Medplum

// SPDX-FileCopyrightText: Copyright Orangebot, Inc. and Medplum contributors // SPDX-License-Identifier: Apache-2.0 import { createReference, getReferenceString, LOINC, SNOMED, UCUM } from '@medplum/core'; import type { BotEvent, MedplumClient, WithId } from '@medplum/core'; import type { AllergyIntolerance, BundleEntry, CarePlan, Communication, Condition, DiagnosticReport, Immunization, MedicationRequest, Observation, Patient, Practitioner, Reference, RequestGroup, RequestGroupAction, Resource, Schedule, Task, } from '@medplum/fhirtypes'; export async function handler(medplum: MedplumClient, event: BotEvent): Promise<any> { const patient = event.input as Patient; const patientHistory = await medplum.readHistory('Patient', patient.id as string); if ((patientHistory.entry?.length ?? 0) > 1) { console.log('Patient already has history'); return; } console.log('Creating questionnaire library...'); await ensureQuestionnaire(medplum); console.log('Setting practitioner...'); const practitioner = await getPractitioner(medplum); patient.generalPractitioner = [createReference(practitioner)]; await medplum.updateResource(patient); console.log('Creating A1C...'); const a1c = await medplum.createResource(createA1CObservation(patient)); console.log('Creating Care Plans...'); await createCompletedCarePlan(medplum, patient); await createActiveCarePlan(medplum, patient); const entries: BundleEntry[] = []; entries.push(createEntry(createDiagnosticReport(patient, a1c))); entries.push(createEntry(createActiveMedicationRequest(patient, practitioner))); entries.push(createEntry(createStoppedMedicationRequest(patient, practitioner))); entries.push(createEntry(createAllergyIntolerance(patient, practitioner))); entries.push(createEntry(createMedicalCondition(patient, practitioner))); entries.push(createEntry(createCompletedImmunization(patient))); entries.push(createEntry(createIncompleteImmunization(patient))); // Simulate 10 visits for (let i = 0; i < 10; i++) { // Date is 10 days ago const date = new Date(); date.setDate(date.getDate() - 10 + i); entries.push(createEntry(createBloodPressureObservation(patient, date))); entries.push(createEntry(createTemperatureObservation(patient, date))); entries.push(createEntry(createHeightObservation(patient, date))); entries.push(createEntry(createWeightObservation(patient, date))); entries.push(createEntry(createRespiratoryRateObservation(patient, date))); entries.push(createEntry(createHeartRateObservation(patient, date))); } entries.push(createEntry(createWelcomeMessage(patient, practitioner))); console.log('Creating history...'); const result = await medplum.executeBatch({ resourceType: 'Bundle', type: 'batch', entry: entries, }); console.log(result.entry?.map((entry) => entry.response?.status)); } /** * Creates the questionnaire if one does not already exist. * @param medplum - The medplum client. */ async function ensureQuestionnaire(medplum: MedplumClient): Promise<void> { const questionnaire = await medplum.searchOne('Questionnaire', 'title=Order Lab Tests'); if (questionnaire) { return; } await medplum.createResource({ resourceType: 'Questionnaire', name: 'Lab Test Orders', title: 'Order Lab Tests', status: 'active', item: [ { id: 'id-4', linkId: 'g2', type: 'display', text: 'For guidance on which labs to order visit: https://www.uptodate.com/contents/search?search=lab%20orders', }, { id: 'id-2', linkId: 'panel', type: 'choice', text: 'What type of lab would you like to order?', answerOption: [ { id: 'id-3', valueString: 'Metabolic Panel LOINC: 24323-8', }, { id: 'id-4', valueString: 'Lipid Panel LOINC: 24331-1', }, { id: 'id-5', valueString: 'CBC With Differential LOINC: 57021-8', }, ], }, { id: 'id-6', linkId: 'specimen', type: 'choice', text: 'What specimen type is required?', answerOption: [ { id: 'id-7', valueString: 'Serum/Plasma', }, { id: 'id-8', valueString: 'Whole blood', }, ], }, ], subjectType: ['Patient'], }); } /** * Returns a practitioner resource. * Creates the practitioner if one does not already exist. * @param medplum - The medplum client. * @returns The practitioner resource. */ async function getPractitioner(medplum: MedplumClient): Promise<Practitioner> { const practitioner = await medplum.createResourceIfNoneExist<Practitioner>( { resourceType: 'Practitioner', identifier: [ { system: 'http://hl7.org/fhir/sid/us-npi', value: '123456789', }, ], name: [ { given: ['Alice'], family: 'Smith', }, ], photo: [ { contentType: 'image/png', url: 'https://www.medplum.com/img/cdc-femaledoc.png', }, ], }, 'identifier=123456789' ); // Make sure the practitioner has a schedule await ensureSchedule(medplum, practitioner); return practitioner; } /** * Ensures that the practitioner has a schedule, and that the schedule has slots. * @param medplum - The medplum client. * @param practitioner - The practitioner. */ async function ensureSchedule(medplum: MedplumClient, practitioner: Practitioner): Promise<void> { // Try to get the schedule const schedule = await medplum.createResourceIfNoneExist<Schedule>( { resourceType: 'Schedule', id: 'schedule', actor: [createReference(practitioner)], }, 'actor=Practitioner/' + practitioner.id ); // Ensure there are slots for the next 30 days const slotDate = new Date(); for (let day = 0; day < 30; day++) { slotDate.setHours(0, 0, 0, 0); await ensureSlots(medplum, schedule, slotDate); slotDate.setDate(slotDate.getDate() + 1); } } /** * Ensures that the schedule has slots for the given date. * @param medplum - The medplum client. * @param schedule - The practitioner's schedule. * @param slotDate - The day of slots. */ async function ensureSlots(medplum: MedplumClient, schedule: WithId<Schedule>, slotDate: Date): Promise<void> { const existingSlots = await medplum.search( 'Slot', new URLSearchParams([ ['_summary', 'true'], ['schedule', getReferenceString(schedule)], ['start', 'gt' + slotDate.toISOString()], ['start', 'lt' + new Date(slotDate.getTime() + 24 * 60 * 60 * 1000).toISOString()], ]) ); if ((existingSlots.total as number) > 0) { return; } for (let hour = 0; hour < 24; hour++) { slotDate.setHours(hour, 0, 0, 0); await medplum.createResource({ resourceType: 'Slot', status: 'free', start: slotDate.toISOString(), end: new Date(slotDate.getTime() + 30 * 60 * 1000).toISOString(), schedule: createReference(schedule), }); } } /** * Creates a CarePlan that was completed in the past. * @param medplum - The medplum client * @param patient - The patient. */ async function createCompletedCarePlan(medplum: MedplumClient, patient: Patient): Promise<void> { const tasks: Task[] = [ { resourceType: 'Task', intent: 'order', status: 'completed', code: { text: 'medical-history' }, description: 'Complete Medical History', location: { display: 'AT HOME', }, owner: createReference(patient), focus: createReference(patient), }, { resourceType: 'Task', intent: 'order', status: 'completed', code: { text: 'respiratory-screening' }, description: 'Respiratory Screening', location: { display: 'FOOMEDICAL HOSPITAL AND MEDICAL CENTERS', }, executionPeriod: { start: '2020-01-01T00:00:00.000Z', end: '2021-01-01T00:00:00.000Z', }, owner: createReference(patient), focus: createReference(patient), }, ]; await createCarePlan(medplum, patient, tasks); } /** * Creates an active CarePlan that starts today. * @param medplum - The medplum client * @param patient - The patient. */ async function createActiveCarePlan(medplum: MedplumClient, patient: Patient): Promise<void> { const tasks: Task[] = [ { resourceType: 'Task', intent: 'order', status: 'in-progress', code: { text: 'antenatal-education' }, location: { display: 'AT HOME', }, description: 'Routine Antenatal Care', owner: createReference(patient), focus: createReference(patient), executionPeriod: { start: new Date().toISOString(), }, }, ]; await createCarePlan(medplum, patient, tasks); } /** * Creates a Care Plan based on the tasks for the given patient * @param medplum - The medplum client * @param patient - The patient * @param tasks - The set of tasks to complete for the care plan * @returns The created care plan */ async function createCarePlan(medplum: MedplumClient, patient: Patient, tasks: Task[]): Promise<CarePlan> { tasks = await Promise.all( tasks.map((task) => { task.owner = createReference(patient); return medplum.createResource(task); }) ); const requestGroup = await medplum.createResource<RequestGroup>({ resourceType: 'RequestGroup', status: 'active', intent: 'order', subject: createReference(patient), action: tasks.map( (t: Task): RequestGroupAction => ({ resource: createReference(t), title: t.description, participant: [t.owner as Reference<Patient>], }) ), }); const