bulk fhir import support

config/config.exs

@@ -50,6 +50,8 @@ config :dart_sass,
     cd: Path.expand("../assets", __DIR__)
   ]
 
+config :kindling, root_resources: ["Patient", "Observation", "Organization"]
+
 # Import environment specific config. This must remain at the bottom
 # of this file so it overrides the configuration defined above.
 import_config "#{Mix.env()}.exs"

lib/epiviewpoint/bulk_fhir_parser.ex

@@ -0,0 +1,229 @@
+defmodule EpiViewpoint.BulkFhirParser do
+  def parse_bulk_fhir(file_list) do
+    with {:ok, contents} <- combine_contents(file_list),
+         {:ok, resources} <- load_resources(file_list),
+         {:ok, extracted} <- extract_resources(resources),
+         {:ok, joined} <- join_resources(extracted) do
+      {:ok, to_map(joined, contents)}
+    end
+  end
+
+  defp combine_contents(file_list) do
+    contents = file_list |> Enum.map(& &1.contents) |> List.to_string()
+    {:ok, contents}
+  end
+
+  defp load_resources(file_list) do
+    result =
+      Enum.reduce_while(file_list, {:ok, %{}}, fn file, {:ok, acc} ->
+        case load_resource_file(file.contents) do
+          {:ok, resources} -> {:cont, {:ok, group_resources(resources, acc)}}
+          {:error, reason} -> {:halt, {:error, reason}}
+        end
+      end)
+
+    case result do
+      {:ok, resources} -> {:ok, resources}
+      {:error, reason} -> {:error, reason}
+    end
+  end
+
+  defp group_resources(resources, acc) do
+    Enum.reduce(resources, acc, fn resource, acc ->
+      Map.update(acc, resource.resource_type, [resource], &[resource | &1])
+    end)
+  end
+
+  defp load_resource_file(file_content) do
+    result =
+      file_content
+      |> String.split("\n")
+      |> Stream.map(&String.trim/1)
+      |> Stream.filter(&(&1 != ""))
+      |> Stream.map(&json_to_kindle_schema/1)
+      |> Enum.to_list()
+
+    {:ok, result}
+  rescue
+    e -> {:error, "Failed to load resource file: #{inspect(e)}"}
+  end
+
+  defp json_to_kindle_schema(json) do
+    case Jason.decode(json) do
+      {:ok, map} -> Kindling.Converter.convert("EpiViewpoint.R4", map)
+      {:error, reason} -> {:error, "Failed to decode JSON: #{inspect(reason)}"}
+    end
+  end
+
+  defp extract_resources(resources) do
+    result =
+      Enum.reduce_while(resources, {:ok, %{}}, fn {resource_type, resource_list}, {:ok, acc} ->
+        case extract_resource(resource_type, resource_list) do
+          {:ok, extracted} -> {:cont, {:ok, Map.put(acc, resource_type, extracted)}}
+          {:error, reason} -> {:halt, {:error, reason}}
+        end
+      end)
+
+    case result do
+      {:ok, extracted} -> {:ok, extracted}
+      {:error, reason} -> {:error, reason}
+    end
+  end
+
+  defp extract_resource("Patient", resource_list) do
+    {:ok, Enum.map(resource_list, &extract_patient/1)}
+  end
+
+  defp extract_resource("Observation", resource_list) do
+    {:ok, Enum.map(resource_list, &extract_observation/1)}
+  end
+
+  defp extract_resource("Organization", resource_list) do
+    {:ok, Enum.map(resource_list, &extract_organization/1)}
+  end
+
+  defp extract_resource(unknown_type, _) do
+    {:error, "Unknown resource type: #{unknown_type}"}
+  end
+
+  defp extract_patient(%EpiViewpoint.R4.Patient{} = patient) do
+    %EpiViewpoint.R4.Patient{
+      id: caseid,
+      identifier: [%EpiViewpoint.R4.Identifier{value: person_tid}],
+      name: [%EpiViewpoint.R4.HumanName{given: [search_firstname], family: search_lastname}],
+      birth_date: dateofbirth,
+      gender: sex,
+      address: [
+        %EpiViewpoint.R4.Address{
+          line: [diagaddress_street1],
+          city: diagaddress_city,
+          state: diagaddress_state,
+          postal_code: diagaddress_zip
+        }
+      ],
+      telecom: [%EpiViewpoint.R4.ContactPoint{value: phonenumber}],
+      extension: extensions
+    } = patient
+
+    %{
+      caseid: caseid,
+      person_tid: person_tid,
+      search_firstname: search_firstname,
+      search_lastname: search_lastname,
