@peopl-health/nexus 6.4.0-dev.18777 → 6.4.0-dev.18778

package/lib/clinical/helpers/doctorPlanHelper.js

@@ -1,95 +1,9 @@
-const { httpError } = require('../../utils/httpErrorUtils');
 const { oneLineOf } = require('../../utils/coercionUtils');
-const { PLAN_FOLLOW_UPS } = require('../../models/escalationReviewModel');
 
-const DEFAULT_FOLLOW_UP_HOURS = { check_in: 24, vigilancia: 48 };
-const FIRST_LINE = '1L';
-const MAX_ENTRIES = 10;
-const MAX_FIELD_LENGTH = 300;
-const MAX_NOTE_LENGTH = 1000;
-const MAX_INSTRUCTIONS_LENGTH = 4000;
-const MAX_DAYS = 90;
-const MAX_FOLLOW_UP_HOURS = 168;
+const DEFAULT_FOLLOW_UP_HOURS = Object.freeze({ check_in: 24, vigilancia: 48 });
 // A route is not a dose: the doctor still says how many tablets.
 const ROUTE_ONLY = /^(vo|v[ií]a oral|oral)$/i;
 
-const textOf = (value, name, max = MAX_FIELD_LENGTH) => {
-  if (value != null && typeof value !== 'string') throw httpError(400, `${name} must be text`);
-  const text = oneLineOf(value);
-  if (text.length > max) throw httpError(400, `${name} exceeds ${max} characters`);
-  return text || null;
-};
-
-const neededText = (value, name) => {
-  const text = textOf(value, name);
-  if (!text) throw httpError(400, `${name} is required`);
-  return text;
-};
-
-const isPlainObject = (value) => Boolean(value) && typeof value === 'object' && !Array.isArray(value);
-
-// Only a number or a string of digits: `true`, `[5]` and `'1e1'` are not days.
-const wholeNumber = (value, name, max) => {
-  const number = typeof value === 'number' || (typeof value === 'string' && /^\d+$/.test(value.trim())) ? Number(value) : NaN;
-  if (!Number.isInteger(number) || number < 1 || number > max) throw httpError(400, `${name} must be a whole number from 1 to ${max}`);
-  return number;
-};
-
-const listOf = (value, name) => {
-  if (value == null) return [];
-  if (!Array.isArray(value)) throw httpError(400, `${name} must be a list`);
-  if (value.length > MAX_ENTRIES) throw httpError(400, `${name} allows at most ${MAX_ENTRIES} entries`);
-  return value;
-};
-
-function itemOf(item, index) {
-  const name = `plan.items[${index}]`;
-  const position = textOf(item?.position, `${name}.position`);
-  const reason = textOf(item?.reason, `${name}.reason`);
-  // An alternative to the first line has to say why the first line does not fit.
-  if (position && position !== FIRST_LINE && !reason) throw httpError(400, `${name}.reason is required for a drug that is not first line`);
-  return {
-    drug: neededText(item?.drug, `${name}.drug`),
-    strength: textOf(item?.strength, `${name}.strength`),
-    dose: neededText(item?.dose, `${name}.dose`),
-    frequency: neededText(item?.frequency, `${name}.frequency`),
-    days: wholeNumber(item?.days, `${name}.days`, MAX_DAYS),
-    position,
-    reason,
-    formularyKey: textOf(item?.formularyKey, `${name}.formularyKey`),
-  };
-}
-
-function followUpOf(value) {
-  if (value != null && !isPlainObject(value)) throw httpError(400, 'plan.followUp must be an object with a kind');
-  const kind = value?.kind ?? 'none';
-  if (!PLAN_FOLLOW_UPS.includes(kind)) throw httpError(400, `plan.followUp.kind must be one of: ${PLAN_FOLLOW_UPS.join(', ')}`);
-  if (kind === 'none') return { kind, hours: null };
-  return { kind, hours: wholeNumber(value?.hours ?? DEFAULT_FOLLOW_UP_HOURS[kind], 'plan.followUp.hours', MAX_FOLLOW_UP_HOURS) };
-}
-
-// The plan as the doctor approved it, refused whole when any line is incomplete.
-function planOf(input) {
-  if (!isPlainObject(input)) throw httpError(400, 'plan is required');
-  const plan = {
-    items: listOf(input.items, 'plan.items').map((item, index) => {
-      if (!isPlainObject(item)) throw httpError(400, `plan.items[${index}] must be an object`);
-      return itemOf(item, index);
-    }),
-    studies: listOf(input.studies, 'plan.studies').map((study, index) => ({
-      name: neededText(study?.name, `plan.studies[${index}].name`),
-      instructions: textOf(study?.instructions, `plan.studies[${index}].instructions`),
-    })),
-    homeCare: listOf(input.homeCare, 'plan.homeCare').map((entry, index) => neededText(entry, `plan.homeCare[${index}]`)),
-    note: textOf(input.note, 'plan.note', MAX_NOTE_LENGTH),
-    followUp: followUpOf(input.followUp),
-  };
-  if (!plan.items.length && !plan.studies.length && !plan.homeCare.length && !plan.note) {
-    throw httpError(400, 'plan needs a drug, a study, a home care measure or a note');
-  }
-  return plan;
-}
-
 const needsPrescriber = (plan) => plan.items.length > 0 || plan.studies.length > 0;
 
