isaacclad
2ce4bc8993
Deploy Ladill Care / deploy (push) Successful in 1m26s
Add a template-driven assessment system with universal intake, clinical pathways, disease instruments (stroke MVP + extended, diabetes, and ten specialty packs), scoring, patient outcome trends, REST/API + FHIR export, and Enterprise org-level assessment analytics. Seed packs and design/licensing docs ship for deploy and pre-GA review.
472 lines
31 KiB
PHP
472 lines
31 KiB
PHP
<x-app-layout :title="'Consultation · '.$consultation->patient->fullName()">
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<div class="flex flex-col gap-4 sm:flex-row sm:items-start sm:justify-between">
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<div>
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<p class="text-xs font-medium uppercase tracking-wide {{ $isCompleted ? 'text-emerald-600' : 'text-amber-600' }}">
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{{ $isCompleted ? 'Completed' : 'In progress' }}
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</p>
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<h1 class="text-2xl font-semibold text-slate-900">{{ $consultation->patient->fullName() }}</h1>
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<p class="mt-1 text-sm text-slate-500">
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{{ $consultation->patient->patient_number }}
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@if ($consultation->practitioner) · {{ $consultation->practitioner->name }} @endif
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</p>
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</div>
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@if ($canManage && ! $isCompleted)
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<x-confirm-dialog
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:name="'complete-consultation-'.$consultation->id"
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title="Complete this consultation?"
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message="Mark the consultation as finished. You can still prescribe or generate a bill afterward."
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:action="route('care.consultations.complete', $consultation)"
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confirm-label="Complete consultation"
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variant="primary"
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>
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<x-slot:trigger>
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<button type="button" class="btn-primary">Complete consultation</button>
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</x-slot:trigger>
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</x-confirm-dialog>
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@endif
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@if ($canPrescribe)
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<a href="{{ route('care.prescriptions.create', $consultation) }}" class="rounded-lg border border-slate-200 bg-white px-4 py-2 text-sm font-medium text-slate-700 hover:bg-slate-50">Prescribe</a>
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@endif
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@if ($canGenerateBill && $isCompleted && $consultation->visit)
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<form method="POST" action="{{ route('care.bills.generate', $consultation->visit) }}">
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@csrf
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<button type="submit" class="rounded-lg bg-slate-800 px-4 py-2 text-sm font-medium text-white hover:bg-slate-900">Generate bill</button>
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</form>
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@endif
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</div>
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@if ($canRequestInvestigations && $investigationTypes->isNotEmpty())
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<section class="mt-6 rounded-2xl border border-slate-200 bg-white p-6">
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<h2 class="text-sm font-semibold uppercase tracking-wide text-slate-500">Request investigations</h2>
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<form method="POST" action="{{ route('care.lab.requests.store', $consultation) }}" class="mt-4 space-y-4">
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@csrf
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<div class="grid gap-2 sm:grid-cols-2 lg:grid-cols-3">
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@foreach ($investigationTypes as $type)
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<label class="flex items-center gap-2 rounded-lg border border-slate-100 bg-slate-50 px-3 py-2 text-sm">
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<input type="checkbox" name="investigation_type_ids[]" value="{{ $type->id }}" class="rounded border-slate-300">
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<span>{{ $type->name }} <span class="text-slate-400">({{ config('care.investigation_categories')[$type->category] ?? $type->category }})</span></span>
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</label>
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@endforeach
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</div>
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<div class="grid gap-4 sm:grid-cols-2">
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<input type="text" name="clinical_notes" placeholder="Clinical notes for lab" class="rounded-lg border-slate-300 text-sm">
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<select name="priority" class="rounded-lg border-slate-300 text-sm">
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<option value="routine">Routine</option>
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<option value="urgent">Urgent</option>
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</select>
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</div>
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<button type="submit" class="btn-primary">Submit requests</button>
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</form>
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@if ($consultation->investigationRequests->isNotEmpty())
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<div class="mt-4 border-t border-slate-100 pt-4 text-sm">
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<p class="font-medium text-slate-700">Requested tests</p>
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@foreach ($consultation->investigationRequests as $req)
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<p class="mt-1">
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<a href="{{ route('care.lab.requests.show', $req) }}" class="text-sky-600">{{ $req->investigationType->name }}</a>
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· {{ config('care.investigation_statuses')[$req->status] ?? $req->status }}
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</p>
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@endforeach
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</div>
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@endif
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</section>
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@endif
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@if ($consultation->prescriptions->isNotEmpty())
