feat: 对接合理用药

hlw/automation/index.js

@@ -274,13 +274,13 @@ async function cancelAutoOpenForHighRisk({
     }
   }
 
-  if (shouldNotify) {
+  // if (shouldNotify) {
-    await sendManualOpenNotification(
+  //   await sendManualOpenNotification(
-      db,
+  //     db,
-      { type: AUTOMATION_TYPES.OPEN_RX, corpId, orderId },
+  //     { type: AUTOMATION_TYPES.OPEN_RX, corpId, orderId },
-      doctorCode
+  //     doctorCode
-    );
+  //   );
-  }
+  // }
   return {
     success: false,
     skipped: true,
@@ -960,6 +960,20 @@ async function handleAutoOpenRx(db, task) {
 
   const params = await buildAutoPrescriptionParams(db, order);
   const diagnosticRecord = require("../diagnostic-record");
+  const reviewResult = await diagnosticRecord(
+    {
+      type: "getYbReviewResult",
+      corpId: order.corpId,
+      params,
+    },
+    db
+  );
+  if (!reviewResult || !reviewResult.success) {
+    throw new AutomationError(
+      reviewResult?.message || "合理用药审核未通过"
+    );
+  }
+
   const result = await diagnosticRecord(
     {
       type: "addConsultDiagnosis",

hlw/automation/index.test.js

@@ -624,6 +624,110 @@ describe("automation task scheduling", () => {
     );
   });
 
+  test("blocks automatic prescription when rational-drug review fails", async () => {
+    tencentIM.mockResolvedValue({ success: true });
+    diagnosticRecord.mockResolvedValue({
+      success: false,
+      message: "该处方存在不合理用药",
+    });
+    const drugId = new ObjectId();
+    const taskUpdateOne = jest.fn().mockResolvedValue({ modifiedCount: 1 });
+    const order = {
+      orderId: "order-review-failed",
+      corpId: "corp-1",
+      orderSource: "ALIPAY_MINI",
+      orderStatus: "processing",
+      doctorCode: "D001",
+      patientId: "P001",
+      name: "患者甲",
+      description: "鼻塞流涕",
+      medInfo: { dise_codg: "J00", dise_name: "普通感冒" },
+      drugs: [
+        {
+          _id: drugId.toString(),
+          dosage: 10,
+          dosage_unit: "mg",
+          quantity: 1,
+          usageName: "口服",
+          frequencyName: "每日两次",
+          unit: "盒",
+        },
+      ],
+      expireTime: Date.now() + 60_000,
+    };
+    const db = createCollectionDb({
+      "hlw-config": {
+        findOne: jest.fn().mockResolvedValue({ autoOpenRx: true }),
+        find: jest.fn().mockReturnValue({
+          toArray: jest.fn().mockResolvedValue([
+            { key: "store-medicine-dosage-unit", list: [{ code: "MG", name: "mg" }] },
+            { key: "store-medicine-frequence", list: [{ code: "BID", name: "每日两次" }] },
+            { key: "store-medicine-administration", list: [{ code: "PO", name: "口服" }] },
+            { key: "medicine-package-unit", list: [{ code: "盒", name: "盒" }] },
+          ]),
+        }),
+      },
+      "consult-order": { findOne: jest.fn().mockResolvedValue(order) },
+      "diagnostic-record": { findOne: jest.fn().mockResolvedValue(null) },
+      "hlw-doctor": {
+        findOne: jest.fn().mockResolvedValue({
+          doctorNo: "D001",
+          signatureUrl: "doctor-sign",
+          onlineStatus: "online",
+        }),
+      },
+      "drug-info": {
+        find: jest.fn().mockReturnValue({
+          toArray: jest.fn().mockResolvedValue([
+            {
+              _id: drugId,
+              onSale: true,
+              name: "测试药品",
+              erpId: "ERP-1",
+              insurance_code: "MED-1",
+              dosage_form: "片剂",
+              days: 3,
+              dosage_unit: "mg",
+              administration_method: "口服",
+              freq: "每日两次",
+              unit: "盒",
+            },
+          ]),
+        }),
+      },
+      [COLLECTION]: { updateOne: taskUpdateOne },
+    });
+    const task = {
+      _id: new ObjectId(),
+      type: AUTOMATION_TYPES.OPEN_RX,
+      corpId: "corp-1",
+      orderId: order.orderId,
+      attempts: 1,
+      expiresAt: Date.now() + 60_000,
+    };
+
+    await processClaimedTask(db, task);
+
+    expect(diagnosticRecord).toHaveBeenCalledTimes(1);
+    expect(diagnosticRecord).toHaveBeenCalledWith(
+      expect.objectContaining({
+        type: "getYbReviewResult",
+        corpId: order.corpId,
+        params: expect.objectContaining({ orderId: order.orderId }),
+      }),
+      db
+    );
+    expect(taskUpdateOne).toHaveBeenCalledWith(
+      expect.objectContaining({ _id: task._id, status: TASK_STATUS.RUNNING }),
+      expect.objectContaining({
+        $set: expect.objectContaining({
+          status: TASK_STATUS.FAILED,
+          lastError: "该处方存在不合理用药",
+        }),
+      })
+    );
+  });
+
   test("fails automatic audit immediately and sends the failure reason", async () => {
     tencentIM.mockResolvedValue({ success: true });
     const rxId = new ObjectId();

