empathy-framework 2.4.0__py3-none-any.whl → 3.8.2__py3-none-any.whl

agents/compliance_anticipation_agent.py

@@ -1,1427 +0,0 @@
-"""
-Compliance Anticipation Agent - Level 4 Anticipatory Empathy
-
-Multi-step LangGraph agent that predicts regulatory audits, identifies compliance
-gaps, and prepares documentation proactively to achieve positive outcomes.
-
-Key Features:
-1. Audit Timeline Prediction (90+ days advance notice)
-2. Compliance Assessment (automated gap detection)
-3. Proactive Documentation (auto-generate audit packages)
-4. Stakeholder Notification (actionable alerts)
-5. Continuous Monitoring (track until audit completion)
-
-Copyright 2025 Smart AI Memory, LLC
-Licensed under Fair Source 0.9
-"""
-
-import logging
-import operator
-from collections.abc import Sequence
-from datetime import datetime, timedelta
-from typing import Annotated, TypedDict
-
-from langchain_core.messages import AIMessage, BaseMessage
-from langgraph.graph import END, StateGraph
-
-logger = logging.getLogger(__name__)
-
-
-# =============================================================================
-# Agent State Management - Level 4 Anticipatory Empathy
-# =============================================================================
-
-
-class ComplianceAgentState(TypedDict):
-    """
-    Level 4 Anticipatory Agent State
-
-    Follows Principle #13: "Agent State as Clinical Flowsheet"
-    Every field answers a compliance question with clear audit trail.
-
-    Design Philosophy:
-    - State fields answer specific questions ("When?", "What?", "Who?", "How?")
-    - All predictions include confidence scores and methods
-    - Comprehensive audit trail for legal compliance
-    - Actionable outputs (not just status reports)
-    """
-
-    # =========================================================================
-    # Progress Tracking
-    # =========================================================================
-    current_step: int  # 1-5
-    completed_steps: list[int]
-    messages: Annotated[Sequence[BaseMessage], operator.add]
-
-    # =========================================================================
-    # Audit Prediction (Step 1) - Answers: "When is next audit?"
-    # =========================================================================
-    next_audit_date: str  # ISO format: "2026-04-15"
-    days_until_audit: int
-    audit_type: str  # "joint_commission", "cms", "state_board", "custom"
-    audit_cycle_months: int  # Typical cycle length (e.g., 36 for Joint Commission)
-
-    # Prediction Metadata
-    prediction_confidence: float  # 0.0-1.0
-    prediction_method: str  # "historical_cycle", "regulatory_schedule", "manual_entry"
-    prediction_generated_at: str  # ISO timestamp
-    last_audit_date: str  # ISO format (basis for prediction)
-
-    # =========================================================================
-    # Anticipation Window (Step 2) - Answers: "Should we act now?"
-    # =========================================================================
-    anticipation_window_days: int  # Optimal range: 60-120 days
-    is_within_anticipation_window: bool
-    time_to_act: str  # "too_early", "early", "timely", "urgent", "too_late"
-
-    # =========================================================================
-    # Compliance Assessment (Step 3) - Answers: "Are we compliant?"
-    # =========================================================================
-    total_compliance_items: int
-    compliant_items: int
-    non_compliant_items: int
-    compliance_percentage: float  # 0.0-100.0
-
-    # Item-Level Detail
-    compliance_categories: list[str]  # ["medication_safety", "documentation", "patient_safety"]
-    category_scores: dict[str, float]  # {"medication_safety": 95.0, "documentation": 88.0}
-
-    # =========================================================================
-    # Gap Identification (Step 3) - Answers: "What needs fixing?"
-    # =========================================================================
-    compliance_gaps: list[dict]  # Detailed gap information
-    gap_severity_distribution: dict[str, int]  # {"critical": 2, "high": 5, "medium": 10}
-
-    # Gap Structure:
-    # {
-    #   "gap_id": "gap_001",
-    #   "category": "medication_safety",
-    #   "item": "High-risk medication double-checks",
-    #   "description": "5 high-risk meds without documented double-check",
-    #   "severity": "critical",  # critical, high, medium, low
-    #   "patient_ids": ["P123", "P456"],
-    #   "incident_dates": ["2025-01-15", "2025-01-18"],
-    #   "action_required": "Review incidents, document verification",
-    #   "estimated_time_to_fix": "50 minutes",
-    #   "can_fix_retroactively": True,
-    #   "legal_risk": "high"
-    # }
-
-    # =========================================================================
-    # Documentation Preparation (Step 4) - Answers: "What evidence do we have?"
-    # =========================================================================
-    documentation_prepared: bool
-    documentation_url: str  # Secure storage location
-    documentation_files: list[str]  # ["compliance_summary.pdf", "gap_analysis.xlsx"]
-
-    # Documentation Package Contents:
-    documentation_package: dict
-    # {
-    #   "summary_report": {...},
-    #   "evidence_files": [...],
-    #   "gap_remediation_plan": {...},
-    #   "timeline": {...},
-    #   "audit_readiness_score": 85.5
-    # }
-
-    # =========================================================================
-    # Stakeholder Notification (Step 5) - Answers: "Who needs to act?"
-    # =========================================================================
-    notification_sent: bool
-    notification_recipients: list[str]  # ["charge_nurse", "nurse_manager", "cno"]
-    notification_timestamp: str  # ISO timestamp
-
-    # Action Items (Assigned Work)
-    action_items: list[dict]
-    # {
-    #   "action_id": "action_001",
-    #   "gap_id": "gap_001",
-    #   "description": "Review 5 incidents, document double-checks",
-    #   "severity": "critical",
-    #   "assignee": "charge_nurse",
-    #   "assignee_email": "charge.nurse@hospital.com",
-    #   "deadline": "2025-02-15",
-    #   "estimated_time": "50 minutes",
-    #   "status": "pending",
-    #   "created_at": "2025-01-20T10:00:00Z"
-    # }
-
-    # =========================================================================
-    # Continuous Monitoring (Step 6) - Answers: "How do we track progress?"
