SMART DAK Cervical Cancer Screening
0.0.1 - ci-build
SMART DAK Cervical Cancer Screening, published by Dan Heslinga (independent contributor). This guide is not an authorized publication; it is the continuous build for version 0.0.1 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/dhes/smart-dak-cxca/ and changes regularly. See the Directory of published versions
| Draft as of 2026-05-14 |
{
"resourceType" : "PlanDefinition",
"id" : "CXCAD18SRecallScheduling",
"meta" : {
"profile" : [
🔗 "http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-recommendationdefinition"
]
},
"text" : {
"status" : "extensions",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<div>\n <table class=\"grid dict\">\n \n <tr>\n <th scope=\"row\"><b>Id: </b></th>\n <td style=\"padding-left: 4px;\">CXCAD18SRecallScheduling</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Url: </b></th>\n <td style=\"padding-left: 4px;\"><a href=\"PlanDefinition-CXCAD18SRecallScheduling.html\">CXCA.D18.S — Recall Scheduling</a></td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Version: </b></th>\n <td style=\"padding-left: 4px;\">0.0.1</td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Title: </b></th>\n <td style=\"padding-left: 4px;\">CXCA.D18.S — Recall Scheduling</td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Status: </b></th>\n <td style=\"padding-left: 4px;\">draft</td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Type: </b></th>\n <td style=\"padding-left: 4px;\">\n \n \n \n <p style=\"margin-bottom: 5px;\">\n <b>system: </b> <span><a href=\"http://terminology.hl7.org/7.1.0/CodeSystem-plan-definition-type.html\">http://terminology.hl7.org/CodeSystem/plan-definition-type</a></span>\n </p>\n \n \n <p style=\"margin-bottom: 5px;\">\n <b>code: </b> <span>eca-rule</span>\n </p>\n \n \n \n \n \n </td>\n </tr>\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Date: </b></th>\n <td style=\"padding-left: 4px;\">2026-05-14 00:50:23+0000</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Publisher: </b></th>\n <td style=\"padding-left: 4px;\">Dan Heslinga (independent contributor)</td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Description: </b></th>\n <td style=\"padding-left: 4px;\"><div><p>Decision support for recall and re-call per Mongolia MOH Order A/641 (2020) section 2.3. Evaluates seven timeout triggers (HPV sample timeout, positive-result follow-up timeout, biopsy timeout, treatment-after-biopsy timeout, cytology unread timeout, second-reminder, missed scheduled exam) and instantiates a CommunicationRequest reminder for each fired trigger. The 187 LTFU women from the April 2026 Khan-Uul pilot represent the empirical case for why this layer matters — DE39 (positive-result follow-up timeout, 4 weeks) is the trigger that should fire for each of them.</p>\n</div></td>\n </tr>\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n <tr>\n <th scope=\"row\"><b>Libraries: </b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n \n <tr>\n <td><a href=\"Library-CXCAD18SRecallSchedulingLogic.html\">CXCAD18SRecallSchedulingLogic</a></td>\n </tr>\n \n </table>\n </td>\n </tr>\n \n\n \n <tr>\n <th scope=\"row\"><b>Actions: </b></th>\n <td style=\"padding-left: 4px;\">\n <table class=\"grid-dict\">\n \n <tr>\n <td>\n \n <b> Recall — HPV sample result missing more than 3 weeks:</b> An HPV sample was dispatched more than 3 weeks ago and no result has been entered. Issue a reminder to follow up with the lab.\n \n <br/>\n \n \n <b>If:</b>\n \n <i>Applicability:</i>\n \n <i>(Recall — HPV sample result timeout)</i>\n <br/>\n \n \n \n \n <b>Then:</b> <i>Definition:</i> <a href=\"ActivityDefinition-CXCAD18ReminderCommunicationRequest.html\">CXCAD18 — Recall Reminder CommunicationRequest</a><br/>\n \n \n \n </td>\n </tr>\n \n <tr>\n <td>\n \n <b> Recall — positive screening result without follow-up exam after 4 weeks:</b> A positive screening result was entered more than 4 weeks ago and no follow-up examination has been recorded. Issue a reminder to the patient and the clinician. THIS IS THE LTFU-PREVENTION TRIGGER — the 187 women lost to follow-up in the April 2026 Khan-Uul pilot would each have had this trigger fire.