This statement defines the expected capabilities of systems wishing to conform to the ‘‘CRD Client’’ role. This role is responsible for initiating CDS Hooks calls and consuming received decision support. It is also responsible for returning data requested by the CRD Server needed to provide that decision support. This capability statement doesn’t define the CDS Hooks capabilities as there is no standard way to do that as yet. Instead, it focuses on the ‘server’ capabilities needed to respond to CRD Server queries. These capabilities are based on US Core.

In addition to the U.S. core expectations, the CRD Client SHALL support all ‘SHOULD’ ‘read’ and ‘search’ capabilities listed below for resources referenced in supported hooks and order types if it does not support returning the associated resources as part of CDS Hooks pre-fetch. The CRD Client SHALL also support ‘update’ functionality for all resources listed below where the client allows invoking hooks based on the resource.

A logical model describing the information that should be captured by CRD implementers about every CRD invocation to support measures evaluating CRD implementation

This profile specifies extensions and constraints on the Appointment resource to support coverage requirements discovery.

This profile specifies constraints on the CommunicationRequest resource to support coverage requirements discovery.

This profile specifies constraints on the Coverage resource to support coverage requirements discovery.

This profile specifies additional constraints on the US Core Device Profile to support coverage requirements discovery.

This profile specifies extensions and constraints on the DeviceRequest resource to support coverage requirements discovery.

This profile specifies additional extensions and constraints on the US Core Encounter profile to support coverage requirements discovery.

This profile specifies constraints on the US Core Location profile to support coverage requirements discovery.

This profile specifies additional constraints on the US Core MedicationRequest profile to support coverage requirements discovery.

This profile specifies extensions and constraints on the NutritionOrder resource to support coverage requirements discovery.

This profile specifies additional constraints on the US Core Organization profile to support coverage requirements discovery.

This profile specifies additional constraints on the US Core Patient profile to support coverage requirements discovery.

This profile specifies constraints on the US Core profile on the Practitioner resource to support coverage requirements discovery.

This profile specifies constraints on the Task resource to support requests for form (Questionnaire) completion.

This profile specifies constraints on the ServiceRequest resource to support coverage requirements discovery.

This profile defines an initial profile on the VisionPrescription resource to support coverage requirements discovery.

Captures assertions from a payer about whether the service is covered and/or requires prior authorization.

An extension for the CDS Hooks ‘services’ object that indicates configuration options supported by the CDS server

Codes identifying a type of CDS Hook

Codes allowed for defining the type of action in a CDS Hooks suggestion

Extends the base HL7-defined value set codes with supplementary codes needed to provide full coverage to the CMS location code set

Actions to take after completing form

List of card types defined by the CRD spec

Allowed data types for configuration settings in the CDS Hook configuration extension

Reasons for a coverage assertion in the coverage-information extension

Restriction of coverage classes for CRD purposes

Codes for name-value-pair details on a coverage assertion

Codes defining whether additional documentation needs to be captured

Codes defining whether the ordered/requested service is covered under patient’s plan

List of reasons for additional documentation

Codes defining whether prior auth will be needed for coverage to be provided

Codes for ordering devices.

NOTE: This value set contains many inappropriate codes because the underlying code systems do not provide a straight-forward mechanism to select only device-related codes and, given the evolving nature of the underlying code systems, strict enumeration is not a viable approach to defining the value set.

Codes defining whether information about the perfomer, location, and/or performance date is needed to determine coverage information

Address codes allowed for CRD locations - those that are physical addresses

A list of codes indicating the perspective from which metric data was captured

A list of codes indicating whether an access token was used as part of CDS Hook processing

Detail codes for products and services that are the focus of a CRD call

Example value set defines a set of CPT, SNOMED CT, HCPCS Level II and LOINC codes mirroring bindings found in the US Core Procedure and Observation Lab profiles

Reasons for creating tasks in CRD

Codes temporarily defined as part of the CRD implementation guide. These will eventually migrate into an officially maintained terminology (likely either SNOMED CT or HL7’s UTG code systems).

Example appointment populated based on CRD profile

Example communication request populated based on CRD profile

Example identified coverage populated based on CRD profile

Example device populated based on CRD profile

Example devicerequest populated based on CRD profile

Example encounter populated based on CRD profile

Example location populated based on CRD profile

Example medication request with an annotation showing coverage expectations

Example medication request populated based on CRD profile

Example nutrition order populated based on CRD profile

Example organization populated based on CRD profile

Example patient populated based on CRD profile

Example practitioner populated based on CRD profile

Example questionnaire-completion Task populated based on CRD profile

Example service request populated based on CRD profile

Example vision prescription based on CRD profile