Resource closure using configured questionnaires

Event management implementation provides the ability to configure a questionnaire so that we can state which resources to close when it is submitted.

Some use cases would be -

Closing CarePlans and Tasks for a patient/family when they are removed.
Closing child-related CarePlans and Tasks if a patient's age is updated to more than 5 years.
Closing ANC CarePlan and Tasks when a pregnancy outcome form is submitted.

This is achieved by use of the EventWorkFlow config.

Sample event workflow configuration

{
  "eventWorkflows": [
    {
      "eventType": "RESOURCE_CLOSURE",
      "eventResources": [
        {
          "id": "sickChildConditionToBeClosed",
          "resource": "Condition",
          "configRules": [
            {
              "name": "patientId",
              "condition": "true",
              "actions": [
                "data.put('patientId', fhirPath.extractValue(CarePlan, 'CarePlan.subject.reference'))"
              ]
            }
          ],
          "dataQueries": [
            {
              "paramName": "code",
              "filterCriteria": [
                {
                  "dataType": "CODEABLECONCEPT",
                  "value": {
                    "system": "http://snomed.info/sct",
                    "code": "275142008"
                  }
                }
              ]
            },
            {
              "paramName": "subject",
              "filterCriteria": [
                {
                  "dataType": "REFERENCE",
                  "computedRule": "patientId"
                }
              ]
            }
          ]
        },
        {
          "id": "carePlanToBeClosed",
          "resource": "CarePlan",
          "configRules": [
            {
              "name": "patientId",
              "condition": "true",
              "actions": [
                "data.put('patientId', fhirPath.extractValue(Patient, 'Patient.id').contains('Patient') ? fhirPath.extractValue(Patient, 'Patient.id') : 'Patient/' +  fhirPath.extractValue(Patient, 'Patient.id'))"
              ]
            }
          ],
          "dataQueries": [
            {
              "paramName": "instantiates-canonical",
              "filterCriteria": [
                {
                  "dataType": "REFERENCE",
                  "value": "PlanDefinition/dc-diabetes-screening-intervention"
                }
              ]
            },
            {
              "paramName": "subject",
              "filterCriteria": [
                {
                  "dataType": "REFERENCE",
                  "computedRule": "patientId"
                }
              ]
            }
          ],
          "relatedResources": [
            {
              "resource": "Task",
              "searchParameter": "based-on"
            }
          ]
        }
      ],
      "updateValues": [
        {
          "jsonPathExpression": "Task.status",
          "value": "cancelled",
          "resourceType": "Task"
        },
        {
          "jsonPathExpression": "CarePlan.status",
          "value": "completed",
          "resourceType": "CarePlan"
        },
        {
          "jsonPathExpression": "Condition.clinicalStatus.coding[0].code",
          "value": "370996005",
          "resourceType": "Condition"
        },
        {
          "jsonPathExpression": "Condition.clinicalStatus.coding[0].system",
          "value": "http://www.snomed.org/",
          "resourceType": "Condition"
        },
        {
          "jsonPathExpression": "Condition.clinicalStatus.coding[0].display",
          "value": "resolved",
          "resourceType": "Condition"
        }
      ],
      "resourceFilterExpressions": [
        {
          "conditionalFhirPathExpressions": [
            "Task.status != 'completed'"
          ],
          "resourceType": "Task"
        }
      ]
    }
  ]
}

The current implementation eventWorkflow config only handle closure of resources, hence the event type defaults to RESOURCE_CLOSURE. This implementation can be expanded in future to handle other types of events.

The trigger conditions determine whether to close resources depending on the the result of evaluating the fhirpath expressions. The fhirpath expressions can be run against

The subject of the questionnaire e.g Patient.active
The Bundle resource which contains the QuestionnaireResponse, the subject as well as additional resources. An example expression would be %resource.entry.where(resource is QuestionnaireResponse).resource.where(questionnaire = 'Questionnaire/450cb100-0c5b-47c6-9f33-2830a79be726').exists()
A combination of both the subject and Bundle e.g Patient.active AND %resource.entry.where(resource is QuestionnaireResponse).resource.where(questionnaire = 'Questionnaire/450cb100-0c5b-47c6-9f33-2830a79be726').exists()

The event resources define which resource is eligible for closure as well as any related resources.

The data queries define how to search for and filter the resources from the database.

Once the resources have been retrieved from the database, the next step is to close the resources by updating the values of certain fields. For the current implementation this has been done in the code. This is not configurable at this point. Closure of any resource that has not been handled will need an update to the code that performs resource closure.

The following table contains the values for each field that is required to close a resource.field

Resource	Field	Value
Careplan	status	Completed
Task	status	cancelled
	lastModified	current date
Condition	Condition.clinicalStatus	code:370996005, display:resolved, system: http://www.snomed.org/
Procedure	Procedure.status	stopped
ServiceRequest	status	revoked

EventWorkflows properties

Property	Description	Required	Default
eventType	The intention of the eventWorkflow. E.g close resources	yes	RESOURCE_CLOSURE is supported for now
triggerConditions	This defines an array of condition for to be met for the event to run	no	null
eventResourceId	uniqueId of resource id to be closed	yes
eventResources	A list of resources to close(Type of ResourceConfig)	yes
updateValues	Defines a list of jsonPath expressions for the fields to update as well as the values to use	yes
resourceFilterExpressions	A list of FhirPath expressions used to filter which resources to close	no

Trigger condition properties

Property	Description	Required	Default
eventResourceId	UniqueId of resource that the trigger conditions are applied to	yes	RESOURCE_CLOSURE is supported for now
conditionalFhirPathExpressions	criteria to ensure we only close the intended resources	yes
matchAll	Determines whether all conditional fhirpath expressions should evaluate to true	no	True
	`True` - Close resources only when all fhirpath expressions evaluate to true
	`False` - Close resources when one or more fhirpath expressions evaluate to true

Event Resource Properties

Property	Description	Required
id	uniqueId of resource id to be closed	yes
resource	The type of resource	yes
configRules	Rules to be that are executed to populate dynamic values such as a patient id	no
dataQueries	Configs used to represent how resources to be closed are retrieved from the database	yes
relatedResources	Configs that represent how to fetch related resources e.g Tasks linked to a CarePlan	no

DataQuery properties

Property	Description	Required	Default
paramName	String representation of the resource field to search on	yes
operation	Logical SQL operation to perform i.e AND, OR	yes	AND
filterCriteria	Configs that represent the datatype and value for filtering data	yes

UpdateValue properties

Property	Description	Required
jsonPathExpression	JsonPath representation of the resource field to update	yes
value	The value to update the resource field with	yes
resourceType	The name of the resource type to be updated	yes

Resource Filter Expression properties

Property	Description	Required	Default
conditionalFhirPathExpressions	Criteria to filter which resources when only a subset of the fetched resources need to be updated e.g only update tasks whose status is not completed	yes
matchAll	Determines whether all conditional FhirPath expressions should evaluate to true	no	true
resourceType	The name of the resource type to be updated	yes

Resource closure using configured questionnaires

Sample event workflow configuration​

EventWorkflows properties​

Trigger condition properties​

Event Resource Properties​

DataQuery properties​

UpdateValue properties​

Resource Filter Expression properties​