US Public Health Profiles Library
1.0.0 - STU1 United States of America flag

US Public Health Profiles Library, published by HL7 Public Health Working Group. This is not an authorized publication; it is the continuous build for version 1.0.0). This version is based on the current content of https://github.com/HL7/fhir-us-ph-common-library-ig/ and changes regularly. See the Directory of published versions

Example Library: US Public Health Executable Library - Rule Filters - Chlamydia Example

Active as of 2023-10-04

Related Artifacts

depends-onFHIR model informationhttp://fhir.org/guides/cqf/common/Library/FHIR-ModelInfo|4.0.1
depends-onLibrary FHIRHelpershttp://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1
depends-onCode system LOINCLogical Observation Identifiers, Names and Codes (LOINC)
depends-onCode system UsageContextUS Public Health CodeSystem - Usage Context Type
depends-onCode system JurisdictionsListUS Public Health CodeSystem Jurisdictions Example
depends-onValue set Chlamydia Laboratory Result Trigger Codeshttp://example.org/fhir/ValueSet/us-ph-triggering-valueset-chlamydia-example
depends-onValue set Indeterminate or Equivocal Lab Result ValueIndeterminate or Equivocal Lab Result Value
depends-onValue set Negative or Undetected Lab Result ValueNegative or Undetected Lab Result Value

Parameters

Triggering Encounterin01Encounter
normalReportingDurationin01Quantity
Patientout01Patient
Chlamydia Test Resultsout0*Observation
Triggering Encountersout0*Encounter
Encounter Location Referencesout0*Reference
Locations Matching Encounter Location Referencesout0*Location
Encounter Location Addressout0*Resource
Patient Addressout0*Resource
Jurisdictionsout0*Resource
Encounter Address Postal Code is in Jurisdiction Codesout0*Resource
Encounter Address State is in Jurisdiction Codesout0*Resource
Patient Address Postal Code is in Jurisdiction Codesout0*Resource
Patient Address State is in Jurisdiction Codesout0*Resource
Address Exists in Jurisdiction Codesout01boolean
Jurisdiction Codes Relevant to Encounter Addressesout0*Resource
Jurisdiction Codes Relevant to Patient Addressesout0*Resource
Indeterminate Chlamydia Test Resultsout0*Observation
Negative Chlamydia Test Resultsout0*Observation
Reportable Triggering Codesout0*Coding
Encounter In Contextout01Encounter
Is Encounter Within Normal Reporting Duration?out01boolean
eICR Compositionsout0*Composition
Existing Reportable Triggering Codesout0*Coding
Is Encounter Reportable and Within Normal Reporting Duration?out01boolean
Is Encounter Longer Than Normal Reporting Duration?out01boolean
Is Encounter In Progressout01boolean
Is Encounter Completeout01boolean
Is Encounter In Progress and Within Normal Reporting Duration or 72h or less after end of encounter?out01boolean
Most recent eICRout01Composition
Most recent eICR sent over 72 hours ago?out01boolean
Suspected Disorder Test Resultsout0*Observation
Suspected Disordersout0*Resource
Is Suspected Disorder?out01boolean

Data Requirements

Type: Patient (Patient)
Type: Composition (Composition)
FilterValue
typeOne of these codes: Logical Observation Identifiers, Names and Codes (LOINC) 55751-2: 55751-2
Type: Encounter (Encounter)
Type: Patient (Patient)
Type: Encounter (Encounter)
Type: Location (Location)
Type: CodeSystem (CodeSystem)
Type: Organization (Organization)
Type: Observation (Observation)
FilterValue
codeIn ValueSet http://example.org/fhir/ValueSet/us-ph-triggering-valueset-chlamydia-example
Type: Location (Location)
Type: CodeSystem (CodeSystem)
Type: CodeSystem (CodeSystem)
Type: Patient (Patient)
Type: CodeSystem (CodeSystem)
Type: Patient (Patient)
Type: Composition (Composition)
FilterValue
typeOne of these codes: Logical Observation Identifiers, Names and Codes (LOINC) 55751-2: 55751-2
Type: Observation (Observation)
Type: Composition (Composition)
FilterValue
typeOne of these codes: Logical Observation Identifiers, Names and Codes (LOINC) 55751-2: 55751-2
Type: Location (Location)
Type: Organization (Organization)
Type: Observation (Observation)
FilterValue
codeIn ValueSet http://example.org/fhir/ValueSet/us-ph-triggering-valueset-chlamydia-example
Type: Encounter (Encounter)
Type: Encounter (Encounter)
Type: Location (Location)
Type: Encounter (Encounter)
Type: CodeSystem (CodeSystem)
Type: Observation (Observation)
FilterValue
codeIn ValueSet http://example.org/fhir/ValueSet/us-ph-triggering-valueset-chlamydia-example

