///<summary>This is the first step of automation, this checks to see if the new object matches one of the trigger conditions. </summary>
/// <param name="triggerObject">Can be DiseaseDef, ICD9, Icd10, Snomed, Medication, RxNorm, Cvx, AllerfyDef, EHRLabResult, Patient, or VitalSign.</param>
/// <param name="PatCur">Triggers and intervention are currently always dependant on current patient. </param>
/// <returns>Returns a dictionary keyed on triggers and a list of all the objects that the trigger matched on. Should be used to generate CDS intervention message and later be passed to FormInfobutton for knowledge request.</returns>
public static List<CDSIntervention> TriggerMatch(object triggerObject,Patient PatCur) {
if(RemotingClient.RemotingRole==RemotingRole.ClientWeb) {
return Meth.GetObject<List<CDSIntervention>>(MethodBase.GetCurrentMethod(),triggerObject,PatCur);
}
//Dictionary<string,List<object>> retVal=new Dictionary<string,List<object>>();
List<CDSIntervention> retVal=new List<CDSIntervention>();
//Define objects to be used in matching triggers.
DiseaseDef diseaseDef;
ICD9 icd9;
Icd10 icd10;
Snomed snomed;
Medication medication;
RxNorm rxNorm;
Cvx cvx;
AllergyDef allergyDef;
EhrLabResult ehrLabResult;
Patient pat;
Vitalsign vitalsign;
string triggerObjectMessage="";
string command="";
switch(triggerObject.GetType().Name) {
case "DiseaseDef":
diseaseDef=(DiseaseDef)triggerObject;
command="SELECT * FROM ehrtrigger"
+" WHERE ProblemDefNumList LIKE '% "+POut.String(diseaseDef.DiseaseDefNum.ToString())+" %'";// '% <code> %' so that we can get exact matches.
if(diseaseDef.ICD9Code!="") {
command+=" OR ProblemIcd9List LIKE '% "+POut.String(diseaseDef.ICD9Code)+" %'";
ICD9 icd10Cur=ICD9s.GetByCode(diseaseDef.ICD9Code);
if(icd10Cur!=null){
triggerObjectMessage+=" -"+diseaseDef.ICD9Code+"(Icd9) "+icd10Cur.Description+"\r\n";
}
}
if(diseaseDef.Icd10Code!="") {
command+=" OR ProblemIcd10List LIKE '% "+POut.String(diseaseDef.Icd10Code)+" %'";
Icd10 icd10Cur=Icd10s.GetByCode(diseaseDef.Icd10Code);
if(icd10Cur!=null) {
triggerObjectMessage+=" -"+diseaseDef.Icd10Code+"(Icd10) "+icd10Cur.Description+"\r\n";
}
}
if(diseaseDef.SnomedCode!="") {
command+=" OR ProblemSnomedList LIKE '% "+POut.String(diseaseDef.SnomedCode)+" %'";
Snomed snomedCur=Snomeds.GetByCode(diseaseDef.SnomedCode);
if(snomedCur!=null) {
triggerObjectMessage+=" -"+diseaseDef.SnomedCode+"(Snomed) "+snomedCur.Description+"\r\n";
}
}
break;
case "ICD9":
icd9=(ICD9)triggerObject;
//TODO: TriggerObjectMessage
command="SELECT * FROM ehrtrigger"
+" WHERE Icd9List LIKE '% "+POut.String(icd9.ICD9Code)+" %'";// '% <code> %' so that we can get exact matches.
break;
case "Icd10":
icd10=(Icd10)triggerObject;
//TODO: TriggerObjectMessage
command="SELECT * FROM ehrtrigger"
+" WHERE Icd10List LIKE '% "+POut.String(icd10.Icd10Code)+" %'";// '% <code> %' so that we can get exact matches.
break;
case "Snomed":
snomed=(Snomed)triggerObject;
//TODO: TriggerObjectMessage
command="SELECT * FROM ehrtrigger"
+" WHERE SnomedList LIKE '% "+POut.String(snomed.SnomedCode)+" %'";// '% <code> %' so that we can get exact matches.
break;
case "Medication":
medication=(Medication)triggerObject;
RxNorm rxNormCur=RxNorms.GetByRxCUI(medication.RxCui.ToString());
if(rxNormCur!=null) {
triggerObjectMessage=" - "+medication.MedName+(medication.RxCui==0?"":" (RxCui:"+rxNormCur.RxCui+")")+"\r\n";
}
command="SELECT * FROM ehrtrigger"
+" WHERE MedicationNumList LIKE '% "+POut.String(medication.MedicationNum.ToString())+" %'";// '% <code> %' so that we can get exact matches.
if(medication.RxCui!=0) {
command+=" OR RxCuiList LIKE '% "+POut.String(medication.RxCui.ToString())+" %'";// '% <code> %' so that we can get exact matches.
}
break;
case "RxNorm":
rxNorm=(RxNorm)triggerObject;
triggerObjectMessage=" - "+rxNorm.Description+"(RxCui:"+rxNorm.RxCui+")\r\n";
command="SELECT * FROM ehrtrigger"
+" WHERE RxCuiList LIKE '% "+POut.String(rxNorm.RxCui)+" %'";// '% <code> %' so that we can get exact matches.
break;
case "Cvx":
cvx=(Cvx)triggerObject;
//TODO: TriggerObjectMessage
command="SELECT * FROM ehrtrigger"
+" WHERE CvxList LIKE '% "+POut.String(cvx.CvxCode)+" %'";// '% <code> %' so that we can get exact matches.
break;
case "AllergyDef":
allergyDef=(AllergyDef)triggerObject;
//TODO: TriggerObjectMessage
command="SELECT * FROM ehrtrigger"
+" WHERE AllergyDefNumList LIKE '% "+POut.String(allergyDef.AllergyDefNum.ToString())+" %'";// '% <code> %' so that we can get exact matches.
