Medplum

// SPDX-FileCopyrightText: Copyright Orangebot, Inc. and Medplum contributors // SPDX-License-Identifier: Apache-2.0 import { createReference } from '@medplum/core'; import type { CompositionSection, Goal, Patient } from '@medplum/fhirtypes'; import { OID_GOAL_OBSERVATION, OID_PLAN_OF_CARE_ACTIVITY_OBSERVATION, OID_PROCEDURE_ACTIVITY_ACT } from '../../oids'; import { LOINC_GOALS_SECTION, LOINC_HISTORY_OF_SOCIAL_FUNCTION, LOINC_OVERALL_GOAL, LOINC_PLAN_OF_TREATMENT_SECTION, } from '../../systems'; import { createGoalEntry } from './goal'; describe('createGoalEntry', () => { let patient: Patient; beforeEach(() => { patient = { id: 'patient-1', resourceType: 'Patient', name: [{ given: ['John'], family: 'Doe' }], }; }); test('should create goal entry with category in goals section', () => { const section: CompositionSection = { title: 'Goals', code: { coding: [{ code: LOINC_GOALS_SECTION }], }, }; const goal: Goal = { id: 'goal-1', resourceType: 'Goal', lifecycleStatus: 'active', subject: createReference(patient), category: [ { coding: [ { system: 'http://snomed.info/sct', code: '273249006', display: 'Assessment scales', }, ], }, ], description: { text: 'Patient will walk 30 minutes daily', }, startDate: '2024-01-01', identifier: [{ system: 'http://example.org', value: 'goal-123' }], }; const result = createGoalEntry(section, goal); expect(result).toBeDefined(); expect(result?.observation).toBeDefined(); expect(result?.observation?.length).toBe(1); const observation = result?.observation?.[0]; expect(observation?.['@_classCode']).toBe('OBS'); expect(observation?.['@_moodCode']).toBe('GOL'); expect(observation?.templateId).toEqual([{ '@_root': OID_GOAL_OBSERVATION }]); expect(observation?.code?.['@_code']).toBe('273249006'); expect(observation?.code?.['@_displayName']).toBe('Assessment scales'); expect(observation?.statusCode?.['@_code']).toBe('active'); expect(observation?.effectiveTime?.[0]?.['@_value']).toBe('20240101'); // Value structure is dynamic based on goal description expect(observation?.value).toBeDefined(); expect(observation?.id).toBeDefined(); }); test('should create goal entry without category in goals section', () => { const section: CompositionSection = { title: 'Goals', code: { coding: [{ code: LOINC_GOALS_SECTION }], }, }; const goal: Goal = { id: 'goal-1', resourceType: 'Goal', lifecycleStatus: 'active', subject: createReference(patient), description: { text: 'Patient will walk 30 minutes daily', }, startDate: '2024-01-01', }; const result = createGoalEntry(section, goal); expect(result).toBeDefined(); const observation = result?.observation?.[0]; expect(observation?.code?.['@_code']).toBe(LOINC_OVERALL_GOAL); expect(observation?.code?.['@_displayName']).toBe("Resident's overall goal established during assessment process"); }); test('should create goal entry for plan of treatment section', () => { const section: CompositionSection = { title: 'Plan of Treatment', code: { coding: [{ code: LOINC_PLAN_OF_TREATMENT_SECTION }], }, }; const goal: Goal = { id: 'goal-1', resourceType: 'Goal', lifecycleStatus: 'completed', subject: createReference(patient), category: [ { coding: [ { system: 'http://snomed.info/sct', code: '273249006', display: 'Assessment scales', }, ], }, ], description: { coding: [ { system: 'http://snomed.info/sct', code: '182856006', display: 'Drug therapy discontinued', }, ], }, startDate: '2024-01-01T10:00:00Z', }; const result = createGoalEntry(section, goal); expect(result).toBeDefined(); const observation = result?.observation?.[0]; expect(observation?.templateId).toEqual([{ '@_root': OID_PLAN_OF_CARE_ACTIVITY_OBSERVATION }]); expect(observation?.statusCode?.['@_code']).toBe('completed'); expect(observation?.effectiveTime?.[0]?.['@_value']).toBe('20240101100000+0000'); expect(observation?.value).toBeDefined(); }); test('should create goal entry for social function', () => { const section: CompositionSection = { title: 'Social History', code: { coding: [{ code: 'social-history' }], }, }; const goal: Goal = { id: 'goal-1', resourceType: 'Goal', lifecycleStatus: 'cancelled', subject: createReference(patient), category: [ { coding: [ { system: 'http://loinc.org', code: LOINC_HISTORY_OF_SOCIAL_FUNCTION, display: 'History of social function Narrative', }, ], }, ], description: { text: 'Social function goal', }, }; const result = createGoalEntry(section, goal); expect(result).toBeDefined(); const observation = result?.observation?.[0]; expect(observation?.templateId).toEqual([ { '@_root': OID_GOAL_OBSERVATION }, { '@_root': OID_GOAL_OBSERVATION, '@_extension': '2022-06-01' }, ]); expect(observation?.statusCode?.