health-data-standards 2.2.1 → 3.0.3

data/lib/health-data-standards/import/c32/immunization_importer.rb

@@ -1,38 +1,20 @@
 module HealthDataStandards
   module Import
     module C32
-      class ImmunizationImporter < SectionImporter
+      class ImmunizationImporter < CDA::SectionImporter
 
-        def initialize
-          @entry_xpath = "//cda:section[cda:templateId/@root='2.16.840.1.113883.3.88.11.83.117']/cda:entry/cda:substanceAdministration"
+        def initialize(entry_finder=CDA::EntryFinder.new("//cda:section[cda:templateId/@root='2.16.840.1.113883.3.88.11.83.117']/cda:entry/cda:substanceAdministration"))
+          super(entry_finder)
           @code_xpath = "./cda:consumable/cda:manufacturedProduct/cda:manufacturedMaterial/cda:code"
           @description_xpath = "./cda:consumable/cda:manufacturedProduct/cda:manufacturedMaterial/cda:code/cda:originalText/cda:reference[@value]"
-          @check_for_usable = true               # Pilot tools will set this to false
+          @entry_class = Immunization
         end
 
-        # Traverses that HITSP C32 document passed in using XPath and creates an Array of Entry
-        # objects based on what it finds                          
-        # @param [Nokogiri::XML::Document] doc It is expected that the root node of this document
-        #        will have the "cda" namespace registered to "urn:hl7-org:v3"
-        #        measure definition
-        # @return [Array] will be a list of Entry objects
-        def create_entries(doc,id_map = {})
-          immunization_list = []
-          entry_elements = doc.xpath(@entry_xpath)
-          entry_elements.each do |entry_element|
-            immunization = Immunization.new
-            extract_codes(entry_element, immunization)
-            extract_dates(entry_element, immunization)
-            extract_description(entry_element, immunization, id_map)
-            extract_negation(entry_element, immunization)
-            extract_performer(entry_element, immunization)
-            if @check_for_usable
-              immunization_list << immunization if immunization.usable?
-            else
-              immunization_list << immunization
-            end
-          end
-          immunization_list
+        def create_entry(entry_element, nrh = CDA::NarrativeReferenceHandler.new)
+          immunization = super
+          extract_negation(entry_element, immunization)
+          extract_performer(entry_element, immunization)
+          immunization
         end
     
         private

data/lib/health-data-standards/import/c32/insurance_provider_importer.rb

@@ -1,36 +1,39 @@
 module HealthDataStandards
   module Import
     module C32
-      class InsuranceProviderImporter < SectionImporter
+      class InsuranceProviderImporter < CDA::SectionImporter
         
-        def initialize
-          @entry_xpath = "//cda:act[cda:templateId/@root='2.16.840.1.113883.10.20.1.26']"
+        def initialize(entry_finder=CDA::EntryFinder.new("//cda:act[cda:templateId/@root='2.16.840.1.113883.10.20.1.26']"))
+          super(entry_finder)
+          @check_for_usable = false # needs to be this way becase InsuranceProvider does not respond
+                                    # to usable?
         end
         
