public static Observation createLOINCObservation(Patient patient, string code_text, string code, Element value)
{
return(new Observation()
{
Id = FhirUtil.createUUID(),
Subject = new ResourceReference()
{
Reference = patient.Id
},
Status = ObservationStatus.Final,
Code = new CodeableConcept()
{
Text = code_text,
Coding = new List <Coding>()
{
new Coding()
{
System = "http://loinc.org",
Code = code,
Display = code_text
}
}
},
Value = value
});
}
public static void Main(string[] args)
{
var basePath = Path.GetDirectoryName(Assembly.GetExecutingAssembly().Location);
Bundle bdl = BundleBuilder.getBundle(basePath);
var xmlText = FhirUtil.tidyXMLString(FhirUtil.generateXML(bdl));
//System.Console.WriteLine(xmlText);
File.WriteAllText(basePath + @"/../../sample/eDischargeSample.xml", xmlText);
}
public static Practitioner create()
{
Practitioner p = new Practitioner();
//まだFHIR Serverに登録されていないので，一時的なリソースIDを生成する
p.Id = FhirUtil.createUUID();
var name = new HumanName().WithGiven("太郎").AndFamily("医師");
name.Use = HumanName.NameUse.Official;
name.AddExtension("http://hl7.org/fhir/StructureDefinition/iso21090-EN-representation", new FhirString("IDE"));
p.Name.Add(name);
return(p);
}
public static Organization create()
{
Organization o = new Organization();
//まだFHIR Serverに登録されていないので，一時的なリソースIDを生成する
o.Id = FhirUtil.createUUID();
o.Name = "日本HL7新橋病院";
o.Telecom.Add(new ContactPoint()
{
Use = ContactPoint.ContactPointUse.Work,
Value = "03-3267-1921"
});
o.Address.Add(new Address()
{
Line = new string[] { "神楽坂一丁目1番地" },
City = "新宿区",
State = "東京都",
PostalCode = "162-0825",
Country = "Japan"
});
return(o);
}
public static Bundle getBundle(string basePath)
{
Bundle bdl = new Bundle();
bdl.Type = Bundle.BundleType.Document;
// A document must have an identifier with a system and a value () type = 'document' implies (identifier.system.exists() and identifier.value.exists())
bdl.Identifier = new Identifier()
{
System = "urn:ietf:rfc:3986",
Value = FhirUtil.createUUID()
};
//Composition for Discharge Summary
Composition c = new Composition();
//B.2 患者基本情報
// TODO 退院時サマリー V1.41 B.2 患者基本情報のproviderOrganizationの意図を確認 B.8 受診、入院時情報に入院した
//医療機関の記述が書かれているならば、ここの医療機関はどういう位置づけのもの？ とりあえず、managingOrganizationにいれておくが。
Patient patient = null;
if (true)
{
//Patientリソースを自前で生成する場合
patient = PatientUtil.create();
}
else
{
//Patientリソースをサーバから取ってくる場合
#pragma warning disable 0162
patient = PatientUtil.get();
}
Practitioner practitioner = PractitionerUtil.create();
Organization organization = OrganizationUtil.create();
patient.ManagingOrganization = new ResourceReference()
{
Reference = organization.Id
};
//Compositionの作成
c.Id = FhirUtil.createUUID(); //まだFHIRサーバにあげられていないから，一時的なUUIDを生成してリソースIDとしてセットする
c.Status = CompositionStatus.Preliminary; //最終版は CompositionStatus.Final
c.Type = new CodeableConcept()
{
Text = "Discharge Summary", //[疑問]Codable Concept内のTextと、Coding内のDisplayとの違いは。Lead Term的な表示？
Coding = new List <Coding>()
{
new Coding()
{
Display = "Discharge Summary",
System = "http://loinc.org",
Code = "18842-5",
}
}
};
c.Date = DateTime.Now.ToString("yyyy-MM-ddTHH:mm:sszzzz");
c.Author = new List <ResourceReference>()
{
new ResourceReference()
{
Reference = practitioner.Id
}
};
c.Subject = new ResourceReference()
{
Reference = patient.Id
};
c.Title = "退院時サマリー"; //タイトルはこれでいいのかな。
//B.3 承認者
var attester = new Composition.AttesterComponent();
var code = new Code <Composition.CompositionAttestationMode>();
code.Value = Composition.CompositionAttestationMode.Legal;
attester.ModeElement.Add(code);
attester.Party = new ResourceReference()
{
Reference = practitioner.Id
};
attester.Time = "20140620";
c.Attester.Add(attester);
//B.4 退院時サマリー記載者
