feat: add proficiency and mode to patient language

containers/ecr-viewer/src/app/api/fhirPath.yaml

@@ -13,7 +13,7 @@ patientRace: "Bundle.entry.resource.where(resourceType = 'Patient').extension.wh
 patientRaceDetailed: "Bundle.entry.resource.where(resourceType = 'Patient').extension.where(url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-race').extension.where(url = 'detailed').valueCoding.display"
 patientEthnicity: "Bundle.entry.resource.where(resourceType = 'Patient').extension.where(url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity').extension.where(url = 'ombCategory').valueCoding.display"
 patientEthnicityDetailed: "Bundle.entry.resource.where(resourceType = 'Patient').extension.where(url = 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-ethnicity').extension.where(url = 'detailed').valueCoding.display"
-patientLanguage: "Bundle.entry.resource.where(resourceType = 'Patient').communication.first().language.coding.first().display"
+patientCommunication: "Bundle.entry.resource.where(resourceType = 'Patient').communication"
 patientTribalAffiliation: "Bundle.entry.resource.where(resourceType = 'Patient').extension.where(url='http://hl7.org/fhir/us/ecr/StructureDefinition/us-ph-tribal-affiliation-extension').extension.where(url='TribeName').value"
 patientEmergencyContact: "Bundle.entry.resource.where(resourceType = 'Patient').contact"
 

containers/ecr-viewer/src/app/services/evaluateFhirDataService.ts

@@ -5,9 +5,11 @@ import {
   Coding,
   Condition,
   Encounter,
+  Extension,
   HumanName,
   Location,
   Organization,
+  PatientCommunication,
   PatientContact,
   Practitioner,
   PractitionerRole,
@@ -337,7 +339,7 @@ export const evaluateDemographicsData = (
     },
     {
       title: "Preferred Language",
-      value: evaluate(fhirBundle, mappings.patientLanguage)[0],
+      value: evaluatePatientLanguage(fhirBundle, mappings),
     },
     {
       title: "Patient Address",
@@ -630,7 +632,10 @@ export const evaluateReference = (
  * @param path - The path within the resource to extract the value from.
  * @returns - The evaluated value as a string.
  */
-export const evaluateValue = (entry: Element, path: string | Path): string => {
+export const evaluateValue = (
+  entry: Element | Element[],
+  path: string | Path,
+): string => {
   let originalValue = evaluate(entry, path, undefined, fhirpath_r4_model)[0];
 
   let value = "";
@@ -737,3 +742,52 @@ export const evaluateEncounterDiagnosis = (
     .map((condition) => condition.code?.coding?.[0].display)
     .join(", ");
 };
+
+/**
+ * Evaluate patient's prefered language
+ * @param fhirBundle - The FHIR bundle containing resources.
+ * @param mappings - Path mappings for resolving references.
+ * @returns String containing language, proficiency, and mode
+ */
+export const evaluatePatientLanguage = (
+  fhirBundle: Bundle,
+  mappings: PathMappings,
+) => {
+  let patientCommunication: PatientCommunication[] = evaluate(
+    fhirBundle,
+    mappings.patientCommunication,
+  );
+  const preferedPatientCommunication = patientCommunication.filter(
+    (communication) => communication.preferred,
+  );
+
+  if (preferedPatientCommunication.length > 0) {
+    patientCommunication = preferedPatientCommunication;
+  }
+
+  return patientCommunication
+    .map((communication) => {
+      const patientProficiencyExtension: Extension[] = evaluate(
+        communication,
+        "extension.where(url = 'http://hl7.org/fhir/StructureDefinition/patient-proficiency')",
+      );
+      const patientLanguage: string | undefined = evaluateValue(
+        communication,
+        "language.coding",
+      );
+      const languageProficency: string | undefined = evaluateValue(
+        patientProficiencyExtension,
+        "extension.where(url = 'level').value",
+      );
+      const languageMode: string | undefined = evaluateValue(
+        patientProficiencyExtension,
+        "extension.where(url = 'type').value",
+      );
+
+      return [patientLanguage, languageProficency, languageMode]
+        .filter(Boolean)
+        .join("\n");
+    })
+    .filter(Boolean)
+    .join("\n\n");
+};

containers/ecr-viewer/src/app/tests/assets/BundlePatient.json

@@ -160,6 +160,17 @@
           }
         ],
         "communication": [
+          {
+            "language": {
+              "coding": [
+                {
+                  "system": "urn:ietf:bcp:47",
+                  "code": "es",
+                  "display": "Spanish"
+                }
+              ]
+            }
+          },
           {
             "language": {
               "coding": [
@@ -169,7 +180,31 @@
                   "display": "English"
                 }
               ]
-            }
+            },
+            "preferred": true,
+            "extension": [
+              {
+                "url": "http://hl7.org/fhir/StructureDefinition/patient-proficiency",
+                "extension": [
+                  {
+                    "url": "type",
+                    "valueCoding": {
+                      "system": "http://terminology.hl7.org/CodeSystem/v3-LanguageAbilityMode",
+                      "code": "ESP",
+                      "display": "Expressed spoken"
+                    }
+                  },
+                  {
+                    "url": "level",
+                    "valueCoding": {
+                      "system": "http://terminology.hl7.org/CodeSystem/v3-LanguageAbilityProficiency",
+                      "code": "G",
+                      "display": "Good"
+                    }
+                  }
+                ]
+              }
+            ]
           }
         ]
       },

