cqm-reports 3.1.10 → 4.0.0

data/lib/qrda-export/catI-r5/qrda_templates/patient_care_experience.mustache

@@ -1,7 +1,7 @@
 <entry>
   <observation classCode="OBS" moodCode="EVN">
     <!-- Patient Care Experience (V4) -->
-    <templateId root="2.16.840.1.113883.10.20.24.3.48" extension="2019-12-01"/>
+    <templateId root="2.16.840.1.113883.10.20.24.3.48" extension="2021-08-01"/>
     <id root="1.3.6.1.4.1.115" extension="{{object_id}}"/>
     <code code="77218-6" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Patient satisfaction with healthcare delivery"/>
     <statusCode code="completed"/>

data/lib/qrda-export/catI-r5/qrda_templates/physical_exam_order.mustache

@@ -3,7 +3,7 @@
     <!-- Conforms to C-CDA R2.1 Planned Observation (V2) -->
     <templateId root="2.16.840.1.113883.10.20.22.4.44" extension="2014-06-09"/>
     <!-- Physical Exam Order (V4) -->
-    <templateId root="2.16.840.1.113883.10.20.24.3.58" extension="2019-12-01"/>
+    <templateId root="2.16.840.1.113883.10.20.24.3.58" extension="2021-08-01"/>
     <id root="1.3.6.1.4.1.115" extension="{{object_id}}"/>
     <code code="29545-1" codeSystem="2.16.840.1.113883.6.1" displayName="physical examination" codeSystemName="LOINC"/>
     <text>{{description}}</text>

data/lib/qrda-export/catI-r5/qrda_templates/physical_exam_performed.mustache

@@ -3,7 +3,7 @@
     <!-- Procedure Activity Procedure (Consolidation) template -->
     <templateId root="2.16.840.1.113883.10.20.22.4.13" extension="2014-06-09"/>
     <!-- Physical Exam, Performed template -->
-    <templateId root="2.16.840.1.113883.10.20.24.3.59" extension="2019-12-01"/>
+    <templateId root="2.16.840.1.113883.10.20.24.3.59" extension="2021-08-01"/>
     <id root="1.3.6.1.4.1.115" extension="{{object_id}}"/>
     <!-- QDM Attribute: Code -->
     {{> _codes}}
@@ -48,9 +48,9 @@
       <!-- QDM Attribute: Components -->
       {{> qrda_templates/template_partials/_component}}
     {{/components}}
-    {{#encounter_id}}
+    {{#relatedTo}}
       <!-- QDM Attribute: relatedTo -->
       {{> qrda_templates/template_partials/_related_to}}
-    {{/encounter_id}}
+    {{/relatedTo}}
   </observation>
 </entry>

data/lib/qrda-export/catI-r5/qrda_templates/physical_exam_recommended.mustache

@@ -3,7 +3,7 @@
     <!-- Conforms to C-CDA R2.1 Planned Observation (V2) -->
     <templateId root="2.16.840.1.113883.10.20.22.4.44" extension="2014-06-09"/>
     <!-- Physical Exam Recommeded (V4) -->
-    <templateId root="2.16.840.1.113883.10.20.24.3.60" extension="2019-12-01"/>
+    <templateId root="2.16.840.1.113883.10.20.24.3.60" extension="2021-08-01"/>
     <id root="1.3.6.1.4.1.115" extension="{{object_id}}"/>
     <code code="29545-1" codeSystem="2.16.840.1.113883.6.1" displayName="physical examination" codeSystemName="LOINC"/>
     <text>{{description}}</text>

data/lib/qrda-export/catI-r5/qrda_templates/procedure_order.mustache

@@ -3,7 +3,7 @@
     <!-- Consolidated Plan of Care Activity Procedure TemplateId (Implied Template) -->
     <templateId root="2.16.840.1.113883.10.20.22.4.41" extension="2014-06-09"/> 
     <!-- QRDA Procedure, Order TemplateId --> 
-    <templateId root="2.16.840.1.113883.10.20.24.3.63" extension="2019-12-01"/> 
+    <templateId root="2.16.840.1.113883.10.20.24.3.63" extension="2021-08-01"/> 
     <id root="1.3.6.1.4.1.115" extension="{{object_id}}"/>
     {{> _codes}}
     <text>{{description}}</text>

