From e054efda8addaf6c60e9760a0cd79841fca6d998 Mon Sep 17 00:00:00 2001
From: Christopher Sande <christopher.sande@canvasmedical.com>
Date: Thu, 24 Oct 2024 12:55:59 -0500
Subject: [PATCH 1/8] Added ProtocolOverride to data module

---
 canvas_sdk/v1/data/protocol_override.py | 59 +++++++++++++++++++++++++
 1 file changed, 59 insertions(+)
 create mode 100644 canvas_sdk/v1/data/protocol_override.py

diff --git a/canvas_sdk/v1/data/protocol_override.py b/canvas_sdk/v1/data/protocol_override.py
new file mode 100644
index 00000000..70a21a84
--- /dev/null
+++ b/canvas_sdk/v1/data/protocol_override.py
@@ -0,0 +1,59 @@
+from django.db import models
+from django.utils.translation import gettext_lazy as _
+
+from canvas_sdk.v1.data.base import CommittableModelManager
+from canvas_sdk.v1.data.patient import Patient
+from canvas_sdk.v1.data.user import CanvasUser
+
+
+class IntervalUnit(models.TextChoices):
+    """ProtocolOverride cycle IntervalUnit."""
+
+    DAYS = "days", _("days")
+    MONTHS = "months", _("months")
+    YEARS = "years", _("years")
+
+
+class Status(models.TextChoices):
+    """ProtocolOverride Status."""
+
+    ACTIVE = "active", _("active")
+    INACTIVE = "inactive", _("inactive")
+
+
+class ProtocolOverride(models.Model):
+    """ProtocolOverride."""
+
+    class Meta:
+        managed = False
+        app_label = "canvas_sdk"
+        db_table = "canvas_sdk_data_api_protocoloverride_001"
+
+    objects = CommittableModelManager()
+
+    id = models.UUIDField()
+    dbid = models.BigIntegerField(primary_key=True)
+    created = models.DateTimeField()
+    modified = models.DateTimeField()
+    deleted = models.BooleanField()
+    committer = models.ForeignKey(CanvasUser, on_delete=models.DO_NOTHING)
+    entered_in_error = models.ForeignKey(CanvasUser, on_delete=models.DO_NOTHING)
+    patient = models.ForeignKey(
+        Patient,
+        on_delete=models.DO_NOTHING,
+        related_name="allergy_intolerances",
+    )
+    protocol_key = models.CharField()
+    is_adjustment = models.BooleanField()
+    reference_date = models.DateTimeField()
+    cycle_in_days = models.IntegerField()
+    is_snooze = models.BooleanField()
+    snooze_date = models.DateField()
+    snoozed_days = models.IntegerField()
+    # reason_id = models.BigIntegerField()
+    snooze_comment = models.TextField()
+    narrative = models.CharField()
+    # note_id = models.BigIntegerField()
+    cycle_quantity = models.IntegerField()
+    cycle_unit = models.CharField(choices=IntervalUnit.choices)
+    status = models.CharField(choices=Status.choices)

From 805445973697ee951b0c0d20a9537d6ac08cd7fb Mon Sep 17 00:00:00 2001
From: Christopher Sande <christopher.sande@canvasmedical.com>
Date: Thu, 31 Oct 2024 10:32:34 -0500
Subject: [PATCH 2/8] Refactored how ValueSet queries are determined

---
 canvas_sdk/v1/data/questionnaire.py      | 14 +-----------
 canvas_sdk/value_set/v2022/assessment.py | 27 +++++++++++++++++-------
 canvas_sdk/value_set/value_set.py        | 14 +++++++++++-
 3 files changed, 33 insertions(+), 22 deletions(-)

diff --git a/canvas_sdk/v1/data/questionnaire.py b/canvas_sdk/v1/data/questionnaire.py
index a2215b0a..1bd8f70d 100644
--- a/canvas_sdk/v1/data/questionnaire.py
+++ b/canvas_sdk/v1/data/questionnaire.py
@@ -1,7 +1,4 @@
-from collections.abc import Container
-
 from django.db import models
-from django.db.models import Q
 
 from canvas_sdk.v1.data import Patient
 from canvas_sdk.v1.data.base import (
@@ -75,15 +72,6 @@ class Meta:
     code = models.CharField()
 
 
-class QuestionnaireValueSetLookupQuerySet(ValueSetLookupByNameQuerySet):
-    """QuerySet class for Questionaire ValueSet lookups."""
-
-    @staticmethod
-    def q_object(system: str, codes: Container[str]) -> Q:
-        """The code system and code values for a Questionnaire are just attributes on the model."""
-        return Q(code_system=system, code__in=codes)
-
-
 class Questionnaire(models.Model):
     """Questionnaire."""
 
@@ -92,7 +80,7 @@ class Meta:
         app_label = "canvas_sdk"
         db_table = "canvas_sdk_data_api_questionnaire_001"
 
-    objects = models.Manager.from_queryset(QuestionnaireValueSetLookupQuerySet)()
+    objects = models.Manager.from_queryset(ValueSetLookupByNameQuerySet)()
 
     id = models.UUIDField()
     dbid = models.BigIntegerField(primary_key=True)
diff --git a/canvas_sdk/value_set/v2022/assessment.py b/canvas_sdk/value_set/v2022/assessment.py
index 0c0eb54e..bf6dce1b 100644
--- a/canvas_sdk/value_set/v2022/assessment.py
+++ b/canvas_sdk/value_set/v2022/assessment.py
@@ -1,7 +1,18 @@
+from typing import Container
+
+from django.db.models import Q
+
 from ..value_set import ValueSet
 
 
-class TobaccoUseScreening(ValueSet):
+class AssessmentValueSet(ValueSet):
+    @staticmethod
+    def q_object(system: str, codes: Container[str]) -> Q:
+        """The code system and code values for a Questionnaire are just attributes on the model."""
+        return Q(code_system=system, code__in=codes)
+
+
+class TobaccoUseScreening(AssessmentValueSet):
     """
     **Clinical Focus:** The purpose of this value set is to represent concepts for assessments to screen for tobacco use.
 
@@ -27,7 +38,7 @@ class TobaccoUseScreening(ValueSet):
     }
 
 
-class FallsScreening(ValueSet):
+class FallsScreening(AssessmentValueSet):
     """
     **Clinical Focus:** The purpose of this value set is to represent concepts for assessments using a falls screening tool.
 
@@ -53,7 +64,7 @@ class FallsScreening(ValueSet):
     }
 
 
-class StandardizedToolsForAssessmentOfCognition(ValueSet):
+class StandardizedToolsForAssessmentOfCognition(AssessmentValueSet):
     """
         **Clinical Focus:** The purpose of this value set is to define concepts for assessments representing total score results for standardized tools used for the evaluation of cognition.
 
