Data Management with FHIR
0.1.0 - ci-build

Data Management with FHIR - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

## StructureMap: Transforms QuestionnaireResponse based on Questionnaire Usage Variables socles into FHIR resources conforming to DM profiles

Official URL: https://interop.aphp.fr/ig/fhir/dm/StructureMap/Q2FSL | Version: 0.1.0
Draft as of 2025-10-23 | Computable Name: Q2FSL

Transforms QuestionnaireResponse based on Questionnaire Usage Variables socles into FHIR resources conforming to DM profiles

    map "https://interop.aphp.fr/ig/fhir/dm/StructureMap/Q2FSL" = "Q2FSL"

    // Transforms QuestionnaireResponse based on Questionnaire Usage Variables socles into FHIR resources conforming to DM profiles

    uses "http://hl7.org/fhir/StructureDefinition/QuestionnaireResponse" alias QuestionnaireResponse as source
    uses "http://hl7.org/fhir/StructureDefinition/Bundle" alias Bundle as target

    // Main entry point: Transform QuestionnaireResponse to Bundle
    group QuestionnaireResponseToBundle(source src : QuestionnaireResponse, target bundle : Bundle) {
      // Initialize Bundle
      src -> bundle.id = uuid() "bundleid";
      src -> bundle.type = 'collection' "bundletype";
      src -> bundle.timestamp = (now()) "setTimestamp";
      // Create Patient resource
      src -> bundle.entry as patientEntry then {
        src -> patientEntry.resource = create('Patient') as patient then {
          src then CreatePatient(src, patient) "createpatient";
          src ->  patient.id as patientId,  patientEntry.fullUrl = append('urn:uuid:', patientId) "setfullUrl";
          // Create Locations from geocoding data
          // src then CreateLocations(src, patient, bundle) "create-locations";
          // Create Encounters from PMSI data
          src then CreateEncounters(src, patient, bundle) "createencounters";
          // Create Laboratory Observations
          src then CreateLaboratoryObservations(src, patient, bundle) "createlabobservations";
          // Create Medication Requests
          src then CreateMedicationRequests(src, patient, bundle) "createmedicationrequests";
          // Create Medication Administrations
          src then CreateMedicationAdministrations(src, patient, bundle) "createmedicationadministrations";
          // Create Vital Sign Observations
          src then CreateVitalSignObservations(src, patient, bundle) "createvitalsigns";
        } "createpatientresource";
      } "patiententry";
    }

    // Group: Create Patient from QuestionnaireResponse
    group CreatePatient(source src : QuestionnaireResponse, target patient : Patient) {
      src -> patient.id = uuid() "patientid";
      src -> patient.meta = create('Meta') as meta then {
        src -> meta.profile = 'https://interop.aphp.fr/ig/fhir/dm/StructureDefinition/DMPatient' "patientprofile";
      } "patientmeta";
      // Extract patient identity data from linkId 4647259356106 > 2958000860428
      src.item as socioDemo where (linkId = '4647259356106') then {
        socioDemo.item as identity where (linkId = '2958000860428') then {
          // Patient name (linkId 8605698058770 = family, 6214879623503 = given)
          identity -> patient.name = create('HumanName') as name then {
            identity.item as familyItem where (linkId = '8605698058770') then {
              familyItem.answer as ans -> name.family = (ans.valueString) "setfamily";
            } "extractfamily";
            identity.item as givenItem where (linkId = '6214879623503') then {
              givenItem.answer as ans -> name.given = (ans.valueString) "setgiven";
            } "extractgiven";
          } "setname";
          // NIR identifier (linkId 5711960356160)
          identity.item as nirItem where (linkId = '5711960356160') then {
            nirItem.answer as ans -> patient.identifier = create('Identifier') as nir then {
              ans -> nir.system = 'urn:oid:1.2.250.1.213.1.4.8' "nirsystem";
              ans -> nir.value = (ans.valueString) "nirvalue";
              ans -> nir.type = cc('http://interopsante.org/fhir/CodeSystem/fr-v2-0203', 'NIR') "nirtype";
            } "setnir";
          } "extractnir";
          // INS identifier (linkId 3764723550987)
          identity.item as insItem where (linkId = '3764723550987') then {
            insItem.answer as ans -> patient.identifier = create('Identifier') as ins then {
              ans -> ins.system = 'urn:oid:1.2.250.1.213.1.4.10' "inssystem";
              ans -> ins.value = (ans.valueString) "insvalue";
              ans -> ins.type = cc('http://interopsante.org/fhir/CodeSystem/fr-v2-0203', 'INS-C') "instype";
            } "setins";
          } "extractins";
          // Birth date (linkId 5036133558154)
          identity.item as birthItem where (linkId = '5036133558154') then {
            birthItem.answer as ans -> patient.birthDate = (ans.valueDate) "setbirthdate";
          } "extractbirthdate";
          // Death date (linkId 5633552097315)
          identity.item as deathItem where (linkId = '5633552097315') then {
            deathItem.answer as ans -> patient.deceased = (ans.valueDate) "setdeceaseddate";
            // Death source (linkId 9098810065693)
            deathItem.item as deathSource where (linkId = '9098810065693') then {
              deathSource.answer as sourceAns -> patient.extension = create('Extension') as ext then {
                sourceAns -> ext.url = 'https://interop.aphp.fr/ig/fhir/dm/StructureDefinition/death-source' "deathsourceurl";
                sourceAns -> ext.value = (sourceAns.valueCoding) "deathsourcevalue";
              } "setdeathsourceext";
            } "extractdeathsource";
          } "extractdeath";
          // Multiple birth rank (linkId 6931296968515)
          identity.item as multipleItem where (linkId = '6931296968515') then {
            multipleItem.answer as ans then {
              ans.valueInteger as valueInteger -> patient.multipleBirth = valueInteger "setmultiplebirth";
            } "navigatevalue";
          } "extractmultiplebirth";
        } "processidentity";
        // Gender from PMSI data (linkId 3894630481120 within 2825244231605)
        src.item as pmsiGroup where (linkId = '2825244231605') then {
          pmsiGroup.item as sexItem where (linkId = '3894630481120') then {
            sexItem.answer as ans then {
              ans.valueCoding as valueCoding -> patient.gender = translate(valueCoding, 'https://interop.aphp.fr/ig/fhir/dm/ConceptMap/dpi-gender-2-hl7-gender', 'code') "setgender";
            } "valueCoding";
          } "extractgender";
          // Address from code géographique (linkId 2446369196222)
          pmsiGroup.item as codeGeoItem where (linkId = '2446369196222') then {
            codeGeoItem.answer as ans -> patient.address = create('Address') as addr then {
              ans -> addr.extension = create('Extension') as ext then {
                ans -> ext.url = 'https://interop.aphp.fr/ig/fhir/dm/StructureDefinition/pmsi-code-geo' "codegeourl";
                ans -> ext.value = (ans.valueCoding) "codegeovalue";
              } "setcodegeoext";
            } "setaddress";
          } "extractcodegeo";
        } "extractpmsidemographics";
      } "processsociodemographics";
    }

