Da Vinci - Documentation Templates and Rules (DTR) 0.1.0 - Ballot for Comment

This page is part of the Documentation Templates and Rules (v0.1.0: STU 1 Ballot 1) based on FHIR R3. The current version which supercedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions

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Overview

The Documentation Templates and Rules (DTR) Implementation Guide (IG) specifies how payer rules can be executed in a provider context to ensure that documentation requirements are met. The IG is a companion to the Coverage Requirements Discovery (CRD) IG, which uses CDS Hooks to query payers to determine if there are documentation requirements for a proposed medication, procedure or other service. When those requirements exist, CDS Hooks Cards will be returned with information about the requirements. This IG leverages the ability of CDS Hooks to link to a SMART on FHIR app to launch and execute payer rules. The IG specifies how to maintain the transaction state as the workflow transitions from CDS Hooks to a SMART on FHIR app. It describes the interactions between the SMART on FHIR app and the Payer IT system to retrieve documentation requirements, in the form of CQL and a FHIR Questionnaire resource.

This IG leverages CQL to allow payers to inspect a patient’s record for the necessary information related to the required documentation for a proposed item. The IG details the use of a payer provided Questionnaire resource and results from CQL execution to generate a QuestionnaireResponse resource containing the necessary information. This IG also provides methods for sending that information to the payer or for persistance in the provider’s EHR system.

Content and Organization

The implementation guide is organized into the following sections:

  • Use Case Provides examples of how this specification can be used by provider and payor organizations.
  • Underlying Technologies Describes the underlying technologies this specification builds upon.
  • Specification Provides the technical conformance details for the specification.
  • Resources Introduces and provides links to the FHIR profiles.
  • Credits Identifies the individuals and organizations involved in developing this implementation guide.

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