Contents

text/cql

library RuleFilters version '1.0.0'

using FHIR version '4.0.1'

include FHIRHelpers version '4.0.1'

codesystem "LOINC": 'http://loinc.org'
codesystem "UsageContext": 'http://hl7.org/fhir/us/ecr/CodeSystem/us-ph-usage-context-type'
codesystem "JurisdictionsList": 'http://example.org/fhir/CodeSystem/ersd-jurisdictions-example'

// Overall triggering value sets, groupings of all condition-specific value sets, grouped by representation in the information model
valueset "Diagnosis Trigger Codes": 'http://example.org/fhir/ValueSet/valueset-dxtc-example'
valueset "Medication Trigger Codes": 'http://example.org/fhir/ValueSet/valueset-mrtc-example'
valueset "Laboratory Order Trigger Codes": 'http://example.org/fhir/ValueSet/valueset-lotc-example'
valueset "Laboratory Result Trigger Codes": 'http://example.org/fhir/ValueSet/valueset-lrtc-example'
valueset "Organism Substance Trigger Codes": 'http://example.org/fhir/ValueSet/valueset-ostc-example'
valueset "Procedure Trigger Codes": 'http://example.org/fhir/ValueSet/valueset-pctc-example'
valueset "Suspected Disorder Trigger Codes": 'http://example.org/fhir/ValueSet/valueset-sdtc-example'

// Condition-specific triggering codes, these would be listed for each condition
valueset "Chlamydia Laboratory Result Trigger Codes": 'http://example.org/fhir/ValueSet/valueset-chlamydia-example'

// Supplemental (or operational) value sets used in suspected reportability determination logic
valueset "Indeterminate or Equivocal Lab Result Value": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1146.1035'
valueset "Negative or Undetected Lab Result Value": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1146.1034'

code "eICRComposition": '55751-2' from "LOINC"

parameter "Triggering Encounter" Encounter
parameter "normalReportingDuration" default 14 days

context Patient

define "Chlamydia Test Results":
  [Observation: "Chlamydia Laboratory Result Trigger Codes"] O
    where O.status in { 'registered', 'preliminary', 'final', 'amended', 'corrected' }

define "Triggering Encounters":
  [Encounter] E

define "Encounter Location References":
  flatten("Triggering Encounters" TriggeringEncounter
    return TriggeringEncounter.location.location)

define "Locations Matching Encounter Location References":
  [Location] Location
    where exists (
        "Encounter Location References" LocationReference
          where ('Location/' + Location.id) ~ LocationReference.reference
      )

define "Encounter Location Address":
  "Locations Matching Encounter Location References" Address
    return Tuple { state: Address.address.state,  postalCode: Address.address.postalCode }

define "Patient Address":
  Patient.address PA
  return Tuple { state: PA.state, postalCode: PA.postalCode }

define "Jurisdictions":
  flatten([CodeSystem] C
    return C.concept Cpt
      return Tuple { jurisdictionCode: Cpt.code,
        definition: Cpt.definition,
        jurisdictionType: Cpt.property P where P.code='type' return P.value as FHIR.string,
        stateCode: Cpt.property P where P.code = 'state' return P.value as FHIR.code,
        postalCode: Cpt.property P where P.code = 'postalcode' return P.value as FHIR.code
        })

define "Encounter Address Postal Code is in Jurisdiction Codes":
  "Jurisdictions" J
    with "Encounter Location Address" LocationAddress
      such that LocationAddress.postalCode in J.postalCode

define "Encounter Address State is in Jurisdiction Codes":
    "Jurisdictions" J
      with "Encounter Location Address" LocationAddress
        such that LocationAddress.state in J.stateCode
          and 'STATE' in J.jurisdictionType

define "Patient Address Postal Code is in Jurisdiction Codes":
  "Jurisdictions" J
    with "Patient Address" PA
      such that PA.postalCode in J.postalCode

define "Patient Address State is in Jurisdiction Codes":
"Jurisdictions" J
  with "Patient Address" PA
    such that (PA.state.value in J.stateCode
      and 'STATE' in J.jurisdictionType)

define "Address Exists in Jurisdiction Codes":
  exists (
    "Encounter Address State is in Jurisdiction Codes"
      union "Encounter Address Postal Code is in Jurisdiction Codes"
        union "Patient Address State is in Jurisdiction Codes"
          union "Patient Address Postal Code is in Jurisdiction Codes"
    )

