const mongoose = require('mongoose/browser'); const Code = require('./basetypes/Code'); const Interval = require('./basetypes/Interval'); const Quantity = require('./basetypes/Quantity'); const DateTime = require('./basetypes/DateTime'); const AllDataElements = require('./AllDataElements'); const [Schema, Number, String, Mixed] = [ mongoose.Schema, mongoose.Schema.Types.Number, mongoose.Schema.Types.String, mongoose.Schema.Types.Mixed, ]; const QDMPatientSchema = new Schema({ birthDatetime: DateTime, qdmVersion: { type: String, default: '5.6' }, // These are the "data criteria", or QDM datatype elements that exist on a // patient. dataElements: [], // This field is for application specific information only. If both Bonnie // Cypress use a common field, it should be made a field on this model, // and not put into extendedData. extendedData: { type: Mixed, default: {}, }, }, { id: false }); // After initialization of a Patient model, initialize every individual data element // to its respective Mongoose Model QDMPatientSchema.methods.initializeDataElements = function initializeDataElements() { let typeStripped; const dataElementsInit = []; this.dataElements.forEach((element) => { typeStripped = element._type.replace(/QDM::/, ''); dataElementsInit.push(new AllDataElements[typeStripped](element)); }); this.set({ dataElements: dataElementsInit }); }; QDMPatientSchema.methods.id = function id() { return this._id; }; // Returns an array of elements that exist on this patient, that // match the given HQMF data criteria OID. QDMPatientSchema.methods.getByHqmfOid = function getByHqmfOid(hqmfOid) { return this.dataElements.filter(element => element.hqmfOid === hqmfOid); }; // Returns an array of elements that exist on this patient, that // match the given QRDA data criteria OID. QDMPatientSchema.methods.getByQrdaOid = function getByQrdaOid(qrdaOid) { return this.dataElements.filter(element => element.qrdaOid === qrdaOid); }; // Returns an array of elements that exist on this patient. Optionally // takes a qdmCategory, which returns all elements of that QDM qdmCategory. // Example: patient.getDataElements({qdmCategory: 'encounters'}) will return // all Encounter QDM data types active on the patient. QDMPatientSchema.methods.getDataElements = function getDataElements(params) { if (params !== undefined && params.qdmCategory !== undefined && params.qdmStatus !== undefined) { return this.dataElements.filter(element => (element.qdmCategory === params.qdmCategory) && (element.qdmStatus === params.qdmStatus)); } else if (params !== undefined && params.qdmCategory !== undefined) { return this.dataElements.filter(element => element.qdmCategory === params.qdmCategory); } return this.dataElements; }; // Returns an array of dataElements that exist on the patient, queried by // QDM profile // @param {string} profile - the data criteria requested by the execution engine // @param {boolean} isNegated - whether dataElements should be returned based on their negation status // @returns {DataElement[]} QDMPatientSchema.methods.getByProfile = function getByProfile(profile, isNegated = null) { // If isNegated == true, only return data elements with a negationRationale that is not null. // If isNegated == false, only return data elements with a null negationRationale. // If isNegated == null, return all matching data elements by type, regardless of negationRationale. const results = this.dataElements.filter(element => (element._type === `QDM::${profile}` || element._type === profile) && (isNegated === null || !!element.negationRationale === isNegated)); return results.map((result) => { const removedMongooseItems = new AllDataElements[profile](result).toObject({ virtuals: true }); // toObject() will remove all mongoose functions but also remove the schema methods, so we add them back Object.entries(result.schema.methods).forEach(([method_name, method]) => { removedMongooseItems[method_name] = method; }); return removedMongooseItems; }); }; // This method is called by the CQL execution engine on a CQLPatient when // the execution engine wants information on a record. A record could be patient // characteristic information about the patient, or it could be data criteria // that currently exist on this patient (data criteria you drag on a patient // in Bonnie patient builder). // @param {String} profile - the data criteria requested by the execution engine // @returns {Object} QDMPatientSchema.methods.findRecords = function findRecords(profile) { // Clear profile cache for this patient if there is no cache or the patient has changed if (QDMPatientSchema.dataElementCache == null || QDMPatientSchema.dataElementCachePatientId !