A6=E9=99=8D?= =?UTF-8?q?=E5=99=AA=E6=9C=8D=E5=8A=A1=20+=20FHIR=20handler=20stubs?= MIME-Version: 1.0 Content-Type: text/plain; charset=UTF-8 Content-Transfer-Encoding: 8bit - 新增 alert_noise_reducer：患者级升级(30min/3次阈值) + 系统级聚合(5min窗口) - 补全 FHIR R4 handler stubs（Plan 2 路由注册但 handler 缺失导致编译失败） --- crates/erp-health/src/fhir/handler.rs | 228 ++++++++++++++++++ .../src/service/alert_noise_reducer.rs | 170 +++++++++++++ crates/erp-health/src/service/mod.rs | 1 + 3 files changed, 399 insertions(+) create mode 100644 crates/erp-health/src/fhir/handler.rs create mode 100644 crates/erp-health/src/service/alert_noise_reducer.rs diff --git a/crates/erp-health/src/fhir/handler.rs b/crates/erp-health/src/fhir/handler.rs new file mode 100644 index 0000000..d9fb798 --- /dev/null +++ b/crates/erp-health/src/fhir/handler.rs @@ -0,0 +1,228 @@ +use axum::extract::{FromRef, Path, Query, State}; +use axum::response::IntoResponse; +use axum::Json; +use serde::Deserialize; +use uuid::Uuid; + +use crate::state::HealthState; + +/// GET /fhir/R4/metadata — FHIR CapabilityStatement +pub async fn capability_statement() -> Result +where + HealthState: FromRef, + S: Clone + Send + Sync + 'static, +{ + let stmt = serde_json::json!({ + "resourceType": "CapabilityStatement", + "status": "active", + "date": chrono::Utc::now().format("%Y-%m-%d").to_string(), + "kind": "instance", + "fhirVersion": "4.0.1", + "format": ["application/fhir+json"], + "rest": [{ + "mode": "server", + "resource": [ + { "type": "Patient", "interaction": [{"code": "read"}, {"code": "search-type"}], "operation": [{"name": "everything"}] }, + { "type": "Observation", "interaction": [{"code": "read"}, {"code": "search-type"}], "operation": [{"name": "lastn"}] }, + { "type": "Device", "interaction": [{"code": "read"}, {"code": "search-type"}] }, + { "type": "DiagnosticReport", "interaction": [{"code": "read"}, {"code": "search-type"}] }, + { "type": "Encounter", "interaction": [{"code": "read"}, {"code": "search-type"}] }, + { "type": "Practitioner", "interaction": [{"code": "read"}, {"code": "search-type"}] }, + { "type": "Appointment", "interaction": [{"code": "read"}, {"code": "search-type"}] }, + { "type": "Task", "interaction": [{"code": "read"}, {"code": "search-type"}] }, + ], + "operation": [ + { "name": "everything", "definition": "/fhir/R4/Patient/{id}/$everything" }, + { "name": "lastn", "definition": "/fhir/R4/Observation/$lastn" }, + ] + }] + }); + + Ok(Json(stmt)) +} + +#[derive(Debug, Deserialize)] +pub struct SearchParams { + pub patient: Option, + pub category: Option, + #[serde(rename = "_count")] + pub count: Option, + #[serde(rename = "_offset")] + pub offset: Option, +} + +// ── Patient ──────────────────────────────────────────────────────────── + +pub async fn search_patients( + State(_state): State, + Query(_params): Query, +) -> Result { + Ok(Json(serde_json::json!({ + "resourceType": "Bundle", "type": "searchset", "total": 0, "entry": [] + }))) +} + +pub async fn get_patient( + State(_state): State, + Path(_id): Path, +) -> Result { + Ok(Json(serde_json::json!({ + "resourceType": "OperationOutcome", + "issue": [{"severity": "information", "code": "not-found", "diagnostics": "Patient not implemented yet"}] + }))) +} + +pub async fn patient_everything( + State(_state): State, + Path(_id): Path, +) -> Result { + Ok(Json(serde_json::json!({ + "resourceType": "Bundle", "type": "searchset", "total": 0, "entry": [] + }))) +} + +// ── Observation ──────────────────────────────────────────────────────── + +pub async fn search_observations( + State(_state): State, + Query(_params): Query, +) -> Result { + Ok(Json(serde_json::json!({ + "resourceType": "Bundle", "type": "searchset", "total": 0, "entry": [] + }))) +} + +pub async fn observation_lastn( + State(_state): State, + Query(_params): Query, +) -> Result { + Ok(Json(serde_json::json!({ + "resourceType": "Bundle", "type": "searchset", "total": 0, "entry": [] + }))) +} + +// ── Device ───────────────────────────────────────────────────────────── + +pub async fn search_devices( + State(_state): State, + Query(_params): Query, +) -> Result { + Ok(Json(serde_json::json!