feat: add marital status and religion (#2975)

* feat: add marital status and religion * test: longer timeout, fix snapshot * feat: plumb through soc-history, clean up use of evaluateValue * fix: handle valueBoolean * test: moar tests * Update containers/ecr-viewer/src/app/tests/utils.test.tsx Co-authored-by: austin-hall-skylight <[email protected]> * fix: update to new release --------- Co-authored-by: austin-hall-skylight <[email protected]>
CDCgov · Dec 4, 2024 · c69e278 · c69e278
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diff --git a/containers/ecr-viewer/src/app/api/fhirPath.yml b/containers/ecr-viewer/src/app/api/fhirPath.yml
@@ -13,18 +13,20 @@ patientRaceDetailed: "Bundle.entry.resource.where(resourceType = 'Patient').exte
 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"
-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.display"
+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"
 
 # Social History
-patientCurrentJobTitle: "Bundle.entry.resource.where(resourceType='Observation').where(meta.profile='http://hl7.org/fhir/us/odh/StructureDefinition/odh-PastOrPresentJob').where(effectivePeriod.end.exists().not()).iif(valueCodeableConcept.coding.display.exists(), valueCodeableConcept.coding.display, valueString)"
-patientTobaccoUse: "Bundle.entry.resource.where(resourceType='Observation').where(code.coding.code='72166-2').where(category.coding.code='social-history').iif(valueCodeableConcept.coding.display.exists(), valueCodeableConcept.coding.display, valueString)"
-patientDisabilityStatus: "Bundle.entry.resource.where(resourceType='Observation').where(meta.profile='http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-disability-status').where(category.coding.code='social-history').iif(valueBoolean.code.coding.display.exists(), valueBoolean.code.coding.display, valueString)"
-patientHomelessStatus: "Bundle.entry.resource.where(resourceType='Observation').where(code.coding.code='75274-1').where(category.coding.code='social-history').iif(valueCodeableConcept.coding.display.exists(), valueCodeableConcept.coding.display, valueString)"
-patientPregnancyStatus: "Bundle.entry.resource.where(resourceType='Observation').where(meta.profile='http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-pregnancy-status-observation').iif(valueCodeableConcept.coding.display.exists(), valueCodeableConcept.coding.display, valueString)"
-patientAlcoholUse: "Bundle.entry.resource.where(resourceType='Observation').where(code.coding.code='11331-6').where(category.coding.code='social-history').iif(valueCodeableConcept.coding.display.exists(), valueCodeableConcept.coding.display, valueString)"
-patientSexualOrientation: "Bundle.entry.resource.where(resourceType='Observation').where(code.coding.code='76690-7').iif(valueCodeableConcept.coding.display.exists(), valueCodeableConcept.coding.display, valueString)"
-patientGenderIdentity: "Bundle.entry.resource.where(resourceType = 'Patient').extension.where(url='http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-genderidentity-extension').extension.iif(valueCodeableConcept.coding.display.exists(), valueCodeableConcept.coding.display, valueString)"
+patientCurrentJobTitle: "Bundle.entry.resource.where(resourceType='Observation').where(meta.profile='http://hl7.org/fhir/us/odh/StructureDefinition/odh-PastOrPresentJob').where(effectivePeriod.end.exists().not()).value"
+patientTobaccoUse: "Bundle.entry.resource.where(resourceType='Observation').where(code.coding.code='72166-2').where(category.coding.code='social-history').value"
+patientDisabilityStatus: "Bundle.entry.resource.where(resourceType='Observation').where(meta.profile='http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-disability-status').where(category.coding.code='social-history').value"
+patientHomelessStatus: "Bundle.entry.resource.where(resourceType='Observation').where(code.coding.code='75274-1').where(category.coding.code='social-history').value"
+patientPregnancyStatus: "Bundle.entry.resource.where(resourceType='Observation').where(meta.profile='http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-pregnancy-status-observation').value"
+patientAlcoholUse: "Bundle.entry.resource.where(resourceType='Observation').where(code.coding.code='11331-6').where(category.coding.code='social-history').value"
+patientSexualOrientation: "Bundle.entry.resource.where(resourceType='Observation').where(code.coding.code='76690-7').value"
+patientGenderIdentity: "Bundle.entry.resource.where(resourceType = 'Patient').extension.where(url='http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-genderidentity-extension').value"
+patientReligion: "Bundle.entry.resource.where(resourceType = 'Patient').extension.where(url='http://hl7.org/fhir/StructureDefinition/patient-religion').value"
+patientMaritalStatus: "Bundle.entry.resource.where(resourceType = 'Patient').maritalStatus"
 
