Formulary drug stu2

app/controllers/application_controller.rb

@@ -27,14 +27,18 @@ def get_patient
   def coverage_plans
     # Read all of the insurance drug plans from the server
     cp_type = "http://terminology.hl7.org/CodeSystem/v3-ActCode|DRUGPOL"
-
     reply = @client.search(FHIR::InsurancePlan, search: { parameters: { type: cp_type}}).resource
-    @plansbyid  = build_coverage_plans(reply)
+    @plansbyid  = JSON.parse(build_coverage_plans(reply).to_json).deep_symbolize_keys
+    @formulary_items_and_drugs = formulary_items_and_drugs
+    @formulary_items = @formulary_items_and_drugs[:formulary_items]
+    @formulary_drugs = @formulary_items_and_drugs[:formulary_drugs]
     @locationsbyid  = locations
     @cp_options = build_coverage_plan_options(reply)
     session[:plansbyid] = compress_hash(@plansbyid.to_json)
     session[:locationsbyid] = compress_hash(@locationsbyid.to_json)
     session[:cp_options] = compress_hash(@cp_options)
+    session[:formularyitemsbyid] = compress_hash(@formulary_items.to_json)
+    session[:formularydrugsbyid] = compress_hash(@formulary_drugs.to_json)
 
     # Prepare the query string for display on the page
   	@search = URI.decode(reply.link.select { |l| l.relation === "self"}.first.url) if reply.link.first
@@ -65,6 +69,37 @@ def get_plansbyid
 
   #-----------------------------------------------------------------------------
 
+  def get_formularyItemsById
+    if session[:formularyitemsbyid]
+      @formularyitemsbyid = JSON.parse(decompress_hash(session[:formularyitemsbyid]))
+      @cp_options = decompress_hash(session[:cp_options])
+      @search = session[:query]
+    else
+      puts "get_formularyItemsById: session[:formularyitemsbyid] is nil, calling formulary_items "
+      @formularyitemsbyid = nil
+      @cp_options = [["N/A (Must connect first)", "-"]]
+      formulary_items_and_drugs
+    end
+  end
+
+  #-----------------------------------------------------------------------------
+
+
+  def get_formularyDrugsById
+    if session[:formularydrugsbyid]
+      @formularydrugsbyid = JSON.parse(decompress_hash(session[:formularydrugsbyid]))
+      @cp_options = decompress_hash(session[:cp_options])
+      @search = session[:query]
+    else
+      puts "get_formularyDrugsById: session[:formularydrugsbyid] is nil, calling formulary_drugs "
+      @formularydrugsbyid = nil
+      @cp_options = [["N/A (Must connect first)", "-"]]
+      formulary_items_and_drugs
+    end
+  end
+
+  #-----------------------------------------------------------------------------
+
   def locations
     profile = "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-InsurancePlanLocation"
     bundle = @client.search(FHIR::Location, search: { parameters: { _profile: profile}}).resource&.entry || []
@@ -76,7 +111,34 @@ def locations
   end
 
   #-----------------------------------------------------------------------------
+
+  def formulary_items_and_drugs
+    profile = "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-FormularyItem"
+    bundle = @client.search(FHIR::Basic, search: { parameters: {_profile: profile, _include: "Basic:subject", _count: 500 }}).resource&.entry || []
+    formulary_drugs = {}
+    formulary_items = bundle.each_with_object({}) do | entry, formularyItemById |
+      if entry.search.mode == "match"
+        formularyItemById[entry.resource.id] = FormularyItem.new(entry.resource, @plansbyid)
+      else
+        formulary_drugs[entry.resource.id] = MedicationKnowledge.new(entry.resource)
+      end
+    end
+    @formulary_items_and_drugs = {formulary_items: formulary_items.deep_symbolize_keys, formulary_drugs: formulary_drugs.deep_symbolize_keys}
+  end
 
