diff --git a/src/cql/dstu2/CDSConnectCommonsForFHIRv102.cql b/src/cql/dstu2/CDSConnectCommonsForFHIRv102.cql new file mode 100644 index 000000000..6cc3002c4 --- /dev/null +++ b/src/cql/dstu2/CDSConnectCommonsForFHIRv102.cql @@ -0,0 +1,668 @@ +// CDS Connect Commons for FHIRv102 +// +// This library provides functions commonly used by CDS Connect CQL libraries as well as the +// CDS Connect CDS Authoring Tool. +// +// Version 2.0.0 implements several best practices prescribed by FHIR Clinical Guidelines, including: +// - Renaming library from CDS_Connect_Commons_for_FHIRv102 to CDSConnectCommonsForFHIRv102 +// - Surrounding all library-level identifiers and datatypes in quotes +// - Using descriptive names (no abbreviations) for query aliases and function arguments +// +// Version 2.0.0 also introduces the following changes from the previous version of this library: +// - Add "ActiveOrCompletedMedicationStatement", "MedicationDispenseLookBack", "NotCancelled", and +// "EncounterLookBack" + +library CDSConnectCommonsForFHIRv102 version '2.0.0' + +using FHIR version '1.0.2' + +// Include the FHIRHelpers library for simplifying interacton w/ the FHIR data model +include FHIRHelpers version '1.0.2' called FHIRHelpers + +// -------------------------------------------------- OBSERVATIONS ----------------------------------------------------- + +/** + * Filters Observations by a concept rather than by a ValueSet. In CQL 1.3, this will be built into the retrieve, + * but for now, we must use a query where clause. + * @param Koncept - the concept to filter on (intentionally mispelled to avoid naming clashes) + * @returns {List<"Observation">} a list of Observations matching the concept, or null if null was passed in + */ +define function "ObservationsByConcept"(Koncept System."Concept"): + ["Observation"] Observation where FHIRHelpers.ToConcept(Observation.code) ~ Koncept + +/** + * Observations that are complete and verified. In FHIR DSTU2, there are two statuses that indicate this state: 'final' + * and 'amended'. + * @see http://hl7.org/fhir/DSTU2/valueset-observation-status.html + * @param Observations - a list of Observations + * @returns {List<"Observation">} a list of verified Observations, or null if null was passed in + */ +define function "Verified"(Observations List<"Observation">): + Observations Observation where Observation.status.value in {'final', 'amended'} + +/** + * Observations that have quantity values recorded in the requested unit. + * @param Observations - a list of Observations + * @param Unit - the unit to require in the Observations quantity value + * @returns {List<"Observation">} a list of Observations with the required unit, or null if null was passed in + */ +define function "WithUnit"(Observations List<"Observation">, Unit "String"): + Observations Observation where Observation.valueQuantity.unit.value = Unit or Observation.valueQuantity.code.value = Unit + +/** + * Observations with an effective or issued date in the specified "look back" period. For example, LDL-C Tests in the + * last 6 years. + * TODO: Rename to LookBack once the execution engine supports overloaded functions. + * @param Observations - a list of Observations + * @returns {List<"Observation">} a list of Observations with effective or issued date specified lookback period, or null + * if null was passed in + */ +define function "ObservationLookBack"(Observations List<"Observation">, LookBack System."Quantity"): + Observations Observation + let LookBackInterval: Interval[Now() - LookBack, Now()] + where Observation.effectiveDateTime.value in LookBackInterval + or FHIRHelpers.ToInterval(Observation.effectivePeriod) overlaps LookBackInterval + or Observation.issued in LookBackInterval + +/** + * The most recent observation. For each Observation, this algorithm will use the Coalesce function, which uses the + * first non-null date value from these fields: effectiveDateTime, effectivePeriod.end, effectivePeriod.start, issued. + * The found date will be used to compare Observations and determine the most recent one. + * NOTE: We can't use "FindDate" because it appears that the execution engine may have problems sorting by the + * result of a function. + * @see Coalesce("Observation") + * @param Observations - a list of Observations + * @returns {"Observation"} the most recent Observation from the list, or null if null was passed in + */ +define function "MostRecent"(Observations List<"Observation">): + Last(Observations Observation sort by Coalesce(effectiveDateTime.value, effectivePeriod."end".value, effectivePeriod."start".value, issued.value)) + +/** + * The First Observation. For each Observation, this algorithm will use the "FindDate" function, which uses the + * first non-null date value from these fields: effectiveDateTime, effectivePeriod.end, effectivePeriod.start, issued. + * The found date will be used to compare Observations and determine the first one. + * NOTE: We can't use "FindDate" because it appears that the execution engine may have problems sorting by the + * result of a function. + * @see Coalesce("Observation") + * @param Observations - a list of Observations + * @returns {"Observation"} the most recent Observation from the list, or null if null was passed in + */ + define function "FirstObservation"(Observations List<"Observation">): + First(Observations Observation sort by Coalesce(effectiveDateTime.value, effectivePeriod."start".value, effectivePeriod."end".value, issued.value)) + +/** + * Extracts the quantity value from an Observation, returning it as a CQL Quantity + * @param Observation - an observation + * @returns {System."Quantity"} the Observation's value as a quantity, or null if there is no quantity value + */ +define function "QuantityValue"(Observation "Observation"): + FHIRHelpers.ToQuantity(Observation.valueQuantity) + +/** + * Extracts the CodeableConcept value from an Observation, returning it as a CQL Concept + * @param Observation - an observation + * @returns {System."Concept"} the Observation's value as a concept, or null if there is no CodeabeConcept value + */ +define function "ConceptValue"(Observation "Observation"): + FHIRHelpers.ToConcept(Observation.valueCodeableConcept) + +/** + * Finds the first non-null meaningful date that can be associated with this Observation. This will look through the + * following fields in the following order: effectiveDateTime, effectivePeriod.end, effectivePeriod.start, issued. + * @param Observation - an Observation + * @returns {System.DateTime} the first non-null meaningful date, or null if non is found + */ +define function "FindDate"(Observation "Observation"): + Coalesce(Observation.effectiveDateTime.value, Observation.effectivePeriod."end".value, Observation.effectivePeriod."start".value, Observation.issued.value) + +// TODO: Confirm that this works as expected +/** + * The highest observation. + * The value will be used to compare Observations and determine the highest one. + * @param Observations - a list of Observations + * @returns {System."Quantity"} the quantity with the highest value from the list, or null if null was passed in + */ +define function "HighestObservation"(Observations List<"Observation">): + Max(Observations Observation return FHIRHelpers.ToQuantity(Observation.valueQuantity)) + +/** + * The Average Observation Value. + * The value will be used to calculate the average ValueQuantity of all non-null elements in the observation list . + * @param Observations - a list of Observations + * @returns {System."Quantity"} a quantity containing the average of the non-null elements of the list + * or null if all elements are null. + */ +define function "AverageObservation"(Observations List<"Observation">): + Avg(Observations Observation return FHIRHelpers.ToQuantity(Observation.valueQuantity)) + +// -------------------------------------------------- CONDITIONS ------------------------------------------------------- + +/** + * Filters Conditions by a concept rather than by a ValueSet. In CQL 1.3, this will be built into the retrieve, + * but for now, we must use a query where clause. + * @param Koncept - the concept to filter on (intentionally mispelled to avoid naming clashes) + * @returns {List<"Observation">} a list of Conditions matching the concept, or null if null was passed in + */ +define function "ConditionsByConcept"(Koncept System."Concept"): + ["Condition"] Condition where FHIRHelpers.ToConcept(Condition.code) ~ Koncept + +/** + * Conditions that are confirmed. In FHIR DSTU2, this is reflected by verificationStatus: 'confirmed'. + * @see http://hl7.org/fhir/DSTU2/valueset-condition-ver-status.html + * @param Conditions - a list of Conditions + * @returns {List<"Condition">} a list of confirmed Conditions, or null if null was passed in + */ +define function "Confirmed"(Conditions List<"Condition">): + Conditions Condition where Condition.verificationStatus.value = 'confirmed' + +/** + * Conditions that are active. In FHIR DSTU2, this is reflected by clinicalStatus: 'active' and the absence of any + * abatement information (i.e., if it abated, it is no longer active). + * TODO: Rename to Active once the execution engine supports overloaded functions. + * @see http://hl7.org/fhir/DSTU2/valueset-condition-clinical.html + * @param Conditions - a list of Conditions + * @returns {List<"Condition">} a list of active Conditions, or null if null was passed in + */ +define function "ActiveCondition"(Conditions List<"Condition">): + Conditions Condition + where Condition.clinicalStatus.value = 'active' + and Condition.abatementDateTime is null + and Condition.abatementQuantity is null + and Condition.abatementBoolean.value is not true + and Condition.abatementPeriod is null + and Condition.abatementRange is null + and Condition.abatementString is null + +/** + * Conditions that are active or recurring. In FHIR DSTU2, this is reflected by clinicalStatus: 'active' or 'relapse'. + * We do not check for null abatement information because it may have dates from when the now recurring condition + * initially went into remission. + * @see http://hl7.org/fhir/DSTU2/valueset-condition-clinical.html + * @param Conditions - a list of Conditions + * @returns {List<"Condition">} a list of active or recurring Conditions, or null if null was passed in + */ +define function "ActiveOrRecurring"(Conditions List<"Condition">): + Conditions Condition where Condition.clinicalStatus.value in {'active', 'relapse'} + +/** + * Conditions with an onset or recorded date in the specified "look back" period. For example, pregnancy in + * the last 42 weeks. + * TODO: Rename to LookBack once the execution engine supports overloaded functions. + * @param Conditions - a list of Conditions + * @returns {List<"Condition">} a list of Conditions with onset or recorded date specified lookback period, or null + * if null was passed in + */ +define function "ConditionLookBack"(Conditions List<"Condition">, LookBack System."Quantity"): + Conditions Condition + let LookBackInterval: Interval[Now() - LookBack, Now()] + where Condition.onsetDateTime.value in LookBackInterval + or FHIRHelpers.ToInterval(Condition.onsetPeriod) overlaps LookBackInterval + or Condition.dateRecorded.value in LookBackInterval + +/** + * The most recent condition. For each Condition, this algorithm will use the Coalesce function, which uses the + * first non-null result from these fields: onsetDateTime, onsetPeriod.end, onsetPeriod.start, dateRecorded. + * The found date will be used to compare Conditions and determine the most recent one. + * @param Conditions - a list of Conditions + * @returns {"Condition"} the most recent Condition from the list, or null if null was passed in + */ +define function "MostRecentCondition"(Conditions List<"Condition">): + Last(Conditions Condition sort by Coalesce(onsetDateTime.value, onsetPeriod."end".value, onsetPeriod."start".value, dateRecorded.value)) + +/** + * The First condition. For each Condition, this algorithm will use the Coalesce function, which uses the + * first non-null result from these fields: onsetDateTime, onsetPeriod.end, onsetPeriod.start, dateRecorded. + * The found date will be used to compare Conditions and determine the most recent one. + * @param Conditions - a list of Conditions + * @returns {"Condition"} the most recent Condition from the list, or null if null was passed in + */ +define function "FirstCondition"(Conditions List<"Condition">): + First(Conditions Condition sort by Coalesce(onsetDateTime.value, onsetPeriod."start".value, onsetPeriod."end".value, dateRecorded.value)) + +// -------------------------------------------------- PROCEDURES ------------------------------------------------------- + + /** + * Filters Procedures by a concept rather than by a ValueSet. In CQL 1.3, this will be built into the retrieve, + * but for now, we must use a query where clause. + * @param Koncept - the concept to filter on (intentionally mispelled to avoid naming clashes) + * @returns {List<"Procedure">} a list of Procedures matching the concept, or null if null was passed in + */ + define function "ProceduresByConcept"(Koncept System."Concept"): + ["Procedure"] Procedure where FHIRHelpers.ToConcept(Procedure.code) ~ Koncept + +/** + * Procedures that are completed. In FHIR DSTU2, this is reflected by status: 'completed'. In addition, the + * notPerformed flag must be checked to ensure it is not 'true'. + * @see http://hl7.org/fhir/DSTU2/valueset-procedure-status.html + * @param Procedures - a list of Procedures + * @returns {List<"Procedure">} a list of completed Procedures, or null if null was passed in + */ +define function "Completed"(Procedures List<"Procedure">): + Procedures Procedure + where Procedure.status.value = 'completed' + and Procedure.notPerformed.value is not true + +/** + * Procedures that are in progress. In FHIR DSTU2, this is reflected by status: 'in-progress'. In addition, the + * notPerformed flag must be checked to ensure it is not 'true'. + * @see http://hl7.org/fhir/DSTU2/valueset-procedure-status.html + * @param Procedures - a list of Procedures + * @returns {List<"Procedure">} a list of completed Procedures, or null if null was passed in + */ +define function "ProcedureInProgress"(Procedures List<"Procedure">): + Procedures Procedure + where Procedure.status.value = 'in-progress' + and Procedure.notPerformed.value is not true + +/** + * Procedures that actually happened or are happening. In FHIR DSTU2, there are a few properties that negate the + * procedure, most notably when status is 'entered-in-error' or notPerformed is true. + * @see http://hl7.org/fhir/DSTU2/valueset-procedure-status.html + * @param Procedures - a list of Procedures + * @returns {List<"Procedure">} a list of Procedures that actually happened or are happening, or null if null was passed in + */ +define function "ProcedurePerformance"(Procedures List<"Procedure">): + Procedures Procedure + where Procedure.status.value != 'entered-in-error' + and Procedure.notPerformed.value is not true + +/** + * Procedures performed in the specified "look back" period. For example, PCIs performed in the + * past 2 weeks. + * TODO: Rename to LookBack once the execution engine supports overloaded functions. + * @param Procedures - a list of Procedures + * @param LookBack - the lookback period for when the procedure was performed + * @returns {List<"Procedure">} a list of Procedures performed in the look back period, or null if null + * was passed in + */ +define function "ProcedureLookBack"(Procedures List<"Procedure">, LookBack System."Quantity"): + Procedures Procedure + let LookBackInterval: Interval[Now() - LookBack, Now()] + where Procedure.performedDateTime.value in LookBackInterval + or FHIRHelpers.ToInterval(Procedure.performedPeriod) overlaps LookBackInterval + +/** + * The most recent procedure. For each Procedure, this algorithm will use the Coalesce function, which returns the + * first non-null result from these fields: performedDateTime, performedPeriod.end, performedPeriod.start. + * The found date will be used to compare Procedures and determine the most recent one. + * @param Procedures - a list of Procedures + * @returns {"Procedure"} the most recent Procedure from the list, or null if null was passed in + */ +define function "MostRecentProcedure"(Procedures List<"Procedure">): + Last(Procedures Procedure sort by Coalesce(performedDateTime.value, performedPeriod."end".value, performedPeriod."start".value)) + +/** + * The First procedure. For each Procedure, this algorithm will use the Coalesce function, which returns the + * first non-null result from these fields: performedDateTime, performedPeriod.end, performedPeriod.start. + * The found date will be used to compare Procedures and determine the first one. + * @param Procedures - a list of Procedures + * @returns {"Procedure"} the most recent Procedure from the list, or null if null was passed in + */ +define function "FirstProcedure"(Procedures List<"Procedure">): + First(Procedures Procedure sort by Coalesce(performedDateTime.value, performedPeriod."start".value, performedPeriod."end".value)) + + +// ---------------------------------------------- PROCEDUREREQUESTS ---------------------------------------------------- + + /** + * Filters ProcedureRequests by a concept rather than by a ValueSet. In CQL 1.3, this will be built into the retrieve, + * but for now, we must use a query where clause. + * @param Koncept - the concept to filter on (intentionally mispelled to avoid naming clashes) + * @returns {List<"ProcedureRequest">} a list of ProcedureRequests matching the concept, or null if null was passed in + */ + define function "ProcedureRequestsByConcept"(Koncept System."Concept"): + ["ProcedureRequest"] Request where FHIRHelpers.ToConcept(Request.code) ~ Koncept + +/** + * ProcedureRequests that are accepted, in progress, or completed. In FHIR DSTU2, this is reflected by the corresponding + * status status values. + * @see http://hl7.org/fhir/DSTU2/valueset-procedure-request-status.html + * @param ProcedureRequests - a list of ProcedureRequests + * @returns {List<"ProcedureRequest">} a list of accepted, in-progress, or completed ProcedureRequests, + * or null if null was passed in + */ +define function "ProcedureRequestAcceptedOrInProgressOrCompleted"(ProcedureRequests List<"ProcedureRequest">): + ProcedureRequests Request + where Request.status.value in List{'accepted', 'in-progress', 'completed'} + +/** + * ProcedureRequests ordered in the specified "look back" period. For example, PCIs ordered in the + * past 2 weeks. + * TODO: Rename to LookBack once the execution engine supports overloaded functions. + * @param ProcedureRequests - a list of ProcedureRequests + * @param LookBack - the lookback period for when the procedure was ordered + * @returns {List<"ProcedureRequest">} a list of ProcedureRequests ordered in the look back period, or null if null + * was passed in + */ +define function "ProcedureRequestLookBack"(ProcedureRequests List<"ProcedureRequest">, LookBack System."Quantity"): + ProcedureRequests Request + where Request.orderedOn.value in Interval[Now() - LookBack, Now()] + +// ----------------------------------------------- REFERRALREQUESTS ---------------------------------------------------- + + /** + * Filters ReferralRequests by a concept rather than by a ValueSet. In CQL 1.3, this will be built into the retrieve, + * but for now, we must use a query where clause. + * @param Koncept - the concept to filter on (intentionally mispelled to avoid naming clashes) + * @returns {List<"ReferralRequest">} a list of ReferralRequests matching the concept, or null if null was passed in + */ + define function "ReferralRequestsByServiceRequestedConcept"(Koncept System."Concept"): + ["ReferralRequest"] Referral + where exists((Referral.serviceRequested) Service where FHIRHelpers.ToConcept(Service) ~ Koncept) + +/** + * ReferralRequests that are accepted, active, or completed. In FHIR DSTU2, this is reflected by the corresponding + * status status values. + * @see http://hl7.org/fhir/DSTU2/valueset-referralstatus.html + * @param Referrals - a list of ReferralRequests + * @returns {List<"ReferralRequest">} a list of accepted, active, or completed ReferralRequests, + * or null if null was passed in + */ +define function "ReferralRequestAcceptedOrActiveOrCompleted"(Referrals List<"ReferralRequest">): + Referrals Referral + where Referral.status.value in List{'accepted', 'active', 'completed'} + +/** + * ReferralRequests requested in the specified "look back" period. For example, pace make insertions referrals sent + * in the past 2 weeks. + * TODO: Rename to LookBack once the execution engine supports overloaded functions. + * @param Referrals - a list of ReferralRequests + * @param LookBack - the lookback period for when the referral was sent + * @returns {List<"ReferralRequest">} a list of ReferralRequests sent in the look back period, or null if null + * was passed in + */ +define function "ReferralRequestLookBack"(Referrals List<"ReferralRequest">, LookBack System."Quantity"): + Referrals Referral + where Referral.dateSent.value in Interval[Now() - LookBack, Now()] + +// -------------------------------------------------- MEDICATIONS ------------------------------------------------------ + +/** + * Filters MedicationStatements by a concept rather than by a ValueSet. In CQL 1.3, this will be built into the retrieve, + * but for now, we must use a query where clause. + * @param Koncept - the concept to filter on (intentionally mispelled to avoid naming clashes) + * @returns {List<"MedicationStatement">} a list of MedicationStatement matching the concept, or null if null was passed in + */ +define function "MedicationStatementsByConcept"(Koncept System."Concept"): + ["MedicationStatement"] Statement where FHIRHelpers.ToConcept(Statement.medicationCodeableConcept) ~ Koncept + +/** + * Filters MedicationOrders by a concept rather than by a ValueSet. In CQL 1.3, this will be built into the retrieve, + * but for now, we must use a query where clause. + * @param Koncept - the concept to filter on (intentionally mispelled to avoid naming clashes) + * @returns {List<"MedicationOrder">} a list of MedicationOrders matching the concept, or null if null was passed in + */ +define function "MedicationOrdersByConcept"(Koncept System."Concept"): + ["MedicationOrder"] Order where FHIRHelpers.ToConcept(Order.medicationCodeableConcept) ~ Koncept + +/** + * Medications that are active, according to a statement, but not necessarily verified via a prescription. For example, + * medications that a patient has self-reported to be taking. In FHIR DSTU2, this is reflected by MedicationStatement + * with status 'active', no flag indicating it wasn't taken, and no end date or an end date in the future. + * TODO: Rename to Active once the execution engine supports overloaded functions. + * @see http://hl7.org/fhir/DSTU2/valueset-medication-statement-status.html + * @param Statements - a list of MedicationStatements + * @returns {List<"MedicationStatement">} a list of active medication statements, or null if null was passed in + */ +define function "ActiveMedicationStatement"(Statements List<"MedicationStatement">): + Statements Statement + let EffectivePeriod: FHIRHelpers.ToInterval(Statement.effectivePeriod) + where Statement.status.value = 'active' + and Statement.wasNotTaken.value is not true + and (end of EffectivePeriod is null or end of EffectivePeriod after Now()) + +/** + * Medications that are active or completed, according to a statement, but not necessarily verified via a prescription. + * For example, medications that a patient has self-reported to be taking. In FHIR DSTU2, this is reflected by + * MedicationStatement with status 'active' or 'completed', and no flag indicating it wasn't taken. + * TODO: Rename to ActiveOrCompleted once the execution engine supports overloaded functions. + * @see http://hl7.org/fhir/DSTU2/valueset-medication-statement-status.html + * @param Statements - a list of MedicationStatements + * @returns {List<"MedicationStatement">} a list of active or completed medication statements, or null if null was passed + * in + */ +define function "ActiveOrCompletedMedicationStatement"(Statements List<"MedicationStatement">): + Statements Statement + where Statement.status.value = 'active' + or Statement.status.value = 'completed' + and Statement.wasNotTaken.value is not true + +/** +* Medications that are active, according to a prescription. In FHIR DSTU2, this is reflected by MedicationOrder +* with status 'active' and no dateEnded. There is currently an open question in the FHIR chat to determine if this +* is the right approach. +* TODO: Revisit based on outcome of FHIR chat. +* TODO: Rename to Active once the execution engine supports overloaded functions. +* @see https://chat.fhir.org/#narrow/stream/implementers/topic/Meaning.20of.20.22active.22.20and.20.22completed.22.20in.20MedicationRequest +* @see http://hl7.org/fhir/DSTU2/valueset-medication-order-status.html +* @param Orders - a list of MedicationOrders +* @returns {List<"MedicationOrder">} a list of active medication orders, or null if null was passed in +*/ +define function "ActiveMedicationOrder"(Orders List<"MedicationOrder">): + Orders Order + where Order.status.value = 'active' + and Order.dateEnded.value is null + +/** +* Medications that are active or completed, according to a prescription. In FHIR DSTU2, this is reflected by MedicationOrder +* with status 'active' or 'completed' +* @see http://hl7.org/fhir/DSTU2/valueset-medication-order-status.html +* @param Orders - a list of MedicationOrders +* @returns {List<"MedicationOrder">} a list of active medication orders, or null if null was passed in +*/ +define function "ActiveOrCompletedMedicationOrder"(Orders List<"MedicationOrder">): + Orders Order + where Order.status.value = 'active' + or Order.status.value = 'completed' + +/** +* Medications that are active, completed, or stopped, according to a prescription. In FHIR DSTU2, this is reflected by +* MedicationOrder with status 'active', 'completed', or 'stopped' +* @see http://hl7.org/fhir/DSTU2/valueset-medication-order-status.html +* @param Orders - a list of MedicationOrders +* @returns {List<"MedicationOrder">} a list of active medication orders, or null if null was passed in +*/ +define function "ActiveCompletedOrStoppedMedicationOrder"(Orders List<"MedicationOrder">): + Orders Order + where Order.status.value = 'active' + or Order.status.value = 'completed' + or Order.status.value = 'stopped' + +/** + * MedicationStatement with an effective date in the specified "look back" period. For example, statements about opioid + * use in the last 180 days. + * TODO: Rename to LookBack once the execution engine supports overloaded functions. + * @param Statements - a list of MedicationStatements + * @param LookBack - a duration Quantity indicating how far back to look for MedicationStatements + * @returns {List<"MedicationStatement">} a list of MedicationStatements with effective date in the specified lookback + * period, or null if null was passed in + */ +define function "MedicationStatementLookBack"(Statements List<"MedicationStatement">, LookBack System."Quantity"): + Statements Statement + let LookBackInterval: Interval[Now() - LookBack, Now()] + where Statement.effectiveDateTime.value in LookBackInterval + or FHIRHelpers.ToInterval(Statement.effectivePeriod) overlaps LookBackInterval + +/** + * MedicationOrders with a written date in the specified "look back" period. For example, opioid orders in the last + * 180 days. + * TODO: Rename to LookBack once the execution engine supports overloaded functions. + * @param Orders - a list of MedicationOrders + * @param LookBack - a duration Quantity indicating how far back to look for MedicationOrders + * @returns {List<"MedicationOrder">} a list of MedicationOrders with written date in the specified lookback period, + * or null if null was passed in + */ +define function "MedicationOrderLookBack"(Orders List<"MedicationOrder">, LookBack System."Quantity"): + Orders Order where Order.dateWritten.value in Interval[Now() - LookBack, Now()] + +/** +* Medication Dispenses that are handed over or prepared in the specified "look back" period. +* TODO: Rename to LookBack once the execution engine supports overloaded functions. +* @param Dispenses - a list of MedicationDispenses +* @param LookBack - the lookback period for when the medication was prescribed +* @returns {List<"MedicationStatement">} a list of MedicationDispenses handed over or prepared in the look back period, +* or null if null was passed in +*/ +define function "MedicationDispenseLookBack"(Dispenses List<"MedicationDispense">, LookBack System."Quantity"): + Dispenses Dispense + let LookBackInterval: Interval[Now() - LookBack, Now()] + where Dispense.whenHandedOver.value in LookBackInterval + or Dispense.whenPrepared.value in LookBackInterval + +// -------------------------------------------------- ENCOUNTERS ------------------------------------------------------ + +/** + * Filters Encounters by a concept rather than by a ValueSet. In CQL 1.3, this will be built into the retrieve, + * but for now, we must use a query where clause. + * @param Koncept - the concept to filter on (intentionally mispelled to avoid naming clashes) + * @returns {List<"Encounter">} a list of Encounters matching the concept, or null if null was passed in + */ +define function "EncountersByConcept"(Koncept System."Concept"): + ["Encounter"] Encounter where exists( (Encounter.type) Type where FHIRHelpers.ToConcept(Type) ~ Koncept ) + +/** + * Encounters that are in progress. In FHIR DSTU2, this is reflected by status: 'in-progress'. + * @see http://hl7.org/fhir/DSTU2/valueset-encounter-state.html + * @param Encounters - a list of Encounters + * @returns {List<"Encounter">} a list of in progress encounters, or null if null was passed in + */ +define function "InProgress"(Encounters List<"Encounter">): + Encounters Encounter + where Encounter.status.value = 'in-progress' + +/** + * Encounters that have not been cancelled. In FHIR DSTU2, this is reflected by andy status other + * than: 'cancelled'. + * @see http://hl7.org/fhir/DSTU2/valueset-encounter-state.html + * @param Encounters - a list of Encounters + * @returns {List<"Encounter">} a list of in progress encounters, or null if null was passed in + */ +define function "NotCancelled"(Encounters List<"Encounter">): + Encounters Encounter + where Encounter.status.value != 'cancelled' + +/** + * Encounters performed in the specified "look back" period. + * TODO: Rename to LookBack once the execution engine supports overloaded functions. + * @param Encounters - a list of Encounters + * @param LookBack - the lookback period for when the encounter occurred + * @returns {List<"Encounter">} a list of Encounters occurring during the look back period, or null if null + * was passed in + */ +define function "EncounterLookBack"(Encounters List<"Encounter">, LookBack System."Quantity"): + Encounters Encounter + let LookBackInterval: Interval[Now() - LookBack, Now()] + where FHIRHelpers.ToInterval(Encounter.period) overlaps LookBackInterval + +// -------------------------------------------------- ALLERGY INTOLERANCES --------------------------------------------- + +/** + * Filters AllergyIntolerances by a concept rather than by a ValueSet. In CQL 1.3, this will be built into the retrieve, + * but for now, we must use a query where clause. + * @param Koncept - the concept to filter on (intentionally mispelled to avoid naming clashes) + * @returns {List<"AllergyIntolerance">} a list of Allergy Intolerances matching the concept, or null if null was passed in + */ +define function "AllergyIntolerancesByConcept"(Koncept System."Concept"): + ["AllergyIntolerance"] Allergy where FHIRHelpers.ToConcept(Allergy.substance) ~ Koncept + +/** +* AllergyIntolerances that are active or confirmed. In FHIR DSTU2, this is reflected by AllergyIntolerance +* with status 'active' or 'confirmed' +* @see http://hl7.org/fhir/DSTU2/valueset-allergy-intolerance-status.html +* @param AllergyIntolerances - a list of AllergyIntolerances +* @returns {List<"AllergyIntolerance">} a list of active or confirmed allergy intolerances, or null if null was passed in +*/ +define function "ActiveOrConfirmedAllergyIntolerance"(AllergyIntolerances List<"AllergyIntolerance">): + AllergyIntolerances Allergy + where Allergy.status.value = 'active' + or Allergy.status.value = 'confirmed' + +// -------------------------------------------------------- GOALS ------------------------------------------------------ + +/** + * Goals with a start, target, or status date in the specified "look back" period. For example, Pain Management Goals + * in the last 2 years. + * TODO: Rename to LookBack once the execution engine supports overloaded functions. + * @param Goals - a list of Goals + * @returns {List<"Goal">} a list of Goals with a start, target, or status date in the specified lookback period, or null + * if null was passed in + */ +define function "GoalLookBack"(Goals List<"Goal">, LookBack System."Quantity"): + Goals Goal + let LookBackInterval: Interval[Now() - LookBack, Now()] + where Goal.startDate.value in LookBackInterval + or Goal.targetDate.value in LookBackInterval + or (Goal.startDate.value + FHIRHelpers.ToQuantity(Goal.targetQuantity)) in LookBackInterval + or Goal.statusDate.value in LookBackInterval + +// -------------------------------------------------- Immunizations ---------------------------------------------------- + + /** + * Filters Immunizations by a concept rather than by a ValueSet. + * @param Koncept - the concept to filter on (intentionally mispelled to avoid naming clashes) + * @returns {List<"Immunization">} a list of Immunizations matching the concept, or null if null was passed in + */ + define function "ImmunizationsByConcept"(Koncept System."Concept"): + ["Immunization"] Immunization where FHIRHelpers.ToConcept(Immunization.vaccineCode) ~ Koncept + +/** + * Immunizations that are completed. In FHIR DSTU2, this is reflected by status: 'completed'. In addition, the + * wasNotGiven flag must be checked to ensure it is not 'true'. + * @see http://hl7.org/fhir/DSTU2/valueset-medication-admin-status.html + * @param Immunizations - a list of Immunizations + * @returns {List<"Immunization">} a list of completed Immunizations, or null if null was passed in + */ +define function "CompletedImmunization"(Immunizations List<"Immunization">): + Immunizations Immunization + where Immunization.status.value = 'completed' + and Immunization.wasNotGiven.value is not true + +/** + * Immunizations given in the specified "look back" period. + * TODO: Rename to LookBack once the execution engine supports overloaded functions. + * @param Immunizations - a list of Immunizations + * @param LookBack - the lookback period for when the immunization was given + * @returns {List<"Immunization">} a list of Immunizations given in the look back period, or null if null + * was passed in + */ +define function "ImmunizationLookBack"(Immunizations List<"Immunization">, LookBack System."Quantity"): + Immunizations Immunization + let LookBackInterval: Interval[Now() - LookBack, Now()] + where Immunization.date.value in LookBackInterval + +/** + * The most recent Immunization. + * @param Immunizations - a list of Immunizations + * @returns {"Immunization"} the most recent Immunization from the list, or null if null was passed in + */ +define function "MostRecentImmunization"(Immunizations List<"Immunization">): + Last(Immunizations Immunization sort by date.value) + +/** + * The First Immunization. + * @param Immunizations - a list of Immunizations + * @returns {"Immunization"} the most recent Immunization from the list, or null if null was passed in + */ +define function "FirstImmunization"(Immunizations List<"Immunization">): + First(Immunizations Immunization sort by date.value) + + +// ----------------------------------------------------- Devices ------------------------------------------------------- + + /** + * Filters Devices by a concept rather than by a ValueSet. + * @param Koncept - the concept to filter on (intentionally mispelled to avoid naming clashes) + * @returns {List<"Device">} a list of Devices matching the concept, or null if null was passed in + */ + define function "DevicesByConcept"(Koncept System."Concept"): + ["Device"] Device where FHIRHelpers.ToConcept(Device.type) ~ Koncept + +/** + * Devices that are active. In FHIR DSTU2, this is reflected by status: 'available'. + * @see http://hl7.org/fhir/DSTU2/valueset-devicestatus.html + * @param Devices - a list of Devices + * @returns {List<"Device">} a list of active Devices, or null if null was passed in + */ +define function "ActiveDevice"(Devices List<"Device">): + Devices Device + where Device.status.value = 'available' diff --git a/src/cql/dstu2/CDS_Connect_Commons_for_FHIRv102.json b/src/cql/dstu2/CDSConnectCommonsForFHIRv102.json similarity index 67% rename from src/cql/dstu2/CDS_Connect_Commons_for_FHIRv102.json rename to src/cql/dstu2/CDSConnectCommonsForFHIRv102.json index a23888acf..41ed7f4db 100644 --- a/src/cql/dstu2/CDS_Connect_Commons_for_FHIRv102.json +++ b/src/cql/dstu2/CDSConnectCommonsForFHIRv102.json @@ -5,8 +5,8 @@ "type" : "CqlToElmInfo" } ], "identifier" : { - "id" : "CDS_Connect_Commons_for_FHIRv102", - "version" : "1.3.1" + "id" : "CDSConnectCommonsForFHIRv102", + "version" : "2.0.0" }, "schemaIdentifier" : { "id" : "urn:hl7-org:elm", @@ -31,280 +31,6 @@ }, "statements" : { "def" : [ { - "name" : "NullSafeToConcept", - "context" : "Patient", - "accessLevel" : "Public", - "type" : "FunctionDef", - "expression" : { - "type" : "If", - "condition" : { - "type" : "Not", - "operand" : { - "type" : "IsNull", - "operand" : { - "name" : "Cpt", - "type" : "OperandRef" - } - } - }, - "then" : { - "name" : "ToConcept", - "libraryName" : "FHIRHelpers", - "type" : "FunctionRef", - "operand" : [ { - "name" : "Cpt", - "type" : "OperandRef" - } ] - }, - "else" : { - "asType" : "{urn:hl7-org:elm-types:r1}Concept", - "type" : "As", - "operand" : { - "type" : "Null" - } - } - }, - "operand" : [ { - "name" : "Cpt", - "operandTypeSpecifier" : { - "name" : "{http://hl7.org/fhir}CodeableConcept", - "type" : "NamedTypeSpecifier" - } - } ] - }, { - "name" : "NullSafePeriodToInterval", - "context" : "Patient", - "accessLevel" : "Public", - "type" : "FunctionDef", - "expression" : { - "type" : "If", - "condition" : { - "type" : "Not", - "operand" : { - "type" : "IsNull", - "operand" : { - "name" : "Pd", - "type" : "OperandRef" - } - } - }, - "then" : { - "lowClosed" : true, - "highClosed" : true, - "type" : "Interval", - "low" : { - "path" : "value", - "type" : "Property", - "source" : { - "path" : "start", - "type" : "Property", - "source" : { - "name" : "Pd", - "type" : "OperandRef" - } - } - }, - "high" : { - "path" : "value", - "type" : "Property", - "source" : { - "path" : "end", - "type" : "Property", - "source" : { - "name" : "Pd", - "type" : "OperandRef" - } - } - } - }, - "else" : { - "type" : "As", - "operand" : { - "type" : "Null" - }, - "asTypeSpecifier" : { - "type" : "IntervalTypeSpecifier", - "pointType" : { - "name" : "{urn:hl7-org:elm-types:r1}DateTime", - "type" : "NamedTypeSpecifier" - } - } - } - }, - "operand" : [ { - "name" : "Pd", - "operandTypeSpecifier" : { - "name" : "{http://hl7.org/fhir}Period", - "type" : "NamedTypeSpecifier" - } - } ] - }, { - "name" : "NullSafeToQuantity", - "context" : "Unfiltered", - "accessLevel" : "Public", - "type" : "FunctionDef", - "expression" : { - "type" : "If", - "condition" : { - "type" : "Not", - "operand" : { - "type" : "IsNull", - "operand" : { - "name" : "Qty", - "type" : "OperandRef" - } - } - }, - "then" : { - "classType" : "{urn:hl7-org:elm-types:r1}Quantity", - "type" : "Instance", - "element" : [ { - "name" : "value", - "value" : { - "path" : "value", - "type" : "Property", - "source" : { - "path" : "value", - "type" : "Property", - "source" : { - "name" : "Qty", - "type" : "OperandRef" - } - } - } - }, { - "name" : "unit", - "value" : { - "type" : "Coalesce", - "operand" : [ { - "path" : "value", - "type" : "Property", - "source" : { - "path" : "unit", - "type" : "Property", - "source" : { - "name" : "Qty", - "type" : "OperandRef" - } - } - }, { - "path" : "value", - "type" : "Property", - "source" : { - "path" : "code", - "type" : "Property", - "source" : { - "name" : "Qty", - "type" : "OperandRef" - } - } - } ] - } - } ] - }, - "else" : { - "asType" : "{urn:hl7-org:elm-types:r1}Quantity", - "type" : "As", - "operand" : { - "type" : "Null" - } - } - }, - "operand" : [ { - "name" : "Qty", - "operandTypeSpecifier" : { - "name" : "{http://hl7.org/fhir}Quantity", - "type" : "NamedTypeSpecifier" - } - } ] - }, { - "name" : "NullSafeRangeToInterval", - "context" : "Patient", - "accessLevel" : "Public", - "type" : "FunctionDef", - "expression" : { - "type" : "If", - "condition" : { - "type" : "Not", - "operand" : { - "type" : "IsNull", - "operand" : { - "name" : "Rg", - "type" : "OperandRef" - } - } - }, - "then" : { - "lowClosed" : true, - "highClosed" : true, - "type" : "Interval", - "low" : { - "name" : "NullSafeToQuantity", - "type" : "FunctionRef", - "operand" : [ { - "path" : "low", - "type" : "Property", - "source" : { - "name" : "Rg", - "type" : "OperandRef" - } - } ] - }, - "high" : { - "name" : "NullSafeToQuantity", - "type" : "FunctionRef", - "operand" : [ { - "path" : "high", - "type" : "Property", - "source" : { - "name" : "Rg", - "type" : "OperandRef" - } - } ] - } - }, - "else" : { - "type" : "As", - "operand" : { - "type" : "Null" - }, - "asTypeSpecifier" : { - "type" : "IntervalTypeSpecifier", - "pointType" : { - "name" : "{urn:hl7-org:elm-types:r1}Quantity", - "type" : "NamedTypeSpecifier" - } - } - } - }, - "operand" : [ { - "name" : "Rg", - "operandTypeSpecifier" : { - "name" : "{http://hl7.org/fhir}Range", - "type" : "NamedTypeSpecifier" - } - } ] - }, { - "name" : "NullSafeToInterval", - "context" : "Patient", - "accessLevel" : "Public", - "type" : "FunctionDef", - "expression" : { - "name" : "NullSafePeriodToInterval", - "type" : "FunctionRef", - "operand" : [ { - "name" : "Pd", - "type" : "OperandRef" - } ] - }, - "operand" : [ { - "name" : "Pd", - "operandTypeSpecifier" : { - "name" : "{http://hl7.org/fhir}Period", - "type" : "NamedTypeSpecifier" - } - } ] - }, { "name" : "ObservationsByConcept", "context" : "Patient", "accessLevel" : "Public", @@ -312,7 +38,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "O", + "alias" : "Observation", "expression" : { "dataType" : "{http://hl7.org/fhir}Observation", "type" : "Retrieve" @@ -322,11 +48,12 @@ "where" : { "type" : "Equivalent", "operand" : [ { - "name" : "NullSafeToConcept", + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "O", + "scope" : "Observation", "type" : "Property" } ] }, { @@ -350,9 +77,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "O", + "alias" : "Observation", "expression" : { - "name" : "ObsList", + "name" : "Observations", "type" : "OperandRef" } } ], @@ -364,7 +91,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "O", + "scope" : "Observation", "type" : "Property" } }, { @@ -382,7 +109,7 @@ } }, "operand" : [ { - "name" : "ObsList", + "name" : "Observations", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -399,9 +126,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "O", + "alias" : "Observation", "expression" : { - "name" : "ObsList", + "name" : "Observations", "type" : "OperandRef" } } ], @@ -418,7 +145,7 @@ "type" : "Property", "source" : { "path" : "valueQuantity", - "scope" : "O", + "scope" : "Observation", "type" : "Property" } } @@ -436,7 +163,7 @@ "type" : "Property", "source" : { "path" : "valueQuantity", - "scope" : "O", + "scope" : "Observation", "type" : "Property" } } @@ -448,7 +175,7 @@ } }, "operand" : [ { - "name" : "ObsList", + "name" : "Observations", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -471,9 +198,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "O", + "alias" : "Observation", "expression" : { - "name" : "ObsList", + "name" : "Observations", "type" : "OperandRef" } } ], @@ -509,7 +236,7 @@ "type" : "Property", "source" : { "path" : "effectiveDateTime", - "scope" : "O", + "scope" : "Observation", "type" : "Property" } }, { @@ -519,11 +246,12 @@ }, { "type" : "Overlaps", "operand" : [ { - "name" : "NullSafeToInterval", + "name" : "ToInterval", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { "path" : "effectivePeriod", - "scope" : "O", + "scope" : "Observation", "type" : "Property" } ] }, { @@ -539,7 +267,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "issued", - "scope" : "O", + "scope" : "Observation", "type" : "Property" } ] }, { @@ -550,7 +278,7 @@ } }, "operand" : [ { - "name" : "ObsList", + "name" : "Observations", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -575,9 +303,9 @@ "source" : { "type" : "Query", "source" : [ { - "alias" : "O", + "alias" : "Observation", "expression" : { - "name" : "ObsList", + "name" : "Observations", "type" : "OperandRef" } } ], @@ -631,7 +359,82 @@ } }, "operand" : [ { - "name" : "ObsList", + "name" : "Observations", + "operandTypeSpecifier" : { + "type" : "ListTypeSpecifier", + "elementType" : { + "name" : "{http://hl7.org/fhir}Observation", + "type" : "NamedTypeSpecifier" + } + } + } ] + }, { + "name" : "FirstObservation", + "context" : "Patient", + "accessLevel" : "Public", + "type" : "FunctionDef", + "expression" : { + "type" : "First", + "source" : { + "type" : "Query", + "source" : [ { + "alias" : "Observation", + "expression" : { + "name" : "Observations", + "type" : "OperandRef" + } + } ], + "relationship" : [ ], + "sort" : { + "by" : [ { + "direction" : "asc", + "type" : "ByExpression", + "expression" : { + "type" : "Coalesce", + "operand" : [ { + "path" : "value", + "type" : "Property", + "source" : { + "name" : "effectiveDateTime", + "type" : "IdentifierRef" + } + }, { + "path" : "value", + "type" : "Property", + "source" : { + "path" : "start", + "type" : "Property", + "source" : { + "name" : "effectivePeriod", + "type" : "IdentifierRef" + } + } + }, { + "path" : "value", + "type" : "Property", + "source" : { + "path" : "end", + "type" : "Property", + "source" : { + "name" : "effectivePeriod", + "type" : "IdentifierRef" + } + } + }, { + "path" : "value", + "type" : "Property", + "source" : { + "name" : "issued", + "type" : "IdentifierRef" + } + } ] + } + } ] + } + } + }, + "operand" : [ { + "name" : "Observations", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -646,19 +449,20 @@ "accessLevel" : "Public", "type" : "FunctionDef", "expression" : { - "name" : "NullSafeToQuantity", + "name" : "ToQuantity", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { "path" : "valueQuantity", "type" : "Property", "source" : { - "name" : "Obs", + "name" : "Observation", "type" : "OperandRef" } } ] }, "operand" : [ { - "name" : "Obs", + "name" : "Observation", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}Observation", "type" : "NamedTypeSpecifier" @@ -670,19 +474,20 @@ "accessLevel" : "Public", "type" : "FunctionDef", "expression" : { - "name" : "NullSafeToConcept", + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { "path" : "valueCodeableConcept", "type" : "Property", "source" : { - "name" : "Obs", + "name" : "Observation", "type" : "OperandRef" } } ] }, "operand" : [ { - "name" : "Obs", + "name" : "Observation", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}Observation", "type" : "NamedTypeSpecifier" @@ -702,7 +507,7 @@ "path" : "effectiveDateTime", "type" : "Property", "source" : { - "name" : "Obs", + "name" : "Observation", "type" : "OperandRef" } } @@ -716,7 +521,7 @@ "path" : "effectivePeriod", "type" : "Property", "source" : { - "name" : "Obs", + "name" : "Observation", "type" : "OperandRef" } } @@ -731,7 +536,7 @@ "path" : "effectivePeriod", "type" : "Property", "source" : { - "name" : "Obs", + "name" : "Observation", "type" : "OperandRef" } } @@ -743,14 +548,14 @@ "path" : "issued", "type" : "Property", "source" : { - "name" : "Obs", + "name" : "Observation", "type" : "OperandRef" } } } ] }, "operand" : [ { - "name" : "Obs", + "name" : "Observation", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}Observation", "type" : "NamedTypeSpecifier" @@ -766,20 +571,21 @@ "source" : { "type" : "Query", "source" : [ { - "alias" : "O", + "alias" : "Observation", "expression" : { - "name" : "ObsList", + "name" : "Observations", "type" : "OperandRef" } } ], "relationship" : [ ], "return" : { "expression" : { - "name" : "NullSafeToQuantity", + "name" : "ToQuantity", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { "path" : "valueQuantity", - "scope" : "O", + "scope" : "Observation", "type" : "Property" } ] } @@ -787,7 +593,7 @@ } }, "operand" : [ { - "name" : "ObsList", + "name" : "Observations", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -797,35 +603,77 @@ } } ] }, { - "name" : "ConditionsByConcept", + "name" : "AverageObservation", "context" : "Patient", "accessLevel" : "Public", "type" : "FunctionDef", "expression" : { - "type" : "Query", - "source" : [ { - "alias" : "C", - "expression" : { - "dataType" : "{http://hl7.org/fhir}Condition", - "type" : "Retrieve" - } - } ], - "relationship" : [ ], - "where" : { - "type" : "Equivalent", - "operand" : [ { - "name" : "NullSafeToConcept", - "type" : "FunctionRef", - "operand" : [ { - "path" : "code", - "scope" : "C", - "type" : "Property" - } ] - }, { - "name" : "Koncept", - "type" : "OperandRef" - } ] - } + "type" : "Avg", + "source" : { + "type" : "Query", + "source" : [ { + "alias" : "Observation", + "expression" : { + "name" : "Observations", + "type" : "OperandRef" + } + } ], + "relationship" : [ ], + "return" : { + "expression" : { + "name" : "ToQuantity", + "libraryName" : "FHIRHelpers", + "type" : "FunctionRef", + "operand" : [ { + "path" : "valueQuantity", + "scope" : "Observation", + "type" : "Property" + } ] + } + } + } + }, + "operand" : [ { + "name" : "Observations", + "operandTypeSpecifier" : { + "type" : "ListTypeSpecifier", + "elementType" : { + "name" : "{http://hl7.org/fhir}Observation", + "type" : "NamedTypeSpecifier" + } + } + } ] + }, { + "name" : "ConditionsByConcept", + "context" : "Patient", + "accessLevel" : "Public", + "type" : "FunctionDef", + "expression" : { + "type" : "Query", + "source" : [ { + "alias" : "Condition", + "expression" : { + "dataType" : "{http://hl7.org/fhir}Condition", + "type" : "Retrieve" + } + } ], + "relationship" : [ ], + "where" : { + "type" : "Equivalent", + "operand" : [ { + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", + "type" : "FunctionRef", + "operand" : [ { + "path" : "code", + "scope" : "Condition", + "type" : "Property" + } ] + }, { + "name" : "Koncept", + "type" : "OperandRef" + } ] + } }, "operand" : [ { "name" : "Koncept", @@ -842,9 +690,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "C", + "alias" : "Condition", "expression" : { - "name" : "CondList", + "name" : "Conditions", "type" : "OperandRef" } } ], @@ -856,7 +704,7 @@ "type" : "Property", "source" : { "path" : "verificationStatus", - "scope" : "C", + "scope" : "Condition", "type" : "Property" } }, { @@ -867,7 +715,7 @@ } }, "operand" : [ { - "name" : "CondList", + "name" : "Conditions", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -884,9 +732,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "C", + "alias" : "Condition", "expression" : { - "name" : "CondList", + "name" : "Conditions", "type" : "OperandRef" } } ], @@ -910,7 +758,7 @@ "type" : "Property", "source" : { "path" : "clinicalStatus", - "scope" : "C", + "scope" : "Condition", "type" : "Property" } }, { @@ -922,7 +770,7 @@ "type" : "IsNull", "operand" : { "path" : "abatementDateTime", - "scope" : "C", + "scope" : "Condition", "type" : "Property" } } ] @@ -930,7 +778,7 @@ "type" : "IsNull", "operand" : { "path" : "abatementQuantity", - "scope" : "C", + "scope" : "Condition", "type" : "Property" } } ] @@ -943,7 +791,7 @@ "type" : "Property", "source" : { "path" : "abatementBoolean", - "scope" : "C", + "scope" : "Condition", "type" : "Property" } } @@ -953,7 +801,7 @@ "type" : "IsNull", "operand" : { "path" : "abatementPeriod", - "scope" : "C", + "scope" : "Condition", "type" : "Property" } } ] @@ -961,7 +809,7 @@ "type" : "IsNull", "operand" : { "path" : "abatementRange", - "scope" : "C", + "scope" : "Condition", "type" : "Property" } } ] @@ -969,14 +817,14 @@ "type" : "IsNull", "operand" : { "path" : "abatementString", - "scope" : "C", + "scope" : "Condition", "type" : "Property" } } ] } }, "operand" : [ { - "name" : "CondList", + "name" : "Conditions", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -993,9 +841,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "C", + "alias" : "Condition", "expression" : { - "name" : "CondList", + "name" : "Conditions", "type" : "OperandRef" } } ], @@ -1007,7 +855,7 @@ "type" : "Property", "source" : { "path" : "clinicalStatus", - "scope" : "C", + "scope" : "Condition", "type" : "Property" } }, { @@ -1025,7 +873,7 @@ } }, "operand" : [ { - "name" : "CondList", + "name" : "Conditions", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -1042,9 +890,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "C", + "alias" : "Condition", "expression" : { - "name" : "CondList", + "name" : "Conditions", "type" : "OperandRef" } } ], @@ -1080,7 +928,7 @@ "type" : "Property", "source" : { "path" : "onsetDateTime", - "scope" : "C", + "scope" : "Condition", "type" : "Property" } }, { @@ -1090,11 +938,12 @@ }, { "type" : "Overlaps", "operand" : [ { - "name" : "NullSafeToInterval", + "name" : "ToInterval", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { "path" : "onsetPeriod", - "scope" : "C", + "scope" : "Condition", "type" : "Property" } ] }, { @@ -1111,7 +960,7 @@ "type" : "Property", "source" : { "path" : "dateRecorded", - "scope" : "C", + "scope" : "Condition", "type" : "Property" } } @@ -1123,7 +972,7 @@ } }, "operand" : [ { - "name" : "CondList", + "name" : "Conditions", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -1138,6 +987,162 @@ "type" : "NamedTypeSpecifier" } } ] + }, { + "name" : "MostRecentCondition", + "context" : "Patient", + "accessLevel" : "Public", + "type" : "FunctionDef", + "expression" : { + "type" : "Last", + "source" : { + "type" : "Query", + "source" : [ { + "alias" : "Condition", + "expression" : { + "name" : "Conditions", + "type" : "OperandRef" + } + } ], + "relationship" : [ ], + "sort" : { + "by" : [ { + "direction" : "asc", + "type" : "ByExpression", + "expression" : { + "type" : "Coalesce", + "operand" : [ { + "path" : "value", + "type" : "Property", + "source" : { + "name" : "onsetDateTime", + "type" : "IdentifierRef" + } + }, { + "path" : "value", + "type" : "Property", + "source" : { + "path" : "end", + "type" : "Property", + "source" : { + "name" : "onsetPeriod", + "type" : "IdentifierRef" + } + } + }, { + "path" : "value", + "type" : "Property", + "source" : { + "path" : "start", + "type" : "Property", + "source" : { + "name" : "onsetPeriod", + "type" : "IdentifierRef" + } + } + }, { + "type" : "ToDateTime", + "operand" : { + "path" : "value", + "type" : "Property", + "source" : { + "name" : "dateRecorded", + "type" : "IdentifierRef" + } + } + } ] + } + } ] + } + } + }, + "operand" : [ { + "name" : "Conditions", + "operandTypeSpecifier" : { + "type" : "ListTypeSpecifier", + "elementType" : { + "name" : "{http://hl7.org/fhir}Condition", + "type" : "NamedTypeSpecifier" + } + } + } ] + }, { + "name" : "FirstCondition", + "context" : "Patient", + "accessLevel" : "Public", + "type" : "FunctionDef", + "expression" : { + "type" : "First", + "source" : { + "type" : "Query", + "source" : [ { + "alias" : "Condition", + "expression" : { + "name" : "Conditions", + "type" : "OperandRef" + } + } ], + "relationship" : [ ], + "sort" : { + "by" : [ { + "direction" : "asc", + "type" : "ByExpression", + "expression" : { + "type" : "Coalesce", + "operand" : [ { + "path" : "value", + "type" : "Property", + "source" : { + "name" : "onsetDateTime", + "type" : "IdentifierRef" + } + }, { + "path" : "value", + "type" : "Property", + "source" : { + "path" : "start", + "type" : "Property", + "source" : { + "name" : "onsetPeriod", + "type" : "IdentifierRef" + } + } + }, { + "path" : "value", + "type" : "Property", + "source" : { + "path" : "end", + "type" : "Property", + "source" : { + "name" : "onsetPeriod", + "type" : "IdentifierRef" + } + } + }, { + "type" : "ToDateTime", + "operand" : { + "path" : "value", + "type" : "Property", + "source" : { + "name" : "dateRecorded", + "type" : "IdentifierRef" + } + } + } ] + } + } ] + } + } + }, + "operand" : [ { + "name" : "Conditions", + "operandTypeSpecifier" : { + "type" : "ListTypeSpecifier", + "elementType" : { + "name" : "{http://hl7.org/fhir}Condition", + "type" : "NamedTypeSpecifier" + } + } + } ] }, { "name" : "ProceduresByConcept", "context" : "Patient", @@ -1146,7 +1151,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "P", + "alias" : "Procedure", "expression" : { "dataType" : "{http://hl7.org/fhir}Procedure", "type" : "Retrieve" @@ -1156,11 +1161,12 @@ "where" : { "type" : "Equivalent", "operand" : [ { - "name" : "NullSafeToConcept", + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "P", + "scope" : "Procedure", "type" : "Property" } ] }, { @@ -1184,9 +1190,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "P", + "alias" : "Procedure", "expression" : { - "name" : "ProcList", + "name" : "Procedures", "type" : "OperandRef" } } ], @@ -1200,7 +1206,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "P", + "scope" : "Procedure", "type" : "Property" } }, { @@ -1217,7 +1223,7 @@ "type" : "Property", "source" : { "path" : "notPerformed", - "scope" : "P", + "scope" : "Procedure", "type" : "Property" } } @@ -1226,7 +1232,7 @@ } }, "operand" : [ { - "name" : "ProcList", + "name" : "Procedures", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -1243,9 +1249,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "P", + "alias" : "Procedure", "expression" : { - "name" : "ProcList", + "name" : "Procedures", "type" : "OperandRef" } } ], @@ -1259,7 +1265,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "P", + "scope" : "Procedure", "type" : "Property" } }, { @@ -1276,7 +1282,7 @@ "type" : "Property", "source" : { "path" : "notPerformed", - "scope" : "P", + "scope" : "Procedure", "type" : "Property" } } @@ -1285,7 +1291,7 @@ } }, "operand" : [ { - "name" : "ProcList", + "name" : "Procedures", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -1302,9 +1308,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "P", + "alias" : "Procedure", "expression" : { - "name" : "ProcList", + "name" : "Procedures", "type" : "OperandRef" } } ], @@ -1320,7 +1326,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "P", + "scope" : "Procedure", "type" : "Property" } }, { @@ -1338,7 +1344,7 @@ "type" : "Property", "source" : { "path" : "notPerformed", - "scope" : "P", + "scope" : "Procedure", "type" : "Property" } } @@ -1347,7 +1353,7 @@ } }, "operand" : [ { - "name" : "ProcList", + "name" : "Procedures", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -1364,9 +1370,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "P", + "alias" : "Procedure", "expression" : { - "name" : "ProcList", + "name" : "Procedures", "type" : "OperandRef" } } ], @@ -1400,7 +1406,7 @@ "type" : "Property", "source" : { "path" : "performedDateTime", - "scope" : "P", + "scope" : "Procedure", "type" : "Property" } }, { @@ -1410,11 +1416,12 @@ }, { "type" : "Overlaps", "operand" : [ { - "name" : "NullSafeToInterval", + "name" : "ToInterval", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { "path" : "performedPeriod", - "scope" : "P", + "scope" : "Procedure", "type" : "Property" } ] }, { @@ -1425,7 +1432,7 @@ } }, "operand" : [ { - "name" : "ProcList", + "name" : "Procedures", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -1441,71 +1448,208 @@ } } ] }, { - "name" : "ProcedureRequestsByConcept", - "context" : "Patient", - "accessLevel" : "Public", - "type" : "FunctionDef", - "expression" : { - "type" : "Query", - "source" : [ { - "alias" : "P", - "expression" : { - "dataType" : "{http://hl7.org/fhir}ProcedureRequest", - "type" : "Retrieve" - } - } ], - "relationship" : [ ], - "where" : { - "type" : "Equivalent", - "operand" : [ { - "name" : "NullSafeToConcept", - "type" : "FunctionRef", - "operand" : [ { - "path" : "code", - "scope" : "P", - "type" : "Property" - } ] - }, { - "name" : "Koncept", - "type" : "OperandRef" - } ] - } - }, - "operand" : [ { - "name" : "Koncept", - "operandTypeSpecifier" : { - "name" : "{urn:hl7-org:elm-types:r1}Concept", - "type" : "NamedTypeSpecifier" - } - } ] - }, { - "name" : "ProcedureRequestAcceptedOrInProgressOrCompleted", + "name" : "MostRecentProcedure", "context" : "Patient", "accessLevel" : "Public", "type" : "FunctionDef", "expression" : { - "type" : "Query", - "source" : [ { - "alias" : "P", - "expression" : { - "name" : "ProcReqList", - "type" : "OperandRef" - } - } ], - "relationship" : [ ], - "where" : { - "type" : "In", - "operand" : [ { - "path" : "value", - "type" : "Property", - "source" : { - "path" : "status", - "scope" : "P", - "type" : "Property" + "type" : "Last", + "source" : { + "type" : "Query", + "source" : [ { + "alias" : "Procedure", + "expression" : { + "name" : "Procedures", + "type" : "OperandRef" } - }, { - "type" : "List", - "element" : [ { + } ], + "relationship" : [ ], + "sort" : { + "by" : [ { + "direction" : "asc", + "type" : "ByExpression", + "expression" : { + "type" : "Coalesce", + "operand" : [ { + "path" : "value", + "type" : "Property", + "source" : { + "name" : "performedDateTime", + "type" : "IdentifierRef" + } + }, { + "path" : "value", + "type" : "Property", + "source" : { + "path" : "end", + "type" : "Property", + "source" : { + "name" : "performedPeriod", + "type" : "IdentifierRef" + } + } + }, { + "path" : "value", + "type" : "Property", + "source" : { + "path" : "start", + "type" : "Property", + "source" : { + "name" : "performedPeriod", + "type" : "IdentifierRef" + } + } + } ] + } + } ] + } + } + }, + "operand" : [ { + "name" : "Procedures", + "operandTypeSpecifier" : { + "type" : "ListTypeSpecifier", + "elementType" : { + "name" : "{http://hl7.org/fhir}Procedure", + "type" : "NamedTypeSpecifier" + } + } + } ] + }, { + "name" : "FirstProcedure", + "context" : "Patient", + "accessLevel" : "Public", + "type" : "FunctionDef", + "expression" : { + "type" : "First", + "source" : { + "type" : "Query", + "source" : [ { + "alias" : "Procedure", + "expression" : { + "name" : "Procedures", + "type" : "OperandRef" + } + } ], + "relationship" : [ ], + "sort" : { + "by" : [ { + "direction" : "asc", + "type" : "ByExpression", + "expression" : { + "type" : "Coalesce", + "operand" : [ { + "path" : "value", + "type" : "Property", + "source" : { + "name" : "performedDateTime", + "type" : "IdentifierRef" + } + }, { + "path" : "value", + "type" : "Property", + "source" : { + "path" : "start", + "type" : "Property", + "source" : { + "name" : "performedPeriod", + "type" : "IdentifierRef" + } + } + }, { + "path" : "value", + "type" : "Property", + "source" : { + "path" : "end", + "type" : "Property", + "source" : { + "name" : "performedPeriod", + "type" : "IdentifierRef" + } + } + } ] + } + } ] + } + } + }, + "operand" : [ { + "name" : "Procedures", + "operandTypeSpecifier" : { + "type" : "ListTypeSpecifier", + "elementType" : { + "name" : "{http://hl7.org/fhir}Procedure", + "type" : "NamedTypeSpecifier" + } + } + } ] + }, { + "name" : "ProcedureRequestsByConcept", + "context" : "Patient", + "accessLevel" : "Public", + "type" : "FunctionDef", + "expression" : { + "type" : "Query", + "source" : [ { + "alias" : "Request", + "expression" : { + "dataType" : "{http://hl7.org/fhir}ProcedureRequest", + "type" : "Retrieve" + } + } ], + "relationship" : [ ], + "where" : { + "type" : "Equivalent", + "operand" : [ { + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", + "type" : "FunctionRef", + "operand" : [ { + "path" : "code", + "scope" : "Request", + "type" : "Property" + } ] + }, { + "name" : "Koncept", + "type" : "OperandRef" + } ] + } + }, + "operand" : [ { + "name" : "Koncept", + "operandTypeSpecifier" : { + "name" : "{urn:hl7-org:elm-types:r1}Concept", + "type" : "NamedTypeSpecifier" + } + } ] + }, { + "name" : "ProcedureRequestAcceptedOrInProgressOrCompleted", + "context" : "Patient", + "accessLevel" : "Public", + "type" : "FunctionDef", + "expression" : { + "type" : "Query", + "source" : [ { + "alias" : "Request", + "expression" : { + "name" : "ProcedureRequests", + "type" : "OperandRef" + } + } ], + "relationship" : [ ], + "where" : { + "type" : "In", + "operand" : [ { + "path" : "value", + "type" : "Property", + "source" : { + "path" : "status", + "scope" : "Request", + "type" : "Property" + } + }, { + "type" : "List", + "element" : [ { "valueType" : "{urn:hl7-org:elm-types:r1}String", "value" : "accepted", "type" : "Literal" @@ -1522,7 +1666,7 @@ } }, "operand" : [ { - "name" : "ProcReqList", + "name" : "ProcedureRequests", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -1539,9 +1683,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "P", + "alias" : "Request", "expression" : { - "name" : "ProcReqList", + "name" : "ProcedureRequests", "type" : "OperandRef" } } ], @@ -1553,7 +1697,7 @@ "type" : "Property", "source" : { "path" : "orderedOn", - "scope" : "P", + "scope" : "Request", "type" : "Property" } }, { @@ -1576,7 +1720,7 @@ } }, "operand" : [ { - "name" : "ProcReqList", + "name" : "ProcedureRequests", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -1599,7 +1743,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "R", + "alias" : "Referral", "expression" : { "dataType" : "{http://hl7.org/fhir}ReferralRequest", "type" : "Retrieve" @@ -1611,10 +1755,10 @@ "operand" : { "type" : "Query", "source" : [ { - "alias" : "SRC", + "alias" : "Service", "expression" : { "path" : "serviceRequested", - "scope" : "R", + "scope" : "Referral", "type" : "Property" } } ], @@ -1622,10 +1766,11 @@ "where" : { "type" : "Equivalent", "operand" : [ { - "name" : "NullSafeToConcept", + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "SRC", + "name" : "Service", "type" : "AliasRef" } ] }, { @@ -1651,9 +1796,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "R", + "alias" : "Referral", "expression" : { - "name" : "ReferralList", + "name" : "Referrals", "type" : "OperandRef" } } ], @@ -1665,7 +1810,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "R", + "scope" : "Referral", "type" : "Property" } }, { @@ -1687,7 +1832,7 @@ } }, "operand" : [ { - "name" : "ReferralList", + "name" : "Referrals", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -1704,9 +1849,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "R", + "alias" : "Referral", "expression" : { - "name" : "ReferralList", + "name" : "Referrals", "type" : "OperandRef" } } ], @@ -1718,7 +1863,7 @@ "type" : "Property", "source" : { "path" : "dateSent", - "scope" : "R", + "scope" : "Referral", "type" : "Property" } }, { @@ -1741,7 +1886,7 @@ } }, "operand" : [ { - "name" : "ReferralList", + "name" : "Referrals", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -1764,7 +1909,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "M", + "alias" : "Statement", "expression" : { "dataType" : "{http://hl7.org/fhir}MedicationStatement", "type" : "Retrieve" @@ -1774,11 +1919,12 @@ "where" : { "type" : "Equivalent", "operand" : [ { - "name" : "NullSafeToConcept", + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { "path" : "medicationCodeableConcept", - "scope" : "M", + "scope" : "Statement", "type" : "Property" } ] }, { @@ -1802,7 +1948,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "M", + "alias" : "Order", "expression" : { "dataType" : "{http://hl7.org/fhir}MedicationOrder", "type" : "Retrieve" @@ -1812,11 +1958,12 @@ "where" : { "type" : "Equivalent", "operand" : [ { - "name" : "NullSafeToConcept", + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { "path" : "medicationCodeableConcept", - "scope" : "M", + "scope" : "Order", "type" : "Property" } ] }, { @@ -1840,20 +1987,21 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "M", + "alias" : "Statement", "expression" : { - "name" : "MedList", + "name" : "Statements", "type" : "OperandRef" } } ], "let" : [ { "identifier" : "EffectivePeriod", "expression" : { - "name" : "NullSafeToInterval", + "name" : "ToInterval", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { "path" : "effectivePeriod", - "scope" : "M", + "scope" : "Statement", "type" : "Property" } ] } @@ -1870,7 +2018,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "M", + "scope" : "Statement", "type" : "Property" } }, { @@ -1887,7 +2035,7 @@ "type" : "Property", "source" : { "path" : "wasNotTaken", - "scope" : "M", + "scope" : "Statement", "type" : "Property" } } @@ -1920,7 +2068,7 @@ } }, "operand" : [ { - "name" : "MedList", + "name" : "Statements", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -1937,9 +2085,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "M", + "alias" : "Statement", "expression" : { - "name" : "MedList", + "name" : "Statements", "type" : "OperandRef" } } ], @@ -1953,7 +2101,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "M", + "scope" : "Statement", "type" : "Property" } }, { @@ -1970,7 +2118,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "M", + "scope" : "Statement", "type" : "Property" } }, { @@ -1987,7 +2135,7 @@ "type" : "Property", "source" : { "path" : "wasNotTaken", - "scope" : "M", + "scope" : "Statement", "type" : "Property" } } @@ -1997,7 +2145,7 @@ } }, "operand" : [ { - "name" : "MedList", + "name" : "Statements", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -2014,9 +2162,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "M", + "alias" : "Order", "expression" : { - "name" : "MedList", + "name" : "Orders", "type" : "OperandRef" } } ], @@ -2030,7 +2178,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "M", + "scope" : "Order", "type" : "Property" } }, { @@ -2045,7 +2193,7 @@ "type" : "Property", "source" : { "path" : "dateEnded", - "scope" : "M", + "scope" : "Order", "type" : "Property" } } @@ -2053,7 +2201,7 @@ } }, "operand" : [ { - "name" : "MedList", + "name" : "Orders", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -2070,9 +2218,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "M", + "alias" : "Order", "expression" : { - "name" : "MedList", + "name" : "Orders", "type" : "OperandRef" } } ], @@ -2086,7 +2234,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "M", + "scope" : "Order", "type" : "Property" } }, { @@ -2101,7 +2249,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "M", + "scope" : "Order", "type" : "Property" } }, { @@ -2113,7 +2261,7 @@ } }, "operand" : [ { - "name" : "MedList", + "name" : "Orders", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -2130,9 +2278,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "M", + "alias" : "Order", "expression" : { - "name" : "MedList", + "name" : "Orders", "type" : "OperandRef" } } ], @@ -2148,7 +2296,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "M", + "scope" : "Order", "type" : "Property" } }, { @@ -2163,7 +2311,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "M", + "scope" : "Order", "type" : "Property" } }, { @@ -2179,7 +2327,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "M", + "scope" : "Order", "type" : "Property" } }, { @@ -2191,7 +2339,7 @@ } }, "operand" : [ { - "name" : "MedList", + "name" : "Orders", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -2208,9 +2356,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "M", + "alias" : "Statement", "expression" : { - "name" : "MedList", + "name" : "Statements", "type" : "OperandRef" } } ], @@ -2244,7 +2392,7 @@ "type" : "Property", "source" : { "path" : "effectiveDateTime", - "scope" : "M", + "scope" : "Statement", "type" : "Property" } }, { @@ -2254,11 +2402,12 @@ }, { "type" : "Overlaps", "operand" : [ { - "name" : "NullSafeToInterval", + "name" : "ToInterval", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { "path" : "effectivePeriod", - "scope" : "M", + "scope" : "Statement", "type" : "Property" } ] }, { @@ -2269,7 +2418,7 @@ } }, "operand" : [ { - "name" : "MedList", + "name" : "Statements", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -2292,9 +2441,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "M", + "alias" : "Order", "expression" : { - "name" : "MedList", + "name" : "Orders", "type" : "OperandRef" } } ], @@ -2306,7 +2455,7 @@ "type" : "Property", "source" : { "path" : "dateWritten", - "scope" : "M", + "scope" : "Order", "type" : "Property" } }, { @@ -2329,7 +2478,7 @@ } }, "operand" : [ { - "name" : "MedList", + "name" : "Orders", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -2344,6 +2493,90 @@ "type" : "NamedTypeSpecifier" } } ] + }, { + "name" : "MedicationDispenseLookBack", + "context" : "Patient", + "accessLevel" : "Public", + "type" : "FunctionDef", + "expression" : { + "type" : "Query", + "source" : [ { + "alias" : "Dispense", + "expression" : { + "name" : "Dispenses", + "type" : "OperandRef" + } + } ], + "let" : [ { + "identifier" : "LookBackInterval", + "expression" : { + "lowClosed" : true, + "highClosed" : true, + "type" : "Interval", + "low" : { + "type" : "Subtract", + "operand" : [ { + "type" : "Now" + }, { + "name" : "LookBack", + "type" : "OperandRef" + } ] + }, + "high" : { + "type" : "Now" + } + } + } ], + "relationship" : [ ], + "where" : { + "type" : "Or", + "operand" : [ { + "type" : "In", + "operand" : [ { + "path" : "value", + "type" : "Property", + "source" : { + "path" : "whenHandedOver", + "scope" : "Dispense", + "type" : "Property" + } + }, { + "name" : "LookBackInterval", + "type" : "QueryLetRef" + } ] + }, { + "type" : "In", + "operand" : [ { + "path" : "value", + "type" : "Property", + "source" : { + "path" : "whenPrepared", + "scope" : "Dispense", + "type" : "Property" + } + }, { + "name" : "LookBackInterval", + "type" : "QueryLetRef" + } ] + } ] + } + }, + "operand" : [ { + "name" : "Dispenses", + "operandTypeSpecifier" : { + "type" : "ListTypeSpecifier", + "elementType" : { + "name" : "{http://hl7.org/fhir}MedicationDispense", + "type" : "NamedTypeSpecifier" + } + } + }, { + "name" : "LookBack", + "operandTypeSpecifier" : { + "name" : "{urn:hl7-org:elm-types:r1}Quantity", + "type" : "NamedTypeSpecifier" + } + } ] }, { "name" : "EncountersByConcept", "context" : "Patient", @@ -2352,7 +2585,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "E", + "alias" : "Encounter", "expression" : { "dataType" : "{http://hl7.org/fhir}Encounter", "type" : "Retrieve" @@ -2364,10 +2597,10 @@ "operand" : { "type" : "Query", "source" : [ { - "alias" : "ET", + "alias" : "Type", "expression" : { "path" : "type", - "scope" : "E", + "scope" : "Encounter", "type" : "Property" } } ], @@ -2375,10 +2608,11 @@ "where" : { "type" : "Equivalent", "operand" : [ { - "name" : "NullSafeToConcept", + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "ET", + "name" : "Type", "type" : "AliasRef" } ] }, { @@ -2404,9 +2638,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "E", + "alias" : "Encounter", "expression" : { - "name" : "EncList", + "name" : "Encounters", "type" : "OperandRef" } } ], @@ -2418,7 +2652,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "E", + "scope" : "Encounter", "type" : "Property" } }, { @@ -2429,7 +2663,7 @@ } }, "operand" : [ { - "name" : "EncList", + "name" : "Encounters", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -2439,28 +2673,142 @@ } } ] }, { - "name" : "AllergyIntolerancesByConcept", + "name" : "NotCancelled", "context" : "Patient", "accessLevel" : "Public", "type" : "FunctionDef", "expression" : { "type" : "Query", "source" : [ { - "alias" : "A", + "alias" : "Encounter", "expression" : { - "dataType" : "{http://hl7.org/fhir}AllergyIntolerance", - "type" : "Retrieve" + "name" : "Encounters", + "type" : "OperandRef" } } ], "relationship" : [ ], "where" : { - "type" : "Equivalent", - "operand" : [ { - "name" : "NullSafeToConcept", - "type" : "FunctionRef", + "type" : "Not", + "operand" : { + "type" : "Equal", "operand" : [ { - "path" : "substance", - "scope" : "A", + "path" : "value", + "type" : "Property", + "source" : { + "path" : "status", + "scope" : "Encounter", + "type" : "Property" + } + }, { + "valueType" : "{urn:hl7-org:elm-types:r1}String", + "value" : "cancelled", + "type" : "Literal" + } ] + } + } + }, + "operand" : [ { + "name" : "Encounters", + "operandTypeSpecifier" : { + "type" : "ListTypeSpecifier", + "elementType" : { + "name" : "{http://hl7.org/fhir}Encounter", + "type" : "NamedTypeSpecifier" + } + } + } ] + }, { + "name" : "EncounterLookBack", + "context" : "Patient", + "accessLevel" : "Public", + "type" : "FunctionDef", + "expression" : { + "type" : "Query", + "source" : [ { + "alias" : "Encounter", + "expression" : { + "name" : "Encounters", + "type" : "OperandRef" + } + } ], + "let" : [ { + "identifier" : "LookBackInterval", + "expression" : { + "lowClosed" : true, + "highClosed" : true, + "type" : "Interval", + "low" : { + "type" : "Subtract", + "operand" : [ { + "type" : "Now" + }, { + "name" : "LookBack", + "type" : "OperandRef" + } ] + }, + "high" : { + "type" : "Now" + } + } + } ], + "relationship" : [ ], + "where" : { + "type" : "Overlaps", + "operand" : [ { + "name" : "ToInterval", + "libraryName" : "FHIRHelpers", + "type" : "FunctionRef", + "operand" : [ { + "path" : "period", + "scope" : "Encounter", + "type" : "Property" + } ] + }, { + "name" : "LookBackInterval", + "type" : "QueryLetRef" + } ] + } + }, + "operand" : [ { + "name" : "Encounters", + "operandTypeSpecifier" : { + "type" : "ListTypeSpecifier", + "elementType" : { + "name" : "{http://hl7.org/fhir}Encounter", + "type" : "NamedTypeSpecifier" + } + } + }, { + "name" : "LookBack", + "operandTypeSpecifier" : { + "name" : "{urn:hl7-org:elm-types:r1}Quantity", + "type" : "NamedTypeSpecifier" + } + } ] + }, { + "name" : "AllergyIntolerancesByConcept", + "context" : "Patient", + "accessLevel" : "Public", + "type" : "FunctionDef", + "expression" : { + "type" : "Query", + "source" : [ { + "alias" : "Allergy", + "expression" : { + "dataType" : "{http://hl7.org/fhir}AllergyIntolerance", + "type" : "Retrieve" + } + } ], + "relationship" : [ ], + "where" : { + "type" : "Equivalent", + "operand" : [ { + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", + "type" : "FunctionRef", + "operand" : [ { + "path" : "substance", + "scope" : "Allergy", "type" : "Property" } ] }, { @@ -2484,9 +2832,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "A", + "alias" : "Allergy", "expression" : { - "name" : "AllergyIntolList", + "name" : "AllergyIntolerances", "type" : "OperandRef" } } ], @@ -2500,7 +2848,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "A", + "scope" : "Allergy", "type" : "Property" } }, { @@ -2515,7 +2863,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "A", + "scope" : "Allergy", "type" : "Property" } }, { @@ -2527,7 +2875,7 @@ } }, "operand" : [ { - "name" : "AllergyIntolList", + "name" : "AllergyIntolerances", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -2544,9 +2892,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "G", + "alias" : "Goal", "expression" : { - "name" : "GoalList", + "name" : "Goals", "type" : "OperandRef" } } ], @@ -2586,7 +2934,7 @@ "type" : "Property", "source" : { "path" : "startDate", - "scope" : "G", + "scope" : "Goal", "type" : "Property" } } @@ -2603,7 +2951,7 @@ "type" : "Property", "source" : { "path" : "targetDate", - "scope" : "G", + "scope" : "Goal", "type" : "Property" } } @@ -2623,15 +2971,16 @@ "type" : "Property", "source" : { "path" : "startDate", - "scope" : "G", + "scope" : "Goal", "type" : "Property" } }, { - "name" : "NullSafeToQuantity", + "name" : "ToQuantity", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { "path" : "targetQuantity", - "scope" : "G", + "scope" : "Goal", "type" : "Property" } ] } ] @@ -2650,7 +2999,7 @@ "type" : "Property", "source" : { "path" : "statusDate", - "scope" : "G", + "scope" : "Goal", "type" : "Property" } } @@ -2662,7 +3011,7 @@ } }, "operand" : [ { - "name" : "GoalList", + "name" : "Goals", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -2677,6 +3026,338 @@ "type" : "NamedTypeSpecifier" } } ] + }, { + "name" : "ImmunizationsByConcept", + "context" : "Patient", + "accessLevel" : "Public", + "type" : "FunctionDef", + "expression" : { + "type" : "Query", + "source" : [ { + "alias" : "Immunization", + "expression" : { + "dataType" : "{http://hl7.org/fhir}Immunization", + "type" : "Retrieve" + } + } ], + "relationship" : [ ], + "where" : { + "type" : "Equivalent", + "operand" : [ { + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", + "type" : "FunctionRef", + "operand" : [ { + "path" : "vaccineCode", + "scope" : "Immunization", + "type" : "Property" + } ] + }, { + "name" : "Koncept", + "type" : "OperandRef" + } ] + } + }, + "operand" : [ { + "name" : "Koncept", + "operandTypeSpecifier" : { + "name" : "{urn:hl7-org:elm-types:r1}Concept", + "type" : "NamedTypeSpecifier" + } + } ] + }, { + "name" : "CompletedImmunization", + "context" : "Patient", + "accessLevel" : "Public", + "type" : "FunctionDef", + "expression" : { + "type" : "Query", + "source" : [ { + "alias" : "Immunization", + "expression" : { + "name" : "Immunizations", + "type" : "OperandRef" + } + } ], + "relationship" : [ ], + "where" : { + "type" : "And", + "operand" : [ { + "type" : "Equal", + "operand" : [ { + "path" : "value", + "type" : "Property", + "source" : { + "path" : "status", + "scope" : "Immunization", + "type" : "Property" + } + }, { + "valueType" : "{urn:hl7-org:elm-types:r1}String", + "value" : "completed", + "type" : "Literal" + } ] + }, { + "type" : "Not", + "operand" : { + "type" : "IsTrue", + "operand" : { + "path" : "value", + "type" : "Property", + "source" : { + "path" : "wasNotGiven", + "scope" : "Immunization", + "type" : "Property" + } + } + } + } ] + } + }, + "operand" : [ { + "name" : "Immunizations", + "operandTypeSpecifier" : { + "type" : "ListTypeSpecifier", + "elementType" : { + "name" : "{http://hl7.org/fhir}Immunization", + "type" : "NamedTypeSpecifier" + } + } + } ] + }, { + "name" : "ImmunizationLookBack", + "context" : "Patient", + "accessLevel" : "Public", + "type" : "FunctionDef", + "expression" : { + "type" : "Query", + "source" : [ { + "alias" : "Immunization", + "expression" : { + "name" : "Immunizations", + "type" : "OperandRef" + } + } ], + "let" : [ { + "identifier" : "LookBackInterval", + "expression" : { + "lowClosed" : true, + "highClosed" : true, + "type" : "Interval", + "low" : { + "type" : "Subtract", + "operand" : [ { + "type" : "Now" + }, { + "name" : "LookBack", + "type" : "OperandRef" + } ] + }, + "high" : { + "type" : "Now" + } + } + } ], + "relationship" : [ ], + "where" : { + "type" : "In", + "operand" : [ { + "path" : "value", + "type" : "Property", + "source" : { + "path" : "date", + "scope" : "Immunization", + "type" : "Property" + } + }, { + "name" : "LookBackInterval", + "type" : "QueryLetRef" + } ] + } + }, + "operand" : [ { + "name" : "Immunizations", + "operandTypeSpecifier" : { + "type" : "ListTypeSpecifier", + "elementType" : { + "name" : "{http://hl7.org/fhir}Immunization", + "type" : "NamedTypeSpecifier" + } + } + }, { + "name" : "LookBack", + "operandTypeSpecifier" : { + "name" : "{urn:hl7-org:elm-types:r1}Quantity", + "type" : "NamedTypeSpecifier" + } + } ] + }, { + "name" : "MostRecentImmunization", + "context" : "Patient", + "accessLevel" : "Public", + "type" : "FunctionDef", + "expression" : { + "type" : "Last", + "source" : { + "type" : "Query", + "source" : [ { + "alias" : "Immunization", + "expression" : { + "name" : "Immunizations", + "type" : "OperandRef" + } + } ], + "relationship" : [ ], + "sort" : { + "by" : [ { + "direction" : "asc", + "type" : "ByExpression", + "expression" : { + "path" : "value", + "type" : "Property", + "source" : { + "name" : "date", + "type" : "IdentifierRef" + } + } + } ] + } + } + }, + "operand" : [ { + "name" : "Immunizations", + "operandTypeSpecifier" : { + "type" : "ListTypeSpecifier", + "elementType" : { + "name" : "{http://hl7.org/fhir}Immunization", + "type" : "NamedTypeSpecifier" + } + } + } ] + }, { + "name" : "FirstImmunization", + "context" : "Patient", + "accessLevel" : "Public", + "type" : "FunctionDef", + "expression" : { + "type" : "First", + "source" : { + "type" : "Query", + "source" : [ { + "alias" : "Immunization", + "expression" : { + "name" : "Immunizations", + "type" : "OperandRef" + } + } ], + "relationship" : [ ], + "sort" : { + "by" : [ { + "direction" : "asc", + "type" : "ByExpression", + "expression" : { + "path" : "value", + "type" : "Property", + "source" : { + "name" : "date", + "type" : "IdentifierRef" + } + } + } ] + } + } + }, + "operand" : [ { + "name" : "Immunizations", + "operandTypeSpecifier" : { + "type" : "ListTypeSpecifier", + "elementType" : { + "name" : "{http://hl7.org/fhir}Immunization", + "type" : "NamedTypeSpecifier" + } + } + } ] + }, { + "name" : "DevicesByConcept", + "context" : "Patient", + "accessLevel" : "Public", + "type" : "FunctionDef", + "expression" : { + "type" : "Query", + "source" : [ { + "alias" : "Device", + "expression" : { + "dataType" : "{http://hl7.org/fhir}Device", + "type" : "Retrieve" + } + } ], + "relationship" : [ ], + "where" : { + "type" : "Equivalent", + "operand" : [ { + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", + "type" : "FunctionRef", + "operand" : [ { + "path" : "type", + "scope" : "Device", + "type" : "Property" + } ] + }, { + "name" : "Koncept", + "type" : "OperandRef" + } ] + } + }, + "operand" : [ { + "name" : "Koncept", + "operandTypeSpecifier" : { + "name" : "{urn:hl7-org:elm-types:r1}Concept", + "type" : "NamedTypeSpecifier" + } + } ] + }, { + "name" : "ActiveDevice", + "context" : "Patient", + "accessLevel" : "Public", + "type" : "FunctionDef", + "expression" : { + "type" : "Query", + "source" : [ { + "alias" : "Device", + "expression" : { + "name" : "Devices", + "type" : "OperandRef" + } + } ], + "relationship" : [ ], + "where" : { + "type" : "Equal", + "operand" : [ { + "path" : "value", + "type" : "Property", + "source" : { + "path" : "status", + "scope" : "Device", + "type" : "Property" + } + }, { + "valueType" : "{urn:hl7-org:elm-types:r1}String", + "value" : "available", + "type" : "Literal" + } ] + } + }, + "operand" : [ { + "name" : "Devices", + "operandTypeSpecifier" : { + "type" : "ListTypeSpecifier", + "elementType" : { + "name" : "{http://hl7.org/fhir}Device", + "type" : "NamedTypeSpecifier" + } + } + } ] } ] } } diff --git a/src/cql/dstu2/CDS_Connect_Commons_for_FHIRv102.cql b/src/cql/dstu2/CDS_Connect_Commons_for_FHIRv102.cql deleted file mode 100644 index 24e5832f1..000000000 --- a/src/cql/dstu2/CDS_Connect_Commons_for_FHIRv102.cql +++ /dev/null @@ -1,538 +0,0 @@ -// CDS Connect Commons for FHIRv102 -// Change log: -// - 1.3.1: -// - Changed C.dateRecorded to C.dateRecorded.value in ConditionLookBack -// - Changed G.statusDate to G.statusDate.value in GoalLookBack -library CDS_Connect_Commons_for_FHIRv102 version '1.3.1' - -using FHIR version '1.0.2' - -// Include the FHIRHelpers library for simplifying interacton w/ the FHIR data model -include FHIRHelpers version '1.0.2' called FHIRHelpers - -// -------------------------------------------------- GENERAL --------------------------------------------------------- - -/** - * A null-safe version of ToConcept. Whereas FHIRHelpers.ToConcept will take a null argument and produce a - * System.Concept that is empty, this implementation returns null instead. - * @param C - a FHIR CodeableConcept - * @returns {System.Concept} a CQL Concept or null if null was passed in - */ -define function NullSafeToConcept(Cpt FHIR.CodeableConcept): - if Cpt is not null then FHIRHelpers.ToConcept(Cpt) else null - -/** - * A null-safe version of ToInterval for Period. Whereas FHIRHelpers.ToInterval will take a null argument and produce a - * System.Interval that is empty, this implementation returns null instead. - * @param P - a FHIR Period - * @returns {System.Interval} a CQL Interval or null if null was passed in - */ -define function NullSafePeriodToInterval(Pd FHIR.Period): - if Pd is not null then Interval[Pd."start".value, Pd."end".value] else null - -/** - * A null-safe version of ToInterval for Range. Whereas FHIRHelpers.ToInterval will take a null argument and produce a - * System.Interval that is empty, this implementation returns null instead. - * @param P - a FHIR Range - * @returns {System.Interval} a CQL Interval or null if null was passed in - */ -define function NullSafeRangeToInterval(Rg FHIR.Range): - if Rg is not null - then Interval[NullSafeToQuantity(Rg.low), NullSafeToQuantity(Rg.high)] - else null - -/** - * Same as NullSafePeriodToInterval; kept for backward compatibility. [Deprecated] - * @param P - a FHIR Period - * @returns {System.Interval} a CQL Interval or null if null was passed in - */ -define function NullSafeToInterval(Pd FHIR.Period): - NullSafePeriodToInterval(Pd) - -/** - * A null-safe version of ToQuantity. Whereas FHIRHelpers.ToQuantity will take a null argument and produce a - * System.Quantity that is empty, this implementation returns null instead. - * @param C - a FHIR Quantity - * @returns {System.Quantity} a CQL Quantity or null if null was passed in - */ -define function NullSafeToQuantity(Qty FHIR.Quantity): - if Qty is not null then - System.Quantity { - value: Qty.value.value, - unit: Coalesce(Qty.unit.value, Qty.code.value) - } - else null - -// -------------------------------------------------- OBSERVATIONS ----------------------------------------------------- - -/** - * Filters Observations by a concept rather than by a ValueSet. In CQL 1.3, this will be built into the retrieve, - * but for now, we must use a query where clause. - * @param Koncept - the concept to filter on (intentionally mispelled to avoid naming clashes) - * @returns {List} a list of Observations matching the concept, or null if null was passed in - */ -define function ObservationsByConcept(Koncept System.Concept): - [Observation] O where NullSafeToConcept(O.code) ~ Koncept - -/** - * Observations that are complete and verified. In FHIR DSTU2, there are two statuses that indicate this state: 'final' - * and 'amended'. - * @see http://hl7.org/fhir/DSTU2/valueset-observation-status.html - * @param ObsList - a list of Observations - * @returns {List} a list of verified Observations, or null if null was passed in - */ -define function Verified(ObsList List): - ObsList O where O.status.value in {'final', 'amended'} - -/** - * Observations that have quantity values recorded in the requested unit. - * @param ObsList - a list of Observations - * @param Unit - the unit to require in the Observations quantity value - * @returns {List} a list of Observations with the required unit, or null if null was passed in - */ -define function WithUnit(ObsList List, Unit String): - ObsList O where O.valueQuantity.unit.value = Unit or O.valueQuantity.code.value = Unit - -/** - * Observations with an effective or issued date in the specified "look back" period. For example, LDL-C Tests in the - * last 6 years. - * TODO: Rename to LookBack once the execution engine supports overloaded functions. - * @param ObsList - a list of Observations - * @returns {List} a list of Observations with effective or issued date specified lookback period, or null - * if null was passed in - */ -define function ObservationLookBack(ObsList List, LookBack System.Quantity): - ObsList O - let LookBackInterval: Interval[Now() - LookBack, Now()] - where O.effectiveDateTime.value in LookBackInterval - or NullSafeToInterval(O.effectivePeriod) overlaps LookBackInterval - or O.issued in LookBackInterval - -/** - * The most recent observation. For each Observation, this algorithm will use the FindDate function, which uses the - * first non-null date value from these fields: effectiveDateTime, effectivePeriod.end, effectivePeriod.start, issued. - * The found date will be used to compare Observations and determine the most recent one. - * @see FindDate(Observation) - * @param ObsList - a list of Observations - * @returns {Observation} the most recent Observation from the list, or null if null was passed in - */ -define function MostRecent(ObsList List): - Last(ObsList O sort by Coalesce(effectiveDateTime.value, effectivePeriod."end".value, effectivePeriod."start".value, issued.value)) - -/** - * Extracts the quantity value from an Observation, returning it as a CQL Quantity - * @param Obs - an observation - * @returns {System.Quantity} the Observation's value as a quantity, or null if there is no quantity value - */ -define function QuantityValue(Obs Observation): - NullSafeToQuantity(Obs.valueQuantity) - -/** - * Extracts the CodeableConcept value from an Observation, returning it as a CQL Concept - * @param Obs - an observation - * @returns {System.Concept} the Observation's value as a concept, or null if there is no CodeabeConcept value - */ -define function ConceptValue(Obs Observation): - NullSafeToConcept(Obs.valueCodeableConcept) - -/** - * Finds the first non-null meaningful date that can be associated with this Observation. This will look through the - * following fields in the following order: effectiveDateTime, effectivePeriod.end, effectivePeriod.start, issued. - * @param Obs - an Observation - * @returns {System.DateTime} the first non-null meaningful date, or null if non is found - */ -define function FindDate(Obs Observation): - Coalesce(Obs.effectiveDateTime.value, Obs.effectivePeriod."end".value, Obs.effectivePeriod."start".value, Obs.issued.value) - -// TODO: Confirm that this works as expected -/** - * The highest observation. - * The value will be used to compare Observations and determine the highest one. - * @param ObsList - a list of Observations - * @returns {System.Quantity} the quantity with the highest value from the list, or null if null was passed in - */ -define function HighestObservation(ObsList List): - Max(ObsList O return NullSafeToQuantity(O.valueQuantity)) - - -// -------------------------------------------------- CONDITIONS ------------------------------------------------------- - -/** - * Filters Conditions by a concept rather than by a ValueSet. In CQL 1.3, this will be built into the retrieve, - * but for now, we must use a query where clause. - * @param Koncept - the concept to filter on (intentionally mispelled to avoid naming clashes) - * @returns {List} a list of Conditions matching the concept, or null if null was passed in - */ -define function ConditionsByConcept(Koncept System.Concept): - [Condition] C where NullSafeToConcept(C.code) ~ Koncept - -/** - * Conditions that are confirmed. In FHIR DSTU2, this is reflected by verificationStatus: 'confirmed'. - * @see http://hl7.org/fhir/DSTU2/valueset-condition-ver-status.html - * @param CondList - a list of Conditions - * @returns {List} a list of confirmed Conditions, or null if null was passed in - */ -define function Confirmed(CondList List): - CondList C where C.verificationStatus.value = 'confirmed' - -/** - * Conditions that are active. In FHIR DSTU2, this is reflected by clinicalStatus: 'active' and the absence of any - * abatement information (i.e., if it abated, it is no longer active). - * TODO: Rename to Active once the execution engine supports overloaded functions. - * @see http://hl7.org/fhir/DSTU2/valueset-condition-clinical.html - * @param CondList - a list of Conditions - * @returns {List} a list of active Conditions, or null if null was passed in - */ -define function ActiveCondition(CondList List): - CondList C - where C.clinicalStatus.value = 'active' - and C.abatementDateTime is null - and C.abatementQuantity is null - and C.abatementBoolean.value is not true - and C.abatementPeriod is null - and C.abatementRange is null - and C.abatementString is null - -/** - * Conditions that are active or recurring. In FHIR DSTU2, this is reflected by clinicalStatus: 'active' or 'relapse'. - * We do not check for null abatement information because it may have dates from when the now recurring condition - * initially went into remission. - * @see http://hl7.org/fhir/DSTU2/valueset-condition-clinical.html - * @param CondList - a list of Conditions - * @returns {List} a list of active or recurring Conditions, or null if null was passed in - */ -define function ActiveOrRecurring(CondList List): - CondList C where C.clinicalStatus.value in {'active', 'relapse'} - -/** - * Conditions with an onset or recorded date in the specified "look back" period. For example, pregnancy in - * the last 42 weeks. - * TODO: Rename to LookBack once the execution engine supports overloaded functions. - * @param CondList - a list of Conditions - * @returns {List} a list of Conditions with onset or recorded date specified lookback period, or null - * if null was passed in - */ -define function ConditionLookBack(CondList List, LookBack System.Quantity): - CondList C - let LookBackInterval: Interval[Now() - LookBack, Now()] - where C.onsetDateTime.value in LookBackInterval - or NullSafeToInterval(C.onsetPeriod) overlaps LookBackInterval - or C.dateRecorded.value in LookBackInterval - // TODO Confirm these are the correct fields to use - -// -------------------------------------------------- PROCEDURES ------------------------------------------------------- - - /** - * Filters Procedures by a concept rather than by a ValueSet. In CQL 1.3, this will be built into the retrieve, - * but for now, we must use a query where clause. - * @param Koncept - the concept to filter on (intentionally mispelled to avoid naming clashes) - * @returns {List} a list of Procedures matching the concept, or null if null was passed in - */ - define function ProceduresByConcept(Koncept System.Concept): - [Procedure] P where NullSafeToConcept(P.code) ~ Koncept - -/** - * Procedures that are completed. In FHIR DSTU2, this is reflected by status: 'completed'. In addition, the - * notPerformed flag must be checked to ensure it is not 'true'. - * @see http://hl7.org/fhir/DSTU2/valueset-procedure-status.html - * @param ProcList - a list of Procedures - * @returns {List} a list of completed Procedures, or null if null was passed in - */ -define function Completed(ProcList List): - ProcList P - where P.status.value = 'completed' - and P.notPerformed.value is not true - -/** - * Procedures that are in progress. In FHIR DSTU2, this is reflected by status: 'in-progress'. In addition, the - * notPerformed flag must be checked to ensure it is not 'true'. - * @see http://hl7.org/fhir/DSTU2/valueset-procedure-status.html - * @param ProcList - a list of Procedures - * @returns {List} a list of completed Procedures, or null if null was passed in - */ -define function ProcedureInProgress(ProcList List): - ProcList P - where P.status.value = 'in-progress' - and P.notPerformed.value is not true - -/** - * Procedures that actually happened or are happening. In FHIR DSTU2, there are a few properties that negate the - * procedure, most notably when status is 'entered-in-error' or notPerformed is true. - * @see http://hl7.org/fhir/DSTU2/valueset-procedure-status.html - * @param ProcList - a list of Procedures - * @returns {List} a list of Procedures that actually happened or are happening, or null if null was passed in - */ -define function ProcedurePerformance(ProcList List): - ProcList P - where P.status.value != 'entered-in-error' - and P.notPerformed.value is not true - -/** - * Procedures performed in the specified "look back" period. For example, PCIs performed in the - * past 2 weeks. - * TODO: Rename to LookBack once the execution engine supports overloaded functions. - * @param ProcList - a list of Procedures - * @param LookBack - the lookback period for when the procedure was performed - * @returns {List} a list of Procedures performed in the look back period, or null if null - * was passed in - */ -define function ProcedureLookBack(ProcList List, LookBack System.Quantity): - ProcList P - let LookBackInterval: Interval[Now() - LookBack, Now()] - where P.performedDateTime.value in LookBackInterval - or NullSafeToInterval(P.performedPeriod) overlaps LookBackInterval - -// ---------------------------------------------- PROCEDUREREQUESTS ---------------------------------------------------- - - /** - * Filters ProcedureRequests by a concept rather than by a ValueSet. In CQL 1.3, this will be built into the retrieve, - * but for now, we must use a query where clause. - * @param Koncept - the concept to filter on (intentionally mispelled to avoid naming clashes) - * @returns {List} a list of ProcedureRequests matching the concept, or null if null was passed in - */ - define function ProcedureRequestsByConcept(Koncept System.Concept): - [ProcedureRequest] P where NullSafeToConcept(P.code) ~ Koncept - -/** - * ProcedureRequests that are accepted, in progress, or completed. In FHIR DSTU2, this is reflected by the corresponding - * status status values. - * @see http://hl7.org/fhir/DSTU2/valueset-procedure-request-status.html - * @param ProcReqList - a list of ProcedureRequests - * @returns {List} a list of accepted, in-progress, or completed ProcedureRequests, - * or null if null was passed in - */ -define function ProcedureRequestAcceptedOrInProgressOrCompleted(ProcReqList List): - ProcReqList P - where P.status.value in List{'accepted', 'in-progress', 'completed'} - -/** - * ProcedureRequests ordered in the specified "look back" period. For example, PCIs ordered in the - * past 2 weeks. - * TODO: Rename to LookBack once the execution engine supports overloaded functions. - * @param ProcReqList - a list of ProcedureRequests - * @param LookBack - the lookback period for when the procedure was ordered - * @returns {List} a list of ProcedureRequests ordered in the look back period, or null if null - * was passed in - */ -define function ProcedureRequestLookBack(ProcReqList List, LookBack System.Quantity): - ProcReqList P - where P.orderedOn.value in Interval[Now() - LookBack, Now()] - -// ----------------------------------------------- REFERRALREQUESTS ---------------------------------------------------- - - /** - * Filters ReferralRequests by a concept rather than by a ValueSet. In CQL 1.3, this will be built into the retrieve, - * but for now, we must use a query where clause. - * @param Koncept - the concept to filter on (intentionally mispelled to avoid naming clashes) - * @returns {List} a list of ReferralRequests matching the concept, or null if null was passed in - */ - define function ReferralRequestsByServiceRequestedConcept(Koncept System.Concept): - [ReferralRequest] R - where exists((R.serviceRequested) SRC where NullSafeToConcept(SRC) ~ Koncept) - -/** - * ReferralRequests that are accepted, active, or completed. In FHIR DSTU2, this is reflected by the corresponding - * status status values. - * @see http://hl7.org/fhir/DSTU2/valueset-referralstatus.html - * @param ReferralList - a list of ReferralRequests - * @returns {List} a list of accepted, active, or completed ReferralRequests, - * or null if null was passed in - */ -define function ReferralRequestAcceptedOrActiveOrCompleted(ReferralList List): - ReferralList R - where R.status.value in List{'accepted', 'active', 'completed'} - -/** - * ReferralRequests requested in the specified "look back" period. For example, pace make insertions referrals sent - * in the past 2 weeks. - * TODO: Rename to LookBack once the execution engine supports overloaded functions. - * @param ReferralList - a list of ReferralRequests - * @param LookBack - the lookback period for when the referral was sent - * @returns {List} a list of ReferralRequests sent in the look back period, or null if null - * was passed in - */ -define function ReferralRequestLookBack(ReferralList List, LookBack System.Quantity): - ReferralList R - where R.dateSent.value in Interval[Now() - LookBack, Now()] - -// -------------------------------------------------- MEDICATIONS ------------------------------------------------------ - -/** - * Filters MedicationStatements by a concept rather than by a ValueSet. In CQL 1.3, this will be built into the retrieve, - * but for now, we must use a query where clause. - * @param Koncept - the concept to filter on (intentionally mispelled to avoid naming clashes) - * @returns {List} a list of MedicationStatement matching the concept, or null if null was passed in - */ -define function MedicationStatementsByConcept(Koncept System.Concept): - [MedicationStatement] M where NullSafeToConcept(M.medicationCodeableConcept) ~ Koncept - -/** - * Filters MedicationOrders by a concept rather than by a ValueSet. In CQL 1.3, this will be built into the retrieve, - * but for now, we must use a query where clause. - * @param Koncept - the concept to filter on (intentionally mispelled to avoid naming clashes) - * @returns {List} a list of MedicationOrders matching the concept, or null if null was passed in - */ -define function MedicationOrdersByConcept(Koncept System.Concept): - [MedicationOrder] M where NullSafeToConcept(M.medicationCodeableConcept) ~ Koncept - -/** - * Medications that are active, according to a statement, but not necessarily verified via a prescription. For example, - * medications that a patient has self-reported to be taking. In FHIR DSTU2, this is reflected by MedicationStatement - * with status 'active', no flag indicating it wasn't taken, and no end date or an end date in the future. - * TODO: Rename to Active once the execution engine supports overloaded functions. - * @see http://hl7.org/fhir/DSTU2/valueset-medication-statement-status.html - * @param MedList - a list of MedicationStatements - * @returns {List} a list of active medication statements, or null if null was passed in - */ -define function ActiveMedicationStatement(MedList List): - MedList M - let EffectivePeriod: NullSafeToInterval(M.effectivePeriod) - where M.status.value = 'active' - and M.wasNotTaken.value is not true - and (end of EffectivePeriod is null or end of EffectivePeriod after Now()) - -/** - * Medications that are active or completed, according to a statement, but not necessarily verified via a prescription. - * For example, medications that a patient has self-reported to be taking. In FHIR DSTU2, this is reflected by - * MedicationStatement with status 'active' or 'completed', and no flag indicating it wasn't taken. - * TODO: Rename to ActiveOrCompleted once the execution engine supports overloaded functions. - * @see http://hl7.org/fhir/DSTU2/valueset-medication-statement-status.html - * @param MedList - a list of MedicationStatements - * @returns {List} a list of active or completed medication statements, or null if null was passed - * in - */ -define function ActiveOrCompletedMedicationStatement(MedList List): - MedList M - where M.status.value = 'active' - or M.status.value = 'completed' - and M.wasNotTaken.value is not true - -/** -* Medications that are active, according to a prescription. In FHIR DSTU2, this is reflected by MedicationOrder -* with status 'active' and no dateEnded. There is currently an open question in the FHIR chat to determine if this -* is the right approach. -* TODO: Revisit based on outcome of FHIR chat. -* TODO: Rename to Active once the execution engine supports overloaded functions. -* @see https://chat.fhir.org/#narrow/stream/implementers/topic/Meaning.20of.20.22active.22.20and.20.22completed.22.20in.20MedicationRequest -* @see http://hl7.org/fhir/DSTU2/valueset-medication-order-status.html -* @param MedList - a list of MedicationOrders -* @returns {List} a list of active medication orders, or null if null was passed in -*/ -define function ActiveMedicationOrder(MedList List): - MedList M - where M.status.value = 'active' - and M.dateEnded.value is null - -/** -* Medications that are active or completed, according to a prescription. In FHIR DSTU2, this is reflected by MedicationOrder -* with status 'active' or 'completed' -* @see http://hl7.org/fhir/DSTU2/valueset-medication-order-status.html -* @param MedList - a list of MedicationOrders -* @returns {List} a list of active medication orders, or null if null was passed in -*/ -define function ActiveOrCompletedMedicationOrder(MedList List): - MedList M - where M.status.value = 'active' - or M.status.value = 'completed' - -/** -* Medications that are active, completed, or stopped, according to a prescription. In FHIR DSTU2, this is reflected by -* MedicationOrder with status 'active', 'completed', or 'stopped' -* @see http://hl7.org/fhir/DSTU2/valueset-medication-order-status.html -* @param MedList - a list of MedicationOrders -* @returns {List} a list of active medication orders, or null if null was passed in -*/ -define function ActiveCompletedOrStoppedMedicationOrder(MedList List): - MedList M - where M.status.value = 'active' - or M.status.value = 'completed' - or M.status.value = 'stopped' - -/** - * MedicationStatement with an effective date in the specified "look back" period. For example, statements about opioid - * use in the last 180 days. - * TODO: Rename to LookBack once the execution engine supports overloaded functions. - * @param MedList - a list of MedicationStatements - * @param LookBack - a duration Quantity indicating how far back to look for MedicationStatements - * @returns {List} a list of MedicationStatements with effective date in the specified lookback - * period, or null if null was passed in - */ -define function MedicationStatementLookBack(MedList List, LookBack System.Quantity): - MedList M - let LookBackInterval: Interval[Now() - LookBack, Now()] - where M.effectiveDateTime.value in LookBackInterval - or NullSafeToInterval(M.effectivePeriod) overlaps LookBackInterval - -/** - * MedicationOrders with a written date in the specified "look back" period. For example, opioid orders in the last - * 180 days. - * TODO: Rename to LookBack once the execution engine supports overloaded functions. - * @param OrderList - a list of MedicationOrders - * @param LookBack - a duration Quantity indicating how far back to look for MedicationOrders - * @returns {List} a list of MedicationOrders with written date in the specified lookback period, - * or null if null was passed in - */ -define function MedicationOrderLookBack(MedList List, LookBack System.Quantity): - MedList M where M.dateWritten.value in Interval[Now() - LookBack, Now()] - -// -------------------------------------------------- ENCOUNTERS ------------------------------------------------------ - -/** - * Filters Encounters by a concept rather than by a ValueSet. In CQL 1.3, this will be built into the retrieve, - * but for now, we must use a query where clause. - * @param Koncept - the concept to filter on (intentionally mispelled to avoid naming clashes) - * @returns {List} a list of Encounters matching the concept, or null if null was passed in - */ -define function EncountersByConcept(Koncept System.Concept): - [Encounter] E where exists( (E.type) ET where NullSafeToConcept(ET) ~ Koncept ) - -/** - * Encounters that are in progress. In FHIR DSTU2, this is reflected by status: 'in-progress'. - * @see http://hl7.org/fhir/DSTU2/valueset-encounter-state.html - * @param EncList - a list of Encounters - * @returns {List} a list of in progress encounters, or null if null was passed in - */ -define function InProgress(EncList List): - EncList E - where E.status.value = 'in-progress' - -// -------------------------------------------------- ALLERGY INTOLERANCES --------------------------------------------- - -/** - * Filters AllergyIntolerances by a concept rather than by a ValueSet. In CQL 1.3, this will be built into the retrieve, - * but for now, we must use a query where clause. - * @param Koncept - the concept to filter on (intentionally mispelled to avoid naming clashes) - * @returns {List} a list of Allergy Intolerances matching the concept, or null if null was passed in - */ -define function AllergyIntolerancesByConcept(Koncept System.Concept): - [AllergyIntolerance] A where NullSafeToConcept(A.substance) ~ Koncept - -/** -* AllergyIntolerances that are active or confirmed. In FHIR DSTU2, this is reflected by AllergyIntolerance -* with status 'active' or 'confirmed' -* @see http://hl7.org/fhir/DSTU2/valueset-allergy-intolerance-status.html -* @param AllergyIntolList - a list of AllergyIntolerances -* @returns {List} a list of active or confirmed allergy intolerances, or null if null was passed in -*/ -define function ActiveOrConfirmedAllergyIntolerance(AllergyIntolList List): - AllergyIntolList A - where A.status.value = 'active' - or A.status.value = 'confirmed' - -// -------------------------------------------------------- GOALS ------------------------------------------------------ - -/** - * Goals with a start, target, or status date in the specified "look back" period. For example, Pain Management Goals - * in the last 2 years. - * TODO: Rename to LookBack once the execution engine supports overloaded functions. - * @param GoalList - a list of Goals - * @returns {List} a list of Goals with a start, target, or status date in the specified lookback period, or null - * if null was passed in - */ -define function GoalLookBack(GoalList List, LookBack System.Quantity): - GoalList G - let LookBackInterval: Interval[Now() - LookBack, Now()] - where G.startDate.value in LookBackInterval - or G.targetDate.value in LookBackInterval - or (G.startDate.value + NullSafeToQuantity(G.targetQuantity)) in LookBackInterval - or G.statusDate.value in LookBackInterval diff --git a/src/cql/dstu2/FactorsToConsiderInManagingChronicPainFHIRv102.cql b/src/cql/dstu2/FactorsToConsiderInManagingChronicPainFHIRv102.cql new file mode 100644 index 000000000..26b78ee71 --- /dev/null +++ b/src/cql/dstu2/FactorsToConsiderInManagingChronicPainFHIRv102.cql @@ -0,0 +1,1079 @@ +// # Introduction + +// The Pain Management Summary artifact provides relevant information to consider when managing a patient’s pain. +// This CDS logic was informed by the Centers for Disease Control and Prevention (CDC) Guideline for Opioid Prescribing +// for Chronic Pain. The CDS is not a direct representation of any one recommendation statement within the guideline. +// Instead, the CDS compiles clinical concepts mentioned throughout the guideline in one consolidated summary for +// clinician review. +// +// In the process of authoring the logic, certain assumptions were made and details developed when the guideline did +// not provide enough specificity. These decisions were made in the context of the CDS Connect Workgroup and CDC +// stakeholders, and are documented in the logic and/or in the CDS Connect artifact metadata. +// +// Version 2.0.0 implements several best practices prescribed by FHIR Clinical Guidelines, including: +// - Rename library from Factors_to_Consider_in_Managing_Chronic_Pain_FHIRv102 to FactorsToConsiderInManagingChronicPainFHIRv102 +// - Update CDS Connect Commons library to CDSConnectCommonsForFHIRv102 version 2.0.0 +// - Surround all library-level identifiers and datatypes in quotes +// - Use descriptive names (no abbreviations) for query aliases and function arguments +// - Replace C3F.NullSafeToConcept with FHIRHelpers.ToConcept (which is now null-safe) +// - Remove use of coalesce where only one argument was provided +// - Fix non-standard use of Exists(...) as a function +// +// Version 2.0.0 also introduces the following changes from the previous version: +// - Replace "Conditions associated with chronic pain" 2.16.840.1.113762.1.4.1032.37 value set with 2.16.840.1.113762.1.4.1021.95 +// - Replace "Pregnancy" 2.16.840.1.113883.3.526.3.378 and "Pregnancy (New ICD10 codes published in 2018 and 2019)" +// 2.16.840.1.113762.1.4.1032.80 value sets with grouping value set "CDS Pregnancy" 2.16.840.1.113762.1.4.1032.264 +// +// NOTE: This version has not been piloted in a clinical setting, but has undergone logic testing and review. +// +// ##Source guideline: [CDC Guideline for Opioid Prescribing for Chronic Pain](https://www.cdc.gov/drugoverdose/prescribing/guideline.html) + +library FactorsToConsiderInManagingChronicPainFHIRv102 version '2.0.0' + +// # Data model # + +// The FHIR DSTU2 model is preferred by CDS Connect artifacts due to its current adoption in Health IT products. +using FHIR version '1.0.2' + +// # Referenced libraries # + +// The CDS Connect Commons for FHIRv102 library provides functions representing commonly used CDS logic and patterns. +include CDSConnectCommonsForFHIRv102 version '2.0.0' called C3F +// The FHIRHelpers library provides common functions for simplifying interaction w/ the FHIR v102 data model. +include FHIRHelpers version '1.0.2' called FHIRHelpers + +// # Value sets and codes # + +// ## Code Systems ## + +codesystem "LOINC": 'http://loinc.org' +codesystem "SNOMED-CT": 'http://snomed.info/sct' + +// Several concepts needed by the Pain Management Summary CDS do not yet have standardized codes associated with them. +// The CDS logic authors have registered new Logical Object Identifier Names and Codes (LOINC) codes, but they are +// not yet available. Once available, the CDS will be updated. Until then, CDS implementors will need to map to +// local codes (signified by the LOCAL code system below) or replace them with their own codes. +codesystem "LOCAL": 'http://cds.ahrq.gov/cdsconnect/pms' + +// ## Value sets ## + +// List value sets used by the artifact. The links to the Value Set Authority Center (VSAC) point to the latest +// expansion of each value set available. + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1021.95/expansion) +valueset "Conditions associated with chronic pain": '2.16.840.1.113762.1.4.1021.95' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.34/expansion) +valueset "Opioid Pain Medications": '2.16.840.1.113762.1.4.1032.34' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.54/expansion) +valueset "Adjuvant Analgesic Medications": '2.16.840.1.113762.1.4.1032.54' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.105.12.1007/expansion) +valueset "Major Depression": '2.16.840.1.113883.3.464.1003.105.12.1007' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.143/expansion) +valueset "Depression Diagnosis ICD9": '2.16.840.1.113883.3.600.143' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.52/expansion) +valueset "Anxiety": '2.16.840.1.113762.1.4.1032.52' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.1240.2017.3.2.1015/expansion) +valueset "Anxiety Disorders ICD9": '2.16.840.1.113883.3.1240.2017.3.2.1015' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.106.12.1004/expansion) +valueset "Substance use disorder": '2.16.840.1.113883.3.464.1003.106.12.1004' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.106.11.1010/expansion) +valueset "Substance Abuse": '2.16.840.1.113883.3.464.1003.106.11.1010' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.102/expansion) +valueset "Suicide Attempt": '2.16.840.1.113762.1.4.1032.102' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.53/expansion) +valueset "Sleep-disordered breathing": '2.16.840.1.113762.1.4.1032.53' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.109.12.1028/expansion) +valueset "Kidney Failure": '2.16.840.1.113883.3.464.1003.109.12.1028' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.199.12.1035/expansion) +valueset "Chronic Liver Disease": '2.16.840.1.113883.3.464.1003.199.12.1035' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1047.42/expansion) +valueset "Liver Disease": '2.16.840.1.113762.1.4.1047.42' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.264/expansion) +valueset "CDS Pregnancy": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.264' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.26/expansion) +valueset "Non opiod pain medications": '2.16.840.1.113762.1.4.1032.26' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.36/expansion) +valueset "Non pharmacologic treatments for chronic pain": '2.16.840.1.113762.1.4.1032.36' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.55/expansion) +valueset "Risk assessments relevant to pain management": '2.16.840.1.113762.1.4.1032.55' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.43/expansion) +valueset "Benzodiazepine medications": '2.16.840.1.113762.1.4.1032.43' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.42/expansion) +valueset "Naloxone medications": '2.16.840.1.113762.1.4.1032.42' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.28/expansion) +valueset "Urine drug screen for pain management": '2.16.840.1.113762.1.4.1032.28' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.44/expansion) +valueset "Stool softeners and laxatives": '2.16.840.1.113762.1.4.1032.44' + +// ## Individual codes ## + +// list individual codes from code systems used directly in the CQL logic. Individual codes are used when there is +// a single code from a particular vocabulary standard used to represent a clinical concept. It is considered +// best-practice not to create value sets containing a single code. + +code "Pregnancy status code": '82810-3' from "LOINC" display 'Pregnancy status' +code "Pregnant code": '77386006' from "SNOMED-CT" display 'Patient currently pregnant (finding)' +code "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported] code": + '55758-7' from "LOINC" display 'Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]' +code "Patient Health Questionnaire 9 item (PHQ-9) total score [Reported] code": + '44261-6' from "LOINC" display 'Patient Health Questionnaire 9 item (PHQ-9) total score [Reported]' +code "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ] code": + '70274-6' from "LOINC" display 'Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]' +code "Total score [AUDIT] code": '75624-7' from "LOINC" display 'Total score [AUDIT]' +code "Total score [AUDIT-C] code": '75626-2' from "LOINC" display 'Total score [AUDIT-C]' +code "Total score [DAST-10] code": '82667-7' from "LOINC" display 'Total score [DAST-10]' +code "Total score ORT code": '91392-1' from "LOINC" display 'Total score ORT' +code "Pain severity Wong-Baker FACES Scale code": '38221-8' from "LOINC" display 'Pain severity Wong-Baker FACES Scale' + +// The Pain intensity, Enjoyment of life, General activity scale [PEG] now has standardized LOINC codes available. +// These LOINC codes were not available when the initial version of the Pain Management Summary was developed. +// New systems implementing the Pain Management Summary should use the standardized codes, but the legacy local codes +// are also retained in order to allow existing systems to continue to function. Existing systems, however, are +// strongly encouraged to adopt the standardized LOINC codes. + +code "Mean score [PEG] code": '91147-9' from "LOINC" display 'Mean score [PEG]' +code "Pain severity in the past week - 0-10 numeric rating [Reported] code": + '75893-8' from "LOINC" display 'Pain severity in the past week - 0-10 numeric rating [Reported]' +code "What number best describes how pain has interfered with your enjoyment of life during the past week code": + '91145-3' from "LOINC" display 'What number best describes how pain has interfered with your enjoyment of life during the past week' +code "What number best describes how pain has interfered with your general activity during the past week code": + '91146-1' from "LOINC" display 'What number best describes how pain has interfered with your general activity during the past week' + +// Legacy local codes for the Pain intensity, Enjoyment of life, General activity scale [PEG]. +// New systems should use the LOINC codes above instead. + +code "Pain Enjoyment General Activity (PEG) Assessment LEGACY code": + 'PEGASSESSMENT' from "LOCAL" display 'Pain Enjoyment General Activity (PEG) Assessment' +code "Pain LEGACY code": 'PEGPAIN' from "LOCAL" display 'Pain' +code "Enjoyment of life LEGACY code": 'PEGENJOYMENT' from "LOCAL" display 'Enjoyment of life' +code "General activity LEGACY code": 'PEGGENERALACTIVITY' from "LOCAL" display 'General activity' + +// The STarT Back Screening Tool now has a standardized LOINC code available. This LOINC code was not available +// when the initial version of the Pain Management Summary was developed. New systems implementing the Pain Management +// "Summary" should use the standardized code, but the legacy local code is also retained in order to allow existing +// systems to continue to function. Existing systems, however, are strongly encouraged to adopt the standardized LOINC +// code. + +code "Total score [STarT Back] code": '91351-7' from "LOINC" display 'Total score [STarT Back]' + +// Legacy local code for the STarT Back Screening Tool. New systems should use the LOINC codes above instead. + +code "STarT Back Screening Tool LEGACY code": 'STARTBACK' from "LOCAL" display 'STarT Back Screening Tool' + +// The following codes do not yet have standardized codes associated with them so are expressed as LOCAL codes. +// As standardized codes become available, this CDS will be updated to use standard codes rather than LOCAL codes. + +code "Single question r/t ETOH use code": 'SQETOHUSE' from "LOCAL" display 'Single question r/t ETOH use' +code "Single question r/t drug use code": 'SQDRUGUSE' from "LOCAL" display 'Single question r/t drug use' +code "Morphine Milligram Equivalent (MME) code": 'MME' from "LOCAL" display 'Morphine Milligram Equivalent (MME)' + +// CQL currently requires concept declarations to contain references to code declarations. + +concept "Pregnancy status": { "Pregnancy status code" } display 'Pregnancy status' +concept "Pregnant": { "Pregnant code" } display 'Patient currently pregnant (finding)' +concept "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]": + { "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported] code" } + display 'Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]' +concept "Patient Health Questionnaire 9 item (PHQ-9) total score [Reported]": + { "Patient Health Questionnaire 9 item (PHQ-9) total score [Reported] code" } + display 'Patient Health Questionnaire 9 item (PHQ-9) total score [Reported]' +concept "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]": + { "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ] code" } + display 'Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]' +concept "Total score [AUDIT]": { "Total score [AUDIT] code" } display 'Total score [AUDIT]' +concept "Total score [AUDIT-C]": { "Total score [AUDIT-C] code" } display 'Total score [AUDIT-C]' +concept "Total score [DAST-10]": { "Total score [DAST-10] code" } display 'Total score [DAST-10]' +concept "Total score ORT": { "Total score ORT code" } display 'Total score ORT' +concept "Pain severity Wong-Baker FACES Scale": + { "Pain severity Wong-Baker FACES Scale code" } display 'Pain severity Wong-Baker FACES Scale' +concept "Pain severity in the past week - 0-10 numeric rating [Reported]": + { "Pain severity in the past week - 0-10 numeric rating [Reported] code" } + display 'Pain severity in the past week - 0-10 numeric rating [Reported]' +concept "What number best describes how pain has interfered with your enjoyment of life during the past week": + { "What number best describes how pain has interfered with your enjoyment of life during the past week code" } + display 'What number best describes how pain has interfered with your enjoyment of life during the past week' +concept "What number best describes how pain has interfered with your general activity during the past week": + { "What number best describes how pain has interfered with your general activity during the past week code" } + display 'What number best describes how pain has interfered with your general activity during the past week' +concept "Mean score [PEG]": { "Mean score [PEG] code" } display 'Mean score [PEG]' +concept "Pain Enjoyment General Activity (PEG) Assessment LEGACY": + { "Pain Enjoyment General Activity (PEG) Assessment LEGACY code" } display 'Pain Enjoyment General Activity (PEG) Assessment' +concept "Pain LEGACY": { "Pain LEGACY code" } display 'Pain' +concept "Enjoyment of life LEGACY": { "Enjoyment of life LEGACY code" } display 'Enjoyment of life' +concept "General activity LEGACY": { "General activity LEGACY code" } display 'General activity' +concept "Total score [STarT Back]": { "Total score [STarT Back] code" } display 'Total score [STarT Back]' +concept "STarT Back Screening Tool LEGACY": { "STarT Back Screening Tool LEGACY code" } display 'STarT Back Screening Tool' +concept "Single question r/t ETOH use": { "Single question r/t ETOH use code" } display 'Single question r/t ETOH use' +concept "Single question r/t drug use": { "Single question r/t drug use code" } display 'Single question r/t drug use' +concept "Morphine Milligram Equivalent (MME)": + { "Morphine Milligram Equivalent (MME) code" } display 'Morphine Milligram Equivalent (MME)' + +// # Parameters # + +// The InclusionMedicationsLookbackPeriod allows CDS implementors to specify how far the inclusion logic should look +// back for qualifying active medications. By default, the inclusion logic will look back 180 days. +parameter "InclusionMedicationsLookbackPeriod" default 180 days + +// # CDS logic # + +context Patient + +// ## Re-usable functions ## + +// The summary logic contains many constructs that are needed throughout the logic. Where possible, these constructs +// have been developed as re-usable functions that can be invoked wherever they are needed. + +// Returns the first-found display text for a CodeableConcept, looking first at the `text` attribute, then the +// `display` on each `coding` until it finds a non-null value. Some PEG codes are normalized due to length. +// @param Koncept - a FHIR CodeableConcept to get text from +// @returns {System."String"} the display text or null if none is found +define function "ConceptText"(Koncept FHIR."CodeableConcept"): + if Koncept ~ "Mean score [PEG]" or Koncept ~ "Pain Enjoyment General Activity (PEG) Assessment LEGACY" + then 'Mean score [PEG]' + else if Koncept ~ "Pain severity in the past week - 0-10 numeric rating [Reported]" or Koncept ~ "Pain LEGACY" + then 'Pain' + else if Koncept ~ "What number best describes how pain has interfered with your enjoyment of life during the past week" + or Koncept ~ "Enjoyment of life LEGACY" + then 'Enjoyment of life' + else if Koncept ~ "What number best describes how pain has interfered with your general activity during the past week" + or Koncept ~ "General activity LEGACY" + then 'General activity' + else + Coalesce(Koncept.text.value, Coalesce((Koncept.coding) c2 return c2.display.value)) + +// We do not reliably get ranges back from EHR data, but ranges are important to understanding assessment scores in +// the summary. This function adds ranges to the name for known assessments. +// @param Koncept - a FHIR CodeableConcept to get the updated text for +// @returns {System.String} the display text with range information appended +define function "ConceptTextWithRange"(Koncept FHIR."CodeableConcept"): + if Koncept ~ "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]" + then "ConceptText"(Koncept) + ' [Range: 0-6]' + else if Koncept ~ "Patient Health Questionnaire 9 item (PHQ-9) total score [Reported]" + then "ConceptText"(Koncept) + ' [Range: 0-27]' + else if Koncept ~ "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]" + then "ConceptText"(Koncept) + ' [Range: 0-21]' + else if Koncept ~ "Total score [AUDIT]" + then "ConceptText"(Koncept) + ' [Range: 0-40]' + else if Koncept ~ "Total score [AUDIT-C]" + then "ConceptText"(Koncept) + ' [Range: 0-12]' + else if Koncept ~ "Total score [DAST-10]" + then "ConceptText"(Koncept) + ' [Range: 0-10]' + else if Koncept ~ "Total score ORT" + then "ConceptText"(Koncept) + ' [Range: 0-26]' + else if Koncept ~ "Pain severity Wong-Baker FACES Scale" + then "ConceptText"(Koncept) + ' [Range: 0-10]' + else if Koncept ~ "Mean score [PEG]" + or Koncept ~ "Pain Enjoyment General Activity (PEG) Assessment LEGACY" + then "ConceptText"(Koncept) + ' [Range: 0-10]' + else if Koncept ~ "Total score [STarT Back]" + or Koncept ~ "STarT Back Screening Tool LEGACY" + then "ConceptText"(Koncept) + ' [Range: 0-9]' + else + "ConceptText"(Koncept) + +// Returns a text representation of a date using the CQL `ToString` function. +// @param Date - a FHIR date to get text for +// @returns {System."String"} the text representation of the date +define function "DateText"(Date FHIR."date"): + ToString(Date.value) + +// Returns a text representation of a dateTime using the CQL `ToString` function. +// @param Date - a FHIR dateTime to get text for +// @returns {System."String"} the text representation of the dateTime +define function "DateTimeText"(Date FHIR."dateTime"): + ToString(Date.value) + +// Returns a text representation of an instant using the CQL `ToString` function. +// @param Instant - a FHIR instant to get text for +// @returns {System."String"} the text representation of the instant +define function "InstantText"(Instant FHIR."instant"): + ToString(Instant.value) + +// Returns a text representation of a Quantity with the Quantity's value and unit. +// If the unit is {score}, then omit it (as it is not useful to display) +// @param Quantity - a FHIR Quantity to get text for +// @returns {System."String"} the text representation of the Quantity +define function "QuantityText"(Quantity FHIR."Quantity"): + if (Quantity is null) then null + else if (Quantity.unit is not null and Quantity.unit.value != '{score}') then ToString(Quantity.value.value) + ' ' + Quantity.unit.value + else if (Quantity.code is not null and Quantity.code.value != '{score}') then ToString(Quantity.value.value) + ' ' + Quantity.code.value + else ToString(Quantity.value.value) + +// Returns a tuple containing a Period's start and end as text representations. +// @param Period - a FHIR Period to get a tuple for +// @returns {Tuple} the tuple representation of the Period +define function "PeriodObject"(Period FHIR."Period"): + if Period is null then null + else + { + Start: "DateTimeText"(Period."start"), + End: "DateTimeText"(Period."end") + } + +// Returns a tuple containing a Range's low and high as text representations. +// @param Range - a FHIR Range to get a tuple for +// @returns {Tuple} the tuple representation of the Range +define function "RangeObject"(Range FHIR."Range"): + if Range is null then null + else + { + Low: "QuantityText"(Range.low), + High: "QuantityText"(Range.high) + } + +// Returns a text representation of a date associated with an Observation, preferring `effectiveDateTime`, then +// `effectivePeriod.start`, then `issued`. +// @param Observation - a FHIR Observation to get the text date from +// @returns {System."String"} the text representation of a relevant date from the Observation +define function "ObservationDate"(Observation FHIR."Observation"): + Coalesce("DateTimeText"(Observation.effectiveDateTime), "DateTimeText"(Observation.effectivePeriod.start), "InstantText"(Observation.issued)) + +// Returns a text representation of a date associated with a MedicationStatement, preferring `effectiveDateTime`, then +// `effectivePeriod.start`. +// @param Statement - a FHIR MedicationStatement to get the text date from +// @returns {System."String"} the text representation of a relevant date from the MedicationStatement +define function "MedicationStatementDate"(Statement FHIR."MedicationStatement"): + Coalesce("DateTimeText"(Statement.effectiveDateTime), "DateTimeText"(Statement.effectivePeriod."start")) + +// Returns a text representation of a Condition's onset, whether represented as a dateTime, Period, Quantity (Age), +// Range (Age), or string. +// @param Condition - a FHIR Condition to get the text representation of the onset from +// @returns {System."String"} the text representation of the Condition's onset +define function "Onset"(Condition FHIR."Condition"): + Coalesce( List{ + "DateTimeText"(Condition.onsetDateTime), + "QuantityText"(Condition.onsetQuantity), + "PeriodObject"(Condition.onsetPeriod), + "RangeObject"(Condition.onsetRange), + Condition.onsetString.value + }) + +// Returns a text representation of a Condition's abatement, whether represented as a dateTime, Period, Quantity (Age), +// Range (Age), string, or boolean. +// @param Condition - a FHIR Condition to get the text representation of the abatement from +// @returns {System."String"} the text representation of the Condition's abatement +define function "Abatement"(Condition FHIR."Condition"): + Coalesce( List{ + "DateTimeText"(Condition.abatementDateTime), + "QuantityText"(Condition.abatementQuantity), + "PeriodObject"(Condition.abatementPeriod), + "RangeObject"(Condition.abatementRange), + Condition.abatementString.value, + ToString(Condition.abatementBoolean.value) + }) + +// ## Target population ## + +// INCLUSIONS + +// Determines if patient's age, in years, at the time CQL is run, is at least 18 years old +define "Is18orOlder": + AgeInYears() >= 18 + +// Conditions associated with chronic pain +define "ConditionsAssociatedWithChronicPain": + C3F."Confirmed"(C3F."ActiveOrRecurring"(["Condition": "Conditions associated with chronic pain"])) + +// Determines if the patient has any of the conditions associated with chronic pain +define "HasConditionAssociatedWithChronicPain": + exists("ConditionsAssociatedWithChronicPain") + +// Determines if the patient has any record of opioid pain medications in the lookback period +// - Medication Order within past 180 days (lookback can be made a parameter) +// - Medication Statement by patient within past 180 days (lookback can be made a parameter) +define "HasRecentOpioidPainMedication": + exists(C3F."ActiveCompletedOrStoppedMedicationOrder"(C3F."MedicationOrderLookBack"( + ["MedicationOrder": "Opioid Pain Medications"], + "InclusionMedicationsLookbackPeriod") + )) + or