@@ -92,7 +103,7 @@ class StandardizedToolsForAssessmentOfCognition(ValueSet):
     }
 
 
-class SexuallyActive(ValueSet):
+class SexuallyActive(AssessmentValueSet):
     """
     **Clinical Focus:** The purpose of this value set is to represent concepts for assessments to indicate vaginal intercourse.
 
@@ -115,7 +126,7 @@ class SexuallyActive(ValueSet):
     }
 
 
-class StandardizedPainAssessmentTool(ValueSet):
+class StandardizedPainAssessmentTool(AssessmentValueSet):
     """
     **Clinical Focus:** The purpose of this value set is to represent concepts for assessments using pain-focused tools or instruments to quantify pain intensity.
 
@@ -142,7 +153,7 @@ class StandardizedPainAssessmentTool(ValueSet):
     }
 
 
-class Phq9AndPhq9MTools(ValueSet):
+class Phq9AndPhq9MTools(AssessmentValueSet):
     """
     **Clinical Focus:** The purpose of this value set is to represent concepts for the assessments of PHQ 9 and PHQ 9M resulting in a completed depression assessment scores for adults and adolescents.
 
@@ -166,7 +177,7 @@ class Phq9AndPhq9MTools(ValueSet):
     }
 
 
-class AverageNumberOfDrinksPerDrinkingDay(ValueSet):
+class AverageNumberOfDrinksPerDrinkingDay(AssessmentValueSet):
     """
     **Clinical Focus:** The purpose of this value set is to represent concepts for assessments measuring the number of alcoholic drinks per drinking day.
 
@@ -189,7 +200,7 @@ class AverageNumberOfDrinksPerDrinkingDay(ValueSet):
     }
 
 
-class HistoryOfHipFractureInParent(ValueSet):
+class HistoryOfHipFractureInParent(AssessmentValueSet):
     """
     **Clinical Focus:** The purpose of this value set is to represent concepts for H145 assessments of a family history of hip fracture in a parent.
 
diff --git a/canvas_sdk/value_set/value_set.py b/canvas_sdk/value_set/value_set.py
index 9ff8d029..b74bd4db 100644
--- a/canvas_sdk/value_set/value_set.py
+++ b/canvas_sdk/value_set/value_set.py
@@ -1,6 +1,9 @@
 from collections import defaultdict
+from collections.abc import Container
 from typing import Dict, Union, cast
 
+from django.db.models import Q
+
 
 class CodeConstants:
     """A class representing different code systems and their URLs."""
@@ -103,4 +106,13 @@ class ValueSet(CodeConstantsURLMapping, metaclass=ValueSystems):
     """The Base class for a ValueSet."""
 
     values: dict[str, set]
-    pass
+
+    @staticmethod
+    def q_object(system: str, codes: Container[str]) -> Q:
+        """
+        Provide the Django Q object for the ValueSet query.
+
+        This method can be overridden if a Q object with different filtering options is needed for a
+        particular ValueSet.
+        """
+        return Q(codings__system=system, codings__code__in=codes)

From d4a85900d90a78914dad8cada9117b9f2135bb24 Mon Sep 17 00:00:00 2001
From: Christopher Sande <christopher.sande@canvasmedical.com>
Date: Fri, 1 Nov 2024 10:28:17 -0500
Subject: [PATCH 3/8] Reverted refactoring

---
 canvas_sdk/v1/data/questionnaire.py      | 14 +++++++++++-
 canvas_sdk/value_set/v2022/assessment.py | 27 +++++++-----------------
 canvas_sdk/value_set/value_set.py        | 13 ------------
 3 files changed, 21 insertions(+), 33 deletions(-)

diff --git a/canvas_sdk/v1/data/questionnaire.py b/canvas_sdk/v1/data/questionnaire.py
index 1bd8f70d..a2215b0a 100644
--- a/canvas_sdk/v1/data/questionnaire.py
+++ b/canvas_sdk/v1/data/questionnaire.py
@@ -1,4 +1,7 @@
+from collections.abc import Container
+
 from django.db import models
+from django.db.models import Q
 
 from canvas_sdk.v1.data import Patient
 from canvas_sdk.v1.data.base import (
@@ -72,6 +75,15 @@ class Meta:
     code = models.CharField()
 
 
+class QuestionnaireValueSetLookupQuerySet(ValueSetLookupByNameQuerySet):
+    """QuerySet class for Questionaire ValueSet lookups."""
+
+    @staticmethod
+    def q_object(system: str, codes: Container[str]) -> Q:
+        """The code system and code values for a Questionnaire are just attributes on the model."""
+        return Q(code_system=system, code__in=codes)
+
+
 class Questionnaire(models.Model):
     """Questionnaire."""
 
@@ -80,7 +92,7 @@ class Meta:
         app_label = "canvas_sdk"
         db_table = "canvas_sdk_data_api_questionnaire_001"
 
-    objects = models.Manager.from_queryset(ValueSetLookupByNameQuerySet)()
+    objects = models.Manager.from_queryset(QuestionnaireValueSetLookupQuerySet)()
 
     id = models.UUIDField()
     dbid = models.BigIntegerField(primary_key=True)
diff --git a/canvas_sdk/value_set/v2022/assessment.py b/canvas_sdk/value_set/v2022/assessment.py
index bf6dce1b..0c0eb54e 100644
--- a/canvas_sdk/value_set/v2022/assessment.py
+++ b/canvas_sdk/value_set/v2022/assessment.py
@@ -1,18 +1,7 @@
-from typing import Container
-
-from django.db.models import Q
-
 from ..value_set import ValueSet
 
 
-class AssessmentValueSet(ValueSet):
-    @staticmethod
-    def q_object(system: str, codes: Container[str]) -> Q:
-        """The code system and code values for a Questionnaire are just attributes on the model."""
-        return Q(code_system=system, code__in=codes)
-
-
-class TobaccoUseScreening(AssessmentValueSet):
+class TobaccoUseScreening(ValueSet):
     """
     **Clinical Focus:** The purpose of this value set is to represent concepts for assessments to screen for tobacco use.
 
@@ -38,7 +27,7 @@ class TobaccoUseScreening(AssessmentValueSet):
     }
 
 
-class FallsScreening(AssessmentValueSet):
+class FallsScreening(ValueSet):
     """
     **Clinical Focus:** The purpose of this value set is to represent concepts for assessments using a falls screening tool.
 
@@ -64,7 +53,7 @@ class FallsScreening(AssessmentValueSet):
     }
 
 
-class StandardizedToolsForAssessmentOfCognition(AssessmentValueSet):
+class StandardizedToolsForAssessmentOfCognition(ValueSet):
     """
         **Clinical Focus:** The purpose of this value set is to define concepts for assessments representing total score results for standardized tools used for the evaluation of cognition.
 
