private void butDelete_Click(object sender, EventArgs e)
{
if (_ehrAptObsCur.IsNew)
{
DialogResult = DialogResult.Cancel;
}
else
{
EhrAptObses.Delete(_ehrAptObsCur.EhrAptObsNum);
_ehrAptObsCur.EhrAptObsNum = 0; //Signal to the calling code that the object has been deleted.
DialogResult = DialogResult.OK;
}
}
private void gridObservations_CellDoubleClick(object sender, UI.ODGridClickEventArgs e)
{
EhrAptObs obs = (EhrAptObs)gridObservations.ListGridRows[e.Row].Tag;
FormEhrAptObsEdit formE = new FormEhrAptObsEdit(obs);
if (formE.ShowDialog() == DialogResult.OK)
{
if (obs.EhrAptObsNum != 0) //Was not deleted.
{
EhrAptObses.Update(obs);
}
FillGridObservations();
}
}
private void butAdd_Click(object sender, EventArgs e)
{
EhrAptObs obs = new EhrAptObs();
obs.IsNew = true;
obs.AptNum = _appt.AptNum;
FormEhrAptObsEdit formE = new FormEhrAptObsEdit(obs);
if (formE.ShowDialog() == DialogResult.OK)
{
EhrAptObses.Insert(obs);
FillGridObservations();
}
}
public static string Validate(Appointment appt)
{
StringBuilder sb = new StringBuilder();
Provider provFacility = Providers.GetProv(PrefC.GetInt(PrefName.PracticeDefaultProv));
if (!Regex.IsMatch(provFacility.NationalProvID, "^(80840)?[0-9]{10}$"))
{
WriteError(sb, "Invalid NPI for provider '" + provFacility.Abbr + "'");
}
if (PrefC.HasClinicsEnabled && appt.ClinicNum != 0) //Using clinics and a clinic is assigned.
{
Clinic clinic = Clinics.GetClinic(appt.ClinicNum);
if (clinic.Description == "")
{
WriteError(sb, "Missing clinic description for clinic attached to appointment.");
}
}
else //Not using clinics for this patient
{
if (PrefC.GetString(PrefName.PracticeTitle) == "")
{
WriteError(sb, "Missing practice title.");
}
}
Patient pat = Patients.GetPat(appt.PatNum);
if (pat.PatStatus == PatientStatus.Deceased && pat.DateTimeDeceased.Year < 1880)
{
WriteError(sb, "Missing date time deceased.");
}
List <EhrAptObs> listObservations = EhrAptObses.Refresh(appt.AptNum);
if (listObservations.Count == 0)
{
WriteError(sb, "Missing observation.");
}
for (int i = 0; i < listObservations.Count; i++)
{
EhrAptObs obs = listObservations[i];
if (obs.ValType == EhrAptObsType.Coded)
{
if (obs.ValCodeSystem.Trim().ToUpper() == "LOINC")
{
Loinc loincVal = Loincs.GetByCode(obs.ValReported);
if (loincVal == null)
{
WriteError(sb, "Loinc code not found '" + loincVal.LoincCode + "'. Please add by going to Setup | Chart | EHR.");
}
}
else if (obs.ValCodeSystem.Trim().ToUpper() == "SNOMEDCT")
{
Snomed snomedVal = Snomeds.GetByCode(obs.ValReported);
if (snomedVal == null)
{
WriteError(sb, "Snomed code not found '" + snomedVal.SnomedCode + "'. Please add by going to Setup | Chart | EHR.");
}
}
else if (obs.ValCodeSystem.Trim().ToUpper() == "ICD9")
{
ICD9 icd9Val = ICD9s.GetByCode(obs.ValReported);
if (icd9Val == null)
{
WriteError(sb, "ICD9 code not found '" + icd9Val.ICD9Code + "'. Please add by going to Setup | Chart | EHR.");
}
}
else if (obs.ValCodeSystem.Trim().ToUpper() == "ICD10")
{
Icd10 icd10Val = Icd10s.GetByCode(obs.ValReported);
if (icd10Val == null)
{
WriteError(sb, "ICD10 code not found '" + icd10Val.Icd10Code + "'. Please add by going to Setup | Chart | EHR.");
}
}
}
else if (obs.ValType == EhrAptObsType.Numeric && obs.UcumCode != "") //We only validate the ucum code if it will be sent out. Blank units allowed.
