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Add TypeScript + Express + Postgres backend with Better Auth
Implements the first temetro backend: an Express 5 API on Postgres via Drizzle ORM, with authentication and multi-tenant clinics powered by Better Auth. - Auth: email/password with required email verification, password reset, rate limiting, CSRF/trusted-origins, secure cookies, session audit hook. - Organizations (clinics) with RBAC (owner/admin/member/viewer) and an extended `patient` permission set; member invitations by email. - Org-scoped patient records mirroring the frontend Patient shape, with CRUD endpoints gated by permission (read/write/delete). - Email helper logs links to the console when SMTP is unset (zero-setup local dev); Dockerfile + docker-compose (db + backend + frontend) with migrations applied on startup and a configurable Postgres host port. Co-Authored-By: Claude Opus 4.8 <noreply@anthropic.com>
This commit is contained in:
Claude
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import { and, asc, eq, inArray } from "drizzle-orm";
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import { db } from "../db/index.js";
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import {
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allergies,
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encounters,
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labs,
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medications,
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patients,
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problems,
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} from "../db/schema/patients.js";
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import { HttpError } from "../lib/http-error.js";
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import type { PatientInput } from "../lib/patient-validation.js";
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import type {
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Allergy,
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Encounter,
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Lab,
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Medication,
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Patient,
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Problem,
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} from "../types/patient.js";
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type PatientRow = typeof patients.$inferSelect;
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type Children = {
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allergies: Allergy[];
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medications: Medication[];
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problems: Problem[];
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labs: Lab[];
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encounters: Encounter[];
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};
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const emptyChildren = (): Children => ({
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allergies: [],
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medications: [],
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problems: [],
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labs: [],
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encounters: [],
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});
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function toPatient(row: PatientRow, children: Children): Patient {
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return {
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fileNumber: row.fileNumber,
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name: row.name,
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age: row.age,
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sex: row.sex,
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pcp: row.pcp,
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status: row.status,
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initials: row.initials,
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allergies: children.allergies,
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alerts: row.alerts,
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medications: children.medications,
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problems: children.problems,
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vitals: {
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bp: row.vitalsBp,
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hr: row.vitalsHr,
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temp: row.vitalsTemp,
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spo2: row.vitalsSpo2,
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takenAt: row.vitalsTakenAt,
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},
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vitalsTrend: row.vitalsTrend,
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labs: children.labs,
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labTrend: row.labTrend,
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encounters: children.encounters,
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};
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}
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// Input children are already in the canonical Patient sub-shapes.
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function childrenFromInput(input: PatientInput): Children {
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return {
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allergies: input.allergies,
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medications: input.medications,
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problems: input.problems,
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labs: input.labs,
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encounters: input.encounters,
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};
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}
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function patientColumns(orgId: string, input: PatientInput, createdBy?: string) {
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return {
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organizationId: orgId,
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fileNumber: input.fileNumber,
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name: input.name,
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age: input.age,
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sex: input.sex,
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pcp: input.pcp,
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status: input.status,
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initials: input.initials,
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alerts: input.alerts,
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vitalsBp: input.vitals.bp,
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vitalsHr: input.vitals.hr,
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vitalsTemp: input.vitals.temp,
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vitalsSpo2: input.vitals.spo2,
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vitalsTakenAt: input.vitals.takenAt,
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vitalsTrend: input.vitalsTrend,
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labTrend: input.labTrend,
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...(createdBy ? { createdBy } : {}),
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};
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}
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// Loads and groups child rows for a set of patients in one round-trip each.