var author = new Practitioner();
author.Id = FhirUtil.createUUID();
var authorName = new HumanName().WithGiven("太郎").AndFamily("本日");
authorName.Use = HumanName.NameUse.Official;
authorName.AddExtension("http://hl7.org/fhir/StructureDefinition/iso21090-EN-representation", new FhirString("IDE"));
author.Name.Add(authorName);
c.Author.Add(new ResourceReference()
{
Reference = author.Id
});
//B.5 原本管理者
c.Custodian = new ResourceReference()
{
Reference = organization.Id
};
//B.6 関係者 保険者 何故退院サマリーに保険者の情報を入れているのかな？
//TODO 未実装
//sections
//B.7 主治医
var section_careteam = new Composition.SectionComponent();
section_careteam.Title = "careteam";
var careteam = new CareTeam();
careteam.Id = FhirUtil.createUUID();
var attendingPhysician = new Practitioner();
attendingPhysician.Id = FhirUtil.createUUID();
var attendingPhysicianName = new HumanName().WithGiven("二郎").AndFamily("日本");
attendingPhysicianName.Use = HumanName.NameUse.Official;
attendingPhysicianName.AddExtension("http://hl7.org/fhir/StructureDefinition/iso21090-EN-representation", new FhirString("IDE"));
attendingPhysician.Name.Add(attendingPhysicianName);
//医師の診療科はPracitionerRole/speciality + PracticeSettingCodeValueSetで表現する.
//TODO: 膠原病内科は、Specilityのprefered ValueSetの中にはなかった。日本の診療科に関するValueSetを作る必要がある。
var attendingPractitionerRole = new PractitionerRole();
attendingPractitionerRole.Id = FhirUtil.createUUID();
attendingPractitionerRole.Practitioner = new ResourceReference()
{
Reference = attendingPhysician.Id
};
attendingPractitionerRole.Code.Add(new CodeableConcept("http://hl7.org/fhir/ValueSet/participant-role", "394733009", "Attending physician"));
attendingPractitionerRole.Specialty.Add(new CodeableConcept("http://hl7.org/fhir/ValueSet/c80-practice-codes", "405279007", "Medical specialty--OTHER--NOT LISTED"));
var participant = new CareTeam.ParticipantComponent();
participant.Member = new ResourceReference()
{
Reference = attendingPractitionerRole.Id
};
careteam.Participant.Add(participant);
section_careteam.Entry.Add(new ResourceReference()
{
Reference = careteam.Id
});
c.Section.Add(section_careteam);
//B.8 受診、入院情報
//B.12 本文 (Entry部） 退院時サマリーV1.41の例では入院時診断を本文に書くような形に
//なっているが、FHIRではadmissionDetailセクション中のEncounterで記載するのが自然だろう。
var section_admissionDetail = new Composition.SectionComponent();
section_admissionDetail.Title = "admissionDetail";
var encounter = new Encounter();
encounter.Id = FhirUtil.createUUID();
encounter.Period = new Period()
{
Start = "20140328", End = "20140404"
};
var hospitalization = new Encounter.HospitalizationComponent();
hospitalization.DischargeDisposition = new CodeableConcept("\thttp://hl7.org/fhir/discharge-disposition", "01", "Discharged to home care or self care (routine discharge)");
encounter.Hospitalization = hospitalization;
var locationComponent = new Encounter.LocationComponent();
var location = new Location()
{
Id = FhirUtil.createUUID(),
Name = "○○クリニック",
Type = new CodeableConcept("http://terminology.hl7.org/ValueSet/v3-ServiceDeliveryLocationRoleType", "COAG", "Coagulation clinic")
};
locationComponent.Location = new ResourceReference()
{
Reference = location.Id
};
section_admissionDetail.Entry.Add(new ResourceReference()
{
Reference = encounter.Id
});
var diagnosisAtAdmission = new Condition()
{
Code = new CodeableConcept("http://hl7.org/fhir/ValueSet/icd-10", "N801", "右卵巣嚢腫")
};
diagnosisAtAdmission.Id = FhirUtil.createUUID();
var diagnosisComponentAtAdmission = new Encounter.DiagnosisComponent()
{
Condition = new ResourceReference()
{
Reference = diagnosisAtAdmission.Id
},
Role = new CodeableConcept("http://hl7.org/fhir/ValueSet/diagnosis-role", "AD", "Admission diagnosis")
};
