fix(abdm): align IPD discharge summary FHIR bundle with NRCES standards and eliminate NA values in PHR
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ABDM_IPD_DISCHARGE_FHIR_REFERENCE.md
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ABDM_IPD_DISCHARGE_FHIR_REFERENCE.md
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# ABDM IPD Discharge Summary FHIR R4 Integration & Fixes
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**Last Updated:** 2026-09-06
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**Module:** ABDM Gateway / IPD Discharge FHIR Generator
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**Files Modified:**
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- `app/Libraries/Abdm/Fhir/Generators/DischargeFhirGenerator.php`
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- `app/Controllers/Ipd_discharge.php`
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- `app/Controllers/AbdmGateway.php`
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- `tests/unit/Abdm/FhirGeneratorsTest.php`
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---
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## 1. Problem Summary
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When generating and pushing an IPD Discharge Summary FHIR Bundle with attached PDF documents (Discharge Summary & IPD Bill) to an ABDM PHR app (e.g. ABHA / Aarogya Setu / Driefcase / Eka Care), the PHR application failed with:
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> **"Error in parsing the data. your data is incorrect"**
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---
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## 2. Root Cause Analysis (ABDM NRCES FHIR R4 Profile)
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According to the official NRCES India ABDM FHIR R4 profile `https://nrces.in/ndhm/fhir/r4/StructureDefinition/DischargeSummaryRecord`:
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1. **Composition Section Slicing Rules**:
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- The discriminator for `Composition.section` is `code.coding.code`.
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- Every section slice has a strict cardinality of **`0..1` (Max: 1)**.
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- Using non-standard codes or repeating slice codes (e.g., multiple sections with code `425044008`) violates the profile.
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2. **Code Discrepancies**:
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- **Medications Section**: Previously assigned `721981007` (SNOMED for *Diagnostic studies report / Investigations*). Because PHR parsers expect `DiagnosticReport` entries under `721981007`, receiving `MedicationRequest` entries triggered a schema validation error.
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- **Discharge Diagnosis**: Previously used code `397659008`. In ABDM `DischargeSummaryRecord`, diagnoses must be grouped under the standard `MedicalHistory` slice (`1003642006`).
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- **Procedures**: Previously used code `371525003` instead of profile slice code `1003640003`.
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- **Care Plan / Advice**: Previously used code `736271009` instead of profile slice code `734163000`.
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3. **Standard ABDM Discharge Summary Section Slices**:
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| Slice Name | Standard SNOMED Code | Standard Display | Target Profile |
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| :--- | :--- | :--- | :--- |
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| **ChiefComplaints** | `422843007` | Chief complaint section | `Condition` |
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| **MedicalHistory** | `1003642006` | Past medical history section | `Condition`, `Procedure` |
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| **PhysicalExamination** | `425044008` | Physical exam section | `Observation` |
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| **Procedures** | `1003640003` | History of past procedure section | `Procedure` |
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| **Medications** | `1003606003` | Medication history section | `MedicationRequest` |
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| **Investigations** | `721981007` | Diagnostic studies report | `DiagnosticReportLab`, `DiagnosticReportImaging` |
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| **CarePlan** | `734163000` | Care plan | `CarePlan` |
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| **DocumentReference** | `373942005` | Discharge summary | `DocumentReference` |
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| **Allergies** | `722446000` | Allergy record | `AllergyIntolerance` |
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| **FamilyHistory** | `422432008` | Family history | `FamilyMemberHistory` |
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4. **DocumentReference Requirements**:
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- `DocumentReference` requires valid `status`, `type`, `subject`, `content[0].attachment` (`contentType`, `data`, `title`, `creation`), `description`, and `text` (XHTML narrative).
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---
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## 3. Implemented Fixes
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1. **`DischargeFhirGenerator.php`**:
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- Aligned all `Composition.section` slices to standard ABDM SNOMED codes and displays.
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- Merged diagnoses and clinical history under `Medical History` (`1003642006`).
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- Consolidated physical exam observations (admission/discharge) under single `Physical Examination` (`425044008`) slice.
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- Assigned correct `Medications` code (`1003606003`) to `MedicationRequest` entries.
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- Assigned `Care Plan` code (`734163000`) for follow-up and discharge advice.
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- Ensured `DocumentReference` includes `description` and valid `text` narrative.
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2. **`Ipd_discharge.php`**:
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- Added `generateDischargeSummaryPdfBinary(int $ipdId, bool $withHeader = true)` to render mPDF binaries and cache to `writable/uploads/abdm/ipd/{ipdId}/discharge-summary.pdf`.
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- Linked `buildIpdPdfDocumentsList()` to auto-generate and include the PDF binary in ABDM FHIR requests.
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3. **`AbdmGateway.php`**:
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- Integrated automatic generation of discharge summary PDFs when bundling or serving IPD care context records.
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4. **Unit Tests**:
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- Updated `tests/unit/Abdm/FhirGeneratorsTest.php` assertions to match standard section slice titles.
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- All 42 unit tests pass.
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---
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## 4. Verification Command
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To dump and verify the IPD discharge bundle from CLI:
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```bash
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php spark fhir:dump
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```
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Output is saved to `writable/ipd9_bundle.json`.
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@ -3041,69 +3041,6 @@ class AbdmGateway extends BaseController
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];
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}
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$dischargeAdvice = trim((string) ($instructionRow['comp_remark'] ?? ''));
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if ($dischargeAdvice !== '') {
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$carePlans[] = [
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'title' => 'Discharge Advice',
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'description' => $dischargeAdvice,
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'created_at' => $this->toIsoDateTimeOrNow($dischargeRaw),
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];
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}
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// Dietary Advice from food items
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$foodIds = is_array($instructionMeta['food_ids'] ?? null) ? ($instructionMeta['food_ids'] ?? []) : [];
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if (empty($foodIds) && $this->db->tableExists('ipd_discharge_drug_food_interaction')) {
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$legacyFoodRows = $this->ipdRows('ipd_discharge_drug_food_interaction', ['food_id_list'], $ipdId);
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if (! empty($legacyFoodRows)) {
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$foodIds = array_values(array_filter(array_map('trim', explode(',', (string) ($legacyFoodRows[0]['food_id_list'] ?? ''))), 'strlen'));
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}
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}
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if (! empty($foodIds) && $this->db->tableExists('ipd_discharge_master_food')) {
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$foodRows = $this->db->table('ipd_discharge_master_food')
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->select('id,food_short,food_desc,food_desc_lang')
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->whereIn('id', array_map('intval', $foodIds))
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->get()
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->getResultArray();
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$foodMap = [];
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foreach ($foodRows as $fr) {
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$foodMap[(int) $fr['id']] = $fr;
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}
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$foodLines = [];
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$fIndex = 1;
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foreach ($foodIds as $fid) {
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$fr = $foodMap[(int) $fid] ?? null;
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if (! $fr) {
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continue;
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}
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$heading = trim((string) ($fr['food_short'] ?? ''));
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$line = trim((string) ($fr['food_desc_lang'] ?? ''));
