Medplum

// SPDX-FileCopyrightText: Copyright Orangebot, Inc. and Medplum contributors // SPDX-License-Identifier: Apache-2.0 import { CPT, HTTP_HL7_ORG, HTTP_TERMINOLOGY_HL7_ORG, LOINC, NDC, RXNORM, SNOMED } from '@medplum/core'; import type { CodeableConcept, Coding, Immunization, MedicationRequest } from '@medplum/fhirtypes'; import { OID_ADMINISTRATIVE_GENDER_CODE_SYSTEM, OID_ASSESSMENT_SCALE_OBSERVATION, OID_ASSESSMENT_SCALE_SUPPORTING_OBSERVATION, OID_AVERAGE_BLOOD_PRESSURE_ORGANIZER, OID_BASIC_INDUSTRY_OBSERVATION, OID_BASIC_OCCUPATION_OBSERVATION, OID_BIRTH_SEX, OID_COGNITIVE_STATUS_RESULT_OBSERVATION, OID_COGNITIVE_STATUS_RESULT_ORGANIZER, OID_CONFIDENTIALITY_VALUE_SET, OID_CPT_CODE_SYSTEM, OID_CURRENT_SMOKING_STATUS_OBSERVATION, OID_CVX_CODE_SYSTEM, OID_DIET_STATEMENT_NUTRITION, OID_FUNCTIONAL_STATUS_RESULT_OBSERVATION, OID_FUNCTIONAL_STATUS_RESULT_ORGANIZER, OID_ICF_CODE_SYSTEM, OID_LABORATORY_BATTERY_ID, OID_LABORATORY_OBSERVATION_ID, OID_LABORATORY_RESULT_ORGANIZER_ID, OID_LOINC_CODE_SYSTEM, OID_MDC_CODE_SYSTEM, OID_MEDICATION_ADHERENCE, OID_MONITORING_EVALUATION_AND_OUTCOME_NUTRITION, OID_NCI_THESAURUS_CODE_SYSTEM, OID_NDC_CODE_SYSTEM, OID_NDF_RT_CODE_SYSTEM, OID_NUCC_TAXONOMY_CODE_SYSTEM, OID_NUTRITION_RECOMMENDATION_V2, OID_PAN_CANADIAN_LOINC_OBSERVATION_CODE_SYSTEM, OID_PREGNANCY_OBSERVATION, OID_PRESSURE_ULCER_OBSERVATION, OID_PROBLEM_OBSERVATION, OID_PROBLEM_OBSSERVATION_V2, OID_PROCEDURE_ACTIVITY_OBSERVATION, OID_PROCEDURES_SECTION_ENTRIES_REQUIRED, OID_RESULT_OBSERVATION, OID_RESULT_OBSERVATION_V2, OID_RESULT_ORGANIZER, OID_RESULT_ORGANIZER_V2, OID_ROLE_CODE_CODE_SYSTEM, OID_RXNORM_CODE_SYSTEM, OID_SECTION_TIME_RANGE, OID_SEX_OBSERVATION, OID_SEXUAL_ORIENTATION_OBSERVATION, OID_SMOKING_STATUS_OBSERVATION, OID_SNOMED_CT_CODE_SYSTEM, OID_SOCIAL_HISTORY_OBSERVATION, OID_SOCIAL_HISTORY_OBSERVATION_V2, OID_SOURCE_OF_PAYMENT_TYPOLOGY_CODE_SYSTEM, OID_TOBACCO_USE_OBSERVATION, OID_TRIBAL_AFFILIATION_OBSERVATION, OID_UNII_CODE_SYSTEM, OID_US_DLN_CODE_SYSTEM, OID_US_NPI_CODE_SYSTEM, OID_US_SSN_CODE_SYSTEM, OID_VA_MED_RT_CODE_SYSTEM, OID_VITAL_SIGNS_OBSERVATION, OID_VITAL_SIGNS_OBSERVATION_V2, OID_VITAL_SIGNS_ORGANIZER, OID_VITAL_SIGNS_ORGANIZER_V2, OID_WOUND_MEASURMENTS_OBSERVATION, OID_WOUND_OBSERVATION, } from './oids'; import type { CcdaCode, CcdaValue } from './types'; export interface EnumEntry<TFhirValue extends string = string, TCcdaValue extends string = string> { fhirValue: TFhirValue; ccdaValue: TCcdaValue; displayName: string; } export interface EnumMapperDetails { readonly ccdaSystemOid?: string; readonly fhirSystemUrl?: string; } export class EnumMapper<TFhirValue extends string, TCcdaValue extends string> { readonly details: EnumMapperDetails; readonly entries: EnumEntry<TFhirValue, TCcdaValue>[]; readonly ccdaToFhirMap: Record<TCcdaValue, EnumEntry<TFhirValue, TCcdaValue>>; readonly fhirToCcdaMap: Record<TFhirValue, EnumEntry<TFhirValue, TCcdaValue>>; constructor(details: EnumMapperDetails, entries: EnumEntry<TFhirValue, TCcdaValue>[]) { this.details = details; this.entries = entries; this.ccdaToFhirMap = {} as Record<TCcdaValue, EnumEntry<TFhirValue, TCcdaValue>>; this.fhirToCcdaMap = {} as Record<TFhirValue, EnumEntry<TFhirValue, TCcdaValue>>; for (const entry of entries) { if (!this.ccdaToFhirMap[entry.ccdaValue]) { this.ccdaToFhirMap[entry.ccdaValue] = entry; } if (!this.fhirToCcdaMap[entry.fhirValue]) { this.fhirToCcdaMap[entry.fhirValue] = entry; } } } getEntryByFhir(fhir: TFhirValue): EnumEntry<TFhirValue, TCcdaValue> | undefined { return this.fhirToCcdaMap[fhir]; } getEntryByCcda(ccda: TCcdaValue): EnumEntry<TFhirValue, TCcdaValue> | undefined { return this.ccdaToFhirMap[ccda]; } mapCcdaToFhir(ccda: TCcdaValue): TFhirValue | undefined { return this.ccdaToFhirMap[ccda]?.fhirValue; } mapCcdaToFhirWithDefault(ccda: TCcdaValue | undefined, defaultValue: TFhirValue): TFhirValue { if (!ccda) { return defaultValue; } return this.mapCcdaToFhir(ccda) ?? defaultValue; } mapFhirToCcdaWithDefault(fhir: TFhirValue | undefined, defaultValue: TCcdaValue): TCcdaValue { if (!fhir) { return defaultValue; } return this.mapFhirToCcda(fhir) ?? defaultValue; } mapCcdaToFhirCodeableConcept(ccda: TCcdaValue): CodeableConcept | undefined { const entry = this.ccdaToFhirMap[ccda]; if (!entry) { return undefined; } return { coding: [{ system: this.details.fhirSystemUrl, code: entry.fhirValue, display: entry.displayName }], text: entry.displayName, }; } mapFhirToCcda(fhir: TFhirValue | undefined): TCcdaValue | undefined { if (!fhir) { return undefined; } return this.fhirToCcdaMap[fhir]?.ccdaValue; } mapFhirToCcdaCode(fhir: TFhirValue | undefined): CcdaCode<TCcdaValue> | undefined { if (!fhir) { return undefined; } const entry = this.fhirToCcdaMap[fhir]; if (!entry) { return undefined; } return { '@_code': entry.ccdaValue, '@_displayName': entry.displayName, '@_codeSystem': this.details.ccdaSystemOid, '@_codeSystemName': this.details.ccdaSystemOid ? SYSTEM_MAPPER.getEntryByCcda(this.details.ccdaSystemOid)?.displayName : undefined, }; } } /** * Every non-HTTPS URL will be flagged by our security tools as a potential vulnerability. * We therefore use one constant to minimize the number of false positives. * All of these URLs are used as identifiers, not as web links. */ export const HTTP = 'http:'; /* * FHIR Code Systems */ export const ADMINISTRATIVE_GENDER_CODE_SYSTEM = `${HTTP_HL7_ORG}/fhir/administrative-gender`; export const CLINICAL_CONDITION_CODE_SYSTEM = `${HTTP_TERMINOLOGY_HL7_ORG}/CodeSystem/condition-clinical`; export const CONDITION_VERIFICATION_CODE_SYSTEM = `${HTTP_TERMINOLOGY_HL7_ORG}/CodeSystem/condition-verification`; export const LANGUAGE_MODE_CODE_SYSTEM = `${HTTP_TERMINOLOGY_HL7_ORG}/CodeSystem/v3-LanguageAbilityMode`; export const LANGUAGE_PROFICIENCY_CODE_SYSTEM = `${HTTP_TERMINOLOGY_HL7_ORG}/CodeSystem/v3-LanguageAbilityProficiency`; export const RACE_CODE_SYSTEM = `${HTTP_TERMINOLOGY_HL7_ORG}/CodeSystem/v3-Race`; export const CONDITION_CATEGORY_CODE_SYSTEM = `${HTTP_TERMINOLOGY_HL7_ORG}/CodeSystem/condition-category`; export const CONDITION_VER_STATUS_CODE_SYSTEM = `${HTTP_TERMINOLOGY_HL7_ORG}/CodeSystem/condition-ver-status`; export const ALLERGY_CLINICAL_CODE_SYSTEM = `${HTTP_TERMINOLOGY_HL7_ORG}/CodeSystem/allergyintolerance-clinical`; export const ALLERGY_VERIFICATION_CODE_SYSTEM = `${HTTP_TERMINOLOGY_HL7_ORG}/CodeSystem/allergyintolerance-verification`; export const ACT_CODE_SYSTEM = `${HTTP_TERMINOLOGY_HL7_ORG}/CodeSystem/v3-ActCode`; export const PARTICIPATION_CODE_SYSTEM = `${HTTP_TERMINOLOGY_HL7_ORG}/CodeSystem/v3-ParticipationType`; export const DIAGNOSIS_ROLE_CODE_SYSTEM = `${HTTP_TERMINOLOGY_HL7_ORG}/CodeSystem/diagnosis-role`; export const CONFIDENTIALITY_CODE_SYSTEM = `${HTTP_TERMINOLOGY_HL7_ORG}/CodeSystem/v3-Confidentiality`; export const OBSERVATION_CATEGORY_CODE_SYSTEM = `${HTTP_TERMINOLOGY_HL7_ORG}/CodeSystem/observation-category`; export const ROLE_CODE_CODE_SYSTEM = `${HTTP_TERMINOLOGY_HL7_ORG}/CodeSystem/v3-RoleCode`; /* * FHIR Value Sets */ export const ADDRESS_USE_VALUE_SET = `${HTTP_HL7_ORG}/fhir/ValueSet/address-use`; export const NAME_USE_VALUE_SET = `${HTTP_HL7_ORG}/fhir/ValueSet/name-use`; export const ADMINISTRATIVE_GENDER_VALUE_SET = `${HTTP_HL7_ORG}/fhir/ValueSet/administrative-gender`; export const CONTACT_ENTITY_USE_VALUE_SET = `${HTTP_HL7_ORG}/fhir/ValueSet/contactentity-use`; export const MEDICATION_REQUEST_STATUS_VALUE_SET = `${HTTP_HL7_ORG}/fhir/ValueSet/medicationrequest-status`; /* * FHIR standard extensions */ export const LANGUAGE_MODE_URL = `${HTTP_HL7_ORG}/fhir/StructureDefinition/language-mode`; export const LANGUAGE_PROFICIENCY_URL = `${HTTP_HL7_ORG}/fhir/StructureDefinition/language-proficiency`; /* * US-Core */ export const US_CORE_PATIENT_URL = `${HTTP_HL7_ORG}/fhir/us/core/StructureDefinition/us-core-patient`; export const US_CORE_RACE_URL = `${HTTP_HL7_ORG}/fhir/us/core/StructureDefinition/us-core-race`; export const US_CORE_ETHNICITY_URL = `${HTTP_HL7_ORG}/fhir/us/core/StructureDefinition/us-core-ethnicity`; export const US_CORE_CONDITION_URL = `${HTTP_HL7_ORG}/fhir/us/core/StructureDefinition/us-core-condition`; export