interface/orders/gen_hl7_order.inc.php

   1 <?php
   2 /**
   3 * Functions to support HL7 order generation.
   4 *
   5 * Copyright (C) 2012-2013 Rod Roark <rod@sunsetsystems.com>
   6 *
   7 * LICENSE: This program is free software; you can redistribute it and/or
   8 * modify it under the terms of the GNU General Public License
   9 * as published by the Free Software Foundation; either version 2
  10 * of the License, or (at your option) any later version.
  11 * This program is distributed in the hope that it will be useful,
  12 * but WITHOUT ANY WARRANTY; without even the implied warranty of
  13 * MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE.  See the
  14 * GNU General Public License for more details.
  15 * You should have received a copy of the GNU General Public License
  16 * along with this program.  If not, see <http://opensource.org/licenses/gpl-license.php>.
  17 *
  18 * @package   OpenEMR
  19 * @author    Rod Roark <rod@sunsetsystems.com>
  20 */
  21
  22 /*
  23 * A bit of documentation that will need to go into the manual:
  24 *
  25 * The lab may want a list of your insurances for mapping into their system.
  26 * To produce it, go into phpmyadmin and run this query:
  27 *
  28 * SELECT i.id, i.name, a.line1, a.line2, a.city, a.state, a.zip, p.area_code,
  29 * p.prefix, p.number FROM insurance_companies AS i
  30 * LEFT JOIN addresses AS a ON a.foreign_id = i.id
  31 * LEFT JOIN phone_numbers AS p ON p.type = 2 AND p.foreign_id = i.id
  32 * ORDER BY i.name, i.id;
  33 *
  34 * Then export as a CSV file and read it into your favorite spreadsheet app.
  35 */
  36
  37 require_once("$srcdir/classes/Address.class.php");
  38 require_once("$srcdir/classes/InsuranceCompany.class.php");
  39 require_once("$webserver_root/custom/code_types.inc.php");
  40
  41 function hl7Text($s) {
  42   // See http://www.interfaceware.com/hl7_escape_protocol.html:
  43   $s = str_replace('\\', '\\E\\'  , $s);
  44   $s = str_replace('^' , '\\S\\'  , $s);
  45   $s = str_replace('|' , '\\F\\'  , $s);
  46   $s = str_replace('~' , '\\R\\'  , $s);
  47   $s = str_replace('&' , '\\T\\'  , $s);
  48   $s = str_replace("\r", '\\X0d\\', $s);
  49   return $s;
  50 }
  51
  52 function hl7Zip($s) {
  53   return hl7Text(preg_replace('/[-\s]*/','',$s));
  54 }
  55
  56 function hl7Date($s) {
  57   return preg_replace('/[^\d]/','',$s);
  58 }
  59
  60 function hl7Time($s) {
  61   if (empty($s)) return '';
  62   return date('YmdHis', strtotime($s));
  63 }
  64
  65 function hl7Sex($s) {
  66   $s = strtoupper(substr($s, 0, 1));
  67   if ($s !== 'M' && $s !== 'F') $s = 'U';
  68   return $s;
  69 }
  70
  71 function hl7Phone($s) {
  72   if (preg_match("/([2-9]\d\d)\D*(\d\d\d)\D*(\d\d\d\d)\D*$/", $s, $tmp)) {
  73     return '(' . $tmp[1] . ')' . $tmp[2] . '-' . $tmp[3];
  74   }
  75   if (preg_match("/(\d\d\d)\D*(\d\d\d\d)\D*$/", $s, $tmp)) {
  76     return $tmp[1] . '-' . $tmp[2];
  77   }
  78   return '';
  79 }
  80
  81 function hl7SSN($s) {
  82   if (preg_match("/(\d\d\d)\D*(\d\d)\D*(\d\d\d\d)\D*$/", $s, $tmp)) {
  83     return $tmp[1] . '-' . $tmp[2] . '-' . $tmp[3];
  84   }
  85   return '';
  86 }
  87
  88 function hl7Priority($s) {
  89   return strtoupper(substr($s, 0, 1)) == 'H' ? 'S' : 'R';
  90 }
  91
  92 function hl7Relation($s) {
  93   $tmp = strtolower($s);
  94   if ($tmp == 'self' || $tmp == '') return 'self';
  95   else if ($tmp == 'spouse') return 'spouse';
  96   else if ($tmp == 'child' ) return 'child';
  97   else if ($tmp == 'other' ) return 'other';
  98   // Should not get here so this will probably get noticed if we do.
