Brazilian healthcare compliance for regulated medical and psychological content.
⚠️ COMPLIANCE WARNING: This skill covers regulated healthcare content in Brazil Regulations: LGPD, CFM (Conselho Federal de Medicina), CRP (Conselho Regional de Psicologia), ANVISA Last Updated: 2025-10-29
Healthcare content in Brazil is subject to strict regulatory oversight from multiple authorities. This skill provides comprehensive compliance frameworks for:
(ns lab.compliance.lgpd.health-data
"LGPD-compliant health data classification and handling")
(def sensitive-data-categories
{:category-1-clinical-direct
{:level :critical
:types [:diagnoses :lab-results :imaging :prescriptions
:treatment-history :allergies :adverse-reactions]
:retention-days 90
:encryption-required true}
:category-2-biometric
{:level :critical
:types [:fingerprints :facial-recognition :iris :voice
:unique-physical-characteristics]
:retention-days 30
:encryption-required true}
:category-3-genetic
{:level :critical
:types [:genetic-sequencing :paternity-tests
:genetic-predispositions :hereditary-info]
:retention-days 180
:encryption-required true}
:category-4-behavioral
{:level :high
:types [:eating-habits :substance-use :physical-activity
:sleep-patterns :mental-health]
:retention-days 60
:encryption-required true}
:category-5-indirect-identification
{:level :medium
:types [:appointment-locations :visit-frequency
:family-relationships :insurance-plans :payment-history]
:retention-days 30
:encryption-required false}})
(defn classify-data-sensitivity
"Classify health data by sensitivity level and compliance requirements"
[data-type]
(some (fn [[category config]]
(when (some #{data-type} (:types config))
(assoc config :category category)))
sensitive-data-categories))
(defn requires-encryption?
"Check if data type requires encryption under LGPD"
[data-type]
(:encryption-required (classify-data-sensitivity data-type)))
(def lgpd-legal-bases
{:life-protection
{:article "Art. 7º, III"
:description "Protection of life or physical safety"
:requires-consent false
:use-cases [:emergency-care :critical-interventions]}
:health-protection
{:article "Art. 11, II, a"
:description "Health protection in procedures by health professionals"
:requires-consent false
:use-cases [:medical-diagnosis :treatment :health-services]}
:public-interest
{:article "Art. 7º, III"
:description "Public interest for public health policy execution"
:requires-consent false
:use-cases [:epidemiology :public-health :health-surveillance]}
:specific-consent
{:article "Art. 11, I"
:description "Specific and highlighted consent"
:requires-consent true
:use-cases [:research :marketing :data-sharing]}})
(defn validate-legal-basis
"Validate if operation has proper legal basis under LGPD"
[operation-type context]
(let [basis (get lgpd-legal-bases operation-type)]
{:valid? (not (nil? basis))
:requires-consent? (:requires-consent basis)
:article (:article basis)
:applicable-use-cases (:use-cases basis)}))
(ns lab.compliance.lgpd.subject-rights
"Implementation of LGPD data subject rights")
(def subject-rights
{:access
{:deadline-days 15
:description "Access to personal data"
:implementation-required [:data-export :readable-format]}
:correction
{:deadline-days 10
:description "Correction of incomplete, inaccurate, or outdated data"
:implementation-required [:update-interface :validation :audit-trail]}
:deletion
{:deadline-days 15
:description "Deletion of unnecessary or excessive data"
:implementation-required [:soft-delete :anonymization :retention-policies]}
:portability
{:deadline-days 20
:description "Data portability to another service provider"
:implementation-required [:structured-export :machine-readable :common-formats]}
:information
{:deadline-days 15
:description "Information about data sharing with public and private entities"
:implementation-required [:sharing-log :third-party-tracking :consent-records]}})
(defn handle-subject-request
"Process data subject rights request according to LGPD requirements"
[request-type patient-id]
(let [right (get subject-rights request-type)
deadline (java.time.LocalDate/now)
deadline (.plusDays deadline (:deadline-days right))]
{:request-type request-type
:patient-id patient-id
:deadline deadline
:required-actions (:implementation-required right)
:status :pending}))
(ns lab.compliance.lgpd.sanitization
"Data sanitization and anonymization utilities")
(def pii-patterns
{:cpf #"\d{3}\.\d{3}\.\d{3}-\d{2}"
:cpf-unformatted #"\d{11}"
:rg #"\d{1,2}\.\d{3}\.\d{3}-[\dXx]"
:phone #"\(?\d{2}\)?\s?\d{4,5}-?\d{4}"
:email #"[a-zA-Z0-9._%+-]+@[a-zA-Z0-9.-]+\.[a-zA-Z]{2,}"
:cep #"\d{5}-?\d{3}"
:full-name #"\b[A-Z][a-z]+\s+([A-Z][a-z]+\s+)*[A-Z][a-z]+\b"
:date-birth #"\d{2}/\d{2}/\d{4}"
:medical-record #"(?i)prontu[aá]rio\s*:?\s*\d+"})
(defn sanitize-text
"Remove or mask PII from text content"
[text mask-char]
(reduce (fn [sanitized [type pattern]]
(clojure.string/replace sanitized pattern
(fn [match]
(case type
:cpf "***.***.***-**"
:email (str (subs match 0 2) "***@***"
(subs match (clojure.string/last-index-of match ".")))
