private Hl7.Fhir.Model.CodeableConcept GenerateVaccineCode(Model.Request.RegistrarInmunizationRequest request)
{
var vaccineCode = new Hl7.Fhir.Model.CodeableConcept
{
Coding = new List <Hl7.Fhir.Model.Coding>
{
new Hl7.Fhir.Model.Coding
{
System = "http://snomed.info/sct",
Code = request.SctConceptId,
Display = request.SctTerm
}
}
};
return(vaccineCode);
}
private async Task MessageReceivedAsync(IDialogContext context, IAwaitable <object> result)
{
var activity = await result as Activity;
string msg = activity.Text.ToLower().Trim();
if (msg == "start over" || msg == "exit" || msg == "quit" || msg == "done" || msg == "start again" || msg == "restart" || msg == "leave" || msg == "reset" || msg == "bye" || msg == "goodbye")
{
context.Done("end");
}
else
{
if (isSessionTimedOut(context))
{
context.Fail(new SessionTimedOutException("Your session has timedout or is invalid."));
}
else
{
string fhirserver = null;
context.PrivateConversationData.TryGetValue <string>("fhirserver", out fhirserver);
string token = null;
context.PrivateConversationData.TryGetValue <string>("bearertoken", out token);
string patid = null;
context.PrivateConversationData.TryGetValue <string>("id", out patid);
//Initialize FHIR Client
FHIRClient client = new FHIRClient(fhirserver, token);
//Determine Intent/Entities from LUIS
var luisresp = await LUISClient.RequestAsync <LUISResponse>(activity.Text);
var intent = luisresp.topScoringIntent;
//Nothing over 50% confidence bail
if (intent == null)
{
await context.PostAsync($"Sorry, I didn't understand {activity.Text}...");
}
if (intent.intent == "FindPractitioner")
{
if (luisresp.entities == null || luisresp.entities.Count() == 0)
{
await context.PostAsync($"Sorry, I think you want to find a practioner but I can't determine the location you want");
}
//Handle Geography
var geo = luisresp.entities.FirstOrDefault();
//Call FHIR Server
string parm = geo.entity.ToLower().StartsWith("anywhere") ? "" : $"city={geo.entity}";
var bundle = (Hl7.Fhir.Model.Bundle)client.LoadResource("Practitioner", parm);
if (bundle.Entry.Count == 0)
{
await context.PostAsync($"Sorry, I couldn't find providers in {geo.entity}...");
}
else
{
StringBuilder sb = new StringBuilder();
sb.Append($"Got {bundle.Entry.Count()} practioners in {geo.entity}\n\n");
foreach (var entry in bundle.Entry)
{
Hl7.Fhir.Model.Practitioner p = (Hl7.Fhir.Model.Practitioner)entry.Resource;
var address = (p.Address.Count > 0 ? p.Address[0] : null);
var tel = (p.Telecom.Count > 0 ? p.Telecom[0] : null);
sb.Append($"{p.Name[0].Text} is accepting new patients.");
if (address != null)
{
sb.Append($"Located at " + address.LineElement[0] + " " + address.City);
}
if (tel != null)
{
sb.Append($" Phone:" + tel.Value);
}
sb.Append("\n\n");
}
await context.PostAsync(sb.ToString());
}
}
else if (intent.intent == "ChartHeartRate")
{
var entity = luisresp.FindEntityByType("builtin.number");
if (entity != null)
{
var hr = Convert.ToDecimal(new String(entity.entity.Where(Char.IsDigit).ToArray()));
Hl7.Fhir.Model.Observation rv = new Hl7.Fhir.Model.Observation();
rv.Status = Hl7.Fhir.Model.ObservationStatus.Final;
rv.Category = new List <Hl7.Fhir.Model.CodeableConcept>();
