<?php

/**
 * Functions to support parsing and saving hl7 results.
 *
 * Copyright (C) 2013-2016 Rod Roark <rod@sunsetsystems.com>
 * Copyright (C) 2017-2020 Jerry Padgett <sjpadgett@gmail.com>
 *
 * LICENSE: This program is free software; you can redistribute it and/or
 * modify it under the terms of the GNU General Public License
 * as published by the Free Software Foundation; either version 2
 * of the License, or (at your option) any later version.
 * This program is distributed in the hope that it will be useful,
 * but WITHOUT ANY WARRANTY; without even the implied warranty of
 * MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE.  See the
 * GNU General Public License for more details.
 * You should have received a copy of the GNU General Public License
 * along with this program.  If not, see <http://opensource.org/licenses/gpl-license.php>.
 *
 * @package OpenEMR
 * @author  Rod Roark <rod@sunsetsystems.com>
 * @author  Jerry Padgett <sjpadgett@gmail.com>
 * 07-2015: Ensoftek: Edited for MU2 170.314(b)(5)(A)
 */

require_once($GLOBALS['srcdir'] . "/forms.inc");
require_once($GLOBALS['srcdir'] . "/pnotes.inc");

use OpenEMR\Common\Crypto\CryptoGen;
use OpenEMR\Common\Logging\EventAuditLogger;
use phpseclib\Net\SFTP;

$rhl7_return = array();

function parseZPS($segment)
{
    $composites = $segment; //explode('|', $segment);

    // Try to parse composites
    foreach ($composites as $key => $composite) {
        // If it is a composite ...
        if (!(strpos($composite, '^') === false)) {
            $composites[$key] = explode('^', $composite);
        }
    }

    // Find out where we are
    $pos = 0;

    [
        $__garbage, // Skip index [0], it's the type
        $zps[$pos]['set_id'],
        $zps[$pos]['lab_id'],
        $zps[$pos]['lab_name'],
        $zps[$pos]['lab_address'],
        $zps[$pos]['lab_phone'],
        $__garbage,
        $zps[$pos]['lab_director'],
        $__garbage,
        $zps[$pos]['lab_clia']
    ] = $composites;
    $labdir = $zps[0]['lab_director'][0] . " " . $zps[0]['lab_director'][1] . ", " . $zps[0]['lab_director'][2];
    $address = $zps[0]['lab_address'][0] . "\n" . $zps[0]['lab_address'][2] . " " . $zps[0]['lab_address'][3] .
        " " . $zps[0]['lab_address'][4];
    $r = $zps[0]['lab_name'] . "\n" . $address . "\n" . $zps[0]['lab_phone'] . "\n" . $labdir . "\n";
    return $r;
}

function rhl7LogMsg($msg, $fatal = true)
{
    global $rhl7_return;
    if ($fatal) {
        $rhl7_return['mssgs'][] = '*' . $msg;
        $rhl7_return['fatal'] = true;
        EventAuditLogger::instance()->newEvent(
            "lab-results-error",
            $_SESSION['authUser'],
            $_SESSION['authProvider'],
            0,
            $msg
        );
    } else {
        $rhl7_return['mssgs'][] = '>' . $msg;
    }

    return $rhl7_return;
}

function rhl7InsertRow(&$arr, $tablename)
{
    if (empty($arr)) {
        return;
    }

    // echo "<!-- ";   // debugging
    // print_r($arr);
    // echo " -->\n";

    $query = "INSERT INTO $tablename SET";
    $binds = array();
    $sep = '';
    foreach ($arr as $key => $value) {
        $query .= "$sep `$key` = ?";
        $sep = ',';
        $binds[] = $value;
    }

    $arr = array();
    return sqlInsert($query, $binds);
}

// Write all of the accumulated reports and their results.
function rhl7FlushMain(&$amain, $commentdelim = "\n")
{
    foreach ($amain as $arr) {
        if (!isset($amain[0]['rep']['procedure_order_id'])) {
            if (!isset($arr['rep']['procedure_order_id'])) {
                continue;
            } elseif (isset($amain[0]['rep']['report_notes'])) {
                $arr['rep']['report_notes'] .= $amain[0]['rep']['report_notes'];
                unset($amain[0]);
            }
        }
        $procedure_report_id = rhl7InsertRow($arr['rep'], 'procedure_report');
        foreach ($arr['res'] as $ares) {
            $ares['procedure_report_id'] = $procedure_report_id;
            // obxkey was used to identify parent results but is not stored.
            unset($ares['obxkey']);
            // If TX result is not over 10 characters, move it from comments to result field.
            if ($ares['result'] === '' && $ares['result_data_type'] == 'L') {
                $i = strpos($ares['comments'], $commentdelim);
                if ($i && $i <= 10) {
                    $ares['result'] = substr($ares['comments'], 0, $i);
                    $ares['comments'] = substr($ares['comments'], $i);
                }
            }

            rhl7InsertRow($ares, 'procedure_result');
        }
    }
}

// Write the MDM document if appropriate.
//
function rhl7FlushMDM($patient_id, $mdm_docname, $mdm_datetime, $mdm_text, $mdm_category_id, $provider)
{
    if ($patient_id) {
        if (!empty($mdm_docname)) {
            $mdm_docname .= '_';
        }

        $mdm_docname .= preg_replace('/[^0-9]/', '', $mdm_datetime);
        $filename = $mdm_docname . '.txt';
        $d = new Document();
        $rc = $d->createDocument($patient_id, $mdm_category_id, $filename, 'text/plain', $mdm_text);
        if (!$rc) {
            rhl7LogMsg(xl('Document created') . ": $filename", false);
            if ($provider) {
                $d->postPatientNote($provider, $mdm_category_id, xl('Electronic document received'));
                rhl7LogMsg(xl('Notification sent to') . ": $provider", false);
            } else {
                rhl7LogMsg(xl('No provider was matched'), false);
            }
        }

        return $rc;
    }

    return '';
}

function rhl7Text($s, $allow_newlines = false)
{
    $s = str_replace('\\S\\', '^', $s);
    $s = str_replace('\\F\\', '|', $s);
    $s = str_replace('\\R\\', '~', $s);
    $s = str_replace('\\T\\', '&', $s);
    $s = str_replace('\\X0d\\', "\r", $s);
    $s = str_replace('\\E\\', '\\', $s);
    if ($allow_newlines) {
        $s = str_replace('\\.br\\', "\n", $s);
    } else {
        $s = str_replace('\\.br\\', '~', $s);
    }

    return $s;
}

function rhl7DateTime($s)
{
    // Remove UTC offset if present.
    if (preg_match('/^([0-9.]+)[+-]/', $s, $tmp)) {
        $s = $tmp[1];
    }

    $s = preg_replace('/[^0-9]/', '', $s);
    if (empty($s)) {
        return '0000-00-00 00:00:00';
    }

    $ret = substr($s, 0, 4) . '-' . substr($s, 4, 2) . '-' . substr($s, 6, 2);
    if (strlen($s) > 8) {
        $ret .= ' ' . substr($s, 8, 2) . ':' . substr($s, 10, 2) . ':';
        if (strlen($s) > 12) {
            $ret .= substr($s, 12, 2);
        } else {
            $ret .= '00';
        }
    }

    return $ret;
}

function rhl7DateTimeZone($s)
{
    // UTC offset if present always begins with "+" or "-".
    if (preg_match('/^[0-9.]+([+-].*)$/', $s, $tmp)) {
        return trim($tmp[1]);
    }

    return '';
}

function rhl7Date($s)
{
    return substr(rhl7DateTime($s), 0, 10);
}

function rhl7Abnormal($s)
{
    if ($s == '') {
        return 'no';
    }

    if ($s == 'N') {
        return 'no';
    }

    if ($s == 'A') {
        return 'yes';
    }

    if ($s == 'H') {
        return 'high';
    }

    if ($s == 'L') {
        return 'low';
    }

    if ($s == 'HH') {
        return 'vhigh';
    }

    if ($s == 'LL') {
        return 'vlow';
    }

    return rhl7Text($s);
}

function rhl7ReportStatus($s)
{
    if ($s == 'F') {
        return 'final';
    }

    if ($s == 'P') {
        return 'prelim';
    }

    if ($s == 'C') {
        return 'correct';
    }

    if ($s == 'X') {
        return 'error';
    }

    return rhl7Text($s);
}

/**
 * Convert a lower case file extension to a MIME type.
 * The extension comes from OBX[5][0] which is itself a huge assumption that
 * the HL7 2.3 standard does not help with. Don't be surprised when we have to
 * adapt to conventions of various other labs.
 *
 * @param string $fileext The lower case extension.
 * @return string            MIME type.
 */
function rhl7MimeType($fileext)
{
    if ($fileext == 'pdf') {
        return 'application/pdf';
    }

    if ($fileext == 'doc') {
        return 'application/msword';
    }

    if ($fileext == 'rtf') {
        return 'application/rtf';
    }

    if ($fileext == 'txt') {
        return 'text/plain';
    }

    if ($fileext == 'zip') {
        return 'application/zip';
    }

    return 'application/octet-stream';
}

/**
 * Extract encapsulated document data according to its encoding type.
 *
 * @param string  $enctype Encoding type from OBX[5][3].
 * @param string &$src     Encoded data  from OBX[5][4].
 * @return string            Decoded data, or FALSE if error.
 */
function rhl7DecodeData($enctype, &$src)
{
    if ($enctype == 'Base64') {
        return base64_decode($src);
    }

    if ($enctype == 'A') {
        return rhl7Text($src);
    }

    if ($enctype == 'Hex') {
        $data = '';
        for ($i = 0; $i < strlen($src) - 1; $i += 2) {
            $data .= chr(hexdec($src[$i] . $src[$i + 1]));
        }

        return $data;
    }

    return false;
}

function rhl7CWE($s, $componentdelimiter)
{
    $out = '';
    if ($s === '') {
        return $out;
    }