@@ -103,7 +92,7 @@ class StandardizedToolsForAssessmentOfCognition(AssessmentValueSet):
     }
 
 
-class SexuallyActive(AssessmentValueSet):
+class SexuallyActive(ValueSet):
     """
     **Clinical Focus:** The purpose of this value set is to represent concepts for assessments to indicate vaginal intercourse.
 
@@ -126,7 +115,7 @@ class SexuallyActive(AssessmentValueSet):
     }
 
 
-class StandardizedPainAssessmentTool(AssessmentValueSet):
+class StandardizedPainAssessmentTool(ValueSet):
     """
     **Clinical Focus:** The purpose of this value set is to represent concepts for assessments using pain-focused tools or instruments to quantify pain intensity.
 
@@ -153,7 +142,7 @@ class StandardizedPainAssessmentTool(AssessmentValueSet):
     }
 
 
-class Phq9AndPhq9MTools(AssessmentValueSet):
+class Phq9AndPhq9MTools(ValueSet):
     """
     **Clinical Focus:** The purpose of this value set is to represent concepts for the assessments of PHQ 9 and PHQ 9M resulting in a completed depression assessment scores for adults and adolescents.
 
@@ -177,7 +166,7 @@ class Phq9AndPhq9MTools(AssessmentValueSet):
     }
 
 
-class AverageNumberOfDrinksPerDrinkingDay(AssessmentValueSet):
+class AverageNumberOfDrinksPerDrinkingDay(ValueSet):
     """
     **Clinical Focus:** The purpose of this value set is to represent concepts for assessments measuring the number of alcoholic drinks per drinking day.
 
@@ -200,7 +189,7 @@ class AverageNumberOfDrinksPerDrinkingDay(AssessmentValueSet):
     }
 
 
-class HistoryOfHipFractureInParent(AssessmentValueSet):
+class HistoryOfHipFractureInParent(ValueSet):
     """
     **Clinical Focus:** The purpose of this value set is to represent concepts for H145 assessments of a family history of hip fracture in a parent.
 
diff --git a/canvas_sdk/value_set/value_set.py b/canvas_sdk/value_set/value_set.py
index b74bd4db..323681cf 100644
--- a/canvas_sdk/value_set/value_set.py
+++ b/canvas_sdk/value_set/value_set.py
@@ -1,9 +1,6 @@
 from collections import defaultdict
-from collections.abc import Container
 from typing import Dict, Union, cast
 
-from django.db.models import Q
-
 
 class CodeConstants:
     """A class representing different code systems and their URLs."""
@@ -106,13 +103,3 @@ class ValueSet(CodeConstantsURLMapping, metaclass=ValueSystems):
     """The Base class for a ValueSet."""
 
     values: dict[str, set]
-
-    @staticmethod
-    def q_object(system: str, codes: Container[str]) -> Q:
-        """
-        Provide the Django Q object for the ValueSet query.
-
-        This method can be overridden if a Q object with different filtering options is needed for a
-        particular ValueSet.
-        """
-        return Q(codings__system=system, codings__code__in=codes)

From e3d9149b67cd0473b7f740f9a0e7088ac01a371f Mon Sep 17 00:00:00 2001
From: Christopher Sande <christopher.sande@canvasmedical.com>
Date: Fri, 1 Nov 2024 12:55:37 -0500
Subject: [PATCH 4/8] Added dysrhythmia plugin for review

---
 hcc004v1_dysrhythmia_suspect.py | 318 ++++++++++++++++++++++++++++++++
 1 file changed, 318 insertions(+)
 create mode 100644 hcc004v1_dysrhythmia_suspect.py