-    # =========================================================================
-    monitoring_scheduled: bool
-    monitoring_frequency: str  # "daily", "weekly", "biweekly", "monthly"
-    next_check_date: str  # ISO format
-    monitoring_until_date: str  # ISO format (audit date)
-
-    # =========================================================================
-    # Positive Outcome Tracking - Answers: "Are we improving?"
-    # =========================================================================
-    baseline_compliance_percentage: float  # Initial assessment
-    current_compliance_percentage: float  # After interventions
-    compliance_improvement: float  # Percentage points improved
-    gaps_closed: int
-    gaps_remaining: int
-
-    # Trend Analysis
-    compliance_trend: str  # "improving", "stable", "declining"
-    trend_confidence: float  # 0.0-1.0
-
-    # =========================================================================
-    # Error Handling & Audit Trail
-    # =========================================================================
-    errors: list[str]
-    warnings: list[str]
-
-    # Full Audit Trail
-    audit_trail: list[dict]
-    # {
-    #   "timestamp": "2025-01-20T10:00:00Z",
-    #   "step": "predict_audit",
-    #   "action": "Generated audit prediction",
-    #   "details": {...},
-    #   "user": "system"
-    # }
-
-    # =========================================================================
-    # Metadata
-    # =========================================================================
-    hospital_id: str
-    facility_name: str
-    agent_version: str
-    execution_id: str  # Unique ID for this agent run
-    created_at: str  # ISO timestamp
-    last_updated: str  # ISO timestamp
-
-
-def create_initial_state(
-    hospital_id: str, audit_type: str = "joint_commission"
-) -> ComplianceAgentState:
-    """
-    Create initial agent state
-
-    Args:
-        hospital_id: Unique identifier for hospital/facility
-        audit_type: Type of audit to anticipate
-
-    Returns:
-        Initialized ComplianceAgentState
-    """
-    now = datetime.now()
-    execution_id = f"compliance_{now.strftime('%Y%m%d_%H%M%S')}_{hospital_id}"
-
-    return ComplianceAgentState(
-        # Progress
-        current_step=1,
-        completed_steps=[],
-        messages=[],
-        # Audit Prediction
-        next_audit_date="",
-        days_until_audit=0,
-        audit_type=audit_type,
-        audit_cycle_months=0,
-        prediction_confidence=0.0,
-        prediction_method="",
-        prediction_generated_at="",
-        last_audit_date="",
-        # Anticipation Window
-        anticipation_window_days=0,
-        is_within_anticipation_window=False,
-        time_to_act="",
-        # Compliance Assessment
-        total_compliance_items=0,
-        compliant_items=0,
-        non_compliant_items=0,
-        compliance_percentage=0.0,
-        compliance_categories=[],
-        category_scores={},
-        # Gaps
-        compliance_gaps=[],
-        gap_severity_distribution={},
-        # Documentation
-        documentation_prepared=False,
-        documentation_url="",
-        documentation_files=[],
-        documentation_package={},
-        # Notification
-        notification_sent=False,
-        notification_recipients=[],
-        notification_timestamp="",
-        action_items=[],
-        # Monitoring
-        monitoring_scheduled=False,
-        monitoring_frequency="",
-        next_check_date="",
-        monitoring_until_date="",
-        # Positive Outcomes
-        baseline_compliance_percentage=0.0,
-        current_compliance_percentage=0.0,
-        compliance_improvement=0.0,
-        gaps_closed=0,
-        gaps_remaining=0,
-        compliance_trend="",
-        trend_confidence=0.0,
-        # Error Handling
-        errors=[],
-        warnings=[],
-        audit_trail=[],
-        # Metadata
-        hospital_id=hospital_id,
-        facility_name="",
-        agent_version="1.0.0",
-        execution_id=execution_id,
-        created_at=now.isoformat(),
-        last_updated=now.isoformat(),
-    )
-
-
-# =============================================================================
-# LangGraph Workflow Definition
-# =============================================================================
-
-
-def create_compliance_agent() -> StateGraph:
-    """
-    Create Level 4 Anticipatory Compliance Agent
-
-    Workflow:
-    1. Predict Audit Timeline → When will next audit occur?
-    2. Check Anticipation Window → Should we act now?
-    3. Assess Compliance → Are we ready?
-    4. Identify Gaps → What needs fixing?
-    5. Prepare Documentation → What evidence do we have?
-    6. Notify Stakeholders → Who needs to act?
-    7. Schedule Monitoring → How do we track progress?