    $arr = explode($componentdelimiter, $s);
    if (!empty($arr[8])) {
        $out = $arr[8];
    } else {
        $out = $arr[0];
        if (isset($arr[1])) {
            $out .= " (" . $arr[1] . ")";
        }
    }

    return $out;
}

/**
 * Parse the SPM segment and get the specimen display name and update the table.
 *
 * @param string $specimen Encoding type from SPM.
 */
function rhl7UpdateReportWithSpecimen(&$amain, $specimen, $d2)
{
    $specimen_display = '';

    // SPM4: Specimen Type: Example: 119297000^BLD^SCT^BldSpc^Blood^99USA^^^Blood Specimen
    $specimen_display = rhl7CWE($specimen[4], $d2);

    $tmpnotes = xl('Specimen type') . ': ' . $specimen_display;
    $tmp = rhl7CWE($specimen[21], $d2);
    if ($tmp) {
        $tmpnotes .= '; ' . xl('Rejected') . ': ' . $tmp;
    }

    $tmp = rhl7CWE($specimen[24], $d2);
    if ($tmp) {
        $tmpnotes .= '; ' . xl('Condition') . ': ' . $tmp;
    }

    $alast = count($amain) - 1;
    $amain[$alast]['rep']['specimen_num'] = $specimen_display;
    $amain[$alast]['rep']['report_notes'] .= rhl7Text($tmpnotes) . "\n";
}

/**
 * Get the Performing Lab Details from the OBX segment. Mandatory for MU2.
 *
 * @param string $obx23 Encoding type from OBX23.
 * @param string $obx23 Encoding type from OBX24.
 * @param string $obx23 Encoding type from OBX25.
 * @param string $obx23 New line character.
 */
function getPerformingOrganizationDetails($obx23, $obx24, $obx25, $componentdelimiter, $commentdelim)
{
    $s = null;

    if (!empty($obx23) || !empty($obx24) || !empty($obx25)) {
        // Organization Name
        // OBX23 Example: "Century Hospital^^^^^NIST-AA-1&2.16.840.1.113883.3.72.5.30.1&ISO^XX^^^987"
        $obx23_segs = explode($componentdelimiter, $obx23);
        if (!empty($obx23_segs[0])) {
            $s .= $obx23_segs[0] . $commentdelim;
        }

        // Medical Director
        // OBX25 Example: "2343242^Knowsalot^Phil^J.^III^Dr.^^^NIST-AA-1&2.16.840.1.113883.3.72.5.30.1&ISO^L^^^DNSPM"
        //             Dr. Phil Knowsalot J. III
        if (!empty($obx25)) {
            $obx25_segs = explode($componentdelimiter, $obx25);
            $s .= "$obx25_segs[5] $obx25_segs[2] $obx25_segs[1] $obx25_segs[3] $obx25_segs[4]" . $commentdelim;
        }

        // Organization Address
        // OBX24 Example: "2070 Test Park^^Los Angeles^CA^90067^USA^B^^06037"
        if (!empty($obx24)) {
            $obx24 = str_replace('~', ' ', $obx24);
            $obx24_segs = explode($componentdelimiter, $obx24);
            $s .= "$obx24_segs[0]$commentdelim$obx24_segs[1]$commentdelim$obx24_segs[2], " .
                "$obx24_segs[3] $obx24_segs[4]$commentdelim$obx24_segs[5]$commentdelim";
            if (!empty($obx24_segs[6])) {
                $s .= "$obx24_segs[6]$commentdelim";
            }
            if (!empty($obx24_segs[8])) {
                $s .= "County/Parish Code: $obx24_segs[8]$commentdelim";
            }
        }
    }

    return $s;
}

/**
 * Look for a patient matching the given data.
 * Return values are:
 *  >0  Definite match, this is the pid.
 *   0  No patient is close to a match.
 *  -1  It's not clear if there is a match.
 */
function match_patient($ptarr)
{
    $in_ss = str_replace('-', '', $ptarr['ss']);
    $in_fname = $ptarr['fname'];
    $in_lname = $ptarr['lname'];
    $in_dob = $ptarr['DOB'];
    $in_sex = strtoupper($ptarr['sex']) == 'M' ? 'Male' : 'Female'; // AND sex IS NOT NULL AND sex = ?

    $patient_id = 0;
    $res = sqlStatement(
        "SELECT pid FROM patient_data WHERE " .
        "((ss IS NULL OR ss = '' OR '' = ?) AND " .
        "fname IS NOT NULL AND fname != '' AND fname = ? AND " .
        "lname IS NOT NULL AND lname != '' AND lname = ? AND " .
        "DOB IS NOT NULL AND DOB = ?) OR " .
        "(ss IS NOT NULL AND ss != '' AND REPLACE(ss, '-', '') = ? AND (" .
        "fname IS NOT NULL AND fname != '' AND fname = ? OR " .
        "lname IS NOT NULL AND lname != '' AND lname = ? OR " .
        "DOB IS NOT NULL AND DOB = ?)) " .
        "ORDER BY ss DESC, pid DESC LIMIT 2",
        array($in_ss, $in_fname, $in_lname, $in_dob, $in_ss, $in_fname, $in_lname, $in_dob)
    );
    if (sqlNumRows($res) > 1) {
        // Multiple matches, so ambiguous.
        $patient_id = -1;
    } elseif (sqlNumRows($res) == 1) {
        // Got exactly one match, so use it.
        $tmp = sqlFetchArray($res);
        $patient_id = intval($tmp['pid']);
    } else {
        // No match good enough, figure out if there's enough ambiguity to ask the user.
        $tmp = sqlQuery(
            "SELECT pid FROM patient_data WHERE " .
            "(ss IS NOT NULL AND ss != '' AND REPLACE(ss, '-', '') = ?) OR " .
            "(fname IS NOT NULL AND fname != '' AND fname = ? AND " .
            "lname IS NOT NULL AND lname != '' AND lname = ?) OR " .
            "(DOB IS NOT NULL AND DOB = ?) " .
            "LIMIT 1",
            array($in_ss, $in_fname, $in_lname, $in_dob)
        );
        if (!empty($tmp['pid'])) {
            $patient_id = -1;
        }
    }

    return $patient_id;
}

/**
 * Look for a lab matching the given XCN field from some segment.
 *
 * @param array $seg MSH seg identifying a provider.
 * @return mixed        TRUE, or FALSE if no match.
 */
function match_lab(&$hl7, $send_acct, $lab_acct = '', $lab_app = '', $lab_npi = '')
{
    if (empty($hl7)) {
        return false;
    }
    $d0 = "\r";
    $d1 = substr($hl7, 3, 1); // typically |

    $segs = explode($d0, $hl7);
    $a = explode($d1, $segs[0]);
    if ($a[0] != 'MSH') {
        unset($segs);
        return false;
    }

    unset($segs);
    // CMS has deactivated NPI 1891752424, not sure who AMMON is
    if ($lab_npi == '1891752424' || strtoupper($lab_npi) == 'AMMON') {
        if (strtoupper(trim($a[5])) == strtoupper(trim($send_acct))) {
            $srch = '|' . strtoupper(trim($send_acct)) . '-';
            $hl7 = str_replace($srch, "|", $hl7);
            return true;
        }
        return false;
    }

    if (
        strtoupper(trim($a[5])) == strtoupper(trim($send_acct)) ||
        strtoupper(trim($a[3])) == strtoupper(trim($lab_acct)) ||
        strtoupper(trim($a[2])) == strtoupper(trim($lab_app))
    ) {
        return true;
    }

    return false;
}

// lookup code from configuration to validate codes after order submit ie manual/batch
function lookupTestCode($labid, $procedure_code)
{

