import { db } from "@/db"; import { providers, patients, appointments, inboxMessages, problems, medications, labResults, orders, careGoals, vitals, clinicalNotes, alerts, } from "@/db/schema"; import { hash } from "bcryptjs"; export async function seedDatabase() { // Check if already seeded const existing = await db.select().from(providers).limit(1); if (existing.length > 0) return; const passwordHash = await hash("clevora2025", 10); // ── Seed Providers (Kenyan doctors) ── const [drWanjiku] = await db .insert(providers) .values([ { email: "dr.wanjiku@clevora.co.ke", passwordHash, firstName: "Grace", lastName: "Wanjiku", specialty: "Internal Medicine", role: "physician", npi: "KE-MED-2024-001", }, { email: "dr.ochieng@clevora.co.ke", passwordHash, firstName: "Peter", lastName: "Ochieng", specialty: "Family Medicine", role: "physician", npi: "KE-MED-2024-002", }, ]) .returning(); // ── Seed Patients (Kenyan names and context) ── const patientData = [ { mrn: "KNH-447182", firstName: "Mary", lastName: "Njeri", dateOfBirth: "1968-03-14", gender: "Female", phone: "+254 722 345 678", email: "mary.njeri@gmail.com", allergies: "Penicillin (Anaphylaxis), Sulfa (Rash)", codeStatus: "Full Code", insuranceName: "SHA (Social Health Authority)", insuranceStatus: "Verified", pcpId: drWanjiku.id, appStatus: "active", appLastLogin: new Date(Date.now() - 2 * 3600000), roomNumber: "Ward 4B-214", }, { mrn: "KNH-552930", firstName: "John", lastName: "Kamau", dateOfBirth: "1955-08-22", gender: "Male", phone: "+254 733 456 789", email: "john.kamau@yahoo.com", allergies: "Aspirin (GI Bleed)", codeStatus: "Full Code", insuranceName: "Jubilee Health Insurance", insuranceStatus: "Verified", pcpId: drWanjiku.id, appStatus: "active", appLastLogin: new Date(Date.now() - 24 * 3600000), roomNumber: null, }, { mrn: "KNH-663871", firstName: "Fatuma", lastName: "Hassan", dateOfBirth: "1972-11-05", gender: "Female", phone: "+254 711 567 890", email: "fatuma.hassan@hotmail.com", allergies: "None Known (NKDA)", codeStatus: "Full Code", insuranceName: "AAR Healthcare", insuranceStatus: "Verified", pcpId: drWanjiku.id, appStatus: "inactive", appLastLogin: new Date(Date.now() - 14 * 86400000), roomNumber: null, }, { mrn: "KNH-774102", firstName: "David", lastName: "Otieno", dateOfBirth: "1990-06-18", gender: "Male", phone: "+254 720 678 901", email: "david.otieno@gmail.com", allergies: "Codeine (Nausea)", codeStatus: "Full Code", insuranceName: "Britam Health", insuranceStatus: "Verified", pcpId: drWanjiku.id, appStatus: "active", appLastLogin: new Date(Date.now() - 1 * 3600000), roomNumber: null, }, { mrn: "KNH-885419", firstName: "Agnes", lastName: "Wambui", dateOfBirth: "1982-01-30", gender: "Female", phone: "+254 700 789 012", email: "agnes.wambui@gmail.com", allergies: "Latex", codeStatus: "Full Code", insuranceName: "SHA (Social Health Authority)", insuranceStatus: "Pending", pcpId: drWanjiku.id, appStatus: "not_enrolled", appLastLogin: null, roomNumber: null, }, { mrn: "KNH-996738", firstName: "Joseph", lastName: "Mwangi", dateOfBirth: "1948-12-03", gender: "Male", phone: "+254 712 890 123", email: "joseph.mwangi@outlook.com", allergies: "Iodine Contrast (Hives)", codeStatus: "DNR/DNI", insuranceName: "NHIF Legacy", insuranceStatus: "Verified", pcpId: drWanjiku.id, appStatus: "active", appLastLogin: new Date(Date.now() - 48 * 3600000), roomNumber: "Ward 3E-108", }, ]; const