-
-    Level 4 Characteristics:
-    - Predictive (acts 60-120 days before audit)
-    - Proactive (prepares documentation without being asked)
-    - Actionable (assigns specific tasks with deadlines)
-    - Transparent (explains reasoning, provides confidence scores)
-    """
-
-    workflow = StateGraph(ComplianceAgentState)
-
-    # Step 1: Audit Prediction
-    workflow.add_node("predict_audit", predict_next_audit)
-    workflow.add_node("check_window", check_anticipation_window)
-
-    # Step 2-3: Assessment
-    workflow.add_node("assess_compliance", assess_current_compliance)
-    workflow.add_node("identify_gaps", identify_compliance_gaps)
-
-    # Step 4: Documentation
-    workflow.add_node("prepare_docs", prepare_audit_documentation)
-
-    # Step 5: Notification
-    workflow.add_node("notify", send_anticipatory_notifications)
-
-    # Step 6: Monitoring
-    workflow.add_node("schedule_monitor", schedule_continuous_monitoring)
-
-    # Define edges
-    workflow.set_entry_point("predict_audit")
-
-    workflow.add_edge("predict_audit", "check_window")
-
-    # Conditional: Only proceed if within anticipation window
-    workflow.add_conditional_edges(
-        "check_window",
-        should_anticipate,
-        {
-            "anticipate": "assess_compliance",
-            "too_early": END,
-            "proceed_anyway": "assess_compliance",  # Urgent cases
-        },
-    )
-
-    workflow.add_edge("assess_compliance", "identify_gaps")
-    workflow.add_edge("identify_gaps", "prepare_docs")
-    workflow.add_edge("prepare_docs", "notify")
-    workflow.add_edge("notify", "schedule_monitor")
-    workflow.add_edge("schedule_monitor", END)
-
-    return workflow.compile()
-
-
-# =============================================================================
-# Node Implementations
-# =============================================================================
-
-
-def predict_next_audit(state: ComplianceAgentState) -> ComplianceAgentState:
-    """
-    Step 1: Predict when next audit will occur
-
-    Methods (in order of preference):
-    1. Regulatory schedule (published audit windows) - confidence: 0.95
-    2. Historical cycle analysis (e.g., Joint Commission every 36 months) - confidence: 0.85
-    3. Risk-based prediction (hospitals with violations audited more) - confidence: 0.70
-    4. Manual entry (user provides expected date) - confidence: 0.90
-
-    For positive outcomes:
-    - Early prediction enables proactive preparation
-    - Reduces stress and scrambling
-    - Allows time to fix gaps without pressure
-    """
-
-    logger.info(f"[Step 1] Predicting {state['audit_type']} audit for {state['hospital_id']}")
-
-    # Add to audit trail
-    state["audit_trail"].append(
-        {
-            "timestamp": datetime.now().isoformat(),
-            "step": "predict_audit",
-            "action": "Starting audit prediction",
-            "details": {"audit_type": state["audit_type"]},
-            "user": "system",
-        }
-    )
-
-    # Get audit cycle for this type
-    audit_cycles = {
-        "joint_commission": 36,  # months
-        "cms": 12,
-        "state_board": 24,
-        "custom": 36,
-    }
-
-    cycle_months = audit_cycles.get(state["audit_type"], 36)
-    state["audit_cycle_months"] = cycle_months
-
-    # TODO: Connect to real database to get last audit date
-    # For now, simulate with example date
-    # last_audit = get_last_audit_date(state["hospital_id"], state["audit_type"])
-
-    # Example: Last Joint Commission audit was 2023-04-15
-    last_audit = datetime(2023, 4, 15)
-    state["last_audit_date"] = last_audit.isoformat()
-
-    # Predict next audit (add cycle duration)
-    predicted_date = last_audit + timedelta(days=cycle_months * 30)
-
-    # Calculate days until
-    days_until = (predicted_date - datetime.now()).days
-
-    # Confidence based on audit type and data quality
-    if state["audit_type"] == "joint_commission":
-        confidence = 0.90  # High confidence - very regular cycle
-    elif state["audit_type"] == "cms":
-        confidence = 0.85  # Good confidence
-    else:
-        confidence = 0.75  # Moderate confidence
-
-    # Update state
-    state["next_audit_date"] = predicted_date.isoformat()
-    state["days_until_audit"] = days_until
-    state["prediction_confidence"] = confidence
-    state["prediction_method"] = "historical_cycle"
-    state["prediction_generated_at"] = datetime.now().isoformat()
-    state["last_updated"] = datetime.now().isoformat()
-
-    # Mark step complete
-    state["completed_steps"].append(1)
-    state["current_step"] = 2
-
-    # Log prediction
-    logger.info(
-        f"Predicted audit: {predicted_date.strftime('%Y-%m-%d')} "
-        f"({days_until} days away, {confidence:.0%} confidence)"
-    )
-
-    # Add message
-    state["messages"].append(
-        AIMessage(
-            content=f"Predicted {state['audit_type']} audit on {predicted_date.strftime('%Y-%m-%d')} "
-            f"(in {days_until} days) with {confidence:.0%} confidence"
-        )
-    )
-
-    # Audit trail
-    state["audit_trail"].append(
-        {
-            "timestamp": datetime.now().isoformat(),
-            "step": "predict_audit",
-            "action": "Prediction completed",
-            "details": {
-                "predicted_date": state["next_audit_date"],
-                "days_until": days_until,
-                "confidence": confidence,
-                "method": "historical_cycle",
-            },
-            "user": "system",
-        }
-    )
-
-    return state
-
-
-def check_anticipation_window(state: ComplianceAgentState) -> ComplianceAgentState:
-    """
-    Step 2: Check if we're within optimal anticipation window
-
-    Level 4 Guardrail:
-    - Too early (>120 days): Preparation may become outdated, waste effort
-    - Optimal (60-120 days): Ideal time for preparation without pressure
-    - Urgent (30-60 days): Still helpful but less time to fix issues
-    - Too late (<30 days): Limited time for comprehensive fixes
-
-    For positive outcomes:
-    - Acting at right time maximizes effectiveness
-    - Avoids wasted effort (too early) or crisis mode (too late)
-    """
-
-    logger.info(f"[Step 2] Checking anticipation window ({state['days_until_audit']} days)")
-
-    days_until = state["days_until_audit"]
-
-    if 60 <= days_until <= 120:
-        state["is_within_anticipation_window"] = True
-        state["time_to_act"] = "timely"
-        state["anticipation_window_days"] = days_until
-        message = (
-            f"✅ Within optimal anticipation window ({days_until} days). Perfect time to prepare."
-        )
-
-    elif days_until > 120:
-        state["is_within_anticipation_window"] = False
-        state["time_to_act"] = "too_early"
-        state["anticipation_window_days"] = days_until
-        message = f"⏰ Audit is {days_until} days away. Will re-check at 120 days out."
-        state["warnings"].append(
-            f"Audit predicted in {days_until} days. "
-            f"Optimal anticipation window is 60-120 days. "
-            f"Will schedule re-check for {(datetime.now() + timedelta(days=days_until - 120)).strftime('%Y-%m-%d')}"
-        )
-
-    elif 30 <= days_until < 60:
-        state["is_within_anticipation_window"] = True
-        state["time_to_act"] = "urgent"
-        state["anticipation_window_days"] = days_until
-        message = f"⚠️ Only {days_until} days until audit. Acting now (ideally would have started at 90 days)."
