renalware-core 2.0.0.pre.rc8 → 2.0.0.pre.rc9

checksums.yaml

@@ -1,7 +1,7 @@
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data/app/assets/stylesheets/renalware/modules/_clinical.scss

@@ -31,3 +31,76 @@ article.clinical-allergies {
     }
   }
 }
+
+
+.clinical-header {
+  background-color: $table-border-colour;
+  padding: .2em .2em .2em .6em;
+
+  &.lozenge {
+    background-color: $white;
+    padding: .2em .3rem;
+
+    ul {
+      li {
+        padding: 0.3rem 0.3rem;
+        border: none;
+        margin: 0.1rem 0.3rem 0.2rem 0;
+        border-radius: 0.3rem;
+        background-color: $light-grey;
+      }
+    }
+
+    dl {
+      padding: 0;
+      margin: 0;
+      font-size: 0.9rem;
+      line-height: 0.9rem;
+    }
+  }
+
+
+  ul {
+    padding: 0;
+    margin: 0;
+
+    li {
+      display: inline-block;
+      padding: 0;
+      border-bottom: 1px dotted $winter-sky;
+      margin: 0.2rem .6rem .2rem 0
+    }
+  }
+
+  dl {
+    padding: 0;
+    margin: 0;
+    font-size: 0.9rem;
+    line-height: 0.8rem;
+
+    dt, dd {
+      padding: 0;
+      margin: 0;
+      display: inline-block;
+    }
+
+    dt {
+      font-weight: normal;
+    }
+
+    dd {
+      font-weight: bold;
+      padding-left: 0.2rem;
+
+      &.date {
+        font-weight: normal;
+        font-style: italic;
+        color: $muted-dark-grey;
+      }
+
+      &.empty {
+        display: none;
+      }
+    }
+  }
+}

data/app/models/concerns/renalware/clinics/most_recent_measurement_scopes.rb.dead

@@ -0,0 +1,43 @@
+require_dependency "renalware/letters"
+
+module Renalware
+  module Clinics
+    module MostRecentMeasurementScopes
+      extend ActiveSupport::Concern
+
+      ClinicalObservation = Struct.new(:date, :measurement)
+
+      class_methods do
+        # Returns [date, weight]
+        def most_recent_weight_for(patient)
+          result = ClinicVisit
+                    .most_recent_for_patient(patient)
+                    .where("weight is not null")
+                    .pluck(:date, :weight).first || []
+
+          ClinicalObservation.new(result.first, result.last)
+        end
+
+        # Returns [date, height]
+        def most_recent_height_for(patient)
+          result = ClinicVisit
+                    .most_recent_for_patient(patient)
+                    .where("height is not null")
+                    .pluck(:date, :height).first || []
+
+          ClinicalObservation.new(result.first, result.last)
+        end
+
+        # Returns [date, [systolic_bp, diastolic_bp]]
+        def most_recent_blood_pressure_for(patient)
+          result = ClinicVisit
+                    .most_recent_for_patient(patient)
+                    .where("systolic_bp is not null and diastolic_bp is not null")
+                    .pluck(:date, :systolic_bp, :diastolic_bp).first || [nil, nil, nil]
+
+          ClinicalObservation.new(result[0], [result[1], result[2]])
+        end
+      end
+    end
+  end
+end

data/app/models/renalware/clinics/clinic_visit.rb

@@ -28,10 +28,10 @@ module Renalware
       enumerize :urine_protein, in: %i(neg trace very_low low medium high)
 
       scope :ordered, ->{ order(date: :desc, created_at: :desc) }
+      scope :most_recent_for_patient, ->(patient) { for_patient(patient).ordered.limit(1) }
 
       def bmi
-        return unless weight && height && height > 0
-        ((weight / height) / height).round(2)
+        BMI.new(weight: weight, height: height).to_f
       end
 
       def bp

data/app/models/renalware/clinics/current_observations.rb

@@ -0,0 +1,57 @@
+require_dependency "renalware/letters"
+require "attr_extras"
+
+module Renalware
+  module Clinics
+    class CurrentObservations
+      NULL_DATE = nil
+      pattr_initialize :patient
+
+      Observation = Struct.new(:date, :measurement)
+
+      # Returns [date, weight]
+      def weight
+        @weight ||= begin
+          result = ClinicVisit
+                    .most_recent_for_patient(patient)
+                    .where("weight is not null")
+                    .pluck(:date, :weight).first || []
+
+          Observation.new(result.first, result.last)
+        end
+      end
+
+      # Returns [date, height]
+      def height
+        @height ||= begin
+          result = ClinicVisit
+                    .most_recent_for_patient(patient)
+                    .where("height is not null")
+                    .pluck(:date, :height).first || []
+
+          Observation.new(result.first, result.last)
+        end
+      end
+
+      # Returns [date, [systolic_bp, diastolic_bp]]
+      def blood_pressure
+        @blood_pressure ||= begin
+          result = ClinicVisit
+                    .most_recent_for_patient(patient)
+                    .where("systolic_bp is not null and diastolic_bp is not null")
+                    .pluck(:date, :systolic_bp, :diastolic_bp).first || [nil, nil, nil]
+
+          Observation.new(result[0], [result[1], result[2]])
+        end
+      end
+
+      def bmi
+        bmi = BMI.new(
+          height: height.measurement,
+          weight: weight.measurement
+        )
+        Observation.new(NULL_DATE, bmi.to_f)
+      end
+    end
+  end
+end