+  #-----------------------------------------------------------------------------
+
+  def formulary_drugs
+    profile = "http://hl7.org/fhir/us/davinci-drug-formulary/StructureDefinition/usdf-FormularyDrug"
+    bundle = @client.search(FHIR::MedicationKnowledge, search: { parameters: {_profile: profile}}).resource&.entry || []
+    formulary_drugs = bundle.each_with_object({}) do | entry, formularyDrugById |
+      formularyDrugById[entry.resource.id] = MedicationKnowledge.new(entry.resource)
+    end
+    formulary_drugs.deep_symbolize_keys
+  end
+
+  #-----------------------------------------------------------------------------
+
   def payer_plans
     # Read all payer insurance plans from the server
     payerplan_type = "http://hl7.org/fhir/us/davinci-pdex-plan-net/CodeSystem/InsuranceProductTypeCS|"

app/controllers/compare_controller.rb

@@ -19,7 +19,6 @@ class CompareController < ApplicationController
 	def index
 		@codes = nil
 		@params = nil 
-
 		get_plansbyid
 		if params[:search].length>0 or params[:code].length>0
 			@drugname = params[:search].split(' ').first 
@@ -109,12 +108,14 @@ def set_table
 		chosen = @cache[:fis]
     @drugsbyid = build_formulary_drugs(@cache[:fds])
 		@table_rows = Hash.new
-
-		chosen.collect!{ |fi| FormularyItem.new(fi, @plansbyid, @drugsbyid) }
+		chosen.collect!{ |fi| FormularyItem.new(fi, @plansbyid)}
 		chosen.each do |fi|
-			code = fi.rxnorm_code
-			plan = fi.plan_id
+			fd = FormularyDrug.new(@cache[:fds].find { |drug| drug.id == fi.subject.reference.split('/')[1] })
+			code = fi.subject.reference.split('/')[1]
+			plan = fi.formulary.reference.split('/')[1]
 			@table_rows.has_key?(code) ? @table_rows[code][plan] = fi : @table_rows[code] = { plan => fi }
+			@table_rows[code][code] = fd
+
 		end
 	end
 

app/controllers/formularies_controller.rb

@@ -43,7 +43,7 @@ def index
     @drugsbyid =  build_formulary_drugs(fhir_formularydrugs)
 		@formularydrugs = []
 		fhir_formularyitems.each do |fhir_formularyitem| 
-			@formularydrugs << FormularyItem.new(fhir_formularyitem,@plansbyid, @drugsbyid)
+			@formularydrugs << FormularyItem.new(fhir_formularyitem, @plansbyid)
 		end
 
 		# Prepare the query string for display on the page
@@ -68,7 +68,7 @@ def show
 		# fhir_formularydrug = @@bundle.entry.map(&:resource).first
 		get_plansbyid
     @drugsbyid =  build_formulary_drugs(fhir_formularydrugs)
-		@formulary_drug = FormularyItem.new(fhir_formularyitem, @plansbyid, @drugsbyid)
+		@formulary_drug = FormularyItem.new(fhir_formularyitem, @plansbyid)
 
 		# Prepare the query string for display on the page
   	@search = "<Search String in Returned Bundle is empty>"

app/controllers/formularyitems_controller.rb

@@ -0,0 +1,42 @@
+################################################################################
+#
+# FormularItems Controller  => Formulary Item (Basic) profile
+#
+# Copyright (c) 2021 The MITRE Corporation.  All rights reserved.
+#
+################################################################################
+
+require 'json'
+
+class FormularyitemsController < ApplicationController
+
+	before_action :check_formulary_server_connection, only: [ :index]
+
+	#-----------------------------------------------------------------------------
+
+	# GET /formularyitems
+
+	def index
+    get_plansbyid
+    get_payers_byid
+    get_formularyItemsById
+    get_formularyDrugsById
+    @formulary_items = @formularyitemsbyid.values.select do |formulary_item|
+      formulary_drug = @formularydrugsbyid.values.find {|drug| formulary_item["subject"]["reference"] == "MedicationKnowledge/" + drug["id"]}
+      include_in_results = true
+      if params[:coverage].present?
+        include_in_results = include_in_results && formulary_item["formulary"]["reference"] == "InsurancePlan/" + params[:coverage]
+      end
+      if params[:drug_tier].present?
+        include_in_results = include_in_results && formulary_item["drug_tier"]["code"] == params[:drug_tier]
+      end
+      if params[:name].present?
+        include_in_results = include_in_results && params[:name].in?(formulary_drug["code"]["display"])
+      end
+      include_in_results
+    end
+	end
+
+	#-----------------------------------------------------------------------------
+
+end

