ISO/HL7 10781 - Electronic Health Record System Functional Model, Release 2.1
0.16.0 - CI Build
ISO/HL7 10781 - Electronic Health Record System Functional Model, Release 2.1
0.16.0 - CI Build
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| Active as of 2024-08-12 |
@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .
# - resource -------------------------------------------------------------------
a fhir:Requirements ;
fhir:nodeRole fhir:treeRoot ;
fhir:id [ fhir:v "EHRSFMR2.1-AS.8.3"] ; #
fhir:meta [
( fhir:profile [
fhir:v "http://hl7.org/ehrs/StructureDefinition/FMFunction"^^xsd:anyURI ;
fhir:link <http://hl7.org/ehrs/StructureDefinition/FMFunction> ] )
] ; #
fhir:text [
fhir:status [ fhir:v "extensions" ] ;
fhir:div "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <span id=\"description\"><b>Statement <a href=\"https://hl7.org/fhir/versions.html#std-process\" title=\"Normative Content\" class=\"normative-flag\">N</a>:</b> <div><p>Support interactions with other systems, applications, and modules to enable the use of cost management information required to guide users and workflows.</p>\n</div></span>\n\n \n <span id=\"purpose\"><b>Description <a href=\"https://hl7.org/fhir/versions.html#std-process\" title=\"Informative Content\" class=\"informative-flag\">I</a>:</b> <div><p>The provider is alerted or presented with the most cost-effective services, referrals, devices, etc., to recommend to the patient. This may be tailored to the patient's health insurance/plan coverage rules. Medications may be presented in order of cost, or the cost of specific interventions may be presented at the time of ordering.</p>\n</div></span>\n \n\n \n\n \n <span id=\"requirements\"><b>Criteria <a href=\"https://hl7.org/fhir/versions.html#std-process\" title=\"Normative Content\" class=\"normative-flag\">N</a>:</b></span>\n \n <table id=\"statements\" class=\"grid dict\">\n \n <tr>\n <td style=\"padding-left: 4px;\">\n \n <span>AS.8.3#01</span>\n \n </td>\n <td style=\"padding-left: 4px;\">\n \n \n \n <span>MAY</span>\n \n </td>\n <td style=\"padding-left: 4px;\" class=\"requirement\">\n \n <span><div><p>The system MAY provide the ability to extract formularies, preferred providers, and other information, from internal or external sources, that are associated with a patient's health care plan and coverage so that the provider can offer cost effective alternatives to patients.</p>\n</div></span>\n \n \n </td>\n </tr>\n \n <tr>\n <td style=\"padding-left: 4px;\">\n \n <span>AS.8.3#02</span>\n \n </td>\n <td style=\"padding-left: 4px;\">\n \n \n \n <span>MAY</span>\n \n </td>\n <td style=\"padding-left: 4px;\" class=\"requirement\">\n \n <span><div><p>The system MAY provide the ability to extract information about exemptions on coverage limitations and guidelines.</p>\n</div></span>\n \n \n </td>\n </tr>\n \n <tr>\n <td style=\"padding-left: 4px;\">\n \n <span>AS.8.3#03</span>\n \n </td>\n <td style=\"padding-left: 4px;\">\n \n \n \n <span>MAY</span>\n \n </td>\n <td style=\"padding-left: 4px;\" class=\"requirement\">\n \n <span><div><p>The system MAY provide the ability to capture or transmit the request for information about exemptions on coverage limitations and guidelines.</p>\n</div></span>\n \n \n </td>\n </tr>\n \n <tr>\n <td style=\"padding-left: 4px;\">\n \n <span>AS.8.3#04</span>\n \n </td>\n <td style=\"padding-left: 4px;\">\n \n \n \n <span>MAY</span>\n \n </td>\n <td style=\"padding-left: 4px;\" class=\"requirement\">\n \n <span><div><p>The system MAY provide the ability to render expected patient out-of- pocket cost information for medications, diagnostic testing, and procedures, from internal or external sources, that are associated with a patients health care plan and coverage.</p>\n</div></span>\n \n \n </td>\n </tr>\n \n <tr>\n <td style=\"padding-left: 4px;\">\n \n <span>AS.8.3#05</span>\n \n </td>\n <td style=\"padding-left: 4px;\">\n \n \n \n <span>MAY</span>\n \n </td>\n <td style=\"padding-left: 4px;\" class=\"requirement\">\n \n <span><div><p>The system MAY provide the ability to render a notification of an alert to the provider of care where formularies, preferred provider and other information indicate the health plan requires an alternative.</p>\n</div></span>\n \n \n </td>\n </tr>\n \n <tr>\n <td style=\"padding-left: 4px;\">\n \n <span>AS.8.3#06</span>\n \n </td>\n <td style=\"padding-left: 4px;\">\n \n \n \n <span>SHOULD</span>\n \n </td>\n <td style=\"padding-left: 4px;\" class=\"requirement\">\n \n <span><div><p>The system SHOULD conform to function [[AS.9.3]] (Support Service Authorizations) to integrate support of prior authorization processes.</p>\n</div></span>\n \n \n </td>\n </tr>\n \n </table>\n</div>"
] ; #
fhir:url [ fhir:v "http://hl7.org/ehrs/Requirements/EHRSFMR2.1-AS.8.3"^^xsd:anyURI] ; #
fhir:version [ fhir:v "0.16.0"] ; #