-        state["warnings"].append(
-            "Less than 60 days until audit. "
-            "Limited time for comprehensive remediation. "
-            "Recommend expedited action."
-        )
-
-    else:  # < 30 days
-        state["is_within_anticipation_window"] = True
-        state["time_to_act"] = "too_late"
-        state["anticipation_window_days"] = days_until
-        message = f"🚨 URGENT: Only {days_until} days until audit. Focus on critical gaps only."
-        state["warnings"].append(
-            "Less than 30 days until audit. "
-            "Very limited time. Focus on critical compliance gaps only."
-        )
-
-    state["messages"].append(AIMessage(content=message))
-    state["completed_steps"].append(2)
-    state["current_step"] = 3
-    state["last_updated"] = datetime.now().isoformat()
-
-    # Audit trail
-    state["audit_trail"].append(
-        {
-            "timestamp": datetime.now().isoformat(),
-            "step": "check_window",
-            "action": "Anticipation window assessed",
-            "details": {
-                "days_until": days_until,
-                "time_to_act": state["time_to_act"],
-                "within_window": state["is_within_anticipation_window"],
-            },
-            "user": "system",
-        }
-    )
-
-    logger.info(f"Anticipation window: {state['time_to_act']}")
-
-    return state
-
-
-def should_anticipate(state: ComplianceAgentState) -> str:
-    """
-    Routing function: Decide whether to proceed with anticipation
-
-    Returns:
-        "anticipate" - Within optimal window, proceed
-        "too_early" - Too far out, schedule for later
-        "proceed_anyway" - Urgent, proceed despite non-optimal timing
-    """
-
-    time_to_act = state["time_to_act"]
-
-    if time_to_act == "too_early":
-        return "too_early"
-    elif time_to_act in ["urgent", "too_late"]:
-        return "proceed_anyway"
-    else:
-        return "anticipate"
-
-
-def assess_current_compliance(state: ComplianceAgentState) -> ComplianceAgentState:
-    """
-    Step 3A: Assess current compliance status
-
-    Scans all compliance requirements for the audit type and determines
-    current compliance percentage.
-
-    For positive outcomes:
-    - Comprehensive assessment identifies all issues upfront
-    - Categorization helps prioritize remediation
-    - Baseline measurement enables tracking improvement
-    """
-
-    logger.info(f"[Step 3A] Assessing compliance for {state['audit_type']}")
-
-    # TODO: Connect to real compliance data
-    # For now, simulate assessment
-
-    # Get requirements for this audit type
-    requirements = get_audit_requirements(state["audit_type"])
-
-    # Example: Joint Commission has ~50 compliance items
-    total_items = len(requirements)
-
-    # Simulate compliance check
-    # In production, this would scan actual documentation, EHR data, etc.
-    compliant = 0
-    non_compliant = 0
-    category_scores = {}
-
-    for req in requirements:
-        # TODO: Check actual compliance
-        # is_compliant = check_requirement_compliance(state["hospital_id"], req)
-
-        # Simulated: 90% compliant
-        import random
-
-        is_compliant = random.random() < 0.90
-
-        if is_compliant:
-            compliant += 1
-        else:
-            non_compliant += 1
-
-        # Track by category
-        category = req["category"]
-        if category not in category_scores:
-            category_scores[category] = {"compliant": 0, "total": 0}
-
-        category_scores[category]["total"] += 1
-        if is_compliant:
-            category_scores[category]["compliant"] += 1
-
-    # Calculate percentages
-    compliance_pct = (compliant / total_items * 100) if total_items > 0 else 0.0
-
-    category_pct = {}
-    for cat, scores in category_scores.items():
-        category_pct[cat] = (
-            (scores["compliant"] / scores["total"] * 100) if scores["total"] > 0 else 0.0
-        )
-
-    # Update state
-    state["total_compliance_items"] = total_items
-    state["compliant_items"] = compliant
-    state["non_compliant_items"] = non_compliant
-    state["compliance_percentage"] = compliance_pct
-    state["compliance_categories"] = list(category_pct.keys())
-    state["category_scores"] = category_pct
-
-    # Set baseline if first assessment
-    if state["baseline_compliance_percentage"] == 0.0:
-        state["baseline_compliance_percentage"] = compliance_pct
-
-    state["current_compliance_percentage"] = compliance_pct
-
-    state["completed_steps"].append(3)
-    state["current_step"] = 4
-    state["last_updated"] = datetime.now().isoformat()
-
-    # Message
-    status_emoji = "✅" if compliance_pct >= 95 else "⚠️" if compliance_pct >= 85 else "🚨"
-    state["messages"].append(
-        AIMessage(
-            content=f"{status_emoji} Compliance Assessment: {compliance_pct:.1f}% "
-            f"({compliant}/{total_items} items compliant)"
-        )
-    )
-
-    # Audit trail
-    state["audit_trail"].append(
-        {
-            "timestamp": datetime.now().isoformat(),
-            "step": "assess_compliance",
-            "action": "Compliance assessed",
-            "details": {
-                "total_items": total_items,
-                "compliant": compliant,
-                "percentage": compliance_pct,
-                "categories": category_pct,
-            },
-            "user": "system",
-        }
-    )
-
-    logger.info(f"Compliance: {compliance_pct:.1f}% ({compliant}/{total_items})")
-
-    return state
-
-
-def identify_compliance_gaps(state: ComplianceAgentState) -> ComplianceAgentState:
-    """
-    Step 3B: Identify specific compliance gaps with actionable details
-
-    For positive outcomes:
-    - Specific patient IDs enable targeted remediation
-    - Severity classification enables prioritization
-    - Time estimates enable resource planning
-    - Retroactive fix capability determines urgency
-    """
-
-    logger.info("[Step 3B] Identifying compliance gaps")
-
-    # TODO: Connect to real gap detection system
-    # For now, simulate common gaps
-
-    gaps = []
-    gap_id_counter = 1
-
-    # Gap 1: Missing signatures (example)
-    if state["compliance_percentage"] < 100:
-        gaps.append(
-            {
-                "gap_id": f"gap_{gap_id_counter:03d}",
-                "category": "documentation_completeness",
-                "item": "Patient assessment signatures",
-                "description": "5 patient assessments missing nurse signatures",
-                "severity": "high",
-                "patient_ids": ["P12345", "P12367", "P12389", "P12401", "P12423"],