app/models/formulary_item.rb

@@ -1,125 +1,52 @@
 ################################################################################
 #
-# Formulary Item Model
+# FormularyItem Model => FormularyItem profile
 #
 # Copyright (c) 2021 The MITRE Corporation.  All rights reserved.
 #
 ################################################################################
 
-class FormularyItem < Resource
+class FormularyItem
 
   include ActiveModel::Model
 
-	attr_accessor :drug_tier, :drug_class, :id, :plan_id, :drug_name, :rxnorm_code,
-									:prior_auth, :step_therapy, :quantity_limit, :errors, :step_therapy_newstart,
-									:warnings, :plan_id_path, :plan_id_name, :rxnorm_path, :prior_auth_newstart,
-									:copay, :coinsurancerate, :formulary_id_path, :plan, :plansbyid, :mailorder
-
-	#-----------------------------------------------------------------------------
-
-	def initialize(fhir_formulary, plansbyid, drugsbyid)
-		@id  							= parse_id(fhir_formulary)
-    drug              = drugsbyid[parse_reference_id(fhir_formulary.subject.reference).to_sym]
-    @drug_name        = drug[:drug_name]
-    @rxnorm_code      = drug[:rxnorm_code]
-		@plansbyid        = plansbyid
-		#@drug_class				= parse_drug_class(fhir_formulary)
-		@rxnorm_path            =    "https://mor.nlm.nih.gov/RxNav/search?searchBy=RXCUI&searchTerm=" + @rxnorm_code 
-		@formulary_id_path            = "/formularies/#{@id}"
-		parse_extensions(fhir_formulary)
-		@plan = plansbyid[@plan_id.to_sym]
-		# Test inclusion of drug tier info in formulary drug for display
-		@tier = @plan[:tiers][@drug_tier.to_sym]
-		if @tier
+  attr_accessor :id, :subject, :formulary, :drug_tier, :prior_authorization, :quantity_limit, :step_therapy_limit,
+                :status, :period, :pharmacy_type, :copay, :coinsurancerate
+
+  def initialize(fhir_formularyitem, plansbyid)
+		@id 		             = fhir_formularyitem.id 
+    @subject             = fhir_formularyitem.subject
+
+    @extension           = fhir_formularyitem.extension
+    @formulary           = find_element_in_extension(@extension, "DrugPlanReference").valueReference
+    @drug_tier           = find_element_in_extension(@extension, "DrugTierID").valueCodeableConcept.coding.first
+    @prior_authorization = find_element_in_extension(@extension, "PriorAuthorization").valueBoolean
+    @quantity_limit      = find_element_in_extension(@extension, "QuantityLimit").valueBoolean
+    @step_therapy_limit  = find_element_in_extension(@extension, "StepTherapyLimit").valueBoolean
+    @status              = find_element_in_extension(@extension, "AvailabilityStatus").valueCode
+    @period              = find_element_in_extension(@extension, "AvailabilityPeriod").valuePeriod
+    @pharmacy_type       = find_element_in_extension(@extension, "PharmacyType").valueCodeableConcept.coding.first
+    @plan = plansbyid[@formulary.reference.split('/')[1].to_sym]
+    @tier = @plan[:tiers][@drug_tier.code.to_sym]
+    if @tier
 			@copay = @tier["1 month in network retail".to_sym][:copay]
 			@coinsurancerate = @tier["1 month in network retail".to_sym][:coinsurancerate]			
 		else
 			@copay = "missing"
 			@coinsurancerate = "missing"
 		end
+
 	end
-
-	#-----------------------------------------------------------------------------
-	private
-	#-----------------------------------------------------------------------------
-
-	# Isolates the ID from the formulary drug resource.
-
-	def parse_id(fhir_formulary)
-		return fhir_formulary.id
-	end
-
-	#-----------------------------------------------------------------------------
-
-  def parse_reference_id(reference)
-    return reference.split("/").last
-  end
 