const US_CORE_MEDICATION_REQUEST_URL = `${HTTP_HL7_ORG}/fhir/us/core/StructureDefinition/us-core-medicationrequest`; /* * External Terminologies: * https://terminology.hl7.org/external_terminologies.html */ export const CCDA_TEMPLATE_CODE_SYSTEM = `${HTTP_HL7_ORG}/cda/template`; export const NCI_THESAURUS_URL = `${HTTP}//ncithesaurus-stage.nci.nih.gov`; export const US_SSN_URL = `${HTTP_HL7_ORG}/fhir/sid/us-ssn`; export const US_DRIVER_LICENSE_URL = `${HTTP_HL7_ORG}/fhir/sid/us-dln`; export const US_NPI_URL = `${HTTP_HL7_ORG}/fhir/sid/us-npi`; export const UNII_URL = `${HTTP}//fdasis.nlm.nih.gov`; export const NUCC_TAXONOMY_URL = `${HTTP}//nucc.org/provider-taxonomy`; export const VA_MEDRT_URL = `${HTTP}//va.gov/terminology/medrt`; export const NDFRT_URL = `${HTTP}//hl7.org/fhir/ndfrt`; export const CVX_URL = `${HTTP}//nucc.org/cvx`; export const FHIR_CVX_URL = `${HTTP_HL7_ORG}/fhir/sid/cvx`; export const FHIR_ICF_URL = `${HTTP_HL7_ORG}/fhir/sid/icf`; export const XSI_URL = `${HTTP}//www.w3.org/2001/XMLSchema-instance`; export const CCDA_NARRATIVE_REFERENCE_URL = 'https://medplum.com/fhir/StructureDefinition/ccda-narrative-reference'; /* * Commonly used LOINC codes */ export const LOINC_ALLERGIES_SECTION = '48765-2'; export const LOINC_IMMUNIZATIONS_SECTION = '11369-6'; export const LOINC_MEDICATIONS_SECTION = '10160-0'; export const LOINC_PROBLEMS_SECTION = '11450-4'; export const LOINC_RESULTS_SECTION = '30954-2'; export const LOINC_SOCIAL_HISTORY_SECTION = '29762-2'; export const LOINC_VITAL_SIGNS_SECTION = '8716-3'; export const LOINC_PROCEDURES_SECTION = '47519-4'; export const LOINC_PLAN_OF_TREATMENT_SECTION = '18776-5'; export const LOINC_ASSESSMENTS_SECTION = '51848-0'; export const LOINC_DEVICES_SECTION = '46264-8'; export const LOINC_GOALS_SECTION = '61146-7'; export const LOINC_HEALTH_CONCERNS_SECTION = '75310-3'; export const LOINC_ENCOUNTERS_SECTION = '46240-8'; export const LOINC_REASON_FOR_REFERRAL_SECTION = '42349-1'; export const LOINC_REFERRAL_NOTE = '57133-1'; export const LOINC_MENTAL_STATUS_SECTION = '10190-7'; export const LOINC_CARE_TEAM_SECTION = '85847-2'; export const LOINC_INSURANCE_SECTION = '48768-6'; export const LOINC_NOTES_SECTION = '11488-4'; export const LOINC_NOTE_DOCUMENT = '34109-9'; export const LOINC_PATIENT_SUMMARY_DOCUMENT = '60591-5'; export const LOINC_SUMMARY_OF_EPISODE_NOTE = '34133-9'; export const LOINC_MEDICATION_INSTRUCTIONS = '76662-6'; export const LOINC_CONDITION = '75323-6'; export const LOINC_OVERALL_GOAL = '58144-7'; export const LOINC_TOBACCO_SMOKING_STATUS = '72166-2'; export const LOINC_HISTORY_OF_TOBACCO_USE = '11367-0'; export const LOINC_ADMINISTRATIVE_SEX = '46098-0'; export const LOINC_BIRTH_SEX = '76689-9'; export const LOINC_HISTORY_OF_SOCIAL_FUNCTION = '8689-2'; export const LOINC_CLINICAL_FINDING = '75321-0'; export const LOINC_FUNCTIONAL_STATUS_SECTION = '47420-5'; export const LOINC_DISABILITY_STATUS = '89571-4'; export const LOINC_FUNCTIONAL_STATUS_ASSESSMENT_NOTE = '47420-5'; export const LOINC_HISTORY_OF_OCCUPATION = '11341-5'; export const LOINC_HISTORY_OF_OCCUPATION_INDUSTRY = '86188-0'; export const LOINC_PREGNANCY_STATUS = '82810-3'; export const LOINC_TRIBAL_AFFILIATION = '95370-3'; export const SYSTEM_MAPPER = new EnumMapper<string, string>({}, [ { ccdaValue: OID_PAN_CANADIAN_LOINC_OBSERVATION_CODE_SYSTEM, fhirValue: 'https://fhir.infoway-inforoute.ca/CodeSystem/pCLOCD', displayName: 'pan-Canadian LOINC Observation Code Database (pCLOCD)', }, { ccdaValue: OID_NCI_THESAURUS_CODE_SYSTEM, fhirValue: NCI_THESAURUS_URL, displayName: 'NCI Thesaurus', }, { ccdaValue: OID_US_SSN_CODE_SYSTEM, fhirValue: US_SSN_URL, displayName: 'SSN' }, { ccdaValue: OID_US_DLN_CODE_SYSTEM, fhirValue: US_DRIVER_LICENSE_URL, displayName: 'DLN' }, { ccdaValue: OID_US_NPI_CODE_SYSTEM, fhirValue: US_NPI_URL, displayName: 'NPI' }, { ccdaValue: OID_UNII_CODE_SYSTEM, fhirValue: UNII_URL, displayName: 'Unique Ingredient Identifier (UNII)', }, { ccdaValue: OID_LOINC_CODE_SYSTEM, fhirValue: LOINC, displayName: 