    // Group: Create Locations from geocoding and IRIS data
    group CreateLocations(source src : QuestionnaireResponse, target patient : Patient, target bundle : Bundle) {
      // Extract geocoding data from linkId 4647259356106 > 5491974639955 > 3816475533472
      src.item as socioDemo where (linkId = '4647259356106') then {
        socioDemo.item as environment where (linkId = '5491974639955') then {
          // Geocoding locations (repeating group 3816475533472)
          environment.item as geocodingItem where (linkId = '3816475533472') -> bundle.entry as locationEntry then {
            geocodingItem -> locationEntry.resource = create('Location') as location then {
              geocodingItem -> location.id = uuid() "locationid";
              geocodingItem -> location.meta = create('Meta') as meta then {
                geocodingItem -> meta.profile = 'https://interop.aphp.fr/ig/fhir/dm/StructureDefinition/DMLocation' "locationprofile";
              } "locationmeta";
              // Position with latitude and longitude
              geocodingItem -> location.position = create('LocationPosition') as pos then {
                // Latitude (linkId 3709843054556)
                geocodingItem.item as latItem where (linkId = '3709843054556') then {
                  latItem.answer as ans -> pos.latitude = (ans.valueDecimal) "setlatitude";
                } "extractlatitude";
                // Longitude (linkId 7651448032665)
                geocodingItem.item as longItem where (linkId = '7651448032665') then {
                  longItem.answer as ans -> pos.longitude = (ans.valueDecimal) "setlongitude";
                } "extractlongitude";
              } "setposition";
              // Extension for collection date (linkId 1185653257776)
              // geocodingItem.item as dateItem where (linkId = '1185653257776') then {             dateItem.answer as ans -> location.extension = create('Extension') as ext then {               ans -> ext.url = 'http://hl7.org/fhir/StructureDefinition/data-collection-date' "date-url";               ans -> ext.value = (ans.valueDate) "date-value";             } "set-collection-date";           } "extract-collection-date";
              location -> locationEntry.request as request then {
                location -> request.method = 'POST' "setmethod";
                location -> request.url = 'Location' "seturl";
              } "setrequest";
              location.id as locId -> locationEntry.fullUrl = append('urn:uuid:', locId) "setfullUrl";
            } "createlocation";
          } "geocodinglocationentry";
          // IRIS locations (repeating item 7621032273792)
          environment.item as irisItem where (linkId = '7621032273792') then {
            irisItem.answer as irisAnswer -> bundle.entry as locationEntry then {
              irisAnswer -> locationEntry.resource = create('Location') as location then {
                irisAnswer -> location.id = uuid() "locationid";
                irisAnswer -> location.meta = create('Meta') as meta then {
                  irisAnswer -> meta.profile = 'https://interop.aphp.fr/ig/fhir/dm/StructureDefinition/DMLocation' "locationprofile";
                } "locationmeta";
                // IRIS code as identifier
                irisAnswer -> location.identifier = create('Identifier') as identifier then {
                  irisAnswer -> identifier.system = 'urn:oid:2.16.840.1.113883.2.8.1.5.5' "irissystem";
                  irisAnswer -> identifier.value = (irisAnswer.valueCoding.code) "irisvalue";
                } "setirisidentifier";
                // Collection date from nested item (linkId 4999580038872)
                // irisAnswer.item as dateItem where (linkId = '4999580038872') then {               dateItem.answer as ans -> location.extension = create('Extension') as ext then {                 ans -> ext.url = 'http://hl7.org/fhir/StructureDefinition/data-collection-date' "date-url";                 ans -> ext.value = (ans.valueDate) "date-value";               } "set-collection-date";             } "extract-iris-date";
                location -> locationEntry.request as request then {
                  location -> request.method = 'POST' "setmethod";
                  location -> request.url = 'Location' "seturl";
                } "setrequest";
                location.id as locId -> locationEntry.fullUrl = append('urn:uuid:', locId) "setfullUrl";
              } "createirislocation";
            } "irislocationentry";
          } "processiris";
        } "processenvironment";
      } "processsociodemographicslocation";
    }

