Common CQL Artifacts for FHIR (US-Based)
2.0.0-cibuild - Informative 2 - CI Build
Common CQL Artifacts for FHIR (US-Based)
2.0.0-cibuild - Informative 2 - CI Build
Common CQL Artifacts for FHIR (US-Based), published by HL7 International / Clinical Decision Support. This guide is not an authorized publication; it is the continuous build for version 2.0.0-cibuild built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/us-cql-ig/ and changes regularly. See the Directory of published versions
| Official URL: http://hl7.org/fhir/us/cql/ImplementationGuide/hl7.fhir.us.cql | Version: 2.0.0-cibuild | ||||
| IG Standards status: Informative | Maturity Level: 3 | Computable Name: CQLUSCommon | |||
This implementation guide contains architectural guidance and re-usable libraries that facilitate the use of Clinical Quality Language (CQL) with FHIR in the US Realm, with an initial use case of Prior Authorization Support Questionnaires as described in the DaVinci Documentation Templates and Rules (DTR) implementation guide. Much of the guidance and content presented here is built on work done in the quality measurement domain, including patterns established by measure developers as part of testing and developing quality measures for use with FHIR. These patterns have been generalized to support US Core as well as harmonized to be usable across use cases.
The content in this implementation guide is provided for reuse and proposed to help streamline implementation and development of CQL-based knowledge artifacts in the US Realm. The guidance here is published informative and the IG imposes no conformance expectations on systems that make use of it. This does not mean that the content cannot be used in production; the content in this implementation guide is stable as of publication, and will use semantic versioning to communicate change impact across new versions, as described in the CRMI IG versioning topic. In particular, this means that production systems can expect no breaking changes without a corresponding major version increment, and that any minor version increment indicates compatible changes.
This guide is a Content Implementation Guide that supports the use of CQL with FHIR in the US Realm by:
The term artifact here refers to a FHIR resource that is definitional in nature or use such as a Questionnaire, or a Library (as opposed to a FHIR resource that is representing instance-specific data, such as an Observation). This implementation guide provides common artifacts that support the use of CQL with FHIR in the US Realm. The artifacts support a broad range of use cases across the healthcare domain, including prior authorization, quality measurement and reporting, clinical decision support, computable guidelines, and public health case reporting. Any use of CQL within the US Realm could benefit from the artifacts provided here, as well as provide feedback to these artifacts, both in the form of proposed changes to existing artifacts, as well as proposing new artifacts that could be re-used across use cases.
Providing standardized CQL libraries will reduce burden by establishing best practices and reusable expressions for common questions across questionnaires, both currently and into the future. As well, these shared CQL artifacts will support a user with deep clinical knowledge but limited technical knowledge to be able to build and maintain CQL-based questionnaires. Open questionnaire authoring environments (i.e., LHC forms builder) exist and will enable the growth of CQL artifacts (see the Tooling Support page for further discussion).
NOTE: Although the current guidance has been developed based on the prior authorization questionnaires as the first use case, the intent is to capture common patterns, guidance, and artifacts that are usable across use-cases.
The artifacts provided by this implementation guide fall into three general categories:
This implementation guide does not:
This implementation guide is targeted at two main audiences:
This Guide is divided into several pages which are listed at the top of each page in the menu bar:
NOTE: This implementation guide is informative, and therefore does not include a "Specification" topic like many other implementation guides do.
Implementers of this content are encouraged to provide feedback through the usual mechanisms for feedback on HL7 FHIR Implementation Guides, by submitting an issue. To see the current status of the feedback for this specification, see the US CQL Specification Dashboard. For more information on how to submit feedback, refer to the Specification Feedback page in the HL7 confluence.
Feedback submitted to this implementation guide is discussed and resolved in the Clinical Decision Support weekly meeting.
This implementation guide will be published for a two-year implementation period, during which time we will seek implementer feedback, applying as needed. The next ballot of this material will take place when the community indicates sufficient feedback and/or need for an updated release.
This Implementation Guide was made possible by the thoughtful contributions of the following people and organizations:
| IG | Package | FHIR | Comment |
|---|---|---|---|
  Common CQL Artifacts for FHIR (US-Based) | hl7.fhir.us.cql#2.0.0-cibuild | R4 | |
 HL7 Terminology (THO) | hl7.terminology.r4#7.2.0 | R4 | Automatically added as a dependency - all IGs depend on HL7 Terminology |
| FHIR Extensions Pack | hl7.fhir.uv.extensions.r4#5.3.0 | R4 | Automatically added as a dependency - all IGs depend on the HL7 Extension Pack |
| Using CQL With FHIR | hl7.fhir.uv.cql#2.0.0 | R4 | |
| Canonical Resource Management Infrastructure Implementation Guide | hl7.fhir.uv.crmi#1.0.0 | R4 | |
| Structured Data Capture | hl7.fhir.uv.sdc#3.0.0 | R4 | |
| US Core Implementation Guide | hl7.fhir.us.core#7.0.0 | R4 | |
  FHIR Tooling Extensions IG | hl7.fhir.uv.tools.r4#1.1.2 | R4 | for example references |
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.us.cql.r4) and R4B (hl7.fhir.us.cql.r4b) are available.
There are no Global profiles defined
This publication includes IP covered under the following statements.
Many of the examples in this implementation guide are informed by prior authorization forms freely available on the internet and used with permission.
IG © 2019+ HL7 International / Clinical Decision Support.
Package hl7.fhir.us.cql#2.0.0-cibuild based on FHIR 4.0.1.
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2026-07-12
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