-                "incident_dates": [
-                    "2025-01-15",
-                    "2025-01-16",
-                    "2025-01-18",
-                    "2025-01-19",
-                    "2025-01-20",
-                ],
-                "action_required": "Nurses must review and sign assessments retroactively",
-                "estimated_time_to_fix": "25 minutes",
-                "can_fix_retroactively": True,
-                "legal_risk": "medium",
-            }
-        )
-        gap_id_counter += 1
-
-    # Gap 2: Medication double-checks
-    if state["compliance_percentage"] < 98:
-        gaps.append(
-            {
-                "gap_id": f"gap_{gap_id_counter:03d}",
-                "category": "medication_safety",
-                "item": "High-risk medication double-checks",
-                "description": "2 high-risk medications administered without documented double-check",
-                "severity": "critical",
-                "patient_ids": ["P12350", "P12375"],
-                "incident_dates": ["2025-01-17", "2025-01-19"],
-                "action_required": "Review incidents, document verification process, implement reminder system",
-                "estimated_time_to_fix": "45 minutes",
-                "can_fix_retroactively": False,  # Can document review but can't undo administration
-                "legal_risk": "high",
-            }
-        )
-        gap_id_counter += 1
-
-    # Gap 3: Restraint orders
-    if state["compliance_percentage"] < 95:
-        gaps.append(
-            {
-                "gap_id": f"gap_{gap_id_counter:03d}",
-                "category": "patient_safety",
-                "item": "Restraint order renewals",
-                "description": "1 restraint order requires renewal",
-                "severity": "high",
-                "patient_ids": ["P12390"],
-                "incident_dates": ["2025-01-18"],
-                "action_required": "Provider must review and renew order immediately",
-                "estimated_time_to_fix": "15 minutes",
-                "can_fix_retroactively": False,
-                "legal_risk": "high",
-            }
-        )
-        gap_id_counter += 1
-
-    # Calculate severity distribution
-    severity_dist = {
-        "critical": sum(1 for g in gaps if g["severity"] == "critical"),
-        "high": sum(1 for g in gaps if g["severity"] == "high"),
-        "medium": sum(1 for g in gaps if g["severity"] == "medium"),
-        "low": sum(1 for g in gaps if g["severity"] == "low"),
-    }
-
-    state["compliance_gaps"] = gaps
-    state["gap_severity_distribution"] = severity_dist
-    state["gaps_remaining"] = len(gaps)
-    state["last_updated"] = datetime.now().isoformat()
-
-    # Message
-    if len(gaps) == 0:
-        state["messages"].append(
-            AIMessage(content="🎉 No compliance gaps identified. Excellent work!")
-        )
-    else:
-        state["messages"].append(
-            AIMessage(
-                content=f"⚠️ Identified {len(gaps)} compliance gaps: "
-                f"{severity_dist['critical']} critical, "
-                f"{severity_dist['high']} high, "
-                f"{severity_dist['medium']} medium, "
-                f"{severity_dist['low']} low"
-            )
-        )
-
-    # Audit trail
-    state["audit_trail"].append(
-        {
-            "timestamp": datetime.now().isoformat(),
-            "step": "identify_gaps",
-            "action": "Gaps identified",
-            "details": {
-                "gap_count": len(gaps),
-                "severity_distribution": severity_dist,
-                "gaps": [{"id": g["gap_id"], "description": g["description"]} for g in gaps],
-            },
-            "user": "system",
-        }
-    )
-
-    logger.info(f"Identified {len(gaps)} gaps: {severity_dist}")
-
-    return state
-
-
-def prepare_audit_documentation(state: ComplianceAgentState) -> ComplianceAgentState:
-    """
-    Step 4: Prepare comprehensive audit documentation package
-
-    For positive outcomes:
-    - Pre-prepared documentation reduces audit day stress
-    - Structured format ensures completeness
-    - Gap remediation plan demonstrates proactive approach
-    - Audit readiness score provides confidence metric
-    """
-
-    logger.info("[Step 4] Preparing audit documentation")
-
-    # Generate documentation package
-    doc_package = {
-        "generated_at": datetime.now().isoformat(),
-        "audit_type": state["audit_type"],
-        "audit_date": state["next_audit_date"],
-        "facility": state["hospital_id"],
-        "summary_report": {
-            "compliance_percentage": state["compliance_percentage"],
-            "compliant_items": state["compliant_items"],
-            "total_items": state["total_compliance_items"],
-            "gap_count": len(state["compliance_gaps"]),
-            "severity_breakdown": state["gap_severity_distribution"],
-            "category_scores": state["category_scores"],
-        },
-        "evidence_files": [
-            f"medication_administration_records_{state['hospital_id']}.pdf",
-            f"patient_assessment_documentation_{state['hospital_id']}.pdf",
-            f"infection_control_protocols_{state['hospital_id']}.pdf",
-            f"emergency_equipment_checks_{state['hospital_id']}.pdf",
-        ],
-        "gap_remediation_plan": {
-            "gaps": state["compliance_gaps"],
-            "prioritization": "Critical → High → Medium → Low",
-            "estimated_total_time": sum(
-                int(g["estimated_time_to_fix"].split()[0])
-                for g in state["compliance_gaps"]
-                if g["estimated_time_to_fix"].split()[0].isdigit()
-            ),
-            "target_completion_date": (
-                datetime.fromisoformat(state["next_audit_date"]) - timedelta(days=14)
-            ).isoformat(),  # 2 weeks before audit
-        },
-        "timeline": {
-            "baseline_assessment": state["created_at"],
-            "gap_identification": datetime.now().isoformat(),
-            "target_remediation_completion": (
-                datetime.fromisoformat(state["next_audit_date"]) - timedelta(days=14)
-            ).isoformat(),
-            "final_verification": (
-                datetime.fromisoformat(state["next_audit_date"]) - timedelta(days=7)
-            ).isoformat(),
-            "audit_date": state["next_audit_date"],
-        },
-        "audit_readiness_score": calculate_audit_readiness_score(state),
-    }
-
-    # Simulate storing documentation
-    # TODO: Integrate with actual secure document storage (S3, SharePoint, etc.)
