///<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);
}
///<summary>Only called from Chart for now. No validation is performed here. Validate before calling. There are many validtion checks, including the NPI must be exactly 10 digits.</summary>
public static string BuildNewCropClickThroughXml(Provider prov, Employee emp, Patient pat, out NCScript ncScript)
{
string deaNumDefault = ProviderClinics.GetDEANum(prov.ProvNum);
ncScript = new NCScript();
ncScript.Credentials = new CredentialsType();
ncScript.Credentials.partnerName = NewCrop.NewCropPartnerName;
ncScript.Credentials.name = NewCrop.NewCropAccountName;
ncScript.Credentials.password = NewCrop.NewCropAccountPasssword;
ncScript.Credentials.productName = NewCrop.NewCropProductName;
ncScript.Credentials.productVersion = NewCrop.NewCropProductVersion;
ncScript.UserRole = new UserRoleType();
bool isMidlevel = false;
if (emp == null) //Provider
{
if (prov.IsSecondary) //Mid-level provider
{
isMidlevel = true;
//Secondary (HYG) providers go accross to NewCrop as midlevel providers for now to satisfy the Ohio prescriber requirements.
//HYG providers are not normally able to click through to NewCrop because they do not have an NPI number and an NPI is required.
//In the future, instead of using the IsSecondary flag as as workaround, we should instead create a new field on the provider table
//or perhaps the userod table to allow the user to select the type of provider.
ncScript.UserRole.user = UserType.MidlevelPrescriber;
ncScript.UserRole.role = RoleType.midlevelPrescriber;
}
else //Fully licensed provider
{
ncScript.UserRole.user = UserType.LicensedPrescriber;
ncScript.UserRole.role = RoleType.doctor;
}
}
else //Employee
{
ncScript.UserRole.user = UserType.Staff;
ncScript.UserRole.role = RoleType.nurse;
}
ncScript.Destination = new DestinationType();
ncScript.Destination.requestedPage = RequestedPageType.compose; //This is the tab that the user will want 90% of the time.
string practiceTitle = Tidy(PrefC.GetString(PrefName.PracticeTitle), 50); //May be blank.
string practicePhone = PrefC.GetString(PrefName.PracticePhone); //Validated to be 10 digits within the chart.
string practiceFax = PrefC.GetString(PrefName.PracticeFax); //Validated to be 10 digits within the chart.
string practiceAddress = PrefC.GetString(PrefName.PracticeAddress); //Validated to exist in chart.
string practiceAddress2 = PrefC.GetString(PrefName.PracticeAddress2); //May be blank.
string practiceCity = PrefC.GetString(PrefName.PracticeCity); //Validated to exist in chart.
string practiceState = PrefC.GetString(PrefName.PracticeST).ToUpper(); //Validated to be a US state code in chart.
string practiceZip = Regex.Replace(PrefC.GetString(PrefName.PracticeZip), "[^0-9]*", ""); //Zip with all non-numeric characters removed. Validated to be 9 digits in chart.
string practiceZip4 = practiceZip.Substring(5); //Last 4 digits of zip.
practiceZip = practiceZip.Substring(0, 5); //First 5 digits of zip.
string country = "US"; //Always United States for now.
//if(CultureInfo.CurrentCulture.Name.Length>=2) {
// country=CultureInfo.CurrentCulture.Name.Substring(CultureInfo.CurrentCulture.Name.Length-2);
//}
ncScript.Account = new AccountTypeRx();
//Each LicensedPrescriberID must be unique within an account. Since we send ProvNum for LicensedPrescriberID, each OD database must have a unique AccountID.
ncScript.Account.ID = PrefC.GetString(PrefName.NewCropAccountId); //Customer account number then a dash then a random alpha-numeric string of 3 characters, followed by 2 digits.
ncScript.Account.accountName = practiceTitle; //May be blank.
ncScript.Account.siteID = "1"; //Always send 1. For each AccountID/SiteID pair, a separate database will be created in NewCrop.
ncScript.Account.AccountAddress = new AddressType();
ncScript.Account.AccountAddress.address1 = practiceAddress; //Validated to exist in chart.
ncScript.Account.AccountAddress.address2 = practiceAddress2; //May be blank.
ncScript.Account.AccountAddress.city = practiceCity; //Validated to exist in chart.
ncScript.Account.AccountAddress.state = practiceState; //Validated to be a US state code in chart.
ncScript.Account.AccountAddress.zip = practiceZip; //Validated to be 9 digits in chart. First 5 digits go in this field.
ncScript.Account.AccountAddress.zip4 = practiceZip4; //Validated to be 9 digits in chart. Last 4 digits go in this field.