'LOINC' }, { ccdaValue: OID_CPT_CODE_SYSTEM, fhirValue: CPT, displayName: 'Current Procedural Terminology (CPT)', }, { ccdaValue: OID_MDC_CODE_SYSTEM, fhirValue: 'urn:iso:std:iso:11073:10101', displayName: 'Medical Device Communications (MDC)', }, { ccdaValue: OID_NDC_CODE_SYSTEM, fhirValue: NDC, displayName: 'National Drug Code (NDC)', }, { ccdaValue: OID_RXNORM_CODE_SYSTEM, fhirValue: RXNORM, displayName: 'RxNorm', }, { ccdaValue: OID_SNOMED_CT_CODE_SYSTEM, fhirValue: SNOMED, displayName: 'SNOMED CT' }, { ccdaValue: OID_NUCC_TAXONOMY_CODE_SYSTEM, fhirValue: NUCC_TAXONOMY_URL, displayName: 'NUCC Health Care Provider Taxonomy', }, { ccdaValue: OID_VA_MED_RT_CODE_SYSTEM, fhirValue: VA_MEDRT_URL, displayName: 'Medication Reference Terminology (MED-RT)', }, { ccdaValue: OID_NDF_RT_CODE_SYSTEM, fhirValue: NDFRT_URL, displayName: 'National Drug File Reference Terminology (NDF-RT)', }, { ccdaValue: OID_CVX_CODE_SYSTEM, fhirValue: CVX_URL, displayName: 'CVX' }, { ccdaValue: OID_CONFIDENTIALITY_VALUE_SET, fhirValue: 'Confidentiality', displayName: 'Confidentiality', }, { ccdaValue: OID_ADMINISTRATIVE_GENDER_CODE_SYSTEM, fhirValue: ADMINISTRATIVE_GENDER_CODE_SYSTEM, displayName: 'Administrative Sex', }, { ccdaValue: OID_ROLE_CODE_CODE_SYSTEM, fhirValue: ROLE_CODE_CODE_SYSTEM, displayName: 'Role Code', }, { ccdaValue: OID_SOURCE_OF_PAYMENT_TYPOLOGY_CODE_SYSTEM, fhirValue: '', displayName: 'Insurance Type Code', }, // Alternate FHIR System: { ccdaValue: OID_CVX_CODE_SYSTEM, fhirValue: FHIR_CVX_URL, displayName: 'Vaccine Administered Code Set (CVX)', }, { ccdaValue: OID_ICF_CODE_SYSTEM, fhirValue: FHIR_ICF_URL, displayName: 'International Classification of Functioning, Disability and Health (ICF)', }, ]); /** * Map the C-CDA system to the FHIR system. * @param ccda - The C-CDA system to map. * @returns The FHIR system. */ export function mapCcdaSystemToFhir(ccda: string | undefined): string | undefined { if (!ccda) { return undefined; } return SYSTEM_MAPPER.mapCcdaToFhir(ccda) ?? `urn:oid:${ccda}`; } /** * Maps a C-CDA code to a FHIR CodeableConcept. * @param ccdaCode - The C-CDA code to map. * @returns The FHIR CodeableConcept. */ export function mapCcdaCodeToCodeableConcept(ccdaCode: CcdaCode | undefined): CodeableConcept | undefined { if (!ccdaCode) { return undefined; } const result: CodeableConcept = { coding: [ { system: mapCcdaSystemToFhir(ccdaCode['@_codeSystem']), code: ccdaCode['@_code'], display: ccdaCode['@_displayName'], }, ], text: ccdaCode['@_displayName'], }; if (ccdaCode.translation) { for (const translation of ccdaCode.translation) { const translationSystem = mapCcdaSystemToFhir(translation['@_codeSystem']); if (translationSystem) { result.coding?.push({ system: translationSystem, code: translation['@_code'], display: translation['@_displayName'], }); } } } return result; } /** * Map the FHIR system to the C-CDA system. * @param system - The system to map. * @returns The C-CDA system. */ export function mapFhirSystemToCcda(system: string | undefined): string | undefined { if (!system) { return undefined; } if (system.startsWith('urn:oid:')) { return system.replace('urn:oid:', ''); } return SYSTEM_MAPPER.mapFhirToCcda(system); } /** * Map the codeable concept to the C-CDA code. * @param codeableConcept - The codeable concept to map. * @returns The C-CDA code. */ export function mapCodeableConceptToCcdaCode(codeableConcept: CodeableConcept | undefined): CcdaCode | undefined { if (!codeableConcept?.coding?.