public function viewXmlAction()
{
$personId = (int) $this->_getParam('personId');
$visitId = (int) $this->_getParam('visitId');
$providerId = (int) Zend_Auth::getInstance()->getIdentity()->personId;
$ccd = new CCD(true);
$contents = $ccd->populate($personId, $providerId, $visitId);
header('Content-Type: text/xml;');
$this->view->contents = $contents;
$this->render();
}
public function printAction()
{
$personId = (int) $this->_getParam('personId');
$visitId = (int) $this->_getParam('visitId');
$providerId = (int) Zend_Auth::getInstance()->getIdentity()->personId;
$auditType = $visitId > 0 ? GenericAccessAudit::CCD_VISIT_PRINT : GenericAccessAudit::CCD_ALL_PRINT;
$this->_createAudit($providerId, $personId, $visitId, $auditType);
$ccd = new CCD(true);
$contents = $ccd->populate($personId, $providerId, $visitId);
header('Content-Type: text/xml;');
$this->view->contents = $contents;
$this->render();
}
public static function populate(CCD $base, SimpleXMLElement $xml)
{
$component = $xml->addChild('component');
$section = $component->addChild('section');
$templateId = $section->addChild('templateId');
$templateId->addAttribute('root', '2.16.840.1.113883.3.88.11.83.112');
$templateId->addAttribute('assigningAuthorityName', 'HITSP/C83');
$templateId = $section->addChild('templateId');
$templateId->addAttribute('root', '1.3.6.1.4.1.19376.1.5.3.1.3.19');
$templateId->addAttribute('assigningAuthorityName', 'IHE PCC');
$templateId = $section->addChild('templateId');
$templateId->addAttribute('root', '2.16.840.1.113883.10.20.1.8');
$templateId->addAttribute('assigningAuthorityName', 'HL7 CCD');
// <!-- Medications section template -->
$code = $section->addChild('code');
$code->addAttribute('code', '10160-0');
$code->addAttribute('codeSystem', '2.16.840.1.113883.6.1');
$code->addAttribute('codeSystemName', 'LOINC');
$code->addAttribute('displayName', 'History of medication use');
$section->addChild('title', 'Medications');
$medications = array();
$rows = array();
$filters = array('patientId' => $base->patient->personId);
$base->setFiltersDateRange($filters);
$iterator = new MedicationIterator();
$iterator->setFilter($filters);
foreach ($iterator as $medication) {
$medications[] = $medication;
$datePrescribed = ' ';
if ($medication->datePrescribed != '0000-00-00 00:00:00') {
$datePrescribed = date('M d, Y', strtotime($medication->datePrescribed));
}
$baseMed24 = $medication->baseMed24;
//$status = ($medication->status != 'Discontinued')?'Active':'Discontinued';
$rows[] = array('rxnorm' => $baseMed24->rxnorm_cuid, 'product' => 'Medication', 'medication' => html_convert_entities($medication->description), 'generic' => html_convert_entities($baseMed24->fdaDrugname), 'brand' => html_convert_entities($baseMed24->tradename), 'instructions' => html_convert_entities($medication->directions), 'strength' => html_convert_entities($medication->strength), 'dose' => html_convert_entities($medication->dose), 'route' => html_convert_entities($medication->route), 'frequency' => html_convert_entities($medication->schedule), 'date' => $datePrescribed, 'status' => html_convert_entities($medication->displayStatus));
}
$text = $section->addChild('text');
if ($rows) {
$table = $text->addChild('table');
$thead = $table->addChild('thead');
$tr = $thead->addChild('tr');
$tr->addChild('th', 'RxNorm Code');
$tr->addChild('th', 'Product');
$tr->addChild('th', 'Medication');
$tr->addChild('th', 'Generic Name');
$tr->addChild('th', 'Brand Name');
$tr->addChild('th', 'Instructions');
$tr->addChild('th', 'Strength');
$tr->addChild('th', 'Dose');
$tr->addChild('th', 'Route');
$tr->addChild('th', 'Frequency');
$tr->addChild('th', 'Date Started');
$tr->addChild('th', 'Status');
$tbody = $table->addChild('tbody');
foreach ($rows as $row) {
$tr = $tbody->addChild('tr');
$tr->addChild('td', $row['rxnorm']);
$tr->addChild('td', $row['product']);
$tr->addChild('td', $row['medication']);
$tr->addChild('td', $row['generic']);
$tr->addChild('td', $row['brand']);
$tr->addChild('td', $row['instructions']);
$tr->addChild('td', $row['strength']);
$tr->addChild('td', $row['dose']);
