Clinical Practice Guidelines
2.0.0-ballot - ballot International flag

Clinical Practice Guidelines, published by HL7 International / Clinical Decision Support. This guide is not an authorized publication; it is the continuous build for version 2.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/cqf-recommendations/ and changes regularly. See the Directory of published versions

Library: Order Medication Library (Experimental)

Official URL: http://hl7.org/fhir/uv/cpg/Library/ordermedication-library Version: 2.0.0-ballot
Active as of 2023-12-19 Computable Name: OrderMedication

Logic for an example recommendation to order a medication

Parameters

Patientout01Patient
Inclusion Criteriaout01boolean
Active or Completed Medication Statementout0*MedicationStatement
Medication Statement Not Takenout0*MedicationStatement
Active or Completed Medication Administrationout0*MedicationAdministration
Medication Administration Not Doneout0*MedicationAdministration
Active or Completed Medication Dispenseout0*MedicationDispense
Medication Dispense Not Doneout0*MedicationDispense
Medication Proposalout0*MedicationRequest
Medication Not Proposedout0*MedicationRequest
Is Recommendation Applicableout01boolean

Data Requirements

Type: MedicationStatement (MedicationStatement)
Type: MedicationStatement (MedicationStatement)
Type: MedicationAdministration (MedicationAdministration)
Type: MedicationAdministration (MedicationAdministration)
Type: MedicationDispense (MedicationDispense)
Type: MedicationDispense (MedicationDispense)
Type: MedicationRequest (MedicationRequest)
Type: MedicationRequest (MedicationRequest)

Contents

text/cql

library OrderMedication

using FHIR version '4.0.1'

include FHIRHelpers version '4.0.1'

context Patient

/* Recommendation to order a medication */

/*
Positive recommendation:

If the medication is not being taken (i.e. dispensed, administered, or documented)
  If the medication has not been ordered
    Propose the medication

Given a proposal, the user can:
  Accept the proposal
  Ignore the proposal
  Reject the proposal without reason
  Reject the proposal with reason

Scenario 1: No event, no plan or proposal, decision support should propose
Scenario 2: No event, incomplete proposal, decision support should not propose
Scenario 3: No event, rejected proposal, decision support should not propose
Scenario 4: Event, no proposal, decision support should not propose
Scenario 5: Event, proposal, decision support should not propose
Scenario 6: Event not done, no proposal, decision support should not propose
Scenario 7: Event not done, proposal, decision support should not propose

*/

define "Inclusion Criteria":
  Patient.active

define "Active or Completed Medication Statement":
  [MedicationStatement] M
    where M.status in { 'active', 'completed', 'intended', 'on-hold' }

define "Medication Statement Not Taken":
  [MedicationStatement] M
    where M.status in { 'not-taken', 'stopped' } // TODO: Is 'stopped' appropriate here?

define "Active or Completed Medication Administration":
  [MedicationAdministration] M
    where M.status in { 'in-progress', 'on-hold', 'completed' }

define "Medication Administration Not Done":
  [MedicationAdministration] M
    where M.status in { 'not-done', 'stopped' } // TODO: Is 'stopped' appropriate here?

define "Active or Completed Medication Dispense":
  [MedicationDispense] M
    where M.status in { 'preparation', 'in-progress', 'on-hold', 'completed' }

define "Medication Dispense Not Done":
  [MedicationDispense] M
    where M.status in { 'cancelled', 'stopped', 'declined' } // TODO: Is 'stopped' appropriate here?

define "Medication Proposal":
  [MedicationRequest] M
    where M.status in { 'draft', 'active', 'on-hold', 'completed' }

define "Medication Not Proposed":
  [MedicationRequest] M
    where M.status in { 'cancelled', 'stopped' }

define "Is Recommendation Applicable":
  "Inclusion Criteria"
    and not exists (
      "Active or Completed Medication Statement"
        union "Medication Statement Not Taken"
        union "Active or Completed Medication Administration"
        union "Medication Administration Not Done"
        union "Active or Completed Medication Dispense"
        union "Medication Dispense Not Done"
    )
    and not exists (
      "Medication Proposal"
        union "Medication Not Proposed"
    )

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