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import { getServerSession } from "next-auth/next";
import { authOptions } from "@/lib/auth";
import { runQuery } from "@/lib/neo4j";
export const dynamic = "force-dynamic";
/**
* Maps demo patient usernames to their assigned FHIR Patient resource IDs.
* In production this would come from an identity provider claim or mapping table.
* patient1 = first Synthea patient (AlphaKlinik Berlin)
* patient2 = second Synthea patient (Limburg Medical Centre)
*/
const PATIENT_RESOURCE_MAP: Record<string, number> = {
patient1: 0, // first patient by name order
patient2: 1, // second patient by name order
};
/**
* Sensitive clinical entries that should not appear in a patient-facing EHR view.
* Synthea generates death certificates, autopsy, and hospice entries for deceased
* patients — these are inappropriate for patient self-service portals.
* Researchers and admins see unfiltered data via /analytics or /graph.
*/
const FILTERED_DISPLAYS = [
"cause of death",
"death certification",
"certificate of death",
"autopsy",
"hospice",
"sudden cardiac death",
] as const;
export async function GET(req: Request) {
try {
const { searchParams } = new URL(req.url);
const patientId = searchParams.get("patientId") ?? "";
// Check session for PATIENT role restriction
const session = await getServerSession(authOptions);
const roles = (session as { roles?: string[] } | null)?.roles ?? [];
const username = session?.user?.name ?? "";
const isPatientRole =
roles.includes("PATIENT") && !roles.includes("EDC_ADMIN");
// List mode: return patients + cohort stats
if (!patientId) {
Iif (isPatientRole) {
// PATIENT role: only return their own record (EHDS Art. 3 / GDPR Art. 15)
const patientIndex = PATIENT_RESOURCE_MAP[username] ?? 0;
const allPatients = await runQuery<{
id: string;
name: string;
gender: string;
birthDate: string;
}>(
`MATCH (p:Patient)
WHERE coalesce(p.id, p.resourceId) IS NOT NULL
RETURN coalesce(p.id, p.resourceId) AS id,
p.name AS name,
p.gender AS gender,
p.birthDate AS birthDate
ORDER BY p.name
LIMIT 200`,
);
// Pick only the patient's own record
const myPatient =
patientIndex < allPatients.length
? [allPatients[patientIndex]]
: allPatients.slice(0, 1);
// Stats for just this patient
const myId = myPatient[0]?.id;
const myStats = myId
? await runQuery<{
encounters: number;
conditions: number;
observations: number;
medications: number;
procedures: number;
}>(
`MATCH (p:Patient) WHERE coalesce(p.id, p.resourceId) = $myId
OPTIONAL MATCH (p)-[:HAS_ENCOUNTER]->(e:Encounter)
WITH p, count(e) AS encounters
OPTIONAL MATCH (p)-[:HAS_CONDITION]->(c:Condition)
WITH p, encounters, count(c) AS conditions
OPTIONAL MATCH (p)-[:HAS_OBSERVATION]->(o:Observation)
WITH p, encounters, conditions, count(o) AS observations
OPTIONAL MATCH (p)-[:HAS_MEDICATION|HAS_MEDICATION_REQUEST]->(m:MedicationRequest)
WITH p, encounters, conditions, observations, count(m) AS medications
OPTIONAL MATCH (p)-[:HAS_PROCEDURE]->(pr:Procedure)
RETURN encounters, conditions, observations, medications, count(pr) AS procedures`,
{ myId },
)
: [];
return NextResponse.json({
patients: myPatient,
stats: {
patients: 1,
...(myStats[0] ?? {
encounters: 0,
conditions: 0,
observations: 0,
medications: 0,
procedures: 0,
}),
},
timeline: [],
restricted: true, // signal to the UI that patient selector should be hidden
});
}
// Non-patient roles: return all patients + full cohort stats
const [patients, stats] = await Promise.all([
runQuery<{
id: string;
name: string;
gender: string;
birthDate: string;
}>(
`MATCH (p:Patient)
WHERE coalesce(p.id, p.resourceId) IS NOT NULL
RETURN coalesce(p.id, p.resourceId) AS id,
p.name AS name,
p.gender AS gender,
p.birthDate AS birthDate
ORDER BY p.name
LIMIT 200`,
),
runQuery<{
patients: number;
encounters: number;
conditions: number;
observations: number;
medications: number;
procedures: number;
}>(
`MATCH (p:Patient) WITH count(p) AS patients
MATCH (e:Encounter) WITH patients, count(e) AS encounters
MATCH (c:Condition) WITH patients, encounters, count(c) AS conditions
MATCH (o:Observation) WITH patients, encounters, conditions, count(o) AS observations
OPTIONAL MATCH (m:MedicationRequest) WITH patients, encounters, conditions, observations, count(m) AS medications
OPTIONAL MATCH (pr:Procedure)
RETURN patients, encounters, conditions, observations, medications, count(pr) AS procedures`,
),
]);
return NextResponse.json({
patients,
stats: stats[0] ?? {},
timeline: [],
restricted: false,
});
}
// Timeline mode: FHIR clinical events + OMOP mappings for one patient
// If PATIENT role, verify they're requesting their own record
Iif (isPatientRole) {
const patientIndex = PATIENT_RESOURCE_MAP[username] ?? 0;
const allPatients = await runQuery<{ id: string }>(
`MATCH (p:Patient)
WHERE coalesce(p.id, p.resourceId) IS NOT NULL
RETURN coalesce(p.id, p.resourceId) AS id
ORDER BY p.name LIMIT 200`,
);
const myId =
patientIndex < allPatients.length
? allPatients[patientIndex].id
: allPatients[0]?.id;
if (patientId !== myId) {
return NextResponse.json(
{ error: "Access denied — you can only view your own health data" },
{ status: 403 },
);
}
}
const rows = await runQuery<{
fhirType: string;
fhirId: string;
date: string;
display: string;
omopType: string;
omopId: string;
}>(
`MATCH (p:Patient)
WHERE coalesce(p.id, p.resourceId) = $patientId
MATCH (p)-[:HAS_ENCOUNTER|HAS_CONDITION|HAS_OBSERVATION|HAS_MEDICATION|HAS_MEDICATION_REQUEST|HAS_PROCEDURE]->(fhir)
OPTIONAL MATCH (fhir)-[:MAPPED_TO]->(omop)
RETURN labels(fhir)[0] AS fhirType,
coalesce(fhir.id, fhir.resourceId) AS fhirId,
coalesce(fhir.date, fhir.onsetDate, fhir.dateTime, fhir.performedStart) AS date,
coalesce(fhir.display, fhir.name, fhir.code) AS display,
labels(omop)[0] AS omopType,
coalesce(omop.id, omop.personId, omop.visitOccurrenceId,
omop.conditionOccurrenceId, omop.measurementId,
omop.drugExposureId) AS omopId
ORDER BY date`,
{ patientId },
);
// Filter out sensitive end-of-life entries (death certificates, hospice, autopsy)
// that Synthea generates for deceased synthetic patients.
// These are inappropriate for patient-facing EHR views.
const filtered = rows.filter((row) => {
Iif (!row.display) return true;
const lower = row.display.toLowerCase();
return !FILTERED_DISPLAYS.some((term) => lower.includes(term));
});
return NextResponse.json({ timeline: filtered });
} catch (err) {
console.error("GET /api/patient error:", err);
return NextResponse.json({ error: "Neo4j unavailable" }, { status: 502 });
}
}
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