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<section class="mt-6 rounded-2xl border border-slate-200 bg-white p-6">
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<h2 class="text-sm font-semibold uppercase tracking-wide text-slate-500">Prescriptions</h2>
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<ul class="mt-4 space-y-2 text-sm">
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@foreach ($consultation->prescriptions as $rx)
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<li>
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<a href="{{ route('care.prescriptions.show', $rx) }}" class="text-sky-600 hover:text-sky-700">
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{{ $rx->created_at->format('d M Y H:i') }}
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</a>
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· {{ config('care.prescription_statuses')[$rx->status] ?? $rx->status }}
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· {{ $rx->items->pluck('name')->join(', ') }}
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</li>
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@endforeach
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</ul>
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</section>
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@endif
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@if ($canViewAssessments ?? false)
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{{-- Layer 1: universal intake (structured overlay; does not replace free-text symptoms) --}}
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@if ($universalTemplate)
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<section class="mt-6 rounded-2xl border border-sky-100 bg-sky-50/40 p-6">
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<div class="flex flex-wrap items-start justify-between gap-3">
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<div>
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<h2 class="text-sm font-semibold uppercase tracking-wide text-sky-800">Universal intake</h2>
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<p class="mt-1 text-xs text-slate-500">
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Structured Layer 1 assessment (presenting complaint, social history, function).
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Free-text <span class="font-medium">Symptoms</span> and <span class="font-medium">Clinical notes</span> below remain the narrative source of truth — they are not auto-copied either way.
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</p>
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</div>
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@if ($universalAssessment)
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<a href="{{ route('care.assessments.show', $universalAssessment) }}" class="rounded-lg bg-sky-600 px-3 py-2 text-sm font-medium text-white hover:bg-sky-700">
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{{ $universalAssessment->isDraft() ? 'Continue intake' : 'View intake' }}
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</a>
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@elseif (($canCaptureUniversal ?? false) && ! $isCompleted)
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<form method="POST" action="{{ route('care.consultations.assessments.store', $consultation) }}">
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@csrf
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<input type="hidden" name="template_code" value="universal_intake">
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<button type="submit" class="rounded-lg bg-sky-600 px-3 py-2 text-sm font-medium text-white hover:bg-sky-700">Start universal intake</button>
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</form>
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@endif
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</div>
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@if ($universalAssessment)
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<p class="mt-3 text-sm text-slate-600">
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Status:
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<span class="font-medium">{{ $assessmentStatuses[$universalAssessment->status] ?? $universalAssessment->status }}</span>
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@if ($universalAssessment->consultation_id !== $consultation->id)
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<span class="text-slate-400">(from another visit — open to review)</span>
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@endif
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</p>
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@php
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$cc = $universalAssessment->answers->first(fn ($a) => $a->question?->code === 'chief_complaint');
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$pain = $universalAssessment->answers->first(fn ($a) => $a->question?->code === 'pain_score');
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@endphp
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@if ($cc || $pain)
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<dl class="mt-3 grid gap-2 text-sm sm:grid-cols-2">
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@if ($cc)
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<div>
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<dt class="text-slate-500">Chief complaint</dt>
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<dd class="font-medium text-slate-800">{{ \Illuminate\Support\Str::limit((string) $cc->authoritativeValue(), 160) }}</dd>
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</div>
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@endif
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@if ($pain)
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<div>
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<dt class="text-slate-500">Pain score</dt>
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<dd class="font-medium text-slate-800">{{ $pain->authoritativeValue() ?? '—' }}</dd>
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</div>
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@endif
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</dl>
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@endif
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@elseif (! ($canCaptureUniversal ?? false))
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<p class="mt-3 text-sm text-slate-400">No universal intake for this patient yet.</p>
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@endif
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</section>
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@endif
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{{-- Layer 2: pathways (suggest from persisted diagnoses; clinician confirms) --}}
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<section class="mt-6 rounded-2xl border border-slate-200 bg-white p-6">
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<div class="flex flex-wrap items-center justify-between gap-2">
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<h2 class="text-sm font-semibold uppercase tracking-wide text-slate-500">Clinical pathways</h2>
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<a href="{{ route('care.pathways.index', $consultation->patient) }}" class="text-sm text-sky-600 hover:text-sky-700">Manage pathways</a>
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</div>
