DevSoftTech Server
23cca1f9ba
- FhirR4Builder: rewrite buildLabReportBundle() with DiagnosticReportLab profile, structured Observation valueQuantity/valueString, reference ranges, interpretation codes, Binary+DocumentReference for HTML report, Encounter resource, HFR-based bundle identifier system - FhirR4Builder: rewrite buildDischargeSummaryBundle() with optional Practitioner/Organization params, structured ABDM sections (chief complaints 422843007, medical history 1003642006, investigations 721981007, procedures 1003640003, medications 721912009, follow-up 736271009), HFR-based bundle identifier system - AbdmGateway: shareIpdDischargeBundle() now builds a real DischargeSummaryRecord FHIR bundle and posts via pushRecord() (POST /v3/records/push) instead of the stale shareIpdDischargeBundle() - AbdmGateway: shareDiagnosisReportBundle() now builds a real DiagnosticReportRecord FHIR bundle and posts via pushRecord() instead of the stale shareDiagnosisReportBundle() - AbdmGateway: add getHospitalProfileForFhir() and mapLabTypeToTitle() helpers; fix pre-existing undefined \ bug in getActiveConsentRecord() - Add ABDM_FHIR reference package, AbdmBridgeLog controller/view, bridge record migration, debug scripts and misc UI/settings updates
2290 lines
108 KiB
PHP
2290 lines
108 KiB
PHP
<?php
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namespace App\Libraries;
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use CodeIgniter\I18n\Time;
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class FhirR4Builder
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{
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/**
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* @param array<string, mixed> $patient
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* @param array<string, mixed> $encounter
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* @param array<int, array<string, mixed>> $medications
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* @param array<int, array<string, mixed>> $conditions
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*
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* @return array<string, mixed>
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*/
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public function buildPrescriptionBundle(array $patient, array $encounter, array $medications, array $conditions = [], array $context = []): array
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{
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$issuedAt = $this->isoTimestamp();
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$practitioner = is_array($context['practitioner'] ?? null) ? (array) $context['practitioner'] : [];
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$organization = is_array($context['organization'] ?? null) ? (array) $context['organization'] : [];
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$observations = is_array($context['observations'] ?? null) ? (array) $context['observations'] : [];
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$allergies = is_array($context['allergies'] ?? null) ? (array) $context['allergies'] : [];
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$complaints = is_array($context['complaints'] ?? null) ? (array) $context['complaints'] : [];
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$serviceRequests = is_array($context['service_requests'] ?? null) ? (array) $context['service_requests'] : [];
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$appointments = is_array($context['appointments'] ?? null) ? (array) $context['appointments'] : [];
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// UUID-based identity for every resource (ABDM IG v6.5.0 requirement)
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$bundleUuid = $this->generateUuid();
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$compositionUuid = $this->generateUuid();
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$patientUuid = $this->generateUuid();
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$encounterUuid = $this->generateUuid();
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$hasPractitioner = trim((string) ($practitioner['id'] ?? '')) !== '' || trim((string) ($practitioner['name'] ?? '')) !== '';
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$hasOrganization = trim((string) ($organization['id'] ?? '')) !== '' || trim((string) ($organization['name'] ?? '')) !== '';
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$practitionerUuid = $hasPractitioner ? $this->generateUuid() : '';
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$organizationUuid = $hasOrganization ? $this->generateUuid() : '';
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$patientRef = 'urn:uuid:' . $patientUuid;
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$encounterRef = 'urn:uuid:' . $encounterUuid;
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$practitionerRef = $hasPractitioner ? ('urn:uuid:' . $practitionerUuid) : '';
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$organizationRef = $hasOrganization ? ('urn:uuid:' . $organizationUuid) : '';
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// ── Tracking arrays ──────────────────────────────────────────────────
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$encounterDiagnosisRefs = [];
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$complaintRefs = [];
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$observationRefs = [];
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$allergyRefs = [];
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$medicationRefs = [];
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$serviceRequestRefs = [];
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$appointmentRefs = [];
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// Resource entries collected here; Composition prepended at the end.
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$resourceEntries = [];
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// ── Practitioner ─────────────────────────────────────────────────────
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if ($hasPractitioner) {
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$practRawName = trim((string) ($practitioner['name'] ?? ''));
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$practNameEntry = ['text' => $practRawName];
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// Split "Dr. Ramesh Sharma" → prefix=["Dr."], given=["Ramesh"], family="Sharma"
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$practParts = preg_split('/\s+/', $practRawName, -1, PREG_SPLIT_NO_EMPTY) ?: [];
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if (count($practParts) >= 2) {
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if (preg_match('/^(Dr\.?|Prof\.?|Mr\.?|Mrs\.?|Ms\.?)$/i', $practParts[0])) {
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$practNameEntry['prefix'] = [array_shift($practParts)];
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}
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if (count($practParts) >= 1) {
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$practNameEntry['family'] = (string) array_pop($practParts);
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}
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if (! empty($practParts)) {
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$practNameEntry['given'] = $practParts;
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}
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}
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$practResource = [
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'resourceType' => 'Practitioner',
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'id' => $practitionerUuid,
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'meta' => ['profile' => ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/Practitioner']],
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'name' => [$practNameEntry],
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];
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$regNumber = trim((string) ($practitioner['registration_number'] ?? ''));
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if ($regNumber !== '') {
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$practResource['identifier'] = [[
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'type' => ['coding' => [[
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'system' => 'http://terminology.hl7.org/CodeSystem/v2-0203',
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'code' => 'MD',
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'display' => 'Medical License number',
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]]],
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'system' => 'https://doctor.ndhm.gov.in',
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'value' => $regNumber,
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]];
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}
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$resourceEntries[] = ['fullUrl' => 'urn:uuid:' . $practitionerUuid, 'resource' => $practResource];
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}
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// ── Organization ─────────────────────────────────────────────────────
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if ($hasOrganization) {
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$orgResource = [
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'resourceType' => 'Organization',
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'id' => $organizationUuid,
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'meta' => ['profile' => ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization']],
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'name' => trim((string) ($organization['name'] ?? '')),
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];
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$hfrId = trim((string) ($organization['hfr_id'] ?? ''));
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if ($hfrId !== '') {
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$orgResource['identifier'] = [[
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'type' => ['coding' => [[
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'system' => 'http://terminology.hl7.org/CodeSystem/v2-0203',
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'code' => 'PRN',
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'display' => 'Provider number',
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]]],
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'system' => 'https://facility.ndhm.gov.in',
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'value' => $hfrId,
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]];
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}
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$resourceEntries[] = ['fullUrl' => 'urn:uuid:' . $organizationUuid, 'resource' => $orgResource];
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}
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// ── Patient ───────────────────────────────────────────────────────────
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$patientResource = $this->buildPatientResource($patient);
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$patientResource['id'] = $patientUuid; // override DB id with UUID
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$resourceEntries[] = ['fullUrl' => $patientRef, 'resource' => $patientResource];
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// ── Encounter (built here, appended after conditions loop) ──────────
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$encounterResource = [
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'resourceType' => 'Encounter',
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'id' => $encounterUuid,
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'meta' => ['profile' => ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/Encounter']],
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'identifier' => [['system' => 'https://ndhm.in', 'value' => (string) ($encounter['id'] ?? $encounterUuid)]],
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'status' => (string) ($encounter['status'] ?? 'finished'),
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'class' => [
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'system' => 'http://terminology.hl7.org/CodeSystem/v3-ActCode',
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'code' => 'AMB',
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'display' => 'Ambulatory',
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],
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'subject' => ['reference' => $patientRef, 'display' => 'Patient'],
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'period' => ['start' => trim((string) ($encounter['period_start'] ?? '')) !== '' ? (string) $encounter['period_start'] : $issuedAt],
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];
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if ($practitionerRef !== '') {
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$encounterResource['participant'] = [['individual' => ['reference' => $practitionerRef]]];
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}
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if ($organizationRef !== '') {
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$encounterResource['serviceProvider'] = ['reference' => $organizationRef];
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}
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// ── Conditions (diagnoses) ────────────────────────────────────────────
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foreach ($conditions as $index => $condition) {
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$text = trim((string) ($condition['text'] ?? ''));
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if ($text === '') {
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continue;
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}
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$condUuid = $this->generateUuid();
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$condRef = 'urn:uuid:' . $condUuid;
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$verification = trim((string) ($condition['verification_status'] ?? 'provisional'));
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$verificationCode = strtolower($verification) === 'confirmed' ? 'confirmed' : 'provisional';
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$useSnomedCode = $verificationCode === 'confirmed' ? '39154008' : '148006';
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$useSnomedDisplay = $verificationCode === 'confirmed' ? 'Clinical diagnosis' : 'Preliminary diagnosis';
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$encounterDiagnosisRefs[] = [
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'condition' => ['reference' => $condRef, 'display' => 'Condition'],
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'use' => ['coding' => [[
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'system' => 'http://snomed.info/sct',
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'code' => $useSnomedCode,
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'display' => $useSnomedDisplay,
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]]],
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];
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$code = ['text' => $text];
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$snomedCode = trim((string) ($condition['snomed_code'] ?? ''));
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if ($snomedCode !== '') {
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$code['coding'] = [[
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'system' => 'http://snomed.info/sct',
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'code' => $snomedCode,
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'display' => trim((string) ($condition['snomed_display'] ?? $text)),
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]];
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}
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$resourceEntries[] = ['fullUrl' => $condRef, 'resource' => [
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'resourceType' => 'Condition',
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'id' => $condUuid,
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'meta' => ['profile' => ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/Condition']],
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'clinicalStatus' => ['coding' => [[
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'system' => 'http://terminology.hl7.org/CodeSystem/condition-clinical',
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'code' => 'active',
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'display' => 'Active',
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]]],
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'verificationStatus' => ['coding' => [[
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'system' => 'http://terminology.hl7.org/CodeSystem/condition-ver-status',
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'code' => $verificationCode,
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'display' => ucfirst($verificationCode),
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]]],
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'code' => $code,
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'subject' => ['reference' => $patientRef, 'display' => 'Patient'],
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]];
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}
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// Append Encounter (now has diagnosis refs)
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if (! empty($encounterDiagnosisRefs)) {
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$encounterResource['diagnosis'] = $encounterDiagnosisRefs;
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}
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$resourceEntries[] = ['fullUrl' => $encounterRef, 'resource' => $encounterResource];
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// ── Complaints (Chief Complaints) ─────────────────────────────────
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foreach ($complaints as $index => $complaint) {
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$text = trim((string) ($complaint['text'] ?? ''));
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if ($text === '') {
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continue;
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}
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$complaintUuid = $this->generateUuid();
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$complaintRef = 'urn:uuid:' . $complaintUuid;
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$complaintRefs[] = ['reference' => $complaintRef, 'display' => 'Condition'];
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$code = ['text' => $text];
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$snomedCode = trim((string) ($complaint['snomed_code'] ?? ''));
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if ($snomedCode !== '') {
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$code['coding'] = [[
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'system' => 'http://snomed.info/sct',
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'code' => $snomedCode,
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'display' => trim((string) ($complaint['snomed_display'] ?? $text)),
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]];
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}
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$complaintResource = [
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'resourceType' => 'Condition',
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'id' => $complaintUuid,
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'meta' => ['profile' => ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/Condition']],
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'clinicalStatus' => ['coding' => [[
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'system' => 'http://terminology.hl7.org/CodeSystem/condition-clinical',
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'code' => 'active',
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'display' => 'Active',
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]]],
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'code' => $code,
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'subject' => ['reference' => $patientRef, 'display' => 'Patient'],
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];
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// Severity (High/Moderate/Low → SNOMED coded)
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$severityText = trim((string) ($complaint['severity'] ?? ''));
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if ($severityText !== '') {
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$severityMap = [