data/lib/qrda-export/catI-r5/qrda_templates/procedure_performed.mustache

@@ -1,7 +1,7 @@
 <entry>
   <procedure classCode="PROC" moodCode="EVN" {{{negation_ind}}}>
     <!--  Procedure performed template -->
-    <templateId root="2.16.840.1.113883.10.20.24.3.64" extension="2019-12-01"/>
+    <templateId root="2.16.840.1.113883.10.20.24.3.64" extension="2021-08-01"/>
     <!-- Procedure Activity Procedure-->
     <templateId root="2.16.840.1.113883.10.20.22.4.14" extension="2014-06-09"/>
     <id root="1.3.6.1.4.1.115" extension="{{object_id}}"/>
@@ -62,6 +62,10 @@
       <!-- QDM Attribute: Components -->
       {{> qrda_templates/template_partials/_component}}
     {{/components}}
+    {{#relatedTo}}
+      <!-- QDM Attribute: relatedTo -->
+      {{> qrda_templates/template_partials/_related_to}}
+    {{/relatedTo}}
   </procedure>
 </entry>
 

data/lib/qrda-export/catI-r5/qrda_templates/procedure_recommended.mustache

@@ -3,7 +3,7 @@
     <!-- Conforms to C-CDA R2.1 Planned Procedure (V2) -->
     <templateId root="2.16.840.1.113883.10.20.22.4.41" extension="2014-06-09"/>
     <!-- Procedure Recommended (V5) -->
-    <templateId root="2.16.840.1.113883.10.20.24.3.65" extension="2019-12-01"/>
+    <templateId root="2.16.840.1.113883.10.20.24.3.65" extension="2021-08-01"/>
     <id root="1.3.6.1.4.1.115" extension="{{object_id}}"/>
     <!-- QDM Attribute: Code -->
     {{> _codes}}

data/lib/qrda-export/catI-r5/qrda_templates/program_participation.mustache

@@ -1,7 +1,7 @@
 <entry>
   <observation classCode="OBS" moodCode="EVN">
     <!-- Program Participation (V2) -->
-    <templateId root="2.16.840.1.113883.10.20.24.3.154" extension="2019-12-01"/>
+    <templateId root="2.16.840.1.113883.10.20.24.3.154" extension="2021-08-01"/>
     <id root="1.3.6.1.4.1.115" extension="{{object_id}}"/>
     <code code="ASSERTION" codeSystem="2.16.840.1.113883.5.4"/>
     <statusCode code="completed" />
@@ -11,11 +11,5 @@
     {{/participationPeriod}}
     <!-- QDM Attribute: Code -->
     {{> qrda_templates/template_partials/_data_element_codes_as_values}}
-    {{#recorder}}
-      <!-- QDM Attribute: Recorder -->
-      <participant typeCode="PRF">
-        {{> qrda_templates/template_partials/_entity}}
-      </participant>
-    {{/recorder}}
   </observation>
 </entry>

data/lib/qrda-export/catI-r5/qrda_templates/provider_care_experience.mustache

@@ -1,7 +1,7 @@
 <entry>
   <observation classCode="OBS" moodCode="EVN">
     <!-- Provider Care Experience (V4) -->
-    <templateId root="2.16.840.1.113883.10.20.24.3.67" extension="2019-12-01"/>
+    <templateId root="2.16.840.1.113883.10.20.24.3.67" extension="2021-08-01"/>
     <id root="1.3.6.1.4.1.115" extension="{{object_id}}"/>
     <code code="77219-4" codeSystem="2.16.840.1.113883.6.1" codeSystemName="LOINC" displayName="Provider satisfaction with healthcare delivery"/>
     <statusCode code="completed" />

data/lib/qrda-export/catI-r5/qrda_templates/substance_recommended.mustache

@@ -3,7 +3,7 @@
     <!-- Conforms to C-CDA R2.1 Planned Medication Activity (V2) -->
     <templateId root="2.16.840.1.113883.10.20.22.4.42" extension="2014-06-09"/>
     <!-- Substance Recommended (V4) -->
-    <templateId root="2.16.840.1.113883.10.20.24.3.75" extension="2019-12-01"/>
+    <templateId root="2.16.840.1.113883.10.20.24.3.75" extension="2021-08-01"/>
     <id root="1.3.6.1.4.1.115" extension="{{object_id}}"/>
     <statusCode code="active"/>
     <effectiveTime xsi:type="IVL_TS">