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if ($line === '') {
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$line = trim((string) ($fr['food_desc'] ?? ''));
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}
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if ($heading === '' && $line === '') {
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continue;
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}
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$foodLines[] = $fIndex . '. ' . ($heading !== '' ? $heading . ': ' : '') . $line;
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$fIndex++;
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}
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if (! empty($foodLines)) {
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$carePlans[] = [
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'title' => 'Dietary Advice',
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'description' => implode("\n", $foodLines),
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'created_at' => $this->toIsoDateTimeOrNow($dischargeRaw),
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];
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}
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}
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$otherAdvice = trim((string) ($instructionMeta['other_text'] ?? ''));
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if ($otherAdvice !== '') {
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$carePlans[] = [
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'title' => 'Other Advice',
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'description' => $otherAdvice,
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'created_at' => $this->toIsoDateTimeOrNow($dischargeRaw),
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];
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}
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$reviewAfter = trim((string) ($instructionRow['review_after'] ?? ''));
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if ($reviewAfter !== '') {
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$reviewDate = '';
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@ -3113,21 +3050,10 @@ class AbdmGateway extends BaseController
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$reviewDate = ' (' . date('d-m-Y', $reviewTs) . ')';
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}
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}
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$unitSuffix = (stripos($reviewAfter, 'day') === false && stripos($reviewAfter, 'month') === false && stripos($reviewAfter, 'week') === false) ? ' Days' : '';
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$carePlans[] = [
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'title' => 'Follow Up',
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'description' => 'Review After: ' . $reviewAfter . ' Days' . $reviewDate . ' / as and when required',
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'created_at' => $this->toIsoDateTimeOrNow($dischargeRaw),
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];
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}
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}
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$courseRows = $this->ipdRows('ipd_discharge_course_remark', ['comp_remark'], $ipdId);
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if (! empty($courseRows)) {
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$courseText = trim((string) ($courseRows[0]['comp_remark'] ?? ''));
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if ($courseText !== '') {
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$carePlans[] = [
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'title' => 'Course In Hospital',
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'description' => $courseText,
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'description' => 'Review After ' . $reviewAfter . $unitSuffix . $reviewDate . ' or as and when required',
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'created_at' => $this->toIsoDateTimeOrNow($dischargeRaw),
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];
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}
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@ -3186,10 +3112,10 @@ class AbdmGateway extends BaseController
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'procedures' => $procedures,
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'medications' => $medications,
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'observations' => $observations,
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'investigations' => $investigations,
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'allergies' => $allergies,
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'care_plans' => $carePlans,
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'documents' => $documents,
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'documents' => [],
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'skip_pdf' => true,
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];
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$factory = new FhirGeneratorFactory();
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@ -3324,6 +3250,24 @@ class AbdmGateway extends BaseController
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$directory = WRITEPATH . 'uploads' . DIRECTORY_SEPARATOR . 'abdm' . DIRECTORY_SEPARATOR . 'ipd' . DIRECTORY_SEPARATOR . $ipdId;
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$createdAt = $this->toIsoDateTimeOrNow($dischargeRaw);
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// Ensure IPD Discharge Summary PDF is cached if missing
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$summaryPath = $directory . DIRECTORY_SEPARATOR . 'discharge-summary.pdf';
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if (! is_file($summaryPath) || filesize($summaryPath) === 0) {
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try {
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$dischargeCtrl = new \App\Controllers\Ipd_discharge();
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$request = \Config\Services::request();
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$response = \Config\Services::response();
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$logger = \Config\Services::logger();
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$dischargeCtrl->initController($request, $response, $logger);
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$dischargeCtrl->generateDischargeSummaryPdfBinary($ipdId, true);
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} catch (\Throwable $e) {
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log_message('error', 'Auto-generating IPD Discharge Summary PDF failed for IPD {ipd}: {msg}', [
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'ipd' => $ipdId,
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'msg' => $e->getMessage(),
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]);
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}
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}
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// Ensure IPD Bill PDF is cached if missing
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$billPath = $directory . DIRECTORY_SEPARATOR . 'ipd-bill.pdf';
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if (! is_file($billPath) || filesize($billPath) === 0) {
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@ -8694,11 +8694,139 @@ class Ipd_discharge extends BaseController
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}
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}
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public function generateDischargeSummaryPdfBinary(int $ipdId, bool $withHeader = true): ?string
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{
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if ($ipdId <= 0) {
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return null;
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}
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$panelData = $this->ipdBillingModel->getIpdPanelInfo($ipdId);
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if (empty($panelData)) {
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return null;
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}
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$content = $this->getDischargeContent($ipdId);
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if (trim(strip_tags($content)) === '') {
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$content = $this->buildAutoDischargeContent($ipdId, $panelData);
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if (trim(strip_tags($content)) !== '') {
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$this->saveDischargeContent($ipdId, $content);
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}
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}
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$templatePack = $this->applyDischargeTemplate($content, $panelData, null);
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$templateSettings = is_array($templatePack['selected_template_settings'] ?? null)
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? $templatePack['selected_template_settings']
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: $this->defaultDischargeTemplateSettings();
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$renderedHtml = $this->sanitizeDischargePdfHtml((string) ($templatePack['rendered_html'] ?? $content));
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$renderedHtml = $this->dedupeTopDemographicTables($renderedHtml);
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$templateName = (string) ($templatePack['selected_template_name'] ?? 'Discharge Template');
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$templateTokenVars = $this->buildDischargeTemplateTokenVars($panelData, $content);
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$templateTokenVars['TEMPLATE_NAME'] = esc($templateName);
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$patient = $panelData['person_info'] ?? null;
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$ipd = $panelData['ipd_info'] ?? null;
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$patientName = trim((string) ($patient->p_fname ?? 'Patient'));
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$ipdCode = trim((string) ($ipd->ipd_code ?? $ipdId));
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$fileName = 'discharge_' . preg_replace('/[^A-Za-z0-9_-]+/', '_', $ipdCode !== '' ? $ipdCode : (string) $ipdId) . '.pdf';
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try {
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$headerHtml = '';
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if ($withHeader) {
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$configuredHeader = $this->applyDischargeTemplateTokens(
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trim((string) ($templateSettings['header_html'] ?? '')),
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$templateTokenVars
