STU 3 Candidate

This page is part of the FHIR Specification (v1.4.0: STU 3 Ballot 3). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions

4.12.10 Resource DecisionSupportServiceModule - Operations

This resource has 1 operation associated with it:

$evaluateEvaluate

For more information about operations, including how they are invoked, see Operations.

4.12.10.1 Evaluate

The evaluate operation requests clinical decision support guidance based on a specific decision support module

Formal Definition (as a OperationDefinition).

URL: [base]/DecisionSupportServiceModule/[id]/$evaluate

In Parameters:
NameCardinalityTypeBindingProfileDocumentation
requestId0..1 (code

An optional client-provided identifier to track the request

evaluateAtDateTime0..1 (dateTime

An optional date and time specifying that the evaluation should be performed as thought it was the given date and time. The most direct implication of this is that references to "Now" within the evaluation logic of the module should result in this value. In addition, wherever possible, the data accessed by the module should appear as though it was accessed at this time. The evaluateAtDateTime value may be any time in the past or future, enabling both retrospective and prospective scenarios. If no value is provided, the date and time of the request is assumed

inputParameters0..1Parameters

The input parameters for a request, if any. These parameters are defined by the module that is the target of the evaluation, and typically supply patient-independent information to the module

inputData0..*Any

The input data for the request. These data are defined by the data requirements of the module and typically provide patient-dependent information

patient0..1Reference(Patient)

The patient in context, if any

encounter0..1Reference(Encounter)

The encounter in context, if any

initiatingOrganization0..1Reference(Organization)

The organization initiating the request

initiatingPerson0..1Reference(Patient|Practitioner|RelatedPerson)

The person initiating the request

userType0..1CodeableConcept

The type of user initiating the request, e.g. patient, healthcare provider, or specific type of healthcare provider (physician, nurse, etc.)

userLanguage0..1CodeableConcept

Preferred language of the person using the system

userTaskContext0..1CodeableConcept

The task the system user is performing, e.g. laboratory results review, medication list review, etc. This information can be used to tailor decision support outputs, such as recommended information resources

receivingOrganization0..1Reference(Organization)

The organization that will receive the response

receivingPerson0..1Reference(Patient|Practitioner|RelatedPerson)

The person in the receiving organization that will receive the response

recipientType0..1CodeableConcept

The type of individual that will consume the response content. This may be different from the requesting user type (e.g. if a clinician is getting disease management guidance for provision to a patient). E.g. patient, healthcare provider or specific type of healthcare provider (physician, nurse, etc.)

recipientLanguage0..1CodeableConcept

Preferred language of the person that will consume the content

setting0..1CodeableConcept

The current setting of the request (inpatient, outpatient, etc)

settingContext0..1CodeableConcept

Additional detail about the setting of the request, if any

Out Parameters:
NameCardinalityTypeBindingProfileDocumentation
return1..1GuidanceResponse

The result of the request as a GuidanceResponse resource. Output parameters, if any, will be contained in the parameters element of the response

Note: as this the only out parameter, it is a resource, and it has the name 'return', the result of this operation is returned directly as a resource

4.12.10.1.1 Examples

Request guideline appropriate ordering assessment (Request):

POST [base]/DecisionSupportServiceModule/example/$evaluate

<?xml version="1.0" encoding="UTF-8"?>
<Parameters xmlns="http://hl7.org/fhir">
  <id value="evaluate-operation-request-example"/>
<!--  This example demonstrates the $evaluate operation against a DecisionSupportServiceModule resource. -->
  <parameter>
	<name value="requestId"/>
	<valueString value="guidanceRequest1"/>
  </parameter>
  <parameter>
	  <name value="setting"/>
	  <valueCoding>
		<system value="http://hl7.org/fhir/encounter-class"/>
		<code value="inpatient"/>
	  </valueCoding>
  </parameter>
  <parameter>
	  <name value="inputParameters"/>
	  <resource>
		  <Parameters>
			  <parameter>
				<name value="patient"/>
				<resource>
				  <Patient>
					<id value="example"/>
					<meta>
					  <profile value="http://hl7.org/fhir/StructureDefinition/qicore-patient"/>
					  <profile value="http://hl7.org/fhir/StructureDefinition/gao-patient"/>
					</meta>
					<text>
					  <status value="generated"/>
					  <div xmlns="http://www.w3.org/1999/xhtml">
						
