sarahmcdougall commented 1 year ago

Summary

For care gaps, updates the GuidanceResponse.reasonCode to have the reasonDetail extension on the reasonCode itself rather than on the coding.

New behavior

When running care gaps, the structure of the generated GuidanceResponse resources will be different if the reason contains a reference. Previously, the output would look like the following:

"reasonCode": [
  {
    "coding": [
      {
        "system": ... ,
        "code": ... ,
        "display": ...
        "extension": [
          {
            "url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/reasonDetail",
            "extension": [<reason detail extension >]
          }
        ]
      }
    ]
  }
]

The expected output should now have the following format:

"reasonCode": [
  {
    "coding": [
      {
        "system": ...,
        "code": ...,
        "display": ...
      }
    ],
    "extension": [
      {
        "url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/reasonDetail",
        "extension": [<reason detail extension>]
      }
    ]
  }
],

See the GuidanceResponse attachment in this Jira issue to get an understanding of the updated structure. NOTE: it appears that there are several ways of attaching the extension (might be possible to attach it to the reasonCode.coding as well as including it on the root of reasonCode). For now, we will use this approach, but the extension may change in the future.

See the resource profile for Detailed Care Gap Guidance Response for more detail.

Code changes

src/gaps/GapsReportBuilder —> Change the generateReasonCoding function to now be named generateReasonCode. Now generates the reasonCode rather than just the coding (which would then be added to the reasonCode outside the function). Update generateGuidanceResponse function according to this change.
- Reasoning for this: We still want to map all the reasons to their reason codings, but creating the whole reason code in this function means we won’t need to do an additional mapping to the detailed extension as well. We can just construct the reason code all at once in this function
test/unit/GapsInCareHelpers.test.ts —> Updates unit test fixtures to have the extension defined on the reasonCode elements rather than on the reasonCode’s coding’s. Also updates the function name from generateReasonCoding to generateReasonCode.

Testing guidance

Run unit tests and check that the new unit test fixtures align with the spec
Run care gaps via the CLI on a measure and patient bundle, and compare the resulting GuidanceResponse structure against the output received from the main branch. The only difference should be the placement of the reasonDetail extension (if present).
- Example CLI command:

npm run cli -- gaps -m <EXM 130 measure bundle> -p <EXM 130 denominator patient bundle> -o -s 2019-01-01 -e 2019-12-31

github-actions[bot] commented 1 year ago

Coverage report

St.^{:grey_question:}	Category	Percentage	Covered / Total
🟢	Statements	85.4% (+0.01% 🔼)	2024/2370
🟡	Branches	73.97%	1802/2436
🟢	Functions	87.5%	357/408
🟢	Lines	85.7% (+0.01% 🔼)	1953/2279

Test suite run success

380 tests passing in 29 suites.

Report generated by 🧪jest coverage report action from 5e087d6322be13b3f331d22437005aec43742612

p9g commented 1 year ago

Can you add a test with 2 items in the reasonCode array, one with just a coding, and the other with a coding and the extension (with reference and path), for example

 "reasonCode": [
    {
      "coding": [
        {
          "code": "Present",
          "system": "http://hl7.org/fhir/us/davinci-deqm/CodeSystem/care-gap-reason",
          "display": "Data Element is Present"
        }
      ]
    },
    {
      "coding": [
        {
          "code": "ValueInRange",
          "system": "http://hl7.org/fhir/us/davinci-deqm/CodeSystem/care-gap-reason",
          "display": "Value is within specified range"
        }
      ],
      "extension": [
        {
          "extension": [
            {
              "url": "reference",
              "valueReference": {
                "reference": "Patient/cfsb1681933662110"
              }
            },
            {
              "url": "path",
              "valueString": "generalPractitioner"
            }
          ],
          "url": "http://hl7.org/fhir/us/davinci-deqm/StructureDefinition/reasonDetail"
        }
      ]
    }
  ]