Clinical Practice Guidelines
2.0.0 - STU2 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: Record Detected Issue Library (Experimental)

Official URL: http://hl7.org/fhir/uv/cpg/Library/recorddetectedissue-library Version: 2.0.0
Active as of 2026-04-29 Computable Name: RecordDetectedIssueLibrary
Other Identifiers: OID:2.16.840.1.113883.4.642.40.48.28.16

Logic for an example recommendation to record a detected issue

Metadata
Title Record Detected Issue Library
Version 2.0.0
Identifier urn:oid:2.16.840.1.113883.4.642.40.48.28.16
Experimental true
Jurisdiction World
Steward (Publisher) HL7 International / Clinical Decision Support
Steward Contact HL7 International / Clinical Decision Support
Description

Logic for an example recommendation to record a detected issue

Type logic-library from http://terminology.hl7.org/CodeSystem/library-type
Dependency Description: Code System Activity Type
Resource: CPG Activity Type Code System
Canonical URL: http://hl7.org/fhir/uv/cpg/CodeSystem/cpg-activity-type-cs
Data Requirement Type: Task
Profile(s): Task
Data Requirement Type: DetectedIssue
Profile(s): DetectedIssue
Parameters
Name Use Card. Type Documentation
Patient Out 0..1 Patient
Inclusion Criteria Out 0..1 boolean
Record Detected Issue Task Out 0..* Task
Detected Issue Out 0..* DetectedIssue
Active or Completed Activity Out 0..* Task
Activity Not Done Out 0..* Task
Activity Proposal Out 0..* Task
Activity Proposal Rejected Out 0..* Task
Is Recommendation Applicable Out 0..1 boolean
Library Content
CQL Content
library RecordDetectedIssue

using FHIR version '4.0.1'

include FHIRHelpers version '4.0.1'

codesystem "Activity Type": 'http://hl7.org/fhir/uv/cpg/CodeSystem/cpg-activity-type-cs'

code "Record detected issue": 'record-detected-issue' from "Activity Type"

context Patient

/* Recommendation to record a detected issue */

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

Specifically:
* There is no terminology, any task on any topic will do
* There is no timing, any task 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 activity.
*/

/*
Positive recommendation:

If the patient meets the inclusion criteria
  If the patient does not have the detected issue
    If recording the detected issue has not been planned or proposed
      Propose recording the detected issue

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 "Record Detected Issue Task":
  [Task] C
    where C.code ~ "Record detected issue"
      and doNotPerform(C) is not true

define "Detected Issue":
  [DetectedIssue] DI
    where DI.status = 'final'

define "Active or Completed Activity":
  "Record Detected Issue Task" C
    where C.status in { 'in-progress', 'on-hold', 'completed' }

define "Activity Not Done":
  "Record Detected Issue Task" C
    where C.status in { 'cancelled', 'failed' }

define "Activity Proposal":
  "Record Detected Issue Task" R
    where R.status in { 'draft', 'requested', 'received', 'accepted', 'ready' }

define "Activity Proposal Rejected":
  "Record Detected Issue Task" R
    where R.status in { 'rejected' }

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

define function doNotPerform(task Task):
  singleton from (
    task.extension E
      where E.url = 'http://hl7.org/fhir/StructureDefinition/request-doNotPerform'
  ).value as boolean
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