    $query = "SELECT procedure_type_id, procedure_code, procedure_type, name, transport " .
        "FROM procedure_type WHERE " .
        "lab_id = ? AND " .
        "(procedure_type LIKE 'ord' OR procedure_type LIKE 'pro') AND " .
        "activity = 1 AND procedure_code = ? " .
        "LIMIT 1";
    $res = sqlQuery($query, array($labid, $procedure_code));

    return $res;
}

// create encounter
function create_encounter($pid, $provider_id, $order_date, $lab_name)
{
    global $orphanLog;
    $conn = $GLOBALS['adodb']['db'];
    $encounter = $conn->GenID("sequences");
    addForm(
        $encounter,
        "Auto Generated Lab Encounter",
        sqlInsert(
            "INSERT INTO form_encounter SET " .
            "date = ?, " .
            "onset_date = '', " .
            "reason = ?, " .
            "sensitivity = 'normal', " .
            "referral_source = '', " .
            "pid = ?, " .
            "encounter = ?, " .
            "provider_id = ?",
            array(
                date('Y-m-d H:i:s', strtotime($order_date)),
                "Generated encounter for " . strtoupper($lab_name) . " result",
                $pid,
                $encounter,
                ($provider_id ?? '')
            )
        ),
        "newpatient",
        $pid,
        0,
        date('Y-m-d'),
        'SYSTEM'
    );
    $orphanLog .= "New Encounter: $encounter created. ";
    return $encounter ?: 0;
}

// send a message (pnote) to provider to inform about orders creation
function labNotice($pid, $newtext, $assigned_to = 'admin', $datetime = '', $labname = '')
{
    if ($pid > 999999990) {
        return;
    }

    $message_sender = $_SESSION['authUser'];
    $message_group = 'Default';
    $authorized = '0';
    $activity = '1';
    $title = 'Lab Results';
    $message_status = 'New';
    if (empty($datetime)) {
        $datetime = date('Y-m-d H:i:s');
    }

    if (!$assigned_to) {
        $assigned_to = $_SESSION['authUser'];
    }
    $notify = $assigned_to; //@todo get user lookup

    $body = date('Y-m-d H:i') . ' (' . $labname . ' to ' . $notify . ') ' . $newtext;

    return sqlInsert(
        "INSERT INTO pnotes (date, body, pid, user, groupname, " .
        "authorized, activity, title, assigned_to, message_status) VALUES (?, ?, ?, ?, ?, ?, ?, ?, ?, ?)",
        array(
            $datetime,
            $body,
            $pid,
            $message_sender,
            $message_group,
            $authorized,
            $activity,
            $title,
            $notify,
            $message_status
        )
    );
}

/**
 * Look for a local provider matching the given XCN field from some segment.
 *
 * @param array $arr array(NPI, lastname, firstname) identifying a provider.
 * @return mixed        Array(id, username), or FALSE if no match.
 */
function match_provider($arr)
{
    if (empty($arr)) {
        return false;
    }

    $op_lname = $op_fname = '';
    $op_npi = preg_replace('/[^0-9]/', '', $arr[0]);
    if (!empty($arr[1])) {
        $op_lname = $arr[1];
    }

    if (!empty($arr[2])) {
        $op_fname = $arr[2];
    }

    if ($op_npi || ($op_fname && $op_lname)) {
        if ($op_npi) {
            if ($op_fname && $op_lname) {
                $where = "((npi IS NOT NULL AND npi = ?) OR ((npi IS NULL OR npi = ?) AND lname = ? AND fname = ?))";
                $qarr = array($op_npi, '', $op_lname, $op_fname);
            } else {
                $where = "npi IS NOT NULL AND npi = ?";
                $qarr = array($op_npi);
            }
        } else {
            $where = "lname = ? AND fname = ?";
            $qarr = array($op_lname, $op_fname);
        }

        $oprow = sqlQuery(
            "SELECT id, username FROM users WHERE " .
            "username IS NOT NULL AND username != '' AND $where " .
            "ORDER BY active DESC, authorized DESC, username, id LIMIT 1",
            $qarr
        );
        if (!empty($oprow)) {
            return $oprow;
        }
    }

    return false;
}

function ucname($string)
{
    $string = ucwords(strtolower($string));

    foreach (array('-', '\'') as $delimiter) {
        if (strpos($string, $delimiter) !== false) {
            $string = implode($delimiter, array_map('ucfirst', explode($delimiter, $string)));
        }
    }
    return $string;
}

/**
 * Create a patient using whatever patient_data attributes are provided.
 */
function create_skeleton_patient($patient_data)
{
    global $orphanLog;
    $employer_data = array();
    $tmp = sqlQuery("SELECT MAX(pid)+1 AS pid FROM patient_data");
    $ptid = empty($tmp['pid']) ? 1 : intval($tmp['pid']);
    if (!isset($patient_data['pubpid'])) {
        $patient_data['pubpid'] = $ptid;
    }

    updatePatientData($ptid, $patient_data, true);
    updateEmployerData($ptid, $employer_data, true);
    newHistoryData($ptid);
    $tmp = "Pid: $ptid " . $patient_data['fname'] . ' ' . $patient_data['lname'] . ' ' . $patient_data['DOB'];
    $orphanLog .= "New Patient for $tmp created. ";
    return $ptid;
}

/**
 * Parse and save.
 *
 * @param string &$hl7        The input HL7 text
 * @param string &$matchreq   Array of shared patient matching requests
 * @param int     $lab_id     Lab ID
 * @param char    $direction  B=Bidirectional, R=Results-only
 * @param bool    $dryrun     True = do not update anything, just report errors
 * @param array   $matchresp  Array of responses to match requests; key is relative segment number,
 *                            value is an existing pid or 0 to specify creating a patient
 * @return array              Array of errors and match requests, if any
 */
function receive_hl7_results(&$hl7, &$matchreq, $lab_id = 0, $direction = 'B', $dryrun = false, $matchresp = null)
{
    global $rhl7_return;
    global $orphanLog;
    global $lab_npi;
    //$direction = 'R';
    // This will hold returned error messages and related variables.
    $rhl7_return = array();
    $rhl7_return['mssgs'] = array();
    $rhl7_return['needmatch'] = false; // indicates if this file is pending a match request

    $rhl7_segnum = 0;
    $obrPerformingOrganization = '';

    if (substr($hl7, 0, 3) != 'MSH') {
        return rhl7LogMsg(xl('Input does not begin with a MSH segment'), true);
    }

    // This array holds everything to be written to the database.
    // We save and postpone these writes in case of errors while processing the message,
    // so we can look up data from parent results when child results are encountered,
    // and for other logic simplification.
    // Each element of this array is another array containing the following possible keys:
    // 'rep' - row of data to write to procedure_report
    // 'res' - array of rows to write to procedure_result for this procedure_report
    // 'fid' - unique lab-provided identifier for this report
    //
    $amain = array();

    // End-of-line delimiter for text in procedure_result.comments and other multi-line notes.
    $commentdelim = "\n";

    // Ensoftek: Different labs seem to send different EOLs. Edit HL7 input to a character we know.
    $hl7 = (string)str_replace(array("\r\n", "\r", "\n"), "\r", $hl7);

    $today = time();
    $in_message_lab_name = '';
    $in_message_id = '';
    $in_ssn = '';
    $in_dob = '';
    $in_lname = '';
    $in_fname = '';
    $in_orderid = 0;
    $in_procedure_code = '';
    $in_report_status = '';
    $in_encounter = 0;
    $patient_id = 0; // for results-only patient matching logic
    $porow = false;
    $pcrow = false;
    $oprow = false;

    $code_seq_array = array(); // tracks sequence numbers of order codes
    $results_category_id = 0;  // document category ID for lab results

    // This is so we know where we are if a segment like NTE that can appear in
    // different places is encountered.
    $context = '';

    // This will be "ORU" or "MDM".
    $msgtype = '';

    // Stuff collected for MDM documents.
    $mdm_datetime = '';
    $mdm_docname = '';
    $mdm_text = '';

    // Delimiters
    $d0 = "\r";
    $d1 = substr($hl7, 3, 1); // typically |
    $d2 = substr($hl7, 4, 1); // typically ^
    $d3 = substr($hl7, 5, 1); // typically ~
    $d4 = substr($hl7, 6, 1); // typically \
    $d5 = substr($hl7, 7, 1); // typically &

    // We'll need the document category IDs for any embedded documents.
    $catrow = sqlQuery(
        "SELECT id FROM categories WHERE name = ?",
        array($GLOBALS['lab_results_category_name'])
    );
    if (empty($catrow['id'])) {
        return rhl7LogMsg(xl('Document category for lab results does not exist') .
            ': ' . $GLOBALS['lab_results_category_name'], true);
    } else {
        $results_category_id = $catrow['id'];
        $mdm_category_id = $results_category_id;
        $catrow = sqlQuery(
            "SELECT id FROM categories WHERE name = ?",
            array($GLOBALS['gbl_mdm_category_name'])
        );
        if (!empty($catrow['id'])) {
            $mdm_category_id = $catrow['id'];
        }
    }

    $segs = explode($d0, $hl7);

    foreach ($segs as $seg) {
        if (empty($seg)) {
            continue;
        }
        if ($seg == chr(28)) {
            continue;
        }
        // echo "<!-- $dryrun $seg -->\n"; // debugging

        ++$rhl7_segnum;
        $a = explode($d1, $seg);

        if ($a[0] == 'MSH') {
            if (!$dryrun) {
                rhl7FlushMain($amain, $commentdelim);
            }

            $amain = array();

            if ('MDM' == $msgtype && !$dryrun) {
                $rc = rhl7FlushMDM(
                    $patient_id,
                    $mdm_docname,
                    $mdm_datetime,
                    $mdm_text,
                    $mdm_category_id,
                    $oprow ? $oprow['username'] : 0
                );
                if ($rc) {
                    return rhl7LogMsg($rc);
                }

