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# -*- coding: utf-8 -*-
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import logging
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import os
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from datetime import datetime, date
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from dateutil.relativedelta import relativedelta
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from django import forms
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from django.conf import settings
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from django.db import models
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from django.contrib.auth.models import User
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import reversion
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from calebasse.choices import LARGE_REGIME_CHOICES
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from calebasse.models import PhoneNumberField, ZipCodeField
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from calebasse.personnes.models import People
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from calebasse.ressources.models import (ServiceLinkedAbstractModel,
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NamedAbstractModel, Service)
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from calebasse.actes.validation import are_all_acts_of_the_day_locked
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DEFAULT_ACT_NUMBER_DIAGNOSTIC = 6
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DEFAULT_ACT_NUMBER_TREATMENT = 30
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DEFAULT_ACT_NUMBER_PROLONGATION = 10
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VALIDITY_PERIOD_TREATMENT_HEALTHCARE_DAYS = 0
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VALIDITY_PERIOD_TREATMENT_HEALTHCARE_MONTHS = 0
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VALIDITY_PERIOD_TREATMENT_HEALTHCARE_YEARS = 1
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logger = logging.getLogger('calebasse.dossiers')
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class HealthCare(models.Model):
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class Meta:
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app_label = 'dossiers'
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start_date = models.DateField(verbose_name=u"Date de début")
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patient = models.ForeignKey('dossiers.PatientRecord',
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verbose_name=u'Dossier patient')
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created = models.DateTimeField(u'Création', auto_now_add=True)
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author = \
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models.ForeignKey(User,
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verbose_name=u'Auteur')
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comment = models.TextField(max_length=3000, blank=True, null=True, verbose_name=u"Commentaire")
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def get_nb_acts_cared(self):
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return len(self.act_set.all())
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class CmppHealthCareDiagnostic(HealthCare):
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class Meta:
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app_label = 'dossiers'
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act_number = models.IntegerField(default=DEFAULT_ACT_NUMBER_DIAGNOSTIC, verbose_name=u"Nombre d'actes couverts")
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def get_act_number(self):
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return self.act_number
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def set_act_number(self, value):
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if value < self.get_nb_acts_cared():
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raise Exception("La valeur doit être supérieur au "
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"nombre d'actes déjà pris en charge")
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self.act_number = value
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self.save()
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def save(self, **kwargs):
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self.start_date = \
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datetime(self.start_date.year, self.start_date.month,
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self.start_date.day)
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super(CmppHealthCareDiagnostic, self).save(**kwargs)
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class CmppHealthCareTreatment(HealthCare):
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class Meta:
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app_label = 'dossiers'
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act_number = models.IntegerField(default=DEFAULT_ACT_NUMBER_TREATMENT,
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verbose_name=u"Nombre d'actes couverts")
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end_date = models.DateField(verbose_name=u"Date de fin")
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prolongation = models.IntegerField(default=0,
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verbose_name=u'Prolongation')
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def get_act_number(self):
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if self.is_extended():
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return self.act_number + self.prolongation
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return self.act_number
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def set_act_number(self, value):
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if value < self.get_nb_acts_cared():
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raise Exception("La valeur doit être supérieur au "
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"nombre d'actes déjà pris en charge")
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self.act_number = value
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self.save()
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def is_extended(self):
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if self.prolongation > 0:
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return True
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return False
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def add_prolongation(self, value=None):
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if not value:
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value = DEFAULT_ACT_NUMBER_PROLONGATION
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if self.is_extended():
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raise Exception(u'Prise en charge déja prolongée')
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self.prolongation = value
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self.save()
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def save(self, **kwargs):
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self.start_date = \
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datetime(self.start_date.year, self.start_date.month,
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self.start_date.day)