{
Ucum ucum = Ucums.GetByCode(obs.UcumCode);
if (ucum == null)
{
WriteError(sb, "Invalid unit code '" + obs.UcumCode + "' for observation (must be UCUM code).");
}
}
}
return(sb.ToString());
}
///<summary>Observation/result segment. Used to transmit observations related to the patient and visit. Guide page 64.</summary>
private void OBX()
{
List <EhrAptObs> listObservations = EhrAptObses.Refresh(_appt.AptNum);
for (int i = 0; i < listObservations.Count; i++)
{
EhrAptObs obs = listObservations[i];
_seg = new SegmentHL7(SegmentNameHL7.OBX);
_seg.SetField(0, "OBX");
_seg.SetField(1, (i + 1).ToString()); //OBX-1 Set ID - OBX. Required (length 1..4). Must start at 1 and increment.
//OBX-2 Value Type. Required (length 1..3). Cardinality [1..1]. Identifies the structure of data in observation value OBX-5. Values allowed: TS=Time Stamp (Date and/or Time),TX=Text,NM=Numeric,CWE=Coded with exceptions,XAD=Address.
if (obs.ValType == EhrAptObsType.Coded)
{
_seg.SetField(2, "CWE");
}
else if (obs.ValType == EhrAptObsType.DateAndTime)
{
_seg.SetField(2, "TS");
}
else if (obs.ValType == EhrAptObsType.Numeric)
{
_seg.SetField(2, "NM");
}
else //obs.ValType==EhrAptObsType.Text
{
_seg.SetField(2, "TX");
}
//OBX-3 Observation Identifier. Required (length up to 478). Cardinality [1..1]. Value set is HL7 table named "Observation Identifier". Type CE. We use LOINC codes because the testing tool used LOINC codes and so do vaccines.
string obsIdCode = "";
string obsIdCodeDescript = "";
string obsIdCodeSystem = "LN";
if (obs.IdentifyingCode == EhrAptObsIdentifier.BodyTemp)
{
obsIdCode = "11289-6";
obsIdCodeDescript = "Body temperature:Temp:Enctrfrst:Patient:Qn:";
}
else if (obs.IdentifyingCode == EhrAptObsIdentifier.CheifComplaint)
{
obsIdCode = "8661-1";
obsIdCodeDescript = "Chief complaint:Find:Pt:Patient:Nom:Reported";
}
else if (obs.IdentifyingCode == EhrAptObsIdentifier.DateIllnessOrInjury)
{
obsIdCode = "11368-8";
obsIdCodeDescript = "Illness or injury onset date and time:TmStp:Pt:Patient:Qn:";
}
else if (obs.IdentifyingCode == EhrAptObsIdentifier.OxygenSaturation)
{
obsIdCode = "59408-5";
obsIdCodeDescript = "Oxygen saturation:MFr:Pt:BldA:Qn:Pulse oximetry";
}
else if (obs.IdentifyingCode == EhrAptObsIdentifier.PatientAge)
{
obsIdCode = "21612-7";
obsIdCodeDescript = "Age Time Patient Reported";
}
else if (obs.IdentifyingCode == EhrAptObsIdentifier.PrelimDiag)
{
obsIdCode = "44833-2";
obsIdCodeDescript = "Diagnosis.preliminary:Imp:Pt:Patient:Nom:";
}
else if (obs.IdentifyingCode == EhrAptObsIdentifier.TreatFacilityID)
{
obsIdCode = "SS001";
obsIdCodeDescript = "Treating Facility Identifier";
obsIdCodeSystem = "PHINQUESTION";
}
else if (obs.IdentifyingCode == EhrAptObsIdentifier.TreatFacilityLocation)
{
obsIdCode = "SS002";
obsIdCodeDescript = "Treating Facility Location";
obsIdCodeSystem = "PHINQUESTION";
}
else if (obs.IdentifyingCode == EhrAptObsIdentifier.TriageNote)
{
obsIdCode = "54094-8";
obsIdCodeDescript = "Triage note:Find:Pt:Emergency department:Doc:";
}
else if (obs.IdentifyingCode == EhrAptObsIdentifier.VisitType)
{
obsIdCode = "SS003";
obsIdCodeDescript = "Facility / Visit Type";
obsIdCodeSystem = "PHINQUESTION";
}
WriteCE(3, obsIdCode, obsIdCodeDescript, obsIdCodeSystem);
//OBX-4 Observation Sub-ID. No longer used.
