1618 lines
66 KiB
PHP
1618 lines
66 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 = Time::now('Asia/Kolkata')->toDateTimeString();
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$bundleId = 'bundle-opd-' . (string) ($encounter['id'] ?? 'unknown') . '-' . date('YmdHis');
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$patientRef = 'Patient/' . (string) ($patient['id'] ?? 'unknown');
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$encounterRef = 'Encounter/' . (string) ($encounter['id'] ?? 'unknown');
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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) $context['appointments'] : [];
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$practitionerId = trim((string) ($practitioner['id'] ?? ''));
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$organizationId = trim((string) ($organization['id'] ?? ''));
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$practitionerRef = $practitionerId !== '' ? ('Practitioner/' . $practitionerId) : '';
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$organizationRef = $organizationId !== '' ? ('Organization/' . $organizationId) : '';
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$encounterResource = [
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'resourceType' => 'Encounter',
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'id' => (string) ($encounter['id'] ?? 'unknown'),
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'status' => (string) ($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' => $patientRef],
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];
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if ($practitionerRef !== '') {
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$encounterResource['participant'] = [[
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'individual' => ['reference' => $practitionerRef],
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]];
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}
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if ($organizationRef !== '') {
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$encounterResource['serviceProvider'] = ['reference' => $organizationRef];
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}
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if (! empty($encounter['period_start']) || ! empty($encounter['period_end'])) {
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$encounterResource['period'] = [
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'start' => (string) ($encounter['period_start'] ?? $issuedAt),
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'end' => (string) ($encounter['period_end'] ?? $issuedAt),
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];
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}
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$conditionRefs = [];
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$observationRefs = [];
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$allergyRefs = [];
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$medicationRefs = [];
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$complaintRefs = [];
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$serviceRequestRefs = [];
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$appointmentRefs = [];
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$entries = [[
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'resource' => $this->buildPatientResource($patient),
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], [
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'resource' => $encounterResource,
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]];
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if ($organizationRef !== '') {
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$organizationResource = [
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'resourceType' => 'Organization',
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'id' => $organizationId,
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'name' => trim((string) ($organization['name'] ?? '')),
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];
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$hfrId = trim((string) ($organization['hfr_id'] ?? ''));
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if ($hfrId !== '') {
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$organizationResource['identifier'] = [[
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'system' => 'https://facility.abdm.gov.in/hfr',
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'value' => $hfrId,
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]];
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}
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$entries[] = ['resource' => $organizationResource];
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}
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if ($practitionerRef !== '') {
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$practitionerResource = [
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'resourceType' => 'Practitioner',
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'id' => $practitionerId,
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'name' => [[
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'text' => trim((string) ($practitioner['name'] ?? '')),
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]],
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];
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$regNumber = trim((string) ($practitioner['registration_number'] ?? ''));
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if ($regNumber !== '') {
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$practitionerResource['identifier'] = [[
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'system' => 'https://hpr.abdm.gov.in/hpr-id',
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'value' => $regNumber,
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]];
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}
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$entries[] = ['resource' => $practitionerResource];
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}
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foreach ($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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$conditionId = 'cond-' . ($index + 1);
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$conditionRefs[] = [
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'condition' => [
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'reference' => 'Condition/' . $conditionId,
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],
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];
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$verification = trim((string) ($condition['verification_status'] ?? 'provisional'));
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$verificationCode = strtolower($verification) === 'confirmed' ? 'confirmed' : 'provisional';
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$code = [
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'text' => $text,
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];
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$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'] ?? $text)),
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]];
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}
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$entries[] = [
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'resource' => [
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'resourceType' => 'Condition',
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'id' => $conditionId,
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'clinicalStatus' => [
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'coding' => [[