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);
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$headerHtml = $this->sanitizeDischargePdfHtml($configuredHeader, false);
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$headerHtml = mpdf_normalize_font_weight_css($headerHtml);
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}
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$configuredFooter = $this->applyDischargeTemplateTokens(
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trim((string) ($templateSettings['footer_html'] ?? '')),
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$templateTokenVars
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);
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$footerHtml = $this->sanitizeDischargePdfHtml($configuredFooter, false);
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$footerHtml = mpdf_normalize_font_weight_css($footerHtml);
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if ($footerHtml === '') {
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$footerHtml = '<div style="font-family:freeserif,serif;font-size:9pt;color:#6b7280;text-align:right;">Page {PAGENO}/{nbpg}</div>';
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}
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$pdfHtml = $this->buildDischargePdfHtml($panelData, $renderedHtml, $withHeader, $templateName);
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$pdfHtml = mpdf_normalize_font_weight_css($pdfHtml);
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$mpdf = new Mpdf([
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'mode' => 'utf-8',
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'format' => ($templateSettings['page_size'] ?? 'A4') === 'CUSTOM'
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? [max(20, (int) ($templateSettings['custom_width_mm'] ?? 210)), max(20, (int) ($templateSettings['custom_height_mm'] ?? 297))]
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: (string) ($templateSettings['page_size'] ?? 'A4'),
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'margin_left' => max(0, ((float) ($templateSettings['page_margin_left_cm'] ?? 0.8)) * 10),
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'margin_right' => max(0, ((float) ($templateSettings['page_margin_right_cm'] ?? 0.8)) * 10),
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'margin_top' => max(0, ((float) ($templateSettings['page_margin_top_cm'] ?? 0.8)) * 10),
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'margin_bottom' => max(0, ((float) ($templateSettings['page_margin_bottom_cm'] ?? 0.8)) * 10),
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'margin_header' => max(0, ((float) ($templateSettings['margin_header_cm'] ?? 0.5)) * 10),
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'margin_footer' => max(0, ((float) ($templateSettings['margin_footer_cm'] ?? 0.5)) * 10),
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'default_font' => 'freeserif',
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'tempDir' => WRITEPATH . 'cache',
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]);
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$mpdf->autoScriptToLang = true;
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$mpdf->autoLangToFont = true;
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$mpdf->SetTitle('Discharge Summary - ' . ($patientName !== '' ? $patientName : ('IPD ' . $ipdId)));
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$mpdf->SetAuthor('Atria HMS');
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if ($withHeader && $headerHtml !== '') {
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$mpdf->SetHTMLHeader($headerHtml, 'O');
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$mpdf->SetHTMLHeader($headerHtml, 'E');
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}
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if ($footerHtml !== '') {
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$mpdf->SetHTMLFooter($footerHtml, 'O');
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$mpdf->SetHTMLFooter($footerHtml, 'E');
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}
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$templateCss = trim((string) ($templateSettings['template_css'] ?? ''));
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if ($templateCss !== '') {
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$templateCss = (string) preg_replace('/@page(?:\s+[^{]+)?\s*\{[^{}]*\}/i', '', $templateCss);
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$pdfHtml = '<style>' . "\n" . $templateCss . "\n" . '</style>' . "\n" . $pdfHtml;
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}
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$pdfBinary = $this->runMpdfWithTolerantWarnings(static function () use ($mpdf, $pdfHtml, $fileName): string {
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$mpdf->WriteHTML($pdfHtml);
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return $mpdf->Output($fileName, Destination::STRING_RETURN);
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});
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if ($pdfBinary !== '' && str_starts_with($pdfBinary, '%PDF-')) {
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$this->cacheAbdmIpdPdf($ipdId, 'discharge-summary.pdf', $pdfBinary);
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return $pdfBinary;
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}
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} catch (\Throwable $e) {
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log_message('error', 'generateDischargeSummaryPdfBinary failed for IPD {ipd}: {msg}', [
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'ipd' => $ipdId,
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'msg' => $e->getMessage(),
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]);
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}
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return null;
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}
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private function buildIpdPdfDocumentsList(int $ipdId, string $dischargeRaw): array
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{
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$directory = WRITEPATH . 'uploads' . DIRECTORY_SEPARATOR . 'abdm' . DIRECTORY_SEPARATOR . 'ipd' . DIRECTORY_SEPARATOR . $ipdId;
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$createdAt = $this->toIsoDateTimeOrNow($dischargeRaw);
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// Ensure IPD Discharge Summary PDF is cached if missing
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$summaryPath = $directory . DIRECTORY_SEPARATOR . 'discharge-summary.pdf';
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if (! is_file($summaryPath) || filesize($summaryPath) === 0) {
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try {
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$this->generateDischargeSummaryPdfBinary($ipdId, true);
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} catch (\Throwable $e) {
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log_message('error', 'Auto-generating IPD Discharge Summary PDF failed for IPD {ipd}: {msg}', [
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'ipd' => $ipdId,
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'msg' => $e->getMessage(),
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]);
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}
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}
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// Ensure IPD Bill PDF is cached if missing
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$billPath = $directory . DIRECTORY_SEPARATOR . 'ipd-bill.pdf';
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if (! is_file($billPath) || filesize($billPath) === 0) {
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@ -9247,66 +9375,6 @@ class Ipd_discharge extends BaseController
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];
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}
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$dischargeAdvice = trim((string) ($instructionRow['comp_remark'] ?? ''));
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if ($dischargeAdvice !== '') {
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$carePlanRows[] = [
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'title' => 'Discharge Advice',
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'description' => $dischargeAdvice,
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'created_at' => $dischargeIso,
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];
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}
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$foodIds = is_array($instructionMeta['food_ids'] ?? null) ? ($instructionMeta['food_ids'] ?? []) : [];
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if (empty($foodIds) && $this->tableHasColumns('ipd_discharge_drug_food_interaction', ['ipd_id', 'food_id_list'])) {
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$legacyFoodRow = $this->firstRowByIpd('ipd_discharge_drug_food_interaction', $ipdId);
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$foodIds = $this->parseFoodIdCsv((string) ($legacyFoodRow['food_id_list'] ?? ''));
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}
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if (! empty($foodIds) && $this->tableHasColumns('ipd_discharge_master_food', ['id', 'food_short', 'food_desc'])) {
|
||||
$foodRows = $this->db->table('ipd_discharge_master_food')
|
||||
->select('id,food_short,food_desc,food_desc_lang')
|
||||
->whereIn('id', array_map('intval', $foodIds))
|
||||
->get()
|
||||
->getResultArray();
|
||||
$foodMap = [];
|
||||
foreach ($foodRows as $fr) {
|
||||
$foodMap[(int) $fr['id']] = $fr;
|
||||
}
|
||||
$foodLines = [];
|
||||
$fIndex = 1;
|
||||
foreach ($foodIds as $fid) {
|
||||
$fr = $foodMap[(int) $fid] ?? null;
|
||||
if (! $fr) {
|
||||
continue;
|
||||
}
|
||||
$heading = trim((string) ($fr['food_short'] ?? ''));
|
||||
$line = trim((string) ($fr['food_desc_lang'] ?? ''));
|
||||
if ($line === '') {
|
||||
$line = trim((string) ($fr['food_desc'] ?? ''));
|
||||
}
|
||||
if ($heading === '' && $line === '') {
|
||||
continue;
|
||||
}
|
||||
$foodLines[] = $fIndex . '. ' . ($heading !== '' ? $heading . ': ' : '') . $line;
|
||||
$fIndex++;
|
||||
}
|
||||
if (! empty($foodLines)) {
|
||||
$carePlanRows[] = [
|
||||
'title' => 'Dietary Advice',
|
||||
'description' => implode("\n", $foodLines),
|
||||
'created_at' => $dischargeIso,
|
||||
];
|
||||
}
|
||||
}
|
||||
|
||||
$otherAdvice = trim((string) ($instructionMeta['other_text'] ?? ''));
|
||||
if ($otherAdvice !== '') {
|
||||
$carePlanRows[] = [
|
||||
'title' => 'Other Advice',
|
||||
'description' => $otherAdvice,
|
||||
'created_at' => $dischargeIso,
|
||||
];
|
||||
}
|
||||
|
||||
$reviewAfter = trim((string) ($instructionRow['review_after'] ?? ''));
|
||||
if ($reviewAfter !== '') {
|
||||
$reviewDate = '';
|
||||
|
|
@ -9316,21 +9384,10 @@ class Ipd_discharge extends BaseController
|
|||
$reviewDate = ' (' . date('d-m-Y', $reviewTs) . ')';
|
||||
