health-data-standards 3.5.2 → 3.5.3

checksums.yaml

@@ -1,7 +1,7 @@
 ---
 SHA1:
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-  data.tar.gz: 204430a5a3aa971fba9199fc316f83604d0cc1c1
+  metadata.gz: f28260b9a20c4a5fa03677dbde72935d0779e1b7
+  data.tar.gz: 758234c177f32a11c9606258a38bf83387fe2fb9
 SHA512:
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+  metadata.gz: 03f1f77b7b63a7ca367c477dda130c115b8df7ecc2128aab02265c405f0db8b96696b3d09a15cb4f1ae59862142e8268d7900abc2e150d4c71ff9932a4f0dc61
+  data.tar.gz: 79d88e0eecd99eddd931977ced5974969a2afee8ae74665721b0740013247183c86bbf75e376891d9427789f56d1a731e3c656631ae1bde4e16ea25095e65500

data/README.md

@@ -29,6 +29,10 @@ Change Log
 
 * Upgrading to mongoid 4
 
+3.5.3 - January 20, 2015
+
+* Support for 2014 QRDA Errata Release
+
 3.4.6 - May 15, 2014
 
 * QRDA Cat I export now exports medical record number if present

data/lib/health-data-standards/export/qrda/hqmf-qrda-oids.json

@@ -623,12 +623,6 @@
     "qrda_name": "Risk Category Assessment",
     "qrda_oid": "2.16.840.1.113883.10.20.24.3.69"
   },
-  {
-    "hqmf_name": "Diagnostic Study, Result not done",
-    "hqmf_oid": "2.16.840.1.113883.3.560.1.111",
-    "qrda_name": "Diagnostic Study Result",
-    "qrda_oid": "2.16.840.1.113883.10.20.24.3.20"
-  },
   {
     "hqmf_name": "Communication: From Provider to Patient not done",
     "hqmf_oid": "2.16.840.1.113883.3.560.1.131",

data/lib/health-data-standards/export/view_helper.rb

@@ -40,6 +40,14 @@ module HealthDataStandards
         end
       end
 
+      def fulfillment_quantity(codes, fulfillmentHistory, dose)
+        if (codes["RxNorm"].present?)
+          doses = (fulfillmentHistory.quantity_dispensed['value'].to_f / dose['value'].to_f ).to_i
+          return "value='#{doses}'"
+        else
+          return "value='#{fulfillmentHistory.quantity_dispensed['value']}' unit='#{fulfillmentHistory.quantity_dispensed['unit']}'"
+        end
+      end
            
       def value_or_null_flavor(time)
         if time 
@@ -49,6 +57,14 @@ module HealthDataStandards
        end
       end
 
+      def dose_quantity(codes, dose)
+        if (codes["RxNorm"].present?)
+          return "value='1'"
+        else
+          return "value=#{dose['value']} unit=#{dose['unit']}" 
+        end
+      end
+
       def time_if_not_nil(*args)
         args.compact.map {|t| Time.at(t).utc}.first
       end
@@ -64,9 +80,16 @@ module HealthDataStandards
       def is_bool?(str)
         return ["true","false"].include? (str || "").downcase
       end
+
+      def identifier_for(obj)
+        Digest::MD5.hexdigest(obj.to_s).upcase
+      end
       
       def convert_field_to_hash(field, codes)
-        codes = codes[0] if codes.is_a? Array
+        if codes.is_a? Array
+          return codes.collect{ |code| convert_field_to_hash(field, convert_field_to_hash(field, code))}.join("<br>")
+        end
+
         if (codes.is_a? Hash)
           clean_hash = {}
           

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

@@ -13,6 +13,7 @@ module HealthDataStandards
           ip = InsuranceProvider.new
           value_element = payer_element.at_xpath('cda:value')
           ip.codes = { 'SOP' => [value_element['code']] } if value_element
+          extract_dates(payer_element, ip)
           ip
         end
 