-  #-----------------------------------------------------------------------------
-
- 	# Parses the values within the extensions defined by the formulary drug 
- 	# resource.
-
-	def parse_extensions(fhir_formulary)
-		extensions = fhir_formulary.extension
-		if extensions.present?
-			extensions.each do |extension|
-				if extension.url.include?("DrugTierID")
-					@drug_tier = parse_drug_tier(extension)
-        elsif extension.url.include?("PharmacyType")
-					if parse_drug_tier(extension).include?("mail")
-            @mailorder = true
-          end
-
-				elsif extension.url.include?("PriorAuthorization-extension")
-					@prior_auth = extension.valueBoolean
-        elsif extension.url.include?("PriorAuthorizationNewStartsOnly")
-					@prior_auth_newstart = extension.valueBoolean
-				elsif extension.url.include?("StepTherapyLimit-extension")
-					@step_therapy = extension.valueBoolean
-        elsif extension.url.include?("StepTherapyLimitNewStartsOnly")
-					@step_therapy_newstart = extension.valueBoolean
-				elsif extension.url.include?("QuantityLimit")
-					@quantity_limit = extension.valueBoolean
-				elsif extension.url.include?("DrugPlanReference")
-					@plan_id = parse_reference_id(extension.valueReference.reference)
-					@plan = plansbyid[plan_id.to_sym]
-					@plan_id_path = "/coverageplans/#{plan_id}"
-					@plan_id_name = plan[:name]
-				end
-			end
-		else
-			@drug_tier = "Required extensions not specified"
-		end
-	end
-
-	#-----------------------------------------------------------------------------
-
-	def parse_drug_tier(extension)
-		if (concept = extension.valueCodeableConcept).present?
-			if (coding = concept.coding).present?
-				value = code_list(coding)
-			else
-				value = "Drug tier not specified"
-			end
-		else
-			value = "Codeable concept not present"
-		end
-
-		return value
-	end
-
-	#-----------------------------------------------------------------------------
-  def display_list(list)
-		list.map{ |element| element.display }.join(', ')
-	end
 
-	#-----------------------------------------------------------------------------
 
-	# Concatenates a list of code elements.
-
-	def code_list(list)
-		list.map{ |element| element.code }.join(', ')
-	end
+  private
 
+  def find_element_in_extension(extensions, reference_key)
+    extensions.each do |extension|
+      if extension.url.include?(reference_key)
+        return extension
+      end
+    end
+  end
 end

app/models/medication_knowledge.rb

@@ -0,0 +1,25 @@
+################################################################################
+#
+# FormularyMedicationKnowledge Model => MedicationKnowledge profile
+#
+# Copyright (c) 2021 The MITRE Corporation.  All rights reserved.
+#
+################################################################################
+
+class MedicationKnowledge
+
+  include ActiveModel::Model
+
+  attr_accessor :id, :status, :code, :synonym, :dose_form, :related_medication_knowledge, :medicine_classification
+
+  def initialize(fhir_medicationknowledge)
+		@id 		                      = fhir_medicationknowledge.id 
+    @code                         = fhir_medicationknowledge.code.coding.first
+    @status                       = fhir_medicationknowledge.status
+    @synonym                      = fhir_medicationknowledge.synonym
+    @dose_form                    = fhir_medicationknowledge.doseForm
+    @related_medication_knowledge = fhir_medicationknowledge.relatedMedicationKnowledge
+    @medicine_classification      = fhir_medicationknowledge.medicineClassification
+
+	end
+end