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feat: add proficiency and mode to patient language #3083

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feat: add proficiency and mode to patient language #3083

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560bd16
feat: add more details to patient language
BobanL Dec 23, 2024
6a609cd
update fhir converter dockerfile
BobanL Dec 23, 2024
cff9ede
add language proficency to example
BobanL Dec 23, 2024
1bcd2fc
update snapshot
BobanL Dec 23, 2024
df75459
add comment to update snapshot testinmg
BobanL Dec 23, 2024
e43b7db
update test name
BobanL Jan 2, 2025
38068b5
use evaluateValue where possible evaluatePatientLanguage
BobanL Jan 2, 2025
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2 changes: 1 addition & 1 deletion ...ners/ecr-viewer/seed-scripts/baseECR/LA/09f39529-69b8-4937-8e01-596b7e966d87/CDA_eICR.xml
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2 changes: 1 addition & 1 deletion containers/ecr-viewer/src/app/api/fhirPath.yml
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Original file line number Diff line number Diff line change
Expand Up @@ -13,7 +13,7 @@ patientRace: "Bundle.entry.resource.where(resourceType = 'Patient').extension.wh
patientRaceDetailed: "Bundle.entry.resource.where(resourceType = 'Patient').extension.where(url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race').extension.where(url = 'detailed').valueCoding.display"
patientEthnicity: "Bundle.entry.resource.where(resourceType = 'Patient').extension.where(url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity').extension.where(url = 'ombCategory').valueCoding.display"
patientEthnicityDetailed: "Bundle.entry.resource.where(resourceType = 'Patient').extension.where(url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity').extension.where(url = 'detailed').valueCoding.display"
patientLanguage: "Bundle.entry.resource.where(resourceType = 'Patient').communication.first().language.coding.first().display"
patientPreferredCommunication: "Bundle.entry.resource.where(resourceType = 'Patient').communication.where(preferred = true)"
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is preferred always set? or would we want the first as a fallback?

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preferred isn't always set, but the field is called preferred language.

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so if preferred isn't set, we will show no language info at all?

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Yes - as it is we won't display any languages if there are none that are preferred.

@ashton-skylight - Should we display any language if there are no "preferred" languages?

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@ashton-skylight ashton-skylight Jan 3, 2025 •
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@BobanL if there is a language specified (that isn't preferred), we should probably still display it

Would this be possible?

  • If there is a preferred language specified, only display the preferred language
  • If there is not a preferred language specified, display any other languages

patientTribalAffiliation: "Bundle.entry.resource.where(resourceType = 'Patient').extension.where(url='http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-tribal-affiliation-extension').extension.where(url='TribeName').value"
patientEmergencyContact: "Bundle.entry.resource.where(resourceType = 'Patient').contact"

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46 changes: 44 additions & 2 deletions containers/ecr-viewer/src/app/services/evaluateFhirDataService.ts
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Original file line number Diff line number Diff line change
Expand Up @@ -5,9 +5,11 @@ import {
Coding,
Condition,
Encounter,
Extension,
HumanName,
Location,
Organization,
PatientCommunication,
PatientContact,
Practitioner,
PractitionerRole,
Expand Down Expand Up @@ -337,7 +339,7 @@ export const evaluateDemographicsData = (
},
{
title: "Preferred Language",
value: evaluate(fhirBundle, mappings.patientLanguage)[0],
value: evaluatePatientLanguage(fhirBundle, mappings),
},
{
title: "Patient Address",
Expand Down Expand Up @@ -630,7 +632,10 @@ export const evaluateReference = (
* @param path - The path within the resource to extract the value from.
* @returns - The evaluated value as a string.
*/
export const evaluateValue = (entry: Element, path: string | Path): string => {
export const evaluateValue = (
entry: Element | Element[],
path: string | Path,
): string => {
let originalValue = evaluate(entry, path, undefined, fhirpath_r4_model)[0];

let value = "";
Expand Down Expand Up @@ -737,3 +742,40 @@ export const evaluateEncounterDiagnosis = (
.map((condition) => condition.code?.coding?.[0].display)
.join(", ");
};

/**
* Evaluate patient's prefered language
* @param fhirBundle - The FHIR bundle containing resources.
* @param mappings - Path mappings for resolving references.
* @returns String containing language, proficiency, and mode
*/
export const evaluatePatientLanguage = (
fhirBundle: Bundle,
mappings: PathMappings,
) => {
const patientCommunication: PatientCommunication[] = evaluate(
fhirBundle,
mappings.patientPreferredCommunication,
);

const patientProficiencyExtension: Extension[] = evaluate(
patientCommunication,
"extension.where(url = 'http://hl7.org/fhir/StructureDefinition/patient-proficiency')",
);
const patientLanguage: string | undefined = evaluateValue(
patientCommunication,
"language.coding",
);
const languageProficency: string | undefined = evaluateValue(
patientProficiencyExtension,
"extension.where(url = 'level').value",
);
const languageMode: string | undefined = evaluateValue(
patientProficiencyExtension,
"extension.where(url = 'type').value",
);

