Merge pull request #2 from barabo/v3.0

implement a cds hook service to launch the smart app

README.md

@@ -2,14 +2,31 @@
 A demonstration SMART app that serves AUC external guidance for PAMA.
 
 Instructions
-------------
+============
 
 ```sh
 npm install
-npm run launch &
-npm run demo
+npm run all
 ```
 
+CDS Hooks Sandbox
+_________________
+
+<img src="./images/v3_pama_tab.png" width="512">
+
+To launch the app via the CDS Hooks Sanbox, [click here](https://sandbox.cds-hooks.org) and configure the `demo-auc-app` service if it isn't already listed in the `PAMA Imaging` tab.
+
+<img src="./images/v3_pama_tab_new_service.png" width="256">
+<img src="./images/v3_discovery_endpoint.png" width="256">
+<img src="./images/v3_select_service.png" width="256">
+<img src="./images/v3_pama_imaging_tab.png" width="256">
+<img src="./images/v3_pama_tab_messages.png" width="256">
+<img src="./images/v3_select_hook.png" width="256">
+
+
+SMART App Launcher
+__________________
+
 To launch the app via SMART launch, [click here](http://launch.smarthealthit.org/?auth_error=&fhir_version_1=r4&fhir_version_2=r4&iss=&launch_ehr=1&launch_url=http%3A%2F%2Flocalhost%3A8899%2Flaunch.html&patient=&prov_skip_auth=1&provider=&pt_skip_auth=1&public_key=&sb=&sde=&sim_ehr=1&token_lifetime=15&user_pt=) and then click the green Launch App button.
 
 <img src="./images/v2launch.png" alt="alt text" width="256">
@@ -24,6 +41,17 @@ determine whether it is within recommended guidelines.
 <img src="./images/v2procedure.png" alt="alt text" width="256">
 <img src="./images/v2rating.png" alt="alt text" width="256">
 
+V3 TODO
+-------
+
+- [x] Make a CDS Hook Service to *always* launch a SMART card for draft orders
+  - [x] Refactor the AUC logic into a module, enabling use in the hook too.
+  - [x] Write a new CDS Hook server to be run with npm
+- [x] Complete the App
+  - [x] Enable the EHR to close the form with a `ui.done` message
+  - [x] Enable the form to read the draft order from the fhir client on load
+  - [x] Enable writes to the form to update the draft order in the EHR
+
 V2 TODO
 -------
 

auc.js

@@ -0,0 +1,69 @@
+const CPT = {
+  _FHIR_CODING_SYSTEM: 'http://www.ama-assn.org/go/cpt',
+  CARDIAC_MRI: '75561',
+  CT_HEAD_NO_CONTRAST: '70450',
+  CTA_WITH_CONTRAST: '71275',
+  LUMBAR_SPINE_CT: '72133',
+  MRA_HEAD: '70544',
+};
+
+const SNOMED = {
+  _FHIR_CODING_SYSTEM: 'http://snomed.info/sct',
+  CONGENITAL_HEART_DISEASE: '13213009',
+  HEADACHE: '25064002',
+  LOW_BACK_PAIN: '279039007',
+  OPTIC_DISC_EDEMA: '423341008',
+  TOOTHACHE: '27355003'
+};
+
+class Criterion {
+  static covers(subset, set) {
+    if (subset.size > set.size) {
+      return false;
+    }
+    for (const member of subset) {
+      if (!set.has(member)) {
+        return false;
+      }
+    }
+    return true;
+  }
+
+  constructor(appropriate, notAppropriate) {
+    this.appropriate = appropriate.map(x => new Set(x));
+    this.notAppropriate = notAppropriate.map(x => new Set(x));
+  }
+
+  getRating(reasons) {
+    if (this.appropriate.filter(s => Criterion.covers(s, reasons)).length) {
+      return 'appropriate';
+    }
+    if (this.notAppropriate.filter(s => Criterion.covers(s, reasons)).length) {
+      return 'not-appropriate';
+    }
+    return 'no-guidelines-apply';
+  }
+};
+
+function evaluate(order, reasons) {
+  if (order) {
+    const criterion = criteria[order];
+    if (criterion && reasons.length) {
+      return criterion.getRating(new Set(reasons));
+    }
+  }
+  return 'no-guidelines-apply';
+}
+
+const criteria = {
+  'no-procedures-for': new Criterion([[SNOMED.TOOTHACHE]], []),
+  [CPT.CT_HEAD_NO_CONTRAST]: new Criterion([[SNOMED.HEADACHE, SNOMED.OPTIC_DISC_EDEMA]], []),
+  [CPT.MRA_HEAD]: new Criterion([], []),
+  [CPT.CTA_WITH_CONTRAST]: new Criterion([], [[SNOMED.CONGENITAL_HEART_DISEASE]]),
+  [CPT.LUMBAR_SPINE_CT]: new Criterion([], [[SNOMED.LOW_BACK_PAIN]]),
+  [CPT.CARDIAC_MRI]: new Criterion([[SNOMED.CONGENITAL_HEART_DISEASE]], []),
+};
+
+module.exports = {
+  CPT, SNOMED, criteria, evaluate, getRating: Criterion.prototype.getRating,
+};

