src/Services/FHIR/FhirConditionService.php

   1 <?php
   2
   3 namespace OpenEMR\Services\FHIR;
   4
   5 use OpenEMR\FHIR\R4\FHIRElement\FHIRCodeableConcept;
   6 use OpenEMR\FHIR\R4\FHIRElement\FHIRCoding;
   7 use OpenEMR\FHIR\R4\FHIRElement\FHIRId;
   8 use OpenEMR\FHIR\R4\FHIRElement\FHIRMeta;
   9 use OpenEMR\FHIR\R4\FHIRElement\FHIRReference;
  10 use OpenEMR\FHIR\R4\FHIRDomainResource\FHIRCondition;
  11 use OpenEMR\Services\FHIR\FhirServiceBase;
  12 use OpenEMR\Services\ConditionService;
  13 use OpenEMR\Services\FHIR\Traits\BulkExportSupportAllOperationsTrait;
  14 use OpenEMR\Services\FHIR\Traits\FhirBulkExportDomainResourceTrait;
  15 use OpenEMR\Services\FHIR\Traits\FhirServiceBaseEmptyTrait;
  16 use OpenEMR\Services\Search\FhirSearchParameterDefinition;
  17 use OpenEMR\Services\Search\ISearchField;
  18 use OpenEMR\Services\Search\SearchFieldType;
  19 use OpenEMR\Services\Search\ServiceField;
  20 use OpenEMR\Validators\ProcessingResult;
  21
  22 /**
  23  * FHIR Condition Service
  24  *
  25  * @coversDefaultClass OpenEMR\Services\FHIR\FhirConditionService
  26  * @package            OpenEMR
  27  * @link               http://www.open-emr.org
  28  * @author             Yash Bothra <yashrajbothra786gmail.com>
  29  * @copyright          Copyright (c) 2020 Yash Bothra <yashrajbothra786gmail.com>
  30  * @license            https://github.com/openemr/openemr/blob/master/LICENSE GNU General Public License 3
  31  */
  32 class FhirConditionService extends FhirServiceBase implements IResourceUSCIGProfileService, IFhirExportableResourceService, IPatientCompartmentResourceService
  33 {
  34     use FhirServiceBaseEmptyTrait;
  35     use BulkExportSupportAllOperationsTrait;
  36     use FhirBulkExportDomainResourceTrait;
  37
  38     /**
  39      * @var ConditionService
  40      */
  41     private $conditionService;
  42
  43
  44     const USCGI_PROFILE_URI = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-condition';
  45
  46     public function __construct()
  47     {
  48         parent::__construct();
  49         $this->conditionService = new ConditionService();
  50     }
  51
  52     /**
  53      * Returns an array mapping FHIR Condition Resource search parameters to OpenEMR Condition search parameters
  54      *
  55      * @return array The search parameters
  56      */
  57     protected function loadSearchParameters()
  58     {
  59         return  [
  60             'patient' => $this->getPatientContextSearchField(),
  61             '_id' => new FhirSearchParameterDefinition('_id', SearchFieldType::TOKEN, [new ServiceField('condition_uuid', ServiceField::TYPE_UUID)]),
  62             '_lastUpdated' => $this->getLastModifiedSearchField(),
  63         ];
  64     }
  65
  66     public function getLastModifiedSearchField(): ?FhirSearchParameterDefinition
  67     {
  68         return new FhirSearchParameterDefinition('_lastUpdated', SearchFieldType::DATETIME, ['last_updated_time']);
  69     }
  70
  71     /**
  72      * Parses an OpenEMR condition record, returning the equivalent FHIR Condition Resource
  73      *
  74      * @param  array   $dataRecord The source OpenEMR data record
  75      * @param  boolean $encode     Indicates if the returned resource is encoded into a string. Defaults to false.
