Merge branch 'main' into resource-store-refactor

Dockerfile

@@ -16,4 +16,4 @@ RUN npm run build
 
 RUN cp build/404.html build/index.html
 
-CMD ["sh", "-c", "npm run build && cp build/404.html build/index.html && npm run start"]
+CMD npm run build && cp build/404.html build/index.html && npm run start

default.env

@@ -27,6 +27,12 @@ COMPOSE_FILE=docker-compose.yaml:docker-compose.static-ingress.yaml
 # Fully qualified domain name; used to configure traefik ingress
 # SERVER_NAME=foo.cirg.uw.edu
 
+VITE_VERSION_STRING=
+
+# Debug option for non-prod deployments using /build output
+# (Works best in Chrome)
+# DEBUG=1
+
 ###
 ### Client environment variables:
 ### Variables with VITE_ prefix will be available to the client
@@ -37,6 +43,9 @@ COMPOSE_FILE=docker-compose.yaml:docker-compose.static-ingress.yaml
 VITE_EPIC_CLIENT_ID=
 VITE_CERNER_CLIENT_ID=
 
+# Bearer auth tokens
+VITE_MEDITECH_BEARER_TOKEN=
+
 # HIMSS 2024 only:
 #VITE_EPIC_HIMSS_CLIENT_ID=
 #VITE_ECW_HIMSS_CLIENT_ID=

src/env.d.ts

@@ -5,9 +5,11 @@ interface ImportMetaEnv {
     readonly VITE_ECW_HIMSS_CLIENT_ID: string
     readonly VITE_EPIC_CLIENT_ID: string
     readonly VITE_CERNER_CLIENT_ID: string
+    readonly VITE_MEDITECH_BEARER_TOKEN: string
     readonly VITE_API_BASE: string
     readonly VITE_VIEWER_BASE: string
     readonly VITE_INTERMEDIATE_FHIR_SERVER_BASE: string
+    readonly VITE_VERSION_STRING: string
     readonly DEV_SERVER_PORT: number
 }
 

src/lib/FetchAD.svelte

@@ -9,8 +9,8 @@
     Spinner
   } from 'sveltestrap';
   import { createEventDispatcher } from 'svelte';
-  import type { ResourceRetrieveEvent } from './types';
-  import type { Attachment, DocumentReference } from 'fhir/r4';
+  import type { DocumentReferencePOLST, ResourceRetrieveEvent } from './types';
+  import type { Attachment, BundleEntry, CodeableConcept, Resource, ServiceRequest } from 'fhir/r4';
 
   export let sectionKey: string = "Advance Directive";
 
@@ -258,6 +258,22 @@
     }
   }
 
+  async function fetchResourceByUrl(url: string) {
+    let result = await fetch(url, {
+        method: 'GET',
+        headers: { accept: 'application/json' }
+      }).then(function (response: any) {
+        if (!response.ok) {
+          // make the promise be rejected if we didn't get a 2xx response
+          //throw new Error('Unable to fetch ', { cause: response });
+          console.error(`Failed to fetch resource from ${url}`);
+        } else {
+          return response;
+        }
+      });
+    return result;
+  }
+
   async function prepareIps() {
     fetchError = '';
     processing = true;
@@ -269,23 +285,113 @@
       content = await contentResponse.json();
       hostname = sources[selectedSource].url;
       processing = false;
-      let resources = content.entry ? content.entry.map((e) => {
+      let resources: Array<DocumentReferencePOLST> = content.entry ? content.entry.map((e: BundleEntry) => {
         return e.resource;
       }) : [];
       if (resources.length === 0) {
         console.warn("No advance directives found for patient "+patient.id);
       }
 
