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This material contains content from LOINC . LOINC is copyright © 1995-2020, Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee and is available at no cost under the license . LOINC® is a registered United States trademark of Regenstrief Institute, Inc.
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- LOINC: Goal/example-BloodPressureGoal , Observation/example-HomeBloodPressure ... Show 6 more
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®) : AdverseEvent/example-UntreatedAdverseEvent , Hypertension ... Show 21 more
This material derives from the HL7 Terminology (THO). THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license.html
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- LibraryType : FHIR
- Observation Category Codes : Observation/example-HomeBloodPressure

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IG © 2020+ Oregon Health and Science University. Package hl7.fhir.us.ohsuhypertensionig#0.1.0 based on FHIR 4.0.1. Generated 2026-02-19 Links: Table of Contents | QA Report | Version History external | ( src )
hl7.fhir.us.hai: Healthcare Associated Infection Implementation Guide ®© HL7 | CC0 ( src )
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Copyright/Legal: © OHSU 2020+. ( src )
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 ( src )
library FHIRHelpers version '4.0.1' using FHIR version '4.0.1' define function ToInterval(period FHIR.Period): if period is null then null else if period."start" is null then Interval(period."start".value, period."end".value] else Interval[period."start".value, period."end".value] define function ToCalendarUnit(unit System.String): case unit when 'ms' then 'millisecond' when 's' then 'second' when 'min' then 'minute' when 'h' then 'hour' when 'd' then 'day' when 'wk' then 'week' when 'mo' then 'month' when 'a' then 'year' else unit end define function ToQuantity(quantity FHIR.Quantity): case when quantity is null then null when quantity.value is null then null when quantity.comparator is not null then Message(null, true, 'FHIRHelpers.ToQuantity.ComparatorQuantityNotSupported', 'Error', 'FHIR Quantity value has a comparator and cannot be converted to a System.Quantity value.') when quantity.system is null or quantity.system.value = 'http://unitsofmeasure.org' or quantity.system.value = 'http://hl7.org/fhirpath/CodeSystem/calendar-units' then System.Quantity { value: quantity.value.value, unit: ToCalendarUnit(Coalesce(quantity.code.value, quantity.unit.value, '1')) } else Message(null, true, 'FHIRHelpers.ToQuantity.InvalidFHIRQuantity', 'Error', 'Invalid FHIR Quantity code: ' & quantity.unit.value & ' (' & quantity.system.value & '|' & quantity.code.value & ')') end define function ToQuantityIgnoringComparator(quantity FHIR.Quantity): case when quantity is null then null when quantity.value is null then null when quantity.system is null or quantity.system.value = 'http://unitsofmeasure.org' or quantity.system.value = 'http://hl7.org/fhirpath/CodeSystem/calendar-units' then System.Quantity { value: quantity.value.value, unit: ToCalendarUnit(Coalesce(quantity.code.value, quantity.unit.value, '1')) } else Message(null, true, 'FHIRHelpers.ToQuantity.InvalidFHIRQuantity', 'Error', 'Invalid FHIR Quantity code: ' & quantity.unit.value & ' (' & quantity.system.value & '|' & quantity.code.value & ')') end define function ToInterval(quantity FHIR.Quantity): if quantity is null then null else case quantity.comparator.value when '<' then Interval[ null, ToQuantityIgnoringComparator(quantity) ) when '<=' then Interval[ null, ToQuantityIgnoringComparator(quantity) ] when '>=' then Interval[ ToQuantityIgnoringComparator(quantity), null ] when '>' then Interval( ToQuantityIgnoringComparator(quantity), null ] else Interval[ToQuantity(quantity), ToQuantity(quantity)] end define function ToRatio(ratio FHIR.Ratio): if ratio is null then null else System.Ratio { numerator: ToQuantity(ratio.numerator), denominator: ToQuantity(ratio.denominator) } define function ToInterval(range FHIR.Range): if range is null then null else Interval[ToQuantity(range.low), ToQuantity(range.high)] define function ToCode(coding FHIR.Coding): if coding is null then null else System.Code { code: coding.code.value, system: coding.system.value // Deliberately omitting version/display so these aren't considered in comparisons } define function ToConcept(concept FHIR.CodeableConcept): if concept is null then null else System.Concept { codes: concept.coding C return ToCode(C), display: concept.text.value } define function ToString(value AccountStatus): value.value define function ToString(value ActionCardinalityBehavior): value.value define function ToString(value ActionConditionKind): value.value define function ToString(value ActionGroupingBehavior): value.value define function ToString(value ActionParticipantType): value.value define function ToString(value ActionPrecheckBehavior): value.value define function ToString(value ActionRelationshipType): value.value define function ToString(value ActionRequiredBehavior): value.value define function ToString(value ActionSelectionBehavior): value.value define function ToString(value ActivityDefinitionKind): value.value define function ToString(value ActivityParticipantType): value.value define function ToString(value AddressType): value.value define function ToString(value AddressUse): value.value define function ToString(value AdministrativeGender): value.value define function ToString(value AdverseEventActuality): value.value define function ToString(value AggregationMode): value.value define function ToString(value AllergyIntoleranceCategory): value.value define function ToString(value AllergyIntoleranceCriticality): value.value define function ToString(value AllergyIntoleranceSeverity): value.value define function ToString(value AllergyIntoleranceType): value.value define function ToString(value AppointmentStatus): value.value define function ToString(value AssertionDirectionType): value.value define function ToString(value AssertionOperatorType): value.value define function ToString(value AssertionResponseTypes): value.value define function ToString(value AuditEventAction): value.value define function ToString(value AuditEventAgentNetworkType): value.value define function ToString(value AuditEventOutcome): value.value define function ToString(value BindingStrength): value.value define function ToString(value BiologicallyDerivedProductCategory): value.value define function ToString(value BiologicallyDerivedProductStatus): value.value define function ToString(value BiologicallyDerivedProductStorageScale): value.value define function ToString(value BundleType): value.value define function ToString(value CapabilityStatementKind): value.value define function ToString(value CarePlanActivityKind): value.value define function ToString(value CarePlanActivityStatus): value.value define function ToString(value CarePlanIntent): value.value define function ToString(value CarePlanStatus): value.value define function ToString(value CareTeamStatus): value.value define function ToString(value CatalogEntryRelationType): value.value define function ToString(value ChargeItemDefinitionPriceComponentType): value.value define function ToString(value ChargeItemStatus): value.value define function ToString(value ClaimResponseStatus): value.value define function ToString(value ClaimStatus): value.value define function ToString(value ClinicalImpressionStatus): value.value define function ToString(value CodeSearchSupport): value.value define function ToString(value CodeSystemContentMode): value.value define function ToString(value CodeSystemHierarchyMeaning): value.value define function ToString(value CommunicationPriority): value.value define function ToString(value CommunicationRequestStatus): value.value define function ToString(value CommunicationStatus): value.value define function ToString(value CompartmentCode): value.value define function ToString(value CompartmentType): value.value define function ToString(value CompositionAttestationMode): value.value define function ToString(value CompositionStatus): value.value define function ToString(value