:phone "(XX) XXXXX-XXXX"
(apply str (repeat (count match) mask-char))))))
text
pii-patterns))
(defn anonymize-patient-data
"Anonymize patient data for research or analytics"
[patient-data]
{:patient-id (generate-anonymous-id (:patient-id patient-data))
:age-range (age-to-range (:age patient-data))
:gender (:gender patient-data)
:region (location-to-region (:location patient-data))
:condition-category (generalize-condition (:diagnosis patient-data))
:treatment-type (generalize-treatment (:treatment patient-data))})
(defn validate-anonymization
"Validate that anonymized data cannot be re-identified"
[anonymized-data original-count]
(let [k-anonymity-threshold 5
unique-combinations (count-unique-combinations anonymized-data)]
{:k-anonymity (/ original-count unique-combinations)
:meets-threshold? (>= (/ original-count unique-combinations)
k-anonymity-threshold)
:risk-level (if (< unique-combinations 5) :high :acceptable)}))
(ns lab.compliance.lgpd.checklist
"LGPD compliance validation checklist")
(def compliance-requirements
{:technical-security-measures
[{:id "SEC-001"
:requirement "Implement encryption for sensitive health data at rest"
:regulation "Art. 46, LGPD"
:severity :critical
:validation-fn #(check-encryption-at-rest %)}
{:id "SEC-002"
:requirement "Implement encryption for data in transit (TLS 1.2+)"
:regulation "Art. 46, LGPD"
:severity :critical
:validation-fn #(check-tls-version %)}
{:id "SEC-003"
:requirement "Implement access control and authentication"
:regulation "Art. 46, LGPD"
:severity :critical
:validation-fn #(check-access-control %)}
{:id "SEC-004"
:requirement "Implement audit logging for data access"
:regulation "Art. 37, LGPD"
:severity :high
:validation-fn #(check-audit-logs %)}]
:administrative-measures
[{:id "ADM-001"
:requirement "Maintain processing activity records"
:regulation "Art. 37, LGPD"
:severity :high
:validation-fn #(check-processing-records %)}
{:id "ADM-002"
:requirement "Conduct privacy impact assessment (DPIA)"
:regulation "Art. 38, LGPD"
:severity :high
:validation-fn #(check-dpia-exists %)}
{:id "ADM-003"
:requirement "Designate Data Protection Officer (DPO) if required"
:regulation "Art. 41, LGPD"
:severity :medium
:validation-fn #(check-dpo-designation %)}]
:incident-response
[{:id "INC-001"
:requirement "Notify ANPD of data breaches within 72 hours"
:regulation "Art. 48, LGPD"
:severity :critical
:validation-fn #(check-notification-procedure %)}
{:id "INC-002"
:requirement "Notify affected data subjects of breaches"
:regulation "Art. 48, II, LGPD"
:severity :critical
:validation-fn #(check-subject-notification-procedure %)}]
:subject-rights
[{:id "SUB-001"
:requirement "Implement data access request mechanism"
:regulation "Art. 18, LGPD"
:severity :high
:validation-fn #(check-access-mechanism %)}
{:id "SUB-002"
:requirement "Implement data deletion mechanism"
:regulation "Art. 18, VI, LGPD"
:severity :high
:validation-fn #(check-deletion-mechanism %)}
{:id "SUB-003"
:requirement "Implement data portability mechanism"
:regulation "Art. 18, V, LGPD"
:severity :medium
:validation-fn #(check-portability-mechanism %)}]})
(defn validate-compliance
"Validate system against LGPD requirements"
[system-config]
(let [all-checks (flatten (vals compliance-requirements))
results (map (fn [check]
(assoc check :result
((:validation-fn check) system-config)))
all-checks)]
{:total-checks (count results)
:passed (count (filter #(:result %) results))
:critical-failures (filter #(and (= :critical (:severity %))
(not (:result %)))
results)
:all-results results}))
(ns lab.compliance.councils.disclaimers
"CFM and CRP required disclaimers for healthcare content")
(def disclaimer-templates
{:cfm-general
{:urgency :critical
:applies-to [:diagnoses :medications :invasive-procedures :contraindications]
:text "As informações apresentadas não substituem a consulta médica. Sempre procure um profissional médico qualificado para diagnóstico e tratamento adequados."
