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("$webserver_root/custom/code_types.inc.php");
  38
  39 function hl7Text($s)
  40 {
  41   // See http://www.interfaceware.com/hl7_escape_protocol.html:
  42     $s = str_replace('\\', '\\E\\', $s);
  43     $s = str_replace('^', '\\S\\', $s);
  44     $s = str_replace('|', '\\F\\', $s);
  45     $s = str_replace('~', '\\R\\', $s);
  46     $s = str_replace('&', '\\T\\', $s);
  47     $s = str_replace("\r", '\\X0d\\', $s);
  48     return $s;
  49 }
  50
  51 function hl7Zip($s)
  52 {
  53     return hl7Text(preg_replace('/[-\s]*/', '', $s));
  54 }
  55
  56 function hl7Date($s)
  57 {
  58     return preg_replace('/[^\d]/', '', $s);
  59 }
  60
  61 function hl7Time($s)
  62 {
  63     if (empty($s)) {
  64         return '';
  65     }
  66
  67     return date('YmdHis', strtotime($s));
  68 }
  69
  70 function hl7Sex($s)
  71 {
  72     $s = strtoupper(substr($s, 0, 1));
  73     if ($s !== 'M' && $s !== 'F') {
  74         $s = 'U';
  75     }
  76
  77     return $s;
  78 }
  79
  80 function hl7Phone($s)
  81 {
  82     if (preg_match("/([2-9]\d\d)\D*(\d\d\d)\D*(\d\d\d\d)\D*$/", $s, $tmp)) {
  83         return '(' . $tmp[1] . ')' . $tmp[2] . '-' . $tmp[3];
  84     }
  85
  86     if (preg_match("/(\d\d\d)\D*(\d\d\d\d)\D*$/", $s, $tmp)) {
  87         return $tmp[1] . '-' . $tmp[2];
  88     }
  89
  90     return '';
  91 }
  92
  93 function hl7SSN($s)
  94 {
  95     if (preg_match("/(\d\d\d)\D*(\d\d)\D*(\d\d\d\d)\D*$/", $s, $tmp)) {
  96         return $tmp[1] . '-' . $tmp[2] . '-' . $tmp[3];
  97     }
  98
  99     return '';
 100 }
 101
 102 function hl7Priority($s)
 103 {
 104     return strtoupper(substr($s, 0, 1)) == 'H' ? 'S' : 'R';
 105 }
 106
 107 function hl7Relation($s)
 108 {
 109     $tmp = strtolower($s);
 110     if ($tmp == 'self' || $tmp == '') {
 111         return 'self';
 112     } else if ($tmp == 'spouse') {
 113         return 'spouse';
 114     } else if ($tmp == 'child') {
 115         return 'child';
 116     } else if ($tmp == 'other') {
 117         return 'other';
 118     }
 119
 120   // Should not get here so this will probably get noticed if we do.
 121     return $s;
 122 }
 123
 124 /**
 125  * Get array of insurance payers for the specified patient as of the specified
 126  * date. If no date is passed then the current date is used.
 127  *
 128  * @param  integer $pid             Patient ID.
 129  * @param  date    $encounter_date  YYYY-MM-DD date.
 130  * @return array   Array containing an array of data for each payer.
 131  */
 132 function loadPayerInfo($pid, $date = '')
 133 {
 134     if (empty($date)) {
 135         $date = date('Y-m-d');
 136     }
 137
 138     $payers = array();
 139     $dres = sqlStatement(
 140         "SELECT * FROM insurance_data WHERE " .
 141         "pid = ? AND date <= ? ORDER BY type ASC, date DESC",
 142         array($pid, $date)
 143     );
 144     $prevtype = ''; // type is primary, secondary or tertiary
 145     while ($drow = sqlFetchArray($dres)) {
 146         if (strcmp($prevtype, $drow['type']) == 0) {
 147             continue;
 148         }
 149
 150         $prevtype = $drow['type'];
 151         // Very important to check for a missing provider because
 152         // that indicates no insurance as of the given date.
 153         if (empty($drow['provider'])) {
 154             continue;
 155         }
 156
 157         $ins = count($payers);
 158         $crow = sqlQuery(
 159             "SELECT * FROM insurance_companies WHERE id = ?",
 160             array($drow['provider'])
 161         );
 162         $orow = new InsuranceCompany($drow['provider']);
 163         $payers[$ins] = array();
 164         $payers[$ins]['data']    = $drow;
 165         $payers[$ins]['company'] = $crow;
 166         $payers[$ins]['object']  = $orow;
 167     }
 168
 169     return $payers;
 170 }
 171
 172 /**
 173  * Generate HL7 for the specified procedure order.