ConceptMapEquivalence): value.value define function ToString(value ConceptMapGroupUnmappedMode): value.value define function ToString(value ConditionalDeleteStatus): value.value define function ToString(value ConditionalReadStatus): value.value define function ToString(value ConsentDataMeaning): value.value define function ToString(value ConsentProvisionType): value.value define function ToString(value ConsentState): value.value define function ToString(value ConstraintSeverity): value.value define function ToString(value ContactPointSystem): value.value define function ToString(value ContactPointUse): value.value define function ToString(value ContractPublicationStatus): value.value define function ToString(value ContractStatus): value.value define function ToString(value ContributorType): value.value define function ToString(value CoverageStatus): value.value define function ToString(value CurrencyCode): value.value define function ToString(value DayOfWeek): value.value define function ToString(value DaysOfWeek): value.value define function ToString(value DetectedIssueSeverity): value.value define function ToString(value DetectedIssueStatus): value.value define function ToString(value DeviceMetricCalibrationState): value.value define function ToString(value DeviceMetricCalibrationType): value.value define function ToString(value DeviceMetricCategory): value.value define function ToString(value DeviceMetricColor): value.value define function ToString(value DeviceMetricOperationalStatus): value.value define function ToString(value DeviceNameType): value.value define function ToString(value DeviceRequestStatus): value.value define function ToString(value DeviceUseStatementStatus): value.value define function ToString(value DiagnosticReportStatus): value.value define function ToString(value DiscriminatorType): value.value define function ToString(value DocumentConfidentiality): value.value define function ToString(value DocumentMode): value.value define function ToString(value DocumentReferenceStatus): value.value define function ToString(value DocumentRelationshipType): value.value define function ToString(value EligibilityRequestPurpose): value.value define function ToString(value EligibilityRequestStatus): value.value define function ToString(value EligibilityResponsePurpose): value.value define function ToString(value EligibilityResponseStatus): value.value define function ToString(value EnableWhenBehavior): value.value define function ToString(value EncounterLocationStatus): value.value define function ToString(value EncounterStatus): value.value define function ToString(value EndpointStatus): value.value define function ToString(value EnrollmentRequestStatus): value.value define function ToString(value EnrollmentResponseStatus): value.value define function ToString(value EpisodeOfCareStatus): value.value define function ToString(value EventCapabilityMode): value.value define function ToString(value EventTiming): value.value define function ToString(value EvidenceVariableType): value.value define function ToString(value ExampleScenarioActorType): value.value define function ToString(value ExplanationOfBenefitStatus): value.value define function ToString(value ExposureState): value.value define function ToString(value ExtensionContextType): value.value define function ToString(value FHIRAllTypes): value.value define function ToString(value FHIRDefinedType): value.value define function ToString(value FHIRDeviceStatus): value.value define function ToString(value FHIRResourceType): value.value define function ToString(value FHIRSubstanceStatus): value.value define function ToString(value FHIRVersion): value.value define function ToString(value FamilyHistoryStatus): value.value define function ToString(value FilterOperator): value.value define function ToString(value FlagStatus): value.value define function ToString(value GoalLifecycleStatus): value.value define function ToString(value GraphCompartmentRule): value.value define function ToString(value GraphCompartmentUse): value.value define function ToString(value GroupMeasure): value.value define function ToString(value GroupType): value.value define function ToString(value GuidanceResponseStatus): value.value define function ToString(value GuidePageGeneration): value.value define function ToString(value GuideParameterCode): value.value define function ToString(value HTTPVerb): value.value define function ToString(value IdentifierUse): value.value define function ToString(value IdentityAssuranceLevel): value.value define function ToString(value ImagingStudyStatus): value.value define function ToString(value ImmunizationEvaluationStatus): value.value define function ToString(value ImmunizationStatus): value.value define function ToString(value InvoicePriceComponentType): value.value define function ToString(value InvoiceStatus): value.value define function ToString(value IssueSeverity): value.value define function ToString(value IssueType): value.value define function ToString(value LinkType): value.value define function ToString(value LinkageType): value.value define function ToString(value ListMode): value.value define function ToString(value ListStatus): value.value define function ToString(value LocationMode): value.value define function ToString(value LocationStatus): value.value define function ToString(value MeasureReportStatus): value.value define function ToString(value MeasureReportType): value.value define function ToString(value MediaStatus): value.value define function ToString(value MedicationAdministrationStatus): value.value define function ToString(value MedicationDispenseStatus): value.value define function ToString(value MedicationKnowledgeStatus): value.value define function ToString(value MedicationRequestIntent): value.value define function ToString(value MedicationRequestPriority): value.value define function ToString(value MedicationRequestStatus): value.value define function ToString(value MedicationStatementStatus): value.value define function ToString(value MedicationStatus): value.value define function ToString(value MessageSignificanceCategory): value.value define function ToString(value Messageheader_Response_Request): value.value define function ToString(value MimeType): value.value define function ToString(value NameUse): value.value define function ToString(value NamingSystemIdentifierType): value.value define function ToString(value NamingSystemType): value.value define function ToString(value NarrativeStatus): value.value define function ToString(value NoteType): value.value define function ToString(value NutritiionOrderIntent): value.value define function ToString(value NutritionOrderStatus): value.value define function ToString(value ObservationDataType): value.value define function ToString(value ObservationRangeCategory): value.value define function ToString(value ObservationStatus): value.value define function ToString(value OperationKind): value.value define function ToString(value OperationParameterUse): value.value define function ToString(value OrientationType): value.value define function ToString(value ParameterUse): value.value define function ToString(value ParticipantRequired): value.value define function ToString(value ParticipantStatus): value.value define function ToString(value ParticipationStatus): value.value define function ToString(value PaymentNoticeStatus): value.value define function ToString(value PaymentReconciliationStatus): value.value define function ToString(value ProcedureStatus): value.value define function ToString(value PropertyRepresentation): value.value define function ToString(value PropertyType): value.value define function ToString(value ProvenanceEntityRole): value.value define function ToString(value PublicationStatus): value.value define function ToString(value QualityType): value.value define function ToString(value QuantityComparator): value.value define function ToString(value QuestionnaireItemOperator): value.value define function ToString(value QuestionnaireItemType): value.value define function ToString(value QuestionnaireResponseStatus): value.value define function ToString(value ReferenceHandlingPolicy): value.value define function