data/lib/qrda-export/catI-r5/qrda_templates/symptom.mustache

@@ -3,7 +3,7 @@
     <!-- Conforms to C-CDA 2.1 Problem Concern Act (V3) -->
     <templateId root="2.16.840.1.113883.10.20.22.4.3" extension="2015-08-01"/>
     <!-- Symptom Concern Act (V3) -->
-    <templateId root="2.16.840.1.113883.10.20.24.3.138" extension="2019-12-01"/>
+    <templateId root="2.16.840.1.113883.10.20.24.3.138" extension="2021-08-01"/>
     <id root="1.3.6.1.4.1.115" extension="{{object_id}}"/>
     <code code="CONC" codeSystem="2.16.840.1.113883.5.6" displayName="Concern"/>
     {{#prevalencePeriod}}
@@ -21,7 +21,7 @@
         <!-- Conforms to C-CDA R2.1 Problem Observation (V3) -->
         <templateId root="2.16.840.1.113883.10.20.22.4.4" extension="2015-08-01"/>
         <!-- Symptom (V2) -->
-        <templateId root="2.16.840.1.113883.10.20.24.3.136" extension="2019-12-01"/>
+        <templateId root="2.16.840.1.113883.10.20.24.3.136" extension="2021-08-01"/>
         <id root="1.3.6.1.4.1.115" extension="{{object_id}}"/>
         <code code="75325-1" codeSystem="2.16.840.1.113883.6.1">
           <translation code="418799008" displayName="Symptom" codeSystem="2.16.840.1.113883.6.96"/>

data/lib/qrda-export/catI-r5/qrda_templates/template_partials/_encounter_class.mustache

@@ -0,0 +1,6 @@
+<entryRelationship typeCode="REFR">
+  <act classCode="ACT" moodCode="EVN">
+    <templateId root="2.16.840.1.113883.10.20.24.3.171" extension="2021-08-01" />
+    <code {{> _code}}/>
+  </act>
+</entryRelationship>

data/lib/qrda-export/catI-r5/qrda_templates/template_partials/_encounter_diagnosis_qdm.mustache

@@ -1,7 +1,7 @@
 <entryRelationship typeCode="REFR">
   <observation classCode="OBS" moodCode="EVN">
     <!--  Encounter Diagnosis QDM  -->
-    <templateId extension="2019-12-01" root="2.16.840.1.113883.10.20.24.3.168"/>
+    <templateId extension="2021-08-01" root="2.16.840.1.113883.10.20.24.3.168"/>
     <code code="29308-4" codeSystem="2.16.840.1.113883.6.1"/>
     <statusCode code="completed"/>
     {{#code}}
@@ -14,7 +14,7 @@
     {{#presentOnAdmissionIndicator}}
       <entryRelationship typeCode="REFR">
         <observation classCode="OBS" moodCode="EVN">
-          <templateId root="2.16.840.1.113883.10.20.24.3.169" extension="2019-12-01"/>
+          <templateId root="2.16.840.1.113883.10.20.24.3.169" extension="2021-08-01"/>
           <code code="78026-2" displayName="Present on admission" codeSystem="2.16.840.1.113883.6.1"/>
           <value {{> _code}} xsi:type="CD"/>
         </observation>

data/lib/qrda-export/catI-r5/qrda_templates/template_partials/_entity.mustache

@@ -1,6 +1,9 @@
 {{#care_partner_entity?}}
 	{{> qrda_templates/template_partials/_entity_care_partner}}
 {{/care_partner_entity?}}
+{{#location_entity?}}
+	{{> qrda_templates/template_partials/_entity_location}}
+{{/location_entity?}}
 {{#patient_entity?}}
 	{{> qrda_templates/template_partials/_entity_patient}}
 {{/patient_entity?}}

data/lib/qrda-export/catI-r5/qrda_templates/template_partials/_entity_location.mustache

@@ -0,0 +1,11 @@
+<participantRole>
+    <templateId root="2.16.840.1.113883.10.20.24.3.172" extension="2021-08-01" />
+    {{#identifier}}
+      <id root="{{{namingSystem}}}" extension="{{{value}}}"/>
+    {{/identifier}}
+    {{#locationType}}
+      <playingEntity>
+        <code {{> _code}}/>
+      </playingEntity>
+    {{/locationType}}
+</participantRole>

data/lib/qrda-export/catI-r5/qrda_templates/template_partials/_entity_organization.mustache