 174  *
 175  * @param  integer $orderid  Procedure order ID.
 176  * @param  string  &$out     Container for target HL7 text.
 177  * @return string            Error text, or empty if no errors.
 178  */
 179 function gen_hl7_order($orderid, &$out)
 180 {
 181
 182   // Delimiters
 183     $d0 = "\r";
 184     $d1 = '|';
 185     $d2 = '^';
 186
 187     $today = time();
 188     $out = '';
 189
 190     $porow = sqlQuery(
 191         "SELECT " .
 192         "po.date_collected, po.date_ordered, po.order_priority, " .
 193         "pp.*, " .
 194         "pd.pid, pd.pubpid, pd.fname, pd.lname, pd.mname, pd.DOB, pd.ss, " .
 195         "pd.phone_home, pd.phone_biz, pd.sex, pd.street, pd.city, pd.state, pd.postal_code, " .
 196         "f.encounter, u.fname AS docfname, u.lname AS doclname, u.npi AS docnpi " .
 197         "FROM procedure_order AS po, procedure_providers AS pp, " .
 198         "forms AS f, patient_data AS pd, users AS u " .
 199         "WHERE " .
 200         "po.procedure_order_id = ? AND " .
 201         "pp.ppid = po.lab_id AND " .
 202         "f.formdir = 'procedure_order' AND " .
 203         "f.form_id = po.procedure_order_id AND " .
 204         "pd.pid = f.pid AND " .
 205         "u.id = po.provider_id",
 206         array($orderid)
 207     );
 208     if (empty($porow)) {
 209         return "Procedure order, ordering provider or lab is missing for order ID '$orderid'";
 210     }
 211
 212     $pcres = sqlStatement(
 213         "SELECT " .
 214         "pc.procedure_code, pc.procedure_name, pc.procedure_order_seq, pc.diagnoses " .
 215         "FROM procedure_order_code AS pc " .
 216         "WHERE " .
 217         "pc.procedure_order_id = ? AND " .
 218         "pc.do_not_send = 0 " .
 219         "ORDER BY pc.procedure_order_seq",
 220         array($orderid)
 221     );
 222
 223   // Message Header
 224     $out .= "MSH" .
 225     $d1 . "$d2~\\&" .               // Encoding Characters (delimiters)
 226     $d1 . $porow['send_app_id'] .   // Sending Application ID
 227     $d1 . $porow['send_fac_id'] .   // Sending Facility ID
 228     $d1 . $porow['recv_app_id'] .   // Receiving Application ID
 229     $d1 . $porow['recv_fac_id'] .   // Receiving Facility ID
 230     $d1 . date('YmdHis', $today) .  // Date and time of this message
 231     $d1 .
 232     $d1 . 'ORM' . $d2 . 'O01' .     // Message Type
 233     $d1 . $orderid .                // Unique Message Number
 234     $d1 . $porow['DorP'] .          // D=Debugging, P=Production
 235     $d1 . '2.3' .                   // HL7 Version ID
 236     $d0;
 237
 238   // Patient Identification
 239     $out .= "PID" .
 240     $d1 . "1" .                      // Set ID (always just 1 of these)
 241     $d1 . $porow['pid'] .            // Patient ID (not required)
 242     $d1 . $porow['pid'] .            // Patient ID (required)
 243     $d1 .                            // Alternate Patient ID (not required)
 244     $d1 . hl7Text($porow['lname']) .
 245       $d2 . hl7Text($porow['fname']);
 246     if ($porow['mname']) {
 247         $out .= $d2 . hl7Text($porow['mname']);
 248     }
 249
 250     $out .=
 251     $d1 .
 252     $d1 . hl7Date($porow['DOB']) .   // DOB
 253     $d1 . hl7Sex($porow['sex'])  .   // Sex: M, F or U
 254     $d1 . $d1 .
 255     $d1 . hl7Text($porow['street']) .
 256       $d2 .
 257       $d2 . hl7Text($porow['city']) .
 258       $d2 . hl7Text($porow['state']) .
 259       $d2 . hl7Zip($porow['postal_code']) .
 260     $d1 .
 261     $d1 . hl7Phone($porow['phone_home']) .