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self.end_date = self.start_date + \
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relativedelta(years=VALIDITY_PERIOD_TREATMENT_HEALTHCARE_YEARS) + \
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relativedelta(months=VALIDITY_PERIOD_TREATMENT_HEALTHCARE_MONTHS) + \
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relativedelta(days=VALIDITY_PERIOD_TREATMENT_HEALTHCARE_DAYS)
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super(CmppHealthCareTreatment, self).save(**kwargs)
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class SessadHealthCareNotification(HealthCare):
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class Meta:
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app_label = 'dossiers'
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end_date = models.DateField()
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def save(self, **kwargs):
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self.start_date = \
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datetime(self.start_date.year, self.start_date.month,
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self.start_date.day)
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self.end_date = \
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datetime(self.end_date.year, self.end_date.month,
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self.end_date.day)
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super(SessadHealthCareNotification, self).save(**kwargs)
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reversion.register(CmppHealthCareDiagnostic, follow=['healthcare_ptr'])
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reversion.register(CmppHealthCareTreatment, follow=['healthcare_ptr'])
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reversion.register(SessadHealthCareNotification, follow=['healthcare_ptr'])
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class Status(NamedAbstractModel):
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class Meta:
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app_label = 'dossiers'
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verbose_name = u"Statut d'un état"
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verbose_name_plural = u"Statuts d'un état"
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type = models.CharField(max_length=80)
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services = models.ManyToManyField('ressources.Service')
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class FileState(models.Model):
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class Meta:
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app_label = 'dossiers'
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verbose_name = u'Etat du dossier patient'
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verbose_name_plural = u'Etats du dossier patient'
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patient = models.ForeignKey('dossiers.PatientRecord',
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verbose_name=u'Dossier patient')
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status = models.ForeignKey('dossiers.Status', verbose_name=u'Statut')
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created = models.DateTimeField(u'Création', auto_now_add=True)
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date_selected = models.DateTimeField()
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author = \
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models.ForeignKey(User,
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verbose_name=u'Auteur')
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comment = models.TextField(max_length=3000, blank=True, null=True)
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previous_state = models.ForeignKey('FileState',
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verbose_name=u'Etat précédent', blank=True, null=True)
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def get_next_state(self):
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try:
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return FileState.objects.get(previous_state=self)
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except:
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return None
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def save(self, **kwargs):
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self.date_selected = \
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datetime(self.date_selected.year,
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self.date_selected.month, self.date_selected.day)
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super(FileState, self).save(**kwargs)
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def __unicode__(self):
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return self.status.name + ' ' + str(self.date_selected)
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def delete(self, *args, **kwargs):
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next_state = self.get_next_state()
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if next_state and self.previous_state:
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next_state.previous_state = self.previous_state
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next_state.save()
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if self.patient.last_state == self:
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self.patient.last_state = self.previous_state
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self.patient.save()
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super(FileState, self).delete(*args, **kwargs)
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class PatientAddress(models.Model):
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display_name = models.CharField(max_length=276,
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verbose_name=u'Adresse complète', editable=False)
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phone = PhoneNumberField(verbose_name=u"Téléphone", blank=True, null=True)
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fax = PhoneNumberField(verbose_name=u"Fax", blank=True, null=True)
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place_of_life = models.BooleanField(verbose_name=u"Lieu de vie")
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number = models.CharField(max_length=12,
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verbose_name=u"Numéro", blank=True, null=True)
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street = models.CharField(max_length=100,
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verbose_name=u"Rue", blank=True, null=True)
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address_complement = models.CharField(max_length=100,
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blank=True, null=True,
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verbose_name=u"Complément d'adresse")
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zip_code = ZipCodeField(verbose_name=u"Code postal", blank=True, null=True)
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city = models.CharField(max_length=60,
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verbose_name=u"Ville", blank=True, null=True)
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comment = models.TextField(verbose_name=u"Commentaire",