-        def create_entries(doc, id_map={})
-          doc.xpath(@entry_xpath).map do |payer_element|
-            ip = InsuranceProvider.new
-            ip.type = extract_code(payer_element, "./cda:code")
-            ip.payer = import_organization(payer_element.at_xpath("./cda:performer/cda:assignedEntity"))
-            ip.guarantors = extract_guarantors(payer_element.xpath("./cda:performer/cda:assignedEntity"))
-            ip.subscriber = import_person(payer_element.at_xpath("./cda:participant[@typeCode='HLD']/cda:participantRole"))
-            member_info_element = payer_element.at_xpath("cda:participant[@typeCode='COV']")
-            extract_dates(member_info_element, ip, "time")
-            name = payer_element.at_xpath("./cda:entryRelationship[@typeCode='REFR']/cda:act[@classCode='ACT' and @moodCode='DEF']/cda:text")
-            ip.name = name.try(:text)
-            patient_element = member_info_element.at_xpath("./cda:participantRole[@classCode='PAT']")
-            ip.member_id = patient_element.at_xpath("./cda:id")
-            ip.relationship = extract_code(patient_element, "./cda:code")
-            ip.financial_responsibility_type = extract_code(payer_element, "./cda:performer/cda:assignedEntity/cda:code")
-          end                  
+        def create_entry(payer_element, nrh = CDA::NarrativeReferenceHandler.new)
+          ip = InsuranceProvider.new
+          type = extract_code(payer_element, "./cda:code")
+          ip.type = type['code'] if type
+          ip.payer = import_organization(payer_element.at_xpath("./cda:performer/cda:assignedEntity[cda:code[@code='PAYOR']]"))
+          ip.guarantors = extract_guarantors(payer_element.xpath("./cda:performer[cda:assignedEntity[cda:code[@code='GUAR']]]"))
+          ip.subscriber = import_person(payer_element.at_xpath("./cda:participant[@typeCode='HLD']/cda:participantRole"))
+          member_info_element = payer_element.at_xpath("cda:participant[@typeCode='COV']")
+          extract_dates(member_info_element, ip, "time")
+          name = payer_element.at_xpath("./cda:entryRelationship[@typeCode='REFR']/cda:act[@classCode='ACT' and @moodCode='DEF']/cda:text")
+          ip.name = name.try(:text)
+          patient_element = member_info_element.at_xpath("./cda:participantRole[@classCode='PAT']")
+          ip.member_id = patient_element.at_xpath("./cda:id")
+          ip.relationship = extract_code(patient_element, "./cda:code")
+          ip.financial_responsibility_type = extract_code(payer_element, "./cda:performer/cda:assignedEntity/cda:code")
+          ip
         end
         
         def extract_guarantors(guarantor_elements)
           guarantor_elements.map do |guarantor_element|
             guarantor = Guarantor.new
-            guarantor.person = import_person(guarantor_element.at_xpath("./cda:assignedPerson"))
-            guarantor.organization = import_organization(guarantor_element.at_xpath("./cda:representedOrganization"))
             extract_dates(guarantor_element, guarantor, element_name="time")
+            guarantor_entity = guarantor_element.at_xpath("./cda:assignedEntity")
+            guarantor.person = import_person(guarantor_entity.at_xpath("./cda:assignedPerson"))
+            guarantor.organization = import_organization(guarantor_entity.at_xpath("./cda:representedOrganization"))
             guarantor
           end
         end

data/lib/health-data-standards/import/c32/patient_importer.rb

@@ -11,7 +11,7 @@ module HealthDataStandards
 
         include Singleton
         include HealthDataStandards::Util
-        include HealthDataStandards::Import::C32::LocatableImportUtils
+        include HealthDataStandards::Import::CDA::LocatableImportUtils
 
