紧急医疗准备评估：为危机情况准备好您的健康信息 | WellAlly康心伴

紧急准备评分 = Σ (能力 x 可获取性 x 关键性)

其中：
- 能力：存在的信息要素（0-2分）
- 可获取性：紧急情况下的信息可用性（0-2分）
- 关键性：信息不可用时的临床影响（1-3倍乘数）
  - 危及生命（过敏史、主要用药）：3.0
  - 紧急（慢性病、近期手术）：2.0
  - 重要（人口统计、保险）：1.0

// 紧急医疗信息系统
interface EmergencyMedicalInformationSystem {
  // 身体信息载体
  physical: {
    alertJewelry: MedicalAlertDevice[];
    walletCard: EmergencyInfoCard;
    keychainTag: EmergencyInfoTag;
    visibleIndicators: ConditionIndicator[];
  };

  // 数字紧急访问
  digital: {
    phoneMedicalId: PhoneMedicalID;
    emergencyApps: EmergencyHealthApp[];
    cloudRecords: EmergencyAccessibleRecord[];
    emergencyBypass: EmergencyAccessConfig;
  };

  // 代理人信息系统
  proxy: {
    primaryContact: EmergencyContact[];
    secondaryContact: EmergencyContact[];
    healthcareProxy: HealthcareProxyInfo;
    familyNetwork: FamilyHealthInfo[];
  };

  // 提供者紧急协议
  providers: {
    primaryCare: EmergencyContactInfo;
    specialists: EmergencySpecialistInfo[];
    pharmacy: EmergencyPharmacyInfo;
    hospital: EmergencyHospitalSystem[];
  };

  // 特殊紧急文件
  special: {
    advanceDirectives: AdvanceDirectiveInfo;
    dnrDocumentation: DNRInfo;
    implantedDevices: DeviceInfo[];
    specialNeeds: SpecialNeedsInfo;
  };

  // 系统验证
  validateEmergencyAccess(): EmergencyReadinessReport;
  testInformationAccess(): AccessTestResult;
  generateEmergencySummary(): EmergencyDocument;
}

class EmergencyInfoValidator {
  /**
   * 验证紧急信息的可获取性
   */
  validateEmergencyAccess(system: EmergencyMedicalInformationSystem): EmergencyReadinessReport {
    const issues: EmergencyGap[] = [];
    const criticalElements = [
      'allergies',
      'medications',
      'majorConditions',
      'emergencyContacts',
      'advanceDirectives'
    ];

    // 检查身体载体
    const physicalCheck = this.checkPhysicalAccess(system);
    if (!physicalCheck.hasAlertIndicator) {
      issues.push({
        severity: 'critical',
        category: 'physical',
        description: '没有医疗警示饰品或可见指示物',
        impact: '急诊提供者不了解昏迷患者的关键状况',
        recommendation: '获取危及生命状况（过敏、主要疾病）的医疗警示饰品'
      });
    }

    // 检查数字访问
    const digitalCheck = this.checkDigitalAccess(system);
    if (!digitalCheck.phoneUnlockable) {
      issues.push({
        severity: 'critical',
        category: 'digital',
        description: '手机锁定无紧急旁路',
        impact: '紧急情况下无法访问数字医疗信息',
        recommendation: '在手机上启用紧急旁路并配置包含关键信息的医疗ID'
      });
    }

    // 检查代理人访问
    const proxyCheck = this.checkProxyAccess(system);
    if (proxyCheck.unawareContacts > 0) {
      issues.push({
        severity: 'high',
        category: 'proxy',
        description: `${proxyCheck.unawareContacts} 名指定的紧急联系人缺乏健康信息`,
        impact: '代理人在紧急情况下被联系时无法提供病史',
        recommendation: '对所有紧急联系人进行关键健康信息和记录位置的教育'
      });
    }

    // 检查预先指示
    const directiveCheck = this.checkAdvanceDirectives(system);
    if (!directiveCheck.emergencyAccessible) {
      issues.push({
        severity: 'critical',
        category: 'special',
        description: '预先指示在紧急情况下无法立即获取',
        impact: '临终意愿可能在紧急情况中得不到尊重',
        recommendation: '携带预先指示钱包卡，如适用佩戴DNR手环，通知代理人'
      });
    }

    return {
      totalGaps: issues.length,
      criticalGaps: issues.filter(i => i.severity === 'critical').length,
      issues,
      readinessScore: this.calculateReadinessScore(issues),
      priorityActions: this.prioritizeActions(issues)
    };
  }

