Medplum

// SPDX-FileCopyrightText: Copyright Orangebot, Inc. and Medplum contributors // SPDX-License-Identifier: Apache-2.0 import type { Location, Observation, Procedure, Reference } from '@medplum/fhirtypes'; import { OID_ENCOUNTER_LOCATION, OID_PROCEDURE_ACTIVITY_ACT, OID_PROCEDURE_ACTIVITY_PROCEDURE } from '../../oids'; import { mapCodeableConceptToCcdaCode } from '../../systems'; import type { CcdaCode, CcdaEntry, CcdaId, CcdaParticipant } from '../../types'; import type { FhirToCcdaConverter } from '../convert'; import { createTextFromExtensions, mapEffectiveTime, mapFhirAddressArrayToCcdaAddressArray, mapIdentifiers, mapTelecom, } from '../utils'; import { mapObservationTemplateId, mapObservationValue } from './observation'; export function createHistoryOfProceduresEntry( converter: FhirToCcdaConverter, resource: Procedure | Observation ): CcdaEntry | undefined { if (resource.resourceType === 'Procedure') { // A <procedure> in C-CDA typically represents a direct intervention, like a surgery, that changes a patient's physical state. // In contrast, an <act> is a broader category encompassing actions that don't necessarily alter the physical state, such as counseling, education, or referrals. // The key distinction lies in whether the action primarily focuses on a physical change in the patient or a broader interaction or process. const actCodes = [ // Counseling and Education: '183948003', // Patient education (procedure) '409063005', // Counseling (procedure) '311331002', // Patient counseling (procedure) '61310001', // Nutrition education (procedure) // Care Management: '183945009', // Referral to specialist (procedure) '309814009', // Discharge planning (procedure) '278373008', // Home visit (procedure) // Social Services: '410606002', // Social service procedure (procedure) '183933003', // Social work assessment (procedure) // Other: '24642003', // Psychiatry procedure or service (procedure) '225338006', // Physiotherapy procedure (procedure) '128939004', // First aid (procedure) ]; const procedureCode = resource.code?.coding?.[0]?.code; if (procedureCode && actCodes.includes(procedureCode)) { // Create an <act> entry return { act: [ { '@_classCode': 'ACT', '@_moodCode': 'EVN', templateId: [ { '@_root': OID_PROCEDURE_ACTIVITY_ACT }, { '@_root': OID_PROCEDURE_ACTIVITY_ACT, '@_extension': '2014-06-09' }, ], id: mapIdentifiers(resource.id, resource.identifier) as CcdaId[], code: mapCodeableConceptToCcdaCode(resource.code) as CcdaCode, statusCode: { '@_code': 'completed' }, effectiveTime: mapEffectiveTime(resource.performedDateTime, resource.performedPeriod), text: createTextFromExtensions(resource.extension), }, ], }; } return { procedure: [ { '@_classCode': 'PROC', '@_moodCode': 'EVN', templateId: [ { '@_root': OID_PROCEDURE_ACTIVITY_PROCEDURE }, { '@_root': OID_PROCEDURE_ACTIVITY_PROCEDURE, '@_extension': '2014-06-09' }, ], id: mapIdentifiers(resource.id, resource.identifier) as CcdaId[], code: mapCodeableConceptToCcdaCode(resource.code) as CcdaCode, statusCode: { '@_code': 'completed' }, effectiveTime: mapEffectiveTime(resource.performedDateTime, resource.performedPeriod), text: createTextFromExtensions(resource.extension), targetSiteCode: mapCodeableConceptToCcdaCode(resource.bodySite?.[0]) as CcdaCode, participant: [mapLocationToParticipant(converter, resource.location)].filter(Boolean) as CcdaParticipant[], }, ], }; } if (resource.resourceType === 'Observation') { // Create an <observation> entry return { observation: [ { '@_classCode': 'OBS', '@_moodCode': 'EVN', templateId: mapObservationTemplateId(resource), id: mapIdentifiers(resource.id, resource.identifier) as CcdaId[], code: mapCodeableConceptToCcdaCode(resource.code) as CcdaCode, value: mapObservationValue(resource), statusCode: { '@_code': 'completed' }, effectiveTime: mapEffectiveTime(resource.effectiveDateTime, resource.effectivePeriod), text: createTextFromExtensions(resource.extension), }, ], }; } throw new Error(`Unknown history of procedures resource type: ${(resource as any).resourceType}`); } function mapLocationToParticipant( converter: FhirToCcdaConverter, ref: Reference<Location> | undefined ): CcdaParticipant | undefined { if (!ref) { return undefined; } const location = converter.findResourceByReference(ref); if (!location) { return undefined; } return { '@_typeCode': 'LOC', participantRole: { '@_classCode': 'SDLOC', templateId: [{ '@_root': OID_ENCOUNTER_LOCATION }], id: mapIdentifiers(location.id, location.identifier), code: mapCodeableConceptToCcdaCode(location.type?.[0]), addr: location.address ? mapFhirAddressArrayToCcdaAddressArray([location.address]) : undefined, telecom: mapTelecom(location.telecom), playingEntity: { '@_classCode': 'PLC', name: location.name ? [location.name] : undefined, }, }, }; }