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  1. FHIR Specification Feedback
  2. FHIR-36468

What's the point of distinguishing CQL vs. human-authored?

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    • Icon: Change Request Change Request
    • Resolution: Not Persuasive with Modification
    • Icon: Medium Medium
    • US Da Vinci DTR (FHIR)
    • 1.0.0 [deprecated]
    • Clinical Decision Support
    • Requesting Additional Information from the User [deprecated]
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      The source (author) of the data is important for both providers and payers to attribute the information to a particular source and provide feedback on the design and use of the questionnaire and the implications regarding provider burden.  Information pulled from the medical record by CQL needs to be clearly identified as should the information entered by a provider or office staff.  As an example, if information is not found in the medical record and needs to be manually entered, or if it is "found" and needs to be changed, then the questionnaire needs to be updated to better utilize the information available in the record where possible. In addition, understanding who is entering the information, will help to optimize questionnaires to focus provider interactions on information that only they can realistically provide.

      Include an indicator for each answer as to origin of the information, medical record auto-populated, medical record auto-populated and overridden, manually entered.  In the last two situations, also who was the final human to adjust. 

      This process SHALL be automatic and populated without human intervention by the DTR application.

      Will include the explanation in the text.

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      The source (author) of the data is important for both providers and payers to attribute the information to a particular source and provide feedback on the design and use of the questionnaire and the implications regarding provider burden.  Information pulled from the medical record by CQL needs to be clearly identified as should the information entered by a provider or office staff.  As an example, if information is not found in the medical record and needs to be manually entered, or if it is "found" and needs to be changed, then the questionnaire needs to be updated to better utilize the information available in the record where possible. In addition, understanding who is entering the information, will help to optimize questionnaires to focus provider interactions on information that only they can realistically provide. Include an indicator for each answer as to origin of the information, medical record auto-populated, medical record auto-populated and overridden, manually entered.  In the last two situations, also who was the final human to adjust.  This process SHALL be automatic and populated without human intervention by the DTR application. Will include the explanation in the text.
    • Bob Dieterle / Greg White : 18-0-0
    • Correction
    • Compatible, substantive

    Description

      From a payer, provider and a patient perspective, all of the information needs to have been reviewed by the submitting provider and the provider needs to be attesting that the information is true.  The CQL is saving time and hopefully improving quality, but the CQL has no "responsibility" in terms of the data submitted to the payer as part of a prior auth request or claim submission (or local document retention for audit).  Also, in some cases, some of the answers for a question might have been populated by CQL and other answers were selected by the human.  I'd strongly suggest ditching the notion of the 'author' extension.

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            lloyd Lloyd McKenzie
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