  /**
   * 为钱包卡和医疗ID生成紧急信息
   */
  generateEmergencySummary(system: EmergencyMedicalInformationSystem): EmergencyDocument {
    return {
      header: {
        name: system.demographics.fullName,
        dateOfBirth: system.demographics.dob,
        emergencyContact: system.proxy.primaryContact[0]
      },

      critical: {
        allergies: system.medical.allergies,
        medications: system.medical.currentMeds,
        majorConditions: system.medical.majorConditions,
        implantedDevices: system.special.implantedDevices
      },

      advanceCare: {
        hasAdvanceDirective: system.special.advanceDirectives.exists,
        directiveLocation: system.special.advanceDirectives.location,
        healthcareProxy: system.special.healthcareProxy,
        dnrStatus: system.special.dnrDocumentation.status
      },

      providers: {
        primaryCare: system.providers.primaryCare,
        preferredHospital: system.providers.hospital[0],
        pharmacy: system.providers.pharmacy
      },

      specialInstructions: {
        communicationNeeds: system.special.specialNeeds.communication,
        mobilityAssistance: system.special.specialNeeds.mobility,
        languagePreferences: system.demographics.language,
        otherConsiderations: system.special.specialNeeds.other
      },

      lastUpdated: new Date().toISOString(),
      version: '2.0'
    };
  }

  private checkPhysicalAccess(system: EmergencyMedicalInformationSystem): PhysicalAccessCheck {
    return {
      hasAlertIndicator: system.physical.alertJewelry.length > 0 ||
                       system.physical.visibleIndicators.length > 0,
      hasWalletCard: system.physical.walletCard !== null,
      cardCurrent: this.verifyCardCurrency(system.physical.walletCard),
      indicatorsVisible: system.physical.visibleIndicators.some(i => i.visible),
      jewelryAppropriate: this.checkJewelryAppropriate(system.physical.alertJewelry)
    };
  }
}

// 提供者紧急信息系统
const EmergencyInfoConfig = {
  // 紧急信息访问
  emergencyAccess: {
    afterHoursProtocol: {
      primaryCare: 'on-call-physician-access',
      specialistConsult: 'emergency-specialist-hotline',
      nurseTriage: '24-7-nurse-line',
      telehealth: 'emergency-video-consult'
    },

    recordAccess: {
      emergencyDepartment: 'instant-record-retrieval',
      ambulanceServices: 'prehospital-data-access',
      otherHospitals: 'emergency-health-information-exchange',
      afterHoursClinics: 'urgent-care-record-access'
    },

    medicationHistory: {
      realTimeAccess: 'pharmacy-connect-emergency',
      insuranceClaims: 'payer-emergency-access',
      statePMP: 'prescription-monitoring-emergency'
    }
  },

  // 紧急文件记录
  emergencyDocumentation: {
    advanceDirectives: {
      registryParticipation: 'state-directive-registry',
      facilityAccess: '24-7-directive-retrieval',
      patientCopy: 'wallet-card-provision',
      electronicAccess: 'patient-portal-emergency'
    },

    dnrOrders: {
      visibleIndicator: 'bracelet-provision',
      eDNR: 'electronic-order-access',
      registry: 'state-dnr-registry',
      transportOrders: 'emt-paramedic-access'
    },

    summaryGeneration: {
      emergencyPassport: 'patient-wallet-document',
      digitalQR: 'scannable-emergency-code',
      smsProvision: 'text-emergency-info',
      emrIntegration: 'emergency-summary-flag'
    }
  },

  // 紧急提供者沟通
  providerCommunication: {
    referralEmergency: {
      specialistHotline: 'direct-physician-line',
      telehealthEmergency: 'immediate-video-consult',
      transferCenter: 'rapid-bed-placement',
      emrMessaging: 'physician-to-physician-chat'
    },

    careContinuity: {
    autoNotification: 'pcp-ed-alert',
      dischargeSummary: 'emergency-discharge-to-pcp',
      medicationReconciliation: 'post-emergency-med-review',
      followUpScheduling: 'automatic-pcp-booking'
    }
  },

  // 患者教育和参与
  patientPreparedness: {
    emergencyEducation: {
      walletCardProvision: 'customized-emergency-cards',
      medicalIdSetup: 'smartphone-configuration-help',
      jewelryResources: 'alert-jewelry-vendors',
      appRecommendations: 'verified-emergency-apps'
    },

    regularUpdates: {
      contactVerification: 'quarterly-contact-confirm',
      medicationUpdate: 'monthly-medication-sync',
      conditionReview: 'annual-condition-update',
      directiveCheck: 'semi-annual-directive-review'
    }
  }
};