    // Group: Create Encounters from PMSI data
    group CreateEncounters(source src : QuestionnaireResponse, target patient : Patient, target bundle : Bundle) {
      // PMSI data group (linkId 2825244231605) - Note: This can repeat in the structure
      src.item as pmsiItem where (linkId = '2825244231605') -> bundle.entry as encounterEntry then {
        pmsiItem -> encounterEntry.resource = create('Encounter') as encounter then {
          pmsiItem -> encounter.id = uuid() "encounterid";
          pmsiItem -> encounter.meta = create('Meta') as meta then {
            pmsiItem -> meta.profile = 'https://interop.aphp.fr/ig/fhir/dm/StructureDefinition/DMEncounter' "encounterprofile";
          } "encountermeta";
          // Link to patient
          src ->  encounter.subject = create('Reference') as ref,  patient.id as patId,  ref.reference = append('Patient/', patId) "setsubject";
          // Encounter period (start: 5991443718282, end: 6114780320846)
          pmsiItem -> encounter.period = create('Period') as period then {
            pmsiItem.item as startItem where (linkId = '5991443718282') then {
              startItem.answer as ans -> period.start = (ans.valueDate) "setstart";
            } "extractstart";
            pmsiItem.item as endItem where (linkId = '6114780320846') then {
              endItem.answer as ans -> period.end = (ans.valueDate) "setend";
            } "extractend";
          } "setperiod";
          // Mode d'entrée (linkId 6172398101212)
          pmsiItem.item as modeInItem where (linkId = '6172398101212') "extractmodein";
          // Mode de sortie (linkId 3354867075704)
          pmsiItem.item as modeOutItem where (linkId = '3354867075704') "extractmodeout";
          src ->  encounter.id as encId,  encounterEntry.fullUrl = append('urn:uuid:', encId) "setfullUrl";
          // Create nested Conditions and Procedures
          pmsiItem then CreateConditions(pmsiItem, patient, encounter, bundle) "createconditions";
          pmsiItem then CreateProcedures(pmsiItem, patient, encounter, bundle) "createprocedures";
        } "createencounter";
      } "encounterentry";
    }

