Medplum

// SPDX-FileCopyrightText: Copyright Orangebot, Inc. and Medplum contributors // SPDX-License-Identifier: Apache-2.0 import { createReference } from '@medplum/core'; import type { Bundle, Composition, Immunization, Organization, Patient, Practitioner, PractitionerRole, } from '@medplum/fhirtypes'; import { OID_IMMUNIZATION_ACTIVITY } from '../../oids'; import type { CcdaText } from '../../types'; import { FhirToCcdaConverter } from '../convert'; import { createImmunizationEntry, mapImmunizationPerformerToCcdaPerformer } from './immunization'; describe('immunization entry functions', () => { let converter: FhirToCcdaConverter; let bundle: Bundle; let patient: Patient; beforeEach(() => { patient = { id: 'patient-1', resourceType: 'Patient', name: [{ given: ['John'], family: 'Doe' }], }; bundle = { resourceType: 'Bundle', type: 'document', entry: [ { resource: patient }, { resource: { id: 'composition-1', resourceType: 'Composition', status: 'final', type: { text: 'test' }, date: new Date().toISOString(), author: [{ display: 'test' }], title: 'test', subject: createReference(patient), section: [], } as Composition, }, ], }; converter = new FhirToCcdaConverter(bundle); }); describe('createImmunizationEntry', () => { test('should create basic immunization entry', () => { const immunization: Immunization = { id: 'immunization-1', resourceType: 'Immunization', status: 'completed', patient: createReference(patient), vaccineCode: { coding: [ { system: 'http://hl7.org/fhir/sid/cvx', code: '03', display: 'MMR', }, ], }, occurrenceDateTime: '2024-01-01T10:00:00Z', identifier: [{ value: 'imm-123' }], }; const result = createImmunizationEntry(converter, immunization); expect(result).toBeDefined(); expect(result.substanceAdministration).toBeDefined(); expect(result.substanceAdministration?.length).toBe(1); const substanceAdmin = result.substanceAdministration?.[0]; expect(substanceAdmin?.['@_classCode']).toBe('SBADM'); expect(substanceAdmin?.['@_moodCode']).toBe('EVN'); expect(substanceAdmin?.['@_negationInd']).toBe('false'); expect(substanceAdmin?.templateId).toEqual([ { '@_root': OID_IMMUNIZATION_ACTIVITY }, { '@_root': OID_IMMUNIZATION_ACTIVITY, '@_extension': '2015-08-01' }, ]); expect(substanceAdmin?.id).toBeDefined(); expect(substanceAdmin?.statusCode?.['@_code']).toBe('completed'); expect(substanceAdmin?.effectiveTime?.[0]?.['@_value']).toBe('20240101'); expect(substanceAdmin?.consumable).toBeDefined(); }); test('should handle immunization with manufacturer', () => { const manufacturer = { display: 'Pfizer Inc.' }; const immunization: Immunization = { id: 'immunization-1', resourceType: 'Immunization', status: 'completed', patient: createReference(patient), vaccineCode: { coding: [ { system: 'http://hl7.org/fhir/sid/cvx', code: '03', display: 'MMR', }, ], }, occurrenceDateTime: '2024-01-01T10:00:00Z', manufacturer, lotNumber: 'LOT123', }; const result = createImmunizationEntry(converter, immunization); expect(result).toBeDefined(); const substanceAdmin = result.substanceAdministration?.[0]; expect(substanceAdmin?.consumable?.manufacturedProduct?.[0]?.manufacturerOrganization).toBeDefined(); expect(substanceAdmin?.consumable?.manufacturedProduct?.[0]?.manufacturerOrganization?.[0]?.name?.[0]).toBe( 'Pfizer Inc.' ); expect(substanceAdmin?.consumable?.manufacturedProduct?.[0]?.manufacturedMaterial?.[0]?.lotNumberText?.[0]).toBe( 'LOT123' ); }); test('should handle immunization with manufacturer with id and identifier', () => { const manufacturer = { id: 'manufacturer-1', identifier: { value: 'mfg-123' }, display: 'Pfizer Inc.', }; const immunization: Immunization = { id: 'immunization-1', resourceType: 'Immunization', status: 'completed', patient: createReference(patient), vaccineCode: { coding: [ { system: 'http://hl7.org/fhir/sid/cvx', code: '03', display: 'MMR', }, ], }, occurrenceDateTime: '2024-01-01T10:00:00Z', manufacturer, }; const result = createImmunizationEntry(converter, immunization); expect(result).toBeDefined(); const substanceAdmin = result.substanceAdministration?.[0]; expect(substanceAdmin?.consumable?.manufacturedProduct?.