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

@@ -42,6 +42,7 @@ module HealthDataStandards
                                              generate_importer(CDA::ProcedureImporter, "./cda:entry/cda:procedure[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.66']", '2.16.840.1.113883.3.560.1.63'),
                                              generate_importer(CDA::ProcedureImporter, "./cda:entry/cda:observation[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.69']", '2.16.840.1.113883.3.560.1.21'), #risk category assessment
                                              generate_importer(CDA::ProcedureImporter, "./cda:entry/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
+                                             generate_importer(CDA::ProcedureImporter, "./cda:entry/cda:observation[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.20']", '2.16.840.1.113883.3.560.1.11'), #diagnostic study result
                                              generate_importer(DiagnosticStudyOrderImporter, nil, '2.16.840.1.113883.3.560.1.40', 'ordered')]
 
           @section_importers[:allergies] = [generate_importer(ProcedureIntoleranceImporter, nil, '2.16.840.1.113883.3.560.1.61'),
@@ -56,7 +57,6 @@ module HealthDataStandards
                                           generate_importer(CDA::ResultImporter, "./cda:entry/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
                                           generate_importer(CDA::ResultImporter, "./cda:entry/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
                                           generate_importer(CDA::ResultImporter, "./cda:entry/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    
-                                          generate_importer(CDA::ResultImporter, "./cda:entry/cda:observation[cda:templateId/@root = '2.16.840.1.113883.10.20.24.3.20']", '2.16.840.1.113883.3.560.1.111'), #diagnostic study result not done
                                           generate_importer(LabResultImporter, nil, '2.16.840.1.113883.3.560.1.12')] #lab result
 
           @section_importers[:encounters] = [generate_importer(EncounterPerformedImporter, "./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
@@ -85,6 +85,7 @@ module HealthDataStandards
           nrh.build_id_map(doc)
           @section_importers.each do |section, entry_packages|
             entry_packages.each do |entry_package|
+              # binding.pry if section == :results
               record.send(section) << entry_package.package_entries(context, nrh)
             end
           end

data/lib/health-data-standards/models/cqm/aggregate_objects.rb

@@ -101,15 +101,15 @@ module HealthDataStandards
         entry_populations = []
         cache_entry.population_ids.each do |population_type, population_id|
           population = populations.find{|pop| pop.id == population_id}
-          if population.nil? && population_type != 'stratification'
+          if population.nil? && population_type != 'stratification' && population_type != 'STRAT'
             population = Population.new
             population.type = population_type
             population.id = population_id
             populations << population
           end
-          unless population_type == 'stratification'
+          unless population_type == 'stratification' || population_type == 'STRAT'
             if cache_entry.is_stratification?
-              strat_id = cache_entry.population_ids['stratification']
+              strat_id = cache_entry.population_ids['STRAT']
               population.add_stratification(strat_id,cache_entry[population_type])
             else
               population.value = cache_entry[population_type]

data/lib/health-data-standards/models/cqm/query_cache.rb

@@ -36,7 +36,7 @@ module HealthDataStandards
       end
 
       def is_stratification?
-        population_ids.has_key?('stratification')
+        population_ids.has_key?('stratification') || population_ids.has_key?('STRAT')
       end
 
       def is_cv?

data/lib/hqmf-parser.rb

@@ -1,6 +1,5 @@
 # require
 require 'nokogiri'
-require 'pry'
 require 'json'
 require 'ostruct'
 require 'health-data-standards'

data/templates/cat1/_2.16.840.1.113883.10.20.24.3.2.cat1.erb

@@ -1,16 +1,16 @@
 <entry>
-  <act classCode="ACT" moodCode="EVN">
+  <act classCode="ACT" moodCode="EVN" <%== negation_indicator(entry) %>>
     <!-- Communication from patient to provider -->
     <templateId root="2.16.840.1.113883.10.20.24.3.2"/>
     <id root="1.3.6.1.4.1.115" extension="<%= entry.id %>"/>  
-    <%== code_display(entry, 'value_set_map' => value_set_map, 'extra_content' => "sdtc:valueSet=\"#{value_set_oid}\"") %>
+    <%== code_display(entry, 'value_set_map' => value_set_map, 'preferred_code_sets' => ['SNOMED-CT'], 'extra_content' => "sdtc:valueSet=\"#{value_set_oid}\"") %>
     <text><%= entry.description %></text>
     <statusCode code="completed"/>
     <effectiveTime>
       <low <%= value_or_null_flavor(entry.start_time) %>/>
       <high <%= value_or_null_flavor(entry.end_time) %>/>
     </effectiveTime>
-
+    
     <participant typeCode="AUT">
       <participantRole classCode="PAT">
         <code code="116154003" codeSystem="2.16.840.1.113883.6.96" codeSystemName="SNOMED CT" displayName="Patient"/>
@@ -23,5 +23,7 @@
       </participantRole>
     </participant>
 