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'system' => 'http://terminology.hl7.org/CodeSystem/condition-clinical',
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'code' => 'active',
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]],
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],
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'verificationStatus' => [
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'coding' => [[
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'system' => 'http://terminology.hl7.org/CodeSystem/condition-ver-status',
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'code' => $verificationCode,
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]],
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],
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'category' => [[
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'coding' => [[
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'system' => 'http://terminology.hl7.org/CodeSystem/condition-category',
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'code' => 'encounter-diagnosis',
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]],
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]],
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'code' => $code,
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'subject' => ['reference' => $patientRef],
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'encounter' => ['reference' => $encounterRef],
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'recordedDate' => $issuedAt,
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],
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];
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}
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foreach ($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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$complaintId = 'complaint-' . ($index + 1);
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$complaintRefs[] = ['reference' => 'Condition/' . $complaintId];
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$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' => $complaintId,
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'clinicalStatus' => [
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'coding' => [[
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'system' => 'http://terminology.hl7.org/CodeSystem/condition-clinical',
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'code' => 'active',
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]],
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],
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'verificationStatus' => [
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'coding' => [[
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'system' => 'http://terminology.hl7.org/CodeSystem/condition-ver-status',
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'code' => 'unconfirmed',
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]],
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],
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'category' => [[
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'coding' => [[
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'system' => 'http://terminology.hl7.org/CodeSystem/condition-category',
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'code' => 'problem-list-item',
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]],
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'text' => 'Chief Complaint',
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]],
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'code' => $code,
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'subject' => ['reference' => $patientRef],
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'encounter' => ['reference' => $encounterRef],
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'recordedDate' => $issuedAt,
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];
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// Severity (High/Moderate/Low → SNOMED coded)
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$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(' | ', $noteParts)]];
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}
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$entries[] = ['resource' => $complaintResource];
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}
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foreach ($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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$observationId = 'obs-' . ($index + 1);
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$observationRefs[] = ['reference' => 'Observation/' . $observationId];
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$entries[] = [
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'resource' => [
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'resourceType' => 'Observation',
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'id' => $observationId,
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'status' => 'final',
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'category' => [[
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'coding' => [[
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'system' => 'http://terminology.hl7.org/CodeSystem/observation-category',
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'code' => 'vital-signs',
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]],
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]],
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'code' => [
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'coding' => [[
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'system' => 'http://loinc.org',
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'code' => (string) ($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],
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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) ($observation['ucum'] ?? ''),
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],
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],
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];
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}
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foreach ($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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$allergyId = 'allergy-' . ($index + 1);
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$allergyRefs[] = ['reference' => 'AllergyIntolerance/' . $allergyId];
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$allergyResource = [
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'resourceType' => 'AllergyIntolerance',
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'id' => $allergyId,
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'clinicalStatus' => [
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'coding' => [[
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'system' => 'http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical',
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'code' => (string) ($allergy['clinical_status'] ?? 'active'),
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]],
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],
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'verificationStatus' => [
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'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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],
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'patient' => ['reference' => $patientRef],
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'code' => [
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'text' => $codeText,
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],