var encounterAtAdmission = new Encounter();
encounterAtAdmission.Id = FhirUtil.createUUID();
encounterAtAdmission.Diagnosis.Add(diagnosisComponentAtAdmission);
section_admissionDetail.Entry.Add(new ResourceReference()
{
Reference = encounterAtAdmission.Id
});
c.Section.Add(section_admissionDetail);
//B.9情報提供者
var section_informant = new Composition.SectionComponent();
section_informant.Title = "informant";
var informant = new RelatedPerson();
informant.Id = FhirUtil.createUUID();
var informantName = new HumanName().WithGiven("藤三郎").AndFamily("東京");
informantName.Use = HumanName.NameUse.Official;
informantName.AddExtension("http://hl7.org/fhir/StructureDefinition/iso21090-EN-representation", new FhirString("IDE"));
informant.Name.Add(informantName);
informant.Patient = new ResourceReference()
{
Reference = patient.Id
};
informant.Relationship = new CodeableConcept("http://hl7.org/fhir/ValueSet/relatedperson-relationshiptype", "FTH", "father");
informant.Address.Add(new Address()
{
Line = new string[] { "新宿区神楽坂一丁目50番地" },
State = "東京都",
PostalCode = "01803",
Country = "日本"
});
informant.Telecom.Add(new ContactPoint()
{
System = ContactPoint.ContactPointSystem.Phone,
Use = ContactPoint.ContactPointUse.Work,
Value = "tel:(03)3555-1212"
});
section_informant.Entry.Add(new ResourceReference()
{
Reference = informant.Id
});
c.Section.Add(section_informant);
// B.10 本文
// B.10.1 本文記述
var section_clinicalSummary = new Composition.SectionComponent();
section_clinicalSummary.Title = "来院理由";
section_clinicalSummary.Code = new CodeableConcept("http://loinc.org", "29299-5", "Reason for visit Narrative");
var dischargeSummaryNarrative = new Narrative();
dischargeSummaryNarrative.Status = Narrative.NarrativeStatus.Additional;
dischargeSummaryNarrative.Div = @"
<div xmlns=""http://www.w3.org/1999/xhtml"">\n\n
<p>平成19年喘息と診断を受けた。平成20年7月喘息の急性増悪にて当院呼吸器内科入院。退院後HL7医院にてFollowされていた</p>
<p>平成21年10月20日頃より右足首にじんじん感が出現。左足首、両手指にも認めるようになった。同時に37℃台の熱発出現しWBC28000、Eosi58%と上昇していた</p>
<p>このとき尿路感染症が疑われセフメタゾン投与されるも改善せず。WBC31500、Eosi64%と上昇、しびれ感の増悪認めた。またHb 7.3 Ht 20.0と貧血を認めた</p>
<p>膠原病、特にChuge-stress-syndoromeが疑われ平成21年11月8日当院膠原病内科入院となった</p>
</div>
";
section_clinicalSummary.Text = dischargeSummaryNarrative;
c.Section.Add(section_clinicalSummary);
//B.10.3 観察・検査等
//section-observations
var section_observations = new Composition.SectionComponent();
section_observations.Title = "observations";
var obs = new List <Observation>()
{
FhirUtil.createLOINCObservation(patient, "8302-2", "身長", new Quantity()
{
Value = (decimal)2.004,
Unit = "m"
}),
FhirUtil.createLOINCObservation(patient, "8302-2", "身長", new Quantity()
{
Value = (decimal)2.004,
Unit = "m"
}),
//Component Resultsの例 血圧- 拡張期血圧、収縮期血圧のコンポーネントを含む。
new Observation()
{
Id = FhirUtil.createUUID(),
Subject = new ResourceReference()
{
Reference = patient.Id
},
Status = ObservationStatus.Final,
Code = new CodeableConcept()
{
Text = "血圧",
Coding = new List <Coding>()
{
new Coding()
{
System = "http://loinc.org",
Code = "18684-1",
Display = "血圧"
}
}
},
Component = new List <Observation.ComponentComponent>()
{
new Observation.ComponentComponent()
{
Code = new CodeableConcept()
{
Text = "収縮期血圧血圧",
Coding = new List <Coding>()
{
new Coding()
{
System = "http://loinc.org",
Code = "8480-6",
Display = "収縮期血圧"
}
}
},
Value = new Quantity()
{
Value = (decimal)120,
Unit = "mm[Hg]"
}
},
new Observation.ComponentComponent()
{
Code = new CodeableConcept()
{
Text = "拡張期血圧",
Coding = new List <Coding>()
{
new Coding()
{
System = "http://loinc.org",
Code = "8462-4",
Display = "拡張期血圧"
}
}
},
Value = new Quantity()
{
Value = (decimal)100,
Unit = "mm[Hg]"
}
},
}
}
};
foreach (var res in obs)
{
section_observations.Entry.Add(new ResourceReference()