 const daysText = (days) => (days === 1 ? '1 día' : `${days} días`);
@@ -139,15 +53,6 @@ function prescriptionText(plan) {
   return lines.join('\n');
 }
 
-// The doctor's edit wins; with none, the instructions follow the plan.
-function approvedInstructions(plan, edited) {
-  if (edited != null && typeof edited !== 'string') throw httpError(400, 'instructions must be text');
-  if (!edited?.trim()) return { instructions: planInstructions(plan), instructionsEdited: false };
-  const instructions = edited.trim();
-  if (instructions.length > MAX_INSTRUCTIONS_LENGTH) throw httpError(400, `instructions exceed ${MAX_INSTRUCTIONS_LENGTH} characters`);
-  return { instructions, instructionsEdited: instructions !== planInstructions(plan) };
-}
-
 // «1 tableta cada 24 horas por 5 días; además, …» → dose, frequency, days and the rest; what does not match is left for the doctor.
 function dosingOf(instructions) {
   const text = oneLineOf(instructions);
@@ -181,13 +86,6 @@ function proposedPlanOf(draft) {
   return { items, studies: [], homeCare: [], note: rests.join('. ') || null, followUp: { kind: 'check_in', hours: DEFAULT_FOLLOW_UP_HOURS.check_in } };
 }
 
-const plain = (text) => String(text ?? '').normalize('NFD').replace(/[\u0300-\u036f]/g, '').toLowerCase();
-const URGENCY_WORDS = /\b(urgencias?|urgente|de inmediato|inmediatamente|emergencias?|911|lo antes posible|cuanto antes|no esperes)\b/g;
-const numbersIn = (text, pattern) => new Set([...plain(text).matchAll(pattern)].map((match) => match[1].replace(',', '.')));
-const HOURS = /cada\s+(\d+)\s*h(?:rs?|oras?)?\b/g;
-const DAYS = /por\s+(\d+)\s+dias?/g;
-const MG = /(\d+(?:[.,]\d+)?)\s*mg\b/g;
-
 // The plan's own words, so what the doctor wrote anywhere in it is never flagged.
 const plannedTextOf = (plan) => [
   ...plan.items.flatMap((item) => [item.drug, item.strength, item.dose, item.frequency, `por ${item.days} dias`]),
@@ -196,37 +94,13 @@ const plannedTextOf = (plan) => [
   plan.note,
 ].filter(Boolean).join('\n');
 
