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agdar/PHASE1_PROGRESS.md
Marwan Alwali 27a71b658a first commit
2025-11-02 14:35:35 +03:00

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Phase 1: Models Implementation - Progress Report

✅ Completed Models (5 of 11 apps - 45% complete)

1. Core App ✅ COMPLETE

File: core/models.py Models: 9 models + 5 base mixins

  • Base Mixins: UUIDPrimaryKeyMixin, TimeStampedMixin, TenantOwnedMixin, ClinicallySignableMixin, SoftDeleteMixin
  • Tenant, User (8 roles), Patient (bilingual), Clinic (5 specialties)
  • File, SubFile, Consent (e-signature), Attachment (GenericFK), AuditLog

2. Appointments App ✅ COMPLETE

File: appointments/models.py Models: 5 models

  • Provider, Room, Schedule (weekly recurring)
  • Appointment (8-state machine with properties)
  • AppointmentReminder

3. Finance App ✅ COMPLETE

File: finance/models.py Models: 7 models

  • Service, Package, Payer
  • Invoice (with properties), InvoiceLineItem, Payment
  • PackagePurchase (usage tracking)

4. Notifications App ✅ COMPLETE

File: notifications/models.py Models: 4 models

  • MessageTemplate (bilingual with render method)
  • Message (delivery tracking)
  • NotificationPreference (with can_send method)
  • MessageLog

5. Nursing App ✅ COMPLETE

File: nursing/models.py Models: 3 models

  • NursingEncounter (MD-N-F-1 with BMI calculation, abnormal vitals detection)
  • GrowthChart (percentiles, auto-population)
  • VitalSignsAlert

📋 Remaining Models to Implement (6 apps - 55%)

6. Medical App - TO DO NEXT

File: medical/models.py (to be created) Based on: MD-F-1 and MD-F-2 forms

Models Required:

MedicalConsultation (MD-F-1)

class MedicalConsultation(UUIDPrimaryKeyMixin, TimeStampedMixin, TenantOwnedMixin, ClinicallySignableMixin):
    """Medical consultation form MD-F-1"""
    patient FK, appointment FK, consultation_date, provider FK
    
    # History Sections
    chief_complaint (TextField)
    present_illness_history (TextField)
    past_medical_history (TextField)
    vaccination_status (TextField)
    family_history (TextField)
    social_history (TextField)
    pregnancy_history (TextField)
    neonatal_history (TextField)
    
    # Developmental Milestones (TextFields)
    developmental_motor_milestones
    developmental_language_milestones
    developmental_social_milestones
    developmental_cognitive_milestones
    
    # Behavioral Symptoms (JSONField - checklist)
    behavioral_symptoms
    
    # Physical Exam (JSONField - structured)
    physical_exam
    
    # Assessment & Plan
    clinical_summary (TextField)
    recommendations (TextField)
    referrals_needed (TextField)
    lab_orders (JSONField)
    radiology_orders (JSONField)
    
    history = HistoricalRecords()

MedicationPlan

class MedicationPlan(UUIDPrimaryKeyMixin):
    """Medication details for consultation"""
    consultation FK
    drug_name, dose
    frequency: TextChoices (DAILY, BID, TID, QID, PRN, OTHER)
    frequency_other
    compliance: TextChoices (GOOD, PARTIAL, BAD)
    gains (TextField)
    side_effects (TextField)
    target_behavior (TextField)
    improved (BooleanField)

MedicalFollowUp (MD-F-2)

class MedicalFollowUp(UUIDPrimaryKeyMixin, TimeStampedMixin, TenantOwnedMixin, ClinicallySignableMixin):
    """Medical follow-up form MD-F-2"""
    patient FK, appointment FK
    previous_consultation FK (to MedicalConsultation)
    followup_date, provider FK
    
    # Previous complaints status (JSONField: complaint → RESOLVED/STATIC/WORSE)
    previous_complaints_status
    new_complaints (TextField)
    