ncScript.Account.AccountAddress.country = country; //Validated above.
ncScript.Account.accountPrimaryPhoneNumber = practicePhone; //Validated to be 10 digits within the chart.
ncScript.Account.accountPrimaryFaxNumber = practiceFax; //Validated to be 10 digits within the chart.
ncScript.Location = new LocationType();
ProviderClinic provClinic = ProviderClinics.GetOne(prov.ProvNum, 0); //Default providerclinic. This is needed for offices that don't use clinics.
if (!PrefC.HasClinicsEnabled ||
(!PrefC.GetBool(PrefName.ElectronicRxClinicUseSelected) && pat.ClinicNum == 0) ||
(PrefC.GetBool(PrefName.ElectronicRxClinicUseSelected) && Clinics.ClinicNum == 0 && pat.ClinicNum == 0))
{ //No clinic.
ncScript.Location.ID = "0"; //Always 0, since clinicnums must be >= 1, will never overlap with a clinic if the office turns clinics on after first use.
ncScript.Location.locationName = practiceTitle; //May be blank.
ncScript.Location.LocationAddress = new AddressType();
ncScript.Location.LocationAddress.address1 = practiceAddress; //Validated to exist in chart.
ncScript.Location.LocationAddress.address2 = practiceAddress2; //May be blank.
ncScript.Location.LocationAddress.city = practiceCity; //Validated to exist in chart.
ncScript.Location.LocationAddress.state = practiceState; //Validated to be a US state code in chart.
ncScript.Location.LocationAddress.zip = practiceZip; //Validated to be 9 digits in chart. First 5 digits go in this field.
ncScript.Location.LocationAddress.zip4 = practiceZip4; //Validated to be 9 digits in chart. Last 4 digits go in this field.
ncScript.Location.LocationAddress.country = country; //Validated above.
ncScript.Location.primaryPhoneNumber = practicePhone; //Validated to be 10 digits within the chart.
ncScript.Location.primaryFaxNumber = practiceFax; //Validated to be 10 digits within the chart.
ncScript.Location.pharmacyContactNumber = practicePhone; //Validated to be 10 digits within the chart.
}
else //Using clinics.
{
Clinic clinic = null;
if (PrefC.GetBool(PrefName.ElectronicRxClinicUseSelected) && Clinics.ClinicNum != 0)
{
clinic = Clinics.GetClinic(Clinics.ClinicNum);
}
else
{
clinic = Clinics.GetClinic(pat.ClinicNum);
}
provClinic = ProviderClinics.GetOneOrDefault(prov.ProvNum, clinic.ClinicNum);
ncScript.Location.ID = clinic.ClinicNum.ToString(); //A positive integer.
ncScript.Location.locationName = clinic.Description; //May be blank.
ncScript.Location.LocationAddress = new AddressType();
ncScript.Location.LocationAddress.address1 = clinic.Address; //Validated to exist in chart.
ncScript.Location.LocationAddress.address2 = clinic.Address2; //May be blank.
ncScript.Location.LocationAddress.city = clinic.City; //Validated to exist in chart.
ncScript.Location.LocationAddress.state = clinic.State.ToUpper(); //Validated to be a US state code in chart.
string clinicZip = Regex.Replace(clinic.Zip, "[^0-9]*", ""); //Zip with all non-numeric characters removed. Validated to be 9 digits in chart.
string clinicZip4 = clinicZip.Substring(5); //Last 4 digits of zip.
clinicZip = clinicZip.Substring(0, 5); //First 5 digits of zip.
ncScript.Location.LocationAddress.zip = clinicZip; //Validated to be 9 digits in chart. First 5 digits go in this field.
ncScript.Location.LocationAddress.zip4 = clinicZip4; //Validated to be 9 digits in chart. Last 4 digits go in this field.
ncScript.Location.LocationAddress.country = country; //Validated above.
ncScript.Location.primaryPhoneNumber = clinic.Phone; //Validated to be 10 digits within the chart.
ncScript.Location.primaryFaxNumber = clinic.Fax; //Validated to be 10 digits within the chart.
ncScript.Location.pharmacyContactNumber = clinic.Phone; //Validated to be 10 digits within the chart.
}
//Each unique provider ID sent to NewCrop will cause a billing charge.
//Some customer databases have provider duplicates, because they have one provider record per clinic with matching NPIs.
//We send NPI as the ID to prevent extra NewCrop charges.
//Conversation with NewCrop:
//Question: If one of our customers clicks through to NewCrop with 2 different LicensedPrescriber.ID values,
// but with the same provider name and NPI, will Open Dental be billed twice or just one time for the NPI used?
