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

Data Models and Exchange

This section contains the data models and data exchange protocols with actors and transactions defined. It is part of the L3 machine-readable knowledge representation.

The pages included in this section are described below.

• System Actors — software or human entities that interact with the system, derived from business requirements at the L2 level.
• Sequence Diagrams — interactions between system actors, derived from business processes at L2.
• Transactions — system transactions at an atomic level for each actor.
• Indicators and Measures — the indicators defined in this IG.

Design notes

The decision logic in this DAK is represented as FHIR PlanDefinition resources conformant to the CPG-on-FHIR Computable Plan Definition profile. Each PlanDefinition references one or more CQL Library resources via canonical URL; library content is base64-encoded CQL embedded in the Library resource. PlanDefinition actions reference CQL define statements by name in their condition expressions.

Each clinical workflow step that produces an order is represented as an ActivityDefinition (kind = #ServiceRequest for screening test orders, kind = #CommunicationRequest for recall reminders). PlanDefinition actions invoke ActivityDefinitions via definitionCanonical; at runtime, the ActivityDefinition is instantiated into a real FHIR resource (e.g., a ServiceRequest for HPV testing with intent = #proposal).

The CQL Libraries follow a layered pattern adapted from WHO IMMZ: a shared CXCAElements library at the substrate level (consumed by both decision-support and quality-measure libraries — the harmonization point per the McClure paper) and per-decision logic libraries above it. See Adapting Guidelines for Country Use for the methodology rationale.

CodeSystems and value sets

The data dictionary CXCA.D is the primary CodeSystem; the bindingness vocabulary CXCA.Bindingness is the second. Where this DAK references concepts that have canonical homes elsewhere (FHIR core code systems, LOINC, SNOMED CT, ICD-10), it does so by URL without re-defining them locally; ConceptMaps bridging local concepts to upstream code systems are deferred to a later iteration.

For the full artifact inventory see the Artifact Index.