COACH (Collaboration Oriented Approach to Controlling High Blood Pressure)
COACH is a patient-facing clinical decision support tool for managing high blood pressure. It integrates with Electronic Health Records using FHIR and with CQF Ruler for executing decision support plan definitions. The plan definitions and recommendation logic are stored in this implementation guide. COACH also uses a MySQL database for application storage.
The COACH home page displays recent blood pressures and a set of recommendations based on the patient's health record. The patient may enter new blood pressure readings, set goals, and review medications.
Docker
The COACH application is packaged as a Docker image, and the latest is available here:
docker pull ghcr.io/ohsucmp/coach:latest
In order to run COACH, connections to the database, the EHR FHIR server, and CQF Ruler must be configured. In addition, an API key for the Value Set Authority Center is required.
If you already have these pieces in place and they are externally addressable, then configure a properties file to provide COACH the information needed. Make a local copy of application.properties, override any configuration needed, and mount the file into the Docker container when running:
docker run -p 8082:8082 -v $(pwd)/override.properties:/opt/app/config/application.properties ghcr.io/ohsucmp/coach
If you want to run everything locally, both the database and CQF Ruler can also be set up as containers. Docker-compose files are provided to facilitate this. To use these, clone this repository. Copy the file "env.sample" to ".env" and fill out the API key in this file.
Running the MySQL database as a container
Using the docker-compose file provided, you can run the MySQL database as a container.
docker-compose up mysql
The schema will be created using the file db-schema.sql the first time the container runs. It will persist on restart.
Running CQF Ruler as a container
Run the CQF Ruler service in the docker-compose setup:
docker-compose up cqfruler
Once this is running, you have to populate it with the plan definitions COACH needs to provide recommendations. Like the mysql service, you only have to do this the first time you run - the resources will persist on restart. To populate CQF Ruler, grab the latest release of the implementation guide, unzip, and run the Python script at specification/PopulateCQFRuler.py
Running COACH with docker-compose
The docker-compose setup creates connections between the three Dockerized containers so they can communicate with each other. Without any other configuration changes, COACH can now be started and will automatically connect to a Logica Sandbox as its source EHR.
docker-compose up app
Configuration
As described above, you can override the application's configuration by making a copy of application.properties, overriding the desired properties, and mounting the file into the container at /opt/app/config/application.properties. An example mount definition is included in docker-compose.override.yml.
Logging
Logs from the COACH container are sent to the console and are also persisted to ./docker_data/coach/logs. On Linux, you will need to ensure that this directory can be written to by the container's UID and GID.
mkdir -p ./docker_data/coach/logs
chown 9999:9999 ./docker_data/coach/logs
chmod -R 755 ./docker_data/coach/logsIf for some reason you cannot allow the container user to write to the file system, you can create a custom container image that overrides the user ID and group ID used to run the application.
If you prefer not to log to files, you can override the logging configuration by mounting a logback.xml file into the container at /opt/app/config/logback.xml. You can find example configuration in logback-console-only.xml and comments in docker-compose.override.yml.
Flyway Migrations
This application uses Flyway to automate database migrations when schema changes occur. Flyway is executed automatically when the latest image is pulled and the application is restarted. It is best practice to take a backup of the database before deploying a new version of COACH in case any errors occur and you need to revert. Migrations are available for both MySQL and SQL Server, but the Microsoft version is not routinely tested.
See (this detailed developer document)[src/main/resources/db/migration/README.md] for how Flyway works.