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null=True, blank=True)
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def __unicode__(self):
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return self.display_name
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def save(self, **kwargs):
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self.display_name = "%s %s, %s %s" % (self.number, self.street, self.zip_code, self.city)
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super(PatientAddress, self).save(**kwargs)
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class PatientContact(People):
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class Meta:
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verbose_name = u'Contact patient'
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verbose_name_plural = u'Contacts patient'
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mobile = PhoneNumberField(verbose_name=u"Téléphone mobile", blank=True, null=True)
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# carte vitale
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social_security_id = models.CharField(max_length=13, verbose_name=u"NIR",
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null=True, blank=True)
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birthdate = models.DateField(verbose_name=u"Date de naissance",
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null=True, blank=True)
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twinning_rank = models.IntegerField(verbose_name=u"Rang (gémellité)",
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null=True, blank=True)
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thirdparty_payer = models.BooleanField(verbose_name=u'Tiers-payant',
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default=False)
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begin_rights = models.DateField(verbose_name=u"Début de droits",
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null=True, blank=True)
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end_rights = models.DateField(verbose_name=u"Fin de droits",
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null=True, blank=True)
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health_center = models.ForeignKey('ressources.HealthCenter',
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verbose_name=u"Centre d'assurance maladie",
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null=True, blank=True)
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addresses = models.ManyToManyField('PatientAddress', verbose_name=u"Adresses")
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contact_comment = models.TextField(verbose_name=u"Commentaire",
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null=True, blank=True)
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def get_control_key(self):
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if self.social_security_id:
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return (97 - (int(self.social_security_id) % 97))
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return None
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class PatientRecordManager(models.Manager):
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def for_service(self, service):
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return self.filter(service=service)
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class PatientRecord(ServiceLinkedAbstractModel, PatientContact):
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objects = PatientRecordManager()
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class Meta:
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verbose_name = u'Dossier'
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verbose_name_plural = u'Dossiers'
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created = models.DateTimeField(u'création', auto_now_add=True)
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creator = \
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models.ForeignKey(User,
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verbose_name=u'Créateur dossier patient',
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editable=True)
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policyholder = models.ForeignKey('PatientContact',
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null=True, blank=True,
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verbose_name="Assuré", related_name="+",
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on_delete=models.SET_NULL)
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contacts = models.ManyToManyField('PatientContact',
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related_name='contact_of')
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nationality = models.CharField(verbose_name=u"Nationalité",
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max_length=70, null=True, blank=True)
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paper_id = models.CharField(max_length=6,
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verbose_name=u"N° dossier papier",
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null=True, blank=True)
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last_state = models.ForeignKey(FileState, related_name='+',
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null=True, on_delete=models.SET_NULL)
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comment = models.TextField(verbose_name=u"Commentaire",
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null=True, blank=True, default=None)
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pause = models.BooleanField(verbose_name=u"Pause facturation",
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default=False)
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socialisation_durations = models.ManyToManyField('ressources.SocialisationDuration',
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related_name='socialisation_duration_of')
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mdph_requests = models.ManyToManyField('ressources.MDPHRequest',
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related_name='mdph_requests_of')
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mdph_responses = models.ManyToManyField('ressources.MDPHResponse',
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related_name='mdph_responses_of')
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# Physiology and health data
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size = models.IntegerField(verbose_name=u"Taille (cm)",
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null=True, blank=True, default=None)
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weight = models.IntegerField(verbose_name=u"Poids (kg)",
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null=True, blank=True, default=None)
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pregnancy_term = models.IntegerField(verbose_name=u"Terme en semaines",
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null=True, blank=True, default=None)
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cranium_perimeter = models.DecimalField(verbose_name=u"Périmètre cranien", max_digits=5, decimal_places=2,
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null=True, blank=True, default=None)
