Generated Narrative: StructureMap ExtractInpatientDeathNote
\r\n/// url = 'https://fhir.slade360.co.ke/fhir/StructureMap/ExtractInpatientDeathNote'\r\n/// name = 'ExtractInpatientDeathNote'\r\n/// title = 'Inpatient Death Note Extraction'\r\n/// status = 'active'\r\n/// description = 'The richest of the seven notes, and the only one that changes a record that already exists. It produces a Composition attested by the clinician who confirmed the death, a Condition carrying the cause as stated, and a FHIRPath PATCH that sets Patient.deceasedDateTime. The PATCH touches that one element and nothing else -- the response carries no demographics, so rebuilding and PUTting the Patient would erase the record. Note this uses the `add` operation: extracting the same death note twice will fail the second time rather than silently overwrite, which is the safer direction for a fact recorded once.'\r\n\r\nuses "http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse" alias QR as source\r\nuses "http://hl7.org/fhir/StructureDefinition/Bundle" alias Bundle as target\r\nuses "http://hl7.org/fhir/StructureDefinition/Composition" alias Composition as target\r\nuses "http://hl7.org/fhir/StructureDefinition/Condition" alias Condition as target\r\nuses "http://hl7.org/fhir/StructureDefinition/Parameters" alias Parameters as target\r\n\r\ngroup ExtractInpatientDeathNote(source qr : QR, target bundle : Bundle) {\r\n qr -> bundle.type = 'transaction' "setBundleType";\r\n qr -> bundle.entry as entry, entry.resource = create('Composition') as comp then {\r\n qr -> comp, entry then BuildNoteBase(qr, comp, entry) "noteBase";\r\n qr -> comp.name = 'InpatientDeathNote' "noteName";\r\n qr -> comp.title = 'Death note' "noteTitle";\r\n // Deliberately not LOINC 64297-5. That code is the civil death certificate,\r\n // a different document with a different author and a different audience.\r\n qr -> comp.type as ty then {\r\n qr -> ty.coding as sghi then {\r\n qr -> sghi.system = 'https://fhir.slade360.co.ke/fhir/CodeSystem/inpatient-document-type-codesystem' "sghiSystem";\r\n qr -> sghi.code = 'death-note' "sghiCode";\r\n qr -> sghi.display = 'Death note' "sghiDisplay";\r\n } "sghiCoding";\r\n qr -> ty.text = 'Death note' "typeText";\r\n } "noteType";\r\n // The clinician who confirmed the death attests the note.\r\n qr.item as itC where (linkId = 'confirmedBy') then {\r\n itC.answer as aC then {\r\n aC.value as cv -> comp.attester as att then {\r\n aC -> att.mode as mode then {\r\n aC -> mode.coding as modec then {\r\n aC -> modec.system = 'http://hl7.org/fhir/composition-attestation-mode' "attModeSystem";\r\n aC -> modec.code = 'professional' "attModeCode";\r\n aC -> modec.display = 'Professional' "attModeDisplay";\r\n } "attModeCoding";\r\n } "attesterMode";\r\n qr.item as itT where (linkId = 'confirmedAt') then {\r\n itT.answer first as aT then {\r\n aT.value as tv -> att.time = tv "attesterTimeFromConfirmedAt";\r\n } "confirmedAtAnswer";\r\n } "attesterTimeRule";\r\n cv -> att.party = cv "attesterParty";\r\n } "attester";\r\n } "confirmedByAnswer";\r\n } "confirmedByRule";\r\n // The confirmed-at time is on the Patient as a fact, and in the document as\r\n // a line, because a printed death note that does not say when is not a\r\n // death note.\r\n qr.item as it where ((linkId = 'confirmedAt') and answer.value.exists()) -> comp.section as sec then {\r\n it -> sec.title = 'Death confirmed at' "confirmedAtTitle";\r\n it -> sec then AddSectionText(it, sec) "confirmedAtText";\r\n } "confirmedAtSectionRule";\r\n qr.item as it where ((linkId = 'circumstances') and answer.value.exists()) -> comp.section as sec then {\r\n it -> sec.title = 'Circumstances' "circumstancesTitle";\r\n it -> sec then AddSectionText(it, sec) "circumstancesText";\r\n } "circumstancesRule";\r\n qr.item as it where ((linkId = 'causeStated') and answer.value.exists()) -> comp.section as sec then {\r\n it -> sec.title = 'Cause of death as stated' "causeTitle";\r\n it -> sec then AddSectionText(it, sec) "causeText";\r\n } "causeSectionRule";\r\n qr.item as it where ((linkId = 'familyInformed') and answer.value.exists()) -> comp.section as sec then {\r\n it -> sec.title = 'Family informed' "familyTitle";\r\n it -> sec then AddSectionText(it, sec) "familyText";\r\n } "familyRule";\r\n } "composition";\r\n // Cause of death as a Condition. verificationStatus is `confirmed`, not\r\n // `provisional` as on the admission note: this is a stated cause, recorded\r\n // after the event, not a working impression.