SGHI FHIR Profile Implementation Guide
0.1.0 - ci-build
SGHI FHIR Profile Implementation Guide, published by Kathurima Kimathi. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/savannahghi/sil_fhir_profile_ig/ and changes regularly. See the Directory of published versions
| Official URL: https://fhir.slade360.co.ke/fhir/StructureMap/ExtractPalliativeCareAssessment | Version: 0.1.0 | |||
| Active as of 2026-09-14 | Computable Name: ExtractPalliativeCareAssessment | |||
The palliative care assessment out as: one symptom-assessment Observation carrying all twenty-two symptoms as components, because the panel is the assessment and a patient with no symptoms ticked has said something a set of absent Observations could not; a Condition for the diagnosis, reconciled against the problem list where the assessor picked an existing one; one Observation for the prior oncological treatment; separate Observations for the patient's own goals and the carer's, because the two often differ and the form asks both; and a CarePlan whose activities are the problem-and-action rows.
/// url = 'https://fhir.slade360.co.ke/fhir/StructureMap/ExtractPalliativeCareAssessment' /// name = 'ExtractPalliativeCareAssessment' /// title = 'Palliative Care Assessment Extraction' /// status = 'active' /// description = 'The palliative care assessment out as: one symptom-assessment Observation carrying all twenty-two symptoms as components, because the panel is the assessment and a patient with no symptoms ticked has said something a set of absent Observations could not; a Condition for the diagnosis, reconciled against the problem list where the assessor picked an existing one; one Observation for the prior oncological treatment; separate Observations for the patient\'s own goals and the carer\'s, because the two often differ and the form asks both; and a CarePlan whose activities are the problem-and-action rows.' 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 uses "http://hl7.org/fhir/StructureDefinition/Condition" alias Condition as target uses "http://hl7.org/fhir/StructureDefinition/CarePlan" alias CarePlan as target group ExtractPalliativeCareAssessment(source qr : QR, target bundle : Bundle) { qr -> bundle.type = 'transaction' "setBundleType"; // ── The symptom checklist, as one panel ───────────────────────────────── // Twenty-two components on one Observation. A palliative assessment is read // as a whole -- which symptoms are present today, against which were present // last week -- and twenty-two loose Observations make that comparison a // twenty-two-query job. qr.item as g where ((linkId = 'symptoms') and item.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"; g -> obs.code as cc then { g -> cc.coding as cg then { g -> cg.system = 'https://fhir.slade360.co.ke/fhir/CodeSystem/concept-codesystem' "sys"; g -> cg.code = 'palliative-symptom' "cd"; g -> cg.display = 'Palliative care symptom' "dsp"; } "coding"; g -> cc.text = 'Palliative care symptom checklist' "codeText"; } "code"; g.item as it where ((linkId = 'symptoms/abdominal-pain') 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 = 'palliative-abdominal-pain' "cd"; it -> cg.display = 'Abdominal pain' "dsp"; } "coding"; } "code"; it -> comp then SetComponentCodedValue(it, comp) "value"; } "comp_palliative_abdominal_pain"; g.item as it where ((linkId = 'symptoms/nausea-vomiting') 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 = 'palliative-nausea-or-vomiting' "cd"; it -> cg.display = 'Nausea or vomiting' "dsp"; } "coding"; } "code"; it -> comp then SetComponentCodedValue(it, comp) "value"; } "comp_palliative_nausea_or_vomiting"; g.item as it where ((linkId = 'symptoms/constipation') 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 = 'palliative-constipation' "cd"; it -> cg.display = 'Constipation' "dsp"; } "coding"; } "code"; it -> comp then SetComponentCodedValue(it, comp) "value"; } "comp_palliative_constipation"; g.item as it where ((linkId = 'symptoms/diarrhoea') 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 = 'palliative-diarrhoea' "cd"; it -> cg.display = 