{
Reference = res.Id
});
}
c.Section.Add(section_observations);
//B.10.4 キー画像
//section-medicalImages
var mediaPath = basePath + "/../../resource/Hydrocephalus_(cropped).jpg";
var media = new Media();
media.Id = FhirUtil.createUUID();
media.Type = Media.DigitalMediaType.Photo;
media.Content = FhirUtil.CreateAttachmentFromFile(mediaPath);
/* R3ではImagingStudyに入れられるのはDICOM画像だけみたい。 R4ではreasonReferenceでMediaも参照できる。
* とりあえずDSTU3ではMediaリソースをmedicalImagesセクションにセットする。
* var imagingStudy = new ImagingStudy();
* imagingStudy.Id = FhirUtil.getUUID(); //まだFHIRサーバにあげられていないから，一時的なUUIDを生成してリソースIDとしてセットする
* imagingStudy.re
*/
var section_medicalImages = new Composition.SectionComponent();
section_medicalImages.Title = "medicalImages";
//TODO: sectionのcodeは？
section_medicalImages.Entry.Add(new ResourceReference()
{
Reference = media.Id
});
c.Section.Add(section_medicalImages);
//Bundleの構築
//Bundleの構成要素
//Bunbdleの一番最初はCompostion Resourceであること。
List <Resource> bdl_entries = new List <Resource> {
c, patient, organization, practitioner, author, careteam, encounter, encounterAtAdmission,
diagnosisAtAdmission, location, informant, media, attendingPhysician, attendingPractitionerRole
};
bdl_entries.AddRange(obs);
foreach (Resource res in bdl_entries)
{
var entry = new Bundle.EntryComponent();
//entry.FullUrl = res.ResourceBase.ToString()+res.ResourceType.ToString() + res.Id;
entry.FullUrl = res.Id;
entry.Resource = res;
bdl.Entry.Add(entry);
}
return(bdl);
}
static public Patient create()
{
// example Patient setup, fictional data only
var pat = new Patient();
//まだFHIR Serverに登録されていないので，一時的なリソースIDを生成する
pat.Id = FhirUtil.createUUID();
var id = new Identifier();
id.System = "2.16.840.1.113883.2.2.3.10.1.2\""; // ex. "http://hl7.org/fhir/sid/us-ssn";
id.Value = "111111";
pat.Identifier.Add(id);
var address = new Address()
{
Line = new string[] { "新橋2丁目5番5号" },
City = "港区",
State = "東京都",
PostalCode = "105-0004",
Country = "日本",
Use = Address.AddressUse.Home
};
pat.Address.Add(address);
var contact = new Patient.ContactComponent();
contact.Telecom.Add(new ContactPoint(ContactPoint.ContactPointSystem.Phone, null, "tel:03-3506-8010"));
pat.Contact.Add(contact);
var sylName = new HumanName().WithGiven("ハナコ").AndFamily("トウキョウ");
sylName.Use = HumanName.NameUse.Official;
sylName.AddExtension("http://hl7.org/fhir/StructureDefinition/iso21090-EN-representation", new FhirString("SYL"));
var ideName = new HumanName().WithGiven("花子").AndFamily("東京");
ideName.Use = HumanName.NameUse.Official;
ideName.AddExtension("http://hl7.org/fhir/StructureDefinition/iso21090-EN-representation", new FhirString("IDE"));
var abcName = new HumanName().WithGiven("Hanako").AndFamily("Tokyo");
abcName.Use = HumanName.NameUse.Official;
abcName.AddExtension("http://hl7.org/fhir/StructureDefinition/iso21090-EN-representation", new FhirString("IDE"));
pat.Name.Add(sylName);
pat.Name.Add(ideName);
pat.Name.Add(abcName);
pat.Gender = AdministrativeGender.Female;
pat.MaritalStatus = new CodeableConcept("http://hl7.org/fhir/ValueSet/marital-status", "M");
pat.BirthDate = "1937-07-23";
var birthplace = new Extension();
birthplace.Url = "http://hl7.org/fhir/StructureDefinition/birthPlace";
birthplace.Value = new Address()
{
City = "葛飾区", Line = new string[] { "亀有公園前派出所" }
};
pat.Extension.Add(birthplace);
var birthtime = new Extension("http://hl7.org/fhir/StructureDefinition/patient-birthTime",
new FhirDateTime(1983, 4, 23, 7, 44, 0, TimeSpan.FromHours(9)));
pat.BirthDateElement.Extension.Add(birthtime);
pat.Deceased = new FhirBoolean(false);
//System.Console.WriteLine(FhirUtil.tidyXMLString(FhirUtil.generateXML(pat)));
return(pat);
}