  99   return $s;
 100 }
 101
 102 /**
 103  * Get array of insurance payers for the specified patient as of the specified
 104  * date. If no date is passed then the current date is used.
 105  *
 106  * @param  integer $pid             Patient ID.
 107  * @param  date    $encounter_date  YYYY-MM-DD date.
 108  * @return array   Array containing an array of data for each payer.
 109  */
 110 function loadPayerInfo($pid, $date='') {
 111   if (empty($date)) $date = date('Y-m-d');
 112   $payers = array();
 113   $dres = sqlStatement("SELECT * FROM insurance_data WHERE " .
 114     "pid = ? AND date <= ? ORDER BY type ASC, date DESC",
 115     array($pid, $date));
 116   $prevtype = ''; // type is primary, secondary or tertiary
 117   while ($drow = sqlFetchArray($dres)) {
 118     if (strcmp($prevtype, $drow['type']) == 0) continue;
 119     $prevtype = $drow['type'];
 120     // Very important to check for a missing provider because
 121     // that indicates no insurance as of the given date.
 122     if (empty($drow['provider'])) continue;
 123     $ins = count($payers);
 124     $crow = sqlQuery("SELECT * FROM insurance_companies WHERE id = ?",
 125       array($drow['provider']));
 126     $orow = new InsuranceCompany($drow['provider']);
 127     $payers[$ins] = array();
 128     $payers[$ins]['data']    = $drow;
 129     $payers[$ins]['company'] = $crow;
 130     $payers[$ins]['object']  = $orow;
 131   }
 132   return $payers;
 133 }
 134
 135 /**
 136  * Generate HL7 for the specified procedure order.
 137  *
 138  * @param  integer $orderid  Procedure order ID.
 139  * @param  string  &$out     Container for target HL7 text.
 140  * @return string            Error text, or empty if no errors.
 141  */
 142 function gen_hl7_order($orderid, &$out) {
 143
 144   // Delimiters
 145   $d0 = "\r";
 146   $d1 = '|';
 147   $d2 = '^';
 148
 149   $today = time();
 150   $out = '';
 151
 152   $porow = sqlQuery("SELECT " .
 153     "po.date_collected, po.date_ordered, po.order_priority, " .
 154     "pp.*, " .
 155     "pd.pid, pd.pubpid, pd.fname, pd.lname, pd.mname, pd.DOB, pd.ss, " .
 156     "pd.phone_home, pd.phone_biz, pd.sex, pd.street, pd.city, pd.state, pd.postal_code, " .
 157     "f.encounter, u.fname AS docfname, u.lname AS doclname, u.npi AS docnpi " .
 158     "FROM procedure_order AS po, procedure_providers AS pp, " .
 159     "forms AS f, patient_data AS pd, users AS u " .
 160     "WHERE " .
 161     "po.procedure_order_id = ? AND " .
 162     "pp.ppid = po.lab_id AND " .
 163     "f.formdir = 'procedure_order' AND " .
 164     "f.form_id = po.procedure_order_id AND " .
 165     "pd.pid = f.pid AND " .
 166     "u.id = po.provider_id",
 167     array($orderid));
 168   if (empty($porow)) return "Procedure order or lab is missing for order ID '$orderid'";
 169
 170   $pcres = sqlStatement("SELECT " .
 171     "pc.procedure_code, pc.procedure_name, pc.procedure_order_seq, pc.diagnoses " .
 172     "FROM procedure_order_code AS pc " .
 173     "WHERE " .
 174     "pc.procedure_order_id = ? " .
 175     "ORDER BY pc.procedure_order_seq",
 176     array($orderid));
 177
 178   // Message Header
 179   $out .= "MSH" .
 180     $d1 . "$d2~\\&" .               // Encoding Characters (delimiters)
 181     $d1 . $porow['send_app_id'] .   // Sending Application ID
 182     $d1 . $porow['send_fac_id'] .   // Sending Facility ID
 183     $d1 . $porow['recv_app_id'] .   // Receiving Application ID
 184     $d1 . $porow['recv_fac_id'] .   // Receiving Facility ID
 185     $d1 . date('YmdHis', $today) .  // Date and time of this message
 186     $d1 .
 187     $d1 . 'ORM' . $d2 . 'O01' .     // Message Type
 188     $d1 . $orderid .                // Unique Message Number
 189     $d1 . $porow['DorP'] .          // D=Debugging, P=Production
 190     $d1 . '2.3' .                   // HL7 Version ID
 191     $d0;
 192
 193   // Patient Identification
 194   $out .= "PID" .