         # Creates a new PatientImporter with the following XPath expressions used to find content in 
         # a HITSP C32:
@@ -55,33 +55,20 @@ module HealthDataStandards
         #    ./cda:consumable/cda:manufacturedProduct/cda:manufacturedMaterial/cda:code
         def initialize(check_usable = true)
           @section_importers = {}
-          @section_importers[:encounters] = EncounterImporter.new
-          @section_importers[:procedures] = ProcedureImporter.new
-          @section_importers[:results] = ResultImporter.new
-          @section_importers[:vital_signs] = VitalSignImporter.new
-          @section_importers[:medications] = MedicationImporter.new
+          @section_importers[:encounters] = CDA::EncounterImporter.new
+          @section_importers[:procedures] = CDA::ProcedureImporter.new
+          @section_importers[:results] = CDA::ResultImporter.new
+          @section_importers[:vital_signs] = CDA::VitalSignImporter.new
+          @section_importers[:medications] = CDA::MedicationImporter.new
           @section_importers[:conditions] = ConditionImporter.new
-          @section_importers[:social_history] = SectionImporter.new("//cda:observation[cda:templateId/@root='2.16.840.1.113883.3.88.11.83.19']")
+          @section_importers[:social_history] = CDA::SectionImporter.new(CDA::EntryFinder.new("//cda:observation[cda:templateId/@root='2.16.840.1.113883.3.88.11.83.19']"))
           @section_importers[:care_goals] = CareGoalImporter.new
-          @section_importers[:medical_equipment] = MedicalEquipmentImporter.new
-          @section_importers[:allergies] = AllergyImporter.new
+          @section_importers[:medical_equipment] = CDA::MedicalEquipmentImporter.new
+          @section_importers[:allergies] = CDA::AllergyImporter.new
           @section_importers[:immunizations] = ImmunizationImporter.new
           @section_importers[:insurance_providers] = InsuranceProviderImporter.new
         end
 
-        def build_id_map(doc)
-          id_map = {}
-          path = "//*[@ID]"
-          ids = doc.xpath(path)
-          ids.each do |id|
-            tag = id['ID']
-            value = id.content
-            id_map[tag] = value
-          end
-
-          id_map
-        end
-
         # @param [boolean] value for check_usable_entries...importer uses true, stats uses false 
         def check_usable(check_usable_entries)
           @section_importers.each_pair do |section, importer|
@@ -110,8 +97,10 @@ module HealthDataStandards
         # @param [Record] c32_patient to check the conditions on and set the expired
         #               property if applicable
         def check_for_cause_of_death(c32_patient)
-          if c32_patient.conditions.any? {|condition| condition.cause_of_death }
+          cause_of_death = c32_patient.conditions.detect {|condition| condition.cause_of_death }
+          if cause_of_death
             c32_patient.expired = true
+            c32_patient.deathdate = cause_of_death.time_of_death
           end
         end
 
@@ -121,9 +110,10 @@ module HealthDataStandards
         #        will have the "cda" namespace registered to "urn:hl7-org:v3"
         # @return [Hash] a represnetation of the patient with symbols as keys for each section
         def create_c32_hash(record, doc)
-          id_map = build_id_map(doc)
+          nrh = CDA::NarrativeReferenceHandler.new
+          nrh.build_id_map(doc)
           @section_importers.each_pair do |section, importer|
-            record.send(section.to_setter, importer.create_entries(doc, id_map))
+            record.send(section.to_setter, importer.create_entries(doc, nrh))
           end
         end
 
@@ -135,15 +125,18 @@ module HealthDataStandards
         def get_demographics(patient, doc)
           effective_date = doc.at_xpath('/cda:ClinicalDocument/cda:effectiveTime')['value']
           patient.effective_time = HL7Helper.timestamp_to_integer(effective_date)
-          patient_element = doc.at_xpath('/cda:ClinicalDocument/cda:recordTarget/cda:patientRole/cda:patient')
+          patient_role_element = doc.at_xpath('/cda:ClinicalDocument/cda:recordTarget/cda:patientRole')
+          patient_element = patient_role_element.at_xpath('./cda:patient')
+          patient.title = patient_element.at_xpath('cda:name/cda:title').try(:text)
           patient.first = patient_element.at_xpath('cda:name/cda:given').text
           patient.last = patient_element.at_xpath('cda:name/cda:family').text
           birthdate_in_hl7ts_node = patient_element.at_xpath('cda:birthTime')
           birthdate_in_hl7ts = birthdate_in_hl7ts_node['value']
           patient.birthdate = HL7Helper.timestamp_to_integer(birthdate_in_hl7ts)
+
           gender_node = patient_element.at_xpath('cda:administrativeGenderCode')
           patient.gender = gender_node['code']
-          id_node = doc.at_xpath('/cda:ClinicalDocument/cda:recordTarget/cda:patientRole/cda:id')
+          id_node = patient_role_element.at_xpath('./cda:id')
           patient.medical_record_number = id_node['extension']
           