@@ -3,9 +3,9 @@
     {{#identifier}}
       <id root="{{{namingSystem}}}" extension="{{{value}}}"/>
     {{/identifier}}
-    {{#type}}
+    {{#organizationType}}
       <playingEntity>
         <code {{> _code}}/>
       </playingEntity>
-    {{/type}}
+    {{/organizationType}}
 </participantRole>

data/lib/qrda-export/catI-r5/qrda_templates/template_partials/_interpretation.mustache

@@ -0,0 +1 @@
+<interpretationCode {{> _code}}/>

data/lib/qrda-export/{catIII-r2-1 → catIII}/_header.mustache

@@ -2,15 +2,11 @@
 <realmCode code="US"/>
 <typeId root="2.16.840.1.113883.1.3" extension="POCD_HD000040"/>
 <!-- US Realm Header Template Id -->
-<templateId root="2.16.840.1.113883.10.20.27.1.1" extension="2017-06-01"/>
+<templateId root="2.16.840.1.113883.10.20.27.1.1" extension="2020-12-01"/>
 {{#ry2022_submission?}}
 <!-- QRDA Category III Report - CMS (V6) -->
 <templateId root="2.16.840.1.113883.10.20.27.1.2" extension="2021-07-01"/>
 {{/ry2022_submission?}}
-{{^ry2022_submission?}}
-<!-- QRDA Category III Report - CMS (V5) -->
-<templateId root="2.16.840.1.113883.10.20.27.1.2" extension="2020-05-01"/>
-{{/ry2022_submission?}}
 <!-- This is the globally unique identifier for this QRDA document -->
 <id root="{{random_id}}"/>
 <!-- QRDA III document type code -->

data/lib/qrda-export/{catIII-r2-1 → catIII}/_measure_section.mustache

@@ -9,7 +9,7 @@
     <templateId root="2.16.840.1.113883.10.20.24.2.2"/>
     <!-- In this case the query is using an eMeasure -->
     <!-- QRDA Category III Measure Section template -->
-    <templateId extension="2017-06-01" root="2.16.840.1.113883.10.20.27.2.1"/>
+    <templateId extension="2020-12-01" root="2.16.840.1.113883.10.20.27.2.1"/>
     <!-- QRDA Category III Measure Section - CMS (V4) -->
     <templateId extension="2019-05-01" root="2.16.840.1.113883.10.20.27.2.3"/>
     <code code="55186-1" codeSystem="2.16.840.1.113883.6.1"/>
@@ -40,7 +40,7 @@
         <!-- Implied template Measure Reference templateId -->
         <templateId root="2.16.840.1.113883.10.20.24.3.98"/>
         <!-- SHALL 1..* (one for each referenced measure) Measure Reference and Results template -->
-        <templateId extension="2016-09-01" root="2.16.840.1.113883.10.20.27.3.1"/>
+        <templateId extension="2020-12-01" root="2.16.840.1.113883.10.20.27.3.1"/>
         <templateId extension="2019-05-01" root="2.16.840.1.113883.10.20.27.3.17"/>
         <id extension="{{random_id}}" root="1.3.6.1.4.1.115"/>
         <statusCode code="completed"/>
@@ -64,7 +64,7 @@
     <entry>
       <act classCode="ACT" moodCode="EVN">
         <!-- This is the templateId for Reporting Parameteres Act -->
-        <templateId root="2.16.840.1.113883.10.20.17.3.8"/>
+        <templateId root="2.16.840.1.113883.10.20.17.3.8" extension="2020-12-01"/>
         <id extension="{{random_id}}" root="1.3.6.1.4.1.115"/>
         <code code="252116004" codeSystem="2.16.840.1.113883.6.96" displayName="Observation Parameters"/>
         <effectiveTime>

data/lib/qrda-export/{catIII-r2-1/qrda3_r21.rb → catIII/qrda3.rb}

@@ -1,5 +1,5 @@
 require 'mustache'
-class Qrda3R21 < Mustache
+class Qrda3 < Mustache
   include Qrda::Export::Helper::DateHelper
   include Qrda::Export::Helper::ViewHelper
   include Qrda::Export::Helper::PatientViewHelper

data/lib/qrda-import/base-importers/section_importer.rb

@@ -1,6 +1,8 @@
 module QRDA
   module Cat1
     class SectionImporter
+      require 'validation_error'
+
       attr_accessor :check_for_usable, :status_xpath, :code_xpath, :warnings, :codes, :codes_modifiers
 