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'high' => ['24484000', 'Severe'],
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'severe' => ['24484000', 'Severe'],
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'moderate' => ['6736007', 'Moderate'],
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'mild' => ['255604002', 'Mild'],
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'low' => ['255604002', 'Mild'],
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];
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$severityKey = strtolower($severityText);
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[$sevCode, $sevDisplay] = $severityMap[$severityKey] ?? ['', $severityText];
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$severityCoding = ['text' => ucfirst($severityText)];
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if ($sevCode !== '') {
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$severityCoding['coding'] = [[
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'system' => 'http://snomed.info/sct',
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'code' => $sevCode,
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'display' => $sevDisplay,
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]];
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}
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$complaintResource['severity'] = $severityCoding;
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}
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// Duration → note
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$durationText = trim((string) ($complaint['duration'] ?? ''));
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$frequencyText = trim((string) ($complaint['frequency'] ?? ''));
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$noteParts = array_filter([$durationText, $frequencyText]);
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if (! empty($noteParts)) {
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$complaintResource['note'] = [['text' => implode(' | ', $noteParts)]];
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}
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$resourceEntries[] = ['fullUrl' => $complaintRef, 'resource' => $complaintResource];
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}
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// ── Observations (Vitals / Physical Examination) ──────────────────────
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foreach ($observations as $index => $observation) {
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$value = $observation['value'] ?? null;
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if (! is_numeric($value)) {
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continue;
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}
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$obsUuid = $this->generateUuid();
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$observationRefs[] = ['reference' => 'urn:uuid:' . $obsUuid, 'display' => 'Observation'];
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$resourceEntries[] = ['fullUrl' => 'urn:uuid:' . $obsUuid, 'resource' => [
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'resourceType' => 'Observation',
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'id' => $obsUuid,
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'meta' => ['profile' => ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/ObservationVitalSigns']],
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'status' => 'final',
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'category' => [['coding' => [[
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'system' => 'http://terminology.hl7.org/CodeSystem/observation-category',
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'code' => 'vital-signs',
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]]]],
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'code' => [
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'coding' => [[
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'system' => 'http://loinc.org',
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'code' => (string) ($observation['loinc'] ?? ''),
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'display' => (string) ($observation['display'] ?? ''),
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]],
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'text' => (string) ($observation['display'] ?? ''),
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],
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'subject' => ['reference' => $patientRef, 'display' => 'Patient'],
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'encounter' => ['reference' => $encounterRef],
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'effectiveDateTime' => $issuedAt,
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'valueQuantity' => [
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'value' => (float) $value,
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'unit' => (string) ($observation['unit'] ?? ''),
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'system' => 'http://unitsofmeasure.org',
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'code' => (string) ($observation['ucum'] ?? ''),
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],
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]];
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}
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foreach ($allergies as $index => $allergy) {
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$codeText = trim((string) ($allergy['code_text'] ?? ''));
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if ($codeText === '') {
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continue;
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}
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$allergyUuid = $this->generateUuid();
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$allergyRefs[] = ['reference' => 'urn:uuid:' . $allergyUuid, 'display' => 'AllergyIntolerance'];
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$allergyResource = [
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'resourceType' => 'AllergyIntolerance',
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'id' => $allergyUuid,
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'meta' => ['profile' => ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/AllergyIntolerance']],
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'clinicalStatus' => ['coding' => [[
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'system' => 'http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical',
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'code' => (string) ($allergy['clinical_status'] ?? 'active'),
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]]],
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'verificationStatus' => ['coding' => [[
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'system' => 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification',
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'code' => (string) ($allergy['verification_status'] ?? 'confirmed'),
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]]],
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'code' => ['text' => $codeText],
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'patient' => ['reference' => $patientRef, 'display' => 'Patient'],
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'recordedDate' => $issuedAt,
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];
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$reaction = trim((string) ($allergy['reaction_text'] ?? ''));
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if ($reaction !== '') {
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$allergyResource['reaction'] = [['description' => $reaction]];
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}
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$resourceEntries[] = ['fullUrl' => 'urn:uuid:' . $allergyUuid, 'resource' => $allergyResource];
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}
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// ── Medications ───────────────────────────────────────────────────────
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foreach ($medications as $index => $medication) {
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$medUuid = $this->generateUuid();
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$medicationRefs[] = ['reference' => 'urn:uuid:' . $medUuid, 'display' => 'MedicationRequest'];
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$drugName = trim((string) ($medication['drug_name'] ?? ''));
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$genericName = trim((string) ($medication['generic_name'] ?? ''));
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$medType = trim((string) ($medication['med_type'] ?? ''));
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$displayText = $drugName;
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if ($genericName !== '' && stripos($drugName, $genericName) === false) {
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$displayText = trim($drugName . ' (' . $genericName . ')');
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}
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$medicationCodeableConcept = ['text' => $displayText !== '' ? $displayText : $drugName];
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$snomedCode = trim((string) ($medication['snomed_code'] ?? ''));
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$atcCode = strtoupper(trim((string) ($medication['atc_code'] ?? '')));
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if ($snomedCode !== '') {
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$medicationCodeableConcept['coding'] = [[
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'system' => 'http://snomed.info/sct',
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'code' => $snomedCode,
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'display' => $displayText !== '' ? $displayText : $drugName,
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]];
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} elseif ($atcCode !== '') {
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$medicationCodeableConcept['coding'] = [[
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'system' => 'http://www.whocc.no/atc',
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'code' => $atcCode,
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'display' => $displayText !== '' ? $displayText : $drugName,
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]];
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}
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$dosageInstruction = ['text' => (string) ($medication['dosage'] ?? '')];
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$routeText = trim((string) ($medication['route_text'] ?? ''));
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if ($routeText !== '') {
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$routeEntry = ['text' => $routeText];
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// Add SNOMED route code when we can resolve it from text or a pre-supplied code
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$routeCode = trim((string) ($medication['route_code'] ?? ''));
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if ($routeCode === '') {
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$routeCode = $this->resolveRouteSnomedCode($routeText);
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}
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if ($routeCode !== '') {
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$routeEntry['coding'] = [[
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'system' => 'http://snomed.info/sct',
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'code' => $routeCode,
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'display' => $routeText,
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]];
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}
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$dosageInstruction['route'] = $routeEntry;
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}
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$methodText = trim((string) ($medication['method_text'] ?? $medType));
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$methodCode = trim((string) ($medication['method_code'] ?? ''));
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if ($methodText !== '') {
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$methodEntry = ['text' => $methodText];
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if ($methodCode !== '') {
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$methodEntry['coding'] = [[
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'system' => 'http://snomed.info/sct',
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'code' => $methodCode,
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'display' => $methodText,
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]];
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}
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$dosageInstruction['method'] = $methodEntry;
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}
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$medRes = [
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'resourceType' => 'MedicationRequest',
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'id' => $medUuid,
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'meta' => ['profile' => ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/MedicationRequest']],
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'status' => (string) ($medication['status'] ?? 'active'),
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'intent' => 'order',
|
|
'medicationCodeableConcept' => $medicationCodeableConcept,
|
|
'subject' => ['reference' => $patientRef, 'display' => 'Patient'],
|
|
'encounter' => ['reference' => $encounterRef],
|
|
'authoredOn' => $issuedAt,
|
|
'dosageInstruction' => [$dosageInstruction],
|
|
];
|
|
if ($practitionerRef !== '') {
|
|
$medRes['requester'] = ['reference' => $practitionerRef];
|
|
}
|
|
$resourceEntries[] = ['fullUrl' => 'urn:uuid:' . $medUuid, 'resource' => $medRes];
|
|
}
|
|
|
|
// ── ServiceRequests (Investigation Advice) ────────────────────────────
|
|
foreach ($serviceRequests as $index => $serviceRequest) {
|
|
$codeText = trim((string) ($serviceRequest['code_text'] ?? ''));
|
|
if ($codeText === '') {
|
|
continue;
|
|
}
|
|
|
|
$svcUuid = $this->generateUuid();
|
|
$serviceRequestRefs[] = ['reference' => 'urn:uuid:' . $svcUuid, 'display' => 'ServiceRequest'];
|
|
$svcRes = [
|
|
'resourceType' => 'ServiceRequest',
|
|
'id' => $svcUuid,
|
|
'meta' => ['profile' => ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/ServiceRequest']],
|
|
'status' => (string) ($serviceRequest['status'] ?? 'active'),
|
|
'intent' => (string) ($serviceRequest['intent'] ?? 'order'),
|
|
'code' => ['text' => $codeText],
|
|
'subject' => ['reference' => $patientRef, 'display' => 'Patient'],
|
|
'encounter' => ['reference' => $encounterRef],
|
|
'authoredOn' => $issuedAt,
|
|
];
|
|
if ($practitionerRef !== '') {
|
|
$svcRes['requester'] = ['reference' => $practitionerRef];
|
|
}
|
|
$resourceEntries[] = ['fullUrl' => 'urn:uuid:' . $svcUuid, 'resource' => $svcRes];
|
|
}
|
|
|
|
// ── Appointments (Follow Up) ──────────────────────────────────────────
|
|
foreach ($appointments as $index => $appointment) {
|
|
$description = trim((string) ($appointment['description'] ?? ''));
|
|
if ($description === '') {
|
|
continue;
|
|
}
|
|
|
|
$apptUuid = $this->generateUuid();
|
|
$appointmentRefs[] = ['reference' => 'urn:uuid:' . $apptUuid, 'display' => 'Appointment'];
|
|
$apptRes = [
|
|
'resourceType' => 'Appointment',
|
|
'id' => $apptUuid,
|
|
'meta' => ['profile' => ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/Appointment']],
|
|
'status' => (string) ($appointment['status'] ?? 'proposed'),
|
|
'description' => $description,
|
|
'participant' => [[
|
|
'actor' => ['reference' => $patientRef, 'display' => 'Patient'],
|
|
'status' => 'accepted',
|
|
]],
|
|
];
|
|
if ($practitionerRef !== '') {
|
|
$apptRes['participant'][] = [
|
|
'actor' => ['reference' => $practitionerRef],
|
|
'status' => 'accepted',
|
|
];
|
|
}
|
|
$resourceEntries[] = ['fullUrl' => 'urn:uuid:' . $apptUuid, 'resource' => $apptRes];
|
|
}
|
|
|
|
// ── Composition sections (ABDM SNOMED section codes) ─────────────────
|
|
$compositionSections = [];
|
|
if (! empty($complaintRefs)) {
|
|
$compositionSections[] = [
|
|
'title' => 'Chief complaints',
|
|
'code' => ['coding' => [[
|
|
'system' => 'http://snomed.info/sct',
|
|
'code' => '422843007',
|
|
'display' => 'Chief complaint section',
|
|
]]],
|
|
'entry' => $complaintRefs,
|
|
];
|
|
}
|
|
if (! empty($allergyRefs)) {
|
|
$compositionSections[] = [
|
|
'title' => 'Allergies',
|
|
'code' => ['coding' => [[
|
|
'system' => 'http://snomed.info/sct',
|
|
'code' => '722446000',
|
|
'display' => 'Allergy record',
|
|
]]],
|
|
'entry' => $allergyRefs,
|
|
];
|
|
}
|
|
if (! empty($observationRefs)) {
|
|
$compositionSections[] = [
|
|
'title' => 'Physical Examination',
|
|
'code' => ['coding' => [[
|
|
'system' => 'http://snomed.info/sct',
|
|
'code' => '425044008',
|
|
'display' => 'Physical exam section',
|
|
]]],
|
|
'entry' => $observationRefs,
|
|
];
|
|
}
|
|
if (! empty($encounterDiagnosisRefs)) {
|
|
// Diagnoses section — conditions referenced from Encounter.diagnosis
|
|
$diagSectionEntries = array_map(static fn ($d) => $d['condition'], $encounterDiagnosisRefs);
|
|
$compositionSections[] = [
|
|
'title' => 'Problems and Diagnoses',
|
|
'code' => ['coding' => [[
|
|
'system' => 'http://snomed.info/sct',
|
|
'code' => '439401001',
|
|
'display' => 'Diagnosis',
|
|
]]],
|
|
'entry' => $diagSectionEntries,
|
|
];
|
|
}
|
|
if (! empty($medicationRefs)) {
|
|
$compositionSections[] = [
|
|
'title' => 'Medications',
|
|
'code' => ['coding' => [[
|
|
'system' => 'http://snomed.info/sct',
|
|
'code' => '721912009',
|
|
'display' => 'Medication summary document',
|
|
]]],
|
|
'entry' => $medicationRefs,
|
|
];
|
|
}
|
|
if (! empty($serviceRequestRefs)) {
|
|
$compositionSections[] = [
|
|
'title' => 'Investigation Advice',
|
|
'code' => ['coding' => [[
|
|
'system' => 'http://snomed.info/sct',
|
|
'code' => '721963009',
|
|
'display' => 'Order document',
|
|
]]],
|
|
'entry' => $serviceRequestRefs,
|
|
];
|
|
}
|
|
if (! empty($appointmentRefs)) {
|
|
$compositionSections[] = [
|
|
'title' => 'Follow Up',
|
|
'code' => ['coding' => [[
|
|
'system' => 'http://snomed.info/sct',
|
|
'code' => '736271009',
|
|
'display' => 'Outpatient care plan',
|
|
]]],
|
|
'entry' => $appointmentRefs,
|
|
];
|
|
}
|
|
|
|
// ── Composition (first entry per ABDM spec) ───────────────────────────
|
|
$composition = [
|
|
'resourceType' => 'Composition',
|
|
'id' => $compositionUuid,
|
|
'meta' => ['profile' => ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/OPConsultRecord']],
|
|
'language' => 'en-IN',
|
|
'identifier' => ['system' => 'https://ndhm.in/phr', 'value' => $compositionUuid],
|
|
'status' => 'final',
|
|
'type' => [
|
|
'coding' => [[
|
|
'system' => 'http://snomed.info/sct',
|
|
'code' => '371530004',
|
|
'display' => 'Clinical consultation report',
|
|
]],
|
|
'text' => 'Clinical Consultation report',
|
|
],
|
|
'subject' => ['reference' => $patientRef, 'display' => 'Patient'],
|
|
'encounter' => ['reference' => $encounterRef, 'display' => 'Encounter'],
|
|
'date' => $issuedAt,
|
|
'author' => $practitionerRef !== ''
|
|
? [['reference' => $practitionerRef, 'display' => 'Practitioner']]
|
|
: [['display' => 'Unknown']],
|
|
'title' => 'Consultation Report',
|
|
'section' => $compositionSections,
|
|
];
|
|
if ($organizationRef !== '') {
|
|
$composition['custodian'] = ['reference' => $organizationRef, 'display' => 'Organization'];
|
|
}
|
|
|
|
// Composition first, then all resource entries
|
|
$allEntries = array_merge(
|
|
[['fullUrl' => 'urn:uuid:' . $compositionUuid, 'resource' => $composition]],
|
|
$resourceEntries
|
|
);
|
|
|
|
// ── Bundle ────────────────────────────────────────────────────────────
|
|
$hfrId = trim((string) ($organization['hfr_id'] ?? ''));
|
|
$bundleIdSystem = $hfrId !== ''
|
|
? 'https://' . strtolower(preg_replace('/[^A-Za-z0-9]/', '', $hfrId)) . '.hfr.abdm.gov.in'
|
|
: 'https://hfr.abdm.gov.in';
|
|
$bundleIdValue = $hfrId !== ''
|
|
? 'OPD-' . ($encounter['id'] ?? $bundleUuid) . '-' . date('Y-m-d')
|
|
: $bundleUuid;
|
|
|
|
return [
|
|
'resourceType' => 'Bundle',
|
|
'id' => $bundleUuid,
|
|
'meta' => [
|
|
'profile' => ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/DocumentBundle'],
|
|
'security' => [[
|
|
'system' => 'http://terminology.hl7.org/CodeSystem/v3-Confidentiality',
|
|
'code' => 'V',
|
|
'display' => 'very restricted',
|
|
]],
|
|
],
|
|
'identifier' => ['system' => $bundleIdSystem, 'value' => $bundleIdValue],
|
|
'type' => 'document',
|
|
'timestamp' => $issuedAt,
|
|
'entry' => $allEntries,
|
|
];
|
|
}
|
|
|
|
/**
|
|
* Build a ABDM-compliant DiagnosticReportRecord FHIR DocumentBundle.
