Abridge CI Integration

Overview

CI/CD pipeline for Abridge clinical documentation integrations. Healthcare CI pipelines require FHIR resource validation, PHI leak scanning, HIPAA compliance checks, and sandbox integration testing.

Prerequisites

Use a non-production Abridge sandbox with synthetic patients only, and store the sandbox URL, client secret, and organization ID as protected CI secrets. Install Node 20 with the project's lockfile, provide FHIR R4 test fixtures, and ensure the repository's test data contains no PHI before enabling the integration job on main.

Instructions

Step 1: GitHub Actions Workflow

# .github/workflows/abridge-ci.yml
name: Abridge Integration CI

on:
  push:
    branches: [main, develop]
  pull_request:
    branches: [main]

env:
  NODE_VERSION: '20'

jobs:
  lint-and-type-check:
    runs-on: ubuntu-latest
    steps:
      - uses: actions/checkout@v4
      - uses: actions/setup-node@v4
        with: { node-version: '${{ env.NODE_VERSION }}' }
      - run: npm ci
      - run: npm run lint
      - run: npm run typecheck

  phi-leak-scan:
    runs-on: ubuntu-latest
    steps:
      - uses: actions/checkout@v4
      - name: Scan for PHI patterns in source code
        run: |
          echo "Scanning for PHI patterns..."
          # SSN patterns
          if grep -rn '\b[0-9]\{3\}-[0-9]\{2\}-[0-9]\{4\}\b' src/ --include='*.ts' --include='*.js'; then
            echo "FAIL: Possible SSN found in source code"
            exit 1
          fi
          # Hardcoded patient names (common test names)
          if grep -rn '"John Doe\|Jane Doe\|Test Patient"' src/ --include='*.ts'; then
            echo "WARN: Hardcoded patient names — use synthetic data"
          fi
          echo "PHI scan passed"

  fhir-validation:
    runs-on: ubuntu-latest
    steps:
      - uses: actions/checkout@v4
      - uses: actions/setup-node@v4
        with: { node-version: '${{ env.NODE_VERSION }}' }
      - run: npm ci
      - name: Validate FHIR resources
        run: |
          npm run test:fhir-schemas
          echo "FHIR R4 validation passed"

  sandbox-integration:
    runs-on: ubuntu-latest
    if: github.event_name == 'push' && github.ref == 'refs/heads/main'
    needs: [lint-and-type-check, phi-leak-scan, fhir-validation]
    steps:
      - uses: actions/checkout@v4
      - uses: actions/setup-node@v4
        with: { node-version: '${{ env.NODE_VERSION }}' }
      - run: npm ci
      - name: Run sandbox integration tests
        env:
          ABRIDGE_SANDBOX_URL: ${{ secrets.ABRIDGE_SANDBOX_URL }}
          ABRIDGE_CLIENT_SECRET: ${{ secrets.ABRIDGE_CLIENT_SECRET }}
          ABRIDGE_ORG_ID: ${{ secrets.ABRIDGE_ORG_ID }}
        run: npm run test:integration

Step 2: FHIR Schema Validation Tests

// tests/fhir-validation.test.ts
import { describe, it, expect } from 'vitest';

describe('FHIR R4 Resource Validation', () => {
  it('should generate valid DocumentReference', () => {
    const docRef = {
      resourceType: 'DocumentReference',
      status: 'current',
      type: { coding: [{ system: 'http://loinc.org', code: '11506-3', display: 'Progress note' }] },
      subject: { reference: 'Patient/test-001' },
      content: [{ attachment: { contentType: 'text/plain', data: btoa('test note') } }],
    };

    expect(docRef.resourceType).toBe('DocumentReference');
    expect(docRef.status).toBe('current');
    expect(docRef.type.coding[0].system).toBe('http://loinc.org');
    expect(docRef.content[0].attachment.contentType).toBe('text/plain');
  });

  it('should generate valid Communication resource for patient summary', () => {
    const comm = {
      resourceType: 'Communication',
      status: 'completed',
      category: [{ coding: [{ system: 'http://terminology.hl7.org/CodeSystem/communication-category', code: 'notification' }] }],
      subject: { reference: 'Patient/test-001' },
      payload: [{ contentString: 'Your visit summary...' }],
    };

    expect(comm.resourceType).toBe('Communication');
    expect(comm.payload[0].contentString).toBeTruthy();
  });
});

Step 3: Integration Test with Sandbox

// tests/integration/sandbox.test.ts
import { describe, it, expect } from 'vitest';
import axios from 'axios';

describe('Abridge Sandbox Integration', () => {
  const api = axios.create({
    baseURL: process.env.ABRIDGE_SANDBOX_URL,
    headers: {
      'Authorization': `Bearer ${process.env.ABRIDGE_CLIENT_SECRET}`,
      'X-Org-Id': process.env.ABRIDGE_ORG_ID!,
    },
  });

  it('should create and finalize an encounter session', async () => {
    const { data: session } = await api.post('/encounters/sessions', {
      patient_id: 'ci-test-patient',
      provider_id: 'ci-test-provider',
      encounter_type: 'outpatient',
      specialty: 'internal_medicine',
      sandbox: true,
    });

    expect(session.session_id).toBeTruthy();
    expect(session.status).toBe('initialized');

    // Submit transcript
    await api.post(`/encounters/sessions/${session.session_id}/transcript`, {
      speaker: 'provider', text: 'CI test — patient presents with headache.',
    });

    // Finalize
    await api.post(`/encounters/sessions/${session.session_id}/finalize`);
  }, 30000);
});

Output

• GitHub Actions workflow with 4 jobs: lint, PHI scan, FHIR validation, sandbox integration
• PHI leak detection scanning source code for SSN/MRN patterns
• FHIR R4 resource validation tests
• Sandbox integration tests (main branch only)

Examples

For a pull request that changes FHIR mapping code, the lint, PHI scan, and FHIR schema jobs run against synthetic fixtures without contacting Abridge. After merge to main, the sandbox job creates ci-test-patient, verifies the encounter session reaches initialized, submits a synthetic transcript, and finalizes it. A timeout or missing secret fails the protected job rather than falling back to a production endpoint.

Error Handling

Issue	Cause	Solution
PHI scan false positive	Regex too broad	Add pattern to allowlist in scan script
Sandbox test timeout	API slow	Increase vitest timeout to 30s
Secrets not available	Missing GitHub Secrets	Add to repo Settings > Secrets

Resources

• Abridge Platform
• GitHub Actions Secrets
• FHIR Validator

Next Steps

For deployment procedures, see abridge-deploy-integration.