/** * @fileoverview Tests for HIPAA compliance and healthcare-specific security requirements * Tests PHI handling, audit trails, access controls, and healthcare data protection */ import { describe, test, expect, beforeEach, afterEach } from '@jest/globals'; import { mockFactory } from '../mocks/mockFactory.js'; describe('HIPAA Compliance and Healthcare Security Tests', () => { let mockEnv; let toolGenerator; beforeEach(() => { mockEnv = mockFactory.createMockEnvironment({ authTypes: ['provider', 'patient'], enableHttpMocks: true, enableAuthMocks: true, enableHealthcareMocks: true }); toolGenerator = mockEnv.toolGenerator; // Setup healthcare authentication mockFactory.authMocks.setMockCredentials('provider', { username: 'test_provider', password: 'test_password' }); mockFactory.authMocks.setMockCredentials('patient', { username: 'test_patient', password: 'test_password' }); }); afterEach(() => { mockFactory.resetAllMocks(); }); describe('PHI (Protected Health Information) Handling', () => { test('should properly encrypt PHI data in transit and at rest', async () => { // Setup const toolName = 'provider_create_emrregisterPatient'; const parameters = { firstName: 'John', lastName: 'Doe', email: 'john.doe@test.com', dateOfBirth: '1990-01-01', personalID: 'SSN123456789', // Sensitive PHI medicalHistory: 'Diabetes, Hypertension' // Sensitive medical data }; // Mock HIPAA-compliant response const mockPatient = mockFactory.healthcareMocks.createHIPAACompliantData('patient', 'provider', { firstName: 'John', lastName: 'Doe', email: 'john.doe@test.com' }); mockFactory.httpMocks.mockRequest('POST', '/api/emr/register-patients', { status: 201, data: { success: true, patient: mockPatient, encryption: { algorithm: 'AES-256-GCM', keyRotation: 'enabled', transitEncryption: 'TLS 1.3' }, hipaaCompliant: true } }); // Execute const result = await toolGenerator.executeTool(toolName, parameters); // Assert HIPAA compliance expect(result.data.hipaaCompliant).toBe(true); expect(result.data.patient.hipaaMetadata).toBeDefined(); expect(result.data.patient.hipaaMetadata.dataClassification).toBe('PHI'); expect(result.data.patient.hipaaMetadata.encryptionStatus).toBe('encrypted'); expect(result.data.encryption.algorithm).toBe('AES-256-GCM'); }); test('should implement minimum necessary standard for PHI access', async () => { const toolName = 'provider_create_getPatientInfo'; const parameters = { patientId: 123, requestedFields: ['firstName', 'lastName', 'dateOfBirth'], // Limited fields accessPurpose: 'treatment' }; // Mock minimum necessary response mockFactory.httpMocks.mockRequest('POST', '/api/get-patient-info/123', { status: 200, data: { success: true, patient: { firstName: 'John', lastName: 'Doe', dateOfBirth: '1990-01-01' // Other sensitive fields excluded based on minimum necessary }, accessControl: { minimumNecessary: true, fieldsProvided: ['firstName', 'lastName', 'dateOfBirth'], fieldsExcluded: ['personalID', 'medicalHistory'], accessPurpose: 'treatment' } } }); const result = await toolGenerator.executeTool(toolName, parameters); expect(result.data.accessControl.minimumNecessary).toBe(true); expect(result.data.accessControl.fieldsExcluded).toContain('personalID'); }); test('should handle PHI de-identification for research purposes', async () => { const toolName = 'provider_get_researchData'; const parameters = { dataset: 'diabetes_study', deidentification_level: 'safe_harbor' }; // Mock de-identified data response mockFactory.httpMocks.mockRequest('GET', '/api/research-data/diabetes_study', { status: 200, data: { success: true, research_data: [ { patient_id: 'DEIDENT_001', // De-identified ID age_range: '30-35', gender: 'M', diagnosis: 'Type 2 Diabetes', treatment_response: 'Positive' // No direct identifiers } ], deidentification: { method: 'safe_harbor', identifiers_removed: [ 'names', 'addresses', 'dates', 'phone_numbers', 'email_addresses', 'ssn', 'medical_record_numbers' ], certification: 'HIPAA_compliant', expert_determination: false } } }); const result = await toolGenerator.executeTool(toolName, parameters); expect(result.data.deidentification.method).toBe('safe_harbor'); expect(result.data.deidentification.identifiers_removed).toContain('ssn'); expect(result.data.research_data[0].patient_id).toMatch(/^DEIDENT_/); }); }); describe('Access Controls and Authorization', () => { test('should implement role-based access control (RBAC)', async () => { const toolName = 'provider_create_getPatientInfo'; const parameters = { patientId: 123 }; // Mock RBAC response mockFactory.httpMocks.mockRequest('POST', '/api/get-patient-info/123', { status: 200, data: { success: true, patient: