[mherman22]

Problem

The real-time EMR → Client Registry (OpenCR) write path is broken. When a patient is saved, exportPatient issues a FHIR conditional update:

PUT /CR/fhir/Patient?identifier=http://sedish-haiti.org/fhir/source-key|<mspp-id>&_format=json

OpenCR does not support conditional update and responds 404 with Cannot PUT /fhir/Patient, so the patient never reaches the registry in real time (it only lands later via the consolidated batch feed).

Verified directly against the live OpenCR:

• PUT /Patient?identifier=... (conditional) → 404 Cannot PUT /fhir/Patient
• PUT /Patient/{id} (by id) → 200 OK, and OpenCR runs matching and creates the golden record.

Fix

Write by a stable id (the patient uuid) instead of a conditional update:

admitMessage.setId(patientExport.getPatient().getUuid());
MethodOutcome result = client.update().resource(admitMessage).execute();   // PUT /Patient/{uuid}

OpenCR matches/dedupes on the in-resource source-key identifier (still added above), so this is idempotent and converges with the consolidated batch feed — which already PUTs by id via the fhir-router mediator. This mirrors that mediator's documented approach ("OpenCR does NOT support FHIR conditional-update, so we PUT by id").

Testing

• mvn clean package green.
• Confirmed the two PUT styles above against the live OpenCR channel (conditional 404s, by-id 200 + golden created).

Builds on #73 (resilient search translation), which remains intact.