+      dateofbirth: format_date(dateofbirth),
+      sex: String.capitalize(to_string(sex)),
+      diagaddress_street1: diagaddress_street1,
+      diagaddress_city: diagaddress_city,
+      diagaddress_state: diagaddress_state,
+      diagaddress_zip: diagaddress_zip,
+      phonenumber: phonenumber,
+      ethnicity: find_extension(extensions, :ethnicity),
+      occupation: find_extension(extensions, :occupation),
+      race: find_extension(extensions, :race)
+    }
+  end
+
+  defp extract_observation(%EpiViewpoint.R4.Observation{} = observation) do
+    %EpiViewpoint.R4.Observation{
+      id: lab_result_tid,
+      subject: %EpiViewpoint.R4.Reference{reference: "Patient/" <> pat_id},
+      effective_date_time: datecollected,
+      issued: resultdate,
+      code: %EpiViewpoint.R4.CodeableConcept{text: testname},
+      interpretation: [%EpiViewpoint.R4.CodeableConcept{coding: [%EpiViewpoint.R4.Coding{display: result}]}],
+      performer: [%EpiViewpoint.R4.Reference{reference: "Organization/" <> org_id}],
+      extension: extensions
+    } = observation
+
+    %{
+      lab_result_tid: lab_result_tid,
+      pat_id: pat_id,
+      datecollected: datecollected,
+      resultdate: format_date(resultdate),
+      testname: testname,
+      result: result,
+      org_id: org_id,
+      datereportedtolhd: find_extension(extensions, :datereportedtolhd)
+    }
+  end
+
+  defp extract_organization(%EpiViewpoint.R4.Organization{} = organization) do
+    %{
+      organization_id: organization.id,
+      ordering_facility_name: organization.name
+    }
+  end
+
+  defp find_extension(extensions, :race) do
+    Enum.find_value(extensions, nil, fn
+      %EpiViewpoint.R4.Extension{
+        url: "http://hl7.org/fhir/us/core/StructureDefinition/us-core-race",
+        extension: [%EpiViewpoint.R4.Extension{url: "ombCategory", value_coding: %EpiViewpoint.R4.Coding{display: value}}, _]
+      } ->
+        value
+
+      _ ->
+        nil
+    end)
+  end
+
+  defp find_extension(extensions, :ethnicity) do
+    Enum.find_value(extensions, nil, fn
+      %EpiViewpoint.R4.Extension{
+        url: "http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity",
+        extension: [%EpiViewpoint.R4.Extension{url: "ombCategory", value_coding: %EpiViewpoint.R4.Coding{display: value}}, _]
+      } ->
+        value
+
+      _ ->
+        nil
+    end)
+  end
+
+  defp find_extension(extensions, :occupation) do
+    Enum.find_value(extensions, nil, fn
+      %EpiViewpoint.R4.Extension{url: "http://hl7.org/fhir/StructureDefinition/patient-occupation", value_string: value} ->
+        value
+
+      _ ->
+        nil
+    end)
+  end
+
+  defp find_extension(extensions, :datereportedtolhd) do
+    Enum.find_value(extensions, nil, fn
+      %EpiViewpoint.R4.Extension{url: "http://hl7.org/fhir/StructureDefinition/datereportedtolhd", value_date: value} ->
+        value
+
+      _ ->
+        nil
+    end)
+  end
+
+  defp join_resources(resources) do
+    patients = Map.get(resources, "Patient", [])
+    observations = Map.get(resources, "Observation", [])
+    organizations = Map.get(resources, "Organization", [])
+
+    joined = Enum.map(observations, &merge_resources(&1, patients, organizations))
+
+    {:ok, joined}
+  end
+
+  defp merge_resources(observation, patients, organizations) do
+    patient = Enum.find(patients, %{}, &(&1.caseid == observation.pat_id))
+    organization = Enum.find(organizations, %{}, &(&1.organization_id == observation.org_id))
+
+    observation
+    |> Map.merge(patient)
+    |> Map.merge(organization)
+    |> Map.drop([:pat_id, :org_id, :organization_id])
+  end
+
+  defp to_map(resources, contents) do
+    %{file_name: "load.bulk_fhir", contents: contents, list: resources}
+  end
+
+  defp format_date(date) when is_struct(date, Date), do: Calendar.strftime(date, "%m/%d/%Y")
+  defp format_date(datetime) when is_struct(datetime, DateTime), do: DateTime.to_date(datetime) |> format_date()
+end