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async function loadChildren(
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patientIds: string[],
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): Promise<Map<string, Children>> {
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const grouped = new Map<string, Children>();
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for (const id of patientIds) grouped.set(id, emptyChildren());
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if (patientIds.length === 0) return grouped;
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const [al, me, pr, la, en] = await Promise.all([
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db
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.select()
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.from(allergies)
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.where(inArray(allergies.patientId, patientIds))
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.orderBy(asc(allergies.position)),
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db
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.select()
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.from(medications)
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.where(inArray(medications.patientId, patientIds))
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.orderBy(asc(medications.position)),
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db
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.select()
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.from(problems)
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.where(inArray(problems.patientId, patientIds))
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.orderBy(asc(problems.position)),
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db
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.select()
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.from(labs)
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.where(inArray(labs.patientId, patientIds))
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.orderBy(asc(labs.position)),
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db
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.select()
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.from(encounters)
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.where(inArray(encounters.patientId, patientIds))
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.orderBy(asc(encounters.position)),
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]);
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for (const a of al)
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grouped.get(a.patientId)?.allergies.push({
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substance: a.substance,
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reaction: a.reaction,
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severity: a.severity,
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});
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for (const m of me)
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grouped.get(m.patientId)?.medications.push({
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name: m.name,
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dose: m.dose,
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frequency: m.frequency,
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});
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for (const p of pr)
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grouped.get(p.patientId)?.problems.push({ label: p.label, since: p.since });
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for (const l of la)
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grouped.get(l.patientId)?.labs.push({
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name: l.name,
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value: l.value,
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flag: l.flag,
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takenAt: l.takenAt,
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});
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for (const e of en)
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grouped.get(e.patientId)?.encounters.push({
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date: e.date,
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type: e.type,
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provider: e.provider,
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summary: e.summary,
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});
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return grouped;
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}
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type Tx = Parameters<Parameters<typeof db.transaction>[0]>[0];
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async function insertChildren(
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tx: Tx,
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patientId: string,
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input: PatientInput,
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): Promise<void> {
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if (input.allergies.length)
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await tx
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.insert(allergies)
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.values(input.allergies.map((a, i) => ({ patientId, position: i, ...a })));
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if (input.medications.length)
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await tx
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.insert(medications)
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.values(
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input.medications.map((m, i) => ({ patientId, position: i, ...m })),
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);
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if (input.problems.length)
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await tx
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.insert(problems)
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.values(input.problems.map((p, i) => ({ patientId, position: i, ...p })));
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if (input.labs.length)
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await tx
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.insert(labs)
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.values(input.labs.map((l, i) => ({ patientId, position: i, ...l })));
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if (input.encounters.length)
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await tx
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.insert(encounters)
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.values(
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input.encounters.map((e, i) => ({ patientId, position: i, ...e })),
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);
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}
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function isUniqueViolation(err: unknown): boolean {
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// drizzle wraps the driver error, so the pg error code (23505) may sit on
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// the error itself or on its `cause`.
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const candidates = [err, (err as { cause?: unknown })?.cause];
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return candidates.some(
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(e) =>
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typeof e === "object" &&
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e !== null &&
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"code" in e &&
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(e as { code?: string }).code === "23505",
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);
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}
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export async function listPatients(orgId: string): Promise<Patient[]> {
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const rows = await db
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.select()
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.from(patients)
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.where(eq(patients.organizationId, orgId))
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.orderBy(asc(patients.name));
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const children = await loadChildren(rows.map((r) => r.id));
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return rows.map((r) => toPatient(r, children.get(r.id) ?? emptyChildren()));
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}
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export async function getPatient(
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orgId: string,
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fileNumber: string,
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): Promise<Patient | null> {
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const [row] = await db
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.select()
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.from(patients)
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.where(
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and(
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eq(patients.organizationId, orgId),
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eq(patients.fileNumber, fileNumber),
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),
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);
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if (!row) return null;
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const children = await loadChildren([row.id]);
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return toPatient(row, children.get(row.id) ?? emptyChildren());
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}
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export async function createPatient(
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orgId: string,
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userId: string,
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input: PatientInput,
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): Promise<Patient> {
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try {
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return await db.transaction(async (tx) => {
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const [row] = await tx
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.insert(patients)
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.values(patientColumns(orgId, input, userId))
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.returning();
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await insertChildren(tx, row!.id, input);
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return toPatient(row!, childrenFromInput(input));
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});
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} catch (err) {
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if (isUniqueViolation(err)) {
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throw new HttpError(
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409,
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`A patient with file number ${input.fileNumber} already exists in this clinic.`,
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);
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}
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throw err;
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}
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}
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export async function updatePatient(
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orgId: string,
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fileNumber: string,
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input: PatientInput,
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): Promise<Patient | null> {
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try {
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return await db.transaction(async (tx) => {
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const [existing] = await tx
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.select({ id: patients.id })
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.from(patients)
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.where(
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and(
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eq(patients.organizationId, orgId),
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eq(patients.fileNumber, fileNumber),
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),
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);
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if (!existing) return null;
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const [row] = await tx
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.update(patients)
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.set(patientColumns(orgId, input))
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.where(eq(patients.id, existing.id))
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.returning();
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// Replace child collections wholesale (form submits the full record).
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await Promise.all([
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tx.delete(allergies).where(eq(allergies.patientId, existing.id)),
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tx.delete(medications).where(eq(medications.patientId, existing.id)),
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tx.delete(problems).where(eq(problems.patientId, existing.id)),
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tx.delete(labs).where(eq(labs.patientId, existing.id)),
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tx.delete(encounters).where(eq(encounters.patientId, existing.id)),
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]);
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await insertChildren(tx, existing.id, input);
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return toPatient(row!, childrenFromInput(input));
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});
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} catch (err) {
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if (isUniqueViolation(err)) {
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throw new HttpError(
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409,
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`A patient with file number ${input.fileNumber} already exists in this clinic.`,
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);
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}
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throw err;
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}
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}
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export async function deletePatient(
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orgId: string,
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fileNumber: string,
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): Promise<boolean> {
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const deleted = await db
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.delete(patients)
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.where(
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and(
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eq(patients.organizationId, orgId),
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eq(patients.fileNumber, fileNumber),
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),
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)
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.returning({ id: patients.id });
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return deleted.length > 0;
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}
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