return [patientLanguage, languageProficency, languageMode]
.filter(Boolean)
.join("\n");
};
37 changes: 36 additions & 1 deletion containers/ecr-viewer/src/app/tests/assets/BundlePatient.json
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Original file line number Diff line number Diff line change
Expand Up @@ -160,6 +160,17 @@
}
],
"communication": [
{
"language": {
"coding": [
{
"system": "urn:ietf:bcp:47",
"code": "es",
"display": "Spanish"
}
]
}
},
{
"language": {
"coding": [
Expand All @@ -169,7 +180,31 @@
"display": "English"
}
]
}
},
"preferred": true,
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/patient-proficiency",
"extension": [
{
"url": "type",
"valueCoding": {
"system": "http://terminology.hl7.org/CodeSystem/v3-LanguageAbilityMode",
"code": "ESP",
"display": "Expressed spoken"
}
},
{
"url": "level",
"valueCoding": {
"system": "http://terminology.hl7.org/CodeSystem/v3-LanguageAbilityProficiency",
"code": "G",
"display": "Good"
}
}
]
}
]
}
]
},
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45 changes: 45 additions & 0 deletions containers/ecr-viewer/src/app/tests/services/evaluateFhirDataServices.test.ts
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Original file line number Diff line number Diff line change
Expand Up @@ -13,6 +13,7 @@ import {
evaluateDemographicsData,
evaluateEncounterCareTeamTable,
evaluateAlcoholUse,
evaluatePatientLanguage,
} from "@/app/services/evaluateFhirDataService";
import { Bundle, Patient } from "fhir/r4";
import BundleWithMiscNotes from "@/app/tests/assets/BundleMiscNotes.json";
Expand Down Expand Up @@ -538,3 +539,47 @@ describe("Evaluate Alcohol Use", () => {
expect(actual).toEqual("");
});
});

describe("Evaluate Patient language", () => {
it("Should display language, proficiency, and mode", () => {
const actual = evaluatePatientLanguage(
BundleWithPatient as unknown as Bundle,
mappings,
);

expect(actual).toEqual("English\nGood\nExpressed spoken");
});

it("Should not display non-preferred language", () => {
const patient = {
resourceType: "Bundle",
entry: [
{
resource: {
resourceType: "Patient",
communication: [
{
language: {
coding: [
{
system: "urn:ietf:bcp:47",
code: "es",
display: "Spanish",
},
],
},
},
],
},
},
],
};

const actual = evaluatePatientLanguage(
patient as unknown as Bundle,
mappings,
);

expect(actual).toEqual("");
});
});
2 changes: 1 addition & 1 deletion containers/fhir-converter/Dockerfile
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Original file line number Diff line number Diff line change
@@ -1,7 +1,7 @@
FROM mcr.microsoft.com/dotnet/sdk:6.0 AS build

# Download FHIR-Converter
RUN git clone https://github.com/skylight-hq/FHIR-Converter.git --branch v7.0-skylight-18 --single-branch /build/FHIR-Converter
RUN git clone https://github.com/skylight-hq/FHIR-Converter.git --branch boban/patient-proficency --single-branch /build/FHIR-Converter
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TODO: update to released before merging


WORKDIR /build/FHIR-Converter

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1 change: 1 addition & 0 deletions containers/fhir-converter/README.md
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Expand Up @@ -176,6 +176,7 @@ Both repos should be checked out and set up per the instructions above. We use r
#### Tips & Tricks

* To run the service tests, use the command `python -m pytest` (make sure the correct environment is activated).
* To update snapshots run `python -m pytest --snapshot-update`
* Make sure your docker image has pulled in the latest changes by building with no cache `make build-image-no-cache`.
* To run the tool tests, run the commands found in the github actions workflow.

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30 changes: 30 additions & 0 deletions containers/fhir-converter/tests/integration/__snapshots__/test_FHIR-Converter.ambr
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Expand Up @@ -609,6 +609,21 @@
'birthDate': '2005-05-01',
'communication': list([
dict({
'extension': list([
dict({
'extension': list([
dict({
'url': str,
'valueCoding': dict({
'code': 'ESP',
'display': 'Expressed spoken',
'system': 'http://terminology.hl7.org/CodeSystem/v3-LanguageAbilityMode',
}),
}),
]),
'url': str,
}),
]),
'language': dict({
'coding': list([
dict({
Expand Down Expand Up @@ -2494,6 +2509,21 @@
'birthDate': '1977-03-25',
'communication': list([
dict({
'extension': list([
dict({
'extension': list([
dict({
'url': str,
'valueCoding': dict({
'code': 'EWR',
'display': 'Expressed written',
'system': 'http://terminology.hl7.org/CodeSystem/v3-LanguageAbilityMode',
}),
}),
]),
'url': str,
}),
]),
'language': dict({
'coding': list([
dict({
Expand Down
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