 195     $d1 . "1" .                      // Set ID (always just 1 of these)
 196     $d1 . $porow['pid'] .            // Patient ID (not required)
 197     $d1 . $porow['pid'] .            // Patient ID (required)
 198     $d1 .                            // Alternate Patient ID (not required)
 199     $d1 . hl7Text($porow['lname']) .
 200       $d2 . hl7Text($porow['fname']);
 201   if ($porow['mname']) $out .= $d2 . hl7Text($porow['mname']);
 202   $out .=
 203     $d1 .
 204     $d1 . hl7Date($porow['DOB']) .   // DOB
 205     $d1 . hl7Sex($porow['sex'])  .   // Sex: M, F or U
 206     $d1 . $d1 .
 207     $d1 . hl7Text($porow['street']) .
 208       $d2 .
 209       $d2 . hl7Text($porow['city']) .
 210       $d2 . hl7Text($porow['state']) .
 211       $d2 . hl7Zip($porow['zip']) .
 212     $d1 .
 213     $d1 . hl7Phone($porow['phone_home']) .
 214     $d1 . hl7Phone($porow['phone_biz']) .
 215     $d1 . $d1 . $d1 .
 216     $d1 . $porow['encounter'] .
 217     $d1 . hl7SSN($porow['ss']) .
 218     $d1 . $d1 . $d1 .
 219     $d0;
 220
 221   // NTE segment(s) omitted.
 222
 223   // Patient Visit.
 224   $out .= "PV1" .
 225     $d1 . "1" .                           // Set ID (always just 1 of these)
 226     $d1 .                                 // Patient Class (if required, O for Outpatient)
 227     $d1 .                                 // Patient Location (for inpatient only?)
 228     $d1 . $d1 . $d1 .
 229     $d1 . hl7Text($porow['docnpi']) .     // Attending Doctor ID
 230       $d2 . hl7Text($porow['doclname']) . // Last Name
 231       $d2 . hl7Text($porow['docfname']) . // First Name
 232     str_repeat($d1, 11) .                 // PV1 8 to 18 all empty
 233     $d1 . $porow['encounter'] .           // Encounter Number
 234     str_repeat($d1, 13) .                 // PV1 20 to 32 all empty
 235     $d0;
 236
 237   // Insurance stuff.
 238   $payers = loadPayerInfo($porow['pid'], $porow['date_ordered']);
 239   $setid = 0;
 240   foreach ($payers as $payer) {
 241     $payer_object = $payer['object'];
 242     $payer_address = $payer_object->get_address();
 243     $out .= "IN1" .
 244       $d1 . ++$setid .                                // Set ID
 245       $d1 .                                           // Insurance Plan Identifier ??
 246       $d1 . hl7Text($payer['company']['id']) .        // Insurance Company ID
 247       $d1 . hl7Text($payer['company']['name'])   .    // Insurance Company Name
 248       $d1 . hl7Text($payer_address->get_line1()) .    // Street Address
 249         $d2 .
 250         $d2 . hl7Text($payer_address->get_city()) .   // City
 251         $d2 . hl7Text($payer_address->get_state()) .  // State
 252         $d2 . hl7Zip($payer_address->get_zip()) .     // Zip Code
 253       $d1 .
 254       $d1 . hl7Phone($payer_object->get_phone()) .    // Phone Number
 255       $d1 . hl7Text($payer['data']['group_number']) . // Insurance Company Group Number
 256       str_repeat($d1, 7) .                            // IN1 9-15 all empty
 257       $d1 . hl7Text($payer['data']['subscriber_lname']) .   // Insured last name
 258         $d2 . hl7Text($payer['data']['subscriber_fname']) . // Insured first name
 259         $d2 . hl7Text($payer['data']['subscriber_mname']) . // Insured middle name
 260       $d1 . hl7Relation($payer['data']['subscriber_relationship']) .
 261       $d1 . hl7Date($payer['data']['subscriber_DOB']) .     // Insured DOB
 262       $d1 . hl7Date($payer['data']['subscriber_street']) .  // Insured Street Address
 263         $d2 .
 264         $d2 . hl7Text($payer['data']['subscriber_city']) .  // City
 265         $d2 . hl7Text($payer['data']['subscriber_state']) . // State
 266         $d2 . hl7Zip($payer['data']['subscriber_postal_code']) . // Zip
 267       $d1 .
 268       $d1 .
