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TransTrack Server

Multi-user, multi-tenant API + HL7 v2 / FHIR R4 integration engine for the TransTrack transplant operations platform.

What's in here

  • REST API (Fastify) — authentication, patient management, organ offers, lab results, audit, calculators
  • FHIR R4 server at /fhir — full USCDI v3 surface (~25 resources) with searchset Bundles, transactions, history, soft delete
  • FHIR Bulk Data Access at /fhir/$export, /fhir/Patient/$export, /fhir/Group/{id}/$export (NDJSON, async, status polling)
  • FHIR R4 Subscriptions with REST-hook delivery and a background dispatcher (5s tick, exponential retry)
  • SMART on FHIR v2 at /.well-known/smart-configuration, /oauth2/authorize, /oauth2/token, /oauth2/register, /oauth2/introspect, /oauth2/revoke — authorization_code + PKCE, refresh, client_credentials, JWT bearer; v1 + v2 scope syntax; enforced on every FHIR call
  • CDS Hooks 1.1 at /cds-services with a pluggable registry and three built-in transplant services (candidate-summary, nephrotoxic-medication-advisory, hla-screening-reminder)
  • HL7 v2 MLLP/TLS listener — accepts ADT (A01-A60 incl. A40 merge), ORU (R01/R30), ORM, OMP, RDE, RDS, MDM (T01/T02), SIU (S12-S26), BAR/DFT (P01-P11), and MFN (M02/M05/M06) from hospital interface engines (Mirth Connect, Rhapsody, Cloverleaf, Corepoint), parses them through a vendor-aware pipeline (Epic/Cerner/Meditech Z-segments + per-org overrides), materialises into native entities, and returns MSA acks
  • Auth — local password + TOTP, plus SAML 2.0 and OIDC for hospital SSO
  • Audit log with hash-chain tamper evidence and DB-level immutability triggers (HIPAA 45 CFR 164.312(b))
  • Postgres with row-level security on every tenant table

See docs/server/architecture.md for the full picture.

Quick start

# Postgres
docker compose -f ../docker/docker-compose.yml up -d postgres

# Server
npm install
cp .env.example .env       # edit JWT_SECRET first
npm run migrate
npm run dev

# REST  : http://localhost:8080
# FHIR  : http://localhost:8080/fhir/metadata
# SMART : http://localhost:8080/.well-known/smart-configuration
# CDS   : http://localhost:8080/cds-services
# MLLP  : tcp://localhost:2575
# MLLP/TLS : tcp://localhost:2576 (set HL7_MLLP_TLS_*)

Test

npm test                      # unit tests, no DB needed
npm run test:integration      # end-to-end, requires Postgres + migrations
INTEGRATION_MIRTH=1 npm run test:mirth

Configuration

All configuration is environment-driven and validated at startup. See .env.example for the full set of variables and their semantics.

Project layout

See docs/server/architecture.md § Directory layout.