 262     $d1 . hl7Phone($porow['phone_biz']) .
 263     $d1 . $d1 . $d1 .
 264     $d1 . $porow['encounter'] .
 265     $d1 . hl7SSN($porow['ss']) .
 266     $d1 . $d1 . $d1 .
 267     $d0;
 268
 269   // NTE segment(s) omitted.
 270
 271   // Patient Visit.
 272     $out .= "PV1" .
 273     $d1 . "1" .                           // Set ID (always just 1 of these)
 274     $d1 .                                 // Patient Class (if required, O for Outpatient)
 275     $d1 .                                 // Patient Location (for inpatient only?)
 276     $d1 . $d1 . $d1 .
 277     $d1 . hl7Text($porow['docnpi']) .     // Attending Doctor ID
 278       $d2 . hl7Text($porow['doclname']) . // Last Name
 279       $d2 . hl7Text($porow['docfname']) . // First Name
 280     str_repeat($d1, 11) .                 // PV1 8 to 18 all empty
 281     $d1 . $porow['encounter'] .           // Encounter Number
 282     str_repeat($d1, 13) .                 // PV1 20 to 32 all empty
 283     $d0;
 284
 285   // Insurance stuff.
 286     $payers = loadPayerInfo($porow['pid'], $porow['date_ordered']);
 287     $setid = 0;
 288     foreach ($payers as $payer) {
 289         $payer_object = $payer['object'];
 290         $payer_address = $payer_object->get_address();
 291         $out .= "IN1" .
 292         $d1 . ++$setid .                                // Set ID
 293         $d1 .                                           // Insurance Plan Identifier ??
 294         $d1 . hl7Text($payer['company']['id']) .        // Insurance Company ID
 295         $d1 . hl7Text($payer['company']['name'])   .    // Insurance Company Name
 296         $d1 . hl7Text($payer_address->get_line1()) .    // Street Address
 297         $d2 .
 298         $d2 . hl7Text($payer_address->get_city()) .   // City
 299         $d2 . hl7Text($payer_address->get_state()) .  // State
 300         $d2 . hl7Zip($payer_address->get_zip()) .     // Zip Code
 301         $d1 .
 302         $d1 . hl7Phone($payer_object->get_phone()) .    // Phone Number
 303         $d1 . hl7Text($payer['data']['group_number']) . // Insurance Company Group Number
 304         str_repeat($d1, 7) .                            // IN1 9-15 all empty
 305         $d1 . hl7Text($payer['data']['subscriber_lname']) .   // Insured last name
 306         $d2 . hl7Text($payer['data']['subscriber_fname']) . // Insured first name
 307         $d2 . hl7Text($payer['data']['subscriber_mname']) . // Insured middle name
 308         $d1 . hl7Relation($payer['data']['subscriber_relationship']) .
 309         $d1 . hl7Date($payer['data']['subscriber_DOB']) .     // Insured DOB
 310         $d1 . hl7Date($payer['data']['subscriber_street']) .  // Insured Street Address
 311         $d2 .
 312         $d2 . hl7Text($payer['data']['subscriber_city']) .  // City
 313         $d2 . hl7Text($payer['data']['subscriber_state']) . // State
 314         $d2 . hl7Zip($payer['data']['subscriber_postal_code']) . // Zip
 315         $d1 .
 316         $d1 .
 317         $d1 . $setid .                                  // 1=Primary, 2=Secondary, 3=Tertiary
 318         str_repeat($d1, 13) .                           // IN1-23 to 35 all empty
 319         $d1 . hl7Text($payer['data']['policy_number']) . // Policy Number
 320         str_repeat($d1, 12) .                           // IN1-37 to 48 all empty
 321         $d0;
 322
 323         // IN2 segment omitted.
 324     }
 325
 326   // Guarantor. OpenEMR doesn't have these so use the patient.
 327     $out .= "GT1" .
 328     $d1 . "1" .                      // Set ID (always just 1 of these)
 329     $d1 .
 330     $d1 . hl7Text($porow['lname']) .
 331       $d2 . hl7Text($porow['fname']);
 332     if ($porow['mname']) {
 333         $out .= $d2 . hl7Text($porow['mname']);
 334     }
 335
 336     $out .=
 337     $d1 .
 338     $d1 . hl7Text($porow['street']) .
 339       $d2 .
 340       $d2 . hl7Text($porow['city']) .
