import api: fix duplication of nested patient resources (#5299)

Sending the same patient resource more than once (either on accident or
for an attribute update) leads to the addresses, phone numbers and
business identifiers being duplicated, because we are generating a new
ID for them every time. We now ensure that these IDs are generated
deterministically so that the resource merge merely updates these values
rather than creating new instances.

app/services/bulk_api_import/fhir_importable.rb

@@ -14,8 +14,8 @@ def timestamps
     }
   end
 
-  def translate_id(id)
-    Digest::UUID.uuid_v5(Digest::UUID::DNS_NAMESPACE, id)
+  def translate_id(id, ns_prefix: "")
+    Digest::UUID.uuid_v5(Digest::UUID::DNS_NAMESPACE + ns_prefix, id)
   end
 
   def translate_facility_id(id)

app/services/bulk_api_import/fhir_patient_importer.rb

@@ -21,9 +21,13 @@ def request_metadata
      request_facility_id: @resource.dig(:managingOrganization, 0, :value)}
   end
 
+  def identifier
+    @resource.dig(:identifier, 0, :value)
+  end
+
   def build_attributes
     {
-      id: translate_id(@resource.dig(:identifier, 0, :value)),
+      id: translate_id(identifier),
       full_name: @resource.dig(:name, :value) || "Anonymous " + Faker::Name.first_name,
       gender: gender,
       status: status,
@@ -68,7 +72,7 @@ def status
   def phone_numbers
     @resource[:telecom]&.map do |telecom|
       {
-        id: SecureRandom.uuid,
+        id: translate_id(identifier, ns_prefix: "patient_phone_number"),
         number: telecom[:value],
         phone_type: telecom[:use] == "mobile" || telecom[:use] == "old" ? "mobile" : "landline",
         active: !(telecom[:use] == "old"),
@@ -80,7 +84,7 @@ def phone_numbers
   def address
     if (address = @resource.dig(:address, 0))
       {
-        id: SecureRandom.uuid,
+        id: translate_id(identifier, ns_prefix: "patient_address"),
         street_address: address[:line]&.join("\n"),
         district: address[:district],
         state: address[:state],
@@ -97,8 +101,8 @@ def address
   def business_identifiers
     [
       {
-        id: SecureRandom.uuid,
-        identifier: @resource.dig(:identifier, 0, :value),
+        id: translate_id(identifier, ns_prefix: "patient_business_identifier"),
+        identifier: identifier,
         identifier_type: :external_import_id,
         **timestamps
       }

spec/services/bulk_api_import/fhir_patient_importer_spec.rb

@@ -17,6 +17,33 @@
             .except(:registrationOrganization)
         ).import
       }.to change(Patient, :count).by(1)
+        .and change(PatientBusinessIdentifier, :count).by(1)
+    end
+
+    context "when a patient is imported twice" do
+      it "does not duplicate the patient or its nested resources" do
+        patient_resource = build_patient_import_resource.merge(address: [{line: ["abc"]}])
+
+        expect {
+          described_class.new(
+            patient_resource
+              .merge(managingOrganization: [{value: facility_identifier.identifier}])
+              .except(:registrationOrganization)
+          ).import
+        }.to change(Patient, :count).by(1)
+          .and change(PatientBusinessIdentifier, :count).by(1)
+          .and change(Address, :count).by(1)
+
+        expect {
+          described_class.new(
+            patient_resource
+              .merge(managingOrganization: [{value: facility_identifier.identifier}])
+              .except(:registrationOrganization)
+          ).import
+        }.to change(Patient, :count).by(0)
+          .and change(PatientBusinessIdentifier, :count).by(0)
+          .and change(Address, :count).by(0)
+      end
     end
   end
 
@@ -51,11 +78,11 @@
   describe "#phone_numbers" do
     it "correctly populates phone_type and active attributes" do
       [
-        {input: {telecom: [{use: "mobile"}]}, expected_phone_type: "mobile", expected_active: true},
-        {input: {telecom: [{use: "home"}]}, expected_phone_type: "landline", expected_active: true},
-        {input: {telecom: [{use: "work"}]}, expected_phone_type: "landline", expected_active: true},
-        {input: {telecom: [{use: "temp"}]}, expected_phone_type: "landline", expected_active: true},
-        {input: {telecom: [{use: "old"}]}, expected_phone_type: "mobile", expected_active: false}
+        {input: {identifier: [value: "foo"], telecom: [{use: "mobile"}]}, expected_phone_type: "mobile", expected_active: true},
+        {input: {identifier: [value: "foo"], telecom: [{use: "home"}]}, expected_phone_type: "landline", expected_active: true},
+        {input: {identifier: [value: "foo"], telecom: [{use: "work"}]}, expected_phone_type: "landline", expected_active: true},
+        {input: {identifier: [value: "foo"], telecom: [{use: "temp"}]}, expected_phone_type: "landline", expected_active: true},
+        {input: {identifier: [value: "foo"], telecom: [{use: "old"}]}, expected_phone_type: "mobile", expected_active: false}
       ].each do |input:, expected_phone_type:, expected_active:|
         expect(described_class.new(input).phone_numbers[0])
           .to include(phone_type: expected_phone_type, active: expected_active)
@@ -66,6 +93,7 @@
   describe "#address" do
     specify do
       expect(described_class.new({
+        identifier: [value: "foo"],
         address: [{line: %w[a b],
                    district: "xyz",
                    state: "foo",