insertedPatients = await db.insert(patients).values(patientData).returning(); // ── Seed Appointments ── const today = new Date(); const appointmentValues = [ { patientId: insertedPatients[0].id, providerId: drWanjiku.id, scheduledAt: new Date(today.getFullYear(), today.getMonth(), today.getDate(), 9, 0), duration: 30, visitType: "Follow-up", chiefComplaint: "Diabetes management - fatigue and increased thirst", status: "checked_in", noShowRisk: "Low" as const, isTelehealth: false, }, { patientId: insertedPatients[1].id, providerId: drWanjiku.id, scheduledAt: new Date(today.getFullYear(), today.getMonth(), today.getDate(), 9, 30), duration: 30, visitType: "Follow-up", chiefComplaint: "Hypertension review, medication adjustment", status: "waiting", noShowRisk: "Low" as const, isTelehealth: false, }, { patientId: insertedPatients[2].id, providerId: drWanjiku.id, scheduledAt: new Date(today.getFullYear(), today.getMonth(), today.getDate(), 10, 0), duration: 20, visitType: "Telehealth", chiefComplaint: "Anxiety follow-up, medication refill", status: "scheduled", noShowRisk: "High" as const, isTelehealth: true, }, { patientId: insertedPatients[3].id, providerId: drWanjiku.id, scheduledAt: new Date(today.getFullYear(), today.getMonth(), today.getDate(), 10, 30), duration: 45, visitType: "New Patient", chiefComplaint: "Chronic low back pain evaluation", status: "scheduled", noShowRisk: "Medium" as const, isTelehealth: false, }, { patientId: insertedPatients[4].id, providerId: drWanjiku.id, scheduledAt: new Date(today.getFullYear(), today.getMonth(), today.getDate(), 11, 30), duration: 30, visitType: "Annual Wellness", chiefComplaint: "Annual physical exam", status: "scheduled", noShowRisk: "Low" as const, isTelehealth: false, }, { patientId: insertedPatients[5].id, providerId: drWanjiku.id, scheduledAt: new Date(today.getFullYear(), today.getMonth(), today.getDate(), 14, 0), duration: 30, visitType: "Follow-up", chiefComplaint: "CHF exacerbation, weight gain monitoring", status: "scheduled", noShowRisk: "Low" as const, isTelehealth: false, }, ]; await db.insert(appointments).values(appointmentValues); // ── Seed Inbox Messages ── await db.insert(inboxMessages).values([ { providerId: drWanjiku.id, patientId: insertedPatients[0].id, category: "critical", priority: "critical", subject: "Critical Lab: HbA1c 10.2% - Mary Njeri", summary: "HbA1c has risen from 7.8% to 10.2% since last check. Immediate intervention recommended.", recommendedAction: "Review & Order", estimatedTime: "~2 minutes", }, { providerId: drWanjiku.id, patientId: insertedPatients[5].id, category: "critical", priority: "critical", subject: "Deterioration Alert: Joseph Mwangi - Weight ↑2.3 kg in 3 days", summary: "RPM device data shows rapid weight gain consistent with fluid retention. BNP trending up.", recommendedAction: "Review & Order", estimatedTime: "~3 minutes", }, { providerId: drWanjiku.id, patientId: insertedPatients[1].id, category: "urgent", priority: "urgent", subject: "Abnormal Result: Potassium 5.8 mEq/L - John Kamau", summary: "Potassium elevated above normal range. Patient on ACE inhibitor. Repeat lab recommended.", recommendedAction: "Review & Order", estimatedTime: "~1 minute", }, { providerId: drWanjiku.id, patientId: insertedPatients[3].id, category: "routine", priority: "routine", subject: "Patient Message: David Otieno - Question about back exercises", summary: "Patient asking about recommended stretches and exercises before his appointment.", recommendedAction: "Reply", estimatedTime: "~30 seconds", }, { providerId: drWanjiku.id, patientId: insertedPatients[2].id, category: "admin", priority: "routine", subject: "Unsigned Note: Fatuma Hassan - Visit 3 days ago", summary: "Telehealth visit note from 3 days ago remains unsigned. Action required within 72 hours.", recommendedAction: "Sign", estimatedTime: "~30 seconds", }, { providerId: drWanjiku.id, patientId: insertedPatients[4].id, category: "patient_app", priority: "routine", subject: "Refill Request: Agnes Wambui - Sertraline 50mg", summary: "Patient submitted refill request via Clevora app. Last fill: 28 days ago. Adherence: 92%.", recommendedAction: "Approve", estimatedTime: "~15 seconds", }, ]); // ── Seed Problems ── await db.insert(problems).values([ { patientId: insertedPatients[0].id, name: "Type 2 Diabetes Mellitus", icdCode: "E11.65", status: "Active", controlStatus: "Uncontrolled", lastResult: "A1C: 10.2% (1 week ago)", patientReported: "Blood sugar running high, increased thirst", aiRecommendation: "Consider GLP-1 RA addition or insulin initiation" }, { patientId: insertedPatients[0].id, name: "Essential Hypertension", icdCode: "I10", status: "Active", controlStatus: "Controlled", lastResult: "BP: 128/78 (last visit)", patientReported: "No complaints", aiRecommendation: "Continue current regimen" }, { patientId: insertedPatients[0].id, name: "Hyperlipidemia", icdCode: "E78.5", status: "Active", controlStatus: "Stable", lastResult: "LDL: 2.5 mmol/L (2 months ago)", patientReported: null, aiRecommendation: "Recheck lipid panel at next visit" }, { patientId: insertedPatients[1].id, name: "Essential Hypertension", icdCode: "I10", status: "Active", controlStatus: "Uncontrolled", lastResult: "BP: 158/94 (last visit)", patientReported: "Headaches in the morning", aiRecommendation: "Consider adding second agent" }, { patientId: insertedPatients[1].id, name: "Chronic Kidney Disease, Stage 3a", icdCode: "N18.31", status: "Active", controlStatus: "Stable", lastResult: "eGFR: 52 (1 month ago)", patientReported: null, aiRecommendation: "Monitor renal function q3 months" }, { patientId: insertedPatients[5].id, name: "Heart Failure with reduced EF", icdCode: "I50.22", status: "Active", controlStatus: "Worsening", lastResult: "BNP: 890 pg/mL (2 days ago)", patientReported: "More short of breath, swollen ankles", aiRecommendation: "Increase diuretic dose, cardiology consult at KNH" }, ]); // ── Seed Medications ── await db.insert(medications).values([ { patientId: insertedPatients[0].id, name: "Metformin", dose: "1000mg", route: "Oral", frequency: "Twice daily", prescriberId: drWanjiku.id, indication: "Type 2 Diabetes", adherenceRate: 78, fillStatus: "Filled" }, { patientId: insertedPatients[0].id, name: "Lisinopril", dose: "20mg", route: "Oral", frequency: "Once daily", prescriberId: drWanjiku.id, indication: "Hypertension", adherenceRate: 92, fillStatus: "Filled" }, { patientId: insertedPatients[0].id, name: "Atorvastatin", dose: "40mg", route: "Oral", frequency: "Once daily at bedtime", prescriberId: drWanjiku.id, indication: "Hyperlipidemia", adherenceRate: 85, fillStatus: "Filled" }, { patientId: insertedPatients[1].id, name: "Amlodipine", dose: "10mg", route: "Oral", frequency: "Once daily", prescriberId: drWanjiku.id, indication: "Hypertension", adherenceRate: 88, fillStatus: "Filled" }, { patientId: insertedPatients[1].id, name: "Losartan", dose: "100mg", route: "Oral", frequency: "Once daily", prescriberId: drWanjiku.id, indication: "Hypertension / CKD", adherenceRate: 90, fillStatus: "Filled" }, { patientId: insertedPatients[5].id, name: "Furosemide", dose: "40mg", route: "Oral", frequency: "Twice daily", prescriberId: drWanjiku.id, indication: "Heart Failure", adherenceRate: 75, fillStatus: "Filled" }, { patientId: insertedPatients[5].id, name: "Carvedilol", dose: "25mg", route: "Oral", frequency: "Twice daily", prescriberId: drWanjiku.id, indication: "Heart Failure", adherenceRate: 82, fillStatus: "Filled" }, { patientId: insertedPatients[5].id, name: "Spironolactone", dose: "25mg", route: "Oral", frequency: "Once daily", prescriberId: drWanjiku.id, indication: "Heart Failure", adherenceRate: 70, fillStatus: "Overdue" }, ]); // ── Seed Lab Results ── const now = Date.now(); await db.insert(labResults).values([ { patientId: insertedPatients[0].id, testName: "Hemoglobin A1c", value: "10.2", unit: "%", referenceRange: "4.0-5.6", status: "Critical", category: "Laboratory", resultDate: new Date(now - 7 * 86400000), aiInterpretation: "Significant rise from 7.8% three months ago. Indicates poor glycemic control. Consider intensification of diabetes management." }, { patientId: insertedPatients[0].id, testName: "Hemoglobin A1c", value: "7.8", unit: "%", referenceRange: "4.0-5.6", status: "Abnormal", category: "Laboratory", resultDate: new Date(now - 97 * 86400000), aiInterpretation: "Above target but improving from prior value." }, { patientId: insertedPatients[0].id, testName: "Hemoglobin A1c", value: "8.4", unit: "%", referenceRange: "4.0-5.6", status: "Abnormal", category: "Laboratory", resultDate: new Date(now - 187 * 86400000), aiInterpretation: "Elevated. Current regimen may be insufficient." }, { patientId: insertedPatients[0].id, testName: "Fasting Glucose", value: "12.1", unit: "mmol/L", referenceRange: "3.9-5.6", status: "Critical", category: "Laboratory", resultDate: new Date(now - 7 * 86400000), aiInterpretation: "Significantly elevated fasting glucose consistent with A1c trend." }, { patientId: insertedPatients[0].id, testName: "Creatinine", value: "80", unit: "μmol/L", referenceRange: "53-106", status: "Normal", category: "Laboratory", resultDate: new Date(now - 7 * 86400000), aiInterpretation: "Within normal limits. eGFR >60." }, { patientId: insertedPatients[0].id, testName: "LDL Cholesterol", value: "2.5", unit: "mmol/L", referenceRange: "<2.6", status: "Normal", category: "Laboratory", resultDate: new Date(now - 60 * 86400000), aiInterpretation: "At goal on current statin therapy." }, { patientId: insertedPatients[1].id, testName: "Potassium", value: "5.8", unit: "mEq/L", referenceRange: "3.5-5.0", status: "Critical", category: "Laboratory", resultDate: new Date(now - 1 * 86400000), aiInterpretation: "Elevated potassium. Patient is on losartan (ARB). Recommend repeat stat, ECG, and consider dose adjustment." }, { patientId: insertedPatients[1].id, testName: "Creatinine", value: "141", unit: "μmol/L", referenceRange: "53-106", status: "Abnormal", category: "Laboratory", resultDate: new Date(now - 1 * 86400000), aiInterpretation: "Elevated consistent with known CKD Stage 3a. Stable from prior." }, { patientId: insertedPatients[5].id, testName: "BNP", value: "890", unit: "pg/mL", referenceRange: "<100", status: "Critical", category: "Laboratory", resultDate: new Date(now - 2 * 86400000), aiInterpretation: "Markedly elevated. Consistent with acute decompensation of chronic heart failure. Prior BNP was 340." }, { patientId: insertedPatients[5].id, testName: "BNP", value: "340", unit: "pg/mL", referenceRange: "<100", status: "Abnormal", category: "Laboratory", resultDate: new Date(now - 32 * 86400000), aiInterpretation: "Elevated but stable, consistent with compensated heart failure." }, ]); // ── Seed Orders ── await db.insert(orders).values([ { patientId: insertedPatients[0].id, providerId: drWanjiku.id, orderName: "Comprehensive Metabolic Panel", orderType: "Laboratory", status: "Resulted", priority: "Routine" }, { patientId: insertedPatients[0].id, providerId: drWanjiku.id, orderName: "Hemoglobin A1c", orderType: "Laboratory", status: "Resulted", priority: "Routine" }, { patientId: insertedPatients[0].id, providerId: drWanjiku.id, orderName: "Diabetic Eye Exam Referral - KNH Ophthalmology", orderType: "Referral", status: "Sent", priority: "Routine" }, { patientId: insertedPatients[1].id, providerId: drWanjiku.id, orderName: "Repeat Potassium - STAT", orderType: "Laboratory", status: "Pending", priority: "Urgent" }, { patientId: insertedPatients[1].id, providerId: drWanjiku.id, orderName: "ECG 12-Lead", orderType: "Procedure", status: "In Progress", priority: "Urgent" }, { patientId: insertedPatients[5].id, providerId: drWanjiku.id, orderName: "Chest X-Ray PA/Lateral", orderType: "Imaging", status: "Completed", priority: "Routine" }, { patientId: insertedPatients[5].id, providerId: drWanjiku.id, orderName: "Echocardiogram", orderType: "Imaging", status: "Pending", priority: "Urgent" }, { patientId: insertedPatients[5].id, providerId: drWanjiku.id, orderName: "Cardiology Consult - KNH Heart Centre", orderType: "Referral", status: "Sent", priority: "Urgent" }, ]); // ── Seed Care Goals ── await db.insert(careGoals).values([ { patientId: insertedPatients[0].id, goalName: "Hemoglobin A1c", targetValue: "< 7.0", currentValue: "10.2", unit: "%", trend: "up", status: "Off Track" }, { patientId: insertedPatients[0].id, goalName: "Systolic Blood Pressure", targetValue: "< 130", currentValue: "128", unit: "mmHg", trend: "stable", status: "At Goal" }, { patientId: insertedPatients[0].id, goalName: "Weight", targetValue: "70", currentValue: "87", unit: "kg", trend: "down", status: "Improving" }, { patientId: insertedPatients[0].id, goalName: "LDL Cholesterol", targetValue: "< 2.6", currentValue: "2.5", unit: "mmol/L", trend: "stable", status: "At Goal" }, { patientId: insertedPatients[1].id, goalName: "Systolic Blood Pressure", targetValue: "< 130", currentValue: "158", unit: "mmHg", trend: "up", status: "Off Track" }, { patientId: insertedPatients[5].id, goalName: "Daily Weight Monitoring", targetValue: "< 88", currentValue: "92", unit: "kg", trend: "up", status: "Off Track" }, { patientId: insertedPatients[5].id, goalName: "Fluid Restriction", targetValue: "< 1.5L/day", currentValue: "2.1L", unit: "L", trend: "up", status: "Off Track" }, ]); // ── Seed Vitals ── const vitalRecords = []; for (let i = 0; i < 14; i++) { const d = new Date(now - i * 86400000); vitalRecords.push( { patientId: insertedPatients[0].id, type: "blood_glucose", value: String(10 + Math.round(Math.random() * 3)), unit: "mmol/L", recordedAt: d, source: "device" }, { patientId: insertedPatients[0].id, type: "systolic_bp", value: String(125 + Math.round(Math.random() * 10)), unit: "mmHg", recordedAt: d, source: "device" }, { patientId: insertedPatients[0].id, type: "weight", value: String((87 + (i > 7 ? 