hostpital_doc.py

from reportlab.lib.pagesizes import letter
from reportlab.platypus import SimpleDocTemplate, Paragraph, Spacer, Table, TableStyle, PageBreak
from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle
from reportlab.lib.units import inch
from reportlab.lib import colors
from reportlab.lib.enums import TA_CENTER, TA_LEFT, TA_RIGHT
from datetime import datetime, timedelta
from reportlab.pdfgen import canvas
from reportlab.lib.utils import ImageReader
from reportlab.lib.validators import isValidQR
import io
import os

def create_medical_document():
    # Create the PDF document
    doc = SimpleDocTemplate("hospital_discharge_summary.pdf", pagesize=letter,
                           rightMargin=72, leftMargin=72,
                           topMargin=72, bottomMargin=72)

    # Container for the 'Flowable' objects
    elements = []

    # Styles
    styles = getSampleStyleSheet()

    # Custom styles
    title_style = ParagraphStyle(
        'CustomTitle',
        parent=styles['Heading1'],
        fontSize=18,
        spaceAfter=30,
        alignment=TA_CENTER,
        textColor=colors.darkblue
    )

    heading_style = ParagraphStyle(
        'CustomHeading',
        parent=styles['Heading2'],
        fontSize=14,
        spaceAfter=12,
        textColor=colors.darkblue
    )

    normal_style = ParagraphStyle(
        'CustomNormal',
        parent=styles['Normal'],
        fontSize=11,
        spaceAfter=6,
        leading=14
    )

    small_style = ParagraphStyle(
        'CustomSmall',
        parent=styles['Normal'],
        fontSize=9,
        spaceAfter=3,
        leading=11
    )

    # Calculate dates
    admission_date = datetime(2026, 6, 29)
    discharge_date = admission_date + timedelta(days=14)
    followup_date = discharge_date + timedelta(days=7)
    document_date = discharge_date + timedelta(days=1)

    # Add hospital header with logo placeholder
    header_data = [
        ['<b>SPOTSYLVANIA REGIONAL MEDICAL CENTER</b>', ''],
        ['<b>A Member of the Virginia Health System</b>', ''],
        ['123 Medical Center Drive, Fredericksburg, VA 22408', ''],
        ['Phone: (540) 741-1000 | Fax: (540) 741-1001', ''],
        ['<b>PATIENT DISCHARGE SUMMARY</b>', '']
    ]

    header_table = Table(header_data, colWidths=[5.5*inch, 1.5*inch])
    header_table.setStyle(TableStyle([
        ('ALIGN', (0, 0), (-1, -1), 'LEFT'),
        ('FONTNAME', (0, 0), (0, 0), 'Helvetica-Bold'),
        ('FONTSIZE', (0, 0), (0, 0), 16),
        ('FONTNAME', (0, 1), (0, 1), 'Helvetica'),
        ('FONTSIZE', (0, 1), (0, 1), 10),
        ('FONTNAME', (0, 2), (0, 2), 'Helvetica'),
        ('FONTSIZE', (0, 2), (0, 2), 10),
        ('FONTNAME', (0, 3), (0, 3), 'Helvetica'),
        ('FONTSIZE', (0, 3), (0, 3), 9),
        ('FONTNAME', (0, 4), (0, 4), 'Helvetica-Bold'),
        ('FONTSIZE', (0, 4), (0, 4), 14),
        ('TEXTCOLOR', (0, 4), (0, 4), colors.darkblue),
        ('BOTTOMPADDING', (0, 4), (0, 4), 20),
    ]))

    elements.append(header_table)
    elements.append(Spacer(1, 0.25*inch))

    # Add document info with timestamps
    doc_info_data = [
        ['Document ID:', 'DS-2026-0714-854721369'],
        ['Document Date:', document_date.strftime('%B %d, %Y')],
        ['Document Time:', '10:45 AM'],
        ['Generated By:', 'MEDITECH EHR v6.15'],
        ['Status:', 'FINAL']
    ]

    doc_info_table = Table(doc_info_data, colWidths=[2*inch, 4*inch])
    doc_info_table.setStyle(TableStyle([
        ('ALIGN', (0, 0), (-1, -1), 'LEFT'),
        ('FONTNAME', (0, 0), (0, -1), 'Helvetica-Bold'),
        ('FONTSIZE', (0, 0), (-1, -1), 9),
        ('TEXTCOLOR', (0, 0), (-1, -1), colors.grey),
        ('BOTTOMPADDING', (0, 0), (-1, -1), 3),
        ('TOPPADDING', (0, 0), (-1, -1), 3)
    ]))

    elements.append(doc_info_table)
    elements.append(Spacer(1, 0.25*inch))