-// What in the assistant's reply strays from the plan, for the team to check; `unplannedDrugs` are the formulary drugs it names beyond the plan.
-function replyIssues(plan, reply, unplannedDrugs = []) {
-  const text = plain(reply);
-  if (!text) return ['no se pudo leer el mensaje enviado'];
-  const planned = plannedTextOf(plan);
-  const issues = [];
-  for (const item of plan.items) {
-    const name = plain(item.drug).split(/[\s/]/)[0];
-    if (name && !text.includes(name)) issues.push(`no menciona ${item.drug}`);
-  }
-  const strays = (pattern) => [...numbersIn(reply, pattern)].filter((value) => !numbersIn(planned, pattern).has(value));
-  for (const value of strays(HOURS)) issues.push(`dice «cada ${value} horas», que no está en el plan`);
-  for (const value of strays(DAYS)) issues.push(`dice «por ${value} días», que no está en el plan`);
-  for (const value of strays(MG)) issues.push(`dice «${value} mg», que no está en el plan`);
-  for (const name of unplannedDrugs) issues.push(`menciona ${name}, que el médico no indicó`);
-  const plannedWords = new Set([...plain(planned).matchAll(URGENCY_WORDS)].map((match) => match[1]));
-  for (const word of new Set([...text.matchAll(URGENCY_WORDS)].map((match) => match[1]))) {
-    if (!plannedWords.has(word)) issues.push(`usa «${word}», que el médico no indicó`);
-  }
-  return issues;
-}
-
 module.exports = {
-  approvedInstructions,
+  DEFAULT_FOLLOW_UP_HOURS,
   assistantInstructionsOf,
   needsPrescriber,
   planInstructions,
-  planOf,
   planSummary,
+  plannedTextOf,
   prescriptionText,
   proposedPlanOf,
-  plannedTextOf,
-  replyIssues,
 };