                $patient_id = 0;
            }

            $context = $a[0];
            // Ensoftek: Could come is as 'ORU^R01^ORU_R01'. Handle all cases when 'ORU^R01' is seen.
            if (strstr($a[8], "ORU^R01")) {
                $msgtype = 'ORU';
            } elseif ($a[8] == 'MDM^T02' || $a[8] == 'MDM^T04' || $a[8] == 'MDM^T08') {
                $msgtype = 'MDM';
                $mdm_datetime = '';
                $mdm_docname = '';
                $mdm_text = '';
            } elseif (strstr($a[8], "ORU")) { // Labcorp does not send trigger
                $msgtype = 'ORU';
            } else {
                return rhl7LogMsg(xl('MSH.8 message type is not supported') . ": '" . $a[8] . "'", true);
            }

            $in_message_id = $a[9];
            $in_message_lab_name = rhl7Text($a[3]);
        } elseif ($a[0] == 'PID') {
            $context = $a[0];

            if ('MDM' == $msgtype && !$dryrun) {
                $rc = rhl7FlushMDM(
                    $patient_id,
                    $mdm_docname,
                    $mdm_datetime,
                    $mdm_text,
                    $mdm_category_id,
                    $oprow ? $oprow['username'] : 0
                );
                if ($rc) {
                    return rhl7LogMsg($rc);
                }
            }
            $porow = false;
            $pcrow = false;
            $oprow = false;
            $in_orderid = 0;
            $in_ssn = preg_replace('/[^0-9]/', '', $a[4]);
            $in_dob = rhl7Date($a[7]);
            // foreign MRN
            $in_pubpid = rhl7Text($a[3] ?? '');
            $tmp = explode($d2, $a[11]);
            $in_street = rhl7Text($tmp[0]) ?? '';
            $in_street1 = rhl7Text($tmp[1] ?? '');
            $in_city = rhl7Text($tmp[2] ?? '');
            $in_state = rhl7Text($tmp[3] ?? '');
            $in_zip = rhl7Text($tmp[4] ?? '');
            $in_phone = rhl7Text($a[13]) ?? '';
            switch (strtoupper($a[8])) {
                case 'M':
                    $in_sex = 'Male';
                    break;
                case 'F':
                    $in_sex = 'Female';
                    break;
                case 'T':
                    $in_sex = 'Transgender';
                    break;
                default:
                    $in_sex = 'Unassigned';
            }
            $tmp = explode($d2, $a[5]);
            $in_lname = rhl7Text($tmp[0]);
            $in_fname = rhl7Text($tmp[1]);
            $in_mname = rhl7Text($tmp[2] ?? '');

            $patient_id = 0;

            // Patient matching is needed for a results-only interface or MDM message type.
            if ('R' == $direction || 'MDM' == $msgtype) {
                $ptarr = array(
                    'ss' => strtoupper($in_ssn),
                    'fname' => ucname($in_fname),
                    'lname' => ucname($in_lname),
                    'mname' => ucname($in_mname),
                    'DOB' => strtoupper($in_dob),
                    'sex' => $in_sex,
                    'street' => $in_street,
                    'city' => $in_city,
                    'state' => $in_state,
                    'postal_code' => $in_zip,
                    'phone_home' => $in_phone,
                    'pubpid' => $in_pubpid
                );
                $patient_id = match_patient($ptarr);
                if ($patient_id == -1) {
                    // Result is indeterminate.
                    // Make a stringified form of $ptarr to use as a key.
                    $ptstring = serialize($ptarr);
                    // Check if the user has specified the patient.
                    if (isset($matchresp[$ptstring])) {
                        // This will be an existing pid, or 0 to specify creating a patient.
                        $patient_id = intval($matchresp[$ptstring]);
                    } else {
                        if ($dryrun) {
                            // Nope, ask the user to match.
                            $matchreq[$ptstring] = true;
                            $rhl7_return['needmatch'] = true;
                        } else {
                            // Should not happen, but it would be bad to abort now.  Create the patient.
                            $patient_id = 0;
                            rhl7LogMsg(xl('Unexpected non-match, creating new patient for segment') .
                                ' ' . $rhl7_segnum, false);
                        }
                    }
                }

                if ($patient_id == 0 && !$dryrun) {
                    // We must create the patient.
                    $patient_id = create_skeleton_patient($ptarr);
                }

                if ($patient_id == -1) {
                    $patient_id = 0;
                }
            } // end results-only/MDM logic
        } elseif ('PD1' == $a[0]) {
            // TBD: Save primary care provider name ($a[4]) somewhere?
        } elseif ('PV1' == $a[0]) {
            if ('ORU' == $msgtype) {
                // Save placer encounter number if present.
                if ($direction != 'R' && !empty($a[19])) {
                    $tmp = explode($d2, $a[19]);
                    $in_encounter = intval($tmp[0]);
                }
            } elseif ('MDM' == $msgtype) {
                // For documents we want the ordering provider.
                // Try Referring Provider first.
                $oprow = match_provider(explode($d2, $a[8]));
                // If no match, try Other Provider.
                if (empty($oprow)) {
                    $oprow = match_provider(explode($d2, $a[52]));
                }
            }
        } elseif ('ORC' == $a[0] && 'ORU' == $msgtype) {
            $context = $a[0];
            $arep = array();
            $porow = false;
            $pcrow = false;
            if ($direction != 'R' && $a[2]) {
                $in_orderid = intval($a[2]);
            }
        } elseif ('TXA' == $a[0] && 'MDM' == $msgtype) {
            $context = $a[0];
            $mdm_datetime = rhl7DateTime($a[4]);
            $mdm_docname = rhl7Text($a[12]);
        } elseif ($a[0] == 'NTE' && ($context == 'ORC' || $context == 'TXA')) {
            // Is this ever used?
        } elseif ('OBR' == $a[0] && 'ORU' == $msgtype) {
            $context = $a[0];
            $arep = array();
            if ($direction != 'R' && $a[2]) {
                $in_orderid = intval($a[2]);
                $porow = false;
                $pcrow = false;
            }

            $tmp = explode($d2, $a[4]);
            $in_procedure_code = $tmp[0];
            $in_procedure_name = rhl7Text($tmp[1]);
            $in_report_status = rhl7ReportStatus($a[25]);
            if ($lab_npi == "QUEST") {
                // for profiles that may return dif component codes for profile code.
                $tmp = explode($d2, $a[20]);
                if (!empty($tmp[3]) && !empty($tmp[4])) {
                    $in_procedure_code = $tmp[3];
                    $in_procedure_name = $tmp[4];
                }
            }
            // Filler identifier is supposed to be unique for each incoming report.
            $in_filler_id = $a[3];
            // Child results will have these pointers to their parent.
            $in_parent_obrkey = '';
            $in_parent_obxkey = '';
            $parent_arep = false; // parent report, if any
            $parent_ares = false; // parent result, if any
            if (!empty($a[29])) {
                // This is a child so there should be a parent.
                $tmp = explode($d2, $a[29]);
                $in_parent_obrkey = str_replace($d5, $d2, $tmp[1]);
                $tmp = explode($d2, $a[26]);
                $in_parent_obxkey = str_replace($d5, $d2, $tmp[0]) . $d1 . $tmp[1];
                // Look for the parent report.
                foreach ($amain as $arr) {
                    if (isset($arr['fid']) && $arr['fid'] == $in_parent_obrkey) {
                        $parent_arep = $arr['rep'];
                        // Now look for the parent result within that report.
                        foreach ($arr['res'] as $tmpres) {
                            if (isset($tmpres['obxkey']) && $tmpres['obxkey'] == $in_parent_obxkey) {
                                $parent_ares = $tmpres;
                                break;
                            }
                        }

                        break;
                    }
                }
            }

            if ($parent_arep) {
                $in_orderid = $parent_arep['procedure_order_id'];
            }

            if ($direction == 'R') {
                // Save their order ID to procedure_order.control_id.
                // Look for an existing order using that plus lab_id.
                // Ordering provider is OBR.16 (NPI^Last^First).
                // Might not need to create a dummy encounter.
                // Need also provider_id (probably), patient_id, date_ordered, lab_id.
                // We have observation date/time in OBR.7.
                // We have report date/time in OBR.22.
                // We do not have an order date.