carePlan: CarePlan = await medplum.createResource<CarePlan>({ resourceType: 'CarePlan', status: 'active', intent: 'order', title: tasks[0].description, subject: createReference(patient), activity: [ { reference: createReference(requestGroup), }, ], }); return carePlan; } function createA1CObservation(patient: Patient): Observation { return { resourceType: 'Observation', status: 'final', subject: createReference(patient), code: { text: 'Hemoglobin A1c', }, valueQuantity: { value: 5.4, unit: 'mmol/L', }, referenceRange: [ { high: { value: 7.0, }, }, ], }; } /** * Creates a DiagnosticReport with an A1C observation. * @param patient - The patient. * @param a1c - The A1C observation. * @returns The DiagnosticReport. */ function createDiagnosticReport(patient: Patient, a1c: Observation): DiagnosticReport { return { resourceType: 'DiagnosticReport', status: 'final', code: { text: 'Hemoglobin A1c', }, subject: createReference(patient), result: [createReference(a1c)], }; } function createActiveMedicationRequest(patient: Patient, practitioner: Practitioner): MedicationRequest { return { resourceType: 'MedicationRequest', status: 'active', intent: 'order', priority: 'routine', subject: createReference(patient), requester: createReference(practitioner), dosageInstruction: [ { text: 'Every six hours (qualifier value)', sequence: 1, timing: { repeat: { frequency: 4, period: 1, periodUnit: 'd', }, }, }, ], authoredOn: new Date().toISOString(), medicationCodeableConcept: { text: 'Amoxicillin 500mg', }, supportingInformation: [ { reference: 'https://www.nlm.nih.gov/medlineplus/druginfo/meds/a682053.html', }, { reference: 'https://www.drugs.com/amoxicillin.html', }, { reference: 'https://www.drugs.com/cons/amoxicillin.html', }, ], }; } function createStoppedMedicationRequest(patient: Patient, practitioner: Practitioner): MedicationRequest { return { resourceType: 'MedicationRequest', status: 'stopped', intent: 'order', priority: 'routine', subject: createReference(patient), requester: createReference(practitioner), dosageInstruction: [ { text: 'Every seventy two hours as needed (qualifier value)', sequence: 1, timing: { repeat: { frequency: 1, period: 3, periodUnit: 'd', }, }, }, ], authoredOn: new Date().toISOString(), medicationCodeableConcept: { text: 'Biaxin XL (clarithromycin) 500mg', }, }; } function createAllergyIntolerance(patient: Patient, practitioner: Practitioner): AllergyIntolerance { return { resourceType: 'AllergyIntolerance', clinicalStatus: { text: 'Active', coding: [ { system: 'http://hl7.org/fhir/ValueSet/allergyintolerance-clinical', code: 'active', display: 'Active', }, ], }, verificationStatus: { text: 'Confirmed', coding: [ { system: 'http://hl7.org/fhir/ValueSet/allergyintolerance-verification', code: 'confirmed', display: 'Confirmed', }, ], }, type: 'allergy', category: ['medication'], criticality: 'high', patient: createReference(patient), code: { text: 'penicillin', }, note: [ { text: 'Allergy decision support resource: https://www.uptodate.com/contents/search?search=penicillin%20allergy', authorReference: createReference(practitioner), }, ], }; } function createMedicalCondition(patient: Patient, practitioner: Practitioner): Condition { return { resourceType: 'Condition', clinicalStatus: { coding: [ { system: 'http://terminology.hl7.org/CodeSystem/condition-clinical', code: 'resolved', }, ], }, verificationStatus: { coding: [ { system: 'http://terminology.hl7.org/CodeSystem/condition-ver-status', code: 'confirmed', }, ], }, category: [ { coding: [ { system: 'http://terminology.hl7.org/CodeSystem/condition-category', code: 'encounter-diagnosis', display: 'Encounter Diagnosis', }, ], }, ], code: { coding: [ { system: SNOMED, code: '192127007', display: 'Child attention deficit disorder', }, ], text: 'Child attention deficit disorder', }, subject: createReference(patient), note: [ { text: 'Medical Condition Clinical Decision Support: https://www.uptodate.com/contents/search?search=adhd', authorReference: createReference(practitioner), }, ], onsetDateTime: '2016-01-29T14:05:06-08:00', abatementDateTime: '2016-05-11T18:05:06-07:00', recordedDate: '2016-01-29T14:05:06-08:00', }; } function createCompletedImmunization(patient: Patient): Immunization { return { resourceType: 'Immunization', status: 'completed', patient: createReference(patient), location: { display: 'FOOMEDICAL HOSPITAL AND MEDICAL CENTERS', }, occurrenceDateTime: new Date().toISOString(), vaccineCode: { text: 'SARS-COV-2 (COVID-19) vaccine, mRNA, spike protein, LNP, preservative free, 100 mcg/0.5mL dose', }, }; } function createIncompleteImmunization(patient: Patient): Immunization { return { resourceType: 'Immunization', status: 'not-done', patient: createReference(patient), location: { display: 'FOOMEDICAL HOSPITAL AND MEDICAL CENTERS', }, vaccineCode: { text: 'Influenza, seasonal, injectable, preservative free', }, }; } function createBloodPressureObservation(patient: Patient, date: Date): Observation { return { resourceType: 'Observation', subject: createReference(patient), issued: date.toISOString(), effectiveDateTime: date.toISOString(), code: { coding: [ { code: '85354-9', display: 'Blood Pressure', system: LOINC, }, ], text: 'Blood Pressure', }, component: [ { code: { coding: [ { code: '8462-4', display: 'Diastolic Blood Pressure', system: LOINC, }, ], text: 'Diastolic Blood Pressure', }, valueQuantity: { code: 'mm[Hg]', system: UCUM, unit: 'mm[Hg]', value: 80 * observationRandomizer(), }, }, { code: { coding: [ { code: '8480-6', display: 'Systolic Blood Pressure', system: LOINC, }, ], text: 'Systolic Blood Pressure', }, valueQuantity: { code: 'mm[Hg]', system: UCUM, unit: 'mm[Hg]', value: 120 * observationRandomizer(), }, }, ], status: 'final', }; } function createTemperatureObservation(patient: Patient, date: Date): Observation { return { resourceType: 'Observation', subject: createReference(patient), issued: date.toISOString(), effectiveDateTime: date.toISOString(), code: { coding: [ { code: '8310-5', display: 'Body temperature', system: LOINC, }, { code: '8331-1', display: 'Oral temperature', system: LOINC, }, ], text: 'Body temperature', }, valueQuantity: { code: 'Cel', system: UCUM, unit: 'Cel', value: 36.6 * observationRandomizer(), }, status: 'final', }; } function createHeightObservation(patient: Patient, date: Date): Observation { return { resourceType: 'Observation', subject: createReference(patient), issued: date.toISOString(), effectiveDateTime: date.toISOString(), code: { coding: [ { code: '8302-2', display: 'Body Height', system: LOINC, }, ], text: 'Body Height', }, valueQuantity: { code: 'cm', system: UCUM, unit: 'cm', value: 175 * observationRandomizer(), }, status: 'final', }; } function createWeightObservation(patient: Patient, date: Date): Observation { return { resourceType: 'Observation', subject: createReference(patient), issued: date.toISOString(), effectiveDateTime: date.toISOString(), code: { coding: [ { code: '29463-7', display: 'Body Weight', system: LOINC, }, ], text: 'Body Weight', }, valueQuantity: { code: 'kg', system: UCUM, unit: 'kg', value: 70 * observationRandomizer(), }, status: 'final', }; } function createRespiratoryRateObservation(patient: Patient, date: Date): Observation { return { resourceType: 'Observation', subject: createReference(patient), issued: date.toISOString(), effectiveDateTime: date.toISOString(), code: { coding: [ { code: '9279-1', display: 'Respiratory rate', system: LOINC, }, ], text: 'Respiratory rate', }, valueQuantity: { code: '/min', system: UCUM, unit: '/min', value: 15 * observationRandomizer(), }, status: 'final', }; } function createHeartRateObservation(patient: Patient, date: Date): Observation { return { resourceType: 'Observation', subject: createReference(patient), issued: date.toISOString(), effectiveDateTime: date.toISOString(), code: { coding: [ { code: '8867-4', display: 'Heart rate', system: LOINC, }, ], text: 'Heart rate', }, valueQuantity: { code: '/min', system: UCUM, unit: '/min', value: 80 * observationRandomizer(), }, status: 'final', }; } function createWelcomeMessage(patient: Patient, practitioner: Practitioner): Communication { return { resourceType: 'Communication', status: 'completed', subject: createReference(patient), recipient: [createReference(patient)], sender: createReference(practitioner), payload: [ { contentString: 'Hello and welcome to our practice', }, ], }; } function createEntry(resource: Resource): BundleEntry { return { resource, request: { url: resource.resourceType, method: 'POST', }, }; } function observationRandomizer(): number { // Return +/- 1% return 0.99 + Math.random() * 0.02; }