Generated Narrative: StructureMap ExtractAntenatalVitalSigns

/// url = 'https://fhir.slade360.co.ke/fhir/StructureMap/ExtractAntenatalVitalSigns'
/// name = 'ExtractAntenatalVitalSigns'
/// title = 'Antenatal Vital Signs Extraction'
/// status = 'active'
/// description = 'Each round out as the four vitals under their real LOINC codes plus an obstetric panel carrying the lie, the presentation and whether the bowels have opened, and the fetal heart rate as its own Observation under LOINC 55283-6 with an interpretation. Outside 110 to 160 is what that column exists to catch, and a reader should not have to remember the range.'

uses "http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse" alias QR as source
uses "http://hl7.org/fhir/StructureDefinition/Bundle" alias Bundle as target
uses "http://hl7.org/fhir/StructureDefinition/Observation" alias Observation as target

group ExtractAntenatalVitalSigns(source qr : QR, target bundle : Bundle) {
  qr -> bundle.type = 'transaction' "setBundleType";
  qr.item as g where (linkId = 'admission') then {
    g.item as it where ((linkId = 'admission/edd') and answer.value.exists()) ->  bundle.entry as entry,  entry.resource = create('Observation') as obs then {
      qr ->  obs,  entry then BuildObsBase(qr, obs, entry) "base";
      qr -> obs then SetSurveyCategory(qr, obs) "category";
      it -> obs.code as cc then {
        it -> cc.coding as cg then {
          it -> cg.system = 'http://loinc.org' "sys";
          it -> cg.code = '11778-8' "cd";
          it -> cg.display = 'Delivery date Estimated' "dsp";
        } "coding";
      } "code";
      it.answer first as a then {
        a.value as v -> obs.value = cast(v, 'dateTime') "set";
      };
    } "measure_11778_8";
    g.item as it where ((linkId = 'admission/reason') and answer.value.exists()) ->  bundle.entry as entry,  entry.resource = create('Observation') as obs then {
      qr ->  obs,  entry then BuildObsBase(qr, obs, entry) "base";
      qr -> obs then SetSurveyCategory(qr, obs) "category";
      it -> obs.code as cc then {
        it -> cc.coding as cg then {
          it -> cg.system = 'http://loinc.org' "sys";
          it -> cg.code = '11450-4' "cd";
          it -> cg.display = 'Problem list - Reported' "dsp";
        } "coding";
        it -> cc.text = 'Reason for antenatal admission' "codeText";
      } "code";
      it.answer first as a then {
        a.value as txt ->  obs.note as n,  n.text = txt "text";
      };
    } "narr_11450_4";
    g.item as it where ((linkId = 'admission/parity') and answer.value.exists()) ->  bundle.entry as entry,  entry.resource = create('Observation') as obs then {
      qr ->  obs,  entry then BuildObsBase(qr, obs, entry) "base";
      qr -> obs then SetSurveyCategory(qr, obs) "category";
      it -> obs.code as cc then {
        it -> cc.coding as cg then {
          it -> cg.system = 'https://fhir.slade360.co.ke/fhir/CodeSystem/concept-codesystem' "sys";
          it -> cg.code = 'obstetric-history-parity' "cd";
          it -> cg.display = 'Parity' "dsp";
        } "coding";
      } "code";
      it.answer first as a then {
        a.value as txt ->  obs.note as n,  n.text = txt "text";
      };
    } "narr_obstetric_history_parity";
  } "admissionGroup";
  qr.item as row where (linkId = 'round') then {
    row.item as it where ((linkId = 'round/temperature') and answer.value.ofType(Quantity).exists()) ->  bundle.entry as entry,  entry.resource = create('Observation') as obs then {
      qr ->  obs,  entry then BuildObsBase(qr, obs, entry) "base";
      qr -> obs then SetVitalSignsCategory(qr, obs) "category";
      it -> obs.code as cc then {
        it -> cc.coding as cg then {
          it -> cg.system = 'http://loinc.org' "sys";
          it -> cg.code = '8310-5' "cd";
          it -> cg.display = 'Body temperature' "dsp";
        } "coding";
      } "code";
      it.answer first as a then {