                $external_order_id = empty((int)$a[2]) ? $a[3] : $a[2];
                $porow = false;

                if (!$in_orderid && $external_order_id) {
                    $porow = sqlQuery(
                        "SELECT * FROM procedure_order " .
                        "WHERE lab_id = ? AND control_id = ? " .
                        "ORDER BY procedure_order_id DESC LIMIT 1",
                        array($lab_id, $external_order_id)
                    );
                }

                if (!empty($porow)) {
                    $in_orderid = intval($porow['procedure_order_id']);
                }

                if (!$in_orderid) {
                    // Create order.
                    // Need to identify the ordering provider and, if possible, a recent encounter.
                    $datetime_report = rhl7DateTime($a[22]);
                    $date_report = substr($datetime_report, 0, 10) . ' 00:00:00';
                    $encounter_id = 0;
                    $provider_id = 0;
                    $external_id = rhl7Text($a[3]) ?? null;
                    // Look for the most recent encounter within 30 days of the report date.
                    $encrow = sqlQuery(
                        "SELECT encounter FROM form_encounter WHERE " .
                        "pid = ? AND date <= ? AND DATE_ADD(date, INTERVAL 30 DAY) > ? " .
                        "ORDER BY date DESC, encounter DESC LIMIT 1",
                        array($patient_id, $date_report, $date_report)
                    );
                    if (!empty($encrow)) {
                        $encounter_id = intval($encrow['encounter']);
                        $provider_id = intval($encrow['provider_id'] ?? '');
                    }

                    if (!$provider_id) {
                        // Attempt ordering provider matching by name or NPI.
                        $oprow = match_provider(explode($d2, $a[16]));
                        if (!empty($oprow)) {
                            $provider_id = (int)$oprow['id'];
                            $provider_username = $oprow['username'];
                        }
                    }

                    if (!$dryrun) {
                        // create an encounter. I mean, why not...
                        if (empty($encrow) && !$encounter_id) {
                            $encounter_id = create_encounter(
                                $patient_id,
                                $provider_id,
                                $datetime_report,
                                $in_message_lab_name
                            );
                        }
                        // Now create the procedure order.
                        $in_orderid = sqlInsert(
                            "INSERT INTO procedure_order SET " .
                                "date_ordered   = ?, " .
                                "provider_id    = ?, " .
                                "lab_id         = ?, " .
                                "date_collected = ?, " .
                                "date_transmitted = ?, " .
                                "patient_id     = ?, " .
                                "encounter_id   = ?, " .
                                "control_id     = ?, " .
                                "external_id    = ?",
                            array(
                                $datetime_report,
                                $provider_id,
                                $lab_id,
                                rhl7DateTime($a[22]),
                                rhl7DateTime($a[7]),
                                $patient_id,
                                $encounter_id,
                                $external_order_id,
                                $external_id
                            )
                        );
                        // If an encounter was identified then link the order to it.
                        $form_name = ($lab_npi > '' ? $lab_npi : "Auto Result") . "-" . $in_orderid;
                        if ($encounter_id && $in_orderid) {
                            addForm($encounter_id, $form_name, $in_orderid, "procedure_order", $patient_id);
                        }
                        // create a note to provider about these actions
                        $txdate = rhl7DateTime($a[7]);
                        $ptext = "$orphanLog $form_name Order ordered by" .  ($provider_username ?? '') .
                            " with lab result file " .
                            "creation date on $datetime_report and specimen collections on $txdate has been created. " .
                            "Please review these items to ensure proper resolution of order results.";
                        $dumb = labNotice($patient_id, $ptext, ($provider_username ?? ''), '', $in_message_lab_name);
                    }
                } // end no $porow
            } // end results-only
            if (empty($porow)) {
                $porow = sqlQuery("SELECT * FROM procedure_order WHERE " .
                    "procedure_order_id = ?", array($in_orderid));
                // The order must already exist. Currently we do not handle electronic
                // results returned for manual orders.
                if (empty($porow) && !($dryrun && $direction == 'R')) {
                    return rhl7LogMsg(xl('Procedure order not found') . ": $in_orderid", true);
                }

                if ($in_encounter) {
                    if ($direction != 'R' && $porow['encounter_id'] != $in_encounter) {
                        return rhl7LogMsg(xl('Encounter ID') .
                            " '" . $porow['encounter_id'] . "' " .
                            xl('for OBR placer order number') .
                            " '$in_orderid' " .
                            xl('does not match the PV1 encounter number') .
                            " '$in_encounter'");
                    }
                } else {
                    // They did not return an encounter number to verify, so more checking
                    // might be done here to make sure the patient seems to match.
                }

                // Save the lab's control ID if there is one.
                $tmp = explode($d2, $a[3]);
                $control_id = $tmp[0];
                if ($control_id && empty($porow['control_id']) && $in_orderid) {
                    sqlStatement("UPDATE procedure_order SET control_id = ? WHERE " .
                        "procedure_order_id = ?", array($control_id, $in_orderid));
                }

                $code_seq_array = array();
            }

            // Find the order line item (procedure code) that matches this result.
            // If there is more than one, then we select the one whose sequence number
            // is next after the last sequence number encountered for this procedure
            // code; this assumes that result OBRs are returned in the same sequence
            // as the corresponding OBRs in the order.
            if (!isset($code_seq_array[$in_procedure_code])) {
                $code_seq_array[$in_procedure_code] = 0;
            }

            $pcquery = "SELECT pc.* FROM procedure_order_code AS pc " .
                "WHERE pc.procedure_order_id = ? AND pc.procedure_code = ? " .
                "ORDER BY (procedure_order_seq <= ?), procedure_order_seq LIMIT 1";
            $pcqueryargs = array($in_orderid, $in_procedure_code, $code_seq_array[$in_procedure_code]);
            $pcrow = sqlQuery($pcquery, $pcqueryargs);
            if (empty($pcrow)) {
                // There is no matching procedure in the order, so it must have been
                // added after the original order was sent, either as a manual request
                // from the physician or as a "reflex" from the lab.
                // procedure_source = '2' indicates this.
                if (!$dryrun) {
                    $lkup = lookupTestCode($lab_id, $in_procedure_code);
                    $code_type = ($lkup['procedure_type'] ?? '') ? trim($lkup['procedure_type']) : '';
                    $code_transport = ($lkup['transport'] ?? '') ? trim($lkup['transport']) : '';
                    sqlBeginTrans();
                    $procedure_order_seq = sqlQuery(
                        "SELECT IFNULL(MAX(procedure_order_seq),0) + 1 AS increment FROM procedure_order_code " .
                        "WHERE procedure_order_id = ? ",
                        array($in_orderid)
                    );
                    sqlInsert(
                        "INSERT INTO procedure_order_code SET " .
                        "procedure_order_id = ?, " .
                        "procedure_order_seq = ?, " .
                        "procedure_code = ?, " .
                        "procedure_name = ?, " .
                        "procedure_type = ?, " .
                        "transport = ?, " .
                        "procedure_source = '2'",
                        array(
                            $in_orderid,
                            $procedure_order_seq['increment'],
                            $in_procedure_code,
                            $in_procedure_name,
                            $code_type,
                            $code_transport
                        )
                    );
                    $pcrow = sqlQuery($pcquery, $pcqueryargs);
                    sqlCommitTrans();
                } else {
                    // Dry run, make a dummy procedure_order_code row.
                    $pcrow = array(
                        'procedure_order_id' => $in_orderid,
                        'procedure_order_seq' => 0, // TBD?
                    );
                }
            }
            if (!empty($a[21])) {
                $obrPerformingOrganization = getPerformingOrganizationDetails('', $a[21], '', $d2, $commentdelim);
            }
            $code_seq_array[$in_procedure_code] = 0 + $pcrow['procedure_order_seq'];
            $arep = array();
            $arep['procedure_order_id'] = $in_orderid;
            $arep['procedure_order_seq'] = $pcrow['procedure_order_seq'];
            $arep['date_collected'] = rhl7DateTime($a[7]);
            $arep['date_collected_tz'] = rhl7DateTimeZone($a[7]);
            $arep['date_report'] = rhl7DateTime($a[22]);
            $arep['date_report_tz'] = rhl7DateTimeZone($a[22]);
            $arep['report_status'] = $in_report_status;
            $arep['report_notes'] = '';
            $arep['specimen_num'] = '';

            // If this is a child report, add some info from the parent.
            if (!empty($parent_ares)) {
                $arep['report_notes'] .= xl('This is a child of result') . ' ' .
                    $parent_ares['result_code'] . ' ' . xl('with value') . ' "' .
                    $parent_ares['result'] . '".' . "\n";
            }

            if (!empty($parent_arep)) {
                $arep['report_notes'] .= $parent_arep['report_notes'];
                $arep['specimen_num'] = $parent_arep['specimen_num'];
            }

            // Create the main array entry for this report and its results.
            $i = count($amain);
            $amain[$i] = array();
            $amain[$i]['rep'] = $arep;
            $amain[$i]['fid'] = $in_filler_id;
            $amain[$i]['res'] = array();
        } elseif ($a[0] == 'NTE' && $context == 'OBR') {
            // Append this note to those for the most recent report.
            $amain[count($amain) - 1]['rep']['report_notes'] .= rhl7Text($a[3], true) . "\n";
        } elseif ('OBX' == $a[0] && 'ORU' == $msgtype) {
            $tmp = explode($d2, $a[3]);
            $result_code = rhl7Text($tmp[0]);
            $result_text = rhl7Text($tmp[1]);
            if ($lab_npi == "QUEST") {
                if (empty($result_code)) {
                    $result_code = rhl7Text($tmp[3]);
                }
                $result_text = rhl7Text($tmp[4]);
            }
            // If this is a text result that duplicates the previous result except
            // for its value, then treat it as an extension of that result's value.
            $i = count($amain) - 1;
            $j = count($amain[$i]['res']) - 1;
            if (
                $j >= 0 && $context == 'OBX' && $a[2] == 'TX'
                && $amain[$i]['res'][$j]['result_data_type'] == 'L'
                && $amain[$i]['res'][$j]['result_code'] == $result_code
                && $amain[$i]['res'][$j]['date'] == rhl7DateTime($a[14] ?? '')
                && ($amain[$i]['res'][$j]['facility'] ?? '') == rhl7Text($a[15] ?? '')
                && $amain[$i]['res'][$j]['abnormal'] == rhl7Abnormal($a[8] ?? '')
                && $amain[$i]['res'][$j]['result_status'] == rhl7ReportStatus($a[11] ?? '')
            ) {
                $amain[$i]['res'][$j]['comments'] =
                    substr(
                        $amain[$i]['res'][$j]['comments'],
                        0,
                        strlen($amain[$i]['res'][$j]['comments'])
                    ) . rhl7Text($a[5] ?? '') . $commentdelim;
                continue;
            }

