Doctor patient CRM

A FHIR-native real-time healthcare operations platform that streams patient alerts, synchronizes clinical workflows, and enables interoperable care coordination.

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FHIR MERN

Monorepo for a full-stack FHIR application with a React frontend, an Express backend, and a shared TypeScript package.

Use this README for repo-level setup and workflow.
Service-specific details live in:

Architecture Overview

flowchart LR
  FE[Frontend]
  FE --> API[Express App]
  API --> MW[Middleware Auth Guard, Role Guard,AssignmentLink Guards, Validation]
  MW --> CTRL[Controllers]
  CTRL --> SVC[Services]
  SVC --> REPO[Repositories]

  REPO <--> MONGO[(MongoDB)]
  REPO <--> FHIR[(HAPI FHIR)]

  FHIR -->|Subscription webhook POST /api/alerts/webhook| API
  API -->|SSE alerts| FE

Request Flow (standard API path)

sequenceDiagram
  participant C as Frontend
  participant A as Express App
  participant M as Middleware
  participant K as Controller
  participant S as Service
  participant R as Repository
  participant D as MongoDB or HAPI FHIR

  C->>A: HTTP request
  A->>M: Auth + role + input guards
  M->>K: Validated request
  K->>S: Business operation
  S->>R: Data/FHIR access call
  R->>D: Query or resource operation
  D-->>R: Result
  R-->>S: Domain data
  S-->>K: DTO/result
  K-->>C: JSend response

Alerting Flow (webhook to SSE)

sequenceDiagram
  participant F as HAPI FHIR
  participant B as Express /api/alerts/webhook
  participant V as verifyWebhookSecret middleware
  participant T as Threshold Evaluator
  participant A as Assignment + Admin lookup
  participant L as Alert Store (MongoDB)
  participant S as SSE Manager
  participant P as Practitioner/Admin Client

  F->>B: Observation webhook POST
  B->>V: Verify X-Webhook-Secret (if configured)
  V-->>B: allowed/rejected
  B->>T: Evaluate observation values
  T-->>B: Alert payload (or null)
  B->>A: Resolve recipients
  A-->>B: Recipient user ids
  B->>L: Persist alert
  L-->>B: Saved alert
  B->>S: sendToUsers(...)
  S-->>P: event: alert

Workspaces

  • frontend/ - React + Vite client
  • backend/ - Express API + Better Auth + MongoDB + FHIR integration
  • shared/ - @fhir-mern/shared DTO/types package consumed by frontend and backend

Prerequisites

  • Node.js 20+
  • npm 9+
  • Docker + Docker Compose

Start Infrastructure

From repo root:

docker compose up -d

Services expected for local development:

  • FHIR gateway at http://localhost:8080/fhir (nginx proxy to HAPI)
  • MongoDB for backend app data
  • PostgreSQL for HAPI FHIR

Install

From repo root:

npm install

This enables Husky hooks for local quality gates.

Environment Setup

Backend

cd backend
cp .env.example .env

Frontend

cd frontend
cp .env.example .env

Set frontend API URL to backend, for example:

VITE_API_URL=http://localhost:3000

Run Locally

Use separate terminals.

Backend

cd backend
npm run dev

Frontend

cd frontend
npm run dev

Quality Gates

From repo root:

npm run check:commit
npm run check:push

Hook behavior:

  • pre-commit: lint-staged + npm run check:commit
  • pre-push: npm run check:push

Service Test Commands

cd backend
npm run test:unit
npm run test:integration
npm run test:api
npm test

cd frontend
npm run test

Formatting

From repo root:

npm run format

API Collection

Postman collection is available at:

  • postman/postman_collection.json
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