[0]) { return undefined; } const result: CcdaCode = mapCodingToCcdaCode(codeableConcept.coding[0]); if (codeableConcept.coding.length > 1) { result.translation = []; for (let i = 1; i < codeableConcept.coding.length; i++) { result.translation.push(mapCodingToCcdaCode(codeableConcept.coding[i])); } } return result; } /** * Map the FHIR coding to the C-CDA code. * @param coding - The FHIR coding to map. * @returns The C-CDA code. */ export function mapCodingToCcdaCode(coding: Coding): CcdaCode { const systemEntry = coding?.system ? SYSTEM_MAPPER.getEntryByFhir(coding.system) : undefined; const system = systemEntry?.ccdaValue; const systemName = systemEntry?.displayName; const systemOid = coding.system?.startsWith('urn:oid:') ? coding.system.replace('urn:oid:', '') : undefined; return { '@_code': coding.code, '@_displayName': coding.display, '@_codeSystem': system ?? systemOid, '@_codeSystemName': systemName, }; } /** * Map the codeable concept to the C-CDA value. * @param codeableConcept - The codeable concept to map. * @returns The C-CDA value. */ export function mapCodeableConceptToCcdaValue(codeableConcept: CodeableConcept | undefined): CcdaValue | undefined { const code = mapCodeableConceptToCcdaCode(codeableConcept); if (!code) { return undefined; } return { '@_xsi:type': 'CD', ...code, }; } export const CONFIDENTIALITY_MAPPER = new EnumMapper( { ccdaSystemOid: OID_CONFIDENTIALITY_VALUE_SET, fhirSystemUrl: CONFIDENTIALITY_CODE_SYSTEM, }, [ { ccdaValue: 'U', fhirValue: 'U', displayName: 'unrestricted' }, { ccdaValue: 'L', fhirValue: 'L', displayName: 'low' }, { ccdaValue: 'M', fhirValue: 'M', displayName: 'moderate' }, { ccdaValue: 'N', fhirValue: 'N', displayName: 'normal' }, { ccdaValue: 'R', fhirValue: 'R', displayName: 'restricted' }, { ccdaValue: 'V', fhirValue: 'V', displayName: 'very restricted' }, ] ); // FHIR Name Use: https://hl7.org/fhir/R4/valueset-name-use.html // CDA Entity Name Use: https://hl7.org/cda/stds/core/2.0.0-sd/ValueSet-CDAEntityNameUse.html // CDA does not have any representation of "old" or "maiden" names // Instead, it should use "L" for legal with a "validTime" element to indicate the time range of the name export const HUMAN_NAME_USE_MAPPER = new EnumMapper( { fhirSystemUrl: NAME_USE_VALUE_SET, }, [ { ccdaValue: 'C', fhirValue: 'usual', displayName: 'Common/Called by' }, { ccdaValue: 'L', fhirValue: 'official', displayName: 'Legal' }, { ccdaValue: 'TEMP', fhirValue: 'temp', displayName: 'Temporary' }, { ccdaValue: 'P', fhirValue: 'nickname', displayName: 'Nickname' }, { ccdaValue: 'ANON', fhirValue: 'anonymous', displayName: 'Anonymous' }, { ccdaValue: 'L', fhirValue: 'maiden', displayName: 'Maiden' }, { ccdaValue: 'L', fhirValue: 'old', displayName: 'Old' }, ] ); export const GENDER_MAPPER = new EnumMapper( { fhirSystemUrl: ADMINISTRATIVE_GENDER_VALUE_SET, }, [ { ccdaValue: 'F', fhirValue: 'female', displayName: 'Female' }, { ccdaValue: 'M', fhirValue: 'male', displayName: 'Male' }, { ccdaValue: 'UN', fhirValue: 'unknown', displayName: 'Unknown' }, { ccdaValue: 'UN', fhirValue: 'other', displayName: 'Other' }, ] ); export const ADDRESS_USE_MAPPER = new EnumMapper( { fhirSystemUrl: ADDRESS_USE_VALUE_SET, }, [ { ccdaValue: 'HP', fhirValue: 'home', displayName: 'Home' }, { ccdaValue: 'WP', fhirValue: 'work', displayName: 'Work' }, ] ); export const TELECOM_USE_MAPPER = new EnumMapper( { fhirSystemUrl: CONTACT_ENTITY_USE_VALUE_SET, }, [ { ccdaValue: 'WP', fhirValue: 'work', displayName: 'Work' }, { ccdaValue: 'HP', fhirValue: 'home', displayName: 'Home' }, { ccdaValue: 'MC', fhirValue: 'mobile', displayName: 'Mobile' }, ] ); export const ALLERGY_STATUS_MAPPER = new EnumMapper<string, string>( { fhirSystemUrl: ALLERGY_VERIFICATION_CODE_SYSTEM, }, [ { ccdaValue: 'unconfirmed', fhirValue: 'unconfirmed', displayName: 'Unconfirmed' }, { ccdaValue: 'provisional', fhirValue: 'provisional', displayName: 'Provisional' }, { ccdaValue: 'differential', fhirValue: 'differential', displayName: 'Differential' }, { ccdaValue: 'confirmed', fhirValue: 'confirmed', displayName: 'Confirmed' }, { ccdaValue: 'refuted', fhirValue: 'refuted', displayName: 'Refuted' }, { ccdaValue: 'entered-in-error', fhirValue: 'entered-in-error', displayName: 'Entered in Error' }, { ccdaValue: 'unknown', fhirValue: 'unknown', displayName: 'Unknown' }, ] ); export const ALLERGY_CATEGORY_MAPPER = new EnumMapper<string, string>( { ccdaSystemOid: OID_SNOMED_CT_CODE_SYSTEM, fhirSystemUrl: ALLERGY_CLINICAL_CODE_SYSTEM, }, [ { ccdaValue: '414285001', fhirValue: 'food', displayName: 'Allergy to food (finding)' }, { ccdaValue: '419511003', fhirValue: 'medication', displayName: 