break;
case "EhrLabResult"://match loinc only, no longer
ehrLabResult=(EhrLabResult)triggerObject;
//TODO: TriggerObjectMessage
command="SELECT * FROM ehrtrigger WHERE "
+"(LabLoincList LIKE '% "+ehrLabResult.ObservationIdentifierID+" %'" //LOINC may be in one of two fields
+"OR LabLoincList LIKE '% "+ehrLabResult.ObservationIdentifierIDAlt+" %')"; //LOINC may be in one of two fields
break;
case "Patient":
pat=(Patient)triggerObject;
List<string> triggerNums=new List<string>();
//TODO: TriggerObjectMessage
command="SELECT * FROM ehrtrigger WHERE DemographicsList !=''";
List<EhrTrigger> triggers=Crud.EhrTriggerCrud.SelectMany(command);
for(int i=0;i<triggers.Count;i++) {
string[] arrayDemoItems=triggers[i].DemographicsList.Split(new string[] { " " },StringSplitOptions.RemoveEmptyEntries);
for(int j=0;j<arrayDemoItems.Length;j++) {
switch(arrayDemoItems[j].Split(',')[0]) {
case "age":
int val=PIn.Int(Regex.Match(arrayDemoItems[j],@"\d+").Value);
if(arrayDemoItems[j].Contains("=")) {//=, >=, or <=
if(val==pat.Age) {
triggerNums.Add(triggers[i].EhrTriggerNum.ToString());
break;
}
}
if(arrayDemoItems[j].Contains("<")){
if(pat.Age<val){
triggerNums.Add(triggers[i].EhrTriggerNum.ToString());
break;
}
}
if(arrayDemoItems[j].Contains(">")) {
if(pat.Age>val) {
triggerNums.Add(triggers[i].EhrTriggerNum.ToString());
break;
}
}
//should never happen, age element didn't contain a comparator
break;
case "gender":
if(arrayDemoItems[j].Split(',')[0].StartsWith(pat.Gender.ToString())) {
triggerNums.Add(triggers[i].EhrTriggerNum.ToString());
}
break;
default:
break;//should never happen
}
}
}
triggerNums.Add("-1");//to ensure the querry is valid.
command="SELECT * FROM ehrTrigger WHERE EhrTriggerNum IN ("+String.Join(",",triggerNums)+")";
break;
case "Vitalsign":
List<string> trigNums=new List<string>();
vitalsign=(Vitalsign)triggerObject;
command="SELECT * FROM ehrtrigger WHERE VitalLoincList !=''";
List<EhrTrigger> triggersVit=Crud.EhrTriggerCrud.SelectMany(command);
for(int i=0;i<triggersVit.Count;i++) {
string[] arrayVitalItems=triggersVit[i].VitalLoincList.Split(new string[] { " " },StringSplitOptions.RemoveEmptyEntries);
for(int j=0;j<arrayVitalItems.Length;j++) {
double val=PIn.Double(Regex.Match(arrayVitalItems[j],@"\d+(.(\d+))*").Value);//decimal value w or w/o decimal.
switch(arrayVitalItems[j].Split(',')[0]) {
case "height":
if(arrayVitalItems[j].Contains("=")) {//=, >=, or <=
if(vitalsign.Height==val) {
trigNums.Add(triggersVit[i].EhrTriggerNum.ToString());
break;
}
}
if(arrayVitalItems[j].Contains("<")) {
if(vitalsign.Height<val) {
trigNums.Add(triggersVit[i].EhrTriggerNum.ToString());
break;
}
}
if(arrayVitalItems[j].Contains(">")) {
if(vitalsign.Height>val) {
trigNums.Add(triggersVit[i].EhrTriggerNum.ToString());
break;
}
}
//should never happen, Height element didn't contain a comparator
break;
case "weight":
if(arrayVitalItems[j].Contains("=")) {//=, >=, or <=
if(vitalsign.Weight==val) {
trigNums.Add(triggersVit[i].EhrTriggerNum.ToString());
break;
}
}
if(arrayVitalItems[j].Contains("<")) {
if(vitalsign.Weight<val) {
trigNums.Add(triggersVit[i].EhrTriggerNum.ToString());
break;
}
}
if(arrayVitalItems[j].Contains(">")) {
if(vitalsign.Weight>val) {
trigNums.Add(triggersVit[i].EhrTriggerNum.ToString());
break;
}
}
break;
case "BMI":
float BMI=Vitalsigns.CalcBMI(vitalsign.Weight,vitalsign.Height);
if(arrayVitalItems[j].Contains("=")) {//=, >=, or <=
if(BMI==val) {
trigNums.Add(triggersVit[i].EhrTriggerNum.ToString());
break;
}
}
if(arrayVitalItems[j].Contains("<")) {
if(BMI<val) {
trigNums.Add(triggersVit[i].EhrTriggerNum.ToString());
break;
}
}
if(arrayVitalItems[j].Contains(">")) {
if(BMI>val) {
trigNums.Add(triggersVit[i].EhrTriggerNum.ToString());
break;
}
}
break;
case "BP":
//TODO
break;
}//end switch
}
}//End Triggers Vit
trigNums.Add("-1");//to ensure the querry is valid.
command="SELECT * FROM ehrTrigger WHERE EhrTriggerNum IN ("+String.Join(",",trigNums)+")";
break;
default:
//command="SELECT * FROM ehrtrigger WHERE false";//should not return any results.
return null;
#if DEBUG
throw new Exception(triggerObject.GetType().ToString()+" object not implemented as intervention trigger yet. Add to the list above to handle.");
#endif
//break;
}
List<EhrTrigger> listEhrTriggers=Crud.EhrTriggerCrud.SelectMany(command);
if(listEhrTriggers.Count==0){
return null;//no triggers matched.
}
//Check for MatchCardinality.One type triggers.----------------------------------------------------------------------------
for(int i=0;i<listEhrTriggers.Count;i++) {
if(listEhrTriggers[i].Cardinality!=MatchCardinality.One) {
continue;
}
string triggerMessage=listEhrTriggers[i].Description+":\r\n";//Example:"Patient over 55:\r\n"
triggerMessage+=triggerObjectMessage;//Example:" -Patient Age 67\r\n"
List<object> ListObjectMatches=new List<object>();
ListObjectMatches.Add(triggerObject);
CDSIntervention cdsi=new CDSIntervention();
cdsi.EhrTrigger=listEhrTriggers[i];
cdsi.InterventionMessage=triggerMessage;
cdsi.TriggerObjects=ListObjectMatches;
retVal.Add(cdsi);
}
//Fill object lists to be checked-------------------------------------------------------------------------------------------------
List<Allergy> ListAllergy=Allergies.GetAll(PatCur.PatNum,false);
List<Disease> ListDisease=Diseases.Refresh(PatCur.PatNum,true);
List<DiseaseDef> ListDiseaseDef=new List<DiseaseDef>();
List<EhrLab> ListEhrLab=EhrLabs.GetAllForPat(PatCur.PatNum);
//List<EhrLabResult> ListEhrLabResults=null;//Lab results are stored in a list in the EhrLab object.