           # parse race, ethnicity, and spoken language
@@ -151,16 +144,16 @@ module HealthDataStandards
           patient.race = { code: race_node['code'], code_set: 'CDC-RE' } if race_node
           ethnicity_node = patient_element.at_xpath('cda:ethnicGroupCode')
           patient.ethnicity = {code: ethnicity_node['code'], code_set: 'CDC-RE'} if ethnicity_node
+          marital_status_node = patient_element.at_xpath("./cda:maritalStatusCode")
+          patient.marital_status = {code: marital_status_node['code'], code_set: "HL7 Marital Status"} if marital_status_node
+          ra_node = patient_element.at_xpath("./cda:religiousAffiliationCode")
+          patient.religious_affiliation = {code: ra_node['code'], code_set: "Religious Affiliation"} if ra_node
           languages = patient_element.search('languageCommunication').map {|lc| lc.at_xpath('cda:languageCode')['code'] }
           patient.languages = languages unless languages.empty?
           
-          # parse address information
-          patient.addresses = doc.xpath('/cda:ClinicalDocument/cda:recordTarget/cda:patientRole/cda:addr').map do |addr_element|
-            import_address(addr_element)
-          end
-          patient.telecoms = doc.xpath('/cda:ClinicalDocument/cda:recordTarget/cda:patientRole/cda:telecom').map do |tele|
-            import_telecom(tele)
-          end
+          patient.addresses = patient_role_element.xpath("./cda:addr").map { |addr| import_address(addr) }
+          patient.telecoms = patient_role_element.xpath("./cda:telecom").map { |tele| import_telecom(tele) }
+          
         end
       end
     end

data/lib/health-data-standards/import/cat1/diagnosis_active_importer.rb

@@ -0,0 +1,19 @@
+module HealthDataStandards
+  module Import
+    module Cat1
+      class DiagnosisActiveImporter < CDA::ConditionImporter
+
+        def initialize
+          super(CDA::EntryFinder.new("//cda:observation[cda:templateId/@root='2.16.840.1.113883.10.20.24.3.11']"))
+          @status_xpath = nil # We'll hardcode this to active in create entry because this is from the 
+                              # diagnosis active template
+        end
+
+        def create_entry(entry_element, nrh = CDA::NarrativeReferenceHandler.new)
+          condition = super
+          condition
+        end
+      end
+    end
+  end
+end

data/lib/health-data-standards/import/cat1/diagnosis_inactive_importer.rb

@@ -0,0 +1,19 @@
+module HealthDataStandards
+  module Import
+    module Cat1
+      class DiagnosisInactiveImporter < CDA::ConditionImporter
+
+        def initialize
+          super(CDA::EntryFinder.new("//cda:observation[cda:templateId/@root='2.16.840.1.113883.10.20.24.3.13']"))
+          @status_xpath = nil # We'll hardcode this to active in create entry because this is from the 
+                              # diagnosis active template
+        end
+
+        def create_entry(entry_element, nrh = CDA::NarrativeReferenceHandler.new)
+          condition = super
+          condition
+        end
+      end
+    end
+  end
+end

data/lib/health-data-standards/import/cat1/diagnostic_study_order_importer.rb

@@ -0,0 +1,24 @@
+module HealthDataStandards
+  module Import
+    module Cat1
+      class DiagnosticStudyOrderImporter < CDA::SectionImporter
+        def initialize(entry_finder=CDA::EntryFinder.new("//cda:observation[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.17']"))
+          super(entry_finder)
+          @entry_class = Procedure
+        end
+        
+        def create_entry(entry_element, nrh = CDA::NarrativeReferenceHandler.new)
+          super
+        end
+
+        private
+
+        def extract_dates(parent_element, entry, element_name="author")
+          if parent_element.at_xpath("cda:#{element_name}/cda:time/@value")
+            entry.start_time = HL7Helper.timestamp_to_integer(parent_element.at_xpath("cda:#{element_name}/cda:time")['value'])
+          end
+        end
+      end
+    end
+  end
+end