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@if (($activePathways ?? collect())->isNotEmpty())
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<div class="mt-3 flex flex-wrap gap-2">
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@foreach ($activePathways as $pp)
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<span class="inline-flex items-center rounded-full bg-emerald-50 px-3 py-1 text-xs font-medium text-emerald-800 ring-1 ring-emerald-100">
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{{ $pp->pathway->name }}
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</span>
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@endforeach
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</div>
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@endif
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@if (($pathwayInstruments ?? collect())->isNotEmpty())
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<div class="mt-4 overflow-hidden rounded-xl border border-slate-100">
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<div class="bg-slate-50 px-3 py-2 text-xs font-semibold uppercase tracking-wide text-slate-500">
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Pathway instruments
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</div>
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<ul class="divide-y divide-slate-100 text-sm">
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@foreach ($pathwayInstruments as $instrument)
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<li class="flex flex-wrap items-center justify-between gap-2 px-3 py-2.5">
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<div>
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<span class="font-medium text-slate-900">{{ $instrument['template_name'] }}</span>
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<span class="text-xs text-slate-400">
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· {{ $instrument['pathway_name'] }}
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· {{ $instrument['template_code'] }}
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@if ($instrument['required']) · required @endif
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</span>
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@if ($instrument['assessment']?->score)
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<span class="ml-1 text-xs font-medium text-emerald-700">
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score {{ $instrument['assessment']->score->total_score }}@if($instrument['assessment']->score->max_score !== null)/{{ $instrument['assessment']->score->max_score }}@endif
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</span>
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@endif
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</div>
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<div class="flex items-center gap-2">
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@if ($instrument['pack_missing'])
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<span class="text-xs text-amber-600">Content pack not seeded</span>
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@elseif ($instrument['assessment'])
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<span class="text-xs text-slate-500">{{ $assessmentStatuses[$instrument['assessment']->status] ?? $instrument['assessment']->status }}</span>
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<a href="{{ route('care.assessments.show', $instrument['assessment']) }}" class="text-sky-600 hover:text-sky-700">
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{{ $instrument['assessment']->isDraft() ? 'Continue' : 'View' }}
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</a>
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@elseif (($canCaptureAssessment ?? false) && ! $isCompleted)
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<form method="POST" action="{{ route('care.consultations.assessments.store', $consultation) }}">
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@csrf
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<input type="hidden" name="template_code" value="{{ $instrument['template_code'] }}">
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<button type="submit" class="text-sm font-medium text-sky-600 hover:text-sky-700">Start</button>
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</form>
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@else
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<span class="text-xs text-slate-400">Not started</span>
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@endif
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</div>
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</li>
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@endforeach
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</ul>
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</div>
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@endif
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@if (($pathwaySuggestions ?? collect())->isNotEmpty())
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<ul class="mt-4 space-y-2 text-sm">
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@foreach ($pathwaySuggestions as $suggestion)
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<li class="flex flex-wrap items-center justify-between gap-2 rounded-xl border border-slate-100 bg-slate-50 px-3 py-2">
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<div>
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<span class="font-medium text-slate-900">{{ $suggestion['pathway_name'] }}</span>
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<span class="text-xs text-slate-400">
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· {{ $suggestion['match_reason'] }}
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@if ($suggestion['already_active']) · already active @endif
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</span>
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</div>
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@if (($canManagePathways ?? false) && ! $suggestion['already_active'] && ! $isCompleted)
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<form method="POST" action="{{ route('care.pathways.store', $consultation->patient) }}">
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@csrf
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<input type="hidden" name="pathway_code" value="{{ $suggestion['pathway_code'] }}">
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<input type="hidden" name="consultation_uuid" value="{{ $consultation->uuid }}">
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<button type="submit" class="text-sm font-medium text-sky-600 hover:text-sky-700">Activate</button>
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</form>
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@endif
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</li>
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@endforeach
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</ul>
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@else
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<p class="mt-3 text-sm text-slate-400">
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@if ($consultation->diagnoses->isEmpty())
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Save diagnoses to see pathway suggestions.
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@else
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No pathway matches for saved diagnoses.
