public function _setActivePatient($personId, $visitId)
{
if (!$personId > 0) {
return;
}
$memcache = Zend_Registry::get('memcache');
$patient = new Patient();
$patient->personId = (int) $personId;
$patient->populate();
$patient->person->populate();
$this->_patient = $patient;
$this->view->patient = $this->_patient;
$mostRecentRaw = $memcache->get('mostRecent');
$currentUserId = (int) Zend_Auth::getInstance()->getIdentity()->personId;
$personId = $patient->personId;
$teamId = $patient->teamId;
if ($mostRecentRaw === false) {
$mostRecent = array();
} else {
$mostRecent = unserialize($mostRecentRaw);
}
if (!array_key_exists($currentUserId, $mostRecent)) {
$mostRecent[$currentUserId] = array();
}
if (array_key_exists($personId, $mostRecent[$currentUserId])) {
unset($mostRecent[$currentUserId][$personId]);
}
$name = $patient->person->last_name . ', ' . $patient->person->first_name . ' ' . substr($patient->person->middle_name, 0, 1) . ' #' . $patient->record_number;
$mostRecent[$currentUserId][$patient->personId] = array('name' => $name, 'teamId' => $teamId);
$memcache->set('mostRecent', serialize($mostRecent));
if (strlen($patient->teamId) > 0) {
$name = TeamMember::ENUM_PARENT_NAME;
$enumeration = new Enumeration();
$enumeration->populateByEnumerationName($name);
$enumerationsClosure = new EnumerationsClosure();
$rowset = $enumerationsClosure->getAllDescendants($enumeration->enumerationId, 1);
$patientEnumerationId = 0;
foreach ($rowset as $row) {
if ($patient->teamId == $row->key) {
$patientEnumerationId = $row->enumerationId;
break;
}
}
if ($patientEnumerationId !== 0) {
$this->view->team = TeamMember::generateTeamTree($patientEnumerationId);
}
}
// POSTINGS
$allergies = array();
$patientAllergy = new PatientAllergy();
$patientAllergyIterator = $patientAllergy->getIteratorByPatient($personId);
foreach ($patientAllergyIterator as $allergy) {
if ($allergy->noKnownAllergies) {
continue;
}
$allergies[] = $allergy->toArray();
}
$this->view->allergies = $allergies;
$notes = array();
$patientNote = new PatientNote();
$patientNoteIterator = $patientNote->getIterator();
$filters = array();
$filters['patient_id'] = $personId;
$filters['active'] = 1;
$filters['posting'] = 1;
$patientNoteIterator->setFilters($filters);
foreach ($patientNoteIterator as $note) {
$notes[] = $note->toArray();
}
$this->view->notes = $notes;
//REMINDERS
$ctr = 0;
$hsa = new HealthStatusAlert();
$hsaIterator = $hsa->getIteratorByStatusWithPatientId('active', $personId);
foreach ($hsaIterator as $row) {
$ctr++;
}
if ($ctr > 0) {
$this->view->reminders = $ctr;
}
// VISITS
//$this->_visit = null;
if (!$visitId > 0) {
return;
}
$visit = new Visit();
$visit->encounter_id = (int) $visitId;
$visit->populate();
$this->_visit = $visit;
$this->view->visit = $this->_visit;
}
public function processMarkActiveAction()
{
$id = (int) $this->_getParam('id');
$active = (int) $this->_getParam('active');
$patientAllergy = new PatientAllergy();
$patientAllergy->patientAllergyId = $id;
$ret = false;
if ($patientAllergy->populate()) {
$patientAllergy->active = $active;
$patientAllergy->persist();
$ret = true;
}
$json = Zend_Controller_Action_HelperBroker::getStaticHelper('json');
$json->suppressExit = true;
$json->direct($ret);
}
public static function populate(CCD $base, SimpleXMLElement $xml)
{
$component = $xml->addChild('component');
$section = $component->addChild('section');
$templateId = $section->addChild('templateId');
$templateId->addAttribute('root', '2.16.840.1.113883.3.88.11.83.102');
$templateId->addAttribute('assigningAuthorityName', 'HITSP/C83');
$templateId = $section->addChild('templateId');
$templateId->addAttribute('root', '1.3.6.1.4.1.19376.1.5.3.1.3.13');
$templateId->addAttribute('assigningAuthorityName', 'IHE PCC');