diff --git a/hcc004v1_dysrhythmia_suspect.py b/hcc004v1_dysrhythmia_suspect.py
new file mode 100644
index 00000000..6d19c13f
--- /dev/null
+++ b/hcc004v1_dysrhythmia_suspect.py
@@ -0,0 +1,318 @@
+from typing import TYPE_CHECKING, Any
+
+import arrow
+from django.db.models import Q
+
+from canvas_sdk.effects import Effect
+from canvas_sdk.effects.protocol_card import ProtocolCard, Recommendation
+from canvas_sdk.events import EventType
+from canvas_sdk.protocols import BaseProtocol
+from canvas_sdk.v1.data.condition import Condition
+from canvas_sdk.v1.data.medication import Medication
+from canvas_sdk.v1.data.patient import Patient
+from canvas_sdk.value_set.value_set import ValueSet
+
+if TYPE_CHECKING:
+    from canvas_sdk.effects import Effect
+
+
+# TODO: Find a home for this
+class DysrhythmiaClassConditionSuspect(ValueSet):
+    """Dysrhythmia Class Condition suspect."""
+
+    VALUE_SET_NAME = "Dysrhythmia Class Condition suspect"
+    EXPANSION_VERSION = "CanvasHCC Update 2018-10-18"
+
+    ICD10CM = {
+        "I420",
+        "I421",
+        "I422",
+        "I423",
+        "I424",
+        "I425",
+        "I426",
+        "I427",
+        "I428",
+        "I429",
+        "I470",
+        "I471",
+        "I4710",
+        "I4711",
+        "I4719",
+        "I472",
+        "I4720",
+        "I4721",
+        "I4729",
+        "I479",
+        "I480",
+        "I481",
+        "I4811",
+        "I4819",
+        "I482",
+        "I4820",
+        "I4821",
+        "I483",
+        "I484",
+        "I4891",
+        "I4892",
+        "I4901",
+        "I4902",
+        "I491",
+        "I492",
+        "I493",
+        "I4940",
+        "I4949",
+        "I495",
+        "I498",
+        "I499",
+    }
+
+
+# TODO: Find a home for this
+class Antiarrhythmics(ValueSet):
+    """Antiarrhythmics."""
+
+    VALUE_SET_NAME = "Antiarrhythmics"
+    EXPANSION_VERSION = "ClassPath Update 18-10-15"
+
+    FDB = {
+        "150358",
+        "151807",
+        "152779",
+        "155773",
+        "157601",
+        "160121",
+        "165621",
+        "166591",
+        "169107",
+        "169508",
+        "170461",
+        "174429",
+        "175363",
+        "175494",
+        "178251",
+        "183239",
+        "184929",
+        "185830",
+        "189377",
+        "189730",
+        "190878",
+        "193821",
+        "194412",
+        "195187",
+        "196380",
+        "198310",
+        "199400",
+        "203114",
+        "205183",
+        "206598",
+        "208686",
+        "210260",
+        "210732",
+        "212898",
+        "221901",
+        "222092",
+        "223459",
+        "224332",
+        "228864",
+        "230155",
+        "237183",
+        "243776",
+        "243776",
+        "248491",
+        "248829",
+        "250272",
+        "251530",
+        "251766",
+        "260972",
+        "261266",
+        "261929",
+        "262594",
+        "265464",
+        "265785",
+        "274471",
+        "278255",
+        "278255",
+        "278255",
+        "278255",
+        "280333",
+        "281153",
+        "283306",
+        "288964",
+        "291187",
+        "296991",
+        "444249",
+        "444249",
+        "444944",
+        "444944",
+        "449494",
+        "449496",
+        "451558",
+        "451559",
+        "451560",
+        "453457",
+        "453462",
+        "454178",
+        "454180",
+        "454181",
+        "454205",
+        "454206",
+        "454207",
+        "454371",
+        "545231",
+        "545231",
+        "545232",
+        "545233",
+        "545238",
+        "545239",
+        "545239",
+        "558741",
+        "558745",
+        "559416",
+        "560050",
+        "563304",
+        "563305",
+        "563306",
+        "563310",
+        "564459",
+        "564460",
+        "565068",
+        "565069",
+        "573523",
+        "583982",
+        "583982",
+        "583985",
+        "583985",
+        "590326",
+        "590375",
+        "590376",
+        "591479",
+        "592349",
+        "592421",
+        "594710",
+        "594714",
+    }
+
+
+class Protocol(BaseProtocol):
+    """Dysrhythmia Suspects."""
+
+    # TODO: Add ProtocolOverride event types
+    RESPONDS_TO = [
+        EventType.Name(EventType.CONDITION_CREATED),
+        EventType.Name(EventType.CONDITION_UPDATED),
+        EventType.Name(EventType.MEDICATION_LIST_ITEM_CREATED),
+        EventType.Name(EventType.MEDICATION_LIST_ITEM_UPDATED),
+    ]
+
+    def __init__(self, *args: Any, **kwargs: Any) -> None:
+        super().__init__(*args, **kwargs)
+        self.patient_id = self.patient_id_from_event()
+
+    # TODO: Getting the patient or patient ID from an objects seems like something that will happen
+    #  a lot. Should this be standardized in a base class? On the flip side, the fields needed from
+    #  a patient may not be standard. Maybe a simple, standard, efficient way to get a patient ID
+    #  from a target is a good place to start.
+    def patient_id_from_event(self) -> str:
+        """Get the patient ID from the event target."""
+        # TODO: Add cases for ProtocolOverride
+        match self.event.type:
+            case EventType.CONDITION_CREATED | EventType.CONDITION_UPDATED:
+                model = Condition
+            case EventType.MEDICATION_LIST_ITEM_CREATED | EventType.MEDICATION_LIST_ITEM_UPDATED:
+                model = Medication
+            case _:
+                raise AssertionError(
+                    f"Event type {self.event.type} not supported by 'patient_id_from_event'"
+                )
+
+        return (
+            model.objects.select_related("patient")
+            .values_list("patient__id")
+            .get(id=self.event.target)[0]
+        )
+
+    def in_denominator(self) -> bool:
+        """
+        Patients with any active medication in Antiarrhythmics Drug Class.
+        """
+        # TODO: Settable time frame is not currently supported — where would it come from?
+        time_frame_provided = False
+        if not time_frame_provided:
+            # TODO: Should these datetimes be based on local time or UTC time?
+            time_frame_end = arrow.get()
+            time_frame_start = time_frame_end.shift(years=-1)
+        else:
+            raise RuntimeError("Time frame is not settable")
+
+        # TODO: Is the status field used at all for medications, or is filtering done just with start/end dates?
+        qs = Medication.objects.filter(patient__id=self.patient_id, start_date__lte=time_frame_end)
+
+        # TODO: still_active=False is not currently supported — where would the value come from?
+        still_active = True
+        if still_active:
+            return qs.filter(Q(end_date__isnull=True) | Q(end_date__gte=time_frame_end)).exists()
+        else:
+            return qs.filter(Q(end_date__isnull=True) | Q(end_date__gte=time_frame_start)).exists()
+
+    def in_numerator(self) -> bool:
+        """
+        Patients without active conditions within the list with ICD 10 I42.* I47.*, I48.*, I49.*.
+        """
+        # TODO: Settable time frame is not currently supported — where would it come from?
+        time_frame_provided = False
+        if not time_frame_provided:
+            # TODO: Should these datetimes be based on local time or UTC time?
+            time_frame_end = arrow.get()
+            time_frame_start = time_frame_end.shift(years=-1)
+        else:
+            raise RuntimeError("Time frame is not settable")
+
+        # TODO: Is the status field used at all for conditions, or is filtering done just with start/end dates?
+        qs = Condition.objects.filter(patient__id=self.patient_id, onset_date__lte=time_frame_end)
+
+        # TODO: still_active=False is not currently supported — where would the value come from?
+        still_active = True
+        if still_active:
+            return qs.filter(
+                Q(resolution_date__isnull=True) | Q(resolution__gte=time_frame_end)
+            ).exists()
+        else:
+            return qs.filter(
+                Q(resolution_date__isnull=True) | Q(resolution_date__gte=time_frame_start)
+            ).exists()
+
+    def compute(self) -> list[Effect]:
+        """Return a ProtocolCard effect if the patient is in both the denominator and numerator."""
+        if self.in_denominator():
+            if self.in_numerator():
+                first_name = Patient.objects.values_list("first_name").get(id=self.patient_id)[0]
+
+                title = "Consider updating the Conditions List to include Dysrhythmia related problem as clinically appropriate."
+                narrative = f"{first_name} has an active medication on the Medication List commonly used for Dysrhythmia. There is no associated condition on the Conditions List."
+
+                card = ProtocolCard(
+                    patient_id=self.patient_id,
+                    key="HCC004v1_RECOMMEND_DIAGNOSE_DYSRHYTHMIA",
+                    title=title,
+                    narrative=narrative,
+                    recommendations=[
+                        Recommendation(
+                            title=title,
+                            button="Diagnose",
+                            # TODO: Is the HREF value needed?
+                            # href=None,
+                            command={"key": "diagnose"},
+                            # TODO: Is the context value needed?
+                            # context=None
+                        )
+                    ],
+                    status=ProtocolCard.Status.DUE,
+                )
+
+                return [card.apply()]
+            else:
+                # TODO: Is an effect required if patient is in denominator but not in numerator?
+                pass
+
+        return []

From c7aa83b92782f6b4f98a9d0629ce648b41e2be87 Mon Sep 17 00:00:00 2001
From: Christopher Sande <christopher.sande@canvasmedical.com>
Date: Fri, 1 Nov 2024 16:12:56 -0500
Subject: [PATCH 5/8] Remove gettext_lazy

---
 canvas_sdk/v1/data/protocol_override.py | 11 +++++------
 1 file changed, 5 insertions(+), 6 deletions(-)

diff --git a/canvas_sdk/v1/data/protocol_override.py b/canvas_sdk/v1/data/protocol_override.py
index 70a21a84..a128eb78 100644
--- a/canvas_sdk/v1/data/protocol_override.py
+++ b/canvas_sdk/v1/data/protocol_override.py
@@ -1,5 +1,4 @@
 from django.db import models
-from django.utils.translation import gettext_lazy as _
 
 from canvas_sdk.v1.data.base import CommittableModelManager
 from canvas_sdk.v1.data.patient import Patient
@@ -9,16 +8,16 @@
 class IntervalUnit(models.TextChoices):
     """ProtocolOverride cycle IntervalUnit."""
 