data/app/models/renalware/letters/letter.rb

@@ -5,6 +5,10 @@ module Renalware
     class Letter < ApplicationRecord
       include Accountable
       extend Enumerize
+      # The letterhead is the only site-specific element in the letter, so we use this
+      # to determine site-specific settings - in this case whether the letter should contain
+      # pathology. At KCH for example, Darren Valley letters should not contain recent pathology.
+      delegate :include_pathology_in_letter_body?, to: :letterhead, allow_nil: true
 
       belongs_to :event, polymorphic: true
       belongs_to :author, class_name: "User"
@@ -25,7 +29,7 @@ module Renalware
                through: :electronic_receipts,
                source: :recipient
       has_one :signature, dependent: :destroy
-      has_one :archive, foreign_key: "letter_id"
+      has_one :archive, foreign_key: "letter_id", inverse_of: :letter
       serialize :pathology_snapshot, Pathology::ObservationsJsonbSerializer
 
       accepts_nested_attributes_for :main_recipient

data/app/models/renalware/pathology/current_observation_set.rb

@@ -37,5 +37,11 @@ module Renalware
         HashWithIndifferentAccess.new.extend(ObservationSetMethods)
       end
     end
+
+    class NullObservationSet
+      def values
+        ObservationsJsonbSerializer.load({})
+      end
+    end
   end
 end

data/app/models/renalware/pathology/observation.rb

@@ -12,6 +12,7 @@ module Renalware
 
       scope :ordered, -> { order(observed_at: :desc) }
       scope :for_description, ->(description) { where(description: description) }
+      scope :having_a_loinc_code, -> { joins(:description).where("loinc_code is not null") }
 
       def observed_on
         observed_at.to_date

data/app/models/renalware/pathology/observation_request.rb

@@ -17,6 +17,9 @@ module Renalware
       validates :requested_at, presence: true
 
       scope :ordered, -> { order(requested_at: :desc) }
+      scope :having_observations_with_a_loinc_code, lambda {
+        joins(observations: :description).where("loinc_code is not null") # TODO: use a merge
+      }
 
       def requested_on
         requested_at.to_date

data/app/models/renalware/pathology/observations_jsonb_serializer.rb

@@ -5,6 +5,8 @@ module Renalware
     # We mix this module into any database-returned jsonb hash of observations
     # (e.g. CurrentObservationSet.values and Letter.pathology_snapshot)
     module ObservationSetMethods
+      VALID_SUFFIXES = %w(_result _observed_at).freeze
+
       # Support these syntaxes
       #   values.hgb # => { result: ... observed_at: ...}
       #   values.HGB # => { result: ... observed_at: ...}
@@ -12,15 +14,14 @@ module Renalware
       #   values.hgb_observed_at # => "2017-17-01"
       # So the values has methods corresponding to the entire set of possible
       # OBX codes, and also methods to reach in and get their result and observed_at date.
-      #
-      # Note that if you get a missing method error for something like #hgb_result it means
-      # that HGB does not exist yet as an ObservationDescription so is not found in
-      # AllObservationCodes hence we can't respond to it.
       # rubocop:disable Style/MethodMissing
       def method_missing(method_name, *_args, &_block)
         code, suffix = method_parts(method_name)
-        return super unless AllObservationCodes.include?(code)
-        observation_hash_or_hash_element_for(code, suffix)
+        if VALID_SUFFIXES.include?(suffix) || AllObservationCodes.include?(code)
+          observation_hash_or_hash_element_for(code, suffix)
+        else
+          super
+        end
       end
       # rubocop:enable Style/MethodMissing
 

data/app/presenters/renalware/clinical/header_presenter.rb

@@ -0,0 +1,33 @@
+require_dependency "renalware"
+require "attr_extras"
+
+module Renalware
+  module Clinical
+    class HeaderPresenter
+      pattr_initialize :patient
+      delegate :weight, :height, :blood_pressure, :bmi, to: :clinical_current_observations
+      delegate :measurement, :date, to: :weight, prefix: true
+      delegate :measurement, :date, to: :height, prefix: true
+      delegate :measurement, :date, to: :blood_pressure, prefix: true
+      delegate :measurement, :date, to: :bmi, prefix: true
+
+      def current_pathology
+        @pathology ||= pathology_current_observation_set.values
+      end
+
+      private
+
+      def pathology_current_observation_set
+        pathology_patient.current_observation_set || Pathology::NullObservationSet.new
+      end
+
+      def pathology_patient
+        Pathology.cast_patient(patient)
+      end
+
+      def clinical_current_observations
+        @clinical_current_observations ||= Clinics::CurrentObservations.new(patient)
+      end
+    end
+  end
+end