-      // If resource.category doesn't exist, ignore the DR - DR's w/out that are simply signature DR's.
-      // Lambda function to check if resource.category exists
-      const nonSignatureDR = (dr: DocumentReference) => dr.category !== undefined;
-      // Filter out resources that don't have a category
+      // Filter out DR's with 'status' == 'superseded'. In May '24 we included these,
+      // but they are just noise since IPS doesn't want to address the complexity of
+      // showing these in the UI behind something like a "history" element.
+      // Lambda function to check this:
+      const nonSupersededDR = (dr: DocumentReferencePOLST) => dr.status !== 'superseded';
+      // Filter out signature resources
+      resources = resources.filter(nonSupersededDR);
+
+      // Iterate over DR's that are for signatures.
+      // Get the date from when it was signed, and show that in the card for the DocumentReference
+      // that it applies to.
+      // That date will be in content.attachment.creation (Lisa to add the evening of 2024-07-17).
+      resources.forEach((dr: DocumentReferencePOLST) => {
+        if (dr.relatesTo && dr.relatesTo[0] && dr.relatesTo[0].code && dr.relatesTo[0].code == 'signs'
+          && dr.relatesTo[0].target && dr.relatesTo[0].target.reference) {
+          // e.g. "DocumentReference/9fad9465-5c95-49cf-a8ff-c3b8d782894d"
+          let target = dr.relatesTo[0].target.reference;
+          target = target.substring(18);
+          let pdfSignDate = '(missing from content.attachment.creation in signature DocumentReference)'; // placeholder until Lisa's change
+          if (dr.content && dr.content[0] && dr.content[0].attachment && dr.content[0].attachment.creation){
+            pdfSignDate = dr.content[0].attachment.creation;
+          }
+          let resourceSigned = resources.find((item) => item.id == target);
+          if (resourceSigned) {
+            resourceSigned.pdfSignedDate = pdfSignDate; // pdfSignedDate is an ad-hoc property name
+          }
+        }
+      });
+
+      // July '24: unlike the May '24 connectathon, signature DR's now have resource.category defined.
+      // The ADI team is planning to add a code for these later, but for the time being they suggest
+      // that we identify these by: "description": "JWS of the FHIR Document",
+      // FIXME may be better to do this when we iterate for the TODO above.
+      const nonSignatureDR = (dr: DocumentReferencePOLST) => dr.description !== 'JWS of the FHIR Document';
+      // Filter out signature resources
       resources = resources.filter(nonSignatureDR);
 
       // if one of the DR's `content` elements has attachment.contentType = 'application/pdf', download if possible, put base64 of pdf in DR.content.attachment.data
-      const hasPdfContent = (dr: DocumentReference) => dr.content && dr.content.some(content => content.attachment && content.attachment.contentType === 'application/pdf' && !content.attachment.data);
+      const hasPdfContent = (dr: DocumentReferencePOLST) => dr.content && dr.content.some(content => content.attachment && content.attachment.contentType === 'application/pdf' && !content.attachment.data);
+
+      // if one of the DR's
+      const isPolst = (dr: DocumentReferencePOLST) => dr.type && dr.type.coding && dr.type.coding.some(coding => coding.system === 'http://loinc.org' && coding.code === '100821-8');
+
+      resources.forEach(async (dr: DocumentReferencePOLST) => {
+        // If this DR is a POLST, add the following chain of queries:
+        if (isPolst(dr)){
+          dr.isPolst = true;
+          // In the POLST find the content[] with format.code = "urn:hl7-org:pe:adipmo-structuredBody:1.1" (ADIPMO Structured Body Bundle),
+          const contentAdipmoBundleRef = dr.content.find(content => content.format && content.format.code && content.format.code === 'urn:hl7-org:pe:adipmo-structuredBody:1.1' && content.attachment && content.attachment.url && content.attachment.url.includes('Bundle'));
+          // look in that content's attachment.url, that will point at a Bundle (e.g. https://qa-rr-fhir2.maxmddirect.com/Bundle/10f4ff31-2c24-414d-8d70-de3a86bed808?_format=json)
+          const adipmoBundleUrl = contentAdipmoBundleRef?.attachment.url;
+          if (adipmoBundleUrl) {
+            // Pull that Bundle.
+            let adipmoBundle = await fetchResourceByUrl(adipmoBundleUrl);
+            let adipmoBundleJson = await adipmoBundle.json();
+
+            let serviceRequests = adipmoBundleJson.entry.filter((entry:BundleEntry) => entry.resource?.resourceType === 'ServiceRequest');
+
+            // TODO The next 4 sections should be generalized into an iteration, just need carve out for "detail" for 2.
+
+            // That bundle will include ServiceRequest resources; look for the one for CPR (loinc 100822-6) 
+            const serviceRequestCpr = serviceRequests.find((resource: ServiceRequest) => {
+              return resource.category?.[0].coding?.[0].code === '100822-6';
+            });
+            dr.isCpr = serviceRequestCpr !== undefined;
+            dr.doNotPerformCpr = serviceRequestCpr.resource.doNotPerform;
+
+            // That bundle will include ServiceRequest resources; look for the one for "Initial portable medical treatment orders" (loinc 100823-4) aka Comfort Treatments
+            const serviceRequestComfortTreatments = serviceRequests.find((resource: ServiceRequest) => {
+              return resource.category?.[0].coding?.[0].code === '100823-4';
+            });
+            dr.isComfortTreatments = false;
+            if (serviceRequestComfortTreatments !== undefined) dr.isComfortTreatments = true;
+            dr.doNotPerformComfortTreatments = serviceRequestComfortTreatments.resource.doNotPerform && serviceRequestComfortTreatments.resource.doNotPerform == true;
 
