Marwan Alwali 263292f6be update

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Insurance Approval Integration - Migration Guide

Overview

This guide provides step-by-step instructions for applying the insurance approval integration to your hospital management system.

Prerequisites

Before starting the migration:

✅ Backup your database
✅ Ensure all existing migrations are applied
✅ Review the integration documentation (INSURANCE_APPROVAL_INTEGRATION.md)
✅ Test in a development environment first

Step 1: Verify Current State

Check Existing Migrations

# Check migration status
python manage.py showmigrations

# Look for these apps:
# - insurance_approvals
# - laboratory
# - radiology
# - pharmacy
# - operating_theatre

Verify Database Backup

# For SQLite (development)
cp db.sqlite3 db.sqlite3.backup

# For PostgreSQL (production)
pg_dump -U username -d database_name > backup_$(date +%Y%m%d_%H%M%S).sql

# For MySQL (production)
mysqldump -u username -p database_name > backup_$(date +%Y%m%d_%H%M%S).sql

Step 2: Create Migrations

Generate Migrations for All Modified Apps

# Create migrations for all integrated modules
python manage.py makemigrations laboratory radiology pharmacy operating_theatre

# Expected output:
# Migrations for 'laboratory':
#   laboratory/migrations/0XXX_add_approval_integration.py
#     - Add field approval_requests to laborder
# Migrations for 'radiology':
#   radiology/migrations/0XXX_add_approval_integration.py
#     - Add field approval_requests to imagingorder
# Migrations for 'pharmacy':
#   pharmacy/migrations/0XXX_add_approval_integration.py
#     - Add field approval_requests to prescription
# Migrations for 'operating_theatre':
#   operating_theatre/migrations/0XXX_add_approval_integration.py
#     - Add field approval_requests to surgicalcase

Step 3: Review Generated Migrations

Check Migration Files

Review each generated migration file to ensure it only adds the GenericRelation field:

# Example: laboratory/migrations/0XXX_add_approval_integration.py

from django.db import migrations
import django.contrib.contenttypes.fields

class Migration(migrations.Migration):
    dependencies = [
        ('laboratory', '0XXX_previous_migration'),
        ('contenttypes', '0002_remove_content_type_name'),
        ('insurance_approvals', '0001_initial'),
    ]

    operations = [
        # Note: GenericRelation doesn't create database fields
        # This migration may be empty or just update model metadata
    ]

Important: GenericRelation fields don't create actual database columns. The migrations might be empty or only update model metadata.

Step 4: Apply Migrations

Run Migrations

# Apply all pending migrations
python manage.py migrate

# Expected output:
# Running migrations:
#   Applying laboratory.0XXX_add_approval_integration... OK
#   Applying radiology.0XXX_add_approval_integration... OK
#   Applying pharmacy.0XXX_add_approval_integration... OK
#   Applying operating_theatre.0XXX_add_approval_integration... OK

Verify Migration Success

# Check migration status again
python manage.py showmigrations

# All migrations should show [X] (applied)

Step 5: Test Integration

Test in Django Shell

python manage.py shell

# Test Laboratory Integration
from laboratory.models import LabOrder
from insurance_approvals.models import InsuranceApprovalRequest

# Get a lab order
order = LabOrder.objects.first()

# Test helper methods
print(f"Requires approval: {order.requires_approval()}")
print(f"Has valid approval: {order.has_valid_approval()}")
print(f"Approval status: {order.approval_status}")

# Test creating an approval
if order.patient.insurance_info.exists():
    approval = InsuranceApprovalRequest.objects.create(
        tenant=order.tenant,
        patient=order.patient,
        insurance_info=order.patient.insurance_info.first(),
        request_type='LABORATORY',
        content_object=order,
        service_description='Test lab order',
        requesting_provider=order.ordering_provider,
        service_start_date=order.created_at.date(),
        status='PENDING_SUBMISSION',
    )
    print(f"Created approval: {approval.approval_number}")
    
    # Verify relationship
    print(f"Order approvals: {order.approval_requests.count()}")
    print(f"Approval content object: {approval.content_object}")

Test Each Module

Repeat the above test for:

✅ Radiology (ImagingOrder)
✅ Pharmacy (Prescription)
✅ Operating Theatre (SurgicalCase)