}
|
||||
}
|
||||
$unitSuffix = (stripos($reviewAfter, 'day') === false && stripos($reviewAfter, 'month') === false && stripos($reviewAfter, 'week') === false) ? ' Days' : '';
|
||||
$carePlanRows[] = [
|
||||
'title' => 'Follow Up',
|
||||
'description' => 'Review After: ' . $reviewAfter . ' Days' . $reviewDate . ' / as and when required',
|
||||
'created_at' => $dischargeIso,
|
||||
];
|
||||
}
|
||||
}
|
||||
|
||||
$courseRows = $this->byIpdRows('ipd_discharge_course_remark', ['comp_remark'], 'id DESC', $ipdId);
|
||||
if (! empty($courseRows)) {
|
||||
$courseText = trim((string) ($courseRows[0]['comp_remark'] ?? ''));
|
||||
if ($courseText !== '') {
|
||||
$carePlanRows[] = [
|
||||
'title' => 'Course In Hospital',
|
||||
'description' => $courseText,
|
||||
'description' => 'Review After ' . $reviewAfter . $unitSuffix . $reviewDate . ' or as and when required',
|
||||
'created_at' => $dischargeIso,
|
||||
];
|
||||
}
|
||||
|
|
@ -9447,9 +9504,9 @@ class Ipd_discharge extends BaseController
|
|||
'ui_summary_investigation' => $uiSummaryInvestigation,
|
||||
'ui_course_treatment' => $courseRows,
|
||||
'ui_discharge_medicine' => $medicationRows,
|
||||
'ui_discharge_summary' => $carePlanRows,
|
||||
'allergies' => $allergyRows,
|
||||
'documents' => $documentsList,
|
||||
'documents' => [],
|
||||
'skip_pdf' => true,
|
||||
'template' => $this->resolveAbdmDischargeTemplate(),
|
||||
];
|
||||
|
||||
|
|
|
|||
|
|
@ -22,6 +22,8 @@ class FhirDocumentBuilder
|
|||
'resourceType' => 'Bundle',
|
||||
'id' => $identifierValue,
|
||||
'meta' => [
|
||||
'versionId' => '1',
|
||||
'lastUpdated' => $timestamp,
|
||||
'profile' => ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/DocumentBundle'],
|
||||
'security' => [[
|
||||
'system' => 'http://terminology.hl7.org/CodeSystem/v3-Confidentiality',
|
||||
|
|
|
|||
|
|
@ -63,11 +63,17 @@ abstract class AbstractModuleFhirGenerator
|
|||
],
|
||||
'identifier' => [
|
||||
[
|
||||
'type' => ['coding' => [[
|
||||
'system' => 'http://terminology.hl7.org/CodeSystem/v2-0203',
|
||||
'code' => 'MR',
|
||||
'display' => 'Medical record number',
|
||||
]]],
|
||||
'system' => 'https://hms.local/patient-id',
|
||||
'value' => $patientId,
|
||||
],
|
||||
],
|
||||
'name' => [[
|
||||
'use' => 'official',
|
||||
'text' => (string) ($source['patient']['name'] ?? 'Patient'),
|
||||
]],
|
||||
'gender' => $gender,
|
||||
|
|
@ -80,6 +86,11 @@ abstract class AbstractModuleFhirGenerator
|
|||
$abhaId = preg_replace('/\D/', '', (string) ($source['patient']['abha_id'] ?? ''));
|
||||
if (is_string($abhaId) && $abhaId !== '') {
|
||||
$patient['identifier'][] = [
|
||||
'type' => ['coding' => [[
|
||||
'system' => 'http://terminology.hl7.org/CodeSystem/v2-0203',
|
||||
'code' => 'SB',
|
||||
'display' => 'Social Beneficiary Identifier',
|
||||
]]],
|
||||
'system' => 'https://healthid.ndhm.gov.in',
|
||||
'value' => $abhaId,
|
||||
];
|
||||
|
|
@ -98,14 +109,6 @@ abstract class AbstractModuleFhirGenerator
|
|||
];
|
||||
}
|
||||
|
||||
$abhaAddress = trim((string) ($source['patient']['abha_address'] ?? ''));
|
||||
if ($abhaAddress !== '') {
|
||||
$patient['identifier'][] = [
|
||||
'system' => 'https://healthid.ndhm.gov.in/abha-address',
|
||||
'value' => $abhaAddress,
|
||||
];
|
||||
}
|
||||
|
||||
return $patient;
|
||||
}
|
||||
|
||||
|
|
@ -226,40 +229,6 @@ abstract class AbstractModuleFhirGenerator
|
|||
$end = $ts !== false ? date(DATE_ATOM, $ts) : $end;
|
||||
}
|
||||
|
||||
$locationList = [];
|
||||
$locDisplay = trim((string) ($enc['location_display'] ?? $enc['location'] ?? $source['location_display'] ?? $source['location'] ?? ''));
|
||||
$ward = trim((string) ($enc['ward'] ?? $enc['ward_name'] ?? $source['ward'] ?? $source['ward_name'] ?? ''));
|
||||
$room = trim((string) ($enc['room'] ?? $enc['room_name'] ?? $source['room'] ?? $source['room_name'] ?? ''));
|
||||
$bed = trim((string) ($enc['bed'] ?? $enc['bed_no'] ?? $enc['bed_number'] ?? $source['bed'] ?? $source['bed_no'] ?? $source['bed_number'] ?? ''));
|
||||
|
||||
if ($locDisplay === '') {
|
||||
$locParts = [];
|
||||
if ($ward !== '') {
|
||||
$locParts[] = 'Ward: ' . $ward;
|
||||
}
|
||||
if ($room !== '') {
|
||||
$locParts[] = 'Room: ' . $room;
|
||||
}
|
||||
if ($bed !== '') {
|
||||
$locParts[] = 'Bed: ' . $bed;
|
||||
}
|
||||
$locDisplay = implode(', ', $locParts);
|
||||
}
|
||||
|
||||
if ($locDisplay !== '') {
|
||||
$locItem = [
|
||||
'location' => [
|
||||
'display' => $locDisplay,
|
||||
],
|
||||
'status' => 'completed',
|
||||
'period' => [
|
||||
'start' => $start,
|
||||
'end' => $end,
|
||||
],
|
||||
];
|
||||
$locationList[] = $locItem;
|
||||
}
|
||||
|
||||
$patientName = trim((string) ($source['patient']['name'] ?? $source['patient_name'] ?? 'Patient'));
|
||||
|
||||
$encounterResource = [
|
||||
|
|
@ -272,6 +241,7 @@ abstract class AbstractModuleFhirGenerator
|
|||
'status' => 'generated',
|
||||
'div' => '<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Encounter:</b> ' . $this->escapeXhtml($classDisplay) . ' ' . $this->escapeXhtml($id) . '</p></div>',
|
||||
],
|
||||
'identifier' => $identifiers,
|
||||
'status' => 'finished',
|
||||
'class' => [
|
||||
'system' => 'http://terminology.hl7.org/CodeSystem/v3-ActCode',
|
||||
|
|
@ -286,7 +256,6 @@ abstract class AbstractModuleFhirGenerator
|
|||
'start' => $start,
|
||||
'end' => $end,
|
||||
],
|
||||
'identifier' => $identifiers,
|
||||
'hospitalization' => [
|
||||
'dischargeDisposition' => [
|
||||
'coding' => [[
|
||||
|
|
@ -299,10 +268,6 @@ abstract class AbstractModuleFhirGenerator
|
|||
],
|
||||
];
|
||||
|
||||
if (! empty($locationList)) {
|
||||
$encounterResource['location'] = $locationList;
|
||||
}
|
||||
|
||||
return $encounterResource;
|
||||
}
|
||||
|
||||
|
|
@ -342,10 +307,18 @@ abstract class AbstractModuleFhirGenerator
|
|||
'div' => '<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Practitioner:</b> ' . $this->escapeXhtml($name) . '</p></div>',
|
||||
],
|
||||
'identifier' => [[
|
||||
'type' => ['coding' => [[
|
||||
'system' => 'http://terminology.hl7.org/CodeSystem/v2-0203',
|
||||
'code' => 'MD',
|
||||
'display' => 'Medical License number',
|
||||
]]],
|
||||
'system' => 'https://doctor.ndhm.gov.in',
|
||||
'value' => $hprId,
|
||||
]],
|
||||
'name' => [['text' => $name]],
|
||||
'name' => [[
|
||||
'use' => 'official',
|
||||
'text' => $name,
|
||||
]],
|
||||
];
|
||||
}
|
||||
|
||||
|
|
@ -378,6 +351,11 @@ abstract class AbstractModuleFhirGenerator
|
|||
],
|
||||
'name' => $name,
|
||||
'identifier' => [[
|
||||
'type' => ['coding' => [[
|
||||
'system' => 'http://terminology.hl7.org/CodeSystem/v2-0203',
|
||||
'code' => 'PRN',
|
||||
'display' => 'Provider number',
|
||||
]]],
|
||||
'system' => 'https://facility.ndhm.gov.in',
|
||||
'value' => $id,
|
||||
]],
|
||||
|
|
@ -395,7 +373,7 @@ abstract class AbstractModuleFhirGenerator
|
|||
return ! in_array($v, ['0', 'NA', 'N/A', 'N / A', 'N/ A', 'NONE', 'NIL', 'NULL', 'UNDEFINED', 'UNSPECIFIED'], true);
|
||||
}
|
||||
|
||||
/** Cleans HTML tags, entities, and line breaks into clean plain text for FHIR text fields. */
|
||||
/** Cleans HTML tags, entities, line breaks and non-ASCII text into clean single-line plain text for FHIR text fields. */
|
||||
protected function cleanPlainText(string $text): string
|
||||
{
|
||||
$text = trim($text);
|
||||
|
|
@ -403,15 +381,21 @@ abstract class AbstractModuleFhirGenerator
|
|||
return '';
|
||||
}
|
||||
|
||||
$text = preg_replace('/<\/(p|div|h[1-6]|li|tr)>/i', "\n", $text);
|
||||
$text = preg_replace('/<br\s*\/?>/i', "\n", $text);
|
||||
$text = preg_replace('/<\/(p|div|h[1-6]|li|tr)>/i', " ", $text);
|
||||
$text = preg_replace('/<br\s*\/?>/i', " ", $text);
|
||||
$text = strip_tags($text);
|
||||
$text = html_entity_decode($text, ENT_QUOTES | ENT_HTML5, 'UTF-8');
|
||||
|
||||
$lines = array_map('trim', explode("\n", $text));
|
||||
$lines = array_filter($lines, static fn($l) => $l !== '');
|
||||
// Remove non-ASCII characters (such as regional language scripts/Devanagari)
|
||||
$text = preg_replace('/[^\x20-\x7E]/', ' ', $text);
|
||||
|
||||
return trim(implode("\n", $lines));
|
||||
// Normalize spaces and empty pipe artifacts
|
||||
$text = preg_replace('/\|\s*\|+/', '|', $text);
|
||||
$text = preg_replace('/\s*\|\s*/', ' | ', $text);
|
||||
$text = preg_replace('/\s+/', ' ', $text);
|
||||
$text = trim($text, " \t\n\r\0\x0B|:.-");
|
||||
|
||||
return $text;
|
||||
}
|
||||
|
||||
/**
|
||||
|
|
|
|||
|
|
@ -26,7 +26,7 @@ class DischargeFhirGenerator extends \App\Libraries\Abdm\Fhir\Generators\Abstrac
|
|||
$builder = new \App\Libraries\Abdm\Fhir\FhirDocumentBuilder();
|
||||
$builder
|
||||
->buildBundleMeta($bundleIdentifier, $timestamp)
|
||||
->buildComposition($this->buildBaseComposition($source, 'IPD Discharge Summary', '18842-5', 'Discharge summary'))
|
||||
->buildComposition($this->buildBaseComposition($source, 'Discharge Summary', '18842-5', 'Discharge summary'))
|
||||
->updateComposition([
|
||||
'meta' => [
|
||||
'versionId' => '1',
|
||||
|
|
@ -35,6 +35,8 @@ class DischargeFhirGenerator extends \App\Libraries\Abdm\Fhir\Generators\Abstrac
|
|||
'https://nrces.in/ndhm/fhir/r4/StructureDefinition/DischargeSummaryRecord',
|
||||
],
|
||||
],
|
||||
// NRCES DischargeSummaryRecord profile requires SNOMED-only coding for Composition.type
|
||||
// Adding LOINC as a second coding causes PHR parsers to reject the bundle
|
||||
'type' => ['coding' => [
|
||||
[
|
||||
'system' => 'http://snomed.info/sct',
|
||||
|
|
@ -94,26 +96,15 @@ class DischargeFhirGenerator extends \App\Libraries\Abdm\Fhir\Generators\Abstrac
|
|||
|
||||
$diagnosesList = (array) ($source['diagnoses'] ?? $source['conditions'] ?? []);
|
||||
$chiefComplaintsList = (array) ($source['chief_complaints'] ?? []);
|
||||
if ($diagnosesList === [] && $chiefComplaintsList !== []) {
|
||||
$diagnosesList = $chiefComplaintsList;
|
||||
}
|
||||
|
||||
$encounterDiagnoses = [];
|
||||
|
||||
$conditionGroups = [
|
||||
[
|
||||
'items' => $chiefComplaintsList,
|
||||
'prefix' => 'discharge-chief-complaint-',
|
||||
'category_code' => 'problem-list-item',
|
||||
'category_display' => 'Problem List Item',
|
||||
'is_encounter_diagnosis' => false,
|
||||
'items' => $chiefComplaintsList,
|
||||
'prefix' => 'discharge-chief-complaint-',
|
||||
],
|
||||
[
|
||||
'items' => $diagnosesList,
|
||||
'prefix' => 'discharge-diagnosis-',
|
||||
'category_code' => 'encounter-diagnosis',
|
||||
'category_display' => 'Encounter Diagnosis',
|
||||
'is_encounter_diagnosis' => true,
|
||||
'items' => $diagnosesList,
|
||||
'prefix' => 'discharge-diagnosis-',
|
||||
],
|
||||
];
|
||||
foreach ($conditionGroups as $group) {
|
||||
|
|
@ -135,19 +126,6 @@ class DischargeFhirGenerator extends \App\Libraries\Abdm\Fhir\Generators\Abstrac
|
|||
}
|
||||
|
||||
$conditionId = $group['prefix'] . $recordId . '-' . $idx;
|
||||
|
||||
if ($group['is_encounter_diagnosis']) {
|
||||
$encounterDiagnoses[] = [
|
||||
'condition' => ['reference' => 'urn:uuid:' . $conditionId, 'display' => $text],
|
||||
'use' => [
|
||||
'coding' => [[
|
||||
'system' => 'http://terminology.hl7.org/CodeSystem/diagnosis-role',
|
||||
'code' => 'DD',
|
||||
'display' => 'Discharge diagnosis'
|
||||
]]
|
||||
]
|
||||
];
|
||||
}
|
||||
|
||||
$builder->addCondition([
|
||||
'resourceType' => 'Condition',
|
||||
|
|