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chest_perimeter = models.DecimalField(verbose_name=u"Périmètre thoracique", max_digits=5, decimal_places=2,
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null=True, blank=True, default=None)
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apgar_score_one = models.IntegerField(verbose_name=u"Test d'Apgar 1",
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null=True, blank=True, default=None)
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apgar_score_two = models.IntegerField(verbose_name=u"Test d'Apgar 2",
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null=True, blank=True, default=None)
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mises_1 = models.ManyToManyField('ressources.CodeCFTMEA', related_name="mises1",
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verbose_name=u"Axe I : catégories cliniques",
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null=True, blank=True, default=None)
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mises_2 = models.ManyToManyField('ressources.CodeCFTMEA', related_name="mises2",
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verbose_name=u"Axe II : facteurs organiques",
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null=True, blank=True, default=None)
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mises_3 = models.ManyToManyField('ressources.CodeCFTMEA', related_name="mises3",
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verbose_name=u"Axe II : facteurs environnementaux",
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null=True, blank=True, default=None)
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# Inscription motive
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analysemotive = models.ForeignKey('ressources.AnalyseMotive',
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verbose_name=u"Motif (analysé)",
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null=True, blank=True, default=None)
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familymotive = models.ForeignKey('ressources.FamilyMotive',
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verbose_name=u"Motif (famille)",
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null=True, blank=True, default=None)
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advicegiver = models.ForeignKey('ressources.AdviceGiver',
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verbose_name=u"Conseilleur",
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null=True, blank=True, default=None)
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# Family
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sibship_place = models.IntegerField(verbose_name=u"Place dans la fratrie",
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null=True, blank=True, default=None)
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nb_children_family = models.IntegerField(verbose_name=u"Nombre d'enfants dans la fratrie",
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null=True, blank=True, default=None)
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parental_authority = models.ForeignKey('ressources.ParentalAuthorityType',
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verbose_name=u"Autorité parentale",
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null=True, blank=True, default=None)
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family_situation = models.ForeignKey('ressources.FamilySituationType',
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verbose_name=u"Situation familiale",
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null=True, blank=True, default=None)
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child_custody = models.ForeignKey('ressources.ParentalCustodyType',
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verbose_name=u"Garde parentale",
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null=True, blank=True, default=None)
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# Transport
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transporttype = models.ForeignKey('ressources.TransportType',
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verbose_name=u"Type de transport",
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null=True, blank=True, default=None)
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transportcompany = models.ForeignKey('ressources.TransportCompany',
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verbose_name=u"Compagnie de transport",
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null=True, blank=True, default=None)
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# FollowUp
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coordinators = models.ManyToManyField('personnes.Worker',
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verbose_name=u"Coordinateurs",
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null=True, blank=True, default=None)
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externaldoctor = models.ForeignKey('personnes.ExternalTherapist',
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verbose_name=u"Médecin extérieur",
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null=True, blank=True, default=None)
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externalintervener = models.ForeignKey('personnes.ExternalWorker',
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verbose_name=u"Intervenant extérieur",
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null=True, blank=True, default=None)
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def __init__(self, *args, **kwargs):
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super(PatientRecord, self).__init__(*args, **kwargs)
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if not hasattr(self, 'service'):
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raise Exception('The field service is mandatory.')
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def get_state(self):
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return self.last_state
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def get_initial_state(self):
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return self.filestate_set.order_by('date_selected')[0]
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def get_current_state(self):
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today = date.today()
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return self.get_state_at_day(today)
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def get_state_at_day(self, date):
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state = self.get_state()
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while(state):
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if datetime(state.date_selected.year,
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state.date_selected.month, state.date_selected.day) <= \
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datetime(date.year, date.month, date.day):
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return state
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state = state.previous_state
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return self.get_state()
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def was_in_state_at_day(self, date, status_type):
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state_at_day = self.get_state_at_day(date)
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if state_at_day and state_at_day.status.type == status_type:
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return True
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return False
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def get_states_history(self):
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return self.filestate_set.order_by('date_selected')
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def can_be_deleted(self):
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for act in self.act_set.all():
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if act.is_state('VALIDE'):
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return False
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return True
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def delete(self, *args, **kwargs):
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if self.can_be_deleted():
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super(PatientRecord, self).delete(*args, **kwargs)
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def get_ondisk_directory(self, service):
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if not settings.PATIENT_FILES_BASE_DIRECTORY:
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return None
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dirnames = []
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dirname = self.last_name.upper()
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dirnames.append(dirname)
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if self.first_name:
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dirname = '%s %s' % (dirname, self.first_name)
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dirnames.append(dirname)
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if self.paper_id:
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dirname = '%s %s' % (dirname, self.paper_id)
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dirnames.append(dirname)
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for i, dirname in enumerate(dirnames):
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fullpath = os.path.join(settings.PATIENT_FILES_BASE_DIRECTORY, service, dirname)
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try:
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next_fullpath = os.path.join(settings.PATIENT_FILES_BASE_DIRECTORY, service, dirnames[i+1])
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except IndexError:
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pass
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else:
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if os.path.exists(fullpath) and not os.path.exists(next_fullpath):
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os.rename(fullpath, next_fullpath)
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continue
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if not os.path.exists(fullpath):
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os.makedirs(fullpath)
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for subdir in settings.PATIENT_SUBDIRECTORIES:
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subdir_fullpath = os.path.join(fullpath, subdir)
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if not os.path.exists(subdir_fullpath):
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os.makedirs(subdir_fullpath)
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return fullpath
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def get_client_side_directory(self, service):
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directory = self.get_ondisk_directory(service)
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if not directory:
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return None
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if not settings.CLIENT_SIDE_PATIENT_FILES_BASE_DIRECTORY:
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return None
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return os.path.join(settings.CLIENT_SIDE_PATIENT_FILES_BASE_DIRECTORY,
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directory[len(settings.PATIENT_FILES_BASE_DIRECTORY)+1:])
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def set_state(self, status, author, date_selected=None, comment=None):
|
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if not author:
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raise Exception('Missing author to set state')
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if not date_selected:
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date_selected = datetime.now()
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current_state = self.get_state()
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|
if not current_state:
|
|
raise Exception('Invalid patient record. '
|
|
'Missing current state.')
|
|
if date_selected < current_state.date_selected:
|
|
raise Exception('You cannot set a state starting the %s that '
|
|
'is before the previous state starting at day %s.' % \
|
|
(str(date_selected), str(current_state.date_selected)))
|
|
filestate = FileState.objects.create(patient=self, status=status,
|
|
date_selected=date_selected, author=author, comment=comment,
|
|
previous_state=current_state)
|
|
self.last_state = filestate
|
|
self.save()
|
|
|
|
def change_day_selected_of_state(self, state, new_date):
|
|
if state.previous_state:
|
|
if new_date < state.previous_state.date_selected:
|
|
raise Exception('You cannot set a state starting the %s '
|
|
'before the previous state starting at day %s.' % \
|
|
(str(new_date), str(state.previous_state.date_selected)))
|
|
next_state = state.get_next_state()
|
|
if next_state:
|
|
if new_date > next_state.date_selected:
|
|
raise Exception('You cannot set a state starting the %s '
|
|
'after the following state starting at day %s.' % \
|
|
(str(new_date), str(next_state.date_selected)))
|
|
state.date_selected = new_date
|
|
state.save()
|
|
|
|
def remove_state(self, state):
|
|
if state.patient.id != self.id:
|
|
raise Exception('The state given is not about this patient '
|
|
'record but about %s' % state.patient)
|
|
next_state = state.get_next_state()
|
|
if not next_state:
|
|
self.remove_last_state()
|
|
else:
|
|
next_state.previous_state = state.previous_state
|
|
next_state.save()
|
|
state.delete()
|
|
|
|
def remove_last_state(self):
|
|
try:
|
|
self.get_state().delete()
|
|
except:
|
|
pass
|
|
|
|
# START Specific to sessad healthcare
|
|
def get_last_notification(self):
|
|
return SessadHealthCareNotification.objects.filter(patient=self, ).\
|
|
latest('end_date')
|
|
|
|
def days_before_notification_expiration(self):
|
|
today = datetime.today()
|
|
notification = self.get_last_notification(self)
|
|
if not notification:
|
|
return 0
|
|
if notification.end_date < today:
|
|
return 0
|
|
else:
|
|
return notification.end_date - today
|
|
# END Specific to sessad healthcare
|
|
|
|
# START Specific to cmpp healthcare
|
|
def create_diag_healthcare(self, modifier):
|
|
"""
|
|
Gestion de l'inscription automatique.
|
|
|
|
Si un premier acte est validé alors une prise en charge
|
|
diagnostique est ajoutée. Cela fera basculer le dossier dans l'état
|
|
en diagnostic.
|
|
|
|
A voir si auto ou manuel :
|
|
Si ce n'est pas le premier acte validé mais que l'acte précédement
|
|
facturé a plus d'un an, on peut créer une prise en charge
|
|
diagnostique. Même s'il y a une prise en charge de traitement
|
|
expirée depuis moins d'un an donc renouvelable.
