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
Through interactions with the DTR process, a user may be prompted with a question that leads to the discovery of a needed action for the desired treatment to proceed. For example, a healthcare provider may be preparing an order for a Continuous Positive Airway Pressure (CPAP) device. In this example, the payer requires that the provider conduct a sleep study that shows a diagnosis of obstructive sleep apnea. While using the DTR process, it prompts the provider that the CQL/Questionnaire execution was unable to find a sleep study in the Electronic Health Record (EHR) system for the patient.
The provider can confirm that the sleep study has not yet been conducted and generate a task for office staff to schedule a sleep study directly in the questionnaire interface. Alternatively, the provider could attest that the sleep study was performed or is already scheduled to be performed, either at this provider or another provider. Attestation by the provider can prevent duplicate tests in the case that the patient’s electronic record is incomplete.
The provider SHOULD have the option to continue with the order directly and deal with the completion of the questionnaire as a separate task or suspend the order and complete both as part of the task execution.
When a questionnaire is suspended the application SHOULD give the user the ability to restart the DTR process (e.g., execute all rules and questionnaire). If this is done, the implementer SHOULD implement a mechanism to copy any user entered data to the new version without reentry.
The ability to create tasks or TODOs is outside of the scope of DTR and should be supported by the EHR implementation. Note: Implementers may want to consider using SMART Web messaging to communicate the specific tasks to the EHR.
Note: At this time SMART Web Messaging is in a draft status.
The questionnaire SHOULD be able to suspend completion until all tasks are completed. How the application is suspended is left to the implementer, but the state of the questionnaire SHOULD be preserved.