 269       $d1 . $setid .                                  // 1=Primary, 2=Secondary, 3=Tertiary
 270       str_repeat($d1, 13) .                           // IN1-23 to 35 all empty
 271       $d1 . hl7Text($payer['data']['policy_number']) . // Policy Number
 272       str_repeat($d1, 12) .                           // IN1-37 to 48 all empty
 273       $d0;
 274
 275     // IN2 segment omitted.
 276   }
 277
 278   // Guarantor. OpenEMR doesn't have these so use the patient.
 279   $out .= "GT1" .
 280     $d1 . "1" .                      // Set ID (always just 1 of these)
 281     $d1 .
 282     $d1 . hl7Text($porow['lname']) .
 283       $d2 . hl7Text($porow['fname']);
 284   if ($porow['mname']) $out .= $d2 . hl7Text($porow['mname']);
 285   $out .=
 286     $d1 .
 287     $d1 . hl7Text($porow['street']) .
 288       $d2 .
 289       $d2 . hl7Text($porow['city']) .
 290       $d2 . hl7Text($porow['state']) .
 291       $d2 . hl7Zip($porow['zip']) .
 292     $d1 . hl7Phone($porow['phone_home']) .
 293     $d1 . hl7Phone($porow['phone_biz']) .
 294     $d1 . hl7Date($porow['DOB']) .   // DOB
 295     $d1 . hl7Sex($porow['sex'])  .   // Sex: M, F or U
 296     $d1 .
 297     $d1 . 'self' .                   // Relationship
 298     $d1 . hl7SSN($porow['ss']) .
 299     $d0;
 300
 301   // Common Order.
 302   $out .= "ORC" .
 303     $d1 . "NW" .                     // New Order
 304     $d1 . $orderid .                 // Placer Order Number
 305     str_repeat($d1, 6) .             // ORC 3-8 not used
 306     $d1 . date('YmdHis') .           // Transaction date/time
 307     $d1 . $d1 .
 308     $d1 . hl7Text($porow['docnpi']) .     // Ordering Provider
 309       $d2 . hl7Text($porow['doclname']) . // Last Name
 310       $d2 . hl7Text($porow['docfname']) . // First Name
 311     str_repeat($d1, 7) .             // ORC 13-19 not used
 312     $d1 . "2" .                      // ABN Status: 2 = Notified & Signed, 4 = Unsigned
 313     $d0;
 314
 315   $setid = 0;
 316   while ($pcrow = sqlFetchArray($pcres)) {
 317     // Observation Request.
 318     $out .= "OBR" .
 319       $d1 . ++$setid .                              // Set ID
 320       $d1 . $orderid .                              // Placer Order Number
 321       $d1 .
 322       $d1 . hl7Text($pcrow['procedure_code']) .
 323         $d2 . hl7Text($pcrow['procedure_name']) .
 324       $d1 . hl7Priority($porow['order_priority']) . // S=Stat, R=Routine
 325       $d1 .
 326       $d1 . hl7Time($porow['date_collected']) .     // Observation Date/Time
 327       str_repeat($d1, 8) .                          // OBR 8-15 not used
 328       $d1 . hl7Text($porow['docnpi']) .             // Physician ID
 329         $d2 . hl7Text($porow['doclname']) .         // Last Name
 330         $d2 . hl7Text($porow['docfname']) .         // First Name
 331       $d1 .
 332       $d1 . (count($payers) ? 'I' : 'P') .          // I=Insurance, C=Client, P=Self Pay
 333       str_repeat($d1, 8) .                          // OBR 19-26 not used
 334       $d1 . '0' .                                   // ?
 335       $d0;
 336
 337     // Diagnoses.  Currently hard-coded for ICD9 and we'll surely want to make
 338     // this more flexible (probably when some lab needs another diagnosis type).
 339     $setid2 = 0;
 340     if (!empty($pcrow['diagnoses'])) {
 341       $relcodes = explode(';', $pcrow['diagnoses']);
 342       foreach ($relcodes as $codestring) {
 343         if ($codestring === '') continue;
 344         list($codetype, $code) = explode(':', $codestring);
 345         if ($codetype !== 'ICD9') continue;
 346         $desc = lookup_code_descriptions($codestring);
 347         $out .= "DG1" .
 348           $d1 . ++$setid2 .                         // Set ID
 349           $d1 .                                     // Diagnosis Coding Method
 350           $d1 . $code .                             // Diagnosis Code
 351           $d1 . hl7Text($desc) .                    // Diagnosis Description
 352           $d0;
 353       }
 354     }
 355
 356     // Order entry questions and answers.
 357     $qres = sqlStatement("SELECT " .
 358       "a.question_code, a.answer, q.fldtype " .