 #eCR Metadata
 eicrIdentifier: "Bundle.entry.resource.where(resourceType= 'Composition').id"

diff --git a/containers/ecr-viewer/src/app/services/evaluateFhirDataService.ts b/containers/ecr-viewer/src/app/services/evaluateFhirDataService.ts
@@ -1,6 +1,7 @@
 import {
   Bundle,
   CodeableConcept,
+  Coding,
   Condition,
   Encounter,
   Location,
@@ -250,6 +251,14 @@ export const evaluateSocialData = (
       title: "Occupation",
       value: evaluateValue(fhirBundle, mappings["patientCurrentJobTitle"]),
     },
+    {
+      title: "Religious Affiliation",
+      value: evaluateValue(fhirBundle, mappings["patientReligion"]),
+    },
+    {
+      title: "Marital Status",
+      value: evaluateValue(fhirBundle, mappings["patientMaritalStatus"]),
+    },
   ];
   return evaluateData(socialData);
 };
@@ -300,7 +309,7 @@ export const evaluateDemographicsData = (
     },
     {
       title: "Tribal Affiliation",
-      value: evaluate(fhirBundle, mappings.patientTribalAffiliation)[0],
+      value: evaluateValue(fhirBundle, mappings.patientTribalAffiliation),
     },
     {
       title: "Preferred Language",
@@ -566,7 +575,7 @@ export const evaluateReference = (
 };
 
 /**
- * Evaluates the FHIR path and returns the appropriate string value. Supports choice elements
+ * Evaluates the FHIR path and returns the appropriate string value. Supports choice elements (e.g. using `.value` in path to get valueString or valueCoding)
  * @param entry - The FHIR resource to evaluate.
  * @param path - The path within the resource to extract the value from.
  * @returns - The evaluated value as a string.
@@ -576,7 +585,11 @@ export const evaluateValue = (entry: Element, path: string | Path): string => {
 
   let value = "";
   const originalValuePath = originalValue?.__path__?.path;
-  if (typeof originalValue === "string" || typeof originalValue === "number") {
+  if (
+    typeof originalValue === "string" ||
+    typeof originalValue === "number" ||
+    typeof originalValue === "boolean"
+  ) {
     value = originalValue.toString();
   } else if (originalValuePath === "Quantity") {
     const data = originalValue as Quantity;
@@ -588,10 +601,15 @@ export const evaluateValue = (entry: Element, path: string | Path): string => {
     value = `${data.value ?? ""}${unit ?? ""}`;
   } else if (originalValuePath === "CodeableConcept") {
     const data = originalValue as CodeableConcept;
-    value = data.coding?.[0].display || data.text || "";
+    value =
+      data.coding?.[0].display || data.text || data.coding?.[0].code || "";
+  } else if (originalValuePath === "Coding") {
+    const data = originalValue as Coding;
+    value = data?.display || data?.code || "";
   } else if (typeof originalValue === "object") {
     console.log(`Not implemented for ${originalValue.__path__}`);
   }
+
   return value.trim();
 };
 

diff --git a/containers/ecr-viewer/src/app/tests/assets/BundlePatient.json b/containers/ecr-viewer/src/app/tests/assets/BundlePatient.json
@@ -98,6 +98,34 @@
                 }
               }
             ]
+          },
+          {
+            "url": "http://hl7.org/fhir/StructureDefinition/patient-religion",
+            "valueCodeableConcept": {
+              "coding": [
+                {
+                  "code": "Baptist",
+                  "system": "urn:oid:2.16.840.1.113883.5.1076"
+                }
+              ]
+            }
+          },
+          {
+            "url": "http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-tribal-affiliation-extension",
+            "extension": [
+              {
+                "url": "TribeName",
+                "valueCoding": {
+                  "code": "91",
+                  "system": "http://terminology.hl7.org/CodeSystem/v3-TribalEntityUS",
+                  "display": "Fort Mojave Indian Tribe of Arizona, California"
+                }
+              },
+              {
+                "url": "EnrolledTribeMember",
+                "valueBoolean": true
+              }
+            ]
           }
         ],
         "address": [
@@ -111,6 +139,15 @@
             "postalCode": "93523-2800"
           }
         ],
+        "maritalStatus": {
+          "coding": [
+            {
+              "code": "M",
+              "system": "urn:oid:2.16.840.1.113883.5.2",
+              "display": "Married"
+            }
+          ]
+        },
         "telecom": [
           {
             "system": "phone",

diff --git a/containers/ecr-viewer/src/app/tests/components/__snapshots__/AccordionContent.test.tsx.snap b/containers/ecr-viewer/src/app/tests/components/__snapshots__/AccordionContent.test.tsx.snap
@@ -682,6 +682,44 @@ exports[`Snapshot test for Accordion Content Given no data, info message for emp
                       class="section__line_gray"
                     />
                   </div>
+                  <div>
+                    <div
+                      class="grid-row"
+                    >
+                      <div
+                        class="data-title padding-right-1"
+                      >
+                        Religious Affiliation
+                      </div>
+                      <div
+                        class="grid-col maxw7 text-pre-line p-list text-italic text-base"
+                      >
+                        No data
+                      </div>
+                    </div>
+                    <div
+                      class="section__line_gray"
+                    />
+                  </div>
+                  <div>
+                    <div
+                      class="grid-row"
+                    >
+                      <div
+                        class="data-title padding-right-1"
+                      >
+                        Marital Status
+                      </div>
+                      <div
+                        class="grid-col maxw7 text-pre-line p-list text-italic text-base"
+                      >
+                        No data
+                      </div>
+                    </div>
+                    <div
+                      class="section__line_gray"
+                    />
+                  </div>
                 </div>
               </div>
               <div