[0]?.manufacturerOrganization).toBeDefined(); expect(substanceAdmin?.consumable?.manufacturedProduct?.[0]?.manufacturerOrganization?.[0]?.id).toBeDefined(); }); test('should handle immunization without manufacturer', () => { const immunization: Immunization = { id: 'immunization-1', resourceType: 'Immunization', status: 'completed', patient: createReference(patient), vaccineCode: { coding: [ { system: 'http://hl7.org/fhir/sid/cvx', code: '03', display: 'MMR', }, ], }, occurrenceDateTime: '2024-01-01T10:00:00Z', }; const result = createImmunizationEntry(converter, immunization); expect(result).toBeDefined(); const substanceAdmin = result.substanceAdministration?.[0]; expect(substanceAdmin?.consumable?.manufacturedProduct?.[0]?.manufacturerOrganization).toBeUndefined(); }); test('should handle immunization without lot number', () => { const immunization: Immunization = { id: 'immunization-1', resourceType: 'Immunization', status: 'completed', patient: createReference(patient), vaccineCode: { coding: [ { system: 'http://hl7.org/fhir/sid/cvx', code: '03', display: 'MMR', }, ], }, occurrenceDateTime: '2024-01-01T10:00:00Z', }; const result = createImmunizationEntry(converter, immunization); expect(result).toBeDefined(); const substanceAdmin = result.substanceAdministration?.[0]; expect( substanceAdmin?.consumable?.manufacturedProduct?.[0]?.manufacturedMaterial?.[0]?.lotNumberText ).toBeUndefined(); }); test('should handle immunization with extension for text reference', () => { const immunization: Immunization = { id: 'immunization-1', resourceType: 'Immunization', status: 'completed', patient: createReference(patient), vaccineCode: { coding: [ { system: 'http://hl7.org/fhir/sid/cvx', code: '03', display: 'MMR', }, ], }, occurrenceDateTime: '2024-01-01T10:00:00Z', extension: [ { url: 'https://medplum.com/fhir/StructureDefinition/ccda-narrative-reference', valueString: '#immunization-narrative', }, ], }; const result = createImmunizationEntry(converter, immunization); expect(result).toBeDefined(); const substanceAdmin = result.substanceAdministration?.[0]; expect((substanceAdmin?.text as CcdaText).reference?.['@_value']).toBe('#immunization-narrative'); }); test('should handle immunization with performer', () => { const practitioner: Practitioner = { id: 'practitioner-1', resourceType: 'Practitioner', name: [{ given: ['Jane'], family: 'Smith' }], identifier: [{ value: 'pract-123' }], address: [ { line: ['123 Main St'], city: 'Anytown', state: 'CA', postalCode: '12345', }, ], telecom: [{ system: 'phone', value: '555-0123' }], }; bundle.entry?.push({ resource: practitioner }); const immunization: Immunization = { id: 'immunization-1', resourceType: 'Immunization', status: 'completed', patient: createReference(patient), vaccineCode: { coding: [ { system: 'http://hl7.org/fhir/sid/cvx', code: '03', display: 'MMR', }, ], }, occurrenceDateTime: '2024-01-01T10:00:00Z', performer: [ { actor: createReference(practitioner), }, ], }; const result = createImmunizationEntry(converter, immunization); expect(result).toBeDefined(); const substanceAdmin = result.substanceAdministration?.[0]; expect(substanceAdmin?.performer).toBeDefined(); expect(substanceAdmin?.performer?.length).toBe(1); expect(substanceAdmin?.performer?.[0]?.assignedEntity?.assignedPerson).toBeDefined(); }); test('should handle immunization with organization performer', () => { const organization: Organization = { id: 'org-1', resourceType: 'Organization', name: 'Test Clinic', identifier: [{ value: 'org-123' }], address: [ { line: ['456 Clinic St'], city: 'Medical City', state: 'NY', postalCode: '67890', }, ], telecom: [{ system: 'phone', value: '555-0456' }], }; bundle.entry?.push({ resource: organization }); const immunization: Immunization = { id: 'immunization-1', resourceType: 'Immunization', status: 'completed', patient: createReference(patient), vaccineCode: { coding: [ { system: 'http://hl7.org/fhir/sid/cvx', code: '03', display: 'MMR', }, ], }, occurrenceDateTime: '2024-01-01T10:00:00Z', performer: [ { actor: createReference(organization), }, ], }; const result = createImmunizationEntry(converter, immunization); expect(result).toBeDefined(); const substanceAdmin = result.substanceAdministration?.