1 : 0) - i * 0.1).toFixed(1)), unit: "kg", recordedAt: d, source: "device" }, ); vitalRecords.push( { patientId: insertedPatients[5].id, type: "weight", value: String((89 + i * 0.2).toFixed(1)), unit: "kg", recordedAt: d, source: "device" }, { patientId: insertedPatients[5].id, type: "systolic_bp", value: String(130 + Math.round(Math.random() * 20)), unit: "mmHg", recordedAt: d, source: "device" }, ); } await db.insert(vitals).values(vitalRecords); // ── Seed Alerts ── await db.insert(alerts).values([ { providerId: drWanjiku.id, patientId: insertedPatients[0].id, category: "Critical Results", title: "HbA1c 10.2% — Significant rise", description: "A1c rose from 7.8% to 10.2% in 3 months. Consider therapy intensification.", severity: "critical" }, { providerId: drWanjiku.id, patientId: insertedPatients[5].id, category: "Deterioration Alert", title: "Weight gain 2.3 kg in 3 days — Joseph Mwangi", description: "Rapid weight gain in CHF patient. BNP trending upward. Consider diuretic adjustment.", severity: "critical" }, { providerId: drWanjiku.id, patientId: insertedPatients[0].id, category: "Missed Medications", title: "Metformin adherence dropped to 78%", description: "Patient reports nausea with metformin. 5 missed doses in past 2 weeks.", severity: "high" }, { providerId: drWanjiku.id, patientId: insertedPatients[1].id, category: "Critical Results", title: "Potassium 5.8 mEq/L — John Kamau", description: "Hyperkalemia in patient on ARB. ECG and repeat stat K+ recommended.", severity: "critical" }, { providerId: drWanjiku.id, patientId: insertedPatients[2].id, category: "Overdue Follow-Up", title: "Fatuma Hassan — 14 days since last app login", description: "Patient has not engaged with app or scheduled follow-up. Anxiety f/u overdue.", severity: "medium" }, { providerId: drWanjiku.id, patientId: insertedPatients[5].id, category: "Device Threshold", title: "SpO2 dropped to 91% — Joseph Mwangi", description: "Pulse oximetry below 92% threshold. Correlates with weight gain and elevated BNP.", severity: "high" }, ]); // ── Seed Clinical Notes ── await db.insert(clinicalNotes).values([ { patientId: insertedPatients[0].id, providerId: drWanjiku.id, noteType: "SOAP", content: `SUBJECTIVE: Patient presents for diabetes follow-up. Reports increased fatigue and polydipsia over the past 3 weeks. Home glucose readings 10-13 mmol/L fasting (usual 7-9 mmol/L). Attributes worsening to increased stress at work and reduced exercise. Denies polyuria, blurred vision, or neuropathy symptoms. OBJECTIVE: Vitals: BP 128/78, HR 76, Temp 36.9°C, Weight 87 kg (down 1.5 kg) General: Alert, NAD CV: RRR, no murmurs Extremities: No edema, intact pedal pulses Neuro: Intact monofilament sensation bilaterally ASSESSMENT: 1. Type 2 Diabetes - Uncontrolled, A1c rising 2. Hypertension - Controlled on current regimen 3. Hyperlipidemia - At goal PLAN: 1. Diabetes: Consider adding GLP-1 RA. Recheck A1c in 3 months. 2. Continue lisinopril and atorvastatin 3. Referral to diabetes education program at Kenyatta National Hospital 4. F/U 3 months`, status: "Signed", visitDate: new Date(now - 90 * 86400000), }, ]); }