Add date of death, age at death, detailed ethnicity, and detailed race (

#2786)

containers/ecr-viewer/src/app/api/fhirPath.yml

@@ -12,10 +12,12 @@ patientCounty: "Bundle.entry.resource.where(resourceType = 'Patient').address.fi
 patientIds: "Bundle.entry.resource.where(resourceType = 'Patient').identifier"
 patientDOB: "Bundle.entry.resource.where(resourceType = 'Patient').birthDate"
 patientVitalStatus: "Bundle.entry.resource.where(resourceType = 'Patient').deceasedBoolean"
+patientDOD: "Bundle.entry.resource.where(resourceType = 'Patient').deceasedDate"
 patientGender: "Bundle.entry.resource.where(resourceType = 'Patient').gender"
 patientRace: "Bundle.entry.resource.where(resourceType = 'Patient').extension.where(url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race').extension.where(url = 'ombCategory').valueCoding.display"
-patinetRaceExtension: "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.first().valueCoding.display"
+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"
 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"
 patientEmergencyContact: "Bundle.entry.resource.where(resourceType = 'Patient').contact.first()"

containers/ecr-viewer/src/app/services/evaluateFhirDataService.ts

@@ -50,16 +50,37 @@ export const evaluatePatientRace = (
   mappings: PathMappings,
 ) => {
   const raceCat = evaluate(fhirBundle, mappings.patientRace)[0];
-  const raceDetailedExt =
-    evaluate(fhirBundle, mappings.patinetRaceExtension)[0] ?? "";
+  const raceDetailed =
+    evaluate(fhirBundle, mappings.patientRaceDetailed)[0] ?? "";
 
-  if (raceDetailedExt) {
-    return `${raceCat}, ${raceDetailedExt}`;
+  if (raceDetailed) {
+    return raceCat + "\n" + raceDetailed;
   } else {
     return raceCat;
   }
 };
 
+/**
+ * Evaluates the patients ethnicity from the FHIR bundle and formats for display.
+ * @param fhirBundle - The FHIR bundle containing patient contact info.
+ * @param mappings - The object containing the fhir paths.
+ * @returns - The patient's ethnicity information, including additional ethnicity extension (if available).
+ */
+export const evaluatePatientEthnicity = (
+  fhirBundle: Bundle,
+  mappings: PathMappings,
+) => {
+  const ethnicity = evaluate(fhirBundle, mappings.patientEthnicity)[0] ?? "";
+  const ethnicityDetailed =
+    evaluate(fhirBundle, mappings.patientEthnicityDetailed)[0] ?? "";
+
+  if (ethnicityDetailed) {
+    return ethnicity + "\n" + ethnicityDetailed;
+  } else {
+    return ethnicity;
+  }
+};
+
 /**
  * Evaluates patient address from the FHIR bundle and formats it into structured data for display.
  * @param fhirBundle - The FHIR bundle containing patient contact info.
@@ -157,22 +178,49 @@ const evaluateTravelHistory = (
 };
 