:placement :top
:visual-style :warning}
:cfm-specialized
{:urgency :high
:applies-to [:specialist-content :treatment-efficacy :medical-procedures]
:text "Este conteúdo é de caráter informativo e não substitui a avaliação médica especializada. O diagnóstico e tratamento devem ser realizados por médico especialista na área."
:placement :top
:visual-style :info}
:cfm-procedures
{:urgency :critical
:applies-to [:surgical-procedures :invasive-treatments :medical-devices]
:text "Os procedimentos médicos mencionados possuem riscos e benefícios que devem ser avaliados individualmente. Consulte sempre um médico especializado."
:placement :top-and-bottom
:visual-style :warning}
:crp-general
{:urgency :high
:applies-to [:mental-health :psychological-assessment :therapy-approaches]
:text "As informações sobre saúde mental são de caráter educativo e não substituem a avaliação psicológica profissional. Procure um psicólogo registrado no CRP."
:placement :top
:visual-style :info}
:crp-therapeutic
{:urgency :high
:applies-to [:therapy-techniques :psychological-interventions :self-help]
:text "As abordagens terapêuticas mencionadas devem ser conduzidas por profissionais qualificados. Não pratique auto-terapia baseada nestas informações."
:placement :top-and-bottom
:visual-style :warning}
:anvisa-medications
{:urgency :critical
:applies-to [:medication-info :drug-recommendations :prescription-drugs]
:text "As informações sobre medicamentos são de caráter educativo. Não utilize medicamentos sem prescrição e orientação médica."
:placement :top
:visual-style :danger}
:anvisa-procedures
{:urgency :high
:applies-to [:aesthetic-procedures :therapeutic-procedures :medical-devices]
:text "Procedimentos estéticos e terapêuticos devem ser realizados por profissionais habilitados em estabelecimentos regularizados pela ANVISA."
:placement :bottom
:visual-style :info}
:emergency-warning
{:urgency :critical
:applies-to [:all-medical-content]
:text "Em caso de emergência médica, procure imediatamente um pronto-socorro ou ligue para o SAMU (192). Este conteúdo não oferece orientações para situações de urgência ou emergência médica."
:placement :bottom
:visual-style :danger}
:results-disclaimer
{:urgency :medium
:applies-to [:treatment-outcomes :success-rates :before-after]
:text "Os resultados podem variar individualmente e dependem de diversos fatores incluindo histórico médico, idade, estilo de vida e adesão ao tratamento. Não há garantia de resultados específicos."
:placement :bottom
:visual-style :info}})
(defn select-required-disclaimers
"Select required disclaimers based on content type"
[content-metadata]
(let [content-type (:type content-metadata)
topics (:topics content-metadata)]
(filter (fn [[key config]]
(some (set (:applies-to config)) topics))
disclaimer-templates)))
(defn format-disclaimer-html
"Format disclaimer as HTML with proper styling"
[disclaimer-key config]
(let [styles {:warning "background: #fff3cd; border-left: 4px solid #ffc107;"
:danger "background: #f8d7da; border-left: 4px solid #dc3545;"
:info "background: #e7f3ff; border: 1px solid #bee5eb;"}
style (get styles (:visual-style config))]
(str "<div class=\"disclaimer-" (name disclaimer-key) "\" "
"style=\"" style " padding: 15px; margin: 20px 0; border-radius: 4px;\">"
"<h4>⚠️ Informações Importantes</h4>"
"<p>" (:text config) "</p>"
"</div>")))
(ns lab.compliance.councils.credentials
"Validation of professional credentials (CRM, CRP, etc.)")