        a.value as v -> obs.value = v;
      };
      row -> obs then SetAntenatalRowTime(row, obs) "rowTime";
    } "vital_round_8310_5";
    row.item as it where ((linkId = 'round/pulse') and answer.value.ofType(Quantity).exists()) ->  bundle.entry as entry,  entry.resource = create('Observation') as obs then {
      qr ->  obs,  entry then BuildObsBase(qr, obs, entry) "base";
      qr -> obs then SetVitalSignsCategory(qr, obs) "category";
      it -> obs.code as cc then {
        it -> cc.coding as cg then {
          it -> cg.system = 'http://loinc.org' "sys";
          it -> cg.code = '8867-4' "cd";
          it -> cg.display = 'Heart rate' "dsp";
        } "coding";
      } "code";
      it.answer first as a then {
        a.value as v -> obs.value = v;
      };
      row -> obs then SetAntenatalRowTime(row, obs) "rowTime";
    } "vital_round_8867_4";
    row.item as it where ((linkId = 'round/respiratory-rate') and answer.value.ofType(Quantity).exists()) ->  bundle.entry as entry,  entry.resource = create('Observation') as obs then {
      qr ->  obs,  entry then BuildObsBase(qr, obs, entry) "base";
      qr -> obs then SetVitalSignsCategory(qr, obs) "category";
      it -> obs.code as cc then {
        it -> cc.coding as cg then {
          it -> cg.system = 'http://loinc.org' "sys";
          it -> cg.code = '9279-1' "cd";
          it -> cg.display = 'Respiratory rate' "dsp";
        } "coding";
      } "code";
      it.answer first as a then {
        a.value as v -> obs.value = v;
      };
      row -> obs then SetAntenatalRowTime(row, obs) "rowTime";
    } "vital_round_9279_1";
    row.item as it where ((linkId = 'round/blood-pressure') and item.answer.value.ofType(Quantity).exists()) ->  bundle.entry as entry,  entry.resource = create('Observation') as obs then {
      qr ->  obs,  entry then BuildObsBase(qr, obs, entry) "base";
      qr -> obs then SetVitalSignsCategory(qr, obs) "category";
      it -> obs.code as cc then {
        it -> cc.coding as cg then {
          it -> cg.system = 'http://loinc.org' "sys";
          it -> cg.code = '85354-9' "cd";
          it -> cg.display = 'Blood pressure panel with all children optional' "dsp";
        } "coding";
      } "code";
      it.item as sbp where ((linkId = 'round/blood-pressure/systolic') and answer.value.ofType(Quantity).exists()) -> obs.component as comp then {
        sbp -> comp.code as cc then {
          sbp -> cc.coding as cg then {
            sbp -> cg.system = 'http://loinc.org' "sys";
            sbp -> cg.code = '8480-6' "cd";
            sbp -> cg.display = 'Systolic blood pressure' "dsp";
          } "coding";
        } "code";
        sbp -> comp then SetComponentValue(sbp, comp) "value";
      } "comp_8480_6";
      it.item as dbp where ((linkId = 'round/blood-pressure/diastolic') and answer.value.ofType(Quantity).exists()) -> obs.component as comp then {
        dbp -> comp.code as cc then {
          dbp -> cc.coding as cg then {
            dbp -> cg.system = 'http://loinc.org' "sys";
            dbp -> cg.code = '8462-4' "cd";
            dbp -> cg.display = 'Diastolic blood pressure' "dsp";
          } "coding";
        } "code";
        dbp -> comp then SetComponentValue(dbp, comp) "value";
      } "comp_8462_4";
      row -> obs then SetAntenatalRowTime(row, obs) "rowTime";
    } "bp_round";
    // ── The fetal heart rate, interpreted ─────────────────────────────────
    row.item as it where ((linkId = 'round/fetal-heart-tones') and answer.value.ofType(Quantity).exists()) ->  bundle.entry as entry,  entry.resource = create('Observation') as obs then {
      qr ->  obs,  entry then BuildObsBase(qr, obs, entry) "base";
      qr -> obs then SetVitalSignsCategory(qr, obs) "category";
      it -> obs.code as cc then {
        it -> cc.coding as cg then {
          it -> cg.system = 'http://loinc.org' "sys";
          it -> cg.code = '55283-6' "cd";