\n \n <br/>\n \n \n <b>If:</b>\n \n <i>Applicability:</i>\n \n <i>(Recall — positive result follow-up timeout)</i>\n <br/>\n \n \n \n \n <b>Then:</b> <i>Definition:</i> <a href=\"ActivityDefinition-CXCAD18ReminderCommunicationRequest.html\">CXCAD18 — Recall Reminder CommunicationRequest</a><br/>\n \n \n \n </td>\n </tr>\n \n <tr>\n <td>\n \n <b> Recall — biopsy result missing more than 4 weeks:</b> A biopsy sample was received at the lab more than 4 weeks ago and no histopathology result has been entered. Follow up with the lab.\n \n <br/>\n \n \n <b>If:</b>\n \n <i>Applicability:</i>\n \n <i>(Recall — biopsy result timeout)</i>\n <br/>\n \n \n \n \n <b>Then:</b> <i>Definition:</i> <a href=\"ActivityDefinition-CXCAD18ReminderCommunicationRequest.html\">CXCAD18 — Recall Reminder CommunicationRequest</a><br/>\n \n \n \n </td>\n </tr>\n \n <tr>\n <td>\n \n <b> Recall — no treatment record more than 4 weeks after positive biopsy:</b> A positive biopsy result has been entered for more than 4 weeks and no treatment record exists. Issue a reminder to schedule treatment.\n \n <br/>\n \n \n <b>If:</b>\n \n <i>Applicability:</i>\n \n <i>(Recall — treatment after positive biopsy timeout)</i>\n <br/>\n \n \n \n \n <b>Then:</b> <i>Definition:</i> <a href=\"ActivityDefinition-CXCAD18ReminderCommunicationRequest.html\">CXCAD18 — Recall Reminder CommunicationRequest</a><br/>\n \n \n \n </td>\n </tr>\n \n <tr>\n <td>\n \n <b> Recall — cytology slide unread more than 2 weeks at lab:</b> A cytology slide was received more than 2 weeks ago and no cytologist conclusion has been entered. Follow up with the lab.\n \n <br/>\n \n \n <b>If:</b>\n \n <i>Applicability:</i>\n \n <i>(Recall — cytology slide unread timeout)</i>\n <br/>\n \n \n \n \n <b>Then:</b> <i>Definition:</i> <a href=\"ActivityDefinition-CXCAD18ReminderCommunicationRequest.html\">CXCAD18 — Recall Reminder CommunicationRequest</a><br/>\n \n \n \n </td>\n </tr>\n \n <tr>\n <td>\n \n <b> Recall — second reminder needed (first sent more than 4 weeks ago):</b> A first reminder was sent more than 4 weeks ago and the underlying gap remains unresolved. Issue a second reminder.\n \n <br/>\n \n \n <b>If:</b>\n \n <i>Applicability:</i>\n \n <i>(Recall — second reminder needed)</i>\n <br/>\n \n \n \n \n <b>Then:</b> <i>Definition:</i> <a href=\"ActivityDefinition-CXCAD18ReminderCommunicationRequest.html\">CXCAD18 — Recall Reminder CommunicationRequest</a><br/>\n \n \n \n </td>\n </tr>\n \n <tr>\n <td>\n \n <b> Recall — missed scheduled examination:</b> Patient missed a scheduled examination. Immediate reminder — no timeout wait.\n \n <br/>\n \n \n <b>If:</b>\n \n <i>Applicability:</i>\n \n <i>(Recall — missed scheduled examination)</i>\n <br/>\n \n \n \n \n <b>Then:</b> <i>Definition:</i> <a href=\"ActivityDefinition-CXCAD18ReminderCommunicationRequest.html\">CXCAD18 — Recall Reminder CommunicationRequest</a><br/>\n \n \n \n </td>\n </tr>\n \n </table>\n </td>\n </tr>\n \n </table>\n</div>\n</div>"
},
"contained" : [
{
"resourceType" : "Library",
"id" : "effective-data-requirements",
"extension" : [
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CXCAD18SRecallSchedulingLogic"
},
{
"url" : "name",
"valueString" : "Recall — treatment after positive biopsy timeout"
},
{
"url" : "statement",
"valueString" : "/*\n * @output: CXCA.D#DE41 \"Recall: treatment timeout after positive biopsy (4 weeks)\"\n */\ndefine \"Recall — treatment after positive biopsy timeout\":\n \"TreatmentAfterPositiveBiopsyTimedOut\""
},
{
"url" : "displaySequence",
"valueInteger" : 0
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CXCAD18SRecallSchedulingLogic"
},
{
"url" : "name",
"valueString" : "Recall — HPV sample result timeout"
},
{
"url" : "statement",
"valueString" : "// =============================================================================\n// Recall trigger rules — one per A/641 section 2.3 timeout\n// =============================================================================\n\n/*\n * @output: CXCA.D#DE38 \"Recall: HPV sample result timeout (3 weeks)\"\n */\ndefine \"Recall — HPV sample result timeout\":\n \"HPVSampleResultTimedOut\""
},
{
"url" : "displaySequence",
"valueInteger" : 1
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CXCAD18SRecallSchedulingLogic"
},
{
"url" : "name",
"valueString" : "Recall — positive result follow-up timeout"
},
{
"url" : "statement",
"valueString" : "/*\n * @output: CXCA.D#DE39 \"Recall: positive result follow-up timeout (4 weeks)\"\n * The single most important trigger — fires for the LTFU population from\n * the April 2026 Khan-Uul pilot.\n */\ndefine \"Recall — positive result follow-up timeout\":\n \"PositiveResultFollowUpTimedOut\""