//Answer: "They would be billed twice. The IDs you send us should always be maintained and unique.
// Users are always identified by LicensedPrescriber ID, since their name or credentials could potentially change."
if (isMidlevel)
{
ncScript.MidlevelPrescriber = new MidlevelPrescriberType();
ncScript.MidlevelPrescriber.ID = prov.NationalProvID;
//UPIN is obsolete
ncScript.MidlevelPrescriber.LicensedPrescriberName = NewCrop.GetPersonNameForProvider(prov);
if (deaNumDefault.ToLower() == "none")
{
ncScript.MidlevelPrescriber.dea = "NONE";
}
else
{
ncScript.MidlevelPrescriber.dea = deaNumDefault;
}
if (provClinic != null)
{
if (provClinic.DEANum != deaNumDefault)
{
//Only set the locationDea if it is different than the default.
ncScript.MidlevelPrescriber.locationDea = provClinic.DEANum;
}
ncScript.MidlevelPrescriber.licenseState = provClinic.StateWhereLicensed.ToUpper(); //Validated to be a US state code in the chart.
ncScript.MidlevelPrescriber.licenseNumber = provClinic.StateLicense; //Validated to exist in chart.
}
ncScript.MidlevelPrescriber.npi = prov.NationalProvID; //Validated to be 10 digits in chart.
}
else //Licensed presriber
{
ncScript.LicensedPrescriber = new LicensedPrescriberType();
ncScript.LicensedPrescriber.ID = prov.NationalProvID;
//UPIN is obsolete
ncScript.LicensedPrescriber.LicensedPrescriberName = NewCrop.GetPersonNameForProvider(prov);
if (deaNumDefault.ToLower() == "none")
{
ncScript.LicensedPrescriber.dea = "NONE";
}
else
{
ncScript.LicensedPrescriber.dea = deaNumDefault;
}
if (provClinic != null)
{
if (provClinic.DEANum != deaNumDefault)
{
//Only set the locationDea if it is different than the default.
ncScript.LicensedPrescriber.locationDea = provClinic.DEANum;
}
ncScript.LicensedPrescriber.licenseState = provClinic.StateWhereLicensed.ToUpper(); //Validated to be a US state code in the chart.
ncScript.LicensedPrescriber.licenseNumber = provClinic.StateLicense; //Validated to exist in chart.
}
ncScript.LicensedPrescriber.npi = prov.NationalProvID; //Validated to be 10 digits in chart.
//ncScript.LicensedPrescriber.freeformCredentials=;//This is where DDS and DMD should go, but we don't support this yet. Probably not necessary anyway.
}
if (emp != null)
{
ncScript.Staff = new StaffType();
ncScript.Staff.ID = "emp" + emp.EmployeeNum.ToString(); //A positive integer. Returned in the ExternalUserID field when retreiving prescriptions from NewCrop. Also, provider ID is returned in the same field if a provider created the prescription, so that we can create a distintion between employee IDs and provider IDs.
ncScript.Staff.StaffName = new PersonNameType();
ncScript.Staff.StaffName.first = emp.FName; //First name or last name will not be blank. Validated in Chart.
ncScript.Staff.StaffName.last = emp.LName; //First name or last name will not be blank. Validated in Chart.
ncScript.Staff.StaffName.middle = emp.MiddleI; //May be blank.
}
ncScript.Patient = new PatientType();
ncScript.Patient.ID = pat.PatNum.ToString(); //A positive integer.
ncScript.Patient.PatientName = new PersonNameType();
ncScript.Patient.PatientName.last = pat.LName; //Validated to exist in Patient Edit window.
ncScript.Patient.PatientName.first = pat.FName; //May be blank.
ncScript.Patient.PatientName.middle = pat.MiddleI; //May be blank.
ncScript.Patient.medicalRecordNumber = pat.PatNum.ToString(); //A positive integer.
//NewCrop specifically requested that we do not send SSN.
//ncScript.Patient.socialSecurityNumber=Regex.Replace(pat.SSN,"[^0-9]*","");//Removes all non-numerical characters.
ncScript.Patient.PatientAddress = new AddressOptionalType();
ncScript.Patient.PatientAddress.address1 = pat.Address; //May be blank.
ncScript.Patient.PatientAddress.address2 = pat.Address2; //May be blank.
ncScript.Patient.PatientAddress.city = pat.City; //May be blank.
ncScript.Patient.PatientAddress.state = pat.State.ToUpper(); //May be blank. Validated in chart to be blank or to be a valid US state code.