fhir:name [ fhir:v "AS_8_3_Support_Integration_of_Cost_Financial_information_into_Patient_Care"] ; #
fhir:title [ fhir:v "AS.8.3 Support Integration of Cost/Financial information into Patient Care (Function)"] ; #
fhir:status [ fhir:v "active"] ; #
fhir:date [ fhir:v "2024-08-12T10:56:01+00:00"^^xsd:dateTime] ; #
fhir:publisher [ fhir:v "EHR WG"] ; #
fhir:contact ( [
( fhir:telecom [
fhir:system [ fhir:v "url" ] ;
fhir:value [ fhir:v "http://www.hl7.org/Special/committees/ehr" ] ] )
] ) ; #
fhir:description [ fhir:v "Support interactions with other systems, applications, and modules to enable the use of cost management information required to guide users and workflows."] ; #
fhir:purpose [ fhir:v "The provider is alerted or presented with the most cost-effective services, referrals, devices, etc., to recommend to the patient. This may be tailored to the patient's health insurance/plan coverage rules. Medications may be presented in order of cost, or the cost of specific interventions may be presented at the time of ordering."] ; #
fhir:statement ( [
( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/ehrs/StructureDefinition/requirements-dependent"^^xsd:anyURI ] ;
fhir:value [ fhir:v "false"^^xsd:boolean ] ] ) ;
fhir:key [ fhir:v "EHRSFMR2.1-AS.8.3-01" ] ;
fhir:label [ fhir:v "AS.8.3#01" ] ;
( fhir:conformance [ fhir:v "MAY" ] ) ;
fhir:conditionality [ fhir:v "false"^^xsd:boolean ] ;
fhir:requirement [ fhir:v "The system MAY provide the ability to extract formularies, preferred providers, and other information, from internal or external sources, that are associated with a patient's health care plan and coverage so that the provider can offer cost effective alternatives to patients." ] ;
fhir:derivedFrom [ fhir:v "EHR-S_FM_R1.1 S.3.2.3#1" ]
] [
( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/ehrs/StructureDefinition/requirements-dependent"^^xsd:anyURI ] ;
fhir:value [ fhir:v "false"^^xsd:boolean ] ] ) ;
fhir:key [ fhir:v "EHRSFMR2.1-AS.8.3-02" ] ;
fhir:label [ fhir:v "AS.8.3#02" ] ;
( fhir:conformance [ fhir:v "MAY" ] ) ;
fhir:conditionality [ fhir:v "false"^^xsd:boolean ] ;
fhir:requirement [ fhir:v "The system MAY provide the ability to extract information about exemptions on coverage limitations and guidelines." ] ;
fhir:derivedFrom [ fhir:v "EHR-S_FM_R1.1 S.3.2.3#2" ]
] [
( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/ehrs/StructureDefinition/requirements-dependent"^^xsd:anyURI ] ;
fhir:value [ fhir:v "false"^^xsd:boolean ] ] ) ;
fhir:key [ fhir:v "EHRSFMR2.1-AS.8.3-03" ] ;
fhir:label [ fhir:v "AS.8.3#03" ] ;
( fhir:conformance [ fhir:v "MAY" ] ) ;
fhir:conditionality [ fhir:v "false"^^xsd:boolean ] ;
fhir:requirement [ fhir:v "The system MAY provide the ability to capture or transmit the request for information about exemptions on coverage limitations and guidelines." ]
] [
( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/ehrs/StructureDefinition/requirements-dependent"^^xsd:anyURI ] ;
fhir:value [ fhir:v "false"^^xsd:boolean ] ] ) ;
fhir:key [ fhir:v "EHRSFMR2.1-AS.8.3-04" ] ;
fhir:label [ fhir:v "AS.8.3#04" ] ;
( fhir:conformance [ fhir:v "MAY" ] ) ;
fhir:conditionality [ fhir:v "false"^^xsd:boolean ] ;
fhir:requirement [ fhir:v "The system MAY provide the ability to render expected patient out-of- pocket cost information for medications, diagnostic testing, and procedures, from internal or external sources, that are associated with a patients health care plan and coverage." ] ;
fhir:derivedFrom [ fhir:v "EHR-S_FM_R1.1 S.3.2.3#3" ]
] [
( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/ehrs/StructureDefinition/requirements-dependent"^^xsd:anyURI ] ;
fhir:value [ fhir:v "false"^^xsd:boolean ] ] ) ;
fhir:key [ fhir:v "EHRSFMR2.1-AS.8.3-05" ] ;
fhir:label [ fhir:v "AS.8.3#05" ] ;
( fhir:conformance [ fhir:v "MAY" ] ) ;
fhir:conditionality [ fhir:v "false"^^xsd:boolean ] ;
fhir:requirement [ fhir:v "The system MAY provide the ability to render a notification of an alert to the provider of care where formularies, preferred provider and other information indicate the health plan requires an alternative." ] ;
fhir:derivedFrom [ fhir:v "EHR-S_FM_R1.1 S.3.2.3#4" ]
] [
( fhir:extension [
fhir:url [ fhir:v "http://hl7.org/ehrs/StructureDefinition/requirements-dependent"^^xsd:anyURI ] ;
fhir:value [ fhir:v "false"^^xsd:boolean ] ] ) ;
fhir:key [ fhir:v "EHRSFMR2.1-AS.8.3-06" ] ;
fhir:label [ fhir:v "AS.8.3#06" ] ;
( fhir:conformance [ fhir:v "SHOULD" ] ) ;
fhir:conditionality [ fhir:v "false"^^xsd:boolean ] ;
fhir:requirement [ fhir:v "The system SHOULD conform to function [[AS.9.3]] (Support Service Authorizations) to integrate support of prior authorization processes." ] ;
fhir:derivedFrom [ fhir:v "EHR-S_FM_R1.1 S.3.2.3#5" ]
] ) . #
IG © 2023 EHR WG. Package hl7.ehrsfmr21.base#0.16.0 based on FHIR 5.0.0. Generated 2024-08-12
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