|
|
*
|
|
* Supports:
|
|
* - LOINC-coded observations (valueQuantity) for structured lab results
|
|
* - HTML report as presentedForm via Binary + DocumentReference
|
|
* - Optional Practitioner, Organization, Encounter
|
|
*
|
|
* @param array<string, mixed> $patient {id, name, given_name, family_name, gender, birthDate, abhaAddress, phone}
|
|
* @param array<string, mixed> $diagnosticReport {id, title, category_snomed_code, category_snomed_display,
|
|
* loinc_code, loinc_display, status, conclusion,
|
|
* reported_at, report_html, report_content_type}
|
|
* @param array<int, array<string, mixed>> $observations Each: {test_name, loinc_code, value, value_type (quantity|string),
|
|
* unit, ucum_code, ref_low, ref_high, interpretation, status}
|
|
* @param array<string, mixed>|null $practitioner {name, registration_number}
|
|
* @param array<string, mixed>|null $organization {name, hfr_id}
|
|
* @param array<string, mixed>|null $encounter {id, status, class_code (AMB|IMP|EMER), period_start, period_end}
|
|
*
|
|
* @return array<string, mixed>
|
|
*/
|
|
public function buildLabReportBundle(
|
|
array $patient,
|
|
array $diagnosticReport,
|
|
array $observations = [],
|
|
?array $practitioner = null,
|
|
?array $organization = null,
|
|
?array $encounter = null
|
|
): array {
|
|
$issuedAt = $this->isoTimestamp();
|
|
$bundleUuid = $this->generateUuid();
|
|
$compositionUuid = $this->generateUuid();
|
|
$patientUuid = $this->generateUuid();
|
|
$reportUuid = $this->generateUuid();
|
|
|
|
$patientRef = 'urn:uuid:' . $patientUuid;
|
|
$reportRef = 'urn:uuid:' . $reportUuid;
|
|
$reportedAt = trim((string) ($diagnosticReport['reported_at'] ?? '')) ?: $issuedAt;
|
|
$reportTitle = trim((string) ($diagnosticReport['title'] ?? 'Diagnostic Report'));
|
|
$reportStatus = trim((string) ($diagnosticReport['status'] ?? 'final'));
|
|
|
|
$hasPractitioner = $practitioner !== null && trim((string) ($practitioner['name'] ?? '')) !== '';
|
|
$hasOrganization = $organization !== null && trim((string) ($organization['name'] ?? '')) !== '';
|
|
$hasEncounter = $encounter !== null;
|
|
$practitionerUuid = $hasPractitioner ? $this->generateUuid() : '';
|
|
$organizationUuid = $hasOrganization ? $this->generateUuid() : '';
|
|
$encounterUuid = $hasEncounter ? $this->generateUuid() : '';
|
|
|
|
$practitionerRef = $hasPractitioner ? ('urn:uuid:' . $practitionerUuid) : '';
|
|
$organizationRef = $hasOrganization ? ('urn:uuid:' . $organizationUuid) : '';
|
|
$encounterRef = $hasEncounter ? ('urn:uuid:' . $encounterUuid) : '';
|
|
|
|
$resourceEntries = [];
|
|
|
|
// ── Practitioner ──────────────────────────────────────────────────────
|
|
if ($hasPractitioner) {
|
|
$practRes = [
|
|
'resourceType' => 'Practitioner',
|
|
'id' => $practitionerUuid,
|
|
'meta' => ['profile' => ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/Practitioner']],
|
|
'name' => [['text' => trim((string) ($practitioner['name'] ?? ''))]],
|
|
];
|
|
$regNo = trim((string) ($practitioner['registration_number'] ?? ''));
|
|
if ($regNo !== '') {
|
|
$practRes['identifier'] = [[
|
|
'type' => ['coding' => [['system' => 'http://terminology.hl7.org/CodeSystem/v2-0203', 'code' => 'MD', 'display' => 'Medical License number']]],
|
|
'system' => 'https://doctor.ndhm.gov.in',
|
|
'value' => $regNo,
|
|
]];
|
|
}
|
|
$resourceEntries[] = ['fullUrl' => $practitionerRef, 'resource' => $practRes];
|
|
}
|
|
|
|
// ── Organization ──────────────────────────────────────────────────────
|
|
if ($hasOrganization) {
|
|
$orgRes = [
|
|
'resourceType' => 'Organization',
|
|
'id' => $organizationUuid,
|
|
'meta' => ['profile' => ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization']],
|
|
'name' => trim((string) ($organization['name'] ?? '')),
|
|
];
|
|
$hfrId = trim((string) ($organization['hfr_id'] ?? ''));
|
|
if ($hfrId !== '') {
|
|
$orgRes['identifier'] = [[
|
|
'type' => ['coding' => [['system' => 'http://terminology.hl7.org/CodeSystem/v2-0203', 'code' => 'PRN', 'display' => 'Provider number']]],
|
|
'system' => 'https://facility.ndhm.gov.in',
|
|
'value' => $hfrId,
|
|
]];
|
|
}
|
|
$resourceEntries[] = ['fullUrl' => $organizationRef, 'resource' => $orgRes];
|
|
}
|
|
|
|
// ── Patient ───────────────────────────────────────────────────────────
|
|
$patientResource = $this->buildPatientResource($patient);
|
|
$patientResource['id'] = $patientUuid;
|
|
$resourceEntries[] = ['fullUrl' => $patientRef, 'resource' => $patientResource];
|
|
|
|
// ── Encounter ─────────────────────────────────────────────────────────
|
|
if ($hasEncounter) {
|
|
$encounterRes = [
|
|
'resourceType' => 'Encounter',
|
|
'id' => $encounterUuid,
|
|
'meta' => ['profile' => ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/Encounter']],
|
|
'identifier' => [['system' => 'https://ndhm.in', 'value' => (string) ($encounter['id'] ?? $encounterUuid)]],
|
|
'status' => (string) ($encounter['status'] ?? 'finished'),
|
|
'class' => [
|
|
'system' => 'http://terminology.hl7.org/CodeSystem/v3-ActCode',
|
|
'code' => (string) ($encounter['class_code'] ?? 'AMB'),
|
|
'display' => (string) ($encounter['class_code'] ?? 'AMB') === 'IMP' ? 'inpatient encounter' : 'Ambulatory',
|
|
],
|
|
'subject' => ['reference' => $patientRef, 'display' => 'Patient'],
|
|
];
|
|
$pStart = trim((string) ($encounter['period_start'] ?? ''));
|
|
if ($pStart !== '') {
|
|
$encounterRes['period'] = ['start' => $pStart];
|
|
$pEnd = trim((string) ($encounter['period_end'] ?? ''));
|
|
if ($pEnd !== '') {
|
|
$encounterRes['period']['end'] = $pEnd;
|
|
}
|
|
}
|
|
if ($practitionerRef !== '') {
|
|
$encounterRes['participant'] = [['individual' => ['reference' => $practitionerRef]]];
|
|
}
|
|
if ($organizationRef !== '') {
|
|
$encounterRes['serviceProvider'] = ['reference' => $organizationRef];
|
|
}
|
|
$resourceEntries[] = ['fullUrl' => $encounterRef, 'resource' => $encounterRes];
|
|
}
|
|
|
|
// ── Observations (structured lab results) ─────────────────────────────
|
|
$observationEntries = [];
|
|
$observationRefs = [];
|
|
foreach ($observations as $obs) {
|
|
$obsUuid = $this->generateUuid();
|
|
$obsRef = 'urn:uuid:' . $obsUuid;
|
|
$observationRefs[] = ['reference' => $obsRef];
|
|
$testName = trim((string) ($obs['test_name'] ?? ''));
|
|
$loincCode = trim((string) ($obs['loinc_code'] ?? ''));
|
|
$codeEntry = ['text' => $testName];
|
|
if ($loincCode !== '') {
|
|
$codeEntry['coding'] = [['system' => 'http://loinc.org', 'code' => $loincCode, 'display' => $testName]];
|
|
}
|
|
$obsResource = [
|
|
'resourceType' => 'Observation',
|
|
'id' => $obsUuid,
|
|
'meta' => ['profile' => ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/Observation']],
|
|
'status' => (string) ($obs['status'] ?? 'final'),
|
|
'code' => $codeEntry,
|
|
'subject' => ['reference' => $patientRef],
|
|
'effectiveDateTime' => $reportedAt,
|
|
];
|
|
if ($encounterRef !== '') {
|
|
$obsResource['encounter'] = ['reference' => $encounterRef];
|
|
}
|
|
if ($practitionerRef !== '') {
|
|
$obsResource['performer'] = [['reference' => $practitionerRef]];
|
|
} elseif ($organizationRef !== '') {
|
|
$obsResource['performer'] = [['reference' => $organizationRef]];
|
|
}
|
|
// Value: quantity or string
|
|
$valueType = trim((string) ($obs['value_type'] ?? 'string'));
|
|
$rawValue = $obs['value'] ?? '';
|
|
if ($valueType === 'quantity' && is_numeric($rawValue)) {
|
|
$ucum = trim((string) ($obs['ucum_code'] ?? ''));
|
|
$unit = trim((string) ($obs['unit'] ?? ''));
|
|
$obsResource['valueQuantity'] = [
|
|
'value' => (float) $rawValue,
|
|
'unit' => $unit !== '' ? $unit : $ucum,
|
|
'system' => 'http://unitsofmeasure.org',
|
|
'code' => $ucum,
|
|
];
|
|
} else {
|
|
$obsResource['valueString'] = (string) $rawValue;
|
|
}
|
|
// Reference range
|
|
$refLow = $obs['ref_low'] ?? null;
|
|
$refHigh = $obs['ref_high'] ?? null;
|
|
if ($refLow !== null || $refHigh !== null) {
|
|
$rr = [];
|
|
$ucum = trim((string) ($obs['ucum_code'] ?? ''));
|
|
$unit = trim((string) ($obs['unit'] ?? ''));
|
|
if ($refLow !== null && is_numeric($refLow)) {
|
|
$rr['low'] = ['value' => (float) $refLow, 'unit' => $unit ?: $ucum, 'system' => 'http://unitsofmeasure.org', 'code' => $ucum];
|
|
}
|
|
if ($refHigh !== null && is_numeric($refHigh)) {
|
|
$rr['high'] = ['value' => (float) $refHigh, 'unit' => $unit ?: $ucum, 'system' => 'http://unitsofmeasure.org', 'code' => $ucum];
|
|
}
|
|
$obsResource['referenceRange'] = [$rr];
|
|
}
|
|
// Interpretation (H/L/N)
|
|
$interp = trim((string) ($obs['interpretation'] ?? ''));
|
|
if ($interp !== '') {
|
|
$interpCode = strtoupper($interp);
|
|
$interpCodeMap = ['H' => 'H', 'HIGH' => 'H', 'L' => 'L', 'LOW' => 'L', 'N' => 'N', 'NORMAL' => 'N'];
|
|
$obsResource['interpretation'] = [[
|
|
'coding' => [[
|
|
'system' => 'http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation',
|
|
'code' => $interpCodeMap[$interpCode] ?? $interpCode,
|
|
'display' => $interp,
|
|
]],
|
|
'text' => $interp,
|
|
]];
|
|
}
|
|
$observationEntries[] = ['fullUrl' => $obsRef, 'resource' => $obsResource];
|
|
}
|
|
|
|
// ── Binary + DocumentReference for HTML report ─────────────────────────
|
|
$docRefEntry = null;
|
|
$docRefRef = null;
|
|
$reportHtml = trim((string) ($diagnosticReport['report_html'] ?? ''));
|
|
if ($reportHtml !== '') {
|
|
$binaryUuid = $this->generateUuid();
|
|
$docRefUuid = $this->generateUuid();
|
|
$docRefRef = 'urn:uuid:' . $docRefUuid;
|
|
$contentType = trim((string) ($diagnosticReport['report_content_type'] ?? 'text/html; charset=utf-8'));
|
|
|
|
$resourceEntries[] = ['fullUrl' => 'urn:uuid:' . $binaryUuid, 'resource' => [
|
|
'resourceType' => 'Binary',
|
|
'id' => $binaryUuid,
|
|
'contentType' => $contentType,
|
|
'data' => base64_encode($reportHtml),
|
|
]];
|
|
|
|
$docRefEntry = [
|
|
'resourceType' => 'DocumentReference',
|
|
'id' => $docRefUuid,
|
|
'meta' => ['profile' => ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/DocumentReference']],
|
|
'status' => 'current',
|
|
'type' => ['coding' => [['system' => 'http://snomed.info/sct', 'code' => '721981007', 'display' => 'Diagnostic studies report']]],
|
|
'subject' => ['reference' => $patientRef],
|
|
'content' => [['attachment' => ['contentType' => $contentType, 'url' => 'urn:uuid:' . $binaryUuid, 'title' => $reportTitle]]],
|
|
];
|
|
$resourceEntries[] = ['fullUrl' => $docRefRef, 'resource' => $docRefEntry];
|
|
}
|
|
|
|
// ── DiagnosticReport ──────────────────────────────────────────────────
