Canonical Resource Management Infrastructure Implementation Guide, published by HL7 International / Clinical Decision Support. This is not an authorized publication; it is the continuous build for version 1.0.0-ballot. This version is based on the current content of https://github.com/HL7/crmi-ig/ and changes regularly. See the Directory of published versions

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Official URL: http://hl7.org/fhir/uv/crmi/ImplementationGuide/hl7.fhir.uv.crmi				Version: 1.0.0-ballot
Draft as of 2022-05-17				Computable Name: CRMI

Canonical Resource Management Infrastructure Implementation Guide

Summary

The Canonical Resource Management Infrastructure implementation guide defines profiles, operations, capability statements and guidance to facilitate the content management lifecycle for authoring, publishing, distribution, and implementation of FHIR knowledge artifacts such as value sets, profiles, libraries, rules, and measures. The guide is intended to be used by specification and content implementation guide authors as both a dependency for validation of published artifacts, and a guide for construction and publication of content.

This implementation guide is based upon work in multiple quality improvement and reporting domains. Various implementation guides have developed similar infrastructure-level profiles for conformance and knowledge artifacts. These profiles are being refactored into universal-realm, domain-independent profiles that can then be re-used in future versions of those specifications, as well as included in future versions of the base FHIR specification.

Canonical Resource Types

The following is a list of FHIR resource types that are considered canonical resources along with a grouping of these resource types by priority of support within this implementation guide. Priority groupings are first described generally and any specific exceptions to those groupings (e.g., a different prioritization for a particular operation) should be described explicitly elsewhere.

Canonical Resource Types

• ActivityDefinition
• CapabilityStatement
• ChargeItemDefinition (not considered in this IG)
• CodeSystem
• CompartmentDefinition (not profiled because only HL7 can define CompartmentDefinition instances)
• ConceptMap
• ConditionDefinition (roadmap item)
• ClinicalUseDefinition (R5)
• DeviceDefinition (roadmap item)
• EffectEvidenceSynthesis (not considered, uses EBM resources)
• EventDefinition (targeted for removal)
• Evidence (not considered, uses EBM resources)
• EvidenceVariable (not considered, uses EBM resources)
• ExampleScenario (roadmap item)
• GraphDefinition
• Group (non-canonical definitional)
• ImplementationGuide
• Library
• Measure
• Medication (non-canonical definitional)
• MedicationKnowledge (non-canonical definitional)
• MessageDefinition (roadmap item)
• NamingSystem
• ObservationDefinition (roadmap item)
• OperationDefinition
• PlanDefinition
• Questionnaire
• ResearchDefinition (not considered, uses EBM resources)
• ResearchElementDefinition (not considered, uses EBM resources)
• RiskEvidenceSynthesis (not considered, uses EBM resources)
• SearchParameter
• SpecimenDefinition (roadmap item)
• SubscriptionTopic (R5)
• Substance (non-canonical definitional)
• StructureDefinition
• StructureMap (roadmap item)
• TerminologyCapabilities
• TestScript (roadmap item)
• ValueSet

The following groupings of these canonical resources indicate priority of support as well as categorization of capability within this implementation guide:

Knowledge Artifacts (Primary)

• ActivityDefinition
• Library
• Measure
• PlanDefinition
• Questionnaire

Terminology Artifacts (Secondary)

• ValueSet
• CodeSystem
• ConceptMap
• NamingSystem

Conformance Artifacts (Tertiary)

• CapabilityStatement
• CompartmentDefinition
• GraphDefinition
• ImplementationGuide
• MessageDefinition
• OperationDefinition
• StructureDefinition
• StructureMap
• SearchParameter
• SubscriptionTopic (R5)
• TerminologyCapabilities

Domain Definition Artifacts

• ActorDefinition (R5)
• CareTeam (non-canonical definitional)
• ConditionDefinition
• ClinicalUseDefinition (R5)
• DeviceDefinition
• Group (non-canonical definitional)
• Location (non-canonical definitional)
• Medication (non-canonical definitional)
• MedicationKnowledge (non-canonical definitional)
• Practitioner (non-canonical definitional)
• PractitionerRole (non-canonical definitional)
• ObservationDefinition
• Organization (non-canonical definitional)
• SpecimenDefinition
• Substance (non-canonical definitional)

Evidence-based Medicine Artifacts (Quarternary)

If you are using these constructs in R4, this implementation guide provides an approach to supporting content development lifecycle for these resources. However, the EBM-on-FHIR project has made significant changes to these and other EBM resources in R5 and moving forward. Contact the EBM-on-FHIR project if you have needs for these constructs in R5.