    # Patient information section
    elements.append(Paragraph("PATIENT INFORMATION", heading_style))

    patient_data = [
        ['<b>Patient Name:</b>', 'Barry Allen Carrington'],
        ['<b>Date of Birth:</b>', 'March 15, 1975 (Age: 51)'],
        ['<b>Medical Record #:</b>', 'MRN-854721369'],
        ['<b>Account #:</b>', 'ACCT-20260629-7854'],
        ['<b>Admission Date:</b>', admission_date.strftime('%B %d, %Y at 4:32 PM')],
        ['<b>Discharge Date:</b>', discharge_date.strftime('%B %d, %Y at 11:15 AM')],
        ['<b>Length of Stay:</b>', '14 days'],
        ['<b>Admitting Physician:</b>', 'Natasha Y. Powell, DO'],
        ['<b>Primary Nurse:</b>', 'NJ'],
        ['<b>Room/Bed:</b>', '312-B'],
        ['<b>Service:</b>', 'Medicine'],
        ['<b>Discharge Disposition:</b>', 'Home']
    ]

    patient_table = Table(patient_data, colWidths=[2.5*inch, 3.5*inch])
    patient_table.setStyle(TableStyle([
        ('ALIGN', (0, 0), (-1, -1), 'LEFT'),
        ('FONTNAME', (0, 0), (0, -1), 'Helvetica-Bold'),
        ('FONTSIZE', (0, 0), (-1, -1), 10),
        ('BOTTOMPADDING', (0, 0), (-1, -1), 5),
        ('TOPPADDING', (0, 0), (-1, -1), 5),
        ('LINEBELOW', (0, 0), (-1, -1), colors.grey, 0.5)
    ]))

    elements.append(patient_table)
    elements.append(Spacer(1, 0.25*inch))

    # Attending physician signature section
    elements.append(Paragraph("PHYSICIAN SIGNATURE", heading_style))

    signature_data = [
        ['<b>Attending Physician:</b>', 'Natasha Y. Powell, DO'],
        ['<b>Specialty:</b>', 'Infectious Disease'],
        ['<b>NPI #:</b>', '1659457841'],
        ['<b>Signature:</b>', ''],
        ['', 'Electronically signed on ' + discharge_date.strftime('%B %d, %Y at 11:45 AM')],
        ['', 'Authentication: ★★★★★★★★★★'],
        ['', 'Document ID: SIG-20260713-1145-NP-854721369']
    ]

    signature_table = Table(signature_data, colWidths=[2.5*inch, 3.5*inch])
    signature_table.setStyle(TableStyle([
        ('ALIGN', (0, 0), (-1, -1), 'LEFT'),
        ('FONTNAME', (0, 0), (0, -1), 'Helvetica-Bold'),
        ('FONTSIZE', (0, 0), (-1, -1), 10),
        ('BOTTOMPADDING', (0, 0), (-1, -1), 5),
        ('TOPPADDING', (0, 0), (-1, -1), 5),
        ('LINEBELOW', (0, 0), (-1, 0), colors.grey, 0.5),
        ('LINEBELOW', (0, 1), (-1, 1), colors.grey, 0.5),
        ('LINEBELOW', (0, 2), (-1, 2), colors.grey, 0.5),
        ('LINEABOVE', (0, 3), (-1, 3), colors.black, 1),
        ('LINEBELOW', (0, 3), (-1, 3), colors.black, 1),
        ('BOTTOMPADDING', (0, 3), (0, 3), 20)
    ]))

    elements.append(signature_table)
    elements.append(Spacer(1, 0.25*inch))

    # Diagnosis section with ICD-10 codes
    elements.append(Paragraph("DISCHARGE DIAGNOSES (ICD-10-CM)", heading_style))

    diagnosis_data = [
        ['1. B37.9', 'Candidiasis, unspecified - Severe fungal infection with cutaneous manifestations'],
        ['2. N17.9', 'Acute kidney failure, unspecified - Secondary to systemic infection'],
        ['3. R60.9', 'Edema, unspecified - Bilateral lower extremity edema'],
        ['4. L03.915', 'Cellulitis of lower limb - Bilateral lower extremities']
    ]

    diagnosis_table = Table(diagnosis_data, colWidths=[1*inch, 5*inch])
    diagnosis_table.setStyle(TableStyle([
        ('ALIGN', (0, 0), (-1, -1), 'LEFT'),
        ('FONTNAME', (0, 0), (0, -1), 'Helvetica-Bold'),
        ('FONTSIZE', (0, 0), (-1, -1), 10),
        ('LEFTPADDING', (0, 0), (0, -1), 20),
        ('BOTTOMPADDING', (0, 0), (-1, -1), 5),
        ('TOPPADDING', (0, 0), (-1, -1), 5)
    ]))

    elements.append(diagnosis_table)
    elements.append(Spacer(1, 0.25*inch))