|
|
$reportRes = [
|
|
'resourceType' => 'DiagnosticReport',
|
|
'id' => $reportUuid,
|
|
'meta' => ['profile' => ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/DiagnosticReportLab']],
|
|
'status' => $reportStatus,
|
|
'code' => array_filter([
|
|
'coding' => trim((string) ($diagnosticReport['loinc_code'] ?? '')) !== ''
|
|
? [['system' => 'http://loinc.org', 'code' => (string) $diagnosticReport['loinc_code'], 'display' => $reportTitle]]
|
|
: null,
|
|
'text' => $reportTitle,
|
|
]),
|
|
'subject' => ['reference' => $patientRef, 'display' => 'Patient'],
|
|
'issued' => $reportedAt,
|
|
];
|
|
if (!empty($observationRefs)) {
|
|
$reportRes['result'] = $observationRefs;
|
|
}
|
|
if ($organizationRef !== '') {
|
|
$reportRes['performer'] = [['reference' => $organizationRef]];
|
|
} elseif ($practitionerRef !== '') {
|
|
$reportRes['performer'] = [['reference' => $practitionerRef]];
|
|
}
|
|
if ($encounterRef !== '') {
|
|
$reportRes['encounter'] = ['reference' => $encounterRef];
|
|
}
|
|
$catSnomedCode = trim((string) ($diagnosticReport['category_snomed_code'] ?? ''));
|
|
if ($catSnomedCode !== '') {
|
|
$reportRes['category'] = [['coding' => [['system' => 'http://snomed.info/sct', 'code' => $catSnomedCode, 'display' => trim((string) ($diagnosticReport['category_snomed_display'] ?? $catSnomedCode))]]]];
|
|
}
|
|
$conclusion = trim((string) ($diagnosticReport['conclusion'] ?? ''));
|
|
if ($conclusion !== '') {
|
|
$reportRes['conclusion'] = $conclusion;
|
|
}
|
|
$resourceEntries[] = ['fullUrl' => $reportRef, 'resource' => $reportRes];
|
|
|
|
// ── Composition section entries ────────────────────────────────────────
|
|
$sectionEntries = [['reference' => $reportRef]];
|
|
if ($docRefRef !== null) {
|
|
$sectionEntries[] = ['reference' => $docRefRef];
|
|
}
|
|
|
|
// ── Composition ───────────────────────────────────────────────────────
|
|
$authorEntry = $practitionerRef !== '' ? ['reference' => $practitionerRef] : ['display' => 'Unknown'];
|
|
$composition = [
|
|
'resourceType' => 'Composition',
|
|
'id' => $compositionUuid,
|
|
'meta' => ['profile' => ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/DiagnosticReportRecord']],
|
|
'language' => 'en-IN',
|
|
'identifier' => ['system' => 'https://ndhm.in/phr', 'value' => $compositionUuid],
|
|
'status' => 'final',
|
|
'type' => [
|
|
'coding' => [['system' => 'http://snomed.info/sct', 'code' => '721981007', 'display' => 'Diagnostic studies report']],
|
|
'text' => 'Diagnostic Report',
|
|
],
|
|
'subject' => ['reference' => $patientRef, 'display' => 'Patient'],
|
|
'date' => $issuedAt,
|
|
'author' => [[$authorEntry]],
|
|
'title' => $reportTitle,
|
|
'section' => [[
|
|
'title' => 'Diagnostic Report',
|
|
'code' => ['coding' => [['system' => 'http://snomed.info/sct', 'code' => '721981007', 'display' => 'Diagnostic studies report']]],
|
|
'entry' => $sectionEntries,
|
|
]],
|
|
];
|
|
if ($encounterRef !== '') {
|
|
$composition['encounter'] = ['reference' => $encounterRef];
|
|
}
|
|
if ($organizationRef !== '') {
|
|
$composition['custodian'] = ['reference' => $organizationRef];
|
|
}
|
|
|
|
// ── Bundle identifier system: HFR ID based or fallback ────────────────
|
|
$hfrId = trim((string) ($organization['hfr_id'] ?? ''));
|
|
$bundleIdSystem = $hfrId !== ''
|
|
? 'https://' . strtolower(preg_replace('/[^A-Za-z0-9]/', '', $hfrId)) . '.hfr.abdm.gov.in'
|
|
: 'https://hfr.abdm.gov.in';
|
|
$bundleIdValue = $hfrId !== ''
|
|
? 'LAB-' . (string) ($diagnosticReport['id'] ?? $bundleUuid)
|
|
: $bundleUuid;
|
|
|
|
return [
|
|
'resourceType' => 'Bundle',
|
|
'id' => $bundleUuid,
|
|
'meta' => [
|
|
'profile' => ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/DocumentBundle'],
|
|
'security' => [['system' => 'http://terminology.hl7.org/CodeSystem/v3-Confidentiality', 'code' => 'V', 'display' => 'very restricted']],
|
|
],
|
|
'identifier' => ['system' => $bundleIdSystem, 'value' => $bundleIdValue],
|
|
'type' => 'document',
|
|
'timestamp' => $issuedAt,
|
|
'entry' => array_merge(
|
|
[['fullUrl' => 'urn:uuid:' . $compositionUuid, 'resource' => $composition]],
|
|
$resourceEntries,
|
|
$observationEntries
|
|
),
|
|
];
|
|
}
|
|
|
|
/**
|
|
* Build an ABDM-compliant DischargeSummaryRecord FHIR DocumentBundle.
|
|
*
|
|
* @param array<string, mixed> $patient {id, name, given_name, family_name, gender, birthDate, abhaAddress, phone}
|
|
* @param array<string, mixed> $encounter {id, admission_date, discharge_date, ipd_code, discharge_disposition}
|
|
* @param array<string, mixed> $summary {title, clinical_summary_html, chief_complaints, diagnosis_text,
|
|
* investigations_text, procedures_text, medications_text, follow_up}
|
|
* @param array<string, mixed>|null $practitioner {name, registration_number}
|
|
* @param array<string, mixed>|null $organization {name, hfr_id}
|
|
*
|
|
* @return array<string, mixed>
|
|
*/
|
|
public function buildDischargeSummaryBundle(
|
|
array $patient,
|
|
array $encounter,
|
|
array $summary,
|
|
?array $practitioner = null,
|
|
?array $organization = null
|
|
): array {
|
|
$issuedAt = $this->isoTimestamp();
|
|
$bundleUuid = $this->generateUuid();
|
|
$compositionUuid = $this->generateUuid();
|
|
$patientUuid = $this->generateUuid();
|
|
$encounterUuid = $this->generateUuid();
|
|
|
|
$patientRef = 'urn:uuid:' . $patientUuid;
|
|
$encounterRef = 'urn:uuid:' . $encounterUuid;
|
|
|
|
$hasPractitioner = $practitioner !== null && trim((string) ($practitioner['name'] ?? '')) !== '';
|
|
$hasOrganization = $organization !== null && trim((string) ($organization['name'] ?? '')) !== '';
|
|
$practitionerUuid = $hasPractitioner ? $this->generateUuid() : '';
|
|
$organizationUuid = $hasOrganization ? $this->generateUuid() : '';
|
|
$practitionerRef = $hasPractitioner ? ('urn:uuid:' . $practitionerUuid) : '';
|
|
$organizationRef = $hasOrganization ? ('urn:uuid:' . $organizationUuid) : '';
|
|
|
|
$resourceEntries = [];
|
|
|
|
// ── Practitioner ──────────────────────────────────────────────────────
|
|
if ($hasPractitioner) {
|
|
$practRes = [
|
|
'resourceType' => 'Practitioner',
|
|
'id' => $practitionerUuid,
|
|
'meta' => ['profile' => ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/Practitioner']],
|
|
'name' => [['text' => trim((string) ($practitioner['name'] ?? ''))]],
|
|
];
|
|
$regNo = trim((string) ($practitioner['registration_number'] ?? ''));
|
|
if ($regNo !== '') {
|
|
$practRes['identifier'] = [[
|
|
'type' => ['coding' => [['system' => 'http://terminology.hl7.org/CodeSystem/v2-0203', 'code' => 'MD', 'display' => 'Medical License number']]],
|
|
'system' => 'https://doctor.ndhm.gov.in',
|
|
'value' => $regNo,
|
|
]];
|
|
}
|
|
$resourceEntries[] = ['fullUrl' => $practitionerRef, 'resource' => $practRes];
|
|
}
|
|
|
|
// ── Organization ──────────────────────────────────────────────────────
|
|
if ($hasOrganization) {
|
|
$orgRes = [
|
|
'resourceType' => 'Organization',
|
|
'id' => $organizationUuid,
|
|
'meta' => ['profile' => ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/Organization']],
|
|
'name' => trim((string) ($organization['name'] ?? '')),
|
|
];
|
|
$hfrId = trim((string) ($organization['hfr_id'] ?? ''));
|
|
if ($hfrId !== '') {
|
|
$orgRes['identifier'] = [[
|
|
'type' => ['coding' => [['system' => 'http://terminology.hl7.org/CodeSystem/v2-0203', 'code' => 'PRN', 'display' => 'Provider number']]],
|
|
'system' => 'https://facility.ndhm.gov.in',
|
|
'value' => $hfrId,
|
|
]];
|
|
}
|
|
$resourceEntries[] = ['fullUrl' => $organizationRef, 'resource' => $orgRes];
|
|
}
|
|
|
|
// ── Patient ───────────────────────────────────────────────────────────
|
|
$patientResource = $this->buildPatientResource($patient);
|
|
$patientResource['id'] = $patientUuid;
|
|
$resourceEntries[] = ['fullUrl' => $patientRef, 'resource' => $patientResource];
|
|
|
|
// ── Encounter (inpatient) ─────────────────────────────────────────────
|
|
$admissionDate = trim((string) ($encounter['admission_date'] ?? '')) ?: $issuedAt;
|
|
$dischargeDate = trim((string) ($encounter['discharge_date'] ?? '')) ?: $issuedAt;
|
|
$encounterResource = [
|
|
'resourceType' => 'Encounter',
|
|
'id' => $encounterUuid,
|
|
'meta' => ['profile' => ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/Encounter']],
|
|
'identifier' => [['system' => 'https://ndhm.in', 'value' => trim((string) ($encounter['ipd_code'] ?? $encounterUuid))]],
|
|
'status' => 'finished',
|
|
'class' => [
|
|
'system' => 'http://terminology.hl7.org/CodeSystem/v3-ActCode',
|
|
'code' => 'IMP',
|
|
'display' => 'inpatient encounter',
|
|
],
|
|
'subject' => ['reference' => $patientRef, 'display' => 'Patient'],
|
|
'period' => ['start' => $admissionDate, 'end' => $dischargeDate],
|
|
];
|
|
$dispText = trim((string) ($encounter['discharge_disposition'] ?? ''));
|
|
if ($dispText !== '') {
|
|
$encounterResource['hospitalization'] = [
|
|
'dischargeDisposition' => [
|
|
'coding' => [['system' => 'http://terminology.hl7.org/CodeSystem/discharge-disposition', 'code' => 'home', 'display' => 'Home']],
|
|
'text' => $dispText,
|
|
],
|
|
];
|
|
}
|
|
if ($practitionerRef !== '') {
|
|
$encounterResource['participant'] = [['individual' => ['reference' => $practitionerRef]]];
|
|
}
|
|
if ($organizationRef !== '') {
|
|
$encounterResource['serviceProvider'] = ['reference' => $organizationRef];
|
|
}
|
|
$resourceEntries[] = ['fullUrl' => $encounterRef, 'resource' => $encounterResource];
|
|
|
|
// ── Composition sections per DischargeSummaryRecord spec ──────────────
|
|
$sections = [];
|
|
$summaryHtml = trim((string) ($summary['clinical_summary_html'] ?? ''));
|
|
|
|
// Chief complaints section (SNOMED 422843007)
|
|
$chiefComplaints = trim((string) ($summary['chief_complaints'] ?? ''));
|
|
if ($chiefComplaints !== '' || $summaryHtml !== '') {
|
|
$ccSection = [
|
|
'title' => 'Chief complaints',
|
|
'code' => ['coding' => [['system' => 'http://snomed.info/sct', 'code' => '422843007', 'display' => 'Chief complaint section']]],
|
|
];
|
|
if ($chiefComplaints !== '') {
|
|
$ccSection['text'] = ['status' => 'generated', 'div' => '<div xmlns="http://www.w3.org/1999/xhtml">' . htmlspecialchars($chiefComplaints) . '</div>'];
|
|
}
|
|
$sections[] = $ccSection;
|
|
}
|
|
|
|
// Medical History section (SNOMED 1003642006)
|
|
$diagnosisText = trim((string) ($summary['diagnosis_text'] ?? ''));
|
|
if ($diagnosisText !== '') {
|
|
$sections[] = [
|
|
