HL7 Patient Merge Messages : Optionally allow reversing merging of pa…

…tient records if clients send duplicated ADT^A40 patient merge messages repeatedly, just reversing the patient identifier values in PID / MRG segments #4589
dcm4che · Oct 23, 2024 · 536f91f · 536f91f
1 parent e600188
commit 536f91f
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Showing 5 changed files with 49 additions and 2 deletions.
diff --git a/dcm4chee-arc-conf/src/main/java/org/dcm4chee/arc/conf/HL7ReferredMergedPatientPolicy.java b/dcm4chee-arc-conf/src/main/java/org/dcm4chee/arc/conf/HL7ReferredMergedPatientPolicy.java
@@ -43,8 +43,9 @@
 
 /**
  * @author Gunter Zeilinger ([email protected])
+ * @author Vrinda Nayak <[email protected]>
  * @since Apr 2020
  */
 public enum HL7ReferredMergedPatientPolicy {
-        REJECT, IGNORE, IGNORE_DUPLICATE_MERGE
+        REJECT, IGNORE, IGNORE_DUPLICATE_MERGE, UNMERGE_DUPLICATED_REPEATED_MERGE
 }
diff --git a/dcm4chee-arc-hl7/src/main/java/org/dcm4chee/arc/hl7/PatientUpdateService.java b/dcm4chee-arc-hl7/src/main/java/org/dcm4chee/arc/hl7/PatientUpdateService.java
@@ -203,6 +203,7 @@ private static Patient changePIDOrMergePatient(
             ArchiveHL7ApplicationExtension arcHL7App) throws HL7Exception {
         UnparsedHL7Message msg = ctx.getUnparsedHL7Message();
         try {
+            ctx.setHl7ReferredMergedPatientPolicy(arcHL7App.hl7ReferredMergedPatientPolicy());
             return msg.msh().getMessageType().equals(CHANGE_PATIENT_IDENTIFIER)
                     ? patientService.changePatientID(ctx)
                     : patientService.mergePatient(ctx);

diff --git a/dcm4chee-arc-patient/src/main/java/org/dcm4chee/arc/patient/PatientMgtContext.java b/dcm4chee-arc-patient/src/main/java/org/dcm4chee/arc/patient/PatientMgtContext.java
@@ -49,6 +49,7 @@
 import org.dcm4che3.soundex.FuzzyStr;
 import org.dcm4chee.arc.conf.ArchiveAEExtension;
 import org.dcm4chee.arc.conf.AttributeFilter;
+import org.dcm4chee.arc.conf.HL7ReferredMergedPatientPolicy;
 import org.dcm4chee.arc.entity.Patient;
 import org.dcm4chee.arc.keycloak.HttpServletRequestInfo;
 
@@ -138,4 +139,8 @@ public interface PatientMgtContext {
     Connection getConnection();
 
