public static Regimen getRegimenOnDate(Patient p, Date regDate) {
Regimen ret = null;
RegimenHistory rh = RegimenUtils.getRegimenHistory(p);
if (rh != null) {
Regimen r = rh.getRegimen(regDate);
if (r != null) {
return r;
}
}
return ret;
}
/*newDrugOrder argument used to pass in the drug or the drug concept*/
public static List<DrugOrder> getDrugOrdersInOrderByDrugOrConcept(
RegimenHistory history, DrugOrder newDrugOrder) {
List<DrugOrder> ret = new ArrayList<DrugOrder>();
List<Regimen> regList = history.getRegimenList();
for (Regimen regimen : regList) {
for (RegimenComponent rc : regimen.getComponents()) {
if (drugOrderMatchesDrugConcept(rc.getDrugOrder(), newDrugOrder)) {
ret.add(rc.getDrugOrder());
}
}
}
return ret;
}
/* here's the logic for what happens if there is a future regimen:
*
*
* //1. if no drug order of a specific DrugOrder, (create the new order). (OUTCOME1)
//2. if DrugOrder, for all DrugOrders:
//a. if new start is before old start
//NEW ORDER HAS STOP DATE -- create the older as is, and make adjustments:
//1. if new end is before or equal to old start (create the new order) (OUTCOME2)
//2. if new end is after old start and ( before old end or old end is infinite)
//if order is different, adjust the start date of the old order to the end date of the new (create the new order) (OUTCOME3)
//if order is same void old order(doesn't matter if old order has infinite stop date or not) (create the new order) (OUTCOME4)
//3. if end date is greater than or equal to old end -- void old order (create the new order) (OUTCOME5)
//NEW ORDER DOESN'T HAVE STOP DATE
//4. orders are different
//set end date of new to beginning of old and stop iterating over existing drug orders time sequence (create the new order, modified) (OUTCOME6)
//5. orders are the same
//delete the old order (create the new order) (OUTCOME7)
//b. if start is the same
// void existing (create the new order) (OUTCOME8)
//c. if start is after existing start
//1. if order is after old drug end (create the new order) (OUTCOME9)
//2. if order is before old drug end or equal to old drug end or old drug end date is infinite
//if orders are the same update the old order with the new, taking the new end date value (Do not create new order) (OUTCOME10)
//if orders are different adjust the old to end on new start date (create the new order) (OUTCOME11)
* */
public static void setRegimen(
Patient patient,
Date effectiveDate,
Collection<DrugOrder> drugOrders,
Concept reasonForChange,
Encounter encounterForChange) {
RegimenHistory history = getRegimenHistory(patient);
Regimen regOnDate = history.getRegimen(effectiveDate);
List<Regimen> regAfterDate = history.getRegimensAfter(effectiveDate);
OrderService os = Context.getOrderService();
if (encounterForChange != null) {
Context.getEncounterService().saveEncounter(encounterForChange);
for (DrugOrder drugOrder : drugOrders) {
drugOrder.setEncounter(encounterForChange);
}
}
if (!anyRegimens(regAfterDate)) {
if (regOnDate == null || regOnDate.getComponents().isEmpty()) {
// case: there is no existing regimen on the regimen start date, and there are no new
// regimens after this date
// go ahead and create the regimen:
for (DrugOrder drugOrder : drugOrders) {
Context.getOrderService().saveOrder(drugOrder);
}
} else {
// case: there are still open orders and there are no new regimens after this date
// first see what existing things we need to stop
for (RegimenComponent before : regOnDate.getComponents()) {
// stop the old order only if it isn't exactly identical to a new order (excluding
// discontinued_date)
for (DrugOrder newOrder : drugOrders) {
// but either concept or drug is the same
if (!before.getDrugOrder().getDiscontinued()
&& drugOrderMatchesDrugConcept(before.getDrugOrder(), newOrder)
&& !regimenComponentIsTheSameAsDrugOrderExcludingDates(
before.getDrugOrder(), newOrder)) {
discontinueOrder(before.getDrugOrder(), effectiveDate, reasonForChange);