//OBX-5 Observation Value. Required if known (length 1..99999). Value must match type in OBX-2.
if (obs.ValType == EhrAptObsType.Address)
{
WriteXAD(5, _sendingFacilityAddress1, _sendingFacilityAddress2, _sendingFacilityCity, _sendingFacilityState, _sendingFacilityZip);
}
else if (obs.ValType == EhrAptObsType.Coded)
{
string codeDescript = "";
string codeSystemAbbrev = "";
if (obs.ValCodeSystem.Trim().ToUpper() == "LOINC")
{
Loinc loincVal = Loincs.GetByCode(obs.ValReported);
codeDescript = loincVal.NameShort;
codeSystemAbbrev = "LN";
}
else if (obs.ValCodeSystem.Trim().ToUpper() == "SNOMEDCT")
{
Snomed snomedVal = Snomeds.GetByCode(obs.ValReported);
codeDescript = snomedVal.Description;
codeSystemAbbrev = "SCT";
}
else if (obs.ValCodeSystem.Trim().ToUpper() == "ICD9")
{
ICD9 icd9Val = ICD9s.GetByCode(obs.ValReported);
codeDescript = icd9Val.Description;
codeSystemAbbrev = "I9";
}
else if (obs.ValCodeSystem.Trim().ToUpper() == "ICD10")
{
Icd10 icd10Val = Icd10s.GetByCode(obs.ValReported);
codeDescript = icd10Val.Description;
codeSystemAbbrev = "I10";
}
WriteCE(5, obs.ValReported.Trim(), codeDescript, codeSystemAbbrev);
}
else if (obs.ValType == EhrAptObsType.DateAndTime)
{
DateTime dateVal = DateTime.Parse(obs.ValReported.Trim());
string strDateOut = dateVal.ToString("yyyyMMdd");
//The testing tool threw errors when there were trailing zeros, even though technically valid.
if (dateVal.Second > 0)
{
strDateOut += dateVal.ToString("HHmmss");
}
else if (dateVal.Minute > 0)
{
strDateOut += dateVal.ToString("HHmm");
}
else if (dateVal.Hour > 0)
{
strDateOut += dateVal.ToString("HH");
}
_seg.SetField(5, strDateOut);
}
else if (obs.ValType == EhrAptObsType.Numeric)
{
_seg.SetField(5, obs.ValReported.Trim());
}
else //obs.ValType==EhrAptObsType.Text
{
_seg.SetField(5, obs.ValReported);
}
//OBX-6 Units. Required if OBX-2 is NM=Numeric. Cardinality [0..1]. Type CE. The guide suggests value sets: Pulse Oximetry Unit, Temperature Unit, or Age Unit. However, the testing tool used UCUM, so we will use UCUM.
if (obs.ValType == EhrAptObsType.Numeric)
{
if (String.IsNullOrEmpty(obs.UcumCode)) //If units are required but known, we must send a null flavor.
{
WriteCE(6, "UNK", "", "NULLFL");
}
else
{
Ucum ucum = Ucums.GetByCode(obs.UcumCode);
WriteCE(6, ucum.UcumCode, ucum.Description, "UCUM");
}
}
//OBX-7 References Range. No longer used.
//OBX-8 Abnormal Flags. No longer used.
//OBX-9 Probability. No longer used.