},
{
"url" : "displaySequence",
"valueInteger" : 2
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CXCAD18SRecallSchedulingLogic"
},
{
"url" : "name",
"valueString" : "Recall — biopsy result timeout"
},
{
"url" : "statement",
"valueString" : "/*\n * @output: CXCA.D#DE40 \"Recall: biopsy result timeout (4 weeks)\"\n */\ndefine \"Recall — biopsy result timeout\":\n \"BiopsyResultTimedOut\""
},
{
"url" : "displaySequence",
"valueInteger" : 3
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CXCAD18SRecallSchedulingLogic"
},
{
"url" : "name",
"valueString" : "Recall — missed scheduled examination"
},
{
"url" : "statement",
"valueString" : "/*\n * @output: CXCA.D#DE44 \"Recall: missed scheduled examination\"\n * No timeout — fires immediately once a missed appointment is detected.\n */\ndefine \"Recall — missed scheduled examination\":\n \"MissedScheduledExamination\""
},
{
"url" : "displaySequence",
"valueInteger" : 4
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CXCAD18SRecallSchedulingLogic"
},
{
"url" : "name",
"valueString" : "Recall — cytology slide unread timeout"
},
{
"url" : "statement",
"valueString" : "/*\n * @output: CXCA.D#DE42 \"Recall: cytology slide unread timeout (2 weeks)\"\n */\ndefine \"Recall — cytology slide unread timeout\":\n \"CytologySlideUnreadTimedOut\""
},
{
"url" : "displaySequence",
"valueInteger" : 5
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
},
{
"extension" : [
{
"url" : "libraryName",
"valueString" : "CXCAD18SRecallSchedulingLogic"
},
{
"url" : "name",
"valueString" : "Recall — second reminder needed"
},
{
"url" : "statement",
"valueString" : "/*\n * @output: CXCA.D#DE43 \"Recall: second reminder (4 weeks after first)\"\n */\ndefine \"Recall — second reminder needed\":\n \"FirstReminderUnresolvedAtSecondTimeout\""
},
{
"url" : "displaySequence",
"valueInteger" : 6
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition"
}
],
"name" : "EffectiveDataRequirements",
"status" : "active",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/library-type",
"code" : "module-definition"
}
]
},
"relatedArtifact" : [
{
"type" : "depends-on",
"display" : "FHIR model information",
"resource" : "http://fhir.org/guides/cqf/common/Library/FHIR-ModelInfo|4.0.1"
}
],
"parameter" : [
{
"name" : "TreatmentAfterPositiveBiopsyTimedOut",
"use" : "in",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "HPVSampleResultTimedOut",
"use" : "in",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "PositiveResultFollowUpTimedOut",
"use" : "in",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "BiopsyResultTimedOut",
"use" : "in",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "MissedScheduledExamination",
"use" : "in",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "CytologySlideUnreadTimedOut",
"use" : "in",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "FirstReminderUnresolvedAtSecondTimeout",
"use" : "in",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "Recall — treatment after positive biopsy timeout",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "Recall — HPV sample result timeout",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "Recall — positive result follow-up timeout",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "Recall — biopsy result timeout",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "Recall — missed scheduled examination",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "Recall — cytology slide unread timeout",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "boolean"
},
{
"name" : "Recall — second reminder needed",
"use" : "out",
"min" : 0,
"max" : "1",
"type" : "boolean"
}
]
}
],
"extension" : [
{
"url" : "http://smart.who.int/cxca/StructureDefinition/cxca-bindingness",
"valueCoding" : {
"system" : "http://smart.who.int/cxca/CodeSystem/CXCA.Bindingness",
"code" : "legal",
"display" : "Legal — binding regulatory instrument"
}
},
{
"url" : "http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements",
"valueCanonical" : "#effective-data-requirements"
}
],
"url" : "http://smart.who.int/cxca/PlanDefinition/CXCAD18SRecallScheduling",
"version" : "0.0.1",
"name" : "CXCAD18SRecallScheduling",
"title" : "CXCA.D18.S — Recall Scheduling",
"type" : {
"coding" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/plan-definition-type",
"code" : "eca-rule"
}
]
},
"status" : "draft",
"experimental" : false,
"date" : "2026-05-14T00:50:23+00:00",