ToString(value ReferenceVersionRules): value.value define function ToString(value ReferredDocumentStatus): value.value define function ToString(value RelatedArtifactType): value.value define function ToString(value RemittanceOutcome): value.value define function ToString(value RepositoryType): value.value define function ToString(value RequestIntent): value.value define function ToString(value RequestPriority): value.value define function ToString(value RequestStatus): value.value define function ToString(value ResearchElementType): value.value define function ToString(value ResearchStudyStatus): value.value define function ToString(value ResearchSubjectStatus): value.value define function ToString(value ResourceType): value.value define function ToString(value ResourceVersionPolicy): value.value define function ToString(value ResponseType): value.value define function ToString(value RestfulCapabilityMode): value.value define function ToString(value RiskAssessmentStatus): value.value define function ToString(value SPDXLicense): value.value define function ToString(value SearchComparator): value.value define function ToString(value SearchEntryMode): value.value define function ToString(value SearchModifierCode): value.value define function ToString(value SearchParamType): value.value define function ToString(value SectionMode): value.value define function ToString(value SequenceType): value.value define function ToString(value ServiceRequestIntent): value.value define function ToString(value ServiceRequestPriority): value.value define function ToString(value ServiceRequestStatus): value.value define function ToString(value SlicingRules): value.value define function ToString(value SlotStatus): value.value define function ToString(value SortDirection): value.value define function ToString(value SpecimenContainedPreference): value.value define function ToString(value SpecimenStatus): value.value define function ToString(value Status): value.value define function ToString(value StrandType): value.value define function ToString(value StructureDefinitionKind): value.value define function ToString(value StructureMapContextType): value.value define function ToString(value StructureMapGroupTypeMode): value.value define function ToString(value StructureMapInputMode): value.value define function ToString(value StructureMapModelMode): value.value define function ToString(value StructureMapSourceListMode): value.value define function ToString(value StructureMapTargetListMode): value.value define function ToString(value StructureMapTransform): value.value define function ToString(value SubscriptionChannelType): value.value define function ToString(value SubscriptionStatus): value.value define function ToString(value SupplyDeliveryStatus): value.value define function ToString(value SupplyRequestStatus): value.value define function ToString(value SystemRestfulInteraction): value.value define function ToString(value TaskIntent): value.value define function ToString(value TaskPriority): value.value define function ToString(value TaskStatus): value.value define function ToString(value TestReportActionResult): value.value define function ToString(value TestReportParticipantType): value.value define function ToString(value TestReportResult): value.value define function ToString(value TestReportStatus): value.value define function ToString(value TestScriptRequestMethodCode): value.value define function ToString(value TriggerType): value.value define function ToString(value TypeDerivationRule): value.value define function ToString(value TypeRestfulInteraction): value.value define function ToString(value UDIEntryType): value.value define function ToString(value UnitsOfTime): value.value define function ToString(value Use): value.value define function ToString(value VariableType): value.value define function ToString(value VisionBase): value.value define function ToString(value VisionEyes): value.value define function ToString(value VisionStatus): value.value define function ToString(value XPathUsageType): value.value define function ToString(value base64Binary): value.value define function ToBoolean(value boolean): value.value define function ToDate(value date): value.value define function ToDateTime(value dateTime): value.value define function ToDecimal(value decimal): value.value define function ToDateTime(value instant): value.value define function ToInteger(value integer): value.value define function ToString(value string): value.value define function ToTime(value time): value.value define function ToString(value uri): value.value define function ToString(value xhtml): value.value ( src )
library OHSUHTNCommon version '0.1' using FHIR version '4.0.1' include FHIRHelpers version '4.0.1' called FHIRHelpers codesystem "LOINC": 'http://loinc.org' codesystem "SNOMED": 'http://snomed.info/sct' codesystem "ConditionClinicalStatusCodes": 'http://terminology.hl7.org/CodeSystem/condition-clinical' codesystem "ConditionVerificationStatusCodes": 'http://terminology.hl7.org/CodeSystem/condition-ver-status' codesystem "v3 Code System ActCode": 'http://terminology.hl7.org/CodeSystem/v3-ActCode' codesystem "ConditionCategorySystem": 'http://terminology.hl7.org/CodeSystem/condition-category' codesystem "Medication request status": 'http://hl7.org/fhir/CodeSystem/medicationrequest-status' valueset "Systolic Blood Pressure": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1104.2' valueset "Diastolic Blood Pressure": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.2.1045' valueset "Blood Pressure Measured": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.2012' valueset "Ambulatory Blood Pressure Monitoring (ABPM)": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.511' valueset "Antihypertensive Medications 1": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1178.10' valueset "Antihypertensive Medications 2": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1200.242' /* Possible exclusions from workflows */ /* valueset "Hypertension": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.3157.4012' */ valueset "Hypertension": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.104.12.1016' valueset "Non essential Hypertension SNOMEDCT": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.10' valueset "Pregnancy": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378' valueset "End Stage Renal Disease": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.2.590' valueset "Hospice care ambulatory": 'http://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1108.15' code "ambulatory": 'AMB' from "v3 Code System ActCode" display 'ambulatory' // Condition Clinical Status Codes - Consider value sets for these code "active": 'active' from "ConditionClinicalStatusCodes" code "recurrence": 'recurrence' from "ConditionClinicalStatusCodes" code "relapse": 'relapse' from "ConditionClinicalStatusCodes" code "inactive": 'inactive' from "ConditionClinicalStatusCodes" code "remission": 'remission' from "ConditionClinicalStatusCodes" code "resolved": 'resolved' from "ConditionClinicalStatusCodes" // Condition Verification Status Codes - Consider value sets for these code "unconfirmed": 'unconfirmed' from ConditionVerificationStatusCodes code "provisional": 'provisional' from ConditionVerificationStatusCodes code "differential": 'differential' from ConditionVerificationStatusCodes code "confirmed": 'confirmed' from ConditionVerificationStatusCodes code "refuted": 'refuted' from ConditionVerificationStatusCodes code "entered-in-error": 'entered-in-error' from ConditionVerificationStatusCodes code "problem-list-item": 'problem-list-item' from "ConditionCategorySystem" display 'Problem List Item' code "encounter-diagnosis": 'encounter-diagnosis' from "ConditionCategorySystem" display 'Encounter Diagnosis' code "home-measurement": '264362003' from "SNOMED" code "Active Medication Request": 'active' from "Medication request status" context Patient define function "Avg Systolic BP"(list List<Tuple { id String, effective DateTime, systolic Decimal, diastolic Decimal, readingType String }>): Avg(list O return all O.systolic) define function "Avg Diastolic BP"(list List<Tuple {id String, effective DateTime, systolic