Patient Consultation: Route to Facility 🏥, Admission Date & Time 🕚, R…

…ename variable: `verified_by` to `treating_physician` (#1678)

* refactor patient_consultation

* rebase migrations

* reorder fields

* fix existing tests

* add tests

* rebase migrations

* Rename and Alter field route to facility instead.
Rebase migrations.

* update tests

* fix tests, season 2

* Apply suggestions based on Code Review

care/abdm/utils/fhir.py

@@ -90,8 +90,8 @@ def _practioner(self):
         id = str(uuid())
         name = (
             (
-                self.consultation.verified_by
-                and f"{self.consultation.verified_by.first_name} {self.consultation.verified_by.last_name}"
+                self.consultation.treating_physician
+                and f"{self.consultation.treating_physician.first_name} {self.consultation.treating_physician.last_name}"
             )
             or self.consultation.deprecated_verified_by
             or f"{self.consultation.created_by.first_name} {self.consultation.created_by.last_name}"

care/facility/api/serializers/patient_consultation.py

@@ -7,6 +7,7 @@
 
 from care.abdm.utils.api_call import AbdmGateway
 from care.facility.api.serializers import TIMESTAMP_FIELDS
+from care.facility.api.serializers.asset import AssetLocationSerializer
 from care.facility.api.serializers.bed import ConsultationBedSerializer
 from care.facility.api.serializers.consultation_diagnosis import (
     ConsultationCreateDiagnosisSerializer,
@@ -22,6 +23,7 @@
     Prescription,
     PrescriptionType,
 )
+from care.facility.models.asset import AssetLocation
 from care.facility.models.bed import Bed, ConsultationBed
 from care.facility.models.icd11_diagnosis import (
     ConditionVerificationStatus,
@@ -31,6 +33,7 @@
 from care.facility.models.patient_base import (
     DISCHARGE_REASON_CHOICES,
     SYMPTOM_CHOICES,
+    RouteToFacility,
     SuggestionChoices,
 )
 from care.facility.models.patient_consultation import PatientConsultation
@@ -70,6 +73,29 @@ class PatientConsultationSerializer(serializers.ModelSerializer):
     referred_to_external = serializers.CharField(
         required=False, allow_null=True, allow_blank=True
     )
+
+    referred_from_facility_object = FacilityBasicInfoSerializer(
+        source="referred_from_facility", read_only=True
+    )
+    referred_from_facility = ExternalIdSerializerField(
+        queryset=Facility.objects.all(),
+        required=False,
+    )
+    referred_from_facility_external = serializers.CharField(
+        required=False, allow_null=True, allow_blank=True
+    )
+    referred_by_external = serializers.CharField(
+        required=False, allow_null=True, allow_blank=True
+    )
+
+    transferred_from_location_object = AssetLocationSerializer(
+        source="transferred_from_location", read_only=True
+    )
+    transferred_from_location = ExternalIdSerializerField(
+        queryset=AssetLocation.objects.all(),
+        required=False,
+    )
+
     patient = ExternalIdSerializerField(queryset=PatientRegistration.objects.all())
     facility = ExternalIdSerializerField(read_only=True)
 
@@ -78,8 +104,10 @@ class PatientConsultationSerializer(serializers.ModelSerializer):
         queryset=User.objects.all(), required=False, allow_null=True
     )
 
-    verified_by_object = UserBaseMinimumSerializer(source="verified_by", read_only=True)
-    verified_by = serializers.PrimaryKeyRelatedField(
+    treating_physician_object = UserBaseMinimumSerializer(
+        source="treating_physician", read_only=True
+    )
+    treating_physician = serializers.PrimaryKeyRelatedField(
         queryset=User.objects.all(), required=False, allow_null=True
     )
 
@@ -230,6 +258,58 @@ def update(self, instance, validated_data):
         return consultation
 