 359       "FROM procedure_answers AS a " .
 360       "LEFT JOIN procedure_questions AS q ON " .
 361       "q.lab_id = ? " .
 362       "AND q.procedure_code = ? AND " .
 363       "q.question_code = a.question_code " .
 364       "WHERE " .
 365       "a.procedure_order_id = ? AND " .
 366       "a.procedure_order_seq = ? " .
 367       "ORDER BY q.seq, a.answer_seq",
 368       array($porow['ppid'], $pcrow['procedure_code'], $orderid, $pcrow['procedure_order_seq']));
 369     $setid2 = 0;
 370     while ($qrow = sqlFetchArray($qres)) {
 371       // Formatting of these answer values may be lab-specific and we'll figure
 372       // out how to deal with that as more labs are supported.
 373       $answer = trim($qrow['answer']);
 374       $fldtype = $qrow['fldtype'];
 375       $datatype = 'ST';
 376       if ($fldtype == 'N') {
 377         $datatype = "NM";
 378       } else if ($fldtype == 'D') {
 379         $answer = hl7Date($answer);
 380       } else if ($fldtype == 'G') {
 381         $weeks = intval($answer / 7);
 382         $days = $answer % 7;
 383         $answer = $weeks . 'wks ' . $days . 'days';
 384       }
 385       $out .= "OBX" .
 386         $d1 . ++$setid2 .                           // Set ID
 387         $d1 . $datatype .                           // Structure of observation value
 388         $d1 . hl7Text($qrow['question_code']) .     // Clinical question code
 389         $d1 .
 390         $d1 . hl7Text($answer) .                    // Clinical question answer
 391         $d0;
 392     }
 393   }
 394
 395   return '';
 396 }
 397
 398 /**
 399  * Transmit HL7 for the specified lab.
 400  *
 401  * @param  integer $ppid  Procedure provider ID.
 402  * @param  string  $out   The HL7 text to be sent.
 403  * @return string         Error text, or empty if no errors.
 404  */
 405 function send_hl7_order($ppid, $out) {
 406   global $srcdir;
 407
 408   $d0 = "\r";
 409
 410   $pprow = sqlQuery("SELECT * FROM procedure_providers " .
 411     "WHERE ppid = ?", array($ppid));
 412   if (empty($pprow)) return xl('Procedure provider') . " $ppid " . xl('not found');
 413
 414   $protocol = $pprow['protocol'];
 415   $remote_host = $pprow['remote_host'];
 416
 417   // Extract MSH-10 which is the message control ID.
 418   $segmsh = explode(substr($out, 3, 1), substr($out, 0, strpos($out, $d0)));
 419   $msgid = $segmsh[9];
 420   if (empty($msgid)) return xl('Internal error: Cannot find MSH-10');
 421
 422   if ($protocol == 'SFTP') {
 423     ini_set('include_path', ini_get('include_path') . PATH_SEPARATOR . "$srcdir/phpseclib");
 424     require_once("$srcdir/phpseclib/Net/SFTP.php");
 425
 426     // Compute the target path/file name.
 427     $filename = $msgid . '.txt';
 428     if ($pprow['orders_path']) $filename = $pprow['orders_path'] . '/' . $filename;
 429
 430     // Connect to the server and write the file.
 431     $sftp = new Net_SFTP($remote_host);
 432     if (!$sftp->login($pprow['login'], $pprow['password'])) {
 433       return xl('Login to this remote host failed') . ": '$remote_host'";
 434     }
 435     if (!$sftp->put($filename, $out)) {
 436       return xl('Creating this file on remote host failed') . ": '$filename'";
 437     }
 438   }
 439
 440   else if ($protocol == 'DL') {
 441     header("Pragma: public");
 442     header("Expires: 0");
 443     header("Cache-Control: must-revalidate, post-check=0, pre-check=0");
 444     header("Content-Type: application/force-download");
 445     header("Content-Disposition: attachment; filename=order_$msgid.hl7");
 446     header("Content-Description: File Transfer");
 447     echo $out;
 448     exit;
 449   }
 450
 451   // TBD: Insert "else if ($protocol == '???') {...}" to support other protocols.
 452
 453   else {
 454     return xl('This protocol is not implemented') . ": '$protocol'";
 455   }
 456
 457   // Falling through to here indicates success.
 458   newEvent("proc_order_xmit", $_SESSION['authUser'], $_SESSION['authProvider'], 1,
 459     "ID: $msgid Protocol: $protocol Host: $remote_host");
 460   return '';
 461 }
 462 ?>