cds-services.js

@@ -0,0 +1,85 @@
+// BONUS: run this hosted in glitch.com
+const auc = require('./auc.js');
+const bodyParser = require('body-parser');
+const cors = require('cors');
+const express = require('express');
+const port = process.env.PORT || '3003';
+const launchUrl = 'http://localhost:8899/launch.html';
+
+app = express();
+app.use(cors());
+app.use(bodyParser.urlencoded({extended : true}));
+app.use(bodyParser.json());
+app.listen(port);
+
+const cardDetails = {
+  'appropriate': {
+    detail: 'This order meets AUC guidelines.',
+    icon: 'https://lh3.googleusercontent.com/bYNztCIytfV24Hzu9O11XcMhcHdcjRbX0TX2JfxX_LN-tKOOvqQi1lAhmBv7hY8UbMBmshW9vq3jFMO5kbCbq4fTsSWmlccsknxRvtGNunP_IktjIAn38prInj-6f6qWcTk3A9C3kkkJIilgeWOeOy3j8rifvViasCyhm5AGxeBs0TwyLIS-rV7LJDEWI9PjhTPcalYmvZBpl5Yti073BFHlBdMQH98D4CLQle9ZOR8zvXs43NGQdDFRk6QYplv7WFy6veT8b_sGeGxssvPVQoL9Kzcdagd1ftrvsY9vEzm9U79x4u9sBH_kw-BjyJilBh3ZLcTISbuSN-zT3Xn77uOh-aIemSKnr7jl33Ex3i0JyqxMcmj1Wc7cH4sCEHJ7bku3yZYndzVZgjvyPOV44EWo5OyDNVdQ22Hv4LbbSGQku0NCiSbm8g17rb3agKRnjmgioe6kWpa4lH16Q80FuRmAyYZ0GbBJl407qRrmMN-oO9R_LnzIABoV8BPyfU4BvsTDO_GZMBlaoy2K1Qv-0RL9faAjpN6iNQdofpJ28qn07MjJM-vHqPyD3U-eA8RgpSsofQscgE57GrSDDLRhgev3iyhhu2XU4pHbvmd4UUf82a2W0_OYkOlkeiTXM_YdrrW7E2Zpp2pWoIhZJIgXAVuaIz4v6k6EREPeBUuYiAoJHNs-UNXg3cvz=s100-no',
+    indicator: 'success',
+  },
+  'no-guidelines-apply': {
+    detail: 'This order is not specified by AUC guidelines.',
+    icon: 'https://lh3.googleusercontent.com/fLQElMed2CFqAHxwRlIe5gJoHp9PFyZUPEcjgdB2Jj2dL7tHKfg4potyo39gsQeP_6wQ7zkWXaMGR7KnfkDrW1ks0jYaHmMdFi-AUer53CQCkKBwkgIEtgRSlozLDqiqpTBMIGRfsj_6oYtruy8O1cFEI54xSjXGtC3l3HThdk93lOjwbxdmqshbkYvm1XYTNcJuBQBdYgIEJusjX_RDBTvJiAxQ0lBeYSHjGBE8JibvQjLboSqNwefLVbIZ24LUenGoub9Y8mhVlxUeQMQPYclnn5W5Nj509L0Oc65ZAvLhoqAJs_sI6gr7ViJqkgdGfRe2pAXbikX2vBvLRHMktcGD5J_YVYTst5vrvfnhfhE0P-kPSp4XLt4WrfP5OQe7lysg-EFyiK6F7REP7NmiPy8x8hf9O9GuUoPFqXwU4psdoXbuNpCsuPA6tfnU6QwC-vUvzOWJgF1bMpu8NimhqPrOgBAUAHh0eVh9p3_ix8OwKBZ70EX8a7E9mq67k0-rTtMoElwBkFNzArTsMd1xp6QboF0F-oV_Li7xje_7Fokn-nDbB72ULX9K-MVbSkZvhD7Y_hJwQPG6wWF4kHaX_zzZsdD5botGT2VMrF-wGklzRrh2bBS-jT12IAeBECGgO_XKOu3Ire3WQ0SUdYGpE5Ebs4KrWAOykznsL9OqfkVuD1SIwjKgR-A2=s100-no',
+    indicator: 'warning'
+  },
+  'not-appropriate': {
+    detail: 'This order does not meet AUC guidelines.',
