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A simple demo "EHR" system that interfaces with the Nuts node

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Please note that this project is currently a work in progress. Not everything will fully work yet

Nuts demo EHR system

This application is pretending to be an electronic health record system. You can use it to demo how healthcare professionals can work together by sharing information with colleagues through the Nuts nodes.

It uses a FHIR server for the storage of patients, observataions and tasks. We use the Smart dev sandbox with FHIR R4 and Synthea data for a quick setup. You can generate a localized data set using the Internaltion profiles for Synthea.

This version is an updated version using vue.js as frontend framework and a Golang backend. It's based on the nuts-registry-admin-demo.

Versions are in sync with the Nuts node version. The main branch uses the master branch of the Nuts node. Older versions have a vX branch.

NOTE THAT THIS APPLICATION IS NOT INTENDED FOR USE WITH REAL MEDICAL INFORMATION! IT IS IN NO WAY DEVELOPED TO BE SAFE, STABLE OR EVEN USABLE FOR SUCH PURPOSE.

Building and running

Production

To build for demo-production:

npm install
npm run build
go run .

This will serve the front end from the embedded filesystem.

Development

During front-end development, you probably want to use the real filesystem and webpack in watch mode:

npm install
npm run watch
go run . live

The API and domain types are generated from the api/api.yaml.

make gen-api

Docker

docker run -p 1304:1304 nutsfoundation/nuts-demo-ehr:main

Configuration

When running in Docker without a config file mounted at /app/server.config.yaml it will use the default configuration.

TLS

To allow Demo EHR to query FHIR servers and eOverdracht notification endpoints which require a client certificate (required according to the Bolt), you need to configure tls.client.certificate and tls.client.key to point to the respective files. Use the same certificate you're using for your Nuts node.

There's no need to configure the truststore: Demo EHR skips verification of the server certificate (it's a demo application after all).

Starting the HAPI FHIR server backend

The simplest way of starting up an out of the box FHIR backend is using the HAPI FHIR server by running the following docker command:

docker run -p 8080:8080 -e hapi.fhir.fhir_version=DSTU3 -e hapi.fhir.partitioning.allow_references_across_partitions=false hapiproject/hapi:v5.4.1

Configuration explanation:

  • hapi.fhir.fhir_version=DSTU3 indicates FHIR version STU3 is used
  • hapi.fhir.partitioning.allow_references_across_partitions=false signals HAPI server to enable partitioning, which allows multi-tenancy.

FHIR server type

If you're using the HAPI FHIR docker image or any other HAPI FHIR server with support for multi-tenancy you should set the fhir.server.type option to: hapi-multi-tenant otherwise choose either hapi (for a single-tenant HAPI FHIR server) or other.

Nuts-node

The Demo-EHR needs a connection to a running Nuts node. The customers.json file also needs to be in sync with the DIDs known to the Nuts node. You can use the nuts-registry-admin-demo for setting up customers.json.

It's important to configure the Nuts node address in the server.config.yaml. The nutsnodeaddr must be used for this:

nutsnodeaddr: "http://localhost:1323"

Technology Stack

Frontend framework is vue.js 3.x

Icons are from https://heroicons.com

CSS framework is https://tailwindcss.com

WIP: complete docker compose setup with 2 instances

Nodes need to find each other by external URL because they need to resolve the web:did

Solution: handout 172.90.0.2 to loadbalancer Set default range to: networks: default: ipam: config: - subnet: 172.90.0.0/16

After clone

  • execute ./generate.sh in docker-compose/lb/tls/
  • load docker-compose/lb/tls/ca.pem into keychain/local certs
  • add left.local, node.left.local, admin.left.local, right.local, admin.right.local and node.right.local to /etc/hosts (127.0.0.1)
  • execute make docker
  • execute ./setup.sh <docker-compose-PEP.yml> (setup is independent of PEP, so usually fine to run without argument (defaults to nginx))

TODO use v6

After complete wipe of data

  • use https://admin.left.local and add "1" as identity
  • issue an NutsOrganizationCredential for the subject's DIDs from the subject's DIDs
  • use https://admin.right.local and add "1" as identity
  • issue an NutsOrganizationCredential for the subject's DIDs from the subject's DIDs
  • activate services for discovery using curl statement from below
  • create customers.json files for demo-ehr config
  • wait

curl statement to add services to DID document:

docker exec nuts-demo-ehr-node-left-1 curl -X POST "http://localhost:8081/internal/discovery/v1/urn:nuts.nl:usecase:eOverdrachtDemo2024/1" -H  "Content-Type: application/json" -d '{"registrationParameters": {"fhir": "https://left.local/fhir/1", "notification":"https://left.local/web/external/transfer/notify"}}'
docker exec nuts-demo-ehr-node-right-1 curl -X POST "http://localhost:8081/internal/discovery/v1/urn:nuts.nl:usecase:eOverdrachtDemo2024/1" -H  "Content-Type: application/json" -d '{"registrationParameters": {"fhir": "https://right.local/fhir/1", "notification":"https://right.local/web/external/transfer/notify"}}'

Run

The repo contains different docker compose setups that each have a different PEP configured

  • NGINX docker-compose-nginx.yml
  • APISIX docker-compose-apisix.yml

Select the PEP you want (use NGINX if unsure) and run