@erosolaraijs/cure 1.0.0

package/dist/integrations/clinicalTrials/clinicalTrialsGov.js.map

@@ -0,0 +1 @@
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package/dist/integrations/ehr/fhir.d.ts

@@ -0,0 +1,455 @@
+/**
+ * HL7 FHIR Integration Layer
+ *
+ * Connects to Electronic Health Record systems using the FHIR R4 standard.
+ * Supports Epic, Cerner, AllScripts, and other FHIR-compliant EHR systems.
+ *
+ * IMPORTANT: This module requires proper HIPAA compliance setup before use.
+ * All PHI access must be logged and patient consent must be verified.
+ */
+import { EventEmitter } from 'events';
+export interface FHIRConfig {
+    baseUrl: string;
+    clientId: string;
+    clientSecret?: string;
+    scopes: string[];
+    authType: 'smart-on-fhir' | 'basic' | 'oauth2' | 'client-credentials';
+    ehrVendor: 'epic' | 'cerner' | 'allscripts' | 'meditech' | 'generic';
+    timeout?: number;
+    retryAttempts?: number;
+}
+export interface FHIRPatient {
+    resourceType: 'Patient';
+    id: string;
+    identifier: FHIRIdentifier[];
+    name: FHIRHumanName[];
+    gender: 'male' | 'female' | 'other' | 'unknown';
+    birthDate: string;
+    address?: FHIRAddress[];
+    telecom?: FHIRContactPoint[];
+    maritalStatus?: FHIRCodeableConcept;
+    communication?: {
+        language: FHIRCodeableConcept;
+        preferred?: boolean;
+    }[];
+    extension?: FHIRExtension[];
+}
+export interface FHIRIdentifier {
+    system: string;
+    value: string;
+    type?: FHIRCodeableConcept;
+    use?: 'usual' | 'official' | 'temp' | 'secondary' | 'old';
+}
+export interface FHIRHumanName {
+    use?: 'usual' | 'official' | 'temp' | 'nickname' | 'anonymous' | 'old' | 'maiden';
+    family?: string;
+    given?: string[];
+    prefix?: string[];
+    suffix?: string[];
+}
+export interface FHIRAddress {
+    use?: 'home' | 'work' | 'temp' | 'old' | 'billing';
+    type?: 'postal' | 'physical' | 'both';
+    line?: string[];
+    city?: string;
+    state?: string;
+    postalCode?: string;
+    country?: string;
+}
+export interface FHIRContactPoint {
+    system?: 'phone' | 'fax' | 'email' | 'pager' | 'url' | 'sms' | 'other';
+    value?: string;
+    use?: 'home' | 'work' | 'temp' | 'old' | 'mobile';
+}
+export interface FHIRCodeableConcept {
+    coding?: FHIRCoding[];
+    text?: string;
+}
+export interface FHIRCoding {
+    system?: string;
+    version?: string;
+    code?: string;
+    display?: string;
+}
+export interface FHIRExtension {
+    url: string;
+    valueString?: string;
+    valueCode?: string;
+    valueDecimal?: number;
+    valueBoolean?: boolean;
+    valueCoding?: FHIRCoding;
+}
+export interface FHIRCondition {
+    resourceType: 'Condition';
+    id: string;
+    clinicalStatus: FHIRCodeableConcept;
+    verificationStatus: FHIRCodeableConcept;
+    category: FHIRCodeableConcept[];
+    severity?: FHIRCodeableConcept;
+    code: FHIRCodeableConcept;
+    bodySite?: FHIRCodeableConcept[];
+    subject: FHIRReference;
+    onsetDateTime?: string;
+    recordedDate?: string;
+    stage?: {
+        summary?: FHIRCodeableConcept;
+        assessment?: FHIRReference[];
+        type?: FHIRCodeableConcept;
+    }[];
+    evidence?: {
+        code?: FHIRCodeableConcept[];
+        detail?: FHIRReference[];
+    }[];
+}
+export interface FHIRObservation {
+    resourceType: 'Observation';
+    id: string;
+    status: 'registered' | 'preliminary' | 'final' | 'amended' | 'corrected' | 'cancelled' | 'entered-in-error' | 'unknown';
+    category?: FHIRCodeableConcept[];
+    code: FHIRCodeableConcept;
+    subject: FHIRReference;
+    effectiveDateTime?: string;