$tr->addChild('td', $row['route']);
$tr->addChild('td', $row['frequency']);
$tr->addChild('td', $row['date']);
$tr->addChild('td', $row['status']);
}
}
foreach ($medications as $medication) {
$quantity = '';
if (strlen($medication->strength) > 0 && strlen($medication->unit) > 0) {
$strength = explode(';', $medication->strength);
$strength = str_replace(',', '', $strength[0]);
$unit = explode(';', $medication->unit);
if ($strength) {
$quantity = '<quantity value="' . $strength . '" unit="' . preg_replace('/ /', '', strtolower($unit[0])) . '"/>';
}
}
$status = $medication->displayStatus;
$description = html_convert_entities($medication->description);
$entry = '<substanceAdministration classCode="SBADM" moodCode="EVN">
<templateId root="2.16.840.1.113883.3.88.11.83.8" assigningAuthorityName="HITSP C83"/>
<templateId root="2.16.840.1.113883.10.20.1.24" assigningAuthorityName="CCD"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.7" assigningAuthorityName="IHE PCC"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.7.1" assigningAuthorityName="IHE PCC"/>
<!--Medication activity template -->
<id root="' . NSDR::create_guid() . '"/>
<statusCode code="completed"/>
<effectiveTime xsi:type="IVL_TS">
<low nullFlavor="UNK"/>
<high nullFlavor="UNK"/>
</effectiveTime>
<effectiveTime xsi:type="PIVL_TS" institutionSpecified="false" operator="A">
<period value="24" unit="h"/>
</effectiveTime>
<routeCode code="C38288" displayName="Oral" codeSystem="2.16.840.1.113883.3.26.1.1" codeSystemName="FDA RouteOfAdministration">
<!--IHE/PCC recommends that the routeCode be taken from the HL7 RouteOfAdministration code system. However, HITSP/C32, C83 and C80 recommend that for the U.S. Realm it be taken from the FDA RouteOfAdministration code system.-->
<translation displayName="Swallow, oral" code="PO" codeSystemName="HL7 RouteOfAdministration" codeSystem="2.16.840.1.113883.5.112"/>
</routeCode>
<doseQuantity value="1"/>
<rateQuantity nullFlavor="NA"/>
<consumable>
<manufacturedProduct>
<templateId root="2.16.840.1.113883.3.88.11.83.8.2" assigningAuthorityName="HITSP C83"/>
<templateId root="2.16.840.1.113883.10.20.1.53" assigningAuthorityName="CCD"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.7.2" assigningAuthorityName="IHE PCC"/>
<!-- Product template -->
<manufacturedMaterial>
<code code="309362" codeSystem="2.16.840.1.113883.6.88" displayName="' . $description . '">
<originalText>' . $description . '<reference/>
</originalText>
<translation code="174742" codeSystem="2.16.840.1.113883.6.88" displayName="' . $description . '" codeSystemName="RxNorm"/>
</code>
<name>Plavix</name>
</manufacturedMaterial>
</manufacturedProduct>
</consumable>
<entryRelationship typeCode="REFR">
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.10.20.1.47"/>
<code code="33999-4" displayName="Status" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC"/>
<value xsi:type="CE" code="55561003" displayName="' . $status . '" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT"/>
</observation>
</entryRelationship>
<entryRelationship typeCode="REFR">
<supply classCode="SPLY" moodCode="INT">
<templateId root="2.16.840.1.113883.10.20.1.34" assigningAuthorityName="CCD"/>
<templateId root="2.16.840.1.113883.3.88.11.83.8.3" assigningAuthorityName="HITSP C83"/>
<templateId root="1.3.6.1.4.1.19376.1.5.3.1.4.7.3" assigningAuthorityName="IHE PCC"/>
<id/>
<statusCode code="completed"/>
<effectiveTime xsi:type="IVL_TS">
<low value="20020101"/>
<high nullFlavor="UNK"/>
</effectiveTime>
<repeatNumber value="1"/>' . $quantity . '
</supply>
</entryRelationship>
<entryRelationship typeCode="SUBJ">
<observation classCode="OBS" moodCode="EVN">
<templateId root="2.16.840.1.113883.3.88.11.83.8.1" assigningAuthorityName="HITSP C83"/>
<code code="73639000" codeSystem="2.16.840.1.113883.6.96" displayName="Prescription Drug"/>
</observation>
</entryRelationship>
</substanceAdministration>';
$entry = $section->addChild('entry', $entry);
$entry->addAttribute('typeCode', 'DRIV');
}
}
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');
}
}