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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'] = [[
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'description' => $reaction,
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]];
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}
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$entries[] = ['resource' => $allergyResource];
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}
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if (! empty($conditionRefs)) {
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$entries[1]['resource']['diagnosis'] = $conditionRefs;
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}
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foreach ($medications as $index => $medication) {
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$entryId = 'medreq-' . ($index + 1);
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$medicationRefs[] = ['reference' => 'MedicationRequest/' . $entryId];
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$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 = [
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'text' => $displayText !== '' ? $displayText : (string) ($medication['drug_name'] ?? ''),
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];
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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 = [
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'text' => (string) ($medication['dosage'] ?? ''),
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];
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$routeText = trim((string) ($medication['route_text'] ?? ''));
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if ($routeText !== '') {
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$dosageInstruction['route'] = [
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'text' => $routeText,
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];
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}
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if ($medType !== '') {
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$dosageInstruction['method'] = [
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'text' => $medType,
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];
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}
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$entries[] = [
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'resource' => [
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'resourceType' => 'MedicationRequest',
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'id' => $entryId,
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'status' => (string) ($medication['status'] ?? 'active'),
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'intent' => 'order',
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'subject' => ['reference' => $patientRef],
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'encounter' => ['reference' => $encounterRef],
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'authoredOn' => $issuedAt,
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'medicationCodeableConcept' => $medicationCodeableConcept,
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'dosageInstruction' => [$dosageInstruction],
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],
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];
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}
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foreach ($serviceRequests as $index => $serviceRequest) {
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$codeText = trim((string) ($serviceRequest['code_text'] ?? ''));
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if ($codeText === '') {
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continue;
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}
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$serviceRequestId = 'svc-' . ($index + 1);
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$serviceRequestRefs[] = ['reference' => 'ServiceRequest/' . $serviceRequestId];
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$entries[] = [
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'resource' => [
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'resourceType' => 'ServiceRequest',
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'id' => $serviceRequestId,
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'status' => (string) ($serviceRequest['status'] ?? 'active'),
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'intent' => (string) ($serviceRequest['intent'] ?? 'order'),
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'subject' => ['reference' => $patientRef],
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'encounter' => ['reference' => $encounterRef],
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'authoredOn' => $issuedAt,
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'code' => [
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'text' => $codeText,
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],
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],
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];
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}
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foreach ($appointments as $index => $appointment) {
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$description = trim((string) ($appointment['description'] ?? ''));
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if ($description === '') {
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continue;
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}
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$appointmentId = 'appt-' . ($index + 1);
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$appointmentRefs[] = ['reference' => 'Appointment/' . $appointmentId];
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$appointmentResource = [
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'resourceType' => 'Appointment',
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'id' => $appointmentId,
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'status' => (string) ($appointment['status'] ?? 'proposed'),
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'description' => $description,
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'participant' => [[
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'actor' => ['reference' => $patientRef],
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'status' => 'accepted',
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]],
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];
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if ($practitionerRef !== '') {
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$appointmentResource['participant'][] = [
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'actor' => ['reference' => $practitionerRef],
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'status' => 'accepted',
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];
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}
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$entries[] = ['resource' => $appointmentResource];
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}
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$compositionSections = [];
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if (! empty($conditionRefs) || ! empty($complaintRefs)) {
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$compositionSections[] = [
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'title' => 'Problems and Diagnoses',
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'entry' => array_values(array_merge($conditionRefs, $complaintRefs)),
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];
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}
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if (! empty($observationRefs)) {