 /**
- * Calculates the age of a patient to a given date or today.
+ * Calculates the age of a patient to a given date or today, unless DOD exists.
  * @param fhirBundle - The FHIR bundle containing patient information.
  * @param fhirPathMappings - The mappings for retrieving patient date of birth.
  * @param [givenDate] - Optional. The target date to calculate the age. Defaults to the current date if not provided.
- * @returns - The age of the patient in years, or undefined if date of birth is not available.
+ * @returns - The age of the patient in years, or undefined if date of birth is not available or if date of death exists.
  */
 export const calculatePatientAge = (
   fhirBundle: Bundle,
   fhirPathMappings: PathMappings,
   givenDate?: string,
 ) => {
   const patientDOBString = evaluate(fhirBundle, fhirPathMappings.patientDOB)[0];
-  if (patientDOBString) {
+  const patientDODString = evaluate(fhirBundle, fhirPathMappings.patientDOD)[0];
+  if (patientDOBString && !patientDODString && !givenDate) {
     const patientDOB = new Date(patientDOBString);
-    const targetDate = givenDate ? new Date(givenDate) : new Date();
-    return dateFns.differenceInYears(targetDate, patientDOB);
+    return dateFns.differenceInYears(new Date(), patientDOB);
+  } else if (patientDOBString && givenDate) {
+    const patientDOB = new Date(patientDOBString);
+    return dateFns.differenceInYears(new Date(givenDate), patientDOB);
+  } else {
+    return undefined;
+  }
+};
+
+/**
+ * Calculates Patient Age at Death if DOB and DOD exist, otherwise returns undefined
+ * @param fhirBundle - The FHIR bundle containing patient information.
+ * @param fhirPathMappings - The mappings for retrieving patient date of birth and date of death.
+ * @returns - The age of the patient at death in years, or undefined if date of birth or date of death is not available.
+ */
+export const calculatePatientAgeAtDeath = (
+  fhirBundle: Bundle,
+  fhirPathMappings: PathMappings,
+) => {
+  const patientDOBString = evaluate(fhirBundle, fhirPathMappings.patientDOB)[0];
+  const patientDODString = evaluate(fhirBundle, fhirPathMappings.patientDOD)[0];
+
+  if (patientDOBString && patientDODString) {
+    const patientDOB = new Date(patientDOBString);
+    const patientDOD = new Date(patientDODString);
+    return dateFns.differenceInYears(patientDOD, patientDOB);
+  } else {
+    return undefined;
   }
 };
 
@@ -247,11 +295,20 @@ export const evaluateDemographicsData = (
       title: "Current Age",
       value: calculatePatientAge(fhirBundle, mappings)?.toString(),
     },
+    {
+      title: "Age at Death",
+      value: calculatePatientAgeAtDeath(fhirBundle, mappings),
+    },
     {
       title: "Vital Status",
-      value: evaluate(fhirBundle, mappings.patientVitalStatus)[0]
-        ? "Deceased"
-        : "Alive",
+      value:
+        evaluate(fhirBundle, mappings.patientVitalStatus)[0] === false
+          ? "Alive"
+          : "Deceased",
+    },
+    {
+      title: "Date of Death",
+      value: evaluate(fhirBundle, mappings.patientDOD)[0],
     },
     { title: "Sex", value: evaluate(fhirBundle, mappings.patientGender)[0] },
     {
@@ -260,7 +317,7 @@ export const evaluateDemographicsData = (
     },
     {
       title: "Ethnicity",
-      value: evaluate(fhirBundle, mappings.patientEthnicity)[0],
+      value: evaluatePatientEthnicity(fhirBundle, mappings),
     },
     {
       title: "Tribal Affiliation",

containers/ecr-viewer/src/app/tests/assets/BundlePatient.json

@@ -65,6 +65,13 @@
                   "display": "Hispanic or Latino"
                 }
               },
+              {
+                "url": "detailed",
+                "valueCoding": {
+                  "code": "2106-3",
+                  "display": "White"
+                }
+              },
               {
                 "url": "text",
                 "valueString": "Hispanic or Latino"