    // Group: Create Conditions from nested diagnostics
    group CreateConditions(source pmsiItem, target patient : Patient, target encounter : Encounter, target bundle : Bundle) {
      // Diagnostics group (linkId 9391816419630) - can repeat
      pmsiItem.item as diagGroup where (linkId = '9391816419630') -> bundle.entry as conditionEntry then {
        diagGroup -> conditionEntry.resource = create('Condition') as condition then {
          diagGroup -> condition.id = uuid() "conditionid";
          diagGroup -> condition.meta = create('Meta') as meta then {
            diagGroup -> meta.profile = 'https://interop.aphp.fr/ig/fhir/dm/StructureDefinition/DMCondition' "conditionprofile";
          } "conditionmeta";
          // Link to patient
          diagGroup ->  condition.subject = create('Reference') as ref,  patient.id as patId,  ref.reference = append('Patient/', patId) "setsubject";
          // Link to encounter
          diagGroup ->  encounter.id as encId,  condition.encounter = create('Reference') as ref,  ref.reference = append('Encounter/', encId) "setencounter";
          // Diagnostic code (linkId 5505101189372) - CIM-10
          diagGroup.item as diagCodeItem where (linkId = '5505101189372') then {
            diagCodeItem.answer as ans -> condition.code = create('CodeableConcept') as code then {
              ans -> code.coding = (ans.valueCoding) "setcoding";
            } "setcode";
          } "extractdiagcode";
          // Type de diagnostic (linkId 6427586743735) - DP/DAS/DR
          diagGroup.item as diagTypeItem where (linkId = '6427586743735') then {
            diagTypeItem.answer as ans -> condition.category = create('CodeableConcept') as category then {
              ans -> category.coding = create('Coding') as coding then {
                ans -> coding.system = 'https://interop.aphp.fr/ig/fhir/dm/CodeSystem/pmsi-mco-diag-type' "diagtypesystem";
                ans -> coding.code = (ans.valueCoding.code) "diagtypecode";
                ans -> coding.display = (ans.valueCoding.display) "diagtypedisplay";
              } "setcategorycoding";
            } "setcategory";
          } "extractdiagtype";
          // Recorded date (linkId 7114466839467)
          diagGroup.item as dateItem where (linkId = '7114466839467') then {
            dateItem.answer as ans -> condition.recordedDate = (ans.valueDate) "setrecordeddate";
          } "extractrecordeddate";
        } "createcondition";
      } "conditionentry";
    }

    // Group: Create Procedures from nested actes
    group CreateProcedures(source pmsiItem, target patient : Patient, target encounter : Encounter, target bundle : Bundle) {
      // Actes group (linkId 591926901726) - can repeat
      pmsiItem.item as acteGroup where (linkId = '591926901726') -> bundle.entry as procedureEntry then {
        acteGroup -> procedureEntry.resource = create('Procedure') as procedure then {
          acteGroup -> procedure.id = uuid() "procedureid";
          acteGroup -> procedure.meta = create('Meta') as meta then {
            acteGroup -> meta.profile = 'https://interop.aphp.fr/ig/fhir/dm/StructureDefinition/DMProcedure' "procedureprofile";
          } "proceduremeta";
          // Link to patient
          acteGroup ->  procedure.subject = create('Reference') as ref,  patient.id as patId,  ref.reference = append('Patient/', patId) "setsubject";
          // Link to encounter
          acteGroup ->  encounter.id as encId,  procedure.encounter = create('Reference') as ref,  ref.reference = append('Encounter/', encId) "setencounter";
          // Acte code (linkId 7758110033600) - CCAM
          acteGroup.item as acteCodeItem where (linkId = '7758110033600') then {
            acteCodeItem.answer as ans -> procedure.code = create('CodeableConcept') as code then {
              ans -> code.coding = (ans.valueCoding) "setcoding";
            } "setcode";
          } "extractactecode";
          // Date de l'acte (linkId 5066866286682)
          acteGroup.item as dateItem where (linkId = '5066866286682') then {
            dateItem.answer as ans -> procedure.performed = (ans.valueDateTime) "setperformed";
          } "extractperformeddate";
        } "createprocedure";
      } "procedureentry";
    }

    // Group: Create Medication Requests
    group CreateMedicationRequests(source src : QuestionnaireResponse, target patient : Patient, target bundle : Bundle) {
      // Exposition médicamenteuse (linkId 817801935685)
      src.item as medExpoGroup where (linkId = '817801935685') then {
        // Médicament prescrit (linkId 156631794800) - repeating
        medExpoGroup.item as prescribedGroup where (linkId = '156631794800') -> bundle.entry as medReqEntry then {
          prescribedGroup -> medReqEntry.resource = create('MedicationRequest') as medReq then {
            prescribedGroup -> medReq.id = uuid() "medreqid";
            prescribedGroup -> medReq.meta = create('Meta') as meta then {
              prescribedGroup -> meta.profile = 'https://interop.aphp.fr/ig/fhir/dm/StructureDefinition/DMMedicationRequest' "medreqprofile";
            } "medreqmeta";
            // Link to patient
            prescribedGroup ->  medReq.subject = create('Reference') as ref,  patient.id as patId,  ref.reference = append('Patient/', patId) "setsubject";
            // Status and intent
            prescribedGroup -> medReq.status = 'active' "setstatus";
            prescribedGroup -> medReq.intent = 'order' "setintent";
            // Create Medication resource and reference
            prescribedGroup -> bundle.entry as medEntry then {
              prescribedGroup -> medEntry.resource = create('Medication') as medication then {
                prescribedGroup -> medication.id = uuid() "medid";
                // ATC code from nested items
                prescribedGroup.item as atcItem where (linkId.contains('ATC')) then {
                  atcItem.answer as ans -> medication.code = create('CodeableConcept') as code then {
                    ans -> code.coding = (ans.valueCoding) "setatccoding";
                  } "setmedcode";
                } "extractatc";
                prescribedGroup ->  medication.id as medId,  medEntry.fullUrl = append('urn:uuid:', medId) "setfullUrl";
                // Link MedicationRequest to Medication
                prescribedGroup ->  medication.id as medId,  medReq.medication = create('Reference') as ref,  ref.reference = append('Medication/', medId) "setmedicationreference";
              } "createmedication";
            } "medicationentry";
            // Dosage instructions
            prescribedGroup -> medReq.dosageInstruction = create('Dosage') as dosage then {
              // Route
              prescribedGroup.item as routeItem where (linkId.contains('voie')) then {
                routeItem.answer as ans -> dosage.route = create('CodeableConcept') as route then {
                  ans -> route.coding = (ans.valueCoding) "setroutecoding";
                } "setroute";
              } "extractroute";
              // Timing
              prescribedGroup.item as timingItem where (linkId.contains('timing') or linkId.contains('fréquence')) then {
                timingItem.answer as ans -> dosage.timing = create('Timing') as timing then {
                  ans -> timing.repeat = create('TimingRepeat') as repeat "settiming";
                } "settimingstructure";
              } "extracttiming";
            } "setdosage";
          } "createmedreq";
        } "medreqentry";
      } "processmedexpo";
    }