+    <%== render(:partial => 'reason', :locals => {:entry => entry, :reason_oids=>field_oids["REASON"]}) %>
+
   </act>
 </entry>

data/templates/cat1/_2.16.840.1.113883.10.20.24.3.23.cat1.erb

@@ -75,20 +75,7 @@
     <% end -%>
 
     <% if entry.reason.present? -%>
-    <entryRelationship typeCode="RSON">
-      <observation classCode="OBS" moodCode="EVN">
-        <templateId root="2.16.840.1.113883.10.20.24.3.88"/>  
-        <code code="410666004" 
-              codeSystem="2.16.840.1.113883.6.96"
-              displayName="reason" 
-              codeSystemName="SNOMED CT"/>
-        <statusCode code="completed"/>
-        <effectiveTime <%= value_or_null_flavor(entry.start_time) %>/>
-        <value xsi:type="CD" 
-             code="<%= entry.reason['code'] %>" 
-             codeSystem="<%= HealthDataStandards::Util::CodeSystemHelper.oid_for_code_system(entry.reason['codeSystem'] ||  entry.reason['code_system']) %>"/>
-      </observation>
-    </entryRelationship>
+      <%= render partial: "reason", locals: {entry: entry} %>
     <% end -%>
   </encounter>
 </entry>

data/templates/cat1/_2.16.840.1.113883.10.20.24.3.41.cat1.erb

@@ -12,10 +12,16 @@
         <low <%= value_or_null_flavor(entry.start_time) %>/>
         <high <%= value_or_null_flavor(entry.end_time) %>/>
     </effectiveTime>
+
+    <% if entry.administrationTiming.present?
+      period = entry.administrationTiming['period'] %>
+      <effectiveTime xsi:type="PIVL_TS" institutionSpecified="true" operator="A">
+        <period value="<%= period['value']%>" unit="<%= period['unit']%>"/>
+      </effectiveTime>
+    <% end %>
     
     <%== render(:partial => 'medication_details', :locals => {:entry => entry, :route_oids=>field_oids["ROUTE"]}) %>
 
-
     <% if entry.product_form.present? -%>
     <administrationUnitCode code="<%= entry.product_form['code'] %>" codeSystem="<%= entry.product_form['codeSystem'] %>"/>
     <% end -%>
@@ -34,5 +40,9 @@
       </manufacturedProduct>
     </consumable>
     <%== render(:partial => 'reason', :locals => {:entry => entry, :reason_oids=>field_oids["REASON"]}) %>
+
+    <%== render(:partial => 'medication_dispense', :collection => entry.fulfillmentHistory, :locals => {:entry => entry, :value_set_map => value_set_map, :value_set_oid => value_set_oid}) %>
+
   </substanceAdministration>
+
 </entry>

data/templates/cat1/_2.16.840.1.113883.10.20.24.3.55.cat1.erb

@@ -5,6 +5,14 @@
     <id root="1.3.6.1.4.1.115" extension="<%= entry.id %>"/>
     <code code="48768-6" codeSystemName="LOINC" codeSystem="2.16.840.1.113883.6.1" displayName="Payment source"/> 
     <statusCode code="completed"/>
+    <effectiveTime>
+      <!-- Attribute: Start Datetime -->
+      <low <%= value_or_null_flavor(entry.start_time) %>/>
+      <% if entry.end_time %>
+        <high value="<%= time_if_not_nil(entry.end_time) %>" />
+      <% end %>
+    </effectiveTime>
     <%== code_display(entry, 'preferred_code_sets' =>["SOP","Source of Payment Typology"] , 'tag_name' => 'value', 'extra_content' => "xsi:type=\"CD\" sdtc:valueSet=\"2.16.840.1.114222.4.11.3591\"") %>
+
   </observation>            
 </entry>