//For some reason, NewCrop will fail to load if a 9 digit zip code is sent.
//One customer had all 9 digit zip codes entered for their patients, so we added code here to only send the first 5 digits of the zip.
//Patient zip is validated in Chart to be blank, or #####, or #####-####, or #########.
if (pat.Zip == "")
{
ncScript.Patient.PatientAddress.zip = ""; //Blank is allowed.
}
else //5 or 9 digit zip. Formats are #####, or #####-####, or #########.
{
ncScript.Patient.PatientAddress.zip = pat.Zip.Substring(0, 5); //First 5 digts only.
}
ncScript.Patient.PatientAddress.country = country; //Validated above.
ncScript.Patient.PatientContact = new ContactType();
//ncScript.Patient.PatientContact.backOfficeFax=;//We do not have a field to pull this information from.
//ncScript.Patient.PatientContact.backOfficeTelephone=;//We do not have a field to pull this information from.
ncScript.Patient.PatientContact.cellularTelephone = pat.WirelessPhone.TrimStart('1'); //May be blank. Required to be 10 digits per NewCrop.
ncScript.Patient.PatientContact.email = pat.Email; //May be blank, or may also contain multiple email addresses separated by commas.
//ncScript.Patient.PatientContact.fax=;//We do not have a field to pull this information from.
ncScript.Patient.PatientContact.homeTelephone = pat.HmPhone.TrimStart('1'); //May be blank. Required to be 10 digits per NewCrop.
//ncScript.Patient.PatientContact.pagerTelephone=;//We do not have a field to pull this information from.
ncScript.Patient.PatientContact.workTelephone = pat.WkPhone.TrimStart('1'); //May be blank. Required to be 10 digits per NewCrop.
ncScript.Patient.PatientCharacteristics = new PatientCharacteristicsType();
ncScript.Patient.PatientCharacteristics.dob = pat.Birthdate.ToString("yyyyMMdd"); //DOB must be in CCYYMMDD format.
if (pat.Gender == PatientGender.Male)
{
ncScript.Patient.PatientCharacteristics.gender = GenderType.M;
}
else if (pat.Gender == PatientGender.Female)
{
ncScript.Patient.PatientCharacteristics.gender = GenderType.F;
}
else
{
ncScript.Patient.PatientCharacteristics.gender = GenderType.U;
}
ncScript.Patient.PatientCharacteristics.genderSpecified = true;
ncScript.Patient.PatientDiagnosis = GetPatDiagnoses(pat.PatNum);
foreach (Vitalsign vitalsign in Vitalsigns.Refresh(pat.PatNum).OrderByDescending(x => x.DateTaken))
{
if (vitalsign.Height != 0 && ncScript.Patient.PatientCharacteristics.height.IsNullOrEmpty()) //Only set once
{
ncScript.Patient.PatientCharacteristics.height = vitalsign.Height.ToString();
ncScript.Patient.PatientCharacteristics.heightUnits = "inches"; //No HeightUnitType field like the one for weight below
}
if (vitalsign.Weight != 0 && ncScript.Patient.PatientCharacteristics.weight.IsNullOrEmpty()) //Only set once
{
ncScript.Patient.PatientCharacteristics.weight = vitalsign.Weight.ToString();
ncScript.Patient.PatientCharacteristics.weightUnits = WeightUnitType.lbs1;
ncScript.Patient.PatientCharacteristics.weightUnitsSpecified = true;
}
}
//NewCrop programmer's comments regarding other fields we are not currently using (these fields are sent back when fetching prescriptions in the Chart):
//ExternalPrescriptionId = your unique identifier for the prescription, only to be used if you are generating the prescription on your own UI.
// This is referenced by NewCrop, and cannot be populated with any other value.
//EncounterIdentifier = unique ID for the patient visit (e.g. John Doe, 11/11/2013).
// This is used by NewCrop for reporting events against a visit, but otherwise does not impact the session.
//EpisodeIdentifier = unique ID for the patient’s issue (e.g. John Doe’s broken leg) which may include multiple visits.
// Currently not used by NewCrop except for being echoed back; it is possible this functionality would be expanded in the future based on its intent as noted.
//ExternalSource = a codified field noting the origin of the prescription. This may not be used.
//Serialize
MemoryStream memoryStream = new MemoryStream();
XmlSerializer xmlSerializer = new XmlSerializer(typeof(NCScript));
xmlSerializer.Serialize(memoryStream, ncScript);
byte[] memoryStreamInBytes = memoryStream.ToArray();
return(Encoding.UTF8.GetString(memoryStreamInBytes, 0, memoryStreamInBytes.Length));
}