List<MedicationPat> ListMedicationPat=MedicationPats.Refresh(PatCur.PatNum,false);
List<AllergyDef> ListAllergyDef=new List<AllergyDef>();
for(int i=0;i<ListAllergy.Count;i++){
ListAllergyDef.Add(AllergyDefs.GetOne(ListAllergy[i].AllergyDefNum));
}
for(int i=0;i<ListDisease.Count;i++){
ListDiseaseDef.Add(DiseaseDefs.GetItem(ListDisease[i].DiseaseDefNum));
}
for(int i=0;i<listEhrTriggers.Count;i++) {
if(listEhrTriggers[i].Cardinality==MatchCardinality.One) {
continue;//we handled these above.
}
string triggerMessage=listEhrTriggers[i].Description+":\r\n";
triggerMessage+=triggerObjectMessage;
List<object> ListObjectMatches=new List<object>();//Allergy, Disease, LabPanels, MedicationPat, Patient, VaccinePat
ListObjectMatches.Add(triggerObject);
//Allergy-----------------------------------------------------------------------------------------------------------------------
//allergy.snomedreaction
//allergy.AllergyDefNum>>AllergyDef.SnomedType
//allergy.AllergyDefNum>>AllergyDef.SnomedAllergyTo
//allergy.AllergyDefNum>>AllergyDef.MedicationNum>>Medication.RxCui
//Disease-----------------------------------------------------------------------------------------------------------------------
//Disease.DiseaseDefNum>>DiseaseDef.ICD9Code
//Disease.DiseaseDefNum>>DiseaseDef.SnomedCode
//Disease.DiseaseDefNum>>DiseaseDef.Icd10Code
//LabPanels---------------------------------------------------------------------------------------------------------------------
//LabPanel.LabPanelNum<<LabResult.TestId (Loinc)
//LabPanel.LabPanelNum<<LabResult.ObsValue (Loinc)
//LabPanel.LabPanelNum<<LabResult.ObsRange (Loinc)
//MedicationPat-----------------------------------------------------------------------------------------------------------------
//MedicationPat.RxCui
//MedicationPat.MedicationNum>>Medication.RxCui
//Patient>>Demographics---------------------------------------------------------------------------------------------------------
//Patient.Gender
//Patient.Birthdate (Loinc age?)
//Patient.SmokingSnoMed
//RxPat-------------------------------------------------------------------------------------------------------------------------
//Do not check RxPat. It is useless.
//VaccinePat--------------------------------------------------------------------------------------------------------------------
//VaccinePat.VaccineDefNum>>VaccineDef.CVXCode
//VitalSign---------------------------------------------------------------------------------------------------------------------
//VitalSign.Height (Loinc)
//VitalSign.Weight (Loinc)
//VitalSign.BpSystolic (Loinc)
//VitalSign.BpDiastolic (Loinc)
//VitalSign.WeightCode (Snomed)
//VitalSign.PregDiseaseNum (Snomed)
//Use object matches to check if required conditions are met-------------------------------------------------------------------------------
switch(listEhrTriggers[i].Cardinality) {
case MatchCardinality.One:
//should never get here, handled above.
continue;
case MatchCardinality.OneOfEachCategory://falls through to two or more, but then branches at the end of the case statement.
case MatchCardinality.TwoOrMore:
//if(ListObjectMatches.Count<2) {
// continue;//Must match at least two objects for this category.
//}
//Medication
for(int m=0;m<ListMedicationPat.Count;m++) {
if(listEhrTriggers[i].MedicationNumList.Contains(" "+ListMedicationPat[m].MedicationNum+" ")) {
ListObjectMatches.Add(ListMedicationPat[m]);
continue;
}
if(ListMedicationPat[m].RxCui!=0
&& listEhrTriggers[i].RxCuiList.Contains(" "+ListMedicationPat[m].RxCui+" "))
{
ListObjectMatches.Add(ListMedicationPat[m]);
continue;
}
}
//Allergy
for(int a=0;a<ListAllergy.Count;a++) {
if(listEhrTriggers[i].AllergyDefNumList.Contains(" "+ListAllergy[a].AllergyDefNum+" ")) {
AllergyDef allergyDefCur=AllergyDefs.GetOne(ListAllergy[a].AllergyDefNum);
if(allergyDefCur!=null) {
ListObjectMatches.Add(allergyDefCur);
triggerMessage+=" -(Allergy) "+allergyDefCur.Description+"\r\n";
}
continue;
}
}
//Problem
for(int d=0;d<ListDiseaseDef.Count;d++) {
if(ListDiseaseDef[d].ICD9Code!=""
&& listEhrTriggers[i].ProblemIcd9List.Contains(" "+ListDiseaseDef[d].ICD9Code+" "))
{
ICD9 currentICD9=ICD9s.GetByCode(ListDiseaseDef[d].ICD9Code);
if(currentICD9!=null) {
ListObjectMatches.Add(ListDiseaseDef[d]);
triggerMessage+=" -(ICD9) "+currentICD9.Description+"\r\n";
}
continue;
}
if(ListDiseaseDef[d].Icd10Code!=""
&& listEhrTriggers[i].ProblemIcd10List.Contains(" "+ListDiseaseDef[d].Icd10Code+" ")) {
Icd10 icd10Cur=Icd10s.GetByCode(ListDiseaseDef[d].Icd10Code);
if(icd10Cur!=null) {
ListObjectMatches.Add(ListDiseaseDef[d]);
triggerMessage+=" -(Icd10) "+icd10Cur.Description+"\r\n";
}
continue;
}
if(ListDiseaseDef[d].SnomedCode!=""
&& listEhrTriggers[i].ProblemSnomedList.Contains(" "+ListDiseaseDef[d].SnomedCode+" ")) {
Snomed snomedCur=Snomeds.GetByCode(ListDiseaseDef[d].SnomedCode);
if(snomedCur!=null) {
ListObjectMatches.Add(ListDiseaseDef[d]);
triggerMessage+=" -(Snomed) "+snomedCur.Description+"\r\n";
}
continue;
}
if(listEhrTriggers[i].ProblemDefNumList.Contains(" "+ListDiseaseDef[d].DiseaseDefNum+" ")) {
ListObjectMatches.Add(ListDiseaseDef[d]);
triggerMessage+=" -(Problem Def) "+ListDiseaseDef[d].DiseaseName+"\r\n";
continue;
}
}
//Vital
//TODO
//Age
//TODO
//Gender
//TODO
//Lab Result
for(int l=0;l<ListEhrLab.Count;l++) {
for(int r=0;r<ListEhrLab[l].ListEhrLabResults.Count;r++) {
if(listEhrTriggers[i].LabLoincList.Contains(" "+ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierID+" ")
|| listEhrTriggers[i].LabLoincList.Contains(" "+ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierIDAlt+" "))
{
ListObjectMatches.Add(ListEhrLab[l].ListEhrLabResults[r]);
if(ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierID!="") {//should almost always be the case.