            $context = $a[0];
            $ares = array();
            $ares['result_data_type'] = substr($a[2], 0, 1); // N, S, F or E
            $ares['comments'] = $commentdelim;
            if ($a[2] == 'ED') {
                // This is the case of results as an embedded document. We will create
                // a normal patient document in the assigned category for lab results.
                $tmp = explode($d2, $a[5]);
                $fileext = strtolower($tmp[2]);
                $filename = date("Ymd_His") . '_orderid_' . $in_orderid . '.' . $fileext;
                if ($tmp[4] != 'EMBEDDED DOCUMENT') { // an OBX indicating a document in next Seg ZEF so pass this by.
                    $data = rhl7DecodeData($tmp[3], $tmp[4]);
                    if ($data === false) {
                        return rhl7LogMsg(xl('Invalid encapsulated data encoding type') . ': ' . $tmp[3]);
                    }
                    if (!$dryrun) {
                        $d = new Document();
                        $rc = $d->createDocument(
                            $porow['patient_id'],
                            $results_category_id, // TBD: Make sure not 0
                            $filename,
                            rhl7MimeType($fileext),
                            $data
                        );
                        if ($rc) {
                            return rhl7LogMsg($rc);
                        }

                        $ares['document_id'] = $d->get_id();
                    }
                } // @todo suspect below!!
                $ares['date'] = $arep['date_report']; // $arep is left over from the OBR logic.
                // Append this result to those for the most recent report.
                // Note the 'procedure_report_id' item is not yet present.
                //$amain[count($amain) - 1]['res'][] = $ares;
            } elseif ($a[2] == 'CWE') {
                $ares['result'] = rhl7CWE($a[5], $d2);
            } elseif ($a[2] == 'SN') {
                $ares['result'] = trim(str_replace($d2, ' ', $a[5]));
            } elseif ($a[2] == 'TX' || strlen($a[5]) > 200) {
                // OBX-5 can be a very long string of text with "~" as line separators.
                // The first line of comments is reserved for such things.
                $ares['result_data_type'] = 'L';
                $ares['result'] = '';
                if (empty($a[5])) {
                    $vTx = rhl7Text(str_replace('^', ' ', $a[3]));
                } else {
                    $vTx = rhl7Text($a[5]);
                }
                $ares['comments'] = $vTx . $commentdelim;
            } else {
                $ares['result'] = rhl7Text($a[5]);
            }

            $ares['result_code'] = $result_code;
            $ares['result_text'] = $result_text;
            $ares['date'] = rhl7DateTime($a[14] ?? '');
            //$ares['facility'] = rhl7Text($a[15]);
            // Ensoftek: Units may have mutiple segments(as seen in MU2 samples), parse and take just first segment.
            $tmp = explode($d2, ($a[6] ?? ''));
            $ares['units'] = rhl7Text($tmp[0]);
            $ares['range'] = rhl7Text($a[7] ?? '');
            $ares['abnormal'] = rhl7Abnormal($a[8] ?? ''); // values are lab dependent
            $ares['result_status'] = rhl7ReportStatus($a[11] ?? '');

            // Ensoftek: Performing Organization Details.
            // Goes into "Pending Review/Patient Results--->Notes--->Facility" section.
            if (empty($obrPerformingOrganization)) {
                $performingOrganization = getPerformingOrganizationDetails(
                    $a[23] ?? '',
                    $a[24] ?? '',
                    $a[25] ?? '',
                    $d2,
                    $commentdelim
                );
            } else {
                $performingOrganization = $obrPerformingOrganization;
            }
            if (!empty($performingOrganization)) {
                $ares['facility'] .= $performingOrganization . $commentdelim;
            }

            /****
             * // Probably need a better way to report this, if it matters.
             * if (!empty($a[19])) {
             * $ares['comments'] .= xl('Analyzed') . ' ' . rhl7DateTime($a[19]) . '.' . $commentdelim;
             * }
             ****/

            // obxkey is to allow matching this as a parent result.
            $ares['obxkey'] = $a[3] . $d1 . ($a[4] ?? '');

            // Append this result to those for the most recent report.
            // Note the 'procedure_report_id' item is not yet present.
            $amain[count($amain) - 1]['res'][] = $ares;
        } elseif ('OBX' == $a[0] && 'MDM' == $msgtype) {
            $context = $a[0];
            if ($a[2] == 'TX') {
                if ($mdm_text !== '') {
                    $mdm_text .= "\r\n";
                }

                $mdm_text .= rhl7Text($a[5]);
            } else {
                return rhl7LogMsg(xl('Unsupported MDM OBX result type') . ': ' . $a[2]);
            }
        } elseif ('ZEF' == $a[0] && 'ORU' == $msgtype) {
            // ZEF segment is treated like an OBX with an embedded Base64-encoded PDF.
            $context = 'OBX';
            $ares = array();
            $ares['result_data_type'] = 'E';
            $ares['comments'] = $commentdelim;
            //
            $fileext = 'pdf';
            $filename = date("Ymd_His") . '_orderid_' . $in_orderid . '.' . $fileext;
            $data = rhl7DecodeData('Base64', $a[2]);
            if ($data === false) {
                return rhl7LogMsg(xl('ZEF segment internal error'));
            }

            if (!$dryrun) {
                $d = new Document();
                $rc = $d->createDocument(
                    $porow['patient_id'],
                    $results_category_id, // TBD: Make sure not 0
                    $filename,
                    rhl7MimeType($fileext),
                    $data
                );
                if ($rc) {
                    return rhl7LogMsg($rc);
                }

                $ares['document_id'] = $d->get_id();
            }

            $ares['date'] = $arep['date_report']; // $arep is left over from the OBR logic.
            // Append this result to those for the most recent report.
            // Note the 'procedure_report_id' item is not yet present.
            $amain[count($amain) - 1]['res'][] = $ares;
        } elseif ('NTE' == $a[0] && 'OBX' == $context && 'ORU' == $msgtype) {
            // Append this note to the most recent result item's comments.
            $alast = count($amain) - 1;
            $rlast = count($amain[$alast]['res']) - 1;
            $amain[$alast]['res'][$rlast]['comments'] .= rhl7Text($a[3] ?? '', true) . $commentdelim;
            // Ensoftek: Get data from SPM segment for specimen.
            // SPM segment always occurs after the OBX segment.
        } elseif ('SPM' == $a[0] && 'ORU' == $msgtype) {
            rhl7UpdateReportWithSpecimen($amain, $a, $d2);
            // Add code here for any other segment types that may be present.
            // Ensoftek: Get data from SPM segment for specimen. Comes in with MU2 samples, but can be ignored.
        } elseif ('TQ1' == $a[0] && 'ORU' == $msgtype) {
            // Ignore and do nothing.
        } elseif ($a[0] == 'NTE' && 'PID' == $context) {
            // will get orderid on save.
            if (!empty($amain[0])) {
                $amain[0]['rep']['report_notes'] .= rhl7Text($a[3], true) . "\n";
            }
        } elseif ('ZPS' == $a[0] && 'ORU' == $msgtype) {
            //global $ares;
            $performingOrganization = parseZPS($a);
            if (!empty($performingOrganization)) {
                $alast = count($amain) - 1;
                $amain[$alast]['res'][0]['facility'] .= $performingOrganization . $commentdelim;
            }
        } else {
            return rhl7LogMsg(xl('Segment name') . " '${a[0]}' " . xl('is misplaced or unknown'));
        }
    }