Step 6: Update Application Code

Add Approval Checks to Views

Example: Laboratory Order Creation

# laboratory/views.py

from django.contrib import messages
from django.shortcuts import redirect
from insurance_approvals.models import InsuranceApprovalRequest

class LabOrderCreateView(LoginRequiredMixin, CreateView):
    model = LabOrder
    form_class = LabOrderForm
    
    def form_valid(self, form):
        response = super().form_valid(form)
        order = self.object
        
        # Check if approval is required
        if order.requires_approval():
            messages.warning(
                self.request,
                f"Insurance approval required for order {order.order_number}. "
                f"Please submit an approval request."
            )
            # Optionally redirect to approval creation
            # return redirect('insurance_approvals:create', order_id=order.id)
        
        return response

Add Approval Status to Templates

Example: Order List Template

<!-- laboratory/templates/laboratory/order_list.html -->

{% for order in orders %}
<tr>
    <td>{{ order.order_number }}</td>
    <td>{{ order.patient.get_full_name }}</td>
    <td>
        {% if order.approval_status == 'APPROVED' %}
            <span class="badge bg-success">
                <i class="fa fa-check"></i> Approved
            </span>
        {% elif order.approval_status == 'APPROVAL_REQUIRED' %}
            <span class="badge bg-warning">
                <i class="fa fa-exclamation-triangle"></i> Approval Required
            </span>
            <a href="{% url 'insurance_approvals:create' %}?order_type=LAB&order_id={{ order.id }}" 
               class="btn btn-sm btn-primary ms-2">
                Request Approval
            </a>
        {% elif order.approval_status == 'NO_INSURANCE' %}
            <span class="badge bg-secondary">No Insurance</span>
        {% else %}
            <span class="badge bg-info">{{ order.approval_status }}</span>
        {% endif %}
    </td>
</tr>
{% endfor %}

Step 7: Generate Sample Data (Optional)

Run Data Generation Script

# Generate sample approval data
python insurance_approvals_data.py

# Expected output:
# 🏥 Creating Insurance Approval Data
# 📋 Found X tenants
# 👥 Found X patients
# 
# 1️⃣ Creating Approval Templates...
# Successfully created X approval templates.
# 
# 2️⃣ Creating Approval Requests...
# Successfully created X approval requests.
# 
# 3️⃣ Creating Status History...
# Successfully created X status history records.
# 
# 4️⃣ Creating Communication Logs...
# Successfully created X communication logs.
# 
# 🎉 Insurance Approval Data Creation Complete!

Step 8: Configure URLs (If Not Already Done)

Add Insurance Approvals URLs

# hospital_management/urls.py

from django.urls import path, include

urlpatterns = [
    # ... existing patterns ...
    path('insurance-approvals/', include('insurance_approvals.urls')),
]

Step 9: Test End-to-End Workflow

Complete Workflow Test

Create an Order

# Create a lab order for a patient with insurance
order = LabOrder.objects.create(
    tenant=tenant,
    patient=patient_with_insurance,
    ordering_provider=provider,
    # ... other fields
)

Check Approval Requirement

if order.requires_approval():
    print("✓ Approval requirement detected")

Create Approval Request

approval = InsuranceApprovalRequest.objects.create(
    tenant=order.tenant,
    patient=order.patient,
    insurance_info=order.patient.insurance_info.first(),
    request_type='LABORATORY',
    content_object=order,
    # ... other fields
)

Update Approval Status

approval.status = 'APPROVED'
approval.authorization_number = 'AUTH123456'
approval.expiration_date = timezone.now().date() + timedelta(days=90)
approval.save()

Verify Approval

assert order.has_valid_approval()
assert order.approval_status == 'APPROVED'
print("✓ Approval workflow complete")

Troubleshooting

Common Issues

Issue 1: Migration Conflicts

Problem: Migration conflicts with existing migrations

Solution:

# Reset migrations (development only!)
python manage.py migrate laboratory zero
python manage.py migrate radiology zero
python manage.py migrate pharmacy zero
python manage.py migrate operating_theatre zero

# Delete migration files
rm laboratory/migrations/0XXX_*.py
rm radiology/migrations/0XXX_*.py
rm pharmacy/migrations/0XXX_*.py
rm operating_theatre/migrations/0XXX_*.py

