Generated Narrative: StructureMap ExtractPsychologicalReview

/// url = 'https://fhir.slade360.co.ke/fhir/StructureMap/ExtractPsychologicalReview'
/// name = 'ExtractPsychologicalReview'
/// title = ' Review Extraction'
/// status = 'active'
/// description = 'A SOAP note extracts as a ClinicalImpression whose summary is the assessment -- that is what ClinicalImpression.summary is for -- with the subjective and objective sections as Observations under LOINC 61150-9 and 61149-1 that the impression names in supportingInfo, and the plan as a CarePlan. Four resources rather than one narrative, because the point of SOAP is that a reader can find the assessment without reading the subjective account first, and because a plan a counsellor set at session four is a thing the next session has to review. LOINC has Subjective and Objective Narrative but no plain Assessment or Plan term, so those two carry local concept codes.'

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/ClinicalImpression" alias ClinicalImpression as target
uses "http://hl7.org/fhir/StructureDefinition/CarePlan" alias CarePlan as target

group ExtractPsychologicalReview(source qr : QR, target bundle : Bundle) {
  qr -> bundle.type = 'transaction' "setBundleType";
  qr.item as g where (linkId = 'session') then {
    qr ->  bundle.entry as entry,  entry.resource = create('ClinicalImpression') as ci then {
      qr ->  ci,  entry then BuildClinicalImpressionBase(qr, ci, entry) "base";
      qr -> ci.status = 'completed' "status";
      qr.encounter as e -> ci.encounter = e;
      qr.authored as t -> ci.date = t "date";
      qr -> ci.description = 'Psychological review, counselling session' "description";
      // The counsellor is the performer, from the form's own signature line
      // rather than from qr.source: the person who keys a session note in is
      // not necessarily the person who held the session.
      g.item as it where ((linkId = 'session/counsellor') and answer.value.exists()) then {
        it.answer first as a then {
          a.value as ref -> ci.performer = ref "performer";
        };
      } "counsellorRule";
      // Effective time is the session date. A note written up a week later is
      // still a note about that session.
      g.item as it where ((linkId = 'session/date') and answer.value.exists()) then {
        it.answer first as a then {
          a.value as v -> ci.effective = cast(v, 'dateTime') "effective";
        };
      } "sessionDateRule";
      g.item as it where ((linkId = 'session/designation') and answer.value.exists()) then {
        it.answer first as a then {
          a.value as txt ->  ci.note as n,  n.text = txt "designationNote";
        };
      } "designationRule";
      g.item as it where ((linkId = 'session/ward-or-clinic') and answer.value.exists()) then {
        it.answer first as a then {
          a.value as txt ->  ci.note as n,  n.text = txt "wardNote";
        };
      } "wardRule";
      // The assessment as the impression's summary. This is the one section
      // with a native home on the resource, and putting it anywhere else would
      // leave ClinicalImpression.summary empty on an impression.
      qr.item as it where ((linkId = 'assessment') and answer.value.exists()) then {
        it.answer first as a then {
          a.value as txt -> ci.summary = txt "summary";
        };
      } "assessmentRule";
      // The subjective and objective sections, created here so the impression
      // can name them. A reference to a resource created in a sibling rule is
      // not reachable -- the target variable does not exist there -- so they
      // have to be built inside this rule.
      qr.item as it where ((linkId = 'subjective') and answer.value.exists()) ->  bundle.entry as sentry,  sentry.resource = create('Observation') as sobs then {
        qr ->  sobs,  sentry then BuildObsBase(qr, sobs, sentry) "base";
        qr -> sobs then SetSurveyCategory(qr, sobs) "category";
        it -> sobs.code as scc then {
          it -> scc.coding as scg then {
            it -> scg.system = 'http://loinc.org' "sys";
            it -> scg.code = '61150-9' "cd";
            it -> scg.display = 'Subjective Narrative' "dsp";
          } "coding";
          it -> scc.text = 'What the client reported at this session' "codeText";
        } "code";
        it.answer first as a then {