Loinc loincCur=Loincs.GetByCode(ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierID);
triggerMessage+=" -(LOINC) "+loincCur.NameShort+"\r\n";
}
else if(ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierIDAlt!="") {
Loinc loincCur=Loincs.GetByCode(ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierIDAlt);
triggerMessage+=" -(LOINC) "+loincCur.NameShort+"\r\n";
}
else if(ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierText!="") {
triggerMessage+=" -(LOINC) "+ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierText+"\r\n";
}
else if(ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierTextAlt!="") {
triggerMessage+=" -(LOINC) "+ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierTextAlt+"\r\n";
}
else if(ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierID!="") {
triggerMessage+=" -(LOINC) "+ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierID+"\r\n";
}
else if(ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierIDAlt!="") {
triggerMessage+=" -(LOINC) "+ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierIDAlt+"\r\n";
}
else if(ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierTextOriginal!="") {
triggerMessage+=" -(LOINC) "+ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierTextOriginal+"\r\n";
}
else {
triggerMessage+=" -(LOINC) Unknown code.\r\n";//should never happen.
}
continue;
}
}
}
ListObjectMatches=RemoveDuplicateObjectsHelper(ListObjectMatches);
if(listEhrTriggers[i].Cardinality==MatchCardinality.TwoOrMore && ListObjectMatches.Count<2) {
continue;//next trigger, do not add to retVal
}
if(listEhrTriggers[i].Cardinality==MatchCardinality.OneOfEachCategory && !OneOfEachCategoryHelper(listEhrTriggers[i],ListObjectMatches)) {
continue;
}
break;
case MatchCardinality.All:
bool allConditionsMet=true;
List<string> MatchedCodes=getCodesFromListHelper(ListObjectMatches);//new List<string>();
//Match all Icd9Codes-------------------------------------------------------------------------------------------------------------------------------------------------
string[] arrayIcd9Codes=listEhrTriggers[i].ProblemIcd9List.Split(new string[] {" "},StringSplitOptions.RemoveEmptyEntries);
for(int c=0;c<arrayIcd9Codes.Length;c++) {
if(MatchedCodes.Contains(arrayIcd9Codes[i])){
continue;//found required code
}
//required code not found, set allConditionsMet to false and continue to next trigger
allConditionsMet=false;
break;
}
if(!allConditionsMet) {
continue;//next trigger
}
//Match all Icd10Codes------------------------------------------------------------------------------------------------------------------------------------------------
string[] arrayIcd10Codes=listEhrTriggers[i].ProblemIcd10List.Split(new string[] {" "},StringSplitOptions.RemoveEmptyEntries);
for(int c=0;c<arrayIcd10Codes.Length;c++) {
if(MatchedCodes.Contains(arrayIcd10Codes[i])){
continue;//found required code
}
//required code not found, set allConditionsMet to false and continue to next trigger
allConditionsMet=false;
break;
}
if(!allConditionsMet) {
continue;//next trigger
}
//Match all SnomedCodes-----------------------------------------------------------------------------------------------------------------------------------------------
string[] arraySnomedCodes=listEhrTriggers[i].ProblemSnomedList.Split(new string[] { " " },StringSplitOptions.RemoveEmptyEntries);
for(int c=0;c<arraySnomedCodes.Length;c++) {
if(MatchedCodes.Contains(arraySnomedCodes[i])) {
continue;//found required code
}
//required code not found, set allConditionsMet to false and continue to next trigger
allConditionsMet=false;
break;
}
if(!allConditionsMet) {
continue;//next trigger
}
//Match all CvxCodes--------------------------------------------------------------------------------------------------------------------------------------------------
string[] arrayCvxCodes=listEhrTriggers[i].CvxList.Split(new string[] { " " },StringSplitOptions.RemoveEmptyEntries);
for(int c=0;c<arrayCvxCodes.Length;c++) {
if(MatchedCodes.Contains(arrayCvxCodes[i])) {
continue;//found required code
}
//required code not found, set allConditionsMet to false and continue to next trigger
allConditionsMet=false;
break;
}
if(!allConditionsMet) {
continue;//next trigger, do not add to retval
}
//Match all LoincCodes------------------------------------------------------------------------------------------------------------------------------------------------
string[] arrayLoincCodes=listEhrTriggers[i].LabLoincList.Split(new string[] { " " },StringSplitOptions.RemoveEmptyEntries);
for(int c=0;c<arrayLoincCodes.Length;c++) {
if(MatchedCodes.Contains(arrayLoincCodes[i])) {
continue;//found required code
}
//required code not found, set allConditionsMet to false and continue to next trigger
allConditionsMet=false;
break;
}
if(!allConditionsMet) {
continue;//next trigger, do not add to retval
}
//TODO:with values
//Match all Vitals----------------------------------------------------------------------------------------------------------------------------------------------------
//TODO:with values
//Match all Demographics---------------------------------------------------------------------------------------------------------------------------------------------
//if(listEhrTriggers[i].DemographicAgeGreaterThan!=0){
// if(PatCur.Birthdate.Year>1880 && PatCur.Birthdate.AddYears(listEhrTriggers[i].DemographicAgeGreaterThan)>DateTime.Now){//patient too young
// continue;//next trigger
// }
//}
//if(listEhrTriggers[i].DemographicAgeLessThan!=0){
// if(PatCur.Birthdate.Year>1880 && PatCur.Birthdate.AddYears(listEhrTriggers[i].DemographicAgeGreaterThan)<DateTime.Now){//patient too old
// continue;//next trigger
// }
//}
//if(listEhrTriggers[i].DemographicGender!=""){
// if(!listEhrTriggers[i].DemographicGender.Contains(PatCur.Gender.ToString())){//Patient Gender not in gender list of trigger
// continue;//next trigger
// }
//}
//TODO: construct trigger message using all the codes in the trigger.