data/app/presenters/renalware/letters/letter_presenter.rb

@@ -41,7 +41,11 @@ module Renalware
       end
 
       def parts
-        letter_event.part_classes.values.map do |part_class|
+        filtered_part_classes = PartClassFilter.new(
+          part_classes: letter_event.part_classes,
+          include_pathology_in_letter_body: letterhead.include_pathology_in_letter_body?
+        )
+        filtered_part_classes.to_h.values.map do |part_class|
           part_class.new(patient, self, letter_event)
         end
       end

data/app/presenters/renalware/letters/part_class_filter.rb

@@ -0,0 +1,36 @@
+require "renalware/letters"
+require "attr_extras"
+
+module Renalware
+  module Letters
+    # Given a hash of letter part classes (i.e. the class names for each Part that should be
+    # included in the letter, where each Part is responsible for rendering a part of the letter)
+    # and other options, this class filters out certain parts based on conditions,
+    # for example if a site does not want pathology, the recent_pathology_results key is
+    # removed from the hash.
+    class PartClassFilter
+      pattr_initialize [:part_classes!, :include_pathology_in_letter_body!]
+
+      def to_h
+        filtered_part_classes
+      end
+
+      private
+
+      def filtered_part_classes
+        remove_recent_observations_part_if_no_pathology_required_in_body(part_classes)
+      end
+
+      # Some sites may not require pathology in letters. This is determined by the boolean
+      # #include_pathology_in_letter_body flag on the letterhead, which is site-specific.
+      # TODO: It might be better to link the letterhead to the Hospitals::Site and
+      # put the site-specific configuration in say a jsonb field on the Site.
+      def remove_recent_observations_part_if_no_pathology_required_in_body(part_klasses)
+        unless include_pathology_in_letter_body
+          part_klasses = part_klasses.reject{ |key| key == :recent_pathology_results }
+        end
+        part_klasses
+      end
+    end
+  end
+end

data/app/presenters/renalware/renal/clinical_summary_presenter.rb

@@ -22,7 +22,6 @@ module Renalware
       def current_problems
         @current_problems ||= @patient.problems
                                       .current
-                                      .with_patient
                                       .ordered
       end
 

data/app/presenters/renalware/ukrdc/patient_presenter.rb

@@ -5,7 +5,6 @@ module Renalware
     class PatientPresenter < SimpleDelegator
       delegate :allergies, to: :clinical_patient
       delegate :clinic_visits, to: :clinics_patient
-      delegate :observation_requests, to: :pathology_patient
       delegate :profile, to: :renal_patient, allow_nil: true
       delegate :first_seen_on, to: :profile, allow_nil: true
       alias_attribute :home_telephone, :telephone1
@@ -17,7 +16,7 @@ module Renalware
 
       def current_modality_hd?
         return false if current_modality.blank?
-        current_modality.description.is_a?(HD::ModalityDescription)
+        current_modality.description.is_a?(Renalware::HD::ModalityDescription)
       end
 
       def smoking_history
@@ -46,6 +45,13 @@ module Renalware
         email || home_telephone || mobile_telephone
       end
 
+      def observation_requests
+        pathology_patient
+          .observation_requests
+          .having_observations_with_a_loinc_code
+          .where(patient_id: id)
+      end
+
       private
 
       def clinical_patient

data/app/values/renalware/bmi.rb

@@ -0,0 +1,20 @@
+require "attr_extras"
+
+module Renalware
+  # Value object representing Body Mass Index. Accepts only meters and kg
+  #
+  # Example usage:
+  #   bmi = Renalware::BMI.new(height: 1.80, weight: 180)
+  #   bmi.to_f # => 55.6
+  #   bmi.to_s # => "55.6"
+  #
+  class BMI
+    pattr_initialize [:weight!, :height!]
+    delegate :to_s, to: :to_f
+
+    def to_f
+      return unless weight && height && height > 0
+      ((weight / height) / height).round(1)
+    end
+  end
+end

data/app/views/renalware/admissions/consults/_table.html.slim

@@ -6,7 +6,7 @@
         th.at-least.col-width-medium Patient
         th.col-width-nhs-no NHS No.
         th.col-width-reference-no Hosp Nos.
-        th.col-width-small Modality
+        th.col-width-medium Modality
         th.col-width-tiny Sex
         th.col-width-tiny Age
         th.col-width-small AKI Risk