diff --git a/containers/ecr-viewer/src/app/tests/services/evaluateFhirDataServices.test.ts b/containers/ecr-viewer/src/app/tests/services/evaluateFhirDataServices.test.ts
@@ -10,6 +10,7 @@ import {
   evaluateEmergencyContact,
   evaluatePatientAddress,
   evaluatePatientName,
+  evaluateDemographicsData,
 } from "@/app/services/evaluateFhirDataService";
 import { Bundle, Patient } from "fhir/r4";
 import BundleWithMiscNotes from "@/app/tests/assets/BundleMiscNotes.json";
@@ -59,6 +60,7 @@ describe("evaluate value", () => {
           coding: [
             {
               display: "Negative",
+              code: "N",
             },
           ],
         },
@@ -68,6 +70,61 @@ describe("evaluate value", () => {
 
     expect(actual).toEqual("Negative");
   });
+  it("should provide the string in the case of valueCoding", () => {
+    const actual = evaluateValue(
+      {
+        resourceType: "Extension",
+        valueCoding: {
+          display: "Negative",
+          code: "N",
+        },
+      } as any,
+      "value",
+    );
+
+    expect(actual).toEqual("Negative");
+  });
+  it("should provide the string in the case of valueBoolean", () => {
+    const actual = evaluateValue(
+      {
+        resourceType: "Extension",
+        valueBoolean: true,
+      } as any,
+      "value",
+    );
+
+    expect(actual).toEqual("true");
+  });
+  it("should provide the code as a fallback in the case of valueCodeableConcept", () => {
+    const actual = evaluateValue(
+      {
+        resourceType: "Observation",
+        valueCodeableConcept: {
+          coding: [
+            {
+              code: "N",
+            },
+          ],
+        },
+      } as any,
+      "value",
+    );
+
+    expect(actual).toEqual("N");
+  });
+  it("should provide the code as a fallback in the case of valueCoding", () => {
+    const actual = evaluateValue(
+      {
+        resourceType: "Extension",
+        valueCoding: {
+          code: "N",
+        },
+      } as any,
+      "value",
+    );
+
+    expect(actual).toEqual("N");
+  });
   describe("Quantity", () => {
     it("should provide the value and string unit with a space inbetween", () => {
       const actual = evaluateValue(
@@ -125,6 +182,20 @@ describe("Evaluate Patient Ethnicity", () => {
   });
 });
 
+it("should return tribal affiliation if available", () => {
+  const actual = evaluateDemographicsData(
+    BundleWithPatient as unknown as Bundle,
+    mappings,
+  );
+  const ext = actual.availableData.filter(
+    (d) => d.title === "Tribal Affiliation",
+  );
+  expect(ext).toHaveLength(1);
+  expect(ext[0].value).toEqual(
+    "Fort Mojave Indian Tribe of Arizona, California",
+  );
+});
+
 describe("Evaluate Facility Id", () => {
   it("should return the facility id", () => {
     const actual = evaluateFacilityId(

diff --git a/containers/ecr-viewer/src/app/tests/utils.test.tsx b/containers/ecr-viewer/src/app/tests/utils.test.tsx
@@ -64,6 +64,28 @@ describe("Utils", () => {
 
       expect(actual.availableData[0].value).toEqual("Other");
     });
+    it("should return religion if available", () => {
+      const actual = evaluateSocialData(
+        BundleWithPatient as unknown as Bundle,
+        mappings,
+      );
+      const ext = actual.availableData.filter(
+        (d) => d.title === "Religious Affiliation",
+      );
+      expect(ext).toHaveLength(1);
+      expect(ext[0].value).toEqual("Baptist");
+    });
+    it("should return marital status if available", () => {
+      const actual = evaluateSocialData(
+        BundleWithPatient as unknown as Bundle,
+        mappings,
+      );
+      const ext = actual.availableData.filter(
+        (d) => d.title === "Marital Status",
+      );
+      expect(ext).toHaveLength(1);
+      expect(ext[0].value).toEqual("Married");
+    });
   });
 
   describe("Evaluate Clinical Info", () => {

diff --git a/containers/fhir-converter/Dockerfile b/containers/fhir-converter/Dockerfile
@@ -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-13 --single-branch /build/FHIR-Converter
+RUN git clone https://github.com/skylight-hq/FHIR-Converter.git --branch v7.0-skylight-14 --single-branch /build/FHIR-Converter
 
 WORKDIR /build/FHIR-Converter