data/templates/cat1/_2.16.840.1.113883.10.20.24.3.64.cat1.erb

@@ -18,6 +18,7 @@
     <entryRelationship typeCode="REFR">
       <procedure classCode="PROC" moodCode="EVN">
         <templateId root="2.16.840.1.113883.10.20.24.3.89"/>
+        <id extension="<%= identifier_for([entry.id, entry.incision_time]) %>" />
         <code code="34896006" 
               codeSystem="2.16.840.1.113883.6.96"
               codeSystemName="SNOMED CT" 

data/templates/cat1/_measures.cat1.erb

@@ -43,12 +43,13 @@
               <templateId root="2.16.840.1.113883.10.20.24.3.98"/>
               <!-- This is the templateId for eMeasure Reference QDM -->
               <templateId root="2.16.840.1.113883.10.20.24.3.97"/>
+              <id extension="<%= measure['id'] %>"/>
               <statusCode code="completed"/>
               <!-- Containing isBranch external references -->
               <reference typeCode="REFR">
                 <externalDocument classCode="DOC" moodCode="EVN">
                   <!-- SHALL: This is the version specific identifier for eMeasure: QualityMeasureDocument/id it is a GUID-->
-                  <id root="<%= measure.hqmf_id %>"/>
+                  <id root="2.16.840.1.113883.4.738" extension="<%= measure.hqmf_id %>"/>
                   <!-- SHOULD This is the title of the eMeasure -->
                   <text><%= measure.title %></text>
                   <!-- SHOULD: setId is the eMeasure version neutral id  -->

data/templates/cat1/_medication_details.cat1.erb

@@ -11,5 +11,5 @@
 <% end -%>
 
 <% if entry.respond_to?(:dose) && entry.dose.present? -%>
-<doseQuantity value="<%= entry.dose['value']%>"/>
+<doseQuantity <%= dose_quantity(entry.codes, entry.dose) %>/>
 <% end -%>

data/templates/cat1/_medication_dispense.cat1.erb

@@ -0,0 +1,22 @@
+
+<entryRelationship typeCode="REFR">
+  <supply classCode="SPLY" moodCode="EVN">
+    <!-- Medication Dispense template -->
+    <templateId root="2.16.840.1.113883.10.20.22.4.18"/>
+    <id root="1.3.6.1.4.1.115" extension="<%= UUID.generate %>"/>
+    <statusCode code="completed"/>
+    <effectiveTime <%= value_or_null_flavor(medication_dispense.dispense_date) %>/>
+    <repeatNumber value="1"/>
+    <quantity <%= fulfillment_quantity(entry.codes, medication_dispense, entry.dose) %>/>
+    <product>
+      <manufacturedProduct classCode="MANU">
+        <!-- Medication Information (consolidation) template -->
+        <templateId root="2.16.840.1.113883.10.20.22.4.23"/>
+        <id root="<%= UUID.generate %>"/>
+        <manufacturedMaterial>
+          <%== code_display(entry, 'preferred_code_sets' =>["RxNorm"], 'value_set_map' => value_set_map, 'extra_content' => "sdtc:valueSet=\"#{value_set_oid}\"") %>
+        </manufacturedMaterial>
+      </manufacturedProduct>
+    </product>
+  </supply>
+</entryRelationship>

data/templates/cat1/_reason.cat1.erb

@@ -4,6 +4,7 @@
 <entryRelationship typeCode="RSON">
   <observation classCode="OBS" moodCode="EVN">
     <templateId root="2.16.840.1.113883.10.20.24.3.88"/>  
+    <id extension="<%= identifier_for([entry.negation_reason, entry.start_time]) %>" />
     <code code="410666004" 
           codeSystem="2.16.840.1.113883.6.96"
           displayName="reason" 

data/templates/cat1/_reporting_parameters.cat1.erb

@@ -13,6 +13,7 @@
             <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"/>
+              <id extension="<%= identifier_for([start_date, end_date]) %>" />
               <code code="252116004" codeSystem="2.16.840.1.113883.6.96" displayName="Observation Parameters"/>
               <effectiveTime>
                 <low value="<%= start_date.to_formatted_s(:number) %>"/>

data/templates/cat3/_measure_data.cat3.erb

@@ -82,7 +82,7 @@
    <!--    SEX Supplemental Data Reporting for <%= population.type %>  <%= population.id %>      --> 
          
