Live OpenEMR for the FHIR EffectVerifier end-to-end test

This stands up a real, local OpenEMR (OpenEMR + MariaDB, via docker-compose) with the REST + FHIR R4 APIs and OAuth2 enabled, so the FHIR EffectVerifier in openadapt_flow/runtime/effects/fhir.py can be exercised against an actual system of record: a real write through OpenEMR's API, then an independent FHIR read-back.

It closes the one honest caveat from the EffectVerifier PR (#63): the verifier was only ever run against a faithful in-repo fake (tests/_fhir_fake.py), because the repo's OpenEMR harness targets the public demo (demo.openemr.io) vision-only and never stands up a FHIR endpoint to write to and read back. Here it runs live.

One-command bring-up

# 1. start OpenEMR + MariaDB (first boot auto-installs; several minutes)
docker compose -f benchmark/openemr_live/docker-compose.yml up -d

# 2. wait for the install, enable the APIs + OAuth2, register a client,
#    mint a bearer token, and export the env the test consumes
eval "$(benchmark/openemr_live/setup.sh)"

# 3. run the live end-to-end test (writes a real Patient, reads it back
#    through FHIR, asserts CONFIRMED / REFUTED / INDETERMINATE)
.venv/bin/pytest tests/test_effect_fhir_live_openemr.py -v

Tear down (removes the containers and their volumes):

docker compose -f benchmark/openemr_live/docker-compose.yml down -v

What setup.sh does

1. Waits for OpenEMR's unattended install to finish.

2. Enables the REST + FHIR R4 APIs and the OAuth2 password grant by setting the OpenEMR globals (rest_api, rest_fhir_api, rest_system_scopes_api, oauth_password_grant).

3. Registers a confidential OAuth2 client via dynamic registration (POST /oauth2/default/registration).

4. Enables that client (newly-registered clients start disabled).

5. Obtains a bearer token via the password grant (POST /oauth2/default/token, grant_type=password, user_role=users, admin/pass).

6. Prints shell-evalable env exports (all logging goes to stderr):

   export OPENEMR_FHIR_BASE_URL='https://localhost:9390/apis/default/fhir'
   export OPENEMR_FHIR_TOKEN='<bearer access token>'
   export OPENEMR_FHIR_VERIFY_TLS='0'   # self-signed localhost cert
   

The test module (tests/test_effect_fhir_live_openemr.py) is skipped unless OPENEMR_FHIR_BASE_URL is set, so normal CI never touches it; CI keeps running the fake-backed contract tests in tests/test_effect_fhir.py.

Ports

Offset to avoid colliding with any other local OpenEMR / MySQL:

service	container	host
OpenEMR (HTTP)	80	8390
OpenEMR (HTTPS)	443	9390
MariaDB	3306	(internal only)

FHIR base: https://localhost:9390/apis/default/fhir. Credentials are the stock OpenEMR docker defaults (admin / pass) — local, throwaway, fake-data instance only. Never point this at a real OpenEMR install.

What the live test proves (and its honest limits)

Against the REAL FHIR server, the verifier under test returns:

• CONFIRMED — a Patient POSTed through OpenEMR's FHIR API is independently read back and matches (both record_written and a field_equals read-back of the given name).
• REFUTED — a deliberately-wrong field expectation against a real record, and an expected write that never happened (the real server returns zero matches).
• INDETERMINATE → HALT — a bad/expired bearer token makes OpenEMR return 401; the verifier reads that as unreadable and halts, never as "record absent". (An unreachable host is covered by the fake-backed suite.)

The write is an API write, not a GUI-driven one. It is a FHIR Patient POST — a real clinical resource in OpenEMR's system of record — read back over FHIR. OpenEMR's FHIR API exposes Observation as read-only (there is no user/Observation.write scope), so the note-as-Observation write the fake models cannot be created over FHIR on a stock OpenEMR. Driving the OpenEMR GUI to make the write and reading it back over FHIR would be the most honest path of all; it is not done here (reliably browser-driving the dense OpenEMR UI is a separate effort). The property this test establishes is exactly the one the fake could not: the verifier's verdicts are correct against a real FHIR server.

Verified end-to-end against openemr/openemr:7.0.3 on 2026-07-13 (6/6 live tests: 2 CONFIRMED, 2 REFUTED, 1 INDETERMINATE, 1 reachability).