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
FHIR resources exchanged in the execution of a DTR application are subject to conformance requirements with the following HL7 Implementation Guides.
The DTR application will access information about a patient to execute rules and gather documentation to satisfy payer needs. To do this, the DTR application will make requests to a FHIR server of the Healthcare Provider Organization’s EHR. The FHIR server SHALL conform to the US Core Implementation Guide STU2 when providing access to FHIR STU3. The FHIR server SHALL conform to the US Core Implementation Guide STU3 when providing access to FHIR R4.
Payers have documentation requirements and rules that must be satisfied as part of their typical operations when reimbursing for care. In an ideal case, all of the information needed by a payer would be stored in a healthcare provider’s EHR system in a structured format for easy retrieval. Unfortunately, this is rarely the case, so measures must be taken to allow users to input information that is not automatically discoverable. To facilitate this, the Structured Data Capture Implementation Guide is used to allow payers to declare information needs and provide the DTR application with a means of obtaining this data from a user.
Payers will describe their information needs through the FHIR Questionnaire resource. When using FHIR STU3, these resources SHALL conform to the CQIF Questionnaire Profile. When using FHIR R4, these resources SHALL conform to the CQF Questionnaire Profile. This profile allows the Questionnaire to be associated with the CQL used to find the desired information within a patient’s data. Further, it allows each individual item in the Questionnaire be associated with an expression in the CQL.