OHSU Hypertension Implementation Guide
0.1.0 - CI Build Unknown region code '840'

OHSU Hypertension Implementation Guide, published by Oregon Health and Science University. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/OHSUCMP/htnu18ig/ and changes regularly. See the Directory of published versions

Library: Therapy - Medicines Logic

Official URL: http://fhir.org/guides/ohsuhypertensionig/Library/Pharma Version: 0.1.0
Draft as of 2025-02-19 Computable Name: Pharma

Copyright/Legal: Published by OHSU under an Apache 2.0 License

Decision logic for recommendations concerning hypertension medications

Id: Pharma
Url: Therapy - Medicines Logic
Version: 0.1.0
Name: Pharma
Title: Therapy - Medicines Logic
Status: draft
Date: 2025-02-19 23:49:00+0000
Publisher: Oregon Health and Science University
Description:

Decision logic for recommendations concerning hypertension medications
Jurisdiction: 840
Copyright:

Published by OHSU under an Apache 2.0 License
Related Artifacts:
TypeResource
depends-onhttp://fhir.org/guides/cqf/common/Library/FHIR-ModelInfo|4.0.1
depends-onhttp://fhir.org/guides/ohsuhypertensionig/Library/FHIRHelpers|4.0.1
depends-onCommon Logicversion: null0.1.0)
depends-onConditionVerificationStatus
depends-onCondition Category Codes
depends-onMedicationrequest status
depends-onHypertension
depends-onNon essential Hypertension SNOMEDCT
depends-onEnd Stage Renal Disease
depends-onPregnancy
depends-onSystolic blood pressure
depends-onDiastolic Blood Pressure
depends-onBlood Pressure Measured
depends-onAntihypertensive Medications
depends-onAnti Hypertensive Drugs
Parameters:
NameTypeMinMaxIn/Out
PatientPatient01Out
Meets Inclusion Criteriaboolean01Out
Meets Exclusion Criteriaboolean01Out
In Populationboolean01Out
Receive Therapyboolean01Out
Enter Workflowboolean01Out
Recommendationstring01Out
Rationalestring01Out
Suggestionsstring01Out
Selection Behaviorstring01Out
Linksstring01Out
Rationale Combined Datastring01Out
Indicator Statusstring01Out
Test Antihypertensive Medicationsboolean01Out
Data Requirements:
TypeProfileMSCode Filter
Patient http://hl7.org/fhir/StructureDefinition/Patient
Condition http://hl7.org/fhir/StructureDefinition/Condition ;
Observation http://hl7.org/fhir/StructureDefinition/Observation ;
Goal http://hl7.org/fhir/StructureDefinition/Goal ;
MedicationRequest http://hl7.org/fhir/StructureDefinition/MedicationRequest ;;;;;;;;;;
Content: text/cql
library Pharma version '0.1'

using FHIR version '4.0.1'

include FHIRHelpers version '4.0.1' called FHIRHelpers
include OHSUHTNCommon version '0.1' called Common

context Patient

define "Meets Inclusion Criteria":
  exists Common."Condition Indicating Preexisting Hypertension"

define "Meets Exclusion Criteria":
  Common."Patient Under Age 18"
    or Common."Patient Over Age 100"
    or exists Common."Condition Indicating End Stage Renal Disease"
    or exists Common."Condition Indicating Pregnancy"
    or Common."HTN Crisis"

define "In Population":
  // Preserve this ordering so excluded patients fail fast
  not "Meets Exclusion Criteria" and "Meets Inclusion Criteria"

// Pharma Therapy should be received if there are 12 home BPs and goal has not been achieved
define "Receive Therapy":
  Common."Has 12 Home BPs" and Common."Patient has a BP Goal" and Common."Above Goal Average Most Recent"

// Tests conditions from other workflows needed for Pharma intervention to proceed
define "Enter Workflow":
    "In Population" and "Receive Therapy"

define "Recommendation":
  'Blood Pressure is not at goal'

define "Rationale Combined Data":
  "Rationale" + '|' + "Suggestions" + '|' + "Selection Behavior" + '|' + "Links"

define "Rationale":
  if Common."Patient is Using Antihypertensive Medications" then 'Your blood pressure is not at goal despite continuous monitoring. You may want to consider starting or changing antihypertensive medication. Other factors that can contribute to BP not being at goal include excessive stress, new over the counter remedies. Contact your care team to discuss options.'
  else 'Your blood pressure is not at goal despite continuous monitoring. You may want to consider starting or changing antihypertensive medication. Other factors that can contribute to BP not being at goal include excessive stress, new over the counter remedies. Contact your care team to discuss options.'

define "Suggestions":
  if Common."Patient is Using Antihypertensive Medications" then '[ { "id": "contact-suggestion", "label": "Contact care team", "type": "suggestion-link", "actions": [{"label":"Contact your care team about options to control your high blood pressure.", "url":"/contact?token=recommend-advancing-treatment"}] } ]'
  else '[ { "id": "contact-suggestion", "label": "Contact care team", "type": "suggestion-link", "actions": [{"label":"Contact your care team about options to control your high blood pressure.", "url":"/contact?token=recommend-pharma"}] } ]'

define "Indicator Status":
  'warning'

define "Selection Behavior":
  'at-most-one'

define "Links":
  ''

define "Test Antihypertensive Medications":
  Common."Patient is Using Antihypertensive Medications"
Content: application/elm+xml
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Content: application/elm+json
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