RequestGroup FHIR Resource Proposal

RequestGroup

NOTE: This resource is a refactoring of the action elements of GuidanceResponse, so they can be used outside of GuidanceResponse, e.g., in a CarePlan

The RequestGroup resource is used to represent a group of optional activities that may be performed for a specific patient or context. The resource is often, but not always, the result of applying a specific PlanDefinition to a particular patient, and can also be used as part of a GuidanceResponse to represent the results of a decision support service evaluation.

Other than differences that tie the resource to a particular patient and context, the structure is identical to the action representations for a PlanDefinition, allowing the same features and functionality to be used in both places to describe optionality of and relationships between activities in a workflow.

The resource is based on the HL7 Standard: Clinical Decision Support Knowledge Artifact Specification (specifically the _Action_ component).

Owning committee name

Clinical Decision Support Work Group

Committee Approval Date:

2017-03-01 - Meeting Minutes Approval of GuidanceResponse: 2016-02-24 - Meeting Minutes

Contributing or Reviewing Work Groups

• Clinical Quality Information Work Group
• FHIR Management Group
• Service Oriented Architecture Work Group

FHIR Resource Development Project Insight ID

1234: FHIR-Based Clinical Quality Framework (CQF-on-FHIR)

Scope of coverage

A RequestGroup is used to capture a group of interrelated activities for a specific patient. Similar to the PlanDefinition, the resource allows for dependencies and relationships between actions to be expressed to model complex workflows such as the application of a chemotherapy regimen to a patient. Individual activities are represented by referencing instances of appropriate request resources such as MedicationRequest and ProcedureRequest, and the relationships between them are described in the action elements.

As with PlanDefinition, the resource allows a hierarchy of actions to be represented, and allows the same type of grouping and selection behavior to be defined for actions and action groups.

The resource can be used as an activity in a CarePlan, as well as referenced by a GuidanceResponse to represent the result of a decision support evaluation, or of a plan definition apply operation.

Resource appropriateness

The PlanDefinition resource provides the ability to describe abstract workflow, and the CarePlan provides the ability to define planned activities for a specific patient. However, RequestGroup provides a mechanism for carrying the optional aspects of a workflow definition forward into the request space, preserving relationships and conditions that are applicable as the workflow is applied to a patient over time, rather than just at the initial point of application. The CarePlan does not provide enough optionality to capture this additional information, so the RequestGroup can be used to augment the existing CarePlan resource.

Expected implementations

The basic structure of the resource was already present in the GuidanceResponse, and was used in several pilots and connectathons in that form. Moving forward with the new independent structure, the resource is expected to be used by systems implementing chemotherapy order templates produced by NCCN.

Content sources

• Clinical Decision Support Knowledge Artifact Specification

Example Scenarios

The core structure of the resource was tested as part of the GuidanceResponse resource in the CQF-on-FHIR track in Connectathons 11, 12, 13, and 14.

Resource Relationships

The RequestGroup resource may reference any number of request resources to describe the specific actions to be performed. In addition, it will reference the originating PlanDefinition resource.

Timelines

May 2016 Ballot Cycle in support of the CQF IG.

gForge Users

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