data/lib/health-data-standards/import/cat1/encounter_order_importer.rb

@@ -0,0 +1,24 @@
+module HealthDataStandards
+  module Import
+    module Cat1
+      class EncounterOrderImporter < CDA::EncounterImporter
+        def initialize(entry_finder=CDA::EntryFinder.new("//cda:encounter[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.22']"))
+          super(entry_finder)
+          @entry_class = Encounter
+        end
+        
+        def create_entry(entry_element, nrh = CDA::NarrativeReferenceHandler.new)
+          super
+        end
+
+        private
+
+        def extract_dates(parent_element, entry, element_name="author")
+          if parent_element.at_xpath("cda:#{element_name}/cda:time/@value")
+            entry.start_time = HL7Helper.timestamp_to_integer(parent_element.at_xpath("cda:#{element_name}/cda:time")['value'])
+          end
+        end
+      end
+    end
+  end
+end

data/lib/health-data-standards/import/cat1/entry_package.rb

@@ -0,0 +1,25 @@
+module HealthDataStandards
+  module Import
+    module Cat1
+      class EntryPackage
+
+        attr_accessor :importer_type, :hqmf_oid, :status
+
+        def initialize (type, oid, stat = nil)
+          self.importer_type = type
+          self.hqmf_oid = oid
+          self.status = stat
+        end  
+
+        def package_entries (doc, nrh)
+          entries = self.importer_type.create_entries(doc, nrh)
+          entries.each do |entry| 
+            entry.oid = self.hqmf_oid
+            entry.status = self.status
+          end          
+          entries
+        end
+      end
+    end
+  end
+end

data/lib/health-data-standards/import/cat1/gestational_age_importer.rb

@@ -0,0 +1,42 @@
+module HealthDataStandards
+  module Import
+    module Cat1
+      class GestationalAgeImporter < CDA::SectionImporter
+
+        def initialize
+          super(CDA::EntryFinder.new("//cda:observation[cda:templateId/@root='2.16.840.1.113883.10.20.24.3.101']"))
+
+        end
+
+        def create_entry(entry_element, nrh = CDA::NarrativeReferenceHandler.new)
+          ga_entry = super
+          swap_code_based_on_value(ga_entry)
+          ga_entry
+        end
+    
+        private
+
+        # QRDA Cat 1 represents gestational age by using the SNOMED code for length
+        # of gestation and then providing the length in weeks in a value element.
+        # The measure value sets use the SNOMED codes that correspond to an actual
+        # gestational length. This method uses the value to replace the SNOMED code
+        # in the entry.
+        def swap_code_based_on_value(ga_entry)
+          value = ga_entry.values.first
+          if value.present?
+            case value.scalar
+            when "39"
+              ga_entry.codes = {'SNOMED-CT' => ['80487005']}
+            when "38"
+              ga_entry.codes = {'SNOMED-CT' => ['13798002']}
+            when "37"
+              ga_entry.codes = {'SNOMED-CT' => ['43697006']}
+            when "36"
+              ga_entry.codes = {'SNOMED-CT' => ['931004']}
+            end
+          end
+        end
+      end
+    end
+  end
+end