hlw/diagnostic-record/format.js

@@ -91,9 +91,9 @@ exports.formatUploadRxData = function (data) {
     hospid: "108",
     phar_code: data.pharmacistNo,
     phar_name: data.pharmacist,
-    phar_chk_time: dayjs(data.auditTime).format("YYYY-MM-DD HH:mm:ss"),
+    phar_chk_time: data.auditTime ? dayjs(data.auditTime).format("YYYY-MM-DD HH:mm:ss") : "",
-    ysjd_time: dayjs(data.prescriptionStartTime).format("YYYY-MM-DD HH:mm:ss"),
+    ysjd_time: data.prescriptionStartTime ? dayjs(data.prescriptionStartTime).format("YYYY-MM-DD HH:mm:ss") : "",
-    prsc_time: dayjs(data.prescriptionEndTime).format("YYYY-MM-DD HH:mm:ss"),
+    prsc_time: data.prescriptionEndTime ? dayjs(data.prescriptionEndTime).format("YYYY-MM-DD HH:mm:ss") : "",
     details: data.drugs.map((i) => {
       const item = {
         erp_id: i.erpId,

hlw/diagnostic-record/index.js

@@ -18,7 +18,7 @@ const consultOrder = require("../consult-order");
 const tencentIM = require("../tencent-im");
 const beijingCa = require("../beijing-ca");
 const BigNumber = require("bignumber.js");
-const timeApi = require("../hlw-time-duration");
+// const timeApi = require("../hlw-time-duration");
 const types = require("./types");
 
 /**
@@ -218,25 +218,25 @@ async function addConsultDiagnosis(item) {
     if (orderExpired) {
       return { success: false, message: "当前订单不在有效期内" };
     }
-    timeApi({ type: "addDoctorRxDuration", orderId }, db);
+    // timeApi({ type: "addDoctorRxDuration", orderId }, db);
     const doctor = await db.collection("hlw-doctor").findOne({ corpId, doctorNo: doctorCode });
     if (!doctor) {
       return { success: false, message: "医生不存在" };
     }
     // 判断是否医生发的消息是否大于2条
-    const chatCount = automated
+    // const chatCount = automated
-      ? 3
+    //   ? 3
-      : await db.collection("im-chat-msg").countDocuments({
+    //   : await db.collection("im-chat-msg").countDocuments({
-        From_Account: doctorCode,
+    //     From_Account: doctorCode,
-        To_Account: orderId,
+    //     To_Account: orderId,
-      });
+    //   });
-    timeData.chatCountQueryTime = dayjs().format('YYYY-MM-DD HH:mm:ss');
+    // timeData.chatCountQueryTime = dayjs().format('YYYY-MM-DD HH:mm:ss');
-    if (!automated && chatCount < 3) {
+    // if (!automated && chatCount < 3) {
-      return {
+    //   return {
-        success: false,
+    //     success: false,
-        message: "请先向患者发送2条提问消息后再开方",
+    //     message: "请先向患者发送2条提问消息后再开方",
-      };
+    //   };
-    }
+    // }
     const record = await db
       .collection("diagnostic-record")
       .findOne(
@@ -2146,47 +2146,119 @@ async function getRxMedicineOrderStatus(ctx, db) {
   }
 }
 