'title' => 'Medical History',
|
|
'code' => ['coding' => [['system' => 'http://snomed.info/sct', 'code' => '1003642006', 'display' => 'Past medical history section']]],
|
|
'text' => ['status' => 'generated', 'div' => '<div xmlns="http://www.w3.org/1999/xhtml">' . htmlspecialchars($diagnosisText) . '</div>'],
|
|
];
|
|
}
|
|
|
|
// Investigations section (SNOMED 721981007)
|
|
$investigationsText = trim((string) ($summary['investigations_text'] ?? ''));
|
|
if ($investigationsText !== '') {
|
|
$sections[] = [
|
|
'title' => 'Investigations',
|
|
'code' => ['coding' => [['system' => 'http://snomed.info/sct', 'code' => '721981007', 'display' => 'Diagnostic studies report']]],
|
|
'text' => ['status' => 'generated', 'div' => '<div xmlns="http://www.w3.org/1999/xhtml">' . htmlspecialchars($investigationsText) . '</div>'],
|
|
];
|
|
}
|
|
|
|
// Procedures section (SNOMED 1003640003)
|
|
$proceduresText = trim((string) ($summary['procedures_text'] ?? ''));
|
|
if ($proceduresText !== '') {
|
|
$sections[] = [
|
|
'title' => 'Procedures',
|
|
'code' => ['coding' => [['system' => 'http://snomed.info/sct', 'code' => '1003640003', 'display' => 'Procedure report']]],
|
|
'text' => ['status' => 'generated', 'div' => '<div xmlns="http://www.w3.org/1999/xhtml">' . htmlspecialchars($proceduresText) . '</div>'],
|
|
];
|
|
}
|
|
|
|
// Medications section (SNOMED 721912009)
|
|
$medicationsText = trim((string) ($summary['medications_text'] ?? ''));
|
|
if ($medicationsText !== '') {
|
|
$sections[] = [
|
|
'title' => 'Medications',
|
|
'code' => ['coding' => [['system' => 'http://snomed.info/sct', 'code' => '721912009', 'display' => 'Medication summary document']]],
|
|
'text' => ['status' => 'generated', 'div' => '<div xmlns="http://www.w3.org/1999/xhtml">' . htmlspecialchars($medicationsText) . '</div>'],
|
|
];
|
|
}
|
|
|
|
// Follow-up section (SNOMED 736271009)
|
|
$followUp = trim((string) ($summary['follow_up'] ?? ''));
|
|
if ($followUp !== '') {
|
|
$sections[] = [
|
|
'title' => 'Follow Up',
|
|
'code' => ['coding' => [['system' => 'http://snomed.info/sct', 'code' => '736271009', 'display' => 'Outpatient care plan']]],
|
|
'text' => ['status' => 'generated', 'div' => '<div xmlns="http://www.w3.org/1999/xhtml">' . htmlspecialchars($followUp) . '</div>'],
|
|
];
|
|
}
|
|
|
|
// Fallback: one summary section if nothing else provided
|
|
if (empty($sections) && $summaryHtml !== '') {
|
|
$sections[] = [
|
|
'title' => 'Discharge Summary',
|
|
'code' => ['coding' => [['system' => 'http://snomed.info/sct', 'code' => '373942005', 'display' => 'Discharge summary']]],
|
|
'text' => ['status' => 'generated', 'div' => $summaryHtml],
|
|
];
|
|
}
|
|
|
|
// ── Composition ───────────────────────────────────────────────────────
|
|
$authorEntry = $practitionerRef !== '' ? ['reference' => $practitionerRef] : ['display' => 'Unknown'];
|
|
$composition = [
|
|
'resourceType' => 'Composition',
|
|
'id' => $compositionUuid,
|
|
'meta' => ['profile' => ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/DischargeSummaryRecord']],
|
|
'language' => 'en-IN',
|
|
'identifier' => ['system' => 'https://ndhm.in/phr', 'value' => $compositionUuid],
|
|
'status' => 'final',
|
|
'type' => [
|
|
'coding' => [['system' => 'http://snomed.info/sct', 'code' => '373942005', 'display' => 'Discharge summary']],
|
|
'text' => 'Discharge Summary',
|
|
],
|
|
'subject' => ['reference' => $patientRef, 'display' => 'Patient'],
|
|
'encounter' => ['reference' => $encounterRef, 'display' => 'Encounter'],
|
|
'date' => $issuedAt,
|
|
'author' => [[$authorEntry]],
|
|
'title' => (string) ($summary['title'] ?? 'Discharge Summary'),
|
|
'section' => $sections,
|
|
];
|
|
if ($organizationRef !== '') {
|
|
$composition['custodian'] = ['reference' => $organizationRef];
|
|
}
|
|
|
|
// ── Bundle identifier system: HFR ID based or fallback ────────────────
|
|
$hfrId = trim((string) ($organization['hfr_id'] ?? ''));
|
|
$bundleIdSystem = $hfrId !== ''
|
|
? 'https://' . strtolower(preg_replace('/[^A-Za-z0-9]/', '', $hfrId)) . '.hfr.abdm.gov.in'
|
|
: 'https://hfr.abdm.gov.in';
|
|
$ipdCode = trim((string) ($encounter['ipd_code'] ?? ''));
|
|
$bundleIdValue = $hfrId !== ''
|
|
? 'IPD-' . ($ipdCode !== '' ? $ipdCode : $bundleUuid)
|
|
: $bundleUuid;
|
|
|
|
return [
|
|
'resourceType' => 'Bundle',
|
|
'id' => $bundleUuid,
|
|
'meta' => [
|
|
'profile' => ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/DocumentBundle'],
|
|
'security' => [['system' => 'http://terminology.hl7.org/CodeSystem/v3-Confidentiality', 'code' => 'V', 'display' => 'very restricted']],
|
|
],
|
|
'identifier' => ['system' => $bundleIdSystem, 'value' => $bundleIdValue],
|
|
'type' => 'document',
|
|
'timestamp' => $issuedAt,
|
|
'entry' => array_merge(
|
|
[['fullUrl' => 'urn:uuid:' . $compositionUuid, 'resource' => $composition]],
|
|
$resourceEntries
|
|
),
|
|
];
|
|
}
|
|
|
|
/**
|
|
* @param array<string, mixed> $patient
|
|
* @param array<string, mixed> $encounter
|
|
* @param array<string, mixed> $claim
|
|
*
|
|
* @return array<string, mixed>
|
|
*/
|
|
public function buildClaimBundle(array $patient, array $encounter, array $claim): array
|
|
{
|
|
$issuedAt = Time::now('Asia/Kolkata')->toDateTimeString();
|
|
$patientRef = 'Patient/' . (string) ($patient['id'] ?? 'unknown');
|
|
$encounterRef = 'Encounter/' . (string) ($encounter['id'] ?? 'unknown');
|
|
|
|
$claimId = (string) ($claim['id'] ?? ('claim-' . time()));
|
|
$items = is_array($claim['items'] ?? null) ? ($claim['items'] ?? []) : [];
|
|
|
|
$claimItems = [];
|
|
foreach ($items as $index => $item) {
|
|
if (! is_array($item)) {
|
|
continue;
|
|
}
|
|
|
|
$claimItems[] = [
|
|
'sequence' => $index + 1,
|
|
'productOrService' => [
|
|
'text' => (string) ($item['name'] ?? $item['description'] ?? ''),
|
|
],
|
|
'quantity' => [
|
|
'value' => (float) ($item['qty'] ?? 1),
|
|
],
|
|
'unitPrice' => [
|
|
'value' => (float) ($item['unit_price'] ?? 0),
|
|
'currency' => (string) ($item['currency'] ?? 'INR'),
|
|
],
|
|
'net' => [
|
|
'value' => (float) ($item['amount'] ?? 0),
|
|
'currency' => (string) ($item['currency'] ?? 'INR'),
|
|
],
|
|
];
|
|
}
|
|
|
|
$claimResource = [
|
|
'resourceType' => 'Claim',
|
|
'id' => $claimId,
|
|
'status' => (string) ($claim['status'] ?? 'active'),
|
|
'use' => (string) ($claim['use'] ?? 'claim'),
|
|
'type' => [
|
|
'text' => (string) ($claim['type'] ?? 'institutional'),
|
|
],
|
|
'patient' => ['reference' => $patientRef],
|
|
'created' => $issuedAt,
|
|
'provider' => [
|
|
'display' => (string) ($claim['provider'] ?? ''),
|
|
],
|
|
'insurer' => [
|
|
'display' => (string) ($claim['insurer'] ?? ''),
|
|
],
|
|
'priority' => [
|
|
'text' => (string) ($claim['priority'] ?? 'normal'),
|
|
],
|
|
'item' => $claimItems,
|
|
'total' => [
|
|
'value' => (float) ($claim['total'] ?? 0),
|
|
'currency' => (string) ($claim['currency'] ?? 'INR'),
|
|
],
|
|
'encounter' => [[
|
|
'reference' => $encounterRef,
|
|
]],
|
|
];
|
|
|
|
return [
|
|
'resourceType' => 'Bundle',
|
|
'type' => 'collection',
|
|
'timestamp' => $issuedAt,
|
|
'entry' => [[
|
|
'resource' => $this->buildPatientResource($patient),
|
|
], [
|
|
'resource' => [
|
|
'resourceType' => 'Encounter',
|
|
'id' => (string) ($encounter['id'] ?? 'unknown'),
|
|
'status' => (string) ($encounter['status'] ?? 'finished'),
|
|
'subject' => ['reference' => $patientRef],
|
|
],
|
|
], [
|
|
'resource' => $claimResource,
|
|
]],
|
|
];
|
|
}
|
|
|
|
/** Generate a cryptographically random UUID v4. */
|
|
private function generateUuid(): string
|
|
{
|
|
$data = random_bytes(16);
|
|
$data[6] = chr(ord($data[6]) & 0x0f | 0x40);
|
|
$data[8] = chr(ord($data[8]) & 0x3f | 0x80);
|
|
|
|
return vsprintf('%s%s-%s-%s-%s-%s%s%s', str_split(bin2hex($data), 4));
|
|
}
|
|
|
|
/** ISO 8601 timestamp with India Standard Time offset (+05:30). */
|
|
private function isoTimestamp(): string
|
|
{
|
|
return (new \DateTime('now', new \DateTimeZone('Asia/Kolkata')))->format('Y-m-d\TH:i:sP');
|
|
}
|
|
|
|
/**
|
|
* @param array<string, mixed> $patient
|
|
*
|
|
* @return array<string, mixed>
|
|
*/
|
|
private function buildPatientResource(array $patient): array
|
|
{
|
|
// Build structured name: prefer explicit given_name/family_name fields;
|
|
// fall back to splitting the full 'name' string.
|
|
$fullText = trim((string) ($patient['name'] ?? ''));
|
|
$givenName = trim((string) ($patient['given_name'] ?? ''));
|
|
$familyName = trim((string) ($patient['family_name'] ?? ''));
|
|
|
|
if ($givenName === '' && $familyName === '' && $fullText !== '') {
|
|
// Try splitting: last word → family, rest → given
|
|
$parts = preg_split('/\s+/', $fullText, -1, PREG_SPLIT_NO_EMPTY) ?: [$fullText];
|
|
$familyName = count($parts) > 1 ? (string) array_pop($parts) : '';
|
|
$givenName = implode(' ', $parts);
|
|
}
|
|
|
|
$nameText = $fullText !== '' ? $fullText : trim($givenName . ' ' . $familyName);
|
|
$nameEntry = ['text' => $nameText];
|
|
if ($givenName !== '') {
|
|
$nameEntry['given'] = [$givenName];
|
|
}
|
|
if ($familyName !== '') {
|
|
$nameEntry['family'] = $familyName;
|
|
}
|
|
|
|
$resource = [
|
|
'resourceType' => 'Patient',
|
|
'id' => (string) ($patient['id'] ?? 'unknown'),
|
|
'name' => [$nameEntry],
|
|
];
|
|
|
|
if (! empty($patient['gender'])) {
|
|
$resource['gender'] = (string) $patient['gender'];
|
|
}
|
|
|
|
if (! empty($patient['birthDate'])) {
|
|
$resource['birthDate'] = (string) $patient['birthDate'];
|
|
}
|
|
|
|
$abhaAddress = trim((string) ($patient['abhaAddress'] ?? ''));
|
|
if ($abhaAddress !== '') {
|
|
$resource['meta'] = ['profile' => ['https://nrces.in/ndhm/fhir/r4/StructureDefinition/Patient']];
|
|
// NI = National unique individual identifier (ABHA number / address)
|
|
$resource['identifier'] = [[
|
|
'type' => ['coding' => [[
|
|
'system' => 'http://terminology.hl7.org/CodeSystem/v2-0203',
|
|
'code' => 'NI',
|
|
'display' => 'National unique individual identifier',
|
|
]]],
|
|
'system' => 'https://healthid.ndhm.gov.in',
|
|
'value' => $abhaAddress,
|
|
]];
|
|
}
|
|
|
|
// Phone / mobile telecom
|
|
$phone = trim((string) ($patient['phone'] ?? ''));
|
|
if ($phone !== '') {
|
|
$resource['telecom'] = [[
|
|
'system' => 'phone',
|
|
'value' => $phone,
|
|
'use' => 'mobile',
|
|
]];
|
|
}
|
|
|
|
return $resource;
|
|
}
|
|
|
|
/**
|
|
* Map common route-of-administration text to SNOMED CT codes.
|
|
* Returns empty string when no mapping is found.