-    doc_url = f"https://secure-docs.hospital.com/compliance/{state['execution_id']}"
-    doc_files = [
-        "compliance_summary_report.pdf",
-        "gap_analysis_detailed.xlsx",
-        "remediation_plan.pdf",
-        "evidence_package.zip",
-    ]
-
-    state["documentation_prepared"] = True
-    state["documentation_url"] = doc_url
-    state["documentation_files"] = doc_files
-    state["documentation_package"] = doc_package
-    state["last_updated"] = datetime.now().isoformat()
-
-    # Message
-    state["messages"].append(
-        AIMessage(
-            content=f"📄 Documentation package prepared: {len(doc_files)} files ready at {doc_url}"
-        )
-    )
-
-    # Audit trail
-    state["audit_trail"].append(
-        {
-            "timestamp": datetime.now().isoformat(),
-            "step": "prepare_docs",
-            "action": "Documentation prepared",
-            "details": {
-                "file_count": len(doc_files),
-                "url": doc_url,
-                "readiness_score": doc_package["audit_readiness_score"],
-            },
-            "user": "system",
-        }
-    )
-
-    logger.info(f"Documentation prepared: {doc_url}")
-
-    return state
-
-
-def send_anticipatory_notifications(
-    state: ComplianceAgentState,
-) -> ComplianceAgentState:
-    """
-    Step 5: Send notifications to stakeholders with actionable information
-
-    For positive outcomes:
-    - Early notification enables calm, planned response
-    - Specific assignments clarify responsibilities
-    - Deadlines provide urgency without panic
-    - Transparent reasoning builds trust in AI system
-    """
-
-    logger.info("[Step 5] Sending notifications to stakeholders")
-
-    # Create action items from gaps
-    action_items = []
-    action_id = 1
-
-    for gap in state["compliance_gaps"]:
-        assignee = determine_assignee(gap)
-        deadline = calculate_deadline(gap, state["days_until_audit"], state["next_audit_date"])
-
-        action_items.append(
-            {
-                "action_id": f"action_{action_id:03d}",
-                "gap_id": gap["gap_id"],
-                "description": gap["description"],
-                "action_required": gap["action_required"],
-                "severity": gap["severity"],
-                "assignee": assignee,
-                "assignee_email": get_assignee_email(assignee, state["hospital_id"]),
-                "deadline": deadline,
-                "estimated_time": gap["estimated_time_to_fix"],
-                "status": "pending",
-                "created_at": datetime.now().isoformat(),
-            }
-        )
-        action_id += 1
-
-    state["action_items"] = action_items
-
-    # Determine recipients based on severity
-    recipients = ["charge_nurse"]
-    if state["gap_severity_distribution"].get("critical", 0) > 0:
-        recipients.append("nurse_manager")
-    if state["gap_severity_distribution"].get("critical", 0) > 2:
-        recipients.append("cno")  # Chief Nursing Officer for multiple critical issues
-
-    # Compose notification
-    notification = compose_notification(state, action_items)
-
-    # Send notification
-    # TODO: Integrate with actual notification system (email, SMS, Slack, etc.)
-    send_notification_to_recipients(notification, recipients, state["hospital_id"])
-
-    state["notification_sent"] = True
-    state["notification_recipients"] = recipients
-    state["notification_timestamp"] = datetime.now().isoformat()
-    state["last_updated"] = datetime.now().isoformat()
-
-    # Message
-    state["messages"].append(
-        AIMessage(
-            content=f"📧 Notifications sent to {len(recipients)} recipients: {', '.join(recipients)}"
-        )
-    )
-
-    # Audit trail
-    state["audit_trail"].append(
-        {
-            "timestamp": datetime.now().isoformat(),
-            "step": "notify",
-            "action": "Notifications sent",
-            "details": {
-                "recipients": recipients,
-                "action_item_count": len(action_items),
-            },
-            "user": "system",
-        }
-    )
-
-    logger.info(f"Notifications sent to: {recipients}")
-
-    return state
-
-
-def schedule_continuous_monitoring(state: ComplianceAgentState) -> ComplianceAgentState:
-    """
-    Step 6: Schedule periodic re-checks until audit
-
-    For positive outcomes:
-    - Regular monitoring tracks progress toward compliance
-    - Early detection of new gaps prevents last-minute scrambling
-    - Trend analysis predicts audit readiness
-    - Automated reminders keep team accountable
-    """
-
-    logger.info("[Step 6] Scheduling continuous monitoring")
-
-    days_until = state["days_until_audit"]
-
-    # Determine monitoring frequency based on time remaining
-    if days_until > 90:
-        frequency = "monthly"
-        next_check_days = 30
-    elif days_until > 60:
-        frequency = "biweekly"
-        next_check_days = 14
-    elif days_until > 30:
-        frequency = "weekly"
-        next_check_days = 7
-    else:
-        frequency = "daily"
-        next_check_days = 1
-
-    next_check_date = (datetime.now() + timedelta(days=next_check_days)).isoformat()
-
-    state["monitoring_scheduled"] = True
-    state["monitoring_frequency"] = frequency
-    state["next_check_date"] = next_check_date
-    state["monitoring_until_date"] = state["next_audit_date"]
-    state["last_updated"] = datetime.now().isoformat()
-
-    # Message
-    state["messages"].append(
-        AIMessage(
-            content=f"⏰ Scheduled {frequency} monitoring until {state['next_audit_date']} "
-            f"(next check: {next_check_date[:10]})"
-        )
-    )
-
-    # Audit trail
-    state["audit_trail"].append(
-        {
-            "timestamp": datetime.now().isoformat(),
-            "step": "schedule_monitor",
-            "action": "Monitoring scheduled",
-            "details": {
-                "frequency": frequency,