     def create(self, validated_data):
+        if route_to_facility := validated_data.get("route_to_facility"):
+            if route_to_facility == RouteToFacility.OUTPATIENT:
+                validated_data["icu_admission_date"] = None
+                validated_data["transferred_from_location"] = None
+                validated_data["referred_from_facility"] = None
+                validated_data["referred_from_facility_external"] = ""
+                validated_data["referred_by_external"] = ""
+
+            if route_to_facility == RouteToFacility.INTRA_FACILITY_TRANSFER:
+                validated_data["referred_from_facility"] = None
+                validated_data["referred_from_facility_external"] = ""
+                validated_data["referred_by_external"] = ""
+
+                if not validated_data.get("transferred_from_location"):
+                    raise ValidationError(
+                        {
+                            "transferred_from_location": [
+                                "This field is required as the patient has been transferred from another location."
+                            ]
+                        }
+                    )
+
+            if route_to_facility == RouteToFacility.INTER_FACILITY_TRANSFER:
+                validated_data["transferred_from_location"] = None
+
+                if not validated_data.get(
+                    "referred_from_facility"
+                ) and not validated_data.get("referred_from_facility_external"):
+                    raise ValidationError(
+                        {
+                            "referred_from_facility": [
+                                "This field is required as the patient has been referred from another facility."
+                            ]
+                        }
+                    )
+
+                if validated_data.get("referred_from_facility") and validated_data.get(
+                    "referred_from_facility_external"
+                ):
+                    raise ValidationError(
+                        {
+                            "referred_from_facility": [
+                                "Only one of referred_from_facility and referred_from_facility_external can be set"
+                            ],
+                            "referred_from_facility_external": [
+                                "Only one of referred_from_facility and referred_from_facility_external can be set"
+                            ],
+                        }
+                    )
+        else:
+            raise ValidationError({"route_to_facility": "This field is required"})
+
         create_diagnosis = validated_data.pop("create_diagnoses")
         action = -1
         review_interval = -1
@@ -401,15 +481,18 @@ def validate(self, attrs):
             "suggestion" in validated
             and validated["suggestion"] != SuggestionChoices.DD
         ):
-            if "verified_by" not in validated:
+            if "treating_physician" not in validated:
                 raise ValidationError(
                     {
-                        "verified_by": [
+                        "treating_physician": [
                             "This field is required as the suggestion is not 'Declared Death'"
                         ]
                     }
                 )
-            if not validated["verified_by"].user_type == User.TYPE_VALUE_MAP["Doctor"]:
+            if (
+                not validated["treating_physician"].user_type
+                == User.TYPE_VALUE_MAP["Doctor"]
+            ):
                 raise ValidationError("Only Doctors can verify a Consultation")
 
             facility = (
@@ -418,8 +501,8 @@ def validate(self, attrs):
                 or validated["patient"].facility
             )
             if (
-                validated["verified_by"].home_facility
-                and validated["verified_by"].home_facility != facility
+                validated["treating_physician"].home_facility
+                and validated["treating_physician"].home_facility != facility
             ):
                 raise ValidationError(
                     "Home Facility of the Doctor must be the same as the Consultation Facility"

care/facility/migrations/0394_rename_consultation_status_patientconsultation_route_to_facility_and_more.py

@@ -0,0 +1,61 @@
+# Generated by Django 4.2.5 on 2023-11-14 06:22
+
+import django.db.models.deletion
+from django.db import migrations, models
+
+
+class Migration(migrations.Migration):
+    dependencies = [
+        (
+            "facility",
+            "0393_rename_diagnosis_patientconsultation_deprecated_diagnosis_and_more",
+        ),
+    ]
+
+    operations = [
+        migrations.RenameField(
+            model_name="patientconsultation",
+            old_name="consultation_status",
+            new_name="route_to_facility",
+        ),
+        migrations.RenameField(
+            model_name="patientconsultation",
+            old_name="verified_by",
+            new_name="treating_physician",
+        ),
+        migrations.AddField(
+            model_name="patientconsultation",
+            name="icu_admission_date",
+            field=models.DateTimeField(blank=True, null=True),
+        ),
+        migrations.AddField(
+            model_name="patientconsultation",
+            name="referred_by_external",
+            field=models.TextField(blank=True, default="", null=True),
+        ),
+        migrations.AddField(
+            model_name="patientconsultation",
+            name="referred_from_facility",
+            field=models.ForeignKey(
+                blank=True,
+                null=True,
+                on_delete=django.db.models.deletion.PROTECT,
+                to="facility.facility",
+            ),
+        ),
+        migrations.AddField(
+            model_name="patientconsultation",
+            name="referred_from_facility_external",
+            field=models.TextField(blank=True, default="", null=True),
+        ),
+        migrations.AddField(
+            model_name="patientconsultation",
+            name="transferred_from_location",
+            field=models.ForeignKey(
+                blank=True,
+                null=True,
+                on_delete=django.db.models.deletion.PROTECT,
+                to="facility.assetlocation",
+            ),
+        ),
+    ]

