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  1. FHIR Specification Feedback
  2. FHIR-43781

Clarify ELM -> DataRequirements expectations

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    • Icon: Change Request Change Request
    • Resolution: Persuasive
    • Icon: Medium Medium
    • US Quality Measures (FHIR)
    • 5.0.0-ballot [deprecated]
    • Clinical Quality Information
    • QMs
    • 3.3.1
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      Agree with recommendation.  Will update conformance statement 3.6 as below:

      1. Conformance Requirement 3.6 

      1. Systems SHOULD populate dataRequirements for each ELM Retrieve element. Each dataRequirement:
        • SHALL have a “type” element representing the type of the retrieve
        • SHALL have a profile element with the value of the templateId attribute of the retrieve, if present
        • If the Retrieve element has a "codes" element referencing a ValueSet, the dataRequirement SHALL have a codeFilter.valueSet element
        • If the Retrieve element has a "codes" element with a direct reference code, the dataRequirement SHALL have a codeFilter.code element

      Systems that can optimize terminology restrictions may include filters that can be inferred from the CQL in the data requirements to provide more selective data requirements.

       

      2. In examples of snippet 3-11, correct reference to OID with correct URL (for acute pharyngitis)

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      Agree with recommendation.  Will update conformance statement 3.6 as below: 1. Conformance Requirement 3.6   Systems SHOULD populate dataRequirements for each ELM Retrieve element. Each dataRequirement: SHALL have a “type” element representing the type of the retrieve SHALL have a profile element with the value of the templateId attribute of the retrieve, if present If the Retrieve element has a "codes" element referencing a ValueSet, the dataRequirement SHALL have a codeFilter.valueSet element If the Retrieve element has a "codes" element with a direct reference code, the dataRequirement SHALL have a codeFilter.code element Systems that can optimize terminology restrictions may include filters that can be inferred from the CQL in the data requirements to provide more selective data requirements.   2. In examples of snippet 3-11, correct reference to OID with correct URL (for acute pharyngitis)
    • Karl Naden / Bryn Rhodes: 23-0-0
    • Correction
    • Compatible, substantive

    Description

      Please revise the conformance requirements to make clear what packaging tools are responsible for producing and what consumers can expect from this information as related to the represented measure. Specific areas of concern to consider:

      1. the current list of conformance requirements don't use any conformance verbs. Only the last one uses the word "should" but not capitalized as expected for conformance requirements. Based on my reading, the first 4 entries in the list constitute an algorithm for identifying and mapping ELM elements to FHIR DataRequirement entries. These should be sub-points under currently entry 5 which should be updated to indicate that systems "SHOULD" (as a conformance verb) populate DataRequirements based on this algorithm.
      2. the current description does not make clear that the algorithm is partial and not guaranteed to return all details of all data requirements for all measures. I've included a specific example below for illustration. I don't believe that it is possible or wise to detail a complete algorithm for data requirements extraction here. However I do think it is appropriate and advisable to include some language indicating that the set of data requirements returned from this algorithm will not always be complete

       

      Specific example of a case where a code filter on a data requirement won't be picked up by the algorithm for retrieves currently described in the section:

      CQL:

      ELM: the Condition fetch is separate from the code filter for the stroke conditions in the ELM…

      Data Requirements: …so the stroke condition codes don’t show up in the data requirements per the logic outlined in the IG

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            jen_seeman Jennifer Seeman
            karlnaden Karl Naden
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              Updated:
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