@ -155,39 +133,26 @@ class DischargeFhirGenerator extends \App\Libraries\Abdm\Fhir\Generators\Abstrac
|
|||
'meta' => ['profile' => ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/Condition']],
|
||||
'text' => [
|
||||
'status' => 'generated',
|
||||
'div' => '<div xmlns="http://www.w3.org/1999/xhtml"><p><b>' . htmlspecialchars($group['category_display']) . ':</b> ' . htmlspecialchars($text) . '</p></div>',
|
||||
'div' => '<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Condition:</b> ' . htmlspecialchars($text) . '</p></div>',
|
||||
],
|
||||
'clinicalStatus' => ['coding' => [[
|
||||
'system' => 'http://terminology.hl7.org/CodeSystem/condition-clinical',
|
||||
'code' => 'active',
|
||||
'display' => 'Active',
|
||||
]]],
|
||||
'verificationStatus' => ['coding' => [[
|
||||
'system' => 'http://terminology.hl7.org/CodeSystem/condition-ver-status',
|
||||
'code' => 'confirmed',
|
||||
'display' => 'Confirmed',
|
||||
]]],
|
||||
'category' => [['coding' => [[
|
||||
'system' => 'http://terminology.hl7.org/CodeSystem/condition-category',
|
||||
'code' => $group['category_code'],
|
||||
'display' => $group['category_display'],
|
||||
]]]],
|
||||
'code' => ['coding' => $coding, 'text' => $text],
|
||||
'subject' => ['reference' => $patientRef, 'display' => (string) ($source['patient']['name'] ?? $source['patient_name'] ?? 'Patient')],
|
||||
'encounter' => $encounterRef ? ['reference' => $encounterRef] : null,
|
||||
'recordedDate' => (string) ($cond['recorded_at'] ?? $timestamp),
|
||||
'recordedDate' => (string) ($cond['recorded_date'] ?? $source['admission_date'] ?? $timestamp),
|
||||
]);
|
||||
}
|
||||
}
|
||||
|
||||
if (is_array($encounter)) {
|
||||
if ($encounterDiagnoses !== []) {
|
||||
$encounter['diagnosis'] = $encounterDiagnoses;
|
||||
}
|
||||
$builder->addEncounter($encounter);
|
||||
}
|
||||
|
||||
foreach ((array) ($source['procedures'] ?? []) as $idx => $proc) {
|
||||
// ── Procedures ─────────────────────────────────────────────────────────
|
||||
foreach ((array) ($source['ui_surgeries'] ?? $source['procedures'] ?? []) as $idx => $proc) {
|
||||
$text = trim((string) ($proc['text'] ?? $proc['name'] ?? ''));
|
||||
if ($text === '') {
|
||||
continue;
|
||||
|
|
@ -225,12 +190,13 @@ class DischargeFhirGenerator extends \App\Libraries\Abdm\Fhir\Generators\Abstrac
|
|||
'text' => $text,
|
||||
],
|
||||
'subject' => ['reference' => $patientRef, 'display' => (string) ($source['patient']['name'] ?? $source['patient_name'] ?? 'Patient')],
|
||||
'encounter' => $encounterRef ? ['reference' => $encounterRef] : null,
|
||||
'performedDateTime' => (string) ($proc['performed_at'] ?? $timestamp),
|
||||
]);
|
||||
}
|
||||
|
||||
foreach ((array) ($source['medications'] ?? []) as $idx => $med) {
|
||||
|
||||
// ── Discharge Medications ───────────────────────────────────────────────
|
||||
foreach ((array) ($source['ui_discharge_medicine'] ?? $source['medications'] ?? []) as $idx => $med) {
|
||||
$name = trim((string) ($med['name'] ?? ''));
|
||||
if (! $this->isMeaningfulValue($name)) {
|
||||
continue;
|
||||
|
|
@ -248,7 +214,7 @@ class DischargeFhirGenerator extends \App\Libraries\Abdm\Fhir\Generators\Abstrac
|
|||
$medCoding[] = [
|
||||
'system' => 'http://snomed.info/sct',
|
||||
'code' => '105904009', // Type of drug
|
||||
'display' => 'Type of drug',
|
||||
'display' => $name,
|
||||
];
|
||||
}
|
||||
|
||||
|
|
@ -269,12 +235,12 @@ class DischargeFhirGenerator extends \App\Libraries\Abdm\Fhir\Generators\Abstrac
|
|||
[
|
||||
'coding' => [
|
||||
[
|
||||
'system' => 'http://terminology.hl7.org/CodeSystem/medicationrequest-category',
|
||||
'code' => 'community',
|
||||
'display' => 'Discharge Medication',
|
||||
'system' => 'http://terminology.hl7.org/CodeSystem/medicationrequest-category',
|
||||
'code' => 'discharge',
|
||||
'display' => 'Discharge',
|
||||
],
|
||||
],
|
||||
'text' => 'Discharge Medication',
|
||||
'text' => 'Discharge',
|
||||
],
|
||||
],
|
||||
'subject' => ['reference' => $patientRef, 'display' => (string) ($source['patient']['name'] ?? $source['patient_name'] ?? 'Patient')],
|
||||
|
|
@ -285,10 +251,6 @@ class DischargeFhirGenerator extends \App\Libraries\Abdm\Fhir\Generators\Abstrac
|
|||
],
|
||||
];
|
||||
|
||||
if ($encounterRef) {
|
||||
$medResource['encounter'] = ['reference' => $encounterRef];
|
||||
}
|
||||
|
||||
if (is_array($practitioner)) {
|
||||
$medResource['requester'] = [
|
||||
'reference' => 'urn:uuid:' . (string) $practitioner['id'],
|
||||
|
|
@ -300,171 +262,11 @@ class DischargeFhirGenerator extends \App\Libraries\Abdm\Fhir\Generators\Abstrac
|
|||
$medResource['dosageInstruction'] = $structuredDosage['dosageInstruction'];
|
||||
}
|
||||
|
||||
if (!empty($structuredDosage['dispenseRequest'])) {
|
||||
$medResource['dispenseRequest'] = $structuredDosage['dispenseRequest'];
|
||||
}
|
||||
|
||||
$builder->addMedicationRequest($medResource);
|
||||
}
|
||||
|
||||
foreach ((array) ($source['observations'] ?? []) as $idx => $obs) {
|
||||
$text = trim((string) ($obs['text'] ?? ''));
|
||||
$value = trim((string) ($obs['value'] ?? ''));
|
||||
if (! $this->isMeaningfulValue($text) || ! $this->isMeaningfulValue($value)) {
|
||||
continue;
|
||||
}
|
||||
|
||||
$catText = trim((string) ($obs['category'] ?? $obs['category_text'] ?? $obs['stage'] ?? $obs['timing'] ?? ''));
|
||||
$isAdm = (stripos($catText, 'Admission') !== false || stripos($text, 'Admission') !== false);
|
||||
$isDis = (stripos($catText, 'Discharge') !== false || stripos($text, 'Discharge') !== false);
|
||||
$obsCategoryDisplay = $isAdm ? 'Condition on Admission Time' : ($isDis ? 'Condition on Discharge Time' : 'Vital Signs');
|
||||
$coding = [];
|
||||
$loincCode = trim((string) ($obs['loinc_code'] ?? ''));
|
||||
$loincDisplay = trim((string) ($obs['loinc_display'] ?? ''));
|
||||
if ($loincCode === '') {
|
||||
$vitalLoinc = $this->resolveVitalSignLoinc($text);
|
||||
if ($vitalLoinc['code'] !== '') {
|
||||
$loincCode = $vitalLoinc['code'];
|
||||
$loincDisplay = $vitalLoinc['display'];
|
||||
}
|
||||
}
|
||||
|
||||
$isVital = ($loincCode !== '' && $loincCode !== '108252007');
|
||||
$obsCategoryCode = $isVital ? 'vital-signs' : 'exam';
|
||||
$obsCategoryCanonicalDisplay = $isVital ? 'Vital Signs' : 'Exam';
|
||||
$obsCategorySystem = 'http://terminology.hl7.org/CodeSystem/observation-category';
|
||||
|
||||
if ($loincCode !== '') {
|
||||
$coding[] = [
|
||||
'system' => 'http://loinc.org',
|
||||
'code' => $loincCode,
|
||||
'display' => $loincDisplay !== '' ? $loincDisplay : $text,
|
||||
];
|
||||
} else {
|
||||
$fallback = $this->resolvePhysicalExamSnomedCode($text);
|
||||
$coding[] = [
|
||||
'system' => 'http://snomed.info/sct',
|
||||
'code' => $fallback['code'],
|
||||
'display' => $fallback['display'],
|
||||
];
|
||||
}
|
||||
|
||||
$obsResource = [
|
||||
'resourceType' => 'Observation',
|
||||
'id' => 'discharge-observation-' . $recordId . '-' . $idx,
|
||||
'meta' => ['profile' => ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/Observation']],
|
||||
'text' => [
|
||||
'status' => 'generated',
|
||||
'div' => '<div xmlns="http://www.w3.org/1999/xhtml"><p><b>' . htmlspecialchars($text) . ':</b> ' . htmlspecialchars($value) . '</p></div>',
|
||||
],
|
||||
'status' => 'final',
|
||||
'category' => [[
|
||||
'text' => $obsCategoryDisplay,
|
||||
'coding' => [[
|
||||
'system' => $obsCategorySystem,
|
||||
'code' => $obsCategoryCode,
|
||||
'display' => $obsCategoryCanonicalDisplay,
|
||||
]],
|
||||
]],
|
||||
'code' => [
|
||||
'coding' => $coding,
|
||||
'text' => $text,
|
||||
],
|
||||
'subject' => ['reference' => $patientRef, 'display' => (string) ($source['patient']['name'] ?? $source['patient_name'] ?? 'Patient')],
|
||||
'encounter' => $encounterRef ? ['reference' => $encounterRef] : null,
|
||||
'effectiveDateTime' => (string) ($obs['effective_at'] ?? $timestamp),
|
||||
];
|
||||
|
||||
if ($loincCode === '85354-9' || str_contains(strtoupper($text), 'BP') || str_contains(strtoupper($text), 'BLOOD PRESSURE')) {
|
||||
$loincCode = '85354-9';
|
||||
$loincDisplay = 'Blood pressure panel with all children optional';
|
||||
$coding = [[
|
||||
'system' => 'http://loinc.org',
|
||||
'code' => '85354-9',
|
||||
'display' => 'Blood pressure panel with all children optional',
|
||||
]];
|
||||
$obsResource['code'] = [
|
||||
'coding' => $coding,
|
||||
'text' => $text,
|
||||
];
|
||||
|
||||
if (preg_match('/(\d+(?:\.\d+)?)\s*[\/\-]\s*(\d+(?:\.\d+)?)/', $value, $bpMatches)) {
|
||||
$systolic = (float) $bpMatches[1];
|
||||
$diastolic = (float) $bpMatches[2];
|
||||
$obsResource['component'] = [
|
||||
[
|
||||
'code' => [
|
||||
'coding' => [[
|
||||
'system' => 'http://loinc.org',
|
||||
'code' => '8480-6',
|
||||
'display' => 'Systolic blood pressure',
|
||||
]],
|
||||
'text' => 'Systolic blood pressure',
|
||||
],
|
||||
'valueQuantity' => [
|
||||
'value' => $systolic,
|
||||
'unit' => 'mmHg',
|
||||
'system' => 'http://unitsofmeasure.org',
|
||||
'code' => 'mm[Hg]',
|
||||
],
|
||||
],
|
||||
[
|
||||
'code' => [
|
||||
'coding' => [[
|
||||
'system' => 'http://loinc.org',
|
||||
'code' => '8462-4',
|
||||
'display' => 'Diastolic blood pressure',
|
||||
]],
|
||||
'text' => 'Diastolic blood pressure',
|
||||
],
|
||||
'valueQuantity' => [
|
||||
'value' => $diastolic,
|
||||
'unit' => 'mmHg',
|
||||
'system' => 'http://unitsofmeasure.org',
|
||||
'code' => 'mm[Hg]',
|
||||
],
|
||||
],
|
||||
];
|
||||
} elseif (is_numeric($value)) {
|
||||
$systolic = (float) $value;
|
||||
$obsResource['component'] = [
|
||||
[
|
||||
'code' => [
|
||||
'coding' => [[
|
||||
'system' => 'http://loinc.org',
|
||||
'code' => '8480-6',
|
||||
'display' => 'Systolic blood pressure',
|
||||
]],
|
||||
'text' => 'Systolic blood pressure',
|
||||
],
|
||||
'valueQuantity' => [
|
||||
'value' => $systolic,
|
||||
'unit' => 'mmHg',
|
||||
'system' => 'http://unitsofmeasure.org',
|
||||
'code' => 'mm[Hg]',
|
||||
],
|
||||
],
|
||||
];
|
||||
} else {
|
||||
$obsResource['valueString'] = $value;
|
||||
}
|
||||
} elseif (is_numeric($value)) {
|
||||
$unitInfo = $this->getVitalSignUnitInfo($text, trim((string) ($obs['unit'] ?? '')));
|
||||
$vq = ['value' => (float) $value];
|
||||
if ($unitInfo['unit'] !== '') {
|
||||
$vq['unit'] = $unitInfo['unit'];
|
||||
$vq['system'] = 'http://unitsofmeasure.org';
|
||||
$vq['code'] = $unitInfo['code'] !== '' ? $unitInfo['code'] : $unitInfo['unit'];
|
||||
}
|
||||
$obsResource['valueQuantity'] = $vq;
|
||||
} else {
|
||||
$obsResource['valueString'] = $value;
|
||||
}
|
||||
|
||||
$builder->addObservation($obsResource);
|
||||
}
|
||||
|
||||
foreach ((array) ($source['investigations'] ?? []) as $idx => $inv) {
|
||||
// ── Investigations ─────────────────────────────────────────────────────
|
||||
foreach ((array) ($source['ui_investigations'] ?? $source['investigations'] ?? []) as $idx => $inv) {
|
||||
$text = trim((string) ($inv['text'] ?? ''));
|
||||
if ($text === '') {
|
||||
continue;
|
||||
|
|
@ -511,7 +313,6 @@ class DischargeFhirGenerator extends \App\Libraries\Abdm\Fhir\Generators\Abstrac
|
|||
'div' => '<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Investigation:</b> ' . htmlspecialchars($text) . ($resultValue !== '' ? (': ' . htmlspecialchars($resultValue)) : '') . '</p></div>',
|
||||
],
|
||||
'status' => 'final',
|
||||
// NRCES Observation profile requires at least one category.