mockFactory.healthcareMocks.createHIPAACompliantData('patient', 'provider'), accessControl: { userRole: 'provider', permissions: ['read:patient_data', 'write:patient_data', 'read:medical_records'], restrictions: ['no_billing_access'], accessLevel: 'full_clinical_access' } } }); const result = await toolGenerator.executeTool(toolName, parameters); expect(result.data.accessControl.userRole).toBe('provider'); expect(result.data.accessControl.permissions).toContain('read:patient_data'); expect(result.data.accessControl.restrictions).toContain('no_billing_access'); }); test('should enforce break-glass emergency access procedures', async () => { const toolName = 'provider_emergency_patientAccess'; const parameters = { patientId: 123, emergencyCode: 'EMERGENCY_001', justification: 'Patient in critical condition, immediate access required', emergencyType: 'life_threatening' }; // Mock emergency access response mockFactory.httpMocks.mockRequest('POST', '/api/emergency-access/patient/123', { status: 200, data: { success: true, patient: mockFactory.healthcareMocks.createHIPAACompliantData('patient', 'provider'), emergencyAccess: { granted: true, emergencyCode: 'EMERGENCY_001', accessLevel: 'full_emergency_access', timeLimit: '4 hours', requiresReview: true, auditFlag: 'emergency_access' }, complianceNote: 'Emergency access granted under HIPAA emergency provisions' } }); const result = await toolGenerator.executeTool(toolName, parameters); expect(result.data.emergencyAccess.granted).toBe(true); expect(result.data.emergencyAccess.requiresReview).toBe(true); expect(result.data.emergencyAccess.auditFlag).toBe('emergency_access'); }); test('should implement patient consent verification', async () => { const toolName = 'provider_create_sharePatientData'; const parameters = { patientId: 123, recipientProvider: 'specialist_456', dataTypes: ['medical_records', 'lab_results'], purpose: 'specialist_consultation' }; // Mock consent verification mockFactory.httpMocks.mockRequest('POST', '/api/share-patient-data', { status: 200, data: { success: true, sharing_authorized: true, consent_verification: { consent_obtained: true, consent_date: '2025-01-15', consent_type: 'written_authorization', expiration_date: '2026-01-15', scope: ['medical_records', 'lab_results'], purpose: 'specialist_consultation' }, sharing_details: { recipient: 'specialist_456', shared_at: new Date().toISOString(), tracking_id: 'SHARE_789' } } }); const result = await toolGenerator.executeTool(toolName, parameters); expect(result.data.consent_verification.consent_obtained).toBe(true); expect(result.data.consent_verification.scope).toContain('medical_records'); expect(result.data.sharing_details.tracking_id).toBe('SHARE_789'); }); }); describe('Audit Trails and Logging', () => { test('should maintain comprehensive audit trails for all PHI access', async () => { const toolName = 'provider_create_getPatientInfo'; const parameters = { patientId: 123 }; // Mock comprehensive audit trail mockFactory.httpMocks.mockRequest('POST', '/api/get-patient-info/123', { status: 200, data: { success: true, patient: mockFactory.healthcareMocks.createHIPAACompliantData('patient', 'provider'), auditTrail: { accessId: 'AUDIT_12345', userId: 'provider_456', userRole: 'provider', patientId: 123, action: 'patient_data_access', timestamp: new Date().toISOString(), ipAddress: '192.168.1.100', userAgent: 'Healthcare Portal v2.1', sessionId: 'SESSION_789', accessPurpose: 'patient_care', dataAccessed: ['demographics', 'medical_history'], accessMethod: 'direct_lookup', workstation: 'WS_001', location: 'Main Clinic - Room 101' } } }); const result = await toolGenerator.executeTool(toolName, parameters); const audit = result.data.auditTrail; expect(audit.accessId).toBeDefined(); expect(audit.userId).toBe('provider_456'); expect(audit.action).toBe('patient_data_access'); expect(audit.dataAccessed).toContain('demographics'); expect(audit.workstation).toBe('WS_001'); }); test('should log failed access attempts for security monitoring', async () => { const toolName = 'provider_create_getPatientInfo'; const parameters = { patientId: 999 // Non-existent patient }; // Mock failed access with audit mockFactory.httpMocks.mockRequest('POST', '/api/get-patient-info/999', null, true, { response: { status: 404, data: { error: 'Patient not found', auditTrail: { accessId: 'AUDIT_FAIL_001', userId: 'provider_456', action: 'failed_patient_access', timestamp: new Date().toISOString(), failureReason: 'patient_not_found', attemptedPatientId: 999, securityFlag: 'potential_unauthorized_access' } } } }); try { await toolGenerator.executeTool(toolName, parameters); } catch (error) { // Verify audit trail exists even for failed attempts