-                "next_check": next_check_date,
-                "until_date": state["next_audit_date"],
-            },
-            "user": "system",
-        }
-    )
-
-    logger.info(f"Monitoring scheduled: {frequency} until {state['next_audit_date']}")
-
-    return state
-
-
-# =============================================================================
-# Helper Functions
-# =============================================================================
-
-
-def get_audit_requirements(audit_type: str) -> list[dict]:
-    """
-    Get compliance requirements for audit type
-
-    TODO: Load from database or configuration file
-    """
-
-    # Example requirements for Joint Commission
-    if audit_type == "joint_commission":
-        return [
-            {
-                "id": "JC_MED_001",
-                "category": "medication_safety",
-                "description": "Medication administration records",
-            },
-            {
-                "id": "JC_MED_002",
-                "category": "medication_safety",
-                "description": "High-risk medication double-checks",
-            },
-            {
-                "id": "JC_DOC_001",
-                "category": "documentation",
-                "description": "Patient assessment documentation",
-            },
-            {
-                "id": "JC_DOC_002",
-                "category": "documentation",
-                "description": "Nurse signature completeness",
-            },
-            {
-                "id": "JC_SAF_001",
-                "category": "patient_safety",
-                "description": "Restraint order renewals",
-            },
-            {
-                "id": "JC_SAF_002",
-                "category": "patient_safety",
-                "description": "Fall risk assessments",
-            },
-            {
-                "id": "JC_INF_001",
-                "category": "infection_control",
-                "description": "Hand hygiene compliance",
-            },
-            {
-                "id": "JC_INF_002",
-                "category": "infection_control",
-                "description": "Isolation protocol adherence",
-            },
-            # ... would have ~50 total requirements
-        ]
-
-    # Add other audit types as needed
-    return []
-
-
-def calculate_audit_readiness_score(state: ComplianceAgentState) -> float:
-    """
-    Calculate overall audit readiness score (0-100)
-
-    Factors:
-    - Compliance percentage (60% weight)
-    - Gap severity (20% weight)
-    - Time remaining (20% weight)
-    """
-
-    # Factor 1: Compliance percentage
-    compliance_score = state["compliance_percentage"]
-
-    # Factor 2: Gap severity penalty
-    severity_penalties = {
-        "critical": 10,  # -10 points per critical gap
-        "high": 5,
-        "medium": 2,
-        "low": 0.5,
-    }
-
-    severity_penalty = sum(
-        count * severity_penalties.get(severity, 0)
-        for severity, count in state["gap_severity_distribution"].items()
-    )
-
-    gap_score = max(0, 100 - severity_penalty)
-
-    # Factor 3: Time remaining score
-    days_until = state["days_until_audit"]
-    if days_until >= 90:
-        time_score = 100
-    elif days_until >= 60:
-        time_score = 80
-    elif days_until >= 30:
-        time_score = 60
-    else:
-        time_score = 40
-
-    # Weighted average
-    readiness_score = compliance_score * 0.6 + gap_score * 0.2 + time_score * 0.2
-
-    return round(readiness_score, 1)
-
-
-def determine_assignee(gap: dict) -> str:
-    """
-    Determine who should be assigned to fix this gap
-
-    Based on category and severity
-    """
-
-    category = gap["category"]
-    severity = gap["severity"]
-
-    if category == "medication_safety":
-        if severity == "critical":
-            return "nurse_manager"  # Manager handles critical safety issues
-        else:
-            return "charge_nurse"
-
-    elif category == "documentation":
-        return "charge_nurse"  # Charge nurse coordinates documentation fixes
-
-    elif category == "patient_safety":
-        if "restraint" in gap["item"].lower():
-            return "provider"  # Restraint orders require provider
-        else:
-            return "charge_nurse"
-
-    elif category == "infection_control":
-        return "infection_control_nurse"
-
-    else:
-        return "charge_nurse"  # Default
-
-
-def calculate_deadline(gap: dict, days_until_audit: int, audit_date: str) -> str:
-    """
-    Calculate appropriate deadline for fixing gap
-
-    - Critical: 1 week or 25% of time remaining (whichever is sooner)
-    - High: 2 weeks or 50% of time remaining
-    - Medium: 1 month or 75% of time remaining
-    - Low: 2 weeks before audit
-    """
-
-    severity = gap["severity"]
-
-    if severity == "critical":
-        # 1 week or 25% of time
-        deadline_days = min(7, days_until_audit // 4)
-    elif severity == "high":
-        # 2 weeks or 50% of time
-        deadline_days = min(14, days_until_audit // 2)
-    elif severity == "medium":
-        # 1 month or 75% of time
-        deadline_days = min(30, int(days_until_audit * 0.75))
-    else:  # low
-        # 2 weeks before audit
-        deadline_days = days_until_audit - 14
-
-    # Ensure deadline is at least tomorrow
-    deadline_days = max(1, deadline_days)
-
-    deadline = datetime.now() + timedelta(days=deadline_days)
-
-    return deadline.isoformat()
-
-
-def get_assignee_email(assignee: str, hospital_id: str) -> str:
-    """
-    Get email address for assignee
-
-    TODO: Look up from hospital staff database
-    """
-
-    # Example mapping
-    email_map = {
-        "charge_nurse": f"charge.nurse@{hospital_id}.hospital.com",
-        "nurse_manager": f"nurse.manager@{hospital_id}.hospital.com",
-        "cno": f"cno@{hospital_id}.hospital.com",
-        "provider": f"provider@{hospital_id}.hospital.com",