data/lib/health-data-standards/import/cat1/lab_order_importer.rb

@@ -0,0 +1,24 @@
+module HealthDataStandards
+  module Import
+    module Cat1
+      class LabOrderImporter < CDA::SectionImporter
+        def initialize(entry_finder=CDA::EntryFinder.new("//cda:observation[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.37']"))
+          super(entry_finder)
+          @entry_class = LabResult
+        end
+        
+        def create_entry(entry_element, nrh = CDA::NarrativeReferenceHandler.new)
+          super
+        end
+
+        private
+
+        def extract_dates(parent_element, entry, element_name="author")
+          if parent_element.at_xpath("cda:#{element_name}/cda:time/@value")
+            entry.start_time = HL7Helper.timestamp_to_integer(parent_element.at_xpath("cda:#{element_name}/cda:time")['value'])
+          end
+        end
+      end
+    end
+  end
+end

data/lib/health-data-standards/import/cat1/medication_dispensed_importer.rb

@@ -0,0 +1,13 @@
+module HealthDataStandards
+  module Import
+    module Cat1
+      class MedicationDispensedImporter < CDA::SectionImporter
+        def initialize(entry_finder=CDA::EntryFinder.new("//cda:supply[cda:templateId/@root='2.16.840.1.113883.10.20.24.3.45']"))
+          super(entry_finder)
+          @code_xpath = "./cda:product/cda:manufacturedProduct/cda:manufacturedMaterial/cda:code"
+          @entry_class = Medication
+        end
+      end
+    end
+  end
+end