+    icon: 'https://lh3.googleusercontent.com/6f3-twVm-TIZr0IWsb4Yuiys58PkeV3RU89XSDjRtV2beBiKxsoSg4-7qNgzLkZZf-Vy-1OoG5pswPQSK8XRuW3lE56wQgkItirK-iBozZMoD5JvcOR6ZxusPjrvMOE-iwaOKYZxnk0qyoDu7W4WQfaTDaGXAL26OuV_VBIxL0SSXzONWCrk70ckTJPzGy7detQTWknOZJNLuLEv0N45q_EoOu6SLgUlf3woVe-zm0JMNV68JsXH5FIlRwidaplY19MnY40If0fGtQkvnrNS4lwZ9pnx_PK_wiTJhhnpfuNRvrhy_Bdphsy_CN0fMj2FfrwhOJl48jlg8IvIkMzDMlEZGthzryIhN2B-94Eq2oNZS9JaAixqLg2P06_HcaVWMi5x6slPMCal_sU78yuta5lNZdxS7XYw9xJWLjW8Mu_LPKoA6m0onGcYLnwYkdXLFvqdF4dWKYOx1uFvPAMOsucST4orXqVTFWFiEm39et-ZUVOArLm9yXh8i4zl5PKTs4sA7c4u8CLwLyW04Unkg59KnL0ZNKX0xRNm052pW_WhX2g48oKjPIqnQ6Zl1omgNgzIyHo2mvpIKstENpGJwsIqNO456kWEbgUmydTZn40d-VdG47d5Xg5R0jl-WGrK_FbG8u0DupeeCE9kRo2GTrqUuVZWOPZnHJqLnJRWsvEdybsWqC5_m8Fz=s100-no',
+    indicator: 'critical',
+  },
+};
+
+function getOrders(serviceRequest) {
+  return serviceRequest.code.coding
+    .map(order => order.code)
+    .filter(x => x);
+}
+
+function getReasons(serviceRequest) {
+  return serviceRequest.reasonCode
+    .map(reason => reason.coding).flat()
+    .map(coding => coding.code).flat();
+}
+
+app.post('/cds-services/demo-auc-app', function(request, response) {
+  const draftOrder = request.body.context.draftOrders.entry[0];
+  const serviceRequest = draftOrder.resource;
+  const orders = getOrders(serviceRequest);
+  const indications = getReasons(serviceRequest);
+
+  if ([...orders, ...indications].length === 0) {
+    response.json({cards: [], actions: []});
+    return;
+  }
+
+  const rating = auc.evaluate(orders.slice().pop(), reasons);
+  const card = cardDetails[rating];
+  const label = 'Click to view the source presentation.';
+  const sourceUrl = 'https://docs.google.com/presentation/d/1QT6HWPW1Kix656s8hZzCMY7fgkTEEck0_aApBASc7rk/edit?usp=sharing';
+  const cards = [{
+    summary: 'Demo AUC Guideline Consultation App',
+    indicator: card.indicator,
+    detail: card.detail,
+    source: { label, url: sourceUrl, icon: card.icon },
+    links: [{
+      appContext: JSON.stringify({indications, orders, draftOrder}),
+      label: 'Edit Order in Demo App',
+      url: launchUrl,
+      type: 'smart'
+    }],
+  }];
+  response.json({ cards });
+});
+
+// Discovery endpoint.
+app.get('/cds-services', function(request, response) {
+  response.json({
+    services: [{
+      hook: 'order-select',
+      title: 'Demo AUC Guidance Consultation - Click to Insert Evidence',
+      description: 'Click to insert evidence of AUC guidance consultation.',
+      id: 'demo-auc-app'
+    }]
+  })
+});