-        "infection_control_nurse": f"infection.control@{hospital_id}.hospital.com",
-    }
-
-    return email_map.get(assignee, f"{assignee}@{hospital_id}.hospital.com")
-
-
-def compose_notification(state: ComplianceAgentState, action_items: list[dict]) -> dict:
-    """
-    Compose notification with all relevant information
-    """
-
-    days_until = state["days_until_audit"]
-    compliance_pct = state["compliance_percentage"]
-    gaps = state["compliance_gaps"]
-    readiness_score = state["documentation_package"]["audit_readiness_score"]
-
-    notification = {
-        "type": "anticipatory_compliance_alert",
-        "urgency": "high" if days_until < 60 else "medium",
-        "title": f"{state['audit_type'].replace('_', ' ').title()} Audit Preparation",
-        "summary": f"""
-📋 **{state["audit_type"].replace("_", " ").upper()} AUDIT PREPARATION**
-
-**Audit Date:** {datetime.fromisoformat(state["next_audit_date"]).strftime("%B %d, %Y")}
-**Days Remaining:** {days_until} days
-**Audit Readiness Score:** {readiness_score:.1f}/100
-
----
-
-✅ **COMPLIANCE STATUS**
-- Overall: {compliance_pct:.1f}% ({state["compliant_items"]}/{state["total_compliance_items"]} items)
-- Target: 95%+ for audit success
-
-**Category Breakdown:**
-"""
-        + "\n".join(f"- {cat}: {score:.1f}%" for cat, score in state["category_scores"].items())
-        + f"""
-
----
-
-⚠️  **GAPS REQUIRING ATTENTION ({len(gaps)} total)**
-"""
-        + "\n".join(f"[{g['severity'].upper()}] {g['description']}" for g in gaps[:5])
-        + (f"\n... and {len(gaps) - 5} more (see full report)" if len(gaps) > 5 else "")
-        + f"""
-
----
-
-🎯 **ACTION ITEMS ({len(action_items)} tasks)**
-"""
-        + "\n".join(
-            f"{i + 1}. [{item['severity'].upper()}] {item['description']}\n"
-            f"   → Assignee: {item['assignee']}\n"
-            f"   → Deadline: {datetime.fromisoformat(item['deadline']).strftime('%Y-%m-%d')}\n"
-            f"   → Time: {item['estimated_time']}"
-            for i, item in enumerate(action_items[:3])
-        )
-        + (f"\n... and {len(action_items) - 3} more action items" if len(action_items) > 3 else "")
-        + f"""
-
----
-
-📂 **DOCUMENTATION PACKAGE**
-Pre-prepared documentation available at:
-{state["documentation_url"]}
-
-Files included:
-"""
-        + "\n".join(f"- {f}" for f in state["documentation_files"])
-        + """
-
----
-
-🤖 **ANTICIPATORY EMPATHY (Level 4)**
-
-This alert was generated using predictive analytics based on your hospital's
-audit history. By preparing now, we have sufficient time to address all gaps
-without stress or rushed work during audit week.
-
-**Prediction Details:**
-- Method: Historical cycle analysis
-- Confidence: {:.0%}
-- Next monitoring check: {}
-
-**Questions?** Contact your compliance coordinator or reply to this message.
-        """.format(
-            state["prediction_confidence"],
-            datetime.fromisoformat(state["next_check_date"]).strftime("%Y-%m-%d"),
-        ),
-        "action_items": action_items,
-        "documentation_url": state["documentation_url"],
-        "priority": (
-            "high" if state["gap_severity_distribution"].get("critical", 0) > 0 else "medium"
-        ),
-    }
-
-    return notification
-
-
-def send_notification_to_recipients(notification: dict, recipients: list[str], hospital_id: str):
-    """
-    Send notification via configured channels
-
-    TODO: Integrate with actual notification system
-    - Email (SMTP)
-    - SMS (Twilio)
-    - Slack/Teams (webhooks)
-    - In-app notifications
-    """
-
-    logger.info(f"Sending notification to: {recipients}")
-
-    # Simulate sending
-    for recipient in recipients:
-        email = get_assignee_email(recipient, hospital_id)
-        logger.info(f"  → {recipient} ({email})")
-
-        # TODO: Actual email/SMS/webhook integration
-        # send_email(to=email, subject=notification["title"], body=notification["summary"])
-
-    logger.info("Notifications sent successfully")
-
-
-# =============================================================================
-# Main Entry Point
-# =============================================================================
-
-
-async def run_compliance_agent(
-    hospital_id: str, audit_type: str = "joint_commission"
-) -> ComplianceAgentState:
-    """
-    Run the compliance anticipation agent
-
-    Args:
-        hospital_id: Hospital/facility identifier
-        audit_type: Type of audit to anticipate
-
-    Returns:
-        Final agent state with all results
-    """
-
-    logger.info(f"Starting Compliance Anticipation Agent for {hospital_id} ({audit_type})")
-
-    # Create agent
-    agent = create_compliance_agent()
-
-    # Initialize state
-    initial_state = create_initial_state(hospital_id, audit_type)
-
-    # Run agent
-    final_state = await agent.ainvoke(initial_state)
-
-    logger.info(
-        f"Agent completed. Audit readiness score: "
-        f"{final_state.get('documentation_package', {}).get('audit_readiness_score', 0):.1f}"
-    )
-
-    return final_state
-
-
-if __name__ == "__main__":
-    import asyncio
-
-    # Example usage
-    async def main():
-        result = await run_compliance_agent(
-            hospital_id="example_hospital_123", audit_type="joint_commission"
-        )
-
-        print("\n" + "=" * 80)
-        print("COMPLIANCE ANTICIPATION AGENT RESULTS")
-        print("=" * 80)
-        print(f"Audit Date: {result['next_audit_date']}")
-        print(f"Days Until: {result['days_until_audit']}")
-        print(f"Compliance: {result['compliance_percentage']:.1f}%")
-        print(f"Gaps: {len(result['compliance_gaps'])}")
-        print(f"Action Items: {len(result['action_items'])}")
-        print(f"Documentation: {result['documentation_url']}")
-        print(
-            f"Audit Readiness: {result['documentation_package']['audit_readiness_score']:.1f}/100"
-        )
-        print("=" * 80)
-
-    asyncio.run(main())