    # Links
    nursing_vitals FK (to nursing.NursingEncounter)
    
    # Assessment
    assessment (TextField)
    recommendations (TextField)
    family_satisfaction: TextChoices (ZERO, FIFTY, HUNDRED)
    medication_snapshot (JSONField)
    
    history = HistoricalRecords()

7. ABA App - TO DO

File: aba/models.py (to be created) Based on: ABA-F-1 form

Models Required:

ABAConsult

class ABAConsult(UUIDPrimaryKeyMixin, TimeStampedMixin, TenantOwnedMixin, ClinicallySignableMixin):
    """ABA consultation form ABA-F-1"""
    patient FK, appointment FK, consultation_date, provider FK
    
    reason_of_referral: TextChoices (from form options)
    parental_concern (TextField)
    school_concern (TextField)
    respondents (CharField)
    interviewer (CharField)
    diagnosed_condition (CharField)
    interaction_hours_per_day (PositiveIntegerField)
    
    # Factors (JSONField with booleans)
    physiological_factors
    medical_factors
    
    recommendations (TextField)
    
    history = HistoricalRecords()

ABABehavior

class ABABehavior(UUIDPrimaryKeyMixin):
    """Behavior details for ABA consult"""
    consult FK
    behavior_description (TextField)
    frequency: TextChoices (HOURLY, DAILY, WEEKLY, LESS_THAN_WEEKLY)
    duration (CharField)
    intensity: TextChoices (MILD, MODERATE, SEVERE)
    antecedents_likely (TextField)
    antecedents_least_likely (TextField)
    consequences (TextField)
    order (PositiveIntegerField for sorting)

8. OT App - TO DO

File: ot/models.py (to be created) Based on: OT-F-1 and OT-F-3 forms

Models Required:

OTConsult (OT-F-1)

class OTConsult(UUIDPrimaryKeyMixin, TimeStampedMixin, TenantOwnedMixin, ClinicallySignableMixin):
    """OT consultation form OT-F-1"""
    patient FK, appointment FK, consultation_date, provider FK
    
    reasons (ArrayField or JSONField with choices)
    top_difficulty_areas (JSONField: 3 text fields)
    
    # Developmental & skills (JSONField matrices)
    developmental_motor_milestones
    self_help_skills
    feeding_participation
    
    # Behavior descriptors (JSONField)
    infant_behavior_descriptors
    current_behavior_descriptors
    
    recommendation: TextChoices (CONTINUE, DISCHARGE, REFER_TO_OTHER)
    recommendation_notes (TextField)
    
    history = HistoricalRecords()

OTSession (OT-F-3)

class OTSession(UUIDPrimaryKeyMixin, TimeStampedMixin, TenantOwnedMixin, ClinicallySignableMixin):
    """OT session notes form OT-F-3"""
    patient FK, appointment FK (nullable), session_date, provider FK
    
    session_type: TextChoices (CONSULT, INDIVIDUAL, GROUP, PARENT_TRAINING)
    cooperative_level (PositiveSmallIntegerField 1-4)
    distraction_tolerance (PositiveSmallIntegerField 1-4)
    
    activities_checklist (JSONField: "Today we work on...")
    observations (TextField)
    activities_performed (TextField)
    recommendations (TextField)
    
    history = HistoricalRecords()

OTTargetSkill

class OTTargetSkill(UUIDPrimaryKeyMixin):
    """Target skills with 0-10 scoring"""
    session FK
    skill_name (CharField)
    score (PositiveSmallIntegerField 0-10)
    notes (TextField)
    order (PositiveIntegerField)

9. SLP App - TO DO

File: slp/models.py (to be created) Based on: SLP-F-1, F-2, F-3, F-4 forms

Models Required:

SLPConsult (SLP-F-1)

class SLPConsult(UUIDPrimaryKeyMixin, TimeStampedMixin, TenantOwnedMixin, ClinicallySignableMixin):
    """SLP consultation form SLP-F-1 with variants"""
    patient FK, appointment FK, consultation_date, provider FK
    
    consult_variant: TextChoices (ASD, LANGUAGE_DELAY, FLUENCY)
    primary_concern (TextField)
    suspected_areas (JSONField)
    type_of_service: TextChoices (CONSULT, EVAL, INTERVENTION, PARENT_TRAINING)
    
    communication_modes (JSONField checklist)
    screen_time_hours (PositiveIntegerField)
    