    # Hospital course summary
    elements.append(Paragraph("HOSPITAL COURSE SUMMARY", heading_style))

    course_text = """
    <b>History of Present Illness:</b> Patient is a 51-year-old male with no significant past medical history
    who presented to the Emergency Department on June 29, 2026 with a 3-day history of progressive swelling
    and erythema of hands and feet. Patient reported inability to perform basic ADLs including holding a cup
    due to severe swelling and pain. No recent travel or sick contacts. No known exposure to fungal agents.

    <b>Hospital Course:</b> Patient was admitted to Medicine service under Dr. Natasha Powell. Initial evaluation
    showed extensive cutaneous involvement with early signs of systemic response. Laboratory studies revealed
    elevated inflammatory markers (WBC 14.3, CRP 12.4 mg/dL) and evidence of acute renal insufficiency
    (Creatinine 2.1 mg/dL, BUN 32 mg/dL). Blood cultures were obtained and initially negative. Dermatology
    consultation was obtained and skin biopsy performed, confirming severe fungal infection. Patient was
    started on intravenous fluconazole 400mg daily and later switched to oral therapy based on sensitivity
    testing. Renal function gradually improved with supportive care and hydration. Physical therapy was
    involved for functional recovery. Patient's condition gradually improved over 14-day hospitalization
    with resolution of acute symptoms and improvement in renal function (discharge Creatinine 1.3 mg/dL).

    <b>Discharge Condition:</b> Patient is afebrile, hemodynamically stable, with significant improvement
    in swelling and pain of extremities. Renal function has returned to near baseline. Patient is able to
    ambulate with minimal assistance and perform basic ADLs.
    """

    elements.append(Paragraph(course_text, normal_style))
    elements.append(Spacer(1, 0.25*inch))

    # Discharge medications with NDC codes
    elements.append(Paragraph("DISCHARGE MEDICATIONS", heading_style))

    medication_data = [
        ['<b>Medication</b>', '<b>Dosage</b>', '<b>Duration</b>', '<b>Refills</b>', '<b>NDC Code</b>'],
        ['Cephalexin', '500 mg orally three times daily', '7 days', '0', 'NDC: 55319-078-01'],
        ['Sulfamethoxazole-Trimethoprim (Bactrim DS)', '1 tablet orally twice daily', '7 days', '0', 'NDC: 51079-513-20'],
        ['Fluconazole', '200 mg orally once daily', '14 days', '0', 'NDC: 60505-3539-1'],
        ['Lisinopril', '10 mg orally once daily', '30 days', '2', 'NDC: 68180-519-10']
    ]

    medication_table = Table(medication_data, colWidths=[2.5*inch, 1.5*inch, 1*inch, 0.8*inch, 1.2*inch])
    medication_table.setStyle(TableStyle([
        ('ALIGN', (0, 0), (-1, -1), 'LEFT'),
        ('FONTNAME', (0, 0), (-1, 0), 'Helvetica-Bold'),
        ('FONTSIZE', (0, 0), (-1, -1), 9),
        ('BOTTOMPADDING', (0, 0), (-1, -1), 5),
        ('TOPPADDING', (0, 0), (-1, -1), 5),
        ('LINEBELOW', (0, 0), (-1, 0), colors.black, 1),
        ('LINEBELOW', (0, 1), (-1, -1), colors.grey, 0.5)
    ]))

    elements.append(medication_table)
    elements.append(Spacer(1, 0.25*inch))