• EffectEvidenceSynthesis
• Evidence
• EvidenceVariable
• ResearchDefinition
• ResearchElementDefinition
• RiskEvidenceSynthesis

Related Resources

• ArtifactAssessment (R5) // Example: https://fevir.net/resources/ArtifactAssessment/122618
• Citation (R5)
• Permission (R5)
• Obligation (R5)
• Requirement (R5)

How to read this Guide

This Guide is divided into several pages which are listed at the top of each page in the menu bar:

• Home: Summary and background information for the Canonical Resource Management Infrastructure Implementation Guide
• Introduction: Detailed overview of the content management lifecycle and the background for this guide
• Content Management
  • Content lifecycle: Content lifecycle of knowledge artifacts
  • Naming conventions: Naming conventions for a package of knowledge artifacts, incluing canonical base, url and name, and operation definitions.
  • Using CQL: Using Clinical Quality Language as part of knowledge artifacts
  • Testing: Simple testing specification to support defining, distributing, and verifying test cases for knowledge artifacts
  • Packaging: Packaging requirements for canonical resources and knowledge artifacts
  • Publishing: Publishing requirements for canonical resources and knowledge artifacts
  • Distribution: Distribution requirements for canonical resources and knowledge artifacts
  • Dealing with unversioned canonical references: Guidance for the use of version manifests to facilitate version management and support stable behavior of artifacts
• Profiles: List of profiles defined for use by knowledge artifacts
• Capabilities: Definitions of services and operations in support of authoring, publishing, and distributing canonical resources and knowledge artifacts
• Downloads: Links to downloadable artifacts for implementations.
• Acknowledgements

References

Health level seven. Clinical Quality Framework - HL7 Clinical Decision Support Work Group Confluence Page. [Online]. Available from: https://confluence.hl7.org/display/CQIWC/Clinical Quality Framework [Accessed 11 October 2019].

Health level seven. Publishing terminology to the FHIR Ecosystem - FHIR Product Family Confluence Page. [Online]. Available from: https://confluence.hl7.org/display/FHIR/Publishing+terminology+to+the+FHIR+Ecosystem [Accessed 17 May 2022]

Dependencies

Package hl7.fhir.uv.cpg#1.0.0 Implementation guidance for creating Clinical Practice Guidelines with formal artifacts to facilitate sharing and implementation of the guideline (built Thu, Feb 11, 2021 20:29+0000+00:00)

Package fhir.cqf.common#4.0.1 This implementation guide contains common FHIR assets for use in CQFramework content IGs, including FHIRHelpers and the FHIR-ModelInfo libraries. (built Fri, Nov 12, 2021 16:25+1100+11:00)

Package hl7.fhir.uv.extensions.r4#1.0.0 This IG defines the global extensions - the ones defined for everyone. These extensions are always in scope wherever FHIR is being used (built Sun, Mar 26, 2023 08:46+1100+11:00)

Cross Version Analysis

This is an R4 IG. None of the features it uses are changed in R4B, so it can be used as is with R4B systems. Packages for both R4 (hl7.fhir.uv.crmi.r4) and R4B (hl7.fhir.uv.crmi.r4b) are available.

Global Profiles

There are no Global profiles defined

IP Statements

This publication includes IP covered under the following statements.

• The UCUM codes, UCUM table (regardless of format), and UCUM Specification are copyright 1999-2009, Regenstrief Institute, Inc. and the Unified Codes for Units of Measures (UCUM) Organization. All rights reserved. https://ucum.org/trac/wiki/TermsOfUse
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  • Unified Code for Units of Measure (UCUM): Medication/definition-example, PublishableActivityDefinitionExample, ShareableActivityDefinitionExample and ShareableActivityDefinitionExampleArtifactReference
• This material contains content that is copyright of SNOMED International. Implementers of these specifications must have the appropriate SNOMED CT Affiliate license - for more information contact https://www.snomed.org/get-snomed or info@snomed.org.
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  • SNOMED Clinical Terms® (SNOMED CT®): Medication/definition-example, MedicationKnowledge/definition-example, PublishableActivityDefinitionExample, ShareableActivityDefinitionExample and ShareableActivityDefinitionExampleArtifactReference
• Using RxNorm codes of type SAB=RXNORM as this specification describes does not require a UMLS license. Access to the full set of RxNorm definitions, and/or additional use of other RxNorm structures and information requires a UMLS license. The use of RxNorm in this specification is pursuant to HL7's status as a licensee of the NLM UMLS. HL7's license does not convey the right to use RxNorm to any users of this specification; implementers must acquire a license to use RxNorm in their own right.
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  • RxNorm: Medication/definition-example