    # Variant-specific questionnaires (JSONField)
    variant_questionnaire
    
    # Skills to observe (JSONField matrix)
    skills_to_observe
    
    # Oral motor screening (JSONField)
    oral_motor_screening
    
    recommendations (TextField)
    
    history = HistoricalRecords()

SLPAssessment (SLP-F-2)

class SLPAssessment(UUIDPrimaryKeyMixin, TimeStampedMixin, TenantOwnedMixin, ClinicallySignableMixin):
    """SLP assessment form SLP-F-2"""
    patient FK, appointment FK, assessment_date, provider FK
    
    diagnosis_statement (TextField)
    case_history (TextField)
    
    # History sections
    prenatal_history (TextField)
    perinatal_history (TextField)
    postnatal_history (TextField)
    developmental_history (TextField)
    medical_status (TextField)
    
    # Speech/Language detail (JSONField)
    speech_language_detail
    
    # Test scores
    gfta3_score (CharField)
    jat_score (CharField)
    ssi_score (CharField)
    
    # Oral mechanism (JSONField)
    oral_mechanism
    
    # Rossetti domains (JSONField: domain → age level)
    rossetti_domains
    
    # Joint attention skills (JSONField)
    joint_attention_skills
    
    # Summary & Plan
    clinical_summary (TextField)
    recommendations (TextField)
    frequency_per_week (PositiveIntegerField)
    session_duration_minutes (PositiveIntegerField)
    referral_rules (JSONField)
    
    history = HistoricalRecords()

SLPIntervention (SLP-F-3)

class SLPIntervention(UUIDPrimaryKeyMixin, TimeStampedMixin, TenantOwnedMixin, ClinicallySignableMixin):
    """SLP intervention session form SLP-F-3"""
    patient FK, appointment FK
    session_number (PositiveIntegerField)
    session_date, session_time
    provider FK
    previous_session FK (self-referential, nullable)
    
    history = HistoricalRecords()

SLPTarget

class SLPTarget(UUIDPrimaryKeyMixin):
    """Intervention targets (SOAP format)"""
    intervention FK
    target_number (PositiveSmallIntegerField 1 or 2)
    subjective (TextField)
    objective (TextField)
    assessment (TextField)
    plan (TextField)
    prompt_strategies (JSONField)

SLPProgressReport (SLP-F-4)

class SLPProgressReport(UUIDPrimaryKeyMixin, TimeStampedMixin, TenantOwnedMixin, ClinicallySignableMixin):
    """SLP progress report form SLP-F-4"""
    patient FK, report_date, provider FK
    
    sessions_scheduled (PositiveIntegerField)
    sessions_attended (PositiveIntegerField)
    final_diagnosis (TextField)
    
    # Objectives & progress (JSONField: objective → % accuracy)
    objectives_progress
    
    # Plan details (JSONField)
    plan_details
    
    overall_progress (TextField)
    participation_level (TextField)
    attendance_rate (DecimalField)
    carryover_level (TextField)
    prognosis (TextField)
    recommendations (TextField)
    
    package_sessions_count (PositiveIntegerField)
    reassessment_needed (BooleanField)
    
    history = HistoricalRecords()

10. Referrals App - TO DO

File: referrals/models.py (to be created)

Models Required:

Referral

class Referral(UUIDPrimaryKeyMixin, TimeStampedMixin, TenantOwnedMixin):
    """Inter-discipline and external referrals"""
    patient FK
    from_clinic FK, to_clinic FK (nullable)
    from_provider FK, to_provider FK (nullable)
    external_provider_name (CharField)
    
    reason (TextField)
    urgency: TextChoices (ROUTINE, URGENT, EMERGENCY)
    status: TextChoices (PENDING, ACCEPTED, REJECTED, COMPLETED)
    
    created_at, responded_at
    notes (TextField)

11. Integrations App - TO DO

File: integrations/models.py (to be created)

Models Required:

