This page is part of the Clinical Guidelines (v1.0.0: STU 1) based on FHIR R4. This is the current published version in it's permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
depends-on | http://hl7.org/fhir/Library/FHIR-ModelInfo|4.0.1 |
depends-on | http://hl7.org/fhir/Library/FHIRHelpers|4.0.1 |
depends-on | CPG Activity Type |
depends-on | Condition Clinical Status Codes |
depends-on | ConditionVerificationStatus |
Patient | out | 0 | 1 | Patient |
Inclusion Criteria | out | 0 | 1 | boolean |
Propose Diagnosis Task | out | 0 | * | Task |
Diagnosis | out | 0 | * | Condition |
Active or Completed Activity | out | 0 | * | Task |
Activity Not Done | out | 0 | * | Task |
Activity Proposal | out | 0 | * | Task |
Activity Proposal Rejected | out | 0 | * | Task |
Is Recommendation Applicable | out | 0 | 1 | boolean |
Type: Task (Task) |
Type: Condition (Condition) |
text/cql
library ProposeDiagnosis
using FHIR version '4.0.1'
include FHIRHelpers version '4.0.1'
codesystem "Activity Type": 'http://hl7.org/fhir/uv/cpg/CodeSystem/cpg-activity-type'
codesystem "Condition Clinical Status Code": 'http://terminology.hl7.org/CodeSystem/condition-clinical'
codesystem "Condition Verification Status Code": 'http://terminology.hl7.org/CodeSystem/condition-ver-status'
code "Propose diagnosis": 'propose-diagnosis' from "Activity Type"
code "Active Condition": 'active' from "Condition Clinical Status Code"
code "Provisional Condition": 'provisional' from "Condition Verification Status Code"
code "Confirmed Condition": 'confirmed' from "Condition Verification Status Code"
context Patient
/* Recommendation to propose a diagnosis */
/*
NOTE: This recommendation is dramatically simplified to illustrate the general
pattern for a positive recommendation to propose a diagnosis, with the ability
for users to reject the recommendation, and flexibility in how the recommendation
is achieved.
Specifically:
* There is no terminology, any task on any topic will do
* There is no timing, any task will do at any time
* There is no reference to participants other than the patient
* There is no relationship to a setting
* There is no relationship to an encounter or episode
* There is no relationship to a care plan
These simplifications allow the example to focus exclusively on the pattern for
recommending and for accepting/rejecting the proposal, as well as documenting
the completion, or explicit non-performance of the activity.
*/
/*
Positive recommendation:
If the patient meets the inclusion criteria
If the patient does not have the diagnosis
If proposing the diagnosis has not been planned or proposed
Propose the diagnosis
Given a proposal, the user can:
Accept the proposal
Ignore the proposal
Reject the proposal without reason
Reject the proposal with reason
Scenario 1: No event, no plan or proposal, decision support should propose
Scenario 2: No event, incomplete proposal, decision support should not propose
Scenario 3: No event, rejected proposal, decision support should not propose
Scenario 4: Event, no proposal, decision support should not propose
Scenario 5: Event, completed proposal, decision support should not propose
Scenario 6: Event not done, no proposal, decision support should not propose
Scenario 7: Event not done, proposal, decision support should not propose
*/
define "Inclusion Criteria":
Patient.active
define "Propose Diagnosis Task":
[Task] C
where C.code ~ "Propose diagnosis"
and not Coalesce(doNotPerform(C), false)
define "Diagnosis":
[Condition] C
where C.clinicalStatus ~ "Active Condition"
and C.verificationStatus ~ "Confirmed Condition"
define "Active or Completed Activity":
"Propose Diagnosis Task" C
where C.status in { 'in-progress', 'on-hold', 'completed' }
define "Activity Not Done":
"Propose Diagnosis Task" C
where C.status in { 'cancelled', 'failed' }
define "Activity Proposal":
"Propose Diagnosis Task" R
where R.status in { 'draft', 'requested', 'received', 'accepted', 'ready' }
define "Activity Proposal Rejected":
"Propose Diagnosis Task" R
where R.status in { 'rejected' }
define "Is Recommendation Applicable":
"Inclusion Criteria"
and not exists ("Diagnosis")
and not exists (
"Active or Completed Activity"
union "Activity Not Done"
)
and not exists (
"Activity Proposal"
union "Activity Proposal Rejected"
)
define function doNotPerform(task Task):
singleton from (
task.extension E
where E.url = 'http://hl7.org/fhir/StructureDefinition/request-doNotPerform'
).value as boolean
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