-async function getYbReviewResult(ctx) {
+async function getYbReviewResult(ctx, db) {
-  let { params = {} } = ctx;
+  const params = ctx && ctx.params && typeof ctx.params === "object" ? ctx.params : {};
-  try {
+  const orderId = typeof params.orderId === "string" ? params.orderId.trim() : "";
-    const drugs = Array.isArray(params.drugs) ? params.drugs : [];
+  const drugs = Array.isArray(params.drugs) ? params.drugs : [];
-    const insuranceCodes = drugs.map(i => i.insurance_code).filter(Boolean);
+  const diagnosisList = Array.isArray(params.diagnosisList) ? params.diagnosisList : [];
-    if (insuranceCodes.length === 0) {
+  const corpId = typeof ctx.corpId === "string" ? ctx.corpId.trim() : "";
-      return { success: false, message: "药品列表不能为空" };
+
-    }
+  if (!orderId) {
-    const { data: hisDrugs } = await zytHis({ type: 'getHisDrugInfo', insuranceCodes, ignoreAreaCode: true });
+    return { success: false, message: "订单号不能为空" };
-    const hisDrugList = Array.isArray(hisDrugs) ? hisDrugs : [];
+  }
-    const validDrugs = []
+  if (drugs.length === 0) {
-    for (let i of params.drugs) {
+    return { success: false, message: "药品信息不能为空" };
-      const hisDrug = hisDrugList.find(j => i.insurance_code && i.insurance_code === j.gjbm);
+  }
-      if (!hisDrug) {
+  if (diagnosisList.length === 0) {
-        continue;
+    return { success: false, message: "诊断信息不能为空" };
-      }
-      validDrugs.push({
-        ...i,
-        hisChargeInfo: {
-          drugGroupNo: hisDrug.group_no,
-          drugId: hisDrug.charge_code,
-          drugSerial: hisDrug.serial,
-          drugPrice: hisDrug.pack_retprice,
-          drugSumamt: new BigNumber(hisDrug.pack_retprice).multipliedBy(i.quantity).toNumber()
-        }
-      })
-    }
-    if (validDrugs.length === 0) {
-      return { success: true, message: '未能有效查询: 药品信息未找到 ', advices: [] }
-    }
-    params.drugs = validDrugs;
-    const payload = formatReviewData(params)
-    const { success, advices, message } = await zytHis({
-      type: 'ybReviewPrescription',
-      data: payload
-    })
-    return { success, message, advices }
-  } catch (e) {
-    return { success: false, message: `获取处方审核结果失败: ${e.message}` }
   }
 
+  try {
+    // 订单中的患者、医保及就诊信息是审核请求的基础数据；药品以本次开方页面提交的数据为准。
+    const orderQuery = { orderId };
+    if (corpId) {
+      orderQuery.corpId = corpId;
+    }
+    const order = await db.collection("consult-order").findOne(orderQuery);
+    if (!order) {
+      return { success: false, message: "订单不存在" };
+    }
+
+    const drugIds = drugs.map((drug) =>
+      drug && typeof drug._id === "string" ? drug._id.trim() : ""
+    );
+    const invalidDrugId = drugIds.find((id) => !ObjectId.isValid(id));
+    if (invalidDrugId !== undefined) {
+      return { success: false, message: "药品ID无效" };
+    }
+    const normalizedDrugIds = drugIds.map((id) => new ObjectId(id).toString());
+
+    const dbDrugs = await db
+      .collection("drug-info")
+      .find(
+        {
+          _id: {
+            $in: [...new Set(normalizedDrugIds)].map((id) => new ObjectId(id)),
+          },
+        },
+        {
+          projection: {
+            erpId: 1,
+            insurance_code: 1,
+            name: 1,
+            dosage_form: 1,
+            specification: 1,
+          },
+        }
+      )
+      .toArray();
+    const dbDrugMap = new Map(
+      dbDrugs.map((drug) => [drug._id.toString(), drug])
+    );
+    const missingDrugId = normalizedDrugIds.find((id) => !dbDrugMap.has(id));
+    if (missingDrugId) {
+      return { success: false, message: `未匹配到药品信息：${missingDrugId}` };
+    }
+
+    const reviewDrugs = drugs.map((drug, index) => {
+      const dbDrug = dbDrugMap.get(normalizedDrugIds[index]);
+      return {
+        erpId: dbDrug.erpId,
+        insurance_code: dbDrug.insurance_code,
+        _id: dbDrug._id.toString(),
+        drugName: dbDrug.name,
+        dosage_form: dbDrug.dosage_form,
+        specification: dbDrug.specification,
+        quantity: drug.quantity,
+        usageCode: drug.usageCode,
+        usageName: drug.usageName,
+        days: drug.days,
+        frequencyCode: drug.frequencyCode,
+        frequencyName: drug.frequencyName,
+        dosage: drug.dosage,
+        dosage_unit: drug.dosage_unit,
+        dose_time_name: drug.dose_time_name,
+      };
+    });
+
+    const medInfo = order.medInfo && typeof order.medInfo === "object" ? order.medInfo : {};
+    const reviewData = {
+      feeType: order.feeType,
+      patientId: order.patientId,
+      medOrgOrderNo: order.registerId,
+      med_type: medInfo.med_type,
+      dise_codg: medInfo.dise_codg,
+      dise_name: medInfo.dise_name,
+      doctorCode: order.doctorCode,
+      unitCode: order.unitCode,
+      doctorCode: order.doctorCode,
+      doctorCode: order.doctorCode,
+      diagnosisList,
+      drugs: reviewDrugs,
+    };
+    const payload = formatUploadRxData(reviewData);
+    const { success, message } = await hnHis({
+      type: "ybReviewPrescription",
+      data: payload,
+    });
+
+    return {
+      success: Boolean(success),
+      message: message ? message : (success ? '查询成功' : '查询合理用药结果失败'),
+    };
+  } catch (e) {
+    return { success: false, message: `获取处方审核结果失败: ${e.message}` };
+  }
 }
 