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@endif
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</p>
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@endif
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</section>
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<section class="mt-6 rounded-2xl border border-slate-200 bg-white p-6">
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<div class="flex flex-wrap items-center justify-between gap-2">
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<h2 class="text-sm font-semibold uppercase tracking-wide text-slate-500">Clinical assessments</h2>
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<a href="{{ route('care.assessments.index', $consultation->patient) }}" class="text-sm text-sky-600 hover:text-sky-700">Patient assessments</a>
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</div>
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@if (($consultationAssessments ?? collect())->isNotEmpty())
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<ul class="mt-4 space-y-2 text-sm">
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@foreach ($consultationAssessments as $item)
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<li>
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<a href="{{ route('care.assessments.show', $item) }}" class="text-sky-600 hover:text-sky-700">
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{{ $item->template->name }}
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</a>
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· {{ ($assessmentStatuses[$item->status] ?? $item->status) }}
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</li>
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@endforeach
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</ul>
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@else
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<p class="mt-4 text-sm text-slate-400">No assessments linked to this consultation yet.</p>
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@endif
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@if (($canCaptureAssessment ?? false) && ! $isCompleted && ($startableTemplates ?? collect())->isNotEmpty())
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<form method="POST" action="{{ route('care.consultations.assessments.store', $consultation) }}" class="mt-4 flex flex-wrap items-end gap-3 border-t border-slate-100 pt-4">
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@csrf
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<div class="min-w-[12rem] flex-1">
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<label class="block text-xs text-slate-500">Start other assessment</label>
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<select name="template_code" required class="mt-1 w-full rounded-lg border-slate-300 text-sm">
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<option value="">Select template…</option>
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@foreach ($startableTemplates as $template)
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<option value="{{ $template->code }}">{{ $template->name }} ({{ $template->code }})</option>
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@endforeach
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</select>
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</div>
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<button type="submit" class="btn-primary">Start</button>
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</form>
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@endif
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</section>
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@endif
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@if (! $isCompleted && ($canManage || $canVitals))
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<form method="POST" action="{{ route('care.consultations.update', $consultation) }}" enctype="multipart/form-data" class="mt-6 space-y-6">
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@csrf @method('PUT')
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@if ($canVitals)
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<section class="rounded-2xl border border-slate-200 bg-white p-6">
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<h2 class="text-sm font-semibold uppercase tracking-wide text-slate-500">Vital signs</h2>
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@php $latestVitals = $consultation->vitalSigns->last(); @endphp
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<div class="mt-4 grid gap-4 sm:grid-cols-2 lg:grid-cols-4">
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<div>
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<label class="block text-xs text-slate-500">BP systolic</label>
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<input type="number" name="vitals[bp_systolic]" value="{{ old('vitals.bp_systolic', $latestVitals?->bp_systolic) }}" class="mt-1 w-full rounded-lg border-slate-300 text-sm">
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</div>
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<div>
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<label class="block text-xs text-slate-500">BP diastolic</label>
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<input type="number" name="vitals[bp_diastolic]" value="{{ old('vitals.bp_diastolic', $latestVitals?->bp_diastolic) }}" class="mt-1 w-full rounded-lg border-slate-300 text-sm">
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</div>
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<div>
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<label class="block text-xs text-slate-500">Pulse</label>
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<input type="number" name="vitals[pulse]" value="{{ old('vitals.pulse', $latestVitals?->pulse) }}" class="mt-1 w-full rounded-lg border-slate-300 text-sm">
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</div>
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<div>
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<label class="block text-xs text-slate-500">Temperature (°C)</label>
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<input type="number" step="0.1" name="vitals[temperature]" value="{{ old('vitals.temperature', $latestVitals?->temperature) }}" class="mt-1 w-full rounded-lg border-slate-300 text-sm">
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</div>
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<div>
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<label class="block text-xs text-slate-500">Weight (kg)</label>
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<input type="number" step="0.01" name="vitals[weight_kg]" value="{{ old('vitals.weight_kg', $latestVitals?->weight_kg) }}" class="mt-1 w-full rounded-lg border-slate-300 text-sm">
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</div>
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<div>
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<label class="block text-xs text-slate-500">Height (cm)</label>
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<input type="number" step="0.1" name="vitals[height_cm]" value="{{ old('vitals.height_cm', $latestVitals?->height_cm) }}" class="mt-1 w-full rounded-lg border-slate-300 text-sm">
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</div>
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<div>
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<label class="block text-xs text-slate-500">SpO₂ (%)</label>
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<input type="number" name="vitals[spo2]" value="{{ old('vitals.spo2', $latestVitals?->spo2) }}" class="mt-1 w-full rounded-lg border-slate-300 text-sm">
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</div>
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<div>
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<label class="block text-xs text-slate-500">Resp. rate</label>
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<input type="number" name="vitals[respiratory_rate]" value="{{ old('vitals.respiratory_rate', $latestVitals?->respiratory_rate) }}" class="mt-1 w-full rounded-lg border-slate-300 text-sm">
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</div>
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</div>
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</section>
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@endif
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@if ($canManage)
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<section class="rounded-2xl border border-slate-200 bg-white p-6">
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<h2 class="text-sm font-semibold uppercase tracking-wide text-slate-500">Clinical notes (narrative)</h2>
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@if ($canViewAssessments ?? false)
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<p class="mt-1 text-xs text-slate-400">
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Narrative source of truth for this encounter. Structured universal intake is a separate overlay above and is not auto-synced with these fields.