-    DAYS = "days", _("days")
-    MONTHS = "months", _("months")
-    YEARS = "years", _("years")
+    DAYS = "days", "days"
+    MONTHS = "months", "months"
+    YEARS = "years", "years"
 
 
 class Status(models.TextChoices):
     """ProtocolOverride Status."""
 
-    ACTIVE = "active", _("active")
-    INACTIVE = "inactive", _("inactive")
+    ACTIVE = "active", "active"
+    INACTIVE = "inactive", "inactive"
 
 
 class ProtocolOverride(models.Model):

From b139a3b0cb329f905b23cc7a9a134a75ece29f5d Mon Sep 17 00:00:00 2001
From: Christopher Sande <christopher.sande@canvasmedical.com>
Date: Wed, 6 Nov 2024 16:39:00 -0600
Subject: [PATCH 6/8] Misc changes for dysrhythmia plugin

---
 canvas_sdk/v1/data/condition.py        |  12 ++
 canvas_sdk/v1/data/medication.py       |  14 +-
 canvas_sdk/value_set/__init__.py       |   0
 canvas_sdk/value_set/custom.py         | 177 +++++++++++++++++++++++++
 canvas_sdk/value_set/v2022/__init__.py |   0
 5 files changed, 200 insertions(+), 3 deletions(-)
 create mode 100644 canvas_sdk/value_set/__init__.py
 create mode 100644 canvas_sdk/value_set/custom.py
 create mode 100644 canvas_sdk/value_set/v2022/__init__.py

diff --git a/canvas_sdk/v1/data/condition.py b/canvas_sdk/v1/data/condition.py
index 10afd58b..2e6f6d68 100644
--- a/canvas_sdk/v1/data/condition.py
+++ b/canvas_sdk/v1/data/condition.py
@@ -1,10 +1,21 @@
 from django.db import models
+from django.db.models import TextChoices
 
 from canvas_sdk.v1.data.base import CommittableModelManager, ValueSetLookupQuerySet
 from canvas_sdk.v1.data.patient import Patient
 from canvas_sdk.v1.data.user import CanvasUser
 
 
+class ClinicalStatus(TextChoices):
+    """Condition clinical status."""
+
+    ACTIVE = "active", "active"
+    RELAPSE = "relapse", "relapse"
+    REMISSION = "remission", "remission"
+    RESOLVED = "resolved", "resolved"
+    INVESTIGATIVE = "investigative", "investigative"
+
+
 class ConditionQuerySet(ValueSetLookupQuerySet):
     """ConditionQuerySet."""
 
@@ -25,6 +36,7 @@ class Meta:
     dbid = models.BigIntegerField(primary_key=True)
     onset_date = models.DateField()
     resolution_date = models.DateField()
+    clinical_status = models.CharField(choices=ClinicalStatus.choices)
     deleted = models.BooleanField()
     entered_in_error = models.ForeignKey(CanvasUser, on_delete=models.DO_NOTHING)
     committer = models.ForeignKey(CanvasUser, on_delete=models.DO_NOTHING)
diff --git a/canvas_sdk/v1/data/medication.py b/canvas_sdk/v1/data/medication.py
index e13061b2..14ab3a4a 100644
--- a/canvas_sdk/v1/data/medication.py
+++ b/canvas_sdk/v1/data/medication.py
@@ -1,10 +1,18 @@
 from django.db import models
+from django.db.models import TextChoices
 
 from canvas_sdk.v1.data.base import CommittableModelManager, ValueSetLookupQuerySet
 from canvas_sdk.v1.data.patient import Patient
 from canvas_sdk.v1.data.user import CanvasUser
 
 
+class Status(TextChoices):
+    """Medication status."""
+
+    ACTIVE = "active", "active"
+    INACTIVE = "inactive", "inactive"
+
+
 class MedicationQuerySet(ValueSetLookupQuerySet):
     """MedicationQuerySet."""
 