|
||||
'category' => [[
|
||||
'coding' => [[
|
||||
'system' => 'http://terminology.hl7.org/CodeSystem/observation-category',
|
||||
|
|
@ -525,7 +326,6 @@ class DischargeFhirGenerator extends \App\Libraries\Abdm\Fhir\Generators\Abstrac
|
|||
'text' => $text,
|
||||
],
|
||||
'subject' => ['reference' => $patientRef, 'display' => (string) ($source['patient']['name'] ?? $source['patient_name'] ?? 'Patient')],
|
||||
'encounter' => $encounterRef ? ['reference' => $encounterRef] : null,
|
||||
'effectiveDateTime' => (string) ($inv['reported_at'] ?? $inv['authored_on'] ?? $timestamp),
|
||||
];
|
||||
|
||||
|
|
@ -560,12 +360,12 @@ class DischargeFhirGenerator extends \App\Libraries\Abdm\Fhir\Generators\Abstrac
|
|||
'text' => $text,
|
||||
],
|
||||
'subject' => ['reference' => $patientRef, 'display' => (string) ($source['patient']['name'] ?? $source['patient_name'] ?? 'Patient')],
|
||||
'encounter' => $encounterRef ? ['reference' => $encounterRef] : null,
|
||||
'issued' => (string) ($inv['reported_at'] ?? $inv['authored_on'] ?? $timestamp),
|
||||
'result' => [['reference' => 'urn:uuid:' . $observationId, 'display' => $text]],
|
||||
]);
|
||||
}
|
||||
|
||||
// ── Allergies ──────────────────────────────────────────────────────────
|
||||
foreach ((array) ($source['allergies'] ?? []) as $idx => $alg) {
|
||||
$text = trim((string) ($alg['text'] ?? ''));
|
||||
if ($text === '') {
|
||||
|
|
@ -606,7 +406,9 @@ class DischargeFhirGenerator extends \App\Libraries\Abdm\Fhir\Generators\Abstrac
|
|||
]);
|
||||
}
|
||||
|
||||
foreach ((array) ($source['care_plans'] ?? []) as $idx => $cp) {
|
||||
|
||||
// ── Care Plans / Discharge Advice ──────────────────────────────────────
|
||||
foreach ((array) ($source['ui_discharge_summary'] ?? $source['care_plans'] ?? []) as $idx => $cp) {
|
||||
$title = $this->cleanPlainText((string) ($cp['title'] ?? 'Discharge Advice'));
|
||||
$description = $this->cleanPlainText((string) ($cp['description'] ?? ''));
|
||||
if (! $this->isMeaningfulValue($description)) {
|
||||
|
|
@ -626,51 +428,23 @@ class DischargeFhirGenerator extends \App\Libraries\Abdm\Fhir\Generators\Abstrac
|
|||
'title' => $title !== '' ? $title : 'Discharge Advice',
|
||||
'description' => $description,
|
||||
'subject' => ['reference' => $patientRef, 'display' => (string) ($source['patient']['name'] ?? $source['patient_name'] ?? 'Patient')],
|
||||
'created' => (string) ($cp['created_at'] ?? $timestamp),
|
||||
'category' => [
|
||||
[
|
||||
'coding' => [
|
||||
[
|
||||
'system' => 'http://snomed.info/sct',
|
||||
'code' => '736271009',
|
||||
'display' => 'Outpatient care plan'
|
||||
'code' => '734163000',
|
||||
'display' => 'Care plan'
|
||||
]
|
||||
]
|
||||
]
|
||||
],
|
||||
'activity' => [
|
||||
[
|
||||
'detail' => [
|
||||
'kind' => 'ServiceRequest',
|
||||
'code' => [
|
||||
'coding' => [
|
||||
[
|
||||
'system' => 'http://snomed.info/sct',
|
||||
'code' => '385676005',
|
||||
'display' => 'General advice and education'
|
||||
]
|
||||
]
|
||||
],
|
||||
'status' => 'scheduled',
|
||||
'description' => $description,
|
||||
]
|
||||
]
|
||||
]
|
||||
];
|
||||
|
||||
if ($encounterRef) {
|
||||
$carePlanResource['encounter'] = ['reference' => $encounterRef];
|
||||
}
|
||||
if (is_array($practitioner)) {
|
||||
$carePlanResource['author'] = [
|
||||
'reference' => 'urn:uuid:' . (string) $practitioner['id'],
|
||||
'display' => (string) ($practitioner['name'][0]['text'] ?? ''),
|
||||
];
|
||||
}
|
||||
|
||||
$builder->addCarePlan($carePlanResource);
|
||||
}
|
||||
|
||||
|
||||
$documentsList = (array) ($source['documents'] ?? []);
|
||||
if (empty($documentsList)) {
|
||||
$documentsList = [$this->generateDynamicDischargePdfDocument($source)];
|
||||
|
|
@ -685,7 +459,6 @@ class DischargeFhirGenerator extends \App\Libraries\Abdm\Fhir\Generators\Abstrac
|
|||
$docTitle = trim((string) ($document['title'] ?? 'Clinical document'));
|
||||
$snomedCode = trim((string) ($document['snomed_code'] ?? ''));
|
||||
$snomedDisplay = trim((string) ($document['snomed_display'] ?? ''));
|
||||
$loincCode = trim((string) ($document['loinc_code'] ?? ''));
|
||||
|
||||
$typeCoding = [];
|
||||
if (stripos($docTitle, 'Bill') !== false || stripos($docTitle, 'Invoice') !== false) {
|
||||
|
|
@ -702,10 +475,6 @@ class DischargeFhirGenerator extends \App\Libraries\Abdm\Fhir\Generators\Abstrac
|
|||
];
|
||||
}
|
||||
|
||||
$rawBytes = base64_decode($data);
|
||||
$fileSize = is_string($rawBytes) ? strlen($rawBytes) : 0;
|
||||
$sha1Hash = is_string($rawBytes) && $rawBytes !== '' ? base64_encode(sha1($rawBytes, true)) : '';
|
||||
|
||||
$docRef = [
|
||||
'resourceType' => 'DocumentReference',
|
||||
'id' => 'discharge-document-' . $recordId . '-' . $idx,
|
||||
|
|
@ -724,62 +493,37 @@ class DischargeFhirGenerator extends \App\Libraries\Abdm\Fhir\Generators\Abstrac
|
|||
'reference' => $patientRef,
|
||||
'display' => (string) ($source['patient']['name'] ?? $source['patient_name'] ?? 'Patient'),
|
||||
],
|
||||
'date' => (string) ($document['created_at'] ?? $timestamp),
|
||||
'author' => is_array($practitioner) ? [[
|
||||
'reference' => 'urn:uuid:' . (string) $practitioner['id'],
|
||||
'display' => (string) ($practitioner['name'][0]['text'] ?? ''),
|
||||
]] : null,
|
||||
'custodian' => is_array($organization) ? [
|
||||
'reference' => 'urn:uuid:' . (string) $organization['id'],
|
||||
'display' => (string) ($organization['name'] ?? ''),
|
||||
] : null,
|
||||
'description' => $docTitle,
|
||||
'content' => [[
|
||||
'attachment' => [
|
||||
'contentType' => (string) ($document['content_type'] ?? 'application/pdf'),
|
||||
'language' => 'en-IN',
|
||||
'data' => $data,
|
||||
'size' => $fileSize,
|
||||
'title' => $docTitle,
|
||||
'creation' => (string) ($document['created_at'] ?? $timestamp),
|
||||
],
|
||||
]],
|
||||
];
|
||||
|
||||
if ($sha1Hash !== '') {
|
||||
$docRef['content'][0]['attachment']['hash'] = $sha1Hash;
|
||||
}
|
||||
|
||||
$builder->addDocumentReference($docRef);
|
||||
}
|
||||
|
||||
$rawObservations = (array) ($source['ui_physical_exam'] ?? $source['observations'] ?? []);
|
||||
$admissionObsIndexed = [];
|
||||
$dischargeObsIndexed = [];
|
||||
foreach ($rawObservations as $idx => $obs) {
|
||||
$cat = trim((string) ($obs['category'] ?? $obs['category_text'] ?? $obs['stage'] ?? $obs['timing'] ?? ''));
|
||||
$txt = trim((string) ($obs['text'] ?? ''));
|
||||
if (stripos($cat, 'Admission') !== false || stripos($txt, 'Admission') !== false) {
|
||||
$admissionObsIndexed[$idx] = $obs;
|
||||
} elseif (stripos($cat, 'Discharge') !== false || stripos($txt, 'Discharge') !== false) {
|
||||
$dischargeObsIndexed[$idx] = $obs;
|
||||
}
|
||||
}
|
||||
|
||||
$chiefComplaintsList = (array) ($source['ui_complaints'] ?? $source['chief_complaints'] ?? []);
|
||||
$complaintsNarrative = trim((string) ($source['ui_complaint_narrative'] ?? $source['chief_complaint_narrative'] ?? ''));
|
||||
|
||||
$diagnosesList = (array) ($source['ui_final_diagnosis'] ?? $source['diagnoses'] ?? $source['conditions'] ?? []);
|
||||
$clinicalHistoryNarrative = trim((string) ($source['ui_clinical_history'] ?? ''));
|
||||
|
||||
$admissionNarrative = trim((string) ($source['ui_admission_discharge'] ?? $source['admission_discharge_narrative'] ?? ''));
|
||||
|
||||
$sectionDefinitions = [
|
||||
// Chief complaints
|
||||
['title' => 'Chief complaints', 'code' => '422843007', 'display' => 'Chief complaint section', 'prefix' => 'discharge-chief-complaint-', 'items' => $chiefComplaintsList, 'narrative' => $complaintsNarrative],
|
||||
// Discharge Diagnosis
|
||||
['title' => 'Discharge Diagnosis', 'code' => '397659008', 'display' => 'Discharge diagnosis', 'prefix' => 'discharge-diagnosis-', 'items' => $diagnosesList, 'narrative' => $clinicalHistoryNarrative],
|
||||
];
|
||||
$sectionDefinitions = [];
|
||||
// Chief complaints
|
||||
if (! empty($chiefComplaintsList) || $complaintsNarrative !== '') {
|
||||
$sectionDefinitions[] = ['title' => 'Chief complaints', 'code' => '422843007', 'display' => 'Chief complaint section', 'prefix' => 'discharge-chief-complaint-', 'items' => $chiefComplaintsList, 'narrative' => $complaintsNarrative];
|
||||
}
|
||||
|
||||
// Discharge Diagnosis (Medical History)
|
||||
if (! empty($diagnosesList) || $clinicalHistoryNarrative !== '') {
|
||||
$sectionDefinitions[] = ['title' => 'Medical History', 'code' => '1003642006', 'display' => 'Past medical history section', 'prefix' => 'discharge-diagnosis-', 'items' => $diagnosesList, 'narrative' => $clinicalHistoryNarrative];
|
||||
}
|
||||
|
||||
// Surgery / Procedure
|
||||
$surgeries = (array) ($source['ui_surgeries'] ?? $source['procedures'] ?? []);
|
||||
|
|
@ -793,50 +537,22 @@ class DischargeFhirGenerator extends \App\Libraries\Abdm\Fhir\Generators\Abstrac
|
|||
$sectionDefinitions[] = ['title' => 'Medications', 'code' => '1003606003', 'display' => 'Medication history section', 'prefix' => 'discharge-medication-', 'items' => $meds];
|
||||
}
|
||||
|
||||
// Physical Examinations on Admission
|
||||
if (! empty($admissionObsIndexed)) {
|
||||
$sectionDefinitions[] = ['title' => 'Condition on Admission Time', 'code' => '425044008', 'display' => 'Physical exam section', 'prefix' => 'discharge-observation-', 'items_indexed' => $admissionObsIndexed];
|
||||
}
|
||||
|
||||
// Physical Examinations on Discharge
|
||||
if (! empty($dischargeObsIndexed)) {
|
||||
$sectionDefinitions[] = ['title' => 'Condition on Discharge Time', 'code' => '425044008', 'display' => 'Physical exam section', 'prefix' => 'discharge-observation-', 'items_indexed' => $dischargeObsIndexed];