'Propensity to adverse reactions to drug (finding)', }, { ccdaValue: '426232007', fhirValue: 'environment', displayName: 'Environmental allergy (finding)' }, { ccdaValue: '418038007', fhirValue: 'biologic', displayName: 'Propensity to adverse reactions to substance (finding)', }, ] ); export const ALLERGY_SEVERITY_MAPPER = new EnumMapper<'mild' | 'moderate' | 'severe', string>( { ccdaSystemOid: OID_SNOMED_CT_CODE_SYSTEM, fhirSystemUrl: ALLERGY_CLINICAL_CODE_SYSTEM, }, [ { ccdaValue: '255604002', fhirValue: 'mild', displayName: 'Mild' }, { ccdaValue: '6736007', fhirValue: 'moderate', displayName: 'Moderate' }, { ccdaValue: '24484000', fhirValue: 'severe', displayName: 'Severe' }, ] ); export const PROBLEM_STATUS_MAPPER = new EnumMapper<string, string>( { fhirSystemUrl: CONDITION_VER_STATUS_CODE_SYSTEM, }, [ { ccdaValue: 'active', fhirValue: 'active', displayName: 'Active' }, { ccdaValue: 'inactive', fhirValue: 'inactive', displayName: 'Inactive' }, { ccdaValue: 'resolved', fhirValue: 'inactive', displayName: 'Resolved' }, { ccdaValue: 'remission', fhirValue: 'inactive', displayName: 'In Remission' }, { ccdaValue: 'relapse', fhirValue: 'active', displayName: 'Relapse' }, { ccdaValue: 'resolved relapse', fhirValue: 'inactive', displayName: 'Resolved Relapse' }, { ccdaValue: 'aborted', fhirValue: 'aborted', displayName: 'Aborted' }, ] ); // FHIR Immunization Status: https://hl7.org/fhir/R4/valueset-immunization-status.html // C-CDA Act Status: https://terminology.hl7.org/5.5.0/ValueSet-v3-ActStatus.html export const IMMUNIZATION_STATUS_MAPPER = new EnumMapper< Immunization['status'], 'active' | 'completed' | 'aborted' | 'cancelled' | 'nullified' | 'obsolete' >({}, [ { ccdaValue: 'completed', fhirValue: 'completed', displayName: 'Completed' }, { ccdaValue: 'nullified', fhirValue: 'entered-in-error', displayName: 'Nullified' }, { ccdaValue: 'aborted', fhirValue: 'not-done', displayName: 'Aborted' }, { ccdaValue: 'cancelled', fhirValue: 'not-done', displayName: 'Cancelled' }, { ccdaValue: 'obsolete', fhirValue: 'not-done', displayName: 'Obsolete' }, ]); export const ENCOUNTER_STATUS_MAPPER = new EnumMapper({}, [ { ccdaValue: 'active', fhirValue: 'in-progress', displayName: 'In Progress' }, { ccdaValue: 'completed', fhirValue: 'finished', displayName: 'Finished' }, { ccdaValue: 'aborted', fhirValue: 'cancelled', displayName: 'Cancelled' }, { ccdaValue: 'cancelled', fhirValue: 'cancelled', displayName: 'Cancelled' }, { ccdaValue: 'unknown', fhirValue: 'unknown', displayName: 'Unknown' }, ]); export const PROCEDURE_STATUS_MAPPER = new EnumMapper({}, [ { ccdaValue: 'completed', fhirValue: 'completed', displayName: 'Completed' }, { ccdaValue: 'active', fhirValue: 'active', displayName: 'Active' }, { ccdaValue: 'aborted', fhirValue: 'stopped', displayName: 'Stopped' }, { ccdaValue: 'cancelled', fhirValue: 'not-done', displayName: 'Not Done' }, { ccdaValue: 'new', fhirValue: 'not-done', displayName: 'Draft' }, { ccdaValue: 'unknown', fhirValue: 'unknown', displayName: 'Unknown' }, ]); // C-CDA Medication Activity status: https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1099.11/expansion // FHIR MedidcationRequest status: https://hl7.org/fhir/R4/valueset-medicationrequest-status.html export const MEDICATION_STATUS_MAPPER = new EnumMapper< Required<MedicationRequest['status']>, 'active' | 'completed' | 'aborted' | 'cancelled' | 'nullified' | 'obsolete' >({}, [ { ccdaValue: 'active', fhirValue: 'active', displayName: 'Active' }, { ccdaValue: 'completed', fhirValue: 'completed', displayName: 'Completed' }, { ccdaValue: 'aborted', fhirValue: 'stopped', displayName: 'Stopped' }, { ccdaValue: 'cancelled', fhirValue: 'cancelled', displayName: 'Cancelled' }, { ccdaValue: 'aborted', fhirValue: 'entered-in-error', displayName: 'Entered in Error' }, { ccdaValue: 'active', fhirValue: 'draft', displayName: 'Draft' }, { ccdaValue: 'cancelled', fhirValue: 'unknown', displayName: 'Unknown' }, { ccdaValue: 'nullified', fhirValue: 'cancelled', displayName: 'Nullified' }, { ccdaValue: 'obsolete', fhirValue: 