          it -> cg.display = 'Fetal Heart rate' "dsp";
        } "coding";
      } "code";
      it.answer first as a then {
        a.value as v -> obs.value = v;
      };
      it -> obs.referenceRange as rr then {
        it -> rr.low = create('Quantity') as lo then {
          it -> lo.value = '110' "loValue";
          it -> lo.unit = 'beats/min' "loUnit";
          it -> lo.system = 'http://unitsofmeasure.org' "loSystem";
          it -> lo.code = '/min' "loCode";
        } "low";
        it -> rr.high = create('Quantity') as hi then {
          it -> hi.value = '160' "hiValue";
          it -> hi.unit = 'beats/min' "hiUnit";
          it -> hi.system = 'http://unitsofmeasure.org' "hiSystem";
          it -> hi.code = '/min' "hiCode";
        } "high";
        it -> rr.text = 'Normal fetal heart rate at term' "rrText";
      } "referenceRange";
      it -> obs.interpretation as interp then {
        it -> interp.coding as icg then {
          it -> icg.system = 'http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation' "sys";
          it -> icg.code = evaluate(it, iif(answer.value.ofType(Quantity).value < 110, 'L', iif(answer.value.ofType(Quantity).value > 160, 'H', 'N'))) "cd";
        } "coding";
      } "interpretation";
      row -> obs then SetAntenatalRowTime(row, obs) "rowTime";
    } "fetalHeartRate";
    // ── The obstetric panel ───────────────────────────────────────────────
    row where (item.where(linkId = 'round/lie').answer.value.exists() or item.where(linkId = 'round/presentation').answer.value.exists() or item.where(linkId = 'round/bowels').answer.value.exists()) ->  bundle.entry as entry,  entry.resource = create('Observation') as obs then {
      qr ->  obs,  entry then BuildObsBase(qr, obs, entry) "base";
      qr -> obs then SetExamCategory(qr, obs) "category";
      row -> obs.code as cc then {
        row -> cc.coding as cg then {
          row -> cg.system = 'https://fhir.slade360.co.ke/fhir/CodeSystem/concept-codesystem' "sys";
          row -> cg.code = 'obstetric-antenatal-examination-on-a-round' "cd";
          row -> cg.display = 'Antenatal examination on a round' "dsp";
        } "coding";
      } "code";
      row.item as it where ((linkId = 'round/lie') and answer.value.exists()) -> obs.component as comp then {
        it -> comp.code as cc then {
          it -> cc.coding as cg then {
            it -> cg.system = 'https://fhir.slade360.co.ke/fhir/CodeSystem/concept-codesystem' "sys";
            it -> cg.code = 'fetal-lie' "cd";
            it -> cg.display = 'Fetal lie' "dsp";
          } "coding";
        } "code";
        it -> comp then SetComponentCodedValue(it, comp) "value";
      } "comp_fetal_lie";
      row.item as it where ((linkId = 'round/presentation') and answer.value.exists()) -> obs.component as comp then {
        it -> comp.code as cc then {
          it -> cc.coding as cg then {
            it -> cg.system = 'https://fhir.slade360.co.ke/fhir/CodeSystem/concept-codesystem' "sys";
            it -> cg.code = 'obstetric-fetal-presentation' "cd";
            it -> cg.display = 'Fetal presentation' "dsp";
          } "coding";
        } "code";
        it -> comp then SetComponentCodedValue(it, comp) "value";
      } "comp_obstetric_fetal_presentation";
      row.item as it where ((linkId = 'round/bowels') and answer.value.exists()) -> obs.component as comp then {
        it -> comp.code as cc then {
          it -> cc.coding as cg then {
            it -> cg.system = 'https://fhir.slade360.co.ke/fhir/CodeSystem/concept-codesystem' "sys";
            it -> cg.code = 'obstetric-bowels-opened' "cd";
            it -> cg.display = 'Bowels opened' "dsp";
          } "coding";
        } "code";
        it -> comp then SetComponentCodedValue(it, comp) "value";
      } "comp_obstetric_bowels_opened";
      row -> obs then SetAntenatalRowTime(row, obs) "rowTime";
    } "obstetricPanel";
  } "roundRows";
}