Decimal, diastolic Decimal, readingType String }>): Avg(list O return all O.diastolic) define function "Avg BP"(list List<Tuple { id String, effective DateTime, systolic Decimal, diastolic Decimal, readingType String }>): Tuple { systolic: "Avg Systolic BP"(list), diastolic: "Avg Diastolic BP"(list) } define function "Normal BP"(list List<Tuple { id String, effective DateTime, systolic Decimal, diastolic Decimal, readingType String }>): ("Avg BP"(list)) O where O.systolic <= 130 and O.diastolic <= 80 define function "Elevated or Above BP"(list List<Tuple { id String, effective DateTime, systolic Decimal, diastolic Decimal, readingType String }>): ("Avg BP"(list)) O where O.systolic > 130 or O.diastolic > 80 define function "HTN Stage 1 BP"(list List<Tuple { id String, effective DateTime, systolic Decimal, diastolic Decimal, readingType String }>): ("Avg BP"(list)) O where (O.systolic > 130 and O.systolic <= 140) or (O.diastolic > 80 and O.diastolic <= 90) define function "HTN Stage 2 BP"(list List<Tuple { id String, effective DateTime, systolic Decimal, diastolic Decimal, readingType String }>): ("Avg BP"(list)) O where O.systolic > 140 or O.diastolic > 90 define function "HTN Stage 2 BP Systolic Second Test"(list List<Tuple { id String, effective DateTime, systolic Decimal, diastolic Decimal, readingType String }>): ("Avg BP"(list)) O where O.systolic > 160 define function "HTN Crisis BP"(O Tuple { id String, effective DateTime, systolic Decimal, diastolic Decimal, readingType String }): O.systolic >= 180 or O.diastolic >= 120 define function "HTN Low Crisis BP"(O Tuple { id String, effective DateTime, systolic Decimal, diastolic Decimal, readingType String }): O.systolic < 90 or O.diastolic < 60 /* Helpers */ define function WithUnit(list List<Observation>, Unit String): list Observations where ( ((singleton from (Observations.component C where C.code in "Systolic Blood Pressure").value as FHIR.Quantity).unit.value ~ Unit and (singleton from (Observations.component C where C.code in "Diastolic Blood Pressure").value as FHIR.Quantity).unit.value ~ Unit) or ((singleton from (Observations.component C where C.code in "Systolic Blood Pressure").value as FHIR.Quantity).code.value ~ Unit and (singleton from (Observations.component C where C.code in "Diastolic Blood Pressure").value as FHIR.Quantity).code.value ~ Unit) ) define function WithUnit(value Quantity, Unit String): ( value quantity where ( quantity.code.value ~ Unit or quantity.unit.value ~ Unit ) ) is not null define function BPReadingType(o FHIR.Observation): if ("MeasurementSettings"(o.extension) contains "home-measurement") then 'home' else 'office' define function QualifiedEncounter(list List<FHIR.Encounter>): list Encounter //planned | arrived | triaged | in-progress | onleave | finished | cancelled + where Encounter.status ~ 'finished' define function QualifiedCondition(list List<FHIR.Condition>): list Condition //active | recurrence | relapse | inactive | remission | resolved //where ActiveCondition(Condition) is not null //unconfirmed | provisional | differential | confirmed | refuted | entered-in-error where ConfirmedCondition(Condition) is not null define function QualifiedObservation(list List<FHIR.Observation>): list Observation where ( //registered | preliminary | final | amended | corrected | cancelled | entered-in-error | unknown Observation.status ~ 'final' or Observation.status ~ 'amended' or Observation.status ~ 'corrected' ) define function QualifiedProcedure(list List<FHIR.Procedure>): list Procedure //preparation | in-progress | not-done | on-hold | stopped | completed | entered-in-error | unknown where Procedure.status ~ 'completed' define function ConfirmedCondition(list List<Condition>): list Condition where Condition.verificationStatus is null or FHIRHelpers.ToConcept(Condition.verificationStatus) ~ "confirmed" define function ConfirmedCondition(value Condition): value Condition where Condition.verificationStatus is null or FHIRHelpers.ToConcept(Condition.verificationStatus) ~ "confirmed" define function ActiveCondition(list List<Condition>): list Condition where ( Condition.clinicalStatus is null or FHIRHelpers.ToConcept(Condition.clinicalStatus) ~ "active" ) and Condition.abatement is null define function ActiveCondition(value Condition): value Condition where ( Condition.clinicalStatus is null or FHIRHelpers.ToConcept(Condition.clinicalStatus) ~ "active" ) and Condition.abatement is null define function ActiveOrRecurring(list List<Condition>): list Condition where ActiveCondition(Condition) is not null // ( // FHIRHelpers.ToConcept(Condition.clinicalStatus) ~ "active" // and Condition.abatement is null // ) or FHIRHelpers.ToConcept(Condition.clinicalStatus) ~ "relapse" // Epic sometimes provides the oid instead of the named system, but we need the named system for comparing to ValueSets define function FixEpicSystemMapping(system String): if Matches(system, 'urn:oid:2.16.840.1.113883.6.96') then 'http://snomed.info/sct' else if Matches(system, 'urn:oid:2.16.840.1.113883.6.90') then 'http://hl7.org/fhir/sid/icd-10-cm' else system // Take the list of Codes and replace the systems when needed define function TranformCodeList(list List<System.Code>): list coding return System.Code { code: coding.code, system: FixEpicSystemMapping(coding.system), version: coding.version, display: coding.display } // Transform the codes in the CodeableConcept, replacing the systems when needed define function TransformCodeableConcept(cc FHIR.CodeableConcept): TranformCodeList(FHIRHelpers.ToConcept(cc).codes) define function QualifiedGoal(list List<Goal>): list Goal //proposed | planned | accepted | active | on-hold | completed | cancelled | entered-in-error | rejected where ( Goal.lifecycleStatus ~ 'accepted' or Goal.lifecycleStatus ~ 'active' ) define function "GetId"(uri String): Last(Split(uri, '/')) /* @description: Normalizes a value that is a choice of timing-valued types to an equivalent interval @comment: Normalizes a choice type of FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instance, FHIR.string, FHIR.Age, or FHIR.Range types to an equivalent interval. This selection of choice types is a superset of the majority of choice types that are used as possible representations for timing-valued elements in FHIR, allowing this function to be used across any resource. NOTE: Due to the complexity of determining a single interval from a Timing or String type, this function will throw a run-time exception if it is used with a Timing or String. */ define function "Normalize Interval"(choice Choice<FHIR.dateTime, FHIR.Period, FHIR.Timing, FHIR.instant, FHIR.string, FHIR.Age, FHIR.Range>): case when choice is FHIR.dateTime then Interval[FHIRHelpers.ToDateTime(choice as FHIR.dateTime), FHIRHelpers.ToDateTime(choice as FHIR.dateTime)] when choice is FHIR.Period then FHIRHelpers.ToInterval(choice as FHIR.Period) when choice is FHIR.instant then Interval[FHIRHelpers.ToDateTime(choice as FHIR.instant), FHIRHelpers.ToDateTime(choice as FHIR.instant)] when choice is FHIR.Age then Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age), FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(choice as FHIR.Age) + 1 year) when choice is FHIR.Range then Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).low), FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((choice as FHIR.Range).high) + 1 year) when choice is FHIR.Timing then Message(null as Interval<DateTime>, true, '1', 'Error', 'Cannot compute a single interval from a Timing type') when choice is FHIR.string then Message(null as Interval<DateTime>, true, '1', 'Error', 'Cannot compute an interval from a String value') else null as Interval<DateTime> end define function "Check Goal Start"(choice Choice<FHIR.date,FHIR.CodeableConcept>): case when choice is FHIR.date then FHIRHelpers.ToDate(choice) else null as System.Date end /* @description: Returns an interval representing the normalized Abatement of a given Condition resource. @comment: NOTE: Due to the complexity of determining an interval from a String, this function will throw a run-time exception if used with a Condition instance that has a String as the abatement value. */ define function "Normalize Abatement"(condition Condition): if condition.abatement is FHIR.dateTime then Interval[FHIRHelpers.ToDateTime(condition.abatement as FHIR.dateTime), FHIRHelpers.ToDateTime(condition.abatement as FHIR.dateTime)] else if condition.abatement is FHIR.Period then FHIRHelpers.ToInterval(condition.abatement as FHIR.Period) else if condition.abatement is FHIR.string then Message(null as Interval<DateTime>, true, '1', 'Error', 'Cannot compute an interval from a String value') else if condition.abatement is FHIR.Age then Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(condition.abatement as FHIR.Age), FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity(condition.abatement as FHIR.Age) + 1 year) else if condition.abatement is FHIR.Range then Interval[FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((condition.abatement as FHIR.Range).low), FHIRHelpers.ToDate(Patient.birthDate) + FHIRHelpers.ToQuantity((condition.abatement as FHIR.Range).high) + 1 year) else if condition.abatement is FHIR.boolean then Interval[end of "Normalize Interval"(condition.onset), condition.recordedDate) else null /* @description: returns TRUE if the prevalence period is specified and encompasses today. considers clinical status as a surrogate in the absence of prevalence period components (onset, abatement). */ define function "Is Valid Prevalence Period"(condition Condition): if condition.onset is not null and condition.abatement is not null then start of "Normalize Interval"(condition.onset) <= Today() + 1 day and end of "Normalize Abatement"(condition) >= Today() + 1 day else if condition.clinicalStatus is null or condition.clinicalStatus ~ "active" or condition.clinicalStatus ~ "recurrence" or condition.clinicalStatus ~ "relapse" then if condition.onset is not null then start of "Normalize Interval"(condition.onset) <= Today() + 1 day else if condition.abatement is not null then end of "Normalize Abatement"(condition) >= Today() + 1 day else true else false /* A pregnancy is considered active if one of the following are true: - An onset and abatement exist, and today is after the onset and before the abatement - Clinical status is active or null and -- Only the onset exists and it's at least 42 weeks in the past -- Only the abatement exists and it's in the future -- Only the recorded date exists and it's at least 42 weeks in the past -- No dates exist to provide additional context */ define function "Is Active Pregnancy"(condition Condition): if condition.onset is not null and condition.abatement is not null then start of "Normalize Interval"(condition.onset) <= Today() + 1 day and end of "Normalize Abatement"(condition) >= Today() + 1 day else if condition.clinicalStatus is null or condition.clinicalStatus ~ "active" then if condition.onset is not null then start of "Normalize Interval"(condition.onset) > Today() - 42 week else if condition.abatement is not null then end of "Normalize Abatement"(condition) >= Today() + 1 day else if condition.recordedDate is not null then condition.recordedDate > Today() - 42 week else true else false /* @description: returns true if the procedure was known to be performed in the previous 2 years. Note that 'performed' seems to be going away in FHIR 5 and another way to get at a date could be through a encounter reference, so this is not very robust. This is only used to decide whether to show someone counseling again if the record is stale, and we will err on the side of showing if we don't know. */ define function "Procedure Occurred In Last 2 Years"(procedure Procedure): if procedure is null then false else if procedure.performed is not null then "Normalize Interval"(procedure.performed) ends 24 months or less before Now() else false /* @description: Returns an interval representing the normalized prevalence period of a given Condition resource. DEPRECATED - storer 2022-07-06 - use "Is Valid Prevalence Period" function above instead */ define function "Prevalence Period"(condition Condition): if condition.clinicalStatus ~ "active" or condition.clinicalStatus ~ "recurrence" or condition.clinicalStatus ~ "relapse" // This prevents errors when a condition has an onset and abatement on the same day and no timestamp is provided (Epic) or end of "Normalize Abatement"(condition) is not null then Interval[start of "Normalize Interval"(condition.onset), end of "Normalize Abatement"(condition)] else // The condition is not active but has no abatement date, so we can't say when it ended Interval[start of "Normalize Interval"(condition.onset), null) /* Extract the Category code from the Condition */ define function "Condition Category"(condition FHIR.Condition): FHIRHelpers.ToCode(singleton from (condition.category.coding c where c.system = 'http://terminology.hl7.org/CodeSystem/condition-category')) /***** Common Data *****/ /* Potential Exclusion Criteria */ define "Patient Under Age 18": AgeInYearsAt(Today()) < 18 define "Patient Over Age 100": AgeInYearsAt(Today()) >= 100 // This query will not work in Epic so we rely on at least one Condition to be present in the prefetch define "Conditions": QualifiedCondition(["Condition"]) define "Problem Conditions": "Conditions" C where "Condition Category"(C) ~ "problem-list-item" define "Encounter Conditions": "Conditions" C where "Condition Category"(C) ~ "encounter-diagnosis" define "Condition Indicating End Stage Renal Disease": "Conditions" Condition where TransformCodeableConcept(Condition.code) in "End Stage Renal Disease" and "Is Valid Prevalence Period"(Condition) define "Condition Indicating Pregnancy": "Conditions" Condition where TransformCodeableConcept(Condition.code) in "Pregnancy" and "Is Active Pregnancy"(Condition) define "Condition Indicating Preexisting Hypertension": "Problem Condition Indicating Preexisting Hypertension" union "Encounter Condition Indicating Preexisting Hypertension" define "Problem Condition Indicating Preexisting Hypertension": "Problem Conditions" Condition where (TransformCodeableConcept(Condition.code) in "Hypertension" or TransformCodeableConcept(Condition.code) in "Non essential Hypertension SNOMEDCT") and "Is Valid Prevalence Period"(Condition) define "Encounter Condition Indicating Preexisting Hypertension": "Encounter Conditions" Condition where (TransformCodeableConcept(Condition.code) in "Hypertension" or TransformCodeableConcept(Condition.code) in "Non essential Hypertension SNOMEDCT") // We do not limit Observations by code to prevent CQF Ruler from looking beyond what is provided in the prefetch define "All Observations": ["Observation"] // "Normal" observations with systolic/diastolic components define "Component BP Observations": (WithUnit(QualifiedObservation("All Observations" A where TransformCodeableConcept(A.code) in "Blood Pressure Measured"), 'mm[Hg]')) O return Tuple { id: O.id.value, effective: Coalesce(start of "Normalize Interval"(O.effective), O.issued), systolic: FHIRHelpers.ToQuantity(singleton from (O.component C where C.code in "Systolic Blood Pressure").value).value, diastolic: FHIRHelpers.ToQuantity(singleton from (O.component C where C.code in "Diastolic Blood Pressure").value).value, readingType: BPReadingType(O) } define function ConvertSystolic(systolic List<FHIR.Observation>): systolic O return Tuple { id: O.id.value, effective: Coalesce(start of "Normalize Interval"(O.effective), O.issued), systolic: FHIRHelpers.ToQuantity(O.value).value, diastolic: null as Decimal, readingType: "BPReadingType"(O) } sort by effective define function ConvertDiastolic(diastolic List<FHIR.Observation>): diastolic O return Tuple { id: O.id.value, effective: Coalesce(start of "Normalize Interval"(O.effective), O.issued), systolic: null as Decimal, diastolic: FHIRHelpers.ToQuantity(O.value).value, readingType: "BPReadingType"(O) } /* For each systolic observation, gather a list of diastolic values that match by date */ define function GatherMatches(s List<Tuple { id String, effective DateTime, systolic Decimal, diastolic Decimal, readingType String }>, d List<Tuple { id String, effective DateTime, systolic Decimal, diastolic Decimal, readingType String }>): s S return Tuple { systolicObservation : S, diastolicValues : (d D where S.effective = D.effective and S.readingType = D.readingType).diastolic } /* For each systolic observation with exactly one disatolic match, return the paired observation */ define function PairMatchedBPObservations(list List<Tuple { systolicObservation Tuple {id String, effective DateTime, systolic Decimal, diastolic Decimal, readingType String }, diastolicValues List<Decimal>} > ): (list B where Count(B.diastolicValues) = 1) matched return { // Only keeping the systolic id on the match - this is just for distinguishing unique readings at the same time which should be an edge case id: matched.systolicObservation.id, effective: matched.systolicObservation.effective, systolic: matched.systolicObservation.systolic, diastolic: matched.diastolicValues[0], readingType: matched.systolicObservation.readingType } define function PairBPObservations(s List<Tuple { id String, effective DateTime, systolic Decimal, diastolic Decimal, readingType String }>, d List<Tuple { id String, effective DateTime, systolic Decimal, diastolic Decimal, readingType String }>): PairMatchedBPObservations(GatherMatches(s, d)) define "Paired BP Observations": PairBPObservations(ConvertSystolic(QualifiedObservation("All Observations" A where TransformCodeableConcept(A.code) in "Systolic Blood Pressure")), ConvertDiastolic(QualifiedObservation("All Observations" A where TransformCodeableConcept(A.code) in "Diastolic Blood Pressure"))) define "All BP Observations": "Component BP Observations" union "Paired BP Observations" define "Most Recent BP Reading": Last("All BP Observations" O sort by effective) define "HTN High Crisis": "Most Recent BP Reading" is not null and "HTN Crisis BP"("Most Recent BP Reading") define "HTN Low Crisis": "Most Recent BP Reading" is not null and "HTN Low Crisis BP"("Most Recent BP Reading") define "HTN Crisis": "HTN High Crisis" or "HTN Low Crisis" define "Blood Pressure Observations for Last 2 Years": "All BP Observations" BP where BP.effective + 24 months >= Today() sort by effective define "Blood Pressure Observations for Last 2 Years Descending": "Blood Pressure Observations for Last 2 Years" O sort by effective desc define function MeasurementSettings(list List<Extension>): list Extension where Extension.url = 'http://hl7.org/fhir/us/vitals/StructureDefinition/MeasurementSettingExt' return FHIRHelpers.ToCode(Extension.value) define "Home Blood Pressure Observations": "Blood Pressure Observations for Last 2 Years" O where O.readingType = 'home' define "Office Blood Pressure Observations": "Blood Pressure Observations for Last 2 Years" except "Home Blood Pressure Observations" // Revisit logic when ready to address ambulatory observations. Check out commit 57046448a24d24a767d402e5fa8a96779a488f02 for old logic define "Ambulatory Blood Pressure Monitoring Observations": {} define "Has BP Set": if not exists "Blood Pressure Observations for Last 2 Years" then false else calculateScore("Blood Pressure Observations for Last 2 Years") >= 4 define "Has 12 Home BPs": if not exists "Home Blood Pressure Observations" then false else Count("Home Blood Pressure Observations") >= 12 define function score(observation Tuple { id String, effective DateTime, systolic Decimal, diastolic Decimal, readingType String }): if observation in "Ambulatory Blood Pressure Monitoring Observations" then 0.334 else if observation in "Home Blood Pressure Observations" then 0.334 else 1 define function calculateScore(list List<Tuple { id String, effective DateTime, systolic Decimal, diastolic Decimal, readingType String }>): Sum(list O return all score(O) ) define "Most Recent BP Set": if not "Has BP Set" then null else if calculateScore(Take("Blood Pressure Observations for Last 2 Years Descending", 4)) >= 4 then Take("Blood Pressure Observations for Last 2 Years Descending", 4) else if calculateScore(Take("Blood Pressure Observations for Last 2 Years Descending", 5)) >= 4 then Take("Blood Pressure Observations for Last 2 Years Descending", 5) else if calculateScore(Take("Blood Pressure Observations for Last 2 Years Descending", 6)) >= 4 then Take("Blood Pressure Observations for Last 2 Years Descending", 6) else if calculateScore(Take("Blood Pressure Observations for Last 2 Years Descending", 7)) >= 4 then Take("Blood Pressure Observations for Last 2 Years Descending", 7) else if calculateScore(Take("Blood Pressure Observations for Last 2 Years Descending", 8)) >= 4 then Take("Blood Pressure Observations for Last 2 Years Descending", 8) else if calculateScore(Take("Blood Pressure Observations for Last 2 Years Descending", 9)) >= 4 then Take("Blood Pressure Observations for Last 2 Years Descending", 9) else if calculateScore(Take("Blood Pressure Observations for Last 2 Years Descending", 10)) >= 4 then Take("Blood Pressure Observations for Last 2 Years Descending", 10) else if calculateScore(Take("Blood Pressure Observations for Last 2 Years Descending", 11)) >= 4 then Take("Blood Pressure Observations for Last 2 Years Descending", 11) else if calculateScore(Take("Blood Pressure Observations for Last 2 Years Descending", 12)) >= 4 then Take("Blood Pressure Observations for Last 2 Years Descending", 12) else null define "Average All BP Last 2 Years": "Avg BP"("Blood Pressure Observations for Last 2 Years") define "Average Most Recent BP Set": "Avg BP"("Most Recent BP Set") // Is last BP set or all BPs avge > 130/80? define "Patient Has Potential HTN Stage 1 BP": ( "HTN Stage 1 BP"("Most Recent BP Set") is not null or "HTN Stage 1 BP"("Blood Pressure Observations for Last 2 Years") is not null ) // Is last BP set or all BPs average > 140 SBP or > 90 DBP? define "Patient Has Potential HTN Stage 2 BP": ( "HTN Stage 2 BP"("Most Recent BP Set") is not null or "HTN Stage 2 BP"("Blood Pressure Observations for Last 2 Years") is not null ) // Does patient have a BP goal? define "Qualifying Blood Pressure Goals": (QualifiedGoal(["Goal"])) BPGoal where ( singleton from (BPGoal.target Systolic where Systolic.measure in "Systolic Blood Pressure" and Systolic.detail is Quantity and WithUnit(Systolic.detail, 'mm[Hg]')) ) SystolicTarget is not null and ( singleton from (BPGoal.target Diastolic where Diastolic.measure in "Diastolic Blood Pressure" and Diastolic.detail is Quantity and WithUnit(Diastolic.detail, 'mm[Hg]')) ) DiastolicTarget is not null define "Most Recently Established Blood Pressure Goal": Last ( "Qualifying Blood Pressure Goals" G sort by (Coalesce("Check Goal Start"(start), FHIRHelpers.ToDate(statusDate))) ) define "Patient has a BP Goal": exists "Qualifying Blood Pressure Goals" define "BP from Most Recent Goal": "Most Recently Established Blood Pressure Goal" BPGoal return Tuple { systolic: (singleton from (BPGoal.target Systolic where Systolic.measure in "Systolic Blood Pressure").detail as Quantity).value, diastolic: (singleton from (BPGoal.target Diastolic where Diastolic.measure in "Diastolic Blood Pressure").detail as Quantity).value } define "Above Goal Average Most Recent": "Average Most Recent BP Set".systolic > "BP from Most Recent Goal".systolic or "Average Most Recent BP Set".diastolic > "BP from Most Recent Goal".diastolic define "Active Medication Requests": ["MedicationRequest"] Rx where Rx.status.value ~ "Active Medication Request".code // Medication may be a Reference or a CodeableConcept. Return it as a Medication - only the code matters for processing define function getMedication(Rx MedicationRequest): if Rx.medication is FHIR.Reference then singleton from ([Medication: id in Last(Split(Rx.medication.reference, '/'))]) else Medication {code: Rx.medication} define "Medication Requests With Medication": "Active Medication Requests" Rx let medication: getMedication(Rx) return MedicationRequest { id: Rx.id, status: Rx.status, intent: Rx.intent, category: Rx.category, medication: medication.code, subject: Rx.subject, authoredOn: Rx.authoredOn, recorder: Rx.recorder, dosageInstruction: Rx.dosageInstruction, dispenseRequest: Rx.dispenseRequest } define "Patient is Using Antihypertensive Medications": "Medication Requests With Medication".medication in "Antihypertensive Medications 1" or "Medication Requests With Medication".medication in "Antihypertensive Medications 2" ( src )
© OHSU 2020+. ( src )