-      resources.forEach(async (dr: DocumentReference) => {
+            dr.detailComfortTreatments = serviceRequestComfortTreatments.resource.note[0].text;
+
+            // That bundle will include ServiceRequest resources; look for the one for "Additional..." (loinc 100824-2)
+            const serviceRequestAdditionalTx = serviceRequests.find((resource: ServiceRequest) => {
+              return resource.category?.[0].coding?.[0].code === '100824-2';
+            });
+            dr.isAdditionalTx = false;
+            if (serviceRequestAdditionalTx !== undefined) dr.isAdditionalTx = true;
+            dr.doNotPerformAdditionalTx = serviceRequestAdditionalTx.resource.doNotPerform && serviceRequestAdditionalTx.resource.doNotPerform == true;
+
+            dr.detailAdditionalTx = serviceRequestAdditionalTx.resource.orderDetail[0].text;
+
+            // That bundle will include ServiceRequest resources; look for the one for "Medically assisted nutrition orders" (loinc 100825-9)
+            const serviceRequestMedicallyAssisted = serviceRequests.find((resource: ServiceRequest) => {
+              return resource.category?.[0].coding?.[0].code === '100825-9';
+            });
+            dr.isMedicallyAssisted = false;
+            if (serviceRequestMedicallyAssisted !== undefined) dr.isMedicallyAssisted = true;
+            dr.doNotPerformMedicallyAssisted = serviceRequestMedicallyAssisted.resource.doNotPerform && serviceRequestMedicallyAssisted.resource.doNotPerform == true;
+
+            dr.detailMedicallyAssisted = serviceRequestMedicallyAssisted.resource.orderDetail[0].text;
+          }
+        }
+      });
+      resources.forEach(async (dr: DocumentReferencePOLST) => {
         if (hasPdfContent(dr)) {
           const pdfContent = dr.content.find(content => content.attachment && content.attachment.contentType === 'application/pdf');
           if (pdfContent && pdfContent.attachment && pdfContent.attachment.url) {

src/lib/FetchTEFCA.svelte

@@ -17,15 +17,16 @@
   const resourceDispatch = createEventDispatcher<{ 'update-resources': ResourceRetrieveEvent }>();
 
   let sources = {
-    Meld: {selected: false, destination: "Meld", url: "https://gw.interop.community/HeliosConnectathonSa/open"},
+    MeldOpen: {selected: false, destination: "MeldOpen", url: "https://gw.interop.community/HeliosConnectathonSa/open"},
     JMCHelios: {selected: false, destination: "JMCHelios", url: "https://gw.interop.community/JMCHeliosSTISandbox/open"},
-    PublicHapi: {selected: false, destination: "PublicHapi", url: "http://hapi.fhir.org/baseR4"},
+    // Patient no longer exists
+    // PublicHapi: {selected: false, destination: "PublicHapi", url: "http://hapi.fhir.org/baseR4"},
     OpenEpic: {selected: false, destination: "OpenEpic", url: ""},
     CernerHelios: {selected: false, destination: "CernerHelios", url: ""}
   }
 