  76      * @return FHIRCondition
  77      */
  78     public function parseOpenEMRRecord($dataRecord = array(), $encode = false)
  79     {
  80         $conditionResource = new FHIRCondition();
  81
  82         $meta = new FHIRMeta();
  83         $meta->setVersionId('1');
  84         if (!empty($dataRecord['last_updated_time'])) {
  85             $meta->setLastUpdated(UtilsService::getLocalDateAsUTC($dataRecord['last_updated_time']));
  86         } else {
  87             $meta->setLastUpdated(UtilsService::getDateFormattedAsUTC());
  88         }
  89         $conditionResource->setMeta($meta);
  90
  91         $id = new FHIRId();
  92         $id->setValue($dataRecord['uuid']);
  93         $conditionResource->setId($id);
  94
  95         // ONC requirements
  96         $this->populateClinicalStatus($dataRecord, $conditionResource);
  97         $this->populateCategory($dataRecord, $conditionResource);
  98         $this->populateVerificationStatus($dataRecord, $conditionResource);
  99         $this->populateCode($dataRecord, $conditionResource);
 100         $this->populateSubject($dataRecord, $conditionResource);
 101
 102         // non-ONC requirements
 103         $this->populateEncounter($dataRecord, $conditionResource);
 104
 105
 106         if ($encode) {
 107             return json_encode($conditionResource);
 108         } else {
 109             return $conditionResource;
 110         }
 111     }
 112
 113     private function populateEncounter($dataRecord, FHIRCondition $conditionResource)
 114     {
 115         if (isset($dataRecord['encounter_uuid'])) {
 116             $encounter = new FHIRReference();
 117             $encounter->setReference('Encounter/' . $dataRecord['encounter_uuid']);
 118             $conditionResource->setEncounter($encounter);
 119         }
 120     }
 121
 122     private function populateSubject($dataRecord, FHIRCondition $conditionResource)
 123     {
 124         if (isset($dataRecord['puuid'])) {
 125             $patient = new FHIRReference();
 126             $patient->setReference('Patient/' . $dataRecord['puuid']);
 127             $conditionResource->setSubject($patient);
 128         }
 129     }
 130
 131     private function populateCode($dataRecord, FHIRCondition $conditionResource)
 132     {
 133         if (!empty($dataRecord['diagnosis'])) {
 134             $diagnosisCoding = new FHIRCoding();
 135             $diagnosisCode = new FHIRCodeableConcept();
 136             foreach ($dataRecord['diagnosis'] as $code => $codeValues) {
 137                 if (!is_string($code)) {
 138                     $code = "$code"; // FHIR expects a string
 139                 }
 140                 $diagnosisCoding->setCode($code);
 141                 $diagnosisCoding->setDisplay($codeValues['description']);
 142                 $diagnosisCoding->setSystem($codeValues['system']);
 143                 $diagnosisCode->addCoding($diagnosisCoding);
 144             }
 145             $conditionResource->setCode($diagnosisCode);
 146         }
 147     }
 148
 149     private function populateVerificationStatus($dataRecord, FHIRCondition $conditionResource)
 150     {
 151         $verificationStatus = new FHIRCodeableConcept();
 152         $verificationCoding = array(
 153             'system' => "http://terminology.hl7.org/CodeSystem/condition-ver-status",
 154             'code' => 'unconfirmed',
 155             'display' => 'Unconfirmed',
 156         );
 157         if (!empty($dataRecord['verification'])) {
 158             $verificationCoding = array(
 159                 'system' => "http://terminology.hl7.org/CodeSystem/condition-ver-status",
 160                 'code' => $dataRecord['verification'],
 161                 'display' => $dataRecord['verification_title']
 162             );
 163         }
 164         $verificationStatus->addCoding($verificationCoding);
 165         $conditionResource->setVerificationStatus($verificationStatus);
 166     }
 167
 168     private function populateCategory($dataRecord, $conditionResource)
 169     {
 170
 171         $conditionCategory = new FHIRCodeableConcept();