\r\n qr.item as itCause where ((linkId = 'causeStated') and answer.value.exists()) then {\r\n itCause.answer first as aCause then {\r\n aCause -> bundle.entry as entryC, entryC.resource = create('Condition') as cond then {\r\n qr -> cond, entryC then BuildConditionBase(qr, cond, entryC) "conditionBase";\r\n qr -> cond.verificationStatus as vs then {\r\n qr -> vs.coding as vsc then {\r\n qr -> vsc.system = 'http://terminology.hl7.org/CodeSystem/condition-ver-status' "verSystem";\r\n qr -> vsc.code = 'confirmed' "verCode";\r\n qr -> vsc.display = 'Confirmed' "verDisplay";\r\n } "verCoding";\r\n } "verificationStatus";\r\n aCause.value as v -> cond.code as code then {\r\n v -> code.text = v "codeText";\r\n } "conditionCode";\r\n qr -> cond.note as note then {\r\n qr -> note.text = 'Cause of death as stated on the inpatient death note.' "noteText";\r\n } "conditionNote";\r\n } "condition";\r\n } "causeAnswer";\r\n } "causeConditionRule";\r\n // Patient.deceasedDateTime, by FHIRPath PATCH.\r\n qr.item as itAt where ((linkId = 'confirmedAt') and answer.value.exists()) then {\r\n itAt.answer first as aAt then {\r\n aAt -> bundle.entry as entryP, entryP.resource = create('Parameters') as params then {\r\n qr.subject as s then {\r\n s.reference as sref -> entryP.request as request then {\r\n qr -> request.method = 'PATCH' "requestMethod";\r\n // The patient reference is already relative ("Patient/1051"), which\r\n // is exactly what a transaction entry URL wants.\r\n sref -> request.url = sref "requestUrl";\r\n } "entryRequest";\r\n } "patientReference";\r\n aAt.value as dv -> params.parameter as op then {\r\n aAt -> op.name = 'operation' "operationName";\r\n aAt -> op.part as partType then {\r\n aAt -> partType.name = 'type' "typeName";\r\n aAt -> partType.value = 'add' "typeValue";\r\n } "operationType";\r\n aAt -> op.part as partPath then {\r\n aAt -> partPath.name = 'path' "pathName";\r\n aAt -> partPath.value = 'Patient' "pathValue";\r\n } "operationPath";\r\n aAt -> op.part as partName then {\r\n aAt -> partName.name = 'name' "nameName";\r\n aAt -> partName.value = 'deceasedDateTime' "nameValue";\r\n } "operationElement";\r\n aAt -> op.part as partValue then {\r\n aAt -> partValue.name = 'value' "valueName";\r\n dv -> partValue.value = dv "valueValue";\r\n } "operationValue";\r\n } "operation";\r\n } "patientPatch";\r\n } "confirmedAtAnswer";\r\n } "deceasedPatchRule";\r\n}\r\n\r\n// ─────────────────────────────────────────────────────────────────────────────\r\n// Shared note scaffolding. Repeated in each note map rather than imported: the\r\n// transform engine resolves `imports` against whatever StructureMaps happen to\r\n// be on the server, and a note that stops extracting because a shared map was\r\n// not uploaded is a worse failure than a duplicated group.\r\n// ─────────────────────────────────────────────────────────────────────────────\r\n// Two notes on what the publisher's StructureMap validator says about this file.\r\n// Source parameters below are left untyped on purpose. Writing `: Element` makes\r\n// the validator compare QuestionnaireResponse.item against the literal 'Element'\r\n// and report them as incompatible with each other, which is noise, not a finding.\r\n// Untyped, it says only that it cannot check the paths.\r\n// `evaluate(context, expression)` is flagged as "takes 1 parameter but 2 were\r\n// found". Leave it. The FML parser in the same jar refuses the one-argument form\r\n// outright -- it wants a parameter, a comma, then the FHIRPath -- so the publisher\r\n// is objecting to what its own compiler emits. Two arguments is the only form that\r\n// compiles, and it is what the R5 transform engine executes.