    // Group: Create Medication Administrations
    group CreateMedicationAdministrations(source src : QuestionnaireResponse, target patient : Patient, target bundle : Bundle) {
      // Exposition médicamenteuse (linkId 817801935685)
      src.item as medExpoGroup where (linkId = '817801935685') then {
        // Médicament administré (linkId 266852453304) - repeating
        medExpoGroup.item as adminGroup where (linkId = '266852453304') -> bundle.entry as medAdminEntry then {
          adminGroup -> medAdminEntry.resource = create('MedicationAdministration') as medAdmin then {
            adminGroup -> medAdmin.id = uuid() "medadminid";
            adminGroup -> medAdmin.meta = create('Meta') as meta then {
              adminGroup -> meta.profile = 'https://interop.aphp.fr/ig/fhir/dm/StructureDefinition/DMMedicationAdministration' "medadminprofile";
            } "medadminmeta";
            // Link to patient
            adminGroup ->  medAdmin.subject = create('Reference') as ref,  patient.id as patId,  ref.reference = append('Patient/', patId) "setsubject";
            // Status
            adminGroup -> medAdmin.status = 'completed' "setstatus";
            // Create Medication resource and reference
            adminGroup -> bundle.entry as medEntry then {
              adminGroup -> medEntry.resource = create('Medication') as medication then {
                adminGroup -> medication.id = uuid() "medid";
                // ATC code from nested items
                adminGroup.item as atcItem where (linkId.contains('ATC')) then {
                  atcItem.answer as ans -> medication.code = create('CodeableConcept') as code then {
                    ans -> code.coding = (ans.valueCoding) "setatccoding";
                  } "setmedcode";
                } "extractatc";
                adminGroup ->  medication.id as medId,  medEntry.fullUrl = append('Medication/', medId) "setfullUrl";
                // Link MedicationAdministration to Medication
                adminGroup ->  medication.id as medId,  medAdmin.medication = create('Reference') as ref,  ref.reference = append('urn:uuid:', medId) "setmedicationreference";
              } "createmedication";
            } "medicationentry";
            // Effective period
            adminGroup -> medAdmin.effective = create('Period') as period then {
              adminGroup.item as startItem where (linkId.contains('début')) then {
                startItem.answer as ans -> period.start = (ans.valueDateTime) "setstart";
              } "extractstart";
              adminGroup.item as endItem where (linkId.contains('fin')) then {
                endItem.answer as ans -> period.end = (ans.valueDateTime) "setend";
              } "extractend";
            } "seteffective";
            // Dosage
            adminGroup -> medAdmin.dosage = create('Dosage') as dosage then {
              // Route
              adminGroup.item as routeItem where (linkId.contains('voie')) then {
                routeItem.answer as ans -> dosage.route = create('CodeableConcept') as route then {
                  ans -> route.coding = (ans.valueCoding) "setroutecoding";
                } "setroute";
              } "extractroute";
              // Dose
              adminGroup.item as doseItem where (linkId.contains('dose')) then {
                doseItem.answer as ans -> dosage.dose = (ans.valueQuantity) "setdose";
              } "extractdose";
            } "setdosage";
          } "createmedadmin";
        } "medadminentry";
      } "processmedexpoadmin";
    }