External References

Type	Reference	Content
web	snomed.info	org/fhir/us/vitals/StructureDefinition/MeasurementSettingExt : SNOMED CT: 264362003 (Dwelling)
web	www.ohsu.edu	contact : Oregon Health and Science University: https://www.ohsu.edu/
web	snomed.info	111438007
web	snomed.info	123799005
web	snomed.info	123800009
web	snomed.info	14973001
web	snomed.info	169465000
web	snomed.info	194783001
web	snomed.info	194785008
web	snomed.info	194788005
web	snomed.info	194791005
web	snomed.info	199008003
web	snomed.info	26078007
web	snomed.info	28119000
web	snomed.info	31992008
web	snomed.info	39018007
web	snomed.info	39727004
web	snomed.info	427889009
web	snomed.info	428575007
web	snomed.info	48552006
web	snomed.info	57684003
web	snomed.info	73410007
web	snomed.info	74451002
web	snomed.info	89242004
web	snomed.info	171057006
web	snomed.info	183388004
web	snomed.info	20093000
web	snomed.info	23915005
web	snomed.info	24165007
web	snomed.info	281078001
web	snomed.info	35637008
web	snomed.info	386449006
web	snomed.info	408945004
web	snomed.info	408946003
web	snomed.info	408947007
web	snomed.info	408948002
web	snomed.info	413130000
web	snomed.info	413473000
web	snomed.info	429291000124102
web	snomed.info	431260004
web	snomed.info	439903005
web	snomed.info	62213004
web	snomed.info	64297001
web	snomed.info	707166002
web	snomed.info	711118008
web	snomed.info	720175009
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Type

Reference

Content

web

snomed.info

org/fhir/us/vitals/StructureDefinition/MeasurementSettingExt : SNOMED CT: 264362003 (Dwelling)