 341       $d2 . hl7Text($porow['state']) .
 342       $d2 . hl7Zip($porow['postal_code']) .
 343     $d1 . hl7Phone($porow['phone_home']) .
 344     $d1 . hl7Phone($porow['phone_biz']) .
 345     $d1 . hl7Date($porow['DOB']) .   // DOB
 346     $d1 . hl7Sex($porow['sex'])  .   // Sex: M, F or U
 347     $d1 .
 348     $d1 . 'self' .                   // Relationship
 349     $d1 . hl7SSN($porow['ss']) .
 350     $d0;
 351
 352   // Common Order.
 353     $out .= "ORC" .
 354     $d1 . "NW" .                     // New Order
 355     $d1 . $orderid .                 // Placer Order Number
 356     str_repeat($d1, 6) .             // ORC 3-8 not used
 357     $d1 . date('YmdHis') .           // Transaction date/time
 358     $d1 . $d1 .
 359     $d1 . hl7Text($porow['docnpi']) .     // Ordering Provider
 360       $d2 . hl7Text($porow['doclname']) . // Last Name
 361       $d2 . hl7Text($porow['docfname']) . // First Name
 362     str_repeat($d1, 7) .             // ORC 13-19 not used
 363     $d1 . "2" .                      // ABN Status: 2 = Notified & Signed, 4 = Unsigned
 364     $d0;
 365
 366     $setid = 0;
 367     while ($pcrow = sqlFetchArray($pcres)) {
 368         // Observation Request.
 369         $out .= "OBR" .
 370         $d1 . ++$setid .                              // Set ID
 371         $d1 . $orderid .                              // Placer Order Number
 372         $d1 .
 373         $d1 . hl7Text($pcrow['procedure_code']) .
 374         $d2 . hl7Text($pcrow['procedure_name']) .
 375         $d1 . hl7Priority($porow['order_priority']) . // S=Stat, R=Routine
 376         $d1 .
 377         $d1 . hl7Time($porow['date_collected']) .     // Observation Date/Time
 378         str_repeat($d1, 8) .                          // OBR 8-15 not used
 379         $d1 . hl7Text($porow['docnpi']) .             // Physician ID
 380         $d2 . hl7Text($porow['doclname']) .         // Last Name
 381         $d2 . hl7Text($porow['docfname']) .         // First Name
 382         $d1 .
 383         $d1 . (count($payers) ? 'I' : 'P') .          // I=Insurance, C=Client, P=Self Pay
 384         str_repeat($d1, 8) .                          // OBR 19-26 not used
 385         $d1 . '0' .                                   // ?
 386         $d0;
 387
 388         // Diagnoses.  Currently hard-coded for ICD9 and we'll surely want to make
 389         // this more flexible (probably when some lab needs another diagnosis type).
 390         $setid2 = 0;
 391         if (!empty($pcrow['diagnoses'])) {
 392             $relcodes = explode(';', $pcrow['diagnoses']);
 393             foreach ($relcodes as $codestring) {
 394                 if ($codestring === '') {
 395                     continue;
 396                 }
 397
 398                 list($codetype, $code) = explode(':', $codestring);
 399                 if ($codetype !== 'ICD9') {
 400                     continue;
 401                 }
 402
 403                 $desc = lookup_code_descriptions($codestring);
 404                 $out .= "DG1" .
 405                 $d1 . ++$setid2 .                         // Set ID
 406                 $d1 .                                     // Diagnosis Coding Method
 407                 $d1 . $code .                             // Diagnosis Code
 408                 $d1 . hl7Text($desc) .                    // Diagnosis Description
 409                 $d0;
 410             }
 411         }
 412
 413         // Order entry questions and answers.
 414         $qres = sqlStatement(
 415             "SELECT " .
 416             "a.question_code, a.answer, q.fldtype " .
 417             "FROM procedure_answers AS a " .
 418             "LEFT JOIN procedure_questions AS q ON " .
 419             "q.lab_id = ? " .
 420             "AND q.procedure_code = ? AND " .
 421             "q.question_code = a.question_code " .
 422             "WHERE " .
 423             "a.procedure_order_id = ? AND " .
 424             "a.procedure_order_seq = ? " .
 425             "ORDER BY q.seq, a.answer_seq",
 426             array($porow['ppid'], $pcrow['procedure_code'], $orderid, $pcrow['procedure_order_seq'])
 427         );
 428         $setid2 = 0;
 429         while ($qrow = sqlFetchArray($qres)) {
 430               // Formatting of these answer values may be lab-specific and we'll figure
 431               // out how to deal with that as more labs are supported.