}
}
}
// now see what new things to start (or extend)
for (DrugOrder newOrder : drugOrders) {
// create a new order if there isn't already an existing match,
// or if there is (excluding discontinued date) you need to extend, or null the stop date
boolean alreadyExists = false;
for (RegimenComponent before : regOnDate.getComponents()) {
if (!before.getDrugOrder().getDiscontinued()
&& regimenComponentIsTheSameAsDrugOrderExcludingDates(
before.getDrugOrder(), newOrder)) {
alreadyExists = true;
before.getDrugOrder().setDiscontinuedDate(newOrder.getDiscontinuedDate());
before.getDrugOrder().setAutoExpireDate(newOrder.getAutoExpireDate());
before.getDrugOrder().setPrn(newOrder.getPrn());
before.getDrugOrder().setInstructions(newOrder.getInstructions());
os.saveOrder(before.getDrugOrder());
newOrder.setOrderId(before.getDrugOrder().getOrderId());
break;
}
}
if (!alreadyExists) {
os.saveOrder(newOrder);
}
}
}
} else { // there is a regimen change after the new drug order start date
for (DrugOrder newOrder : drugOrders) {
boolean saveOrder = false;
boolean merged = false;
history = getRegimenHistory(patient);
List<DrugOrder> existingDrugOrders = getDrugOrdersInOrderByDrugOrConcept(history, newOrder);
if (existingDrugOrders.size() == 0) {
saveOrder = setSaveOrder(merged); // (OUTCOME1)
} else {
for (DrugOrder before : existingDrugOrders) {
if (newOrder.getStartDate().before(before.getStartDate())) {
if (newOrder.getDiscontinuedDate() != null) {
if (newOrder.getDiscontinuedDate().before(before.getStartDate())
|| newOrder.getDiscontinuedDate().equals(before.getStartDate())) {
saveOrder = setSaveOrder(merged); // (OUTCOME2)
} else if (newOrder.getDiscontinuedDate().after(before.getStartDate())
&& (before.getDiscontinuedDate() == null
|| newOrder.getDiscontinuedDate().before(before.getDiscontinuedDate()))) {
if (!regimenComponentIsTheSameAsDrugOrderExcludingDates(before, newOrder)) {
// (OUTCOME3)
before.setStartDate(newOrder.getDiscontinuedDate());
os.saveOrder(before);
saveOrder = setSaveOrder(merged);
} else {
// (OUTCOME4)
os.voidOrder(before, "overwritten");
saveOrder = setSaveOrder(merged);
}
} else if (before.getDiscontinuedDate() != null
&& (newOrder.getDiscontinuedDate().after(before.getDiscontinuedDate())
|| newOrder.getDiscontinuedDate().equals(before.getDiscontinuedDate()))) {
// (OUTCOME5)
os.voidOrder(before, "overwritten");
saveOrder = setSaveOrder(merged);
}
} else { // new order has infinite end date
if (!regimenComponentIsTheSameAsDrugOrderExcludingDates(before, newOrder)) {
// (OUTCOME6)
newOrder.setDiscontinuedDate(before.getStartDate());
saveOrder = setSaveOrder(merged);
break;
} else {
// (OUTCOME7)
os.voidOrder(before, "overwritten");
saveOrder = setSaveOrder(merged);
}
}
} else if (newOrder.getStartDate().equals(before.getStartDate())) { // b
// (OUTCOME8)
os.voidOrder(before, "overwritten");
saveOrder = setSaveOrder(merged);
} else { // c -- start date is after or equal to old end date
if (before.getDiscontinuedDate() != null
&& newOrder.getStartDate().after(before.getDiscontinuedDate())) // 1
// (OUTCOME9)
saveOrder = setSaveOrder(merged);
if (before.getDiscontinuedDate() == null
|| newOrder.getStartDate().before(before.getDiscontinuedDate())
|| newOrder.getStartDate().equals(before.getDiscontinuedDate())) { // 2
if (regimenComponentIsTheSameAsDrugOrderExcludingDates(before, newOrder)) {
// (OUTCOME10)
before.setDiscontinuedDate(newOrder.getDiscontinuedDate());
before.setAutoExpireDate(newOrder.getAutoExpireDate());
before.setPrn(newOrder.getPrn());
before.setInstructions(newOrder.getInstructions());
os.saveOrder(before);
saveOrder = false;
newOrder.setOrderId(before.getOrderId());
merged = true;
} else {
// (OUTCOME11)
before.setDiscontinuedDate(newOrder.getStartDate());
os.saveOrder(before);
saveOrder = setSaveOrder(merged);
}
}
}
}
}
if (saveOrder) os.saveOrder(newOrder);
}
}
}