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</p>
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@endif
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<div class="mt-4 space-y-4">
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<div>
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<label class="block text-sm font-medium text-slate-700">Symptoms</label>
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<textarea name="symptoms" rows="3" class="mt-1 w-full rounded-lg border-slate-300 text-sm">{{ old('symptoms', $consultation->symptoms) }}</textarea>
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</div>
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<div>
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<label class="block text-sm font-medium text-slate-700">Clinical notes</label>
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<textarea name="clinical_notes" rows="5" class="mt-1 w-full rounded-lg border-slate-300 text-sm">{{ old('clinical_notes', $consultation->clinical_notes) }}</textarea>
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</div>
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<div>
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<label class="block text-sm font-medium text-slate-700">Practitioner</label>
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<select name="practitioner_id" class="mt-1 w-full rounded-lg border-slate-300 text-sm">
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<option value="">—</option>
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@foreach ($practitioners as $practitioner)
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<option value="{{ $practitioner->id }}" @selected(old('practitioner_id', $consultation->practitioner_id) == $practitioner->id)>{{ $practitioner->name }}</option>
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@endforeach
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</select>
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</div>
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</div>
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</section>
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<section class="rounded-2xl border border-slate-200 bg-white p-6" x-data="{ diagnoses: {{ json_encode(old('diagnoses', $consultation->diagnoses->map(fn ($d) => ['code' => $d->code, 'description' => $d->description, 'is_primary' => $d->is_primary, 'notes' => $d->notes])->values()->all() ?: [['code' => '', 'description' => '', 'is_primary' => true, 'notes' => '']])) }} }">
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<div class="flex items-center justify-between">
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<h2 class="text-sm font-semibold uppercase tracking-wide text-slate-500">Diagnoses</h2>
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<button type="button" @click="diagnoses.push({code:'',description:'',is_primary:false,notes:''})" class="text-sm text-sky-600 hover:text-sky-700">Add diagnosis</button>
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</div>
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<template x-for="(dx, index) in diagnoses" :key="index">
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<div class="mt-4 grid gap-3 rounded-xl border border-slate-100 bg-slate-50 p-4 sm:grid-cols-2">
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<div>
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<label class="block text-xs text-slate-500">ICD code</label>
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<input type="text" :name="'diagnoses['+index+'][code]'" x-model="dx.code" class="mt-1 w-full rounded-lg border-slate-300 text-sm">
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</div>
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<div>
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<label class="block text-xs text-slate-500">Description</label>
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<input type="text" :name="'diagnoses['+index+'][description]'" x-model="dx.description" class="mt-1 w-full rounded-lg border-slate-300 text-sm">
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</div>
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<div class="sm:col-span-2">
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<label class="inline-flex items-center gap-2 text-sm">
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<input type="checkbox" :name="'diagnoses['+index+'][is_primary]'" value="1" x-model="dx.is_primary" class="rounded border-slate-300">
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Primary diagnosis
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</label>
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</div>
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</div>
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</template>
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</section>
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<section class="rounded-2xl border border-slate-200 bg-white p-6">
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<h2 class="text-sm font-semibold uppercase tracking-wide text-slate-500">Documents</h2>
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<input type="file" name="documents[]" multiple accept=".pdf,.jpg,.jpeg,.png,.webp" class="mt-4 block w-full text-sm text-slate-500">
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</section>
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@endif
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<div class="flex flex-wrap gap-3">
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<button type="submit" class="btn-primary">Save</button>
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@if ($canManage && ($canViewAssessments ?? false))
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<button type="submit" name="suggest_pathways" value="1" class="rounded-lg border border-sky-200 bg-sky-50 px-4 py-2 text-sm font-medium text-sky-800 hover:bg-sky-100">
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Save diagnoses & suggest pathways
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</button>