    # Follow-up instructions
    elements.append(Paragraph("FOLLOW-UP INSTRUCTIONS", heading_style))

    followup_data = [
        ['<b>Specialist</b>', '<b>Clinic</b>', '<b>Date</b>', '<b>Phone</b>', '<b>Status</b>'],
        ['Infectious Disease', 'KHAEN', followup_date.strftime('%m/%d/%Y'), '(540) 741-2000', 'Scheduled'],
        ['Primary Care', 'Fredericksburg Family Practice', (followup_date + timedelta(days=7)).strftime('%m/%d/%Y'), '(540) 373-4000', 'Pending'],
        ['Nephrology', 'Virginia Kidney Specialists', (followup_date + timedelta(days=14)).strftime('%m/%d/%Y'), '(540) 741-3100', 'Pending']
    ]

    followup_table = Table(followup_data, colWidths=[1.5*inch, 2*inch, 1*inch, 1.5*inch, 1*inch])
    followup_table.setStyle(TableStyle([
        ('ALIGN', (0, 0), (-1, -1), 'LEFT'),
        ('FONTNAME', (0, 0), (-1, 0), 'Helvetica-Bold'),
        ('FONTSIZE', (0, 0), (-1, -1), 9),
        ('BOTTOMPADDING', (0, 0), (-1, -1), 5),
        ('TOPPADDING', (0, 0), (-1, -1), 5),
        ('LINEBELOW', (0, 0), (-1, 0), colors.black, 1),
        ('LINEBELOW', (0, 1), (-1, -1), colors.grey, 0.5)
    ]))

    elements.append(followup_table)
    elements.append(Spacer(1, 0.25*inch))

    # Patient instructions
    elements.append(Paragraph("PATIENT INSTRUCTIONS", heading_style))

    instructions_text = """
    <b>Medications:</b> Take all prescribed medications as directed. Do not skip doses. Complete full course of antibiotics.

    <b>Wound Care:</b> Keep hands and feet clean and dry. Avoid prolonged moisture exposure. Change socks daily.

    <b>Activity:</b> Limit activity until follow-up appointment. Avoid prolonged standing or walking until swelling resolves.

    <b>Diet:</b> Follow renal diet as provided. Limit sodium intake to less than 2g per day. Drink 8-10 glasses of water daily unless otherwise directed.

    <b>Monitoring:</b> Monitor for signs of infection recurrence (fever, increased redness, swelling, pain). Check temperature daily.

    <b>Return to ED:</b> Return to emergency department immediately if experiencing fever >101°F, worsening swelling, difficulty breathing, or decreased urine output.
    """

    elements.append(Paragraph(instructions_text, normal_style))
    elements.append(Spacer(1, 0.5*inch))

    # Add page break before footer
    elements.append(PageBreak())

    # Footer with confidentiality notice
    footer_text = """
    <b>CONFIDENTIALITY NOTICE:</b> This document contains confidential patient information protected by federal and state law.
    Unauthorized disclosure is prohibited. If you have received this document in error, please notify us immediately and destroy the document.

    <b>HIPAA PRIVACY NOTICE:</b> This information is being disclosed to you with the patient's written authorization.
    You may not re-disclose this information to any other person or entity without additional written authorization from the patient.

    <b>DOCUMENT AUTHENTICATION:</b> This document was generated through the MEDITECH EHR system on """ + document_date.strftime('%B %d, %Y at %I:%M %P') + """
    and is electronically signed by the attending physician. This document is a legal medical record and is admissible in court.

    <b>QUESTIONS:</b> If you have any questions regarding this document, please contact Health Information Management at (540) 741-1200.
    """

    elements.append(Paragraph(footer_text, small_style))
    elements.append(Spacer(1, 0.25*inch))

    # Add hospital contact information
    contact_info = """
    <b>SPOTSYLVANIA REGIONAL MEDICAL CENTER</b><br/>
    123 Medical Center Drive<br/>
    Fredericksburg, VA 22408<br/>
    Phone: (540) 741-1000<br/>
    Fax: (540) 741-1001<br/>
    Website: www.spotsylvaniahealth.org<br/>
    """

    elements.append(Paragraph(contact_info, small_style))

    # Custom page function to add watermark and page numbers
    def add_page_number(canvas, doc):
        # Add watermark
        canvas.saveState()
        canvas.setFont("Helvetica", 50)
        canvas.setFillColor(colors.grey, alpha=0.1)
        canvas.drawCentredText(letter[0]/2, letter[1]/2, "CONFIDENTIAL")
        canvas.restoreState()

        # Add page number
        canvas.saveState()
        canvas.setFont("Helvetica", 9)
        canvas.setFillColor(colors.grey)
        canvas.drawRightString(letter[0]-0.75*inch, 0.5*inch, "Page %d" % (doc.page))
        canvas.restoreState()

    # Build the document with custom page function
    doc.build(elements, onFirstPage=add_page_number, onLaterPages=add_page_number)
    print("Enhanced medical document created successfully: hospital_discharge_summary.pdf")

# Run the function
if __name__ == "__main__":
    create_medical_document()