"publisher" : "Dan Heslinga (independent contributor)",
"contact" : [
{
"name" : "Dan Heslinga (independent contributor)",
"telecom" : [
{
"system" : "url",
"value" : "https://github.com/dhes"
}
]
}
],
"description" : "Decision support for recall and re-call per Mongolia MOH Order A/641 (2020) section 2.3. Evaluates seven timeout triggers (HPV sample timeout, positive-result follow-up timeout, biopsy timeout, treatment-after-biopsy timeout, cytology unread timeout, second-reminder, missed scheduled exam) and instantiates a CommunicationRequest reminder for each fired trigger. The 187 LTFU women from the April 2026 Khan-Uul pilot represent the empirical case for why this layer matters — DE39 (positive-result follow-up timeout, 4 weeks) is the trigger that should fire for each of them.",
"library" : [
🔗 "http://smart.who.int/cxca/Library/CXCAD18SRecallSchedulingLogic"
],
"action" : [
{
"title" : "Recall — HPV sample result missing more than 3 weeks",
"description" : "An HPV sample was dispatched more than 3 weeks ago and no result has been entered. Issue a reminder to follow up with the lab.",
"condition" : [
{
"kind" : "applicability",
"expression" : {
"language" : "text/cql-identifier",
"expression" : "Recall — HPV sample result timeout"
}
}
],
"definitionCanonical" : "http://smart.who.int/cxca/ActivityDefinition/CXCAD18ReminderCommunicationRequest"
},
{
"title" : "Recall — positive screening result without follow-up exam after 4 weeks",
"description" : "A positive screening result was entered more than 4 weeks ago and no follow-up examination has been recorded. Issue a reminder to the patient and the clinician. THIS IS THE LTFU-PREVENTION TRIGGER — the 187 women lost to follow-up in the April 2026 Khan-Uul pilot would each have had this trigger fire.",
"condition" : [
{
"kind" : "applicability",
"expression" : {
"language" : "text/cql-identifier",
"expression" : "Recall — positive result follow-up timeout"
}
}
],
"definitionCanonical" : "http://smart.who.int/cxca/ActivityDefinition/CXCAD18ReminderCommunicationRequest"
},
{
"title" : "Recall — biopsy result missing more than 4 weeks",
"description" : "A biopsy sample was received at the lab more than 4 weeks ago and no histopathology result has been entered. Follow up with the lab.",
"condition" : [
{
"kind" : "applicability",
"expression" : {
"language" : "text/cql-identifier",
"expression" : "Recall — biopsy result timeout"
}
}
],
"definitionCanonical" : "http://smart.who.int/cxca/ActivityDefinition/CXCAD18ReminderCommunicationRequest"
},
{
"title" : "Recall — no treatment record more than 4 weeks after positive biopsy",
"description" : "A positive biopsy result has been entered for more than 4 weeks and no treatment record exists. Issue a reminder to schedule treatment.",
"condition" : [
{
"kind" : "applicability",
"expression" : {
"language" : "text/cql-identifier",
"expression" : "Recall — treatment after positive biopsy timeout"
}
}
],
"definitionCanonical" : "http://smart.who.int/cxca/ActivityDefinition/CXCAD18ReminderCommunicationRequest"
},
{
"title" : "Recall — cytology slide unread more than 2 weeks at lab",
"description" : "A cytology slide was received more than 2 weeks ago and no cytologist conclusion has been entered. Follow up with the lab.",
"condition" : [
{
"kind" : "applicability",
"expression" : {
"language" : "text/cql-identifier",
"expression" : "Recall — cytology slide unread timeout"
}
}
],
"definitionCanonical" : "http://smart.who.int/cxca/ActivityDefinition/CXCAD18ReminderCommunicationRequest"
},
{
"title" : "Recall — second reminder needed (first sent more than 4 weeks ago)",
"description" : "A first reminder was sent more than 4 weeks ago and the underlying gap remains unresolved. Issue a second reminder.",
"condition" : [
{
"kind" : "applicability",
"expression" : {
"language" : "text/cql-identifier",
"expression" : "Recall — second reminder needed"
}
}
],
"definitionCanonical" : "http://smart.who.int/cxca/ActivityDefinition/CXCAD18ReminderCommunicationRequest"
},
{
"title" : "Recall — missed scheduled examination",
"description" : "Patient missed a scheduled examination. Immediate reminder — no timeout wait.",
"condition" : [
{
"kind" : "applicability",
"expression" : {
"language" : "text/cql-identifier",
"expression" : "Recall — missed scheduled examination"
}
}
],
"definitionCanonical" : "http://smart.who.int/cxca/ActivityDefinition/CXCAD18ReminderCommunicationRequest"
}
]
}