          a.value as txt ->  sobs.note as n,  n.text = txt "text";
        };
        it ->  ci.supportingInfo = create('Reference') as sref,  sref.reference = reference(sobs) "linkSupporting";
      } "soap_subjective";
      qr.item as it where ((linkId = 'objective') and answer.value.exists()) ->  bundle.entry as sentry,  sentry.resource = create('Observation') as sobs then {
        qr ->  sobs,  sentry then BuildObsBase(qr, sobs, sentry) "base";
        qr -> sobs then SetSurveyCategory(qr, sobs) "category";
        it -> sobs.code as scc then {
          it -> scc.coding as scg then {
            it -> scg.system = 'http://loinc.org' "sys";
            it -> scg.code = '61149-1' "cd";
            it -> scg.display = 'Objective Narrative' "dsp";
          } "coding";
          it -> scc.text = 'What the counsellor observed at this session' "codeText";
        } "code";
        it.answer first as a then {
          a.value as txt ->  sobs.note as n,  n.text = txt "text";
        };
        it ->  ci.supportingInfo = create('Reference') as sref,  sref.reference = reference(sobs) "linkSupporting";
      } "soap_objective";
    } "psychologicalImpression";
  } "sessionGroup";
  // ── The session number ──────────────────────────────────────────────────
  // Its own Observation. A counselling episode is a series and "which session
  // was this" is the question every review of that series starts from; there
  // is nowhere on ClinicalImpression that a query would find it.
  qr.item as g where (linkId = 'session') then {
    g.item as it where ((linkId = 'session/number') 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 = 'soap-counselling-session-number' "cd";
          it -> cg.display = 'Counselling session number' "dsp";
        } "coding";
      } "code";
      it.answer first as a then {
        a.value as v -> obs.value = v "set";
      };
    } "measure_soap_component";
  } "sessionNumberGroup";
  // ── The plan ────────────────────────────────────────────────────────────
  // A CarePlan, because what a counsellor agrees at the end of a session is
  // what the next session opens by reviewing. As a note on the impression it
  // would be findable only by reading the last note.
  qr.item as it where ((linkId = 'plan') and answer.value.exists()) ->  bundle.entry as entry,  entry.resource = create('CarePlan') as plan then {
    qr ->  plan,  entry then BuildCarePlanBase(qr, plan, entry) "base";
    it -> plan.status = 'active' "status";
    it -> plan.intent = 'plan' "intent";
    it -> plan.title = 'Plan agreed at psychological review' "title";
    qr.authored as t -> plan.created = t "created";
    qr.encounter as e -> plan.encounter = e;
    it -> plan.category as cat then {
      it -> cat.coding as cg then {
        it -> cg.system = 'http://loinc.org' "sys";
        it -> cg.code = '18776-5' "cd";
        it -> cg.display = 'Plan of care note' "dsp";
      } "coding";
    } "category";
    it.answer first as a then {
      a.value as txt -> plan.description = txt "description";
    };
    qr.item as g where (linkId = 'session') then {
      g.item as c where ((linkId = 'session/counsellor') and answer.value.exists()) then {
        c.answer first as a then {
          a.value as ref -> plan.contributor = ref "contributor";
        };
      } "counsellorRule";
    } "sessionGroupForPlan";
  } "psychologicalPlan";
}

// ─────────────────────────────────────────────────────────────────────────────
// 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 BuildClinicalImpressionBase(source qr : QR, target r : ClinicalImpression, target entry) {
  qr -> r then SetResponseProvenance(qr, r) "responseProvenance";
  qr -> r.id = uuid() then SetClinicalImpressionFullUrl(r, entry) "idAndFullUrl";
  qr -> entry.request as request then {
    qr -> request.method = 'POST' "requestMethod";
    qr -> request.url = 'ClinicalImpression' "requestUrl";
  } "entryRequest";
  qr.subject as s -> r.subject = s;
}

group SetClinicalImpressionFullUrl(source r : ClinicalImpression, target entry) {
  r.id as id -> entry.fullUrl = append('https://fhir.slade360.co.ke/fhir/ClinicalImpression/', 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 = 'psychological-review' "provenanceCode";
      qr -> t.display = 'Psychological review notes' "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";
}