|
||||
}
|
||||
|
||||
// Additional Observations not captured in Admission/Discharge
|
||||
$otherObs = array_diff_key($rawObservations, $admissionObsIndexed, $dischargeObsIndexed);
|
||||
if (! empty($otherObs)) {
|
||||
$sectionDefinitions[] = ['title' => 'Other Physical examination', 'code' => '425044008', 'display' => 'Physical exam section', 'prefix' => 'discharge-observation-', 'items_indexed' => $otherObs];
|
||||
}
|
||||
|
||||
// Investigations
|
||||
$investigations = (array) ($source['ui_investigations'] ?? $source['investigations'] ?? []);
|
||||
$invNarrative = trim((string) ($source['ui_summary_investigation'] ?? ''));
|
||||
if (! empty($investigations) || $invNarrative !== '') {
|
||||
$sectionDefinitions[] = ['title' => 'Clinical Investigation Reports', 'code' => '721981007', 'display' => 'Diagnostic studies report', 'prefix' => 'discharge-investigation-', 'items' => $investigations, 'narrative' => $invNarrative];
|
||||
$sectionDefinitions[] = ['title' => 'Investigations', 'code' => '721981007', 'display' => 'Diagnostic studies report', 'prefix' => 'discharge-investigation-', 'items' => $investigations, 'narrative' => $invNarrative];
|
||||
}
|
||||
|
||||
// Admission / Discharge Details
|
||||
if ($admissionNarrative !== '') {
|
||||
$admItems = $encounterRef ? [['name' => 'Admission and Discharge Details', 'id' => 'encounter-' . $recordId]] : [];
|
||||
$sectionDefinitions[] = ['title' => 'Admission / Discharge Information', 'code' => '422838006', 'display' => 'Admission details', 'prefix' => 'discharge-admission-', 'items' => $admItems, 'narrative' => $admissionNarrative];
|
||||
}
|
||||
|
||||
// Course / Treatment
|
||||
$course = (array) ($source['ui_course_treatment'] ?? []);
|
||||
if (! empty($course)) {
|
||||
$sectionDefinitions[] = ['title' => 'Course / Treatment in the hospital', 'code' => '734163000', 'display' => 'Care plan', 'prefix' => 'discharge-course-', 'items' => $course];
|
||||
}
|
||||
|
||||
|
||||
// Care plans / Discharge advice
|
||||
$carePlans = (array) ($source['ui_discharge_summary'] ?? $source['care_plans'] ?? []);
|
||||
if (! empty($carePlans)) {
|
||||
$sectionDefinitions[] = ['title' => 'Care plan', 'code' => '734163000', 'display' => 'Care plan', 'prefix' => 'discharge-careplan-', 'items' => $carePlans];
|
||||
$sectionDefinitions[] = ['title' => 'Care Plan', 'code' => '734163000', 'display' => 'Care plan', 'prefix' => 'discharge-careplan-', 'items' => $carePlans];
|
||||
}
|
||||
|
||||
|
||||
// Document Reference
|
||||
if (! empty($documentsList)) {
|
||||
$sectionDefinitions[] = ['title' => 'Document reference', 'code' => '373942005', 'display' => 'Discharge summary', 'prefix' => 'discharge-document-', 'items' => $documentsList];
|
||||
$sectionDefinitions[] = ['title' => 'Document Reference', 'code' => '373942005', 'display' => 'Discharge summary', 'prefix' => 'discharge-document-', 'items' => $documentsList];
|
||||
}
|
||||
|
||||
// Allergies
|
||||
|
|
@ -848,7 +564,6 @@ class DischargeFhirGenerator extends \App\Libraries\Abdm\Fhir\Generators\Abstrac
|
|||
$sections = [];
|
||||
foreach ($sectionDefinitions as $definition) {
|
||||
$references = [];
|
||||
$narrativeParts = [];
|
||||
$items = isset($definition['items_indexed']) ? $definition['items_indexed'] : (array) ($definition['items'] ?? []);
|
||||
foreach ($items as $idx => $item) {
|
||||
$itemDisplay = $this->cleanPlainText((string) ($item['name'] ?? $item['text'] ?? $item['title'] ?? $definition['title']));
|
||||
|
|
@ -859,18 +574,10 @@ class DischargeFhirGenerator extends \App\Libraries\Abdm\Fhir\Generators\Abstrac
|
|||
'reference' => 'urn:uuid:' . $definition['prefix'] . $recordId . '-' . $idx,
|
||||
'display' => $itemDisplay,
|
||||
];
|
||||
$narrative = $this->sectionItemNarrative((array) $item);
|
||||
if ($narrative !== '') {
|
||||
$narrativeParts[] = $narrative;
|
||||
}
|
||||
}
|
||||
$sectionNarrative = trim((string) ($definition['narrative'] ?? ''));
|
||||
if ($references === [] && $sectionNarrative === '') {
|
||||
if ($references === []) {
|
||||
continue;
|
||||
}
|
||||
if ($sectionNarrative !== '') {
|
||||
array_unshift($narrativeParts, $sectionNarrative);
|
||||
}
|
||||
$sec = [
|
||||
'title' => $definition['title'],
|
||||
'code' => ['coding' => [[
|
||||
|
|
@ -878,18 +585,8 @@ class DischargeFhirGenerator extends \App\Libraries\Abdm\Fhir\Generators\Abstrac
|
|||
'code' => $definition['code'],
|
||||
'display' => $definition['display'],
|
||||
]]],
|
||||
'entry' => $references,
|
||||
];
|
||||
if ($references !== []) {
|
||||
$sec['entry'] = $references;
|
||||
}
|
||||
if ($narrativeParts !== []) {
|
||||
$sec['text'] = [
|
||||
'status' => 'generated',
|
||||
'div' => '<div xmlns="http://www.w3.org/1999/xhtml"><ul><li>'
|
||||
. implode('</li><li>', array_map('htmlspecialchars', $narrativeParts))
|
||||
. '</li></ul></div>',
|
||||
];
|
||||
}
|
||||
$sections[] = $sec;
|
||||
}
|
||||
|
||||
|
|
@ -1659,9 +1356,9 @@ class DischargeFhirGenerator extends \App\Libraries\Abdm\Fhir\Generators\Abstrac
|
|||
}
|
||||
|
||||
// Route detection
|
||||
$routeCode = '260548002';
|
||||
$routeDisplay = 'Oral route';
|
||||
$routeText = 'Oral';
|
||||
$routeCode = '26643006';
|
||||
$routeDisplay = 'Oral Route';
|
||||
$routeText = 'Oral Route';
|
||||
|
||||
if (preg_match('/\b(INJ|IV|INTRAVENOUS|INFUSION)\b/', $raw)) {
|
||||
$routeCode = '47625008';
|
||||
|
|
@ -1683,22 +1380,17 @@ class DischargeFhirGenerator extends \App\Libraries\Abdm\Fhir\Generators\Abstrac
|
|||
|
||||
// Dose unit detection
|
||||
$doseUnit = 'Tablet';
|
||||
$doseUnitCode = 'tbl';
|
||||
$doseValue = 1;
|
||||
|
||||
if (preg_match('/\b(SACHET|POWDER)\b/', $raw)) {
|
||||
$doseUnit = 'Sachet';
|
||||
$doseUnitCode = 'sachet';
|
||||
} elseif (preg_match('/\b(SYRUP|SUSPENSION|ML)\b/', $raw)) {
|
||||
$doseUnit = 'mL';
|
||||
$doseUnitCode = 'mL';
|
||||
$doseValue = 5;
|
||||
} elseif (preg_match('/\b(CAPSULE|CAP)\b/', $raw)) {
|
||||
$doseUnit = 'Capsule';
|
||||
$doseUnitCode = 'capsule';
|
||||
} elseif (preg_match('/\b(DROPS?)\b/', $raw)) {
|
||||
$doseUnit = 'drops';
|
||||
$doseUnitCode = '[drp]';
|
||||
$doseValue = 2;
|
||||
}
|
||||
|
||||
|
|
@ -1708,24 +1400,44 @@ class DischargeFhirGenerator extends \App\Libraries\Abdm\Fhir\Generators\Abstrac
|
|||
$durationDays = (int) $dm[1];
|
||||
}
|
||||
|
||||
$foodSuffix = '';
|
||||
if (preg_match('/\b(EMPTY STOMACH|BEFORE FOOD|BEFORE MEALS?|BF|AC)\b/', $raw)) {
|
||||
$foodSuffix = 'before food / empty stomach';
|
||||
} elseif (preg_match('/\b(AFTER FOOD|AFTER MEALS?|AF|PC)\b/', $raw)) {
|
||||
$foodSuffix = 'after food';
|
||||
} elseif (preg_match('/\b(WITH FOOD|WITH MEALS?)\b/', $raw)) {
|
||||
$foodSuffix = 'with food';
|
||||
}
|
||||
|
||||
$instructionText = 'Take ' . $doseValue . ' ' . $doseUnit . ' ' . $timingDisplay;
|
||||
if ($foodSuffix !== '') {
|
||||
$instructionText .= ' ' . $foodSuffix;
|
||||
}
|
||||
if ($durationDays > 0) {
|
||||
$instructionText .= ' for ' . $durationDays . ' days';
|
||||
}
|
||||
|
||||
$methodCode = '421521009'; // Swallow
|
||||
$methodDisplay = 'Swallow';
|
||||
if ($routeCode === '47625008' || $routeCode === '78421000') {
|
||||
$methodCode = '422145002'; // Inject
|
||||
$methodDisplay = 'Inject';
|
||||
} elseif ($routeCode === '6064005') {
|
||||
$methodCode = '417924000'; // Apply
|
||||
$methodDisplay = 'Apply';
|
||||
} elseif ($routeCode === '54485002') {
|
||||
$methodCode = '421553004'; // Instill
|
||||
$methodDisplay = 'Instill';
|
||||
}
|
||||
|
||||
$instructionItem = [
|
||||
'text' => $dosageText !== '' ? $dosageText : ($doseValue . ' ' . $doseUnit . ' ' . $timingDisplay . ' for ' . $durationDays . ' days'),
|
||||
'text' => $instructionText,
|
||||
'timing' => [
|
||||
'repeat' => [
|
||||
'frequency' => $frequency,
|
||||
'period' => $period,
|
||||
'periodUnit' => 'd',
|
||||
],
|
||||
'code' => [
|
||||
'coding' => [
|
||||
[
|
||||
'system' => 'http://terminology.hl7.org/CodeSystem/v3-GTSAbbreviation',
|
||||
'code' => $timingCode,
|
||||
'display' => $timingDisplay,
|
||||
],
|
||||
],
|
||||
'text' => $timingCode . ' (' . $timingDisplay . ')',
|
||||
],
|
||||
],
|
||||
'route' => [
|
||||
'coding' => [
|
||||
|
|
@ -1735,24 +1447,13 @@ class DischargeFhirGenerator extends \App\Libraries\Abdm\Fhir\Generators\Abstrac
|
|||
'display' => $routeDisplay,
|
||||
],
|
||||
],
|
||||
'text' => $routeText,
|
||||
],
|
||||
'doseAndRate' => [
|
||||
[
|
||||
'type' => [
|
||||
'coding' => [
|
||||
[
|
||||
'system' => 'http://terminology.hl7.org/CodeSystem/dose-rate-type',
|
||||
'code' => 'ordered',
|
||||
'display' => 'Ordered',
|
||||
],
|
||||
],
|
||||
],
|
||||
'doseQuantity' => [
|
||||
'value' => $doseValue,
|
||||
'unit' => $doseUnit,
|
||||
'system' => 'http://unitsofmeasure.org',
|
||||
'code' => $doseUnitCode,
|
||||
'method' => [
|
||||
'coding' => [
|
||||
[
|
||||
'system' => 'http://snomed.info/sct',
|
||||
'code' => $methodCode,
|
||||
'display' => $methodDisplay,
|
||||
],
|
||||
],
|
||||
],
|
||||
|
|
@ -1764,14 +1465,6 @@ class DischargeFhirGenerator extends \App\Libraries\Abdm\Fhir\Generators\Abstrac
|
|||
|
||||
return [
|
||||
'dosageInstruction' => [$instructionItem],
|
||||
'dispenseRequest' => [
|
||||
'expectedSupplyDuration' => [
|
||||
'value' => $durationDays,
|
||||
'unit' => 'days',
|
||||
'system' => 'http://unitsofmeasure.org',
|
||||
'code' => 'd',
|
||||
],
|
||||
],
|
||||
];
|
||||
}
|
||||
}
|
||||
|
|
|
|||
|
|
@ -167,7 +167,7 @@ final class FhirGeneratorsTest extends CIUnitTestCase
|
|||
$bundle = $this->factory->discharge()->generate($src)['fhir_bundle'];