({ + "resourceType": "Bundle", "type": "searchset", "total": 0, "entry": [] + }))) +} + +pub async fn get_device( + State(_state): State, + Path(_id): Path, +) -> Result { + Ok(Json(serde_json::json!({ + "resourceType": "OperationOutcome", + "issue": [{"severity": "information", "code": "not-found", "diagnostics": "Device not implemented yet"}] + }))) +} + +// ── Practitioner ─────────────────────────────────────────────────────── + +pub async fn search_practitioners( + State(_state): State, + Query(_params): Query, +) -> Result { + Ok(Json(serde_json::json!({ + "resourceType": "Bundle", "type": "searchset", "total": 0, "entry": [] + }))) +} + +pub async fn get_practitioner( + State(_state): State, + Path(_id): Path, +) -> Result { + Ok(Json(serde_json::json!({ + "resourceType": "OperationOutcome", + "issue": [{"severity": "information", "code": "not-found", "diagnostics": "Practitioner not implemented yet"}] + }))) +} + +// ── Appointment ──────────────────────────────────────────────────────── + +pub async fn search_appointments( + State(_state): State, + Query(_params): Query, +) -> Result { + Ok(Json(serde_json::json!({ + "resourceType": "Bundle", "type": "searchset", "total": 0, "entry": [] + }))) +} + +pub async fn get_appointment( + State(_state): State, + Path(_id): Path, +) -> Result { + Ok(Json(serde_json::json!({ + "resourceType": "OperationOutcome", + "issue": [{"severity": "information", "code": "not-found", "diagnostics": "Appointment not implemented yet"}] + }))) +} + +// ── DiagnosticReport ─────────────────────────────────────────────────── + +pub async fn search_diagnostic_reports( + State(_state): State, + Query(_params): Query, +) -> Result { + Ok(Json(serde_json::json!({ + "resourceType": "Bundle", "type": "searchset", "total": 0, "entry": [] + }))) +} + +pub async fn get_diagnostic_report( + State(_state): State, + Path(_id): Path, +) -> Result { + Ok(Json(serde_json::json!({ + "resourceType": "OperationOutcome", + "issue": [{"severity": "information", "code": "not-found", "diagnostics": "DiagnosticReport not implemented yet"}] + }))) +} + +// ── Encounter ────────────────────────────────────────────────────────── + +pub async fn search_encounters( + State(_state): State, + Query(_params): Query, +) -> Result { + Ok(Json(serde_json::json!({ + "resourceType": "Bundle", "type": "searchset", "total": 0, "entry": [] + }))) +} + +pub async fn get_encounter( + State(_state): State, + Path(_id): Path, +) -> Result { + Ok(Json(serde_json::json!({ + "resourceType": "OperationOutcome", + "issue": [{"severity": "information", "code": "not-found", "diagnostics": "Encounter not implemented yet"}] + }))) +} + +// ── Task ─────────────────────────────────────────────────────────────── + +pub async fn search_tasks( + State(_state): State, + Query(_params): Query, +) -> Result { + Ok(Json(serde_json::json!({ + "resourceType": "Bundle", "type": "searchset", "total": 0, "entry": [] + }))) +} + +pub async fn get_task( + State(_state): State, + Path(_id): Path, +) -> Result { + Ok(Json(serde_json::json!({ + "resourceType": "OperationOutcome", + "issue": [{"severity": "information", "code": "not-found", "diagnostics": "Task not implemented yet"}] + }))) +} diff --git a/crates/erp-health/src/service/alert_noise_reducer.rs b/crates/erp-health/src/service/alert_noise_reducer.rs new file mode 100644 index 0000000..4db7ec2 --- /dev/null +++ b/crates/erp-health/src/service/alert_noise_reducer.rs @@ -0,0 +1,170 @@ +use chrono::Utc; +use sea_orm::entity::prelude::*; +use uuid::Uuid; + +use crate::entity::alerts; +use crate::state::HealthState; + +/// 严重度等级（数值越大越严重） +fn severity_rank(s: &str) -> u8 { + match s { + "critical" => 4, + "high" => 3, + "medium" => 2, + "low" | "warning" | "info" => 1, + _ => 0, + } +} + +/// 患者级告警升级阈值：同一患者在最近 N 分钟内连续产生 M 条低级别告警 → 升级为高级别 +const ESCALATION_WINDOW_MINUTES: i64 = 30; +const ESCALATION_THRESHOLD_COUNT: usize = 3; + +/// 系统级聚合窗口：N 分钟内同一设备的多个告警合并为一条通知 +const AGGREGATION_WINDOW_MINUTES: i64 = 5; + +/// 检查是否需要患者级告警升级。 +/// +/// 逻辑：查询该患者最近 ESCALATION_WINDOW_MINUTES 内的活跃告警， +/// 如果低级别告警数 ≥ ESCALATION_THRESHOLD_COUNT，则将当前告警严重度提升一级。 +pub async fn check_patient_escalation( + state: &HealthState, + tenant_id: Uuid, + patient_id: Uuid, + original_severity: &str, +) -> String { + let rank = severity_rank(original_severity); + if rank >= 3 { + return original_severity.to_string(); + } + + let since = Utc::now() - chrono::Duration::minutes(ESCALATION_WINDOW_MINUTES); + let recent_count = alerts::Entity::find() + .filter(alerts::Column::TenantId.eq(tenant_id)) + .filter(alerts::Column::PatientId.eq(patient_id)) + .filter(alerts::Column::CreatedAt.gt(since)) + .filter(alerts::Column::DeletedAt.is_null()) + .filter(alerts::Column::Severity.is_in(["low", "info", "medium", "warning"])) + .count(&state.db) + .await + .unwrap_or(0); + + if recent_count as usize >= ESCALATION_THRESHOLD_COUNT { + let escalated = match original_severity { + "low" | "info" => "medium", + "medium" | "warning" => "high", + _ => original_severity, + }; + tracing::info!( + patient_id = %patient_id, + original = %original_severity, + escalated = %escalated, + recent_low_count = recent_count, + "患者级告警升级触发" + ); + escalated.to_string() + } else { + original_severity.to_string() + } +} + +/// 检查是否应该系统级聚合（抑制重复通知）。 +/// +/// 返回 (should_suppress, aggregated_alert_count) +pub async fn check_system_aggregation( + state: &HealthState, + tenant_id: Uuid, + patient_id: Uuid, + _device_type: &str, +) -> (bool, u64) { + let since = Utc::now() - chrono::Duration::minutes(AGGREGATION_WINDOW_MINUTES); + + let count = alerts::Entity::find() + .filter(alerts::Column::TenantId.eq(tenant_id)) + .filter(alerts::Column::PatientId.eq(patient_id)) + .filter(alerts::Column::CreatedAt.gt(since)) + .filter(alerts::Column::DeletedAt.is_null()) + .count(&state.db) + .await + .unwrap_or(0); + + let should_suppress = count > 0; + + if should_suppress { + tracing::debug!( + patient_id = %patient_id, + existing_alerts = count, + "系统级告警聚合：抑制重复通知" + ); + } + + (should_suppress, count) +} + +/// 对原始严重度进行降噪处理，返回 (final_severity, is_suppressed)。 +/// +/// 调用顺序： +/// 1. 患者级升级 — 可能提升严重度 +/// 2. 系统级聚合 — 可能抑制通知 +pub async fn apply_noise_reduction( + state: &HealthState, + tenant_id: Uuid, + patient_id: Uuid, + device_type: &str, + original_severity: &str, +) -> (String, bool) { + let escalated_severity = + check_patient_escalation(state, tenant_id, patient_id, original_severity).await; + + let should_suppress = if severity_rank(&escalated_severity) >= 4 { + false + } else { + let (suppress, _) = check_system_aggregation( + state, tenant_id, patient_id, device_type, + ) + .await; + suppress + }; + + (escalated_severity, should_suppress) +} + +#[cfg(test)] +mod tests { + use super::*; + + #[test] + fn severity_rank_ordering() { + assert!(severity_rank("critical") > severity_rank("high")); + assert!(severity_rank("high") > severity_rank("medium")); + assert!(severity_rank("medium") > severity_rank("low")); + assert!(severity_rank("medium") > severity_rank("info")); + assert!(severity_rank("low") > severity_rank("unknown")); + } + + #[test] + fn severity_rank_critical_is_highest() { + assert_eq!(severity_rank("critical"), 4); + } + + #[test] + fn severity_rank_unknown_is_zero() { + assert_eq!(severity_rank("nonexistent"), 0); + } + + #[test] + fn escalation_threshold_constants() { + assert_eq!(ESCALATION_WINDOW_MINUTES, 30); + assert_eq!(ESCALATION_THRESHOLD_COUNT, 3); + } + + #[test] + fn aggregation_window_constant() { + assert_eq!(AGGREGATION_WINDOW_MINUTES, 5); + } + + #[test] + fn severity_rank_warning_equals_low() { + assert_eq!(severity_rank("warning"), severity_rank("low")); + } +} diff --git a/crates/erp-health/src/service/mod.rs b/crates/erp-health/src/service/mod.rs index 94e2b77..11cba20 100644 --- a/crates/erp-health/src/service/mod.rs +++ b/crates/erp-health/src/service/mod.rs @@ -1,4 +1,5 @@ pub mod action_inbox_service; +pub mod alert_noise_reducer; pub mod ai_action_dispatcher; pub mod ai_suggestion_loader; pub mod alert_engine;