break;
}//end switch trigger cardinality
//retVal.Add(triggerMessage,ListObjectMatches);
CDSIntervention cdsi=new CDSIntervention();
cdsi.EhrTrigger=listEhrTriggers[i];
cdsi.InterventionMessage=triggerMessage;
cdsi.TriggerObjects=ListObjectMatches;
retVal.Add(cdsi);
}//end triggers
return retVal;
}
///<summary>This is the first step of automation, this checks to see if the new object matches one of the trigger conditions. </summary>
/// <param name="triggerObject">Can be DiseaseDef, ICD9, Icd10, Snomed, Medication, RxNorm, Cvx, AllerfyDef, EHRLabResult, Patient, or VitalSign.</param>
/// <param name="PatCur">Triggers and intervention are currently always dependant on current patient. </param>
/// <returns>Returns a dictionary keyed on triggers and a list of all the objects that the trigger matched on. Should be used to generate CDS intervention message and later be passed to FormInfobutton for knowledge request.</returns>
public static List <CDSIntervention> TriggerMatch(object triggerObject, Patient PatCur)
{
if (RemotingClient.RemotingRole == RemotingRole.ClientWeb)
{
return(Meth.GetObject <List <CDSIntervention> >(MethodBase.GetCurrentMethod(), triggerObject, PatCur));
}
//Dictionary<string,List<object>> retVal=new Dictionary<string,List<object>>();
List <CDSIntervention> retVal = new List <CDSIntervention>();
//Define objects to be used in matching triggers.
DiseaseDef diseaseDef;
ICD9 icd9;
Icd10 icd10;
Snomed snomed;
Medication medication;
RxNorm rxNorm;
Cvx cvx;
AllergyDef allergyDef;
EhrLabResult ehrLabResult;
Patient pat;
Vitalsign vitalsign;
string triggerObjectMessage = "";
string command = "";
switch (triggerObject.GetType().Name)
{
case "DiseaseDef":
diseaseDef = (DiseaseDef)triggerObject;
command = "SELECT * FROM ehrtrigger"
+ " WHERE ProblemDefNumList LIKE '% " + POut.String(diseaseDef.DiseaseDefNum.ToString()) + " %'"; // '% <code> %' so that we can get exact matches.
if (diseaseDef.ICD9Code != "")
{
command += " OR ProblemIcd9List LIKE '% " + POut.String(diseaseDef.ICD9Code) + " %'";
triggerObjectMessage += " -" + diseaseDef.ICD9Code + "(Icd9) " + ICD9s.GetByCode(diseaseDef.ICD9Code).Description + "\r\n";
}
if (diseaseDef.Icd10Code != "")
{
command += " OR ProblemIcd10List LIKE '% " + POut.String(diseaseDef.Icd10Code) + " %'";
triggerObjectMessage += " -" + diseaseDef.Icd10Code + "(Icd10) " + Icd10s.GetByCode(diseaseDef.Icd10Code).Description + "\r\n";
}
if (diseaseDef.SnomedCode != "")
{
command += " OR ProblemSnomedList LIKE '% " + POut.String(diseaseDef.SnomedCode) + " %'";
triggerObjectMessage += " -" + diseaseDef.SnomedCode + "(Snomed) " + Snomeds.GetByCode(diseaseDef.SnomedCode).Description + "\r\n";
}
break;
case "ICD9":
icd9 = (ICD9)triggerObject;
//TODO: TriggerObjectMessage
command = "SELECT * FROM ehrtrigger"
+ " WHERE Icd9List LIKE '% " + POut.String(icd9.ICD9Code) + " %'"; // '% <code> %' so that we can get exact matches.
break;
case "Icd10":
icd10 = (Icd10)triggerObject;
//TODO: TriggerObjectMessage
command = "SELECT * FROM ehrtrigger"
+ " WHERE Icd10List LIKE '% " + POut.String(icd10.Icd10Code) + " %'"; // '% <code> %' so that we can get exact matches.
break;
case "Snomed":
snomed = (Snomed)triggerObject;
//TODO: TriggerObjectMessage
command = "SELECT * FROM ehrtrigger"
+ " WHERE SnomedList LIKE '% " + POut.String(snomed.SnomedCode) + " %'"; // '% <code> %' so that we can get exact matches.
break;
case "Medication":
medication = (Medication)triggerObject;
triggerObjectMessage = " - " + medication.MedName + (medication.RxCui == 0?"":" (RxCui:" + RxNorms.GetByRxCUI(medication.RxCui.ToString()).RxCui + ")") + "\r\n";
command = "SELECT * FROM ehrtrigger"
+ " WHERE MedicationNumList LIKE '% " + POut.String(medication.MedicationNum.ToString()) + " %'"; // '% <code> %' so that we can get exact matches.
if (medication.RxCui != 0)
{
command += " OR RxCuiList LIKE '% " + POut.String(medication.RxCui.ToString()) + " %'"; // '% <code> %' so that we can get exact matches.
}
break;
case "RxNorm":
rxNorm = (RxNorm)triggerObject;
triggerObjectMessage = " - " + rxNorm.Description + "(RxCui:" + rxNorm.RxCui + ")\r\n";
command = "SELECT * FROM ehrtrigger"
+ " WHERE RxCuiList LIKE '% " + POut.String(rxNorm.RxCui) + " %'"; // '% <code> %' so that we can get exact matches.
break;
case "Cvx":
cvx = (Cvx)triggerObject;
//TODO: TriggerObjectMessage
command = "SELECT * FROM ehrtrigger"
+ " WHERE CvxList LIKE '% " + POut.String(cvx.CvxCode) + " %'"; // '% <code> %' so that we can get exact matches.
break;
case "AllergyDef":
allergyDef = (AllergyDef)triggerObject;
//TODO: TriggerObjectMessage
command = "SELECT * FROM ehrtrigger"
+ " WHERE AllergyDefNumList LIKE '% " + POut.String(allergyDef.AllergyDefNum.ToString()) + " %'"; // '% <code> %' so that we can get exact matches.