   <%== render :partial => 'supplemental_data', :locals => {:template_name => 'Sex Supplemental Data', 
-                :template_id => '2.16.840.1.113883.10.20.27.3.6', :supplemental_data_code => '184100006',
+                :template_ids => ['2.16.840.1.113883.10.20.27.3.6'], :supplemental_data_code => '184100006',
                 :supplemental_data_code_system => '2.16.840.1.113883.6.96', :supplemental_data_value_code => sex,
                 :supplemental_data_value_code_system => '2.16.840.1.113883.5.1', :count => count} %>   
       <% end -%>
@@ -94,7 +94,7 @@
     <!--     ETHNICITY Supplemental Data Reporting  for <%= population.type %>  <%= population.id %>     --> 
 
   <%== render :partial => 'supplemental_data', :locals => {:template_name => 'Ethnicity Supplemental Data', 
-                :template_id => '2.16.840.1.113883.10.20.27.3.7', :supplemental_data_code => '364699009',
+                :template_ids => ['2.16.840.1.113883.10.20.27.3.7'], :supplemental_data_code => '364699009',
                 :supplemental_data_code_system => '2.16.840.1.113883.6.96', :supplemental_data_value_code => ethnicity,
                 :supplemental_data_value_code_system => '2.16.840.1.113883.6.238', :count => count} %>   
       <% end -%>
@@ -106,7 +106,7 @@
    <!--      RACE Supplemental Data Reporting  for <%= population.type %>  <%= population.id %> --> 
 
   <%== render :partial => 'supplemental_data', :locals => {:template_name => 'Race Supplemental Data', 
-                :template_id => '2.16.840.1.113883.10.20.27.3.8', :supplemental_data_code => '103579009',
+                :template_ids => ['2.16.840.1.113883.10.20.27.3.8'], :supplemental_data_code => '103579009',
                 :supplemental_data_code_system => '2.16.840.1.113883.6.96', :supplemental_data_value_code => race,
                 :supplemental_data_value_code_system => '2.16.840.1.113883.6.238', :count => count} %>   
       <% end -%>
@@ -116,8 +116,8 @@
          payer_supplimental_data.each do |payer, count| -%>
 
  <!--         PAYER Supplemental Data Reporting   for<%= population.type %>  <%= population.id %>   -->        
-  <%== render :partial => 'supplemental_data', :locals => {:template_name => 'Payer Supplemental Data', 
-                :template_id => '2.16.840.1.113883.10.20.27.3.9', :supplemental_data_code => '48768-6',
+ <%== render :partial => 'supplemental_data', :locals => {:template_name => 'Payer Supplemental Data', 
+                :template_ids => ['2.16.840.1.113883.10.20.27.3.9', '2.16.840.1.113883.10.20.24.3.55'], :supplemental_data_code => '48768-6',
                 :supplemental_data_code_system => '2.16.840.1.113883.6.1', :supplemental_data_value_code => payer,
                 :supplemental_data_value_code_system => '2.16.840.1.113883.3.221.5', :count => count} %>   
       <% end -%>

data/templates/cat3/_reporting_parameters.cat3.erb

@@ -15,8 +15,9 @@
           </text>
           <entry typeCode="DRIV">
             <act classCode="ACT" moodCode="EVN">
-              <!-- This is the templateId for Reporting Parameteres Act -->
+              <!-- This is the templateId for Reporting Parameters Act -->
               <templateId root="2.16.840.1.113883.10.20.17.3.8"/>
+              <id extension="<%= identifier_for([start_date, end_date]) %>" />
               <code code="252116004" codeSystem="2.16.840.1.113883.6.96" displayName="Observation Parameters"/>
               <effectiveTime>
                 <low value="<%= start_date.to_formatted_s(:number) %>"/>