exists(C3F."ActiveOrCompletedMedicationStatement"(C3F."MedicationStatementLookBack"( + ["MedicationStatement": "Opioid Pain Medications"], + "InclusionMedicationsLookbackPeriod") + )) + +// Determines if the patient has any record of adjuvant analgesic medications in the lookback period +// - Medication Order within past 180 days (lookback can be made a parameter) +// - Medication Statement by patient within past 180 days (lookback can be made a parameter) +define "HasRecentAdjuvantAnalgesicMedication": + exists(C3F."ActiveCompletedOrStoppedMedicationOrder"(C3F."MedicationOrderLookBack"( + ["MedicationOrder": "Adjuvant Analgesic Medications"], + "InclusionMedicationsLookbackPeriod") + )) + or exists(C3F."ActiveOrCompletedMedicationStatement"(C3F."MedicationStatementLookBack"( + ["MedicationStatement": "Adjuvant Analgesic Medications"], + "InclusionMedicationsLookbackPeriod") + )) + +// Determines if the patient meets the inclusion criteria for the CDS. Inclusion criteria is: +// - Age >=18 years +// - AND +// - OR Conditions associated with chronic pain +// - OR Opioid pain medication +// - OR Adjuvant analgesic medication +define "MeetsInclusionCriteria": + "Is18orOlder" + and ( + "HasConditionAssociatedWithChronicPain" + or "HasRecentOpioidPainMedication" + or "HasRecentAdjuvantAnalgesicMedication" + ) + +// EXCLUSIONS + +// TAKE NOTICE: This CDS is not intended for patients who meet any of the following criteria: +// 1. Younger than 18 years of age +// 2. Undergoing end-of-life care (hospice or palliative) +// 3. Undergoing active cancer treatment +// +// The first exclusion is explicitly accounted for under INCLUSIONS. +// The second and third exclusions cannot be realiably detected for all patients using just EHR data. For that reason +// they are not implemented in this CDS. Care providers should use their judgement when applying this CDS to their +// patients. + +// ## Intervention(s) ## + +// DISPLAY and POPULATE a Pain Management Summary of the following items: + +// PERTINENT MEDICAL HISTORY + +// Conditions associated with chronic pain and their dates of onset + +define "ReportConditionsAssociatedWithChronicPain": + ("ConditionsAssociatedWithChronicPain") Condition + return { + Name: "ConceptText"(Condition.code), + Status: Condition.clinicalStatus.value, + Onset: "Onset"(Condition), + DateRecorded: "DateText"(Condition.dateRecorded) + } + sort by (Onset as "String") desc + +// Conditions that are risk factors for opioid-related harms and their dates of onset +// This is a union of nine value sets (w/ different filtering criteria) + +define "DepressionConditions": + C3F."Confirmed"(C3F."ActiveOrRecurring"(["Condition": "Major Depression"])) + union C3F."Confirmed"(C3F."ActiveOrRecurring"(["Condition": "Depression Diagnosis ICD9"])) + +define "AnxietyConditions": + C3F."Confirmed"(C3F."ActiveOrRecurring"(["Condition": "Anxiety"])) + union C3F."Confirmed"(C3F."ActiveOrRecurring"(["Condition": "Anxiety Disorders ICD9"])) + +define "SubstanceUseDisorderConditions": + C3F."Confirmed"(["Condition": "Substance use disorder"]) + union C3F."Confirmed"(["Condition": "Substance Abuse"]) + +define "SuicideAttemptConditions": + C3F."Confirmed"(["Condition": "Suicide Attempt"]) + +define "SleepDisorderedBreathingConditions": + C3F."Confirmed"(C3F."ActiveOrRecurring"(["Condition": "Sleep-disordered breathing"])) + +define "RenalDysfunctionConditions": + C3F."Confirmed"(C3F."ActiveOrRecurring"(["Condition": "Kidney Failure"])) + +define "HepaticDysfunctionConditions": + C3F."Confirmed"(C3F."ActiveOrRecurring"(["Condition": "Chronic Liver Disease"])) + union C3F."Confirmed"(C3F."ActiveOrRecurring"(["Condition": "Liver Disease"])) + +define "PregnancyConditions": + C3F."Confirmed"(C3F."ConditionLookBack"(C3F."ActiveOrRecurring"( + ["Condition": "CDS Pregnancy"]), + 42 weeks + )) + +define "PregnancyObservations": + C3F."Verified"(C3F."ObservationLookBack"(["Observation": "Pregnancy status"], 42 weeks)) + +define "MostRecentPregnancyObservation": + C3F."MostRecent"("PregnancyObservations") + +define "MostRecentPregnancyObservationIsPositive": + C3F."ConceptValue"("MostRecentPregnancyObservation") ~ "Pregnant" + +define "Is65orOlder": + AgeInYears() >= 65 + +define "ConditionRiskFactorsForOpioidRelatedHarms": + "DepressionConditions" + union "AnxietyConditions" + union "SubstanceUseDisorderConditions" + union "SuicideAttemptConditions" + union "SleepDisorderedBreathingConditions" + union "RenalDysfunctionConditions" + union "HepaticDysfunctionConditions" + union "PregnancyConditions" + +// Encounter diagnoses that are risk factors for opioid-related harms and their dates of onset. Some risk factors may +// not exist on the problem list, and therefore may not be represented as Conditions (depending on EHR implementation). +// For this, the logic also looks at the patient's encounters, trying to find risk factors recorded as encounter +// diagnoses. + +define "EncounterRiskFactorsForOpioidRelatedHarms": + ["Encounter"] Encounter where exists( + Encounter.reason Reason where + FHIRHelpers.ToConcept(Reason) in "Major Depression" + or FHIRHelpers.ToConcept(Reason) in "Depression Diagnosis ICD9" + or FHIRHelpers.ToConcept(Reason) in "Anxiety" + or FHIRHelpers.ToConcept(Reason) in "Anxiety Disorders ICD9" + or FHIRHelpers.ToConcept(Reason) in "Substance use disorder" + or FHIRHelpers.ToConcept(Reason) in "Substance Abuse" + or FHIRHelpers.ToConcept(Reason) in "Suicide Attempt" + or FHIRHelpers.ToConcept(Reason) in "Sleep-disordered breathing" + or FHIRHelpers.ToConcept(Reason) in "Kidney Failure" + or FHIRHelpers.ToConcept(Reason) in "Chronic Liver Disease" + or FHIRHelpers.ToConcept(Reason) in "Liver Disease" + // Pregnancy not considered in Encounter diagnoses because this is an unrestricted lookback. + ) + +// NOTE: As a convention, if an expression's name starts with "Report", its purpose is to format data for the purpose +// of building the final summary object. + +// Format the risk factors in a uniform way despite the different sources of the data (conditions, encounter diagnoses, +// etc.). Note that conditions do not have a "Visit" date and encounter diagnoses do not have a status, onset date, +// recorded date, or abatement date. + +define "ReportConditionRiskFactorsForOpioidRelatedHarms": + ("ConditionRiskFactorsForOpioidRelatedHarms") Condition + return { + Name: "ConceptText"(Condition.code), + Status: Condition.clinicalStatus.value, + Onset: "Onset"(Condition), + DateRecorded: "DateText"(Condition.dateRecorded), + Abatement: "Abatement"(Condition), + Visit: null as Tuple{ Start "String", End "String" } + } + sort by (Onset as "String") desc, (Abatement as "String") desc + +define function "GetEncounterDiagnosesRiskFactorsForOpioidRelatedHarms"(Encounter "Encounter"): + (Encounter.reason) Reason + where FHIRHelpers.ToConcept(Reason) in "Major Depression" + or FHIRHelpers.ToConcept(Reason) in "Depression Diagnosis ICD9" + or FHIRHelpers.ToConcept(Reason) in "Anxiety" + or FHIRHelpers.ToConcept(Reason) in "Anxiety Disorders ICD9" + or FHIRHelpers.ToConcept(Reason) in "Substance use disorder" + or FHIRHelpers.ToConcept(Reason) in "Substance Abuse" + or FHIRHelpers.ToConcept(Reason) in "Suicide Attempt" + or FHIRHelpers.ToConcept(Reason) in "Sleep-disordered breathing" + or FHIRHelpers.ToConcept(Reason) in "Kidney Failure" + or FHIRHelpers.ToConcept(Reason) in "Chronic Liver Disease" + or FHIRHelpers.ToConcept(Reason) in "Liver Disease" + // Pregnancy not considered in Encounter diagnoses because this is an unrestricted lookback. + return { + Name: "ConceptText"(Reason), + Status: null as "String", + Onset: null as "String", + DateRecorded: null as "String", + Abatement: null as "String", + Visit: "PeriodObject"(Encounter.period) + } + +define "ReportEncounterRiskFactorsForOpioidRelatedHarms": + (flatten(("EncounterRiskFactorsForOpioidRelatedHarms") Encounter + return "GetEncounterDiagnosesRiskFactorsForOpioidRelatedHarms"(Encounter))) Reason + sort by Visit.Start desc, Visit.End desc + +// Shape the pregnancy Observation as a Condition, since this is the backup approach for detecting a pregnancy in case +// there are no active Conditions found. +define "ReportMostRecentPositivePregnancyObservation": + if "MostRecentPregnancyObservationIsPositive" then + { + Name: "ConceptText"("MostRecentPregnancyObservation".code), + Status: "ConceptText"("MostRecentPregnancyObservation".valueCodeableConcept), + Onset: ToString(Coalesce( + "MostRecentPregnancyObservation".effectiveDateTime.value, + "MostRecentPregnancyObservation".effectivePeriod.start + )), + DateRecorded: ToString("MostRecentPregnancyObservation".issued), + Abatement: null as "String", + Visit: null as Tuple{ Start "String", End "String" } + } + else + null + +// Shape the case of being 65 or older as a Condition for the purposes of building the summary. +define "ReportOlderThan65": + if "Is65orOlder" then + { + Name: '65 years or older', + Status: 'active', + Onset: null as "String", + DateRecorded: null as "String", + Abatement: null as "String", + Visit: null as Tuple{ Start "String", End "String" } + } + else + null + +define "ReportRiskFactorsForOpioidRelatedHarms": + // If a pregnancy Condition is present, use that. + if exists "PregnancyConditions" then + ("ReportConditionRiskFactorsForOpioidRelatedHarms" + union "ReportEncounterRiskFactorsForOpioidRelatedHarms" + union "ReportOlderThan65") Condition + // Otherwise, try to find a positive pregnancy status in an Observation. + else + ("ReportConditionRiskFactorsForOpioidRelatedHarms" + union "ReportEncounterRiskFactorsForOpioidRelatedHarms" + union "ReportOlderThan65" + union "ReportMostRecentPositivePregnancyObservation") Condition + sort by (if Onset is not null then Onset as "String" else Visit.Start) desc, Visit.End desc, (Abatement as "String") desc + +// PAIN ASSESSMENT + +// Numeric pain intensity assessment - scores and dates (lookback 2 years) + +define "NumericPainIntensityAssessments": + C3F."Verified"(C3F."ObservationLookBack"(["Observation": "Pain severity Wong-Baker FACES Scale"], 2 years)) + +define "ReportNumericPainIntensityAssessments": + ("NumericPainIntensityAssessments") Assessment + return { + Name: "ConceptTextWithRange"(Assessment.code), + Score: "QuantityText"(Assessment.valueQuantity), + Interpretation: Coalesce( "ConceptText"(Assessment.interpretation), "ConceptText"(Assessment.valueCodeableConcept) ), + Date: "ObservationDate"(Assessment) + } + sort by Date desc + +// Pain Enjoyment General Activity (PEG) Assessment - scores and dates (lookback 2 years) +// Note: this includes listing the response to each of the 3 questions, plus the total score. The Pain Management +// Sumnmary currently supports both the LOINC representations and the legacy local code representations. +// +// 1. Observation w/ LOINC mean score as primary code and mean score as valueQuantity +// * code: LOINC 91147-9 "Mean score [PEG]" +// * valueQuantity: (mean score) +// * component: +// - +// * code: LOINC 75893-8 "What number best describes your pain on average in the past week?" +// * valueQuantity: (pain score) +// - +// * code: LOINC 91145-3 "What number best describes how, during the past week, pain has interfered with your enjoyment of life?" +// * valueQuantity: (enjoyment of life score) +// - +// * code: LOINC 91146-1 "What number best describes how, during the past week, pain has interfered with your general activity?" +// * valueQuantity: (general activity score) +// +// 2. LEGACY: Observation w/ LOCAL code as primary code and mean score as valueQuantity +// * code: LOCAL PEGASSESSMENT "Pain Enjoyment General Activity (PEG) Assessment" +// * valueQuantity: (mean score) +// * component: +// - +// * code: LOCAL PEGPAIN "Pain" +// * valueQuantity: (pain score) +// - +// * code: LOCAL PEGENJOYMENT "Enjoyment of life" +// * valueQuantity: (enjoyment of life score) +// - +// * code: LOCAL PEGGENERALACTIVITY "General activity" +// * valueQuantity: (general activity score) + +define "PainEnjoymentGeneralActivityAssessments": + C3F."Verified"(C3F."ObservationLookBack"( + ["Observation": "Mean score [PEG]"] + union ["Observation": "Pain Enjoyment General Activity (PEG) Assessment LEGACY"], + 2 years + )) + +define "ReportPainEnjoymentGeneralActivityAssessments": + ("PainEnjoymentGeneralActivityAssessments") Assessment + let + Pain: (Assessment.component) Component + where Component.code ~ "Pain severity in the past week - 0-10 numeric rating [Reported]" + or Component.code ~ "Pain LEGACY", + Enjoyment: (Assessment.component) Component + where Component.code ~ "What number best describes how pain has interfered with your enjoyment of life during the past week" + or Component.code ~ "Enjoyment of life LEGACY", + GeneralActivity: (Assessment.component) Component + where Component.code ~ "What number best describes how pain has interfered with your general activity during the past week" + or Component.code ~ "General activity LEGACY" + where true // grammar needs a where statement to separate the "let" from the "return" + return { + // NOTE: Hard-code in names because the real LOINC code displays are quite long + Name: "ConceptTextWithRange"(Assessment.code), + Score: "QuantityText"(Assessment.valueQuantity), + Interpretation: Coalesce( "ConceptText"(Assessment.interpretation), "ConceptText"(Assessment.valueCodeableConcept) ), + Questions: ({ First(Pain), First(Enjoyment), First(GeneralActivity) }) Component + where Component is not null + return { "Name": "ConceptText"(Component.code), "Score": "QuantityText"(Component.valueQuantity) }, + Date: "ObservationDate"(Assessment) + } + sort by Date desc + +// STarT Back Screening Tool - Overall score and dates (lookback 2 years) + +define "STarTBackAssessments": + C3F."Verified"(C3F."ObservationLookBack"( + ["Observation": "Total score [STarT Back]"] + union ["Observation": "STarT Back Screening Tool LEGACY"], + 2 years + )) + + +define "ReportSTarTBackAssessments": + ("STarTBackAssessments") Assessment + return { + Name: "ConceptTextWithRange"(Assessment.code), + Score: "QuantityText"(Assessment.valueQuantity), + Interpretation: Coalesce( "ConceptText"(Assessment.interpretation), "ConceptText"(Assessment.valueCodeableConcept) ), + Date: "ObservationDate"(Assessment) + } + sort by Date desc + +// HISTORICAL TREATMENTS + +// Opioid medication orders and statements with dates (lookback 2 years) + +define "OpioidMedicationOrders": + C3F."ActiveCompletedOrStoppedMedicationOrder"(C3F."MedicationOrderLookBack"( + ["MedicationOrder": "Opioid Pain Medications"], + 2 years + )) + +define "OpioidMedicationStatements": + C3F."ActiveOrCompletedMedicationStatement"(C3F."MedicationStatementLookBack"( + ["MedicationStatement": "Opioid Pain Medications"], + 2 years + )) + +define "ReportOpioidMedicationOrders": + ("OpioidMedicationOrders") Order + return { + Type: 'Order', + Name: "ConceptText"(Order.medicationCodeableConcept), + Start: "DateTimeText"(Order.dateWritten), + End: "DateTimeText"(Order.dateEnded), + Status: Order.status.value + } + sort by Start desc, End desc + +define "ReportOpioidMedicationStatements": + ("OpioidMedicationStatements") Statement + return { + Type: 'Statement', + Name: "ConceptText"(Statement.medicationCodeableConcept), + Start: "MedicationStatementDate"(Statement), + End: "DateTimeText"(Statement.effectivePeriod."end"), + Status: Statement.status.value + } + sort by Start desc, End desc + +define "ReportOpioidMedications": + ("ReportOpioidMedicationOrders" union "ReportOpioidMedicationStatements") Medication + sort by Start desc, End desc + +// Non-opioid medication orders and statements with dates (lookback 2 years) + +define "NonOpioidMedicationOrders": + C3F."ActiveCompletedOrStoppedMedicationOrder"(C3F."MedicationOrderLookBack"( + ["MedicationOrder": "Non opiod pain medications"], + 2 years + )) + +define "NonOpioidMedicationStatements": + C3F."ActiveOrCompletedMedicationStatement"(C3F."MedicationStatementLookBack"( + ["MedicationStatement": "Non opiod pain medications"], + 2 years + )) + +define "ReportNonOpioidMedicationOrders": + ("NonOpioidMedicationOrders") Order + return { + Type: 'Order', + Name: "ConceptText"(Order.medicationCodeableConcept), + Start: "DateTimeText"(Order.dateWritten), + End: "DateTimeText"(Order.dateEnded), + Status: Order.status.value + } + sort by Start desc, End desc + +define "ReportNonOpioidMedicationStatements": + ("NonOpioidMedicationStatements") Statement + return { + Type: 'Statement', + Name: "ConceptText"(Statement.medicationCodeableConcept), + Start: "MedicationStatementDate"(Statement), + End: "DateTimeText"(Statement.effectivePeriod."end"), + Status: Statement.status.value + } + sort by Start desc, End desc + +define "ReportNonOpioidMedications": + ("ReportNonOpioidMedicationOrders" union "ReportNonOpioidMedicationStatements") Medication + sort by Start desc, End desc + +// Non-pharmacologic treatment orders and referrals with dates (lookback 2 years) + +define "NonPharmacologicTreatmentProcedures": + C3F."ProcedurePerformance"(C3F."ProcedureLookBack"(["Procedure": "Non pharmacologic treatments for chronic pain"], 2 years)) + +define "ReportNonPharmacologicTreatmentProcedures": + ("NonPharmacologicTreatmentProcedures") Procedure + return { + Type: 'Procedure', + Name: "ConceptText"(Procedure.code), + Date: Coalesce("DateTimeText"(Procedure.performedDateTime), "DateTimeText"(Procedure.performedPeriod."start")) + } + sort by Date desc + +define "NonPharmacologicTreatmentProcedureRequests": + C3F."ProcedureRequestAcceptedOrInProgressOrCompleted"( + C3F."ProcedureRequestLookBack"(["ProcedureRequest": "Non pharmacologic treatments for chronic pain"], 2 years) + ) + +define "ReportNonPharmacologicTreatmentProcedureRequests": + ("NonPharmacologicTreatmentProcedureRequests") Request + return { + Type: 'ProcedureRequest', + Name: "ConceptText"(Request.code), + Date: "DateTimeText"(Request.orderedOn) + } + sort by Date desc + +define "NonPharmacologicTreatmentReferralRequests": + C3F."ReferralRequestAcceptedOrActiveOrCompleted"(C3F."ReferralRequestLookBack"( + ["ReferralRequest"] Referral where exists( + (Referral.serviceRequested) Service where Service in "Non pharmacologic treatments for chronic pain" + ), + 2 years + )) + +define "ReportNonPharmacologicTreatmentReferralRequests": + ("NonPharmacologicTreatmentReferralRequests") Referral + return { + Type: 'Referral', + Name: Coalesce((Referral.serviceRequested) Service return "ConceptText"(Service)), + Date: "DateTimeText"(Referral.dateSent) + } + sort by Date desc + +define "ReportNonPharmacologicTreatments": + ("ReportNonPharmacologicTreatmentProcedures" + union "ReportNonPharmacologicTreatmentProcedureRequests" + union "ReportNonPharmacologicTreatmentReferralRequests") TreatmentOrRequest + sort by Date desc + +// Stool softeners and laxatives - orders and statements with dates (lookback 6 months) + +define "StoolSoftenersAndLaxativesOrders": + C3F."ActiveCompletedOrStoppedMedicationOrder"(C3F."MedicationOrderLookBack"( + ["MedicationOrder": "Stool softeners and laxatives"], + 6 months + )) + +define "StoolSoftenersAndLaxativesStatements": + C3F."ActiveOrCompletedMedicationStatement"(C3F."MedicationStatementLookBack"( + ["MedicationStatement": "Stool softeners and laxatives"], + 6 months + )) + +define "ReportStoolSoftenersAndLaxativesOrders": + ("StoolSoftenersAndLaxativesOrders") Order + return { + Type: 'Order', + Name: "ConceptText"(Order.medicationCodeableConcept), + Start: "DateTimeText"(Order.dateWritten), + End: "DateTimeText"(Order.dateEnded), + Status: Order.status.value + } + sort by Start desc, End desc + +define "ReportStoolSoftenersAndLaxativesStatements": + ("StoolSoftenersAndLaxativesStatements") Statement + return { + Type: 'Statement', + Name: "ConceptText"(Statement.medicationCodeableConcept), + Start: "MedicationStatementDate"(Statement), + End: "DateTimeText"(Statement.effectivePeriod."end"), + Status: Statement.status.value + } + sort by Start desc, End desc + +define "ReportStoolSoftenersAndLaxatives": + ("ReportStoolSoftenersAndLaxativesOrders" union "ReportStoolSoftenersAndLaxativesStatements") Laxative + sort by Start desc, End desc + +// RISK CONSIDERATIONS + +// MME (MOST RECENT w/ lookback 6 months) - amount and date + +define "MostRecentMME": + C3F."MostRecent"(C3F."Verified"(C3F."ObservationLookBack"(["Observation": "Morphine Milligram Equivalent (MME)"], 6 months))) + +define "ReportMostRecentMME": + if "MostRecentMME" is null + then null + else + ("MostRecentMME") MME + return { + Name: "ConceptText"(MME.code), + Result: "QuantityText"(MME.valueQuantity), + Date: "ObservationDate"(MME) + } + +// Urine drug screen - dates and results (all screens w/ lookback of 1 year) + +define "UrineDrugScreens": + C3F."Verified"(C3F."ObservationLookBack"(["Observation": "Urine drug screen for pain management"], 1 year)) + +define "ReportUrineDrugScreens": + ("UrineDrugScreens") Screening + return { + Name: "ConceptText"(Screening.code), + Result: Coalesce( "QuantityText"(Screening.valueQuantity), Screening.valueString.value, "ConceptText"(Screening.valueCodeableConcept) ), + Interpretation: "ConceptText"(Screening.interpretation), + Date: "ObservationDate"(Screening) + } + sort by Date desc + +// Benzodiazepine Medications (lookback of 2 years)- orders and statements with dates + +define "BenzodiazepineMedicationOrders": + C3F."ActiveCompletedOrStoppedMedicationOrder"(C3F."MedicationOrderLookBack"( + ["MedicationOrder": "Benzodiazepine medications"], + 2 years + )) + +define "BenzodiazepineMedicationStatements": + C3F."ActiveOrCompletedMedicationStatement"(C3F."MedicationStatementLookBack"( + ["MedicationStatement": "Benzodiazepine medications"], + 2 years + )) + +define "ReportBenzodiazepineMedicationOrders": + ("BenzodiazepineMedicationOrders") Order + return { + Type: 'Order', + Name: "ConceptText"(Order.medicationCodeableConcept), + Start: "DateTimeText"(Order.dateWritten), + End: "DateTimeText"(Order.dateEnded), + Status: Order.status.value + } + sort by Start desc, End desc + +define "ReportBenzodiazepineMedicationStatements": + ("BenzodiazepineMedicationStatements") Statement + return { + Type: 'Statement', + Name: "ConceptText"(Statement.medicationCodeableConcept), + Start: "MedicationStatementDate"(Statement), + End: "DateTimeText"(Statement.effectivePeriod."end"), + Status: Statement.status.value + } + sort by Start desc, End desc + +define "ReportBenzodiazepineMedications": + ("ReportBenzodiazepineMedicationOrders" union "ReportBenzodiazepineMedicationStatements") Medication + sort by Start desc, End desc + +// Naloxone Medications (unrestricted lookback) - orders and statements with dates + +define "NaloxoneMedicationOrders": + C3F."ActiveCompletedOrStoppedMedicationOrder"(["MedicationOrder": "Naloxone medications"]) + +define "NaloxoneMedicationStatements": + C3F."ActiveOrCompletedMedicationStatement"(["MedicationStatement": "Naloxone medications"]) + +define "ReportNaloxoneMedicationOrders": + ("NaloxoneMedicationOrders") Order + return { + Type: 'Order', + Name: "ConceptText"(Order.medicationCodeableConcept), + Start: "DateTimeText"(Order.dateWritten), + End: "DateTimeText"(Order.dateEnded), + Status: Order.status.value + } + sort by Start desc, End desc + +define "ReportNaloxoneMedicationStatements": + ("NaloxoneMedicationStatements") Statement + return { + Type: 'Statement', + Name: "ConceptText"(Statement.medicationCodeableConcept), + Start: "MedicationStatementDate"(Statement), + End: "DateTimeText"(Statement.effectivePeriod."end"), + Status: Statement.status.value + } + sort by Start desc, End desc + +define "ReportNaloxoneMedications": + ("ReportNaloxoneMedicationOrders" union "ReportNaloxoneMedicationStatements") Medication + sort by Start desc, End desc + +// Risk screenings relevant to pain management - overall scores and dates (MOST RECENT w/ lookback 1 year) + +define "RiskScreeningsRelevantToPainManagement": + C3F."Verified"(C3F."ObservationLookBack"( + ["Observation": "Risk assessments relevant to pain management"] + union ["Observation": "Single question r/t ETOH use"] + union ["Observation": "Single question r/t drug use"] + , 1 year)) + +define "ReportRiskScreeningsRelevantToPainManagement": + ("RiskScreeningsRelevantToPainManagement") Screening + return { + Name: "ConceptTextWithRange"(Screening.code), + Score: Coalesce( "QuantityText"(Screening.valueQuantity), Screening.valueString.value ), + Interpretation: Coalesce( "ConceptText"(Screening.interpretation), "ConceptText"(Screening.valueCodeableConcept) ), + Date: "ObservationDate"(Screening) + } + sort by Date desc + +// SUMMARY + +// The "Summary" object represents the full Pain Management Summary to be displayed to the clinician. All values are +// returned as user-friendly text representations, but a robust user interface (UI) should be implemented to +// display the data to the user in a friendly manner. See the Pain Management Summary SMART on FHIR application as +// an example of how to integrate this summary into an EHR using modern web UI technologies. + +define "Summary": { + Patient: { + Name: Combine(Patient.name.given Given return Given.value, ' ') + ' ' + Combine(Patient.name.family Family return Family.value, ' '), + Gender: Patient.gender.value, + Age: AgeInYears(), + MeetsInclusionCriteria: "MeetsInclusionCriteria" + }, + PertinentMedicalHistory: { + ConditionsAssociatedWithChronicPain: "ReportConditionsAssociatedWithChronicPain", + RiskFactorsForOpioidRelatedHarms: "ReportRiskFactorsForOpioidRelatedHarms" + }, + PainAssessments: { + NumericPainIntensityAssessments: "ReportNumericPainIntensityAssessments", + PainEnjoymentGeneralActivityAssessments: "ReportPainEnjoymentGeneralActivityAssessments", + STarTBackAssessments: "ReportSTarTBackAssessments" + }, + HistoricalTreatments: { + OpioidMedications: "ReportOpioidMedications", + NonOpioidMedications: "ReportNonOpioidMedications", + NonPharmacologicTreatments: "ReportNonPharmacologicTreatments", + StoolSoftenersAndLaxatives: "ReportStoolSoftenersAndLaxatives" + }, + RiskConsiderations: { + MostRecentMME: "ReportMostRecentMME", + UrineDrugScreens: "ReportUrineDrugScreens", + BenzodiazepineMedications: "ReportBenzodiazepineMedications", + NaloxoneMedications: "ReportNaloxoneMedications", + RiskScreeningsRelevantToPainManagement: "ReportRiskScreeningsRelevantToPainManagement" + } +} diff --git a/src/cql/dstu2/Factors_to_Consider_in_Managing_Chronic_Pain.json b/src/cql/dstu2/FactorsToConsiderInManagingChronicPainFHIRv102.json similarity index 94% rename from src/cql/dstu2/Factors_to_Consider_in_Managing_Chronic_Pain.json rename to src/cql/dstu2/FactorsToConsiderInManagingChronicPainFHIRv102.json index 9748bf74e..e7dc75a03 100644 --- a/src/cql/dstu2/Factors_to_Consider_in_Managing_Chronic_Pain.json +++ b/src/cql/dstu2/FactorsToConsiderInManagingChronicPainFHIRv102.json @@ -5,8 +5,8 @@ "type" : "CqlToElmInfo" } ], "identifier" : { - "id" : "Factors_to_Consider_in_Managing_Chronic_Pain", - "version" : "1.1.0" + "id" : "FactorsToConsiderInManagingChronicPainFHIRv102", + "version" : "2.0.0" }, "schemaIdentifier" : { "id" : "urn:hl7-org:elm", @@ -25,8 +25,8 @@ "includes" : { "def" : [ { "localIdentifier" : "C3F", - "path" : "CDS_Connect_Commons_for_FHIRv102", - "version" : "1.3.1" + "path" : "CDSConnectCommonsForFHIRv102", + "version" : "2.0.0" }, { "localIdentifier" : "FHIRHelpers", "path" : "FHIRHelpers", @@ -62,7 +62,7 @@ "valueSets" : { "def" : [ { "name" : "Conditions associated with chronic pain", - "id" : "2.16.840.1.113762.1.4.1032.37", + "id" : "2.16.840.1.113762.1.4.1021.95", "accessLevel" : "Public" }, { "name" : "Opioid Pain Medications", @@ -117,12 +117,8 @@ "id" : "2.16.840.1.113762.1.4.1047.42", "accessLevel" : "Public" }, { - "name" : "Pregnancy", - "id" : "2.16.840.1.113883.3.526.3.378", - "accessLevel" : "Public" - }, { - "name" : "Pregnancy (New ICD10 codes published in 2018 and 2019)", - "id" : "2.16.840.1.113762.1.4.1032.80", + "name" : "CDS Pregnancy", + "id" : "https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.264", "accessLevel" : "Public" }, { "name" : "Non opiod pain medications", @@ -537,7 +533,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -551,7 +547,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -576,7 +572,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -590,7 +586,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -615,7 +611,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -629,7 +625,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -654,7 +650,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -668,7 +664,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -691,7 +687,7 @@ "path" : "text", "type" : "Property", "source" : { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } } @@ -705,7 +701,7 @@ "path" : "coding", "type" : "Property", "source" : { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } } @@ -730,7 +726,7 @@ } }, "operand" : [ { - "name" : "c", + "name" : "Koncept", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}CodeableConcept", "type" : "NamedTypeSpecifier" @@ -750,7 +746,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -764,7 +760,7 @@ "name" : "ConceptText", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -782,7 +778,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -796,7 +792,7 @@ "name" : "ConceptText", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -814,7 +810,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -828,7 +824,7 @@ "name" : "ConceptText", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -846,7 +842,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -860,7 +856,7 @@ "name" : "ConceptText", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -878,7 +874,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -892,7 +888,7 @@ "name" : "ConceptText", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -910,7 +906,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -924,7 +920,7 @@ "name" : "ConceptText", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -942,7 +938,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -956,7 +952,7 @@ "name" : "ConceptText", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -974,7 +970,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -988,7 +984,7 @@ "name" : "ConceptText", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -1008,7 +1004,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -1022,7 +1018,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -1037,7 +1033,7 @@ "name" : "ConceptText", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -1057,7 +1053,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -1071,7 +1067,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -1086,7 +1082,7 @@ "name" : "ConceptText", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -1099,7 +1095,7 @@ "name" : "ConceptText", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] } @@ -1114,7 +1110,7 @@ } }, "operand" : [ { - "name" : "c", + "name" : "Koncept", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}CodeableConcept", "type" : "NamedTypeSpecifier" @@ -1131,13 +1127,13 @@ "path" : "value", "type" : "Property", "source" : { - "name" : "d", + "name" : "Date", "type" : "OperandRef" } } }, "operand" : [ { - "name" : "d", + "name" : "Date", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}date", "type" : "NamedTypeSpecifier" @@ -1154,13 +1150,13 @@ "path" : "value", "type" : "Property", "source" : { - "name" : "d", + "name" : "Date", "type" : "OperandRef" } } }, "operand" : [ { - "name" : "d", + "name" : "Date", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}dateTime", "type" : "NamedTypeSpecifier" @@ -1177,13 +1173,13 @@ "path" : "value", "type" : "Property", "source" : { - "name" : "i", + "name" : "Instant", "type" : "OperandRef" } } }, "operand" : [ { - "name" : "i", + "name" : "Instant", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}instant", "type" : "NamedTypeSpecifier" @@ -1199,7 +1195,7 @@ "condition" : { "type" : "IsNull", "operand" : { - "name" : "q", + "name" : "Quantity", "type" : "OperandRef" } }, @@ -1222,7 +1218,7 @@ "path" : "unit", "type" : "Property", "source" : { - "name" : "q", + "name" : "Quantity", "type" : "OperandRef" } } @@ -1238,7 +1234,7 @@ "path" : "unit", "type" : "Property", "source" : { - "name" : "q", + "name" : "Quantity", "type" : "OperandRef" } } @@ -1263,7 +1259,7 @@ "path" : "value", "type" : "Property", "source" : { - "name" : "q", + "name" : "Quantity", "type" : "OperandRef" } } @@ -1280,7 +1276,7 @@ "path" : "unit", "type" : "Property", "source" : { - "name" : "q", + "name" : "Quantity", "type" : "OperandRef" } } @@ -1298,7 +1294,7 @@ "path" : "code", "type" : "Property", "source" : { - "name" : "q", + "name" : "Quantity", "type" : "OperandRef" } } @@ -1314,7 +1310,7 @@ "path" : "code", "type" : "Property", "source" : { - "name" : "q", + "name" : "Quantity", "type" : "OperandRef" } } @@ -1339,7 +1335,7 @@ "path" : "value", "type" : "Property", "source" : { - "name" : "q", + "name" : "Quantity", "type" : "OperandRef" } } @@ -1356,7 +1352,7 @@ "path" : "code", "type" : "Property", "source" : { - "name" : "q", + "name" : "Quantity", "type" : "OperandRef" } } @@ -1371,7 +1367,7 @@ "path" : "value", "type" : "Property", "source" : { - "name" : "q", + "name" : "Quantity", "type" : "OperandRef" } } @@ -1381,7 +1377,7 @@ } }, "operand" : [ { - "name" : "q", + "name" : "Quantity", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}Quantity", "type" : "NamedTypeSpecifier" @@ -1397,7 +1393,7 @@ "condition" : { "type" : "IsNull", "operand" : { - "name" : "p", + "name" : "Period", "type" : "OperandRef" } }, @@ -1434,7 +1430,7 @@ "path" : "start", "type" : "Property", "source" : { - "name" : "p", + "name" : "Period", "type" : "OperandRef" } } ] @@ -1448,7 +1444,7 @@ "path" : "end", "type" : "Property", "source" : { - "name" : "p", + "name" : "Period", "type" : "OperandRef" } } ] @@ -1457,7 +1453,7 @@ } }, "operand" : [ { - "name" : "p", + "name" : "Period", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}Period", "type" : "NamedTypeSpecifier" @@ -1473,7 +1469,7 @@ "condition" : { "type" : "IsNull", "operand" : { - "name" : "r", + "name" : "Range", "type" : "OperandRef" } }, @@ -1510,7 +1506,7 @@ "path" : "low", "type" : "Property", "source" : { - "name" : "r", + "name" : "Range", "type" : "OperandRef" } } ] @@ -1524,7 +1520,7 @@ "path" : "high", "type" : "Property", "source" : { - "name" : "r", + "name" : "Range", "type" : "OperandRef" } } ] @@ -1533,7 +1529,7 @@ } }, "operand" : [ { - "name" : "r", + "name" : "Range", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}Range", "type" : "NamedTypeSpecifier" @@ -1553,7 +1549,7 @@ "path" : "effectiveDateTime", "type" : "Property", "source" : { - "name" : "o", + "name" : "Observation", "type" : "OperandRef" } } ] @@ -1567,7 +1563,7 @@ "path" : "effectivePeriod", "type" : "Property", "source" : { - "name" : "o", + "name" : "Observation", "type" : "OperandRef" } } @@ -1579,14 +1575,14 @@ "path" : "issued", "type" : "Property", "source" : { - "name" : "o", + "name" : "Observation", "type" : "OperandRef" } } ] } ] }, "operand" : [ { - "name" : "o", + "name" : "Observation", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}Observation", "type" : "NamedTypeSpecifier" @@ -1606,7 +1602,7 @@ "path" : "effectiveDateTime", "type" : "Property", "source" : { - "name" : "s", + "name" : "Statement", "type" : "OperandRef" } } ] @@ -1620,7 +1616,7 @@ "path" : "effectivePeriod", "type" : "Property", "source" : { - "name" : "s", + "name" : "Statement", "type" : "OperandRef" } } @@ -1628,7 +1624,7 @@ } ] }, "operand" : [ { - "name" : "s", + "name" : "Statement", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}MedicationStatement", "type" : "NamedTypeSpecifier" @@ -1650,7 +1646,7 @@ "path" : "onsetDateTime", "type" : "Property", "source" : { - "name" : "c", + "name" : "Condition", "type" : "OperandRef" } } ] @@ -1661,7 +1657,7 @@ "path" : "onsetQuantity", "type" : "Property", "source" : { - "name" : "c", + "name" : "Condition", "type" : "OperandRef" } } ] @@ -1672,7 +1668,7 @@ "path" : "onsetPeriod", "type" : "Property", "source" : { - "name" : "c", + "name" : "Condition", "type" : "OperandRef" } } ] @@ -1683,7 +1679,7 @@ "path" : "onsetRange", "type" : "Property", "source" : { - "name" : "c", + "name" : "Condition", "type" : "OperandRef" } } ] @@ -1694,7 +1690,7 @@ "path" : "onsetString", "type" : "Property", "source" : { - "name" : "c", + "name" : "Condition", "type" : "OperandRef" } } @@ -1702,7 +1698,7 @@ } ] }, "operand" : [ { - "name" : "c", + "name" : "Condition", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}Condition", "type" : "NamedTypeSpecifier" @@ -1724,7 +1720,7 @@ "path" : "abatementDateTime", "type" : "Property", "source" : { - "name" : "c", + "name" : "Condition", "type" : "OperandRef" } } ] @@ -1735,7 +1731,7 @@ "path" : "abatementQuantity", "type" : "Property", "source" : { - "name" : "c", + "name" : "Condition", "type" : "OperandRef" } } ] @@ -1746,7 +1742,7 @@ "path" : "abatementPeriod", "type" : "Property", "source" : { - "name" : "c", + "name" : "Condition", "type" : "OperandRef" } } ] @@ -1757,7 +1753,7 @@ "path" : "abatementRange", "type" : "Property", "source" : { - "name" : "c", + "name" : "Condition", "type" : "OperandRef" } } ] @@ -1768,7 +1764,7 @@ "path" : "abatementString", "type" : "Property", "source" : { - "name" : "c", + "name" : "Condition", "type" : "OperandRef" } } @@ -1781,7 +1777,7 @@ "path" : "abatementBoolean", "type" : "Property", "source" : { - "name" : "c", + "name" : "Condition", "type" : "OperandRef" } } @@ -1790,7 +1786,7 @@ } ] }, "operand" : [ { - "name" : "c", + "name" : "Condition", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}Condition", "type" : "NamedTypeSpecifier" @@ -2003,7 +1999,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "C", + "alias" : "Condition", "expression" : { "name" : "ConditionsAssociatedWithChronicPain", "type" : "ExpressionRef" @@ -2020,7 +2016,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "C", + "scope" : "Condition", "type" : "Property" } ] } @@ -2031,7 +2027,7 @@ "type" : "Property", "source" : { "path" : "clinicalStatus", - "scope" : "C", + "scope" : "Condition", "type" : "Property" } } @@ -2041,7 +2037,7 @@ "name" : "Onset", "type" : "FunctionRef", "operand" : [ { - "name" : "C", + "name" : "Condition", "type" : "AliasRef" } ] } @@ -2052,7 +2048,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "dateRecorded", - "scope" : "C", + "scope" : "Condition", "type" : "Property" } ] } @@ -2332,28 +2328,16 @@ "libraryName" : "C3F", "type" : "FunctionRef", "operand" : [ { - "type" : "Union", + "name" : "ActiveOrRecurring", + "libraryName" : "C3F", + "type" : "FunctionRef", "operand" : [ { - "name" : "ActiveOrRecurring", - "libraryName" : "C3F", - "type" : "FunctionRef", - "operand" : [ { - "dataType" : "{http://hl7.org/fhir}Condition", - "codeProperty" : "code", - "codeComparator" : "in", - "type" : "Retrieve", - "codes" : { - "name" : "Pregnancy", - "type" : "ValueSetRef" - } - } ] - }, { "dataType" : "{http://hl7.org/fhir}Condition", "codeProperty" : "code", "codeComparator" : "in", "type" : "Retrieve", "codes" : { - "name" : "Pregnancy (New ICD10 codes published in 2018 and 2019)", + "name" : "CDS Pregnancy", "type" : "ValueSetRef" } } ] @@ -2508,7 +2492,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "E", + "alias" : "Encounter", "expression" : { "dataType" : "{http://hl7.org/fhir}Encounter", "type" : "Retrieve" @@ -2520,10 +2504,10 @@ "operand" : { "type" : "Query", "source" : [ { - "alias" : "R", + "alias" : "Reason", "expression" : { "path" : "reason", - "scope" : "E", + "scope" : "Encounter", "type" : "Property" } } ], @@ -2551,11 +2535,11 @@ "operand" : [ { "type" : "InValueSet", "code" : { - "name" : "NullSafeToConcept", - "libraryName" : "C3F", + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -2566,11 +2550,11 @@ }, { "type" : "InValueSet", "code" : { - "name" : "NullSafeToConcept", - "libraryName" : "C3F", + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -2582,11 +2566,11 @@ }, { "type" : "InValueSet", "code" : { - "name" : "NullSafeToConcept", - "libraryName" : "C3F", + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -2598,11 +2582,11 @@ }, { "type" : "InValueSet", "code" : { - "name" : "NullSafeToConcept", - "libraryName" : "C3F", + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -2614,11 +2598,11 @@ }, { "type" : "InValueSet", "code" : { - "name" : "NullSafeToConcept", - "libraryName" : "C3F", + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -2630,11 +2614,11 @@ }, { "type" : "InValueSet", "code" : { - "name" : "NullSafeToConcept", - "libraryName" : "C3F", + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -2646,11 +2630,11 @@ }, { "type" : "InValueSet", "code" : { - "name" : "NullSafeToConcept", - "libraryName" : "C3F", + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -2662,11 +2646,11 @@ }, { "type" : "InValueSet", "code" : { - "name" : "NullSafeToConcept", - "libraryName" : "C3F", + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -2678,11 +2662,11 @@ }, { "type" : "InValueSet", "code" : { - "name" : "NullSafeToConcept", - "libraryName" : "C3F", + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -2694,11 +2678,11 @@ }, { "type" : "InValueSet", "code" : { - "name" : "NullSafeToConcept", - "libraryName" : "C3F", + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -2710,11 +2694,11 @@ }, { "type" : "InValueSet", "code" : { - "name" : "NullSafeToConcept", - "libraryName" : "C3F", + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -2734,7 +2718,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "C", + "alias" : "Condition", "expression" : { "name" : "ConditionRiskFactorsForOpioidRelatedHarms", "type" : "ExpressionRef" @@ -2751,7 +2735,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "C", + "scope" : "Condition", "type" : "Property" } ] } @@ -2762,7 +2746,7 @@ "type" : "Property", "source" : { "path" : "clinicalStatus", - "scope" : "C", + "scope" : "Condition", "type" : "Property" } } @@ -2772,7 +2756,7 @@ "name" : "Onset", "type" : "FunctionRef", "operand" : [ { - "name" : "C", + "name" : "Condition", "type" : "AliasRef" } ] } @@ -2783,7 +2767,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "dateRecorded", - "scope" : "C", + "scope" : "Condition", "type" : "Property" } ] } @@ -2793,7 +2777,7 @@ "name" : "Abatement", "type" : "FunctionRef", "operand" : [ { - "name" : "C", + "name" : "Condition", "type" : "AliasRef" } ] } @@ -2867,12 +2851,12 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "R", + "alias" : "Reason", "expression" : { "path" : "reason", "type" : "Property", "source" : { - "name" : "enc", + "name" : "Encounter", "type" : "OperandRef" } } @@ -2901,11 +2885,11 @@ "operand" : [ { "type" : "InValueSet", "code" : { - "name" : "NullSafeToConcept", - "libraryName" : "C3F", + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -2916,11 +2900,11 @@ }, { "type" : "InValueSet", "code" : { - "name" : "NullSafeToConcept", - "libraryName" : "C3F", + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -2932,11 +2916,11 @@ }, { "type" : "InValueSet", "code" : { - "name" : "NullSafeToConcept", - "libraryName" : "C3F", + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -2948,11 +2932,11 @@ }, { "type" : "InValueSet", "code" : { - "name" : "NullSafeToConcept", - "libraryName" : "C3F", + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -2964,11 +2948,11 @@ }, { "type" : "InValueSet", "code" : { - "name" : "NullSafeToConcept", - "libraryName" : "C3F", + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -2980,11 +2964,11 @@ }, { "type" : "InValueSet", "code" : { - "name" : "NullSafeToConcept", - "libraryName" : "C3F", + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -2996,11 +2980,11 @@ }, { "type" : "InValueSet", "code" : { - "name" : "NullSafeToConcept", - "libraryName" : "C3F", + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -3012,11 +2996,11 @@ }, { "type" : "InValueSet", "code" : { - "name" : "NullSafeToConcept", - "libraryName" : "C3F", + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -3028,11 +3012,11 @@ }, { "type" : "InValueSet", "code" : { - "name" : "NullSafeToConcept", - "libraryName" : "C3F", + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -3044,11 +3028,11 @@ }, { "type" : "InValueSet", "code" : { - "name" : "NullSafeToConcept", - "libraryName" : "C3F", + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -3060,11 +3044,11 @@ }, { "type" : "InValueSet", "code" : { - "name" : "NullSafeToConcept", - "libraryName" : "C3F", + "name" : "ToConcept", + "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -3083,7 +3067,7 @@ "name" : "ConceptText", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] } @@ -3148,7 +3132,7 @@ "path" : "period", "type" : "Property", "source" : { - "name" : "enc", + "name" : "Encounter", "type" : "OperandRef" } } ] @@ -3158,7 +3142,7 @@ } }, "operand" : [ { - "name" : "enc", + "name" : "Encounter", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}Encounter", "type" : "NamedTypeSpecifier" @@ -3171,13 +3155,13 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "D", + "alias" : "Reason", "expression" : { "type" : "Flatten", "operand" : { "type" : "Query", "source" : [ { - "alias" : "E", + "alias" : "Encounter", "expression" : { "name" : "EncounterRiskFactorsForOpioidRelatedHarms", "type" : "ExpressionRef" @@ -3189,7 +3173,7 @@ "name" : "GetEncounterDiagnosesRiskFactorsForOpioidRelatedHarms", "type" : "FunctionRef", "operand" : [ { - "name" : "E", + "name" : "Encounter", "type" : "AliasRef" } ] } @@ -3584,7 +3568,7 @@ "then" : { "type" : "Query", "source" : [ { - "alias" : "C", + "alias" : "Condition", "expression" : { "type" : "Union", "operand" : [ { @@ -3610,7 +3594,7 @@ "else" : { "type" : "Query", "source" : [ { - "alias" : "C", + "alias" : "Condition", "expression" : { "type" : "Union", "operand" : [ { @@ -3747,7 +3731,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "A", + "alias" : "Assessment", "expression" : { "name" : "NumericPainIntensityAssessments", "type" : "ExpressionRef" @@ -3764,7 +3748,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "A", + "scope" : "Assessment", "type" : "Property" } ] } @@ -3775,7 +3759,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "valueQuantity", - "scope" : "A", + "scope" : "Assessment", "type" : "Property" } ] } @@ -3788,7 +3772,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "interpretation", - "scope" : "A", + "scope" : "Assessment", "type" : "Property" } ] }, { @@ -3796,7 +3780,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "valueCodeableConcept", - "scope" : "A", + "scope" : "Assessment", "type" : "Property" } ] } ] @@ -3807,7 +3791,7 @@ "name" : "ObservationDate", "type" : "FunctionRef", "operand" : [ { - "name" : "A", + "name" : "Assessment", "type" : "AliasRef" } ] } @@ -3877,7 +3861,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "A", + "alias" : "Assessment", "expression" : { "name" : "PainEnjoymentGeneralActivityAssessments", "type" : "ExpressionRef" @@ -3888,10 +3872,10 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "C", + "alias" : "Component", "expression" : { "path" : "component", - "scope" : "A", + "scope" : "Assessment", "type" : "Property" } } ], @@ -3906,7 +3890,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "C", + "scope" : "Component", "type" : "Property" } ] }, { @@ -3921,7 +3905,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "C", + "scope" : "Component", "type" : "Property" } ] }, { @@ -3936,10 +3920,10 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "C", + "alias" : "Component", "expression" : { "path" : "component", - "scope" : "A", + "scope" : "Assessment", "type" : "Property" } } ], @@ -3954,7 +3938,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "C", + "scope" : "Component", "type" : "Property" } ] }, { @@ -3969,7 +3953,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "C", + "scope" : "Component", "type" : "Property" } ] }, { @@ -3984,10 +3968,10 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "C", + "alias" : "Component", "expression" : { "path" : "component", - "scope" : "A", + "scope" : "Assessment", "type" : "Property" } } ], @@ -4002,7 +3986,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "C", + "scope" : "Component", "type" : "Property" } ] }, { @@ -4017,7 +4001,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "C", + "scope" : "Component", "type" : "Property" } ] }, { @@ -4044,7 +4028,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "A", + "scope" : "Assessment", "type" : "Property" } ] } @@ -4055,7 +4039,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "valueQuantity", - "scope" : "A", + "scope" : "Assessment", "type" : "Property" } ] } @@ -4068,7 +4052,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "interpretation", - "scope" : "A", + "scope" : "Assessment", "type" : "Property" } ] }, { @@ -4076,7 +4060,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "valueCodeableConcept", - "scope" : "A", + "scope" : "Assessment", "type" : "Property" } ] } ] @@ -4086,7 +4070,7 @@ "value" : { "type" : "Query", "source" : [ { - "alias" : "C", + "alias" : "Component", "expression" : { "type" : "List", "element" : [ { @@ -4116,7 +4100,7 @@ "operand" : { "type" : "IsNull", "operand" : { - "name" : "C", + "name" : "Component", "type" : "AliasRef" } } @@ -4131,7 +4115,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "C", + "scope" : "Component", "type" : "Property" } ] } @@ -4142,7 +4126,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "valueQuantity", - "scope" : "C", + "scope" : "Component", "type" : "Property" } ] } @@ -4156,7 +4140,7 @@ "name" : "ObservationDate", "type" : "FunctionRef", "operand" : [ { - "name" : "A", + "name" : "Assessment", "type" : "AliasRef" } ] } @@ -4226,7 +4210,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "A", + "alias" : "Assessment", "expression" : { "name" : "STarTBackAssessments", "type" : "ExpressionRef" @@ -4243,7 +4227,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "A", + "scope" : "Assessment", "type" : "Property" } ] } @@ -4254,7 +4238,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "valueQuantity", - "scope" : "A", + "scope" : "Assessment", "type" : "Property" } ] } @@ -4267,7 +4251,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "interpretation", - "scope" : "A", + "scope" : "Assessment", "type" : "Property" } ] }, { @@ -4275,7 +4259,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "valueCodeableConcept", - "scope" : "A", + "scope" : "Assessment", "type" : "Property" } ] } ] @@ -4286,7 +4270,7 @@ "name" : "ObservationDate", "type" : "FunctionRef", "operand" : [ { - "name" : "A", + "name" : "Assessment", "type" : "AliasRef" } ] } @@ -4364,7 +4348,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "O", + "alias" : "Order", "expression" : { "name" : "OpioidMedicationOrders", "type" : "ExpressionRef" @@ -4388,7 +4372,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "medicationCodeableConcept", - "scope" : "O", + "scope" : "Order", "type" : "Property" } ] } @@ -4399,7 +4383,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "dateWritten", - "scope" : "O", + "scope" : "Order", "type" : "Property" } ] } @@ -4410,7 +4394,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "dateEnded", - "scope" : "O", + "scope" : "Order", "type" : "Property" } ] } @@ -4421,7 +4405,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "O", + "scope" : "Order", "type" : "Property" } } @@ -4447,7 +4431,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "S", + "alias" : "Statement", "expression" : { "name" : "OpioidMedicationStatements", "type" : "ExpressionRef" @@ -4471,7 +4455,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "medicationCodeableConcept", - "scope" : "S", + "scope" : "Statement", "type" : "Property" } ] } @@ -4481,7 +4465,7 @@ "name" : "MedicationStatementDate", "type" : "FunctionRef", "operand" : [ { - "name" : "S", + "name" : "Statement", "type" : "AliasRef" } ] } @@ -4495,7 +4479,7 @@ "type" : "Property", "source" : { "path" : "effectivePeriod", - "scope" : "S", + "scope" : "Statement", "type" : "Property" } } ] @@ -4507,7 +4491,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "S", + "scope" : "Statement", "type" : "Property" } } @@ -4533,7 +4517,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "M", + "alias" : "Medication", "expression" : { "type" : "Union", "operand" : [ { @@ -4621,7 +4605,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "O", + "alias" : "Order", "expression" : { "name" : "NonOpioidMedicationOrders", "type" : "ExpressionRef" @@ -4645,7 +4629,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "medicationCodeableConcept", - "scope" : "O", + "scope" : "Order", "type" : "Property" } ] } @@ -4656,7 +4640,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "dateWritten", - "scope" : "O", + "scope" : "Order", "type" : "Property" } ] } @@ -4667,7 +4651,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "dateEnded", - "scope" : "O", + "scope" : "Order", "type" : "Property" } ] } @@ -4678,7 +4662,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "O", + "scope" : "Order", "type" : "Property" } } @@ -4704,7 +4688,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "S", + "alias" : "Statement", "expression" : { "name" : "NonOpioidMedicationStatements", "type" : "ExpressionRef" @@ -4728,7 +4712,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "medicationCodeableConcept", - "scope" : "S", + "scope" : "Statement", "type" : "Property" } ] } @@ -4738,7 +4722,7 @@ "name" : "MedicationStatementDate", "type" : "FunctionRef", "operand" : [ { - "name" : "S", + "name" : "Statement", "type" : "AliasRef" } ] } @@ -4752,7 +4736,7 @@ "type" : "Property", "source" : { "path" : "effectivePeriod", - "scope" : "S", + "scope" : "Statement", "type" : "Property" } } ] @@ -4764,7 +4748,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "S", + "scope" : "Statement", "type" : "Property" } } @@ -4790,7 +4774,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "M", + "alias" : "Medication", "expression" : { "type" : "Union", "operand" : [ { @@ -4850,7 +4834,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "P", + "alias" : "Procedure", "expression" : { "name" : "NonPharmacologicTreatmentProcedures", "type" : "ExpressionRef" @@ -4874,7 +4858,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "P", + "scope" : "Procedure", "type" : "Property" } ] } @@ -4887,7 +4871,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "performedDateTime", - "scope" : "P", + "scope" : "Procedure", "type" : "Property" } ] }, { @@ -4898,7 +4882,7 @@ "type" : "Property", "source" : { "path" : "performedPeriod", - "scope" : "P", + "scope" : "Procedure", "type" : "Property" } } ] @@ -4950,7 +4934,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "P", + "alias" : "Request", "expression" : { "name" : "NonPharmacologicTreatmentProcedureRequests", "type" : "ExpressionRef" @@ -4974,7 +4958,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "P", + "scope" : "Request", "type" : "Property" } ] } @@ -4985,7 +4969,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "orderedOn", - "scope" : "P", + "scope" : "Request", "type" : "Property" } ] } @@ -5015,7 +4999,7 @@ "operand" : [ { "type" : "Query", "source" : [ { - "alias" : "R", + "alias" : "Referral", "expression" : { "dataType" : "{http://hl7.org/fhir}ReferralRequest", "type" : "Retrieve" @@ -5027,10 +5011,10 @@ "operand" : { "type" : "Query", "source" : [ { - "alias" : "SR", + "alias" : "Service", "expression" : { "path" : "serviceRequested", - "scope" : "R", + "scope" : "Referral", "type" : "Property" } } ], @@ -5042,7 +5026,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "SR", + "name" : "Service", "type" : "AliasRef" } ] }, @@ -5067,7 +5051,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "P", + "alias" : "Referral", "expression" : { "name" : "NonPharmacologicTreatmentReferralRequests", "type" : "ExpressionRef" @@ -5091,10 +5075,10 @@ "operand" : [ { "type" : "Query", "source" : [ { - "alias" : "SR", + "alias" : "Service", "expression" : { "path" : "serviceRequested", - "scope" : "P", + "scope" : "Referral", "type" : "Property" } } ], @@ -5104,7 +5088,7 @@ "name" : "ConceptText", "type" : "FunctionRef", "operand" : [ { - "name" : "SR", + "name" : "Service", "type" : "AliasRef" } ] } @@ -5118,7 +5102,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "dateSent", - "scope" : "P", + "scope" : "Referral", "type" : "Property" } ] } @@ -5140,7 +5124,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "M", + "alias" : "TreatmentOrRequest", "expression" : { "type" : "Union", "operand" : [ { @@ -5230,7 +5214,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "O", + "alias" : "Order", "expression" : { "name" : "StoolSoftenersAndLaxativesOrders", "type" : "ExpressionRef" @@ -5254,7 +5238,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "medicationCodeableConcept", - "scope" : "O", + "scope" : "Order", "type" : "Property" } ] } @@ -5265,7 +5249,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "dateWritten", - "scope" : "O", + "scope" : "Order", "type" : "Property" } ] } @@ -5276,7 +5260,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "dateEnded", - "scope" : "O", + "scope" : "Order", "type" : "Property" } ] } @@ -5287,7 +5271,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "O", + "scope" : "Order", "type" : "Property" } } @@ -5313,7 +5297,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "S", + "alias" : "Statement", "expression" : { "name" : "StoolSoftenersAndLaxativesStatements", "type" : "ExpressionRef" @@ -5337,7 +5321,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "medicationCodeableConcept", - "scope" : "S", + "scope" : "Statement", "type" : "Property" } ] } @@ -5347,7 +5331,7 @@ "name" : "MedicationStatementDate", "type" : "FunctionRef", "operand" : [ { - "name" : "S", + "name" : "Statement", "type" : "AliasRef" } ] } @@ -5361,7 +5345,7 @@ "type" : "Property", "source" : { "path" : "effectivePeriod", - "scope" : "S", + "scope" : "Statement", "type" : "Property" } } ] @@ -5373,7 +5357,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "S", + "scope" : "Statement", "type" : "Property" } } @@ -5399,7 +5383,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "M", + "alias" : "Laxative", "expression" : { "type" : "Union", "operand" : [ { @@ -5505,7 +5489,7 @@ "else" : { "type" : "Query", "source" : [ { - "alias" : "M", + "alias" : "MME", "expression" : { "name" : "MostRecentMME", "type" : "ExpressionRef" @@ -5522,7 +5506,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "M", + "scope" : "MME", "type" : "Property" } ] } @@ -5533,7 +5517,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "valueQuantity", - "scope" : "M", + "scope" : "MME", "type" : "Property" } ] } @@ -5543,7 +5527,7 @@ "name" : "ObservationDate", "type" : "FunctionRef", "operand" : [ { - "name" : "M", + "name" : "MME", "type" : "AliasRef" } ] } @@ -5587,7 +5571,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "S", + "alias" : "Screening", "expression" : { "name" : "UrineDrugScreens", "type" : "ExpressionRef" @@ -5604,7 +5588,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "S", + "scope" : "Screening", "type" : "Property" } ] } @@ -5617,7 +5601,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "valueQuantity", - "scope" : "S", + "scope" : "Screening", "type" : "Property" } ] }, { @@ -5625,7 +5609,7 @@ "type" : "Property", "source" : { "path" : "valueString", - "scope" : "S", + "scope" : "Screening", "type" : "Property" } }, { @@ -5633,7 +5617,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "valueCodeableConcept", - "scope" : "S", + "scope" : "Screening", "type" : "Property" } ] } ] @@ -5641,18 +5625,12 @@ }, { "name" : "Interpretation", "value" : { - "type" : "Coalesce", + "name" : "ConceptText", + "type" : "FunctionRef", "operand" : [ { - "type" : "ToList", - "operand" : { - "name" : "ConceptText", - "type" : "FunctionRef", - "operand" : [ { - "path" : "interpretation", - "scope" : "S", - "type" : "Property" - } ] - } + "path" : "interpretation", + "scope" : "Screening", + "type" : "Property" } ] } }, { @@ -5661,7 +5639,7 @@ "name" : "ObservationDate", "type" : "FunctionRef", "operand" : [ { - "name" : "S", + "name" : "Screening", "type" : "AliasRef" } ] } @@ -5739,7 +5717,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "O", + "alias" : "Order", "expression" : { "name" : "BenzodiazepineMedicationOrders", "type" : "ExpressionRef" @@ -5763,7 +5741,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "medicationCodeableConcept", - "scope" : "O", + "scope" : "Order", "type" : "Property" } ] } @@ -5774,7 +5752,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "dateWritten", - "scope" : "O", + "scope" : "Order", "type" : "Property" } ] } @@ -5785,7 +5763,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "dateEnded", - "scope" : "O", + "scope" : "Order", "type" : "Property" } ] } @@ -5796,7 +5774,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "O", + "scope" : "Order", "type" : "Property" } } @@ -5822,7 +5800,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "S", + "alias" : "Statement", "expression" : { "name" : "BenzodiazepineMedicationStatements", "type" : "ExpressionRef" @@ -5846,7 +5824,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "medicationCodeableConcept", - "scope" : "S", + "scope" : "Statement", "type" : "Property" } ] } @@ -5856,7 +5834,7 @@ "name" : "MedicationStatementDate", "type" : "FunctionRef", "operand" : [ { - "name" : "S", + "name" : "Statement", "type" : "AliasRef" } ] } @@ -5870,7 +5848,7 @@ "type" : "Property", "source" : { "path" : "effectivePeriod", - "scope" : "S", + "scope" : "Statement", "type" : "Property" } } ] @@ -5882,7 +5860,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "S", + "scope" : "Statement", "type" : "Property" } } @@ -5908,7 +5886,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "M", + "alias" : "Medication", "expression" : { "type" : "Union", "operand" : [ { @@ -5978,7 +5956,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "O", + "alias" : "Order", "expression" : { "name" : "NaloxoneMedicationOrders", "type" : "ExpressionRef" @@ -6002,7 +5980,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "medicationCodeableConcept", - "scope" : "O", + "scope" : "Order", "type" : "Property" } ] } @@ -6013,7 +5991,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "dateWritten", - "scope" : "O", + "scope" : "Order", "type" : "Property" } ] } @@ -6024,7 +6002,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "dateEnded", - "scope" : "O", + "scope" : "Order", "type" : "Property" } ] } @@ -6035,7 +6013,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "O", + "scope" : "Order", "type" : "Property" } } @@ -6061,7 +6039,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "S", + "alias" : "Statement", "expression" : { "name" : "NaloxoneMedicationStatements", "type" : "ExpressionRef" @@ -6085,7 +6063,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "medicationCodeableConcept", - "scope" : "S", + "scope" : "Statement", "type" : "Property" } ] } @@ -6095,7 +6073,7 @@ "name" : "MedicationStatementDate", "type" : "FunctionRef", "operand" : [ { - "name" : "S", + "name" : "Statement", "type" : "AliasRef" } ] } @@ -6109,7 +6087,7 @@ "type" : "Property", "source" : { "path" : "effectivePeriod", - "scope" : "S", + "scope" : "Statement", "type" : "Property" } } ] @@ -6121,7 +6099,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "S", + "scope" : "Statement", "type" : "Property" } } @@ -6147,7 +6125,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "M", + "alias" : "Medication", "expression" : { "type" : "Union", "operand" : [ { @@ -6239,7 +6217,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "S", + "alias" : "Screening", "expression" : { "name" : "RiskScreeningsRelevantToPainManagement", "type" : "ExpressionRef" @@ -6256,7 +6234,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "S", + "scope" : "Screening", "type" : "Property" } ] } @@ -6269,7 +6247,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "valueQuantity", - "scope" : "S", + "scope" : "Screening", "type" : "Property" } ] }, { @@ -6277,7 +6255,7 @@ "type" : "Property", "source" : { "path" : "valueString", - "scope" : "S", + "scope" : "Screening", "type" : "Property" } } ] @@ -6291,7 +6269,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "interpretation", - "scope" : "S", + "scope" : "Screening", "type" : "Property" } ] }, { @@ -6299,7 +6277,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "valueCodeableConcept", - "scope" : "S", + "scope" : "Screening", "type" : "Property" } ] } ] @@ -6310,7 +6288,7 @@ "name" : "ObservationDate", "type" : "FunctionRef", "operand" : [ { - "name" : "S", + "name" : "Screening", "type" : "AliasRef" } ] } @@ -6346,7 +6324,7 @@ "source" : { "type" : "Query", "source" : [ { - "alias" : "G", + "alias" : "Given", "expression" : { "type" : "Flatten", "operand" : { @@ -6394,7 +6372,7 @@ "return" : { "expression" : { "path" : "value", - "scope" : "G", + "scope" : "Given", "type" : "Property" } } @@ -6414,7 +6392,7 @@ "source" : { "type" : "Query", "source" : [ { - "alias" : "F", + "alias" : "Family", "expression" : { "type" : "Flatten", "operand" : { @@ -6462,7 +6440,7 @@ "return" : { "expression" : { "path" : "value", - "scope" : "F", + "scope" : "Family", "type" : "Property" } } diff --git a/src/cql/dstu2/Factors_to_Consider_in_Managing_Chronic_Pain.cql b/src/cql/dstu2/Factors_to_Consider_in_Managing_Chronic_Pain.cql deleted file mode 100644 index 51602b8b5..000000000 --- a/src/cql/dstu2/Factors_to_Consider_in_Managing_Chronic_Pain.cql +++ /dev/null @@ -1,1087 +0,0 @@ -// # Introduction - -// The Pain Management Summary artifact provides relevant information to consider when managing a patient’s pain. -// This CDS logic was informed by the Centers for Disease Control and Prevention (CDC) Guideline for Opioid Prescribing -// for Chronic Pain. The CDS is not a direct representation of any one recommendation statement within the guideline. -// Instead, the CDS compiles clinical concepts mentioned throughout the guideline in one consolidated summary for -// clinician review. -// -// In the process of authoring the logic, certain assumptions were made and details developed when the guideline did -// not provide enough specificity. These decisions were made in the context of the CDS Connect Workgroup and CDC -// stakeholders, and are documented in the logic and/or in the CDS Connect artifact metadata. -// -// Version 1.0.1 updates the CDS Connect Commons library to 1.3.1 to resolve an implicit conversion from FHIR.Date -// to System.DateTime that is no longer allowed by the CQL-to-ELM translator. -// -// Version 1.1.0 contains the following changes from the artifact that was piloted: -// - Added the following value sets for identifying Risk Factors for Opiod-Related Harms (in addition to existing ones) -// - Depression Diagnosis ICD9 (2.16.840.1.113883.3.600.143) -// - Anxiety Disorders ICD9 (2.16.840.1.113883.3.1240.2017.3.2.1015) -// - Substance Abuse (2.16.840.1.113883.3.464.1003.106.11.1010) -// - Pregnancy (New ICD10 codes published in 2018 and 2019)": '2.16.840.1.113762.1.4.1032.80' -// - Changed the Suicide Attempt value set to 2.16.840.1.113762.1.4.1032.102 -// - Removed specific inclusion of SNOMED-CT 86849004 since it is now in the Suicide Attempt value set -// - Added LOINC codes for the Pain intensity, Enjoyment of life, General activity scale [PEG] -// - Previous local codes are still supported (but discouraged) -// - Added logic to normalize long LOINC display text for PEG codes to shorter names -// - Added LOINC code for the STarT Back Screening Tool -// - Previous local code is still supported (but discouraged) -// - Added logic to display range for Opioid Risk Tool (ORT) -// - Updated QuantityText logic to not include '{score}' units (since scalar number is enough in those cases) - -// -// ##Source guideline: [CDC Guideline for Opioid Prescribing for Chronic Pain](https://www.cdc.gov/drugoverdose/prescribing/guideline.html) - -library Factors_to_Consider_in_Managing_Chronic_Pain version '1.1.0' - -// # Data model # - -// The FHIR DSTU2 model is preferred by CDS Connect artifacts due to its current adoption in Health IT products. -using FHIR version '1.0.2' - -// # Referenced libraries # - -// The CDS Connect Commons for FHIRv102 library provides functions representing commonly used CDS logic and patterns. -include CDS_Connect_Commons_for_FHIRv102 version '1.3.1' called C3F -// The FHIRHelpers library provides common functions for simplifying interaction w/ the FHIR v102 data model. -include FHIRHelpers version '1.0.2' called FHIRHelpers - -// # Value sets and codes # - -// ## Code Systems ## - -codesystem "LOINC": 'http://loinc.org' -codesystem "SNOMED-CT": 'http://snomed.info/sct' - -// Several concepts needed by the Pain