    // Write all reports and their results to the database.
    // This will do nothing if a dry run or MDM message type.
    if ('ORU' == $msgtype && !$dryrun) {
        rhl7FlushMain($amain, $commentdelim);
    }

    if ('MDM' == $msgtype && !$dryrun) {
        // Write documents.
        $rc = rhl7FlushMDM(
            $patient_id,
            $mdm_docname,
            $mdm_datetime,
            $mdm_text,
            $mdm_category_id,
            $oprow ? $oprow['username'] : 0
        );
        if ($rc) {
            return rhl7LogMsg($rc);
        }
    }

    return $rhl7_return;
}

/**
 * Poll all eligible labs for new results and store them in the database.
 *
 * @param array &$info Conveys information to and from the caller:
 *                     FROM THE CALLER:
 *                     $info["$ppid/$filename"]['delete'] = a non-empty value if file deletion is requested.
 *                     $info['select'] = array of patient matching responses where key is serialized patient
 *                     attributes and value is selected pid for this patient, or 0 to create the patient.
 *                     TO THE CALLER:
 *                     $info["$ppid/$filename"]['mssgs'] = array of messages from this function.
 *                     $info['match'] = array of patient matching requests where key is serialized patient
 *                     attributes (ss, fname, lname, DOB) and value is TRUE (irrelevant).
 *
 * @return string  Error text, or empty if no errors.
 */
function poll_hl7_results(&$info, $labs = 0)
{
    global $srcdir, $orphanLog, $lab_npi;
    $labs = (int)$labs + 0;
    // echo "<!-- post: "; print_r($_POST); echo " -->\n"; // debugging
    // echo "<!-- in:   "; print_r($info); echo " -->\n"; // debugging

    $filecount = 0;
    $badcount = 0;
    $maxdl = $_REQUEST['form_max_results'] ?? 9999; // in case to prevent not running report.
    if (!isset($info['match'])) {
        $info['match'] = array(); // match requests
    }

    if (!isset($info['select'])) {
        $info['select'] = array(); // match request responses
    }

    $ppres = sqlStatement("SELECT * FROM procedure_providers ORDER BY name");

    while ($pprow = sqlFetchArray($ppres)) {
        $ppid = (int)$pprow['ppid'];
        $protocol = $pprow['protocol'];
        $remote_host = $pprow['remote_host'];
        $send_account = $pprow['send_fac_id'];
        $recv_account = $pprow['recv_fac_id'];
        $lab_app = $pprow['recv_app_id'];
        $lab_name = $pprow['name'];
        $lab_npi = strtoupper(trim($pprow['npi']));
        $debug = trim($pprow['DorP']) === 'D';
        $hl7 = '';
        $orphanLog = '';
        $log = '';
        $logpath = $GLOBALS['OE_SITE_DIR'] . "/documents/procedure_results/logs/$lab_npi";

        if ($ppid !== $labs && $labs > 0) {
            continue;
        }
        $filecount = 0;
        // Support manual results when doing electronic orders
        // without an existing patient and/or procedure and/or order.
        //
        if (isset($info['orphaned_order'])) {
            $pprow['direction'] = $info['orphaned_order']; // manual results or order not found
        }

        if ($protocol == 'SFTP') {
            $remote_port = 22;
            // Hostname may have ":port" appended to specify a nonstandard port number.
            if ($i = strrpos($remote_host, ':')) {
                $remote_port = (int)substr($remote_host, $i + 1);
                $remote_host = substr($remote_host, 0, $i);
            }

            // Compute the target path name.
            $pathname = '.';
            if ($pprow['results_path']) {
                $pathname = $pprow['results_path'] . '/' . $pathname;
            }

            // Connect to the server and enumerate files to process.
            $sftp = new SFTP($remote_host, $remote_port);
            if (!$sftp->login($pprow['login'], $pprow['password'])) {
                return xl('Login to remote host') . " '$remote_host' " . xl('failed');
            }

            $files = $sftp->nlist($pathname);
            foreach ($files as $file) {
                if (str_starts_with($file, '.')) {
                    continue;
                }

                if (!isset($info["$lab_name/$ppid/$file"])) {
                    $info["$lab_name/$ppid/$file"] = array();
                }

                // Ensure that archive directory exists.
                $prpath = $GLOBALS['OE_SITE_DIR'] . "/documents/procedure_results";
                if (!file_exists($prpath)) {
                    if (!mkdir($prpath, 0755, true) && !is_dir($prpath)) {
                        throw new RuntimeException(sprintf('Directory "%s" was not created', $prpath));
                    }
                }

                $prpath .= '/' . $pprow['ppid'] . '-' . $pprow['npi'];
                if (!file_exists($prpath)) {
                    if (!mkdir($prpath, 0755, true) && !is_dir($prpath)) {
                        throw new RuntimeException(sprintf('Directory "%s" was not created', $prpath));
                    }
                }

                // Get file contents.
                $hl7 = $sftp->get("$pathname/$file");

                ++$filecount;
                $fh = fopen("$prpath/$file", 'w');
                if ($fh) {
                    // Store the file, encrypted when enabled
                    $hl7_crypt = hl7Crypt($hl7);
                    fwrite($fh, $hl7_crypt);
                    fclose($fh);
                    $log .= "Retrieved and Saved File #$filecount: $file\n";
                } else {
                    $log .= "Retrieved but Couldn't Save File #$filecount: $file\n";
                    //return xl('Cannot create file') . ' "' . "$prpath/$file" . '"';
                }

                // If user requested reject and delete, do that.
                if (!empty($info["$lab_name/$ppid/$file"]['delete'])) {
                    $fh = fopen("$prpath/$file.rejected", 'w');
                    if ($fh) {
                        $hl7_crypt = hl7Crypt($hl7);
                        fwrite($fh, $hl7_crypt);
                        fclose($fh);
                    } else {
                        $log .= "Retrieved but Couldn't Save Rejected File #$filecount: $file\n";
                        //return xl('Cannot create file') . ' "' . "$prpath/$file.rejected" . '"';
                    }

                    if (strtoupper($lab_npi) != 'LABCORP') { // this is nuts
                        if (!$sftp->delete("$pathname/$file")) {
                            return xl('Cannot delete (from SFTP server) file') . ' "' . "$pathname/$file" . '"';
                        }
                    }
                    continue;
                }

                if (!match_lab($hl7, $send_account, $recv_account, $lab_app, $lab_npi)) {
                    $log .= "No Lab Account Matched for File #$filecount: Account: $send_account\n";
                    continue;
                }
                if ($filecount > $maxdl) {
                    break;
                }
                // Do a dry run of its contents and check for errors and match requests.
                $tmp = receive_hl7_results($hl7, $info['match'], $ppid, $pprow['direction'], true, $info['select']);
                $log .= "Lab matched account $send_account. Results Dry Run Parse for Errors: " .
                    $tmp['mssgs'] ? print_r($tmp['mssgs'], true) : "None" . "\n";

                $info["$lab_name/$ppid/$file"]['mssgs'] = $tmp['mssgs'];
                // $info["$lab_name/$ppid/$file"]['match'] = $tmp['match'];
                if (!empty($tmp['fatal']) || !empty($tmp['needmatch'])) {
                    // There are errors or matching requests so skip this file.
                    continue;
                }
                $orphanLog = '';
                // Now the money shot - not a dry run.
                $tmp = receive_hl7_results($hl7, $info['match'], $ppid, $pprow['direction'], false, $info['select']);
                $info["$lab_name/$ppid/$file"]['mssgs'] = $tmp['mssgs'];
                // $info["$lab_name/$ppid/$file"]['match'] = $tmp['match'];
                if (empty($tmp['fatal']) && empty($tmp['needmatch'])) {
                    // It worked, archive and delete the file.
                    $fh = fopen("$prpath/$file", 'w');
                    if ($fh) {
                        $hl7_crypt = hl7Crypt($hl7);
                        fwrite($fh, $hl7_crypt);
                        fclose($fh);
                        $log .= "Success Saved Results #$filecount to: $file\n";
                    } else {
                        $log .= "Success but Couldn't Save File #$filecount: $file\n";
                        return xl('Cannot create file') . ' "' . "$prpath/$file" . '"';
                    }
                    if (strtoupper($lab_npi) != 'LABCORP') { // this is nuts
                        if (!$sftp->delete("$pathname/$file")) {
                            return xl('Cannot delete (from SFTP server) file') . ' "' . "$pathname/$file" . '"';
                        }
                    }
                }
            } // end of this file
            if (!file_exists($logpath)) {
                if (!mkdir($logpath, 0755, true) && !is_dir($logpath)) {
                    throw new RuntimeException(sprintf('Directory "%s" was not created', $logpath));
                }
            }
            $logfile = "batchrun_" . date("m-d-y_His") . ".log";
            $fh = fopen("$logpath/$logfile", 'w');
            if ($fh) {
                $logadd = print_r($info, true);
                $log .= "Done Batch Run. Debug shows:\n" . $logadd . "\n";
                fwrite($fh, $log);
                fclose($fh);
            }
        } elseif ($protocol == 'FS') {
            // Filesystem directory containing results files.
            $pathname = $pprow['results_path'];
            if (!($dh = opendir($pathname))) {
                return xl('Unable to access directory for lab npi:') . " $lab_npi";
            }

            // Sort by filename just because.
            $files = array();
            while (false !== ($file = readdir($dh))) {
                if (str_starts_with($file, '.')) {
                    continue;
                }
                if (is_dir($file)) {
                    continue;
                }
                $files[$file] = $file;
            }
            closedir($dh);
            ksort($files);
            // For each file...
            foreach ($files as $file) {
                if (!isset($info["$lab_name/$ppid/$file"])) {
                    $info["$lab_name/$ppid/$file"] = array();
                }

