Details
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Change Request
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Resolution: Persuasive
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Medium
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US Da Vinci DTR (FHIR)
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1.0.0 [deprecated]
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Clinical Decision Support
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CQL [deprecated]
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Bob Dieterle / Jeff Brown : 12-0-2
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Correction
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Compatible, substantive
Description
"This specification uses Clinical Quality Language (CQL) for the expression of payer rules. By using CQL, this specification allows payers to query for patient information to verify that the patient's condition meets the requirements related to coverage of a particular treatment.
Payers should construct CQL to gather information needed and test expected conditions about a patient. The DTR process will provide the CQL access to FHIR resources for the patient in question. This CQL will be executed and the resulting information will be made available for further use by the DTR process. Mainly, this information will be used to populate a Questionnaire that is also supplied by the payer."
This sounds like CQL is expressing the patient's rules for coverage or payment. It is also too focused on 'condition'. The second paragraph refers to a 'DTR process', but actually the rules around how the CQL expression results will be used are defined by SDC.
Recommended substitution language:
"As part of the SDC Questionnaires that define the information payers require to be captured, CQL is used to support automatic population of answers from existing EHR data and, occasionally, to enforce complex logic around what questions should be displayed. FOr example, whether answers are required, what answers should be enabled, etc. This CQL may query for patient observations, conditions, or other discrete information within the EHR to use as part of the population process or logic. The SDC provides guidance about how CQL expressions can be used for different purposes, as well as how information gathered by CQL in one portion of the Questionnaire can be made available in other portions of the Questionnaire. See [Using expressions]."
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