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@endif
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<a href="{{ route('care.queue.index') }}" class="rounded-lg border border-slate-200 px-4 py-2 text-sm text-slate-600">Back to queue</a>
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</div>
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</form>
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@else
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<div class="mt-6 space-y-6">
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@if ($consultation->vitalSigns->isNotEmpty())
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<section class="rounded-2xl border border-slate-200 bg-white p-6">
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<h2 class="text-sm font-semibold uppercase tracking-wide text-slate-500">Vital signs</h2>
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@foreach ($consultation->vitalSigns as $vitals)
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<dl class="mt-4 grid gap-3 text-sm sm:grid-cols-4">
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<div><dt class="text-slate-500">BP</dt><dd class="font-medium">{{ $vitals->bp_systolic }}/{{ $vitals->bp_diastolic }}</dd></div>
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<div><dt class="text-slate-500">Pulse</dt><dd class="font-medium">{{ $vitals->pulse ?? '—' }}</dd></div>
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<div><dt class="text-slate-500">Temp</dt><dd class="font-medium">{{ $vitals->temperature ?? '—' }}°C</dd></div>
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<div><dt class="text-slate-500">SpO₂</dt><dd class="font-medium">{{ $vitals->spo2 ? $vitals->spo2.'%' : '—' }}</dd></div>
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</dl>
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@endforeach
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</section>
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@endif
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|
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|
@if ($consultation->symptoms || $consultation->clinical_notes)
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|
<section class="rounded-2xl border border-slate-200 bg-white p-6">
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<h2 class="text-sm font-semibold uppercase tracking-wide text-slate-500">Clinical notes (narrative)</h2>
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|
@if ($consultation->symptoms)
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<p class="mt-4 text-sm"><span class="font-medium text-slate-700">Symptoms:</span> {{ $consultation->symptoms }}</p>
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@endif
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@if ($consultation->clinical_notes)
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<p class="mt-2 whitespace-pre-wrap text-sm text-slate-600">{{ $consultation->clinical_notes }}</p>
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@endif
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|
</section>
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@endif
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|
|
|
@if (($canViewAssessments ?? false) && ($universalAssessment ?? null)?->isCompleted())
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|
<section class="rounded-2xl border border-sky-100 bg-white p-6">
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|
<div class="flex items-center justify-between gap-2">
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|
<h2 class="text-sm font-semibold uppercase tracking-wide text-slate-500">Universal intake (structured)</h2>
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|
<a href="{{ route('care.assessments.show', $universalAssessment) }}" class="text-sm text-sky-600 hover:text-sky-700">Open</a>
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</div>
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|
<dl class="mt-4 space-y-2 text-sm">
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|
@foreach ($universalAssessment->answers->sortBy(fn ($a) => $a->question?->sort_order ?? 0) as $answer)
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@if ($answer->question)
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<div class="grid gap-1 sm:grid-cols-3">
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<dt class="text-slate-500">{{ $answer->question->label }}</dt>
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<dd class="sm:col-span-2 font-medium text-slate-800">
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@php $v = $answer->authoritativeValue(); @endphp
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@if (is_array($v))
|
|
{{ implode(', ', $v) }}
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@elseif (is_bool($v))
|
|
{{ $v ? 'Yes' : 'No' }}
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@else
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|
{{ $v ?? '—' }}
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@endif
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|
</dd>
|
|
</div>
|
|
@endif
|
|
@endforeach
|
|
</dl>
|
|
</section>
|
|
@endif
|
|
|
|
@if ($consultation->diagnoses->isNotEmpty())
|
|
<section class="rounded-2xl border border-slate-200 bg-white p-6">
|
|
<h2 class="text-sm font-semibold uppercase tracking-wide text-slate-500">Diagnoses</h2>
|
|
<ul class="mt-4 space-y-2 text-sm">
|
|
@foreach ($consultation->diagnoses as $diagnosis)
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|
<li>
|
|
<span class="font-medium">{{ $diagnosis->description }}</span>
|
|
@if ($diagnosis->code) <span class="text-slate-400">({{ $diagnosis->code }})</span> @endif
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@if ($diagnosis->is_primary) <span class="text-sky-600">primary</span> @endif
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|
</li>
|
|
@endforeach
|
|
</ul>
|
|
</section>
|
|
@endif
|
|
</div>
|
|
@endif
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|
</x-app-layout>
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