# Recreate migrations
python manage.py makemigrations
python manage.py migrate

Issue 2: ContentType Not Found

Problem: ContentType matching query does not exist

Solution:

# Run in Django shell
from django.contrib.contenttypes.models import ContentType
from laboratory.models import LabOrder

# Ensure ContentType exists
ct = ContentType.objects.get_for_model(LabOrder)
print(f"ContentType created: {ct}")

Issue 3: Circular Import

Problem: Circular import when accessing approval_requests

Solution:

# In helper methods, import inside the function
def has_valid_approval(self):
    from django.utils import timezone  # Import inside method
    return self.approval_requests.filter(
        status__in=['APPROVED', 'PARTIALLY_APPROVED'],
        expiration_date__gte=timezone.now().date()
    ).exists()

Rollback Procedure

If You Need to Rollback

# 1. Rollback migrations
python manage.py migrate laboratory 0XXX  # Previous migration number
python manage.py migrate radiology 0XXX
python manage.py migrate pharmacy 0XXX
python manage.py migrate operating_theatre 0XXX

# 2. Restore database backup
# For SQLite
cp db.sqlite3.backup db.sqlite3

# For PostgreSQL
psql -U username -d database_name < backup_file.sql

# For MySQL
mysql -u username -p database_name < backup_file.sql

# 3. Remove migration files
rm laboratory/migrations/0XXX_add_approval_integration.py
rm radiology/migrations/0XXX_add_approval_integration.py
rm pharmacy/migrations/0XXX_add_approval_integration.py
rm operating_theatre/migrations/0XXX_add_approval_integration.py

Post-Migration Checklist

All migrations applied successfully
Helper methods work correctly
Approval requests can be created
Approval status displays correctly
No errors in application logs
Templates updated with approval status
Views updated with approval checks
Sample data generated (if needed)
End-to-end workflow tested
Documentation reviewed
Team trained on new features

Performance Considerations

Database Indexes

The integration uses GenericForeignKey which queries ContentType. Ensure these indexes exist:

-- These should already exist from insurance_approvals migrations
CREATE INDEX idx_approval_content_type ON insurance_approvals_insuranceapprovalrequest(content_type_id);
CREATE INDEX idx_approval_object_id ON insurance_approvals_insuranceapprovalrequest(object_id);
CREATE INDEX idx_approval_status ON insurance_approvals_insuranceapprovalrequest(status);
CREATE INDEX idx_approval_expiration ON insurance_approvals_insuranceapprovalrequest(expiration_date);

Query Optimization

# Use select_related for better performance
orders = LabOrder.objects.select_related(
    'patient',
    'patient__insurance_info'
).prefetch_related(
    'approval_requests'
)

# Check approval status efficiently
for order in orders:
    if order.requires_approval():
        # Process...

Support

For issues or questions:

Review INSURANCE_APPROVAL_INTEGRATION.md
Check this migration guide
Review the insurance_approvals README.md
Check Django logs for errors

Summary

✅ Migration Complete When:

All migrations applied
Helper methods working
Approval workflow tested
Templates updated
No errors in logs

🎉 You're ready to use the insurance approval integration!

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Insurance Approval Integration - Migration Guide

Overview

Prerequisites

Step 1: Verify Current State

Check Existing Migrations

Verify Database Backup

Step 2: Create Migrations

Generate Migrations for All Modified Apps

Step 3: Review Generated Migrations

Check Migration Files

Step 4: Apply Migrations

Run Migrations

Verify Migration Success

Step 5: Test Integration

Test in Django Shell

Test Each Module

Step 6: Update Application Code

Add Approval Checks to Views

Example: Laboratory Order Creation

Add Approval Status to Templates

Example: Order List Template

Step 7: Generate Sample Data (Optional)

Run Data Generation Script

Step 8: Configure URLs (If Not Already Done)

Add Insurance Approvals URLs

Step 9: Test End-to-End Workflow

Complete Workflow Test

Troubleshooting

Common Issues

Issue 1: Migration Conflicts

Issue 2: ContentType Not Found

Issue 3: Circular Import

Rollback Procedure

If You Need to Rollback

Post-Migration Checklist

Performance Considerations

Database Indexes

Query Optimization

Support

Summary

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