Clinical Reasoning Module

Return to Clinical Decision Support Work Group

Project Co-Sponsors:

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

Project Information

Project Insight 1234 Entry

This project is a continuation of FHIR-Based Clinical Decision Support, as well as CQF-on-FHIR. The project is focused on enabling decision support, and with the engagement of the CQI work group, quality measurement within the FHIR specification.

R4 Roadmap

The FHIR Clinical Reasoning Module is part of the FHIR Specification, and is accessible from the Homepage, or directly at:

http://build.fhir.org/clinicalreasoning-module.html

This roadmap is aligned with the FHIR R4 Ballot Prep roadmap described here:

FHIR Ballot Prep

At a high-level, the balloting plan is:

• January 2018: For Comment
• May 2018: STU (some Normative content, but none of CRM)
• September 2018: Possible re-ballot as STU
• December 2018: Publication

R4 Goals

• Support maturity levels of 3 or higher for most content
• Support key use cases
  • Decision Support (CDS Hooks, Zika Reporting, Opioid Management, Radiology Appropriateness)
  • Quality Measurement (Payer quality measures, MIPS/MACRA/QPP reporting)
  • Order Templates (International Chemotherapy IG)
  • Order Catalogs
  • Advance Directives
• Support alignment with other specifications
  • Knowledge Artifact Specification
  • Health Quality Measure Format
  • Quality Reporting Document Architecture

Discussion Points/Major Tasks

• Decision Support
  • Remove ServiceDefinition
  • Update Clinical Reasoning to reference CDS Hooks
  • Next Steps for GuidanceResponse, RiskAssessment, DetectedIssue
• Quality Measurement
  • Generalize Measure and MeasureReport for usage beyond just population quality measures
  • Public health reporting, aggregate data reporting, etc
• Advance Directives
• Order Templates/Catalogs
• Resource Review
  • Alignment to workflow patterns
  • QA guidelines
• Resource Mappings (To KAS, HQMF, and QRDA)
• Tracker Resolution
• Resolve all build errors and warnings

Maturity Targets

These maturity targets are based on the FHIR Maturity Model:

http://build.fhir.org/versions.html#maturity

To hit maturity level 3, we need to meet Trial Use QA Guidelines, as described here:

http://wiki.hl7.org/index.php?title=FHIR_Conformance_QA_Criteria

Resource	Committee	Maturity Level	Target
ActivityDefinition	CDS	2	3
DetectedIssue	CDS	1	2
EventDefiniton	CDS	0	2
GuidanceResponse	CDS	2	3
Library	CDS	2	3
PlanDefinition	CDS	2	3
RequestGroup	CDS	2	3
RiskAssessment	CDS	1	2
ServiceDefinition	CDS	0	-
Measure	CQI	2	3
MeasureReport	CQI	2	3