                // Ensure that archive directory exists.
                $prpath = $GLOBALS['OE_SITE_DIR'] . "/documents/procedure_results";
                if (!file_exists($prpath) && !mkdir($prpath, 0755, true) && !is_dir($prpath)) {
                    throw new RuntimeException(sprintf('Directory "%s" was not created', $prpath));
                }

                $prpath .= '/' . $pprow['ppid'] . '-' . $pprow['npi'];
                if (!file_exists($prpath) && !mkdir($prpath, 0755, true) && !is_dir($prpath)) {
                    throw new RuntimeException(sprintf('Directory "%s" was not created', $prpath));
                }

                // Get file contents.
                $hl7 = file_get_contents("$pathname/$file");

                ++$filecount;
                if (empty($hl7)) {
                    $log .= "Result file empty for some reason. #$filecount: $file\n";
                    continue;
                }

                $fh = fopen("$prpath/$file", 'w');
                if ($fh) {
                    $hl7_crypt = hl7Crypt($hl7);
                    fwrite($fh, $hl7_crypt);
                    fclose($fh);
                    $log .= "Retrieved and Saved File #$filecount: $file\n";
                }
                // If user requested reject and delete, do that.
                if (!empty($info["$lab_name/$ppid/$file"]['delete'])) {
                    $fh = fopen("$prpath/$file.rejected", 'w');
                    if ($fh) {
                        $hl7_crypt = hl7Crypt($hl7);
                        fwrite($fh, $hl7_crypt);
                        fclose($fh);
                    } else {
                        return xl('Cannot create file') . ' "' . "$prpath/$file.rejected" . '"';
                    }

                    if (!unlink("$pathname/$file")) {
                        return xl('Cannot delete file') . ' "' . "$pathname/$file" . '"';
                    }

                    continue;
                }

                if (!match_lab($hl7, $send_account, $recv_account, $lab_app, $lab_npi)) {
                    $log .= "No Lab Match File #$filecount: Account: $send_account\n";
                    continue;
                }
                if ($filecount > $maxdl) {
                    break;
                }

                // Do a dry run of its contents and check for errors and match requests.
                $tmp = receive_hl7_results($hl7, $info['match'], $ppid, $pprow['direction'], true, $info['select']);
                if (!empty($tmp['mssgs'])) {
                    $log .= "Lab matched account $send_account. Results Dry Run Parse for Errors: " .
                        $tmp['mssgs'] ? print_r($tmp['mssgs'][0], true) : "None" . "\n";
                }

                $info["$lab_name/$ppid/$file"]['mssgs'] = $tmp['mssgs'];
                // $info["$lab_name/$ppid/$file"]['match'] = $tmp['match'];
                if (!empty($tmp['fatal']) || !empty($tmp['needmatch'])) {
                    // There are errors or matching requests so skip this file.
                    continue;
                }
                $orphanLog = '';
                // Now the money shot - not a dry run.
                $tmp = receive_hl7_results($hl7, $info['match'], $ppid, $pprow['direction'], false, $info['select']);
                $info["$lab_name/$ppid/$file"]['mssgs'] = $tmp['mssgs'];
                // $info["$lab_name/$ppid/$file"]['match'] = $tmp['match'];
                if (empty($tmp['fatal']) && empty($tmp['needmatch'])) {
                    // It worked, archive and delete the file.
                    $fh = fopen("$prpath/$file", 'w');
                    if ($fh) {
                        $hl7_crypt = hl7Crypt($hl7);
                        fwrite($fh, $hl7_crypt);
                        fclose($fh);
                        $log .= "Success Saved Results #$filecount to: $prpath/$file\n";
                    } else {
                        return xl('Cannot create file') . ' "' . "$prpath/$file" . '"';
                    }

                    if (!unlink("$pathname/$file")) {
                        return xl('Cannot delete file') . ' "' . "$pathname/$file" . '"';
                    }
                }
            } // end of this file
            if (!file_exists($logpath)) {
                if (!mkdir($logpath, 0755, true) && !is_dir($logpath)) {
                    throw new RuntimeException(sprintf('Directory "%s" was not created', $logpath));
                }
            }
            $logfile = "batchrun_" . date("m-d-y_His") . ".log";
            $fh = fopen("$logpath/$logfile", 'w');
            if ($fh) {
                $logadd = print_r($info, true);
                $log .= "End of Run Debug Log is:\n" . $logadd . "\n";
                fwrite($fh, $log);
                fclose($fh);
            }
        } elseif ($protocol == 'WS' && strtoupper($lab_npi) == 'QUEST') {
            if ($debug) {
                continue;
            }
            // Compute the target path name.
            $pathname = '.';
            if ($pprow['results_path']) {
                $pathname = $pprow['results_path'] . '/' . $pathname;
            }

            $client = new QuestResultClient($ppid);

            // Connect to the web service and enumerate files to process.

            $client->buildRequest(20);
            $order_results = $client->getResultsBatch(false);
            $request_id = $order_results->requestId;
            $results = $order_results->results;
            if (empty($results)) {
                return ''; // nothing to do
            }

            foreach ($results as $result) {
                $control_id = $result->HL7Message->controlId;
                $file = "result_" . $control_id . ".hl7";

                ++$filecount;
                if (!isset($info["$lab_name/$ppid/$file"])) {
                    $info["$lab_name/$ppid/$file"] = array();
                }

                // Ensure that archive directory exists.
                $prpath = $GLOBALS['OE_SITE_DIR'] . "/documents/procedure_results";
                if (!file_exists($prpath)) {
                    if (!mkdir($prpath, 0755, true) && !is_dir($prpath)) {
                        throw new RuntimeException(sprintf('Directory "%s" was not created', $prpath));
                    }
                }

                $prpath .= '/' . $pprow['ppid'] . '-' . $pprow['npi'];
                if (!file_exists($prpath)) {
                    if (!mkdir($prpath, 0755, true) && !is_dir($prpath)) {
                        throw new RuntimeException(sprintf('Directory "%s" was not created', $prpath));
                    }
                }

                // Get result contents.
                $hl7 = $result->HL7Message->message;
                if (!$hl7) {
                    break;
                }
                $segs = explode("\r", $result->HL7Message->message);
                $a = explode('|', $segs[0]);
                $client->SENDING_FACILITY = $a[5];
                $client->RECEIVING_APPLICATION = $a[2];
                $client->RECEIVING_FACILITY = $a[3];
                unset($segs);
                // If user requested reject and delete, do that.
                if (!empty($info["$lab_name/$ppid/$file"]['delete'])) {
                    $fh = fopen("$prpath/$file.rejected", 'w');
                    if ($fh) {
                        $hl7_crypt = hl7Crypt($hl7);
                        fwrite($fh, $hl7_crypt);
                        fclose($fh);
                    } else {
                        return xl('Cannot create file') . ' "' . "$prpath/$file.rejected" . '"';
                    }

                    $acks = $client->buildResultAck($control_id);
                    $response = $client->sendResultAck($request_id, $acks, false);
                    continue;
                }

                if (!match_lab($hl7, $send_account, $recv_account, $lab_app, $lab_npi)) {
                    $log .= "No Lab Match Account: $send_account\n";
                    continue;
                }

                // Do a dry run of its contents and check for errors and match requests.
                $tmp = receive_hl7_results($hl7, $info['match'], $ppid, $pprow['direction'], true, $info['select']);
                $info["$lab_name/$ppid/$file"]['mssgs'] = $tmp['mssgs'];
                // $info["$lab_name/$ppid/$file"]['match'] = $tmp['match'];
                if (!empty($tmp['fatal']) || !empty($tmp['needmatch'])) {
                    // There are errors or matching requests so skip this file.
                    continue;
                }
                $orphanLog = '';
                // Now the money shot - not a dry run.
                $tmp = receive_hl7_results($hl7, $info['match'], $ppid, $pprow['direction'], false, $info['select']);
                $info["$lab_name/$ppid/$file"]['mssgs'] = $tmp['mssgs'];
                if (empty($tmp['fatal']) && empty($tmp['needmatch'])) {
                    // It worked, archive and delete the file.
                    $fh = fopen("$prpath/$file", 'w');
                    if ($fh) {
                        $hl7_crypt = hl7Crypt($hl7);
                        fwrite($fh, $hl7_crypt);
                        fclose($fh);
                    } else {
                        return xl('Cannot create file') . ' "' . "$prpath/$file" . '"';
                    }
                    // remove ie ack
                    $acks = $client->buildResultAck($control_id);
                    $response = $client->sendResultAck($request_id, $acks, false);
                }
            } // end of this file
            // remove from service.
        } // end quest
        // TBD: Insert "else if ($protocol == '???') {...}" to support other protocols.
    } // end procedure provider

    // echo "<!-- out: "; print_r($info); echo " -->\n"; // debugging

    return '';
}

/**
 * Encrypt the content of the hl7 file if the global is turned on.
 *
 * @param string $content The unencrypted content of the hl7.
 * @return string         The encrypted content of the hl7 if the global is set.
 */
function hl7Crypt($content)
{
    if ($GLOBALS['drive_encryption']) {
        $content = (new CryptoGen())->encryptStandard($content, null, 'database');
    }

    return $content;
}