|
|
|
|
"""
|
|
acts = self.act_set.order_by('date')
|
|
hcds = CmppHealthCareDiagnostic.objects.filter(patient=self).order_by('-start_date')
|
|
if not hcds:
|
|
# Pas de prise en charge, on recherche l'acte facturable le plus
|
|
# ancien, on crée une pc diag à la même date.
|
|
for act in acts:
|
|
if act.is_state('VALIDE') and act.is_billable():
|
|
CmppHealthCareDiagnostic(patient=self, author=modifier,
|
|
start_date=act.date).save()
|
|
break
|
|
else:
|
|
# On recherche l'acte facturable non facturé le plus ancien et
|
|
# l'on regarde s'il a plus d'un an
|
|
try:
|
|
last_billed_act = self.act_set.filter(is_billed=True).\
|
|
latest('date')
|
|
if last_billed_act:
|
|
for act in acts:
|
|
if act.is_state('VALIDE') and \
|
|
act.is_billable() and \
|
|
(act.date - last_billed_act.date).days >= 365:
|
|
return True
|
|
except:
|
|
pass
|
|
return False
|
|
|
|
def automated_switch_state(self, modifier):
|
|
# Quel est le dernier acte facturable.
|
|
acts = self.act_set.order_by('-date')
|
|
# Si cet acte peut-être pris en charge en diagnostic c'est un acte de
|
|
# diagnostic, sinon c'est un acte de traitement.
|
|
last_state_services = self.last_state.status.\
|
|
services.values_list('name', flat=True)
|
|
cmpp = Service.objects.get(name='CMPP')
|
|
for act in acts:
|
|
if act.is_state('VALIDE') and act.is_billable() and \
|
|
act.date >= self.get_state().date_selected and \
|
|
are_all_acts_of_the_day_locked(act.date):
|
|
cared, hc = act.is_act_covered_by_diagnostic_healthcare()
|
|
if hc:
|
|
if (self.last_state.status.type == "ACCUEIL" \
|
|
or self.last_state.status.type == "TRAITEMENT") \
|
|
and "CMPP" in last_state_services:
|
|
status = Status.objects.filter(type="DIAGNOSTIC").\
|
|
filter(services__name='CMPP')[0]
|
|
try:
|
|
self.set_state(status, modifier,
|
|
date_selected=act.date)
|
|
except:
|
|
pass
|
|
# Sinon, si le dossier est en diag, s'il ne peut être couvert
|
|
# en diag, il est en traitement.
|
|
elif self.last_state.status.type == "DIAGNOSTIC" and \
|
|
"CMPP" in last_state_services:
|
|
status = Status.objects.filter(type="TRAITEMENT").\
|
|
filter(services__name='CMPP')[0]
|
|
try:
|
|
self.set_state(status, modifier,
|
|
date_selected=act.date)
|
|
except:
|
|
pass
|
|
break
|
|
# END Specific to cmpp healthcare
|
|
|
|
reversion.register(PatientRecord, follow=['people_ptr'])
|
|
|
|
|
|
def create_patient(first_name, last_name, service, creator,
|
|
date_selected=None):
|
|
logger.debug('create_patient: creation for patient %s %s in service %s '
|
|
'by %s' % (first_name, last_name, service, creator))
|
|
if not (first_name and last_name and service and creator):
|
|
raise Exception('Missing parameter to create a patient record.')
|
|
status = Status.objects.filter(type="ACCUEIL").filter(services=service)
|
|
if not status:
|
|
raise Exception('%s has no ACCEUIL status' % service.name)
|
|
patient = PatientRecord.objects.create(first_name=first_name,
|
|
last_name=last_name, service=service,
|
|
creator=creator)
|
|
fs = FileState(status=status[0], author=creator, previous_state=None)
|
|
if not date_selected:
|
|
date_selected = patient.created
|
|
fs.patient = patient
|
|
fs.date_selected = date_selected
|
|
fs.save()
|
|
patient.last_state = fs
|
|
patient.save()
|
|
return patient
|