care/facility/migrations/0395_alter_patientconsultation_route_to_facility.py

@@ -0,0 +1,94 @@
+# Generated by Django 4.2.5 on 2023-11-14 06:23
+
+import datetime
+
+from django.db import migrations, models
+from django.db.models import DurationField, ExpressionWrapper, F
+from django.db.models.functions import TruncDay
+from django.utils import timezone
+
+
+class Migration(migrations.Migration):
+    dependencies = [
+        (
+            "facility",
+            "0394_rename_consultation_status_patientconsultation_route_to_facility_and_more",
+        ),
+    ]
+
+    def clean_admission_date(apps, schema_editor):
+        """
+        Clean admission_date field to be 00:00:00 IST
+
+        For example:
+
+        `2023-10-06 06:00:00 +05:30 IST` (`2023-10-06 00:30:00 +00:00 UTC`) would be updated to
+        `2023-10-06 00:00:00 +05:30 IST` (`2023-10-05 18:30:00 +00:00 UTC`)
+
+        Equivalent to the following SQL:
+
+        ```sql
+        UPDATE facility_patientconsultation
+        SET admission_date =
+            timezone('IST', admission_date) AT TIME ZONE 'UTC' +
+            (date_trunc('day', timezone('IST', admission_date)) - timezone('IST', admission_date)) +
+            (interval '-5 hours -30 minutes')
+        WHERE admission_date IS NOT NULL;
+        ```
+        """
+
+        current_timezone = timezone.get_current_timezone()
+        tz_offset = timezone.timedelta(
+            minutes=current_timezone.utcoffset(datetime.datetime.utcnow()).seconds / 60
+        )
+
+        PatientConsultation = apps.get_model("facility", "PatientConsultation")
+        PatientConsultation.objects.filter(admission_date__isnull=False).update(
+            admission_date=ExpressionWrapper(
+                # Convert the admission_date to UTC by subtracting the current offset
+                F("admission_date") - tz_offset +
+                # Get the day part of the admission_date and subtract the actual admission_date from it
+                (TruncDay(F("admission_date")) - F("admission_date")),
+                output_field=DurationField(),
+            )
+        )
+
+    def migrate_route_to_facility(apps, schema_editor):
+        PatientConsultation = apps.get_model("facility", "PatientConsultation")
+        qs = PatientConsultation.objects.all()
+
+        # Unknown -> None
+        qs.filter(route_to_facility=0).update(route_to_facility=None)
+        # Brought Dead/Outpatient -> Outpatient/Emergency Room
+        qs.filter(models.Q(route_to_facility=1) | models.Q(route_to_facility=5)).update(
+            route_to_facility=10
+        )
+        # Transferred from Ward/ICU -> Internal Transfer within facility
+        qs.filter(models.Q(route_to_facility=2) | models.Q(route_to_facility=3)).update(
+            route_to_facility=30
+        )
+        # Referred from other hospital -> Referred from another facility
+        qs.filter(route_to_facility=4).update(route_to_facility=20)
+
+    operations = [
+        migrations.RunPython(
+            clean_admission_date, reverse_code=migrations.RunPython.noop
+        ),
+        migrations.AlterField(
+            model_name="patientconsultation",
+            name="route_to_facility",
+            field=models.SmallIntegerField(
+                blank=True,
+                choices=[
+                    (None, "(Unknown)"),
+                    (10, "Outpatient/Emergency Room"),
+                    (20, "Referred from another facility"),
+                    (30, "Internal Transfer within the facility"),
+                ],
+                null=True,
+            ),
+        ),
+        migrations.RunPython(
+            migrate_route_to_facility, reverse_code=migrations.RunPython.noop
+        ),
+    ]

care/facility/models/patient.py

@@ -31,8 +31,8 @@
     BLOOD_GROUP_CHOICES,
     DISEASE_STATUS_CHOICES,
     REVERSE_CATEGORY_CHOICES,
-    REVERSE_CONSULTATION_STATUS_CHOICES,
     REVERSE_DISCHARGE_REASON_CHOICES,
+    REVERSE_ROUTE_TO_FACILITY_CHOICES,
 )
 from care.facility.models.patient_consultation import PatientConsultation
 from care.facility.static_data.icd11 import get_icd11_diagnoses_objects_by_ids
@@ -515,7 +515,7 @@ def annotate_diagnosis_ids(*args, **kwargs):
         "created_date": "Date of Registration",
         "created_date__time": "Time of Registration",
         # Last Consultation Details
-        "last_consultation__consultation_status": "Status during consultation",
+        "last_consultation__route_to_facility": "Route to Facility",
         "last_consultation__created_date": "Date of first consultation",
         "last_consultation__created_date__time": "Time of first consultation",
         # Diagnosis Details
@@ -555,8 +555,8 @@ def format_diagnoses(diagnosis_ids):
         "provisional_diagnoses": format_diagnoses,
         "differential_diagnoses": format_diagnoses,
         "confirmed_diagnoses": format_diagnoses,
-        "last_consultation__consultation_status": (
-            lambda x: REVERSE_CONSULTATION_STATUS_CHOICES.get(x, "-").replace("_", " ")
+        "last_consultation__route_to_facility": (
+            lambda x: REVERSE_ROUTE_TO_FACILITY_CHOICES.get(x, "-")
         ),
         "last_consultation__category": lambda x: REVERSE_CATEGORY_CHOICES.get(x, "-"),
         "last_consultation__discharge_reason": (
@@ -689,7 +689,7 @@ class FacilityPatientStatsHistory(FacilityBaseModel, FacilityRelatedPermissionMi
         "facilitypatientstatshistory__num_patients_visited": "Vistited Patients",
         "facilitypatientstatshistory__num_patients_home_quarantine": "Home Quarantined Patients",
         "facilitypatientstatshistory__num_patients_isolation": "Patients Isolated",
-        "facilitypatientstatshistory__num_patient_referred": "Patients Reffered",
+        "facilitypatientstatshistory__num_patient_referred": "Patients Referred",
         "facilitypatientstatshistory__num_patient_confirmed_positive": "Patients Confirmed Positive",
     }