Hl7.Fhir.Model.CodeableConcept cc = new Hl7.Fhir.Model.CodeableConcept("http://hl7.org/fhir/observation-category", "vital-signs", "Vital Signs");
rv.Category.Add(cc);
rv.Code = new Hl7.Fhir.Model.CodeableConcept("http://loinc.org", "8867-4", "Heart rate");
rv.Subject = new Hl7.Fhir.Model.ResourceReference("patient/" + patid);
rv.Effective = Hl7.Fhir.Model.FhirDateTime.Now();
rv.Value = new Hl7.Fhir.Model.Quantity(hr, "beats/minute");
var rslt = client.SaveResource(rv);
if (rslt)
{
await context.PostAsync($"Thanks, I recorded your heart rate of {entity.entity} in your medical record");
}
else
{
await context.PostAsync($"Sorry I had a problem posting your heartrate...try again later.");
}
}
else
{
await context.PostAsync($"Sorry, I think you want to record your heartrate vital but I can't understand the value you provided.");
}
}
else if (intent.intent == "ChartWeight")
{
string entity_weight = null;
var entity = luisresp.FindEntityByType("weight");
if (entity == null)
{
entity = luisresp.FindEntityByType("builtin.number");
if (entity != null)
{
entity_weight = entity.entity;
var wt = luisresp.FindEntityByType("builtin.dimension");
if (wt != null)
{
if (wt.entity.ToLower().EndsWith("kilograms") || wt.entity.ToLower().EndsWith("kg"))
{
entity_weight = entity_weight + "kg";
}
else
{
entity_weight = entity_weight + "lbs";
}
}
}
}
else
{
entity_weight = entity.entity;
}
if (entity_weight != null)
{
var weight = Convert.ToDecimal(new String(entity_weight.Where(Char.IsDigit).ToArray()));
//Determine pounds or kg
if (entity_weight.ToLower().EndsWith("kg"))
{
weight = weight * (decimal)2.20462;
}
Hl7.Fhir.Model.Observation rv = new Hl7.Fhir.Model.Observation();
rv.Status = Hl7.Fhir.Model.ObservationStatus.Final;
rv.Category = new List <Hl7.Fhir.Model.CodeableConcept>();
Hl7.Fhir.Model.CodeableConcept cc = new Hl7.Fhir.Model.CodeableConcept("http://hl7.org/fhir/observation-category", "vital-signs", "Vital Signs");
rv.Category.Add(cc);
rv.Code = new Hl7.Fhir.Model.CodeableConcept("http://loinc.org", "29463-7", "Body Weight");
rv.Code.Coding.Add(new Hl7.Fhir.Model.Coding("http://snomed.info/sct", "27113001", "Body Weight"));
rv.Subject = new Hl7.Fhir.Model.ResourceReference("patient/" + patid);
rv.Effective = Hl7.Fhir.Model.FhirDateTime.Now();
rv.Value = new Hl7.Fhir.Model.Quantity(weight, "lbs");
((Hl7.Fhir.Model.Quantity)rv.Value).Code = "[lb_av]";
var rslt = client.SaveResource(rv);
if (rslt)
{
string weightmsg = "";
string parm = $"patient={patid}";
var bundle = (Hl7.Fhir.Model.Bundle)client.LoadResource("Observation", parm);
List <Hl7.Fhir.Model.Observation> weights = new List <Hl7.Fhir.Model.Observation>();
foreach (Hl7.Fhir.Model.Bundle.EntryComponent entry in bundle.Entry)
{
Hl7.Fhir.Model.Observation o = (Hl7.Fhir.Model.Observation)entry.Resource;
if (FHIRUtils.isCodeMatch(o.Code.Coding, "http://loinc.org", "29463-7"))
{
weights.Add(o);
}
}
if (weights.Count > 1)
{
Hl7.Fhir.Model.Observation[] sorted = weights.OrderBy(o => Convert.ToDateTime(o.Effective.ToString())).ToArray();
decimal prevw = ((Hl7.Fhir.Model.SimpleQuantity)sorted[sorted.Length - 2].Value).Value.Value;