$templateId = $section->addChild('templateId');
$templateId->addAttribute('root', '2.16.840.1.113883.10.20.1.2');
$templateId->addAttribute('assigningAuthorityName', 'HL7 CCD');
// <!--Allergies/Reactions section template-->
$code = $section->addChild('code');
$code->addAttribute('code', '48765-2');
$code->addAttribute('codeSystem', '2.16.840.1.113883.6.1');
$code->addAttribute('codeSystemName', 'LOINC');
$code->addAttribute('displayName', 'Allergies');
$section->addChild('title', 'Allergies and Adverse Reactions');
$enumeration = new Enumeration();
$listSymptoms = array();
$enumeration->populateByEnumerationName(PatientAllergy::ENUM_SYMPTOM_PARENT_NAME);
$enumerationsClosure = new EnumerationsClosure();
$enumerationIterator = $enumerationsClosure->getAllDescendants($enumeration->enumerationId, 1);
foreach ($enumerationIterator as $enum) {
$listSymptoms[$enum->key] = $enum->name;
}
$filters = array('patientId' => $base->patient->personId);
$base->setFiltersDateRange($filters);
$rows = array();
$allergies = PatientAllergy::listMedicationAllergies($filters);
foreach ($allergies as $key => $allergy) {
$exp = explode(',', $allergy['symptoms']);
$symptoms = array();
foreach ($exp as $symp) {
$symptoms[] = isset($listSymptoms[$symp]) ? $listSymptoms[$symp] : '';
}
$reactionType = $allergy['reactionType'];
if (!strlen($reactionType) > 0) {
$reactionType = 'Unknown';
}
$active = (int) $allergy['active'] ? 'Active' : 'Inactive';
$snomed = '';
$row = array();
$row['type'] = $reactionType;
//'Drug Allergy';
if ($reactionType == 'Specific Drug Allergy') {
$snomed = '416098002';
}
$row['snomed'] = $snomed;
$row['substance'] = html_convert_entities($allergy['causativeAgent']);
$row['rxnorm'] = html_convert_entities($allergy['rxnorm_cuid']);
$row['reaction'] = array('id' => 'ReactionID-' . $key, 'value' => html_convert_entities(implode(', ', $symptoms)));
$row['date'] = date('M d, Y', strtotime($allergy['dateTimeReaction']));
$row['status'] = html_convert_entities($active);
$rows[] = $row;
}
/*
-**SNOMED Allergy Type Code** (note from NIST: "The SNOMED Allergy Type Code is required by HITSP/C83, which is a component of the HITSP/C32 implementation guide specified by ONC in the Final Rule")
-**Medication/Agent Allergy** (including medication/agent allergy and associated RxNorm code)
*/
$text = $section->addChild('text');
if ($rows) {
$table = $text->addChild('table');
$thead = $table->addChild('thead');
$tr = $thead->addChild('tr');
$tr->addChild('th', 'Type');
$tr->addChild('th', 'Drug allergy SNOMED code');
$tr->addChild('th', 'Substance');
$tr->addChild('th', 'Substance RxNorm code');
$tr->addChild('th', 'Reaction');
$tr->addChild('th', 'Date Identified');
$tr->addChild('th', 'Status');
$tbody = $table->addChild('tbody');
foreach ($rows as $row) {
$tr = $tbody->addChild('tr');
$tr->addChild('td', $row['type']);
$tr->addChild('td', $row['snomed']);
$tr->addChild('td', $row['substance']);
$tr->addChild('td', $row['rxnorm']);
$td = $tr->addChild('td', $row['reaction']['value']);
$td->addAttribute('ID', $row['reaction']['id']);
$tr->addChild('td', $row['date']);
$tr->addChild('td', $row['status']);
}
}
foreach ($allergies as $allergy) {
$type = $allergy['reactionType'];
if (!strlen($type) > 0) {
$type = 'Unknown';
}
$substance = html_convert_entities($allergy['causativeAgent']);
$exp = explode(',', $allergy['symptoms']);
$symptoms = array();
foreach ($exp as $symp) {
$symptoms[] = isset($listSymptoms[$symp]) ? $listSymptoms[$symp] : '';
}
$reaction = '';
if ($symptoms) {
$reaction = html_convert_entities(implode(', ', $symptoms));
}
$status = 'Inactive';
$statusCode = 'completed';
$effectiveTimeHigh = '<high nullFlavor="UNK"/>';
if ((int) $allergy['active']) {
$status = 'Active';
$statusCode = 'active';