|
|
*/
|
|
private function resolveRouteSnomedCode(string $routeText): string
|
|
{
|
|
static $map = [
|
|
// Oral
|
|
'oral' => '26643006',
|
|
'by mouth' => '26643006',
|
|
'po' => '26643006',
|
|
'per oral' => '26643006',
|
|
// Intravenous
|
|
'intravenous' => '47625008',
|
|
'iv' => '47625008',
|
|
'i.v.' => '47625008',
|
|
'intravenously' => '47625008',
|
|
// Intramuscular
|
|
'intramuscular' => '78421000',
|
|
'im' => '78421000',
|
|
'i.m.' => '78421000',
|
|
// Subcutaneous
|
|
'subcutaneous' => '34206005',
|
|
'sc' => '34206005',
|
|
's.c.' => '34206005',
|
|
'subcut' => '34206005',
|
|
// Topical
|
|
'topical' => '6064005',
|
|
'locally' => '6064005',
|
|
// Inhaled / nebulisation
|
|
'inhaled' => '18679011000001101',
|
|
'inhalation' => '18679011000001101',
|
|
'nebulisation' => '18679011000001101',
|
|
'nebulizer' => '18679011000001101',
|
|
// Sublingual
|
|
'sublingual' => '37839007',
|
|
'sl' => '37839007',
|
|
// Rectal
|
|
'rectal' => '37161004',
|
|
'per rectal' => '37161004',
|
|
'pr' => '37161004',
|
|
// Nasal
|
|
'nasal' => '46713006',
|
|
'intranasal' => '46713006',
|
|
// Ophthalmic / eye
|
|
'ophthalmic' => '54485002',
|
|
'eye' => '54485002',
|
|
'otic' => '10547007',
|
|
'ear' => '10547007',
|
|
];
|
|
$key = strtolower(trim($routeText));
|
|
return $map[$key] ?? '';
|
|
}
|
|
|
|
// =========================================================================
|
|
// Enhanced FHIR Bundle Builders (ABDM M3 Compliant)
|
|
// =========================================================================
|
|
|
|
/**
|
|
* Build a full DiagnosticReport FHIR Bundle (ABDM M3 — DiagnosticReportRecord).
|
|
*
|
|
* Supports LOINC-coded observations, specimen metadata, Practitioner performer,
|
|
* and an optional scanned-document attachment via DocumentReference + Binary.
|
|
*
|
|
* @param array<string, mixed> $patient Patient demographics
|
|
* @param array<string, mixed> $diagnosticReport {id, title, category_loinc,
|
|
* category_display, status, conclusion, reported_at}
|
|
* @param array<int, array<string, mixed>> $observations Each: {test_name, loinc_code, value,
|
|
* value_type (quantity|string), unit, ucum_code,
|
|
* reference_range_low, reference_range_high,
|
|
* interpretation, status}
|
|
* @param array<string, mixed>|null $specimen {id, type_text, collection_date}
|
|
* @param array<string, mixed>|null $attachment {content_type, data_base64, title}
|
|
* @param array<string, mixed>|null $practitioner {id, name, registration_number}
|
|
* @param array<string, mixed>|null $organization {id, name, hfr_id}
|
|
*
|
|
* @return array<string, mixed>
|
|
*/
|
|
public function buildEnhancedLabReportBundle(
|
|
array $patient,
|
|
array $diagnosticReport,
|
|
array $observations = [],
|
|
?array $specimen = null,
|
|
?array $attachment = null,
|
|
?array $practitioner = null,
|
|
?array $organization = null
|
|
): array {
|
|
$issuedAt = Time::now('Asia/Kolkata')->toDateTimeString();
|
|
$patientRef = 'Patient/' . (string) ($patient['id'] ?? 'unknown');
|
|
$reportId = 'lab-rpt-' . (string) ($diagnosticReport['id'] ?? date('YmdHis'));
|
|
|
|
$entries = [['resource' => $this->buildPatientResource($patient)]];
|
|
|
|
$practitionerRef = '';
|
|
$organizationRef = '';
|
|
|
|
if ($practitioner !== null) {
|
|
$practId = trim((string) ($practitioner['id'] ?? ''));
|
|
$practitionerRef = $practId !== '' ? ('Practitioner/' . $practId) : '';
|
|
if ($practitionerRef !== '') {
|
|
$practRes = [
|
|
'resourceType' => 'Practitioner',
|
|
'id' => $practId,
|
|
'name' => [['text' => trim((string) ($practitioner['name'] ?? ''))]],
|
|
];
|
|
$regNo = trim((string) ($practitioner['registration_number'] ?? ''));
|
|
if ($regNo !== '') {
|
|
$practRes['identifier'] = [[
|
|
'system' => 'https://hpr.abdm.gov.in/hpr-id',
|
|
'value' => $regNo,
|
|
]];
|
|
}
|
|
$entries[] = ['resource' => $practRes];
|
|
}
|
|
}
|
|
|
|
if ($organization !== null) {
|
|
$orgId = trim((string) ($organization['id'] ?? ''));
|
|
$organizationRef = $orgId !== '' ? ('Organization/' . $orgId) : '';
|
|
if ($organizationRef !== '') {
|
|
$orgRes = [
|
|
'resourceType' => 'Organization',
|
|
'id' => $orgId,
|
|
'name' => trim((string) ($organization['name'] ?? '')),
|
|
];
|
|
$hfrId = trim((string) ($organization['hfr_id'] ?? ''));
|
|
if ($hfrId !== '') {
|
|
$orgRes['identifier'] = [[
|
|
'system' => 'https://facility.abdm.gov.in/hfr',
|
|
'value' => $hfrId,
|
|
]];
|
|
}
|
|
$entries[] = ['resource' => $orgRes];
|
|
}
|
|
}
|
|
|
|
// Specimen (optional)
|
|
$specimenRef = '';
|
|
if ($specimen !== null) {
|
|
$specimenId = 'specimen-' . (string) ($specimen['id'] ?? '1');
|
|
$specimenRef = 'Specimen/' . $specimenId;
|
|
$specimenRes = [
|
|
'resourceType' => 'Specimen',
|
|
'id' => $specimenId,
|
|
'subject' => ['reference' => $patientRef],
|
|
'type' => ['text' => (string) ($specimen['type_text'] ?? 'Blood')],
|
|
];
|
|
$collDate = trim((string) ($specimen['collection_date'] ?? ''));
|
|
if ($collDate !== '') {
|
|
$specimenRes['collection'] = ['collectedDateTime' => $collDate];
|
|
}
|
|
$entries[] = ['resource' => $specimenRes];
|
|
}
|
|
|
|
// Observations
|
|
$observationRefs = [];
|
|
foreach ($observations as $index => $obs) {
|
|
$obsId = 'obs-' . ($index + 1);
|
|
$observationRefs[] = ['reference' => 'Observation/' . $obsId];
|
|
|
|
$loincCode = trim((string) ($obs['loinc_code'] ?? ''));
|
|
$testName = (string) ($obs['test_name'] ?? '');
|
|
$valueType = trim((string) ($obs['value_type'] ?? 'string'));
|
|
$rawValue = $obs['value'] ?? '';
|
|
$unit = (string) ($obs['unit'] ?? '');
|
|
$ucumCode = (string) ($obs['ucum_code'] ?? $unit);
|
|
$interpText = (string) ($obs['interpretation'] ?? '');
|
|
|
|
$code = ['text' => $testName];
|
|
if ($loincCode !== '') {
|
|
$code['coding'] = [[
|
|
'system' => 'http://loinc.org',
|
|
'code' => $loincCode,
|
|
'display' => $testName,
|
|
]];
|
|
}
|
|
|
|
$obsResource = [
|
|
'resourceType' => 'Observation',
|
|
'id' => $obsId,
|
|
'status' => (string) ($obs['status'] ?? 'final'),
|
|
'category' => [[
|
|
'coding' => [[
|
|
'system' => 'http://terminology.hl7.org/CodeSystem/observation-category',
|
|
'code' => 'laboratory',
|
|
'display' => 'Laboratory',
|
|
]],
|
|
]],
|
|
'code' => $code,
|
|
'subject' => ['reference' => $patientRef],
|
|
'issued' => $issuedAt,
|
|
];
|
|
|
|
if ($specimenRef !== '') {
|
|
$obsResource['specimen'] = ['reference' => $specimenRef];
|
|
}
|
|
if ($practitionerRef !== '') {
|
|
$obsResource['performer'] = [['reference' => $practitionerRef]];
|
|
}
|
|
|
|
if ($valueType === 'quantity' && is_numeric($rawValue)) {
|
|
$obsResource['valueQuantity'] = [
|
|
'value' => (float) $rawValue,
|
|
'unit' => $unit,
|
|
'system' => 'http://unitsofmeasure.org',
|
|
'code' => $ucumCode !== '' ? $ucumCode : $unit,
|
|
];
|
|
} else {
|
|
$obsResource['valueString'] = (string) $rawValue;
|
|
}
|
|
|
|
$refLow = $obs['reference_range_low'] ?? null;
|
|
$refHigh = $obs['reference_range_high'] ?? null;
|
|
if ($refLow !== null || $refHigh !== null) {
|
|
$refRange = [];
|
|
if (is_numeric($refLow)) { $refRange['low'] = ['value' => (float) $refLow, 'unit' => $unit]; }
|
|
if (is_numeric($refHigh)) { $refRange['high'] = ['value' => (float) $refHigh, 'unit' => $unit]; }
|
|
if (! empty($refRange)) {
|
|
$obsResource['referenceRange'] = [$refRange];
|
|
}
|
|
}
|
|
|
|
if ($interpText !== '') {
|
|
$obsResource['interpretation'] = [['text' => $interpText]];
|
|
}
|
|
|
|
$entries[] = ['resource' => $obsResource];
|
|
}
|
|
|
|
// Optional scanned attachment
|
|
$docRefRef = '';
|
|
if ($attachment !== null && ! empty($attachment['data_base64'])) {
|
|
$docEntries = $this->buildDocumentReferenceEntry(
|
|
'doc-lab-' . $reportId,
|
|
(string) ($attachment['title'] ?? 'Lab Report Document'),
|
|
(string) ($attachment['content_type'] ?? 'application/pdf'),
|
|
(string) $attachment['data_base64'],
|
|
$patientRef,
|
|
$issuedAt
|
|
);
|
|
$docRefRef = 'DocumentReference/doc-lab-' . $reportId;
|
|
foreach ($docEntries as $entry) {
|
|
$entries[] = $entry;
|
|
}
|
|
}
|
|
|
|
$performers = [];
|
|
if ($practitionerRef !== '') { $performers[] = ['reference' => $practitionerRef]; }
|
|
if ($organizationRef !== '') { $performers[] = ['reference' => $organizationRef]; }
|
|
|
|
$categoryLoinc = trim((string) ($diagnosticReport['category_loinc'] ?? '26436-6'));
|
|
$categoryDisplay = trim((string) ($diagnosticReport['category_display'] ?? 'Laboratory studies (procedure)'));
|
|
|
|
$drResource = [
|
|
'resourceType' => 'DiagnosticReport',
|
|
'id' => $reportId,
|
|
'status' => (string) ($diagnosticReport['status'] ?? 'final'),
|
|
'category' => [[
|
|
'coding' => [[
|
|
'system' => 'http://loinc.org',
|
|
'code' => $categoryLoinc,
|
|
'display' => $categoryDisplay,
|
|
]],
|
|
]],
|
|
'code' => ['text' => (string) ($diagnosticReport['title'] ?? 'Laboratory Report')],
|
|
'subject' => ['reference' => $patientRef],
|
|
'issued' => (string) ($diagnosticReport['reported_at'] ?? $issuedAt),
|
|
'result' => $observationRefs,
|
|
'conclusion' => (string) ($diagnosticReport['conclusion'] ?? ''),
|
|
];
|
|
|
|
if ($specimenRef !== '') {
|
|
$drResource['specimen'] = [['reference' => $specimenRef]];
|
|
}
|
|
if (! empty($performers)) {
|
|
$drResource['performer'] = $performers;
|
|
}
|
|
if ($docRefRef !== '') {
|
|
$drResource['presentedForm'] = [[
|
|
'contentType' => (string) ($attachment['content_type'] ?? 'application/pdf'),
|
|
'title' => (string) ($attachment['title'] ?? 'Lab Report'),
|
|
]];
|
|
}
|
|
$entries[] = ['resource' => $drResource];
|
|
|
|
// Composition (LOINC 11502-2 = Laboratory report)
|
|
$compositionSections = [
|
|
['title' => 'Lab Results', 'entry' => $observationRefs],
|
|
];
|
|
if ($docRefRef !== '') {
|
|
$compositionSections[] = [
|
|
'title' => 'Report Document',
|
|
'entry' => [['reference' => $docRefRef]],
|
|
];
|
|
}
|
|
|
|
$composition = [
|
|
'resourceType' => 'Composition',
|
|
'id' => 'comp-' . $reportId,
|
|
'status' => 'final',
|
|
'type' => [
|
|
'coding' => [[
|
|
'system' => 'http://loinc.org',
|
|
'code' => '11502-2',
|
|
'display' => 'Laboratory report',
|
|
]],
|
|
'text' => 'Diagnostic Report - Lab',
|
|
],
|
|
'subject' => ['reference' => $patientRef],
|
|
'date' => $issuedAt,
|
|
'title' => (string) ($diagnosticReport['title'] ?? 'Laboratory Report'),
|
|
'section' => $compositionSections,
|
|
];
|
|
if ($practitionerRef !== '') {
|
|
$composition['author'] = [['reference' => $practitionerRef]];
|
|
}
|
|
$entries[] = ['resource' => $composition];
|
|
|
|
return [
|
|
'resourceType' => 'Bundle',
|
|
'identifier' => [
|
|
'system' => 'urn:ietf:rfc:3986',
|
|
'value' => 'urn:uuid:bundle-lab-' . $reportId . '-' . date('YmdHis'),
|
|
],
|
|
'type' => 'document',
|
|
'timestamp' => $issuedAt,
|
|
'entry' => $entries,
|
|
];
|
|
}
|
|
|
|
// -------------------------------------------------------------------------
|
|
|
|
/**
|
|
* Build a full Discharge Summary FHIR Bundle (ABDM M3 — DischargeSummaryRecord).