@@ -27,9 +35,9 @@ class Meta:
     deleted = models.BooleanField()
     entered_in_error = models.ForeignKey(CanvasUser, on_delete=models.DO_NOTHING)
     committer = models.ForeignKey(CanvasUser, on_delete=models.DO_NOTHING)
-    status = models.CharField()
-    start_date = models.DateField()
-    end_date = models.DateField()
+    status = models.CharField(choices=Status.choices)
+    start_date = models.DateTimeField()
+    end_date = models.DateTimeField()
     quantity_qualifier_description = models.CharField()
     clinical_quantity_description = models.CharField()
     potency_unit_code = models.CharField()
diff --git a/canvas_sdk/value_set/__init__.py b/canvas_sdk/value_set/__init__.py
new file mode 100644
index 00000000..e69de29b
diff --git a/canvas_sdk/value_set/custom.py b/canvas_sdk/value_set/custom.py
new file mode 100644
index 00000000..759cbc58
--- /dev/null
+++ b/canvas_sdk/value_set/custom.py
@@ -0,0 +1,177 @@
+from canvas_sdk.value_set.value_set import ValueSet
+
+
+class DysrhythmiaClassConditionSuspect(ValueSet):
+    """Dysrhythmia Class Condition suspect."""
+
+    VALUE_SET_NAME = "Dysrhythmia Class Condition suspect"
+    EXPANSION_VERSION = "CanvasHCC Update 2024-11-04"
+
+    ICD10CM = {
+        "I420",
+        "I421",
+        "I422",
+        "I423",
+        "I424",
+        "I425",
+        "I426",
+        "I427",
+        "I428",
+        "I429",
+        "I470",
+        "I471",
+        "I4710",
+        "I4711",
+        "I4719",
+        "I472",
+        "I4720",
+        "I4721",
+        "I4729",
+        "I479",
+        "I480",
+        "I481",
+        "I4811",
+        "I4819",
+        "I482",
+        "I4820",
+        "I4821",
+        "I483",
+        "I484",
+        "I4891",
+        "I4892",
+        "I4901",
+        "I4902",
+        "I491",
+        "I492",
+        "I493",
+        "I4940",
+        "I4949",
+        "I495",
+        "I498",
+        "I499",
+    }
+
+
+class Antiarrhythmics(ValueSet):
+    """Antiarrhythmics."""
+
+    VALUE_SET_NAME = "Antiarrhythmics"
+    EXPANSION_VERSION = "ClassPath Update 18-10-15"
+
+    FDB = {
+        "150358",
+        "151807",
+        "152779",
+        "155773",
+        "157601",
+        "160121",
+        "165621",
+        "166591",
+        "169107",
+        "169508",
+        "170461",
+        "174429",
+        "175363",
+        "175494",
+        "178251",
+        "183239",
+        "184929",
+        "185830",
+        "189377",
+        "189730",
+        "190878",
+        "193821",
+        "194412",
+        "195187",
+        "196380",
+        "198310",
+        "199400",
+        "203114",
+        "205183",
+        "206598",
+        "208686",
+        "210260",
+        "210732",
+        "212898",
+        "221901",
+        "222092",
+        "223459",
+        "224332",
+        "228864",
+        "230155",
+        "237183",
+        "243776",
+        "243776",
+        "248491",
+        "248829",
+        "250272",
+        "251530",
+        "251766",
+        "260972",
+        "261266",
+        "261929",
+        "262594",
+        "265464",
+        "265785",
+        "274471",
+        "278255",
+        "278255",
+        "278255",
+        "278255",
+        "280333",
+        "281153",
+        "283306",
+        "288964",
+        "291187",
+        "296991",
+        "444249",
+        "444249",
+        "444944",
+        "444944",
+        "449494",
+        "449496",
+        "451558",
+        "451559",
+        "451560",
+        "453457",
+        "453462",
+        "454178",
+        "454180",
+        "454181",
+        "454205",
+        "454206",
+        "454207",
+        "454371",
+        "545231",
+        "545231",
+        "545232",
+        "545233",
+        "545238",
+        "545239",
+        "545239",
+        "558741",
+        "558745",
+        "559416",
+        "560050",
+        "563304",
+        "563305",
+        "563306",
+        "563310",
+        "564459",
+        "564460",
+        "565068",
+        "565069",
+        "573523",
+        "583982",
+        "583982",
+        "583985",
+        "583985",
+        "590326",
+        "590375",
+        "590376",
+        "591479",
+        "592349",
+        "592421",
+        "594710",
+        "594714",
+    }
diff --git a/canvas_sdk/value_set/v2022/__init__.py b/canvas_sdk/value_set/v2022/__init__.py
new file mode 100644
index 00000000..e69de29b

From fe192d4d924132ab5d403f0f6110fd01a37b7c3a Mon Sep 17 00:00:00 2001
From: Christopher Sande <christopher.sande@canvasmedical.com>
Date: Thu, 7 Nov 2024 12:39:52 -0600
Subject: [PATCH 7/8] Reverted a few changes

---
 canvas_sdk/v1/data/condition.py  |  12 ---
 canvas_sdk/v1/data/medication.py |  14 +--
 canvas_sdk/value_set/custom.py   | 177 -------------------------------
 3 files changed, 3 insertions(+), 200 deletions(-)
 delete mode 100644 canvas_sdk/value_set/custom.py

diff --git a/canvas_sdk/v1/data/condition.py b/canvas_sdk/v1/data/condition.py
index 2e6f6d68..10afd58b 100644
--- a/canvas_sdk/v1/data/condition.py
+++ b/canvas_sdk/v1/data/condition.py
@@ -1,21 +1,10 @@
 from django.db import models
-from django.db.models import TextChoices
 
 from canvas_sdk.v1.data.base import CommittableModelManager, ValueSetLookupQuerySet
 from canvas_sdk.v1.data.patient import Patient
 from canvas_sdk.v1.data.user import CanvasUser
 
 
-class ClinicalStatus(TextChoices):
-    """Condition clinical status."""
-
-    ACTIVE = "active", "active"
-    RELAPSE = "relapse", "relapse"
-    REMISSION = "remission", "remission"
-    RESOLVED = "resolved", "resolved"
-    INVESTIGATIVE = "investigative", "investigative"
-
-
 class ConditionQuerySet(ValueSetLookupQuerySet):
     """ConditionQuerySet."""
 
@@ -36,7 +25,6 @@ class Meta:
     dbid = models.BigIntegerField(primary_key=True)
     onset_date = models.DateField()
     resolution_date = models.DateField()
-    clinical_status = models.CharField(choices=ClinicalStatus.choices)
     deleted = models.BooleanField()
     entered_in_error = models.ForeignKey(CanvasUser, on_delete=models.DO_NOTHING)
     committer = models.ForeignKey(CanvasUser, on_delete=models.DO_NOTHING)
diff --git a/canvas_sdk/v1/data/medication.py b/canvas_sdk/v1/data/medication.py
index 14ab3a4a..e13061b2 100644
--- a/canvas_sdk/v1/data/medication.py
+++ b/canvas_sdk/v1/data/medication.py
@@ -1,18 +1,10 @@
 from django.db import models
-from django.db.models import TextChoices
 
 from canvas_sdk.v1.data.base import CommittableModelManager, ValueSetLookupQuerySet
 from canvas_sdk.v1.data.patient import Patient
 from canvas_sdk.v1.data.user import CanvasUser
 
 
-class Status(TextChoices):
-    """Medication status."""
-
-    ACTIVE = "active", "active"
-    INACTIVE = "inactive", "inactive"
-
-
 class MedicationQuerySet(ValueSetLookupQuerySet):
     """MedicationQuerySet."""
 