 432               $answer = trim($qrow['answer']);
 433               $fldtype = $qrow['fldtype'];
 434               $datatype = 'ST';
 435             if ($fldtype == 'N') {
 436                 $datatype = "NM";
 437             } else if ($fldtype == 'D') {
 438                   $answer = hl7Date($answer);
 439             } else if ($fldtype == 'G') {
 440                   $weeks = intval($answer / 7);
 441                   $days = $answer % 7;
 442                   $answer = $weeks . 'wks ' . $days . 'days';
 443             }
 444
 445               $out .= "OBX" .
 446                 $d1 . ++$setid2 .                           // Set ID
 447                 $d1 . $datatype .                           // Structure of observation value
 448                 $d1 . hl7Text($qrow['question_code']) .     // Clinical question code
 449                 $d1 .
 450                 $d1 . hl7Text($answer) .                    // Clinical question answer
 451                 $d0;
 452         }
 453     }
 454
 455     return '';
 456 }
 457
 458 /**
 459  * Transmit HL7 for the specified lab.
 460  *
 461  * @param  integer $ppid  Procedure provider ID.
 462  * @param  string  $out   The HL7 text to be sent.
 463  * @return string         Error text, or empty if no errors.
 464  */
 465 function send_hl7_order($ppid, $out)
 466 {
 467     global $srcdir;
 468
 469     $d0 = "\r";
 470
 471     $pprow = sqlQuery("SELECT * FROM procedure_providers " .
 472     "WHERE ppid = ?", array($ppid));
 473     if (empty($pprow)) {
 474         return xl('Procedure provider') . " $ppid " . xl('not found');
 475     }
 476
 477     $protocol = $pprow['protocol'];
 478     $remote_host = $pprow['remote_host'];
 479
 480   // Extract MSH-10 which is the message control ID.
 481     $segmsh = explode(substr($out, 3, 1), substr($out, 0, strpos($out, $d0)));
 482     $msgid = $segmsh[9];
 483     if (empty($msgid)) {
 484         return xl('Internal error: Cannot find MSH-10');
 485     }
 486
 487     if ($protocol == 'DL' || $pprow['orders_path'] === '') {
 488         header("Pragma: public");
 489         header("Expires: 0");
 490         header("Cache-Control: must-revalidate, post-check=0, pre-check=0");
 491         header("Content-Type: application/force-download");
 492         header("Content-Disposition: attachment; filename=order_$msgid.hl7");
 493         header("Content-Description: File Transfer");
 494         echo $out;
 495         exit;
 496     } else if ($protocol == 'SFTP') {
 497         // Compute the target path/file name.
 498         $filename = $msgid . '.txt';
 499         if ($pprow['orders_path']) {
 500             $filename = $pprow['orders_path'] . '/' . $filename;
 501         }
 502
 503         // Connect to the server and write the file.
 504         $sftp = new \phpseclib\Net\SFTP($remote_host);
 505         if (!$sftp->login($pprow['login'], $pprow['password'])) {
 506             return xl('Login to this remote host failed') . ": '$remote_host'";
 507         }
 508
 509         if (!$sftp->put($filename, $out)) {
 510             return xl('Creating this file on remote host failed') . ": '$filename'";
 511         }
 512     } else if ($protocol == 'FS') {
 513         // Compute the target path/file name.
 514         $filename = $msgid . '.txt';
 515         if ($pprow['orders_path']) {
 516             $filename = $pprow['orders_path'] . '/' . $filename;
 517         }
 518
 519         $fh = fopen("$filename", 'w');
 520         if ($fh) {
 521             fwrite($fh, $out);
 522             fclose($fh);
 523         } else {
 524             return xl('Cannot create file') . ' "' . "$filename" . '"';
 525         }
 526     } // TBD: Insert "else if ($protocol == '???') {...}" to support other protocols.
 527
 528     else {
 529         return xl('This protocol is not implemented') . ": '$protocol'";
 530     }
 531
 532   // Falling through to here indicates success.
 533     newEvent(
 534         "proc_order_xmit",
 535         $_SESSION['authUser'],
 536         $_SESSION['authProvider'],
 537         1,
 538         "ID: $msgid Protocol: $protocol Host: $remote_host"
 539     );
 540     return '';
 541 }