web

www.ohsu.edu

contact : Oregon Health and Science University: https://www.ohsu.edu/

web

snomed.info

111438007

web

snomed.info

123799005

web

snomed.info

123800009

web

snomed.info

14973001

web

snomed.info

169465000

web

snomed.info

194783001

web

snomed.info

194785008

web

snomed.info

194788005

web

snomed.info

194791005

web

snomed.info

199008003

web

snomed.info

26078007

web

snomed.info

28119000

web

snomed.info

31992008

web

snomed.info

39018007

web

snomed.info

39727004

web

snomed.info

427889009

web

snomed.info

428575007

web

snomed.info

48552006

web

snomed.info

57684003

web

snomed.info

73410007

web

snomed.info

74451002

web

snomed.info

89242004

web

snomed.info

171057006

web

snomed.info

183388004

web

snomed.info

20093000

web

snomed.info

23915005

web

snomed.info

24165007

web

snomed.info

281078001

web

snomed.info

35637008

web

snomed.info

386449006

web

snomed.info

408945004

web

snomed.info

408946003

web

snomed.info

408947007

web

snomed.info

408948002

web

snomed.info

413130000

web

snomed.info

413473000

web

snomed.info

429291000124102

web

snomed.info

431260004

web

snomed.info

439903005

web

snomed.info

62213004

web

snomed.info

64297001

web

snomed.info

707166002

web

snomed.info

711118008

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snomed.info

720175009

web

snomed.info

720176005

web

snomed.info

720178006

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snomed.info

737363002

web

snomed.info

827094004

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snomed.info

87106005

web

snomed.info

164783007

web

snomed.info

413153004

web

snomed.info

448489007

web

snomed.info

448678005

web

snomed.info

271649006

web

snomed.info

399304008

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snomed.info

385763009

web

snomed.info

385765002

web

browser.ihtsdotools.org

281090004

web

browser.ihtsdotools.org

304507003

web

browser.ihtsdotools.org

304549008

web

browser.ihtsdotools.org

386291006

web

browser.ihtsdotools.org

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web

browser.ihtsdotools.org

386373004

web

browser.ihtsdotools.org

386463000

web

browser.ihtsdotools.org

410289001

web

snomed.info

170795002

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snomed.info

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snomed.info

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snomed.info

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snomed.info

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snomed.info

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snomed.info

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snomed.info

361231003

web

snomed.info

370847001

web

snomed.info

386291006

web

snomed.info

386292004

web

snomed.info

386373004

web

snomed.info

386463000

web

snomed.info

386464006

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snomed.info

410177006

web

snomed.info

413315001

web

snomed.info

418995006

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snomed.info

424753004

web

snomed.info

429095004

web

snomed.info

443288003

web

browser.ihtsdotools.org

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web

browser.ihtsdotools.org

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browser.ihtsdotools.org

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web

browser.ihtsdotools.org

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web

browser.ihtsdotools.org

191812006

web

browser.ihtsdotools.org

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browser.ihtsdotools.org

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web

browser.ihtsdotools.org

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web

browser.ihtsdotools.org

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web

browser.ihtsdotools.org

268645007

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browser.ihtsdotools.org

284591009

web

browser.ihtsdotools.org

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web

browser.ihtsdotools.org

66590003

web

browser.ihtsdotools.org

713583005

web

browser.ihtsdotools.org

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web

browser.ihtsdotools.org

714829008

web

browser.ihtsdotools.org

7200002

web

browser.ihtsdotools.org

97571000119109

web

snomed.info

104931000119100

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snomed.info

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web

snomed.info

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web

snomed.info

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web

snomed.info

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snomed.info

11399002

web

snomed.info

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snomed.info

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snomed.info

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web

snomed.info

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web

snomed.info

129151000119102

web

snomed.info

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web

snomed.info

129171000119106

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github.com

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github.com

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

web

www.ohsu.edu

IG © 2020+ Oregon Health and Science University . Package hl7.fhir.us.ohsuhypertensionig#0.1.0 based on FHIR 4.0.1 . Generated 2026-02-19
Links: Table of Contents | QA Report | Version History external

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github.com

CQF Ruler is a HAPI FHIR Server implementation with extensions built-in to implement FHIR's Clinical Reasoning Module , allowing it to execute CQL .

web

hapifhir.io

CQF Ruler is a HAPI FHIR Server implementation with extensions built-in to implement FHIR's Clinical Reasoning Module , allowing it to execute CQL .

web

git-scm.com

To install CQF Ruler, use git to execute the following:

            /git
 $ git clone https://github.com/DBCG/cqf-ruler.git

This will clone the current version of CQF Ruler to the folder in which the above command was executed.

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maven.apache.org

To run CQF Ruler, use Apache Maven to execute the following:

            /git/cqf-ruler
 $ mvn -Djetty.port=8080 jetty:run -am --projects cqf-ruler-r4

This will execute the CQF Ruler service, using its FHIR R4 configuration, on localhost port 8080 .

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github.com

Note that at the time of this writing, CQF Ruler must be run on port 8080 in order for CDS Services to operate correctly. See this issue documented on CQF Ruler's bug tracker for details.

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github.com

To configure CQF Ruler with artifacts in this Implementation Guide, use the PopulateCQFRuler.py script found in this IG's input/ folder:

            /git/htnu18ig/input
 $ python PopulateCQFRuler.py
CQF Ruler URL = http://localhost:8080/cqf-ruler-r4/fhir/
processing valueset-2.16.840.1.113762.1.4.1032.10.json
processing valueset-2.16.840.1.113762.1.4.1032.124.json
processing valueset-2.16.840.1.113762.1.4.1047.511.json
processing valueset-2.16.840.1.113762.1.4.1104.2.json
processing valueset-2.16.840.1.113762.1.4.1108.15.json
processing valueset-2.16.840.1.113762.1.4.1116.418.json
processing valueset-2.16.840.1.113762.1.4.1116.420.json
processing valueset-2.16.840.1.113762.1.4.1146.1330.json
processing valueset-2.16.840.1.113762.1.4.1178.10.json
processing valueset-2.16.840.1.113762.1.4.1195.111.json
processing valueset-2.16.840.1.113762.1.4.1222.24.json
processing valueset-2.16.840.1.113883.3.3157.4012.json
processing valueset-2.16.840.1.113883.3.464.1003.106.11.1030.json
processing valueset-2.16.840.1.113883.3.464.1003.195.12.1003.json
processing valueset-2.16.840.1.113883.3.526.2.1045.json
processing valueset-2.16.840.1.113883.3.526.2.422.json
processing valueset-2.16.840.1.113883.3.526.2.590.json
processing valueset-2.16.840.1.113883.3.526.3.378.json
processing valueset-2.16.840.1.113883.3.526.3.509.json
processing valueset-2.16.840.1.113883.3.600.1.1490.json
processing valueset-2.16.840.1.113883.3.600.2012.json
processing library-AdverseEvents.json
processing library-FHIR-ModelInfo.json
processing library-FHIRHelpers.json
processing library-Hypertension.json
processing library-HypertensiveEmergency.json
processing library-Monitoring.json
processing library-NonPharmacologicIntervention.json
processing library-OHSUHTNCommon.json
processing library-Pharma.json
processing plandefinition-AdverseEvents.json
processing plandefinition-Hypertension.json
processing plandefinition-HypertensiveEmergency.json
processing plandefinition-Monitoring.json
processing plandefinition-NonPharmacologicIntervention.json
processing plandefinition-Pharma.json
processing cqf-tooling.json

            /git/htnu18ig/input
 $

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fhir.epic.com

This is done in large part due to the environment in which this system was developed, which employs a FHIR server backed by an Epic system. At the time of development, Epic requires a ResearchStudy FHIR ID to be included in any AdverseEvent searches, which in the context of our usage both doesn't make sense, and we don't have any such FHIR IDs to reference, making searching for all AdverseEvent resources for a given Patient impossible. In fact, an error is thrown by the FHIR server if a study FHIR ID isn't included on an AdverseEvent search, which cascades through CQF Ruler causing the Recommendation execution to crash. See Epic's FHIR API Specification for AdverseEvent.Search (R4) for details.

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github.com

The client application developed alongside this Implementation Guide ( COACH ) uses Google Gson to deserialize JSON objects produced by CQF Ruler into Java Objects for further processing. See this code fragment for technical details relating to how the JSON is deserialized and processed.

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github.com

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github.com

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mustache.github.io

Note: All data serialized into the Card response is processed by the client application through the Mustache templating engine , in order to tailor the displayed text to the appropriate Audience , either patient or careTeam . That is, when a user logs into the client application via a patient context, any text enclosed within {{#careTeam}}...{{/careTeam}} will be discarded, prior to display. Similarly, when a user logs into the client application via an EHR context, any text enclosed within {{#patient}}...{{/patient}} will be discarded, prior to display.

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github.com

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github.com

Originally, we used CQL borrowed from the FHIR Common file in the CQ Framework to determine whether a condition was active. In practice, we found many conditions falling through the cracks that a clinician would still deem current.

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www.heart.org

AHA: Understanding High Blood Pressure Readings

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www.heart.org

AHA: Monitoring your blood pressure at home

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my.clevelandclinic.org

Cleveland Clinic: 24-hour ambulatory blood pressure monitoring

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www.heart.org

AHA: Understanding Blood Pressure Readings