'cancelled', displayName: 'Obsolete' }, ]); export const OBSERVATION_CATEGORY_MAPPER = new EnumMapper<string, string>( { fhirSystemUrl: OBSERVATION_CATEGORY_CODE_SYSTEM, }, [ // ## social-history // FHIR Definition: Social History Observations define the patient's occupational, personal (e.g., lifestyle), social, familial, and environmental history and health risk factors that may impact the patient's health. // Mapped C-CDA Templates: { ccdaValue: OID_SOCIAL_HISTORY_OBSERVATION, fhirValue: 'social-history', displayName: 'Social History' }, { ccdaValue: OID_SOCIAL_HISTORY_OBSERVATION_V2, fhirValue: 'social-history', displayName: 'Social History V2' }, { ccdaValue: OID_SMOKING_STATUS_OBSERVATION, fhirValue: 'social-history', displayName: 'Smoking Status' }, { ccdaValue: OID_CURRENT_SMOKING_STATUS_OBSERVATION, fhirValue: 'social-history', displayName: 'Current Smoking Status', }, { ccdaValue: OID_TOBACCO_USE_OBSERVATION, fhirValue: 'social-history', displayName: 'Tobacco Use' }, { ccdaValue: OID_BASIC_OCCUPATION_OBSERVATION, fhirValue: 'social-history', displayName: 'Basic Occupation' }, { ccdaValue: OID_BASIC_INDUSTRY_OBSERVATION, fhirValue: 'social-history', displayName: 'Basic Industry' }, { ccdaValue: OID_SEXUAL_ORIENTATION_OBSERVATION, fhirValue: 'social-history', displayName: 'Sexual Orientation' }, { ccdaValue: OID_SEX_OBSERVATION, fhirValue: 'social-history', displayName: 'Sex Observation' }, { ccdaValue: OID_BIRTH_SEX, fhirValue: 'social-history', displayName: 'Gender Identity' }, { ccdaValue: OID_SECTION_TIME_RANGE, fhirValue: 'social-history', displayName: 'Gender Identity V2' }, { ccdaValue: OID_PREGNANCY_OBSERVATION, fhirValue: 'social-history', displayName: 'Pregnancy Status' }, { ccdaValue: OID_TRIBAL_AFFILIATION_OBSERVATION, fhirValue: 'social-history', displayName: 'Tribal Affiliation' }, // ## vital-signs // FHIR Definition: Clinical observations measure the body's basic functions such as blood pressure, heart rate, respiratory rate, height, weight, body mass index, head circumference, pulse oximetry, temperature, and body surface area. // Mapped C-CDA Templates: { ccdaValue: OID_VITAL_SIGNS_OBSERVATION, fhirValue: 'vital-signs', displayName: 'Vital Signs Observation' }, { ccdaValue: OID_VITAL_SIGNS_OBSERVATION_V2, fhirValue: 'vital-signs', displayName: 'Vital Signs Observation V2', }, { ccdaValue: OID_VITAL_SIGNS_ORGANIZER, fhirValue: 'vital-signs', displayName: 'Vital Signs Organizer' }, { ccdaValue: OID_VITAL_SIGNS_ORGANIZER_V2, fhirValue: 'vital-signs', displayName: 'Vital Signs Organizer V2', }, { ccdaValue: OID_AVERAGE_BLOOD_PRESSURE_ORGANIZER, fhirValue: 'vital-signs', displayName: 'Average Blood Pressure Organizer', }, // ## laboratory // FHIR Definition: The results of observations generated by laboratories. Laboratory results are typically generated by laboratories providing analytic services in areas such as chemistry, hematology, serology, histology, cytology, anatomic pathology (including digital pathology), microbiology, and/or virology. // Mapped C-CDA Templates: { ccdaValue: OID_RESULT_OBSERVATION, fhirValue: 'laboratory', displayName: 'Result Observation' }, { ccdaValue: OID_RESULT_OBSERVATION_V2, fhirValue: 'laboratory', displayName: 'Result Observation V2' }, { ccdaValue: OID_LABORATORY_BATTERY_ID, fhirValue: 'laboratory', displayName: 'Laboratory Battery (ID)' }, { ccdaValue: OID_LABORATORY_OBSERVATION_ID, fhirValue: 'laboratory', displayName: 'Laboratory Observation (ID)', }, { ccdaValue: OID_LABORATORY_RESULT_ORGANIZER_ID, fhirValue: 'laboratory', displayName: 'Laboratory Result Organizer (ID)', }, { ccdaValue: OID_RESULT_ORGANIZER, fhirValue: 'laboratory', displayName: 'Result Organizer' }, { ccdaValue: OID_RESULT_ORGANIZER_V2, fhirValue: 'laboratory', displayName: 'Result Organizer V2' }, // ## survey // FHIR Definition: Assessment tool/survey instrument observations (e.g., Apgar Scores, Montreal Cognitive Assessment (MoCA)). // Mapped C-CDA Templates: { ccdaValue: OID_ASSESSMENT_SCALE_OBSERVATION, fhirValue: 'survey', displayName: 'Assessment