					  </div>
					</text>
				  <!--  MRN assigned by ACME healthcare on 6-May 2001  -->
					<identifier>
					  <use value="usual"/>
					  <type>
						<coding>
						  <system value="http://hl7.org/fhir/v2/0203"/>
						  <code value="MRN"/>
						</coding>
					  </type>
					  <system value="urn:oid:1.2.36.146.595.217.0.1"/>
					  <value value="12345"/>
					  <period>
						<start value="2001-05-06"/>
					  </period>
					  <assigner>
						<display value="Acme Healthcare"/>
					  </assigner>
					</identifier>
					<active value="true"/>
				  <!--  Peter James Chalmers, but called "Jim"  -->
					<name>
					  <use value="official"/>
					  <family value="Chalmers"/>
					  <given value="Peter"/>
					  <given value="James"/>
					</name>
					<name>
					  <use value="usual"/>
					  <given value="Jim"/>
					</name>
					<telecom>
					  <use value="home"/>
					<!--  home communication details aren't known  -->
					</telecom>
					<telecom>
					  <system value="phone"/>
					  <value value="(03) 5555 6473"/>
					  <use value="work"/>
					</telecom>
				  <!--  use FHIR code system for male / female  -->
					<gender value="male"/>
					<birthDate value="1974-12-25">
					  <extension url="http://hl7.org/fhir/StructureDefinition/patient-birthTime">
						<valueDateTime value="1974-12-25T14:35:45-05:00"/>
					  </extension>
					</birthDate>
					<deceasedBoolean value="false"/>
					<address>
					  <use value="home"/>
					  <line value="534 Erewhon St"/>
					  <city value="PleasantVille"/>
					  <state value="Vic"/>
					  <postalCode value="3999"/>
					</address>
					<contact>
					  <relationship>
						<coding>
						  <system value="http://hl7.org/fhir/patient-contact-relationship"/>
						  <code value="partner"/>
						</coding>
					  </relationship>
					  <name>
						<family value="du">
						<!--  the "du" part is a family name prefix (VV in iso 21090)  -->
						  <extension url="http://hl7.org/fhir/StructureDefinition/iso21090-EN-qualifier">
							<valueCode value="VV"/>
						  </extension>
						</family>
						<family value="Marché"/>
						<given value="Bénédicte"/>
					  </name>
					  <telecom>
						<system value="phone"/>
						<value value="+33 (237) 998327"/>
					  </telecom>
					</contact>
					<managingOrganization>
					  <reference value="Organization/1"/>
					</managingOrganization>
				  </Patient>
				</resource>
			  </parameter>
			  <parameter>
				<name value="order"/>
				<resource>
				  <Order>
					<id value="order1"/>
					<meta>
					  <profile value="http://hl7.org/fhir/StructureDefinition/gao-order"/>
					</meta>
					<text>
					  <status value="generated"/>
					  <div xmlns="http://www.w3.org/1999/xhtml">
						