+    valueQuantity?: FHIRQuantity;
+    valueCodeableConcept?: FHIRCodeableConcept;
+    valueString?: string;
+    interpretation?: FHIRCodeableConcept[];
+    referenceRange?: {
+        low?: FHIRQuantity;
+        high?: FHIRQuantity;
+        type?: FHIRCodeableConcept;
+        text?: string;
+    }[];
+    component?: {
+        code: FHIRCodeableConcept;
+        valueQuantity?: FHIRQuantity;
+        valueCodeableConcept?: FHIRCodeableConcept;
+        valueString?: string;
+    }[];
+}
+export interface FHIRQuantity {
+    value?: number;
+    comparator?: '<' | '<=' | '>=' | '>';
+    unit?: string;
+    system?: string;
+    code?: string;
+}
+export interface FHIRReference {
+    reference?: string;
+    type?: string;
+    identifier?: FHIRIdentifier;
+    display?: string;
+}
+export interface FHIRMedicationRequest {
+    resourceType: 'MedicationRequest';
+    id: string;
+    status: 'active' | 'on-hold' | 'cancelled' | 'completed' | 'entered-in-error' | 'stopped' | 'draft' | 'unknown';
+    intent: 'proposal' | 'plan' | 'order' | 'original-order' | 'reflex-order' | 'filler-order' | 'instance-order' | 'option';
+    medicationCodeableConcept?: FHIRCodeableConcept;
+    medicationReference?: FHIRReference;
+    subject: FHIRReference;
+    authoredOn?: string;
+    requester?: FHIRReference;
+    dosageInstruction?: FHIRDosage[];
+}
+export interface FHIRDosage {
+    sequence?: number;
+    text?: string;
+    timing?: {
+        repeat?: {
+            frequency?: number;
+            period?: number;
+            periodUnit?: 's' | 'min' | 'h' | 'd' | 'wk' | 'mo' | 'a';
+        };
+    };
+    route?: FHIRCodeableConcept;
+    doseAndRate?: {
+        doseQuantity?: FHIRQuantity;
+        rateQuantity?: FHIRQuantity;
+    }[];
+}
+export interface FHIRDiagnosticReport {
+    resourceType: 'DiagnosticReport';
+    id: string;
+    status: 'registered' | 'partial' | 'preliminary' | 'final' | 'amended' | 'corrected' | 'appended' | 'cancelled' | 'entered-in-error' | 'unknown';
+    category?: FHIRCodeableConcept[];
+    code: FHIRCodeableConcept;
+    subject: FHIRReference;
+    effectiveDateTime?: string;
+    issued?: string;
+    performer?: FHIRReference[];
+    result?: FHIRReference[];
+    conclusion?: string;
+    conclusionCode?: FHIRCodeableConcept[];
+    presentedForm?: {
+        contentType?: string;
+        data?: string;
+        url?: string;
+        title?: string;
+    }[];
+}
+export interface FHIRProcedure {
+    resourceType: 'Procedure';
+    id: string;
+    status: 'preparation' | 'in-progress' | 'not-done' | 'on-hold' | 'stopped' | 'completed' | 'entered-in-error' | 'unknown';
+    code: FHIRCodeableConcept;
+    subject: FHIRReference;
+    performedDateTime?: string;
+    performedPeriod?: {
+        start?: string;
+        end?: string;
+    };
+    performer?: {
+        actor: FHIRReference;
+        function?: FHIRCodeableConcept;
+    }[];
+    bodySite?: FHIRCodeableConcept[];
+    outcome?: FHIRCodeableConcept;
+    report?: FHIRReference[];
+}
+export interface FHIRBundle {
+    resourceType: 'Bundle';
+    id?: string;
+    type: 'document' | 'message' | 'transaction' | 'transaction-response' | 'batch' | 'batch-response' | 'history' | 'searchset' | 'collection';
+    total?: number;
+    link?: {
+        relation: string;
+        url: string;
+    }[];
+    entry?: {
+        fullUrl?: string;
+        resource?: FHIRResource;
+        search?: {
+            mode?: 'match' | 'include' | 'outcome';
+            score?: number;
+        };
+    }[];
+}
