This page is part of the Documentation Templates and Rules (v1.1.0-ballot: STU 1.1 Ballot 1) 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

Questionnaire Evaluation

Comparing CQL Execution Results to Questionnaire

While Structured Data Capture (SDC) provides methods for Questionnaire population, this IG relies on the approach that has been created within Clinical Reasoning Module of the FHIR specification. The Documentation Template concept is a good fit for the use case being addressed by this IG.

As an example, given the following Clinical Quality Language (CQL) fragment:

context Patient
define DateOfBirth: Patient.birthDate.value

This will create a CQL expression named DateOfBirth. The expression can then be used to populate an item within a Questionnaire. The following JSON fragment represents the portion of the Questionnaire that can be populated from the CQL:

{
    "linkId": "1.4",
    "extension": [
      {
        "url": "http://hl7.org/fhir/StructureDefinition/cqf-expression",
        "valueExpression": {
          "language": "text/cql",
          "expression": "DateOfBirth"
        }
      }
    ],
    "text": "Date of Birth:",
    "type": "date",
    "required": true
},

Using the cqf-expression extension, the item SHALL refer to the named expression in the CQL rules that contains the desired information.

Generation of QuestionnaireResponse

The DTR process is responsible for iterating through all of the Questionnaire.item elements and checking the cqf-expression for values to populate a QuestionnaireResponse. The DTR process SHALL create a QuestionnaireResponse resource. For each Questionnaire.item, there SHALL be a corresponding QuestionnaireResponse.item. When the cqf-expression is not null, the value of the expression SHALL be used as the answer in the QuestionnaireResponse. The following JSON fragment shows an example representation of item in the QuestionnaireResponse based on the example above.

{
    "linkId": "1.4",
    "text": "Date Of Birth",
    "answer": [
      {
        "valueDate": "2015-02-23"
      }
    ]
},

For each Questionnaire.item with a null value for the cqf-expression, user input will be required to obtain the desired information, which is described in Section 4.4.4.