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fix naloxone alert for active opioid meds only #217

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merged 1 commit into from
Nov 22, 2024
Merged

fix naloxone alert for active opioid meds only #217

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32 changes: 28 additions & 4 deletions src/config/summary_config.json
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Original file line number Diff line number Diff line change
Expand Up @@ -360,10 +360,34 @@
},
{
"flag": {
"ifOneOrMore": {
"table": "MedicationRequestsForNaloxoneConsideration",
"source": "RiskConsiderations"
}
"ifAnd": [
{
"ifEqualTo": {
"header": "Class",
"targetValue": "opioid"
}
},
{
"ifGreaterThanOrEqualTo": {
"header": "MME",
"targetValue": 50
}
},
{
"ifEqualTo": {
"header": "isActive",
"type": "boolean",
"targetValue": true
}
},
{
"ifEqualTo": {
"header": "isBup",
"type": "boolean",
"targetValue": false
}
}
]
},
"flagText": "Current MME 50 or more, consider prescribing Naloxone",
"flagClass": "info"
Expand Down
7 changes: 5 additions & 2 deletions src/cql/r4/Factors_to_Consider_in_Managing_Chronic_Pain_FHIRv400.cql
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Original file line number Diff line number Diff line change
Expand Up @@ -726,7 +726,8 @@ define ReportPDMPMedicationRequests:
CalculatedEnd: GetMedicationRequestEndDate(O),
dispenseRequest: O.dispenseRequest,
MME_Object: MMECalculator.MME(O),
c: (O.medication as FHIR.CodeableConcept)
c: (O.medication as FHIR.CodeableConcept),
RxnormCode: Coalesce((c.coding) c2 where c2.system.value ~ 'http://www.nlm.nih.gov/research/umls/rxnorm' return c2.code.value)
return {
Type: 'Request',
Name: ConceptText(c),
Expand All @@ -744,7 +745,9 @@ define ReportPDMPMedicationRequests:
Prescriber: O.requester.display.value,
Pharmacy: GetMedicationRequestPharmacy(O),
NDC_Code: Coalesce((c.coding) c2 where c2.system.value ~ 'http://hl7.org/fhir/sid/ndc' return c2.code.value),
RXNorm_Code: Coalesce((c.coding) c2 where c2.system.value ~ 'http://www.nlm.nih.gov/research/umls/rxnorm' return c2.code.value),
RXNorm_Code: RxnormCode,
isBup: RxnormCode in BuprenorphineRxCUIs,
isActive: CalculatedEnd same or after Today(),
Status: O.status.value,
Class: getMedicationRequestDrugClass(O),
AuthoredOn: O.authoredOn
Expand Down
111 changes: 70 additions & 41 deletions src/cql/r4/Factors_to_Consider_in_Managing_Chronic_Pain_FHIRv400.json
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Original file line number Diff line number Diff line change
Expand Up @@ -4607,6 +4607,53 @@
"type" : "NamedTypeSpecifier"
}
}
}, {
"identifier" : "RxnormCode",
"expression" : {
"type" : "Coalesce",
"operand" : [ {
"type" : "Query",
"source" : [ {
"alias" : "c2",
"expression" : {
"path" : "coding",
"type" : "Property",
"source" : {
"name" : "c",
"type" : "QueryLetRef"
}
}
} ],
"relationship" : [ ],
"where" : {
"type" : "Equivalent",
"operand" : [ {
"path" : "value",
"type" : "Property",
"source" : {
"path" : "system",
"scope" : "c2",
"type" : "Property"
}
}, {
"valueType" : "{urn:hl7-org:elm-types:r1}String",
"value" : "http://www.nlm.nih.gov/research/umls/rxnorm",
"type" : "Literal"
} ]
},
"return" : {
"expression" : {
"path" : "value",
"type" : "Property",
"source" : {
"path" : "code",
"scope" : "c2",
"type" : "Property"
}
}
}
} ]
}
} ],
"relationship" : [ ],
"return" : {
Expand Down Expand Up @@ -4885,48 +4932,30 @@
}, {
"name" : "RXNorm_Code",
"value" : {
"type" : "Coalesce",
"name" : "RxnormCode",
"type" : "QueryLetRef"
}
}, {
"name" : "isBup",
"value" : {
"type" : "In",
"operand" : [ {
"type" : "Query",
"source" : [ {
"alias" : "c2",
"expression" : {
"path" : "coding",
"type" : "Property",
"source" : {
"name" : "c",
"type" : "QueryLetRef"
}
}
} ],
"relationship" : [ ],
"where" : {
"type" : "Equivalent",
"operand" : [ {
"path" : "value",
"type" : "Property",
"source" : {
"path" : "system",
"scope" : "c2",
"type" : "Property"
}
}, {
"valueType" : "{urn:hl7-org:elm-types:r1}String",
"value" : "http://www.nlm.nih.gov/research/umls/rxnorm",
"type" : "Literal"
} ]
},
"return" : {
"expression" : {
"path" : "value",
"type" : "Property",
"source" : {
"path" : "code",
"scope" : "c2",
"type" : "Property"
}
}
}
"name" : "RxnormCode",
"type" : "QueryLetRef"
}, {
"name" : "BuprenorphineRxCUIs",
"type" : "ExpressionRef"
} ]
}
}, {
"name" : "isActive",
"value" : {
"type" : "SameOrAfter",
"operand" : [ {
"name" : "CalculatedEnd",
"type" : "QueryLetRef"
}, {
"type" : "Today"
} ]
}
}, {
Expand Down
7 changes: 5 additions & 2 deletions src/helpers/flagit.js
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Original file line number Diff line number Diff line change
Expand Up @@ -59,7 +59,6 @@ export default function flagit(entry, subSection, summary) {
function ifAnd(flagRulesArray, entry, subSection, summary) {
for (let i = 0; i < flagRulesArray.length; ++i) {
const flagRule = flagRulesArray[i];

let match;
if (typeof flagRule === 'string') {
match = functions[flagRule](entry, entry, subSection, summary);
Expand Down Expand Up @@ -120,14 +119,18 @@ function ifGreaterThanOrEqualTo(value, entry, subSection, summary) {
if (Array.isArray(targetEntry) && targetEntry.length) {
targetEntry = targetEntry[0]
}
return parseInt(targetEntry[value.header], 10) >= value.value;
const valueToCompare = value.targetValue != null ? value.targetValue : value.value;
return parseInt(targetEntry[value.header], 10) >= valueToCompare;
}
/*
* return true if an entry's value for a field matches the specified target value
*/
function ifEqualTo(value, entry, subSection, summary) {
if (!entry) return false;
if (Array.isArray(entry[value.header])) return entry[value.header].indexOf(value.targetValue) !== -1;
if (value.type === "boolean") {
return Boolean(entry[value.header]) === Boolean(value.targetValue);
}
return entry[value.header] === value.targetValue;
}
/*
Expand Down
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