decimal curw = ((Hl7.Fhir.Model.SimpleQuantity)sorted[sorted.Length - 1].Value).Value.Value;
decimal dif = prevw - curw;
if (dif < 0)
{
weightmsg = "Looks like you gained around " + Math.Round(Math.Abs(dif), 1) + " lbs.";
}
else if (dif > 0)
{
weightmsg = "Looks like you loss around " + Math.Round(Math.Abs(dif), 1) + " lbs. Keep it up!!";
}
else
{
weightmsg = "Your weight is holding steady";
}
}
await context.PostAsync($"Thanks, I recorded your weight of {weight} lbs in your medical record\n\n{weightmsg}");
}
else
{
await context.PostAsync($"Sorry I had a problem posting your weight...try again later.");
}
}
}
else if (intent.intent == "ChartGlucose")
{
var entity = luisresp.FindEntityByType("builtin.number");
if (entity != null)
{
var glucose = Convert.ToDecimal(new String(entity.entity.Where(Char.IsDigit).ToArray()));
var unit = "mg/dL";
Hl7.Fhir.Model.CodeableConcept loinc = new Hl7.Fhir.Model.CodeableConcept("http://loinc.org", "2345-7", "Glucose [Mass/volume] in Serum or Plasma");
//convert mg/DL if mmol/l
if (glucose < 20)
{
glucose = glucose * 18;
}
Hl7.Fhir.Model.Observation rv = new Hl7.Fhir.Model.Observation();
rv.Status = Hl7.Fhir.Model.ObservationStatus.Final;
rv.Category = new List <Hl7.Fhir.Model.CodeableConcept>();
Hl7.Fhir.Model.CodeableConcept cc = new Hl7.Fhir.Model.CodeableConcept("http://hl7.org/fhir/observation-category", "laboratory", "Laboratory");
rv.Category.Add(cc);
rv.Code = loinc;
rv.Subject = new Hl7.Fhir.Model.ResourceReference("patient/" + patid);
rv.Effective = Hl7.Fhir.Model.FhirDateTime.Now();
rv.Issued = DateTimeOffset.UtcNow;
rv.ReferenceRange = new List <Hl7.Fhir.Model.Observation.ReferenceRangeComponent>();
Hl7.Fhir.Model.Observation.ReferenceRangeComponent rrc = new Hl7.Fhir.Model.Observation.ReferenceRangeComponent();
rrc.High = new Hl7.Fhir.Model.SimpleQuantity();
rrc.High.Unit = "mg/dL";
rrc.High.Code = rrc.High.Unit;
rrc.High.System = "http://unitsofmeasure.org";
rrc.High.Value = 140;
rrc.Low = new Hl7.Fhir.Model.SimpleQuantity();
rrc.Low.Unit = "mg/dL";
rrc.Low.Code = rrc.Low.Unit;
rrc.Low.System = "http://unitsofmeasure.org";
rrc.Low.Value = 70;
rv.ReferenceRange.Add(rrc);
rv.Value = new Hl7.Fhir.Model.Quantity(glucose, unit);
((Hl7.Fhir.Model.Quantity)rv.Value).Code = unit;
var rslt = client.SaveResource(rv);
if (rslt)
{
int numglucose = 0;
string parm = $"patient={patid}";
var bundle = (Hl7.Fhir.Model.Bundle)client.LoadResource("Observation", parm);
decimal bga = 0;
foreach (Hl7.Fhir.Model.Bundle.EntryComponent entry in bundle.Entry)
{
Hl7.Fhir.Model.Observation o = (Hl7.Fhir.Model.Observation)entry.Resource;
if (FHIRUtils.isCodeMatch(o.Code.Coding, "http://loinc.org", "2345-7"))
{
bga = bga + ((Hl7.Fhir.Model.SimpleQuantity)o.Value).Value.Value;
numglucose++;
}
}
bga = Math.Round(bga / numglucose, 1);
decimal a1c = ((Convert.ToDecimal(46.7) + bga) / Convert.ToDecimal(28.7));
string bgmsg = $"Your blood glucose is averaging {bga} mg/dL " + (bga > 140 ? "looks like it's running high" : (bga < 70 ? "looks like it's running low" : ""));
bgmsg = bgmsg + "\n\nYour estimated A1C is " + Convert.ToString(Math.Round(a1c, 1));
await context.PostAsync($"Thanks, I recorded your blood glucose of {glucose} mg/dL in your medical record\n\n{bgmsg}");