lib/epiviewpoint/cases.ex

@@ -34,6 +34,10 @@ defmodule EpiViewpoint.Cases do
   def count_lab_results(), do: LabResult |> Repo.aggregate(:count)
   def create_lab_result!({attrs, audit_meta}), do: %LabResult{} |> change_lab_result(attrs) |> AuditingRepo.insert!(audit_meta)
   def import_lab_results(lab_result_data_file_string, originator), do: Import.import_data_file(lab_result_data_file_string, originator)
+
+  def import_bulk_fhir_lab_results(lab_result_data_file_list, originator),
+    do: Import.import_bulk_fhir_data_file(lab_result_data_file_list, originator)
+
   def list_lab_results(), do: LabResult.Query.all() |> Repo.all()
   def preload_initiating_lab_result(case_investigations_or_nil), do: case_investigations_or_nil |> Repo.preload(:initiating_lab_result)
   def preload_lab_results(person_or_people_or_nil), do: person_or_people_or_nil |> Repo.preload(lab_results: LabResult.Query.display_order())

lib/epiviewpoint/cases/import.ex

@@ -1,6 +1,7 @@
 defmodule EpiViewpoint.Cases.Import do
   alias EpiViewpoint.Accounts
   alias EpiViewpoint.AuditLog
+  alias EpiViewpoint.BulkFhirParser
   alias EpiViewpoint.Cases
   alias EpiViewpoint.Cases.Import
   alias EpiViewpoint.Cases.LabResult
@@ -59,6 +60,11 @@ defmodule EpiViewpoint.Cases.Import do
     ]
   end
 
+  def import_bulk_fhir_data_file(lab_result_data_file_list, originator) do
+    {:ok, bulk_fhir_data} = BulkFhirParser.parse_bulk_fhir(lab_result_data_file_list)
+    import_data_file(bulk_fhir_data, originator)
+  end
+
   def import_data_file(_file, %{admin: false}), do: {:error, "Originator must be an admin"}
 
   def import_data_file(file, %Accounts.User{} = originator) do
@@ -103,6 +109,7 @@ defmodule EpiViewpoint.Cases.Import do
     case Path.extname(file.file_name) do
       ".csv" -> DataFile.read(file.contents, :csv, &rename_headers/1, @fields)
       ".ndjson" -> DataFile.read(file.contents, :ndjson, &rename_headers/1, @fields)
+      ".bulk_fhir" -> DataFile.read(file.list, :bulk_fhir, &rename_headers/1, @fields)
       _ -> {:error, "Unsupported file type: #{file.extension}"}
     end
   end

lib/epiviewpoint/data_file.ex

@@ -21,6 +21,10 @@ defmodule EpiViewpoint.DataFile do
     read(string, header_transformer, headers, &parse_ndjson/1)
   end
 
+  def read(string, :bulk_fhir, header_transformer, headers) when is_list(string) do
+    read(string, header_transformer, headers, &parse_bulk_fhir/1)
+  end
+
   def read(input, header_transformer, [required: required_headers, optional: optional_headers], parser) do
     with {:ok, df} <- parser.(input),
          {:ok, provided_headers} <- extract_provided_headers(df, header_transformer),
@@ -84,6 +88,10 @@ defmodule EpiViewpoint.DataFile do
     DataFrame.load_ndjson(input)
   end
 
+  defp parse_bulk_fhir(input) do
+    {:ok, DataFrame.new(input)}
+  end
+
   defp validate_csv(input) do
     EpiViewpoint.DataFile.Parser.parse_string(input, headers: true)
     input

lib/epiviewpoint/r4/address.ex

@@ -0,0 +1,68 @@
+defmodule EpiViewpoint.R4.Address do
+  use Ecto.Schema
+  import Ecto.Changeset
+
+  @fields [
+    :city,
+    :country,
+    :district,
+    :id,
+    :line,
+    :postal_code,
+    :state,
+    :text,
+    :type,
+    :use
+  ]
+  @required_fields []
+
+  embedded_schema do
+    # Fields
+    field(:city, :string)
+    field(:country, :string)
+    field(:district, :string)
+    field(:postal_code, :string)
+    field(:state, :string)
+    field(:text, :string)
+
+    field(:line, {:array, :string})
+
+    # Enum
+    field(:type, Ecto.Enum,
+      values: [
+        :postal,
+        :physical,
+        :both
+      ]
+    )
+
+    field(:use, Ecto.Enum,
+      values: [
+        :home,
+        :work,
+        :temp,
+        :old,
+        :billing
+      ]
+    )
+
+    # Embed One
+    embeds_one(:period, EpiViewpoint.R4.Period)
+
+    # Embed Many
+    embeds_many(:extension, EpiViewpoint.R4.Extension)
+  end
+
+  def choices(_), do: nil
+
+  def version_namespace, do: EpiViewpoint.R4
+  def version, do: "R4"
+
+  def changeset(data \\ %__MODULE__{}, attrs) do
+    data
+    |> cast(attrs, @fields)
+    |> cast_embed(:period)
+    |> cast_embed(:extension)
+    |> validate_required(@required_fields)
+  end
+end