|
|
*
|
|
* Covers all mandatory composition sections: chief complaints, diagnosis,
|
|
* allergies, procedures, medications, investigations, care plan, and a
|
|
* free-text clinical notes narrative.
|
|
*
|
|
* @param array<string, mixed> $patient Patient demographics
|
|
* @param array<string, mixed> $practitioner {id, name, registration_number}
|
|
* @param array<string, mixed> $organization {id, name, hfr_id}
|
|
* @param array<string, mixed> $encounter {id, admission_date, discharge_date}
|
|
* @param array<string, mixed> $summary {
|
|
* title, chief_complaints[], conditions[], allergies[],
|
|
* procedures[], medications[], investigations[], care_plan,
|
|
* follow_up_date, clinical_notes_html
|
|
* }
|
|
*
|
|
* @return array<string, mixed>
|
|
*/
|
|
public function buildEnhancedDischargeSummaryBundle(
|
|
array $patient,
|
|
array $practitioner,
|
|
array $organization,
|
|
array $encounter,
|
|
array $summary
|
|
): array {
|
|
$issuedAt = Time::now('Asia/Kolkata')->toDateTimeString();
|
|
$encounterId = (string) ($encounter['id'] ?? 'enc-' . date('YmdHis'));
|
|
$patientRef = 'Patient/' . (string) ($patient['id'] ?? 'unknown');
|
|
$encounterRef = 'Encounter/' . $encounterId;
|
|
|
|
$practId = trim((string) ($practitioner['id'] ?? ''));
|
|
$orgId = trim((string) ($organization['id'] ?? ''));
|
|
$practitionerRef = $practId !== '' ? ('Practitioner/' . $practId) : '';
|
|
$organizationRef = $orgId !== '' ? ('Organization/' . $orgId) : '';
|
|
|
|
$entries = [['resource' => $this->buildPatientResource($patient)]];
|
|
|
|
// Practitioner
|
|
if ($practitionerRef !== '') {
|
|
$practRes = [
|
|
'resourceType' => 'Practitioner',
|
|
'id' => $practId,
|
|
'name' => [['text' => (string) ($practitioner['name'] ?? '')]],
|
|
];
|
|
$regNo = trim((string) ($practitioner['registration_number'] ?? ''));
|
|
if ($regNo !== '') {
|
|
$practRes['identifier'] = [[
|
|
'system' => 'https://hpr.abdm.gov.in/hpr-id',
|
|
'value' => $regNo,
|
|
]];
|
|
}
|
|
$entries[] = ['resource' => $practRes];
|
|
}
|
|
|
|
// Organization
|
|
if ($organizationRef !== '') {
|
|
$orgRes = [
|
|
'resourceType' => 'Organization',
|
|
'id' => $orgId,
|
|
'name' => (string) ($organization['name'] ?? ''),
|
|
];
|
|
$hfrId = trim((string) ($organization['hfr_id'] ?? ''));
|
|
if ($hfrId !== '') {
|
|
$orgRes['identifier'] = [[
|
|
'system' => 'https://facility.abdm.gov.in/hfr',
|
|
'value' => $hfrId,
|
|
]];
|
|
}
|
|
$entries[] = ['resource' => $orgRes];
|
|
}
|
|
|
|
// Encounter (inpatient)
|
|
$encounterResource = [
|
|
'resourceType' => 'Encounter',
|
|
'id' => $encounterId,
|
|
'status' => 'finished',
|
|
'class' => [
|
|
'system' => 'http://terminology.hl7.org/CodeSystem/v3-ActCode',
|
|
'code' => 'IMP',
|
|
'display' => 'inpatient encounter',
|
|
],
|
|
'subject' => ['reference' => $patientRef],
|
|
'period' => [
|
|
'start' => (string) ($encounter['admission_date'] ?? $encounter['period_start'] ?? $issuedAt),
|
|
'end' => (string) ($encounter['discharge_date'] ?? $encounter['period_end'] ?? $issuedAt),
|
|
],
|
|
];
|
|
if ($practitionerRef !== '') {
|
|
$encounterResource['participant'] = [['individual' => ['reference' => $practitionerRef]]];
|
|
}
|
|
if ($organizationRef !== '') {
|
|
$encounterResource['serviceProvider'] = ['reference' => $organizationRef];
|
|
}
|
|
$entries[] = ['resource' => $encounterResource];
|
|
|
|
$sections = [];
|
|
|
|
// --- Chief Complaints ---
|
|
$complaintRefs = [];
|
|
foreach ((array) ($summary['chief_complaints'] ?? []) as $idx => $complaint) {
|
|
$text = is_array($complaint)
|
|
? trim((string) ($complaint['text'] ?? ''))
|
|
: trim((string) $complaint);
|
|
if ($text === '') { continue; }
|
|
|
|
$condId = 'cc-' . ($idx + 1);
|
|
$code = ['text' => $text];
|
|
$snomedCode = is_array($complaint) ? trim((string) ($complaint['snomed_code'] ?? '')) : '';
|
|
if ($snomedCode !== '') {
|
|
$code['coding'] = [['system' => 'http://snomed.info/sct', 'code' => $snomedCode, 'display' => $text]];
|
|
}
|
|
|
|
$complaintRefs[] = ['reference' => 'Condition/' . $condId];
|
|
$entries[] = ['resource' => [
|
|
'resourceType' => 'Condition',
|
|
'id' => $condId,
|
|
'clinicalStatus' => ['coding' => [['system' => 'http://terminology.hl7.org/CodeSystem/condition-clinical', 'code' => 'active']]],
|
|
'category' => [['coding' => [['system' => 'http://terminology.hl7.org/CodeSystem/condition-category', 'code' => 'problem-list-item']], 'text' => 'Chief Complaint']],
|
|
'code' => $code,
|
|
'subject' => ['reference' => $patientRef],
|
|
'encounter' => ['reference' => $encounterRef],
|
|
]];
|
|
}
|
|
if (! empty($complaintRefs)) {
|
|
$sections[] = ['title' => 'Chief Complaints', 'entry' => $complaintRefs];
|
|
}
|
|
|
|
// --- Diagnosis / Conditions ---
|
|
$conditionRefs = [];
|
|
$encounterDiagnosis = [];
|
|
foreach ((array) ($summary['conditions'] ?? []) as $idx => $cond) {
|
|
$text = is_array($cond) ? trim((string) ($cond['text'] ?? '')) : trim((string) $cond);
|
|
if ($text === '') { continue; }
|
|
|
|
$condId = 'diag-' . ($idx + 1);
|
|
$code = ['text' => $text];
|
|
$snomedCode = is_array($cond) ? trim((string) ($cond['snomed_code'] ?? '')) : '';
|
|
if ($snomedCode !== '') {
|
|
$code['coding'] = [[
|
|
'system' => 'http://snomed.info/sct',
|
|
'code' => $snomedCode,
|
|
'display' => is_array($cond) ? (string) ($cond['snomed_display'] ?? $text) : $text,
|
|
]];
|
|
}
|
|
|
|
$verStatus = is_array($cond) && strtolower((string) ($cond['verification_status'] ?? '')) === 'confirmed'
|
|
? 'confirmed'
|
|
: 'provisional';
|
|
|
|
$conditionRefs[] = ['reference' => 'Condition/' . $condId];
|
|
$encounterDiagnosis[] = ['condition' => ['reference' => 'Condition/' . $condId]];
|
|
|
|
$entries[] = ['resource' => [
|
|
'resourceType' => 'Condition',
|
|
'id' => $condId,
|
|
'clinicalStatus' => ['coding' => [['system' => 'http://terminology.hl7.org/CodeSystem/condition-clinical', 'code' => 'active']]],
|
|
'verificationStatus' => ['coding' => [['system' => 'http://terminology.hl7.org/CodeSystem/condition-ver-status', 'code' => $verStatus]]],
|
|
'category' => [['coding' => [['system' => 'http://terminology.hl7.org/CodeSystem/condition-category', 'code' => 'encounter-diagnosis']]]],
|
|
'code' => $code,
|
|
'subject' => ['reference' => $patientRef],
|
|
'encounter' => ['reference' => $encounterRef],
|
|
]];
|
|
}
|
|
if (! empty($conditionRefs)) {
|
|
$sections[] = ['title' => 'Diagnosis', 'entry' => $conditionRefs];
|
|
// Back-patch encounter diagnosis references
|
|
$encounterResource['diagnosis'] = $encounterDiagnosis;
|
|
}
|
|
|
|
// --- Allergies ---
|
|
$allergyRefs = [];
|
|
foreach ((array) ($summary['allergies'] ?? []) as $idx => $allergy) {
|
|
$codeText = is_array($allergy)
|
|
? trim((string) ($allergy['code_text'] ?? ''))
|
|
: trim((string) $allergy);
|
|
if ($codeText === '') { continue; }
|
|
|
|
$allergyId = 'allergy-ds-' . ($idx + 1);
|
|
$allergyRefs[] = ['reference' => 'AllergyIntolerance/' . $allergyId];
|
|
$allergyRes = [
|
|
'resourceType' => 'AllergyIntolerance',
|
|
'id' => $allergyId,
|
|
'clinicalStatus' => ['coding' => [['system' => 'http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical', 'code' => 'active']]],
|
|
'verificationStatus' => ['coding' => [['system' => 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification', 'code' => 'confirmed']]],
|
|
'patient' => ['reference' => $patientRef],
|
|
'code' => ['text' => $codeText],
|
|
];
|
|
$reaction = is_array($allergy) ? trim((string) ($allergy['reaction_text'] ?? '')) : '';
|
|
if ($reaction !== '') {
|
|
$allergyRes['reaction'] = [['description' => $reaction]];
|
|
}
|
|
$entries[] = ['resource' => $allergyRes];
|
|
}
|
|
if (! empty($allergyRefs)) {
|
|
$sections[] = ['title' => 'Allergies', 'entry' => $allergyRefs];
|
|
}
|
|
|
|
// --- Procedures ---
|
|
$procedureRefs = [];
|
|
foreach ((array) ($summary['procedures'] ?? []) as $idx => $procedure) {
|
|
$text = is_array($procedure)
|
|
? trim((string) ($procedure['text'] ?? ''))
|
|
: trim((string) $procedure);
|
|
if ($text === '') { continue; }
|
|
|
|
$procId = 'proc-' . ($idx + 1);
|
|
$code = ['text' => $text];
|
|
$snomedCode = is_array($procedure) ? trim((string) ($procedure['snomed_code'] ?? '')) : '';
|
|
if ($snomedCode !== '') {
|
|
$code['coding'] = [['system' => 'http://snomed.info/sct', 'code' => $snomedCode, 'display' => $text]];
|
|
}
|
|
|
|
$procedureRefs[] = ['reference' => 'Procedure/' . $procId];
|
|
$entries[] = ['resource' => [
|
|
'resourceType' => 'Procedure',
|
|
'id' => $procId,
|
|
'status' => is_array($procedure) ? (string) ($procedure['status'] ?? 'completed') : 'completed',
|
|
'code' => $code,
|
|
'subject' => ['reference' => $patientRef],
|
|
'encounter' => ['reference' => $encounterRef],
|
|
]];
|
|
}
|
|
if (! empty($procedureRefs)) {
|
|
$sections[] = ['title' => 'Procedures', 'entry' => $procedureRefs];
|
|
}
|
|
|
|
// --- Medications ---
|
|
$medicationRefs = [];
|
|
foreach ((array) ($summary['medications'] ?? []) as $idx => $med) {
|
|
$drugName = is_array($med) ? trim((string) ($med['drug_name'] ?? '')) : trim((string) $med);
|
|
if ($drugName === '') { continue; }
|
|
|
|
$medId = 'medreq-ds-' . ($idx + 1);
|
|
$mc = ['text' => $drugName];
|
|
$snomedCode = is_array($med) ? trim((string) ($med['snomed_code'] ?? '')) : '';
|
|
$atcCode = is_array($med) ? strtoupper(trim((string) ($med['atc_code'] ?? ''))) : '';
|
|
if ($snomedCode !== '') {
|
|
$mc['coding'] = [['system' => 'http://snomed.info/sct', 'code' => $snomedCode, 'display' => $drugName]];
|
|
} elseif ($atcCode !== '') {
|
|
$mc['coding'] = [['system' => 'http://www.whocc.no/atc', 'code' => $atcCode, 'display' => $drugName]];
|
|
}
|
|
|
|
$medicationRefs[] = ['reference' => 'MedicationRequest/' . $medId];
|
|
$entries[] = ['resource' => [
|
|
'resourceType' => 'MedicationRequest',
|
|
'id' => $medId,
|
|
'status' => 'active',
|
|
'intent' => 'order',
|
|
'subject' => ['reference' => $patientRef],
|
|
'encounter' => ['reference' => $encounterRef],
|
|
'medicationCodeableConcept' => $mc,
|
|
'dosageInstruction' => [['text' => is_array($med) ? (string) ($med['dosage'] ?? '') : '']],
|
|
]];
|
|
}
|
|
if (! empty($medicationRefs)) {
|
|
$sections[] = ['title' => 'Medications', 'entry' => $medicationRefs];
|
|
}
|
|
|
|
// --- Investigations ---
|
|
$investigationRefs = [];
|
|