Scale Observation' }, { ccdaValue: OID_ASSESSMENT_SCALE_SUPPORTING_OBSERVATION, fhirValue: 'survey', displayName: 'Assessment Scale Supporting Observation', }, { ccdaValue: OID_COGNITIVE_STATUS_RESULT_OBSERVATION, fhirValue: 'survey', displayName: 'Cognitive Status Result Observation', }, { ccdaValue: OID_COGNITIVE_STATUS_RESULT_ORGANIZER, fhirValue: 'survey', displayName: 'Cognitive Status Result Organizer', }, { ccdaValue: OID_FUNCTIONAL_STATUS_RESULT_OBSERVATION, fhirValue: 'survey', displayName: 'Functional Status Result Observation', }, { ccdaValue: OID_FUNCTIONAL_STATUS_RESULT_ORGANIZER, fhirValue: 'survey', displayName: 'Functional Status Result Organizer', }, // ## exam // FHIR Definition: Observations generated by physical exam findings including direct observations made by a clinician and use of simple instruments and the result of simple maneuvers performed directly on the patient's body. // Mapped C-CDA Templates: { ccdaValue: OID_PROCEDURE_ACTIVITY_OBSERVATION, fhirValue: 'exam', displayName: 'Procedure Activity Observation' }, { ccdaValue: OID_PROBLEM_OBSERVATION, fhirValue: 'exam', displayName: 'Problem Observation' }, { ccdaValue: OID_PROBLEM_OBSSERVATION_V2, fhirValue: 'exam', displayName: 'Problem Observation V2' }, { ccdaValue: OID_PRESSURE_ULCER_OBSERVATION, fhirValue: 'exam', displayName: 'Pressure Ulcer Observation' }, { ccdaValue: OID_WOUND_OBSERVATION, fhirValue: 'exam', displayName: 'Wound Observation' }, { ccdaValue: OID_WOUND_MEASURMENTS_OBSERVATION, fhirValue: 'exam', displayName: 'Wound Measurements Observation' }, { ccdaValue: OID_PROCEDURES_SECTION_ENTRIES_REQUIRED, fhirValue: 'exam', displayName: 'Procedure Section' }, // ## therapy // FHIR Definition: Observations generated by non-interventional treatment protocols (e.g. occupational, physical, radiation, nutritional and medication therapy) // Mapped C-CDA Templates: { ccdaValue: OID_MEDICATION_ADHERENCE, fhirValue: 'therapy', displayName: 'Medication Adherence' }, { ccdaValue: OID_NUTRITION_RECOMMENDATION_V2, fhirValue: 'therapy', displayName: 'Nutrition Recommendations' }, { ccdaValue: OID_DIET_STATEMENT_NUTRITION, fhirValue: 'therapy', displayName: 'Diet Statement (Nutrition)' }, { ccdaValue: OID_MONITORING_EVALUATION_AND_OUTCOME_NUTRITION, fhirValue: 'therapy', displayName: 'Monitoring, Evaluation and Outcome (Nutrition)', }, ] ); // Coverage type // FHIR uses: https://hl7.org/fhir/R4/valueset-coverage-type.html // C-CDA uses: Source of Payment Typology (SOPT) // https://www.nahdo.org/sites/default/files/2020-12/SourceofPaymentTypologyVersion9_2%20-Dec%2011_2020_Final2.pdf // Analysis: https://docs.google.com/spreadsheets/d/1w69E-SB05sJ2YYWCUzNz1yGd_yGije01Ktui2l-zhWw // // These are very different code systems with different codes and meanings // We're going to implement a basic mapping here, but this will need to be revisited in the future // A full mapping would require looking at `Coverage.payor` and `Organization.type` to determine the correct mapping // // SOPT Codes: // 71 HMO // 72 PPO // 73 POS // 79 Other Managed Care // 81 Self-pay (Includes applicants for insurance and Medicaid applicants) // 82 No Charge // 99 No Typology Code available for payment source // 9999 Unavailable / No Payer Specified / Blank // // FHIR ValueSet Codes: // pay Self Pay // MCPOL managed care policy // POS point of service policy // HMO health maintenance organization policy // PPO preferred provider organization policy // (blank) Other or Unknown export const INSURANCE_COVERAGE_TYPE_MAPPER = new EnumMapper<string, string>( { fhirSystemUrl: ACT_CODE_SYSTEM, }, [ { ccdaValue: '71', fhirValue: 'HMO', displayName: 'Health Maintenance Organization' }, { ccdaValue: '72', fhirValue: 'PPO', displayName: 'Preferred Provider Organization' }, { ccdaValue: '73', fhirValue: 'POS', displayName: 'Point of Service' }, { ccdaValue: '79', fhirValue: 'MCPOL', displayName: 'Managed Care Policy' }, { ccdaValue: '81', fhirValue: 'pay', displayName: 'Self Pay' }, { ccdaValue: '9999', fhirValue: '', displayName: 'Unknown' }, ] );