containers/ecr-viewer/src/app/tests/assets/BundlePatientDeceased.json

@@ -0,0 +1,143 @@
+{
+  "resourceType": "Bundle",
+  "type": "batch",
+  "entry": [
+    {
+      "fullUrl": "urn:uuid:6b6b3c4c-4884-4a96-b6ab-c46406839cea",
+      "resource": {
+        "resourceType": "Patient",
+        "id": "6b6b3c4c-4884-4a96-b6ab-c46406839cea",
+        "meta": {
+          "profile": [
+            "http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient"
+          ],
+          "source": [
+            "ecr"
+          ]
+        },
+        "identifier": [
+          {
+            "system": "urn:oid:2.16.840.1.113883.3.3316.100",
+            "value": "10308625"
+          }
+        ],
+        "name": [
+          {
+            "family": "CASTILLO",
+            "given": [
+              "ABEL"
+            ]
+          }
+        ],
+        "birthDate": "2015-04-15",
+        "deceasedBoolean": true,
+        "deceasedDate": "2020-02-27",
+        "gender": "male",
+        "extension": [
+          {
+            "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race",
+            "extension": [
+              {
+                "url": "ombCategory",
+                "valueCoding": {
+                  "code": "2054-5",
+                  "display": "Black or African American"
+                }
+              },
+              {
+                "url": "detailed",
+                "valueCoding": {
+                  "code": "2076-8",
+                  "display": "African"
+                }
+              },
+              {
+                "url": "text",
+                "valueString": "Black or African American"
+              }
+            ]
+          },
+          {
+            "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity",
+            "extension": [
+              {
+                "url": "ombCategory",
+                "valueCoding": {
+                  "code": "2135-2",
+                  "display": "Hispanic or Latino"
+                }
+              },
+              {
+                "url": "detailed",
+                "valueCoding": {
+                  "code": "2106-3",
+                  "display": "White"
+                }
+              },
+              {
+                "url": "text",
+                "valueString": "Hispanic or Latino"
+              }
+            ]
+          },
+          {
+            "url": "http://hl7.org/fhir/us/core/StructureDefinition/us-core-birthsex",
+            "extension": [
+              {
+                "url": "value",
+                "valueCodeableConcept": {
+                  "coding": [
+                    {
+                      "code": "M",
+                      "display": "Male",
+                      "system": "urn:oid:2.16.840.1.113883.5.1"
+                    }
+                  ]
+                }
+              }
+            ]
+          }
+        ],
+        "address": [
+          {
+            "line": [
+              "1050 CARPENTER ST"
+            ],
+            "city": "EDWARDS",
+            "state": "CA",
+            "country": "US",
+            "postalCode": "93523-2800"
+          }
+        ],
+        "telecom": [
+          {
+            "system": "phone",
+            "value": "+18184195968",
+            "use": "home"
+          },
+          {
+            "system": "email",
+            "value": "MELLY.C.A.16@GMAIL.COM"
+          }
+        ],
+        "communication": [
+          {
+            "language": {
+              "coding": [
+                {
+                  "system": "urn:ietf:bcp:47",
+                  "code": "en",
+                  "display": "English"
+                }
+              ]
+            }
+          }
+        ]
+      },
+      "request": {
+        "method": "PUT",
+        "url": "Patient/6b6b3c4c-4884-4a96-b6ab-c46406839cea"
+      }
+    }
+  ]
+}

containers/ecr-viewer/src/app/tests/components/__snapshots__/AccordionContent.test.tsx.snap

@@ -74,7 +74,7 @@ exports[`Snapshot test for Accordion Content Given no data, info message for emp
                   <div
                     class="grid-col maxw7 text-pre-line"
                   >
-                    Alive
+                    Deceased
                   </div>
                 </div>
                 <div
@@ -284,6 +284,44 @@ 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"
+                      >
+                        Age at Death
+                      </div>
+                      <div
+                        class="grid-col maxw7 text-pre-line 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"
+                      >
+                        Date of Death
+                      </div>
+                      <div
+                        class="grid-col maxw7 text-pre-line text-italic text-base"
+                      >
+                        No data
+                      </div>
+                    </div>
+                    <div
+                      class="section__line_gray"
+                    />
+                  </div>
                   <div>
                     <div
                       class="grid-row"

containers/ecr-viewer/src/app/tests/services/evaluateFhirDataServices.test.ts

@@ -4,6 +4,7 @@ import {
   evaluateFacilityId,
   evaluateIdentifiers,
   evaluatePatientRace,
+  evaluatePatientEthnicity,
   evaluatePractitionerRoleReference,
   evaluateReference,
   evaluateValue,
@@ -107,7 +108,17 @@ describe("Evaluate Patient Race", () => {
       BundleWithPatient as unknown as Bundle,
       mappings,
     );
-    expect(actual).toEqual("Black or African American, African");
+    expect(actual).toEqual("Black or African American\nAfrican");
+  });
+});
+
+describe("Evaluate Patient Ethnicity", () => {
+  it("should return ethnicity category and extension if available", () => {
+    const actual = evaluatePatientEthnicity(
+      BundleWithPatient as unknown as Bundle,
+      mappings,
+    );
+    expect(actual).toEqual("Hispanic or Latino\nWhite");
   });
 });