The following Library resources and contained rules constitute examples that show various aspects of rules and intended use. They do not constitute properly tested or production-ready rules, even if they might come close.
Automated Processing Type Library Resource Examples
Common to the Library resource examples is that they have a Library.type set to automated-processing.
In the example descriptions, Coding values have been reduced to the Coding.code element solely for brevity and where there is little if any ambiguity when the reader checks the ValueSet binding of the corresponding element in the profile. As apparent in the actual rule code listings here (which is not normative), Coding values must be specified properly and in accordance with the eHealth Implementation Guide’s General Guidance.
The Fallback Library
Library Triaging Against Reference Ranges
This Library is intended for use with an ActivityDefinition which specifies submitting of an Observation where the submitted Observation.value is to be compared against the reference range(s) defined in the ProcedureRequest associated with the ActivityDefinition.
The Library rule sets up instructions that causes production of a:
a Task with:
.categoryset toMeasurementForAssessment(a Coding signifying a measurement should be assessed/evaluated).priorityset to:routinewhen theObservation.valueis within reference rangeurgentwhen theObservation.valueis outside a “Yellow Alarm” type reference range (if defined) but within a “Red Alarm” type reference range (if defined)asapwhen theObservation.valueis outside the “Red Alarm” type reference range (if defined)
.descriptionset to “Måling til vurdering” which is Danish for measurement to be assessedfurther elements set as described in Output from automated processing
a ClinicalImpression with:
.codeset toTriagingResult.finding.itemCodeableConcept.Codingset to:a Coding signifying a finding that a measurement is within reference range when that is the case
a Coding signifying a finding that a measurement is above reference range when that is the case - this whether above Red Alarm or above Yellow Alarm (but within Red Alarm)
a Coding signifying a finding that a measurement is below reference range when that is the case - this whether below Red Alarm or below Yellow Alarm (but within Red Alarm)
.descriptionset to “Automatisk processering grundet måling modtaget” which is Danish for automated processing due to submitted measurementfurther elements set as described in Output from automated processing
a Communication (of ehealth-message profile) provided that the
Task.priorityis notroutine(that is, when the measurement is outside any reference range) with:.ehealth-restriction-categorythat restricts access for Practitioners to those monitoring measurements.reasonCodeset toMeasurementForAssessment.payload.contentset to “Måling til vurdering” which is Danish for measurement to be assessed (in the Default message)further elements set as described in Output from automated processing
The Library rule (in Library.content.data) is:
package rules
import org.hl7.fhir.dstu3.model.Observation
// additional imports omitted for brevity
global com.systematic.ehealth.automatedprocessing.AutomatedProcessingDTO ruleResult
function CodingDTO withinReferenceRangeCoding() {
// Measurement finding within reference range
return new CodingDTO("http://snomed.info/sct", "442082004", "fund ved måling inden for referenceinterval");
}
function CodingDTO belowReferenceRangeCoding() {
// Measurement finding below reference range
return new CodingDTO("http://snomed.info/sct", "442686002", "fund ved måling under referenceinterval");
}
function CodingDTO aboveReferenceRangeCoding() {
// Measurement finding above reference range
return new CodingDTO("http://snomed.info/sct", "442756004", "fund ved måling over referenceinterval");
}
function CodingDTO redAlarmCoding() {
return new CodingDTO("urn:oid:1.2.208.184.100.1", "RAL", "Terapeutiske grænseværdier for RØD alarm");
}
function CodingDTO yellowAlarmCoding() {
return new CodingDTO("urn:oid:1.2.208.184.100.1", "GAL", "Terapeutiske grænseværdier for GUL alarm");
}
function ClinicalImpressionDTO createClinicalImpression(CodingDTO finding) {
String clinicalImpressionDescription = "Automatisk processering grundet måling modtaget";
CodingDTO clinicalImpressionCode = new CodingDTO("http://ehealth.sundhed.dk/cs/clinicalimpression-codes", "TriagingResult", "Result of triaging");
return new ClinicalImpressionDTO(clinicalImpressionCode, clinicalImpressionDescription, List.of(finding), List.of());
}
function TaskDTO createTask(String taskPriority) {
List<CommunicationDTO> communications = new ArrayList<>();
String description = "Måling til vurdering"; // Need assessment of measurement
CodingDTO taskCategory = new CodingDTO("http://ehealth.sundhed.dk/cs/task-category", "MeasurementForAssessment", "Need assessment of measurement");
if (!taskPriority.equals("routine")) {
CodingDTO communicationRestrictionCategory = new CodingDTO("http://ehealth.sundhed.dk/cs/restriction-category", "measurement-monitoring", "Monitoring of measurement(s)");
communications.add(new CommunicationDTO(taskCategory, description, communicationRestrictionCategory));
}
CodingDTO taskRestrictionCategory = new CodingDTO("http://ehealth.sundhed.dk/cs/restriction-category", "measurement-monitoring", "Monitoring of measurement(s)");
return new TaskDTO(taskCategory, description, taskPriority, List.of(taskRestrictionCategory), communications);
}
function Observation.ObservationReferenceRangeComponent getReferenceRange(Observation obs, CodingDTO code) {
for (Observation.ObservationReferenceRangeComponent r : obs.getReferenceRange()) {
String matchingCode = r.getType().getCoding().stream()
.filter(coding -> coding.getSystem().equals(code.getSystem()))
.filter(coding -> coding.getCode().equals(code.getCode()))
.map(Coding::getCode)
.findFirst()
.orElse(null);
if (matchingCode != null) {
return r;
}
}
return null;
}
rule "ObservationTriageMedcomReferenceRangesRule"
dialect "java"
when
col : Collection()
listObs : ArrayList() from collect (EHealthObservation() from col)
o : EHealthObservation() from listObs.get(0)
then
String priority = "routine";
// Get value from observation
BigDecimal value = ((Quantity)o.getValue()).getValue();
Observation.ObservationReferenceRangeComponent redRefRange = getReferenceRange(o, redAlarmCoding());
if (redRefRange != null) {
if (redRefRange.getLow() != null && redRefRange.getLow().hasValue() && redRefRange.getLow().getValue().compareTo(value) > 0) {
priority = "asap";
ruleResult.setClinicalImpressions(List.of(createClinicalImpression(belowReferenceRangeCoding())));
} else if (redRefRange.getHigh() != null && redRefRange.getHigh().hasValue() && redRefRange.getHigh().getValue().compareTo(value) < 0) {
priority = "asap";
ruleResult.setClinicalImpressions(List.of(createClinicalImpression(aboveReferenceRangeCoding())));
}
}
// Not necessary to check yellow alarm range if already outside red alarm range
if (!priority.equals("asap")) {
Observation.ObservationReferenceRangeComponent yellowRefRange = getReferenceRange(o, yellowAlarmCoding());
if (yellowRefRange != null) {
if (yellowRefRange.getLow() != null && yellowRefRange.getLow().hasValue() && yellowRefRange.getLow().getValue().compareTo(value) > 0) {
priority = "urgent";
ruleResult.setClinicalImpressions(List.of(createClinicalImpression(belowReferenceRangeCoding())));
} else if (yellowRefRange.getHigh() != null && yellowRefRange.getHigh().hasValue() && yellowRefRange.getHigh().getValue().compareTo(value) < 0) {
priority = "urgent";
ruleResult.setClinicalImpressions(List.of(createClinicalImpression(aboveReferenceRangeCoding())));
}
}
}
if (priority.equals("routine")) {
ruleResult.setClinicalImpressions(List.of(createClinicalImpression(withinReferenceRangeCoding())));
}
ruleResult.setTasks(List.of(createTask(priority)));;
end;