== this._id) { QDMPatientSchema.dataElementCache = {}; QDMPatientSchema.dataElementCachePatientId = this._id; } // If there is a cache 'hit', return it if (Object.prototype.hasOwnProperty.call(QDMPatientSchema.dataElementCache, profile)) { return QDMPatientSchema.dataElementCache[profile]; } let profileStripped; if (profile === 'Patient') { // Requested generic patient info const info = { birthDatetime: this.birthDatetime }; QDMPatientSchema.dataElementCache[profile] = [info]; return [info]; } else if (/PatientCharacteristic/.test(profile)) { // Requested a patient characteristic profileStripped = profile.replace(/ *\{[^)]*\} */g, ''); QDMPatientSchema.dataElementCache[profile] = this.getByProfile(profileStripped); return QDMPatientSchema.dataElementCache[profile]; } else if (profile != null) { // Requested something else (probably a QDM data type). // Strip model details from request. The requested profile string contains // a lot of things we do not need or care about. Example, we might see // something like: // "{urn:healthit-gov:qdm:v5_0_draft}PatientCharacteristicEthnicity" // Where we only care about: "PatientCharacteristicEthnicity". profileStripped = profile.replace(/ *\{[^)]*\} */g, ''); // Check and handle negation status if (/Positive/.test(profileStripped)) { profileStripped = profileStripped.replace(/Positive/, ''); // Since the data criteria is 'Positive', it is not negated. QDMPatientSchema.dataElementCache[profile] = this.getByProfile(profileStripped, false); return QDMPatientSchema.dataElementCache[profile]; } else if (/Negative/.test(profileStripped)) { profileStripped = profileStripped.replace(/Negative/, ''); // Since the data criteria is 'Negative', it is negated. QDMPatientSchema.dataElementCache[profile] = this.getByProfile(profileStripped, true); return QDMPatientSchema.dataElementCache[profile]; } // No negation status, proceed normally QDMPatientSchema.dataElementCache[profile] = this.getByProfile(profileStripped); return QDMPatientSchema.dataElementCache[profile]; } return []; }; QDMPatientSchema.methods.adverse_events = function adverse_events() { return this.getDataElements({ qdmCategory: 'adverse_event' }); }; QDMPatientSchema.methods.allergies = function allergies() { return this.getDataElements({ qdmCategory: 'allergy' }); }; QDMPatientSchema.methods.assessments = function assessments() { return this.getDataElements({ qdmCategory: 'assessment' }); }; QDMPatientSchema.methods.care_experiences = function care_experiences() { return this.getDataElements({ qdmCategory: 'care_experience' }); }; QDMPatientSchema.methods.care_goals = function care_goals() { return this.getDataElements({ qdmCategory: 'care_goal' }); }; QDMPatientSchema.methods.communications = function communications() { return this.getDataElements({ qdmCategory: 'communication' }); }; QDMPatientSchema.methods.conditions = function conditions() { return this.getDataElements({ qdmCategory: 'condition' }); }; QDMPatientSchema.methods.devices = function devices() { return this.getDataElements({ qdmCategory: 'device' }); }; QDMPatientSchema.methods.diagnostic_studies = function diagnostic_studies() { return this.getDataElements({ qdmCategory: 'diagnostic_study' }); }; QDMPatientSchema.methods.encounters = function encounters() { return this.getDataElements({ qdmCategory: 'encounter' }); }; QDMPatientSchema.methods.family_history = function family_history() { return this.getDataElements({ qdmCategory: 'family_history' }); }; QDMPatientSchema.methods.functional_statuses = function functional_statuses() { return this.getDataElements({ qdmCategory: 'functional_status' }); }; QDMPatientSchema.methods.immunizations = function immunizations() { return this.getDataElements({ qdmCategory: 'immunization' }); }; QDMPatientSchema.methods.interventions = function interventions() { return this.getDataElements({ qdmCategory: 'intervention' }); }; QDMPatientSchema.methods.laboratory_tests = function laboratory_tests() { return this.getDataElements({ qdmCategory: 'laboratory_test' }); }; QDMPatientSchema.methods.medical_equipment = function medical_equipment() { return this.getDataElements({ qdmCategory: 'medical_equipment' }); }; QDMPatientSchema.methods.medications = function medications() { return this.getDataElements({ qdmCategory: 'medication' }); }; QDMPatientSchema.methods.patient_characteristics = function patient_characteristics() { return this.getDataElements({ qdmCategory: 'patient_characteristic' }); }; QDMPatientSchema.methods.physical_exams = function physical_exams() { return this.getDataElements({ qdmCategory: 'physical_exam' }); }; QDMPatientSchema.methods.preferences = function preferences() { return this.getDataElements({ qdmCategory: 'preference' }); }; QDMPatientSchema.methods.procedures = function procedures() { return this.getDataElements({ qdmCategory: 'procedure' }); }; QDMPatientSchema.methods.results = function results() { return this.getDataElements({ qdmCategory: 'result' }); }; QDMPatientSchema.methods.risk_category_assessments = function risk_category_assessments() { return this.getDataElements({ qdmCategory: 'risk_category_assessment' }); }; QDMPatientSchema.methods.social_history = function social_history() { return this.getDataElements({ qdmCategory: 'social_history' }); }; QDMPatientSchema.methods.substances = function substances() { return this.getDataElements({ qdmCategory: 'substance' }); }; QDMPatientSchema.methods.symptoms = function symptoms() { return this.getDataElements({ qdmCategory: 'symptom' }); }; QDMPatientSchema.methods.system_characteristics = function system_characteristics() { return this.getDataElements({ qdmCategory: 'system_characteristic' }); }; QDMPatientSchema.methods.transfers = function transfers() { return this.getDataElements({ qdmCategory: 'transfer' }); }; QDMPatientSchema.methods.vital_signs = function vital_signs() { return this.getDataElements({ qdmCategory: 'vital_sign' }); }; QDMPatientSchema.clearDataElementCache = function clearDataElementCache() { QDMPatientSchema.dataElementCachePatientId = null; QDMPatientSchema.dataElementCache = null; }; module.exports.QDMPatientSchema = QDMPatientSchema; class QDMPatient extends mongoose.Document { constructor(object) { super(object, QDMPatientSchema); this.initializeDataElements(); } } module.exports.QDMPatient = QDMPatient;