(def professional-registries
{:crm {:name "Conselho Regional de Medicina"
:pattern #"CRM/[A-Z]{2}\s+\d{4,6}"
:validation-url "https://portal.cfm.org.br/busca-medicos/"
:required-for [:medical-content :prescriptions :diagnoses]}
:crp {:name "Conselho Regional de Psicologia"
:pattern #"CRP\s+\d{2}/\d{5,6}"
:validation-url "https://cadastro.cfp.org.br/"
:required-for [:psychological-content :therapy :mental-health]}
:crn {:name "Conselho Regional de Nutrição"
:pattern #"CRN-\d+\s+\d{4,6}"
:validation-url "http://www.cfn.org.br/index.php/consulta-de-nutricionistas/"
:required-for [:nutrition-content :diet-plans :nutritional-advice]}
:crefito {:name "Conselho Regional de Fisioterapia e Terapia Ocupacional"
:pattern #"CREFITO-\d+\s+\d{5,6}"
:validation-url "https://www.coffito.gov.br/"
:required-for [:physical-therapy :rehabilitation :occupational-therapy]}})
(defn validate-credential-format
"Validate professional credential format"
[credential-type credential-number]
(let [registry (get professional-registries credential-type)
pattern (:pattern registry)]
{:valid-format? (boolean (re-matches pattern credential-number))
:registry-name (:name registry)
:validation-url (:validation-url registry)
:requires-online-verification true}))
(defn extract-professional-data
"Extract and validate professional data from content"
[content]
{:professionals-mentioned
(extract-professional-mentions content)
:credentials-found
(extract-credentials content)
:validation-required
(identify-validation-needs content)
:compliance-status
(check-credential-compliance content)})
(ns lab.compliance.research.validation
"Scientific research validation protocols")
(def evidence-hierarchy
{:level-1-meta-analysis
{:strength :highest
:description "Meta-analyses and systematic reviews"
:minimum-studies 5
:peer-review-required true
:recency-years 5}
:level-2-rct
{:strength :high
:description "Randomized controlled trials"
:minimum-sample-size 50
:peer-review-required true
:recency-years 10}
:level-3-cohort
{:strength :moderate-high
:description "Cohort studies"
:minimum-sample-size 100
:peer-review-required true
:recency-years 10}
:level-4-case-control
{:strength :moderate
:description "Case-control studies"
:minimum-sample-size 50
:peer-review-required true
:recency-years 10}
:level-5-case-series
{:strength :low-moderate
:description "Case series"
:minimum-cases 10
:peer-review-required true
:recency-years 15}
:level-6-case-report
{:strength :low
:description "Case reports"
:minimum-cases 1
:peer-review-required true
:recency-years 15}})
(def research-databases
{:primary
[{:name "PubMed/MEDLINE"
:url "https://pubmed.ncbi.nlm.nih.gov/"
:specialty :general-medicine
:priority :high}
{:name "Cochrane Library"
:url "https://www.cochranelibrary.com/"
:specialty :systematic-reviews
:priority :highest}
{:name "Embase"
:url "https://www.embase.com/"
:specialty :biomedicine-pharmacology
:priority :high}
{:name "PsycINFO"
:url "https://www.apa.org/pubs/databases/psycinfo"
:specialty :psychology-psychiatry
:priority :high}]
:secondary
[{:name "SciELO"
:url "https://scielo.org/"
:specialty :latin-american-research
:priority :medium}
{:name "LILACS"
:url "https://lilacs.bvsalud.org/"
:specialty :latin-american-health
:priority :medium}
{:name "Google Scholar"
:url "https://scholar.google.com/"
:specialty :broad-access
:priority :low}]})
(defn build-search-query
"Build advanced search query for scientific validation"
[claim-type main-concept keywords]
(case claim-type
:treatment-efficacy
{:structure "[TREATMENT] AND [CONDITION] AND [OUTCOME]"
:example (str "\"" (:treatment keywords) "\" AND \""
(:condition keywords) "\" AND (\"improvement\" OR \"reduction\")")
:filters ["Clinical trials" "Systematic reviews" "Meta-analyses"]
:timeframe-years 10}
:health-statistics