Management Summary CDS do not yet have standardized codes associated with them. -// The CDS logic authors have registered new Logical Object Identifier Names and Codes (LOINC) codes, but they are -// not yet available. Once available, the CDS will be updated. Until then, CDS implementors will need to map to -// local codes (signified by the LOCAL code system below) or replace them with their own codes. -codesystem "LOCAL": 'http://cds.ahrq.gov/cdsconnect/pms' - -// ## Value sets ## - -// List value sets used by the artifact. The links to the Value Set Authority Center (VSAC) point to the latest -// expansion of each value set available. - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.37/expansion) -valueset "Conditions associated with chronic pain": '2.16.840.1.113762.1.4.1032.37' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.34/expansion) -valueset "Opioid Pain Medications": '2.16.840.1.113762.1.4.1032.34' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.54/expansion) -valueset "Adjuvant Analgesic Medications": '2.16.840.1.113762.1.4.1032.54' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.105.12.1007/expansion) -valueset "Major Depression": '2.16.840.1.113883.3.464.1003.105.12.1007' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.143/expansion) -valueset "Depression Diagnosis ICD9": '2.16.840.1.113883.3.600.143' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.52/expansion) -valueset "Anxiety": '2.16.840.1.113762.1.4.1032.52' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.1240.2017.3.2.1015/expansion) -valueset "Anxiety Disorders ICD9": '2.16.840.1.113883.3.1240.2017.3.2.1015' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.106.12.1004/expansion) -valueset "Substance use disorder": '2.16.840.1.113883.3.464.1003.106.12.1004' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.106.11.1010/expansion) -valueset "Substance Abuse": '2.16.840.1.113883.3.464.1003.106.11.1010' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.102/expansion) -valueset "Suicide Attempt": '2.16.840.1.113762.1.4.1032.102' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.53/expansion) -valueset "Sleep-disordered breathing": '2.16.840.1.113762.1.4.1032.53' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.109.12.1028/expansion) -valueset "Kidney Failure": '2.16.840.1.113883.3.464.1003.109.12.1028' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.199.12.1035/expansion) -valueset "Chronic Liver Disease": '2.16.840.1.113883.3.464.1003.199.12.1035' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1047.42/expansion) -valueset "Liver Disease": '2.16.840.1.113762.1.4.1047.42' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.378/expansion) -valueset "Pregnancy": '2.16.840.1.113883.3.526.3.378' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.80/expansion) -valueset "Pregnancy (New ICD10 codes published in 2018 and 2019)": '2.16.840.1.113762.1.4.1032.80' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.26/expansion) -valueset "Non opiod pain medications": '2.16.840.1.113762.1.4.1032.26' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.36/expansion) -valueset "Non pharmacologic treatments for chronic pain": '2.16.840.1.113762.1.4.1032.36' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.55/expansion) -valueset "Risk assessments relevant to pain management": '2.16.840.1.113762.1.4.1032.55' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.43/expansion) -valueset "Benzodiazepine medications": '2.16.840.1.113762.1.4.1032.43' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.42/expansion) -valueset "Naloxone medications": '2.16.840.1.113762.1.4.1032.42' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.28/expansion) -valueset "Urine drug screen for pain management": '2.16.840.1.113762.1.4.1032.28' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.44/expansion) -valueset "Stool softeners and laxatives": '2.16.840.1.113762.1.4.1032.44' - -// ## Individual codes ## - -// list individual codes from code systems used directly in the CQL logic. Individual codes are used when there is -// a single code from a particular vocabulary standard used to represent a clinical concept. It is considered -// best-practice not to create value sets containing a single code. - -code "Pregnancy status code": '82810-3' from "LOINC" display 'Pregnancy status' -code "Pregnant code": '77386006' from "SNOMED-CT" display 'Patient currently pregnant (finding)' -code "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported] code": - '55758-7' from "LOINC" display 'Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]' -code "Patient Health Questionnaire 9 item (PHQ-9) total score [Reported] code": - '44261-6' from "LOINC" display 'Patient Health Questionnaire 9 item (PHQ-9) total score [Reported]' -code "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ] code": - '70274-6' from "LOINC" display 'Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]' -code "Total score [AUDIT] code": '75624-7' from "LOINC" display 'Total score [AUDIT]' -code "Total score [AUDIT-C] code": '75626-2' from "LOINC" display 'Total score [AUDIT-C]' -code "Total score [DAST-10] code": '82667-7' from "LOINC" display 'Total score [DAST-10]' -code "Total score ORT code": '91392-1' from "LOINC" display 'Total score ORT' -code "Pain severity Wong-Baker FACES Scale code": '38221-8' from "LOINC" display 'Pain severity Wong-Baker FACES Scale' - -// The Pain intensity, Enjoyment of life, General activity scale [PEG] now has standardized LOINC codes available. -// These LOINC codes were not available when the initial version of the Pain Management Summary was developed. -// New systems implementing the Pain Management Summary should use the standardized codes, but the legacy local codes -// are also retained in order to allow existing systems to continue to function. Existing systems, however, are -// strongly encouraged to adopt the standardized LOINC codes. - -code "Mean score [PEG] code": '91147-9' from "LOINC" display 'Mean score [PEG]' -code "Pain severity in the past week - 0-10 numeric rating [Reported] code": - '75893-8' from "LOINC" display 'Pain severity in the past week - 0-10 numeric rating [Reported]' -code "What number best describes how pain has interfered with your enjoyment of life during the past week code": - '91145-3' from "LOINC" display 'What number best describes how pain has interfered with your enjoyment of life during the past week' -code "What number best describes how pain has interfered with your general activity during the past week code": - '91146-1' from "LOINC" display 'What number best describes how pain has interfered with your general activity during the past week' - -// Legacy local codes for the Pain intensity, Enjoyment of life, General activity scale [PEG]. -// New systems should use the LOINC codes above instead. - -code "Pain Enjoyment General Activity (PEG) Assessment LEGACY code": - 'PEGASSESSMENT' from "LOCAL" display 'Pain Enjoyment General Activity (PEG) Assessment' -code "Pain LEGACY code": 'PEGPAIN' from "LOCAL" display 'Pain' -code "Enjoyment of life LEGACY code": 'PEGENJOYMENT' from "LOCAL" display 'Enjoyment of life' -code "General activity LEGACY code": 'PEGGENERALACTIVITY' from "LOCAL" display 'General activity' - -// The STarT Back Screening Tool now has a standardized LOINC code available. This LOINC code was not available -// when the initial version of the Pain Management Summary was developed. New systems implementing the Pain Management -// Summary should use the standardized code, but the legacy local code is also retained in order to allow existing -// systems to continue to function. Existing systems, however, are strongly encouraged to adopt the standardized LOINC -// code. - -code "Total score [STarT Back] code": '91351-7' from "LOINC" display 'Total score [STarT Back]' - -// Legacy local code for the STarT Back Screening Tool. New systems should use the LOINC codes above instead. - -code "STarT Back Screening Tool LEGACY code": 'STARTBACK' from "LOCAL" display 'STarT Back Screening Tool' - -// The following codes do not yet have standardized codes associated with them so are expressed as LOCAL codes. -// As standardized codes become available, this CDS will be updated to use standard codes rather than LOCAL codes. - -code "Single question r/t ETOH use code": 'SQETOHUSE' from "LOCAL" display 'Single question r/t ETOH use' -code "Single question r/t drug use code": 'SQDRUGUSE' from "LOCAL" display 'Single question r/t drug use' -code "Morphine Milligram Equivalent (MME) code": 'MME' from "LOCAL" display 'Morphine Milligram Equivalent (MME)' - -// CQL currently requires concept declarations to contain references to code declarations. - -concept "Pregnancy status": { "Pregnancy status code" } display 'Pregnancy status' -concept "Pregnant": { "Pregnant code" } display 'Patient currently pregnant (finding)' -concept "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]": - { "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported] code" } - display 'Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]' -concept "Patient Health Questionnaire 9 item (PHQ-9) total score [Reported]": - { "Patient Health Questionnaire 9 item (PHQ-9) total score [Reported] code" } - display 'Patient Health Questionnaire 9 item (PHQ-9) total score [Reported]' -concept "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]": - { "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ] code" } - display 'Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]' -concept "Total score [AUDIT]": { "Total score [AUDIT] code" } display 'Total score [AUDIT]' -concept "Total score [AUDIT-C]": { "Total score [AUDIT-C] code" } display 'Total score [AUDIT-C]' -concept "Total score [DAST-10]": { "Total score [DAST-10] code" } display 'Total score [DAST-10]' -concept "Total score ORT": { "Total score ORT code" } display 'Total score ORT' -concept "Pain severity Wong-Baker FACES Scale": - { "Pain severity Wong-Baker FACES Scale code" } display 'Pain severity Wong-Baker FACES Scale' -concept "Pain severity in the past week - 0-10 numeric rating [Reported]": - { "Pain severity in the past week - 0-10 numeric rating [Reported] code" } - display 'Pain severity in the past week - 0-10 numeric rating [Reported]' -concept "What number best describes how pain has interfered with your enjoyment of life during the past week": - { "What number best describes how pain has interfered with your enjoyment of life during the past week code" } - display 'What number best describes how pain has interfered with your enjoyment of life during the past week' -concept "What number best describes how pain has interfered with your general activity during the past week": - { "What number best describes how pain has interfered with your general activity during the past week code" } - display 'What number best describes how pain has interfered with your general activity during the past week' -concept "Mean score [PEG]": { "Mean score [PEG] code" } display 'Mean score [PEG]' -concept "Pain Enjoyment General Activity (PEG) Assessment LEGACY": - { "Pain Enjoyment General Activity (PEG) Assessment LEGACY code" } display 'Pain Enjoyment General Activity (PEG) Assessment' -concept "Pain LEGACY": { "Pain LEGACY code" } display 'Pain' -concept "Enjoyment of life LEGACY": { "Enjoyment of life LEGACY code" } display 'Enjoyment of life' -concept "General activity LEGACY": { "General activity LEGACY code" } display 'General activity' -concept "Total score [STarT Back]": { "Total score [STarT Back] code" } display 'Total score [STarT Back]' -concept "STarT Back Screening Tool LEGACY": { "STarT Back Screening Tool LEGACY code" } display 'STarT Back Screening Tool' -concept "Single question r/t ETOH use": { "Single question r/t ETOH use code" } display 'Single question r/t ETOH use' -concept "Single question r/t drug use": { "Single question r/t drug use code" } display 'Single question r/t drug use' -concept "Morphine Milligram Equivalent (MME)": - { "Morphine Milligram Equivalent (MME) code" } display 'Morphine Milligram Equivalent (MME)' - -// # Parameters # - -// The InclusionMedicationsLookbackPeriod allows CDS implementors to specify how far the inclusion logic should look -// back for qualifying active medications. By default, the inclusion logic will look back 180 days. -parameter InclusionMedicationsLookbackPeriod default 180 days - -// # CDS logic # - -context Patient - -// ## Re-usable functions ## - -// The summary logic contains many constructs that are needed throughout the logic. Where possible, these constructs -// have been developed as re-usable functions that can be invoked wherever they are needed. - -// Returns the first-found display text for a CodeableConcept, looking first at the `text` attribute, then the -// `display` on each `coding` until it finds a non-null value. Some PEG codes are normalized due to length. -// @param c - a FHIR CodeableConcept to get text from -// @returns {System.String} the display text or null if none is found -define function ConceptText(c FHIR.CodeableConcept): - if c ~ "Mean score [PEG]" or c ~ "Pain Enjoyment General Activity (PEG) Assessment LEGACY" - then 'Mean score [PEG]' - else if c ~ "Pain severity in the past week - 0-10 numeric rating [Reported]" or c ~ "Pain LEGACY" - then 'Pain' - else if c ~ "What number best describes how pain has interfered with your enjoyment of life during the past week" - or c ~ "Enjoyment of life LEGACY" - then 'Enjoyment of life' - else if c ~ "What number best describes how pain has interfered with your general activity during the past week" - or c ~ "General activity LEGACY" - then 'General activity' - else - Coalesce(c.text.value, Coalesce((c.coding) c2 return c2.display.value)) - -// We do not reliably get ranges back from EHR data, but ranges are important to understanding assessment scores in -// the summary. This function adds ranges to the name for known assessments. -// @param c - a FHIR CodeableConcept to get the updated text for -// @returns {System.String} the display text with range information appended -define function ConceptTextWithRange(c FHIR.CodeableConcept): - if c ~ "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]" - then ConceptText(c) + ' [Range: 0-6]' - else if c ~ "Patient Health Questionnaire 9 item (PHQ-9) total score [Reported]" - then ConceptText(c) + ' [Range: 0-27]' - else if c ~ "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]" - then ConceptText(c) + ' [Range: 0-21]' - else if c ~ "Total score [AUDIT]" - then ConceptText(c) + ' [Range: 0-40]' - else if c ~ "Total score [AUDIT-C]" - then ConceptText(c) + ' [Range: 0-12]' - else if c ~ "Total score [DAST-10]" - then ConceptText(c) + ' [Range: 0-10]' - else if c ~ "Total score ORT" - then ConceptText(c) + ' [Range: 0-26]' - else if c ~ "Pain severity Wong-Baker FACES Scale" - then ConceptText(c) + ' [Range: 0-10]' - else if c ~ "Mean score [PEG]" - or c ~ "Pain Enjoyment General Activity (PEG) Assessment LEGACY" - then ConceptText(c) + ' [Range: 0-10]' - else if c ~ "Total score [STarT Back]" - or c ~ "STarT Back Screening Tool LEGACY" - then ConceptText(c) + ' [Range: 0-9]' - else - ConceptText(c) - -// Returns a text representation of a date using the CQL `ToString` function. -// @param d - a FHIR date to get text for -// @returns {System.String} the text representation of the date -define function DateText(d FHIR.date): - ToString(d.value) - -// Returns a text representation of a dateTime using the CQL `ToString` function. -// @param d - a FHIR dateTime to get text for -// @returns {System.String} the text representation of the dateTime -define function DateTimeText(d FHIR.dateTime): - ToString(d.value) - -// Returns a text representation of an instant using the CQL `ToString` function. -// @param i - a FHIR instant to get text for -// @returns {System.String} the text representation of the instant -define function InstantText(i FHIR.instant): - ToString(i.value) - -// Returns a text representation of a Quantity with the Quantity's value and unit. -// If the unit is {score}, then omit it (as it is not useful to display) -// @param q - a FHIR Quantity to get text for -// @returns {System.String} the text representation of the Quantity -define function QuantityText(q FHIR.Quantity): - if (q is null) then null - else if (q.unit is not null and q.unit.value != '{score}') then ToString(q.value.value) + ' ' + q.unit.value - else if (q.code is not null and q.code.value != '{score}') then ToString(q.value.value) + ' ' + q.code.value - else ToString(q.value.value) - -// Returns a tuple containing a Period's start and end as text representations. -// @param p - a FHIR Period to get a tuple for -// @returns {Tuple} the tuple representation of the Period -define function PeriodObject(p FHIR.Period): - if p is null then null - else - { - Start: DateTimeText(p."start"), - End: DateTimeText(p."end") - } - -// Returns a tuple containing a Range's low and high as text representations. -// @param r - a FHIR Range to get a tuple for -// @returns {Tuple} the tuple representation of the Range -define function RangeObject(r FHIR.Range): - if r is null then null - else - { - Low: QuantityText(r.low), - High: QuantityText(r.high) - } - -// Returns a text representation of a date associated with an Observation, preferring `effectiveDateTime`, then -// `effectivePeriod.start`, then `issued`. -// @param o - a FHIR Observation to get the text date from -// @returns {System.String} the text representation of a relevant date from the Observation -define function ObservationDate(o FHIR.Observation): - Coalesce(DateTimeText(o.effectiveDateTime), DateTimeText(o.effectivePeriod.start), InstantText(o.issued)) - -// Returns a text representation of a date associated with a MedicationStatement, preferring `effectiveDateTime`, then -// `effectivePeriod.start`. -// @param m - a FHIR MedicationStatement to get the text date from -// @returns {System.String} the text representation of a relevant date from the MedicationStatement -define function MedicationStatementDate(s FHIR.MedicationStatement): - Coalesce(DateTimeText(s.effectiveDateTime), DateTimeText(s.effectivePeriod."start")) - -// Returns a text representation of a Condition's onset, whether represented as a dateTime, Period, Quantity (Age), -// Range (Age), or string. -// @param c - a FHIR Condition to get the text representation of the onset from -// @returns {System.String} the text representation of the Condition's onset -define function Onset(c FHIR.Condition): - Coalesce( List{ - DateTimeText(c.onsetDateTime), - QuantityText(c.onsetQuantity), - PeriodObject(c.onsetPeriod), - RangeObject(c.onsetRange), - c.onsetString.value - }) - -// Returns a text representation of a Condition's abatement, whether represented as a dateTime, Period, Quantity (Age), -// Range (Age), string, or boolean. -// @param c - a FHIR Condition to get the text representation of the abatement from -// @returns {System.String} the text representation of the Condition's abatement -define function Abatement(c FHIR.Condition): - Coalesce( List{ - DateTimeText(c.abatementDateTime), - QuantityText(c.abatementQuantity), - PeriodObject(c.abatementPeriod), - RangeObject(c.abatementRange), - c.abatementString.value, - ToString(c.abatementBoolean.value) - }) - -// ## Target population ## - -// INCLUSIONS - -// Determines if patient's age, in years, at the time CQL is run, is at least 18 years old -define Is18orOlder: - AgeInYears() >= 18 - -// Conditions associated with chronic pain -define ConditionsAssociatedWithChronicPain: - C3F.Confirmed(C3F.ActiveOrRecurring([Condition: "Conditions associated with chronic pain"])) - -// Determines if the patient has any of the conditions associated with chronic pain -define HasConditionAssociatedWithChronicPain: - exists(ConditionsAssociatedWithChronicPain) - -// Determines if the patient has any record of opioid pain medications in the lookback period -// - Medication Order within past 180 days (lookback can be made a parameter) -// - Medication Statement by patient within past 180 days (lookback can be made a parameter) -define HasRecentOpioidPainMedication: - exists(C3F.ActiveCompletedOrStoppedMedicationOrder(C3F.MedicationOrderLookBack( - [MedicationOrder: "Opioid Pain Medications"], - InclusionMedicationsLookbackPeriod) - )) - or exists(C3F.ActiveOrCompletedMedicationStatement(C3F.MedicationStatementLookBack( - [MedicationStatement: "Opioid Pain Medications"], - InclusionMedicationsLookbackPeriod) - )) - -// Determines if the patient has any record of adjuvant analgesic medications in the lookback period -// - Medication Order within past 180 days (lookback can be made a parameter) -// - Medication Statement by patient within past 180 days (lookback can be made a parameter) -define HasRecentAdjuvantAnalgesicMedication: - exists(C3F.ActiveCompletedOrStoppedMedicationOrder(C3F.MedicationOrderLookBack( - [MedicationOrder: "Adjuvant Analgesic Medications"], - InclusionMedicationsLookbackPeriod) - )) - or exists(C3F.ActiveOrCompletedMedicationStatement(C3F.MedicationStatementLookBack( - [MedicationStatement: "Adjuvant Analgesic Medications"], - InclusionMedicationsLookbackPeriod) - )) - -// Determines if the patient meets the inclusion criteria for the CDS. Inclusion criteria is: -// - Age >=18 years -// - AND -// - OR Conditions associated with chronic pain -// - OR Opioid pain medication -// - OR Adjuvant analgesic medication -define MeetsInclusionCriteria: - Is18orOlder - and ( - HasConditionAssociatedWithChronicPain - or HasRecentOpioidPainMedication - or HasRecentAdjuvantAnalgesicMedication - ) - -// EXCLUSIONS - -// TAKE NOTICE: This CDS is not intended for patients who meet any of the following criteria: -// 1. Younger than 18 years of age -// 2. Undergoing end-of-life care (hospice or palliative) -// 3. Undergoing active cancer treatment -// -// The first exclusion is explicitly accounted for under INCLUSIONS. -// The second and third exclusions cannot be realiably detected for all patients using just EHR data. For that reason -// they are not implemented in this CDS. Care providers should use their judgement when applying this CDS to their -// patients. - -// ## Intervention(s) ## - -// DISPLAY and POPULATE a Pain Management Summary of the following items: - -// PERTINENT MEDICAL HISTORY - -// Conditions associated with chronic pain and their dates of onset - -define ReportConditionsAssociatedWithChronicPain: - (ConditionsAssociatedWithChronicPain) C - return { - Name: ConceptText(C.code), - Status: C.clinicalStatus.value, - Onset: Onset(C), - DateRecorded: DateText(C.dateRecorded) - } - sort by (Onset as String) desc - -// Conditions that are risk factors for opioid-related harms and their dates of onset -// This is a union of nine value sets (w/ different filtering criteria) - -define DepressionConditions: - C3F.Confirmed(C3F.ActiveOrRecurring([Condition: "Major Depression"])) - union C3F.Confirmed(C3F.ActiveOrRecurring([Condition: "Depression Diagnosis ICD9"])) - -define AnxietyConditions: - C3F.Confirmed(C3F.ActiveOrRecurring([Condition: "Anxiety"])) - union C3F.Confirmed(C3F.ActiveOrRecurring([Condition: "Anxiety Disorders ICD9"])) - -define SubstanceUseDisorderConditions: - C3F.Confirmed([Condition: "Substance use disorder"]) - union C3F.Confirmed([Condition: "Substance Abuse"]) - -define SuicideAttemptConditions: - C3F.Confirmed([Condition: "Suicide Attempt"]) - -define SleepDisorderedBreathingConditions: - C3F.Confirmed(C3F.ActiveOrRecurring([Condition: "Sleep-disordered breathing"])) - -define RenalDysfunctionConditions: - C3F.Confirmed(C3F.ActiveOrRecurring([Condition: "Kidney Failure"])) - -define HepaticDysfunctionConditions: - C3F.Confirmed(C3F.ActiveOrRecurring([Condition: "Chronic Liver Disease"])) - union C3F.Confirmed(C3F.ActiveOrRecurring([Condition: "Liver Disease"])) - -define PregnancyConditions: - C3F.Confirmed(C3F.ConditionLookBack(C3F.ActiveOrRecurring( - [Condition: "Pregnancy"]) - union [Condition: "Pregnancy (New ICD10 codes published in 2018 and 2019)"], - 42 weeks - )) - -define PregnancyObservations: - C3F.Verified(C3F.ObservationLookBack([Observation: "Pregnancy status"], 42 weeks)) - -define MostRecentPregnancyObservation: - C3F.MostRecent(PregnancyObservations) - -define MostRecentPregnancyObservationIsPositive: - C3F.ConceptValue(MostRecentPregnancyObservation) ~ "Pregnant" - -define Is65orOlder: - AgeInYears() >= 65 - -define ConditionRiskFactorsForOpioidRelatedHarms: - DepressionConditions - union AnxietyConditions - union SubstanceUseDisorderConditions - union SuicideAttemptConditions - union SleepDisorderedBreathingConditions - union RenalDysfunctionConditions - union HepaticDysfunctionConditions - union PregnancyConditions - -// Encounter diagnoses that are risk factors for opioid-related harms and their dates of onset. Some risk factors may -// not exist on the problem list, and therefore may not be represented as Conditions (depending on EHR implementation). -// For this, the logic also looks at the patient's encounters, trying to find risk factors recorded as encounter -// diagnoses. - -define EncounterRiskFactorsForOpioidRelatedHarms: - [Encounter] E where exists( - E.reason R where - C3F.NullSafeToConcept(R) in "Major Depression" - or C3F.NullSafeToConcept(R) in "Depression Diagnosis ICD9" - or C3F.NullSafeToConcept(R) in "Anxiety" - or C3F.NullSafeToConcept(R) in "Anxiety Disorders ICD9" - or C3F.NullSafeToConcept(R) in "Substance use disorder" - or C3F.NullSafeToConcept(R) in "Substance Abuse" - or C3F.NullSafeToConcept(R) in "Suicide Attempt" - or C3F.NullSafeToConcept(R) in "Sleep-disordered breathing" - or C3F.NullSafeToConcept(R) in "Kidney Failure" - or C3F.NullSafeToConcept(R) in "Chronic Liver Disease" - or C3F.NullSafeToConcept(R) in "Liver Disease" - // Pregnancy not considered in Encounter diagnoses because this is an unrestricted lookback. - ) - -// NOTE: As a convention, if an expression's name starts with "Report", its purpose is to format data for the purpose -// of building the final summary object. - -// Format the risk factors in a uniform way despite the different sources of the data (conditions, encounter diagnoses, -// etc.). Note that conditions do not have a "Visit" date and encounter diagnoses do not have a status, onset date, -// recorded date, or abatement date. - -define ReportConditionRiskFactorsForOpioidRelatedHarms: - (ConditionRiskFactorsForOpioidRelatedHarms) C - return { - Name: ConceptText(C.code), - Status: C.clinicalStatus.value, - Onset: Onset(C), - DateRecorded: DateText(C.dateRecorded), - Abatement: Abatement(C), - Visit: null as Tuple{ Start String, End String } - } - sort by (Onset as String) desc, (Abatement as String) desc - -define function GetEncounterDiagnosesRiskFactorsForOpioidRelatedHarms(enc Encounter): - (enc.reason) R - where C3F.NullSafeToConcept(R) in "Major Depression" - or C3F.NullSafeToConcept(R) in "Depression Diagnosis ICD9" - or C3F.NullSafeToConcept(R) in "Anxiety" - or C3F.NullSafeToConcept(R) in "Anxiety Disorders ICD9" - or C3F.NullSafeToConcept(R) in "Substance use disorder" - or C3F.NullSafeToConcept(R) in "Substance Abuse" - or C3F.NullSafeToConcept(R) in "Suicide Attempt" - or C3F.NullSafeToConcept(R) in "Sleep-disordered breathing" - or C3F.NullSafeToConcept(R) in "Kidney Failure" - or C3F.NullSafeToConcept(R) in "Chronic Liver Disease" - or C3F.NullSafeToConcept(R) in "Liver Disease" - // Pregnancy not considered in Encounter diagnoses because this is an unrestricted lookback. - return { - Name: ConceptText(R), - Status: null as String, - Onset: null as String, - DateRecorded: null as String, - Abatement: null as String, - Visit: PeriodObject(enc.period) - } - -define ReportEncounterRiskFactorsForOpioidRelatedHarms: - (flatten((EncounterRiskFactorsForOpioidRelatedHarms) E - return GetEncounterDiagnosesRiskFactorsForOpioidRelatedHarms(E))) D - sort by Visit.Start desc, Visit.End desc - -// Shape the pregnancy Observation as a Condition, since this is the backup approach for detecting a pregnancy in case -// there are no active Conditions found. -define ReportMostRecentPositivePregnancyObservation: - if MostRecentPregnancyObservationIsPositive then - { - Name: ConceptText(MostRecentPregnancyObservation.code), - Status: ConceptText(MostRecentPregnancyObservation.valueCodeableConcept), - Onset: ToString(Coalesce( - MostRecentPregnancyObservation.effectiveDateTime.value, - MostRecentPregnancyObservation.effectivePeriod.start - )), - DateRecorded: ToString(MostRecentPregnancyObservation.issued), - Abatement: null as String, - Visit: null as Tuple{ Start String, End String } - } - else - null - -// Shape the case of being 65 or older as a Condition for the purposes of building the summary. -define ReportOlderThan65: - if Is65orOlder then - { - Name: '65 years or older', - Status: 'active', - Onset: null as String, - DateRecorded: null as String, - Abatement: null as String, - Visit: null as Tuple{ Start String, End String } - } - else - null - -define ReportRiskFactorsForOpioidRelatedHarms: - // If a pregnancy Condition is present, use that. - if Exists(PregnancyConditions) then - (ReportConditionRiskFactorsForOpioidRelatedHarms - union ReportEncounterRiskFactorsForOpioidRelatedHarms - union ReportOlderThan65) C - // Otherwise, try to find a positive pregnancy status in an Observation. - else - (ReportConditionRiskFactorsForOpioidRelatedHarms - union ReportEncounterRiskFactorsForOpioidRelatedHarms - union ReportOlderThan65 - union ReportMostRecentPositivePregnancyObservation) C - sort by (if Onset is not null then Onset as String else Visit.Start) desc, Visit.End desc, (Abatement as String) desc - -// PAIN ASSESSMENT - -// Numeric pain intensity assessment - scores and dates (lookback 2 years) - -define NumericPainIntensityAssessments: - C3F.Verified(C3F.ObservationLookBack([Observation: "Pain severity Wong-Baker FACES Scale"], 2 years)) - -define ReportNumericPainIntensityAssessments: - (NumericPainIntensityAssessments) A - return { - Name: ConceptTextWithRange(A.code), - Score: QuantityText(A.valueQuantity), - Interpretation: Coalesce( ConceptText(A.interpretation), ConceptText(A.valueCodeableConcept) ), - Date: ObservationDate(A) - } - sort by Date desc - -// Pain Enjoyment General Activity (PEG) Assessment - scores and dates (lookback 2 years) -// Note: this includes listing the response to each of the 3 questions, plus the total score. The Pain Management -// Sumnmary currently supports both the LOINC representations and the legacy local code representations. -// -// 1. Observation w/ LOINC mean score as primary code and mean score as valueQuantity -// * code: LOINC 91147-9 "Mean score [PEG]" -// * valueQuantity: (mean score) -// * component: -// - -// * code: LOINC 75893-8 "What number best describes your pain on average in the past week?" -// * valueQuantity: (pain score) -// - -// * code: LOINC 91145-3 "What number best describes how, during the past week, pain has interfered with your enjoyment of life?" -// * valueQuantity: (enjoyment of life score) -// - -// * code: LOINC 91146-1 "What number best describes how, during the past week, pain has interfered with your general activity?" -// * valueQuantity: (general activity score) -// -// 2. LEGACY: Observation w/ LOCAL code as primary code and mean score as valueQuantity -// * code: LOCAL PEGASSESSMENT "Pain Enjoyment General Activity (PEG) Assessment" -// * valueQuantity: (mean score) -// * component: -// - -// * code: LOCAL PEGPAIN "Pain" -// * valueQuantity: (pain score) -// - -// * code: LOCAL PEGENJOYMENT "Enjoyment of life" -// * valueQuantity: (enjoyment of life score) -// - -// * code: LOCAL PEGGENERALACTIVITY "General activity" -// * valueQuantity: (general activity score) - -define PainEnjoymentGeneralActivityAssessments: - C3F.Verified(C3F.ObservationLookBack( - [Observation: "Mean score [PEG]"] - union [Observation: "Pain Enjoyment General Activity (PEG) Assessment LEGACY"], - 2 years - )) - -define ReportPainEnjoymentGeneralActivityAssessments: - (PainEnjoymentGeneralActivityAssessments) A - let - Pain: (A.component) C - where C.code ~ "Pain severity in the past week - 0-10 numeric rating [Reported]" - or C.code ~ "Pain LEGACY", - Enjoyment: (A.component) C - where C.code ~ "What number best describes how pain has interfered with your enjoyment of life during the past week" - or C.code ~ "Enjoyment of life LEGACY", - GeneralActivity: (A.component) C - where C.code ~ "What number best describes how pain has interfered with your general activity during the past week" - or C.code ~ "General activity LEGACY" - where true // grammar needs a where statement to separate the "let" from the "return" - return { - // NOTE: Hard-code in names because the real LOINC code displays are quite long - Name: ConceptTextWithRange(A.code), - Score: QuantityText(A.valueQuantity), - Interpretation: Coalesce( ConceptText(A.interpretation), ConceptText(A.valueCodeableConcept) ), - Questions: ({ First(Pain), First(Enjoyment), First(GeneralActivity) }) C - where C is not null - return { "Name": ConceptText(C.code), "Score": QuantityText(C.valueQuantity) }, - Date: ObservationDate(A) - } - sort by Date desc - -// STarT Back Screening Tool - Overall score and dates (lookback 2 years) - -define STarTBackAssessments: - C3F.Verified(C3F.ObservationLookBack( - [Observation: "Total score [STarT Back]"] - union [Observation: "STarT Back Screening Tool LEGACY"], - 2 years - )) - - -define ReportSTarTBackAssessments: - (STarTBackAssessments) A - return { - Name: ConceptTextWithRange(A.code), - Score: QuantityText(A.valueQuantity), - Interpretation: Coalesce( ConceptText(A.interpretation), ConceptText(A.valueCodeableConcept) ), - Date: ObservationDate(A) - } - sort by Date desc - -// HISTORICAL TREATMENTS - -// Opioid medication orders and statements with dates (lookback 2 years) - -define OpioidMedicationOrders: - C3F.ActiveCompletedOrStoppedMedicationOrder(C3F.MedicationOrderLookBack( - [MedicationOrder: "Opioid Pain Medications"], - 2 years - )) - -define OpioidMedicationStatements: - C3F.ActiveOrCompletedMedicationStatement(C3F.MedicationStatementLookBack( - [MedicationStatement: "Opioid Pain Medications"], - 2 years - )) - -define ReportOpioidMedicationOrders: - (OpioidMedicationOrders) O - return { - Type: 'Order', - Name: ConceptText(O.medicationCodeableConcept), - Start: DateTimeText(O.dateWritten), - End: DateTimeText(O.dateEnded), - Status: O.status.value - } - sort by Start desc, End desc - -define ReportOpioidMedicationStatements: - (OpioidMedicationStatements) S - return { - Type: 'Statement', - Name: ConceptText(S.medicationCodeableConcept), - Start: MedicationStatementDate(S), - End: DateTimeText(S.effectivePeriod."end"), - Status: S.status.value - } - sort by Start desc, End desc - -define ReportOpioidMedications: - (ReportOpioidMedicationOrders union ReportOpioidMedicationStatements) M - sort by Start desc, End desc - -// Non-opioid medication orders and statements with dates (lookback 2 years) - -define NonOpioidMedicationOrders: - C3F.ActiveCompletedOrStoppedMedicationOrder(C3F.MedicationOrderLookBack( - [MedicationOrder: "Non opiod pain medications"], - 2 years - )) - -define NonOpioidMedicationStatements: - C3F.ActiveOrCompletedMedicationStatement(C3F.MedicationStatementLookBack( - [MedicationStatement: "Non opiod pain medications"], - 2 years - )) - -define ReportNonOpioidMedicationOrders: - (NonOpioidMedicationOrders) O - return { - Type: 'Order', - Name: ConceptText(O.medicationCodeableConcept), - Start: DateTimeText(O.dateWritten), - End: DateTimeText(O.dateEnded), - Status: O.status.value - } - sort by Start desc, End desc - -define ReportNonOpioidMedicationStatements: - (NonOpioidMedicationStatements) S - return { - Type: 'Statement', - Name: ConceptText(S.medicationCodeableConcept), - Start: MedicationStatementDate(S), - End: DateTimeText(S.effectivePeriod."end"), - Status: S.status.value - } - sort by Start desc, End desc - -define ReportNonOpioidMedications: - (ReportNonOpioidMedicationOrders union ReportNonOpioidMedicationStatements) M - sort by Start desc, End desc - -// Non-pharmacologic treatment orders and referrals with dates (lookback 2 years) - -define NonPharmacologicTreatmentProcedures: - C3F.ProcedurePerformance(C3F.ProcedureLookBack([Procedure: "Non pharmacologic treatments for chronic pain"], 2 years)) - -define ReportNonPharmacologicTreatmentProcedures: - (NonPharmacologicTreatmentProcedures) P - return { - Type: 'Procedure', - Name: ConceptText(P.code), - Date: Coalesce(DateTimeText(P.performedDateTime), DateTimeText(P.performedPeriod."start")) - } - sort by Date desc - -define NonPharmacologicTreatmentProcedureRequests: - C3F.ProcedureRequestAcceptedOrInProgressOrCompleted( - C3F.ProcedureRequestLookBack([ProcedureRequest: "Non pharmacologic treatments for chronic pain"], 2 years) - ) - -define ReportNonPharmacologicTreatmentProcedureRequests: - (NonPharmacologicTreatmentProcedureRequests) P - return { - Type: 'ProcedureRequest', - Name: ConceptText(P.code), - Date: DateTimeText(P.orderedOn) - } - sort by Date desc - -define NonPharmacologicTreatmentReferralRequests: - C3F.ReferralRequestAcceptedOrActiveOrCompleted(C3F.ReferralRequestLookBack( - [ReferralRequest] R where exists( - (R.serviceRequested) SR where SR in "Non pharmacologic treatments for chronic pain" - ), - 2 years - )) - -define ReportNonPharmacologicTreatmentReferralRequests: - (NonPharmacologicTreatmentReferralRequests) P - return { - Type: 'Referral', - Name: Coalesce((P.serviceRequested) SR return ConceptText(SR)), - Date: DateTimeText(P.dateSent) - } - sort by Date desc - -define ReportNonPharmacologicTreatments: - (ReportNonPharmacologicTreatmentProcedures - union ReportNonPharmacologicTreatmentProcedureRequests - union ReportNonPharmacologicTreatmentReferralRequests) M - sort by Date desc - -// Stool softeners and laxatives - orders and statements with dates (lookback 6 months) - -define StoolSoftenersAndLaxativesOrders: - C3F.ActiveCompletedOrStoppedMedicationOrder(C3F.MedicationOrderLookBack( - [MedicationOrder: "Stool softeners and laxatives"], - 6 months - )) - -define StoolSoftenersAndLaxativesStatements: - C3F.ActiveOrCompletedMedicationStatement(C3F.MedicationStatementLookBack( - [MedicationStatement: "Stool softeners and laxatives"], - 6 months - )) - -define ReportStoolSoftenersAndLaxativesOrders: - (StoolSoftenersAndLaxativesOrders) O - return { - Type: 'Order', - Name: ConceptText(O.medicationCodeableConcept), - Start: DateTimeText(O.dateWritten), - End: DateTimeText(O.dateEnded), - Status: O.status.value - } - sort by Start desc, End desc - -define ReportStoolSoftenersAndLaxativesStatements: - (StoolSoftenersAndLaxativesStatements) S - return { - Type: 'Statement', - Name: ConceptText(S.medicationCodeableConcept), - Start: MedicationStatementDate(S), - End: DateTimeText(S.effectivePeriod."end"), - Status: S.status.value - } - sort by Start desc, End desc - -define ReportStoolSoftenersAndLaxatives: - (ReportStoolSoftenersAndLaxativesOrders union ReportStoolSoftenersAndLaxativesStatements) M - sort by Start desc, End desc - -// RISK CONSIDERATIONS - -// MME (MOST RECENT w/ lookback 6 months) - amount and date - -define MostRecentMME: - C3F.MostRecent(C3F.Verified(C3F.ObservationLookBack([Observation: "Morphine Milligram Equivalent (MME)"], 6 months))) - -define ReportMostRecentMME: - if MostRecentMME is null - then null - else - (MostRecentMME) M - return { - Name: ConceptText(M.code), - Result: QuantityText(M.valueQuantity), - Date: ObservationDate(M) - } - -// Urine drug screen - dates and results (all screens w/ lookback of 1 year) - -define UrineDrugScreens: - C3F.Verified(C3F.ObservationLookBack([Observation: "Urine drug screen for pain management"], 1 year)) - -define ReportUrineDrugScreens: - (UrineDrugScreens) S - return { - Name: ConceptText(S.code), - Result: Coalesce( QuantityText(S.valueQuantity), S.valueString.value, ConceptText(S.valueCodeableConcept) ), - Interpretation: Coalesce( ConceptText(S.interpretation) ), - Date: ObservationDate(S) - } - sort by Date desc - -// Benzodiazepine Medications (lookback of 2 years)- orders and statements with dates - -define BenzodiazepineMedicationOrders: - C3F.ActiveCompletedOrStoppedMedicationOrder(C3F.MedicationOrderLookBack( - [MedicationOrder: "Benzodiazepine medications"], - 2 years - )) - -define BenzodiazepineMedicationStatements: - C3F.ActiveOrCompletedMedicationStatement(C3F.MedicationStatementLookBack( - [MedicationStatement: "Benzodiazepine medications"], - 2 years - )) - -define ReportBenzodiazepineMedicationOrders: - (BenzodiazepineMedicationOrders) O - return { - Type: 'Order', - Name: ConceptText(O.medicationCodeableConcept), - Start: DateTimeText(O.dateWritten), - End: DateTimeText(O.dateEnded), - Status: O.status.value - } - sort by Start desc, End desc - -define ReportBenzodiazepineMedicationStatements: - (BenzodiazepineMedicationStatements) S - return { - Type: 'Statement', - Name: ConceptText(S.medicationCodeableConcept), - Start: MedicationStatementDate(S), - End: DateTimeText(S.effectivePeriod."end"), - Status: S.status.value - } - sort by Start desc, End desc - -define ReportBenzodiazepineMedications: - (ReportBenzodiazepineMedicationOrders union ReportBenzodiazepineMedicationStatements) M - sort by Start desc, End desc - -// Naloxone Medications (unrestricted lookback) - orders and statements with dates - -define NaloxoneMedicationOrders: - C3F.ActiveCompletedOrStoppedMedicationOrder([MedicationOrder: "Naloxone medications"]) - -define NaloxoneMedicationStatements: - C3F.ActiveOrCompletedMedicationStatement([MedicationStatement: "Naloxone medications"]) - -define ReportNaloxoneMedicationOrders: - (NaloxoneMedicationOrders) O - return { - Type: 'Order', - Name: ConceptText(O.medicationCodeableConcept), - Start: DateTimeText(O.dateWritten), - End: DateTimeText(O.dateEnded), - Status: O.status.value - } - sort by Start desc, End desc - -define ReportNaloxoneMedicationStatements: - (NaloxoneMedicationStatements) S - return { - Type: 'Statement', - Name: ConceptText(S.medicationCodeableConcept), - Start: MedicationStatementDate(S), - End: DateTimeText(S.effectivePeriod."end"), - Status: S.status.value - } - sort by Start desc, End desc - -define ReportNaloxoneMedications: - (ReportNaloxoneMedicationOrders union ReportNaloxoneMedicationStatements) M - sort by Start desc, End desc - -// Risk screenings relevant to pain management - overall scores and dates (MOST RECENT w/ lookback 1 year) - -define RiskScreeningsRelevantToPainManagement: - C3F.Verified(C3F.ObservationLookBack( - [Observation: "Risk assessments relevant to pain management"] - union [Observation: "Single question r/t ETOH use"] - union [Observation: "Single question r/t drug use"] - , 1 year)) - -define ReportRiskScreeningsRelevantToPainManagement: - (RiskScreeningsRelevantToPainManagement) S - return { - Name: ConceptTextWithRange(S.code), - Score: Coalesce( QuantityText(S.valueQuantity), S.valueString.value ), - Interpretation: Coalesce( ConceptText(S.interpretation), ConceptText(S.valueCodeableConcept) ), - Date: ObservationDate(S) - } - sort by Date desc - -// SUMMARY - -// The Summary object represents the full Pain Management Summary to be displayed to the clinician. All values are -// returned as user-friendly text representations, but a robust user interface (UI) should be implemented to -// display the data to the user in a friendly manner. See the Pain Management Summary SMART on FHIR application as -// an example of how to integrate this summary into an EHR using modern web UI technologies. - -define Summary: { - Patient: { - Name: Combine(Patient.name.given G return G.value, ' ') + ' ' + Combine(Patient.name.family F return F.value, ' '), - Gender: Patient.gender.value, - Age: AgeInYears(), - MeetsInclusionCriteria: MeetsInclusionCriteria - }, - PertinentMedicalHistory: { - ConditionsAssociatedWithChronicPain: ReportConditionsAssociatedWithChronicPain, - RiskFactorsForOpioidRelatedHarms: ReportRiskFactorsForOpioidRelatedHarms - }, - PainAssessments: { - NumericPainIntensityAssessments: ReportNumericPainIntensityAssessments, - PainEnjoymentGeneralActivityAssessments: ReportPainEnjoymentGeneralActivityAssessments, - STarTBackAssessments: ReportSTarTBackAssessments - }, - HistoricalTreatments: { - OpioidMedications: ReportOpioidMedications, - NonOpioidMedications: ReportNonOpioidMedications, - NonPharmacologicTreatments: ReportNonPharmacologicTreatments, - StoolSoftenersAndLaxatives: ReportStoolSoftenersAndLaxatives - }, - RiskConsiderations: { - MostRecentMME: ReportMostRecentMME, - UrineDrugScreens: ReportUrineDrugScreens, - BenzodiazepineMedications: ReportBenzodiazepineMedications, - NaloxoneMedications: ReportNaloxoneMedications, - RiskScreeningsRelevantToPainManagement: ReportRiskScreeningsRelevantToPainManagement - } -} diff --git a/src/cql/r4/CDSConnectCommonsForFHIRv401.cql b/src/cql/r4/CDSConnectCommonsForFHIRv401.cql new file mode 100644 index 000000000..792229679 --- /dev/null +++ b/src/cql/r4/CDSConnectCommonsForFHIRv401.cql @@ -0,0 +1,657 @@ +// CDS Connect Commons for FHIRv401 +// +// This library provides functions commonly used by CDS Connect CQL libraries as well as the +// CDS Connect CDS Authoring Tool. +// +// Version 2.0.0 implements several best practices prescribed by FHIR Clinical Guidelines, including: +// - Renaming library from CDS_Connect_Commons_for_FHIRv401 to CDSConnectCommonsForFHIRv401 +// - Surrounding all library-level identifiers and datatypes in quotes +// - Using descriptive names (no abbreviations) for query aliases and function arguments +// +// Version 2.0.0 also introduces the following changes from the previous version of this library: +// - Add functions to align with CDS_Connect_Commons_for_FHIRv400.cql v1.0.4: +// - "FirstObservation", "AverageObservation", "FirstCondition", "FirstProcedure", +// "ActiveOrCompletedServiceRequest", "ActiveServiceRequest", "CompletedServiceRequest", +// "CompletedImmunization", "ImmunizationLookBack", "MostRecentImmunization", "FirstImmunization", +// and "ActiveDevice" + +library CDSConnectCommonsForFHIRv401 version '2.0.0' + +using FHIR version '4.0.1' + +// Include the FHIRHelpers library for simplifying interacton w/ the FHIR data model +include FHIRHelpers version '4.0.1' called FHIRHelpers + +codesystem "AIVERSTATUS": 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' +codesystem "AICLINSTATUS": 'http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical' +codesystem "CONDVERSTATUS": 'http://terminology.hl7.org/CodeSystem/condition-ver-status' +codesystem "CONDCLINSTATUS": 'http://terminology.hl7.org/CodeSystem/condition-clinical' +code "AllergyIntolerance Confirmed code": 'confirmed' from "AIVERSTATUS" display 'Confirmed' +code "AllergyIntolerance Active code": 'active' from "AICLINSTATUS" display 'Active' +code "Condition Confirmed code": 'confirmed' from "CONDVERSTATUS" display 'Confirmed' +code "Condition Active code": 'active' from "CONDCLINSTATUS" display 'Active' +code "Condition Recurrence code": 'recurrence' from "CONDCLINSTATUS" display 'Recurrence' +code "Condition Relapse code": 'relapse' from "CONDCLINSTATUS" display 'Relapse' +concept "AllergyIntolerance Confirmed": { "AllergyIntolerance Confirmed code" } display 'Confirmed' +concept "AllergyIntolerance Active": { "AllergyIntolerance Active code" } display 'Active' +concept "Condition Confirmed": { "Condition Confirmed code" } display 'Confirmed' +concept "Condition Active": { "Condition Active code" } display 'Active' +concept "Condition Recurrence": { "Condition Recurrence code" } display 'Recurrence' +concept "Condition Relapse": { "Condition Relapse code" } display 'Relapse' + +// -------------------------------------------------- GENERAL --------------------------------------------------------- + +/** + * Converts a FHIR Period to a CQL Interval. FHIRHelpers provides a function for this, but + * FHIRHelpers provides several overloads of the ToInterval function, and the JavaScript CQL + * Execution Framework apparently does not handle this correctly. Creating uniquely named + * functions here ensures safe execution. + * @param period - a FHIR Period + * @returns {System.Interval} a CQL Interval or null if null was passed in + */ +define function "PeriodToInterval"(Period FHIR."Period"): + if Period is null then + null + else + Interval[Period."start".value, Period."end".value] + +/** + * Converts a FHIR Range to a CQL Interval. FHIRHelpers provides a function for this, but + * FHIRHelpers provides several overloads of the ToInterval function, and the JavaScript CQL + * Execution Framework apparently does not handle this correctly. Creating uniquely named + * functions here ensures safe execution. + * @param range - a FHIR Range + * @returns {System.Interval} a CQL Interval or null if null was passed in + */ +define function "RangeToInterval"(Range FHIR."Range"): + if Range is null then + null + else + Interval[FHIRHelpers.ToQuantity(Range.low), FHIRHelpers.ToQuantity(Range.high)] + +// -------------------------------------------------- OBSERVATIONS ----------------------------------------------------- + +/** + * Observations that are complete and verified. In FHIR R4, there are three statuses that indicate this state: 'final', + * 'corrected', and 'amended'. + * @see http://hl7.org/fhir/R4/valueset-observation-status.html + * @param Observations - a list of Observations + * @returns {List<"Observation">} a list of verified Observations, or null if null was passed in + */ +define function "Verified"(Observations List<"Observation">): + Observations Observation where Observation.status.value in {'final', 'corrected', 'amended'} + +/** + * Observations that have quantity values recorded in the requested unit. + * @param Observations - a list of Observations + * @param Unit - the unit to require in the Observations quantity value + * @returns {List<"Observation">} a list of Observations with the required unit, or null if null was passed in + */ +define function "WithUnit"(Observations List<"Observation">, Unit "String"): + Observations Observation + where (Observation.value as FHIR."Quantity").unit.value = Unit or (Observation.value as FHIR."Quantity").code.value = Unit + +/** + * Observations with an effective or issued date in the specified "look back" period. For example, LDL-C Tests in the + * last 6 years. + * TODO: Rename to LookBack once the execution engine supports overloaded functions. + * @param Observations - a list of Observations + * @returns {List<"Observation">} a list of Observations with effective or issued date specified lookback period, or null + * if null was passed in + */ +define function "ObservationLookBack"(Observations List<"Observation">, LookBack System."Quantity"): + Observations Observation + let LookBackInterval: Interval[Now() - LookBack, Now()] + where (Observation.effective as FHIR."dateTime").value in LookBackInterval + or (Observation.effective as FHIR."instant").value in LookBackInterval + or "PeriodToInterval"(Observation.effective as FHIR."Period") overlaps LookBackInterval + or Observation.issued.value in LookBackInterval + +/** + * The most recent observation. For each Observation, this algorithm will use the Coalesce function, which uses the + * first non-null date value from these fields: effectiveDateTime, effectiveInstant, effectivePeriod.end, + * effectivePeriod.start, issued. The found date will be used to compare Observations and determine the most recent + * one. NOTE: We can't use "FindDate" because it appears that the execution engine may have problems sorting by the + * result of a function. + * @param Observations - a list of Observations + * @returns {"Observation"} the most recent Observation from the list, or null if null was passed in + */ +define function "MostRecent"(Observations List<"Observation">): + Last(Observations Observation sort by Coalesce( + (effective as FHIR."dateTime").value, + (effective as FHIR."instant").value, + (effective as FHIR."Period")."end".value, + (effective as FHIR."Period")."start".value, + issued.value) + ) + +/** + * The First Observation. For each Observation, this algorithm will use the Coalesce function, which uses the + * first non-null date value from these fields: effectiveDateTime, effectiveInstant, effectivePeriod.end, + * effectivePeriod.start, issued. The found date will be used to compare Observations and determine the most recent + * one. NOTE: We can't use "FindDate" because it appears that the execution engine may have problems sorting by the + * result of a function. + * @param Observations - a list of Observations + * @returns {"Observation"} the first Observation from the list, or null if only null elements were passed in + */ +define function "FirstObservation"(Observations List<"Observation">): + First(Observations Observation sort by Coalesce( + (effective as FHIR."dateTime").value, + (effective as FHIR."instant").value, + (effective as FHIR."Period")."start".value, + (effective as FHIR."Period")."end".value, + issued.value) + ) + +/** + * Extracts the quantity value from an Observation, returning it as a CQL Quantity + * @param Observation - an observation + * @returns {System."Quantity"} the Observation's value as a quantity, or null if there is no quantity value + */ +define function "QuantityValue"(Observation "Observation"): + FHIRHelpers.ToQuantity(Observation.value as FHIR."Quantity") + +/** + * Extracts the CodeableConcept value from an Observation, returning it as a CQL Concept + * @param Observation - an observation + * @returns {System.Concept} the Observation's value as a concept, or null if there is no CodeabeConcept value + */ +define function "ConceptValue"(Observation "Observation"): + FHIRHelpers.ToConcept(Observation.value as FHIR."CodeableConcept") + +/** + * Finds the first non-null meaningful date that can be associated with this Observation. This will look through the + * following fields in the following order: effectiveDateTime, effectiveInstant, effectivePeriod.end, + * effectivePeriod.start, issued. + * @param Observation - an Observation + * @returns {System.DateTime} the first non-null meaningful date, or null if non is found + */ +define function "FindDate"(Observation "Observation"): + Coalesce( + (Observation.effective as FHIR."dateTime").value, + (Observation.effective as FHIR."instant").value, + (Observation.effective as FHIR."Period")."end".value, + (Observation.effective as FHIR."Period")."start".value, + Observation.issued.value + ) + +/** + * The highest observation. + * The value will be used to compare Observations and determine the highest one. + * @param Observations - a list of Observations + * @returns {System."Quantity"} the quantity with the highest value from the list, or null if null was passed in + */ +define function "HighestObservation"(Observations List<"Observation">): + Max(Observations Observation return FHIRHelpers.ToQuantity(Observation.value as FHIR."Quantity")) + +/** + * The average observation. + * The value will be used to compare Observations and determine the highest one. + * @param Observations - a list of Observations + * @returns {System."Quantity"} containing average value of the non-null elements of the list, + * or null if all list elements are null. + */ +define function "AverageObservation"(Observations List<"Observation">): + Avg(Observations Observation return FHIRHelpers.ToQuantity(Observation.value as FHIR."Quantity")) + +// -------------------------------------------------- CONDITIONS ------------------------------------------------------- + +/** + * Conditions that are confirmed. In FHIR R4, this is reflected by verificationStatus: 'confirmed'. + * @see http://hl7.org/fhir/R4/valueset-condition-ver-status.html + * @param Conditions - a list of Conditions + * @returns {List<"Condition">} a list of confirmed Conditions, or null if null was passed in + */ +define function "Confirmed"(Conditions List<"Condition">): + Conditions Condition where Condition.verificationStatus ~ "Condition Confirmed" + +/** + * Conditions that are active. In FHIR R4, this is reflected by clinicalStatus: 'active' and the absence of any + * abatement information (i.e., if it abated, it is no longer active). + * TODO: Rename to Active once the execution engine supports overloaded functions. + * @see http://hl7.org/fhir/R4/valueset-condition-clinical.html + * @param Conditions - a list of Conditions + * @returns {List<"Condition">} a list of active Conditions, or null if null was passed in + */ +define function "ActiveCondition"(Conditions List<"Condition">): + Conditions Condition + where Condition.clinicalStatus ~ "Condition Active" + and Condition.abatement is null + +/** + * Conditions that are active or recurring. In FHIR R4, this is reflected by clinicalStatus: 'active', 'recurrence', or + * 'relapse'. We do not check for null abatement information because it may have dates from when the now recurring + * condition initially went into remission. + * @see http://hl7.org/fhir/R4/valueset-condition-clinical.html + * @param Conditions - a list of Conditions + * @returns {List<"Condition">} a list of active or recurring Conditions, or null if null was passed in + */ +define function "ActiveOrRecurring"(Conditions List<"Condition">): + Conditions Condition + where Condition.clinicalStatus ~ "Condition Active" + or Condition.clinicalStatus ~ "Condition Recurrence" + or Condition.clinicalStatus ~ "Condition Relapse" + +/** + * Conditions with an onset or recorded date in the specified "look back" period. For example, pregnancy in + * the last 42 weeks. + * TODO: Rename to LookBack once the execution engine supports overloaded functions. + * @param Conditions - a list of Conditions + * @returns {List<"Condition">} a list of Conditions with onset or recorded date specified lookback period, or null + * if null was passed in + */ +define function "ConditionLookBack"(Conditions List<"Condition">, LookBack System."Quantity"): + Conditions Condition + let LookBackInterval: Interval[Now() - LookBack, Now()] + where (Condition.onset as FHIR."dateTime").value in LookBackInterval + or "PeriodToInterval"(Condition.onset as FHIR."Period") overlaps LookBackInterval + or Condition.recordedDate.value in LookBackInterval + +/** + * The most recent condition. For each Condition, this algorithm will use the Coalesce function, which uses the + * first non-null result from these fields: onsetDateTime, onsetPeriod.end, onsetPeriod.start, assertedDate. + * The found date will be used to compare Conditions and determine the most recent one. + * @param Conditions - a list of Conditions + * @returns {"Condition"} the most recent Condition from the list, or null if null was passed in + */ +define function "MostRecentCondition"(Conditions List<"Condition">): + Last(Conditions Condition sort by Coalesce( + (onset as FHIR."dateTime").value, + (onset as FHIR."Period")."end".value, + (onset as FHIR."Period")."start".value, + recordedDate.value) + ) + +/** + * The First condition. For each Condition, this algorithm will use the Coalesce function, which uses the + * first non-null result from these fields: onsetDateTime, onsetPeriod.end, onsetPeriod.start, assertedDate. + * The found date will be used to compare Conditions and determine the most recent one. + * @param Conditions - a list of Conditions + * @returns {"Condition"} the first Condition from the list, or null if null was passed in + */ +define function "FirstCondition"(Conditions List<"Condition">): + First(Conditions Condition sort by Coalesce( + (onset as FHIR."dateTime").value, + (onset as FHIR."Period")."start".value, + (onset as FHIR."Period")."end".value, + recordedDate.value) + ) + + // -------------------------------------------------- PROCEDURES ------------------------------------------------------ + +/** + * Procedures that are completed. In FHIR R4, this is reflected by status: 'completed'. + * @see http://hl7.org/fhir/R4/valueset-event-status.html + * @param Procedures - a list of Procedures + * @returns {List<"Procedure">} a list of completed Procedures, or null if null was passed in + */ +define function "Completed"(Procedures List<"Procedure">): + Procedures Procedure + where Procedure.status.value = 'completed' + +/** + * Procedures that are in progress. In FHIR R4, this is reflected by status: 'in-progress'. + * @see http://hl7.org/fhir/R4/valueset-event-status.html + * @param Procedures - a list of Procedures + * @returns {List<"Procedure">} a list of completed Procedures, or null if null was passed in + */ +define function "ProcedureInProgress"(Procedures List<"Procedure">): + Procedures Procedure + where Procedure.status.value = 'in-progress' + +/** + * Procedures that actually happened or are happening. In FHIR R4, there are a few properties that negate the + * procedure, most notably when status is 'preparation', 'not-done', 'entered-in-error', or 'unknown'. + * @see http://hl7.org/fhir/R4/valueset-event-status.html + * @param Procedures - a list of Procedures + * @returns {List<"Procedure">} a list of Procedures that actually happened or are happening, or null if null was passed in + */ +define function "ProcedurePerformance"(Procedures List<"Procedure">): + Procedures Procedure + where not (Procedure.status.value in {'preparation', 'not-done', 'entered-in-error', 'unknown'}) + +/** + * Procedures performed in the specified "look back" period. For example, PCIs performed in the + * past 2 weeks. + * TODO: Rename to LookBack once the execution engine supports overloaded functions. + * @param Procedures - a list of Procedures + * @param LookBack - the lookback period for when the procedure was performed + * @returns {List<"Procedure">} a list of Procedures performed in the look back period, or null if null + * was passed in + */ +define function "ProcedureLookBack"(Procedures List<"Procedure">, LookBack System."Quantity"): + Procedures Procedure + let LookBackInterval: Interval[Now() - LookBack, Now()] + where (Procedure.performed as FHIR."dateTime").value in LookBackInterval + or "PeriodToInterval"(Procedure.performed as FHIR."Period") overlaps LookBackInterval + +/** + * The most recent procedure. For each Procedure, this algorithm will use the Coalesce function, which returns the + * first non-null result from these fields: performedDateTime, performedPeriod.end, performedPeriod.start. + * The found date will be used to compare Procedures and determine the most recent one. + * @param Procedures - a list of Procedures + * @returns {"Procedure"} the most recent Procedure from the list, or null if null was passed in + */ +define function "MostRecentProcedure"(Procedures List<"Procedure">): + Last(Procedures Procedure sort by Coalesce( + (performed as FHIR."dateTime").value, + (performed as FHIR."Period")."end".value, + (performed as FHIR."Period")."start".value) + ) + +/** + * The first procedure. For each Procedure, this algorithm will use the Coalesce function, which returns the + * first non-null result from these fields: performedDateTime, performedPeriod.end, performedPeriod.start. + * The found date will be used to compare Procedures and determine the most recent one. + * @param Procedures - a list of Procedures + * @returns {"Procedure"} the first Procedure from the list, or null if null was passed in + */ +define function "FirstProcedure"(Procedures List<"Procedure">): + First(Procedures Procedure sort by Coalesce( + (performed as FHIR."dateTime").value, + (performed as FHIR."Period")."start".value), + (performed as FHIR."Period")."end".value + ) + +// ----------------------------------------------- SERVICEREQUESTS ----------------------------------------------------- + +// NOTE: In FHIR R4, ProcedureRequest and ReferralRequest are replaced by ServiceRequest + +/** + * ServiceRequests that are active or completed. In FHIR R4, this is reflected by the corresponding + * status values. + * @see http://hl7.org/fhir/R4/valueset-request-status.html + * @param ServiceRequests - a list of ServiceRequests + * @returns {List<"ServiceRequest">} a list of accepted, in-progress, or completed ProcedureRequests, + * or null if null was passed in + * NOTE: This function is deprecated and is maintained only for backwards compatibility + * Please use C3F."ActiveOrCompletedServiceRequest" instead + */ +define function "ServiceRequestActiveOrCompleted"(ServiceRequests List<"ServiceRequest">): + ServiceRequests Request + where Request.status.value in List{'active', 'completed'} + +/** + * ServiceRequests that are active or completed. In FHIR R4, this is reflected by the corresponding + * status values. + * @see http://hl7.org/fhir/R4/valueset-request-status.html + * @param ServiceRequests - a list of ServiceRequests + * @returns {List<"ServiceRequest">} a list of accepted, in-progress, or completed ProcedureRequests, + * or null if null was passed in + */ +define function "ActiveOrCompletedServiceRequest"(ServiceRequests List<"ServiceRequest">): + ServiceRequests Request + where Request.status.value in List{'active', 'completed'} + +/** + * ServiceRequests ordered in the specified "look back" period. For example, PCIs ordered in the + * past 2 weeks. + * TODO: Rename to LookBack once the execution engine supports overloaded functions. + * @param ServiceRequests - a list of ServiceRequests + * @param LookBack - the lookback period for when the service was ordered + * @returns {List<"ServiceRequest">} a list of ServiceRequests ordered in the look back period, or null if null + * was passed in + */ +define function "ServiceRequestLookBack"(ServiceRequests List<"ServiceRequest">, LookBack System."Quantity"): + ServiceRequests Request + where Request.authoredOn.value in Interval[Now() - LookBack, Now()] + +/** + * ServiceRequests that are active. In FHIR R4, this is reflected by the corresponding + * status values. + * @see http://hl7.org/fhir/R4/valueset-request-status.html + * @param ServiceRequests - a list of ServiceRequests + * @returns {List<"ServiceRequest">} a list of active Service Requests, + * or null if null was passed in + */ +define function "ActiveServiceRequest"(ServiceRequests List<"ServiceRequest">): + ServiceRequests Request + where Request.status.value = 'active' + +/** + * ServiceRequests that are completed. In FHIR R4, this is reflected by the corresponding + * status values. + * @see http://hl7.org/fhir/R4/valueset-request-status.html + * @param ServiceRequests - a list of ServiceRequests + * @returns {List<"ServiceRequest">} a list of completed Service Requests, + * or null if null was passed in + */ +define function "CompletedServiceRequest"(ServiceRequests List<"ServiceRequest">): + ServiceRequests Request + where Request.status.value = 'completed' + +// -------------------------------------------------- MEDICATIONS ------------------------------------------------------ + +/** + * Medications that are active, according to a statement, but not necessarily verified via a prescription. For example, + * medications that a patient has self-reported to be taking. This may, however, also represent medications that are + * expected to be active after providing a prescription (e.g., clinician-reported). In FHIR R4, this is reflected by + * MedicationStatement with status 'active' and no end date or an end date in the future. + * TODO: Rename to Active once the execution engine supports overloaded functions. + * @see http://hl7.org/fhir/R4/valueset-medication-statement-status.html + * @param Statements - a list of MedicationStatements + * @returns {List<"MedicationStatement">} a list of active medication statements, or null if null was passed in + */ +define function "ActiveMedicationStatement"(Statements List<"MedicationStatement">): + Statements Statement + let EffectivePeriod: "PeriodToInterval"(Statement.effective as FHIR."Period") + where Statement.status.value = 'active' + and (end of EffectivePeriod is null or end of EffectivePeriod after Now()) + +/** +* Medication requests that are active. In FHIR R4, this is reflected by MedicationRequest with status 'active'. +* Note that in R4, the MedicationRequest Boundaries and Relationships now says: "When reporting on the usage of +* a medication by a patient, the MedicationStatement resource should be used." It also indicates that: +* "A medication statement is not a part of the prescribe->dispense->administer sequence but is a report that +* such a sequence (or at least a part of it) did take place resulting in a belief that the patient has received +* a particular medication." In this regard, MedicationStatement is more appropriate as an indication of an actually +* active medication, although it's not clear if vendors really will automatically create MedicationStatements in +* these cases or not. Until we know, MedicationRequest may be the best proxy we have for an active medication. +* TODO: Should the "intent" field be considered (e.g., is it still active if intent is "proposal" or "plan")? +* TODO: Rename to Active once the execution engine supports overloaded functions. +* @see http://hl7.org/fhir/R4/valueset-medicationrequest-status.html +* @param Requests - a list of MedicationRequests +* @returns {List<"MedicationRequest">} a list of active medication requests, or null if null was passed in +*/ +define function "ActiveMedicationRequest"(Requests List<"MedicationRequest">): + Requests Request where Request.status.value = 'active' + +/** +* Medication requests that are active or completed, according to a prescription. In FHIR R4, this is reflected by MedicationRequest +* with status 'active' or 'completed'. See the note above (in "ActiveMedicationRequest") for more nuance regarding MedicationRequest +* vs. MedicationStatement. +* @see http://hl7.org/fhir/R4/valueset-medicationrequest-status.html +* @param Requests - a list of MedicationRequests +* @returns {List<"MedicationRequest">} a list of active medication requests, or null if null was passed in +*/ +define function "ActiveOrCompletedMedicationRequest"(Requests List<"MedicationRequest">): + Requests Request + where Request.status.value = 'active' + or Request.status.value = 'completed' + +/** + * Medications that are active or completed, according to a statement, but not necessarily verified via a prescription. + * For example, medications that a patient has self-reported to be taking. This may, however, also represent + * medications that are expected to be active after providing a prescription (e.g., clinician-reported). In FHIR R4, + * this is reflected by MedicationStatement with status 'active' or 'completed'. + * TODO: Rename to ActiveOrCompleted once the execution engine supports overloaded functions. + * @see http://hl7.org/fhir/R4/valueset-medication-statement-status.html + * @param Statements - a list of MedicationStatements + * @returns {List<"MedicationStatement">} a list of active or completed medication statements, or null if null was passed + * in + */ +define function "ActiveOrCompletedMedicationStatement"(Statements List<"MedicationStatement">): + Statements Statement + where Statement.status.value = 'active' + or Statement.status.value = 'completed' + +/** +* Medication requests that are active, completed, or stopped, according to a prescription. In FHIR R4, this is +* reflected by MedicationRequest with status 'active', 'completed', or 'stopped'. See the note above +* (in "ActiveMedicationRequest") for more nuance regarding MedicationRequest vs. MedicationStatement. +* @see http://hl7.org/fhir/R4/valueset-medicationrequest-status.html +* @param Requests - a list of MedicationOrders +* @returns {List<"MedicationRequest">} a list of active medication requests, or null if null was passed in +*/ +define function "ActiveCompletedOrStoppedMedicationRequest"(Requests List<"MedicationRequest">): + Requests Request + where Request.status.value = 'active' + or Request.status.value = 'completed' + or Request.status.value = 'stopped' + +/** +* Medication requests that are issued in the specified "look back" period. +* TODO: Rename to LookBack once the execution engine supports overloaded functions. +* @param Requests - a list of MedicationRequests +* @param LookBack - the lookback period for when the medication was prescribed +* @returns {List<"MedicationRequest">} a list of MedicationRequests prescribed in the look back period, or null if null +* was passed in +*/ +define function "MedicationRequestLookBack"(Requests List<"MedicationRequest">, LookBack System."Quantity"): + Requests Request + let LookBackInterval: Interval[Now() - LookBack, Now()] + where Request.authoredOn.value in LookBackInterval + // DSTU2 also checked the dateEnded property of MedicationOrder, but this doesn't exist for MedicationRequest + +/** +* Medication Statements that are issued in the specified "look back" period. +* TODO: Rename to LookBack once the execution engine supports overloaded functions. +* @param Statements - a list of MedicationStatements +* @param LookBack - the lookback period for when the medication was prescribed +* @returns {List<"MedicationStatement">} a list of MedicationStatements prescribed in the look back period, or null if null +* was passed in +*/ +define function "MedicationStatementLookBack"(Statements List<"MedicationStatement">, LookBack System."Quantity"): + Statements Statement + let LookBackInterval: Interval[Now() - LookBack, Now()] + where (Statement.effective as FHIR."dateTime").value in LookBackInterval + or "PeriodToInterval"(Statement.effective as FHIR."Period") overlaps LookBackInterval + +/** +* Medication Dispenses that are handed over or prepared in the specified "look back" period. +* TODO: Rename to LookBack once the execution engine supports overloaded functions. +* @param Dispenses - a list of MedicationDispenses +* @param LookBack - the lookback period for when the medication was prescribed +* @returns {List<"MedicationStatement">} a list of MedicationDispenses handed over or prepared in the look back period, +* or null if null was passed in +*/ +define function "MedicationDispenseLookBack"(Dispenses List<"MedicationDispense">, LookBack System."Quantity"): + Dispenses Dispense + let LookBackInterval: Interval[Now() - LookBack, Now()] + where Dispense.whenHandedOver.value in LookBackInterval + or Dispense.whenPrepared.value in LookBackInterval + +// -------------------------------------------------- ENCOUNTERS ------------------------------------------------------ + +/** + * Encounters that are in progress. In FHIR R4, this is reflected by status: 'in-progress'. + * @see http://hl7.org/fhir/R4/valueset-encounter-status.html + * @param Encounters - a list of Encounters + * @returns {List<"Encounter">} a list of in progress encounters, or null if null was passed in + */ +define function "InProgress"(Encounters List<"Encounter">): + Encounters Encounter + where Encounter.status.value = 'in-progress' + +/** + * Encounters performed in the specified "look back" period. + * TODO: Rename to LookBack once the execution engine supports overloaded functions. + * @param Encounters - a list of Encounters + * @param LookBack - the lookback period for when the encounter occurred + * @returns {List<"Encounter">} a list of Encounters occurring during the look back period, or null if null + * was passed in + */ +define function "EncounterLookBack"(Encounters List<"Encounter">, LookBack System."Quantity"): + Encounters Encounter + let LookBackInterval: Interval[Now() - LookBack, Now()] + where FHIRHelpers.ToInterval(Encounter.period) overlaps LookBackInterval + +// -------------------------------------------------- ALLERGY INTOLERANCES ------------------------------------------------------ + +/** +* AllergyIntolerances that are active or confirmed. In FHIR R4, this is reflected by AllergyIntolerance +* with clinicalStatus 'active' or verificationStatus 'confirmed' +* @see https://www.hl7.org/fhir/R4/valueset-allergy-clinical-status.html +* @see https://www.hl7.org/fhir/R4/valueset-allergy-verification-status.html +* @param AllergyIntolerances - a list of AllergyIntolerances +* @returns {List<"AllergyIntolerance">} a list of active or confirmed allergy intolerances, or null if null was passed in +*/ +define function "ActiveOrConfirmedAllergyIntolerance"(AllergyIntolerances List<"AllergyIntolerance">): + AllergyIntolerances Allergy + where Allergy.clinicalStatus ~ "AllergyIntolerance Active" + or Allergy.verificationStatus ~ "AllergyIntolerance Confirmed" + +// -------------------------------------------------------- GOALS ------------------------------------------------------ + +/** + * Goals with a start, target, or status date in the specified "look back" period. For example, Pain Management Goals + * in the last 2 years. + * TODO: Rename to LookBack once the execution engine supports overloaded functions. + * @param Goals - a list of Goals + * @returns {List<"Goal">} a list of Goals with a start, target, or status date in the specified lookback period, or null + * if null was passed in + */ +define function "GoalLookBack"(Goals List<"Goal">, LookBack System."Quantity"): + Goals Goal + let LookBackInterval: Interval[Now() - LookBack, Now()], + StartDate: (Goal.start as FHIR."date").value, + StatusDate: Goal.statusDate.value, + TargetDates: (Goal.target) Target return (Target.due as FHIR."date").value, + TargetQuantities: (Goal.target) Target return FHIRHelpers.ToQuantity(Target.due as FHIR."Duration") + where StartDate in LookBackInterval + or StatusDate in LookBackInterval + or exists(TargetDates Date where Date in LookBackInterval) + or exists(TargetQuantities Quantity where (StartDate + Quantity) in LookBackInterval) + +// -------------------------------------------------- Immunizations ---------------------------------------------------- + +/** + * Immunizations that are completed. In FHIR R4, this is reflected by status: 'completed'. + * @see http://hl7.org/fhir/R4/valueset-immunization-status.html + * @param Immunizations - a list of Immunizations + * @returns {List<"Immunization">} a list of completed Immunizations, or null if null was passed in + */ +define function "CompletedImmunization"(Immunizations List<"Immunization">): + Immunizations Immunization + where Immunization.status.value = 'completed' + +/** + * Immunizations given in the specified "look back" period. + * TODO: Rename to LookBack once the execution engine supports overloaded functions. + * @param Immunizations - a list of Immunizations + * @param LookBack - the lookback period for when the immunization was given + * @returns {List<"Immunization">} a list of Immunizations given in the look back period, or null if null + * was passed in + */ +define function "ImmunizationLookBack"(Immunizations List<"Immunization">, LookBack System."Quantity"): + Immunizations Immunization + let LookBackInterval: Interval[Now() - LookBack, Now()] + where (Immunization.occurrence as FHIR."dateTime").value in LookBackInterval + +/** + * The most recent Immunization. + * @param Immunizations - a list of Immunizations + * @returns {"Immunization"} the most recent Immunization from the list, or null if null was passed in + */ +define function "MostRecentImmunization"(Immunizations List<"Immunization">): + Last(Immunizations Immunization sort by (occurrence as FHIR."dateTime").value) + +/** + * The First Immunization. + * @param Immunizations - a list of Immunizations + * @returns {"Immunization"} the First Immunization from the list, or null if only null elements passed in + */ +define function "FirstImmunization"(Immunizations List<"Immunization">): + First(Immunizations Immunization sort by (occurrence as FHIR."dateTime").value) + +// ----------------------------------------------------- Devices ------------------------------------------------------- + +/** + * Devices that are active. In FHIR R4, this is reflected by status: 'active'. + * @see http://hl7.org/fhir/R4/valueset-device-status.html + * @param Devices - a list of Devices + * @returns {List<"Device">} a list of active Devices, or null if null was passed in + */ +define function "ActiveDevice"(Devices List<"Device">): + Devices Device + where Device.status.value = 'active' diff --git a/src/cql/r4/CDS_Connect_Commons_for_FHIRv401.json b/src/cql/r4/CDSConnectCommonsForFHIRv401.json similarity index 72% rename from src/cql/r4/CDS_Connect_Commons_for_FHIRv401.json rename to src/cql/r4/CDSConnectCommonsForFHIRv401.json index 44b34d909..6f54f63e8 100644 --- a/src/cql/r4/CDS_Connect_Commons_for_FHIRv401.json +++ b/src/cql/r4/CDSConnectCommonsForFHIRv401.json @@ -5,8 +5,8 @@ "type" : "CqlToElmInfo" } ], "identifier" : { - "id" : "CDS_Connect_Commons_for_FHIRv401", - "version" : "1.0.0" + "id" : "CDSConnectCommonsForFHIRv401", + "version" : "2.0.0" }, "schemaIdentifier" : { "id" : "urn:hl7-org:elm", @@ -155,7 +155,7 @@ "condition" : { "type" : "IsNull", "operand" : { - "name" : "period", + "name" : "Period", "type" : "OperandRef" } }, @@ -183,7 +183,7 @@ "path" : "start", "type" : "Property", "source" : { - "name" : "period", + "name" : "Period", "type" : "OperandRef" } } @@ -195,7 +195,7 @@ "path" : "end", "type" : "Property", "source" : { - "name" : "period", + "name" : "Period", "type" : "OperandRef" } } @@ -203,7 +203,7 @@ } }, "operand" : [ { - "name" : "period", + "name" : "Period", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}Period", "type" : "NamedTypeSpecifier" @@ -219,7 +219,7 @@ "condition" : { "type" : "IsNull", "operand" : { - "name" : "range", + "name" : "Range", "type" : "OperandRef" } }, @@ -248,7 +248,7 @@ "path" : "low", "type" : "Property", "source" : { - "name" : "range", + "name" : "Range", "type" : "OperandRef" } } ] @@ -261,7 +261,7 @@ "path" : "high", "type" : "Property", "source" : { - "name" : "range", + "name" : "Range", "type" : "OperandRef" } } ] @@ -269,7 +269,7 @@ } }, "operand" : [ { - "name" : "range", + "name" : "Range", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}Range", "type" : "NamedTypeSpecifier" @@ -283,9 +283,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "O", + "alias" : "Observation", "expression" : { - "name" : "ObsList", + "name" : "Observations", "type" : "OperandRef" } } ], @@ -297,7 +297,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "O", + "scope" : "Observation", "type" : "Property" } }, { @@ -319,7 +319,7 @@ } }, "operand" : [ { - "name" : "ObsList", + "name" : "Observations", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -336,9 +336,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "O", + "alias" : "Observation", "expression" : { - "name" : "ObsList", + "name" : "Observations", "type" : "OperandRef" } } ], @@ -358,7 +358,7 @@ "type" : "As", "operand" : { "path" : "value", - "scope" : "O", + "scope" : "Observation", "type" : "Property" }, "asTypeSpecifier" : { @@ -384,7 +384,7 @@ "type" : "As", "operand" : { "path" : "value", - "scope" : "O", + "scope" : "Observation", "type" : "Property" }, "asTypeSpecifier" : { @@ -401,7 +401,7 @@ } }, "operand" : [ { - "name" : "ObsList", + "name" : "Observations", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -424,9 +424,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "O", + "alias" : "Observation", "expression" : { - "name" : "ObsList", + "name" : "Observations", "type" : "OperandRef" } } ], @@ -467,7 +467,7 @@ "type" : "As", "operand" : { "path" : "effective", - "scope" : "O", + "scope" : "Observation", "type" : "Property" }, "asTypeSpecifier" : { @@ -489,7 +489,7 @@ "type" : "As", "operand" : { "path" : "effective", - "scope" : "O", + "scope" : "Observation", "type" : "Property" }, "asTypeSpecifier" : { @@ -512,7 +512,7 @@ "type" : "As", "operand" : { "path" : "effective", - "scope" : "O", + "scope" : "Observation", "type" : "Property" }, "asTypeSpecifier" : { @@ -532,7 +532,7 @@ "type" : "Property", "source" : { "path" : "issued", - "scope" : "O", + "scope" : "Observation", "type" : "Property" } }, { @@ -543,7 +543,7 @@ } }, "operand" : [ { - "name" : "ObsList", + "name" : "Observations", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -568,9 +568,9 @@ "source" : { "type" : "Query", "source" : [ { - "alias" : "O", + "alias" : "Observation", "expression" : { - "name" : "ObsList", + "name" : "Observations", "type" : "OperandRef" } } ], @@ -663,7 +663,121 @@ } }, "operand" : [ { - "name" : "ObsList", + "name" : "Observations", + "operandTypeSpecifier" : { + "type" : "ListTypeSpecifier", + "elementType" : { + "name" : "{http://hl7.org/fhir}Observation", + "type" : "NamedTypeSpecifier" + } + } + } ] + }, { + "name" : "FirstObservation", + "context" : "Patient", + "accessLevel" : "Public", + "type" : "FunctionDef", + "expression" : { + "type" : "First", + "source" : { + "type" : "Query", + "source" : [ { + "alias" : "Observation", + "expression" : { + "name" : "Observations", + "type" : "OperandRef" + } + } ], + "relationship" : [ ], + "sort" : { + "by" : [ { + "direction" : "asc", + "type" : "ByExpression", + "expression" : { + "type" : "Coalesce", + "operand" : [ { + "path" : "value", + "type" : "Property", + "source" : { + "strict" : false, + "type" : "As", + "operand" : { + "name" : "effective", + "type" : "IdentifierRef" + }, + "asTypeSpecifier" : { + "name" : "{http://hl7.org/fhir}dateTime", + "type" : "NamedTypeSpecifier" + } + } + }, { + "path" : "value", + "type" : "Property", + "source" : { + "strict" : false, + "type" : "As", + "operand" : { + "name" : "effective", + "type" : "IdentifierRef" + }, + "asTypeSpecifier" : { + "name" : "{http://hl7.org/fhir}instant", + "type" : "NamedTypeSpecifier" + } + } + }, { + "path" : "value", + "type" : "Property", + "source" : { + "path" : "start", + "type" : "Property", + "source" : { + "strict" : false, + "type" : "As", + "operand" : { + "name" : "effective", + "type" : "IdentifierRef" + }, + "asTypeSpecifier" : { + "name" : "{http://hl7.org/fhir}Period", + "type" : "NamedTypeSpecifier" + } + } + } + }, { + "path" : "value", + "type" : "Property", + "source" : { + "path" : "end", + "type" : "Property", + "source" : { + "strict" : false, + "type" : "As", + "operand" : { + "name" : "effective", + "type" : "IdentifierRef" + }, + "asTypeSpecifier" : { + "name" : "{http://hl7.org/fhir}Period", + "type" : "NamedTypeSpecifier" + } + } + } + }, { + "path" : "value", + "type" : "Property", + "source" : { + "name" : "issued", + "type" : "IdentifierRef" + } + } ] + } + } ] + } + } + }, + "operand" : [ { + "name" : "Observations", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -688,7 +802,7 @@ "path" : "value", "type" : "Property", "source" : { - "name" : "Obs", + "name" : "Observation", "type" : "OperandRef" } }, @@ -699,7 +813,7 @@ } ] }, "operand" : [ { - "name" : "Obs", + "name" : "Observation", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}Observation", "type" : "NamedTypeSpecifier" @@ -721,7 +835,7 @@ "path" : "value", "type" : "Property", "source" : { - "name" : "Obs", + "name" : "Observation", "type" : "OperandRef" } }, @@ -732,7 +846,7 @@ } ] }, "operand" : [ { - "name" : "Obs", + "name" : "Observation", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}Observation", "type" : "NamedTypeSpecifier" @@ -755,7 +869,7 @@ "path" : "effective", "type" : "Property", "source" : { - "name" : "Obs", + "name" : "Observation", "type" : "OperandRef" } }, @@ -774,7 +888,7 @@ "path" : "effective", "type" : "Property", "source" : { - "name" : "Obs", + "name" : "Observation", "type" : "OperandRef" } }, @@ -796,7 +910,7 @@ "path" : "effective", "type" : "Property", "source" : { - "name" : "Obs", + "name" : "Observation", "type" : "OperandRef" } }, @@ -819,7 +933,7 @@ "path" : "effective", "type" : "Property", "source" : { - "name" : "Obs", + "name" : "Observation", "type" : "OperandRef" } }, @@ -836,14 +950,14 @@ "path" : "issued", "type" : "Property", "source" : { - "name" : "Obs", + "name" : "Observation", "type" : "OperandRef" } } } ] }, "operand" : [ { - "name" : "Obs", + "name" : "Observation", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}Observation", "type" : "NamedTypeSpecifier" @@ -859,9 +973,58 @@ "source" : { "type" : "Query", "source" : [ { - "alias" : "O", + "alias" : "Observation", + "expression" : { + "name" : "Observations", + "type" : "OperandRef" + } + } ], + "relationship" : [ ], + "return" : { + "expression" : { + "name" : "ToQuantity", + "libraryName" : "FHIRHelpers", + "type" : "FunctionRef", + "operand" : [ { + "strict" : false, + "type" : "As", + "operand" : { + "path" : "value", + "scope" : "Observation", + "type" : "Property" + }, + "asTypeSpecifier" : { + "name" : "{http://hl7.org/fhir}Quantity", + "type" : "NamedTypeSpecifier" + } + } ] + } + } + } + }, + "operand" : [ { + "name" : "Observations", + "operandTypeSpecifier" : { + "type" : "ListTypeSpecifier", + "elementType" : { + "name" : "{http://hl7.org/fhir}Observation", + "type" : "NamedTypeSpecifier" + } + } + } ] + }, { + "name" : "AverageObservation", + "context" : "Patient", + "accessLevel" : "Public", + "type" : "FunctionDef", + "expression" : { + "type" : "Avg", + "source" : { + "type" : "Query", + "source" : [ { + "alias" : "Observation", "expression" : { - "name" : "ObsList", + "name" : "Observations", "type" : "OperandRef" } } ], @@ -876,7 +1039,7 @@ "type" : "As", "operand" : { "path" : "value", - "scope" : "O", + "scope" : "Observation", "type" : "Property" }, "asTypeSpecifier" : { @@ -889,7 +1052,7 @@ } }, "operand" : [ { - "name" : "ObsList", + "name" : "Observations", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -906,9 +1069,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "C", + "alias" : "Condition", "expression" : { - "name" : "CondList", + "name" : "Conditions", "type" : "OperandRef" } } ], @@ -921,7 +1084,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "verificationStatus", - "scope" : "C", + "scope" : "Condition", "type" : "Property" } ] }, { @@ -931,7 +1094,7 @@ } }, "operand" : [ { - "name" : "CondList", + "name" : "Conditions", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -948,9 +1111,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "C", + "alias" : "Condition", "expression" : { - "name" : "CondList", + "name" : "Conditions", "type" : "OperandRef" } } ], @@ -965,7 +1128,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "clinicalStatus", - "scope" : "C", + "scope" : "Condition", "type" : "Property" } ] }, { @@ -976,14 +1139,14 @@ "type" : "IsNull", "operand" : { "path" : "abatement", - "scope" : "C", + "scope" : "Condition", "type" : "Property" } } ] } }, "operand" : [ { - "name" : "CondList", + "name" : "Conditions", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -1000,9 +1163,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "C", + "alias" : "Condition", "expression" : { - "name" : "CondList", + "name" : "Conditions", "type" : "OperandRef" } } ], @@ -1019,7 +1182,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "clinicalStatus", - "scope" : "C", + "scope" : "Condition", "type" : "Property" } ] }, { @@ -1034,7 +1197,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "clinicalStatus", - "scope" : "C", + "scope" : "Condition", "type" : "Property" } ] }, { @@ -1050,7 +1213,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "clinicalStatus", - "scope" : "C", + "scope" : "Condition", "type" : "Property" } ] }, { @@ -1061,7 +1224,7 @@ } }, "operand" : [ { - "name" : "CondList", + "name" : "Conditions", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -1078,9 +1241,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "C", + "alias" : "Condition", "expression" : { - "name" : "CondList", + "name" : "Conditions", "type" : "OperandRef" } } ], @@ -1119,7 +1282,7 @@ "type" : "As", "operand" : { "path" : "onset", - "scope" : "C", + "scope" : "Condition", "type" : "Property" }, "asTypeSpecifier" : { @@ -1141,7 +1304,7 @@ "type" : "As", "operand" : { "path" : "onset", - "scope" : "C", + "scope" : "Condition", "type" : "Property" }, "asTypeSpecifier" : { @@ -1161,7 +1324,7 @@ "type" : "Property", "source" : { "path" : "recordedDate", - "scope" : "C", + "scope" : "Condition", "type" : "Property" } }, { @@ -1172,7 +1335,7 @@ } }, "operand" : [ { - "name" : "CondList", + "name" : "Conditions", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -1197,9 +1360,9 @@ "source" : { "type" : "Query", "source" : [ { - "alias" : "C", + "alias" : "Condition", "expression" : { - "name" : "CondList", + "name" : "Conditions", "type" : "OperandRef" } } ], @@ -1277,7 +1440,106 @@ } }, "operand" : [ { - "name" : "CondList", + "name" : "Conditions", + "operandTypeSpecifier" : { + "type" : "ListTypeSpecifier", + "elementType" : { + "name" : "{http://hl7.org/fhir}Condition", + "type" : "NamedTypeSpecifier" + } + } + } ] + }, { + "name" : "FirstCondition", + "context" : "Patient", + "accessLevel" : "Public", + "type" : "FunctionDef", + "expression" : { + "type" : "First", + "source" : { + "type" : "Query", + "source" : [ { + "alias" : "Condition", + "expression" : { + "name" : "Conditions", + "type" : "OperandRef" + } + } ], + "relationship" : [ ], + "sort" : { + "by" : [ { + "direction" : "asc", + "type" : "ByExpression", + "expression" : { + "type" : "Coalesce", + "operand" : [ { + "path" : "value", + "type" : "Property", + "source" : { + "strict" : false, + "type" : "As", + "operand" : { + "name" : "onset", + "type" : "IdentifierRef" + }, + "asTypeSpecifier" : { + "name" : "{http://hl7.org/fhir}dateTime", + "type" : "NamedTypeSpecifier" + } + } + }, { + "path" : "value", + "type" : "Property", + "source" : { + "path" : "start", + "type" : "Property", + "source" : { + "strict" : false, + "type" : "As", + "operand" : { + "name" : "onset", + "type" : "IdentifierRef" + }, + "asTypeSpecifier" : { + "name" : "{http://hl7.org/fhir}Period", + "type" : "NamedTypeSpecifier" + } + } + } + }, { + "path" : "value", + "type" : "Property", + "source" : { + "path" : "end", + "type" : "Property", + "source" : { + "strict" : false, + "type" : "As", + "operand" : { + "name" : "onset", + "type" : "IdentifierRef" + }, + "asTypeSpecifier" : { + "name" : "{http://hl7.org/fhir}Period", + "type" : "NamedTypeSpecifier" + } + } + } + }, { + "path" : "value", + "type" : "Property", + "source" : { + "name" : "recordedDate", + "type" : "IdentifierRef" + } + } ] + } + } ] + } + } + }, + "operand" : [ { + "name" : "Conditions", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -1294,9 +1556,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "P", + "alias" : "Procedure", "expression" : { - "name" : "ProcList", + "name" : "Procedures", "type" : "OperandRef" } } ], @@ -1308,7 +1570,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "P", + "scope" : "Procedure", "type" : "Property" } }, { @@ -1319,7 +1581,7 @@ } }, "operand" : [ { - "name" : "ProcList", + "name" : "Procedures", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -1336,9 +1598,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "P", + "alias" : "Procedure", "expression" : { - "name" : "ProcList", + "name" : "Procedures", "type" : "OperandRef" } } ], @@ -1350,7 +1612,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "P", + "scope" : "Procedure", "type" : "Property" } }, { @@ -1361,7 +1623,7 @@ } }, "operand" : [ { - "name" : "ProcList", + "name" : "Procedures", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -1378,9 +1640,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "P", + "alias" : "Procedure", "expression" : { - "name" : "ProcList", + "name" : "Procedures", "type" : "OperandRef" } } ], @@ -1394,7 +1656,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "P", + "scope" : "Procedure", "type" : "Property" } }, { @@ -1421,7 +1683,7 @@ } }, "operand" : [ { - "name" : "ProcList", + "name" : "Procedures", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -1438,9 +1700,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "P", + "alias" : "Procedure", "expression" : { - "name" : "ProcList", + "name" : "Procedures", "type" : "OperandRef" } } ], @@ -1477,7 +1739,7 @@ "type" : "As", "operand" : { "path" : "performed", - "scope" : "P", + "scope" : "Procedure", "type" : "Property" }, "asTypeSpecifier" : { @@ -1499,7 +1761,7 @@ "type" : "As", "operand" : { "path" : "performed", - "scope" : "P", + "scope" : "Procedure", "type" : "Property" }, "asTypeSpecifier" : { @@ -1515,7 +1777,7 @@ } }, "operand" : [ { - "name" : "ProcList", + "name" : "Procedures", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -1540,9 +1802,9 @@ "source" : { "type" : "Query", "source" : [ { - "alias" : "P", + "alias" : "Procedure", "expression" : { - "name" : "ProcList", + "name" : "Procedures", "type" : "OperandRef" } } ], @@ -1613,7 +1875,103 @@ } }, "operand" : [ { - "name" : "ProcList", + "name" : "Procedures", + "operandTypeSpecifier" : { + "type" : "ListTypeSpecifier", + "elementType" : { + "name" : "{http://hl7.org/fhir}Procedure", + "type" : "NamedTypeSpecifier" + } + } + } ] + }, { + "name" : "FirstProcedure", + "context" : "Patient", + "accessLevel" : "Public", + "type" : "FunctionDef", + "expression" : { + "type" : "First", + "source" : { + "type" : "Query", + "source" : [ { + "alias" : "Procedure", + "expression" : { + "name" : "Procedures", + "type" : "OperandRef" + } + } ], + "relationship" : [ ], + "sort" : { + "by" : [ { + "direction" : "asc", + "type" : "ByExpression", + "expression" : { + "type" : "Coalesce", + "operand" : [ { + "path" : "value", + "type" : "Property", + "source" : { + "strict" : false, + "type" : "As", + "operand" : { + "name" : "performed", + "type" : "IdentifierRef" + }, + "asTypeSpecifier" : { + "name" : "{http://hl7.org/fhir}dateTime", + "type" : "NamedTypeSpecifier" + } + } + }, { + "path" : "value", + "type" : "Property", + "source" : { + "path" : "start", + "type" : "Property", + "source" : { + "strict" : false, + "type" : "As", + "operand" : { + "name" : "performed", + "type" : "IdentifierRef" + }, + "asTypeSpecifier" : { + "name" : "{http://hl7.org/fhir}Period", + "type" : "NamedTypeSpecifier" + } + } + } + } ] + } + }, { + "direction" : "asc", + "type" : "ByExpression", + "expression" : { + "path" : "value", + "type" : "Property", + "source" : { + "path" : "end", + "type" : "Property", + "source" : { + "strict" : false, + "type" : "As", + "operand" : { + "name" : "performed", + "type" : "IdentifierRef" + }, + "asTypeSpecifier" : { + "name" : "{http://hl7.org/fhir}Period", + "type" : "NamedTypeSpecifier" + } + } + } + } + } ] + } + } + }, + "operand" : [ { + "name" : "Procedures", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -1630,9 +1988,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "S", + "alias" : "Request", "expression" : { - "name" : "ServiceRequestList", + "name" : "ServiceRequests", "type" : "OperandRef" } } ], @@ -1644,7 +2002,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "S", + "scope" : "Request", "type" : "Property" } }, { @@ -1662,7 +2020,56 @@ } }, "operand" : [ { - "name" : "ServiceRequestList", + "name" : "ServiceRequests", + "operandTypeSpecifier" : { + "type" : "ListTypeSpecifier", + "elementType" : { + "name" : "{http://hl7.org/fhir}ServiceRequest", + "type" : "NamedTypeSpecifier" + } + } + } ] + }, { + "name" : "ActiveOrCompletedServiceRequest", + "context" : "Patient", + "accessLevel" : "Public", + "type" : "FunctionDef", + "expression" : { + "type" : "Query", + "source" : [ { + "alias" : "Request", + "expression" : { + "name" : "ServiceRequests", + "type" : "OperandRef" + } + } ], + "relationship" : [ ], + "where" : { + "type" : "In", + "operand" : [ { + "path" : "value", + "type" : "Property", + "source" : { + "path" : "status", + "scope" : "Request", + "type" : "Property" + } + }, { + "type" : "List", + "element" : [ { + "valueType" : "{urn:hl7-org:elm-types:r1}String", + "value" : "active", + "type" : "Literal" + }, { + "valueType" : "{urn:hl7-org:elm-types:r1}String", + "value" : "completed", + "type" : "Literal" + } ] + } ] + } + }, + "operand" : [ { + "name" : "ServiceRequests", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -1679,44 +2086,134 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "S", + "alias" : "Request", + "expression" : { + "name" : "ServiceRequests", + "type" : "OperandRef" + } + } ], + "relationship" : [ ], + "where" : { + "type" : "In", + "operand" : [ { + "path" : "value", + "type" : "Property", + "source" : { + "path" : "authoredOn", + "scope" : "Request", + "type" : "Property" + } + }, { + "lowClosed" : true, + "highClosed" : true, + "type" : "Interval", + "low" : { + "type" : "Subtract", + "operand" : [ { + "type" : "Now" + }, { + "name" : "LookBack", + "type" : "OperandRef" + } ] + }, + "high" : { + "type" : "Now" + } + } ] + } + }, + "operand" : [ { + "name" : "ServiceRequests", + "operandTypeSpecifier" : { + "type" : "ListTypeSpecifier", + "elementType" : { + "name" : "{http://hl7.org/fhir}ServiceRequest", + "type" : "NamedTypeSpecifier" + } + } + }, { + "name" : "LookBack", + "operandTypeSpecifier" : { + "name" : "{urn:hl7-org:elm-types:r1}Quantity", + "type" : "NamedTypeSpecifier" + } + } ] + }, { + "name" : "ActiveServiceRequest", + "context" : "Patient", + "accessLevel" : "Public", + "type" : "FunctionDef", + "expression" : { + "type" : "Query", + "source" : [ { + "alias" : "Request", + "expression" : { + "name" : "ServiceRequests", + "type" : "OperandRef" + } + } ], + "relationship" : [ ], + "where" : { + "type" : "Equal", + "operand" : [ { + "path" : "value", + "type" : "Property", + "source" : { + "path" : "status", + "scope" : "Request", + "type" : "Property" + } + }, { + "valueType" : "{urn:hl7-org:elm-types:r1}String", + "value" : "active", + "type" : "Literal" + } ] + } + }, + "operand" : [ { + "name" : "ServiceRequests", + "operandTypeSpecifier" : { + "type" : "ListTypeSpecifier", + "elementType" : { + "name" : "{http://hl7.org/fhir}ServiceRequest", + "type" : "NamedTypeSpecifier" + } + } + } ] + }, { + "name" : "CompletedServiceRequest", + "context" : "Patient", + "accessLevel" : "Public", + "type" : "FunctionDef", + "expression" : { + "type" : "Query", + "source" : [ { + "alias" : "Request", "expression" : { - "name" : "ServiceRequestList", + "name" : "ServiceRequests", "type" : "OperandRef" } } ], "relationship" : [ ], "where" : { - "type" : "In", + "type" : "Equal", "operand" : [ { "path" : "value", "type" : "Property", "source" : { - "path" : "authoredOn", - "scope" : "S", + "path" : "status", + "scope" : "Request", "type" : "Property" } }, { - "lowClosed" : true, - "highClosed" : true, - "type" : "Interval", - "low" : { - "type" : "Subtract", - "operand" : [ { - "type" : "Now" - }, { - "name" : "LookBack", - "type" : "OperandRef" - } ] - }, - "high" : { - "type" : "Now" - } + "valueType" : "{urn:hl7-org:elm-types:r1}String", + "value" : "completed", + "type" : "Literal" } ] } }, "operand" : [ { - "name" : "ServiceRequestList", + "name" : "ServiceRequests", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -1724,12 +2221,6 @@ "type" : "NamedTypeSpecifier" } } - }, { - "name" : "LookBack", - "operandTypeSpecifier" : { - "name" : "{urn:hl7-org:elm-types:r1}Quantity", - "type" : "NamedTypeSpecifier" - } } ] }, { "name" : "ActiveMedicationStatement", @@ -1739,9 +2230,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "M", + "alias" : "Statement", "expression" : { - "name" : "MedList", + "name" : "Statements", "type" : "OperandRef" } } ], @@ -1755,7 +2246,7 @@ "type" : "As", "operand" : { "path" : "effective", - "scope" : "M", + "scope" : "Statement", "type" : "Property" }, "asTypeSpecifier" : { @@ -1775,7 +2266,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "M", + "scope" : "Statement", "type" : "Property" } }, { @@ -1810,7 +2301,7 @@ } }, "operand" : [ { - "name" : "MedList", + "name" : "Statements", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -1827,9 +2318,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "M", + "alias" : "Request", "expression" : { - "name" : "MedList", + "name" : "Requests", "type" : "OperandRef" } } ], @@ -1841,7 +2332,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "M", + "scope" : "Request", "type" : "Property" } }, { @@ -1852,7 +2343,7 @@ } }, "operand" : [ { - "name" : "MedList", + "name" : "Requests", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -1869,9 +2360,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "M", + "alias" : "Request", "expression" : { - "name" : "MedList", + "name" : "Requests", "type" : "OperandRef" } } ], @@ -1885,7 +2376,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "M", + "scope" : "Request", "type" : "Property" } }, { @@ -1900,7 +2391,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "M", + "scope" : "Request", "type" : "Property" } }, { @@ -1912,7 +2403,7 @@ } }, "operand" : [ { - "name" : "MedList", + "name" : "Requests", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -1929,9 +2420,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "M", + "alias" : "Statement", "expression" : { - "name" : "MedList", + "name" : "Statements", "type" : "OperandRef" } } ], @@ -1945,7 +2436,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "M", + "scope" : "Statement", "type" : "Property" } }, { @@ -1960,7 +2451,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "M", + "scope" : "Statement", "type" : "Property" } }, { @@ -1972,7 +2463,7 @@ } }, "operand" : [ { - "name" : "MedList", + "name" : "Statements", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -1989,9 +2480,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "M", + "alias" : "Request", "expression" : { - "name" : "MedList", + "name" : "Requests", "type" : "OperandRef" } } ], @@ -2007,7 +2498,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "M", + "scope" : "Request", "type" : "Property" } }, { @@ -2022,7 +2513,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "M", + "scope" : "Request", "type" : "Property" } }, { @@ -2038,7 +2529,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "M", + "scope" : "Request", "type" : "Property" } }, { @@ -2050,7 +2541,7 @@ } }, "operand" : [ { - "name" : "MedList", + "name" : "Requests", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -2067,9 +2558,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "M", + "alias" : "Request", "expression" : { - "name" : "MedList", + "name" : "Requests", "type" : "OperandRef" } } ], @@ -2101,7 +2592,7 @@ "type" : "Property", "source" : { "path" : "authoredOn", - "scope" : "M", + "scope" : "Request", "type" : "Property" } }, { @@ -2111,7 +2602,7 @@ } }, "operand" : [ { - "name" : "MedList", + "name" : "Requests", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -2134,9 +2625,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "M", + "alias" : "Statement", "expression" : { - "name" : "MedList", + "name" : "Statements", "type" : "OperandRef" } } ], @@ -2173,7 +2664,7 @@ "type" : "As", "operand" : { "path" : "effective", - "scope" : "M", + "scope" : "Statement", "type" : "Property" }, "asTypeSpecifier" : { @@ -2195,7 +2686,7 @@ "type" : "As", "operand" : { "path" : "effective", - "scope" : "M", + "scope" : "Statement", "type" : "Property" }, "asTypeSpecifier" : { @@ -2211,7 +2702,7 @@ } }, "operand" : [ { - "name" : "MedList", + "name" : "Statements", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -2234,9 +2725,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "M", + "alias" : "Dispense", "expression" : { - "name" : "MedList", + "name" : "Dispenses", "type" : "OperandRef" } } ], @@ -2270,7 +2761,7 @@ "type" : "Property", "source" : { "path" : "whenHandedOver", - "scope" : "M", + "scope" : "Dispense", "type" : "Property" } }, { @@ -2284,7 +2775,7 @@ "type" : "Property", "source" : { "path" : "whenPrepared", - "scope" : "M", + "scope" : "Dispense", "type" : "Property" } }, { @@ -2295,7 +2786,7 @@ } }, "operand" : [ { - "name" : "MedList", + "name" : "Dispenses", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -2318,9 +2809,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "E", + "alias" : "Encounter", "expression" : { - "name" : "EncList", + "name" : "Encounters", "type" : "OperandRef" } } ], @@ -2332,7 +2823,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "E", + "scope" : "Encounter", "type" : "Property" } }, { @@ -2343,7 +2834,7 @@ } }, "operand" : [ { - "name" : "EncList", + "name" : "Encounters", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -2360,9 +2851,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "E", + "alias" : "Encounter", "expression" : { - "name" : "EncList", + "name" : "Encounters", "type" : "OperandRef" } } ], @@ -2395,7 +2886,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "period", - "scope" : "E", + "scope" : "Encounter", "type" : "Property" } ] }, { @@ -2405,7 +2896,7 @@ } }, "operand" : [ { - "name" : "EncList", + "name" : "Encounters", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -2428,9 +2919,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "A", + "alias" : "Allergy", "expression" : { - "name" : "AllergyIntolList", + "name" : "AllergyIntolerances", "type" : "OperandRef" } } ], @@ -2445,7 +2936,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "clinicalStatus", - "scope" : "A", + "scope" : "Allergy", "type" : "Property" } ] }, { @@ -2460,7 +2951,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "verificationStatus", - "scope" : "A", + "scope" : "Allergy", "type" : "Property" } ] }, { @@ -2471,7 +2962,7 @@ } }, "operand" : [ { - "name" : "AllergyIntolList", + "name" : "AllergyIntolerances", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -2488,9 +2979,9 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "G", + "alias" : "Goal", "expression" : { - "name" : "GoalList", + "name" : "Goals", "type" : "OperandRef" } } ], @@ -2523,7 +3014,7 @@ "type" : "As", "operand" : { "path" : "start", - "scope" : "G", + "scope" : "Goal", "type" : "Property" }, "asTypeSpecifier" : { @@ -2539,7 +3030,7 @@ "type" : "Property", "source" : { "path" : "statusDate", - "scope" : "G", + "scope" : "Goal", "type" : "Property" } } @@ -2548,10 +3039,10 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "T", + "alias" : "Target", "expression" : { "path" : "target", - "scope" : "G", + "scope" : "Goal", "type" : "Property" } } ], @@ -2565,7 +3056,7 @@ "type" : "As", "operand" : { "path" : "due", - "scope" : "T", + "scope" : "Target", "type" : "Property" }, "asTypeSpecifier" : { @@ -2581,10 +3072,10 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "T", + "alias" : "Target", "expression" : { "path" : "target", - "scope" : "G", + "scope" : "Goal", "type" : "Property" } } ], @@ -2599,7 +3090,7 @@ "type" : "As", "operand" : { "path" : "due", - "scope" : "T", + "scope" : "Target", "type" : "Property" }, "asTypeSpecifier" : { @@ -2648,7 +3139,7 @@ "operand" : { "type" : "Query", "source" : [ { - "alias" : "TD", + "alias" : "Date", "expression" : { "name" : "TargetDates", "type" : "QueryLetRef" @@ -2660,7 +3151,7 @@ "operand" : [ { "type" : "ToDateTime", "operand" : { - "name" : "TD", + "name" : "Date", "type" : "AliasRef" } }, { @@ -2675,7 +3166,7 @@ "operand" : { "type" : "Query", "source" : [ { - "alias" : "TQ", + "alias" : "Quantity", "expression" : { "name" : "TargetQuantities", "type" : "QueryLetRef" @@ -2692,7 +3183,7 @@ "name" : "StartDate", "type" : "QueryLetRef" }, { - "name" : "TQ", + "name" : "Quantity", "type" : "AliasRef" } ] } @@ -2706,7 +3197,7 @@ } }, "operand" : [ { - "name" : "GoalList", + "name" : "Goals", "operandTypeSpecifier" : { "type" : "ListTypeSpecifier", "elementType" : { @@ -2721,6 +3212,267 @@ "type" : "NamedTypeSpecifier" } } ] + }, { + "name" : "CompletedImmunization", + "context" : "Patient", + "accessLevel" : "Public", + "type" : "FunctionDef", + "expression" : { + "type" : "Query", + "source" : [ { + "alias" : "Immunization", + "expression" : { + "name" : "Immunizations", + "type" : "OperandRef" + } + } ], + "relationship" : [ ], + "where" : { + "type" : "Equal", + "operand" : [ { + "path" : "value", + "type" : "Property", + "source" : { + "path" : "status", + "scope" : "Immunization", + "type" : "Property" + } + }, { + "valueType" : "{urn:hl7-org:elm-types:r1}String", + "value" : "completed", + "type" : "Literal" + } ] + } + }, + "operand" : [ { + "name" : "Immunizations", + "operandTypeSpecifier" : { + "type" : "ListTypeSpecifier", + "elementType" : { + "name" : "{http://hl7.org/fhir}Immunization", + "type" : "NamedTypeSpecifier" + } + } + } ] + }, { + "name" : "ImmunizationLookBack", + "context" : "Patient", + "accessLevel" : "Public", + "type" : "FunctionDef", + "expression" : { + "type" : "Query", + "source" : [ { + "alias" : "Immunization", + "expression" : { + "name" : "Immunizations", + "type" : "OperandRef" + } + } ], + "let" : [ { + "identifier" : "LookBackInterval", + "expression" : { + "lowClosed" : true, + "highClosed" : true, + "type" : "Interval", + "low" : { + "type" : "Subtract", + "operand" : [ { + "type" : "Now" + }, { + "name" : "LookBack", + "type" : "OperandRef" + } ] + }, + "high" : { + "type" : "Now" + } + } + } ], + "relationship" : [ ], + "where" : { + "type" : "In", + "operand" : [ { + "path" : "value", + "type" : "Property", + "source" : { + "strict" : false, + "type" : "As", + "operand" : { + "path" : "occurrence", + "scope" : "Immunization", + "type" : "Property" + }, + "asTypeSpecifier" : { + "name" : "{http://hl7.org/fhir}dateTime", + "type" : "NamedTypeSpecifier" + } + } + }, { + "name" : "LookBackInterval", + "type" : "QueryLetRef" + } ] + } + }, + "operand" : [ { + "name" : "Immunizations", + "operandTypeSpecifier" : { + "type" : "ListTypeSpecifier", + "elementType" : { + "name" : "{http://hl7.org/fhir}Immunization", + "type" : "NamedTypeSpecifier" + } + } + }, { + "name" : "LookBack", + "operandTypeSpecifier" : { + "name" : "{urn:hl7-org:elm-types:r1}Quantity", + "type" : "NamedTypeSpecifier" + } + } ] + }, { + "name" : "MostRecentImmunization", + "context" : "Patient", + "accessLevel" : "Public", + "type" : "FunctionDef", + "expression" : { + "type" : "Last", + "source" : { + "type" : "Query", + "source" : [ { + "alias" : "Immunization", + "expression" : { + "name" : "Immunizations", + "type" : "OperandRef" + } + } ], + "relationship" : [ ], + "sort" : { + "by" : [ { + "direction" : "asc", + "type" : "ByExpression", + "expression" : { + "path" : "value", + "type" : "Property", + "source" : { + "strict" : false, + "type" : "As", + "operand" : { + "name" : "occurrence", + "type" : "IdentifierRef" + }, + "asTypeSpecifier" : { + "name" : "{http://hl7.org/fhir}dateTime", + "type" : "NamedTypeSpecifier" + } + } + } + } ] + } + } + }, + "operand" : [ { + "name" : "Immunizations", + "operandTypeSpecifier" : { + "type" : "ListTypeSpecifier", + "elementType" : { + "name" : "{http://hl7.org/fhir}Immunization", + "type" : "NamedTypeSpecifier" + } + } + } ] + }, { + "name" : "FirstImmunization", + "context" : "Patient", + "accessLevel" : "Public", + "type" : "FunctionDef", + "expression" : { + "type" : "First", + "source" : { + "type" : "Query", + "source" : [ { + "alias" : "Immunization", + "expression" : { + "name" : "Immunizations", + "type" : "OperandRef" + } + } ], + "relationship" : [ ], + "sort" : { + "by" : [ { + "direction" : "asc", + "type" : "ByExpression", + "expression" : { + "path" : "value", + "type" : "Property", + "source" : { + "strict" : false, + "type" : "As", + "operand" : { + "name" : "occurrence", + "type" : "IdentifierRef" + }, + "asTypeSpecifier" : { + "name" : "{http://hl7.org/fhir}dateTime", + "type" : "NamedTypeSpecifier" + } + } + } + } ] + } + } + }, + "operand" : [ { + "name" : "Immunizations", + "operandTypeSpecifier" : { + "type" : "ListTypeSpecifier", + "elementType" : { + "name" : "{http://hl7.org/fhir}Immunization", + "type" : "NamedTypeSpecifier" + } + } + } ] + }, { + "name" : "ActiveDevice", + "context" : "Patient", + "accessLevel" : "Public", + "type" : "FunctionDef", + "expression" : { + "type" : "Query", + "source" : [ { + "alias" : "Device", + "expression" : { + "name" : "Devices", + "type" : "OperandRef" + } + } ], + "relationship" : [ ], + "where" : { + "type" : "Equal", + "operand" : [ { + "path" : "value", + "type" : "Property", + "source" : { + "path" : "status", + "scope" : "Device", + "type" : "Property" + } + }, { + "valueType" : "{urn:hl7-org:elm-types:r1}String", + "value" : "active", + "type" : "Literal" + } ] + } + }, + "operand" : [ { + "name" : "Devices", + "operandTypeSpecifier" : { + "type" : "ListTypeSpecifier", + "elementType" : { + "name" : "{http://hl7.org/fhir}Device", + "type" : "NamedTypeSpecifier" + } + } + } ] } ] } } diff --git a/src/cql/r4/CDS_Connect_Commons_for_FHIRv401.cql b/src/cql/r4/CDS_Connect_Commons_for_FHIRv401.cql deleted file mode 100644 index dbef114bd..000000000 --- a/src/cql/r4/CDS_Connect_Commons_for_FHIRv401.cql +++ /dev/null @@ -1,496 +0,0 @@ -// CDS Connect Commons for FHIRv401 -// Initial version (1.0.0) based on CDS_Connect_Commons_for_FHIRv400.cql v1.0.1 -// with the addition of "EncounterLookback" and "MedicationDispenseLookback" functions. -library CDS_Connect_Commons_for_FHIRv401 version '1.0.0' - -using FHIR version '4.0.1' - -// Include the FHIRHelpers library for simplifying interacton w/ the FHIR data model -include FHIRHelpers version '4.0.1' called FHIRHelpers - -codesystem "AIVERSTATUS": 'http://terminology.hl7.org/CodeSystem/allergyintolerance-verification' -codesystem "AICLINSTATUS": 'http://terminology.hl7.org/CodeSystem/allergyintolerance-clinical' -codesystem "CONDVERSTATUS": 'http://terminology.hl7.org/CodeSystem/condition-ver-status' -codesystem "CONDCLINSTATUS": 'http://terminology.hl7.org/CodeSystem/condition-clinical' -code "AllergyIntolerance Confirmed code": 'confirmed' from "AIVERSTATUS" display 'Confirmed' -code "AllergyIntolerance Active code": 'active' from "AICLINSTATUS" display 'Active' -code "Condition Confirmed code": 'confirmed' from "CONDVERSTATUS" display 'Confirmed' -code "Condition Active code": 'active' from "CONDCLINSTATUS" display 'Active' -code "Condition Recurrence code": 'recurrence' from "CONDCLINSTATUS" display 'Recurrence' -code "Condition Relapse code": 'relapse' from "CONDCLINSTATUS" display 'Relapse' -concept "AllergyIntolerance Confirmed": { "AllergyIntolerance Confirmed code" } display 'Confirmed' -concept "AllergyIntolerance Active": { "AllergyIntolerance Active code" } display 'Active' -concept "Condition Confirmed": { "Condition Confirmed code" } display 'Confirmed' -concept "Condition Active": { "Condition Active code" } display 'Active' -concept "Condition Recurrence": { "Condition Recurrence code" } display 'Recurrence' -concept "Condition Relapse": { "Condition Relapse code" } display 'Relapse' - -// -------------------------------------------------- GENERAL --------------------------------------------------------- - -/** - * Converts a FHIR Period to a CQL Interval. FHIRHelpers provides a function for this, but - * FHIRHelpers provides several overloads of the ToInterval function, and the JavaScript CQL - * Execution Framework apparently does not handle this correctly. Creating uniquely named - * functions here ensures safe execution. - * @param period - a FHIR Period - * @returns {System.Interval} a CQL Interval or null if null was passed in - */ -define function PeriodToInterval(period FHIR.Period): - if period is null then - null - else - Interval[period."start".value, period."end".value] - -/** - * Converts a FHIR Range to a CQL Interval. FHIRHelpers provides a function for this, but - * FHIRHelpers provides several overloads of the ToInterval function, and the JavaScript CQL - * Execution Framework apparently does not handle this correctly. Creating uniquely named - * functions here ensures safe execution. - * @param range - a FHIR Range - * @returns {System.Interval} a CQL Interval or null if null was passed in - */ -define function RangeToInterval(range FHIR.Range): - if range is null then - null - else - Interval[FHIRHelpers.ToQuantity(range.low), FHIRHelpers.ToQuantity(range.high)] - -// -------------------------------------------------- OBSERVATIONS ----------------------------------------------------- - -/** - * Observations that are complete and verified. In FHIR R4, there are three statuses that indicate this state: 'final', - * 'corrected', and 'amended'. - * @see http://hl7.org/fhir/R4/valueset-observation-status.html - * @param ObsList - a list of Observations - * @returns {List} a list of verified Observations, or null if null was passed in - */ -define function Verified(ObsList List): - ObsList O where O.status.value in {'final', 'corrected', 'amended'} - -/** - * Observations that have quantity values recorded in the requested unit. - * @param ObsList - a list of Observations - * @param Unit - the unit to require in the Observations quantity value - * @returns {List} a list of Observations with the required unit, or null if null was passed in - */ -define function WithUnit(ObsList List, Unit String): - ObsList O - where (O.value as FHIR.Quantity).unit.value = Unit or (O.value as FHIR.Quantity).code.value = Unit - -/** - * Observations with an effective or issued date in the specified "look back" period. For example, LDL-C Tests in the - * last 6 years. - * TODO: Rename to LookBack once the execution engine supports overloaded functions. - * @param ObsList - a list of Observations - * @returns {List} a list of Observations with effective or issued date specified lookback period, or null - * if null was passed in - */ -define function ObservationLookBack(ObsList List, LookBack System.Quantity): - ObsList O - let LookBackInterval: Interval[Now() - LookBack, Now()] - where (O.effective as FHIR.dateTime).value in LookBackInterval - or (O.effective as FHIR.instant).value in LookBackInterval - or PeriodToInterval(O.effective as FHIR.Period) overlaps LookBackInterval - or O.issued.value in LookBackInterval - -/** - * The most recent observation. For each Observation, this algorithm will use the Coalesce function, which uses the - * first non-null date value from these fields: effectiveDateTime, effectiveInstant, effectivePeriod.end, - * effectivePeriod.start, issued. The found date will be used to compare Observations and determine the most recent - * one. NOTE: We can't use FindDate because it appears that the execution engine may have problems sorting by the - * result of a function. - * @param ObsList - a list of Observations - * @returns {Observation} the most recent Observation from the list, or null if null was passed in - */ -define function MostRecent(ObsList List): - Last(ObsList O sort by Coalesce( - (effective as FHIR.dateTime).value, - (effective as FHIR.instant).value, - (effective as FHIR.Period)."end".value, - (effective as FHIR.Period)."start".value, - issued.value) - ) - -/** - * Extracts the quantity value from an Observation, returning it as a CQL Quantity - * @param Obs - an observation - * @returns {System.Quantity} the Observation's value as a quantity, or null if there is no quantity value - */ -define function QuantityValue(Obs Observation): - FHIRHelpers.ToQuantity(Obs.value as FHIR.Quantity) - -/** - * Extracts the CodeableConcept value from an Observation, returning it as a CQL Concept - * @param Obs - an observation - * @returns {System.Concept} the Observation's value as a concept, or null if there is no CodeabeConcept value - */ -define function ConceptValue(Obs Observation): - FHIRHelpers.ToConcept(Obs.value as FHIR.CodeableConcept) - -/** - * Finds the first non-null meaningful date that can be associated with this Observation. This will look through the - * following fields in the following order: effectiveDateTime, effectiveInstant, effectivePeriod.end, - * effectivePeriod.start, issued. - * @param Obs - an Observation - * @returns {System.DateTime} the first non-null meaningful date, or null if non is found - */ -define function FindDate(Obs Observation): - Coalesce( - (Obs.effective as FHIR.dateTime).value, - (Obs.effective as FHIR.instant).value, - (Obs.effective as FHIR.Period)."end".value, - (Obs.effective as FHIR.Period)."start".value, - Obs.issued.value - ) - -/** - * The highest observation. - * The value will be used to compare Observations and determine the highest one. - * @param ObsList - a list of Observations - * @returns {System.Quantity} the quantity with the highest value from the list, or null if null was passed in - */ -define function HighestObservation(ObsList List): - Max(ObsList O return FHIRHelpers.ToQuantity(O.value as FHIR.Quantity)) - - -// -------------------------------------------------- CONDITIONS ------------------------------------------------------- - -/** - * Conditions that are confirmed. In FHIR R4, this is reflected by verificationStatus: 'confirmed'. - * @see http://hl7.org/fhir/R4/valueset-condition-ver-status.html - * @param CondList - a list of Conditions - * @returns {List} a list of confirmed Conditions, or null if null was passed in - */ -define function Confirmed(CondList List): - CondList C where C.verificationStatus ~ "Condition Confirmed" - -/** - * Conditions that are active. In FHIR R4, this is reflected by clinicalStatus: 'active' and the absence of any - * abatement information (i.e., if it abated, it is no longer active). - * TODO: Rename to Active once the execution engine supports overloaded functions. - * @see http://hl7.org/fhir/R4/valueset-condition-clinical.html - * @param CondList - a list of Conditions - * @returns {List} a list of active Conditions, or null if null was passed in - */ -define function ActiveCondition(CondList List): - CondList C - where C.clinicalStatus ~ "Condition Active" - and C.abatement is null - -/** - * Conditions that are active or recurring. In FHIR R4, this is reflected by clinicalStatus: 'active', 'recurrence', or - * 'relapse'. We do not check for null abatement information because it may have dates from when the now recurring - * condition initially went into remission. - * @see http://hl7.org/fhir/R4/valueset-condition-clinical.html - * @param CondList - a list of Conditions - * @returns {List} a list of active or recurring Conditions, or null if null was passed in - */ -define function ActiveOrRecurring(CondList List): - CondList C - where C.clinicalStatus ~ "Condition Active" - or C.clinicalStatus ~ "Condition Recurrence" - or C.clinicalStatus ~ "Condition Relapse" - -/** - * Conditions with an onset or recorded date in the specified "look back" period. For example, pregnancy in - * the last 42 weeks. - * TODO: Rename to LookBack once the execution engine supports overloaded functions. - * @param CondList - a list of Conditions - * @returns {List} a list of Conditions with onset or recorded date specified lookback period, or null - * if null was passed in - */ -define function ConditionLookBack(CondList List, LookBack System.Quantity): - CondList C - let LookBackInterval: Interval[Now() - LookBack, Now()] - where (C.onset as FHIR.dateTime).value in LookBackInterval - or PeriodToInterval(C.onset as FHIR.Period) overlaps LookBackInterval - or C.recordedDate.value in LookBackInterval - -/** - * The most recent condition. For each Condition, this algorithm will use the Coalesce function, which uses the - * first non-null result from these fields: onsetDateTime, onsetPeriod.end, onsetPeriod.start, assertedDate. - * The found date will be used to compare Conditions and determine the most recent one. - * @param CondList - a list of Conditions - * @returns {Condition} the most recent Condition from the list, or null if null was passed in - */ -define function MostRecentCondition(CondList List): - Last(CondList C sort by Coalesce( - (onset as FHIR.dateTime).value, - (onset as FHIR.Period)."end".value, - (onset as FHIR.Period)."start".value, - recordedDate.value) - ) - - // -------------------------------------------------- PROCEDURES ------------------------------------------------------ - -/** - * Procedures that are completed. In FHIR R4, this is reflected by status: 'completed'. - * @see http://hl7.org/fhir/R4/valueset-event-status.html - * @param ProcList - a list of Procedures - * @returns {List} a list of completed Procedures, or null if null was passed in - */ -define function Completed(ProcList List): - ProcList P - where P.status.value = 'completed' - -/** - * Procedures that are in progress. In FHIR R4, this is reflected by status: 'in-progress'. - * @see http://hl7.org/fhir/R4/valueset-event-status.html - * @param ProcList - a list of Procedures - * @returns {List} a list of completed Procedures, or null if null was passed in - */ -define function ProcedureInProgress(ProcList List): - ProcList P - where P.status.value = 'in-progress' - -/** - * Procedures that actually happened or are happening. In FHIR R4, there are a few properties that negate the - * procedure, most notably when status is 'preparation', 'not-done', 'entered-in-error', or 'unknown'. - * @see http://hl7.org/fhir/R4/valueset-event-status.html - * @param ProcList - a list of Procedures - * @returns {List} a list of Procedures that actually happened or are happening, or null if null was passed in - */ -define function ProcedurePerformance(ProcList List): - ProcList P - where not (P.status.value in {'preparation', 'not-done', 'entered-in-error', 'unknown'}) - -/** - * Procedures performed in the specified "look back" period. For example, PCIs performed in the - * past 2 weeks. - * TODO: Rename to LookBack once the execution engine supports overloaded functions. - * @param ProcList - a list of Procedures - * @param LookBack - the lookback period for when the procedure was performed - * @returns {List} a list of Procedures performed in the look back period, or null if null - * was passed in - */ -define function ProcedureLookBack(ProcList List, LookBack System.Quantity): - ProcList P - let LookBackInterval: Interval[Now() - LookBack, Now()] - where (P.performed as FHIR.dateTime).value in LookBackInterval - or PeriodToInterval(P.performed as FHIR.Period) overlaps LookBackInterval - -/** - * The most recent procedure. For each Procedure, this algorithm will use the Coalesce function, which returns the - * first non-null result from these fields: performedDateTime, performedPeriod.end, performedPeriod.start. - * The found date will be used to compare Procedures and determine the most recent one. - * @param ProcList - a list of Procedures - * @returns {Procedure} the most recent Procedure from the list, or null if null was passed in - */ -define function MostRecentProcedure(ProcList List): - Last(ProcList P sort by Coalesce( - (performed as FHIR.dateTime).value, - (performed as FHIR.Period)."end".value, - (performed as FHIR.Period)."start".value) - ) - -// ----------------------------------------------- SERVICEREQUESTS ----------------------------------------------------- - -// NOTE: In FHIR R4, ProcedureRequest and ReferralRequest are replaced by ServiceRequest - -/** - * ServiceRequests that are active or completed. In FHIR R4, this is reflected by the corresponding - * status values. - * @see http://hl7.org/fhir/R4/valueset-request-status.html - * @param ServiceRequestList - a list of ServiceRequests - * @returns {List} a list of accepted, in-progress, or completed ProcedureRequests, - * or null if null was passed in - */ -define function ServiceRequestActiveOrCompleted(ServiceRequestList List): - ServiceRequestList S - where S.status.value in List{'active', 'completed'} - -/** - * ServiceRequests ordered in the specified "look back" period. For example, PCIs ordered in the - * past 2 weeks. - * TODO: Rename to LookBack once the execution engine supports overloaded functions. - * @param ServiceRequestList - a list of ServiceRequests - * @param LookBack - the lookback period for when the service was ordered - * @returns {List} a list of ServiceRequests ordered in the look back period, or null if null - * was passed in - */ -define function ServiceRequestLookBack(ServiceRequestList List, LookBack System.Quantity): - ServiceRequestList S - where S.authoredOn.value in Interval[Now() - LookBack, Now()] - -// -------------------------------------------------- MEDICATIONS ------------------------------------------------------ - -/** - * Medications that are active, according to a statement, but not necessarily verified via a prescription. For example, - * medications that a patient has self-reported to be taking. This may, however, also represent medications that are - * expected to be active after providing a prescription (e.g., clinician-reported). In FHIR R4, this is reflected by - * MedicationStatement with status 'active' and no end date or an end date in the future. - * TODO: Rename to Active once the execution engine supports overloaded functions. - * @see http://hl7.org/fhir/R4/valueset-medication-statement-status.html - * @param MedList - a list of MedicationStatements - * @returns {List} a list of active medication statements, or null if null was passed in - */ -define function ActiveMedicationStatement(MedList List): - MedList M - let EffectivePeriod: PeriodToInterval(M.effective as FHIR.Period) - where M.status.value = 'active' - and (end of EffectivePeriod is null or end of EffectivePeriod after Now()) - -/** -* Medication requests that are active. In FHIR R4, this is reflected by MedicationRequest with status 'active'. -* Note that in R4, the MedicationRequest Boundaries and Relationships now says: "When reporting on the usage of -* a medication by a patient, the MedicationStatement resource should be used." It also indicates that: -* "A medication statement is not a part of the prescribe->dispense->administer sequence but is a report that -* such a sequence (or at least a part of it) did take place resulting in a belief that the patient has received -* a particular medication." In this regard, MedicationStatement is more appropriate as an indication of an actually -* active medication, although it's not clear if vendors really will automatically create MedicationStatements in -* these cases or not. Until we know, MedicationRequest may be the best proxy we have for an active medication. -* TODO: Should the "intent" field be considered (e.g., is it still active if intent is "proposal" or "plan")? -* TODO: Rename to Active once the execution engine supports overloaded functions. -* @see http://hl7.org/fhir/R4/valueset-medicationrequest-status.html -* @param MedList - a list of MedicationRequests -* @returns {List} a list of active medication requests, or null if null was passed in -*/ -define function ActiveMedicationRequest(MedList List): - MedList M where M.status.value = 'active' - -/** -* Medication requests that are active or completed, according to a prescription. In FHIR R4, this is reflected by MedicationRequest -* with status 'active' or 'completed'. See the note above (in ActiveMedicationRequest) for more nuance regarding MedicationRequest -* vs. MedicationStatement. -* @see http://hl7.org/fhir/R4/valueset-medicationrequest-status.html -* @param MedList - a list of MedicationRequests -* @returns {List} a list of active medication requests, or null if null was passed in -*/ -define function ActiveOrCompletedMedicationRequest(MedList List): - MedList M - where M.status.value = 'active' - or M.status.value = 'completed' - -/** - * Medications that are active or completed, according to a statement, but not necessarily verified via a prescription. - * For example, medications that a patient has self-reported to be taking. This may, however, also represent - * medications that are expected to be active after providing a prescription (e.g., clinician-reported). In FHIR R4, - * this is reflected by MedicationStatement with status 'active' or 'completed'. - * TODO: Rename to ActiveOrCompleted once the execution engine supports overloaded functions. - * @see http://hl7.org/fhir/R4/valueset-medication-statement-status.html - * @param MedList - a list of MedicationStatements - * @returns {List} a list of active or completed medication statements, or null if null was passed - * in - */ -define function ActiveOrCompletedMedicationStatement(MedList List): - MedList M - where M.status.value = 'active' - or M.status.value = 'completed' - -/** -* Medication requests that are active, completed, or stopped, according to a prescription. In FHIR R4, this is -* reflected by MedicationRequest with status 'active', 'completed', or 'stopped'. See the note above -* (in ActiveMedicationRequest) for more nuance regarding MedicationRequest vs. MedicationStatement. -* @see http://hl7.org/fhir/R4/valueset-medicationrequest-status.html -* @param MedList - a list of MedicationOrders -* @returns {List} a list of active medication requests, or null if null was passed in -*/ -define function ActiveCompletedOrStoppedMedicationRequest(MedList List): - MedList M - where M.status.value = 'active' - or M.status.value = 'completed' - or M.status.value = 'stopped' - -/** -* Medication requests that are issued in the specified "look back" period. -* TODO: Rename to LookBack once the execution engine supports overloaded functions. -* @param MedList - a list of MedicationRequests -* @param LookBack - the lookback period for when the medication was prescribed -* @returns {List} a list of MedicationRequests prescribed in the look back period, or null if null -* was passed in -*/ -define function MedicationRequestLookBack(MedList List, LookBack System.Quantity): - MedList M - let LookBackInterval: Interval[Now() - LookBack, Now()] - where M.authoredOn.value in LookBackInterval - // DSTU2 also checked the dateEnded property of MedicationOrder, but this doesn't exist for MedicationRequest - -/** -* Medication Statements that are issued in the specified "look back" period. -* TODO: Rename to LookBack once the execution engine supports overloaded functions. -* @param MedList - a list of MedicationStatements -* @param LookBack - the lookback period for when the medication was prescribed -* @returns {List} a list of MedicationStatements prescribed in the look back period, or null if null -* was passed in -*/ -define function MedicationStatementLookBack(MedList List, LookBack System.Quantity): - MedList