package/lib/clinical/services/doctorPlanService.js

@@ -0,0 +1,131 @@
+const { DEFAULT_FOLLOW_UP_HOURS, planInstructions, plannedTextOf } = require('../helpers/doctorPlanHelper');
+const { httpError } = require('../../utils/httpErrorUtils');
+const { oneLineOf } = require('../../utils/coercionUtils');
+const { PLAN_FOLLOW_UPS } = require('../../models/escalationReviewModel');
+const { unplannedDrugsIn } = require('./treatmentProposalService');
+
+const FIRST_LINE = '1L';
+const MAX_ENTRIES = 10;
+const MAX_FIELD_LENGTH = 300;
+const MAX_NOTE_LENGTH = 1000;
+const MAX_INSTRUCTIONS_LENGTH = 4000;
+const MAX_DAYS = 90;
+const MAX_FOLLOW_UP_HOURS = 168;
+
+const textOf = (value, name, max = MAX_FIELD_LENGTH) => {
+  if (value != null && typeof value !== 'string') throw httpError(400, `${name} must be text`);
+  const text = oneLineOf(value);
+  if (text.length > max) throw httpError(400, `${name} exceeds ${max} characters`);
+  return text || null;
+};
+
+const neededText = (value, name) => {
+  const text = textOf(value, name);
+  if (!text) throw httpError(400, `${name} is required`);
+  return text;
+};
+
+const isPlainObject = (value) => Boolean(value) && typeof value === 'object' && !Array.isArray(value);
+
+// Only a number or a string of digits: `true`, `[5]` and `'1e1'` are not days.
+const wholeNumber = (value, name, max) => {
+  const number = typeof value === 'number' || (typeof value === 'string' && /^\d+$/.test(value.trim())) ? Number(value) : NaN;
+  if (!Number.isInteger(number) || number < 1 || number > max) throw httpError(400, `${name} must be a whole number from 1 to ${max}`);
+  return number;
+};
+
+const listOf = (value, name) => {
+  if (value == null) return [];
+  if (!Array.isArray(value)) throw httpError(400, `${name} must be a list`);
+  if (value.length > MAX_ENTRIES) throw httpError(400, `${name} allows at most ${MAX_ENTRIES} entries`);
+  return value;
+};
+
+function itemOf(item, index) {
+  const name = `plan.items[${index}]`;
+  const position = textOf(item?.position, `${name}.position`);
+  const reason = textOf(item?.reason, `${name}.reason`);
+  // An alternative to the first line has to say why the first line does not fit.
+  if (position && position !== FIRST_LINE && !reason) throw httpError(400, `${name}.reason is required for a drug that is not first line`);
+  return {
+    drug: neededText(item?.drug, `${name}.drug`),
+    strength: textOf(item?.strength, `${name}.strength`),
+    dose: neededText(item?.dose, `${name}.dose`),
+    frequency: neededText(item?.frequency, `${name}.frequency`),
+    days: wholeNumber(item?.days, `${name}.days`, MAX_DAYS),
+    position,
+    reason,
+    formularyKey: textOf(item?.formularyKey, `${name}.formularyKey`),
+  };
+}
+
+function followUpOf(value) {
+  if (value != null && !isPlainObject(value)) throw httpError(400, 'plan.followUp must be an object with a kind');
+  const kind = value?.kind ?? 'none';
+  if (!PLAN_FOLLOW_UPS.includes(kind)) throw httpError(400, `plan.followUp.kind must be one of: ${PLAN_FOLLOW_UPS.join(', ')}`);
+  if (kind === 'none') return { kind, hours: null };
+  return { kind, hours: wholeNumber(value?.hours ?? DEFAULT_FOLLOW_UP_HOURS[kind], 'plan.followUp.hours', MAX_FOLLOW_UP_HOURS) };
+}
+
+// The plan as the doctor approved it, refused whole when any line is incomplete.
+function planOf(input) {
+  if (!isPlainObject(input)) throw httpError(400, 'plan is required');
+  const plan = {
+    items: listOf(input.items, 'plan.items').map((item, index) => {
+      if (!isPlainObject(item)) throw httpError(400, `plan.items[${index}] must be an object`);
+      return itemOf(item, index);
+    }),
+    studies: listOf(input.studies, 'plan.studies').map((study, index) => ({
+      name: neededText(study?.name, `plan.studies[${index}].name`),
+      instructions: textOf(study?.instructions, `plan.studies[${index}].instructions`),
+    })),
+    homeCare: listOf(input.homeCare, 'plan.homeCare').map((entry, index) => neededText(entry, `plan.homeCare[${index}]`)),
+    note: textOf(input.note, 'plan.note', MAX_NOTE_LENGTH),
+    followUp: followUpOf(input.followUp),
+  };
+  if (!plan.items.length && !plan.studies.length && !plan.homeCare.length && !plan.note) {
+    throw httpError(400, 'plan needs a drug, a study, a home care measure or a note');
+  }
+  return plan;
+}
+
+// The doctor's edit wins; with none, the instructions follow the plan.
+function approvedInstructions(plan, edited) {
+  if (edited != null && typeof edited !== 'string') throw httpError(400, 'instructions must be text');
+  if (!edited?.trim()) return { instructions: planInstructions(plan), instructionsEdited: false };
+  const instructions = edited.trim();
+  if (instructions.length > MAX_INSTRUCTIONS_LENGTH) throw httpError(400, `instructions exceed ${MAX_INSTRUCTIONS_LENGTH} characters`);
+  return { instructions, instructionsEdited: instructions !== planInstructions(plan) };
+}
+
+const plain = (text) => String(text ?? '').normalize('NFD').replace(/[\u0300-\u036f]/g, '').toLowerCase();
+const URGENCY_WORDS = /\b(urgencias?|urgente|de inmediato|inmediatamente|emergencias?|911|lo antes posible|cuanto antes|no esperes)\b/g;
+const numbersIn = (text, pattern) => new Set([...plain(text).matchAll(pattern)].map((match) => match[1].replace(',', '.')));
+const HOURS = /cada\s+(\d+)\s*h(?:rs?|oras?)?\b/g;
+const DAYS = /por\s+(\d+)\s+dias?/g;
+const MG = /(\d+(?:[.,]\d+)?)\s*mg\b/g;
+
+// What in the assistant's reply strays from the plan, for the team to check.
+function replyIssues(plan, reply) {
+  const text = plain(reply);
+  if (!text) return ['no se pudo leer el mensaje enviado'];
+  const planned = plannedTextOf(plan);
+  const unplannedDrugs = unplannedDrugsIn(reply, planned);
+  const issues = [];
+  for (const item of plan.items) {
+    const name = plain(item.drug).split(/[\s/]/)[0];
+    if (name && !text.includes(name)) issues.push(`no menciona ${item.drug}`);
+  }
+  const strays = (pattern) => [...numbersIn(reply, pattern)].filter((value) => !numbersIn(planned, pattern).has(value));
+  for (const value of strays(HOURS)) issues.push(`dice «cada ${value} horas», que no está en el plan`);
+  for (const value of strays(DAYS)) issues.push(`dice «por ${value} días», que no está en el plan`);
+  for (const value of strays(MG)) issues.push(`dice «${value} mg», que no está en el plan`);
+  for (const name of unplannedDrugs) issues.push(`menciona ${name}, que el médico no indicó`);
+  const plannedWords = new Set([...plain(planned).matchAll(URGENCY_WORDS)].map((match) => match[1]));
+  for (const word of new Set([...text.matchAll(URGENCY_WORDS)].map((match) => match[1]))) {
+    if (!plannedWords.has(word)) issues.push(`usa «${word}», que el médico no indicó`);
+  }
+  return issues;
+}
+
+module.exports = { approvedInstructions, planOf, replyIssues };