ExternalOrder (Lab/Radiology)

class ExternalOrder(UUIDPrimaryKeyMixin, TimeStampedMixin, TenantOwnedMixin):
    """Lab and radiology orders"""
    patient FK
    order_type: TextChoices (LAB, RADIOLOGY)
    order_details (JSONField)
    status: TextChoices (ORDERED, IN_PROGRESS, COMPLETED, CANCELLED)
    result_url (URLField)
    result_data (JSONField)
    ordered_by FK, ordered_at, completed_at

NphiesMessage (Insurance e-Claims)

class NphiesMessage(UUIDPrimaryKeyMixin, TimeStampedMixin, TenantOwnedMixin):
    """NPHIES FHIR messages"""
    direction: TextChoices (OUTBOUND, INBOUND)
    resource_type: TextChoices (ELIGIBILITY, PRIOR_AUTH, CLAIM, PAYMENT_NOTICE, PAYMENT_RECONCILIATION)
    fhir_json (JSONField)
    status: TextChoices (QUEUED, SENT, ACK, ERROR)
    correlation_id (CharField)
    response_http_status (PositiveIntegerField)
    error_code, error_message
    created_at, sent_at

NphiesEncounterLink

class NphiesEncounterLink(UUIDPrimaryKeyMixin, TenantOwnedMixin):
    """Link appointments to NPHIES encounters"""
    patient FK, appointment FK
    encounter_id, claim_id, claim_response_id (CharField)

PayerContract

class PayerContract(UUIDPrimaryKeyMixin, TimeStampedMixin, TenantOwnedMixin):
    """Insurance payer configurations"""
    payer_code, payer_name
    credentials (JSONField encrypted)
    endpoints (JSONField)
    supports_eligibility, supports_prior_auth, supports_claims (BooleanField)
    is_active

EInvoice (ZATCA)

class EInvoice(UUIDPrimaryKeyMixin, TimeStampedMixin, TenantOwnedMixin):
    """ZATCA e-invoices"""
    invoice FK (to finance.Invoice)
    uuid (UUIDField)
    xml_payload (TextField)
    qr_base64 (TextField)
    clearance_status: TextChoices (PENDING, CLEARED, REJECTED, REPORTED)
    zatca_document_type (CharField)
    submission_mode: TextChoices (CLEARANCE, REPORTING)
    response_payload (JSONField)
    error_code, error_message
    submitted_at

ZatcaCredential

class ZatcaCredential(UUIDPrimaryKeyMixin, TimeStampedMixin, TenantOwnedMixin):
    """ZATCA credentials (CSIDs)"""
    environment: TextChoices (SIMULATION, COMPLIANCE, PRODUCTION)
    csid, certificate, private_key (TextField encrypted)
    is_active, expires_at

Summary Statistics

Total Models Across All Apps: ~50 models Completed: 28 models (56%) Remaining: 22 models (44%)

Apps Complete: 5 of 11 (45%) Apps Remaining: 6 of 11 (55%)

Next Steps

  1. ✅ Create medical app models (3 models)
  2. ✅ Create aba app models (2 models)
  3. ✅ Create ot app models (3 models)
  4. ✅ Create slp app models (5 models)
  5. ✅ Create referrals app models (1 model)
  6. ✅ Create integrations app models (6 models)
  7. Run python manage.py makemigrations
  8. Run python manage.py migrate
  9. Create signals for auto-generation (MRN, file numbers, etc.)
  10. Begin Phase 2 (Forms)

Key Features Implemented So Far

✅ UUID primary keys throughout ✅ Multi-tenancy support ✅ Role-based access control (8 roles) ✅ Bilingual support (Arabic/English) ✅ Audit trail with simple_history ✅ E-signature support ✅ State machines (Appointments) ✅ Auto-calculations (BMI, totals, percentiles) ✅ Property methods for business logic ✅ Comprehensive indexes ✅ Proper relationships and on_delete rules ✅ JSONField for flexible data structures ✅ MoneyField for currency handling ✅ Template rendering for notifications ✅ Growth chart tracking ✅ Vital signs alerts ✅ Package usage tracking