    // Group: Create Vital Sign Observations
    group CreateVitalSignObservations(source src : QuestionnaireResponse, target patient : Patient, target bundle : Bundle) {
      // Examen clinique (linkId 214880328197)
      src.item as examGroup where (linkId = '214880328197') then {
        // Dossier de soins (linkId 305831246173) - repeating
        examGroup.item as dossierGroup where (linkId = '305831246173') then {
          // Height (linkId 4846902346416)
          dossierGroup.item as heightItem where (linkId = '4846902346416') then {
            heightItem.answer as ans -> bundle.entry as obsEntry then {
              ans -> obsEntry.resource = create('Observation') as obs then {
                ans -> obs.id = uuid() "obsid";
                ans ->  obs.id as obsId,  obsEntry.fullUrl = append('urn:uuid:', obsId) "setfullUrl";
                ans -> obs.meta = create('Meta') as meta then {
                  ans -> meta.profile = 'https://interop.aphp.fr/ig/fhir/dm/StructureDefinition/DMObservationBodyHeight' "obsprofile";
                } "obsmeta";
                ans -> obs.status = 'final' "obsstatus";
                ans -> obs.category = cc('http://terminology.hl7.org/CodeSystem/observation-category', 'vital-signs') "obscategory";
                ans -> obs.code = cc('http://loinc.org', '8302-2', 'Body height') "obscode";
                // Link to patient
                ans ->  obs.subject = create('Reference') as ref,  patient.id as patId,  ref.reference = append('Patient/', patId) "setsubject";
                // Value
                ans -> obs.value = (ans.valueQuantity) "setvalue";
                // Effective date from nested item
                heightItem.item as dateItem where (linkId.contains('Date')) then {
                  dateItem.answer as dateAns -> obs.effective = (dateAns.valueDate) "seteffective";
                } "extracteffective";
              } "createheightobs";
            } "heightobsentry";
          } "extractheight";
          // Weight (linkId 451513217936)
          dossierGroup.item as weightItem where (linkId = '451513217936') then {
            weightItem.answer as ans -> bundle.entry as obsEntry then {
              ans -> obsEntry.resource = create('Observation') as obs then {
                ans -> obs.id = uuid() "obsid";
                ans ->  obs.id as obsId,  obsEntry.fullUrl = append('urn:uuid:', obsId) "setfullUrl";
                ans -> obs.meta = create('Meta') as meta then {
                  ans -> meta.profile = 'https://interop.aphp.fr/ig/fhir/dm/StructureDefinition/DMObservationBodyWeight' "obsprofile";
                } "obsmeta";
                ans -> obs.status = 'final' "obsstatus";
                ans -> obs.category = cc('http://terminology.hl7.org/CodeSystem/observation-category', 'vital-signs') "obscategory";
                ans -> obs.code = cc('http://loinc.org', '29463-7', 'Body weight') "obscode";
                // Link to patient
                ans ->  obs.subject = create('Reference') as ref,  patient.id as patId,  ref.reference = append('Patient/', patId) "setsubject";
                // Value
                ans -> obs.value = (ans.valueQuantity) "setvalue";
                // Effective date from nested item
                weightItem.item as dateItem where (linkId.contains('Date')) then {
                  dateItem.answer as dateAns -> obs.effective = (dateAns.valueDate) "seteffective";
                } "extracteffective";
              } "createweightobs";
            } "weightobsentry";
          } "extractweight";
          // Blood Pressure - need both systolic and diastolic
          dossierGroup.item as sysItem where (linkId = '4160905247955') then {
            sysItem.answer as sysAns then {
              dossierGroup.item as diaItem where (linkId = '848797127998') then {
                diaItem.answer as diaAns -> bundle.entry as obsEntry then {
                  sysAns -> obsEntry.resource = create('Observation') as obs then {
                    sysAns -> obs.id = uuid() "obsid";
                    sysAns ->  obs.id as obsId,  obsEntry.fullUrl = append('urn:uuid:', obsId) "setfullUrl";
                    sysAns -> obs.meta = create('Meta') as meta then {
                      sysAns -> meta.profile = 'https://interop.aphp.fr/ig/fhir/dm/StructureDefinition/DMObservationBloodPressure' "obsprofile";
                    } "obsmeta";
                    sysAns -> obs.status = 'final' "obsstatus";
                    sysAns -> obs.category = cc('http://terminology.hl7.org/CodeSystem/observation-category', 'vital-signs') "obscategory";
                    sysAns -> obs.code = cc('http://loinc.org', '85354-9', 'Blood pressure panel') "obscode";
                    // Link to patient
                    sysAns ->  obs.subject = create('Reference') as ref,  patient.id as patId,  ref.reference = append('Patient/', patId) "setsubject";
                    // Systolic component
                    sysAns -> obs.component = create('Observation') as sysComp then {
                      sysAns -> sysComp.code = cc('http://loinc.org', '8480-6', 'Systolic blood pressure') "syscode";
                      sysAns -> sysComp.value = (sysAns.valueQuantity) "sysvalue";
                    } "setsystolic";
                    // Diastolic component
                    diaAns -> obs.component = create('Observation') as diaComp then {
                      diaAns -> diaComp.code = cc('http://loinc.org', '8462-4', 'Diastolic blood pressure') "diacode";
                      diaAns -> diaComp.value = (diaAns.valueQuantity) "diavalue";
                    } "setdiastolic";
                    // Effective date from nested item
                    sysItem.item as dateItem where (linkId.contains('Date')) then {
                      dateItem.answer as dateAns -> obs.effective = (dateAns.valueDate) "seteffective";
                    } "extracteffective";
                  } "createbpobs";
                } "bpobsentr";
              } "extractdiastolic";
            } "processsystolic";
          } "extractbloodpressure";
        } "processdossier";
      } "processexam";
    }