       def initialize(entry_finder)
@@ -75,12 +77,7 @@ module QRDA
           code_list << code_if_present(code_element)
           translations = code_element.xpath('cda:translation')
           translations.each do |translation|
-            translation_code = code_if_present(translation)
-            next unless translation_code
-
-            code_list << translation_code
-            @warnings << ValidationError.new(message: "Translation code #{translation_code.system}:#{translation_code.code} may not be used for eCQM calculation by a receiving system.  Ensure that the root code includes a code from the eCQM valueset.",
-                                             location: coded_element.path)
+            code_list << code_if_present(translation)
           end
         end
         code_list.compact
@@ -292,43 +289,64 @@ module QRDA
       end
 
       def extract_entity(parent_element, entity_xpath)
-        care_partner_entity_element = parent_element.at_xpath(entity_xpath + "/cda:participantRole[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.160']")
-        patient_entity_element = parent_element.at_xpath(entity_xpath + "/cda:participantRole[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.161']")
-        practitioner_entity_element = parent_element.at_xpath(entity_xpath + "/cda:participantRole[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.162']")
-        organization_entity_element = parent_element.at_xpath(entity_xpath + "/cda:participantRole[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.163']")
-        return extract_care_partner_entity(care_partner_entity_element) if care_partner_entity_element
-        return extract_patient_entity(patient_entity_element) if patient_entity_element
-        return extract_practitioner_entity(practitioner_entity_element) if practitioner_entity_element
-        return extract_organization_entity(organization_entity_element) if organization_entity_element
+        entities = []
+        care_partner_entity_element = parent_element.xpath(entity_xpath + "/cda:participantRole[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.160']")
+        patient_entity_element = parent_element.xpath(entity_xpath + "/cda:participantRole[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.161']")
+        practitioner_entity_element = parent_element.xpath(entity_xpath + "/cda:participantRole[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.162']")
+        organization_entity_element = parent_element.xpath(entity_xpath + "/cda:participantRole[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.163']")
+        location_entity_element = parent_element.xpath(entity_xpath + "/cda:participantRole[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.172']")
+        extract_care_partner_entity(care_partner_entity_element, entities) if care_partner_entity_element
+        extract_patient_entity(patient_entity_element, entities) if patient_entity_element
+        extract_practitioner_entity(practitioner_entity_element, entities) if practitioner_entity_element
+        extract_organization_entity(organization_entity_element, entities) if organization_entity_element
+        extract_location_entity(location_entity_element, entities) if location_entity_element
+        entities.empty? ? nil : entities
       end
 
-      def extract_care_partner_entity(care_partner_entity_element)
-        care_partner_entity = QDM::CarePartner.new
-        care_partner_entity.identifier = extract_id(care_partner_entity_element, './cda:id')
-        care_partner_entity.relationship = code_if_present(care_partner_entity_element.at_xpath('./cda:playingEntity/cda:code'))
-        care_partner_entity
+      def extract_care_partner_entity(care_partner_entity_elements, entities)
+        care_partner_entity_elements&.each do |care_partner_entity_element|
+          care_partner_entity = QDM::CarePartner.new
+          care_partner_entity.identifier = extract_id(care_partner_entity_element, './cda:id')
+          care_partner_entity.relationship = code_if_present(care_partner_entity_element.at_xpath('./cda:playingEntity/cda:code'))
+          entities << care_partner_entity
+        end
       end
 
-      def extract_patient_entity(patient_entity_element)
-        patient_entity = QDM::PatientEntity.new
-        patient_entity.identifier = extract_id(patient_entity_element, './cda:id')
-        patient_entity
+      def extract_patient_entity(patient_entity_elements, entities)
+        patient_entity_elements&.each do |patient_entity_element|
+          patient_entity = QDM::PatientEntity.new
+          patient_entity.identifier = extract_id(patient_entity_element, './cda:id')
+          entities << patient_entity
+        end
       end
 