+export type FHIRResource = FHIRPatient | FHIRCondition | FHIRObservation | FHIRMedicationRequest | FHIRDiagnosticReport | FHIRProcedure | FHIRBundle;
+export interface CancerDiagnosis {
+    patientId: string;
+    conditionId: string;
+    cancerType: string;
+    icdCode: string;
+    snomedCode?: string;
+    histology?: string;
+    primarySite?: string;
+    laterality?: 'left' | 'right' | 'bilateral' | 'not-applicable';
+    stage?: {
+        system: 'ajcc' | 'figo' | 'rai' | 'binet' | 'iss' | 'other';
+        stage: string;
+        tnm?: {
+            t?: string;
+            n?: string;
+            m?: string;
+        };
+        grade?: string;
+    };
+    diagnosisDate: Date;
+    verificationStatus: 'confirmed' | 'provisional' | 'differential' | 'refuted';
+}
+export interface CancerBiomarkers {
+    patientId: string;
+    collectionDate: Date;
+    biomarkers: {
+        name: string;
+        value: string | number;
+        unit?: string;
+        status: 'positive' | 'negative' | 'equivocal' | 'not-tested';
+        method?: string;
+        loincCode?: string;
+    }[];
+    genomicAlterations?: {
+        gene: string;
+        alteration: string;
+        type: 'mutation' | 'amplification' | 'deletion' | 'fusion' | 'rearrangement';
+        variantAlleleFrequency?: number;
+        pathogenicity?: 'pathogenic' | 'likely-pathogenic' | 'vus' | 'likely-benign' | 'benign';
+    }[];
+    tumorMutationalBurden?: {
+        value: number;
+        unit: 'mutations/Mb';
+        status: 'high' | 'intermediate' | 'low';
+        threshold?: number;
+    };
+    microsatelliteInstability?: {
+        status: 'MSI-H' | 'MSI-L' | 'MSS';
+        method: 'PCR' | 'NGS' | 'IHC';
+    };
+    pdl1Expression?: {
+        score: number;
+        scoreType: 'TPS' | 'CPS' | 'IC';
+        antibody?: string;
+    };
+    hrdStatus?: {
+        status: 'positive' | 'negative';
+        score?: number;
+        components?: {
+            loh?: number;
+            tai?: number;
+            lst?: number;
+        };
+    };
+}
+export interface TreatmentHistory {
+    patientId: string;
+    treatments: {
+        id: string;
+        type: 'chemotherapy' | 'immunotherapy' | 'targeted-therapy' | 'radiation' | 'surgery' | 'hormone-therapy' | 'car-t' | 'other';
+        regimen?: string;
+        drugs?: {
+            name: string;
+            dose?: string;
+            route?: string;
+            rxNormCode?: string;
+        }[];
+        startDate: Date;
+        endDate?: Date;
+        status: 'planned' | 'active' | 'completed' | 'stopped' | 'on-hold';
+        cycles?: number;
+        response?: 'CR' | 'PR' | 'SD' | 'PD' | 'NE';
+        responseDate?: Date;
+        reasonStopped?: string;
+        adverseEvents?: {
+            name: string;
+            grade: number;
+            ctcaeCode?: string;
+        }[];
+    }[];
+}
+export declare class FHIRClient extends EventEmitter {
+    private config;
+    private accessToken?;
+    private tokenExpiry?;
+    private auditLogger?;
+    constructor(config: FHIRConfig);
+    /**
+     * Set audit logger for HIPAA compliance
+     */
+    setAuditLogger(logger: (event: AuditEvent) => Promise<void>): void;
+    /**
+     * Authenticate with the FHIR server
+     */
+    authenticate(): Promise<void>;
+    private smartOnFhirAuth;
+    private clientCredentialsAuth;
+    private oauth2Auth;
+    private discoverTokenEndpoint;
+    /**
+     * Get a patient by ID
+     */
+    getPatient(patientId: string): Promise<FHIRPatient>;
+    /**
+     * Search for patients
+     */
+    searchPatients(params: Record<string, string>): Promise<FHIRBundle>;
+    /**
+     * Get cancer diagnosis for a patient