}
else
{
await context.PostAsync($"Sorry I had a problem posting your blood glucose...you can try again later.");
}
}
else
{
await context.PostAsync($"Sorry, I couldnt determine your blood glucose value...try again");
}
}
else if (intent.intent == "DisplayGlucose")
{
int numglucose = 0;
string parm = $"patient={patid}";
var bundle = (Hl7.Fhir.Model.Bundle)client.LoadResource("Observation", parm);
decimal bga = 0;
decimal la1c = 0;
decimal ea1c = 0;
DateTime?dta1c = null;
foreach (Hl7.Fhir.Model.Bundle.EntryComponent entry in bundle.Entry)
{
Hl7.Fhir.Model.Observation o = (Hl7.Fhir.Model.Observation)entry.Resource;
if (FHIRUtils.isCodeMatch(o.Code.Coding, "http://loinc.org", "2345-7"))
{
bga = bga + ((Hl7.Fhir.Model.SimpleQuantity)o.Value).Value.Value;
numglucose++;
}
else if (FHIRUtils.isCodeMatch(o.Code.Coding, "http://loinc.org", "4548-4"))
{
la1c = ((Hl7.Fhir.Model.SimpleQuantity)o.Value).Value.Value;
dta1c = Convert.ToDateTime(o.Effective.ToString());
}
}
if (numglucose > 0)
{
bga = Math.Round(bga / numglucose, 1);
ea1c = ((Convert.ToDecimal(46.7) + bga) / Convert.ToDecimal(28.7));
}
string a1cmsg = "I don't see any A1C tests on file for you.";
string bgmsg = "I don't see any blood glucose tests on file for you.";
if (la1c > 0)
{
a1cmsg = $"Your last A1C test was on " + String.Format("{0:MM/dd/yyyy}", dta1c.Value) + " the result was " + Convert.ToString(la1c) + "% " + (la1c > 6 ? "thats high" : "");
}
if (bga > 0)
{
bgmsg = $"Your blood glucose is averaging {bga} mg/dL " + (bga > 140 ? "looks like it's running high" : (bga < 70 ? "looks like it's running low" : ""));
bgmsg = bgmsg + "\n\nYour current estimated A1C is " + Convert.ToString(Math.Round(ea1c, 1)) + (ea1c < 6 ? " great control!" : (ea1c <= 7 ? " doing good for a diabetic!" : " need to work at lowering!"));
}
await context.PostAsync($"{a1cmsg}\n\n{bgmsg}");
}
else if (intent.intent == "DisplayCareplan")
{
//Call FHIR Server
string parm = $"patient={patid}";
var bundle = (Hl7.Fhir.Model.Bundle)client.LoadResource("CarePlan", parm);
if (bundle.Entry.Count == 0)
{
await context.PostAsync($"Sorry, I couldn't find a plan of care for you in the database...");
}
else
{
StringBuilder sb = new StringBuilder();
sb.Append("Your current plan of care addresses the following conditions:\n\n");
Hl7.Fhir.Model.CarePlan cp = (Hl7.Fhir.Model.CarePlan)bundle.Entry[0].Resource;
int x = 1;
foreach (var cond in cp.Addresses)
{
sb.Append(x++ + ". " + cond.Display + "\n\n");
}
sb.Append("\n\nYou have the following goals:\n\n");
x = 1;
foreach (var goal in cp.Goal)
{
sb.Append(x++ + ". " + goal.Display + "\n\n");
}
sb.Append("\n\nYou should:\n\n");
x = 1;
foreach (var act in cp.Activity)
{
if (act.Detail != null)
{
sb.Append(x++ + ". " + act.Detail.Description + "\n\n");
}
else
{
if (act.Reference != null && act.Reference.Reference.StartsWith("MedicationRequest"))
{
sb.Append(x++ + ". Take " + act.Reference.Display + " as directed.\n\n");
}
}
}
await context.PostAsync(sb.ToString());
}
}
else
{
await context.PostAsync($"Sorry, I didn't understand {activity.Text}...");
}
}
context.Wait(MessageReceivedAsync);
}
}