'Diarrhoea' "dsp"; } "coding"; } "code"; it -> comp then SetComponentCodedValue(it, comp) "value"; } "comp_palliative_diarrhoea"; g.item as it where ((linkId = 'symptoms/melaena') 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 = 'palliative-melaena' "cd"; it -> cg.display = 'Melaena' "dsp"; } "coding"; } "code"; it -> comp then SetComponentCodedValue(it, comp) "value"; } "comp_palliative_melaena"; g.item as it where ((linkId = 'symptoms/loss-of-appetite') 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 = 'palliative-loss-of-appetite' "cd"; it -> cg.display = 'Loss of appetite' "dsp"; } "coding"; } "code"; it -> comp then SetComponentCodedValue(it, comp) "value"; } "comp_palliative_loss_of_appetite"; g.item as it where ((linkId = 'symptoms/body-weakness') 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 = 'palliative-body-weakness' "cd"; it -> cg.display = 'Body weakness' "dsp"; } "coding"; } "code"; it -> comp then SetComponentCodedValue(it, comp) "value"; } "comp_palliative_body_weakness"; g.item as it where ((linkId = 'symptoms/pr-bleeding') 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 = 'palliative-per-rectal-bleeding' "cd"; it -> cg.display = 'Per rectal bleeding' "dsp"; } "coding"; } "code"; it -> comp then SetComponentCodedValue(it, comp) "value"; } "comp_palliative_per_rectal_bleeding"; g.item as it where ((linkId = 'symptoms/pr-pain') 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 = 'palliative-per-rectal-pain' "cd"; it -> cg.display = 'Per rectal pain' "dsp"; } "coding"; } "code"; it -> comp then SetComponentCodedValue(it, comp) "value"; } "comp_palliative_per_rectal_pain"; g.item as it where ((linkId = 'symptoms/weight-loss') 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 = 'palliative-weight-loss' "cd"; it -> cg.display = 'Weight loss' "dsp"; } "coding"; } "code"; it -> comp then SetComponentCodedValue(it, comp) "value"; } "comp_palliative_weight_loss"; g.item as it where ((linkId = 'symptoms/jaundice') 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 = 'palliative-jaundice' "cd"; it -> cg.display = 'Jaundice' "dsp"; } "coding"; } "code"; it -> comp then SetComponentCodedValue(it, comp) "value"; } "comp_palliative_jaundice"; g.item as it where ((linkId = 'symptoms/fever') 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 = 'palliative-fever' "cd"; it -> cg.display = 'Fever' "dsp"; } "coding"; } "code"; it -> comp then SetComponentCodedValue(it, comp) "value"; } "comp_palliative_fever"; g.item as it where ((linkId = 'symptoms/chest-pain') 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 = 'palliative-chest-pain' "cd"; it -> cg.display = 'Chest pain' "dsp"; } "coding"; } "code"; it -> comp then SetComponentCodedValue(it, comp) "value"; } "comp_palliative_chest_pain"; g.item as it where ((linkId = 'symptoms/cough') 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 = 'palliative-cough' "cd"; it -> cg.display = 'Cough' "dsp"; } "coding"; } "code"; it -> comp then SetComponentCodedValue(it, comp) "value"; } "comp_palliative_cough"; g.item as it where ((linkId = 'symptoms/incontinence') 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 = 'palliative-incontinence' "cd"; it -> cg.display = 'Incontinence' "dsp"; } "coding"; } "code"; it -> comp then SetComponentCodedValue(it, comp) "value"; } "comp_palliative_incontinence"; g.item as it where ((linkId = 'symptoms/headache') 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 = 'palliative-headache' "cd"; it -> cg.display = 'Headache' "dsp"; } "coding"; } "code"; it -> comp then SetComponentCodedValue(it, comp) "value"; } "comp_palliative_headache"; g.item as it where ((linkId = 'symptoms/poor-vision') 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 = 'palliative-poor-vision' "cd"; it -> cg.display = 'Poor vision' "dsp"; } "coding"; } "code"; it -> comp then SetComponentCodedValue(it, comp) "value"; } "comp_palliative_poor_vision"; g.item as it where ((linkId = 'symptoms/weakness-of-limbs') 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 = 'palliative-weakness-of-limbs' "cd"; it -> cg.display = 'Weakness of limbs' "dsp"; } "coding"; } "code"; it -> comp then SetComponentCodedValue(it, comp) "value"; } "comp_palliative_weakness_of_limbs"; g.item as it where ((linkId = 'symptoms/dry-mouth') 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 = 'palliative-dry-mouth' "cd"; it -> cg.display = 'Dry mouth' "dsp"; } "coding"; } "code"; it -> comp then SetComponentCodedValue(it, comp) "value"; } "comp_palliative_dry_mouth"; g.item as it where ((linkId = 'symptoms/excessive-sleep') 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 = 'palliative-excessive-sleep' "cd"; it -> cg.display = 'Excessive sleep' "dsp"; } "coding"; } "code"; it -> comp then SetComponentCodedValue(it, comp) "value"; } "comp_palliative_excessive_sleep"; g.item as it where ((linkId = 'symptoms/hallucinations') 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 = 'palliative-hallucinations' "cd"; it -> cg.display = 'Hallucinations' "dsp"; } "coding"; } "code"; it -> comp then SetComponentCodedValue(it, comp) "value"; } "comp_palliative_hallucinations"; g.item as it where ((linkId = 'symptoms/sore-mouth') 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 = 'palliative-sore-mouth' "cd"; it -> cg.display = 'Sore mouth' "dsp"; } "coding"; } "code"; it -> comp then SetComponentCodedValue(it, comp) "value"; } "comp_palliative_sore_mouth"; } "symptomPanel"; // ── Diagnosis ─────────────────────────────────────────────────────────── // The form asks for both an existing Condition and the diagnosis as written. // Where an existing one was picked, the map records the reference as evidence // rather than creating a second Condition -- a palliative referral should not // fork the problem list of a patient who already has a coded cancer on it. qr.item as g where (linkId = 'diagnosis') then { g.item as it where ((linkId = 'diagnosis/text') and answer.value.exists()) -> bundle.entry as entry, entry.resource = create('Condition') as cond then { qr -> cond, entry then BuildConditionBase(qr, cond, entry) "base"; it -> cond.clinicalStatus as cs then { it -> cs.coding as cg then { it -> cg.system = 'http://terminology.hl7.org/CodeSystem/condition-clinical' "sys"; it -> cg.code = 'active' "cd"; it -> cg.display = 'Active' "dsp"; } "coding"; } "clinicalStatus"; it -> cond.category as cat then { it -> cat.coding as cg then { it -> cg.system = 'http://terminology.hl7.org/CodeSystem/condition-category' "sys"; it -> cg.code = 'problem-list-item' "cd"; it -> cg.display = 'Problem List Item' "dsp"; } "coding"; } "category"; it.answer first as a then { a.value as txt -> cond.code as cc, cc.text = txt "codeText"; }; qr.authored as t -> cond.recordedDate = t "recordedDate"; qr.encounter as e -> cond.encounter = e; g.item as ex where ((linkId = 'diagnosis/condition') and answer.value.exists()) then { ex.answer first as ea then { ea.value as existing -> cond.evidence as ev, ev.reference = existing "evidenceReference"; }; } "existingRule"; } "diagnosisCondition"; } "diagnosisGroup"; // ── Prior oncological treatment ───────────────────────────────────────── // One Observation with a note per modality. The form takes free text -- "RT // 2024, 25 fractions" -- and a Procedure built from that would claim a date // and a body site it does not have. qr.item as g where ((linkId = 'prior-treatment') and item.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"; g -> obs.code as cc then { g -> cc.coding as cg then { g -> cg.system = 'https://fhir.slade360.co.ke/fhir/CodeSystem/concept-codesystem' "sys"; g -> cg.code = 'prior-oncological-treatment' "cd"; g -> cg.display = 'Prior oncological treatment' "dsp"; } "coding"; } "code"; g.item as it where (linkId = 'prior-treatment/radiotherapy') then { it.answer first as a then { a.value as txt -> obs.note as n, n.text = txt "text"; }; } "note"; g.item as it where (linkId = 'prior-treatment/chemotherapy') then { it.answer first as a then { a.value as txt -> obs.note as n, n.text = txt "text"; }; } "note2"; g.item as it where (linkId = 'prior-treatment/surgery') then { it.answer first as a then { a.value as txt -> obs.note as n, n.text = txt "text"; }; } "note3"; g.item as it where (linkId = 'prior-treatment/other') then { it.answer first as a then { a.value as txt -> obs.note as n, n.text = txt "text"; }; } "note4"; g.item as it where (linkId = 'prior-treatment/p24-markers') then { it.answer first as a then { a.value as txt -> obs.note as n, n.text = txt "text"; }; } "note5"; g.item as it where ((linkId = 'prior-treatment/not-discussed') 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 = 'prior-treatment-not-discussed-with-the-patient' "cd"; it -> cg.display = 'Prior treatment not discussed with the patient' "dsp"; } "coding"; } "code"; it -> comp then SetComponentCodedValue(it, comp) "value"; } "comp_prior_treatment_not_discussed_with_the_patient"; } "priorTreatmentPanel"; // ── Goals, patient's and carer's, kept apart ──────────────────────────── // Two Observations, deliberately. A carer who wants their relative admitted // and a patient who wants to die at home are both recorded, and folding them // into one note would hide exactly the conflict a palliative team has to work // with. qr.item as g where (linkId = 'psychosocial') then { g.item as it where ((linkId = 'psychosocial/patient-goals') 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 = 'patient-goals' "cd"; it -> cg.display = 'Patient goals and expectations' "dsp"; } "coding"; } "code"; it.answer first as a then { a.value as txt -> obs.note as n, n.text = txt "text"; }; } "narr_patient_goals"; g.item as it where ((linkId = 'psychosocial/patient-stresses') 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 = 'patient-goals' "cd"; it -> cg.display = 'Patient goals and expectations' "dsp"; } "coding"; it -> cc.text = 'Stresses the patient carries, and the help they feel is appropriate' "codeText"; } "code"; it.answer first as a then { a.value as txt -> obs.note as n, n.text = txt "text"; }; } "narr_patient_goals2"; g.item as it where ((linkId = 'psychosocial/carer-goals') 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 = 'carer-goals' "cd"; it -> cg.display = 'Carer goals and expectations' "dsp"; } "coding"; } "code"; it.answer first as a then { a.value as txt -> obs.note as n, n.text = txt "text"; }; } "narr_carer_goals"; g.item as it where ((linkId = 'psychosocial/carer-stresses') 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 = 'carer-goals' "cd"; it -> cg.display = 'Carer goals and expectations' "dsp"; } "coding"; it -> cc.text = 'Stresses the carer carries, and the help they feel is appropriate' "codeText"; } "code"; it.answer first as a then { a.value as txt -> obs.note as n, n.text = txt "text"; }; } "narr_carer_goals2"; g.item as it where ((linkId = 'psychosocial/spiritual-assessment') 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 = 'spiritual-assessment' "cd"; it -> cg.display = 'Spiritual assessment' "dsp"; } "coding"; } "code"; it.answer first as a then { a.value as txt -> obs.note as n, n.text = txt "text"; }; } "narr_spiritual_assessment"; g.item as it where ((linkId = 'psychosocial/social-issues') 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 = '29762-2' "cd"; it -> cg.display = 'Social history note' "dsp"; } "coding"; } "code"; it.answer first as a then { a.value as txt -> obs.note as n, n.text = txt "text"; }; } "narr_29762_2"; g.item as it where ((linkId = 'psychosocial/current-treatment') 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 = '10160-0' "cd"; it -> cg.display = 'History of Medication use Narrative' "dsp"; } "coding"; it -> cc.text = 'Current treatment' "codeText"; } "code"; it.answer first as a then { a.value as txt -> obs.note as n, n.text = txt "text"; }; } "narr_10160_0"; } "psychosocialGroup"; qr.item as it where ((linkId = 'history-of-illness') 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 = '10164-2' "cd"; it -> cg.display = 'History of Present illness Narrative' "dsp"; } "coding"; } "code"; it.answer first as a then { a.value as txt -> obs.note as n, n.text = txt "text"; }; } "narr_10164_2"; qr.item as g where (linkId = 'referral') then { g.item as it where ((linkId = 'referral/source') 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 = 'palliative-referral-source' "cd"; it -> cg.display = 'Palliative referral source' "dsp"; } "coding"; } "code"; it.answer first as a then { a.value as cv -> obs.value = create('CodeableConcept') as cc then { cv -> cc.coding = cv "valueCoding"; cv.display as d -> cc.text = d "valueText"; } "codedValue"; }; } "coded_palliative_symptom"; g.item as it where ((linkId = 'referral/source-detail') 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 = 'palliative-referral-source' "cd"; it -> cg.display = 'Palliative referral source' "dsp"; } "coding"; it -> cc.text = 'Referral detail' "codeText"; } "code"; it.answer first as a then { a.value as txt -> obs.note as n, n.text = txt "text"; }; } "narr_palliative_referral_source"; } "referralGroup"; // ── The problem and action plan ───────────────────────────────────────── // One CarePlan, with a row per problem. Each row becomes an activity whose // display is the problem and whose progress note is the action -- the plan is // the deliverable of a palliative assessment, and the ward picks it up from // there rather than from the assessment narrative. // Guarded on at least one problem row: a CarePlan with no activities is a // plan nobody made. qr where (item.where(linkId = 'problem').item.where(linkId = 'problem/description').answer.value.exists()) -> bundle.entry as entry, entry.resource = create('CarePlan') as plan then { qr -> plan, entry then BuildCarePlanBase(qr, plan, entry) "base"; qr -> plan.status = 'active' "status"; qr -> plan.intent = 'plan' "intent"; qr -> plan.title = 'Palliative care plan' "title"; qr.authored as t -> plan.created = t "created"; qr.encounter as e -> plan.encounter = e; qr.source as src -> plan.custodian = src "custodian"; qr -> plan.category as cat then { qr -> cat.coding as cg then { qr -> cg.system = 'https://fhir.slade360.co.ke/fhir/CodeSystem/concept-codesystem' "sys"; qr -> cg.code = 'palliative-problem' "cd"; qr -> cg.display = 'Palliative care problem' "dsp"; } "coding"; } "category"; qr.item as g where (linkId = 'problem') then { g.item as it where ((linkId = 'problem/description') and answer.value.exists()) -> plan.activity as act then { it.answer first as a then { a.value as txt -> act.plannedActivityReference = create('Reference') as ref, ref.display = txt "problemDisplay"; }; } "problemRow"; g.item as it where ((linkId = 'problem/action-plan') and answer.value.exists()) then { it.answer first as a then { a.value as txt -> plan.note as n, n.text = txt "actionNote"; }; } "actionRow"; } "problemRows"; } "palliativeCarePlan"; } // ───────────────────────────────────────────────────────────────────────────── // 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 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"; } 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 BuildConditionBase(source qr : QR, target r : Condition, target entry) { qr -> r then SetResponseProvenance(qr, r) "responseProvenance"; qr -> r.id = uuid() then SetConditionFullUrl(r, entry) "idAndFullUrl"; qr -> entry.request as request then { qr -> request.method = 'POST' "requestMethod"; qr -> request.url = 'Condition' "requestUrl"; } "entryRequest"; qr.subject as s -> r.subject = s; } group SetConditionFullUrl(source r : Condition, target entry) { r.id as id -> entry.fullUrl = append('https://fhir.slade360.co.ke/fhir/Condition/', id) "assignFullUrl"; } group BuildCarePlanBase(source qr : QR, target r : CarePlan, target entry) { qr -> r then SetResponseProvenance(qr, r) "responseProvenance"; qr -> r.id = uuid() then SetCarePlanFullUrl(r, entry) "idAndFullUrl"; qr -> entry.request as request then { qr -> request.method = 'POST' "requestMethod"; qr -> request.url = 'CarePlan' "requestUrl"; } "entryRequest"; qr.subject as s -> r.subject = s; } group SetCarePlanFullUrl(source r : CarePlan, target entry) { r.id as id -> entry.fullUrl = append('https://fhir.slade360.co.ke/fhir/CarePlan/', id) "assignFullUrl"; } // ── 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 = 'palliative-care-assessment' "provenanceCode"; qr -> t.display = 'Palliative care assessment' "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"; }