   let baseUrl = "https://concept01.ehealthexchange.org:52780/fhirproxy/r4";
-  let selectedSource = "Meld";
+  let selectedSource = "MeldOpen";
   let method = 'destination'; // url or destination
   let processing = false;
   let fetchError = '';
@@ -74,7 +75,7 @@
       zip = '';
       phone = '';
       gender = '';
-      if (selectedSource === 'Meld') {
+      if (selectedSource === 'MeldOpen') {
         last = "BLACKSTONE";
         first = "VERONICA";
         gender = "Female";
@@ -95,6 +96,7 @@
         gender = "Female";
         dob = "2023-08-29";
       } else if (selectedSource === 'PublicHapi') {
+        // Patient/test data no longer available
         last = "Sanity";
         first = "TestforPatientR4";
         gender = "Male";
@@ -107,7 +109,7 @@
 
   $: {
     if (method) {
-      if (method === 'url' && selectedSource &&sources[selectedSource].url === "") {
+      if (method === 'url' && selectedSource && sources[selectedSource].url === "") {
         selectedSource = "";
       }
     }
@@ -191,9 +193,9 @@
     if (method === 'url') {
       url = sources[selectedSource].url;
     } else if (method === 'destination') {
-      headers['X-Request-Id'] = '5c92758f-79c8-4137-b104-9c0064205407',
-      headers['X-DESTINATION'] = selectedSource,
-      headers['X-POU'] = 'PUBHLTH'
+      headers['X-Request-Id'] = '21143678-7bd5-4caa-bdae-ee35a409d4f2';
+      headers['X-DESTINATION'] = selectedSource;
+      headers['X-POU'] = (selectedSource === 'OpenEpic' ? 'TREAT' : 'PUBHLTH');
     }
     
     let query = buildPatientSearchQuery();
@@ -227,9 +229,9 @@
     if (method === 'url') {
       url = sources[selectedSource].url;
     } else if (method === 'destination') {
-      headers['X-Request-Id'] = '5c92758f-79c8-4137-b104-9c0064205407',
-      headers['X-DESTINATION'] = selectedSource,
-      headers['X-POU'] = 'PUBHLTH'
+      headers['X-Request-Id'] = '21143678-7bd5-4caa-bdae-ee35a409d4f2';
+      headers['X-DESTINATION'] = selectedSource;
+      headers['X-POU'] = (selectedSource === 'OpenEpic' ? 'TREAT' : 'PUBHLTH');
     }
 
     let results = await Promise.allSettled(
@@ -259,7 +261,7 @@
     let resources = resultJson.filter(x => x.status == "fulfilled").map(x => x.value);
     resources = resources.map((r) => {
         if (r.resourceType === "Bundle") {
-          if (r.total == 0) {
+          if (r.total == 0 || !r.entry) {
             return [];
           } else {
             return r.entry.map(e => e.resource);

src/lib/FetchUrl.svelte

@@ -13,7 +13,7 @@
     Row,
     Spinner } from 'sveltestrap';
 
-  import { PATIENT_IPS, EXAMPLE_IPS, IPS_DEFAULT } from './config';
+  import { PATIENT_IPS, EXAMPLE_IPS, IPS_DEFAULT, BEARER_AUTHORIZATION } from './config';
   import type { SHCRetrieveEvent, IPSRetrieveEvent } from './types';
   import { createEventDispatcher } from 'svelte';
 
@@ -53,8 +53,12 @@
     try {
       let content;
       let hostname;
+      let headers: any = { accept: 'application/fhir+json' };
+      if (summaryUrlValidated?.toString().includes('meditech')) {
+        headers['authorization'] = `Bearer ${BEARER_AUTHORIZATION['Meditech']}`
+      }
       const contentResponse = await fetch(summaryUrlValidated!, {
-      headers: { accept: 'application/fhir+json' }
+      headers: headers
       }).then(function(response) {
         if (!response.ok) {
           // make the promise be rejected if we didn't get a 2xx response