					  </div>
					</text>
					<contained>
					  <DiagnosticOrder>
						<id value="diagnosticOrder1"/>
						<meta>
						  <profile value="http://hl7.org/fhir/StructureDefinition/gao-diagnosticorder"/>
						</meta>
						<subject>
						  <reference value="Patient/example"/>
						</subject>
						<item>
						  <code>
							<coding>
							<!--  TODO: This will need to use the ACR Commons code  -->
							  <system value="http://www.ama-assn.org/go/cpt"/>
							  <code value="70450"/>
							  <display value="CT, head, wo iv contrast"/>
							</coding>
						  </code>
						</item>
					  </DiagnosticOrder>
					</contained>
					<date value="2012-12-28T09:03:04+11:00"/>
					<subject>
					  <reference value="Patient/example"/>
					</subject>
					<source>
					  <reference value="Practitioner/example"/>
					</source>
					<reasonCodeableConcept>
					  <coding>
					  <!--  TODO: This will need to use the ACR Commons code  -->
						<system value="http://hl7.org/fhir/sid/icd-9"/>
						<code value="70450"/>
						<display value="Headache, Chronic, no new features"/>
					  </coding>
					</reasonCodeableConcept>
					<detail>
					  <reference value="#diagnosticOrder1"/>
					</detail>
				  </Order>
				</resource>
			  </parameter>
		  </Parameters>
	  </resource>
  </parameter>
</Parameters>

Returned on successful assessment (Response):


HTTP/1.1 200 OK

<?xml version="1.0" encoding="UTF-8"?>
<GuidanceResponse xmlns="http://hl7.org/fhir">
	<!-- This example demonstrates the response to an $evaluate operation using the GuidanceResponse resource. -->
	<contained>
		<Parameters >
			<id value="outputParameters1"/>
			<parameter>
				<name value="order"/>
				<valueReference>
					<reference value="#order1"/>
				</valueReference>
			</parameter>
			<parameter>
				<name value="result"/>
				<resource>
					<!-- GAO Result, profile of Basic -->
					<Basic>
						<id value="result1"/> <!-- Could also be the Response Identifier (guidanceResponse1 in this example)? -->
						<meta>
							<!-- TODO: Profile url for GAO Result profile -->
							<!--profile value="http://hl7.org/fhir/StructureDefinition/result-gao-gao-result"/-->
						</meta>
						<extension url="http://hl7.org/fhir/StructureDefinition/result-gao-score">
							<valueDecimal value="7"/>
						</extension>
						<extension url="http://hl7.org/fhir/StructureDefinition/result-gao-item">
							<extension url="http://hl7.org/fhir/StructureDefinition/result-gao-item#code">
								<valueCodeableConcept>
									<coding>
										<!-- TODO: This will need to use the ACR Commons code -->
										<system value="http://www.ama-assn.org/go/cpt"/>
										<code value="70450"/>
										<display value="CT, head, wo iv contrast"/>
									</coding>  
								</valueCodeableConcept>
							</extension>
						</extension>
						<!-- Appropriate Use Criteria Identifier -->
						<extension url="http://hl7.org/fhir/StructureDefinition/result-gao-guideline">
							<valueUri value="http://someguidelineprovider.org/radiology-appropriateness-guidelines.html"/>
						</extension>
						<!-- Certified HealthCare Information Technology Identifier -->
						<extension url="http://hl7.org/fhir/StructureDefinition/result-gao-device">
							<valueReference>
								<reference value="#device1"/>
							</valueReference>
						</extension>
						<!-- Provider NPI -->
						<extension url="http://hl7.org/fhir/StructureDefinition/result-gao-practitioner">
							<valueIdentifier>
								<value value="exampleNPI"/>
							</valueIdentifier>
						</extension>
						<identifier>
							<value value="result1"/>
						</identifier>
						<code>
							<coding>
								<code value="within"/>
								<display value="Order is within identified guidelines"/>
							</coding>
						</code>
						<subject>
							<reference value="#order1"/>
						</subject>
					</Basic>
				</resource>
			</parameter>
		</Parameters>
	</contained>
	<requestId value="guidanceRequest1"/>
	<module>
		<reference value="DecisionSupportServiceModule/example"/>
	</module>
	<status value="success"/>
	<outputParameters>
		<reference value="#outputParameters1"/>
	</outputParameters>
</GuidanceResponse>