{:structure "[CONDITION] AND [POPULATION] AND (\"prevalence\" OR \"incidence\" OR \"epidemiology\")"
:example (str "\"" (:condition keywords) "\" AND \""
(:population keywords) "\" AND \"prevalence\"")
:filters ["Population studies" "Cross-sectional studies"]
:timeframe-years 5}
:side-effects
{:structure "[TREATMENT] AND (\"side effects\" OR \"adverse events\" OR \"complications\")"
:example (str "\"" (:treatment keywords) "\" AND (\"side effects\" OR \"adverse events\")")
:filters ["Case reports" "Adverse event studies"]
:timeframe-years :all}
:contraindications
{:structure "[TREATMENT] AND (\"contraindications\" OR \"precautions\" OR \"warnings\")"
:example (str "\"" (:treatment keywords) "\" AND (\"contraindications\" OR \"precautions\")")
:filters ["Clinical guidelines" "Safety reports"]
:timeframe-years 15}))
(defn validate-scientific-claim
"Validate medical claim against scientific evidence"
[claim search-results]
(let [evidence-levels (map :evidence-level search-results)
highest-evidence (first (sort-by :strength > evidence-levels))
study-count (count search-results)
recent-studies (filter #(within-recency? %) search-results)]
{:claim claim
:evidence-found (> study-count 0)
:highest-evidence-level highest-evidence
:total-studies study-count
:recent-studies (count recent-studies)
:validation-status (determine-validation-status
study-count highest-evidence recent-studies)
:confidence-level (calculate-confidence-level
study-count highest-evidence recent-studies)}))
(ns lab.compliance.pipeline
"Complete compliance validation pipeline"
(:require [lab.compliance.lgpd.health-data :as lgpd-data]
[lab.compliance.lgpd.sanitization :as sanitization]
[lab.compliance.councils.disclaimers :as disclaimers]
[lab.compliance.councils.credentials :as credentials]
[lab.compliance.research.validation :as research]))
(defn validate-healthcare-content
"Complete healthcare content compliance validation"
[content metadata]
(let [;; LGPD Data Protection
sensitive-data (lgpd-data/identify-sensitive-data content)
sanitized-content (if (seq sensitive-data)
(sanitization/sanitize-text content "*")
content)
;; Professional Credentials
credentials-check (credentials/extract-professional-data content)
;; Required Disclaimers
required-disclaimers (disclaimers/select-required-disclaimers metadata)
;; Scientific Validation
claims (extract-medical-claims content)
validated-claims (map research/validate-scientific-claim claims)
;; Overall Compliance
compliance-score (calculate-compliance-score
{:lgpd-compliant? (empty? sensitive-data)
:credentials-valid? (:all-valid? credentials-check)
:disclaimers-present? (seq required-disclaimers)
:claims-validated? (all-claims-validated? validated-claims)})]
{:sanitized-content sanitized-content
:sensitive-data-found sensitive-data
:credentials credentials-check
:required-disclaimers required-disclaimers
:validated-claims validated-claims
:compliance-score compliance-score
:approved? (>= compliance-score 0.95)
:issues (collect-compliance-issues
sensitive-data credentials-check validated-claims)}))
(defn generate-compliance-report
"Generate detailed compliance report"
[validation-result]
{:timestamp (java.time.Instant/now)
:overall-status (if (:approved? validation-result) :approved :needs-review)
:compliance-score (:compliance-score validation-result)
:critical-issues (filter #(= :critical (:severity %)) (:issues validation-result))
:warnings (filter #(= :warning (:severity %)) (:issues validation-result))
:recommendations (generate-recommendations validation-result)
:next-steps (generate-next-steps validation-result)})
LGPD Compliance
Professional Credentials
Required Disclaimers
Scientific Validation
Content Quality
Technical Security
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