Clinical Practice Guidelines
2.0.0 - trial-use 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 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 Service Library (Experimental)

Official URL: http://hl7.org/fhir/uv/cpg/Library/orderservice-library Version: 2.0.0
Active as of 2024-11-21 Computable Name: OrderServiceLibrary
Other Identifiers: OID:2.16.840.1.113883.4.642.40.48.28.13

Logic for an example recommendation to order a service

Generated Narrative: Library orderservice-library

Related Artifacts

Depends OnCode System Task CodesTask Codes

Parameters

Patientout01Patient
Inclusion Criteriaout01boolean
Active or Completed Procedureout0*Procedure
Procedure Not Doneout0*Procedure
Rejected Taskout0*Task
Procedure Proposalout0*ServiceRequest
Procedure Prohibitedout0*ServiceRequest
Procedure Rejectedout0*ServiceRequest
Is Recommendation Applicableout01boolean

Data Requirements

Type: Procedure (Procedure)
Type: Procedure (Procedure)
Type: Task (Task)
Type: ServiceRequest (ServiceRequest)
Type: ServiceRequest (ServiceRequest)
Type: ServiceRequest (ServiceRequest)

Contents

text/cql

library OrderService

using FHIR version '4.0.1'

include FHIRHelpers version '4.0.1'

codesystem "Task Codes": 'http://hl7.org/fhir/CodeSystem/task-code'

code "fulfill": 'fulfill' from "Task Codes" display 'Fulfill'

context Patient

/* Recommendation to order a service */

/*
NOTE: This recommendation is dramatically simplified to illustrate the general
pattern for a positive recommendation, with the ability for users to reject
the recommendation, and flexibility in how the recommendation is achieved.

Specifically:
* There is no terminology, any service request/event on any topic will do
* There is no timing, any service request/event will do at any time
* There is no reference to participants other than the patient
* There is no relationship to a setting
* There is no relationship to an encounter or episode
* There is no relationship to a care plan

These simplifications allow the example to focus exclusively on the pattern for
recommending and for accepting/rejecting the proposal, as well as documenting
the completion, or explicit non-performance of the communication.
*/

/*
Positive recommendation:

If the activity has not been performed
  If the activity has not been planned or proposed
    Propose the activity

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, completed 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 Procedure":
  [Procedure] C
    where C.status in { 'preparation', 'in-progress', 'on-hold', 'completed' }

define "Procedure Not Done":
  [Procedure] C
    where C.status in { 'not-done', 'stopped' }

define "Rejected Task":
  [Task] T
    where T.code ~ "fulfill"
      and T.status = 'rejected'

define "Procedure Proposal":
  [ServiceRequest] R
    without "Rejected Task" T
      such that R.id = Last(Split(T.focus.reference, '/'))
    where R.status in { 'draft', 'active', 'on-hold' }
      and R.doNotPerform is not true

define "Procedure Prohibited":
  [ServiceRequest] R
    where R.status in { 'active' }
      and R.doNotPerform is true

define "Procedure Rejected":
  [ServiceRequest] R
    with "Rejected Task" T
      such that R.id = Last(Split(T.focus.reference, '/'))
    where R.status in { 'draft', 'active', 'on-hold' }
      and R.doNotPerform is not true

define "Is Recommendation Applicable":
  "Inclusion Criteria"
    and not exists (
      "Active or Completed Procedure"
        union "Procedure Not Done"
    )
    and not exists (
      "Procedure Proposal"
        union "Procedure Prohibited"
        union "Procedure Rejected"
    )

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