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  1. FHIR Specification Feedback
  2. FHIR-36362

"CQL and FHIR Questionnaires SHALL be required" is unclear

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    • Icon: Change Request Change Request
    • Resolution: Persuasive with Modification
    • Icon: Medium Medium
    • US Da Vinci DTR (FHIR)
    • 1.0.0 [deprecated]
    • Clinical Decision Support
    • Documentation Templates and Rules Implementation Guide Home Page
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      Will revise

      "CQL and FHIR Questionnaires SHALL be required."

      to:

      "All DTR applications SHALL support rendering according to the extensions supported in the DTR Questionnaire profile as well as executing all CQL found within Questionnaire extensions. Payers SHALL craft their Questionnaires such that they include CQL that attempts to pre-populate QuestionnaireResponse answers where such population can be accomplished using discrete data returned by EHR FHIR APIs that are required as part of current regulation (including simple calculations there-on - e.g. age from birthdate). Translation between standard codes SHOULD be supported where possible.".

       

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      Will revise "CQL and FHIR Questionnaires SHALL be required." to: "All DTR applications SHALL support rendering according to the extensions supported in the DTR Questionnaire profile as well as executing all CQL found within Questionnaire extensions. Payers SHALL craft their Questionnaires such that they include CQL that attempts to pre-populate QuestionnaireResponse answers where such population can be accomplished using discrete data returned by EHR FHIR APIs that are required as part of current regulation (including simple calculations there-on - e.g. age from birthdate). Translation between standard codes SHOULD be supported where possible.".  
    • Bob Dieterle / Howard Strasberg: 13-0-2
    • Clarification
    • Non-substantive

    Description

      This statement doesn't really make any sense.  Required by whom?  For what purpose?  Are we saying it's prohibited to have a Questionnaire that doesn't have CQL even when the questions have no logic and no hope of pre-population?

      Expectations for what RESTful capabilities need to be supported should be explicit in the CapabilityStatements.  "Must create, read, search Questionnaire instances" is much clearer.  Requirements around CQL should similarly be clear.  Presumably what we want to say is that systems that process DTR Questionnaires (so 'full' DTR EHRs as well as DTR Smart apps must be capable of processing arbitrary CQL declared or referenced in enableWhenExpression, initialExpression and possibly other extensions.  In any case, that language should be in the section that talks about Questionnaire-handling.  A bigger question is what we expect of payers.  Is a Questionnaire that could have used CQL to auto-populate some answers but didn't conformant?

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            lloyd Lloyd McKenzie
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