    // Group: Create Laboratory Observations
    group CreateLaboratoryObservations(source src : QuestionnaireResponse, target patient : Patient, target bundle : Bundle) {
      // Biologie group (linkId 7702944131447)
      src.item as bioGroup where (linkId = '7702944131447') then {
        // Fonction rénale (linkId 5241323453538)
        bioGroup.item as renalGroup where (linkId = '5241323453538') then {
          // Urée (linkId 7169026818760)
          renalGroup.item as ureaItem where (linkId = '7169026818760') then {
            ureaItem.answer as ans -> bundle then CreateLabObservation(ans, ureaItem, patient, bundle) "createureaobs";
          } "extracturea";
          // Créatininémie (linkId 500408205043)
          renalGroup.item as creatItem where (linkId = '500408205043') then {
            creatItem.answer as ans -> bundle then CreateLabObservation(ans, creatItem, patient, bundle) "createcreatobs";
          } "extractcreat";
          // DFG (linkId 786621340679)
          renalGroup.item as dfgItem where (linkId = '786621340679') then {
            dfgItem.answer as ans -> bundle then CreateLabObservation(ans, dfgItem, patient, bundle) "createdfgobs";
          } "extractdfg";
        } "processrenal";
        // Hémogramme (linkId 419282985970)
        bioGroup.item as hemoGroup where (linkId = '419282985970') then {
          // Leucocytes (linkId 210077225604)
          hemoGroup.item as leukoItem where (linkId = '210077225604') then {
            leukoItem.answer as ans -> bundle then CreateLabObservation(ans, leukoItem, patient, bundle) "createleukoobs";
          } "extractleuko";
          // Hémoglobine (linkId 304159088493)
          hemoGroup.item as hemoItem where (linkId = '304159088493') then {
            hemoItem.answer as ans -> bundle then CreateLabObservation(ans, hemoItem, patient, bundle) "createhemoobs";
          } "extracthemo";
          // Hématocrite (linkId 5687959006070)
          hemoGroup.item as hematItem where (linkId = '5687959006070') then {
            hematItem.answer as ans -> bundle then CreateLabObservation(ans, hematItem, patient, bundle) "createhematobs";
          } "extracthemat";
          // Erythrocytes (linkId 8697447896867)
          hemoGroup.item as eryItem where (linkId = '8697447896867') then {
            eryItem.answer as ans -> bundle then CreateLabObservation(ans, eryItem, patient, bundle) "createeryobs";
          } "extractery";
          // VGM (linkId 5584978899134)
          hemoGroup.item as vgmItem where (linkId = '5584978899134') then {
            vgmItem.answer as ans -> bundle then CreateLabObservation(ans, vgmItem, patient, bundle) "createvgmobs";
          } "extractvgm";
          // Plaquettes (linkId 2881119993430)
          hemoGroup.item as platItem where (linkId = '2881119993430') then {
            platItem.answer as ans -> bundle then CreateLabObservation(ans, platItem, patient, bundle) "createplatobs";
          } "extractplat";
          // Neutrophiles (linkId 7408951746270)
          hemoGroup.item as neutItem where (linkId = '7408951746270') then {
            neutItem.answer as ans -> bundle then CreateLabObservation(ans, neutItem, patient, bundle) "createneutobs";
          } "extractneut";
          // Lymphocytes (linkId 809808816195)
          hemoGroup.item as lymphItem where (linkId = '809808816195') then {
            lymphItem.answer as ans -> bundle then CreateLabObservation(ans, lymphItem, patient, bundle) "createlymphobs";
          } "extractlymph";
          // Eosinophiles (linkId 6451887990893)
          hemoGroup.item as eosiItem where (linkId = '6451887990893') then {
            eosiItem.answer as ans -> bundle then CreateLabObservation(ans, eosiItem, patient, bundle) "createeosiobs";
          } "extracteosi";
          // Monocytes (linkId 7935935816936)
          hemoGroup.item as monoItem where (linkId = '7935935816936') then {
            monoItem.answer as ans -> bundle then CreateLabObservation(ans, monoItem, patient, bundle) "createmonoobs";
          } "extractmono";
          // TP (linkId 2055949655770)
          hemoGroup.item as tpItem where (linkId = '2055949655770') then {
            tpItem.answer as ans -> bundle then CreateLabObservation(ans, tpItem, patient, bundle) "createtpobs";
          } "extracttp";
          // TCA (linkId 2527095476817)
          hemoGroup.item as tcaItem where (linkId = '2527095476817') then {
            tcaItem.answer as ans -> bundle then CreateLabObservation(ans, tcaItem, patient, bundle) "createtcaobs";
          } "extracttca";
        } "processhemo";
        // Bilan hépatique (linkId 3893612773040)
        bioGroup.item as liverGroup where (linkId = '3893612773040') then {
          // ASAT (linkId 3028330976100)
          liverGroup.item as asatItem where (linkId = '3028330976100') then {
            asatItem.answer as ans -> bundle then CreateLabObservation(ans, asatItem, patient, bundle) "createasatobs";
          } "extractasat";
          // ALAT (linkId 8486813893880)
          liverGroup.item as alatItem where (linkId = '8486813893880') then {
            alatItem.answer as ans -> bundle then CreateLabObservation(ans, alatItem, patient, bundle) "createalatobs";
          } "extractalat";
          // GGT (linkId 3663296044037)
          liverGroup.item as ggtItem where (linkId = '3663296044037') then {
            ggtItem.answer as ans -> bundle then CreateLabObservation(ans, ggtItem, patient, bundle) "createggtobs";
          } "extractggt";
          // PAL (linkId 2690026606933)
          liverGroup.item as palItem where (linkId = '2690026606933') then {
            palItem.answer as ans -> bundle then CreateLabObservation(ans, palItem, patient, bundle) "createpalobs";
          } "extractpal";
          // Bilirubine totale (linkId 9068831071023)
          liverGroup.item as bilTotItem where (linkId = '9068831071023') then {
            bilTotItem.answer as ans -> bundle then CreateLabObservation(ans, bilTotItem, patient, bundle) "createbiltotobs";
          } "extractbiltot";
          // Bilirubine conjuguée (linkId 8893717988787)
          liverGroup.item as bilConjItem where (linkId = '8893717988787') then {
            bilConjItem.answer as ans -> bundle then CreateLabObservation(ans, bilConjItem, patient, bundle) "createbilconjobs";
          } "extractbilconj";
        } "processliver";
        // Métabolisme glucidique (linkId 8929068894076)
        bioGroup.item as glucoseGroup where (linkId = '8929068894076') then {
          // Glycémie à jeun (linkId 8193929027997)
          glucoseGroup.item as glycItem where (linkId = '8193929027997') then {
            glycItem.answer as ans -> bundle then CreateLabObservation(ans, glycItem, patient, bundle) "createglycobs";
          } "extractglyc";
          // HbA1c (linkId 7063892830923)
          glucoseGroup.item as hba1cItem where (linkId = '7063892830923') then {
            hba1cItem.answer as ans -> bundle then CreateLabObservation(ans, hba1cItem, patient, bundle) "createhba1cobs";
          } "extracthba1c";
        } "processglucose";
      } "processbiology";
    }