// The row's own timestamp on everything extracted from that row.
group SetAntenatalRowTime(source row, target obs : Observation) {
  row.item as it where ((linkId = 'round/at') and answer.value.exists()) then {
    it.answer first as a then {
      a.value as v -> obs.effective = v "effective";
    };
  } "rowTimeRule";
  row.item as it where ((linkId = 'round/taken-by') and answer.value.exists()) then {
    it.answer first as a then {
      a.value as ref -> obs.performer = ref "by";
    };
  } "rowByRule";
}

// ─────────────────────────────────────────────────────────────────────────────
// Shared scaffolding. Repeated in each map rather than imported: the transform
// engine resolves `imports` against whatever StructureMaps happen to be on the
// server, and a form that stops extracting because a shared map was not
// uploaded is a worse failure than a duplicated group.
// Two notes on what the publisher's StructureMap validator says about this file.
// Source parameters below are left untyped on purpose. Writing `: Element` makes
// the validator compare QuestionnaireResponse.item against the literal 'Element'
// and report them as incompatible with each other, which is noise, not a finding.
// `evaluate(context, expression)` is flagged as "takes 1 parameter but 2 were
// found". Leave it. The FML parser in the same jar refuses the one-argument form
// outright -- it wants a parameter, a comma, then the FHIRPath -- so the
// publisher is objecting to what its own compiler emits. Two arguments is the
// only form that compiles, and it is what the R5 transform engine executes.
// ─────────────────────────────────────────────────────────────────────────────
group BuildObsBase(source qr : QR, target obs : Observation, target entry) {
  qr -> obs then SetResponseProvenance(qr, obs) "responseProvenance";
  qr -> obs.id = uuid() then SetObservationFullUrl(obs, entry) "idAndFullUrl";
  qr -> entry.request as request then {
    qr -> request.method = 'POST' "requestMethod";
    qr -> request.url = 'Observation' "requestUrl";
  } "entryRequest";
  qr -> obs.status = 'final' "status";
  qr.subject as s -> obs.subject = s;
  qr.encounter as e -> obs.encounter = e;
  qr.authored as t -> obs.effective = t "effective";
  qr.source as src -> obs.performer = src "performerFromSource";
  qr where (source.exists().not()) then {
    qr.author as a -> obs.performer = a "performerFromAuthor";
  } "performerFallback";
  // A stored response's id already reads "QuestionnaireResponse/<id>", so it is
  // a relative reference as it stands. The hasValue() guard is what stops an
  // unsaved response -- one posted straight to $extract rather than saved first
  // -- from writing "QuestionnaireResponse/null" into the record.
  qr.id as qid where ($this.hasValue()) ->  obs.derivedFrom = create('Reference') as ref,  ref.reference = qid "linkQuestionnaireResponse";
}

group SetObservationFullUrl(source obs : Observation, target entry) {
  obs.id as id -> entry.fullUrl = append('https://fhir.slade360.co.ke/fhir/Observation/', id) "assignFullUrl";
}

// The two answer shapes a component can carry. Both read the answer through the
// untyped `.value` accessor: reading `valueCoding` or `valueQuantity` by its
// typed property name fails at transform time on HAPI R5 with "Attempt to read
// invalid property ... on QuestionnaireResponse.item.answer".
group SetComponentCodedValue(source it, target comp) {
  it.answer first as a then {
    a.value as cv -> comp.value = create('CodeableConcept') as cc then {
      cv -> cc.coding = cv "valueCoding";
      cv.display as d -> cc.text = d "valueText";
    } "codedValue";
  } "componentAnswer";
}

group SetComponentValue(source it, target comp) {
  it.answer first as a then {
    a.value as v -> comp.value = v "plainValue";
  } "componentAnswer";
}

group SetSurveyCategory(source qr : QR, target obs : Observation) {
  qr -> obs.category as cat then {
    qr -> cat.coding as coding then {
      qr -> coding.system = 'http://terminology.hl7.org/CodeSystem/observation-category' "categorySystem";
      qr -> coding.code = 'survey' "categoryCode";
      qr -> coding.display = 'Survey' "categoryDisplay";
    } "categoryCoding";
  } "category";
}

group SetVitalSignsCategory(source qr : QR, target obs : Observation) {
  qr -> obs.category as cat then {
    qr -> cat.coding as coding then {
      qr -> coding.system = 'http://terminology.hl7.org/CodeSystem/observation-category' "categorySystem";
      qr -> coding.code = 'vital-signs' "categoryCode";
      qr -> coding.display = 'Vital Signs' "categoryDisplay";
    } "categoryCoding";
  } "category";
}

group SetExamCategory(source qr : QR, target obs : Observation) {
  qr -> obs.category as cat then {
    qr -> cat.coding as coding then {
      qr -> coding.system = 'http://terminology.hl7.org/CodeSystem/observation-category' "categorySystem";
      qr -> coding.code = 'exam' "categoryCode";
      qr -> coding.display = 'Exam' "categoryDisplay";
    } "categoryCoding";
  } "category";
}

// ── Provenance and tenancy ───────────────────────────────────────────────────
// Two tags on everything this map creates. The first says which questionnaire
// produced it, so a form that reopens mid-admission recalls its own earlier
// entries and not another form's. The second copies the tenant tags off the
// response, because nothing else on the path puts them there.
// The code is the form's document type, not the questionnaire's id: every
// environment mints its own ids, and there is only one set of maps, so an id
// here would tie the tag to whichever environment stamped it.
// ── Provenance and tenancy ───────────────────────────────────────────────────
group SetResponseProvenance(source qr : QR, target r) {
  qr -> r.meta as m then {
    qr -> m.tag as t then {
      qr -> t.system = 'http://slade360edi.com/questionnaire-provenance' "provenanceSystem";
      qr -> t.code = 'antenatal-vital-signs' "provenanceCode";
      qr -> t.display = 'Antenatal vital signs' "provenanceDisplay";
    } "provenanceTag";
  } "provenanceMeta";
  // Every tag the response carries, onto the resource. `meta` is 0..1, so this
  // lands on the same meta the rule above created rather than a second one.
  qr.meta as qm then {
    qm.tag as qt ->  r.meta as m,  m.tag = qt "copyTag";
  } "tenantTags";
}