M - let LookBackInterval: Interval[Now() - LookBack, Now()] - where (M.effective as FHIR.dateTime).value in LookBackInterval - or PeriodToInterval(M.effective as FHIR.Period) overlaps LookBackInterval - -/** -* Medication Dispenses that are handed over or prepared in the specified "look back" period. -* TODO: Rename to LookBack once the execution engine supports overloaded functions. -* @param MedList - a list of MedicationDispenses -* @param LookBack - the lookback period for when the medication was prescribed -* @returns {List} a list of MedicationDispenses handed over or prepared in the look back period, -* or null if null was passed in -*/ -define function MedicationDispenseLookBack(MedList List, LookBack System.Quantity): - MedList M - let LookBackInterval: Interval[Now() - LookBack, Now()] - where M.whenHandedOver.value in LookBackInterval - or M.whenPrepared.value in LookBackInterval - -// -------------------------------------------------- ENCOUNTERS ------------------------------------------------------ - -/** - * Encounters that are in progress. In FHIR R4, this is reflected by status: 'in-progress'. - * @see http://hl7.org/fhir/R4/valueset-encounter-status.html - * @param EncList - a list of Encounters - * @returns {List} a list of in progress encounters, or null if null was passed in - */ -define function InProgress(EncList List): - EncList E - where E.status.value = 'in-progress' - -/** - * Encounters performed in the specified "look back" period. - * TODO: Rename to LookBack once the execution engine supports overloaded functions. - * @param EncList - a list of Encounters - * @param LookBack - the lookback period for when the encounter occurred - * @returns {List} a list of Encounters occurring during the look back period, or null if null - * was passed in - */ -define function EncounterLookBack(EncList List, LookBack System.Quantity): - EncList E - let LookBackInterval: Interval[Now() - LookBack, Now()] - where FHIRHelpers.ToInterval(E.period) overlaps LookBackInterval - -// -------------------------------------------------- ALLERGY INTOLERANCES ------------------------------------------------------ - -/** -* AllergyIntolerances that are active or confirmed. In FHIR STU3, this is reflected by AllergyIntolerance -* with clinicalStatus 'active' or verificationStatus 'confirmed' -* @see https://www.hl7.org/fhir/R4/valueset-allergy-clinical-status.html -* @see https://www.hl7.org/fhir/R4/valueset-allergy-verification-status.html -* @param AllergyIntolList - a list of AllergyIntolerances -* @returns {List} a list of active or confirmed allergy intolerances, or null if null was passed in -*/ -define function ActiveOrConfirmedAllergyIntolerance(AllergyIntolList List): - AllergyIntolList A - where A.clinicalStatus ~ "AllergyIntolerance Active" - or A.verificationStatus ~ "AllergyIntolerance Confirmed" - -// -------------------------------------------------------- GOALS ------------------------------------------------------ - -/** - * Goals with a start, target, or status date in the specified "look back" period. For example, Pain Management Goals - * in the last 2 years. - * TODO: Rename to LookBack once the execution engine supports overloaded functions. - * @param GoalList - a list of Goals - * @returns {List} a list of Goals with a start, target, or status date in the specified lookback period, or null - * if null was passed in - */ -define function GoalLookBack(GoalList List, LookBack System.Quantity): - GoalList G - let LookBackInterval: Interval[Now() - LookBack, Now()], - StartDate: (G.start as FHIR.date).value, - StatusDate: G.statusDate.value, - TargetDates: (G.target) T return (T.due as FHIR.date).value, - TargetQuantities: (G.target) T return FHIRHelpers.ToQuantity(T.due as FHIR.Duration) - where StartDate in LookBackInterval - or StatusDate in LookBackInterval - or exists(TargetDates TD where TD in LookBackInterval) - or exists(TargetQuantities TQ where (StartDate + TQ) in LookBackInterval) diff --git a/src/cql/r4/FactorsToConsiderInManagingChronicPainFHIRv401.cql b/src/cql/r4/FactorsToConsiderInManagingChronicPainFHIRv401.cql new file mode 100644 index 000000000..d8169a9f5 --- /dev/null +++ b/src/cql/r4/FactorsToConsiderInManagingChronicPainFHIRv401.cql @@ -0,0 +1,1040 @@ +// # Introduction + +// The Pain Management Summary artifact provides relevant information to consider when managing a patient’s pain. +// This CDS logic was informed by the Centers for Disease Control and Prevention (CDC) Guideline for Opioid Prescribing +// for Chronic Pain. The CDS is not a direct representation of any one recommendation statement within the guideline. +// Instead, the CDS compiles clinical concepts mentioned throughout the guideline in one consolidated summary for +// clinician review. +// +// In the process of authoring the logic, certain assumptions were made and details developed when the guideline did +// not provide enough specificity. These decisions were made in the context of the CDS Connect Workgroup and CDC +// stakeholders, and are documented in the logic and/or in the CDS Connect artifact metadata. +// +// Version 2.0.0 implements several best practices prescribed by FHIR Clinical Guidelines, including: +// - Rename library from Factors_to_Consider_in_Managing_Chronic_Pain_FHIRv401 to FactorsToConsiderInManagingChronicPainFHIRv401 +// - Update CDS Connect Commons library to CDSConnectCommonsForFHIRv401 version 2.0.0 +// - Surround all library-level identifiers and datatypes in quotes +// - Use descriptive names (no abbreviations) for query aliases and function arguments +// - Fix non-standard use of Exists(...) as a function +// +// Version 2.0.0 also introduces the following changes from the previous version: +// - Replace "Conditions associated with chronic pain" 2.16.840.1.113762.1.4.1032.37 value set with 2.16.840.1.113762.1.4.1021.95 +// - Replace "Pregnancy" 2.16.840.1.113883.3.526.3.378 and "Pregnancy (New ICD10 codes published in 2018 and 2019)" +// 2.16.840.1.113762.1.4.1032.80 value sets with grouping value set "CDS Pregnancy" 2.16.840.1.113762.1.4.1032.264 +// +// NOTE: This version has not been piloted in a clinical setting, but has undergone logic testing and review. +// +// ##Source guideline: [CDC Guideline for Opioid Prescribing for Chronic Pain](https://www.cdc.gov/drugoverdose/prescribing/guideline.html) + +library FactorsToConsiderInManagingChronicPainFHIRv401 version '2.0.0' + +// # Data model # + +// The FHIR R4 model is used for testing purposes only. It has not been piloted. +using FHIR version '4.0.1' + +// # Referenced libraries # + +// The CDS Connect Commons for FHIRv401 library provides functions representing commonly used CDS logic and patterns. +include CDSConnectCommonsForFHIRv401 version '2.0.0' called C3F +// The FHIRHelpers library provides common functions for simplifying interaction w/ the FHIR R4 data model. +include FHIRHelpers version '4.0.1' called FHIRHelpers + +// # Value sets and codes # + +// ## Code Systems ## + +codesystem "LOINC": 'http://loinc.org' +codesystem "SNOMED-CT": 'http://snomed.info/sct' + +// Several concepts needed by the Pain Management Summary CDS do not yet have standardized codes associated with them. +// The CDS logic authors have registered new Logical Object Identifier Names and Codes (LOINC) codes, but they are +// not yet available. Once available, the CDS will be updated. Until then, CDS implementors will need to map to +// local codes (signified by the LOCAL code system below) or replace them with their own codes. +codesystem "LOCAL": 'http://cds.ahrq.gov/cdsconnect/pms' + +// ## Value sets ## + +// List value sets used by the artifact. The links to the Value Set Authority Center (VSAC) point to the latest +// expansion of each value set available. + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1021.95/expansion) +valueset "Conditions associated with chronic pain": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1021.95' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.34/expansion) +valueset "Opioid Pain Medications": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.34' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.54/expansion) +valueset "Adjuvant Analgesic Medications": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.54' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.105.12.1007/expansion) +valueset "Major Depression": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.105.12.1007' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.143/expansion) +valueset "Depression Diagnosis ICD9": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.143' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.52/expansion) +valueset "Anxiety": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.52' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.1240.2017.3.2.1015/expansion) +valueset "Anxiety Disorders ICD9": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.1240.2017.3.2.1015' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.106.12.1004/expansion) +valueset "Substance use disorder": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.106.12.1004' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.106.11.1010/expansion) +valueset "Substance Abuse": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.106.11.1010' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.102/expansion) +valueset "Suicide Attempt": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.102' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.53/expansion) +valueset "Sleep-disordered breathing": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.53' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.109.12.1028/expansion) +valueset "Kidney Failure": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.109.12.1028' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.199.12.1035/expansion) +valueset "Chronic Liver Disease": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.199.12.1035' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1047.42/expansion) +valueset "Liver Disease": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.42' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.264/expansion) +valueset "CDS Pregnancy": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.264' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.26/expansion) +valueset "Non opiod pain medications": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.26' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.36/expansion) +valueset "Non pharmacologic treatments for chronic pain": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.36' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.55/expansion) +valueset "Risk assessments relevant to pain management": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.55' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.43/expansion) +valueset "Benzodiazepine medications": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.43' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.42/expansion) +valueset "Naloxone medications": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.42' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.28/expansion) +valueset "Urine drug screen for pain management": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.28' + +// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.44/expansion) +valueset "Stool softeners and laxatives": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.44' + +// ## Individual codes ## + +// list individual codes from code systems used directly in the CQL logic. Individual codes are used when there is +// a single code from a particular vocabulary standard used to represent a clinical concept. It is considered +// best-practice not to create value sets containing a single code. + +code "Pregnancy status": '82810-3' from "LOINC" display 'Pregnancy status' +code "Pregnant": '77386006' from "SNOMED-CT" display 'Patient currently pregnant (finding)' +code "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]": + '55758-7' from "LOINC" display 'Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]' +code "Patient Health Questionnaire 9 item (PHQ-9) total score [Reported]": + '44261-6' from "LOINC" display 'Patient Health Questionnaire 9 item (PHQ-9) total score [Reported]' +code "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]": + '70274-6' from "LOINC" display 'Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]' +code "Total score [AUDIT]": '75624-7' from "LOINC" display 'Total score [AUDIT]' +code "Total score [AUDIT-C]": '75626-2' from "LOINC" display 'Total score [AUDIT-C]' +code "Total score [DAST-10]": '82667-7' from "LOINC" display 'Total score [DAST-10]' +code "Total score ORT": '91392-1' from "LOINC" display 'Total score ORT' +code "Pain severity Wong-Baker FACES Scale": '38221-8' from "LOINC" display 'Pain severity Wong-Baker FACES Scale' + +// The Pain intensity, Enjoyment of life, General activity scale [PEG] now has standardized LOINC codes available. +// These LOINC codes were not available when the initial version of the Pain Management Summary was developed. +// New systems implementing the Pain Management Summary should use the standardized codes, but the legacy local codes +// are also retained in order to allow existing systems to continue to function. Existing systems, however, are +// strongly encouraged to adopt the standardized LOINC codes. + +code "Mean score [PEG]": '91147-9' from "LOINC" display 'Mean score [PEG]' +code "Pain severity in the past week - 0-10 numeric rating [Reported]": + '75893-8' from "LOINC" display 'Pain severity in the past week - 0-10 numeric rating [Reported]' +code "What number best describes how pain has interfered with your enjoyment of life during the past week": + '91145-3' from "LOINC" display 'What number best describes how pain has interfered with your enjoyment of life during the past week' +code "What number best describes how pain has interfered with your general activity during the past week": + '91146-1' from "LOINC" display 'What number best describes how pain has interfered with your general activity during the past week' + +// Legacy local codes for the Pain intensity, Enjoyment of life, General activity scale [PEG]. +// New systems should use the LOINC codes above instead. + +code "Pain Enjoyment General Activity (PEG) Assessment LEGACY": + 'PEGASSESSMENT' from "LOCAL" display 'Pain Enjoyment General Activity (PEG) Assessment' +code "Pain LEGACY": 'PEGPAIN' from "LOCAL" display 'Pain' +code "Enjoyment of life LEGACY": 'PEGENJOYMENT' from "LOCAL" display 'Enjoyment of life' +code "General activity LEGACY": 'PEGGENERALACTIVITY' from "LOCAL" display 'General activity' + +// The STarT Back Screening Tool now has a standardized LOINC code available. This LOINC code was not available +// when the initial version of the Pain Management Summary was developed. New systems implementing the Pain Management +// "Summary" should use the standardized code, but the legacy local code is also retained in order to allow existing +// systems to continue to function. Existing systems, however, are strongly encouraged to adopt the standardized LOINC +// code. + +code "Total score [STarT Back]": '91351-7' from "LOINC" display 'Total score [STarT Back]' + +// Legacy local code for the STarT Back Screening Tool. New systems should use the LOINC codes above instead. + +code "STarT Back Screening Tool LEGACY": 'STARTBACK' from "LOCAL" display 'STarT Back Screening Tool' + +// The following codes do not yet have standardized codes associated with them so are expressed as LOCAL codes. +// As standardized codes become available, this CDS will be updated to use standard codes rather than LOCAL codes. + +code "Single question r/t ETOH use": 'SQETOHUSE' from "LOCAL" display 'Single question r/t ETOH use' +code "Single question r/t drug use": 'SQDRUGUSE' from "LOCAL" display 'Single question r/t drug use' +code "Morphine Milligram Equivalent (MME)": 'MME' from "LOCAL" display 'Morphine Milligram Equivalent (MME)' + +// # Parameters # + +// The InclusionMedicationsLookbackPeriod allows CDS implementors to specify how far the inclusion logic should look +// back for qualifying active medications. By default, the inclusion logic will look back 180 days. +parameter "InclusionMedicationsLookbackPeriod" default 180 days + +// # CDS logic # + +context Patient + +// ## Re-usable functions ## + +// The summary logic contains many constructs that are needed throughout the logic. Where possible, these constructs +// have been developed as re-usable functions that can be invoked wherever they are needed. + +// Returns the first-found display text for a CodeableConcept, looking first at the `text` attribute, then the +// `display` on each `coding` until it finds a non-null value. Some PEG codes are normalized due to length. +// @param Koncept - a FHIR CodeableConcept to get text from +// @returns {System."String"} the display text or null if none is found + +define function "ConceptText"(Koncept FHIR."CodeableConcept"): + if Koncept ~ "Mean score [PEG]" or Koncept ~ "Pain Enjoyment General Activity (PEG) Assessment LEGACY" + then 'Mean score [PEG]' + else if Koncept ~ "Pain severity in the past week - 0-10 numeric rating [Reported]" or Koncept ~ "Pain LEGACY" + then 'Pain' + else if Koncept ~ "What number best describes how pain has interfered with your enjoyment of life during the past week" + or Koncept ~ "Enjoyment of life LEGACY" + then 'Enjoyment of life' + else if Koncept ~ "What number best describes how pain has interfered with your general activity during the past week" + or Koncept ~ "General activity LEGACY" + then 'General activity' + else + Coalesce(Koncept.text.value, Coalesce((Koncept.coding) c2 return c2.display.value)) + +// We do not reliably get ranges back from EHR data, but ranges are important to understanding assessment scores in +// the summary. This function adds ranges to the name for known assessments. +// @param Koncept - a FHIR CodeableConcept to get the updated text for +// @returns {System."String"} the display text with range information appended +define function "ConceptTextWithRange"(Koncept FHIR."CodeableConcept"): + if Koncept ~ "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]" + then "ConceptText"(Koncept) + ' [Range: 0-6]' + else if Koncept ~ "Patient Health Questionnaire 9 item (PHQ-9) total score [Reported]" + then "ConceptText"(Koncept) + ' [Range: 0-27]' + else if Koncept ~ "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]" + then "ConceptText"(Koncept) + ' [Range: 0-21]' + else if Koncept ~ "Total score [AUDIT]" + then "ConceptText"(Koncept) + ' [Range: 0-40]' + else if Koncept ~ "Total score [AUDIT-C]" + then "ConceptText"(Koncept) + ' [Range: 0-12]' + else if Koncept ~ "Total score [DAST-10]" + then "ConceptText"(Koncept) + ' [Range: 0-10]' + else if Koncept ~ "Total score ORT" + then "ConceptText"(Koncept) + ' [Range: 0-26]' + else if Koncept ~ "Pain severity Wong-Baker FACES Scale" + then "ConceptText"(Koncept) + ' [Range: 0-10]' + else if Koncept ~ "Mean score [PEG]" + or Koncept ~ "Pain Enjoyment General Activity (PEG) Assessment LEGACY" + then "ConceptText"(Koncept) + ' [Range: 0-10]' + else if Koncept ~ "Total score [STarT Back]" + or Koncept ~ "STarT Back Screening Tool LEGACY" + then "ConceptText"(Koncept) + ' [Range: 0-9]' + else + "ConceptText"(Koncept) + +// Returns a text representation of a date using the CQL `ToString` function. +// @param Date - a FHIR date to get text for +// @returns {System."String"} the text representation of the date +define function "DateText"(Date FHIR."date"): + ToString(Date.value) + +// Returns a text representation of a dateTime using the CQL `ToString` function. +// @param Date - a FHIR dateTime to get text for +// @returns {System."String"} the text representation of the dateTime +define function "DateTimeText"(Date FHIR."dateTime"): + ToString(Date.value) + +// Returns a text representation of an instant using the CQL `ToString` function. +// @param Instant - a FHIR instant to get text for +// @returns {System."String"} the text representation of the instant +define function "InstantText"(Instant FHIR."instant"): + ToString(Instant.value) + +// Returns a text representation of a Quantity with the Quantity's value and unit. +// If the unit is {score}, then omit it (as it is not useful to display) +// @param Quantity - a FHIR Quantity to get text for +// @returns {System."String"} the text representation of the Quantity +define function "QuantityText"(Quantity FHIR."Quantity"): + if (Quantity is null) then null + else if (Quantity.unit is not null and Quantity.unit.value != '{score}') then ToString(Quantity.value.value) + ' ' + Quantity.unit.value + else if (Quantity.code is not null and Quantity.code.value != '{score}') then ToString(Quantity.value.value) + ' ' + Quantity.code.value + else ToString(Quantity.value.value) + +// Returns a tuple containing a Period's start and end as text representations. +// @param Period - a FHIR Period to get a tuple for +// @returns {Tuple} the tuple representation of the Period +define function "PeriodObject"(Period FHIR."Period"): + if Period is null then null + else + { + Start: "DateTimeText"(Period."start"), + End: "DateTimeText"(Period."end") + } + +// Returns a tuple containing a Range's low and high as text representations. +// @param Range - a FHIR Range to get a tuple for +// @returns {Tuple} the tuple representation of the Range +define function "RangeObject"(Range FHIR."Range"): + if Range is null then null + else + { + Low: "QuantityText"(Range.low), + High: "QuantityText"(Range.high) + } + +// Returns a text representation of a date associated with an Observation, preferring `effectiveDateTime`, then +// `effectivePeriod.start`, then `issued`. +// @param Observation - a FHIR Observation to get the text date from +// @returns {System."String"} the text representation of a relevant date from the Observation +define function "ObservationDate"(Observation FHIR."Observation"): + Coalesce( + "DateTimeText"(Observation.effective as FHIR."dateTime"), + "InstantText"(Observation.effective as FHIR."instant"), + "DateTimeText"((Observation.effective as FHIR."Period")."start"), + "InstantText"(Observation.issued) + ) + +// Returns a text representation of a date associated with a MedicationStatement, preferring `effectiveDateTime`, then +// `.start`. +// @param Statement - a FHIR MedicationStatement to get the text date from +// @returns {System."String"} the text representation of a relevant date from the MedicationStatement +define function "MedicationStatementDate"(Statement FHIR."MedicationStatement"): + Coalesce( + "DateTimeText"(Statement.effective as FHIR."dateTime"), + "DateTimeText"((Statement.effective as FHIR."Period")."start") + ) + +// Returns a text representation of a Condition's onset, whether represented as a dateTime, Period, Quantity (Age), +// Range (Age), or string. +// @param Condition - a FHIR Condition to get the text representation of the onset from +// @returns {System."String"} the text representation of the Condition's onset +define function "Onset"(Condition FHIR."Condition"): + Coalesce( List{ + "DateTimeText"(Condition.onset as FHIR."dateTime"), + "QuantityText"(Condition.onset as FHIR."Age"), + "PeriodObject"(Condition.onset as FHIR."Period"), + "RangeObject"(Condition.onset as FHIR."Range"), + (Condition.onset as FHIR."string").value + }) + +// Returns a text representation of a Condition's abatement, whether represented as a dateTime, Period, Quantity (Age), +// Range (Age), string, or boolean. +// @param Condition - a FHIR Condition to get the text representation of the abatement from +// @returns {System."String"} the text representation of the Condition's abatement +define function "Abatement"(Condition FHIR."Condition"): + Coalesce( List{ + "DateTimeText"(Condition.abatement as FHIR."dateTime"), + "QuantityText"(Condition.abatement as FHIR."Age"), + "PeriodObject"(Condition.abatement as FHIR."Period"), + "RangeObject"(Condition.abatement as FHIR."Range"), + (Condition.abatement as FHIR."string").value + }) + +// ## Target population ## + +// INCLUSIONS + +// Determines if patient's age, in years, at the time CQL is run, is at least 18 years old +define "Is18orOlder": + AgeInYears() >= 18 + +// Conditions associated with chronic pain +define "ConditionsAssociatedWithChronicPain": + C3F."Confirmed"(C3F."ActiveOrRecurring"(["Condition": "Conditions associated with chronic pain"])) + +// Determines if the patient has any of the conditions associated with chronic pain +define "HasConditionAssociatedWithChronicPain": + exists("ConditionsAssociatedWithChronicPain") + +// Determines if the patient has any record of opioid pain medications in the lookback period +// - Medication Request within past 180 days (lookback can be made a parameter) +// - Medication Statement by patient within past 180 days (lookback can be made a parameter) +define "HasRecentOpioidPainMedication": + exists(C3F."ActiveCompletedOrStoppedMedicationRequest"(C3F."MedicationRequestLookBack"( + ["MedicationRequest": "Opioid Pain Medications"], + "InclusionMedicationsLookbackPeriod") + )) + or exists(C3F."ActiveOrCompletedMedicationStatement"(C3F."MedicationStatementLookBack"( + ["MedicationStatement": "Opioid Pain Medications"], + "InclusionMedicationsLookbackPeriod") + )) + +// Determines if the patient has any record of adjuvant analgesic medications in the lookback period +// - Medication Request within past 180 days (lookback can be made a parameter) +// - Medication Statement by patient within past 180 days (lookback can be made a parameter) +define "HasRecentAdjuvantAnalgesicMedication": + exists(C3F."ActiveCompletedOrStoppedMedicationRequest"(C3F."MedicationRequestLookBack"( + ["MedicationRequest": "Adjuvant Analgesic Medications"], + "InclusionMedicationsLookbackPeriod") + )) + or exists(C3F."ActiveOrCompletedMedicationStatement"(C3F."MedicationStatementLookBack"( + ["MedicationStatement": "Adjuvant Analgesic Medications"], + "InclusionMedicationsLookbackPeriod") + )) + +// Determines if the patient meets the inclusion criteria for the CDS. Inclusion criteria is: +// - Age >=18 years +// - AND +// - OR Conditions associated with chronic pain +// - OR Opioid pain medication +// - OR Adjuvant analgesic medication +define "MeetsInclusionCriteria": + "Is18orOlder" + and ( + "HasConditionAssociatedWithChronicPain" + or "HasRecentOpioidPainMedication" + or "HasRecentAdjuvantAnalgesicMedication" + ) + +// EXCLUSIONS + +// TAKE NOTICE: This CDS is not intended for patients who meet any of the following criteria: +// 1. Younger than 18 years of age +// 2. Undergoing end-of-life care (hospice or palliative) +// 3. Undergoing active cancer treatment +// +// The first exclusion is explicitly accounted for under INCLUSIONS. +// The second and third exclusions cannot be realiably detected for all patients using just EHR data. For that reason +// they are not implemented in this CDS. Care providers should use their judgement when applying this CDS to their +// patients. + +// ## Intervention(s) ## + +// DISPLAY and POPULATE a Pain Management Summary of the following items: + +// PERTINENT MEDICAL HISTORY + +// Conditions associated with chronic pain and their dates of onset + +define "ReportConditionsAssociatedWithChronicPain": + ("ConditionsAssociatedWithChronicPain") Condition + return { + Name: "ConceptText"(Condition.code), + Status: Condition.clinicalStatus.coding[0].code.value, + Onset: "Onset"(Condition), + DateRecorded: "DateTimeText"(Condition.recordedDate) + } + sort by (Onset as "String") desc + +// Conditions that are risk factors for opioid-related harms and their dates of onset +// This is a union of nine value sets (w/ different filtering criteria) + +define "DepressionConditions": + C3F."Confirmed"(C3F."ActiveOrRecurring"(["Condition": "Major Depression"])) + union C3F."Confirmed"(C3F."ActiveOrRecurring"(["Condition": "Depression Diagnosis ICD9"])) + +define "AnxietyConditions": + C3F."Confirmed"(C3F."ActiveOrRecurring"(["Condition": "Anxiety"])) + union C3F."Confirmed"(C3F."ActiveOrRecurring"(["Condition": "Anxiety Disorders ICD9"])) + +define "SubstanceUseDisorderConditions": + C3F."Confirmed"(["Condition": "Substance use disorder"]) + union C3F."Confirmed"(["Condition": "Substance Abuse"]) + +define "SuicideAttemptConditions": + C3F."Confirmed"(["Condition": "Suicide Attempt"]) + +define "SleepDisorderedBreathingConditions": + C3F."Confirmed"(C3F."ActiveOrRecurring"(["Condition": "Sleep-disordered breathing"])) + +define "RenalDysfunctionConditions": + C3F."Confirmed"(C3F."ActiveOrRecurring"(["Condition": "Kidney Failure"])) + +define "HepaticDysfunctionConditions": + C3F."Confirmed"(C3F."ActiveOrRecurring"(["Condition": "Chronic Liver Disease"])) + union C3F."Confirmed"(C3F."ActiveOrRecurring"(["Condition": "Liver Disease"])) + +define "PregnancyConditions": + C3F."Confirmed"(C3F."ConditionLookBack"(C3F."ActiveOrRecurring"( + ["Condition": "CDS Pregnancy"]), + 42 weeks + )) + +define "PregnancyObservations": + C3F."Verified"(C3F."ObservationLookBack"(["Observation": "Pregnancy status"], 42 weeks)) + +define "MostRecentPregnancyObservation": + C3F."MostRecent"("PregnancyObservations") + +define "MostRecentPregnancyObservationIsPositive": + C3F."ConceptValue"("MostRecentPregnancyObservation") ~ "Pregnant" + +define "Is65orOlder": + AgeInYears() >= 65 + +define "ConditionRiskFactorsForOpioidRelatedHarms": + "DepressionConditions" + union "AnxietyConditions" + union "SubstanceUseDisorderConditions" + union "SuicideAttemptConditions" + union "SleepDisorderedBreathingConditions" + union "RenalDysfunctionConditions" + union "HepaticDysfunctionConditions" + union "PregnancyConditions" + +// Encounter diagnoses that are risk factors for opioid-related harms and their dates of onset. Some risk factors may +// not exist on the problem list, and therefore may not be represented as Conditions (depending on EHR implementation). +// For this, the logic also looks at the patient's encounters, trying to find risk factors recorded as encounter +// diagnosis codes. We do not look at the reasonReference field because the Conditions referred to would already be +// reflected in the expression that queries over Conditions. + +define "EncounterRiskFactorsForOpioidRelatedHarms": + ["Encounter"] Encounter where exists( + Encounter.reasonCode Reason where + FHIRHelpers.ToConcept(Reason) in "Major Depression" + or FHIRHelpers.ToConcept(Reason) in "Depression Diagnosis ICD9" + or FHIRHelpers.ToConcept(Reason) in "Anxiety" + or FHIRHelpers.ToConcept(Reason) in "Anxiety Disorders ICD9" + or FHIRHelpers.ToConcept(Reason) in "Substance use disorder" + or FHIRHelpers.ToConcept(Reason) in "Substance Abuse" + or FHIRHelpers.ToConcept(Reason) in "Suicide Attempt" + or FHIRHelpers.ToConcept(Reason) in "Sleep-disordered breathing" + or FHIRHelpers.ToConcept(Reason) in "Kidney Failure" + or FHIRHelpers.ToConcept(Reason) in "Chronic Liver Disease" + or FHIRHelpers.ToConcept(Reason) in "Liver Disease" + // Pregnancy not considered in Encounter diagnoses because this is an unrestricted lookback. + ) + +// NOTE: As a convention, if an expression's name starts with "Report", its purpose is to format data for the purpose +// of building the final summary object. + +// Format the risk factors in a uniform way despite the different sources of the data (conditions, encounter diagnoses, +// etc.). Note that conditions do not have a "Visit" date and encounter diagnoses do not have a status, onset date, +// recorded date, or abatement date. + +define "ReportConditionRiskFactorsForOpioidRelatedHarms": + ("ConditionRiskFactorsForOpioidRelatedHarms") Condition + return { + Name: "ConceptText"(Condition.code), + Status: Condition.clinicalStatus.coding[0].code.value, + Onset: "Onset"(Condition), + DateRecorded: "DateTimeText"(Condition.recordedDate), + Abatement: "Abatement"(Condition), + Visit: null as Tuple{ Start "String", End "String" } + } + sort by (Onset as "String") desc, (Abatement as "String") desc + +define function "GetEncounterDiagnosesRiskFactorsForOpioidRelatedHarms"(Encounter "Encounter"): + (Encounter.reasonCode) Reason + where FHIRHelpers.ToConcept(Reason) in "Major Depression" + or FHIRHelpers.ToConcept(Reason) in "Depression Diagnosis ICD9" + or FHIRHelpers.ToConcept(Reason) in "Anxiety" + or FHIRHelpers.ToConcept(Reason) in "Anxiety Disorders ICD9" + or FHIRHelpers.ToConcept(Reason) in "Substance use disorder" + or FHIRHelpers.ToConcept(Reason) in "Substance Abuse" + or FHIRHelpers.ToConcept(Reason) in "Suicide Attempt" + or FHIRHelpers.ToConcept(Reason) in "Sleep-disordered breathing" + or FHIRHelpers.ToConcept(Reason) in "Kidney Failure" + or FHIRHelpers.ToConcept(Reason) in "Chronic Liver Disease" + or FHIRHelpers.ToConcept(Reason) in "Liver Disease" + // Pregnancy not considered in Encounter diagnoses because this is an unrestricted lookback. + return { + Name: "ConceptText"(Reason), + Status: null as "String", + Onset: null as "String", + DateRecorded: null as "String", + Abatement: null as "String", + Visit: "PeriodObject"(Encounter.period) + } + +define "ReportEncounterRiskFactorsForOpioidRelatedHarms": + (flatten(("EncounterRiskFactorsForOpioidRelatedHarms") Encounter + return "GetEncounterDiagnosesRiskFactorsForOpioidRelatedHarms"(Encounter))) Reason + sort by Visit.Start desc, Visit.End desc + +// Shape the pregnancy Observation as a Condition, since this is the backup approach for detecting a pregnancy in case +// there are no active Conditions found. +define "ReportMostRecentPositivePregnancyObservation": + if "MostRecentPregnancyObservationIsPositive" then + { + Name: "ConceptText"("MostRecentPregnancyObservation".code), + Status: "ConceptText"("MostRecentPregnancyObservation".value as FHIR."CodeableConcept"), + Onset: ToString(Coalesce( + ("MostRecentPregnancyObservation".effective as FHIR."dateTime").value, + ("MostRecentPregnancyObservation".effective as FHIR."instant").value, + ("MostRecentPregnancyObservation".effective as FHIR."Period")."start".value + )), + DateRecorded: ToString("MostRecentPregnancyObservation".issued.value), + Abatement: null as "String", + Visit: null as Tuple{ Start "String", End "String" } + } + else + null + +// Shape the case of being 65 or older as a Condition for the purposes of building the summary. +define "ReportOlderThan65": + if "Is65orOlder" then + { + Name: '65 years or older', + Status: 'active', + Onset: null as "String", + DateRecorded: null as "String", + Abatement: null as "String", + Visit: null as Tuple{ Start "String", End "String" } + } + else + null + +define "ReportRiskFactorsForOpioidRelatedHarms": + // If a pregnancy Condition is present, use that. + if exists "PregnancyConditions" then + ("ReportConditionRiskFactorsForOpioidRelatedHarms" + union "ReportEncounterRiskFactorsForOpioidRelatedHarms" + union "ReportOlderThan65") Condition + // Otherwise, try to find a positive pregnancy status in an Observation. + else + ("ReportConditionRiskFactorsForOpioidRelatedHarms" + union "ReportEncounterRiskFactorsForOpioidRelatedHarms" + union "ReportOlderThan65" + union "ReportMostRecentPositivePregnancyObservation") Condition + sort by (if Onset is not null then Onset as "String" else Visit.Start) desc, Visit.End desc, (Abatement as "String") desc + +// PAIN ASSESSMENT + +// Numeric pain intensity assessment - scores and dates (lookback 2 years) + +define "NumericPainIntensityAssessments": + C3F."Verified"(C3F."ObservationLookBack"(["Observation": "Pain severity Wong-Baker FACES Scale"], 2 years)) + +define "ReportNumericPainIntensityAssessments": + ("NumericPainIntensityAssessments") Assessment + return { + Name: "ConceptTextWithRange"(Assessment.code), + Score: "QuantityText"(Assessment.value as FHIR."Quantity"), + Interpretation: Coalesce( "ConceptText"(First(Assessment.interpretation)), "ConceptText"(Assessment.value as FHIR."CodeableConcept") ), + Date: "ObservationDate"(Assessment) + } + sort by Date desc + +// Pain Enjoyment General Activity (PEG) Assessment - scores and dates (lookback 2 years) +// Note: this includes listing the response to each of the 3 questions, plus the total score. The Pain Management +// Sumnmary currently supports both the LOINC representations and the legacy local code representations. +// +// 1. Observation w/ LOINC mean score as primary code and mean score as valueQuantity +// * code: LOINC 91147-9 "Mean score [PEG]" +// * valueQuantity: (mean score) +// * component: +// - +// * code: LOINC 75893-8 "What number best describes your pain on average in the past week?" +// * valueQuantity: (pain score) +// - +// * code: LOINC 91145-3 "What number best describes how, during the past week, pain has interfered with your enjoyment of life?" +// * valueQuantity: (enjoyment of life score) +// - +// * code: LOINC 91146-1 "What number best describes how, during the past week, pain has interfered with your general activity?" +// * valueQuantity: (general activity score) +// +// 2. LEGACY: Observation w/ LOCAL code as primary code and mean score as valueQuantity +// * code: LOCAL PEGASSESSMENT "Pain Enjoyment General Activity (PEG) Assessment" +// * valueQuantity: (mean score) +// * component: +// - +// * code: LOCAL PEGPAIN "Pain" +// * valueQuantity: (pain score) +// - +// * code: LOCAL PEGENJOYMENT "Enjoyment of life" +// * valueQuantity: (enjoyment of life score) +// - +// * code: LOCAL PEGGENERALACTIVITY "General activity" +// * valueQuantity: (general activity score) + +define "PainEnjoymentGeneralActivityAssessments": + C3F."Verified"(C3F."ObservationLookBack"( + ["Observation": "Mean score [PEG]"] + union ["Observation": "Pain Enjoyment General Activity (PEG) Assessment LEGACY"], + 2 years + )) + +define "ReportPainEnjoymentGeneralActivityAssessments": + ("PainEnjoymentGeneralActivityAssessments") Assessment + let + Pain: (Assessment.component) Component + where Component.code ~ "Pain severity in the past week - 0-10 numeric rating [Reported]" + or Component.code ~ "Pain LEGACY", + Enjoyment: (Assessment.component) Component + where Component.code ~ "What number best describes how pain has interfered with your enjoyment of life during the past week" + or Component.code ~ "Enjoyment of life LEGACY", + GeneralActivity: (Assessment.component) Component + where Component.code ~ "What number best describes how pain has interfered with your general activity during the past week" + or Component.code ~ "General activity LEGACY" + where true // grammar needs a where statement to separate the "let" from the "return" + return { + // NOTE: Hard-code in names because the real LOINC code displays are quite long + Name: "ConceptTextWithRange"(Assessment.code), + Score: "QuantityText"(Assessment.value as FHIR."Quantity"), + Interpretation: Coalesce( "ConceptText"(First(Assessment.interpretation)), "ConceptText"(Assessment.value as FHIR."CodeableConcept") ), + Questions: ({ First(Pain), First(Enjoyment), First(GeneralActivity) }) Component + where Component is not null + return { "Name": "ConceptText"(Component.code), "Score": "QuantityText"(Component.value as FHIR."Quantity") }, + Date: "ObservationDate"(Assessment) + } + sort by Date desc + +// STarT Back Screening Tool - Overall score and dates (lookback 2 years) + +define "STarTBackAssessments": + C3F."Verified"(C3F."ObservationLookBack"( + ["Observation": "Total score [STarT Back]"] + union ["Observation": "STarT Back Screening Tool LEGACY"], + 2 years + )) + +define "ReportSTarTBackAssessments": + ("STarTBackAssessments") Assessment + return { + Name: "ConceptTextWithRange"(Assessment.code), + Score: "QuantityText"(Assessment.value as FHIR."Quantity"), + Interpretation: Coalesce( "ConceptText"(First(Assessment.interpretation)), "ConceptText"(Assessment.value as FHIR."CodeableConcept") ), + Date: "ObservationDate"(Assessment) + } + sort by Date desc + +// HISTORICAL TREATMENTS + +// Opioid medication orders and statements with dates (lookback 2 years) + +define "OpioidMedicationRequests": + C3F."ActiveCompletedOrStoppedMedicationRequest"(C3F."MedicationRequestLookBack"( + ["MedicationRequest": "Opioid Pain Medications"], + 2 years + )) + +define "OpioidMedicationStatements": + C3F."ActiveOrCompletedMedicationStatement"(C3F."MedicationStatementLookBack"( + ["MedicationStatement": "Opioid Pain Medications"], + 2 years + )) + +define "ReportOpioidMedicationRequests": + ("OpioidMedicationRequests") Request + return { + Type: 'Request', + Name: "ConceptText"(Request.medication as FHIR."CodeableConcept"), + Start: "DateTimeText"(Request.authoredOn), + End: null as "String", // MedicationRequest end date not supported in R4, + Status: Request.status.value + } + sort by Start desc, End desc + +define "ReportOpioidMedicationStatements": + ("OpioidMedicationStatements") Statement + return { + Type: 'Statement', + Name: "ConceptText"(Statement.medication as FHIR."CodeableConcept"), + Start: "MedicationStatementDate"(Statement), + End: "DateTimeText"((Statement.effective as FHIR."Period")."end"), + Status: Statement.status.value + } + sort by Start desc, End desc + +define "ReportOpioidMedications": + ("ReportOpioidMedicationRequests" union "ReportOpioidMedicationStatements") Medication + sort by Start desc, End desc + +// Non-opioid medication orders and statements with dates (lookback 2 years) + +define "NonOpioidMedicationRequests": + C3F."ActiveCompletedOrStoppedMedicationRequest"(C3F."MedicationRequestLookBack"( + ["MedicationRequest": "Non opiod pain medications"], + 2 years + )) + +define "NonOpioidMedicationStatements": + C3F."ActiveOrCompletedMedicationStatement"(C3F."MedicationStatementLookBack"( + ["MedicationStatement": "Non opiod pain medications"], + 2 years + )) + +define "ReportNonOpioidMedicationRequests": + ("NonOpioidMedicationRequests") Request + return { + Type: 'Request', + Name: "ConceptText"(Request.medication as FHIR."CodeableConcept"), + Start: "DateTimeText"(Request.authoredOn), + End: null as "String", // MedicationRequest end date not supported in R4, + Status: Request.status.value + } + sort by Start desc, End desc + +define "ReportNonOpioidMedicationStatements": + ("NonOpioidMedicationStatements") Statement + return { + Type: 'Statement', + Name: "ConceptText"(Statement.medication as FHIR."CodeableConcept"), + Start: "MedicationStatementDate"(Statement), + End: "DateTimeText"((Statement.effective as FHIR."Period")."end"), + Status: Statement.status.value + } + sort by Start desc, End desc + +define "ReportNonOpioidMedications": + ("ReportNonOpioidMedicationRequests" union "ReportNonOpioidMedicationStatements") Medication + sort by Start desc, End desc + +// Non-pharmacologic treatments, orders, and referrals with dates (lookback 2 years) + +define "NonPharmacologicTreatmentProcedures": + C3F."ProcedurePerformance"(C3F."ProcedureLookBack"(["Procedure": "Non pharmacologic treatments for chronic pain"], 2 years)) + +define "ReportNonPharmacologicTreatmentProcedures": + ("NonPharmacologicTreatmentProcedures") Procedure + return { + Type: 'Procedure', + Name: "ConceptText"(Procedure.code), + Date: Coalesce( + "DateTimeText"(Procedure.performed as FHIR."dateTime"), + "DateTimeText"((Procedure.performed as FHIR."Period")."start") + ) + } + sort by Date desc + +define "NonPharmacologicTreatmentServiceRequests": + C3F."ActiveOrCompletedServiceRequest"( + C3F."ServiceRequestLookBack"(["ServiceRequest": "Non pharmacologic treatments for chronic pain"], 2 years) + ) + +define "ReportNonPharmacologicTreatmentServiceRequests": + ("NonPharmacologicTreatmentServiceRequests") Request + return { + Type: 'ServiceRequest', + Name: "ConceptText"(Request.code), + Date: "DateTimeText"(Request.authoredOn) + } + sort by Date desc + +define "ReportNonPharmacologicTreatments": + ("ReportNonPharmacologicTreatmentProcedures" + union "ReportNonPharmacologicTreatmentServiceRequests") TreatmentOrRequest + sort by Date desc + +// Stool softeners and laxatives - orders and statements with dates (lookback 6 months) + +define "StoolSoftenersAndLaxativesRequests": + C3F."ActiveCompletedOrStoppedMedicationRequest"(C3F."MedicationRequestLookBack"( + ["MedicationRequest": "Stool softeners and laxatives"], + 6 months + )) + +define "StoolSoftenersAndLaxativesStatements": + C3F."ActiveOrCompletedMedicationStatement"(C3F."MedicationStatementLookBack"( + ["MedicationStatement": "Stool softeners and laxatives"], + 6 months + )) + +define "ReportStoolSoftenersAndLaxativesRequests": + ("StoolSoftenersAndLaxativesRequests") Request + return { + Type: 'Request', + Name: "ConceptText"(Request.medication as FHIR."CodeableConcept"), + Start: "DateTimeText"(Request.authoredOn), + End: null as "String", // MedicationRequest end date not supported in R4, + Status: Request.status.value + } + sort by Start desc, End desc + +define "ReportStoolSoftenersAndLaxativesStatements": + ("StoolSoftenersAndLaxativesStatements") Statement + return { + Type: 'Statement', + Name: "ConceptText"(Statement.medication as FHIR."CodeableConcept"), + Start: "MedicationStatementDate"(Statement), + End: "DateTimeText"((Statement.effective as FHIR."Period")."end"), + Status: Statement.status.value + } + sort by Start desc, End desc + +define "ReportStoolSoftenersAndLaxatives": + ("ReportStoolSoftenersAndLaxativesRequests" union "ReportStoolSoftenersAndLaxativesStatements") Laxative + sort by Start desc, End desc + +// RISK CONSIDERATIONS + +// MME (MOST RECENT w/ lookback 6 months) - amount and date + +define "MostRecentMME": + C3F."MostRecent"(C3F."Verified"(C3F."ObservationLookBack"(["Observation": "Morphine Milligram Equivalent (MME)"], 6 months))) + +define "ReportMostRecentMME": + if "MostRecentMME" is null + then null + else + ("MostRecentMME") MME + return { + Name: "ConceptText"(MME.code), + Result: "QuantityText"(MME.value as FHIR."Quantity"), + Date: "ObservationDate"(MME) + } + +// Urine drug screen - dates and results (all screens w/ lookback of 1 year) + +define "UrineDrugScreens": + C3F."Verified"(C3F."ObservationLookBack"(["Observation": "Urine drug screen for pain management"], 1 year)) + +define "ReportUrineDrugScreens": + ("UrineDrugScreens") Screening + return { + Name: "ConceptText"(Screening.code), + Result: Coalesce( + "QuantityText"(Screening.value as FHIR."Quantity"), + (Screening.value as FHIR."string").value, + "ConceptText"(Screening.value as FHIR."CodeableConcept") + ), + Interpretation: "ConceptText"(First(Screening.interpretation)), + Date: "ObservationDate"(Screening) + } + sort by Date desc + +// Benzodiazepine Medications (lookback of 2 years)- orders and statements with dates + +define "BenzodiazepineMedicationRequests": + C3F."ActiveCompletedOrStoppedMedicationRequest"(C3F."MedicationRequestLookBack"( + ["MedicationRequest": "Benzodiazepine medications"], + 2 years + )) + +define "BenzodiazepineMedicationStatements": + C3F."ActiveOrCompletedMedicationStatement"(C3F."MedicationStatementLookBack"( + ["MedicationStatement": "Benzodiazepine medications"], + 2 years + )) + +define "ReportBenzodiazepineMedicationRequests": + ("BenzodiazepineMedicationRequests") Request + return { + Type: 'Request', + Name: "ConceptText"(Request.medication as FHIR."CodeableConcept"), + Start: "DateTimeText"(Request.authoredOn), + End: null as "String", // MedicationRequest end date not supported in R4, + Status: Request.status.value + } + sort by Start desc, End desc + +define "ReportBenzodiazepineMedicationStatements": + ("BenzodiazepineMedicationStatements") Statement + return { + Type: 'Statement', + Name: "ConceptText"(Statement.medication as FHIR."CodeableConcept"), + Start: "MedicationStatementDate"(Statement), + End: "DateTimeText"((Statement.effective as FHIR."Period")."end"), + Status: Statement.status.value + } + sort by Start desc, End desc + +define "ReportBenzodiazepineMedications": + ("ReportBenzodiazepineMedicationRequests" union "ReportBenzodiazepineMedicationStatements") Medication + sort by Start desc, End desc + +// Naloxone Medications (unrestricted lookback) - orders and statements with dates + +define "NaloxoneMedicationRequests": + C3F."ActiveCompletedOrStoppedMedicationRequest"(["MedicationRequest": "Naloxone medications"]) + +define "NaloxoneMedicationStatements": + C3F."ActiveOrCompletedMedicationStatement"(["MedicationStatement": "Naloxone medications"]) + +define "ReportNaloxoneMedicationRequests": + ("NaloxoneMedicationRequests") Request + return { + Type: 'Request', + Name: "ConceptText"(Request.medication as FHIR."CodeableConcept"), + Start: "DateTimeText"(Request.authoredOn), + End: null as "String", // MedicationRequest end date not supported in R4, + Status: Request.status.value + } + sort by Start desc, End desc + +define "ReportNaloxoneMedicationStatements": + ("NaloxoneMedicationStatements") Statement + return { + Type: 'Statement', + Name: "ConceptText"(Statement.medication as FHIR."CodeableConcept"), + Start: "MedicationStatementDate"(Statement), + End: "DateTimeText"((Statement.effective as FHIR."Period")."end"), + Status: Statement.status.value + } + sort by Start desc, End desc + +define "ReportNaloxoneMedications": + ("ReportNaloxoneMedicationRequests" union "ReportNaloxoneMedicationStatements") Medication + sort by Start desc, End desc + +// Risk screenings relevant to pain management - overall scores and dates (MOST RECENT w/ lookback 1 year) + +define "RiskScreeningsRelevantToPainManagement": + C3F."Verified"(C3F."ObservationLookBack"( + ["Observation": "Risk assessments relevant to pain management"] + union ["Observation": "Single question r/t ETOH use"] + union ["Observation": "Single question r/t drug use"] + , 1 year)) + +define "ReportRiskScreeningsRelevantToPainManagement": + ("RiskScreeningsRelevantToPainManagement") Screening + return { + Name: "ConceptTextWithRange"(Screening.code), + Score: Coalesce( + "QuantityText"(Screening.value as FHIR."Quantity"), + (Screening.value as FHIR."string").value + ), + Interpretation: Coalesce( + "ConceptText"(First(Screening.interpretation)), + "ConceptText"(Screening.value as FHIR."CodeableConcept") + ), + Date: "ObservationDate"(Screening) + } + sort by Date desc + +// SUMMARY + +// The "Summary" object represents the full Pain Management Summary to be displayed to the clinician. All values are +// returned as user-friendly text representations, but a robust user interface (UI) should be implemented to +// display the data to the user in a friendly manner. See the Pain Management Summary SMART on FHIR application as +// an example of how to integrate this summary into an EHR using modern web UI technologies. + +define "Summary": { + Patient: { + Name: Combine(Patient.name.given Given return Given.value, ' ') + ' ' + Combine(Patient.name.family Family return Family.value, ' '), + Gender: Patient.gender.value, + Age: AgeInYears(), + MeetsInclusionCriteria: "MeetsInclusionCriteria" + }, + PertinentMedicalHistory: { + ConditionsAssociatedWithChronicPain: "ReportConditionsAssociatedWithChronicPain", + RiskFactorsForOpioidRelatedHarms: "ReportRiskFactorsForOpioidRelatedHarms" + }, + PainAssessments: { + NumericPainIntensityAssessments: "ReportNumericPainIntensityAssessments", + PainEnjoymentGeneralActivityAssessments: "ReportPainEnjoymentGeneralActivityAssessments", + STarTBackAssessments: "ReportSTarTBackAssessments" + }, + HistoricalTreatments: { + OpioidMedications: "ReportOpioidMedications", + NonOpioidMedications: "ReportNonOpioidMedications", + NonPharmacologicTreatments: "ReportNonPharmacologicTreatments", + StoolSoftenersAndLaxatives: "ReportStoolSoftenersAndLaxatives" + }, + RiskConsiderations: { + MostRecentMME: "ReportMostRecentMME", + UrineDrugScreens: "ReportUrineDrugScreens", + BenzodiazepineMedications: "ReportBenzodiazepineMedications", + NaloxoneMedications: "ReportNaloxoneMedications", + RiskScreeningsRelevantToPainManagement: "ReportRiskScreeningsRelevantToPainManagement" + } +} diff --git a/src/cql/r4/Factors_to_Consider_in_Managing_Chronic_Pain_FHIRv401.json b/src/cql/r4/FactorsToConsiderInManagingChronicPainFHIRv401.json similarity index 95% rename from src/cql/r4/Factors_to_Consider_in_Managing_Chronic_Pain_FHIRv401.json rename to src/cql/r4/FactorsToConsiderInManagingChronicPainFHIRv401.json index 040abc84e..fc47142d7 100644 --- a/src/cql/r4/Factors_to_Consider_in_Managing_Chronic_Pain_FHIRv401.json +++ b/src/cql/r4/FactorsToConsiderInManagingChronicPainFHIRv401.json @@ -5,8 +5,8 @@ "type" : "CqlToElmInfo" } ], "identifier" : { - "id" : "Factors_to_Consider_in_Managing_Chronic_Pain_FHIRv401", - "version" : "1.0.0" + "id" : "FactorsToConsiderInManagingChronicPainFHIRv401", + "version" : "2.0.0" }, "schemaIdentifier" : { "id" : "urn:hl7-org:elm", @@ -25,8 +25,8 @@ "includes" : { "def" : [ { "localIdentifier" : "C3F", - "path" : "CDS_Connect_Commons_for_FHIRv401", - "version" : "1.0.0" + "path" : "CDSConnectCommonsForFHIRv401", + "version" : "2.0.0" }, { "localIdentifier" : "FHIRHelpers", "path" : "FHIRHelpers", @@ -62,7 +62,7 @@ "valueSets" : { "def" : [ { "name" : "Conditions associated with chronic pain", - "id" : "https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.37", + "id" : "https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1021.95", "accessLevel" : "Public" }, { "name" : "Opioid Pain Medications", @@ -117,12 +117,8 @@ "id" : "https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.42", "accessLevel" : "Public" }, { - "name" : "Pregnancy", - "id" : "https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378", - "accessLevel" : "Public" - }, { - "name" : "Pregnancy (New ICD10 codes published in 2018 and 2019)", - "id" : "https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.80", + "name" : "CDS Pregnancy", + "id" : "https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.264", "accessLevel" : "Public" }, { "name" : "Non opiod pain medications", @@ -374,7 +370,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -391,7 +387,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -419,7 +415,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -436,7 +432,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -464,7 +460,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -481,7 +477,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -509,7 +505,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -526,7 +522,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -552,7 +548,7 @@ "path" : "text", "type" : "Property", "source" : { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } } @@ -566,7 +562,7 @@ "path" : "coding", "type" : "Property", "source" : { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } } @@ -591,7 +587,7 @@ } }, "operand" : [ { - "name" : "c", + "name" : "Koncept", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}CodeableConcept", "type" : "NamedTypeSpecifier" @@ -611,7 +607,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -628,7 +624,7 @@ "name" : "ConceptText", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -646,7 +642,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -663,7 +659,7 @@ "name" : "ConceptText", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -681,7 +677,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -698,7 +694,7 @@ "name" : "ConceptText", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -716,7 +712,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -733,7 +729,7 @@ "name" : "ConceptText", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -751,7 +747,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -768,7 +764,7 @@ "name" : "ConceptText", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -786,7 +782,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -803,7 +799,7 @@ "name" : "ConceptText", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -821,7 +817,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -838,7 +834,7 @@ "name" : "ConceptText", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -856,7 +852,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -873,7 +869,7 @@ "name" : "ConceptText", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -893,7 +889,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -910,7 +906,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -928,7 +924,7 @@ "name" : "ConceptText", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -948,7 +944,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -965,7 +961,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -983,7 +979,7 @@ "name" : "ConceptText", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] }, { @@ -996,7 +992,7 @@ "name" : "ConceptText", "type" : "FunctionRef", "operand" : [ { - "name" : "c", + "name" : "Koncept", "type" : "OperandRef" } ] } @@ -1011,7 +1007,7 @@ } }, "operand" : [ { - "name" : "c", + "name" : "Koncept", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}CodeableConcept", "type" : "NamedTypeSpecifier" @@ -1028,13 +1024,13 @@ "path" : "value", "type" : "Property", "source" : { - "name" : "d", + "name" : "Date", "type" : "OperandRef" } } }, "operand" : [ { - "name" : "d", + "name" : "Date", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}date", "type" : "NamedTypeSpecifier" @@ -1051,13 +1047,13 @@ "path" : "value", "type" : "Property", "source" : { - "name" : "d", + "name" : "Date", "type" : "OperandRef" } } }, "operand" : [ { - "name" : "d", + "name" : "Date", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}dateTime", "type" : "NamedTypeSpecifier" @@ -1074,13 +1070,13 @@ "path" : "value", "type" : "Property", "source" : { - "name" : "i", + "name" : "Instant", "type" : "OperandRef" } } }, "operand" : [ { - "name" : "i", + "name" : "Instant", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}instant", "type" : "NamedTypeSpecifier" @@ -1096,7 +1092,7 @@ "condition" : { "type" : "IsNull", "operand" : { - "name" : "q", + "name" : "Quantity", "type" : "OperandRef" } }, @@ -1119,7 +1115,7 @@ "path" : "unit", "type" : "Property", "source" : { - "name" : "q", + "name" : "Quantity", "type" : "OperandRef" } } @@ -1135,7 +1131,7 @@ "path" : "unit", "type" : "Property", "source" : { - "name" : "q", + "name" : "Quantity", "type" : "OperandRef" } } @@ -1160,7 +1156,7 @@ "path" : "value", "type" : "Property", "source" : { - "name" : "q", + "name" : "Quantity", "type" : "OperandRef" } } @@ -1177,7 +1173,7 @@ "path" : "unit", "type" : "Property", "source" : { - "name" : "q", + "name" : "Quantity", "type" : "OperandRef" } } @@ -1195,7 +1191,7 @@ "path" : "code", "type" : "Property", "source" : { - "name" : "q", + "name" : "Quantity", "type" : "OperandRef" } } @@ -1211,7 +1207,7 @@ "path" : "code", "type" : "Property", "source" : { - "name" : "q", + "name" : "Quantity", "type" : "OperandRef" } } @@ -1236,7 +1232,7 @@ "path" : "value", "type" : "Property", "source" : { - "name" : "q", + "name" : "Quantity", "type" : "OperandRef" } } @@ -1253,7 +1249,7 @@ "path" : "code", "type" : "Property", "source" : { - "name" : "q", + "name" : "Quantity", "type" : "OperandRef" } } @@ -1268,7 +1264,7 @@ "path" : "value", "type" : "Property", "source" : { - "name" : "q", + "name" : "Quantity", "type" : "OperandRef" } } @@ -1278,7 +1274,7 @@ } }, "operand" : [ { - "name" : "q", + "name" : "Quantity", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}Quantity", "type" : "NamedTypeSpecifier" @@ -1294,7 +1290,7 @@ "condition" : { "type" : "IsNull", "operand" : { - "name" : "p", + "name" : "Period", "type" : "OperandRef" } }, @@ -1331,7 +1327,7 @@ "path" : "start", "type" : "Property", "source" : { - "name" : "p", + "name" : "Period", "type" : "OperandRef" } } ] @@ -1345,7 +1341,7 @@ "path" : "end", "type" : "Property", "source" : { - "name" : "p", + "name" : "Period", "type" : "OperandRef" } } ] @@ -1354,7 +1350,7 @@ } }, "operand" : [ { - "name" : "p", + "name" : "Period", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}Period", "type" : "NamedTypeSpecifier" @@ -1370,7 +1366,7 @@ "condition" : { "type" : "IsNull", "operand" : { - "name" : "r", + "name" : "Range", "type" : "OperandRef" } }, @@ -1407,7 +1403,7 @@ "path" : "low", "type" : "Property", "source" : { - "name" : "r", + "name" : "Range", "type" : "OperandRef" } } ] @@ -1421,7 +1417,7 @@ "path" : "high", "type" : "Property", "source" : { - "name" : "r", + "name" : "Range", "type" : "OperandRef" } } ] @@ -1430,7 +1426,7 @@ } }, "operand" : [ { - "name" : "r", + "name" : "Range", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}Range", "type" : "NamedTypeSpecifier" @@ -1453,7 +1449,7 @@ "path" : "effective", "type" : "Property", "source" : { - "name" : "o", + "name" : "Observation", "type" : "OperandRef" } }, @@ -1472,7 +1468,7 @@ "path" : "effective", "type" : "Property", "source" : { - "name" : "o", + "name" : "Observation", "type" : "OperandRef" } }, @@ -1494,7 +1490,7 @@ "path" : "effective", "type" : "Property", "source" : { - "name" : "o", + "name" : "Observation", "type" : "OperandRef" } }, @@ -1511,14 +1507,14 @@ "path" : "issued", "type" : "Property", "source" : { - "name" : "o", + "name" : "Observation", "type" : "OperandRef" } } ] } ] }, "operand" : [ { - "name" : "o", + "name" : "Observation", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}Observation", "type" : "NamedTypeSpecifier" @@ -1541,7 +1537,7 @@ "path" : "effective", "type" : "Property", "source" : { - "name" : "s", + "name" : "Statement", "type" : "OperandRef" } }, @@ -1563,7 +1559,7 @@ "path" : "effective", "type" : "Property", "source" : { - "name" : "s", + "name" : "Statement", "type" : "OperandRef" } }, @@ -1576,7 +1572,7 @@ } ] }, "operand" : [ { - "name" : "s", + "name" : "Statement", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}MedicationStatement", "type" : "NamedTypeSpecifier" @@ -1601,7 +1597,7 @@ "path" : "onset", "type" : "Property", "source" : { - "name" : "c", + "name" : "Condition", "type" : "OperandRef" } }, @@ -1620,7 +1616,7 @@ "path" : "onset", "type" : "Property", "source" : { - "name" : "c", + "name" : "Condition", "type" : "OperandRef" } }, @@ -1639,7 +1635,7 @@ "path" : "onset", "type" : "Property", "source" : { - "name" : "c", + "name" : "Condition", "type" : "OperandRef" } }, @@ -1658,7 +1654,7 @@ "path" : "onset", "type" : "Property", "source" : { - "name" : "c", + "name" : "Condition", "type" : "OperandRef" } }, @@ -1677,7 +1673,7 @@ "path" : "onset", "type" : "Property", "source" : { - "name" : "c", + "name" : "Condition", "type" : "OperandRef" } }, @@ -1690,7 +1686,7 @@ } ] }, "operand" : [ { - "name" : "c", + "name" : "Condition", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}Condition", "type" : "NamedTypeSpecifier" @@ -1715,7 +1711,7 @@ "path" : "abatement", "type" : "Property", "source" : { - "name" : "c", + "name" : "Condition", "type" : "OperandRef" } }, @@ -1734,7 +1730,7 @@ "path" : "abatement", "type" : "Property", "source" : { - "name" : "c", + "name" : "Condition", "type" : "OperandRef" } }, @@ -1753,7 +1749,7 @@ "path" : "abatement", "type" : "Property", "source" : { - "name" : "c", + "name" : "Condition", "type" : "OperandRef" } }, @@ -1772,7 +1768,7 @@ "path" : "abatement", "type" : "Property", "source" : { - "name" : "c", + "name" : "Condition", "type" : "OperandRef" } }, @@ -1791,7 +1787,7 @@ "path" : "abatement", "type" : "Property", "source" : { - "name" : "c", + "name" : "Condition", "type" : "OperandRef" } }, @@ -1804,7 +1800,7 @@ } ] }, "operand" : [ { - "name" : "c", + "name" : "Condition", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}Condition", "type" : "NamedTypeSpecifier" @@ -2022,7 +2018,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "C", + "alias" : "Condition", "expression" : { "name" : "ConditionsAssociatedWithChronicPain", "type" : "ExpressionRef" @@ -2039,7 +2035,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "C", + "scope" : "Condition", "type" : "Property" } ] } @@ -2058,7 +2054,7 @@ "type" : "Property", "source" : { "path" : "clinicalStatus", - "scope" : "C", + "scope" : "Condition", "type" : "Property" } }, { @@ -2075,7 +2071,7 @@ "name" : "Onset", "type" : "FunctionRef", "operand" : [ { - "name" : "C", + "name" : "Condition", "type" : "AliasRef" } ] } @@ -2086,7 +2082,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "recordedDate", - "scope" : "C", + "scope" : "Condition", "type" : "Property" } ] } @@ -2377,30 +2373,17 @@ "libraryName" : "C3F", "type" : "FunctionRef", "operand" : [ { - "type" : "Union", + "name" : "ActiveOrRecurring", + "libraryName" : "C3F", + "type" : "FunctionRef", "operand" : [ { - "name" : "ActiveOrRecurring", - "libraryName" : "C3F", - "type" : "FunctionRef", - "operand" : [ { - "dataType" : "{http://hl7.org/fhir}Condition", - "templateId" : "http://hl7.org/fhir/StructureDefinition/Condition", - "codeProperty" : "code", - "codeComparator" : "in", - "type" : "Retrieve", - "codes" : { - "name" : "Pregnancy", - "type" : "ValueSetRef" - } - } ] - }, { "dataType" : "{http://hl7.org/fhir}Condition", "templateId" : "http://hl7.org/fhir/StructureDefinition/Condition", "codeProperty" : "code", "codeComparator" : "in", "type" : "Retrieve", "codes" : { - "name" : "Pregnancy (New ICD10 codes published in 2018 and 2019)", + "name" : "CDS Pregnancy", "type" : "ValueSetRef" } } ] @@ -2558,7 +2541,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "E", + "alias" : "Encounter", "expression" : { "dataType" : "{http://hl7.org/fhir}Encounter", "templateId" : "http://hl7.org/fhir/StructureDefinition/Encounter", @@ -2571,10 +2554,10 @@ "operand" : { "type" : "Query", "source" : [ { - "alias" : "R", + "alias" : "Reason", "expression" : { "path" : "reasonCode", - "scope" : "E", + "scope" : "Encounter", "type" : "Property" } } ], @@ -2606,7 +2589,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -2621,7 +2604,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -2637,7 +2620,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -2653,7 +2636,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -2669,7 +2652,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -2685,7 +2668,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -2701,7 +2684,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -2717,7 +2700,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -2733,7 +2716,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -2749,7 +2732,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -2765,7 +2748,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -2785,7 +2768,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "C", + "alias" : "Condition", "expression" : { "name" : "ConditionRiskFactorsForOpioidRelatedHarms", "type" : "ExpressionRef" @@ -2802,7 +2785,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "C", + "scope" : "Condition", "type" : "Property" } ] } @@ -2821,7 +2804,7 @@ "type" : "Property", "source" : { "path" : "clinicalStatus", - "scope" : "C", + "scope" : "Condition", "type" : "Property" } }, { @@ -2838,7 +2821,7 @@ "name" : "Onset", "type" : "FunctionRef", "operand" : [ { - "name" : "C", + "name" : "Condition", "type" : "AliasRef" } ] } @@ -2849,7 +2832,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "recordedDate", - "scope" : "C", + "scope" : "Condition", "type" : "Property" } ] } @@ -2859,7 +2842,7 @@ "name" : "Abatement", "type" : "FunctionRef", "operand" : [ { - "name" : "C", + "name" : "Condition", "type" : "AliasRef" } ] } @@ -2933,12 +2916,12 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "R", + "alias" : "Reason", "expression" : { "path" : "reasonCode", "type" : "Property", "source" : { - "name" : "enc", + "name" : "Encounter", "type" : "OperandRef" } } @@ -2971,7 +2954,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -2986,7 +2969,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -3002,7 +2985,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -3018,7 +3001,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -3034,7 +3017,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -3050,7 +3033,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -3066,7 +3049,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -3082,7 +3065,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -3098,7 +3081,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -3114,7 +3097,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -3130,7 +3113,7 @@ "libraryName" : "FHIRHelpers", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] }, @@ -3149,7 +3132,7 @@ "name" : "ConceptText", "type" : "FunctionRef", "operand" : [ { - "name" : "R", + "name" : "Reason", "type" : "AliasRef" } ] } @@ -3214,7 +3197,7 @@ "path" : "period", "type" : "Property", "source" : { - "name" : "enc", + "name" : "Encounter", "type" : "OperandRef" } } ] @@ -3224,7 +3207,7 @@ } }, "operand" : [ { - "name" : "enc", + "name" : "Encounter", "operandTypeSpecifier" : { "name" : "{http://hl7.org/fhir}Encounter", "type" : "NamedTypeSpecifier" @@ -3237,13 +3220,13 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "D", + "alias" : "Reason", "expression" : { "type" : "Flatten", "operand" : { "type" : "Query", "source" : [ { - "alias" : "E", + "alias" : "Encounter", "expression" : { "name" : "EncounterRiskFactorsForOpioidRelatedHarms", "type" : "ExpressionRef" @@ -3255,7 +3238,7 @@ "name" : "GetEncounterDiagnosesRiskFactorsForOpioidRelatedHarms", "type" : "FunctionRef", "operand" : [ { - "name" : "E", + "name" : "Encounter", "type" : "AliasRef" } ] } @@ -3691,7 +3674,7 @@ "then" : { "type" : "Query", "source" : [ { - "alias" : "C", + "alias" : "Condition", "expression" : { "type" : "Union", "operand" : [ { @@ -3717,7 +3700,7 @@ "else" : { "type" : "Query", "source" : [ { - "alias" : "C", + "alias" : "Condition", "expression" : { "type" : "Union", "operand" : [ { @@ -3854,7 +3837,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "A", + "alias" : "Assessment", "expression" : { "name" : "NumericPainIntensityAssessments", "type" : "ExpressionRef" @@ -3871,7 +3854,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "A", + "scope" : "Assessment", "type" : "Property" } ] } @@ -3885,7 +3868,7 @@ "type" : "As", "operand" : { "path" : "value", - "scope" : "A", + "scope" : "Assessment", "type" : "Property" }, "asTypeSpecifier" : { @@ -3905,7 +3888,7 @@ "type" : "First", "source" : { "path" : "interpretation", - "scope" : "A", + "scope" : "Assessment", "type" : "Property" } } ] @@ -3917,7 +3900,7 @@ "type" : "As", "operand" : { "path" : "value", - "scope" : "A", + "scope" : "Assessment", "type" : "Property" }, "asTypeSpecifier" : { @@ -3933,7 +3916,7 @@ "name" : "ObservationDate", "type" : "FunctionRef", "operand" : [ { - "name" : "A", + "name" : "Assessment", "type" : "AliasRef" } ] } @@ -4003,7 +3986,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "A", + "alias" : "Assessment", "expression" : { "name" : "PainEnjoymentGeneralActivityAssessments", "type" : "ExpressionRef" @@ -4014,10 +3997,10 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "C", + "alias" : "Component", "expression" : { "path" : "component", - "scope" : "A", + "scope" : "Assessment", "type" : "Property" } } ], @@ -4032,7 +4015,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "C", + "scope" : "Component", "type" : "Property" } ] }, { @@ -4050,7 +4033,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "C", + "scope" : "Component", "type" : "Property" } ] }, { @@ -4068,10 +4051,10 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "C", + "alias" : "Component", "expression" : { "path" : "component", - "scope" : "A", + "scope" : "Assessment", "type" : "Property" } } ], @@ -4086,7 +4069,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "C", + "scope" : "Component", "type" : "Property" } ] }, { @@ -4104,7 +4087,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "C", + "scope" : "Component", "type" : "Property" } ] }, { @@ -4122,10 +4105,10 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "C", + "alias" : "Component", "expression" : { "path" : "component", - "scope" : "A", + "scope" : "Assessment", "type" : "Property" } } ], @@ -4140,7 +4123,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "C", + "scope" : "Component", "type" : "Property" } ] }, { @@ -4158,7 +4141,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "C", + "scope" : "Component", "type" : "Property" } ] }, { @@ -4188,7 +4171,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "A", + "scope" : "Assessment", "type" : "Property" } ] } @@ -4202,7 +4185,7 @@ "type" : "As", "operand" : { "path" : "value", - "scope" : "A", + "scope" : "Assessment", "type" : "Property" }, "asTypeSpecifier" : { @@ -4222,7 +4205,7 @@ "type" : "First", "source" : { "path" : "interpretation", - "scope" : "A", + "scope" : "Assessment", "type" : "Property" } } ] @@ -4234,7 +4217,7 @@ "type" : "As", "operand" : { "path" : "value", - "scope" : "A", + "scope" : "Assessment", "type" : "Property" }, "asTypeSpecifier" : { @@ -4249,7 +4232,7 @@ "value" : { "type" : "Query", "source" : [ { - "alias" : "C", + "alias" : "Component", "expression" : { "type" : "List", "element" : [ { @@ -4279,7 +4262,7 @@ "operand" : { "type" : "IsNull", "operand" : { - "name" : "C", + "name" : "Component", "type" : "AliasRef" } } @@ -4294,7 +4277,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "C", + "scope" : "Component", "type" : "Property" } ] } @@ -4308,7 +4291,7 @@ "type" : "As", "operand" : { "path" : "value", - "scope" : "C", + "scope" : "Component", "type" : "Property" }, "asTypeSpecifier" : { @@ -4327,7 +4310,7 @@ "name" : "ObservationDate", "type" : "FunctionRef", "operand" : [ { - "name" : "A", + "name" : "Assessment", "type" : "AliasRef" } ] } @@ -4397,7 +4380,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "A", + "alias" : "Assessment", "expression" : { "name" : "STarTBackAssessments", "type" : "ExpressionRef" @@ -4414,7 +4397,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "A", + "scope" : "Assessment", "type" : "Property" } ] } @@ -4428,7 +4411,7 @@ "type" : "As", "operand" : { "path" : "value", - "scope" : "A", + "scope" : "Assessment", "type" : "Property" }, "asTypeSpecifier" : { @@ -4448,7 +4431,7 @@ "type" : "First", "source" : { "path" : "interpretation", - "scope" : "A", + "scope" : "Assessment", "type" : "Property" } } ] @@ -4460,7 +4443,7 @@ "type" : "As", "operand" : { "path" : "value", - "scope" : "A", + "scope" : "Assessment", "type" : "Property" }, "asTypeSpecifier" : { @@ -4476,7 +4459,7 @@ "name" : "ObservationDate", "type" : "FunctionRef", "operand" : [ { - "name" : "A", + "name" : "Assessment", "type" : "AliasRef" } ] } @@ -4556,7 +4539,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "O", + "alias" : "Request", "expression" : { "name" : "OpioidMedicationRequests", "type" : "ExpressionRef" @@ -4583,7 +4566,7 @@ "type" : "As", "operand" : { "path" : "medication", - "scope" : "O", + "scope" : "Request", "type" : "Property" }, "asTypeSpecifier" : { @@ -4599,7 +4582,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "authoredOn", - "scope" : "O", + "scope" : "Request", "type" : "Property" } ] } @@ -4623,7 +4606,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "O", + "scope" : "Request", "type" : "Property" } } @@ -4649,7 +4632,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "S", + "alias" : "Statement", "expression" : { "name" : "OpioidMedicationStatements", "type" : "ExpressionRef" @@ -4676,7 +4659,7 @@ "type" : "As", "operand" : { "path" : "medication", - "scope" : "S", + "scope" : "Statement", "type" : "Property" }, "asTypeSpecifier" : { @@ -4691,7 +4674,7 @@ "name" : "MedicationStatementDate", "type" : "FunctionRef", "operand" : [ { - "name" : "S", + "name" : "Statement", "type" : "AliasRef" } ] } @@ -4708,7 +4691,7 @@ "type" : "As", "operand" : { "path" : "effective", - "scope" : "S", + "scope" : "Statement", "type" : "Property" }, "asTypeSpecifier" : { @@ -4725,7 +4708,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "S", + "scope" : "Statement", "type" : "Property" } } @@ -4751,7 +4734,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "M", + "alias" : "Medication", "expression" : { "type" : "Union", "operand" : [ { @@ -4841,7 +4824,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "O", + "alias" : "Request", "expression" : { "name" : "NonOpioidMedicationRequests", "type" : "ExpressionRef" @@ -4868,7 +4851,7 @@ "type" : "As", "operand" : { "path" : "medication", - "scope" : "O", + "scope" : "Request", "type" : "Property" }, "asTypeSpecifier" : { @@ -4884,7 +4867,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "authoredOn", - "scope" : "O", + "scope" : "Request", "type" : "Property" } ] } @@ -4908,7 +4891,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "O", + "scope" : "Request", "type" : "Property" } } @@ -4934,7 +4917,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "S", + "alias" : "Statement", "expression" : { "name" : "NonOpioidMedicationStatements", "type" : "ExpressionRef" @@ -4961,7 +4944,7 @@ "type" : "As", "operand" : { "path" : "medication", - "scope" : "S", + "scope" : "Statement", "type" : "Property" }, "asTypeSpecifier" : { @@ -4976,7 +4959,7 @@ "name" : "MedicationStatementDate", "type" : "FunctionRef", "operand" : [ { - "name" : "S", + "name" : "Statement", "type" : "AliasRef" } ] } @@ -4993,7 +4976,7 @@ "type" : "As", "operand" : { "path" : "effective", - "scope" : "S", + "scope" : "Statement", "type" : "Property" }, "asTypeSpecifier" : { @@ -5010,7 +4993,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "S", + "scope" : "Statement", "type" : "Property" } } @@ -5036,7 +5019,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "M", + "alias" : "Medication", "expression" : { "type" : "Union", "operand" : [ { @@ -5097,7 +5080,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "P", + "alias" : "Procedure", "expression" : { "name" : "NonPharmacologicTreatmentProcedures", "type" : "ExpressionRef" @@ -5121,7 +5104,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "P", + "scope" : "Procedure", "type" : "Property" } ] } @@ -5137,7 +5120,7 @@ "type" : "As", "operand" : { "path" : "performed", - "scope" : "P", + "scope" : "Procedure", "type" : "Property" }, "asTypeSpecifier" : { @@ -5156,7 +5139,7 @@ "type" : "As", "operand" : { "path" : "performed", - "scope" : "P", + "scope" : "Procedure", "type" : "Property" }, "asTypeSpecifier" : { @@ -5183,7 +5166,7 @@ "context" : "Patient", "accessLevel" : "Public", "expression" : { - "name" : "ServiceRequestActiveOrCompleted", + "name" : "ActiveOrCompletedServiceRequest", "libraryName" : "C3F", "type" : "FunctionRef", "operand" : [ { @@ -5214,7 +5197,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "P", + "alias" : "Request", "expression" : { "name" : "NonPharmacologicTreatmentServiceRequests", "type" : "ExpressionRef" @@ -5238,7 +5221,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "P", + "scope" : "Request", "type" : "Property" } ] } @@ -5249,7 +5232,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "authoredOn", - "scope" : "P", + "scope" : "Request", "type" : "Property" } ] } @@ -5271,7 +5254,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "M", + "alias" : "TreatmentOrRequest", "expression" : { "type" : "Union", "operand" : [ { @@ -5357,7 +5340,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "O", + "alias" : "Request", "expression" : { "name" : "StoolSoftenersAndLaxativesRequests", "type" : "ExpressionRef" @@ -5384,7 +5367,7 @@ "type" : "As", "operand" : { "path" : "medication", - "scope" : "O", + "scope" : "Request", "type" : "Property" }, "asTypeSpecifier" : { @@ -5400,7 +5383,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "authoredOn", - "scope" : "O", + "scope" : "Request", "type" : "Property" } ] } @@ -5424,7 +5407,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "O", + "scope" : "Request", "type" : "Property" } } @@ -5450,7 +5433,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "S", + "alias" : "Statement", "expression" : { "name" : "StoolSoftenersAndLaxativesStatements", "type" : "ExpressionRef" @@ -5477,7 +5460,7 @@ "type" : "As", "operand" : { "path" : "medication", - "scope" : "S", + "scope" : "Statement", "type" : "Property" }, "asTypeSpecifier" : { @@ -5492,7 +5475,7 @@ "name" : "MedicationStatementDate", "type" : "FunctionRef", "operand" : [ { - "name" : "S", + "name" : "Statement", "type" : "AliasRef" } ] } @@ -5509,7 +5492,7 @@ "type" : "As", "operand" : { "path" : "effective", - "scope" : "S", + "scope" : "Statement", "type" : "Property" }, "asTypeSpecifier" : { @@ -5526,7 +5509,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "S", + "scope" : "Statement", "type" : "Property" } } @@ -5552,7 +5535,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "M", + "alias" : "Laxative", "expression" : { "type" : "Union", "operand" : [ { @@ -5658,7 +5641,7 @@ "else" : { "type" : "Query", "source" : [ { - "alias" : "M", + "alias" : "MME", "expression" : { "name" : "MostRecentMME", "type" : "ExpressionRef" @@ -5675,7 +5658,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "M", + "scope" : "MME", "type" : "Property" } ] } @@ -5689,7 +5672,7 @@ "type" : "As", "operand" : { "path" : "value", - "scope" : "M", + "scope" : "MME", "type" : "Property" }, "asTypeSpecifier" : { @@ -5704,7 +5687,7 @@ "name" : "ObservationDate", "type" : "FunctionRef", "operand" : [ { - "name" : "M", + "name" : "MME", "type" : "AliasRef" } ] } @@ -5749,7 +5732,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "S", + "alias" : "Screening", "expression" : { "name" : "UrineDrugScreens", "type" : "ExpressionRef" @@ -5766,7 +5749,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "S", + "scope" : "Screening", "type" : "Property" } ] } @@ -5782,7 +5765,7 @@ "type" : "As", "operand" : { "path" : "value", - "scope" : "S", + "scope" : "Screening", "type" : "Property" }, "asTypeSpecifier" : { @@ -5798,7 +5781,7 @@ "type" : "As", "operand" : { "path" : "value", - "scope" : "S", + "scope" : "Screening", "type" : "Property" }, "asTypeSpecifier" : { @@ -5814,7 +5797,7 @@ "type" : "As", "operand" : { "path" : "value", - "scope" : "S", + "scope" : "Screening", "type" : "Property" }, "asTypeSpecifier" : { @@ -5833,7 +5816,7 @@ "type" : "First", "source" : { "path" : "interpretation", - "scope" : "S", + "scope" : "Screening", "type" : "Property" } } ] @@ -5844,7 +5827,7 @@ "name" : "ObservationDate", "type" : "FunctionRef", "operand" : [ { - "name" : "S", + "name" : "Screening", "type" : "AliasRef" } ] } @@ -5924,7 +5907,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "O", + "alias" : "Request", "expression" : { "name" : "BenzodiazepineMedicationRequests", "type" : "ExpressionRef" @@ -5951,7 +5934,7 @@ "type" : "As", "operand" : { "path" : "medication", - "scope" : "O", + "scope" : "Request", "type" : "Property" }, "asTypeSpecifier" : { @@ -5967,7 +5950,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "authoredOn", - "scope" : "O", + "scope" : "Request", "type" : "Property" } ] } @@ -5991,7 +5974,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "O", + "scope" : "Request", "type" : "Property" } } @@ -6017,7 +6000,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "S", + "alias" : "Statement", "expression" : { "name" : "BenzodiazepineMedicationStatements", "type" : "ExpressionRef" @@ -6044,7 +6027,7 @@ "type" : "As", "operand" : { "path" : "medication", - "scope" : "S", + "scope" : "Statement", "type" : "Property" }, "asTypeSpecifier" : { @@ -6059,7 +6042,7 @@ "name" : "MedicationStatementDate", "type" : "FunctionRef", "operand" : [ { - "name" : "S", + "name" : "Statement", "type" : "AliasRef" } ] } @@ -6076,7 +6059,7 @@ "type" : "As", "operand" : { "path" : "effective", - "scope" : "S", + "scope" : "Statement", "type" : "Property" }, "asTypeSpecifier" : { @@ -6093,7 +6076,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "S", + "scope" : "Statement", "type" : "Property" } } @@ -6119,7 +6102,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "M", + "alias" : "Medication", "expression" : { "type" : "Union", "operand" : [ { @@ -6191,7 +6174,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "O", + "alias" : "Request", "expression" : { "name" : "NaloxoneMedicationRequests", "type" : "ExpressionRef" @@ -6218,7 +6201,7 @@ "type" : "As", "operand" : { "path" : "medication", - "scope" : "O", + "scope" : "Request", "type" : "Property" }, "asTypeSpecifier" : { @@ -6234,7 +6217,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "authoredOn", - "scope" : "O", + "scope" : "Request", "type" : "Property" } ] } @@ -6258,7 +6241,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "O", + "scope" : "Request", "type" : "Property" } } @@ -6284,7 +6267,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "S", + "alias" : "Statement", "expression" : { "name" : "NaloxoneMedicationStatements", "type" : "ExpressionRef" @@ -6311,7 +6294,7 @@ "type" : "As", "operand" : { "path" : "medication", - "scope" : "S", + "scope" : "Statement", "type" : "Property" }, "asTypeSpecifier" : { @@ -6326,7 +6309,7 @@ "name" : "MedicationStatementDate", "type" : "FunctionRef", "operand" : [ { - "name" : "S", + "name" : "Statement", "type" : "AliasRef" } ] } @@ -6343,7 +6326,7 @@ "type" : "As", "operand" : { "path" : "effective", - "scope" : "S", + "scope" : "Statement", "type" : "Property" }, "asTypeSpecifier" : { @@ -6360,7 +6343,7 @@ "type" : "Property", "source" : { "path" : "status", - "scope" : "S", + "scope" : "Statement", "type" : "Property" } } @@ -6386,7 +6369,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "M", + "alias" : "Medication", "expression" : { "type" : "Union", "operand" : [ { @@ -6479,7 +6462,7 @@ "expression" : { "type" : "Query", "source" : [ { - "alias" : "S", + "alias" : "Screening", "expression" : { "name" : "RiskScreeningsRelevantToPainManagement", "type" : "ExpressionRef" @@ -6496,7 +6479,7 @@ "type" : "FunctionRef", "operand" : [ { "path" : "code", - "scope" : "S", + "scope" : "Screening", "type" : "Property" } ] } @@ -6512,7 +6495,7 @@ "type" : "As", "operand" : { "path" : "value", - "scope" : "S", + "scope" : "Screening", "type" : "Property" }, "asTypeSpecifier" : { @@ -6528,7 +6511,7 @@ "type" : "As", "operand" : { "path" : "value", - "scope" : "S", + "scope" : "Screening", "type" : "Property" }, "asTypeSpecifier" : { @@ -6549,7 +6532,7 @@ "type" : "First", "source" : { "path" : "interpretation", - "scope" : "S", + "scope" : "Screening", "type" : "Property" } } ] @@ -6561,7 +6544,7 @@ "type" : "As", "operand" : { "path" : "value", - "scope" : "S", + "scope" : "Screening", "type" : "Property" }, "asTypeSpecifier" : { @@ -6577,7 +6560,7 @@ "name" : "ObservationDate", "type" : "FunctionRef", "operand" : [ { - "name" : "S", + "name" : "Screening", "type" : "AliasRef" } ] } @@ -6613,7 +6596,7 @@ "source" : { "type" : "Query", "source" : [ { - "alias" : "G", + "alias" : "Given", "expression" : { "type" : "Flatten", "operand" : { @@ -6661,7 +6644,7 @@ "return" : { "expression" : { "path" : "value", - "scope" : "G", + "scope" : "Given", "type" : "Property" } } @@ -6681,7 +6664,7 @@ "source" : { "type" : "Query", "source" : [ { - "alias" : "F", + "alias" : "Family", "expression" : { "type" : "Query", "source" : [ { @@ -6726,7 +6709,7 @@ "return" : { "expression" : { "path" : "value", - "scope" : "F", + "scope" : "Family", "type" : "Property" } } diff --git a/src/cql/r4/Factors_to_Consider_in_Managing_Chronic_Pain_FHIRv401.cql b/src/cql/r4/Factors_to_Consider_in_Managing_Chronic_Pain_FHIRv401.cql deleted file mode 100644 index ef135e3b0..000000000 --- a/src/cql/r4/Factors_to_Consider_in_Managing_Chronic_Pain_FHIRv401.cql +++ /dev/null @@ -1,1081 +0,0 @@ -// # Introduction - -// The Pain Management Summary artifact provides relevant information to consider when managing a patient’s pain. -// This CDS logic was informed by the Centers for Disease Control and Prevention (CDC) Guideline for Opioid Prescribing -// for Chronic Pain. The CDS is not a direct representation of any one recommendation statement within the guideline. -// Instead, the CDS compiles clinical concepts mentioned throughout the guideline in one consolidated summary for -// clinician review. -// -// In the process of authoring the logic, certain assumptions were made and details developed when the guideline did -// not provide enough specificity. These decisions were made in the context of the CDS Connect Workgroup and CDC -// stakeholders, and are documented in the logic and/or in the CDS Connect artifact metadata. -// -// NOTE: This is a FHIR R4 port of the original FHIR DSTU2 CQL piloted for CDS Connect. In addition to the changes -// to support FHIR R4, it contains the following changes from the artifact that was piloted: -// - Added the following value sets for identifying Risk Factors for Opiod-Related Harms (in addition to existing ones) -// - Depression Diagnosis ICD9 (2.16.840.1.113883.3.600.143) -// - Anxiety Disorders ICD9 (2.16.840.1.113883.3.1240.2017.3.2.1015) -// - Substance Abuse (2.16.840.1.113883.3.464.1003.106.11.1010) -// - Pregnancy (New ICD10 codes published in 2018 and 2019)": '2.16.840.1.113762.1.4.1032.80' -// - Changed the Suicide Attempt value set to 2.16.840.1.113762.1.4.1032.102 -// - Removed specific inclusion of SNOMED-CT 86849004 since it is now in the Suicide Attempt value set -// - Added LOINC codes for the Pain intensity, Enjoyment of life, General activity scale [PEG] -// - Previous local codes are still supported (but discouraged) -// - Added logic to normalize long LOINC display text for PEG codes to shorter names -// - Added LOINC code for the STarT Back Screening Tool -// - Previous local code is still supported (but discouraged) -// - Added logic to display range for Opioid Risk Tool (ORT) -// - Updated QuantityText logic to not include '{score}' units (since scalar number is enough in those cases) -// -// In addition to the changes above, the R4 representation contains the following changes related to the movement from -// FHIR DSTU2 to FHIR R4: -// -// - MedicationOrder is replaced by MedicationRequest, and as a result, the reported type has changed from -// "Order" to "Request" -// - MedicationOrder dateWritten is replaced by MedicationRequest authoredOn -// - MedicationRequest no longer supports the dateEnded property, so end dates will always be blank -// for MedicationRequests -// - MedicationStatement no longer supports the wasNotTaken property -// - Observation adds an "instant" variant of the effective time -// - Observation's interpretation changed from single-value to multi-value, so the FHIR R4-based CQL only looks at the -// first interpretation value -// - Observations now check for verificationStatus "corrected", in addition to "final" and "amended" -// - Condition no longer supports the abatementBoolean property -// - Condition's clinicalStatus was changed from a code to a CodeableConcept -// - Condition's dateRecorded (Date) is replaced by recordedDate (DateTime) -// - ActiveOrRecurring Conditions now check for clinicalStatus "recurrence" in addition to "active" and "relapse" -// - ProcedureRequest is replaced by ServiceRequest -// - ProcedureRequest's orderedOn is replaced by ServiceRequest's authoredOn -// - ReferralRequest is replaced by ServiceRequest -// - ProcedureRequest's dateSent is replaced by ServiceRequest's authoredOn -// - NonPharmacologicTreatmentServiceRequests now queries for active or completed ServiceRequests rather than -// accepted, in-progress, or completed ProcedureRequests and accepted, active, or completed ReferralRequests -// - Procedure no longer supports the notDone property -// - ProcedurePerformance now excludes statuses: preparation, not-done, entered-in-error, and unknown -// - Due to changes in the CQL model representation of FHIR, choices are now accessed via CQL casts rather than -// explicit properties -// -// The initial R4 port of this artifact used the FHIR 4.0.0 model and CQL 1.3. This version uses the FHIR 4.0.1 model and -// CQL 1.5 (although it is expected to be backward compatible to CQL 1.4 and CQL 1.3). For this most recent update to FHIR -// 4.0.1, the following additional changes were made based on new capabilities in later versions of the CQL spec and tooling: -// - URL-based value set identifiers are used rather than plain OIDs -// - code/concept pairs are no longer needed; code definitions are sufficient, so concept definitions have been removed -// -// ##Source guideline: [CDC Guideline for Opioid Prescribing for Chronic Pain](https://www.cdc.gov/drugoverdose/prescribing/guideline.html) - -library Factors_to_Consider_in_Managing_Chronic_Pain_FHIRv401 version '1.0.0' - -// # Data model # - -// The FHIR R4 model is used for testing purposes only. It has not been piloted. -using FHIR version '4.0.1' - -// # Referenced libraries # - -// The CDS Connect Commons for FHIRv401 library provides functions representing commonly used CDS logic and patterns. -include CDS_Connect_Commons_for_FHIRv401 version '1.0.0' called C3F -// The FHIRHelpers library provides common functions for simplifying interaction w/ the FHIR R4 data model. -include FHIRHelpers version '4.0.1' called FHIRHelpers - -// # Value sets and codes # - -// ## Code Systems ## - -codesystem "LOINC": 'http://loinc.org' -codesystem "SNOMED-CT": 'http://snomed.info/sct' - -// Several concepts needed by the Pain Management Summary CDS do not yet have standardized codes associated with them. -// The CDS logic authors have registered new Logical Object Identifier Names and Codes (LOINC) codes, but they are -// not yet available. Once available, the CDS will be updated. Until then, CDS implementors will need to map to -// local codes (signified by the LOCAL code system below) or replace them with their own codes. -codesystem "LOCAL": 'http://cds.ahrq.gov/cdsconnect/pms' - -// ## Value sets ## - -// List value sets used by the artifact. The links to the Value Set Authority Center (VSAC) point to the latest -// expansion of each value set available. - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.37/expansion) -valueset "Conditions associated with chronic pain": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.37' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.34/expansion) -valueset "Opioid Pain Medications": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.34' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.54/expansion) -valueset "Adjuvant Analgesic Medications": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.54' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.105.12.1007/expansion) -valueset "Major Depression": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.105.12.1007' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.600.143/expansion) -valueset "Depression Diagnosis ICD9": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.600.143' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.52/expansion) -valueset "Anxiety": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.52' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.1240.2017.3.2.1015/expansion) -valueset "Anxiety Disorders ICD9": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.1240.2017.3.2.1015' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.106.12.1004/expansion) -valueset "Substance use disorder": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.106.12.1004' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.106.11.1010/expansion) -valueset "Substance Abuse": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.106.11.1010' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.102/expansion) -valueset "Suicide Attempt": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.102' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.53/expansion) -valueset "Sleep-disordered breathing": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.53' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.109.12.1028/expansion) -valueset "Kidney Failure": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.109.12.1028' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.464.1003.199.12.1035/expansion) -valueset "Chronic Liver Disease": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.464.1003.199.12.1035' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1047.42/expansion) -valueset "Liver Disease": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1047.42' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113883.3.526.3.378/expansion) -valueset "Pregnancy": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113883.3.526.3.378' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.80/expansion) -valueset "Pregnancy (New ICD10 codes published in 2018 and 2019)": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.80' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.26/expansion) -valueset "Non opiod pain medications": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.26' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.36/expansion) -valueset "Non pharmacologic treatments for chronic pain": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.36' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.55/expansion) -valueset "Risk assessments relevant to pain management": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.55' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.43/expansion) -valueset "Benzodiazepine medications": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.43' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.42/expansion) -valueset "Naloxone medications": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.42' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.28/expansion) -valueset "Urine drug screen for pain management": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.28' - -// [See value set in VSAC](https://vsac.nlm.nih.gov/valueset/2.16.840.1.113762.1.4.1032.44/expansion) -valueset "Stool softeners and laxatives": 'https://cts.nlm.nih.gov/fhir/ValueSet/2.16.840.1.113762.1.4.1032.44' - -// ## Individual codes ## - -// list individual codes from code systems used directly in the CQL logic. Individual codes are used when there is -// a single code from a particular vocabulary standard used to represent a clinical concept. It is considered -// best-practice not to create value sets containing a single code. - -code "Pregnancy status": '82810-3' from "LOINC" display 'Pregnancy status' -code "Pregnant": '77386006' from "SNOMED-CT" display 'Patient currently pregnant (finding)' -code "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]": - '55758-7' from "LOINC" display 'Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]' -code "Patient Health Questionnaire 9 item (PHQ-9) total score [Reported]": - '44261-6' from "LOINC" display 'Patient Health Questionnaire 9 item (PHQ-9) total score [Reported]' -code "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]": - '70274-6' from "LOINC" display 'Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]' -code "Total score [AUDIT]": '75624-7' from "LOINC" display 'Total score [AUDIT]' -code "Total score [AUDIT-C]": '75626-2' from "LOINC" display 'Total score [AUDIT-C]' -code "Total score [DAST-10]": '82667-7' from "LOINC" display 'Total score [DAST-10]' -code "Total score ORT": '91392-1' from "LOINC" display 'Total score ORT' -code "Pain severity Wong-Baker FACES Scale": '38221-8' from "LOINC" display 'Pain severity Wong-Baker FACES Scale' - -// The Pain intensity, Enjoyment of life, General activity scale [PEG] now has standardized LOINC codes available. -// These LOINC codes were not available when the initial version of the Pain Management Summary was developed. -// New systems implementing the Pain Management Summary should use the standardized codes, but the legacy local codes -// are also retained in order to allow existing systems to continue to function. Existing systems, however, are -// strongly encouraged to adopt the standardized LOINC codes. - -code "Mean score [PEG]": '91147-9' from "LOINC" display 'Mean score [PEG]' -code "Pain severity in the past week - 0-10 numeric rating [Reported]": - '75893-8' from "LOINC" display 'Pain severity in the past week - 0-10 numeric rating [Reported]' -code "What number best describes how pain has interfered with your enjoyment of life during the past week": - '91145-3' from "LOINC" display 'What number best describes how pain has interfered with your enjoyment of life during the past week' -code "What number best describes how pain has interfered with your general activity during the past week": - '91146-1' from "LOINC" display 'What number best describes how pain has interfered with your general activity during the past week' - -// Legacy local codes for the Pain intensity, Enjoyment of life, General activity scale [PEG]. -// New systems should use the LOINC codes above instead. - -code "Pain Enjoyment General Activity (PEG) Assessment LEGACY": - 'PEGASSESSMENT' from "LOCAL" display 'Pain Enjoyment General Activity (PEG) Assessment' -code "Pain LEGACY": 'PEGPAIN' from "LOCAL" display 'Pain' -code "Enjoyment of life LEGACY": 'PEGENJOYMENT' from "LOCAL" display 'Enjoyment of life' -code "General activity LEGACY": 'PEGGENERALACTIVITY' from "LOCAL" display 'General activity' - -// The STarT Back Screening Tool now has a standardized LOINC code available. This LOINC code was not available -// when the initial version of the Pain Management Summary was developed. New systems implementing the Pain Management -// Summary should use the standardized code, but the legacy local code is also retained in order to allow existing -// systems to continue to function. Existing systems, however, are strongly encouraged to adopt the standardized LOINC -// code. - -code "Total score [STarT Back]": '91351-7' from "LOINC" display 'Total score [STarT Back]' - -// Legacy local code for the STarT Back Screening Tool. New systems should use the LOINC codes above instead. - -code "STarT Back Screening Tool LEGACY": 'STARTBACK' from "LOCAL" display 'STarT Back Screening Tool' - -// The following codes do not yet have standardized codes associated with them so are expressed as LOCAL codes. -// As standardized codes become available, this CDS will be updated to use standard codes rather than LOCAL codes. - -code "Single question r/t ETOH use": 'SQETOHUSE' from "LOCAL" display 'Single question r/t ETOH use' -code "Single question r/t drug use": 'SQDRUGUSE' from "LOCAL" display 'Single question r/t drug use' -code "Morphine Milligram Equivalent (MME)": 'MME' from "LOCAL" display 'Morphine Milligram Equivalent (MME)' - -// # Parameters # - -// The InclusionMedicationsLookbackPeriod allows CDS implementors to specify how far the inclusion logic should look -// back for qualifying active medications. By default, the inclusion logic will look back 180 days. -parameter InclusionMedicationsLookbackPeriod default 180 days - -// # CDS logic # - -context Patient - -// ## Re-usable functions ## - -// The summary logic contains many constructs that are needed throughout the logic. Where possible, these constructs -// have been developed as re-usable functions that can be invoked wherever they are needed. - -// Returns the first-found display text for a CodeableConcept, looking first at the `text` attribute, then the -// `display` on each `coding` until it finds a non-null value. Some PEG codes are normalized due to length. -// @param c - a FHIR CodeableConcept to get text from -// @returns {System.String} the display text or null if none is found - -define function ConceptText(c FHIR.CodeableConcept): - if c ~ "Mean score [PEG]" or c ~ "Pain Enjoyment General Activity (PEG) Assessment LEGACY" - then 'Mean score [PEG]' - else if c ~ "Pain severity in the past week - 0-10 numeric rating [Reported]" or c ~ "Pain LEGACY" - then 'Pain' - else if c ~ "What number best describes how pain has interfered with your enjoyment of life during the past week" - or c ~ "Enjoyment of life LEGACY" - then 'Enjoyment of life' - else if c ~ "What number best describes how pain has interfered with your general activity during the past week" - or c ~ "General activity LEGACY" - then 'General activity' - else - Coalesce(c.text.value, Coalesce((c.coding) c2 return c2.display.value)) - -// We do not reliably get ranges back from EHR data, but ranges are important to understanding assessment scores in -// the summary. This function adds ranges to the name for known assessments. -// @param c - a FHIR CodeableConcept to get the updated text for -// @returns {System.String} the display text with range information appended -define function ConceptTextWithRange(c FHIR.CodeableConcept): - if c ~ "Patient Health Questionnaire 2 item (PHQ-2) total score [Reported]" - then ConceptText(c) + ' [Range: 0-6]' - else if c ~ "Patient Health Questionnaire 9 item (PHQ-9) total score [Reported]" - then ConceptText(c) + ' [Range: 0-27]' - else if c ~ "Generalized anxiety disorder 7 item (GAD-7) total score [Reported.PHQ]" - then ConceptText(c) + ' [Range: 0-21]' - else if c ~ "Total score [AUDIT]" - then ConceptText(c) + ' [Range: 0-40]' - else if c ~ "Total score [AUDIT-C]" - then ConceptText(c) + ' [Range: 0-12]' - else if c ~ "Total score [DAST-10]" - then ConceptText(c) + ' [Range: 0-10]' - else if c ~ "Total score ORT" - then ConceptText(c) + ' [Range: 0-26]' - else if c ~ "Pain severity Wong-Baker FACES Scale" - then ConceptText(c) + ' [Range: 0-10]' - else if c ~ "Mean score [PEG]" - or c ~ "Pain Enjoyment General Activity (PEG) Assessment LEGACY" - then ConceptText(c) + ' [Range: 0-10]' - else if c ~ "Total score [STarT Back]" - or c ~ "STarT Back Screening Tool LEGACY" - then ConceptText(c) + ' [Range: 0-9]' - else - ConceptText(c) - -// Returns a text representation of a date using the CQL `ToString` function. -// @param d - a FHIR date to get text for -// @returns {System.String} the text representation of the date -define function DateText(d FHIR.date): - ToString(d.value) - -// Returns a text representation of a dateTime using the CQL `ToString` function. -// @param d - a FHIR dateTime to get text for -// @returns {System.String} the text representation of the dateTime -define function DateTimeText(d FHIR.dateTime): - ToString(d.value) - -// Returns a text representation of an instant using the CQL `ToString` function. -// @param i - a FHIR instant to get text for -// @returns {System.String} the text representation of the instant -define function InstantText(i FHIR.instant): - ToString(i.value) - -// Returns a text representation of a Quantity with the Quantity's value and unit. -// If the unit is {score}, then omit it (as it is not useful to display) -// @param q - a FHIR Quantity to get text for -// @returns {System.String} the text representation of the Quantity -define function QuantityText(q FHIR.Quantity): - if (q is null) then null - else if (q.unit is not null and q.unit.value != '{score}') then ToString(q.value.value) + ' ' + q.unit.value - else if (q.code is not null and q.code.value != '{score}') then ToString(q.value.value) + ' ' + q.code.value - else ToString(q.value.value) - -// Returns a tuple containing a Period's start and end as text representations. -// @param p - a FHIR Period to get a tuple for -// @returns {Tuple} the tuple representation of the Period -define function PeriodObject(p FHIR.Period): - if p is null then null - else - { - Start: DateTimeText(p."start"), - End: DateTimeText(p."end") - } - -// Returns a tuple containing a Range's low and high as text representations. -// @param r - a FHIR Range to get a tuple for -// @returns {Tuple} the tuple representation of the Range -define function RangeObject(r FHIR.Range): - if r is null then null - else - { - Low: QuantityText(r.low), - High: QuantityText(r.high) - } - -// Returns a text representation of a date associated with an Observation, preferring `effectiveDateTime`, then -// `effectivePeriod.start`, then `issued`. -// @param o - a FHIR Observation to get the text date from -// @returns {System.String} the text representation of a relevant date from the Observation -define function ObservationDate(o FHIR.Observation): - Coalesce( - DateTimeText(o.effective as FHIR.dateTime), - InstantText(o.effective as FHIR.instant), - DateTimeText((o.effective as FHIR.Period)."start"), - InstantText(o.issued) - ) - -// Returns a text representation of a date associated with a MedicationStatement, preferring `effectiveDateTime`, then -// `.start`. -// @param s - a FHIR MedicationStatement to get the text date from -// @returns {System.String} the text representation of a relevant date from the MedicationStatement -define function MedicationStatementDate(s FHIR.MedicationStatement): - Coalesce( - DateTimeText(s.effective as FHIR.dateTime), - DateTimeText((s.effective as FHIR.Period)."start") - ) - -// Returns a text representation of a Condition's onset, whether represented as a dateTime, Period, Quantity (Age), -// Range (Age), or string. -// @param c - a FHIR Condition to get the text representation of the onset from -// @returns {System.String} the text representation of the Condition's onset -define function Onset(c FHIR.Condition): - Coalesce( List{ - DateTimeText(c.onset as FHIR.dateTime), - QuantityText(c.onset as FHIR.Age), - PeriodObject(c.onset as FHIR.Period), - RangeObject(c.onset as FHIR.Range), - (c.onset as FHIR.string).value - }) - -// Returns a text representation of a Condition's abatement, whether represented as a dateTime, Period, Quantity (Age), -// Range (Age), string, or boolean. -// @param c - a FHIR Condition to get the text representation of the abatement from -// @returns {System.String} the text representation of the Condition's abatement -define function Abatement(c FHIR.Condition): - Coalesce( List{ - DateTimeText(c.abatement as FHIR.dateTime), - QuantityText(c.abatement as FHIR.Age), - PeriodObject(c.abatement as FHIR.Period), - RangeObject(c.abatement as FHIR.Range), - (c.abatement as FHIR.string).value - }) - -// ## Target population ## - -// INCLUSIONS - -// Determines if patient's age, in years, at the time CQL is run, is at least 18 years old -define Is18orOlder: - AgeInYears() >= 18 - -// Conditions associated with chronic pain -define ConditionsAssociatedWithChronicPain: - C3F.Confirmed(C3F.ActiveOrRecurring([Condition: "Conditions associated with chronic pain"])) - -// Determines if the patient has any of the conditions associated with chronic pain -define HasConditionAssociatedWithChronicPain: - exists(ConditionsAssociatedWithChronicPain) - -// Determines if the patient has any record of opioid pain medications in the lookback period -// - Medication Request within past 180 days (lookback can be made a parameter) -// - Medication Statement by patient within past 180 days (lookback can be made a parameter) -define HasRecentOpioidPainMedication: - exists(C3F.ActiveCompletedOrStoppedMedicationRequest(C3F.MedicationRequestLookBack( - [MedicationRequest: "Opioid Pain Medications"], - InclusionMedicationsLookbackPeriod) - )) - or exists(C3F.ActiveOrCompletedMedicationStatement(C3F.MedicationStatementLookBack( - [MedicationStatement: "Opioid Pain Medications"], - InclusionMedicationsLookbackPeriod) - )) - -// Determines if the patient has any record of adjuvant analgesic medications in the lookback period -// - Medication Request within past 180 days (lookback can be made a parameter) -// - Medication Statement by patient within past 180 days (lookback can be made a parameter) -define HasRecentAdjuvantAnalgesicMedication: - exists(C3F.ActiveCompletedOrStoppedMedicationRequest(C3F.MedicationRequestLookBack( - [MedicationRequest: "Adjuvant Analgesic Medications"], - InclusionMedicationsLookbackPeriod) - )) - or exists(C3F.ActiveOrCompletedMedicationStatement(C3F.MedicationStatementLookBack( - [MedicationStatement: "Adjuvant Analgesic Medications"], - InclusionMedicationsLookbackPeriod) - )) - -// Determines if the patient meets the inclusion criteria for the CDS. Inclusion criteria is: -// - Age >=18 years -// - AND -// - OR Conditions associated with chronic pain -// - OR Opioid pain medication -// - OR Adjuvant analgesic medication -define MeetsInclusionCriteria: - Is18orOlder - and ( - HasConditionAssociatedWithChronicPain - or HasRecentOpioidPainMedication - or HasRecentAdjuvantAnalgesicMedication - ) - -// EXCLUSIONS - -// TAKE NOTICE: This CDS is not intended for patients who meet any of the following criteria: -// 1. Younger than 18 years of age -// 2. Undergoing end-of-life care (hospice or palliative) -// 3. Undergoing active cancer treatment -// -// The first exclusion is explicitly accounted for under INCLUSIONS. -// The second and third exclusions cannot be realiably detected for all patients using just EHR data. For that reason -// they are not implemented in this CDS. Care providers should use their judgement when applying this CDS to their -// patients. - -// ## Intervention(s) ## - -// DISPLAY and POPULATE a Pain Management Summary of the following items: - -// PERTINENT MEDICAL HISTORY - -// Conditions associated with chronic pain and their dates of onset - -define ReportConditionsAssociatedWithChronicPain: - (ConditionsAssociatedWithChronicPain) C - return { - Name: ConceptText(C.code), - Status: C.clinicalStatus.coding[0].code.value, - Onset: Onset(C), - DateRecorded: DateTimeText(C.recordedDate) - } - sort by (Onset as String) desc - -// Conditions that are risk factors for opioid-related harms and their dates of onset -// This is a union of nine value sets (w/ different filtering criteria) - -define DepressionConditions: - C3F.Confirmed(C3F.ActiveOrRecurring([Condition: "Major Depression"])) - union C3F.Confirmed(C3F.ActiveOrRecurring([Condition: "Depression Diagnosis ICD9"])) - -define AnxietyConditions: - C3F.Confirmed(C3F.ActiveOrRecurring([Condition: "Anxiety"])) - union C3F.Confirmed(C3F.ActiveOrRecurring([Condition: "Anxiety Disorders ICD9"])) - -define SubstanceUseDisorderConditions: - C3F.Confirmed([Condition: "Substance use disorder"]) - union C3F.Confirmed([Condition: "Substance Abuse"]) - -define SuicideAttemptConditions: - C3F.Confirmed([Condition: "Suicide Attempt"]) - -define SleepDisorderedBreathingConditions: - C3F.Confirmed(C3F.ActiveOrRecurring([Condition: "Sleep-disordered breathing"])) - -define RenalDysfunctionConditions: - C3F.Confirmed(C3F.ActiveOrRecurring([Condition: "Kidney Failure"])) - -define HepaticDysfunctionConditions: - C3F.Confirmed(C3F.ActiveOrRecurring([Condition: "Chronic Liver Disease"])) - union C3F.Confirmed(C3F.ActiveOrRecurring([Condition: "Liver Disease"])) - -define PregnancyConditions: - C3F.Confirmed(C3F.ConditionLookBack(C3F.ActiveOrRecurring( - [Condition: "Pregnancy"]) - union [Condition: "Pregnancy (New ICD10 codes published in 2018 and 2019)"], - 42 weeks - )) - -define PregnancyObservations: - C3F.Verified(C3F.ObservationLookBack([Observation: "Pregnancy status"], 42 weeks)) - -define MostRecentPregnancyObservation: - C3F.MostRecent(PregnancyObservations) - -define MostRecentPregnancyObservationIsPositive: - C3F.ConceptValue(MostRecentPregnancyObservation) ~ "Pregnant" - -define Is65orOlder: - AgeInYears() >= 65 - -define ConditionRiskFactorsForOpioidRelatedHarms: - DepressionConditions - union AnxietyConditions - union SubstanceUseDisorderConditions - union SuicideAttemptConditions - union SleepDisorderedBreathingConditions - union RenalDysfunctionConditions - union HepaticDysfunctionConditions - union PregnancyConditions - -// Encounter diagnoses that are risk factors for opioid-related harms and their dates of onset. Some risk factors may -// not exist on the problem list, and therefore may not be represented as Conditions (depending on EHR implementation). -// For this, the logic also looks at the patient's encounters, trying to find risk factors recorded as encounter -// diagnosis codes. We do not look at the reasonReference field because the Conditions referred to would already be -// reflected in the expression that queries over Conditions. - -define EncounterRiskFactorsForOpioidRelatedHarms: - [Encounter] E where exists( - E.reasonCode R where - FHIRHelpers.ToConcept(R) in "Major Depression" - or FHIRHelpers.ToConcept(R) in "Depression Diagnosis ICD9" - or FHIRHelpers.ToConcept(R) in "Anxiety" - or FHIRHelpers.ToConcept(R) in "Anxiety Disorders ICD9" - or FHIRHelpers.ToConcept(R) in "Substance use disorder" - or FHIRHelpers.ToConcept(R) in "Substance Abuse" - or FHIRHelpers.ToConcept(R) in "Suicide Attempt" - or FHIRHelpers.ToConcept(R) in "Sleep-disordered breathing" - or FHIRHelpers.ToConcept(R) in "Kidney Failure" - or FHIRHelpers.ToConcept(R) in "Chronic Liver Disease" - or FHIRHelpers.ToConcept(R) in "Liver Disease" - // Pregnancy not considered in Encounter diagnoses because this is an unrestricted lookback. - ) - -// NOTE: As a convention, if an expression's name starts with "Report", its purpose is to format data for the purpose -// of building the final summary object. - -// Format the risk factors in a uniform way despite the different sources of the data (conditions, encounter diagnoses, -// etc.). Note that conditions do not have a "Visit" date and encounter diagnoses do not have a status, onset date, -// recorded date, or abatement date. - -define ReportConditionRiskFactorsForOpioidRelatedHarms: - (ConditionRiskFactorsForOpioidRelatedHarms) C - return { - Name: ConceptText(C.code), - Status: C.clinicalStatus.coding[0].code.value, - Onset: Onset(C), - DateRecorded: DateTimeText(C.recordedDate), - Abatement: Abatement(C), - Visit: null as Tuple{ Start String, End String } - } - sort by (Onset as String) desc, (Abatement as String) desc - -define function GetEncounterDiagnosesRiskFactorsForOpioidRelatedHarms(enc Encounter): - (enc.reasonCode) R - where FHIRHelpers.ToConcept(R) in "Major Depression" - or FHIRHelpers.ToConcept(R) in "Depression Diagnosis ICD9" - or FHIRHelpers.ToConcept(R) in "Anxiety" - or FHIRHelpers.ToConcept(R) in "Anxiety Disorders ICD9" - or FHIRHelpers.ToConcept(R) in "Substance use disorder" - or FHIRHelpers.ToConcept(R) in "Substance Abuse" - or FHIRHelpers.ToConcept(R) in "Suicide Attempt" - or FHIRHelpers.ToConcept(R) in "Sleep-disordered breathing" - or FHIRHelpers.ToConcept(R) in "Kidney Failure" - or FHIRHelpers.ToConcept(R) in "Chronic Liver Disease" - or FHIRHelpers.ToConcept(R) in "Liver Disease" - // Pregnancy not considered in Encounter diagnoses because this is an unrestricted lookback. - return { - Name: ConceptText(R), - Status: null as String, - Onset: null as String, - DateRecorded: null as String, - Abatement: null as String, - Visit: PeriodObject(enc.period) - } - -define ReportEncounterRiskFactorsForOpioidRelatedHarms: - (flatten((EncounterRiskFactorsForOpioidRelatedHarms) E - return GetEncounterDiagnosesRiskFactorsForOpioidRelatedHarms(E))) D - sort by Visit.Start desc, Visit.End desc - -// Shape the pregnancy Observation as a Condition, since this is the backup approach for detecting a pregnancy in case -// there are no active Conditions found. -define ReportMostRecentPositivePregnancyObservation: - if MostRecentPregnancyObservationIsPositive then - { - Name: ConceptText(MostRecentPregnancyObservation.code), - Status: ConceptText(MostRecentPregnancyObservation.value as FHIR.CodeableConcept), - Onset: ToString(Coalesce( - (MostRecentPregnancyObservation.effective as FHIR.dateTime).value, - (MostRecentPregnancyObservation.effective as FHIR.instant).value, - (MostRecentPregnancyObservation.effective as FHIR.Period)."start".value - )), - DateRecorded: ToString(MostRecentPregnancyObservation.issued.value), - Abatement: null as String, - Visit: null as Tuple{ Start String, End String } - } - else - null - -// Shape the case of being 65 or older as a Condition for the purposes of building the summary. -define ReportOlderThan65: - if Is65orOlder then - { - Name: '65 years or older', - Status: 'active', - Onset: null as String, - DateRecorded: null as String, - Abatement: null as String, - Visit: null as Tuple{ Start String, End String } - } - else - null - -define ReportRiskFactorsForOpioidRelatedHarms: - // If a pregnancy Condition is present, use that. - if Exists(PregnancyConditions) then - (ReportConditionRiskFactorsForOpioidRelatedHarms - union ReportEncounterRiskFactorsForOpioidRelatedHarms - union ReportOlderThan65) C - // Otherwise, try to find a positive pregnancy status in an Observation. - else - (ReportConditionRiskFactorsForOpioidRelatedHarms - union ReportEncounterRiskFactorsForOpioidRelatedHarms - union ReportOlderThan65 - union ReportMostRecentPositivePregnancyObservation) C - sort by (if Onset is not null then Onset as String else Visit.Start) desc, Visit.End desc, (Abatement as String) desc - -// PAIN ASSESSMENT - -// Numeric pain intensity assessment - scores and dates (lookback 2 years) - -define NumericPainIntensityAssessments: - C3F.Verified(C3F.ObservationLookBack([Observation: "Pain severity Wong-Baker FACES Scale"], 2 years)) - -define ReportNumericPainIntensityAssessments: - (NumericPainIntensityAssessments) A - return { - Name: ConceptTextWithRange(A.code), - Score: QuantityText(A.value as FHIR.Quantity), - Interpretation: Coalesce( ConceptText(First(A.interpretation)), ConceptText(A.value as FHIR.CodeableConcept) ), - Date: ObservationDate(A) - } - sort by Date desc - -// Pain Enjoyment General Activity (PEG) Assessment - scores and dates (lookback 2 years) -// Note: this includes listing the response to each of the 3 questions, plus the total score. The Pain Management -// Sumnmary currently supports both the LOINC representations and the legacy local code representations. -// -// 1. Observation w/ LOINC mean score as primary code and mean score as valueQuantity -// * code: LOINC 91147-9 "Mean score [PEG]" -// * valueQuantity: (mean score) -// * component: -// - -// * code: LOINC 75893-8 "What number best describes your pain on average in the past week?" -// * valueQuantity: (pain score) -// - -// * code: LOINC 91145-3 "What number best describes how, during the past week, pain has interfered with your enjoyment of life?" -// * valueQuantity: (enjoyment of life score) -// - -// * code: LOINC 91146-1 "What number best describes how, during the past week, pain has interfered with your general activity?" -// * valueQuantity: (general activity score) -// -// 2. LEGACY: Observation w/ LOCAL code as primary code and mean score as valueQuantity -// * code: LOCAL PEGASSESSMENT "Pain Enjoyment General Activity (PEG) Assessment" -// * valueQuantity: (mean score) -// * component: -// - -// * code: LOCAL PEGPAIN "Pain" -// * valueQuantity: (pain score) -// - -// * code: LOCAL PEGENJOYMENT "Enjoyment of life" -// * valueQuantity: (enjoyment of life score) -// - -// * code: LOCAL PEGGENERALACTIVITY "General activity" -// * valueQuantity: (general activity score) - -define PainEnjoymentGeneralActivityAssessments: - C3F.Verified(C3F.ObservationLookBack( - [Observation: "Mean score [PEG]"] - union [Observation: "Pain Enjoyment General Activity (PEG) Assessment LEGACY"], - 2 years - )) - -define ReportPainEnjoymentGeneralActivityAssessments: - (PainEnjoymentGeneralActivityAssessments) A - let - Pain: (A.component) C - where C.code ~ "Pain severity in the past week - 0-10 numeric rating [Reported]" - or C.code ~ "Pain LEGACY", - Enjoyment: (A.component) C - where C.code ~ "What number best describes how pain has interfered with your enjoyment of life during the past week" - or C.code ~ "Enjoyment of life LEGACY", - GeneralActivity: (A.component) C - where C.code ~ "What number best describes how pain has interfered with your general activity during the past week" - or C.code ~ "General activity LEGACY" - where true // grammar needs a where statement to separate the "let" from the "return" - return { - // NOTE: Hard-code in names because the real LOINC code displays are quite long - Name: ConceptTextWithRange(A.code), - Score: QuantityText(A.value as FHIR.Quantity), - Interpretation: Coalesce( ConceptText(First(A.interpretation)), ConceptText(A.value as FHIR.CodeableConcept) ), - Questions: ({ First(Pain), First(Enjoyment), First(GeneralActivity) }) C - where C is not null - return { "Name": ConceptText(C.code), "Score": QuantityText(C.value as FHIR.Quantity) }, - Date: ObservationDate(A) - } - sort by Date desc - -// STarT Back Screening Tool - Overall score and dates (lookback 2 years) - -define STarTBackAssessments: - C3F.Verified(C3F.ObservationLookBack( - [Observation: "Total score [STarT Back]"] - union [Observation: "STarT Back Screening Tool LEGACY"], - 2 years - )) - -define ReportSTarTBackAssessments: - (STarTBackAssessments) A - return { - Name: ConceptTextWithRange(A.code), - Score: QuantityText(A.value as FHIR.Quantity), - Interpretation: Coalesce( ConceptText(First(A.interpretation)), ConceptText(A.value as FHIR.CodeableConcept) ), - Date: ObservationDate(A) - } - sort by Date desc - -// HISTORICAL TREATMENTS - -// Opioid medication orders and statements with dates (lookback 2 years) - -define OpioidMedicationRequests: - C3F.ActiveCompletedOrStoppedMedicationRequest(C3F.MedicationRequestLookBack( - [MedicationRequest: "Opioid Pain Medications"], - 2 years - )) - -define OpioidMedicationStatements: - C3F.ActiveOrCompletedMedicationStatement(C3F.MedicationStatementLookBack( - [MedicationStatement: "Opioid Pain Medications"], - 2 years - )) - -define ReportOpioidMedicationRequests: - (OpioidMedicationRequests) O - return { - Type: 'Request', - Name: ConceptText(O.medication as FHIR.CodeableConcept), - Start: DateTimeText(O.authoredOn), - End: null as String, // MedicationRequest end date not supported in R4, - Status: O.status.value - } - sort by Start desc, End desc - -define ReportOpioidMedicationStatements: - (OpioidMedicationStatements) S - return { - Type: 'Statement', - Name: ConceptText(S.medication as FHIR.CodeableConcept), - Start: MedicationStatementDate(S), - End: DateTimeText((S.effective as FHIR.Period)."end"), - Status: S.status.value - } - sort by Start desc, End desc - -define ReportOpioidMedications: - (ReportOpioidMedicationRequests union ReportOpioidMedicationStatements) M - sort by Start desc, End desc - -// Non-opioid medication orders and statements with dates (lookback 2 years) - -define NonOpioidMedicationRequests: - C3F.ActiveCompletedOrStoppedMedicationRequest(C3F.MedicationRequestLookBack( - [MedicationRequest: "Non opiod pain medications"], - 2 years - )) - -define NonOpioidMedicationStatements: - C3F.ActiveOrCompletedMedicationStatement(C3F.MedicationStatementLookBack( - [MedicationStatement: "Non opiod pain medications"], - 2 years - )) - -define ReportNonOpioidMedicationRequests: - (NonOpioidMedicationRequests) O - return { - Type: 'Request', - Name: ConceptText(O.medication as FHIR.CodeableConcept), - Start: DateTimeText(O.authoredOn), - End: null as String, // MedicationRequest end date not supported in R4, - Status: O.status.value - } - sort by Start desc, End desc - -define ReportNonOpioidMedicationStatements: - (NonOpioidMedicationStatements) S - return { - Type: 'Statement', - Name: ConceptText(S.medication as FHIR.CodeableConcept), - Start: MedicationStatementDate(S), - End: DateTimeText((S.effective as FHIR.Period)."end"), - Status: S.status.value - } - sort by Start desc, End desc - -define ReportNonOpioidMedications: - (ReportNonOpioidMedicationRequests union ReportNonOpioidMedicationStatements) M - sort by Start desc, End desc - -// Non-pharmacologic treatments, orders, and referrals with dates (lookback 2 years) - -define NonPharmacologicTreatmentProcedures: - C3F.ProcedurePerformance(C3F.ProcedureLookBack([Procedure: "Non pharmacologic treatments for chronic pain"], 2 years)) - -define ReportNonPharmacologicTreatmentProcedures: - (NonPharmacologicTreatmentProcedures) P - return { - Type: 'Procedure', - Name: ConceptText(P.code), - Date: Coalesce( - DateTimeText(P.performed as FHIR.dateTime), - DateTimeText((P.performed as FHIR.Period)."start") - ) - } - sort by Date desc - -define NonPharmacologicTreatmentServiceRequests: - C3F.ServiceRequestActiveOrCompleted( - C3F.ServiceRequestLookBack([ServiceRequest: "Non pharmacologic treatments for chronic pain"], 2 years) - ) - -define ReportNonPharmacologicTreatmentServiceRequests: - (NonPharmacologicTreatmentServiceRequests) P - return { - Type: 'ServiceRequest', - Name: ConceptText(P.code), - Date: DateTimeText(P.authoredOn) - } - sort by Date desc - -define ReportNonPharmacologicTreatments: - (ReportNonPharmacologicTreatmentProcedures - union ReportNonPharmacologicTreatmentServiceRequests) M - sort by Date desc - -// Stool softeners and laxatives - orders and statements with dates (lookback 6 months) - -define StoolSoftenersAndLaxativesRequests: - C3F.ActiveCompletedOrStoppedMedicationRequest(C3F.MedicationRequestLookBack( - [MedicationRequest: "Stool softeners and laxatives"], - 6 months - )) - -define StoolSoftenersAndLaxativesStatements: - C3F.ActiveOrCompletedMedicationStatement(C3F.MedicationStatementLookBack( - [MedicationStatement: "Stool softeners and laxatives"], - 6 months - )) - -define ReportStoolSoftenersAndLaxativesRequests: - (StoolSoftenersAndLaxativesRequests) O - return { - Type: 'Request', - Name: ConceptText(O.medication as FHIR.CodeableConcept), - Start: DateTimeText(O.authoredOn), - End: null as String, // MedicationRequest end date not supported in R4, - Status: O.status.value - } - sort by Start desc, End desc - -define ReportStoolSoftenersAndLaxativesStatements: - (StoolSoftenersAndLaxativesStatements) S - return { - Type: 'Statement', - Name: ConceptText(S.medication as FHIR.CodeableConcept), - Start: MedicationStatementDate(S), - End: DateTimeText((S.effective as FHIR.Period)."end"), - Status: S.status.value - } - sort by Start desc, End desc - -define ReportStoolSoftenersAndLaxatives: - (ReportStoolSoftenersAndLaxativesRequests union ReportStoolSoftenersAndLaxativesStatements) M - sort by Start desc, End desc - -// RISK CONSIDERATIONS - -// MME (MOST RECENT w/ lookback 6 months) - amount and date - -define MostRecentMME: - C3F.MostRecent(C3F.Verified(C3F.ObservationLookBack([Observation: "Morphine Milligram Equivalent (MME)"], 6 months))) - -define ReportMostRecentMME: - if MostRecentMME is null - then null - else - (MostRecentMME) M - return { - Name: ConceptText(M.code), - Result: QuantityText(M.value as FHIR.Quantity), - Date: ObservationDate(M) - } - -// Urine drug screen - dates and results (all screens w/ lookback of 1 year) - -define UrineDrugScreens: - C3F.Verified(C3F.ObservationLookBack([Observation: "Urine drug screen for pain management"], 1 year)) - -define ReportUrineDrugScreens: - (UrineDrugScreens) S - return { - Name: ConceptText(S.code), - Result: Coalesce( - QuantityText(S.value as FHIR.Quantity), - (S.value as FHIR.string).value, - ConceptText(S.value as FHIR.CodeableConcept) - ), - Interpretation: ConceptText(First(S.interpretation)), - Date: ObservationDate(S) - } - sort by Date desc - -// Benzodiazepine Medications (lookback of 2 years)- orders and statements with dates - -define BenzodiazepineMedicationRequests: - C3F.ActiveCompletedOrStoppedMedicationRequest(C3F.MedicationRequestLookBack( - [MedicationRequest: "Benzodiazepine medications"], - 2 years - )) - -define BenzodiazepineMedicationStatements: - C3F.ActiveOrCompletedMedicationStatement(C3F.MedicationStatementLookBack( - [MedicationStatement: "Benzodiazepine medications"], - 2 years - )) - -define ReportBenzodiazepineMedicationRequests: - (BenzodiazepineMedicationRequests) O - return { - Type: 'Request', - Name: ConceptText(O.medication as FHIR.CodeableConcept), - Start: DateTimeText(O.authoredOn), - End: null as String, // MedicationRequest end date not supported in R4, - Status: O.status.value - } - sort by Start desc, End desc - -define ReportBenzodiazepineMedicationStatements: - (BenzodiazepineMedicationStatements) S - return { - Type: 'Statement', - Name: ConceptText(S.medication as FHIR.CodeableConcept), - Start: MedicationStatementDate(S), - End: DateTimeText((S.effective as FHIR.Period)."end"), - Status: S.status.value - } - sort by Start desc, End desc - -define ReportBenzodiazepineMedications: - (ReportBenzodiazepineMedicationRequests union ReportBenzodiazepineMedicationStatements) M - sort by Start desc, End desc - -// Naloxone Medications (unrestricted lookback) - orders and statements with dates - -define NaloxoneMedicationRequests: - C3F.ActiveCompletedOrStoppedMedicationRequest([MedicationRequest: "Naloxone medications"]) - -define NaloxoneMedicationStatements: - C3F.ActiveOrCompletedMedicationStatement([MedicationStatement: "Naloxone medications"]) - -define ReportNaloxoneMedicationRequests: - (NaloxoneMedicationRequests) O - return { - Type: 'Request', - Name: ConceptText(O.medication as FHIR.CodeableConcept), - Start: DateTimeText(O.authoredOn), - End: null as String, // MedicationRequest end date not supported in R4, - Status: O.status.value - } - sort by Start desc, End desc - -define ReportNaloxoneMedicationStatements: - (NaloxoneMedicationStatements) S - return { - Type: 'Statement', - Name: ConceptText(S.medication as FHIR.CodeableConcept), - Start: MedicationStatementDate(S), - End: DateTimeText((S.effective as FHIR.Period)."end"), - Status: S.status.value - } - sort by Start desc, End desc - -define ReportNaloxoneMedications: - (ReportNaloxoneMedicationRequests union ReportNaloxoneMedicationStatements) M - sort by Start desc, End desc - -// Risk screenings relevant to pain management - overall scores and dates (MOST RECENT w/ lookback 1 year) - -define RiskScreeningsRelevantToPainManagement: - C3F.Verified(C3F.ObservationLookBack( - [Observation: "Risk assessments relevant to pain management"] - union [Observation: "Single question r/t ETOH use"] - union [Observation: "Single question r/t drug use"] - , 1 year)) - -define ReportRiskScreeningsRelevantToPainManagement: - (RiskScreeningsRelevantToPainManagement) S - return { - Name: ConceptTextWithRange(S.code), - Score: Coalesce( - QuantityText(S.value as FHIR.Quantity), - (S.value as FHIR.string).value - ), - Interpretation: Coalesce( - ConceptText(First(S.interpretation)), - ConceptText(S.value as FHIR.CodeableConcept) - ), - Date: ObservationDate(S) - } - sort by Date desc - -// SUMMARY - -// The Summary object represents the full Pain Management Summary to be displayed to the clinician. All values are -// returned as user-friendly text representations, but a robust user interface (UI) should be implemented to -// display the data to the user in a friendly manner. See the Pain Management Summary SMART on FHIR application as -// an example of how to integrate this summary into an EHR using modern web UI technologies. - -define Summary: { - Patient: { - Name: Combine(Patient.name.given G return G.value, ' ') + ' ' + Combine(Patient.name.family F return F.value, ' '), - Gender: Patient.gender.value, - Age: AgeInYears(), - MeetsInclusionCriteria: MeetsInclusionCriteria - }, - PertinentMedicalHistory: { - ConditionsAssociatedWithChronicPain: ReportConditionsAssociatedWithChronicPain, - RiskFactorsForOpioidRelatedHarms: ReportRiskFactorsForOpioidRelatedHarms - }, - PainAssessments: { - NumericPainIntensityAssessments: ReportNumericPainIntensityAssessments, - PainEnjoymentGeneralActivityAssessments: ReportPainEnjoymentGeneralActivityAssessments, - STarTBackAssessments: ReportSTarTBackAssessments - }, - HistoricalTreatments: { - OpioidMedications: ReportOpioidMedications, - NonOpioidMedications: ReportNonOpioidMedications, - NonPharmacologicTreatments: ReportNonPharmacologicTreatments, - StoolSoftenersAndLaxatives: ReportStoolSoftenersAndLaxatives - }, - RiskConsiderations: { - MostRecentMME: ReportMostRecentMME, - UrineDrugScreens: ReportUrineDrugScreens, - BenzodiazepineMedications: ReportBenzodiazepineMedications, - NaloxoneMedications: ReportNaloxoneMedications, - RiskScreeningsRelevantToPainManagement: ReportRiskScreeningsRelevantToPainManagement - } -} diff --git a/src/cql/valueset-db.json b/src/cql/valueset-db.json index 0d77c0199..694332bbd 100644 --- a/src/cql/valueset-db.json +++ b/src/cql/valueset-db.json @@ -1,47599 +1,47230 @@ { - "2.16.840.1.113762.1.4.1032.102": { + "2.16.840.1.113762.1.4.1021.95": { "Latest": [ { - "code": "161474000", + "code": "100211000119106", "system": "http://snomed.info/sct", - "version": "2021-03" + "version": "2022-09" }, { - "code": "23233009", + "code": "109300000", "system": "http://snomed.info/sct", - "version": "2021-03" + "version": "2022-09" }, { - "code": "247650009", + "code": "10948005", "system": "http://snomed.info/sct", - 