    // Helper: Create a single Laboratory Observation
    group CreateLabObservation(source ans, source parentItem, target patient : Patient, target bundle : Bundle) {
      ans -> bundle.entry as obsEntry then {
        ans -> obsEntry.resource = create('Observation') as obs then {
          ans -> obs.id = uuid() "obsid";
          ans ->  obs.id as obsId,  obsEntry.fullUrl = append('urn:uuid:', obsId) "setfullUrl";
          ans -> obs.meta = create('Meta') as meta then {
            ans -> meta.profile = 'https://interop.aphp.fr/ig/fhir/dm/StructureDefinition/dm-observation-laboratory-generic' "obsprofile";
          } "obsmeta";
          // Status
          ans -> obs.status = 'final' "obsstatus";
          // Category
          ans -> obs.category = create('CodeableConcept') as cat then {
            ans -> cat.coding = create('Coding') as coding then {
              ans -> coding.system = 'http://terminology.hl7.org/CodeSystem/observation-category' "catsystem";
              ans -> coding.code = 'laboratory' "catcode";
            } "setcategorycoding";
          } "setcategory";
          // Link to patient
          ans ->  obs.subject = create('Reference') as ref,  patient.id as patId,  ref.reference = append('Patient/', patId) "setsubject";
          // Value as Quantity
          ans -> obs.value = (ans.valueQuantity) "setvalue";
          // Extract nested items - LOINC code, effective date, status, reference ranges
          parentItem.item as loincItem where (linkId.contains('code loinc')) then {
            loincItem.answer as loincAns -> obs.code = create('CodeableConcept') as code then {
              loincAns -> code.coding = (loincAns.valueCoding) "setloinccoding";
            } "setcode";
          } "extractloinc";
          parentItem.item as dateItem where (linkId.contains('Date et heure du prélèvement')) then {
            dateItem.answer as dateAns -> obs.effective = (dateAns.valueDateTime) "seteffective";
          } "extracteffective";
        } "createobs";
      } "obsentry";
    }