define function EncounterAddressJurisdictions():
  if exists ("Encounter Address Postal Code is in Jurisdiction Codes")
    then "Encounter Address Postal Code is in Jurisdiction Codes"
      else "Encounter Address State is in Jurisdiction Codes"

define function PatientAddressJurisdictions():
  if exists ("Patient Address Postal Code is in Jurisdiction Codes")
    then "Patient Address Postal Code is in Jurisdiction Codes"
      else "Patient Address State is in Jurisdiction Codes"

define "Jurisdiction Codes Relevant to Encounter Addresses":
  EncounterAddressJurisdictions()

define "Jurisdiction Codes Relevant to Patient Addresses":
  PatientAddressJurisdictions()

define "Indeterminate Chlamydia Test Results":
  "Chlamydia Test Results" O
    let organization: [Organization]
    where (
      (
        exists (
            O.interpretation interpretationConcept
              where interpretationConcept as CodeableConcept in "Indeterminate or Equivocal Lab Result Value"
        )
          or O.value as CodeableConcept in "Indeterminate or Equivocal Lab Result Value"
      )
        and "Address Exists in Jurisdiction Codes"
    )

define "Negative Chlamydia Test Results":
  "Chlamydia Test Results" O
    let organization: [Organization]
    where (
      (
        exists (
            O.interpretation interpretationConcept
              where interpretationConcept as CodeableConcept in "Negative or Undetected Lab Result Value"
        )
          or O.value as CodeableConcept in "Negative or Undetected Lab Result Value"
      )
        and "Address Exists in Jurisdiction Codes"
    )

define "Reportable Triggering Codes":
  flatten ("Indeterminate Chlamydia Test Results" O return O.code.coding)
    union flatten ("Negative Chlamydia Test Results" O return O.code.coding)
    // ... reportable triggering codes for other conditions

define "Is Encounter Within Normal Reporting Duration?":
  "Current Encounter Duration"("Encounter In Context") <= "normalReportingDuration"

define "Is Encounter Reportable and Within Normal Reporting Duration?":
  exists (
    "Reportable Triggering Codes"
      except "Existing Reportable Triggering Codes"
  )
    and "Is Encounter Within Normal Reporting Duration?"

define "Existing Reportable Triggering Codes":
  flatten (
    "eICR Compositions" C
      return
        C.section.entry.extension E
          where E.url = 'http://hl7.org/fhir/us/ecr/StructureDefinition/eicr-trigger-code-flag-extension'
            return (singleton from (E.extension SE where SE.url = 'triggerCode')).value as Coding
  )

define function "Current Encounter Duration"(encounter Encounter):
  Quantity {
    value: decimal {
      value: duration in days between encounter.period.start and Coalesce(encounter.period.end.value, Now())
    },
    unit: string { value: 'days' }
  }

define "Encounter In Context":
  if "Triggering Encounter" is not null
    then "Triggering Encounter"
      else singleton from "Triggering Encounters"

define "Is Encounter Longer Than Normal Reporting Duration?":
  "Current Encounter Duration"("Encounter In Context") > "normalReportingDuration"

define "Is Encounter In Progress":
  "Encounter In Context".status ~ 'in-progress'

define "Is Encounter Complete":
  "Encounter In Context".status ~ 'finished'

define "Is Encounter In Progress and Within Normal Reporting Duration or 72h or less after end of encounter?":
  (
    "Is Encounter In Progress"
      and "Is Encounter Within Normal Reporting Duration?"
  )
    or (not IsNull("Triggering Encounter") and "Triggering Encounter".period.end 72 hours or less before Now())
    or (exists ("Triggering Encounters") and singleton from "Triggering Encounters".period.end 72 hours or less before Now())

define "eICR Compositions":
  [Composition : "eICRComposition"]

define "Most recent eICR sent over 72 hours ago?":
  if "Most recent eICR" is not null
    then "Most recent eICR".date 72 hours or more before Now()
    else false

define "Most recent eICR":
  First (
    "eICR Compositions" eICRs
      sort by date desc
  )

define "Suspected Disorder Test Results":
  [Observation] O
    where O.status in { 'registered', 'preliminary', 'final', 'amended', 'corrected' }
      and O.value as CodeableConcept in "Suspected Disorder Trigger Codes"

define "Suspected Disorders":
  [Condition: "Suspected Disorder Trigger Codes"]
    union [MedicationRequest: "Suspected Disorder Trigger Codes"]
    union "Suspected Disorder Test Results"

define "Is Suspected Disorder?":
  exists (
    "Suspected Disorders"
  )

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