src/lib/IPSResourceCollection.ts

@@ -21,6 +21,7 @@ const allowableResourceTypes = [
     'DiagnosticReport',
     'DocumentReference',
     'Encounter',
+    'Flag',
     'Immunization',
     'Location',
     'Media',

src/lib/ResourceSelectorStores.svelte

@@ -17,7 +17,7 @@
     import { ResourceHelper } from './ResourceHelper.js';
     import type { IPSResourceCollection } from './IPSResourceCollection.js';
     import type { IPSRetrieveEvent } from './types.js';
-    import type { CompositionSection } from 'fhir/r4';
+    import type { CompositionSection, BundleEntry } from 'fhir/r4';
 
     import AdvanceDirective from './resource-templates/AdvanceDirective.svelte';
     import AllergyIntolerance from './resource-templates/AllergyIntolerance.svelte';
@@ -137,8 +137,8 @@
         if (content) {
             content = resourceCollection.extendIPS(content);
         }
-        content.entry.map(entry => {
-            if (entry.resource.extension) {
+        content.entry.map((entry: BundleEntry) => {
+            if (entry.resource && 'extension' in entry.resource && entry.resource.extension) {
                 entry.resource.extension = entry.resource.extension.filter(function(item) {
                     return item.url !== "http://hl7.org/fhir/StructureDefinition/narrativeLink";
                 });

src/lib/config.ts

@@ -5,6 +5,8 @@ export const API_BASE = import.meta.env.VITE_API_BASE;
 
 export const INTERMEDIATE_FHIR_SERVER_BASE = import.meta.env.VITE_INTERMEDIATE_FHIR_SERVER_BASE;
 
+export const VERSION_STRING = import.meta.env.VITE_VERSION_STRING;
+
 export const SOF_HOSTS = [
   // {
   //   id: "epic-himss",
@@ -42,6 +44,10 @@ export const SOF_HOSTS = [
     note: "Credentials provided"
   }
 ];
+
+export const BEARER_AUTHORIZATION = {
+  'Meditech': import.meta.env.VITE_MEDITECH_BEARER_TOKEN
+}
 export const SOF_REDIRECT_URI = '/create';
 export const SOF_RESOURCES = [
   'Patient',
@@ -91,12 +97,14 @@ export const VIEWER_BASE = new URL(
   window.location.href
 ).toString();
 export const PATIENT_IPS = {
-  'Dave deBronkart': 'https://fhir.ips-demo.dev.cirg.uw.edu/fhir/Patient/16501/$summary'
+  'Dave deBronkart': 'https://fhir.ips-demo.dev.cirg.uw.edu/fhir/Patient/16501/$summary',
+  'Peter Kieth Jordan': 'https://terminz.azurewebsites.net/fhir/Patient/$summary?profile=http://hl7.org/fhir/uv/ips/StructureDefinition/Bundle-uv-ips&identifier=https://standards.digital.health.nz/ns/nhi-id|NNJ9186&_format=json'
 }
 export const EXAMPLE_IPS = {
   'Maria SEATTLE Gravitate': 'https://fhir.ips-demo.dev.cirg.uw.edu/fhir/Patient/14599/$summary',
   'Martha Mum': 'https://hl7-ips-server.hl7.org/fhir/Patient/15/$summary',
-  'Peter Keith Jones': 'https://fhir.ips-demo.dev.cirg.uw.edu/fhir/Patient/11013/$summary',
+  'Meditech 1': 'https://dev-mtx-interop.meditech.com:443/v2/ips/STU1/Patient/f3b430be-1f8a-53d3-8261-4ffbafa05a61/$summary',
+  // 'Meditech 2': 'https://dev-mtx-interop.meditech.com:443/v2/ips/STU1/Patient/9bad7dc5-47ad-5022-82e7-0cb0aab13ee9/$summary', // Error returned
   'Angela Roster': 'https://fhir.ips-demo.dev.cirg.uw.edu/fhir/Patient/10965/$summary',
   'Horace Skelly': 'https://fhir.ips-demo.dev.cirg.uw.edu/fhir/Patient/11142/$summary',
   'Anonymous': 'https://fhir.ips-demo.dev.cirg.uw.edu/fhir/Patient/10999/$summary',