Da Vinci - Documentation Templates and Rules 0.2.0 - STU Ballot

This page is part of the Documentation Templates and Rules (v0.2.0: STU 1 Ballot 2) based on FHIR R4. The current version which supercedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions

Retrieval of Payer Resources

The Documentation Templates and Rules (DTR) application will need to retrieve resources from a payer IT system to operate properly. This application will need to obtain a FHIR Questionnaire and associated Clinical Quality Language (CQL) logic files in order to execute. The information needed to obtain the required resources will be provided as escaped JSON in the appContext property of the Clinical Decision Support (CDS) Hooks Card Link object, as described in Section 4.2.1. That object will have the following properties:

Field Optionality Type Description
filePath OPTIONAL string The base URL for the questionnaire and related CQL resources. If left blank the app should use a default base URL.
template REQUIRED string The id of the Questionnaire for the DTR application to use for execution.
request REQUIRED string The URL of the request resource in the EHR FHIR server.

The request resource created during the CRD workflow should be persisted in the EHR FHIR server for retrieval by the DTR application. This might, for example, be the ServiceRequest resource that is sent in the CDS hook to the CRD server.

Authentication of SMART on FHIR application to payer API

Payers SHALL require the DTR application to authenticate in order to retrieve resources when PHI is exchanged. In the case that authentication is required, the following JSON structure SHALL be populated by the payer system. This JSON is based on the structure for FHIR Authorization in CDS Hooks.

Field Optionality Type Description
access_token REQUIRED string The OAuth 2 access token that provides access to the Payer FHIR server.
token_type REQUIRED string Fixed value: Bearer.
expires_in REQUIRED integer The lifetime of the access token in seconds.
scope REQUIRED string Fixed value: user/Questionnaire.read user/Library.read.
subject REQUIRED string The OAuth 2.0 client identifier of the DTR application, as registered with the Payer’s authorization server.

Questionnaire

The DTR application SHALL use the URL provided in the template property of the appContext to retrieve a Questionnaire resource. The payer SHALL provide this as a FHIR resource, such that the DTR application will be executing a FHIR read interaction on the payer’s server. The returned Questionnaire resource SHALL conform to the CQF Questionnaire profile and MAY conform to Structured Data Capture.

The Questionnaire SHALL have a cqf-library extension property specified when using FHIR R4. When using FHIR STU3, The Questionnaire SHALL have a cqif-library extension property specified. That property SHALL provide the location of one or more CQL libraries needed to execute the payer rules.

CQL Rules

The DTR application SHALL use the URL provided in the cqf-library or cqif-library extension to retrieve the CQL necessary to execute the payer rules. Metadata about the rules will be represented as a FHIR Library resource. The payer SHALL provide this as a FHIR resource, such that the DTR application will be executing a FHIR read interaction on the payer’s server.