-      def extract_practitioner_entity(practitioner_entity_element)
-        practitioner_entity = QDM::Practitioner.new
-        practitioner_entity.identifier = extract_id(practitioner_entity_element, './cda:id')
-        practitioner_entity.role = code_if_present(practitioner_entity_element.at_xpath('./cda:code'))
-        practitioner_entity.specialty = code_if_present(practitioner_entity_element.at_xpath('./cda:playingEntity/cda:code'))
-        practitioner_entity.qualification = code_if_present(practitioner_entity_element.at_xpath('./cda:scopingEntity/cda:code'))
-        practitioner_entity
+      def extract_practitioner_entity(practitioner_entity_elements, entities)
+        practitioner_entity_elements&.each do |practitioner_entity_element|
+          practitioner_entity = QDM::Practitioner.new
+          practitioner_entity.identifier = extract_id(practitioner_entity_element, './cda:id')
+          practitioner_entity.role = code_if_present(practitioner_entity_element.at_xpath('./cda:code'))
+          practitioner_entity.specialty = code_if_present(practitioner_entity_element.at_xpath('./cda:playingEntity/cda:code'))
+          practitioner_entity.qualification = code_if_present(practitioner_entity_element.at_xpath('./cda:scopingEntity/cda:code'))
+          entities << practitioner_entity
+        end
       end
 
-      def extract_organization_entity(organization_entity_element)
-        organization_entity = QDM::Organization.new
-        organization_entity.identifier = extract_id(organization_entity_element, './cda:id')
-        organization_entity.type = code_if_present(organization_entity_element.at_xpath('./cda:playingEntity/cda:code'))
-        organization_entity
+      def extract_organization_entity(organization_entity_elements, entities)
+        organization_entity_elements&.each do |organization_entity_element|
+          organization_entity = QDM::Organization.new
+          organization_entity.identifier = extract_id(organization_entity_element, './cda:id')
+          organization_entity.organizationType = code_if_present(organization_entity_element.at_xpath('./cda:playingEntity/cda:code'))
+          entities << organization_entity
+        end
+      end
+
+      def extract_location_entity(location_entity_elements, entities)
+        location_entity_elements&.each do |location_entity_element|
+          location_entity = QDM::Location.new
+          location_entity.identifier = extract_id(location_entity_element, './cda:id')
+          location_entity.locationType = code_if_present(location_entity_element.at_xpath('./cda:playingEntity/cda:code'))
+          entities << location_entity
+        end
       end
     end
   end

data/lib/qrda-import/data-element-importers/adverse_event_importer.rb

@@ -18,7 +18,8 @@ module QRDA
         adverse_event.severity = code_if_present(entry_element.at_xpath(@severity_xpath))
         adverse_event.type = code_if_present(entry_element.at_xpath(@type_xpath))
         adverse_event.facilityLocation = extract_facility_locations(entry_element)[0]
-        adverse_event.recorder = extract_entity(entry_element, "./cda:participant[@typeCode='PRF']")
+        entity = extract_entity(entry_element, "./cda:participant[@typeCode='PRF']")
+        adverse_event.recorder.concat(entity) if entity
         adverse_event
       end
 

data/lib/qrda-import/data-element-importers/allergy_intolerance_importer.rb

@@ -16,7 +16,8 @@ module QRDA
         allergy_intolerance = super
         allergy_intolerance.severity = code_if_present(entry_element.at_xpath(@severity_xpath))
         allergy_intolerance.type = code_if_present(entry_element.at_xpath(@type_xpath))
-        allergy_intolerance.recorder = extract_entity(entry_element, "./cda:participant[@typeCode='PRF']")
+        entity = extract_entity(entry_element, "./cda:participant[@typeCode='PRF']")
+        allergy_intolerance.recorder.concat(entity) if entity
         allergy_intolerance
       end
 

data/lib/qrda-import/data-element-importers/assessment_order_importer.rb

@@ -13,7 +13,8 @@ module QRDA
       def create_entry(entry_element, nrh = NarrativeReferenceHandler.new)
         assessment_order = super
         assessment_order.reason = extract_reason(entry_element)
-        assessment_order.requester = extract_entity(entry_element, "./cda:participant[@typeCode='PRF']")
+        entity = extract_entity(entry_element, "./cda:participant[@typeCode='PRF']")
+        assessment_order.requester.concat(entity) if entity
         assessment_order
       end
 

data/lib/qrda-import/data-element-importers/assessment_performed_importer.rb

@@ -8,19 +8,24 @@ module QRDA
         @author_datetime_xpath = "./cda:author[cda:templateId/@root='2.16.840.1.113883.10.20.24.3.155']/cda:time"
         @result_xpath = "./cda:value"
         @method_xpath = './cda:methodCode'
+        @interpretation_xpath = './cda:interpretationCode'
         @components_xpath = "./cda:entryRelationship/cda:observation[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.149']"
         @reason_xpath = "./cda:entryRelationship[@typeCode='RSON']/cda:observation[cda:templateId/@root='2.16.840.1.113883.10.20.24.3.88']/cda:value"
         @relevant_period_xpath = "./cda:effectiveTime"
         @relevant_date_time_xpath = './cda:effectiveTime[@value]'
+        @related_to_xpath = "./sdtc:inFulfillmentOf1/sdtc:actReference"
         @entry_class = QDM::AssessmentPerformed
       end
 