['@_code']).toBe('cancelled'); }); test('should create goal entry with targets', () => { const section: CompositionSection = { title: 'Goals', code: { coding: [{ code: LOINC_GOALS_SECTION }], }, }; const goal: Goal = { id: 'goal-1', resourceType: 'Goal', lifecycleStatus: 'active', subject: createReference(patient), description: { text: 'Weight management goal', }, target: [ { measure: { coding: [ { system: 'http://loinc.org', code: '29463-7', display: 'Body weight', }, ], }, detailQuantity: { value: 150, unit: 'lbs', }, }, { measure: { coding: [ { system: 'http://loinc.org', code: '39156-5', display: 'Body mass index (BMI)', }, ], }, detailQuantity: { value: 25, unit: 'kg/m2', }, }, ], startDate: '2024-01-01', }; const result = createGoalEntry(section, goal); expect(result).toBeDefined(); const observation = result?.observation?.[0]; expect(observation?.entryRelationship).toBeDefined(); expect(observation?.entryRelationship?.length).toBe(2); const firstTarget = observation?.entryRelationship?.[0]; expect(firstTarget?.['@_typeCode']).toBe('RSON'); expect(firstTarget?.['@_inversionInd']).toBe('true'); expect(firstTarget?.act?.[0]?.['@_classCode']).toBe('ACT'); expect(firstTarget?.act?.[0]?.['@_moodCode']).toBe('EVN'); expect(firstTarget?.act?.[0]?.templateId).toEqual([ { '@_root': OID_PROCEDURE_ACTIVITY_ACT }, { '@_root': OID_PROCEDURE_ACTIVITY_ACT, '@_extension': '2014-06-09' }, ]); expect(firstTarget?.act?.[0]?.code?.['@_code']).toBe('29463-7'); expect(firstTarget?.act?.[0]?.code?.['@_displayName']).toBe('Body weight'); expect(firstTarget?.act?.[0]?.statusCode?.['@_code']).toBe('completed'); }); test('should return undefined when goal has no category, description coding, or is in wrong section', () => { const section: CompositionSection = { title: 'Some Other Section', code: { coding: [{ code: 'other-section' }], }, }; const goal: Goal = { id: 'goal-1', resourceType: 'Goal', lifecycleStatus: 'active', subject: createReference(patient), description: { text: 'Some goal text', }, }; const result = createGoalEntry(section, goal); expect(result).toBeUndefined(); }); test('should create goal entry with description text in plan of treatment section', () => { const section: CompositionSection = { title: 'Plan of Treatment', code: { coding: [{ code: LOINC_PLAN_OF_TREATMENT_SECTION }], }, }; const goal: Goal = { id: 'goal-1', resourceType: 'Goal', lifecycleStatus: 'active', subject: createReference(patient), description: { text: 'Some goal text without coding', }, }; const result = createGoalEntry(section, goal); expect(result).toBeDefined(); const observation = result?.observation?.[0]; expect(observation?.templateId).toEqual([{ '@_root': OID_PLAN_OF_CARE_ACTIVITY_OBSERVATION }]); expect(observation?.code).toBeUndefined(); // No category or description coding // Value structure is dynamic based on goal description expect(observation?.value).toBeDefined(); }); test('should handle goal without startDate', () => { const section: CompositionSection = { title: 'Goals', code: { coding: [{ code: LOINC_GOALS_SECTION }], }, }; const goal: Goal = { id: 'goal-1', resourceType: 'Goal', lifecycleStatus: 'active', subject: createReference(patient), description: { text: 'Patient will walk 30 minutes daily', }, }; const result = createGoalEntry(section, goal); expect(result).toBeDefined(); const observation = result?.observation?.[0]; expect(observation?.effectiveTime?.[0]?.['@_value']).toBeUndefined(); }); test('should handle goal with extension for text reference', () => { const section: CompositionSection = { title: 'Goals', code: { coding: [{ code: LOINC_GOALS_SECTION }], }, }; const goal: Goal = { id: 'goal-1', resourceType: 'Goal', lifecycleStatus: 'active', subject: createReference(patient), description: { text: 'Goal with narrative reference', }, extension: [ { url: 'https://medplum.com/fhir/StructureDefinition/ccda-narrative-reference', valueString: '#goal-narrative', }, ], }; const result = createGoalEntry(section, goal); expect(result).toBeDefined(); const observation = result?.observation?.[0]; expect(observation?.text?.reference?.['@_value']).toBe('#goal-narrative'); }); test('should handle goal without id or identifiers', () => { const section: CompositionSection = { title: 'Goals', code: { coding: [{ code: LOINC_GOALS_SECTION }], }, }; const goal: Goal = { resourceType: 'Goal', lifecycleStatus: 'active', subject: createReference(patient), description: { text: 'Goal without ID', }, }; const result = createGoalEntry(section, goal); expect(result).toBeDefined(); const observation = result?.observation?.[0]; expect(observation?.id).toBeDefined(); }); });