data/templates/cat3/_supplemental_data.cat3.erb

@@ -3,11 +3,17 @@
   <entryRelationship typeCode="COMP">
     <observation classCode="OBS" moodCode="EVN">
       <!-- <%= template_name %> -->
-      <templateId root="<%= template_id %>"/>
+      <% template_ids.each do |tid| %>
+        <templateId root="<%= tid %>"/>
+      <% end %>
         <id nullFlavor="NA" />
       <code code="<%= supplemental_data_code %>" 
             codeSystem="<%= supplemental_data_code_system %>"/>
       <statusCode code="completed"/>
+      <effectiveTime>
+        <low nullFlavor="NA"/>
+        <high nullFlavor="NA"/>
+      </effectiveTime>
       <% if supplemental_data_value_code == "" || supplemental_data_value_code == "UNK" -%>
       <value xsi:type="CD" 
              nullFlavor="UNK" />

data/templates/cat3/show.cat3.erb

@@ -107,12 +107,13 @@ Measure Section
               <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 root="2.16.840.1.113883.10.20.27.3.1"/>
+              <id extension="<%= measure['id'] || UUID.generate %>"/>
               <statusCode code="completed"/>
               <reference typeCode="REFR">
                 <externalDocument classCode="DOC" moodCode="EVN">
                   <!-- SHALL: required Id but not restricted to the eMeasure Document/Id-->
                   <!-- QualityMeasureDocument/id This is the version specific identifier for eMeasure -->
-                  <id root="<%= measure['hqmf_id'] %>"/>
+                  <id root="2.16.840.1.113883.4.738" extension="<%= measure['hqmf_id'] %>"/>
 
                   <!-- SHOULD This is the title of the eMeasure -->
                   <text><%= measure['name'] %></text>

data/templates/html/_entry.html.erb

@@ -44,17 +44,16 @@
 	  <% 
 	    (entry.attributes.keys.reject {|key| ['codes', 'time', 'description', 'mood_code', 'values', '_id', '_type', 'start_time', 'end_time', 'status_code', 'negationInd', 'oid'].include? key}).sort.each do |field|
       field_value = convert_field_to_hash(field, entry.attributes[field])
-
     %>
         <% if field_value && !field_value.empty? %> 
         <dl>
           <% if field_value.is_a? Hash %>
             <dt><b><%= field.titleize %>:</b></dt>
 	          <% field_value.keys.sort.reverse.each do |fieldkey| %>
-	            <dd><%= fieldkey %>: <i><%= field_value[fieldkey] %></i></dd>
+                    <dd><%= fieldkey %>: <i><%== field_value[fieldkey] %></i></dd>
 	          <% end %>
           <% else %>
-            <dt><b><%= field.titleize %></b>: <%= field_value%></dt>
+            <dt><b><%= field.titleize %></b>: <%== field_value%></dt>
           <% end %>
         <dl>
         <% end %>

metadata

@@ -1,7 +1,7 @@
 --- !ruby/object:Gem::Specification
 name: health-data-standards
 version: !ruby/object:Gem::Version
-  version: 3.5.2
+  version: 3.5.3
 platform: ruby
 authors:
 - Andy Gregorowicz
@@ -12,7 +12,7 @@ authors:
 autorequire: 
 bindir: bin
 cert_chain: []
-date: 2014-09-23 00:00:00.000000000 Z
+date: 2015-01-21 00:00:00.000000000 Z
 dependencies:
 - !ruby/object:Gem::Dependency
   name: rest-client
@@ -489,6 +489,7 @@ files:
 - templates/cat1/_id.cat1.erb
 - templates/cat1/_measures.cat1.erb
 - templates/cat1/_medication_details.cat1.erb
+- templates/cat1/_medication_dispense.cat1.erb
 - templates/cat1/_ordinality.cat1.erb
 - templates/cat1/_organization.cat1.erb
 - templates/cat1/_patient_data.cat1.erb
@@ -580,7 +581,7 @@ required_rubygems_version: !ruby/object:Gem::Requirement
       version: '0'
 requirements: []
 rubyforge_project: 
-rubygems_version: 2.2.0
+rubygems_version: 2.4.3
 signing_key: 
 specification_version: 4
 summary: A library for generating and consuming various healthcare related formats.