package/lib/services/escalationReviewService.js

@@ -31,11 +31,10 @@ const { generateEscalationDraft } = require('../clinical/services/escalationDraf
 const { conversationLink, readGroupMessageId, writeUnresolvedRequest } = require('../clinical/services/clinicalAirtableService');
 const { doctorAlertHeadline, doctorAlertOpener, renderDoctorMessage, templateSummary, withIdentity } = require('../clinical/helpers/doctorReviewMessageHelper');
 const { generateKeyQuestions } = require('../clinical/services/escalationQuestionsService');
-const { drugsNamedIn, unplannedDrugsIn } = require('../clinical/services/treatmentProposalService');
+const { drugsNamedIn } = require('../clinical/services/treatmentProposalService');
 const { characterizationSeedOf } = require('../clinical/helpers/reviewUpdateHelper');
-const {
-  approvedInstructions, assistantInstructionsOf, needsPrescriber, planInstructions, planOf, planSummary, prescriptionText, plannedTextOf, proposedPlanOf, replyIssues,
-} = require('../clinical/helpers/doctorPlanHelper');
+const { assistantInstructionsOf, needsPrescriber, planInstructions, planSummary, prescriptionText, proposedPlanOf } = require('../clinical/helpers/doctorPlanHelper');
+const { approvedInstructions, planOf, replyIssues } = require('../clinical/services/doctorPlanService');
 const { readNoteFacts, assertionOf } = require('../clinical/services/escalationNoteFactsService');
 const { humanReplyFilter } = require('../clinical/config/safetyNetConfig');
 const {
@@ -2219,8 +2218,7 @@ async function sendPlanThroughAssistant({ claimed, claim, decisionNumber, plan,
   const queued = outcome === 'queued';
   const prescriptionRecordId = prescriberEmail ? await issuePrescription(claimed, plan, prescriberEmail) : null;
   const prescriptionFailed = Boolean(prescriberEmail) && !prescriptionRecordId;
-  const unplanned = reply ? unplannedDrugsIn(reply, plannedTextOf(plan)) : [];
-  const issues = [...replyIssues(plan, reply, unplanned), ...(prescriptionFailed ? ['no se pudo crear la receta'] : [])];
+  const issues = [...replyIssues(plan, reply), ...(prescriptionFailed ? ['no se pudo crear la receta'] : [])];
   const record = {
     decisionNumber, messageId: delivery.messageId || null, status: delivery.status || null, transport: 'assistant', deferred: queued, sentBy: operator,
     ...(prescriptionRecordId && { prescriptionRecordId }),

package/package.json

@@ -1,6 +1,6 @@
 {
   "name": "@peopl-health/nexus",
-  "version": "6.4.0-dev.18777",
+  "version": "6.4.0-dev.18778",
   "description": "Core messaging and assistant library for WhatsApp communication platforms",
   "keywords": [
     "whatsapp",