Clinical Reasoning Module

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