break;
case "EhrLabResult": //match loinc only, no longer
ehrLabResult = (EhrLabResult)triggerObject;
//TODO: TriggerObjectMessage
command = "SELECT * FROM ehrtrigger WHERE "
+ "(LabLoincList LIKE '% " + ehrLabResult.ObservationIdentifierID + " %'" //LOINC may be in one of two fields
+ "OR LabLoincList LIKE '% " + ehrLabResult.ObservationIdentifierIDAlt + " %')"; //LOINC may be in one of two fields
break;
case "Patient":
pat = (Patient)triggerObject;
List <string> triggerNums = new List <string>();
//TODO: TriggerObjectMessage
command = "SELECT * FROM ehrtrigger WHERE DemographicsList !=''";
List <EhrTrigger> triggers = Crud.EhrTriggerCrud.SelectMany(command);
for (int i = 0; i < triggers.Count; i++)
{
string[] arrayDemoItems = triggers[i].DemographicsList.Split(new string[] { " " }, StringSplitOptions.RemoveEmptyEntries);
for (int j = 0; j < arrayDemoItems.Length; j++)
{
switch (arrayDemoItems[j].Split(',')[0])
{
case "age":
int val = PIn.Int(Regex.Match(arrayDemoItems[j], @"\d+").Value);
if (arrayDemoItems[j].Contains("=")) //=, >=, or <=
{
if (val == pat.Age)
{
triggerNums.Add(triggers[i].EhrTriggerNum.ToString());
break;
}
}
if (arrayDemoItems[j].Contains("<"))
{
if (pat.Age < val)
{
triggerNums.Add(triggers[i].EhrTriggerNum.ToString());
break;
}
}
if (arrayDemoItems[j].Contains(">"))
{
if (pat.Age > val)
{
triggerNums.Add(triggers[i].EhrTriggerNum.ToString());
break;
}
}
//should never happen, age element didn't contain a comparator
break;
case "gender":
if (arrayDemoItems[j].Split(',')[0].StartsWith(pat.Gender.ToString()))
{
triggerNums.Add(triggers[i].EhrTriggerNum.ToString());
}
break;
default:
break; //should never happen
}
}
}
triggerNums.Add("-1"); //to ensure the querry is valid.
command = "SELECT * FROM ehrTrigger WHERE EhrTriggerNum IN (" + String.Join(",", triggerNums) + ")";
break;
case "Vitalsign":
List <string> trigNums = new List <string>();
vitalsign = (Vitalsign)triggerObject;
command = "SELECT * FROM ehrtrigger WHERE VitalLoincList !=''";
List <EhrTrigger> triggersVit = Crud.EhrTriggerCrud.SelectMany(command);
for (int i = 0; i < triggersVit.Count; i++)
{
string[] arrayVitalItems = triggersVit[i].VitalLoincList.Split(new string[] { " " }, StringSplitOptions.RemoveEmptyEntries);
for (int j = 0; j < arrayVitalItems.Length; j++)
{
double val = PIn.Double(Regex.Match(arrayVitalItems[j], @"\d+(.(\d+))*").Value); //decimal value w or w/o decimal.
switch (arrayVitalItems[j].Split(',')[0])
{
case "height":
if (arrayVitalItems[j].Contains("=")) //=, >=, or <=
{
if (vitalsign.Height == val)
{
trigNums.Add(triggersVit[i].EhrTriggerNum.ToString());
break;
}
}
if (arrayVitalItems[j].Contains("<"))
{
if (vitalsign.Height < val)
{
trigNums.Add(triggersVit[i].EhrTriggerNum.ToString());
break;
}
}
if (arrayVitalItems[j].Contains(">"))
{
if (vitalsign.Height > val)
{
trigNums.Add(triggersVit[i].EhrTriggerNum.ToString());
break;
}
}
//should never happen, Height element didn't contain a comparator
break;
case "weight":
if (arrayVitalItems[j].Contains("=")) //=, >=, or <=
{
if (vitalsign.Weight == val)
{
trigNums.Add(triggersVit[i].EhrTriggerNum.ToString());
break;
}
}
if (arrayVitalItems[j].Contains("<"))
{
if (vitalsign.Weight < val)
{
trigNums.Add(triggersVit[i].EhrTriggerNum.ToString());
break;
}
}
if (arrayVitalItems[j].Contains(">"))
{
if (vitalsign.Weight > val)
{
trigNums.Add(triggersVit[i].EhrTriggerNum.ToString());
break;
}
}
break;
case "BMI":
float BMI = Vitalsigns.CalcBMI(vitalsign.Weight, vitalsign.Height);
if (arrayVitalItems[j].Contains("=")) //=, >=, or <=
{
if (BMI == val)
{
trigNums.Add(triggersVit[i].EhrTriggerNum.ToString());
break;
}
}
if (arrayVitalItems[j].Contains("<"))
{
if (BMI < val)
{
trigNums.Add(triggersVit[i].EhrTriggerNum.ToString());
break;
}
}
if (arrayVitalItems[j].Contains(">"))
{
if (BMI > val)
{
trigNums.Add(triggersVit[i].EhrTriggerNum.ToString());
break;
}
}
break;
case "BP":
//TODO
break;
} //end switch
}
} //End Triggers Vit
trigNums.Add("-1"); //to ensure the querry is valid.
command = "SELECT * FROM ehrTrigger WHERE EhrTriggerNum IN (" + String.Join(",", trigNums) + ")";
break;
default:
//command="SELECT * FROM ehrtrigger WHERE false";//should not return any results.
return(null);
#if DEBUG
throw new Exception(triggerObject.GetType().ToString() + " object not implemented as intervention trigger yet. Add to the list above to handle.");
#endif
//break;
}
List <EhrTrigger> listEhrTriggers = Crud.EhrTriggerCrud.SelectMany(command);
if (listEhrTriggers.Count == 0)
{
return(null); //no triggers matched.
}
//Check for MatchCardinality.One type triggers.----------------------------------------------------------------------------
for (int i = 0; i < listEhrTriggers.Count; i++)
{
if (listEhrTriggers[i].Cardinality != MatchCardinality.One)
{
continue;
}
string triggerMessage = listEhrTriggers[i].Description + ":\r\n"; //Example:"Patient over 55:\r\n"
triggerMessage += triggerObjectMessage; //Example:" -Patient Age 67\r\n"
List <object> ListObjectMatches = new List <object>();
ListObjectMatches.Add(triggerObject);
CDSIntervention cdsi = new CDSIntervention();
cdsi.EhrTrigger = listEhrTriggers[i];
cdsi.InterventionMessage = triggerMessage;
cdsi.TriggerObjects = ListObjectMatches;
retVal.Add(cdsi);
}
//Fill object lists to be checked-------------------------------------------------------------------------------------------------
List <Allergy> ListAllergy = Allergies.GetAll(PatCur.PatNum, false);
List <Disease> ListDisease = Diseases.Refresh(PatCur.PatNum, true);
List <DiseaseDef> ListDiseaseDef = new List <DiseaseDef>();
List <EhrLab> ListEhrLab = EhrLabs.GetAllForPat(PatCur.PatNum);
//List<EhrLabResult> ListEhrLabResults=null;//Lab results are stored in a list in the EhrLab object.