     Socket getSocket();
+
+    HL7ReferredMergedPatientPolicy getHl7ReferredMergedPatientPolicy();
+
+    void setHl7ReferredMergedPatientPolicy(HL7ReferredMergedPatientPolicy hl7ReferredMergedPatientPolicy);
 }
diff --git a/dcm4chee-arc-patient/src/main/java/org/dcm4chee/arc/patient/impl/PatientMgtContextImpl.java b/dcm4chee-arc-patient/src/main/java/org/dcm4chee/arc/patient/impl/PatientMgtContextImpl.java
@@ -78,6 +78,7 @@ public class PatientMgtContextImpl implements PatientMgtContext {
     private Collection<IDWithIssuer> previousPatientIDs;
     private Attributes previousAttributes;
     private Attributes.UpdatePolicy attributeUpdatePolicy = Attributes.UpdatePolicy.OVERWRITE;
+    private HL7ReferredMergedPatientPolicy hl7ReferredMergedPatientPolicy;
     private String eventActionCode = AuditMessages.EventActionCode.Read;
     private Exception exception;
     private Patient patient;
@@ -329,4 +330,14 @@ public Connection getConnection() {
     public Socket getSocket() {
         return socket;
     }
+
+    @Override
+    public HL7ReferredMergedPatientPolicy getHl7ReferredMergedPatientPolicy() {
+        return hl7ReferredMergedPatientPolicy;
+    }
+
+    @Override
+    public void setHl7ReferredMergedPatientPolicy(HL7ReferredMergedPatientPolicy hl7ReferredMergedPatientPolicy) {
+        this.hl7ReferredMergedPatientPolicy = hl7ReferredMergedPatientPolicy;
+    }
 }
diff --git a/dcm4chee-arc-patient/src/main/java/org/dcm4chee/arc/patient/impl/PatientServiceEJB.java b/dcm4chee-arc-patient/src/main/java/org/dcm4chee/arc/patient/impl/PatientServiceEJB.java
@@ -52,6 +52,7 @@
 import org.dcm4chee.arc.conf.ArchiveDeviceExtension;
 import org.dcm4chee.arc.conf.ArchiveHL7ApplicationExtension;
 import org.dcm4chee.arc.conf.AttributeFilter;
+import org.dcm4chee.arc.conf.HL7ReferredMergedPatientPolicy;
 import org.dcm4chee.arc.entity.*;
 import org.dcm4chee.arc.patient.*;
 import org.hibernate.annotations.QueryHints;
@@ -148,6 +149,31 @@ private void logSuppressPatientCreate(PatientMgtContext ctx) {
         LOG.info("{}: Suppress creation of Patient[id={}] by {}", ctx, ctx.getPatientIDs(), ctx.getUnparsedHL7Message().msh());
     }
 
+    public Patient findPatient(Collection<IDWithIssuer> pids, Collection<IDWithIssuer> prev,
+                               HL7ReferredMergedPatientPolicy hl7ReferredMergedPatientPolicy)
+            throws NonUniquePatientException, PatientMergedException {
+        Collection<Patient> list = findPatients(pids);
+        if (list.isEmpty())
+            return null;
+
+        if (list.size() > 1)
+            throw new NonUniquePatientException("Multiple Patients with ID " + pids);
+
+        Patient pat = list.iterator().next();
+        Patient mergedWith = pat.getMergedWith();
+        if (mergedWith != null) {
+            if (hl7ReferredMergedPatientPolicy != HL7ReferredMergedPatientPolicy.UNMERGE_DUPLICATED_REPEATED_MERGE
+                    || mergedWith.getPatientIDs().stream()
+                        .map(PatientID::getIDWithIssuer)
+                        .collect(Collectors.toList())
+                        .stream()
+                        .noneMatch(prev::contains))
+            throw new PatientMergedException("" + pat + " merged with " + mergedWith);
+        }
+
+        return pat;
+    }
+
     public Patient findPatient(Collection<IDWithIssuer> pids)
             throws NonUniquePatientException, PatientMergedException {
         Collection<Patient> list = findPatients(pids);
@@ -276,7 +302,8 @@ private static IDWithIssuer removeByID(Collection<IDWithIssuer> newPatientIDs, S
 
     public Patient mergePatient(PatientMgtContext ctx)
             throws NonUniquePatientException, PatientMergedException {
-        Patient pat = findPatient(ctx.getPatientIDs());
+        HL7ReferredMergedPatientPolicy hl7ReferredMergedPatientPolicy = ctx.getHl7ReferredMergedPatientPolicy();
+        Patient pat = findPatient(ctx.getPatientIDs(), ctx.getPreviousPatientIDs(), hl7ReferredMergedPatientPolicy);
         Patient prev = findPatient(ctx.getPreviousPatientIDs());
         if (pat == null && prev == null && ctx.isNoPatientCreate()) {
             logSuppressPatientCreate(ctx);
@@ -301,6 +328,8 @@ public Patient mergePatient(PatientMgtContext ctx)
             ctx.setAttributes(pat.getAttributes());
             ctx.setPreviousAttributes(prev.getAttributes());
         }
+        if (hl7ReferredMergedPatientPolicy == HL7ReferredMergedPatientPolicy.UNMERGE_DUPLICATED_REPEATED_MERGE)
+            pat.setMergedWith(null);
         prev.setMergedWith(pat);
         return pat;
     }