@@ -35,9 +27,9 @@ class Meta:
     deleted = models.BooleanField()
     entered_in_error = models.ForeignKey(CanvasUser, on_delete=models.DO_NOTHING)
     committer = models.ForeignKey(CanvasUser, on_delete=models.DO_NOTHING)
-    status = models.CharField(choices=Status.choices)
-    start_date = models.DateTimeField()
-    end_date = models.DateTimeField()
+    status = models.CharField()
+    start_date = models.DateField()
+    end_date = models.DateField()
     quantity_qualifier_description = models.CharField()
     clinical_quantity_description = models.CharField()
     potency_unit_code = models.CharField()
diff --git a/canvas_sdk/value_set/custom.py b/canvas_sdk/value_set/custom.py
deleted file mode 100644
index 759cbc58..00000000
--- a/canvas_sdk/value_set/custom.py
+++ /dev/null
@@ -1,177 +0,0 @@
-from canvas_sdk.value_set.value_set import ValueSet
-
-
-class DysrhythmiaClassConditionSuspect(ValueSet):
-    """Dysrhythmia Class Condition suspect."""
-
-    VALUE_SET_NAME = "Dysrhythmia Class Condition suspect"
-    EXPANSION_VERSION = "CanvasHCC Update 2024-11-04"
-
-    ICD10CM = {
-        "I420",
-        "I421",
-        "I422",
-        "I423",
-        "I424",
-        "I425",
-        "I426",
-        "I427",
-        "I428",
-        "I429",
-        "I470",
-        "I471",
-        "I4710",
-        "I4711",
-        "I4719",
-        "I472",
-        "I4720",
-        "I4721",
-        "I4729",
-        "I479",
-        "I480",
-        "I481",
-        "I4811",
-        "I4819",
-        "I482",
-        "I4820",
-        "I4821",
-        "I483",
-        "I484",
-        "I4891",
-        "I4892",
-        "I4901",
-        "I4902",
-        "I491",
-        "I492",
-        "I493",
-        "I4940",
-        "I4949",
-        "I495",
-        "I498",
-        "I499",
-    }
-
-
-class Antiarrhythmics(ValueSet):
-    """Antiarrhythmics."""
-
-    VALUE_SET_NAME = "Antiarrhythmics"
-    EXPANSION_VERSION = "ClassPath Update 18-10-15"
-
-    FDB = {
-        "150358",
-        "151807",
-        "152779",
-        "155773",
-        "157601",
-        "160121",
-        "165621",
-        "166591",
-        "169107",
-        "169508",
-        "170461",
-        "174429",
-        "175363",
-        "175494",
-        "178251",
-        "183239",
-        "184929",
-        "185830",
-        "189377",
-        "189730",
-        "190878",
-        "193821",
-        "194412",
-        "195187",
-        "196380",
-        "198310",
-        "199400",
-        "203114",
-        "205183",
-        "206598",
-        "208686",
-        "210260",
-        "210732",
-        "212898",
-        "221901",
-        "222092",
-        "223459",
-        "224332",
-        "228864",
-        "230155",
-        "237183",
-        "243776",
-        "243776",
-        "248491",
-        "248829",
-        "250272",
-        "251530",
-        "251766",
-        "260972",
-        "261266",
-        "261929",
-        "262594",
-        "265464",
-        "265785",
-        "274471",
-        "278255",
-        "278255",
-        "278255",
-        "278255",
-        "280333",
-        "281153",
-        "283306",
-        "288964",
-        "291187",
-        "296991",
-        "444249",
-        "444249",
-        "444944",
-        "444944",
-        "449494",
-        "449496",
-        "451558",
-        "451559",
-        "451560",
-        "453457",
-        "453462",
-        "454178",
-        "454180",
-        "454181",
-        "454205",
-        "454206",
-        "454207",
-        "454371",
-        "545231",
-        "545231",
-        "545232",
-        "545233",
-        "545238",
-        "545239",
-        "545239",
-        "558741",
-        "558745",
-        "559416",
-        "560050",
-        "563304",
-        "563305",
-        "563306",
-        "563310",
-        "564459",
-        "564460",
-        "565068",
-        "565069",
-        "573523",
-        "583982",
-        "583982",
-        "583985",
-        "583985",
-        "590326",
-        "590375",
-        "590376",
-        "591479",
-        "592349",
-        "592421",
-        "594710",
-        "594714",
-    }

From a3aafc42bf2c5b11ba8a7d77c8f179fa0aa652e7 Mon Sep 17 00:00:00 2001
From: Christopher Sande <christopher.sande@canvasmedical.com>
Date: Mon, 11 Nov 2024 15:01:01 -0600
Subject: [PATCH 8/8] Deleted file

---
 hcc004v1_dysrhythmia_suspect.py | 318 --------------------------------
 1 file changed, 318 deletions(-)
 delete mode 100644 hcc004v1_dysrhythmia_suspect.py