[0]; expect(substanceAdmin?.performer).toBeDefined(); expect(substanceAdmin?.performer?.length).toBe(1); expect(substanceAdmin?.performer?.[0]?.assignedEntity?.representedOrganization).toBeDefined(); expect(substanceAdmin?.performer?.[0]?.assignedEntity?.assignedPerson).toBeUndefined(); }); test('should handle immunization with practitioner role performer', () => { const practitioner: Practitioner = { id: 'practitioner-1', resourceType: 'Practitioner', name: [{ given: ['Jane'], family: 'Smith' }], identifier: [{ value: 'pract-123' }], address: [ { line: ['123 Main St'], city: 'Anytown', state: 'CA', postalCode: '12345', }, ], }; const organization: Organization = { id: 'org-1', resourceType: 'Organization', name: 'Test Clinic', identifier: [{ value: 'org-123' }], address: [ { line: ['456 Clinic St'], city: 'Medical City', state: 'NY', postalCode: '67890', }, ], telecom: [{ system: 'phone', value: '555-0456' }], }; const practitionerRole: PractitionerRole = { id: 'role-1', resourceType: 'PractitionerRole', practitioner: createReference(practitioner), organization: createReference(organization), identifier: [{ value: 'role-123' }], telecom: [{ system: 'phone', value: '555-0789' }], }; bundle.entry?.push({ resource: practitioner }, { resource: organization }, { resource: practitionerRole }); const immunization: Immunization = { id: 'immunization-1', resourceType: 'Immunization', status: 'completed', patient: createReference(patient), vaccineCode: { coding: [ { system: 'http://hl7.org/fhir/sid/cvx', code: '03', display: 'MMR', }, ], }, occurrenceDateTime: '2024-01-01T10:00:00Z', performer: [ { actor: createReference(practitionerRole), }, ], }; const result = createImmunizationEntry(converter, immunization); expect(result).toBeDefined(); const substanceAdmin = result.substanceAdministration?.[0]; expect(substanceAdmin?.performer).toBeDefined(); expect(substanceAdmin?.performer?.length).toBe(1); expect(substanceAdmin?.performer?.[0]?.assignedEntity?.assignedPerson).toBeDefined(); expect(substanceAdmin?.performer?.[0]?.assignedEntity?.representedOrganization).toBeDefined(); }); test('should filter out invalid performers', () => { const immunization: Immunization = { id: 'immunization-1', resourceType: 'Immunization', status: 'completed', patient: createReference(patient), vaccineCode: { coding: [ { system: 'http://hl7.org/fhir/sid/cvx', code: '03', display: 'MMR', }, ], }, occurrenceDateTime: '2024-01-01T10:00:00Z', performer: [ { actor: { reference: 'Practitioner/nonexistent' }, }, undefined as any, // Invalid performer ], }; const result = createImmunizationEntry(converter, immunization); expect(result).toBeDefined(); const substanceAdmin = result.substanceAdministration?.[0]; expect(substanceAdmin?.performer).toBeDefined(); expect(substanceAdmin?.performer?.length).toBe(0); }); test('should handle various immunization statuses', () => { const immunization: Immunization = { id: 'immunization-1', resourceType: 'Immunization', status: 'not-done', patient: createReference(patient), vaccineCode: { coding: [ { system: 'http://hl7.org/fhir/sid/cvx', code: '03', display: 'MMR', }, ], }, occurrenceDateTime: '2024-01-01T10:00:00Z', }; const result = createImmunizationEntry(converter, immunization); expect(result).toBeDefined(); const substanceAdmin = result.substanceAdministration?.[0]; // Status mapper should handle non-standard statuses expect(substanceAdmin?.statusCode?.