List <MedicationPat> ListMedicationPat = MedicationPats.Refresh(PatCur.PatNum, false);
List <AllergyDef> ListAllergyDef = new List <AllergyDef>();
for (int i = 0; i < ListAllergy.Count; i++)
{
ListAllergyDef.Add(AllergyDefs.GetOne(ListAllergy[i].AllergyDefNum));
}
for (int i = 0; i < ListDisease.Count; i++)
{
ListDiseaseDef.Add(DiseaseDefs.GetItem(ListDisease[i].DiseaseDefNum));
}
for (int i = 0; i < listEhrTriggers.Count; i++)
{
if (listEhrTriggers[i].Cardinality == MatchCardinality.One)
{
continue; //we handled these above.
}
string triggerMessage = listEhrTriggers[i].Description + ":\r\n";
triggerMessage += triggerObjectMessage;
List <object> ListObjectMatches = new List <object>(); //Allergy, Disease, LabPanels, MedicationPat, Patient, VaccinePat
ListObjectMatches.Add(triggerObject);
//Allergy-----------------------------------------------------------------------------------------------------------------------
//allergy.snomedreaction
//allergy.AllergyDefNum>>AllergyDef.SnomedType
//allergy.AllergyDefNum>>AllergyDef.SnomedAllergyTo
//allergy.AllergyDefNum>>AllergyDef.MedicationNum>>Medication.RxCui
//Disease-----------------------------------------------------------------------------------------------------------------------
//Disease.DiseaseDefNum>>DiseaseDef.ICD9Code
//Disease.DiseaseDefNum>>DiseaseDef.SnomedCode
//Disease.DiseaseDefNum>>DiseaseDef.Icd10Code
//LabPanels---------------------------------------------------------------------------------------------------------------------
//LabPanel.LabPanelNum<<LabResult.TestId (Loinc)
//LabPanel.LabPanelNum<<LabResult.ObsValue (Loinc)
//LabPanel.LabPanelNum<<LabResult.ObsRange (Loinc)
//MedicationPat-----------------------------------------------------------------------------------------------------------------
//MedicationPat.RxCui
//MedicationPat.MedicationNum>>Medication.RxCui
//Patient>>Demographics---------------------------------------------------------------------------------------------------------
//Patient.Gender
//Patient.Birthdate (Loinc age?)
//Patient.SmokingSnoMed
//RxPat-------------------------------------------------------------------------------------------------------------------------
//Do not check RxPat. It is useless.
//VaccinePat--------------------------------------------------------------------------------------------------------------------
//VaccinePat.VaccineDefNum>>VaccineDef.CVXCode
//VitalSign---------------------------------------------------------------------------------------------------------------------
//VitalSign.Height (Loinc)
//VitalSign.Weight (Loinc)
//VitalSign.BpSystolic (Loinc)
//VitalSign.BpDiastolic (Loinc)
//VitalSign.WeightCode (Snomed)
//VitalSign.PregDiseaseNum (Snomed)
//Use object matches to check if required conditions are met-------------------------------------------------------------------------------
switch (listEhrTriggers[i].Cardinality)
{
case MatchCardinality.One:
//should never get here, handled above.
continue;
case MatchCardinality.OneOfEachCategory: //falls through to two or more, but then branches at the end of the case statement.
case MatchCardinality.TwoOrMore:
//if(ListObjectMatches.Count<2) {
// continue;//Must match at least two objects for this category.
//}
//Medication
for (int m = 0; m < ListMedicationPat.Count; m++)
{
if (listEhrTriggers[i].MedicationNumList.Contains(" " + ListMedicationPat[m].MedicationNum + " "))
{
ListObjectMatches.Add(ListMedicationPat[m]);
continue;
}
if (ListMedicationPat[m].RxCui != 0 &&
listEhrTriggers[i].RxCuiList.Contains(" " + ListMedicationPat[m].RxCui + " "))
{
ListObjectMatches.Add(ListMedicationPat[m]);
continue;
}
}
//Allergy
for (int a = 0; a < ListAllergy.Count; a++)
{
if (listEhrTriggers[i].AllergyDefNumList.Contains(" " + ListAllergy[a].AllergyDefNum + " "))
{
ListObjectMatches.Add(AllergyDefs.GetOne(ListAllergy[a].AllergyDefNum));
triggerMessage += " -(Allergy) " + AllergyDefs.GetOne(ListAllergy[a].AllergyDefNum).Description + "\r\n";
continue;
}
}
//Problem
for (int d = 0; d < ListDiseaseDef.Count; d++)
{
if (ListDiseaseDef[d].ICD9Code != "" &&
listEhrTriggers[i].ProblemIcd9List.Contains(" " + ListDiseaseDef[d].ICD9Code + " "))
{
ListObjectMatches.Add(ListDiseaseDef[d]);
triggerMessage += " -(ICD9) " + ICD9s.GetByCode(ListDiseaseDef[d].ICD9Code).Description + "\r\n";
continue;
}
if (ListDiseaseDef[d].Icd10Code != "" &&
listEhrTriggers[i].ProblemIcd10List.Contains(" " + ListDiseaseDef[d].Icd10Code + " "))
{
ListObjectMatches.Add(ListDiseaseDef[d]);
triggerMessage += " -(Icd10) " + Icd10s.GetByCode(ListDiseaseDef[d].Icd10Code).Description + "\r\n";
continue;
}
if (ListDiseaseDef[d].SnomedCode != "" &&
listEhrTriggers[i].ProblemSnomedList.Contains(" " + ListDiseaseDef[d].SnomedCode + " "))
{
ListObjectMatches.Add(ListDiseaseDef[d]);
triggerMessage += " -(Snomed) " + Snomeds.GetByCode(ListDiseaseDef[d].SnomedCode).Description + "\r\n";
continue;
}
if (listEhrTriggers[i].ProblemDefNumList.Contains(" " + ListDiseaseDef[d].DiseaseDefNum + " "))
{
ListObjectMatches.Add(ListDiseaseDef[d]);
triggerMessage += " -(Problem Def) " + ListDiseaseDef[d].DiseaseName + "\r\n";
continue;
}
}
//Vital
//TODO
//Age
//TODO
//Gender
//TODO
//Lab Result
for (int l = 0; l < ListEhrLab.Count; l++)
{
for (int r = 0; r < ListEhrLab[l].ListEhrLabResults.Count; r++)
{
if (listEhrTriggers[i].LabLoincList.Contains(" " + ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierID + " ") ||
listEhrTriggers[i].LabLoincList.Contains(" " + ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierIDAlt + " "))
{
ListObjectMatches.Add(ListEhrLab[l].ListEhrLabResults[r]);
if (ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierID != "") //should almost always be the case.