diff --git a/hcc004v1_dysrhythmia_suspect.py b/hcc004v1_dysrhythmia_suspect.py
deleted file mode 100644
index 6d19c13f..00000000
--- a/hcc004v1_dysrhythmia_suspect.py
+++ /dev/null
@@ -1,318 +0,0 @@
-from typing import TYPE_CHECKING, Any
-
-import arrow
-from django.db.models import Q
-
-from canvas_sdk.effects import Effect
-from canvas_sdk.effects.protocol_card import ProtocolCard, Recommendation
-from canvas_sdk.events import EventType
-from canvas_sdk.protocols import BaseProtocol
-from canvas_sdk.v1.data.condition import Condition
-from canvas_sdk.v1.data.medication import Medication
-from canvas_sdk.v1.data.patient import Patient
-from canvas_sdk.value_set.value_set import ValueSet
-
-if TYPE_CHECKING:
-    from canvas_sdk.effects import Effect
-
-
-# TODO: Find a home for this
-class DysrhythmiaClassConditionSuspect(ValueSet):
-    """Dysrhythmia Class Condition suspect."""
-
-    VALUE_SET_NAME = "Dysrhythmia Class Condition suspect"
-    EXPANSION_VERSION = "CanvasHCC Update 2018-10-18"
-
-    ICD10CM = {
-        "I420",
-        "I421",
-        "I422",
-        "I423",
-        "I424",
-        "I425",
-        "I426",
-        "I427",
-        "I428",
-        "I429",
-        "I470",
-        "I471",
-        "I4710",
-        "I4711",
-        "I4719",
-        "I472",
-        "I4720",
-        "I4721",
-        "I4729",
-        "I479",
-        "I480",
-        "I481",
-        "I4811",
-        "I4819",
-        "I482",
-        "I4820",
-        "I4821",
-        "I483",
-        "I484",
-        "I4891",
-        "I4892",
-        "I4901",
-        "I4902",
-        "I491",
-        "I492",
-        "I493",
-        "I4940",
-        "I4949",
-        "I495",
-        "I498",
-        "I499",
-    }
-
-
-# TODO: Find a home for this
-class Antiarrhythmics(ValueSet):
-    """Antiarrhythmics."""
-
-    VALUE_SET_NAME = "Antiarrhythmics"
-    EXPANSION_VERSION = "ClassPath Update 18-10-15"
-
-    FDB = {
-        "150358",
-        "151807",
-        "152779",
-        "155773",
-        "157601",
-        "160121",
-        "165621",
-        "166591",
-        "169107",
-        "169508",
-        "170461",
-        "174429",
-        "175363",
-        "175494",
-        "178251",
-        "183239",
-        "184929",
-        "185830",
-        "189377",
-        "189730",
-        "190878",
-        "193821",
-        "194412",
-        "195187",
-        "196380",
-        "198310",
-        "199400",
-        "203114",
-        "205183",
-        "206598",
-        "208686",
-        "210260",
-        "210732",
-        "212898",
-        "221901",
-        "222092",
-        "223459",
-        "224332",
-        "228864",
-        "230155",
-        "237183",
-        "243776",
-        "243776",
-        "248491",
-        "248829",
-        "250272",
-        "251530",
-        "251766",
-        "260972",
-        "261266",
-        "261929",
-        "262594",
-        "265464",
-        "265785",
-        "274471",
-        "278255",
-        "278255",
-        "278255",
-        "278255",
-        "280333",
-        "281153",
-        "283306",
-        "288964",
-        "291187",
-        "296991",
-        "444249",
-        "444249",
-        "444944",
-        "444944",
-        "449494",
-        "449496",
-        "451558",
-        "451559",
-        "451560",
-        "453457",
-        "453462",
-        "454178",
-        "454180",
-        "454181",
-        "454205",
-        "454206",
-        "454207",
-        "454371",
-        "545231",
-        "545231",
-        "545232",
-        "545233",
-        "545238",
-        "545239",
-        "545239",
-        "558741",
-        "558745",
-        "559416",
-        "560050",
-        "563304",
-        "563305",
-        "563306",
-        "563310",
-        "564459",
-        "564460",
-        "565068",
-        "565069",
-        "573523",
-        "583982",
-        "583982",
-        "583985",
-        "583985",
-        "590326",
-        "590375",
-        "590376",
-        "591479",
-        "592349",
-        "592421",
-        "594710",
-        "594714",
-    }
-
-
-class Protocol(BaseProtocol):
-    """Dysrhythmia Suspects."""
-
-    # TODO: Add ProtocolOverride event types
-    RESPONDS_TO = [
-        EventType.Name(EventType.CONDITION_CREATED),
-        EventType.Name(EventType.CONDITION_UPDATED),
-        EventType.Name(EventType.MEDICATION_LIST_ITEM_CREATED),
-        EventType.Name(EventType.MEDICATION_LIST_ITEM_UPDATED),
-    ]
-
-    def __init__(self, *args: Any, **kwargs: Any) -> None:
-        super().__init__(*args, **kwargs)
-        self.patient_id = self.patient_id_from_event()
-
-    # TODO: Getting the patient or patient ID from an objects seems like something that will happen
-    #  a lot. Should this be standardized in a base class? On the flip side, the fields needed from
-    #  a patient may not be standard. Maybe a simple, standard, efficient way to get a patient ID
-    #  from a target is a good place to start.
-    def patient_id_from_event(self) -> str:
-        """Get the patient ID from the event target."""
-        # TODO: Add cases for ProtocolOverride
-        match self.event.type:
-            case EventType.CONDITION_CREATED | EventType.CONDITION_UPDATED:
-                model = Condition
-            case EventType.MEDICATION_LIST_ITEM_CREATED | EventType.MEDICATION_LIST_ITEM_UPDATED:
-                model = Medication
-            case _:
-                raise AssertionError(
-                    f"Event type {self.event.type} not supported by 'patient_id_from_event'"
-                )
-
-        return (
-            model.objects.select_related("patient")
-            .values_list("patient__id")
-            .get(id=self.event.target)[0]
-        )
-
-    def in_denominator(self) -> bool:
-        """
-        Patients with any active medication in Antiarrhythmics Drug Class.
-        """
-        # TODO: Settable time frame is not currently supported — where would it come from?
-        time_frame_provided = False
-        if not time_frame_provided:
-            # TODO: Should these datetimes be based on local time or UTC time?
-            time_frame_end = arrow.get()
-            time_frame_start = time_frame_end.shift(years=-1)
-        else:
-            raise RuntimeError("Time frame is not settable")
-
-        # TODO: Is the status field used at all for medications, or is filtering done just with start/end dates?
-        qs = Medication.objects.filter(patient__id=self.patient_id, start_date__lte=time_frame_end)
-
-        # TODO: still_active=False is not currently supported — where would the value come from?
-        still_active = True
-        if still_active:
-            return qs.filter(Q(end_date__isnull=True) | Q(end_date__gte=time_frame_end)).exists()
-        else:
-            return qs.filter(Q(end_date__isnull=True) | Q(end_date__gte=time_frame_start)).exists()
-
-    def in_numerator(self) -> bool:
-        """
-        Patients without active conditions within the list with ICD 10 I42.* I47.*, I48.*, I49.*.
-        """
-        # TODO: Settable time frame is not currently supported — where would it come from?
-        time_frame_provided = False
-        if not time_frame_provided:
-            # TODO: Should these datetimes be based on local time or UTC time?
-            time_frame_end = arrow.get()
-            time_frame_start = time_frame_end.shift(years=-1)
-        else:
-            raise RuntimeError("Time frame is not settable")
-
-        # TODO: Is the status field used at all for conditions, or is filtering done just with start/end dates?
-        qs = Condition.objects.filter(patient__id=self.patient_id, onset_date__lte=time_frame_end)
-
-        # TODO: still_active=False is not currently supported — where would the value come from?
-        still_active = True
-        if still_active:
-            return qs.filter(
-                Q(resolution_date__isnull=True) | Q(resolution__gte=time_frame_end)
-            ).exists()
-        else:
-            return qs.filter(
-                Q(resolution_date__isnull=True) | Q(resolution_date__gte=time_frame_start)
-            ).exists()
-
-    def compute(self) -> list[Effect]:
-        """Return a ProtocolCard effect if the patient is in both the denominator and numerator."""
-        if self.in_denominator():
-            if self.in_numerator():
-                first_name = Patient.objects.values_list("first_name").get(id=self.patient_id)[0]
-
-                title = "Consider updating the Conditions List to include Dysrhythmia related problem as clinically appropriate."
-                narrative = f"{first_name} has an active medication on the Medication List commonly used for Dysrhythmia. There is no associated condition on the Conditions List."
-
-                card = ProtocolCard(
-                    patient_id=self.patient_id,
-                    key="HCC004v1_RECOMMEND_DIAGNOSE_DYSRHYTHMIA",
-                    title=title,
-                    narrative=narrative,
-                    recommendations=[
-                        Recommendation(
-                            title=title,
-                            button="Diagnose",
-                            # TODO: Is the HREF value needed?
-                            # href=None,
-                            command={"key": "diagnose"},
-                            # TODO: Is the context value needed?
-                            # context=None
-                        )
-                    ],
-                    status=ProtocolCard.Status.DUE,
-                )
-
-                return [card.apply()]
-            else:
-                # TODO: Is an effect required if patient is in denominator but not in numerator?
-                pass
-
-        return []