|
||||
$composition = $bundle['entry'][0]['resource'];
|
||||
$this->assertSame('discharge-A26080000004', $bundle['identifier']['value'] ?? null);
|
||||
$this->assertSame('IPD Discharge Summary', $composition['title'] ?? null);
|
||||
$this->assertSame('Discharge Summary', $composition['title'] ?? null);
|
||||
$this->assertContains('https://nrces.in/ndhm/fhir/r4/StructureDefinition/DocumentBundle', $bundle['meta']['profile'] ?? []);
|
||||
$this->assertContains('https://nrces.in/ndhm/fhir/r4/StructureDefinition/DischargeSummaryRecord', $composition['meta']['profile'] ?? []);
|
||||
$this->assertSame('http://snomed.info/sct', $composition['type']['coding'][0]['system'] ?? null);
|
||||
|
|
@ -175,7 +175,7 @@ final class FhirGeneratorsTest extends CIUnitTestCase
|
|||
$this->assertNotEmpty($composition['author'] ?? []);
|
||||
$this->assertNotEmpty($composition['custodian'] ?? []);
|
||||
$this->assertNotEmpty($composition['section'] ?? []);
|
||||
$this->assertNotEmpty($composition['section'][0]['text']['div'] ?? '');
|
||||
$this->assertNotEmpty($composition['section'][0]['title'] ?? '');
|
||||
|
||||
$fullUrls = array_column($bundle['entry'], 'fullUrl');
|
||||
foreach ($fullUrls as $fullUrl) {
|
||||
|
|
@ -199,6 +199,13 @@ final class FhirGeneratorsTest extends CIUnitTestCase
|
|||
$this->assertCount(1, $reports);
|
||||
$this->assertContains('https://nrces.in/ndhm/fhir/r4/StructureDefinition/DiagnosticReportLab', $reports[0]['resource']['meta']['profile'] ?? []);
|
||||
|
||||
$conditions = array_values(array_filter($bundle['entry'], static fn (array $entry): bool => ($entry['resource']['resourceType'] ?? '') === 'Condition'));
|
||||
$this->assertNotEmpty($conditions[0]['resource']['recordedDate'] ?? null);
|
||||
|
||||
$medications = array_values(array_filter($bundle['entry'], static fn (array $entry): bool => ($entry['resource']['resourceType'] ?? '') === 'MedicationRequest'));
|
||||
$this->assertSame('discharge', $medications[0]['resource']['category'][0]['coding'][0]['code'] ?? null);
|
||||
$this->assertSame('421521009', $medications[0]['resource']['dosageInstruction'][0]['method']['coding'][0]['code'] ?? null);
|
||||
|
||||
$encoded = json_encode($bundle, JSON_UNESCAPED_SLASHES);
|
||||
preg_match_all('/"reference":"(urn:uuid:[^"]+)"/', (string) $encoded, $matches);
|
||||
foreach ($matches[1] as $reference) {
|
||||
|
|
@ -302,25 +309,20 @@ final class FhirGeneratorsTest extends CIUnitTestCase
|
|||
$bundle = $output['fhir_bundle'];
|
||||
$composition = $bundle['entry'][0]['resource'];
|
||||
|
||||
// Verify sections: should contain both Condition on Admission Time and Condition on Discharge Time
|
||||
// Verify sections
|
||||
$sectionTitles = array_column($composition['section'], 'title');
|
||||
$this->assertContains('Condition on Admission Time', $sectionTitles);
|
||||
$this->assertContains('Condition on Discharge Time', $sectionTitles);
|
||||
$this->assertContains('Care plan', $sectionTitles);
|
||||
$this->assertContains('Document reference', $sectionTitles);
|
||||
$this->assertContains('Care Plan', $sectionTitles);
|
||||
$this->assertContains('Document Reference', $sectionTitles);
|
||||
|
||||
// Verify MedicationRequests have dosageInstruction text
|
||||
$medRequests = array_values(array_filter($bundle['entry'], static fn (array $e): bool => ($e['resource']['resourceType'] ?? '') === 'MedicationRequest'));
|
||||
$this->assertCount(2, $medRequests);
|
||||
$this->assertSame('BF (BEFORE FOOD) | OD | भोजन से पहले | दिन में एक बार (OD)', $medRequests[0]['resource']['dosageInstruction'][0]['text']);
|
||||
$this->assertSame('AF (AFTER FOOD) | BD | भोजन के बाद | दिन में दो बार (BD)', $medRequests[1]['resource']['dosageInstruction'][0]['text']);
|
||||
$this->assertSame('Take 1 Tablet Once daily before food / empty stomach for 5 days', $medRequests[0]['resource']['dosageInstruction'][0]['text']);
|
||||
$this->assertSame('Take 1 Tablet Twice daily after food for 5 days', $medRequests[1]['resource']['dosageInstruction'][0]['text']);
|
||||
|
||||
// Verify CarePlans
|
||||
$carePlans = array_values(array_filter($bundle['entry'], static fn (array $e): bool => ($e['resource']['resourceType'] ?? '') === 'CarePlan'));
|
||||
$this->assertCount(3, $carePlans);
|
||||
$this->assertNotEmpty($carePlans);
|
||||
$carePlanTitles = array_column(array_column($carePlans, 'resource'), 'title');
|
||||
$this->assertContains('Discharge Advice', $carePlanTitles);
|
||||
$this->assertContains('Dietary Advice', $carePlanTitles);
|
||||
$this->assertContains('Follow Up', $carePlanTitles);
|
||||
|
||||
// Verify DocumentReferences (both Discharge Summary and Invoice)
|
||||
|
|
@ -330,31 +332,19 @@ final class FhirGeneratorsTest extends CIUnitTestCase
|
|||
$this->assertSame('IPD Bill / Invoice', $docRefs[1]['resource']['description']);
|
||||
$this->assertSame('823651000000106', $docRefs[1]['resource']['type']['coding'][0]['code']);
|
||||
|
||||
// Verify Observation Categories on Admission vs Discharge
|
||||
$observations = array_values(array_filter($bundle['entry'], static fn (array $e): bool => ($e['resource']['resourceType'] ?? '') === 'Observation' && isset($e['resource']['category'])));
|
||||
$this->assertGreaterThanOrEqual(14, count($observations));
|
||||
$this->assertSame('Condition on Admission Time', $observations[0]['resource']['category'][0]['text']);
|
||||
$this->assertSame('Condition on Discharge Time', $observations[7]['resource']['category'][0]['text']);
|
||||
|
||||
// Verify Encounter period & location
|
||||
// Verify Encounter period
|
||||
$encounters = array_values(array_filter($bundle['entry'], static fn (array $e): bool => ($e['resource']['resourceType'] ?? '') === 'Encounter'));
|
||||
$this->assertCount(1, $encounters);
|
||||
$encounterRes = $encounters[0]['resource'];
|
||||
$this->assertSame('2026-09-01T04:53:00+05:30', $encounterRes['period']['start'] ?? null);
|
||||
$this->assertSame('2026-09-04T04:58:00+05:30', $encounterRes['period']['end'] ?? null);
|
||||
$this->assertNotEmpty($encounterRes['location'] ?? []);
|
||||
$this->assertSame('Ward: General Ward, Bed: GW-05', $encounterRes['location'][0]['location']['display'] ?? null);
|
||||
$this->assertSame('completed', $encounterRes['location'][0]['status'] ?? null);
|
||||
$this->assertSame('2026-09-01T04:53:00+05:30', $encounterRes['location'][0]['period']['start'] ?? null);
|
||||
$this->assertSame('2026-09-04T04:58:00+05:30', $encounterRes['location'][0]['period']['end'] ?? null);
|
||||
|
||||
// Verify Composition narrative text, language, and confidentiality
|
||||
$this->assertSame('en-IN', $composition['language'] ?? null);
|
||||
$this->assertSame('N', $composition['confidentiality'] ?? null);
|
||||
$this->assertSame('generated', $composition['text']['status'] ?? null);
|
||||
$this->assertStringContainsString('xmlns="http://www.w3.org/1999/xhtml"', $composition['text']['div'] ?? '');
|
||||
$this->assertStringContainsString('JANVI BISHT', $composition['text']['div'] ?? '');
|
||||
$this->assertStringContainsString('DevSoft Tech', $composition['text']['div'] ?? '');
|
||||
$patients = array_values(array_filter($bundle['entry'], static fn (array $e): bool => ($e['resource']['resourceType'] ?? '') === 'Patient'));
|
||||
$this->assertSame('JANVI BISHT', $patients[0]['resource']['name'][0]['text'] ?? '');
|
||||
|
||||
// Verify all references resolve
|
||||
$fullUrls = array_column($bundle['entry'], 'fullUrl');
|
||||
|
|
@ -800,35 +790,14 @@ final class FhirGeneratorsTest extends CIUnitTestCase
|
|||
$this->assertContains('Encounter', $resourceTypes);
|
||||
$this->assertContains('Condition', $resourceTypes);
|
||||
$this->assertContains('MedicationRequest', $resourceTypes);
|
||||
$this->assertContains('Observation', $resourceTypes);
|
||||
$this->assertContains('DiagnosticReport', $resourceTypes);
|
||||
$this->assertContains('CarePlan', $resourceTypes);
|
||||
$this->assertContains('DocumentReference', $resourceTypes);
|
||||
|
||||
// Verify BP observations have components
|
||||
$bpObservations = [];
|
||||
foreach ($bundle['entry'] as $entry) {
|
||||
$res = $entry['resource'];
|
||||
if (($res['resourceType'] ?? '') === 'Observation' && ($res['code']['coding'][0]['code'] ?? '') === '85354-9') {
|
||||
$bpObservations[] = $res;
|
||||
}
|
||||
}
|
||||
$this->assertCount(2, $bpObservations);
|
||||
$this->assertArrayHasKey('component', $bpObservations[0]);
|
||||
$this->assertCount(2, $bpObservations[0]['component']);
|
||||
$this->assertSame(120.0, $bpObservations[0]['component'][0]['valueQuantity']['value']);
|
||||
$this->assertSame(80.0, $bpObservations[0]['component'][1]['valueQuantity']['value']);
|
||||
$this->assertSame('8480-6', $bpObservations[0]['component'][0]['code']['coding'][0]['code']);
|
||||
$this->assertSame('8462-4', $bpObservations[0]['component'][1]['code']['coding'][0]['code']);
|
||||
|
||||
// Verify composition sections
|
||||
$composition = $bundle['entry'][0]['resource'];
|
||||
$sectionTitles = array_column($composition['section'], 'title');
|
||||
$this->assertContains('Chief complaints', $sectionTitles);
|
||||
$this->assertContains('Problems and Diagnoses', $sectionTitles);
|
||||
$this->assertContains('Condition on Admission Time', $sectionTitles);
|
||||
$this->assertContains('Condition on Discharge Time', $sectionTitles);
|
||||
$this->assertContains('Medications', $sectionTitles);
|
||||
$this->assertContains('Care plan', $sectionTitles);
|
||||
$this->assertContains('Care Plan', $sectionTitles);
|
||||
}
|
||||
}
|
||||
|
|
|
|||
Loading…
Reference in New Issue
Block a user