data/lib/health-data-standards/import/cat1/patient_importer.rb

@@ -0,0 +1,104 @@
+module HealthDataStandards
+  module Import
+    module Cat1
+
+      # This class is the central location for taking a QRDA Cat 1 XML document and converting it
+      # into the processed form we store in MongoDB. The class does this by running each measure
+      # independently on the XML document
+      #
+      # This class is a Singleton. It should be accessed by calling PatientImporter.instance
+      class PatientImporter
+        include Singleton
+
+        def initialize
+          # This differs from other HDS patient importers in that sections can have multiple importers
+          @section_importers = {}
+          @section_importers[:care_goals] = [EntryPackage.new(CDA::SectionImporter.new(CDA::EntryFinder.new("//cda:observation[cda:templateId/@root='2.16.840.1.113883.10.20.24.3.1']")), '2.16.840.1.113883.3.560.1.9')].compact #care goal
+
+          ecog_status_importer = CDA::SectionImporter.new(CDA::EntryFinder.new("//cda:observation[cda:templateId/@root='2.16.840.1.113883.10.20.24.3.103']"))
+          ecog_status_importer.code_xpath = './cda:value'
+          symptom_active_importer = CDA::SectionImporter.new(CDA::EntryFinder.new("//cda:observation[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.76']"))
+          symptom_active_importer.code_xpath = './cda:value'
+          
+          @section_importers[:conditions] = [EntryPackage.new(GestationalAgeImporter.new, '2.16.840.1.113883.3.560.1.1001'),
+                                             EntryPackage.new(ecog_status_importer, '2.16.840.1.113883.3.560.1.1001'),
+                                             EntryPackage.new(symptom_active_importer, '2.16.840.1.113883.3.560.1.69', 'active'),
+                                             EntryPackage.new(DiagnosisActiveImporter.new, '2.16.840.1.113883.3.560.1.2', 'active'),
+                                             EntryPackage.new(CDA::ConditionImporter.new(CDA::EntryFinder.new("//cda:observation[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.54']")), '2.16.840.1.113883.3.560.1.404'), # patient characteristic age
+                                             EntryPackage.new(CDA::ConditionImporter.new(CDA::EntryFinder.new("//cda:observation[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.14']")), '2.16.840.1.113883.3.560.1.24', 'resolved'), #diagnosis resolved
+                                             EntryPackage.new(DiagnosisInactiveImporter.new, '2.16.840.1.113883.3.560.1.23', 'inactive')].compact #diagnosis inactive
+  
+          
+          @section_importers[:medications] = [EntryPackage.new(CDA::MedicationImporter.new(CDA::EntryFinder.new("//cda:act[cda:templateId/@root='2.16.840.1.113883.10.20.24.3.105']/cda:entryRelationship/cda:substanceAdministration[cda:templateId/@root='2.16.840.1.113883.10.20.24.3.41']")), '2.16.840.1.113883.3.560.1.199', 'discharge'), #discharge medication active
+                                              EntryPackage.new(CDA::MedicationImporter.new(CDA::EntryFinder.new("//cda:substanceAdministration[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.41']")), '2.16.840.1.113883.3.560.1.13', 'active'), #medication active
+                                              EntryPackage.new(CDA::MedicationImporter.new(CDA::EntryFinder.new("//cda:act[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.42']/cda:entryRelationship/cda:substanceAdministration[cda:templateId/@root='2.16.840.1.113883.10.20.22.4.16']")), '2.16.840.1.113883.3.560.1.14', 'administered'), #medication administered
+                                              EntryPackage.new(CDA::MedicationImporter.new(CDA::EntryFinder.new("//cda:substanceAdministration[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.47']")), '2.16.840.1.113883.3.560.1.17', 'ordered'), #medication order TODO: ADD NEGATON REASON HANDLING SOMEHOW
+                                              EntryPackage.new(MedicationDispensedImporter.new, '2.16.840.1.113883.3.560.1.8', 'dispensed')].compact
+
+          @section_importers[:procedures] = [EntryPackage.new(CDA::ProcedureImporter.new(CDA::EntryFinder.new("//cda:observation[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.59']")), '2.16.840.1.113883.3.560.1.57', 'performed'), #physical exam performed
+                                             EntryPackage.new(CDA::ProcedureImporter.new(CDA::EntryFinder.new("//cda:act[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.3']")), '2.16.840.1.113883.3.560.1.131'), #comm from provider to patient
+                                             EntryPackage.new(CDA::ProcedureImporter.new(CDA::EntryFinder.new("//cda:act[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.31']")), '2.16.840.1.113883.3.560.1.45', 'ordered'), #intervention ordered
+                                             EntryPackage.new(CDA::ProcedureImporter.new(CDA::EntryFinder.new("//cda:act[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.32']")), '2.16.840.1.113883.3.560.1.46', 'performed'), #intervention performed
+                                             EntryPackage.new(CDA::ProcedureImporter.new(CDA::EntryFinder.new("//cda:act[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.34']")), '2.16.840.1.113883.3.560.1.47'), #intervention result
+                                             EntryPackage.new(CDA::ProcedureImporter.new(CDA::EntryFinder.new("//cda:act[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.4']")), '2.16.840.1.113883.3.560.1.129'), #comm from provider to provider