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$compositionSections[] = [
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'title' => 'Vitals',
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'entry' => $observationRefs,
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];
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}
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if (! empty($allergyRefs)) {
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$compositionSections[] = [
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'title' => 'Allergies',
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'entry' => $allergyRefs,
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];
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}
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if (! empty($medicationRefs)) {
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$compositionSections[] = [
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'title' => 'Medications',
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'entry' => $medicationRefs,
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];
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}
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if (! empty($serviceRequestRefs)) {
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$compositionSections[] = [
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'title' => 'Investigations',
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'entry' => $serviceRequestRefs,
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];
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}
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if (! empty($appointmentRefs)) {
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$compositionSections[] = [
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'title' => 'Follow Up',
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'entry' => $appointmentRefs,
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];
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}
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|
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$composition = [
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'resourceType' => 'Composition',
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'id' => 'composition-' . (string) ($encounter['id'] ?? 'unknown'),
|
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'status' => 'final',
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'type' => [
|
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'coding' => [[
|
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'system' => 'http://loinc.org',
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'code' => '34133-9',
|
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'display' => 'Summarization of Episode Note',
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]],
|
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'text' => 'OP Consultation Record',
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|
],
|
|
'subject' => ['reference' => $patientRef],
|
|
'encounter' => ['reference' => $encounterRef],
|
|
'date' => $issuedAt,
|
|
'title' => 'OP Consultation and Prescription',
|
|
'section' => $compositionSections,
|
|
];
|
|
if ($practitionerRef !== '') {
|
|
$composition['author'] = [[
|
|
'reference' => $practitionerRef,
|
|
]];
|
|
}
|
|
$entries[] = ['resource' => $composition];
|
|
|
|
return [
|
|
'resourceType' => 'Bundle',
|
|
'identifier' => [
|
|
'system' => 'urn:ietf:rfc:3986',
|
|
'value' => 'urn:uuid:' . $bundleId,
|
|
],
|
|
'type' => 'document',
|
|
'timestamp' => $issuedAt,
|
|
'entry' => $entries,
|
|
];
|
|
}
|
|
|
|
/**
|
|
* @param array<string, mixed> $patient
|
|
* @param array<string, mixed> $diagnosticReport
|
|
* @param array<int, array<string, mixed>> $observations
|
|
*
|
|
* @return array<string, mixed>
|
|
*/
|
|
public function buildLabReportBundle(array $patient, array $diagnosticReport, array $observations): array
|
|
{
|
|
$issuedAt = Time::now('Asia/Kolkata')->toDateTimeString();
|
|
$patientRef = 'Patient/' . (string) ($patient['id'] ?? 'unknown');
|
|
$reportId = (string) ($diagnosticReport['id'] ?? 'lab-report-1');
|
|
|
|
$entries = [[
|
|
'resource' => $this->buildPatientResource($patient),
|
|
]];
|
|
|
|
$observationRefs = [];
|
|
foreach ($observations as $index => $observation) {
|
|
$observationId = 'obs-' . ($index + 1);
|
|
$observationRefs[] = ['reference' => 'Observation/' . $observationId];
|
|
$entries[] = [
|
|
'resource' => [
|
|
'resourceType' => 'Observation',
|
|
'id' => $observationId,
|
|
'status' => (string) ($observation['status'] ?? 'final'),
|
|
'code' => [
|
|
'text' => (string) ($observation['test_name'] ?? ''),
|
|
],
|
|
'subject' => ['reference' => $patientRef],
|
|
'valueString' => (string) ($observation['value'] ?? ''),
|
|
'interpretation' => [[
|
|
'text' => (string) ($observation['interpretation'] ?? ''),
|
|
]],
|
|
],
|
|
];
|
|
}
|
|
|
|
$entries[] = [
|
|
'resource' => [
|
|
'resourceType' => 'DiagnosticReport',
|
|
'id' => $reportId,
|
|
'status' => (string) ($diagnosticReport['status'] ?? 'final'),
|
|
'code' => [
|
|
'text' => (string) ($diagnosticReport['title'] ?? 'Laboratory Report'),
|
|
],
|
|
'subject' => ['reference' => $patientRef],
|
|
'issued' => $issuedAt,
|
|
'result' => $observationRefs,
|
|
'conclusion' => (string) ($diagnosticReport['conclusion'] ?? ''),
|
|
],
|
|
];
|
|
|
|
return [
|
|
'resourceType' => 'Bundle',
|
|
'type' => 'collection',
|
|
'timestamp' => $issuedAt,
|
|
'entry' => $entries,
|
|
];
|
|
}
|
|
|
|
/**
|
|
* @param array<string, mixed> $patient
|
|
* @param array<string, mixed> $encounter
|
|
* @param array<string, mixed> $summary
|
|
*
|
|
* @return array<string, mixed>
|
|
*/
|
|
public function buildDischargeSummaryBundle(array $patient, array $encounter, array $summary): array
|
|
{
|
|
$issuedAt = Time::now('Asia/Kolkata')->toDateTimeString();
|
|
$patientId = (string) ($patient['id'] ?? 'unknown');
|
|
$encounterId = (string) ($encounter['id'] ?? 'unknown');
|
|
|
|
return [
|
|
'resourceType' => 'Bundle',
|
|
'type' => 'document',
|
|
'timestamp' => $issuedAt,
|
|
'entry' => [[
|
|
'resource' => $this->buildPatientResource($patient),
|
|
], [
|
|
'resource' => [
|
|
'resourceType' => 'Composition',
|
|
'status' => 'final',
|
|
'type' => [
|
|
'text' => 'Discharge Summary',
|
|
],
|
|
'subject' => [
|
|
'reference' => 'Patient/' . $patientId,
|
|
],
|
|
'encounter' => [
|
|
'reference' => 'Encounter/' . $encounterId,
|
|
],
|
|
'date' => $issuedAt,
|
|
'title' => (string) ($summary['title'] ?? 'Discharge Summary'),
|
|
'section' => [[
|
|
'title' => 'Clinical Summary',
|
|
'text' => [
|
|
'status' => 'generated',
|
|
'div' => (string) ($summary['clinical_summary_html'] ?? ''),
|
|
],
|
|
]],
|
|
],
|
|
]],
|
|
];
|
|
}
|
|
|
|
/**
|
|
* @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,
|
|
]],
|
|
];
|
|
}
|
|
|
|
/**
|
|
* @param array<string, mixed> $patient
|
|
*
|
|
* @return array<string, mixed>
|
|
*/
|
|
private function buildPatientResource(array $patient): array
|
|
{
|
|
$resource = [
|
|
'resourceType' => 'Patient',
|
|
'id' => (string) ($patient['id'] ?? 'unknown'),
|
|
'name' => [[
|
|
'text' => (string) ($patient['name'] ?? ''),
|
|
]],
|
|
];
|
|
|
|
if (! empty($patient['gender'])) {
|
|
$resource['gender'] = (string) $patient['gender'];
|
|
}
|
|
|
|
if (! empty($patient['birthDate'])) {
|
|
$resource['birthDate'] = (string) $patient['birthDate'];
|
|
}
|
|
|
|
$abhaAddress = trim((string) ($patient['abhaAddress'] ?? ''));
|
|
if ($abhaAddress !== '') {
|
|
$resource['identifier'] = [[
|
|
'system' => 'https://healthid.abdm.gov.in/abha-address',
|
|
'value' => $abhaAddress,
|
|
]];
|
|
}
|
|
|
|
return $resource;
|
|
}
|
|
|
|
// =========================================================================
|
|
// 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) : '';
|
|
}
|
|
}
|