//OBX-10 Nature of Abnormal Test. No longer used.
_seg.SetField(11, "F"); //OBX-11 Observation Result Status. Required (length 1..1). Expected value is "F".
//OBX-12 Effective Date of Reference Range. No longer used.
//OBX-13 User Defined Access Checks. No longer used.
//OBX-14 Date/Time of the Observation. Optional.
//OBX-15 Producer's ID. No longer used.
//OBX-16 Responsible Observer. No longer used.
//OBX-17 Observation Method. No longer used.
//OBX-18 Equipment Instance Identifier. No longer used.
//OBX-19 Date/Time of the Analysis. No longer used.
_msg.Segments.Add(_seg);
}
}
private void FillGridObservations()
{
gridObservations.BeginUpdate();
gridObservations.ListGridColumns.Clear();
gridObservations.ListGridColumns.Add(new UI.GridColumn("Observation", 200)); //0
gridObservations.ListGridColumns.Add(new UI.GridColumn("Value Type", 200)); //1
gridObservations.ListGridColumns.Add(new UI.GridColumn("Value", 0)); //2
gridObservations.ListGridRows.Clear();
List <EhrAptObs> listEhrAptObses = EhrAptObses.Refresh(_appt.AptNum);
for (int i = 0; i < listEhrAptObses.Count; i++)
{
EhrAptObs obs = listEhrAptObses[i];
UI.GridRow row = new UI.GridRow();
row.Tag = obs;
row.Cells.Add(obs.IdentifyingCode.ToString()); //0 Observation
if (obs.ValType == EhrAptObsType.Coded)
{
row.Cells.Add(obs.ValType.ToString() + " - " + obs.ValCodeSystem); //1 Value Type
if (obs.ValCodeSystem == "LOINC")
{
Loinc loincValue = Loincs.GetByCode(obs.ValReported);
row.Cells.Add(loincValue.NameShort); //2 Value
}
else if (obs.ValCodeSystem == "SNOMEDCT")
{
Snomed snomedValue = Snomeds.GetByCode(obs.ValReported);
row.Cells.Add(snomedValue.Description); //2 Value
}
else if (obs.ValCodeSystem == "ICD9")
{
ICD9 icd9Value = ICD9s.GetByCode(obs.ValReported);
row.Cells.Add(icd9Value.Description); //2 Value
}
else if (obs.ValCodeSystem == "ICD10")
{
Icd10 icd10Value = Icd10s.GetByCode(obs.ValReported);
row.Cells.Add(icd10Value.Description); //2 Value
}
}
else if (obs.ValType == EhrAptObsType.Address)
{
string sendingFacilityAddress1 = PrefC.GetString(PrefName.PracticeAddress);
string sendingFacilityAddress2 = PrefC.GetString(PrefName.PracticeAddress2);
string sendingFacilityCity = PrefC.GetString(PrefName.PracticeCity);
string sendingFacilityState = PrefC.GetString(PrefName.PracticeST);
string sendingFacilityZip = PrefC.GetString(PrefName.PracticeZip);
if (PrefC.HasClinicsEnabled && _appt.ClinicNum != 0) //Using clinics and a clinic is assigned.
{
Clinic clinic = Clinics.GetClinic(_appt.ClinicNum);
sendingFacilityAddress1 = clinic.Address;
sendingFacilityAddress2 = clinic.Address2;
sendingFacilityCity = clinic.City;
sendingFacilityState = clinic.State;
sendingFacilityZip = clinic.Zip;
}
row.Cells.Add(obs.ValType.ToString()); //1 Value Type
row.Cells.Add(sendingFacilityAddress1 + " " + sendingFacilityAddress2 + " " + sendingFacilityCity + " " + sendingFacilityState + " " + sendingFacilityZip); //2 Value
}
else
{
row.Cells.Add(obs.ValType.ToString()); //1 Value Type
row.Cells.Add(obs.ValReported); //2 Value
}
gridObservations.ListGridRows.Add(row);
}
gridObservations.EndUpdate();
}