+                                             EntryPackage.new(CDA::ProcedureImporter.new(CDA::EntryFinder.new("//cda:act[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.2']")), '2.16.840.1.113883.3.560.1.30'), #comm from patient to provider
+                                             EntryPackage.new(ProcedureOrderImporter.new, '2.16.840.1.113883.3.560.1.62', 'ordered'),
+                                             EntryPackage.new(CDA::ProcedureImporter.new(CDA::EntryFinder.new("//cda:procedure[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.64']")), '2.16.840.1.113883.3.560.1.6'),
+                                             EntryPackage.new(CDA::ProcedureImporter.new(CDA::EntryFinder.new("//cda:procedure[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.66']")), '2.16.840.1.113883.3.560.1.63'),
+                                             EntryPackage.new(CDA::ProcedureImporter.new(CDA::EntryFinder.new("//cda:observation[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.69']")), '2.16.840.1.113883.3.560.1.21'),
+                                             EntryPackage.new(CDA::ProcedureImporter.new(CDA::EntryFinder.new("//cda:observation[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.18']")), '2.16.840.1.113883.3.560.1.103', 'performed'), #diagnostic study performed
+                                             EntryPackage.new(DiagnosticStudyOrderImporter.new, '2.16.840.1.113883.3.560.1.40', 'ordered')].compact
+
+          @section_importers[:allergies] = [EntryPackage.new(ProcedureIntoleranceImporter.new, '2.16.840.1.113883.3.560.1.61'),
+                                            EntryPackage.new(CDA::AllergyImporter.new(CDA::EntryFinder.new("//cda:observation[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.46']")), '2.16.840.1.113883.3.560.1.67'), #medication intolerance
+                                            EntryPackage.new(CDA::AllergyImporter.new(CDA::EntryFinder.new("//cda:observation[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.43']")), '2.16.840.1.113883.3.560.1.7'), #medication adverse effect
+                                            EntryPackage.new(CDA::AllergyImporter.new(CDA::EntryFinder.new("//cda:observation[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.44']")), '2.16.840.1.113883.3.560.1.1')].compact #medication allergy
+
+          @section_importers[:medical_equipment] = [EntryPackage.new(CDA::MedicalEquipmentImporter.new(CDA::EntryFinder.new("//cda:procedure[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.7']")), '2.16.840.1.113883.3.560.1.110', 'applied')].compact
+
+          @section_importers[:results] = [EntryPackage.new(LabOrderImporter.new, '2.16.840.1.113883.3.560.1.50', 'ordered'), #lab ordered
+                                          EntryPackage.new(CDA::ResultImporter.new(CDA::EntryFinder.new("//cda:observation[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.38']")), '2.16.840.1.113883.3.560.1.5', 'performed'), #lab performed
+                                          EntryPackage.new(CDA::ResultImporter.new(CDA::EntryFinder.new("//cda:act[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.34']")), '2.16.840.1.113883.3.560.1.47'), #intervention result
+                                          EntryPackage.new(CDA::ResultImporter.new(CDA::EntryFinder.new("//cda:observation[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.57']")), '2.16.840.1.113883.3.560.1.18'), #physical exam finding
+                                          EntryPackage.new(CDA::ResultImporter.new(CDA::EntryFinder.new("//cda:observation[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.28']")), '2.16.840.1.113883.3.560.1.88'), #functional status result    
+                                          EntryPackage.new(CDA::ResultImporter.new(CDA::EntryFinder.new("//cda:observation[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.20']")), '2.16.840.1.113883.3.560.1.111')].compact #diagnostic study result not done
+
+          @section_importers[:encounters] = [EntryPackage.new(CDA::EncounterImporter.new(CDA::EntryFinder.new("//cda:encounter[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.23']")), '2.16.840.1.113883.3.560.1.79', 'performed'), #encounter performed
+                                             EntryPackage.new(EncounterOrderImporter.new, '2.16.840.1.113883.3.560.1.83', 'ordered')].compact
+
+          @section_importers[:social_history] = [EntryPackage.new(TobaccoUseImporter.new, '2.16.840.1.113883.3.560.1.1001', 'completed')].compact
+
+        end 
+
+        def parse_cat1(doc)
+          record = Record.new
+          HealthDataStandards::Import::C32::PatientImporter.instance.get_demographics(record, doc)
+          import_sections(record, doc)
+          get_clinical_trial_participant(record, doc)
+          get_patient_expired(record, doc)
+          record
+        end
+
+        def import_sections(record, doc)
+          nrh = CDA::NarrativeReferenceHandler.new
+          nrh.build_id_map(doc)
+          @section_importers.each do |section, entry_packages|
+            entry_packages.each do |entry_package|
+              record.send(section) << entry_package.package_entries(doc, nrh)
+            end
+          end
+        end
+
+        def get_clinical_trial_participant(record, doc)
+          entry_elements = doc.xpath("//cda:observation[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.51']")
+          record.clinicalTrialParticipant = true unless entry_elements.nil? 
+        end
+
+        def get_patient_expired(record, doc)
+          entry_elements = doc.xpath("//cda:observation[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.54']")
+          record.expired = true unless entry_elements.nil?
+        end
+      end
+    end
+  end
+end