 async function runOnlineRxExpireSchedule(db) {

hlw/hn-his/index.js

@@ -174,7 +174,7 @@ async function addHisCustomer(item) {
  */
 async function hlwuploadprescription(item) {
   try {
-    const params = { type: "hlwuploadprescription", data:item.data };
+    const params = { type: "hlwuploadprescription", data: item.data };
 
     const { code, status_code, message } = await request.main(url, params, "POST");
 
@@ -681,39 +681,25 @@ async function uploadWinePurchaseRx(item) {
   }
 }
 
-// hlwuploadprescription
 async function ybReviewPrescription(item) {
   try {
-    const url = `${baseUrl}/his/hlw/ybsh`;
+    const params = { type: "rationalDrugReview", data: item.data };
-    const { code, data, status_code, message } = await request.main(
+    const { status_code, code, data, message } = await request.main(url, params, "POST");
-      url,
+    if (status_code == 200 && code == '1') {
-      item.data,
-      "POST"
-    );
-    if (status_code == 200 && code == '1' && !message) {
-      const str = Buffer.from(data, 'base64');
-      const dataStr = decode(str, 'gbk');
-      const strData = JSON.parse(dataStr);
-      const result = strData && strData.output && Array.isArray(strData.output.result) ? strData.output.result.filter(Boolean) : [];
-      const advices = result.map(i => ({
-        name: typeof i.rule_name === 'string' ? i.rule_name.trim() : '',
-        text: typeof i.vola_cont === 'string' ? i.vola_cont.trim() : '',
-      })).filter(i => i.name || i.text)
       return {
         success: true,
-        advices,
+        message: message,
-        message: "[his]医保审核成功",
       };
     } else {
       return {
         success: false,
-        message: `[his]医保审核失败: ${message || '未知错误'}`,
+        message: message || '查询合理用药结果失败',
       };
     }
   } catch (err) {
     return {
       success: false,
-      message: `[his]医保审核错误: ${err.message || '未知错误'}`,
+      message: `[his]查询合理用药错误: ${err.message || '未知错误'}`,
     };
   }
 }
@@ -939,4 +925,4 @@ async function hisTest() {
   // }
   // const data = { "patientid": "30015424", "registerid": "h202501070833145550001", "orderno": "h202501070833145550001", "doctorcode": "10010", "unitcode": "1005000", "visit_time": "2025-12-04 13:15", "area_code": "330602", "hospid": "108", "icds": [{ "icd_code ": "R51.x00", "icd_name": "头痛", "sort": 1 }], "details": [{ "drug_type": "xy", "drug_groupno": "7X", "drug_group": "", "drug_id": "00110", "drug_serial": "01", "drug_name": "富马酸替诺福韦二吡呋酯片", "drug_spec": "300mg×30片/盒", "drug_pric": "329.41", "drug_cnt": "1", "drug_sumamt": "329.41", "supple_code": "1", "supple_name": "口服", "medc_days": "3", "drug_times": "1", "drug_comm": "", "drug_ma": "", "remark": "", "limit_flag": "0", "usage": "11", "usage_name": "每天一次（qd）", "sin_doscnt": "2.00", "sin_dosunt": "片", "unit": "盒" }] }
   // return await syncHisChargeStatus(data);
-}
+}