$effectiveTimeHigh = '';
}
$status = (int) $allergy['active'] ? 'Active' : 'Inactive';
// STATUS CODES: active, suspended, aborted, completed
$statusCode = (int) $allergy['active'] ? 'active' : 'completed';
$entry = '<act classCode="ACT" moodCode="EVN">
<templateId root="2.16.840.1.113883.3.88.11.83.6" assigningAuthorityName="HITSP C83"/>
<templateId root="2.16.840.1.113883.10.20.1.27" assigningAuthorityName="CCD"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.5.1" assigningAuthorityName="IHE PCC"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.5.3" assigningAuthorityName="IHE PCC"/>
<id root="' . NSDR::create_guid() . '"/>
<code nullFlavor="NA"/>
<statusCode code="' . $statusCode . '"/>
<effectiveTime>
<low nullFlavor="UNK"/>' . $effectiveTimeHigh . '
</effectiveTime>
<entryRelationship typeCode="SUBJ" inversionInd="false">
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.1.18" assigningAuthorityName="CCD"/>
<templateId root="2.16.840.1.113883.10.20.1.28" assigningAuthorityName="CCD"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.5" assigningAuthorityName="IHE PCC"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.6" assigningAuthorityName="IHE PCC"/>
<id root="' . NSDR::create_guid() . '"/>
<code code="416098002" codeSystem="2.16.840.1.113883.6.96" displayName="drug allergy" codeSystemName="SNOMED CT" />
<text>
<reference value="PtrToValueInSectionText"/>
</text>
<statusCode code="completed"/>
<effectiveTime>
<low nullFlavor="UNK"/>
</effectiveTime>
<value xsi:type="CD"/>
<participant typeCode="CSM">
<participantRole classCode="MANU">
<addr/>
<telecom/>
<playingEntity classCode="MMAT">
<code code="70618" codeSystem="2.16.840.1.113883.6.88" displayName="' . $substance . '">
<originalText>
<reference value="PointrToSectionText"/>
</originalText>
</code>
<name>' . $substance . '</name>
</playingEntity>
</participantRole>';
if ($reaction != '' && false) {
$entry .= '
<entryRelationship typeCode="MFST" inversionInd="true">
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.1.54" assigningAuthorityName="CCD"/>
<!--Reaction observation template -->
<code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
<text/>
<statusCode code="completed"/>
<value xsi:type="CD" code="247472004" codeSystem="2.16.840.1.113883.6.96" displayName="' . $reaction . '"/>
<entryRelationship typeCode="SUBJ">
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.1.55" assigningAuthorityName="CCD"/>
<code code="SEV" displayName="Severity" codeSystemName="HL7 ActCode" codeSystem="2.16.840.1.113883.5.4"/>
<text>Required by HITSP C-83</text>
<statusCode code="completed"/>
<value xsi:type="CE" displayName="moderate" code="6736007" codeSystemName="SNOMED" codeSystem="2.16.840.1.113883.6.96"/>
</observation>
</entryRelationship>
</observation>
</entryRelationship>';
}
$entry .= '
<!--<entryRelationship typeCode="REFR">
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.1.39"/>
<code code="33999-4" codeSystem="2.16.840.1.113883.6.1" displayName="Status"/>
<statusCode code="completed"/>
<value xsi:type="CE" code="55561003" codeSystem="2.16.840.1.113883.6.96" displayName="' . $status . '"/>
</observation>
</entryRelationship>-->
</participant>
</observation>
</entryRelationship>
</act>';
$entry = $section->addChild('entry', $entry);
$entry->addAttribute('typeCode', 'DRIV');
}
}
public function processMarkEnteredInErrorAction()
{
$id = (int) $this->_getParam('id');
$patientAllergy = new PatientAllergy();
$patientAllergy->patientAllergyId = $id;
$patientAllergy->populate();
if ($patientAllergy->patientId > 0) {
$patientAllergy->enteredInError = 1;
$patientAllergy->persist();
}
$json = Zend_Controller_Action_HelperBroker::getStaticHelper('json');
$json->suppressExit = true;
$json->direct(true);
}