expect(error.response?.data?.auditTrail).toBeDefined(); expect(error.response.data.auditTrail.action).toBe('failed_patient_access'); expect(error.response.data.auditTrail.securityFlag).toBe('potential_unauthorized_access'); } }); test('should implement audit log integrity protection', async () => { const toolName = 'admin_get_auditLogs'; const parameters = { date_range: { start: '2025-07-01', end: '2025-07-09' } }; // Mock audit log response with integrity protection mockFactory.httpMocks.mockRequest('GET', '/api/admin/audit-logs', { status: 200, data: { success: true, audit_logs: [ { id: 'AUDIT_001', timestamp: '2025-07-09T10:00:00Z', action: 'patient_data_access', userId: 'provider_456', checksum: 'SHA256:abc123def456', signature: 'RSA_SIGNATURE_HERE' } ], integrity: { total_logs: 1, verified_checksums: 1, tamper_detected: false, last_integrity_check: new Date().toISOString(), protection_method: 'cryptographic_hash_chain' } } }); const result = await toolGenerator.executeTool(toolName, parameters); expect(result.data.integrity.tamper_detected).toBe(false); expect(result.data.integrity.verified_checksums).toBe(1); expect(result.data.audit_logs[0].checksum).toMatch(/^SHA256:/); }); }); describe('Data Breach Prevention and Response', () => { test('should detect and prevent potential data breaches', async () => { const toolName = 'provider_bulk_patientExport'; const parameters = { patient_ids: Array.from({length: 1000}, (_, i) => i + 1), // Large bulk export export_format: 'csv' }; // Mock breach prevention response mockFactory.httpMocks.mockRequest('POST', '/api/bulk-export-patients', null, true, { response: { status: 403, data: { error: 'Potential data breach detected', breach_prevention: { trigger: 'bulk_export_threshold_exceeded', threshold: 100, requested_count: 1000, risk_level: 'high', action_taken: 'request_blocked', incident_id: 'INCIDENT_001' }, required_approvals: ['security_officer', 'privacy_officer'], compliance_note: 'Large data exports require additional authorization' } } }); try { await toolGenerator.executeTool(toolName, parameters); } catch (error) { expect(error.response.data.breach_prevention.trigger).toBe('bulk_export_threshold_exceeded'); expect(error.response.data.breach_prevention.risk_level).toBe('high'); expect(error.response.data.required_approvals).toContain('security_officer'); } }); test('should implement automatic breach notification procedures', async () => { const toolName = 'system_security_incident'; const parameters = { incident_type: 'unauthorized_access_detected', affected_records: 50, incident_details: 'Suspicious login patterns detected' }; // Mock breach notification response mockFactory.httpMocks.mockRequest('POST', '/api/security-incident', { status: 200, data: { success: true, incident: { id: 'BREACH_001', type: 'unauthorized_access_detected', severity: 'medium', affected_records: 50, notification_required: true }, breach_response: { immediate_actions: [ 'affected_accounts_locked', 'security_team_notified', 'audit_log_preserved' ], notification_timeline: { internal_notification: 'immediate', patient_notification: 'within_60_days', regulatory_notification: 'within_60_days' }, compliance_requirements: [ 'HIPAA_breach_notification_rule', 'state_breach_notification_laws' ] } } }); const result = await toolGenerator.executeTool(toolName, parameters); expect(result.data.incident.notification_required).toBe(true); expect(result.data.breach_response.immediate_actions).toContain('security_team_notified'); expect(result.data.breach_response.compliance_requirements).toContain('HIPAA_breach_notification_rule'); }); }); describe('Business Associate Agreements (BAA)', () => { test('should verify BAA compliance for third-party integrations', async () => { const toolName = 'provider_integrate_thirdPartyService'; const parameters = { service_name: 'Lab Results API', service_provider: 'LabCorp', integration_type: 'api_connection' }; // Mock BAA verification mockFactory.httpMocks.mockRequest('POST', '/api/integrate-third-party', { status: 200, data: { success: true, integration_approved: true, baa_compliance: { baa_signed: true, baa_date: '2025-01-01', baa_expiration: '2026-01-01', service_provider: 'LabCorp', compliance_verified: true, permitted_uses: ['lab_result_transmission', 'patient_data_processing'], safeguards_required: ['encryption', 'access_controls', 'audit_logging'] } } }); const result = await toolGenerator.executeTool(toolName, parameters); expect(result.data.baa_compliance.baa_signed).toBe(true); expect(result.data.baa_compliance.compliance_verified).toBe(true); expect(result.data.baa_compliance.safeguards_required).toContain('encryption'); }); }); });