{
triggerMessage += " -(LOINC) " + Loincs.GetByCode(ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierID).NameShort + "\r\n";
}
else if (ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierID != "")
{
triggerMessage += " -(LOINC) " + Loincs.GetByCode(ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierIDAlt).NameShort + "\r\n";
}
else if (ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierText != "")
{
triggerMessage += " -(LOINC) " + ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierText + "\r\n";
}
else if (ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierTextAlt != "")
{
triggerMessage += " -(LOINC) " + ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierTextAlt + "\r\n";
}
else if (ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierID != "")
{
triggerMessage += " -(LOINC) " + ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierID + "\r\n";
}
else if (ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierIDAlt != "")
{
triggerMessage += " -(LOINC) " + ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierIDAlt + "\r\n";
}
else if (ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierTextOriginal != "")
{
triggerMessage += " -(LOINC) " + ListEhrLab[l].ListEhrLabResults[r].ObservationIdentifierTextOriginal + "\r\n";
}
else
{
triggerMessage += " -(LOINC) Unknown code.\r\n"; //should never happen.
}
continue;
}
}
}
ListObjectMatches = RemoveDuplicateObjectsHelper(ListObjectMatches);
if (listEhrTriggers[i].Cardinality == MatchCardinality.TwoOrMore && ListObjectMatches.Count < 2)
{
continue; //next trigger, do not add to retVal
}
if (listEhrTriggers[i].Cardinality == MatchCardinality.OneOfEachCategory && !OneOfEachCategoryHelper(listEhrTriggers[i], ListObjectMatches))
{
continue;
}
break;
case MatchCardinality.All:
bool allConditionsMet = true;
List <string> MatchedCodes = getCodesFromListHelper(ListObjectMatches); //new List<string>();
//Match all Icd9Codes-------------------------------------------------------------------------------------------------------------------------------------------------
string[] arrayIcd9Codes = listEhrTriggers[i].ProblemIcd9List.Split(new string[] { " " }, StringSplitOptions.RemoveEmptyEntries);
for (int c = 0; c < arrayIcd9Codes.Length; c++)
{
if (MatchedCodes.Contains(arrayIcd9Codes[i]))
{
continue; //found required code
}
//required code not found, set allConditionsMet to false and continue to next trigger
allConditionsMet = false;
break;
}
if (!allConditionsMet)
{
continue; //next trigger
}
//Match all Icd10Codes------------------------------------------------------------------------------------------------------------------------------------------------
string[] arrayIcd10Codes = listEhrTriggers[i].ProblemIcd10List.Split(new string[] { " " }, StringSplitOptions.RemoveEmptyEntries);
for (int c = 0; c < arrayIcd10Codes.Length; c++)
{
if (MatchedCodes.Contains(arrayIcd10Codes[i]))
{
continue; //found required code
}
//required code not found, set allConditionsMet to false and continue to next trigger
allConditionsMet = false;
break;
}
if (!allConditionsMet)
{
continue; //next trigger
}
//Match all SnomedCodes-----------------------------------------------------------------------------------------------------------------------------------------------
string[] arraySnomedCodes = listEhrTriggers[i].ProblemSnomedList.Split(new string[] { " " }, StringSplitOptions.RemoveEmptyEntries);
for (int c = 0; c < arraySnomedCodes.Length; c++)
{
if (MatchedCodes.Contains(arraySnomedCodes[i]))
{
continue; //found required code
}
//required code not found, set allConditionsMet to false and continue to next trigger
allConditionsMet = false;
break;
}
if (!allConditionsMet)
{
continue; //next trigger
}
//Match all CvxCodes--------------------------------------------------------------------------------------------------------------------------------------------------
string[] arrayCvxCodes = listEhrTriggers[i].CvxList.Split(new string[] { " " }, StringSplitOptions.RemoveEmptyEntries);
for (int c = 0; c < arrayCvxCodes.Length; c++)
{
if (MatchedCodes.Contains(arrayCvxCodes[i]))
{
continue; //found required code
}
//required code not found, set allConditionsMet to false and continue to next trigger
allConditionsMet = false;
break;
}
if (!allConditionsMet)
{
continue; //next trigger, do not add to retval
}
//Match all LoincCodes------------------------------------------------------------------------------------------------------------------------------------------------
string[] arrayLoincCodes = listEhrTriggers[i].LabLoincList.Split(new string[] { " " }, StringSplitOptions.RemoveEmptyEntries);
for (int c = 0; c < arrayLoincCodes.Length; c++)
{
if (MatchedCodes.Contains(arrayLoincCodes[i]))
{
continue; //found required code
}
//required code not found, set allConditionsMet to false and continue to next trigger
allConditionsMet = false;
break;
}
if (!allConditionsMet)
{
continue; //next trigger, do not add to retval
}
//TODO:with values
//Match all Vitals----------------------------------------------------------------------------------------------------------------------------------------------------
//TODO:with values
//Match all Demographics---------------------------------------------------------------------------------------------------------------------------------------------
//if(listEhrTriggers[i].DemographicAgeGreaterThan!=0){
// if(PatCur.Birthdate.Year>1880 && PatCur.Birthdate.AddYears(listEhrTriggers[i].DemographicAgeGreaterThan)>DateTime.Now){//patient too young
// continue;//next trigger
// }
//}
//if(listEhrTriggers[i].DemographicAgeLessThan!=0){
// if(PatCur.Birthdate.Year>1880 && PatCur.Birthdate.AddYears(listEhrTriggers[i].DemographicAgeGreaterThan)<DateTime.Now){//patient too old
// continue;//next trigger
// }
//}
//if(listEhrTriggers[i].DemographicGender!=""){
// if(!listEhrTriggers[i].DemographicGender.Contains(PatCur.Gender.ToString())){//Patient Gender not in gender list of trigger
// continue;//next trigger
// }
//}
//TODO: construct trigger message using all the codes in the trigger.
break;
} //end switch trigger cardinality
//retVal.Add(triggerMessage,ListObjectMatches);
CDSIntervention cdsi = new CDSIntervention();
cdsi.EhrTrigger = listEhrTriggers[i];
cdsi.InterventionMessage = triggerMessage;
cdsi.TriggerObjects = ListObjectMatches;
retVal.Add(cdsi);
} //end triggers
return(retVal);
}