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 and changes regularly. See the Directory of published versions

Artifact Packaging

To facilitate publishing and distribution of knowledge artifacts, this Implementation Guide defines several profiles that enable the use of FHIR Bundle to package knowledge artifacts, either independently, or as part of a collection of related artifacts.

Artifact Lifecycle

Knowledge artifacts as represented within FHIR follow a general, high-level content development work flow:

  • draft: The artifact is under development and not yet considered to be ready for normal use. In particular, there is no guarantee that the version element associated with the artifact is established, and the actual content of the artifact may change.
  • active: The artifact is ready for normal use. In particular, the content of the artifact related to the version element is stable and SHALL NOT change. Changes to the artifact require a new version to be introduced in draft status.
  • retired: The artifact has been withdrawn or superseded and should no longer be used.

In addition, the experimental element may be used to indicate that the artifact is intended for testing/experimental usage only and should not be used in production settings.

Packaging Artifacts

In general, artifacts such as libraries, measures, and test cases are packaged as a Bundle of type collection, indicating that the Bundle is a collection of resources for distribution and carries no additional processing semantics (as opposed to a transaction, or document bundle).

An artifact bundle contains the artifact as the first entry in the bundle, and optionally the dependencies and associated artifacts as subsequent entries as follows:

  1. Artifact: The main artifact resource for the package (such as a PlanDefinition, Measure or Library)
  2. Artifact Dependencies: Any artifact dependencies required for use of the artifact
  3. Test Cases: Any test cases defined for the artifact

Artifact content conforming to this implementation guide SHALL use the CPGArtifactBundle profile to package artifacts for distribution.

Packaging for Target Environments

Depending on the capabilities of intended target environments, artifacts may be packaged with different profiles to support different expectations. For example, a ValueSet may be packaged as only an ExecutableValueSet when it is intended for use in an environment that does not have the ability to expand a ComputableValueSet, and needs to be careful about overall resource size. In addition, some environments may have specific formatting expectations, such as the use of JSON for serialization of both FHIR resources and CQL ELM. The profiles in this implementation guide support the construction of these types of packages, but are not prescriptive about that, leaving flexibility for content implementation guides to make decisions relevant to their expected target environments.

Artifact content conforming to this implementation guide SHOULD provide artifact packages appropriate for their expected target environment, and SHALL provide guidance about what those expectations are.

Artifact Collections

In addition to artifact bundles for distribution purposes, this implementation guide supports the definition of an artifact collection using the Library resource to define a collection of related artifacts. The CPGAssetCollection profile supports this capability.

Packaging Test Cases

Basic testing of artifact logic should involve at least one positive and negative test of each artifact. A test case is represented as a set of test resources, together with a expected outcome resource that defines the expected results. The test case bundle can then be used to package and distribute the test case.

For general purpose evaluation and decision support content, the expected outcome is represented using a GuidanceResponse resource, while the use case of measure evaluation is represented using a MeasureReport resource. Test cases in general are represented using a bundle with the following general structure:

  1. Expected Outcome: A GuidanceResponse or MeasureReport containing the expected outcome of the test case.
  2. Test Case Data: Any number of additional resources that define the input test data for the test case.

Content conforming to this implementation guide SHALL use the CPGTestCaseBundle bundle to define and distribute test cases.