containers/ecr-viewer/src/app/tests/services/evaluateFhirDataServices.test.ts

@@ -13,6 +13,7 @@ import {
   evaluateDemographicsData,
   evaluateEncounterCareTeamTable,
   evaluateAlcoholUse,
+  evaluatePatientLanguage,
 } from "@/app/services/evaluateFhirDataService";
 import { Bundle, Patient } from "fhir/r4";
 import BundleWithMiscNotes from "@/app/tests/assets/BundleMiscNotes.json";
@@ -538,3 +539,114 @@ describe("Evaluate Alcohol Use", () => {
     expect(actual).toEqual("");
   });
 });
+
+describe("Evaluate Patient language", () => {
+  it("Should display language, proficiency, and mode", () => {
+    const actual = evaluatePatientLanguage(
+      BundleWithPatient as unknown as Bundle,
+      mappings,
+    );
+
+    expect(actual).toEqual("English\nGood\nExpressed spoken");
+  });
+
+  it("Should only display preferred languages", () => {
+    const patient = {
+      resourceType: "Bundle",
+      entry: [
+        {
+          resource: {
+            resourceType: "Patient",
+            communication: [
+              {
+                language: {
+                  coding: [
+                    {
+                      system: "urn:ietf:bcp:47",
+                      code: "es",
+                      display: "Spanish",
+                    },
+                  ],
+                },
+              },
+              {
+                preferred: true,
+                language: {
+                  coding: [
+                    {
+                      system: "urn:ietf:bcp:47",
+                      code: "en",
+                      display: "English",
+                    },
+                  ],
+                },
+              },
+              {
+                preferred: true,
+                language: {
+                  coding: [
+                    {
+                      system: "urn:ietf:bcp:47",
+                      code: "hi",
+                      display: "Hindi",
+                    },
+                  ],
+                },
+              },
+            ],
+          },
+        },
+      ],
+    };
+
+    const actual = evaluatePatientLanguage(
+      patient as unknown as Bundle,
+      mappings,
+    );
+
+    expect(actual).toEqual("English\n\nHindi");
+  });
+  it("Should display language when there are no preferred languages", () => {
+    const patient = {
+      resourceType: "Bundle",
+      entry: [
+        {
+          resource: {
+            resourceType: "Patient",
+            communication: [
+              {
+                language: {
+                  coding: [
+                    {
+                      system: "urn:ietf:bcp:47",
+                      code: "es",
+                      display: "Spanish",
+                    },
+                  ],
+                },
+              },
+              {
+                language: {
+                  coding: [
+                    {
+                      system: "urn:ietf:bcp:47",
+                      code: "en",
+                      display: "English",
+                    },
+                  ],
+                },
+              },
+            ],
+          },
+        },
+      ],
+    };
+
+    const actual = evaluatePatientLanguage(
+      patient as unknown as Bundle,
+      mappings,
+    );
+
+    expect(actual).toEqual("Spanish\n\nEnglish");
+  });
+});

containers/fhir-converter/Dockerfile

@@ -1,7 +1,7 @@
 FROM mcr.microsoft.com/dotnet/sdk:8.0 AS build
 
 # Download FHIR-Converter
-RUN git clone https://github.com/skylight-hq/FHIR-Converter.git --branch v7.0-skylight-19 --single-branch /build/FHIR-Converter
+RUN git clone https://github.com/skylight-hq/FHIR-Converter.git --branch v7.0-skylight-20 --single-branch /build/FHIR-Converter
 
 WORKDIR /build/FHIR-Converter
 

containers/fhir-converter/README.md

@@ -176,6 +176,7 @@ Both repos should be checked out and set up per the instructions above. We use r
 #### Tips & Tricks
 
 * To run the service tests, use the command `python -m pytest` (make sure the correct environment is activated).
+  * To update snapshots run `python -m pytest --snapshot-update`
   * Make sure your docker image has pulled in the latest changes by building with no cache `make build-image-no-cache`.
 * To run the tool tests, run the commands found in the github actions workflow.
 

containers/fhir-converter/tests/integration/__snapshots__/test_FHIR-Converter.ambr

@@ -609,6 +609,21 @@
             'birthDate': '2005-05-01',
             'communication': list([
               dict({
+                'extension': list([
+                  dict({
+                    'extension': list([
+                      dict({
+                        'url': str,
+                        'valueCoding': dict({
+                          'code': 'ESP',
+                          'display': 'Expressed spoken',
+                          'system': 'http://terminology.hl7.org/CodeSystem/v3-LanguageAbilityMode',
+                        }),
+                      }),
+                    ]),
+                    'url': str,
+                  }),
+                ]),
                 'language': dict({
                   'coding': list([
                     dict({
@@ -2494,6 +2509,21 @@
             'birthDate': '1977-03-25',
             'communication': list([
               dict({
+                'extension': list([
+                  dict({
+                    'extension': list([
+                      dict({
+                        'url': str,
+                        'valueCoding': dict({
+                          'code': 'EWR',
+                          'display': 'Expressed written',
+                          'system': 'http://terminology.hl7.org/CodeSystem/v3-LanguageAbilityMode',
+                        }),
+                      }),
+                    ]),
+                    'url': str,
+                  }),
+                ]),
                 'language': dict({
                   'coding': list([
                     dict({