Details
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Change Request
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Resolution: Persuasive with Modification
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Medium
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US QI Core (FHIR)
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2.0 [deprecated]
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Clinical Quality Information
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QICore MedicationRequest
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D.4.1 MedicationNotRequested
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Anne Smith/Linda Michaelsen:18-0-0
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Enhancement
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Non-compatible
Description
The current modeling for many QI-Core NotDone profile code elements is confusing to implementers and considered potentially ambiguous. Other NotDone profile specify code cardinality of 0..1 but then require a cardinality of 1..1 for referencing the notDoneValueSet. MedicationNotRequested does include a code cardinality of 1..1. However, it specifically addresses a single use case that none of a group of items was done. Consistent with the evaluation for ProcedureNotDone FHIR 31930, it is suggested that a more generic option with a specific slice for the eCQM use case to express that none of the value set items occurred.
Will need to maintain MedicationNotRequested.medication[x] as cardinality 1..1 (as it currently states), but change MedicationNotRequested.medication[x].coding.valueSetReference to cardinality 0..1
AND
create a slice on coding specific to the use case where the reference is to indicate the entire value set is negated and not a specific code. That slice is specific to using the value set cardinality of the extension 1..1 (the code.coding.code cardinality to be 0..0)