 172         $conditionCategory->addCoding(
 173             array(
 174                 'system' => "http://terminology.hl7.org/CodeSystem/condition-category",
 175                 'code' => 'problem-list-item',
 176                 'display' => 'Problem List Item'
 177             )
 178         );
 179         $conditionResource->addCategory($conditionCategory);
 180     }
 181
 182     private function populateClinicalStatus($dataRecord, FHIRCondition $conditionResource)
 183     {
 184         $clinicalStatus = "inactive";
 185         $clinicalSysytem = "http://terminology.hl7.org/CodeSystem/condition-clinical";
 186         if (
 187             (!isset($dataRecord['enddate']) && isset($dataRecord['begdate']))
 188             || isset($dataRecord['enddate']) && strtotime($dataRecord['enddate']) >= strtotime("now")
 189         ) {
 190             // Active if Only Begin Date isset OR End Date isnot expired
 191             $clinicalStatus = "active";
 192             if ($dataRecord['occurrence'] == 1 || $dataRecord['outcome'] == 1) {
 193                 $clinicalStatus = "resolved";
 194             } elseif ($dataRecord['occurrence'] > 1) {
 195                 $clinicalStatus = "recurrence";
 196             }
 197         } elseif (isset($dataRecord['enddate']) && strtotime($dataRecord['enddate']) < strtotime("now")) {
 198             //Inactive if End Date is expired
 199             $clinicalStatus = "inactive";
 200         } else {
 201             $clinicalSysytem = "http://terminology.hl7.org/CodeSystem/data-absent-reason";
 202             $clinicalStatus = "unknown";
 203         }
 204         $clinical_Status = new FHIRCodeableConcept();
 205         $clinical_Status->addCoding(
 206             array(
 207                 'system' => $clinicalSysytem,
 208                 'code' => $clinicalStatus,
 209                 'display' => ucwords($clinicalStatus),
 210             )
 211         );
 212         $conditionResource->setClinicalStatus($clinical_Status);
 213     }
 214
 215     /**
 216      * Searches for OpenEMR records using OpenEMR search parameters
 217      *
 218      * @param  array openEMRSearchParameters OpenEMR search fields
 219      * @param $puuidBind - Optional variable to only allow visibility of the patient with this puuid.
 220      * @return ProcessingResult
 221      */
 222     protected function searchForOpenEMRRecords($openEMRSearchParameters, $puuidBind = null): ProcessingResult
 223     {
 224         $result = $this->conditionService->getAll($openEMRSearchParameters, true, $puuidBind);
 225         return $result;
 226     }
 227
 228     public function createProvenanceResource($dataRecord = array(), $encode = false)
 229     {
 230         if (!($dataRecord instanceof FHIRCondition)) {
 231             throw new \BadMethodCallException("Data record should be correct instance class");
 232         }
 233         $fhirProvenanceService = new FhirProvenanceService();
 234         $fhirProvenance = $fhirProvenanceService->createProvenanceForDomainResource($dataRecord);
 235         if ($encode) {
 236             return json_encode($fhirProvenance);
 237         } else {
 238             return $fhirProvenance;
 239         }
 240     }
 241
 242     /**
 243      * Returns the Canonical URIs for the FHIR resource for each of the US Core Implementation Guide Profiles that the
 244      * resource implements.  Most resources have only one profile, but several like DiagnosticReport and Observation
 245      * has multiple profiles that must be conformed to.
 246      * @see https://www.hl7.org/fhir/us/core/CapabilityStatement-us-core-server.html for the list of profiles
 247      * @return string[]
 248      */
 249     function getProfileURIs(): array
 250     {
 251         return [self::USCGI_PROFILE_URI];
 252     }
 253
 254     public function getPatientContextSearchField(): FhirSearchParameterDefinition
 255     {
 256         return new FhirSearchParameterDefinition('patient', SearchFieldType::REFERENCE, [new ServiceField('puuid', ServiceField::TYPE_UUID)]);
 257     }
 258 }