+     */
+    getCancerDiagnosis(patientId: string): Promise<CancerDiagnosis[]>;
+    /**
+     * Get biomarkers and genomic data for a patient
+     */
+    getBiomarkers(patientId: string): Promise<CancerBiomarkers | null>;
+    /**
+     * Get treatment history for a patient
+     */
+    getTreatmentHistory(patientId: string): Promise<TreatmentHistory>;
+    /**
+     * Get all observations for a patient
+     */
+    getObservations(patientId: string, category?: string): Promise<FHIRObservation[]>;
+    /**
+     * Get all medications for a patient
+     */
+    getMedications(patientId: string): Promise<FHIRMedicationRequest[]>;
+    /**
+     * Get diagnostic reports for a patient
+     */
+    getDiagnosticReports(patientId: string): Promise<FHIRDiagnosticReport[]>;
+    /**
+     * Create a comprehensive cancer patient summary
+     */
+    getComprehensiveCancerSummary(patientId: string): Promise<{
+        patient: FHIRPatient;
+        diagnoses: CancerDiagnosis[];
+        biomarkers: CancerBiomarkers | null;
+        treatmentHistory: TreatmentHistory;
+        recentLabs: FHIRObservation[];
+        performanceStatus?: {
+            score: number;
+            scale: 'ECOG' | 'KPS';
+            date: Date;
+        };
+    }>;
+    /**
+     * Read a resource by ID
+     */
+    read<T extends FHIRResource>(resourceType: string, id: string): Promise<T>;
+    /**
+     * Search for resources
+     */
+    search(resourceType: string, params: Record<string, string>): Promise<FHIRBundle>;
+    /**
+     * Create a resource
+     */
+    create<T extends FHIRResource>(resource: T): Promise<T>;
+    /**
+     * Update a resource
+     */
+    update<T extends FHIRResource>(resource: T & {
+        id: string;
+    }): Promise<T>;
+    private getAuthHeaders;
+    private httpRequest;
+    private mapConditionToCancerDiagnosis;
+    private determineStageSystem;
+    private mapVerificationStatus;
+    private aggregateBiomarkerData;
+    private mapObservationToBiomarker;
+    private mapObservationToGenomicAlteration;
+    private determineAlterationType;
+    private interpretBiomarkerStatus;
+    private findBiomarker;
+    private categorizeTMB;
+    private categorizeMSI;
+    private aggregateTreatmentHistory;
+    private categorizeTreatment;
+    private mapMedicationStatus;
+    private mapProcedureStatus;
+    private isSurgicalProcedure;
+    private isRadiationProcedure;
+    private logAudit;
+}
+export interface AuditEvent {
+    timestamp: Date;
+    userId: string;
+    ipAddress: string;
+    action: string;
+    resourceType: string;
+    resourceId?: string;
+    outcome: 'success' | 'failure' | 'unknown';
+    duration?: number;
+    errorMessage?: string;
+    details?: Record<string, any>;
+}
+export declare class EpicFHIRClient extends FHIRClient {
+    constructor(config: Omit<FHIRConfig, 'ehrVendor'>);
+    /**
+     * Epic-specific: Get MyChart patient context
+     */
+    getMyChartContext(launchToken: string): Promise<{
+        patient: string;
+        encounter?: string;
+        practitioner?: string;
+    }>;
+}
+export declare class CernerFHIRClient extends FHIRClient {
+    constructor(config: Omit<FHIRConfig, 'ehrVendor'>);
+    /**
+     * Cerner-specific: Handle Millennium-specific extensions
+     */
+    parseMillenniumExtensions(resource: FHIRResource): Record<string, any>;
+}
+export declare function createFHIRClient(config: FHIRConfig): FHIRClient;
+export default FHIRClient;
+//# sourceMappingURL=fhir.d.ts.map

package/dist/integrations/ehr/fhir.d.ts.map

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