foreach ((array) ($summary['investigations'] ?? []) as $idx => $inv) {
|
|
$text = is_array($inv) ? trim((string) ($inv['text'] ?? '')) : trim((string) $inv);
|
|
if ($text === '') { continue; }
|
|
|
|
$svcId = 'svc-ds-' . ($idx + 1);
|
|
$investigationRefs[] = ['reference' => 'ServiceRequest/' . $svcId];
|
|
$entries[] = ['resource' => [
|
|
'resourceType' => 'ServiceRequest',
|
|
'id' => $svcId,
|
|
'status' => 'completed',
|
|
'intent' => 'order',
|
|
'code' => ['text' => $text],
|
|
'subject' => ['reference' => $patientRef],
|
|
'encounter' => ['reference' => $encounterRef],
|
|
]];
|
|
}
|
|
if (! empty($investigationRefs)) {
|
|
$sections[] = ['title' => 'Investigations', 'entry' => $investigationRefs];
|
|
}
|
|
|
|
// --- Care Plan ---
|
|
$carePlanRefs = [];
|
|
$carePlanText = trim((string) ($summary['care_plan'] ?? ''));
|
|
if ($carePlanText !== '') {
|
|
$cpId = 'careplan-1';
|
|
$carePlanRefs[] = ['reference' => 'CarePlan/' . $cpId];
|
|
$cpResource = [
|
|
'resourceType' => 'CarePlan',
|
|
'id' => $cpId,
|
|
'status' => 'active',
|
|
'intent' => 'plan',
|
|
'subject' => ['reference' => $patientRef],
|
|
'encounter' => ['reference' => $encounterRef],
|
|
'description' => $carePlanText,
|
|
];
|
|
$followUpDate = trim((string) ($summary['follow_up_date'] ?? ''));
|
|
if ($followUpDate !== '') {
|
|
$cpResource['period'] = ['start' => $issuedAt, 'end' => $followUpDate];
|
|
}
|
|
$entries[] = ['resource' => $cpResource];
|
|
$sections[] = ['title' => 'Care Plan', 'entry' => $carePlanRefs];
|
|
}
|
|
|
|
// Clinical notes narrative (unstructured)
|
|
$clinicalNotesHtml = (string) ($summary['clinical_notes_html'] ?? '');
|
|
|
|
// Composition (LOINC 18842-5 = Discharge summary)
|
|
$composition = [
|
|
'resourceType' => 'Composition',
|
|
'id' => 'comp-discharge-' . $encounterId,
|
|
'status' => 'final',
|
|
'type' => [
|
|
'coding' => [[
|
|
'system' => 'http://loinc.org',
|
|
'code' => '18842-5',
|
|
'display' => 'Discharge summary',
|
|
]],
|
|
'text' => 'Discharge Summary',
|
|
],
|
|
'subject' => ['reference' => $patientRef],
|
|
'encounter' => ['reference' => $encounterRef],
|
|
'date' => $issuedAt,
|
|
'title' => (string) ($summary['title'] ?? 'Discharge Summary'),
|
|
'section' => $sections,
|
|
];
|
|
if ($practitionerRef !== '') {
|
|
$composition['author'] = [['reference' => $practitionerRef]];
|
|
}
|
|
if ($clinicalNotesHtml !== '') {
|
|
$composition['section'][] = [
|
|
'title' => 'Clinical Summary Notes',
|
|
'text' => ['status' => 'generated', 'div' => $clinicalNotesHtml],
|
|
];
|
|
}
|
|
$entries[] = ['resource' => $composition];
|
|
|
|
return [
|
|
'resourceType' => 'Bundle',
|
|
'identifier' => [
|
|
'system' => 'urn:ietf:rfc:3986',
|
|
'value' => 'urn:uuid:bundle-discharge-' . $encounterId . '-' . date('YmdHis'),
|
|
],
|
|
'type' => 'document',
|
|
'timestamp' => $issuedAt,
|
|
'entry' => $entries,
|
|
];
|
|
}
|
|
|
|
// -------------------------------------------------------------------------
|
|
|
|
/**
|
|
* Build a WellnessRecord FHIR Bundle (ABDM M3 — WellnessRecord).
|
|
*
|
|
* Contains vital-sign / body-measurement Observations and
|
|
* social-history lifestyle Observations.
|
|
*
|
|
* @param array<string, mixed> $patient Patient demographics
|
|
* @param array<int, array<string, mixed>> $vitals Each: {loinc_code, display, value,
|
|
* value_type (quantity|string), unit, ucum_code}
|
|
* @param array<int, array<string, mixed>> $lifestyle Each: {code, display, value, system}
|
|
* @param array<string, mixed>|null $practitioner {id, name}
|
|
*
|
|
* @return array<string, mixed>
|
|
*/
|
|
public function buildWellnessBundle(
|
|
array $patient,
|
|
array $vitals = [],
|
|
array $lifestyle = [],
|
|
?array $practitioner = null
|
|
): array {
|
|
$issuedAt = Time::now('Asia/Kolkata')->toDateTimeString();
|
|
$patientRef = 'Patient/' . (string) ($patient['id'] ?? 'unknown');
|
|
$entries = [['resource' => $this->buildPatientResource($patient)]];
|
|
|
|
$practitionerRef = '';
|
|
if ($practitioner !== null) {
|
|
$practId = trim((string) ($practitioner['id'] ?? ''));
|
|
$practitionerRef = $practId !== '' ? ('Practitioner/' . $practId) : '';
|
|
if ($practitionerRef !== '') {
|
|
$entries[] = ['resource' => [
|
|
'resourceType' => 'Practitioner',
|
|
'id' => $practId,
|
|
'name' => [['text' => (string) ($practitioner['name'] ?? '')]],
|
|
]];
|
|
}
|
|
}
|
|
|
|
$observationRefs = [];
|
|
|
|
// Vital signs / body measurements
|
|
foreach ($vitals as $idx => $vital) {
|
|
$loincCode = trim((string) ($vital['loinc_code'] ?? ''));
|
|
$display = (string) ($vital['display'] ?? '');
|
|
$value = $vital['value'] ?? '';
|
|
$unit = (string) ($vital['unit'] ?? '');
|
|
$ucumCode = (string) ($vital['ucum_code'] ?? $unit);
|
|
$valueType = (string) ($vital['value_type'] ?? 'quantity');
|
|
|
|
if ($valueType === 'quantity' && ! is_numeric($value)) { continue; }
|
|
if (trim((string) $value) === '') { continue; }
|
|
|
|
$obsId = 'wellness-obs-' . ($idx + 1);
|
|
$observationRefs[] = ['reference' => 'Observation/' . $obsId];
|
|
|
|
$code = ['text' => $display];
|
|
if ($loincCode !== '') {
|
|
$code['coding'] = [['system' => 'http://loinc.org', 'code' => $loincCode, 'display' => $display]];
|
|
}
|
|
|
|
$obsResource = [
|
|
'resourceType' => 'Observation',
|
|
'id' => $obsId,
|
|
'status' => 'final',
|
|
'category' => [[
|
|
'coding' => [[
|
|
'system' => 'http://terminology.hl7.org/CodeSystem/observation-category',
|
|
'code' => 'vital-signs',
|
|
'display' => 'Vital Signs',
|
|
]],
|
|
]],
|
|
'code' => $code,
|
|
'subject' => ['reference' => $patientRef],
|
|
'effectiveDateTime' => $issuedAt,
|
|
];
|
|
|
|
if ($practitionerRef !== '') {
|
|
$obsResource['performer'] = [['reference' => $practitionerRef]];
|
|
}
|
|
|
|
if ($valueType === 'quantity' && is_numeric($value)) {
|
|
$obsResource['valueQuantity'] = [
|
|
'value' => (float) $value,
|
|
'unit' => $unit,
|
|
'system' => 'http://unitsofmeasure.org',
|
|
'code' => $ucumCode,
|
|
];
|
|
} else {
|
|
$obsResource['valueString'] = (string) $value;
|
|
}
|
|
|
|
$entries[] = ['resource' => $obsResource];
|
|
}
|
|
|
|
// Lifestyle / social-history observations
|
|
foreach ($lifestyle as $idx => $ls) {
|
|
$code = trim((string) ($ls['code'] ?? ''));
|
|
$display = (string) ($ls['display'] ?? '');
|
|
$value = (string) ($ls['value'] ?? '');
|
|
$system = (string) ($ls['system'] ?? 'http://snomed.info/sct');
|
|
|
|
if ($value === '' || $display === '') { continue; }
|
|
|
|
$obsId = 'wellness-ls-' . ($idx + 1);
|
|
$observationRefs[] = ['reference' => 'Observation/' . $obsId];
|
|
|
|
$obsCode = ['text' => $display];
|
|
if ($code !== '') {
|
|
$obsCode['coding'] = [['system' => $system, 'code' => $code, 'display' => $display]];
|
|
}
|
|
|
|
$entries[] = ['resource' => [
|
|
'resourceType' => 'Observation',
|
|
'id' => $obsId,
|
|
'status' => 'final',
|
|
'category' => [[
|
|
'coding' => [[
|
|
'system' => 'http://terminology.hl7.org/CodeSystem/observation-category',
|
|
'code' => 'social-history',
|
|
'display' => 'Social History',
|
|
]],
|
|
]],
|
|
'code' => $obsCode,
|
|
'subject' => ['reference' => $patientRef],
|
|
'effectiveDateTime' => $issuedAt,
|
|
'valueString' => $value,
|
|
]];
|
|
}
|
|
|
|
$composition = [
|
|
'resourceType' => 'Composition',
|
|
'id' => 'comp-wellness-' . date('YmdHis'),
|
|
'status' => 'final',
|
|
'type' => [
|
|
'coding' => [[
|
|
'system' => 'http://snomed.info/sct',
|
|
'code' => '371529009',
|
|
'display' => 'Health maintenance report (record artifact)',
|
|
]],
|
|
'text' => 'Wellness Record',
|
|
],
|
|
'subject' => ['reference' => $patientRef],
|
|
'date' => $issuedAt,
|
|
'title' => 'Wellness Record',
|
|
'section' => [
|
|
['title' => 'Vital Signs and Body Measurements', 'entry' => $observationRefs],
|
|
],
|
|
];
|
|
if ($practitionerRef !== '') {
|
|
$composition['author'] = [['reference' => $practitionerRef]];
|
|
}
|
|
$entries[] = ['resource' => $composition];
|
|
|
|
return [
|
|
'resourceType' => 'Bundle',
|
|
'identifier' => [
|
|
'system' => 'urn:ietf:rfc:3986',
|
|
'value' => 'urn:uuid:bundle-wellness-' . date('YmdHis'),
|
|
],
|
|
'type' => 'document',
|
|
'timestamp' => $issuedAt,
|
|
'entry' => $entries,
|
|
];
|
|
}
|
|
|
|
// -------------------------------------------------------------------------
|
|
|
|
/**
|
|
* Build DocumentReference + Binary resource entries for a scanned attachment.
|
|
*
|
|
* Usage: append the returned entries directly to an existing Bundle's entry array.
|
|
*
|
|
* @param string $id Resource ID stem (without "DocumentReference/")
|
|
* @param string $title Document title (human-readable)
|
|
* @param string $contentType MIME type — application/pdf | image/jpeg | image/png
|
|
* @param string $dataBase64 Base64-encoded raw file content
|
|
* @param string $subjectRef Patient reference string (e.g. "Patient/123")
|
|
* @param string $date ISO 8601 date/datetime string
|
|
*
|
|
* @return array<int, array<string, mixed>> [ [resource => Binary], [resource => DocumentReference] ]
|
|
*/
|
|
public function buildDocumentReferenceEntry(
|
|
string $id,
|
|
string $title,
|
|
string $contentType,
|
|
string $dataBase64,
|
|
string $subjectRef,
|
|
string $date
|
|
): array {
|
|
$binaryId = 'binary-' . $id;
|
|
$binaryRef = 'Binary/' . $binaryId;
|
|
|
|
$binaryResource = [
|
|
'resourceType' => 'Binary',
|
|
'id' => $binaryId,
|
|
'contentType' => $contentType,
|
|
'data' => $dataBase64,
|
|
];
|
|
|
|
$docRefResource = [
|
|
'resourceType' => 'DocumentReference',
|
|
'id' => $id,
|
|
'status' => 'current',
|
|
'type' => ['text' => $title],
|
|
'subject' => ['reference' => $subjectRef],
|
|
'date' => $date,
|
|
'content' => [[
|
|
'attachment' => [
|
|
'contentType' => $contentType,
|
|
'url' => $binaryRef,
|
|
'title' => $title,
|
|
],
|
|
]],
|
|
];
|
|
|
|
return [
|
|
['resource' => $binaryResource],
|
|
['resource' => $docRefResource],
|
|
];
|
|
}
|
|
|
|
/**
|
|
* Read a file from disk and return its base64-encoded content.
|
|
* Returns an empty string when the file is absent or unreadable.
|
|
*/
|
|
public function encodeFileAsBase64(string $filePath): string
|
|
{
|
|
if ($filePath === '' || ! is_file($filePath) || ! is_readable($filePath)) {
|
|
return '';
|
|
}
|
|
|
|
$content = file_get_contents($filePath);
|
|
|
|
return $content !== false ? base64_encode($content) : '';
|
|
}
|
|
}
|