['@_code']).toBeDefined(); }); }); describe('mapImmunizationPerformerToCcdaPerformer', () => { test('should return undefined for undefined performer', () => { const result = mapImmunizationPerformerToCcdaPerformer(converter, undefined); expect(result).toBeUndefined(); }); test('should return undefined for performer with invalid reference', () => { const performer = { actor: { reference: 'Practitioner/nonexistent' }, }; const result = mapImmunizationPerformerToCcdaPerformer(converter, performer); expect(result).toBeUndefined(); }); test('should map practitioner performer', () => { const practitioner: Practitioner = { id: 'practitioner-1', resourceType: 'Practitioner', name: [{ given: ['Jane'], family: 'Smith' }], identifier: [{ value: 'pract-123' }], address: [ { line: ['123 Main St'], city: 'Anytown', state: 'CA', postalCode: '12345', }, ], telecom: [{ system: 'phone', value: '555-0123' }], }; bundle.entry?.push({ resource: practitioner }); const performer = { actor: createReference(practitioner), }; const result = mapImmunizationPerformerToCcdaPerformer(converter, performer); expect(result).toBeDefined(); expect(result?.assignedEntity?.assignedPerson).toBeDefined(); expect(result?.assignedEntity?.representedOrganization).toBeUndefined(); expect(result?.assignedEntity?.addr).toBeDefined(); expect(result?.assignedEntity?.telecom).toBeDefined(); }); test('should map organization performer', () => { const organization: Organization = { id: 'org-1', resourceType: 'Organization', name: 'Test Clinic', identifier: [{ value: 'org-123' }], address: [ { line: ['456 Clinic St'], city: 'Medical City', state: 'NY', postalCode: '67890', }, ], telecom: [{ system: 'phone', value: '555-0456' }], }; bundle.entry?.push({ resource: organization }); const performer = { actor: createReference(organization), }; const result = mapImmunizationPerformerToCcdaPerformer(converter, performer); expect(result).toBeDefined(); expect(result?.assignedEntity?.assignedPerson).toBeUndefined(); expect(result?.assignedEntity?.representedOrganization).toBeDefined(); expect(result?.assignedEntity?.representedOrganization?.name?.[0]).toBe('Test Clinic'); }); test('should map practitioner role performer', () => { const practitioner: Practitioner = { id: 'practitioner-1', resourceType: 'Practitioner', name: [{ given: ['Jane'], family: 'Smith' }], identifier: [{ value: 'pract-123' }], address: [ { line: ['123 Main St'], city: 'Anytown', state: 'CA', postalCode: '12345', }, ], }; const organization: Organization = { id: 'org-1', resourceType: 'Organization', name: 'Test Clinic', identifier: [{ value: 'org-123' }], address: [ { line: ['456 Clinic St'], city: 'Medical City', state: 'NY', postalCode: '67890', }, ], telecom: [{ system: 'phone', value: '555-0456' }], }; const practitionerRole: PractitionerRole = { id: 'role-1', resourceType: 'PractitionerRole', practitioner: createReference(practitioner), organization: createReference(organization), identifier: [{ value: 'role-123' }], telecom: [{ system: 'phone', value: '555-0789' }], }; bundle.entry?.push({ resource: practitioner }, { resource: organization }, { resource: practitionerRole }); const performer = { actor: createReference(practitionerRole), }; const result = mapImmunizationPerformerToCcdaPerformer(converter, performer); expect(result).toBeDefined(); expect(result?.assignedEntity?.assignedPerson).toBeDefined(); expect(result?.assignedEntity?.representedOrganization).toBeDefined(); expect(result?.assignedEntity?.addr).toBeDefined(); expect(result?.assignedEntity?.telecom).toBeDefined(); }); test('should handle organization without name', () => { const organization: Organization = { id: 'org-1', resourceType: 'Organization', identifier: [{ value: 'org-123' }], }; bundle.entry?.push({ resource: organization }); const performer = { actor: createReference(organization), }; const result = mapImmunizationPerformerToCcdaPerformer(converter, performer); expect(result).toBeDefined(); expect(result?.assignedEntity?.representedOrganization?.name).toBeUndefined(); }); test('should handle unknown resource type performer', () => { // Create a Patient as an example of unsupported resource type const unknownResource = { id: 'unknown-1', resourceType: 'Patient', // Unsupported type for performer name: [{ given: ['Test'], family: 'Patient' }], }; bundle.entry?.push({ resource: unknownResource as any }); const performer = { actor: { reference: 'Patient/unknown-1' }, }; const result = mapImmunizationPerformerToCcdaPerformer(converter, performer); expect(result).toBeDefined(); expect(result?.assignedEntity?.assignedPerson).toBeUndefined(); expect(result?.assignedEntity?.representedOrganization).toBeUndefined(); }); }); });