private static string GetStatus(POCD_MT000040SubstanceAdministration medicationEntry)
{
return(string.Empty); //TODO:
////first, look for an explicit status observation
//var statusCode = medicationEntry?.SelectSingleNode(
// $"entryrelationship/observation[code[@code='{LoincConstants.STATUS_OBSERVATION}']]/value")
// ?.GetCode();
////TODO: is this logic correct?
///*
// http://motorcycleguy.blogspot.com/2011/03/medication-status-in-ccd.html
// One of the things that people often want to know about medications is whether they are still actively be used by the patient, or whether they are historical.
// Some look to find this in the status element of the substanceAdministation or supply act, but that is used for a different purpose. It is used to record
// the state of the act according to the state model defined in the HL7 RIM. For example, when dealing with a request or order for medications, the state is
// completed when the order is filled. When dealing with an event, such as the administration of a medication, the state is completed when the med has been
// given to the patient. That means that what that statusCode element implies about the medication depends upon the type of act (specifically its mood).
// -----> The problem is, most sample CCDs do NOT have a status observation under Medication! - NJS
// https://wiki.ihe.net/index.php/1.3.6.1.4.1.19376.1.5.3.1.4.7#Medication_Fields
// <statusCode code='completed'/>
// The status of all <substanceAdministration> elements must be "completed". The act has either occurred, or the request or order has been placed.
//*/
//if (string.IsNullOrWhiteSpace(statusCode?.Value))
//{
// //if not found, look for supply order status
// statusCode = medicationEntry?.SelectSingleNode("entryrelationship/supply[templateid[@root='{TemplateOidConstants.MEDICATION_SUPPLY_ORDER}']]/statuscode")?.GetCode();
// if (string.IsNullOrWhiteSpace(statusCode?.Value))
// {
// //if still not found, use substance administration status
// statusCode = medicationEntry?.SelectSingleNode("statuscode")?.GetCode();
// }
//}
//// All of our DataSubType logic keys off of descriptive status names,
//// per the CQMSolution spec, so use DisplayName if possible.
//var statusName = statusCode?.DisplayName;
//if (string.IsNullOrWhiteSpace(statusName))
//{
// statusName = statusCode?.Value;
//}
//return statusName ?? string.Empty;
}
public static Medication GetMedicationFromMedicationEntry(this POCD_MT000040SubstanceAdministration medicationEntry, Client client,
List <AllergyAdverseEvent> allergyAdverseEvents, CqmSolutionDateRange dischargeDateRange)
{
var productNode = (medicationEntry?.consumable?.manufacturedProduct?.Item as POCD_MT000040Material)?.code;
var productCode = productNode?.GetCode();
var dataSubType = GetDataSubType(medicationEntry, productCode, allergyAdverseEvents, dischargeDateRange, out var notPresent);
var medication = new Medication(client, dataSubType)
{
Product = productCode,
Generic = productNode?.translation?.FirstOrDefault()?.GetCode(), //TODO: handle multiple translation nodes?
AdministeredDateRange = medicationEntry?.effectiveTime?.GetDateRangeFromArray(), //TODO: verify this date parsing logic
Refills = (medicationEntry?.entryRelationship?.FirstOrDefault(r => r.Item is POCD_MT000040Supply)?.Item as POCD_MT000040Supply)?.repeatNumber?.value,
NotPresent = notPresent,
//TODO: NegationRationale = notPresent ? medicationEntry.SelectSingleNode(@"entryrelationship/observation/value")?.GetCode() : null //TODO: is this correct?
};
return(medication);
}
private static string GetDataSubType(POCD_MT000040SubstanceAdministration medicationEntry, Code productCode,
List <AllergyAdverseEvent> allergyAdverseEvents, CqmSolutionDateRange dischargeDateRange, out bool notPresent)
{
notPresent = false;
if (medicationEntry == null)
{
return(string.Empty);
}
notPresent = medicationEntry.negationInd;
//TODO: is this correct? if so, should we compare the whole code, not just the value?
if (!string.IsNullOrWhiteSpace(productCode?.Value))
{
//if patient has an allergy or adverse event for the same product, return the appropriate dataSubType
var allergyAdverseEvent =
allergyAdverseEvents.FirstOrDefault(a => !a.NotPresent && a.Cause?.Value == productCode.Value);
if (allergyAdverseEvent != null)
{
return(allergyAdverseEvent.DataSubType);
}
}
//TODO: Are these the correct logic and codes for Discharge/Discharge Not Done?
if (dischargeDateRange?.DateHigh?.DateTime.HasValue == true)
{
return("DSC");
}
//
if (dischargeDateRange?.DateLow?.DateTime.HasValue == true)
{
return("DSCND");
}
//
var statusName = GetStatus(medicationEntry);
switch (medicationEntry.moodCode)
{
case x_DocumentSubstanceMood.EVN: //administered
return(statusName.Equals("completed", StringComparison.InvariantCultureIgnoreCase) ? (notPresent ? "ADMND" : "ADM") : "ACT");
//TODO: is this logic correct, and are these ^-------^
//the right codes for Administered and Administered Not Done?
case x_DocumentSubstanceMood.INT: //to be administered
return(statusName.Equals("active", StringComparison.InvariantCultureIgnoreCase) ? "ACT" : "DISP");
//TODO: is this logic correct, and is this --^
//the right code for Dispensed?
//Also, shouldn't there be a subtype for "No Longer Active?"
case x_DocumentSubstanceMood.RQO: //ordered
return(notPresent ? "ORDND" : "ORD");
//TODO: Handle notPresent in all cases?
default:
return(string.Empty); //TODO: default to what?
}
}
public POCD_MT000040SubstanceAdministration ToPocd()
{
POCD_MT000040SubstanceAdministration returnVal = new POCD_MT000040SubstanceAdministration();
returnVal.classCode = "SBADM";
returnVal.moodCode = x_DocumentSubstanceMood.EVN;
returnVal.templateId = new II[]
{
new II {
root = "2.16.840.1.113883.10.20.1.24"
},
new II {
root = "1.3.6.1.4.1.19376.1.5.3.1.4.7"
},
new II {
root = "1.3.6.1.4.1.19376.1.5.3.1.4.7.1"
}
};
returnVal.id = new II[] { new II {
root = this.Id
} };
returnVal.statusCode = new CS {
code = "completed"
};
returnVal.effectiveTime = new IVL_TS[1];
returnVal.effectiveTime[0] = this.EffectiveTime.ToIvlTs();
returnVal.consumable = new POCD_MT000040Consumable();
returnVal.consumable.manufacturedProduct = new POCD_MT000040ManufacturedProduct();
returnVal.consumable.manufacturedProduct.templateId = new II[]
{
new II {
root = "1.3.6.1.4.1.19376.1.5.3.1.4.7.2"
},
new II {
root = "2.16.840.1.113883.10.20.1.53"
}
};
POCD_MT000040Material material = new POCD_MT000040Material();
material.name = new EN()
{
Text = new string[] { this.Description }
};
if (this.ProductCode != null)
{
material.code = this.ProductCode.ToCE();
}
else
{
material.code = new CE()
{
nullFlavor = "UNK", originalText = new ED()
{
reference = new TEL()
{
value = "N/A"
}
}
}
};
returnVal.consumable.manufacturedProduct.Item = material;
return(returnVal);
}
}