       def create_entry(entry_element, nrh = NarrativeReferenceHandler.new)
         assessment_performed = super
         assessment_performed.method = code_if_present(entry_element.at_xpath(@method_xpath))
+        assessment_performed.interpretation = code_if_present(entry_element.at_xpath(@interpretation_xpath))
         assessment_performed.components = extract_components(entry_element)
         assessment_performed.reason = extract_reason(entry_element)
-        assessment_performed.performer = extract_entity(entry_element, "./cda:participant[@typeCode='PRF']")
+        entity = extract_entity(entry_element, "./cda:participant[@typeCode='PRF']")
+        assessment_performed.performer.concat(entity) if entity
+        assessment_performed.relatedTo = extract_related_to(entry_element)
         assessment_performed
       end
 

data/lib/qrda-import/data-element-importers/assessment_recommended_importer.rb

@@ -13,7 +13,8 @@ module QRDA
       def create_entry(entry_element, nrh = NarrativeReferenceHandler.new)
         assessment_recommended = super
         assessment_recommended.reason = extract_reason(entry_element)
-        assessment_recommended.requester = extract_entity(entry_element, "./cda:participant[@typeCode='PRF']")
+        entity = extract_entity(entry_element, "./cda:participant[@typeCode='PRF']")
+        assessment_recommended.requester.concat(entity) if entity
         assessment_recommended
       end
 

data/lib/qrda-import/data-element-importers/communication_performed_importer.rb

@@ -20,8 +20,10 @@ module QRDA
         communication_performed.medium = code_if_present(entry_element.at_xpath(@medium_xpath))
         communication_performed.sentDatetime = extract_time(entry_element, @sent_datetime_xpath)
         communication_performed.receivedDatetime = extract_time(entry_element, @received_datetime_xpath)
-        communication_performed.sender = extract_entity(entry_element, "./cda:participant[@typeCode='AUT']")
-        communication_performed.recipient = extract_entity(entry_element, "./cda:participant[@typeCode='IRCP']")
+        entity1 = extract_entity(entry_element, "./cda:participant[@typeCode='AUT']")
+        communication_performed.sender.concat(entity1) if entity1
+        entity2 = extract_entity(entry_element, "./cda:participant[@typeCode='IRCP']")
+        communication_performed.recipient.concat(entity2) if entity2
         communication_performed.relatedTo = extract_related_to(entry_element)
         communication_performed
       end

data/lib/qrda-import/data-element-importers/device_order_importer.rb

@@ -12,7 +12,8 @@ module QRDA
 
       def create_entry(entry_element, nrh = NarrativeReferenceHandler.new)
         device_order = super
-        device_order.requester = extract_entity(entry_element, "./cda:entryRelationship/cda:supply//cda:participant[@typeCode='PRF']")
+        entity = extract_entity(entry_element, "./cda:entryRelationship/cda:supply//cda:participant[@typeCode='PRF']")
+        device_order.requester.concat(entity) if entity
         device_order.reason = extract_reason(entry_element)
         device_order
       end

data/lib/qrda-import/data-element-importers/device_recommended_importer.rb

@@ -13,7 +13,8 @@ module QRDA
       def create_entry(entry_element, nrh = NarrativeReferenceHandler.new)
         device_recommended = super
         device_recommended.reason = extract_reason(entry_element)
-        device_recommended.requester = extract_entity(entry_element, "./cda:entryRelationship/cda:supply//cda:participant[@typeCode='PRF']")
+        entity = extract_entity(entry_element, "./cda:entryRelationship/cda:supply//cda:participant[@typeCode='PRF']")
+        device_recommended.requester.concat(entity) if entity
         device_recommended
       end
 

data/lib/qrda-import/data-element-importers/diagnosis_importer.rb

@@ -16,7 +16,8 @@ module QRDA
         diagnosis = super
         diagnosis.anatomicalLocationSite = code_if_present(entry_element.at_xpath(@anatomical_location_site_xpath))
         diagnosis.severity = code_if_present(entry_element.at_xpath(@severity_xpath))
-        diagnosis.recorder = extract_entity(entry_element, "./cda:entryRelationship/cda:observation//cda:participant[@typeCode='PRF']")
+        entity = extract_entity(entry_element, "./cda:entryRelationship/cda:observation//cda:participant[@typeCode='PRF']")
+        diagnosis.recorder.concat(entity) if entity
         diagnosis
       end
 