\r\ngroup BuildNoteBase(source qr : QR, target comp : Composition, target entry) {\r\n qr -> comp.id = uuid() then SetCompositionFullUrl(comp, entry) "idAndFullUrl";\r\n qr -> entry.request as request then {\r\n qr -> request.method = 'POST' "requestMethod";\r\n qr -> request.url = 'Composition' "requestUrl";\r\n } "entryRequest";\r\n qr -> comp.status = 'final' "status";\r\n qr.subject as s -> comp.subject = s;\r\n qr.encounter as e -> comp.encounter = e;\r\n // Composition.date is 1..1. `authored` is only 0..1 on the response, so when a\r\n // client sends none the extraction time stands in. It is a poor substitute for\r\n // when the note was written, but a document with no date at all is worse, and\r\n // extraction happens moments after submission in practice.\r\n qr.authored as t -> comp.date = t "date";\r\n qr where (authored.exists().not()) then {\r\n qr -> comp.date = evaluate(qr, now()) "dateFromExtractionTime";\r\n } "dateFallback";\r\n // Composition.author is 1..1 minimum. R5 QuestionnaireResponse carries both\r\n // `author` (who recorded the answers) and `source` (who supplied them); the\r\n // author is the one who wrote the note, so it wins, and `source` only stands\r\n // in when the client did not send an author. If the response carries neither,\r\n // the note comes out unauthored -- there is nothing on a QuestionnaireResponse\r\n // to invent one from, and guessing at who wrote a clinical note is not a thing\r\n // a map should do.\r\n qr.author as a -> comp.author = a "authorFromAuthor";\r\n qr where (author.exists().not()) then {\r\n qr.source as src -> comp.author = src "authorFromSource";\r\n } "authorFallback";\r\n qr -> comp.relatesTo as rel then {\r\n qr -> rel.type = 'derived-from' "relatesToType";\r\n qr -> rel.resourceReference = create('Reference') as ref then {\r\n qr.id as qid -> ref.reference = qid "relatesToRef";\r\n } "relatesToTarget";\r\n } "linkQuestionnaireResponse";\r\n}\r\n\r\ngroup AddSectionText(source it, target sec) {\r\n it.answer first as a then {\r\n a.value as v -> sec.text as narrative then {\r\n v -> narrative.status = 'generated' "narrativeStatus";\r\n v -> narrative.div = create('xhtml') as xhtml then {\r\n v -> xhtml.value = evaluate(a, '<div xmlns="http://www.w3.org/1999/xhtml"><p>' + value.toString().escape('html') + '</p></div>') "narrativeDiv";\r\n } "narrativeXhtml";\r\n } "sectionText";\r\n } "sectionAnswer";\r\n}\r\n\r\ngroup SetCompositionFullUrl(source comp : Composition, target entry) {\r\n comp.id as id -> entry.fullUrl = append('https://fhir.slade360.co.ke/fhir/Composition/', id) "assignFullUrl";\r\n}\r\n\r\ngroup BuildConditionBase(source qr : QR, target cond : Condition, target entry) {\r\n qr -> cond.id = uuid() then SetConditionFullUrl(cond, entry) "idAndFullUrl";\r\n qr -> entry.request as request then {\r\n qr -> request.method = 'POST' "requestMethod";\r\n qr -> request.url = 'Condition' "requestUrl";\r\n } "entryRequest";\r\n qr -> cond.clinicalStatus as cs then {\r\n qr -> cs.coding as csc then {\r\n qr -> csc.system = 'http://terminology.hl7.org/CodeSystem/condition-clinical' "clinSystem";\r\n qr -> csc.code = 'active' "clinCode";\r\n qr -> csc.display = 'Active' "clinDisplay";\r\n } "clinCoding";\r\n } "clinicalStatus";\r\n qr -> cond.category as cat then {\r\n qr -> cat.coding as catc then {\r\n qr -> catc.system = 'http://terminology.hl7.org/CodeSystem/condition-category' "catSystem";\r\n qr -> catc.code = 'encounter-diagnosis' "catCode";\r\n qr -> catc.display = 'Encounter Diagnosis' "catDisplay";\r\n } "catCoding";\r\n } "category";\r\n qr.subject as s -> cond.subject = s;\r\n qr.encounter as e -> cond.encounter = e;\r\n qr.authored as t -> cond.recordedDate = t "recordedDate";\r\n qr.author as a -> cond.participant as part then {\r\n qr -> part.actor = a "participantActor";\r\n } "participantFromAuthor";\r\n qr where (author.exists().not()) then {\r\n qr.source as src -> cond.participant as part2 then {\r\n qr -> part2.actor = src "participantActorFromSource";\r\n } "participantFromSource";\r\n } "participantFallback";\r\n qr -> cond.evidence as ev then {\r\n qr -> ev.reference = create('Reference') as ref then {\r\n qr.id as qid -> ref.reference = qid "evidenceRef";\r\n } "evidenceTarget";\r\n } "linkQuestionnaireResponse";\r\n}\r\n\r\ngroup SetConditionFullUrl(source cond : Condition, target entry) {\r\n cond.id as id -> entry.fullUrl = append('https://fhir.slade360.co.ke/fhir/Condition/', id) "assignFullUrl";\r\n}\r\n\r\n
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