data/lib/qrda-import/data-element-importers/diagnostic_study_order_importer.rb

@@ -13,7 +13,8 @@ module QRDA
       def create_entry(entry_element, nrh = NarrativeReferenceHandler.new)
         diagnostic_study_order = super
         diagnostic_study_order.reason = extract_reason(entry_element)
-        diagnostic_study_order.requester = extract_entity(entry_element, "./cda:participant[@typeCode='PRF']")
+        entity = extract_entity(entry_element, "./cda:participant[@typeCode='PRF']")
+        diagnostic_study_order.requester.concat(entity) if entity
         diagnostic_study_order
       end
 

data/lib/qrda-import/data-element-importers/diagnostic_study_performed_importer.rb

@@ -12,9 +12,11 @@ module QRDA
         @result_datetime_xpath = "./cda:entryRelationship/cda:observation[cda:templateId/@root = '2.16.840.1.113883.10.20.22.4.2']/cda:effectiveTime"
         @status_xpath = "./cda:entryRelationship/cda:observation[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.93']/cda:value"
         @method_xpath = './cda:methodCode'
+        @interpretation_xpath = './cda:interpretationCode'
         @facility_locations_xpath = "./cda:participant[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.100']"
         @components_xpath = "./cda:entryRelationship/cda:observation[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.149']"
         @reason_xpath = "./cda:entryRelationship[@typeCode='RSON']/cda:observation[cda:templateId/@root='2.16.840.1.113883.10.20.24.3.88']/cda:value"
+        @related_to_xpath = "./sdtc:inFulfillmentOf1/sdtc:actReference"
         @entry_class = QDM::DiagnosticStudyPerformed
       end
 
@@ -24,10 +26,13 @@ module QRDA
         diagnostic_study_performed.resultDatetime ||= extract_interval(entry_element, @result_datetime_xpath)&.low
         diagnostic_study_performed.status = code_if_present(entry_element.at_xpath(@status_xpath))
         diagnostic_study_performed.method = code_if_present(entry_element.at_xpath(@method_xpath))
+        diagnostic_study_performed.interpretation = code_if_present(entry_element.at_xpath(@interpretation_xpath))
         diagnostic_study_performed.facilityLocation = extract_facility_locations(entry_element)[0]
         diagnostic_study_performed.components = extract_components(entry_element)
         diagnostic_study_performed.reason = extract_reason(entry_element)
-        diagnostic_study_performed.performer = extract_entity(entry_element, "./cda:participant[@typeCode='PRF']")
+        entity = extract_entity(entry_element, "./cda:participant[@typeCode='PRF']")
+        diagnostic_study_performed.performer.concat(entity) if entity
+        diagnostic_study_performed.relatedTo = extract_related_to(entry_element)
         diagnostic_study_performed
       end
 

data/lib/qrda-import/data-element-importers/diagnostic_study_recommended_importer.rb

@@ -11,7 +11,8 @@ module QRDA
 
       def create_entry(entry_element, nrh = NarrativeReferenceHandler.new)
         diagnostic_study_recommended = super
-        diagnostic_study_recommended.requester = extract_entity(entry_element, "./cda:participant[@typeCode='PRF']")
+        entity = extract_entity(entry_element, "./cda:participant[@typeCode='PRF']")
+        diagnostic_study_recommended.requester.concat(entity) if entity
         diagnostic_study_recommended
       end
 

data/lib/qrda-import/data-element-importers/encounter_order_importer.rb

@@ -17,7 +17,8 @@ module QRDA
         encounter_order.facilityLocation = extract_facility_locations(entry_element)[0]
         encounter_order.reason = extract_reason(entry_element)
         encounter_order.priority = code_if_present(entry_element.at_xpath(@priority_xpath))
-        encounter_order.requester = extract_entity(entry_element, "./cda:entryRelationship/cda:encounter//cda:participant[@typeCode='PRF']")
+        entity = extract_entity(entry_element, "./cda:entryRelationship/cda:encounter//cda:participant[@typeCode='PRF']")
+        encounter_order.requester.concat(entity) if entity
         encounter_order
       end