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"code": "O9A.519", - "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "code": "767810006", + "system": "http://snomed.info/sct", + "version": "2022-09" }, { - "code": "Z33.1", - "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "code": "76783007", + "system": "http://snomed.info/sct", + "version": "2022-09" }, { - "code": "Z33.3", - "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "code": "768006009", + "system": "http://snomed.info/sct", + "version": "2022-09" }, { - "code": "Z34.00", - "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "code": "768125005", + "system": "http://snomed.info/sct", + "version": "2022-09" }, { - "code": "Z34.01", - "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "code": "768126006", + "system": "http://snomed.info/sct", + "version": "2022-09" }, { - "code": "Z34.02", - "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "code": "768127002", + "system": "http://snomed.info/sct", + "version": "2022-09" }, { - "code": "Z34.03", - "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "code": "768288001", + "system": "http://snomed.info/sct", + "version": "2022-09" }, { - "code": "Z34.80", - "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "code": "768289009", + "system": "http://snomed.info/sct", + "version": "2022-09" }, { - "code": "Z34.81", - "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "code": "78208005", + "system": "http://snomed.info/sct", + "version": "2022-09" }, { - "code": "Z34.82", - "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "code": "79607001", + "system": "http://snomed.info/sct", + "version": "2022-09" }, { - "code": "Z34.83", - "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "code": "79720007", + "system": "http://snomed.info/sct", + "version": "2022-09" }, { - "code": "Z34.90", - "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "code": "86454000", + "system": "http://snomed.info/sct", + "version": "2022-09" }, { - "code": "Z34.91", - "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "code": "88518009", + "system": "http://snomed.info/sct", + "version": "2022-09" }, { - "code": "Z34.92", - "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "code": "89789003", + "system": "http://snomed.info/sct", + "version": "2022-09" }, { - "code": "Z34.93", + "code": "K70.0", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.01", + "code": "K70.2", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.08", + "code": "K70.30", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.09", + "code": "K70.31", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.10", + "code": "K70.40", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.11", + "code": "K70.41", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.12", + "code": "K70.9", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.13", + "code": "K71.0", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.14", + "code": "K71.10", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.15", + "code": "K71.11", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.16", + "code": "K71.3", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.17", + "code": "K71.4", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.18", + "code": "K71.50", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.19", + "code": "K71.51", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.20", + "code": "K71.7", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.21", + "code": "K72.10", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.22", + "code": "K72.11", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.23", + "code": "K73.0", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.24", + "code": "K73.1", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.25", + "code": "K73.2", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.26", + "code": "K73.8", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.27", + "code": "K73.9", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.28", + "code": "K74.00", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.29", + "code": "K74.01", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.30", + "code": "K74.02", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.31", + "code": "K74.1", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.32", + "code": "K74.2", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.33", + "code": "K74.3", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.34", + "code": "K74.4", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.35", + "code": "K74.5", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.36", + "code": "K74.60", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.37", + "code": "K74.69", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.38", + "code": "K76.1", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.39", + "code": "K76.2", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.40", + "code": "K76.3", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.41", + "code": "K76.5", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.42", + "code": "K76.6", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" }, { - "code": "Z3A.49", + "code": "K76.7", "system": "http://hl7.org/fhir/sid/icd-10-cm", - "version": "2022" + "version": "2023" } ] }, diff --git a/src/utils/dstu2_test_patients/ben_jackson.json b/src/utils/dstu2_test_patients/ben_jackson.json index 85320a2e2..3e0207143 100644 --- a/src/utils/dstu2_test_patients/ben_jackson.json +++ b/src/utils/dstu2_test_patients/ben_jackson.json @@ -2,7 +2,7 @@ "resourceType": "Bundle", "id": "ben_jackson", "meta": { - "lastUpdated": "2022-12-01T19:51:44.684Z" + "lastUpdated": "2022-12-29T22:11:06.869Z" }, "type": "collection", "entry": [ @@ -21,7 +21,7 @@ } ], "gender": "male", - "birthDate": "1959-09-22T19:51:44.684Z" + "birthDate": "1959-10-20T22:11:06.869Z" } }, { @@ -43,8 +43,8 @@ }, "clinicalStatus": "active", "verificationStatus": "confirmed", - "onsetDateTime": "2016-10-22T19:51:44.684Z", - "dateRecorded": "2016-10-22T19:51:44.684Z" + "onsetDateTime": "2016-11-19T22:11:06.869Z", + "dateRecorded": "2016-11-19T22:11:06.869Z" } }, { @@ -66,8 +66,8 @@ }, "clinicalStatus": "active", "verificationStatus": "confirmed", - "onsetDateTime": "2019-03-20T19:51:44.684Z", - "dateRecorded": "2019-08-31T19:51:44.684Z" + "onsetDateTime": "2019-04-17T22:11:06.869Z", + "dateRecorded": "2019-09-28T22:11:06.869Z" } }, { @@ -91,7 +91,7 @@ } ], "period": { - "start": "2019-08-20T19:51:44.684Z" + "start": "2019-09-17T22:11:06.869Z" } } }, @@ -99,7 +99,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "dfa79ee7-6f59-40ad-a3dc-b677d960b979", - "dateWritten": "2022-08-29T19:51:44.684Z", + "dateWritten": "2022-09-26T22:11:06.869Z", "status": "active", "patient": { "reference": "Patient/35dfbf37-98f5-45ce-a3b0-0b490a241f1f" @@ -120,7 +120,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "456d0857-34ab-4b4e-9c20-64259f678e80", - "dateWritten": "2022-07-25T19:51:44.684Z", + "dateWritten": "2022-08-22T22:11:06.869Z", "status": "active", "patient": { "reference": "Patient/35dfbf37-98f5-45ce-a3b0-0b490a241f1f" @@ -146,7 +146,7 @@ }, "status": "active", "wasNotTaken": false, - "effectiveDateTime": "2022-10-01T19:51:44.684Z", + "effectiveDateTime": "2022-10-29T22:11:06.869Z", "medicationCodeableConcept": { "coding": [ { @@ -168,7 +168,7 @@ }, "status": "active", "wasNotTaken": false, - "effectiveDateTime": "2022-05-31T19:51:44.684Z", + "effectiveDateTime": "2022-06-28T22:11:06.869Z", "medicationCodeableConcept": { "coding": [ { @@ -207,7 +207,7 @@ "subject": { "reference": "Patient/35dfbf37-98f5-45ce-a3b0-0b490a241f1f" }, - "issued": "2022-11-16T19:51:44.684Z", + "issued": "2022-12-14T22:11:06.869Z", "valueQuantity": { "value": 60, "unit": "{MME}/d" @@ -240,7 +240,7 @@ "subject": { "reference": "Patient/35dfbf37-98f5-45ce-a3b0-0b490a241f1f" }, - "issued": "2022-08-29T19:51:44.684Z", + "issued": "2022-09-26T22:11:06.869Z", "valueQuantity": { "value": 8 }, @@ -275,7 +275,7 @@ "subject": { "reference": "Patient/35dfbf37-98f5-45ce-a3b0-0b490a241f1f" }, - "issued": "2022-05-08T19:51:44.684Z", + "issued": "2022-06-05T22:11:06.869Z", "valueQuantity": { "value": 7 }, @@ -310,7 +310,7 @@ "subject": { "reference": "Patient/35dfbf37-98f5-45ce-a3b0-0b490a241f1f" }, - "issued": "2022-08-29T19:51:44.684Z", + "issued": "2022-09-26T22:11:06.869Z", "valueQuantity": { "value": 5 }, @@ -389,7 +389,7 @@ "subject": { "reference": "Patient/35dfbf37-98f5-45ce-a3b0-0b490a241f1f" }, - "issued": "2022-08-29T19:51:44.684Z", + "issued": "2022-09-26T22:11:06.869Z", "valueQuantity": { "value": 4 }, @@ -417,7 +417,7 @@ "text": "Chiropraxy (regime/therapy)" }, "notPerformed": false, - "performedDateTime": "2022-10-22T19:51:44.684Z" + "performedDateTime": "2022-11-19T22:11:06.869Z" } } ] diff --git a/src/utils/dstu2_test_patients/brenda_jackson.json b/src/utils/dstu2_test_patients/brenda_jackson.json index 981feba9d..717a37b4c 100644 --- a/src/utils/dstu2_test_patients/brenda_jackson.json +++ b/src/utils/dstu2_test_patients/brenda_jackson.json @@ -2,7 +2,7 @@ "resourceType": "Bundle", "id": "brenda_jackson", "meta": { - "lastUpdated": "2022-12-01T19:51:44.685Z" + "lastUpdated": "2022-12-29T22:11:06.870Z" }, "type": "collection", "entry": [ @@ -21,7 +21,7 @@ } ], "gender": "female", - "birthDate": "1960-08-12" + "birthDate": "1960-09-08" } }, { @@ -43,8 +43,8 @@ }, "clinicalStatus": "active", "verificationStatus": "confirmed", - "onsetDateTime": "2017-02-03T11:51:44.685Z", - "dateRecorded": "2017-02-01" + "onsetDateTime": "2017-03-03T14:11:06.870Z", + "dateRecorded": "2017-02-28" } }, { @@ -66,8 +66,8 @@ }, "clinicalStatus": "active", "verificationStatus": "confirmed", - "onsetDateTime": "2012-09-12T11:51:44.685Z", - "dateRecorded": "2012-09-10" + "onsetDateTime": "2012-10-10T14:11:06.870Z", + "dateRecorded": "2012-10-07" } }, { @@ -89,8 +89,8 @@ }, "clinicalStatus": "active", "verificationStatus": "confirmed", - "onsetDateTime": "2015-12-02T11:51:44.685Z", - "dateRecorded": "2015-12-15" + "onsetDateTime": "2015-12-30T14:11:06.870Z", + "dateRecorded": "2016-01-11" } }, { @@ -112,7 +112,7 @@ }, "clinicalStatus": "active", "verificationStatus": "confirmed", - "onsetDateTime": "2020-10-02T11:51:44.685Z" + "onsetDateTime": "2020-10-30T14:11:06.870Z" } }, { @@ -141,7 +141,7 @@ "subject": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, - "issued": "2022-08-09T11:51:44.685Z", + "issued": "2022-09-06T14:11:06.870Z", "valueQuantity": { "value": 10 }, @@ -176,7 +176,7 @@ "subject": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, - "issued": "2021-09-15T11:51:44.685Z", + "issued": "2021-10-13T14:11:06.870Z", "valueQuantity": { "value": 6 }, @@ -211,7 +211,7 @@ "subject": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, - "issued": "2020-10-02T11:51:44.685Z", + "issued": "2020-10-30T14:11:06.870Z", "valueQuantity": { "value": 6 }, @@ -246,7 +246,7 @@ "subject": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, - "issued": "2021-09-15T11:51:44.685Z", + "issued": "2021-10-13T14:11:06.870Z", "valueQuantity": { "value": 5 }, @@ -325,7 +325,7 @@ "subject": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, - "issued": "2021-03-30T11:51:44.685Z", + "issued": "2021-04-27T14:11:06.870Z", "valueQuantity": { "value": 7 }, @@ -404,7 +404,7 @@ "subject": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, - "issued": "2020-10-02T11:51:44.685Z", + "issued": "2020-10-30T14:11:06.870Z", "valueQuantity": { "value": 8 }, @@ -483,7 +483,7 @@ "subject": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, - "issued": "2022-09-15T11:51:44.685Z", + "issued": "2022-10-13T14:11:06.870Z", "valueQuantity": { "value": 4 }, @@ -518,7 +518,7 @@ "subject": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, - "issued": "2021-09-15T11:51:44.685Z", + "issued": "2021-10-13T14:11:06.870Z", "valueQuantity": { "value": 3 }, @@ -553,7 +553,7 @@ "subject": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, - "issued": "2020-10-02T11:51:44.685Z", + "issued": "2020-10-30T14:11:06.870Z", "valueQuantity": { "value": 5 }, @@ -566,7 +566,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "b8171048-6d38-4592-a66e-6a4b1bd70881", - "dateWritten": "2022-11-15T11:53:44.685Z", + "dateWritten": "2022-12-13T14:13:06.870Z", "status": "active", "patient": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" @@ -587,9 +587,9 @@ "resource": { "resourceType": "MedicationOrder", "id": "9b144b0a-3df2-4523-9c03-ea14c1e940ae", - "dateWritten": "2022-08-15T11:53:44.685Z", + "dateWritten": "2022-09-12T14:13:06.870Z", "status": "active", - "dateEnded": "2022-11-14T19:51:44.685Z", + "dateEnded": "2022-12-12T22:11:06.870Z", "patient": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, @@ -609,9 +609,9 @@ "resource": { "resourceType": "MedicationOrder", "id": "b586f985-d5f2-4357-8528-99021b1da9c4", - "dateWritten": "2022-05-15T11:53:44.685Z", + "dateWritten": "2022-06-12T14:13:06.870Z", "status": "active", - "dateEnded": "2022-08-14T19:51:44.685Z", + "dateEnded": "2022-09-11T22:11:06.870Z", "patient": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, @@ -631,9 +631,9 @@ "resource": { "resourceType": "MedicationOrder", "id": "a8f61a54-290c-4479-ad8e-5b8140b49f36", - "dateWritten": "2022-02-13T11:53:44.685Z", + "dateWritten": "2022-03-13T14:13:06.870Z", "status": "active", - "dateEnded": "2022-05-14T19:51:44.685Z", + "dateEnded": "2022-06-11T22:11:06.870Z", "patient": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, @@ -653,9 +653,9 @@ "resource": { "resourceType": "MedicationOrder", "id": "351879c9-5ffa-44c7-9bfe-a9522ccb784a", - "dateWritten": "2021-11-15T11:53:44.685Z", + "dateWritten": "2021-12-13T14:13:06.870Z", "status": "active", - "dateEnded": "2022-02-12T19:51:44.685Z", + "dateEnded": "2022-03-12T22:11:06.870Z", "patient": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, @@ -675,9 +675,9 @@ "resource": { "resourceType": "MedicationOrder", "id": "eb94ebad-06d3-4510-9987-70155a1c8517", - "dateWritten": "2021-08-15T11:53:44.685Z", + "dateWritten": "2021-09-12T14:13:06.870Z", "status": "active", - "dateEnded": "2021-11-14T19:51:44.685Z", + "dateEnded": "2021-12-12T22:11:06.870Z", "patient": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, @@ -697,9 +697,9 @@ "resource": { "resourceType": "MedicationOrder", "id": "dab4f604-e56a-403d-81e6-50e7571e0a8c", - "dateWritten": "2021-05-15T11:53:44.685Z", + "dateWritten": "2021-06-12T14:13:06.870Z", "status": "active", - "dateEnded": "2021-08-14T19:51:44.685Z", + "dateEnded": "2021-09-11T22:11:06.870Z", "patient": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, @@ -719,9 +719,9 @@ "resource": { "resourceType": "MedicationOrder", "id": "1702921d-8d69-4718-9402-98b1ae300228", - "dateWritten": "2021-02-13T11:53:44.685Z", + "dateWritten": "2021-03-13T14:13:06.870Z", "status": "active", - "dateEnded": "2021-05-14T19:51:44.685Z", + "dateEnded": "2021-06-11T22:11:06.870Z", "patient": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, @@ -741,9 +741,9 @@ "resource": { "resourceType": "MedicationOrder", "id": "7f9352c9-2668-4d42-8c2c-eac5e8f6866b", - "dateWritten": "2020-11-15T11:53:44.685Z", + "dateWritten": "2020-12-13T14:13:06.870Z", "status": "active", - "dateEnded": "2021-02-12T19:51:44.685Z", + "dateEnded": "2021-03-12T22:11:06.870Z", "patient": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, @@ -763,9 +763,9 @@ "resource": { "resourceType": "MedicationOrder", "id": "a0ce6b1c-841b-4856-8021-23104def702d", - "dateWritten": "2020-08-15T11:53:44.685Z", + "dateWritten": "2020-09-12T14:13:06.870Z", "status": "active", - "dateEnded": "2020-11-14T19:51:44.685Z", + "dateEnded": "2020-12-12T22:11:06.870Z", "patient": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, @@ -785,7 +785,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "595158d5-bedf-464c-b140-2b94059e2120", - "dateWritten": "2022-11-15T11:52:44.685Z", + "dateWritten": "2022-12-13T14:12:06.870Z", "status": "active", "patient": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" @@ -806,9 +806,9 @@ "resource": { "resourceType": "MedicationOrder", "id": "b78a3067-5303-49e3-bb18-61ec9affc69a", - "dateWritten": "2022-08-15T11:52:44.685Z", + "dateWritten": "2022-09-12T14:12:06.870Z", "status": "active", - "dateEnded": "2022-11-14T19:51:44.685Z", + "dateEnded": "2022-12-12T22:11:06.870Z", "patient": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, @@ -828,9 +828,9 @@ "resource": { "resourceType": "MedicationOrder", "id": "1732a849-0e22-4598-9d99-7a231ba32add", - "dateWritten": "2022-05-15T11:52:44.685Z", + "dateWritten": "2022-06-12T14:12:06.870Z", "status": "active", - "dateEnded": "2022-08-14T19:51:44.685Z", + "dateEnded": "2022-09-11T22:11:06.870Z", "patient": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, @@ -850,9 +850,9 @@ "resource": { "resourceType": "MedicationOrder", "id": "9f918b6d-c6e9-44e2-945d-c853815fea24", - "dateWritten": "2022-02-13T11:52:44.685Z", + "dateWritten": "2022-03-13T14:12:06.870Z", "status": "active", - "dateEnded": "2022-05-14T19:51:44.685Z", + "dateEnded": "2022-06-11T22:11:06.870Z", "patient": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, @@ -872,9 +872,9 @@ "resource": { "resourceType": "MedicationOrder", "id": "6390df46-6804-4b0b-81d4-ad2a068d6b6c", - "dateWritten": "2021-11-15T11:52:44.685Z", + "dateWritten": "2021-12-13T14:12:06.870Z", "status": "active", - "dateEnded": "2022-02-12T19:51:44.685Z", + "dateEnded": "2022-03-12T22:11:06.870Z", "patient": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, @@ -894,9 +894,9 @@ "resource": { "resourceType": "MedicationOrder", "id": "c6a68cc3-d68b-48cf-95c7-084c7ca31ee5", - "dateWritten": "2021-08-15T11:52:44.685Z", + "dateWritten": "2021-09-12T14:12:06.870Z", "status": "active", - "dateEnded": "2021-11-14T19:51:44.685Z", + "dateEnded": "2021-12-12T22:11:06.870Z", "patient": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, @@ -916,9 +916,9 @@ "resource": { "resourceType": "MedicationOrder", "id": "83be5a32-ecd9-4a61-acf3-8ab4228738bc", - "dateWritten": "2021-05-15T11:52:44.685Z", + "dateWritten": "2021-06-12T14:12:06.870Z", "status": "active", - "dateEnded": "2021-08-14T19:51:44.685Z", + "dateEnded": "2021-09-11T22:11:06.870Z", "patient": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, @@ -938,9 +938,9 @@ "resource": { "resourceType": "MedicationOrder", "id": "fdab6079-bb56-41e1-89a1-40c7b464efb1", - "dateWritten": "2021-02-13T11:52:44.685Z", + "dateWritten": "2021-03-13T14:12:06.870Z", "status": "active", - "dateEnded": "2021-05-14T19:51:44.685Z", + "dateEnded": "2021-06-11T22:11:06.870Z", "patient": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, @@ -960,9 +960,9 @@ "resource": { "resourceType": "MedicationOrder", "id": "2ca030a9-ba2e-4a9f-9fe2-46c4fca09914", - "dateWritten": "2020-11-15T11:52:44.685Z", + "dateWritten": "2020-12-13T14:12:06.870Z", "status": "active", - "dateEnded": "2021-02-12T19:51:44.685Z", + "dateEnded": "2021-03-12T22:11:06.870Z", "patient": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, @@ -982,9 +982,9 @@ "resource": { "resourceType": "MedicationOrder", "id": "c481a22b-f625-4a26-af30-4e62227b19be", - "dateWritten": "2020-08-15T11:52:44.685Z", + "dateWritten": "2020-09-12T14:12:06.870Z", "status": "active", - "dateEnded": "2020-11-14T19:51:44.685Z", + "dateEnded": "2020-12-12T22:11:06.870Z", "patient": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, @@ -1004,9 +1004,9 @@ "resource": { "resourceType": "MedicationOrder", "id": "1d101d04-5730-4867-9531-52f557ab696d", - "dateWritten": "2020-10-02T11:51:44.685Z", + "dateWritten": "2020-10-30T14:11:06.870Z", "status": "active", - "dateEnded": "2021-09-14T19:51:44.685Z", + "dateEnded": "2021-10-12T22:11:06.870Z", "patient": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, @@ -1026,9 +1026,9 @@ "resource": { "resourceType": "MedicationOrder", "id": "59055a73-3ce2-473c-82b7-7d5b224d7669", - "dateWritten": "2020-10-02T11:51:44.685Z", + "dateWritten": "2020-10-30T14:11:06.870Z", "status": "active", - "dateEnded": "2021-09-14T19:51:44.685Z", + "dateEnded": "2021-10-12T22:11:06.870Z", "patient": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, @@ -1048,7 +1048,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "4c176c88-d2cd-4cb3-b32d-011cf8570fbd", - "dateWritten": "2021-09-15T11:51:44.685Z", + "dateWritten": "2021-10-13T14:11:06.870Z", "status": "active", "patient": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" @@ -1069,7 +1069,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "99ea18d2-4605-4663-8f28-47de8b81c2aa", - "dateWritten": "2021-09-15T11:51:44.685Z", + "dateWritten": "2021-10-13T14:11:06.870Z", "status": "active", "patient": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" @@ -1105,7 +1105,7 @@ "text": "Referral to chiropractor (procedure)" }, "notPerformed": false, - "performedDateTime": "2020-10-02T11:51:44.685Z" + "performedDateTime": "2020-10-30T14:11:06.870Z" } }, { @@ -1127,7 +1127,7 @@ "text": "Referral for physical therapy (procedure)" }, "notPerformed": false, - "performedDateTime": "2020-10-02T11:51:44.685Z" + "performedDateTime": "2020-10-30T14:11:06.870Z" } }, { @@ -1149,7 +1149,7 @@ "text": "Patient referral for psychotherapy (procedure)" }, "notPerformed": false, - "performedDateTime": "2021-09-15T11:51:44.685Z" + "performedDateTime": "2021-10-13T14:11:06.870Z" } }, { @@ -1171,7 +1171,7 @@ "text": "Referral to chiropractor (procedure)" }, "notPerformed": false, - "performedDateTime": "2022-08-15T11:51:44.685Z" + "performedDateTime": "2022-09-12T14:11:06.870Z" } }, { @@ -1193,16 +1193,16 @@ "text": "Referral for physical therapy (procedure)" }, "notPerformed": false, - "performedDateTime": "2022-08-15T11:51:44.685Z" + "performedDateTime": "2022-09-12T14:11:06.870Z" } }, { "resource": { "resourceType": "MedicationOrder", "id": "72fd1329-c137-4ce8-b40a-56773af806b7", - "dateWritten": "2021-03-15T11:51:44.685Z", + "dateWritten": "2021-04-12T14:11:06.870Z", "status": "active", - "dateEnded": "2021-09-14T19:51:44.685Z", + "dateEnded": "2021-10-12T22:11:06.870Z", "patient": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, @@ -1222,9 +1222,9 @@ "resource": { "resourceType": "MedicationOrder", "id": "715d6d5c-d2d1-4897-b7ba-5ebc8a7d2426", - "dateWritten": "2021-09-15T11:51:44.685Z", + "dateWritten": "2021-10-13T14:11:06.870Z", "status": "active", - "dateEnded": "2022-03-14T19:51:44.685Z", + "dateEnded": "2022-04-11T22:11:06.870Z", "patient": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, @@ -1244,9 +1244,9 @@ "resource": { "resourceType": "MedicationOrder", "id": "9462c4d0-b60f-4426-a476-a5f79ad3eb65", - "dateWritten": "2022-03-14T19:51:44.685Z", + "dateWritten": "2022-04-11T22:11:06.870Z", "status": "active", - "dateEnded": "2022-09-14T19:51:44.685Z", + "dateEnded": "2022-10-12T22:11:06.870Z", "patient": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, @@ -1266,7 +1266,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "916cdca9-da7b-455b-8688-7cad054fdaf1", - "dateWritten": "2022-11-15T11:51:44.685Z", + "dateWritten": "2022-12-13T14:11:06.870Z", "status": "active", "patient": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" @@ -1309,7 +1309,7 @@ "subject": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, - "issued": "2022-11-15T11:51:44.685Z", + "issued": "2022-12-13T14:11:06.870Z", "valueQuantity": { "value": 220, "unit": "{MME}/d" @@ -1342,7 +1342,7 @@ "subject": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, - "issued": "2022-08-09T11:51:44.685Z", + "issued": "2022-09-06T14:11:06.870Z", "valueQuantity": { "value": 220, "unit": "{MME}/d" @@ -1375,7 +1375,7 @@ "subject": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, - "issued": "2021-09-15T11:51:44.685Z", + "issued": "2021-10-13T14:11:06.870Z", "valueQuantity": { "value": 190, "unit": "{MME}/d" @@ -1408,7 +1408,7 @@ "subject": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, - "issued": "2020-10-02T11:51:44.685Z", + "issued": "2020-10-30T14:11:06.870Z", "valueQuantity": { "value": 160, "unit": "{MME}/d" @@ -1433,7 +1433,7 @@ "subject": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, - "issued": "2022-08-15T11:51:44.685Z", + "issued": "2022-09-12T14:11:06.870Z", "valueQuantity": { "value": 2500, "unit": "ng/mL" @@ -1468,7 +1468,7 @@ "subject": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, - "issued": "2021-09-16T11:51:44.685Z", + "issued": "2021-10-14T14:11:06.870Z", "valueQuantity": { "value": 2500, "unit": "ng/mL" @@ -1503,7 +1503,7 @@ "subject": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, - "issued": "2020-10-03T11:51:44.685Z", + "issued": "2020-10-31T14:11:06.870Z", "valueQuantity": { "value": 2200, "unit": "ng/mL" @@ -1524,7 +1524,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "02fcc044-36e4-478d-98d6-141344ef4b38", - "dateWritten": "2017-02-03T11:51:44.685Z", + "dateWritten": "2017-03-03T14:11:06.870Z", "status": "active", "patient": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" @@ -1567,7 +1567,7 @@ "subject": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, - "issued": "2022-07-16T11:51:44.685Z", + "issued": "2022-08-13T14:11:06.870Z", "valueQuantity": { "value": 8 }, @@ -1602,7 +1602,7 @@ "subject": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, - "issued": "2021-09-15T11:51:44.685Z", + "issued": "2021-10-13T14:11:06.870Z", "valueQuantity": { "value": 15 }, @@ -1637,7 +1637,7 @@ "subject": { "reference": "Patient/5c41cecf-cf81-434f-9da7-e24e5a99dbc2" }, - "issued": "2020-10-02T11:51:44.685Z", + "issued": "2020-10-30T14:11:06.870Z", "valueQuantity": { "value": 18 }, diff --git a/src/utils/dstu2_test_patients/carson_jackson.json b/src/utils/dstu2_test_patients/carson_jackson.json index 9c7c06dcc..2ac1278a2 100644 --- a/src/utils/dstu2_test_patients/carson_jackson.json +++ b/src/utils/dstu2_test_patients/carson_jackson.json @@ -2,7 +2,7 @@ "resourceType": "Bundle", "id": "carson_jackson", "meta": { - "lastUpdated": "2022-12-01T19:51:44.685Z" + "lastUpdated": "2022-12-29T22:11:06.871Z" }, "type": "collection", "entry": [ @@ -21,7 +21,7 @@ } ], "gender": "male", - "birthDate": "1964-07-13T19:51:44.685Z" + "birthDate": "1964-08-10T22:11:06.871Z" } }, { @@ -43,8 +43,8 @@ }, "clinicalStatus": "active", "verificationStatus": "confirmed", - "onsetDateTime": "2016-10-22T19:51:44.685Z", - "dateRecorded": "2016-10-22T19:51:44.685Z" + "onsetDateTime": "2016-11-19T22:11:06.871Z", + "dateRecorded": "2016-11-19T22:11:06.871Z" } }, { @@ -66,8 +66,8 @@ }, "clinicalStatus": "active", "verificationStatus": "confirmed", - "onsetDateTime": "2019-03-20T19:51:44.685Z", - "dateRecorded": "2019-08-31T19:51:44.685Z" + "onsetDateTime": "2019-04-17T22:11:06.871Z", + "dateRecorded": "2019-09-28T22:11:06.871Z" } }, { @@ -91,7 +91,7 @@ } ], "period": { - "start": "2019-08-20T19:51:44.685Z" + "start": "2019-09-17T22:11:06.871Z" } } }, @@ -99,7 +99,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "16759710-7cd7-42ad-81e5-9a83c27e686d", - "dateWritten": "2022-07-25T19:51:44.685Z", + "dateWritten": "2022-08-22T22:11:06.871Z", "status": "active", "patient": { "reference": "Patient/3d2cd91f-944d-4ded-ad97-0ee83b68bcbb" @@ -120,7 +120,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "fbfc3dbf-8e32-41f9-b74e-0275a29e3516", - "dateWritten": "2022-09-21T19:51:44.685Z", + "dateWritten": "2022-10-19T22:11:06.871Z", "status": "active", "patient": { "reference": "Patient/3d2cd91f-944d-4ded-ad97-0ee83b68bcbb" @@ -141,7 +141,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "90188b3c-6268-4a9b-a514-65674608ab4d", - "dateWritten": "2022-09-21T19:51:44.685Z", + "dateWritten": "2022-10-19T22:11:06.871Z", "status": "active", "patient": { "reference": "Patient/3d2cd91f-944d-4ded-ad97-0ee83b68bcbb" @@ -167,7 +167,7 @@ }, "status": "active", "wasNotTaken": false, - "effectiveDateTime": "2022-05-31T19:51:44.685Z", + "effectiveDateTime": "2022-06-28T22:11:06.871Z", "medicationCodeableConcept": { "coding": [ { @@ -189,7 +189,7 @@ }, "status": "active", "wasNotTaken": false, - "effectiveDateTime": "2022-10-22T19:51:44.685Z", + "effectiveDateTime": "2022-11-19T22:11:06.871Z", "medicationCodeableConcept": { "coding": [ { @@ -211,7 +211,7 @@ }, "status": "active", "wasNotTaken": false, - "effectiveDateTime": "2022-11-16T19:51:44.685Z", + "effectiveDateTime": "2022-12-14T22:11:06.871Z", "medicationCodeableConcept": { "coding": [ { @@ -250,7 +250,7 @@ "subject": { "reference": "Patient/3d2cd91f-944d-4ded-ad97-0ee83b68bcbb" }, - "issued": "2022-11-16T19:51:44.685Z", + "issued": "2022-12-14T22:11:06.871Z", "valueQuantity": { "value": 60, "unit": "{MME}/d" @@ -283,7 +283,7 @@ "subject": { "reference": "Patient/3d2cd91f-944d-4ded-ad97-0ee83b68bcbb" }, - "issued": "2022-08-29T19:51:44.685Z", + "issued": "2022-09-26T22:11:06.871Z", "valueQuantity": { "value": 8 }, @@ -318,7 +318,7 @@ "subject": { "reference": "Patient/3d2cd91f-944d-4ded-ad97-0ee83b68bcbb" }, - "issued": "2022-05-08T19:51:44.685Z", + "issued": "2022-06-05T22:11:06.871Z", "valueQuantity": { "value": 7 }, @@ -353,7 +353,7 @@ "subject": { "reference": "Patient/3d2cd91f-944d-4ded-ad97-0ee83b68bcbb" }, - "issued": "2022-08-29T19:51:44.685Z", + "issued": "2022-09-26T22:11:06.871Z", "valueQuantity": { "value": 5 }, @@ -432,7 +432,7 @@ "subject": { "reference": "Patient/3d2cd91f-944d-4ded-ad97-0ee83b68bcbb" }, - "issued": "2022-08-29T19:51:44.685Z", + "issued": "2022-09-26T22:11:06.871Z", "valueQuantity": { "value": 4 }, @@ -460,7 +460,7 @@ "text": "Chiropraxy (regime/therapy)" }, "notPerformed": false, - "performedDateTime": "2022-10-22T19:51:44.685Z" + "performedDateTime": "2022-11-19T22:11:06.871Z" } } ] diff --git a/src/utils/dstu2_test_patients/don_jackson.json b/src/utils/dstu2_test_patients/don_jackson.json index e348b7aa7..3847972eb 100644 --- a/src/utils/dstu2_test_patients/don_jackson.json +++ b/src/utils/dstu2_test_patients/don_jackson.json @@ -2,7 +2,7 @@ "resourceType": "Bundle", "id": "don_jackson", "meta": { - "lastUpdated": "2022-12-01T19:51:44.686Z" + "lastUpdated": "2022-12-29T22:11:06.871Z" }, "type": "collection", "entry": [ @@ -21,7 +21,7 @@ } ], "gender": "male", - "birthDate": "1968-03-10T19:51:44.686Z" + "birthDate": "1968-04-07T22:11:06.871Z" } }, { @@ -43,8 +43,8 @@ }, "clinicalStatus": "active", "verificationStatus": "confirmed", - "onsetDateTime": "2016-10-22T19:51:44.686Z", - "dateRecorded": "2016-10-22T19:51:44.686Z" + "onsetDateTime": "2016-11-19T22:11:06.871Z", + "dateRecorded": "2016-11-19T22:11:06.871Z" } }, { @@ -66,8 +66,8 @@ }, "clinicalStatus": "active", "verificationStatus": "confirmed", - "onsetDateTime": "2019-03-20T19:51:44.686Z", - "dateRecorded": "2019-08-31T19:51:44.686Z" + "onsetDateTime": "2019-04-17T22:11:06.871Z", + "dateRecorded": "2019-09-28T22:11:06.871Z" } }, { @@ -91,7 +91,7 @@ } ], "period": { - "start": "2019-08-20T19:51:44.686Z" + "start": "2019-09-17T22:11:06.871Z" } } }, @@ -99,7 +99,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "e407f925-f2d3-4ebe-b76b-3a0110ce2357", - "dateWritten": "2022-09-21T19:51:44.686Z", + "dateWritten": "2022-10-19T22:11:06.871Z", "status": "active", "patient": { "reference": "Patient/281c4535-496f-4966-a46f-6265c93ee1f9" @@ -125,7 +125,7 @@ }, "status": "active", "wasNotTaken": false, - "effectiveDateTime": "2022-10-22T19:51:44.686Z", + "effectiveDateTime": "2022-11-19T22:11:06.871Z", "medicationCodeableConcept": { "coding": [ { @@ -164,7 +164,7 @@ "subject": { "reference": "Patient/281c4535-496f-4966-a46f-6265c93ee1f9" }, - "issued": "2022-05-08T19:51:44.686Z", + "issued": "2022-06-05T22:11:06.871Z", "valueQuantity": { "value": 2300, "unit": "ng/mL" @@ -207,7 +207,7 @@ "subject": { "reference": "Patient/281c4535-496f-4966-a46f-6265c93ee1f9" }, - "issued": "2022-11-16T19:51:44.686Z", + "issued": "2022-12-14T22:11:06.871Z", "valueQuantity": { "value": 20, "unit": "{MME}/d" @@ -240,7 +240,7 @@ "subject": { "reference": "Patient/281c4535-496f-4966-a46f-6265c93ee1f9" }, - "issued": "2022-08-29T19:51:44.686Z", + "issued": "2022-09-26T22:11:06.871Z", "valueQuantity": { "value": 8 }, @@ -275,7 +275,7 @@ "subject": { "reference": "Patient/281c4535-496f-4966-a46f-6265c93ee1f9" }, - "issued": "2022-05-08T19:51:44.686Z", + "issued": "2022-06-05T22:11:06.871Z", "valueQuantity": { "value": 7 }, @@ -310,7 +310,7 @@ "subject": { "reference": "Patient/281c4535-496f-4966-a46f-6265c93ee1f9" }, - "issued": "2022-08-29T19:51:44.686Z", + "issued": "2022-09-26T22:11:06.871Z", "valueQuantity": { "value": 5 }, @@ -389,7 +389,7 @@ "subject": { "reference": "Patient/281c4535-496f-4966-a46f-6265c93ee1f9" }, - "issued": "2022-08-29T19:51:44.686Z", + "issued": "2022-09-26T22:11:06.871Z", "valueQuantity": { "value": 4 }, diff --git a/src/utils/dstu2_test_patients/evan_jackson.json b/src/utils/dstu2_test_patients/evan_jackson.json index 5cc7ff4bd..a6a0a07cf 100644 --- a/src/utils/dstu2_test_patients/evan_jackson.json +++ b/src/utils/dstu2_test_patients/evan_jackson.json @@ -2,7 +2,7 @@ "resourceType": "Bundle", "id": "evan_jackson", "meta": { - "lastUpdated": "2022-12-01T19:51:44.686Z" + "lastUpdated": "2022-12-29T22:11:06.872Z" }, "type": "collection", "entry": [ @@ -21,7 +21,7 @@ } ], "gender": "male", - "birthDate": "1969-08-01T19:51:44.686Z" + "birthDate": "1969-08-29T22:11:06.872Z" } }, { @@ -43,8 +43,8 @@ }, "clinicalStatus": "active", "verificationStatus": "confirmed", - "onsetDateTime": "2016-10-22T19:51:44.686Z", - "dateRecorded": "2016-10-22T19:51:44.686Z" + "onsetDateTime": "2016-11-19T22:11:06.872Z", + "dateRecorded": "2016-11-19T22:11:06.872Z" } }, { @@ -66,8 +66,8 @@ }, "clinicalStatus": "active", "verificationStatus": "confirmed", - "onsetDateTime": "2019-03-20T19:51:44.686Z", - "dateRecorded": "2019-08-31T19:51:44.686Z" + "onsetDateTime": "2019-04-17T22:11:06.872Z", + "dateRecorded": "2019-09-28T22:11:06.872Z" } }, { @@ -91,7 +91,7 @@ } ], "period": { - "start": "2019-08-20T19:51:44.686Z" + "start": "2019-09-17T22:11:06.872Z" } } }, @@ -99,7 +99,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "76e4f16c-21ac-4dea-be7b-5aa01dd3bf17", - "dateWritten": "2022-08-29T19:51:44.686Z", + "dateWritten": "2022-09-26T22:11:06.872Z", "status": "active", "patient": { "reference": "Patient/d23cf4f1-e5d7-4e5d-9164-86fbba1f21a7" @@ -120,7 +120,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "737fac47-6376-4671-9975-f1e9b4438166", - "dateWritten": "2022-07-25T19:51:44.686Z", + "dateWritten": "2022-08-22T22:11:06.872Z", "status": "active", "patient": { "reference": "Patient/d23cf4f1-e5d7-4e5d-9164-86fbba1f21a7" @@ -141,7 +141,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "55fb5b8c-79c5-4242-a417-878e0281e952", - "dateWritten": "2022-09-21T19:51:44.686Z", + "dateWritten": "2022-10-19T22:11:06.872Z", "status": "active", "patient": { "reference": "Patient/d23cf4f1-e5d7-4e5d-9164-86fbba1f21a7" @@ -162,7 +162,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "83577dc9-3077-456f-b730-080328bc0acc", - "dateWritten": "2022-09-21T19:51:44.686Z", + "dateWritten": "2022-10-19T22:11:06.872Z", "status": "active", "patient": { "reference": "Patient/d23cf4f1-e5d7-4e5d-9164-86fbba1f21a7" @@ -188,7 +188,7 @@ }, "status": "active", "wasNotTaken": false, - "effectiveDateTime": "2022-10-01T19:51:44.686Z", + "effectiveDateTime": "2022-10-29T22:11:06.872Z", "medicationCodeableConcept": { "coding": [ { @@ -210,7 +210,7 @@ }, "status": "active", "wasNotTaken": false, - "effectiveDateTime": "2022-05-31T19:51:44.686Z", + "effectiveDateTime": "2022-06-28T22:11:06.872Z", "medicationCodeableConcept": { "coding": [ { @@ -232,7 +232,7 @@ }, "status": "active", "wasNotTaken": false, - "effectiveDateTime": "2022-10-22T19:51:44.686Z", + "effectiveDateTime": "2022-11-19T22:11:06.872Z", "medicationCodeableConcept": { "coding": [ { @@ -254,7 +254,7 @@ }, "status": "active", "wasNotTaken": false, - "effectiveDateTime": "2022-11-16T19:51:44.686Z", + "effectiveDateTime": "2022-12-14T22:11:06.872Z", "medicationCodeableConcept": { "coding": [ { @@ -293,7 +293,7 @@ "subject": { "reference": "Patient/d23cf4f1-e5d7-4e5d-9164-86fbba1f21a7" }, - "issued": "2022-05-08T19:51:44.686Z", + "issued": "2022-06-05T22:11:06.872Z", "valueQuantity": { "value": 2300, "unit": "ng/mL" @@ -336,7 +336,7 @@ "subject": { "reference": "Patient/d23cf4f1-e5d7-4e5d-9164-86fbba1f21a7" }, - "issued": "2022-11-16T19:51:44.686Z", + "issued": "2022-12-14T22:11:06.872Z", "valueQuantity": { "value": 20, "unit": "{MME}/d" @@ -369,7 +369,7 @@ "subject": { "reference": "Patient/d23cf4f1-e5d7-4e5d-9164-86fbba1f21a7" }, - "issued": "2022-08-29T19:51:44.686Z", + "issued": "2022-09-26T22:11:06.872Z", "valueQuantity": { "value": 8 }, @@ -404,7 +404,7 @@ "subject": { "reference": "Patient/d23cf4f1-e5d7-4e5d-9164-86fbba1f21a7" }, - "issued": "2022-05-08T19:51:44.686Z", + "issued": "2022-06-05T22:11:06.872Z", "valueQuantity": { "value": 7 }, @@ -439,7 +439,7 @@ "subject": { "reference": "Patient/d23cf4f1-e5d7-4e5d-9164-86fbba1f21a7" }, - "issued": "2022-08-29T19:51:44.686Z", + "issued": "2022-09-26T22:11:06.872Z", "valueQuantity": { "value": 5 }, @@ -518,7 +518,7 @@ "subject": { "reference": "Patient/d23cf4f1-e5d7-4e5d-9164-86fbba1f21a7" }, - "issued": "2022-08-29T19:51:44.686Z", + "issued": "2022-09-26T22:11:06.872Z", "valueQuantity": { "value": 4 }, @@ -546,7 +546,7 @@ "text": "Chiropraxy (regime/therapy)" }, "notPerformed": false, - "performedDateTime": "2022-10-22T19:51:44.686Z" + "performedDateTime": "2022-11-19T22:11:06.872Z" } } ] diff --git a/src/utils/dstu2_test_patients/frankie_jackson.json b/src/utils/dstu2_test_patients/frankie_jackson.json index 0776cb9d5..dd36c0ad1 100644 --- a/src/utils/dstu2_test_patients/frankie_jackson.json +++ b/src/utils/dstu2_test_patients/frankie_jackson.json @@ -2,7 +2,7 @@ "resourceType": "Bundle", "id": "frankie_jackson", "meta": { - "lastUpdated": "2022-12-01T19:51:44.687Z" + "lastUpdated": "2022-12-29T22:11:06.872Z" }, "type": "collection", "entry": [ @@ -21,7 +21,7 @@ } ], "gender": "male", - "birthDate": "2014-10-03T19:51:44.687Z" + "birthDate": "2014-10-31T22:11:06.872Z" } }, { @@ -43,8 +43,8 @@ }, "clinicalStatus": "active", "verificationStatus": "confirmed", - "onsetDateTime": "2016-10-22T19:51:44.687Z", - "dateRecorded": "2016-10-22T19:51:44.687Z" + "onsetDateTime": "2016-11-19T22:11:06.872Z", + "dateRecorded": "2016-11-19T22:11:06.872Z" } }, { @@ -66,8 +66,8 @@ }, "clinicalStatus": "active", "verificationStatus": "confirmed", - "onsetDateTime": "2019-03-20T19:51:44.687Z", - "dateRecorded": "2019-08-31T19:51:44.687Z" + "onsetDateTime": "2019-04-17T22:11:06.872Z", + "dateRecorded": "2019-09-28T22:11:06.872Z" } }, { @@ -91,7 +91,7 @@ } ], "period": { - "start": "2019-08-20T19:51:44.687Z" + "start": "2019-09-17T22:11:06.872Z" } } }, @@ -99,7 +99,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "5be5d8a7-e41e-4fc8-80a2-20631d3e7526", - "dateWritten": "2022-08-29T19:51:44.687Z", + "dateWritten": "2022-09-26T22:11:06.872Z", "status": "active", "patient": { "reference": "Patient/2e4cec53-7d30-4933-868d-21493a51f572" @@ -120,7 +120,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "629a6f51-c10a-4c8b-80f8-1bb456deb165", - "dateWritten": "2022-07-25T19:51:44.687Z", + "dateWritten": "2022-08-22T22:11:06.872Z", "status": "active", "patient": { "reference": "Patient/2e4cec53-7d30-4933-868d-21493a51f572" @@ -141,7 +141,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "56da3758-f757-4682-b4d6-88797e7628d1", - "dateWritten": "2022-09-21T19:51:44.687Z", + "dateWritten": "2022-10-19T22:11:06.872Z", "status": "active", "patient": { "reference": "Patient/2e4cec53-7d30-4933-868d-21493a51f572" @@ -162,7 +162,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "2b169f4b-e5bf-4311-ad25-499017263877", - "dateWritten": "2022-09-21T19:51:44.687Z", + "dateWritten": "2022-10-19T22:11:06.872Z", "status": "active", "patient": { "reference": "Patient/2e4cec53-7d30-4933-868d-21493a51f572" @@ -183,7 +183,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "32790a3c-1b04-452c-a507-a48f432aa96d", - "dateWritten": "2022-11-06T19:51:44.687Z", + "dateWritten": "2022-12-04T22:11:06.872Z", "status": "active", "patient": { "reference": "Patient/2e4cec53-7d30-4933-868d-21493a51f572" @@ -209,7 +209,7 @@ }, "status": "active", "wasNotTaken": false, - "effectiveDateTime": "2022-10-01T19:51:44.687Z", + "effectiveDateTime": "2022-10-29T22:11:06.872Z", "medicationCodeableConcept": { "coding": [ { @@ -231,7 +231,7 @@ }, "status": "active", "wasNotTaken": false, - "effectiveDateTime": "2022-05-31T19:51:44.687Z", + "effectiveDateTime": "2022-06-28T22:11:06.872Z", "medicationCodeableConcept": { "coding": [ { @@ -253,7 +253,7 @@ }, "status": "active", "wasNotTaken": false, - "effectiveDateTime": "2022-10-22T19:51:44.687Z", + "effectiveDateTime": "2022-11-19T22:11:06.872Z", "medicationCodeableConcept": { "coding": [ { @@ -275,7 +275,7 @@ }, "status": "active", "wasNotTaken": false, - "effectiveDateTime": "2022-11-16T19:51:44.687Z", + "effectiveDateTime": "2022-12-14T22:11:06.872Z", "medicationCodeableConcept": { "coding": [ { @@ -297,7 +297,7 @@ }, "status": "active", "wasNotTaken": false, - "effectiveDateTime": "2022-10-27T19:51:44.687Z", + "effectiveDateTime": "2022-11-24T22:11:06.872Z", "medicationCodeableConcept": { "coding": [ { @@ -336,7 +336,7 @@ "subject": { "reference": "Patient/2e4cec53-7d30-4933-868d-21493a51f572" }, - "issued": "2022-05-08T19:51:44.687Z", + "issued": "2022-06-05T22:11:06.872Z", "valueQuantity": { "value": 2300, "unit": "ng/mL" @@ -379,7 +379,7 @@ "subject": { "reference": "Patient/2e4cec53-7d30-4933-868d-21493a51f572" }, - "issued": "2022-11-16T19:51:44.687Z", + "issued": "2022-12-14T22:11:06.872Z", "valueQuantity": { "value": 20, "unit": "{MME}/d" @@ -412,7 +412,7 @@ "subject": { "reference": "Patient/2e4cec53-7d30-4933-868d-21493a51f572" }, - "issued": "2022-08-29T19:51:44.687Z", + "issued": "2022-09-26T22:11:06.872Z", "valueQuantity": { "value": 8 }, @@ -447,7 +447,7 @@ "subject": { "reference": "Patient/2e4cec53-7d30-4933-868d-21493a51f572" }, - "issued": "2022-05-08T19:51:44.687Z", + "issued": "2022-06-05T22:11:06.872Z", "valueQuantity": { "value": 7 }, @@ -482,7 +482,7 @@ "subject": { "reference": "Patient/2e4cec53-7d30-4933-868d-21493a51f572" }, - "issued": "2022-08-29T19:51:44.687Z", + "issued": "2022-09-26T22:11:06.872Z", "valueQuantity": { "value": 5 }, @@ -561,7 +561,7 @@ "subject": { "reference": "Patient/2e4cec53-7d30-4933-868d-21493a51f572" }, - "issued": "2022-08-29T19:51:44.687Z", + "issued": "2022-09-26T22:11:06.872Z", "valueQuantity": { "value": 4 }, @@ -589,7 +589,7 @@ "text": "Chiropraxy (regime/therapy)" }, "notPerformed": false, - "performedDateTime": "2022-10-22T19:51:44.687Z" + "performedDateTime": "2022-11-19T22:11:06.872Z" } } ] diff --git a/src/utils/dstu2_test_patients/fred_jackson.json b/src/utils/dstu2_test_patients/fred_jackson.json index 070d6d308..9729b2d4f 100644 --- a/src/utils/dstu2_test_patients/fred_jackson.json +++ b/src/utils/dstu2_test_patients/fred_jackson.json @@ -2,7 +2,7 @@ "resourceType": "Bundle", "id": "fred_jackson", "meta": { - "lastUpdated": "2022-12-01T19:51:44.687Z" + "lastUpdated": "2022-12-29T22:11:06.873Z" }, "type": "collection", "entry": [ @@ -21,7 +21,7 @@ } ], "gender": "male", - "birthDate": "1957-09-29T19:51:44.687Z" + "birthDate": "1957-10-27T22:11:06.873Z" } }, { @@ -43,8 +43,8 @@ }, "clinicalStatus": "active", "verificationStatus": "confirmed", - "onsetDateTime": "2016-10-22T19:51:44.687Z", - "dateRecorded": "2016-10-22T19:51:44.687Z" + "onsetDateTime": "2016-11-19T22:11:06.873Z", + "dateRecorded": "2016-11-19T22:11:06.873Z" } }, { @@ -66,8 +66,8 @@ }, "clinicalStatus": "active", "verificationStatus": "confirmed", - "onsetDateTime": "2019-03-20T19:51:44.687Z", - "dateRecorded": "2019-08-31T19:51:44.687Z" + "onsetDateTime": "2019-04-17T22:11:06.873Z", + "dateRecorded": "2019-09-28T22:11:06.873Z" } }, { @@ -91,7 +91,7 @@ } ], "period": { - "start": "2019-08-20T19:51:44.687Z" + "start": "2019-09-17T22:11:06.873Z" } } }, @@ -99,7 +99,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "36e1b7d8-56e5-4ddb-baa0-c5df8661b88d", - "dateWritten": "2022-08-29T19:51:44.687Z", + "dateWritten": "2022-09-26T22:11:06.873Z", "status": "active", "patient": { "reference": "Patient/6848f536-c2b7-497e-abed-4c9cf39e0885" @@ -120,7 +120,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "7ed2ad85-ff4b-4657-b305-fecd7dfe50c6", - "dateWritten": "2022-07-25T19:51:44.687Z", + "dateWritten": "2022-08-22T22:11:06.873Z", "status": "active", "patient": { "reference": "Patient/6848f536-c2b7-497e-abed-4c9cf39e0885" @@ -141,7 +141,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "df047adb-1dfb-459a-aeab-6af98d85ccc7", - "dateWritten": "2022-09-21T19:51:44.687Z", + "dateWritten": "2022-10-19T22:11:06.873Z", "status": "active", "patient": { "reference": "Patient/6848f536-c2b7-497e-abed-4c9cf39e0885" @@ -162,7 +162,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "e12767d7-9194-4b11-90ad-a90c07801a42", - "dateWritten": "2022-09-21T19:51:44.687Z", + "dateWritten": "2022-10-19T22:11:06.873Z", "status": "active", "patient": { "reference": "Patient/6848f536-c2b7-497e-abed-4c9cf39e0885" @@ -183,7 +183,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "508befdc-034b-4ddb-88ad-e330121ba4b7", - "dateWritten": "2022-11-06T19:51:44.687Z", + "dateWritten": "2022-12-04T22:11:06.873Z", "status": "active", "patient": { "reference": "Patient/6848f536-c2b7-497e-abed-4c9cf39e0885" @@ -209,7 +209,7 @@ }, "status": "active", "wasNotTaken": false, - "effectiveDateTime": "2022-10-01T19:51:44.687Z", + "effectiveDateTime": "2022-10-29T22:11:06.873Z", "medicationCodeableConcept": { "coding": [ { @@ -231,7 +231,7 @@ }, "status": "active", "wasNotTaken": false, - "effectiveDateTime": "2022-05-31T19:51:44.687Z", + "effectiveDateTime": "2022-06-28T22:11:06.873Z", "medicationCodeableConcept": { "coding": [ { @@ -253,7 +253,7 @@ }, "status": "active", "wasNotTaken": false, - "effectiveDateTime": "2022-10-22T19:51:44.687Z", + "effectiveDateTime": "2022-11-19T22:11:06.873Z", "medicationCodeableConcept": { "coding": [ { @@ -275,7 +275,7 @@ }, "status": "active", "wasNotTaken": false, - "effectiveDateTime": "2022-11-16T19:51:44.687Z", + "effectiveDateTime": "2022-12-14T22:11:06.873Z", "medicationCodeableConcept": { "coding": [ { @@ -297,7 +297,7 @@ }, "status": "active", "wasNotTaken": false, - "effectiveDateTime": "2022-10-27T19:51:44.687Z", + "effectiveDateTime": "2022-11-24T22:11:06.873Z", "medicationCodeableConcept": { "coding": [ { @@ -336,7 +336,7 @@ "subject": { "reference": "Patient/6848f536-c2b7-497e-abed-4c9cf39e0885" }, - "issued": "2022-05-08T19:51:44.687Z", + "issued": "2022-06-05T22:11:06.873Z", "valueQuantity": { "value": 2300, "unit": "ng/mL" @@ -379,7 +379,7 @@ "subject": { "reference": "Patient/6848f536-c2b7-497e-abed-4c9cf39e0885" }, - "issued": "2022-11-16T19:51:44.687Z", + "issued": "2022-12-14T22:11:06.873Z", "valueQuantity": { "value": 70, "unit": "{MME}/d" @@ -412,7 +412,7 @@ "subject": { "reference": "Patient/6848f536-c2b7-497e-abed-4c9cf39e0885" }, - "issued": "2022-08-29T19:51:44.687Z", + "issued": "2022-09-26T22:11:06.873Z", "valueQuantity": { "value": 8 }, @@ -447,7 +447,7 @@ "subject": { "reference": "Patient/6848f536-c2b7-497e-abed-4c9cf39e0885" }, - "issued": "2022-05-08T19:51:44.687Z", + "issued": "2022-06-05T22:11:06.873Z", "valueQuantity": { "value": 7 }, @@ -482,7 +482,7 @@ "subject": { "reference": "Patient/6848f536-c2b7-497e-abed-4c9cf39e0885" }, - "issued": "2022-08-29T19:51:44.687Z", + "issued": "2022-09-26T22:11:06.873Z", "valueQuantity": { "value": 5 }, @@ -561,7 +561,7 @@ "subject": { "reference": "Patient/6848f536-c2b7-497e-abed-4c9cf39e0885" }, - "issued": "2022-08-29T19:51:44.687Z", + "issued": "2022-09-26T22:11:06.873Z", "valueQuantity": { "value": 4 }, @@ -589,7 +589,7 @@ "text": "Chiropraxy (regime/therapy)" }, "notPerformed": false, - "performedDateTime": "2022-10-22T19:51:44.687Z" + "performedDateTime": "2022-11-19T22:11:06.873Z" } } ] diff --git a/src/utils/dstu2_test_patients/fuller_jackson.json b/src/utils/dstu2_test_patients/fuller_jackson.json index 5629a210a..0e9374c3f 100644 --- a/src/utils/dstu2_test_patients/fuller_jackson.json +++ b/src/utils/dstu2_test_patients/fuller_jackson.json @@ -2,7 +2,7 @@ "resourceType": "Bundle", "id": "fuller_jackson", "meta": { - "lastUpdated": "2022-12-01T19:51:44.688Z" + "lastUpdated": "2022-12-29T22:11:06.873Z" }, "type": "collection", "entry": [ @@ -21,7 +21,7 @@ } ], "gender": "male", - "birthDate": "1958-09-04T19:51:44.688Z" + "birthDate": "1958-10-02T22:11:06.873Z" } }, { @@ -43,8 +43,8 @@ }, "clinicalStatus": "active", "verificationStatus": "confirmed", - "onsetDateTime": "2016-10-22T19:51:44.688Z", - "dateRecorded": "2016-10-22T19:51:44.688Z" + "onsetDateTime": "2016-11-19T22:11:06.873Z", + "dateRecorded": "2016-11-19T22:11:06.873Z" } }, { @@ -66,8 +66,8 @@ }, "clinicalStatus": "active", "verificationStatus": "confirmed", - "onsetDateTime": "2019-03-20T19:51:44.688Z", - "dateRecorded": "2019-08-31T19:51:44.688Z" + "onsetDateTime": "2019-04-17T22:11:06.873Z", + "dateRecorded": "2019-09-28T22:11:06.873Z" } }, { @@ -91,7 +91,7 @@ } ], "period": { - "start": "2019-08-20T19:51:44.688Z" + "start": "2019-09-17T22:11:06.873Z" } } }, @@ -99,7 +99,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "5c3866f8-eed5-4677-a83e-311d1635c8a9", - "dateWritten": "2022-08-29T19:51:44.688Z", + "dateWritten": "2022-09-26T22:11:06.873Z", "status": "active", "patient": { "reference": "Patient/7a286cf5-09a7-457a-ad11-ed33a50509e7" @@ -120,7 +120,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "ce4965fd-0871-4150-9f41-6a1cff782f87", - "dateWritten": "2022-07-25T19:51:44.688Z", + "dateWritten": "2022-08-22T22:11:06.873Z", "status": "active", "patient": { "reference": "Patient/7a286cf5-09a7-457a-ad11-ed33a50509e7" @@ -141,7 +141,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "3fb285c0-4ea4-4dd3-a1bb-eaf55b1ec2f2", - "dateWritten": "2022-09-21T19:51:44.688Z", + "dateWritten": "2022-10-19T22:11:06.873Z", "status": "active", "patient": { "reference": "Patient/7a286cf5-09a7-457a-ad11-ed33a50509e7" @@ -162,7 +162,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "d921835e-bf94-4562-8b31-b6506a58d716", - "dateWritten": "2022-09-21T19:51:44.688Z", + "dateWritten": "2022-10-19T22:11:06.873Z", "status": "active", "patient": { "reference": "Patient/7a286cf5-09a7-457a-ad11-ed33a50509e7" @@ -183,7 +183,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "3c60ab9d-5dd9-4a52-bf71-a639b22010d2", - "dateWritten": "2022-11-06T19:51:44.688Z", + "dateWritten": "2022-12-04T22:11:06.873Z", "status": "active", "patient": { "reference": "Patient/7a286cf5-09a7-457a-ad11-ed33a50509e7" @@ -209,7 +209,7 @@ }, "status": "active", "wasNotTaken": false, - "effectiveDateTime": "2022-10-01T19:51:44.688Z", + "effectiveDateTime": "2022-10-29T22:11:06.873Z", "medicationCodeableConcept": { "coding": [ { @@ -231,7 +231,7 @@ }, "status": "active", "wasNotTaken": false, - "effectiveDateTime": "2022-05-31T19:51:44.688Z", + "effectiveDateTime": "2022-06-28T22:11:06.873Z", "medicationCodeableConcept": { "coding": [ { @@ -253,7 +253,7 @@ }, "status": "active", "wasNotTaken": false, - "effectiveDateTime": "2022-10-22T19:51:44.688Z", + "effectiveDateTime": "2022-11-19T22:11:06.873Z", "medicationCodeableConcept": { "coding": [ { @@ -275,7 +275,7 @@ }, "status": "active", "wasNotTaken": false, - "effectiveDateTime": "2022-11-16T19:51:44.688Z", + "effectiveDateTime": "2022-12-14T22:11:06.873Z", "medicationCodeableConcept": { "coding": [ { @@ -297,7 +297,7 @@ }, "status": "active", "wasNotTaken": false, - "effectiveDateTime": "2022-10-27T19:51:44.688Z", + "effectiveDateTime": "2022-11-24T22:11:06.873Z", "medicationCodeableConcept": { "coding": [ { @@ -336,7 +336,7 @@ "subject": { "reference": "Patient/7a286cf5-09a7-457a-ad11-ed33a50509e7" }, - "issued": "2022-05-08T19:51:44.688Z", + "issued": "2022-06-05T22:11:06.873Z", "valueQuantity": { "value": 2300, "unit": "ng/mL" @@ -379,7 +379,7 @@ "subject": { "reference": "Patient/7a286cf5-09a7-457a-ad11-ed33a50509e7" }, - "issued": "2022-11-16T19:51:44.688Z", + "issued": "2022-12-14T22:11:06.873Z", "valueQuantity": { "value": 20, "unit": "{MME}/d" @@ -412,7 +412,7 @@ "subject": { "reference": "Patient/7a286cf5-09a7-457a-ad11-ed33a50509e7" }, - "issued": "2022-08-29T19:51:44.688Z", + "issued": "2022-09-26T22:11:06.873Z", "valueQuantity": { "value": 8 }, @@ -447,7 +447,7 @@ "subject": { "reference": "Patient/7a286cf5-09a7-457a-ad11-ed33a50509e7" }, - "issued": "2022-05-08T19:51:44.688Z", + "issued": "2022-06-05T22:11:06.873Z", "valueQuantity": { "value": 7 }, @@ -482,7 +482,7 @@ "subject": { "reference": "Patient/7a286cf5-09a7-457a-ad11-ed33a50509e7" }, - "issued": "2022-08-29T19:51:44.688Z", + "issued": "2022-09-26T22:11:06.873Z", "valueQuantity": { "value": 5 }, @@ -561,7 +561,7 @@ "subject": { "reference": "Patient/7a286cf5-09a7-457a-ad11-ed33a50509e7" }, - "issued": "2022-08-29T19:51:44.688Z", + "issued": "2022-09-26T22:11:06.873Z", "valueQuantity": { "value": 4 }, @@ -589,7 +589,7 @@ "text": "Chiropraxy (regime/therapy)" }, "notPerformed": false, - "performedDateTime": "2022-10-22T19:51:44.688Z" + "performedDateTime": "2022-11-19T22:11:06.873Z" } } ] diff --git a/src/utils/dstu2_test_patients/george_jackson.json b/src/utils/dstu2_test_patients/george_jackson.json index 6428126c7..6468d07d8 100644 --- a/src/utils/dstu2_test_patients/george_jackson.json +++ b/src/utils/dstu2_test_patients/george_jackson.json @@ -2,7 +2,7 @@ "resourceType": "Bundle", "id": "george_jackson", "meta": { - "lastUpdated": "2022-12-01T19:51:44.688Z" + "lastUpdated": "2022-12-29T22:11:06.873Z" }, "type": "collection", "entry": [ @@ -21,7 +21,7 @@ } ], "gender": "male", - "birthDate": "1962-02-01T19:51:44.688Z" + "birthDate": "1962-03-01T22:11:06.873Z" } }, { @@ -43,7 +43,7 @@ }, "clinicalStatus": "active", "verificationStatus": "confirmed", - "onsetDateTime": "2016-10-22T19:51:44.688Z" + "onsetDateTime": "2016-11-19T22:11:06.873Z" } }, { @@ -65,7 +65,7 @@ }, "clinicalStatus": "active", "verificationStatus": "confirmed", - "onsetDateTime": "2019-03-24T19:51:44.688Z" + "onsetDateTime": "2019-04-21T22:11:06.873Z" } }, { @@ -89,7 +89,7 @@ } ], "period": { - "start": "2019-08-20T19:51:44.688Z" + "start": "2019-09-17T22:11:06.873Z" } } }, @@ -97,7 +97,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "3e50555f-1ad4-4878-9725-2727c939a698", - "dateWritten": "2022-08-29T19:51:44.688Z", + "dateWritten": "2022-09-26T22:11:06.873Z", "status": "active", "patient": { "reference": "Patient/1e6d8f06-9a55-4689-a61b-f632297e757e" @@ -118,7 +118,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "a7e810fc-cd7c-4b8e-aace-13e5f55ed0d6", - "dateWritten": "2022-07-25T19:51:44.688Z", + "dateWritten": "2022-08-22T22:11:06.873Z", "status": "active", "patient": { "reference": "Patient/1e6d8f06-9a55-4689-a61b-f632297e757e" @@ -139,7 +139,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "f3d5576d-cce2-4cfb-bfcc-24b6b485b4ed", - "dateWritten": "2022-09-21T19:51:44.688Z", + "dateWritten": "2022-10-19T22:11:06.873Z", "status": "active", "patient": { "reference": "Patient/1e6d8f06-9a55-4689-a61b-f632297e757e" @@ -160,7 +160,7 @@ "resource": { "resourceType": "MedicationOrder", "id": "c73b1b07-c128-4475-9ccc-eade401a69eb", - "dateWritten": "2022-09-21T19:51:44.688Z", + "dateWritten": "2022-10-19T22:11:06.873Z", "status": "active", "patient": { "reference": "Patient/1e6d8f06-9a55-4689-a61b-f632297e757e" @@ -186,7 +186,7 @@ }, "status": "active", "wasNotTaken": false, - "effectiveDateTime": "2022-10-01T19:51:44.688Z", + "effectiveDateTime": "2022-10-29T22:11:06.873Z", "medicationCodeableConcept": { "coding": [ { @@ -208,7 +208,7 @@ }, "status": "active", "wasNotTaken": false, - "effectiveDateTime": "2022-05-31T19:51:44.688Z", + "effectiveDateTime": "2022-06-28T22:11:06.873Z", "medicationCodeableConcept": { "coding": [ { @@ -230,7 +230,7 @@ }, "status": "active", "wasNotTaken": false, - "effectiveDateTime": "2022-10-22T19:51:44.688Z", + "effectiveDateTime": "2022-11-19T22:11:06.873Z", "medicationCodeableConcept": { "coding": [ { @@ -252,7 +252,7 @@ }, "status": "active", "wasNotTaken": false, - "effectiveDateTime": "2022-11-16T19:51:44.688Z", + "effectiveDateTime": "2022-12-14T22:11:06.873Z", "medicationCodeableConcept": { "coding": [ { @@ -291,7 +291,7 @@ "subject": { "reference": "Patient/1e6d8f06-9a55-4689-a61b-f632297e757e" }, - "issued": "2022-05-08T19:51:44.688Z", + "issued": "2022-06-05T22:11:06.873Z", "valueQuantity": { "value": 2300, "unit": "ng/mL" @@ -334,7 +334,7 @@ "subject": { "reference": "Patient/1e6d8f06-9a55-4689-a61b-f632297e757e" }, - "issued": "2022-11-16T19:51:44.688Z", + "issued": "2022-12-14T22:11:06.873Z", "valueQuantity": { "value": 60, "unit": "{MME}/d" @@ -367,7 +367,7 @@ "subject": { "reference": "Patient/1e6d8f06-9a55-4689-a61b-f632297e757e" }, - "issued": "2022-08-29T19:51:44.688Z", + "issued": "2022-09-26T22:11:06.873Z", "valueQuantity": { "value": 8 }, @@ -402,7 +402,7 @@ "subject": { "reference": "Patient/1e6d8f06-9a55-4689-a61b-f632297e757e" }, - "issued": "2022-05-08T19:51:44.688Z", + "issued": "2022-06-05T22:11:06.873Z", "valueQuantity": { "value": 7 }, @@ -437,7 +437,7 @@ "subject": { "reference": "Patient/1e6d8f06-9a55-4689-a61b-f632297e757e" }, - "issued": "2022-08-29T19:51:44.688Z", + "issued": "2022-09-26T22:11:06.873Z", "valueQuantity": { "value": 5 }, @@ -516,7 +516,7 @@ "subject": { "reference": "Patient/1e6d8f06-9a55-4689-a61b-f632297e757e" }, - "issued": "2022-08-29T19:51:44.688Z", + "issued": "2022-09-26T22:11:06.873Z", "valueQuantity": { "value": 4 }, @@ -544,7 +544,7 @@ "text": "Chiropraxy (regime/therapy)" }, "notPerformed": false, - "performedDateTime": "2022-10-22T19:51:44.688Z" + "performedDateTime": "2022-11-19T22:11:06.873Z" } } ] diff --git a/src/utils/executeELM.js b/src/utils/executeELM.js index 590f256dc..b9d5baac5 100644 --- a/src/utils/executeELM.js +++ b/src/utils/executeELM.js @@ -2,11 +2,11 @@ import FHIR from 'fhirclient'; import cql from 'cql-execution'; import cqlfhir from 'cql-exec-fhir'; import extractResourcesFromELM from './extractResourcesFromELM'; -import dstu2FactorsELM from '../cql/dstu2/Factors_to_Consider_in_Managing_Chronic_Pain.json' -import dstu2CommonsELM from '../cql/dstu2/CDS_Connect_Commons_for_FHIRv102.json'; +import dstu2FactorsELM from '../cql/dstu2/FactorsToConsiderInManagingChronicPainFHIRv102.json' +import dstu2CommonsELM from '../cql/dstu2/CDSConnectCommonsForFHIRv102.json'; import dstu2HelpersELM from '../cql/dstu2/FHIRHelpers.json'; -import r4FactorsELM from '../cql/r4/Factors_to_Consider_in_Managing_Chronic_Pain_FHIRv401.json'; -import r4CommonsELM from '../cql/r4/CDS_Connect_Commons_for_FHIRv401.json'; +import r4FactorsELM from '../cql/r4/FactorsToConsiderInManagingChronicPainFHIRv401.json'; +import r4CommonsELM from '../cql/r4/CDSConnectCommonsForFHIRv401.json'; import r4HelpersELM from '../cql/r4/FHIRHelpers.json'; import valueSetDB from '../cql/valueset-db.json'; @@ -99,12 +99,12 @@ function getLibrary(release) { switch(release) { case 2: return new cql.Library(dstu2FactorsELM, new cql.Repository({ - CDS_Connect_Commons_for_FHIRv102: dstu2CommonsELM, + CDSConnectCommonsForFHIRv102: dstu2CommonsELM, FHIRHelpers: dstu2HelpersELM })); case 4: return new cql.Library(r4FactorsELM, new cql.Repository({ - CDS_Connect_Commons_for_FHIRv401: r4CommonsELM, + CDSConnectCommonsForFHIRv401: r4CommonsELM, FHIRHelpers: r4HelpersELM })); default: diff --git a/src/utils/r4_test_patients/brenda_jackson.json b/src/utils/r4_test_patients/brenda_jackson.json index 4b36973e4..a1fad8582 100644 --- a/src/utils/r4_test_patients/brenda_jackson.json +++ b/src/utils/r4_test_patients/brenda_jackson.json @@ -2,7 +2,7 @@ "resourceType": "Bundle", "id": "brenda_jackson", "meta": { - "lastUpdated": "2022-12-01T19:51:44.689Z" + "lastUpdated": "2022-12-29T22:11:06.874Z" }, "type": "collection", "entry": [ @@ -19,7 +19,7 @@ } ], "gender": "female", - "birthDate": "1960-03-15" + "birthDate": "1960-04-11" } }, { @@ -59,8 +59,8 @@ ], "text": "Fibromyalgia (disorder)" }, - "onsetDateTime": "2016-09-06T11:51:44.689Z", - "recordedDate": "2016-09-05T19:51:44.689Z" + "onsetDateTime": "2016-10-04T14:11:06.874Z", + "recordedDate": "2016-10-03T22:11:06.874Z" } }, { @@ -100,8 +100,8 @@ ], "text": "Low back pain" }, - "onsetDateTime": "2012-04-15T11:51:44.689Z", - "recordedDate": "2012-04-14T19:51:44.689Z" + "onsetDateTime": "2012-05-13T14:11:06.874Z", + "recordedDate": "2012-05-12T22:11:06.874Z" } }, { @@ -141,8 +141,8 @@ ], "text": "Lumbar post-laminectomy syndrome (disorder)" }, - "onsetDateTime": "2015-07-05T11:51:44.689Z", - "recordedDate": "2015-07-19T19:51:44.689Z" + "onsetDateTime": "2015-08-02T14:11:06.874Z", + "recordedDate": "2015-08-16T22:11:06.874Z" } }, { @@ -182,7 +182,7 @@ ], "text": "Moderate major depression (disorder)" }, - "onsetDateTime": "2020-05-05T11:51:44.689Z" + "onsetDateTime": "2020-06-02T14:11:06.874Z" } }, { @@ -221,7 +221,7 @@ "text": "Hurts Worst" } ], - "issued": "2022-11-16T11:51:44.689Z" + "issued": "2022-12-14T14:11:06.874Z" } }, { @@ -260,7 +260,7 @@ "text": "Hurts Even More" } ], - "issued": "2022-03-12T11:51:44.689Z" + "issued": "2022-04-09T14:11:06.874Z" } }, { @@ -299,7 +299,7 @@ "text": "Hurts Even More" } ], - "issued": "2021-04-18T11:51:44.689Z" + "issued": "2021-05-16T14:11:06.874Z" } }, { @@ -338,7 +338,7 @@ "text": "Hurts Even More" } ], - "issued": "2020-05-05T11:51:44.689Z" + "issued": "2020-06-02T14:11:06.874Z" } }, { @@ -372,7 +372,7 @@ "valueQuantity": { "value": 5 }, - "issued": "2022-03-12T11:51:44.689Z", + "issued": "2022-04-09T14:11:06.874Z", "component": [ { "code": { @@ -453,7 +453,7 @@ "valueQuantity": { "value": 7 }, - "issued": "2021-04-18T11:51:44.689Z", + "issued": "2021-05-16T14:11:06.874Z", "component": [ { "code": { @@ -534,7 +534,7 @@ "valueQuantity": { "value": 8 }, - "issued": "2020-05-05T11:51:44.689Z", + "issued": "2020-06-02T14:11:06.874Z", "component": [ { "code": { @@ -620,7 +620,7 @@ "text": "Medium risk" } ], - "issued": "2022-04-18T11:51:44.689Z" + "issued": "2022-05-16T14:11:06.874Z" } }, { @@ -659,7 +659,7 @@ "text": "Low risk" } ], - "issued": "2021-04-18T11:51:44.689Z" + "issued": "2021-05-16T14:11:06.874Z" } }, { @@ -698,7 +698,7 @@ "text": "High risk" } ], - "issued": "2020-05-05T11:51:44.689Z" + "issued": "2020-06-02T14:11:06.874Z" } }, { @@ -721,7 +721,7 @@ ], "text": "12 HR Oxycodone Hydrochloride 60 MG Extended Release Oral Tablet" }, - "authoredOn": "2022-09-16T11:53:44.689Z" + "authoredOn": "2022-10-14T14:13:06.874Z" } }, { @@ -744,7 +744,7 @@ ], "text": "12 HR Oxycodone Hydrochloride 60 MG Extended Release Oral Tablet" }, - "authoredOn": "2022-06-18T11:53:44.689Z" + "authoredOn": "2022-07-16T14:13:06.874Z" } }, { @@ -767,7 +767,7 @@ ], "text": "12 HR Oxycodone Hydrochloride 60 MG Extended Release Oral Tablet" }, - "authoredOn": "2022-03-18T11:53:44.689Z" + "authoredOn": "2022-04-15T14:13:06.874Z" } }, { @@ -790,7 +790,7 @@ ], "text": "12 HR Oxycodone Hydrochloride 60 MG Extended Release Oral Tablet" }, - "authoredOn": "2021-12-16T11:53:44.689Z" + "authoredOn": "2022-01-13T14:13:06.874Z" } }, { @@ -813,7 +813,7 @@ ], "text": "12 HR Oxycodone Hydrochloride 60 MG Extended Release Oral Tablet" }, - "authoredOn": "2021-09-16T11:53:44.689Z" + "authoredOn": "2021-10-14T14:13:06.874Z" } }, { @@ -836,7 +836,7 @@ ], "text": "12 HR Oxycodone Hydrochloride 60 MG Extended Release Oral Tablet" }, - "authoredOn": "2021-06-18T11:53:44.689Z" + "authoredOn": "2021-07-16T14:13:06.874Z" } }, { @@ -859,7 +859,7 @@ ], "text": "12 HR Oxycodone Hydrochloride 60 MG Extended Release Oral Tablet" }, - "authoredOn": "2021-03-18T11:53:44.689Z" + "authoredOn": "2021-04-15T14:13:06.874Z" } }, { @@ -882,7 +882,7 @@ ], "text": "12 HR Oxycodone Hydrochloride 60 MG Extended Release Oral Tablet" }, - "authoredOn": "2020-12-16T11:53:44.689Z" + "authoredOn": "2021-01-13T14:13:06.874Z" } }, { @@ -905,7 +905,7 @@ ], "text": "12 HR Oxycodone Hydrochloride 60 MG Extended Release Oral Tablet" }, - "authoredOn": "2020-09-16T11:53:44.689Z" + "authoredOn": "2020-10-14T14:13:06.874Z" } }, { @@ -928,7 +928,7 @@ ], "text": "12 HR Oxycodone Hydrochloride 60 MG Extended Release Oral Tablet" }, - "authoredOn": "2020-06-18T11:53:44.689Z" + "authoredOn": "2020-07-16T14:13:06.874Z" } }, { @@ -951,7 +951,7 @@ ], "text": "12 HR Oxycodone Hydrochloride 60 MG Extended Release Oral Tablet" }, - "authoredOn": "2020-03-18T11:53:44.689Z" + "authoredOn": "2020-04-15T14:13:06.874Z" } }, { @@ -974,7 +974,7 @@ ], "text": "Oxycodone Hydrochloride 10 MG Oral Capsule" }, - "authoredOn": "2022-09-16T11:52:44.689Z" + "authoredOn": "2022-10-14T14:12:06.874Z" } }, { @@ -997,7 +997,7 @@ ], "text": "Oxycodone Hydrochloride 10 MG Oral Capsule" }, - "authoredOn": "2022-06-18T11:52:44.689Z" + "authoredOn": "2022-07-16T14:12:06.874Z" } }, { @@ -1020,7 +1020,7 @@ ], "text": "Oxycodone Hydrochloride 10 MG Oral Capsule" }, - "authoredOn": "2022-03-18T11:52:44.689Z" + "authoredOn": "2022-04-15T14:12:06.874Z" } }, { @@ -1043,7 +1043,7 @@ ], "text": "Oxycodone Hydrochloride 10 MG Oral Capsule" }, - "authoredOn": "2021-12-16T11:52:44.689Z" + "authoredOn": "2022-01-13T14:12:06.874Z" } }, { @@ -1066,7 +1066,7 @@ ], "text": "Oxycodone Hydrochloride 10 MG Oral Capsule" }, - "authoredOn": "2021-09-16T11:52:44.689Z" + "authoredOn": "2021-10-14T14:12:06.874Z" } }, { @@ -1089,7 +1089,7 @@ ], "text": "Oxycodone Hydrochloride 10 MG Oral Capsule" }, - "authoredOn": "2021-06-18T11:52:44.689Z" + "authoredOn": "2021-07-16T14:12:06.874Z" } }, { @@ -1112,7 +1112,7 @@ ], "text": "Oxycodone Hydrochloride 10 MG Oral Capsule" }, - "authoredOn": "2021-03-18T11:52:44.689Z" + "authoredOn": "2021-04-15T14:12:06.874Z" } }, { @@ -1135,7 +1135,7 @@ ], "text": "Oxycodone Hydrochloride 10 MG Oral Capsule" }, - "authoredOn": "2020-12-16T11:52:44.689Z" + "authoredOn": "2021-01-13T14:12:06.874Z" } }, { @@ -1158,7 +1158,7 @@ ], "text": "Oxycodone Hydrochloride 10 MG Oral Capsule" }, - "authoredOn": "2020-09-16T11:52:44.689Z" + "authoredOn": "2020-10-14T14:12:06.874Z" } }, { @@ -1181,7 +1181,7 @@ ], "text": "Oxycodone Hydrochloride 10 MG Oral Capsule" }, - "authoredOn": "2020-06-18T11:52:44.689Z" + "authoredOn": "2020-07-16T14:12:06.874Z" } }, { @@ -1204,7 +1204,7 @@ ], "text": "Oxycodone Hydrochloride 10 MG Oral Capsule" }, - "authoredOn": "2020-03-18T11:52:44.689Z" + "authoredOn": "2020-04-15T14:12:06.874Z" } }, { @@ -1227,7 +1227,7 @@ ], "text": "Ibuprofen 600 MG Oral Tablet" }, - "authoredOn": "2020-05-05T11:51:44.689Z" + "authoredOn": "2020-06-02T14:11:06.874Z" } }, { @@ -1250,7 +1250,7 @@ ], "text": "Acetaminophen 500 MG Oral Tablet" }, - "authoredOn": "2020-05-05T11:51:44.689Z" + "authoredOn": "2020-06-02T14:11:06.874Z" } }, { @@ -1273,7 +1273,7 @@ ], "text": "Ibuprofen 600 MG Oral Tablet" }, - "authoredOn": "2021-04-18T11:51:44.689Z" + "authoredOn": "2021-05-16T14:11:06.874Z" } }, { @@ -1296,7 +1296,7 @@ ], "text": "Acetaminophen 500 MG Oral Tablet" }, - "authoredOn": "2021-04-18T11:51:44.689Z" + "authoredOn": "2021-05-16T14:11:06.874Z" } }, { @@ -1317,7 +1317,7 @@ ], "text": "Referral to chiropractor (procedure)" }, - "performedDateTime": "2020-05-05T11:51:44.689Z" + "performedDateTime": "2020-06-02T14:11:06.874Z" } }, { @@ -1338,7 +1338,7 @@ ], "text": "Referral for physical therapy (procedure)" }, - "performedDateTime": "2020-05-05T11:51:44.689Z" + "performedDateTime": "2020-06-02T14:11:06.874Z" } }, { @@ -1359,7 +1359,7 @@ ], "text": "Patient referral for psychotherapy (procedure)" }, - "performedDateTime": "2021-04-18T11:51:44.689Z" + "performedDateTime": "2021-05-16T14:11:06.874Z" } }, { @@ -1380,7 +1380,7 @@ ], "text": "Referral to chiropractor (procedure)" }, - "performedDateTime": "2022-03-18T11:51:44.689Z" + "performedDateTime": "2022-04-15T14:11:06.874Z" } }, { @@ -1401,7 +1401,7 @@ ], "text": "Referral for physical therapy (procedure)" }, - "performedDateTime": "2022-03-18T11:51:44.689Z" + "performedDateTime": "2022-04-15T14:11:06.874Z" } }, { @@ -1424,7 +1424,7 @@ ], "text": "POLYETHYLENE GLYCOL 3350 17000 MG Powder for Oral Solution" }, - "authoredOn": "2020-10-16T11:51:44.689Z" + "authoredOn": "2020-11-13T14:11:06.874Z" } }, { @@ -1447,7 +1447,7 @@ ], "text": "POLYETHYLENE GLYCOL 3350 17000 MG Powder for Oral Solution" }, - "authoredOn": "2021-04-18T11:51:44.689Z" + "authoredOn": "2021-05-16T14:11:06.874Z" } }, { @@ -1470,7 +1470,7 @@ ], "text": "POLYETHYLENE GLYCOL 3350 17000 MG Powder for Oral Solution" }, - "authoredOn": "2021-10-16T11:51:44.689Z" + "authoredOn": "2021-11-13T14:11:06.874Z" } }, { @@ -1493,7 +1493,7 @@ ], "text": "POLYETHYLENE GLYCOL 3350 17000 MG Powder for Oral Solution" }, - "authoredOn": "2022-06-18T11:51:44.689Z" + "authoredOn": "2022-07-16T14:11:06.874Z" } }, { @@ -1516,7 +1516,7 @@ ], "text": "POLYETHYLENE GLYCOL 3350 17000 MG Powder for Oral Solution" }, - "authoredOn": "2022-09-16T11:51:44.689Z" + "authoredOn": "2022-10-14T14:11:06.874Z" } }, { @@ -1553,7 +1553,7 @@ "system": "http://unitsofmeasure.org", "code": "{MME}/d" }, - "issued": "2022-09-16T11:51:44.689Z" + "issued": "2022-10-14T14:11:06.874Z" } }, { @@ -1590,7 +1590,7 @@ "system": "http://unitsofmeasure.org", "code": "{MME}/d" }, - "issued": "2022-06-18T11:51:44.689Z" + "issued": "2022-07-16T14:11:06.874Z" } }, { @@ -1627,7 +1627,7 @@ "system": "http://unitsofmeasure.org", "code": "{MME}/d" }, - "issued": "2022-03-12T11:51:44.689Z" + "issued": "2022-04-09T14:11:06.874Z" } }, { @@ -1664,7 +1664,7 @@ "system": "http://unitsofmeasure.org", "code": "{MME}/d" }, - "issued": "2021-04-18T11:51:44.689Z" + "issued": "2021-05-16T14:11:06.874Z" } }, { @@ -1701,7 +1701,7 @@ "system": "http://unitsofmeasure.org", "code": "{MME}/d" }, - "issued": "2020-05-05T11:51:44.689Z" + "issued": "2020-06-02T14:11:06.874Z" } }, { @@ -1740,7 +1740,7 @@ "text": "Positive" } ], - "issued": "2022-03-18T11:51:44.689Z" + "issued": "2022-04-15T14:11:06.874Z" } }, { @@ -1779,7 +1779,7 @@ "text": "Positive" } ], - "issued": "2021-04-19T11:51:44.689Z" + "issued": "2021-05-17T14:11:06.874Z" } }, { @@ -1818,7 +1818,7 @@ "text": "Positive" } ], - "issued": "2020-05-06T11:51:44.689Z" + "issued": "2020-06-03T14:11:06.874Z" } }, { @@ -1841,7 +1841,7 @@ ], "text": "Chlordiazepoxide Hydrochloride 25 MG Oral Tablet" }, - "authoredOn": "2016-09-06T11:51:44.689Z" + "authoredOn": "2016-10-04T14:11:06.874Z" } }, { @@ -1880,7 +1880,7 @@ "text": "Mild depression" } ], - "issued": "2022-02-16T11:51:44.689Z" + "issued": "2022-03-16T14:11:06.874Z" } }, { @@ -1919,7 +1919,7 @@ "text": "Moderately severe depression" } ], - "issued": "2021-04-18T11:51:44.689Z" + "issued": "2021-05-16T14:11:06.874Z" } }, { @@ -1958,7 +1958,7 @@ "text": "Moderately severe depression" } ], - "issued": "2020-05-05T11:51:44.689Z" + "issued": "2020-06-02T14:11:06.874Z" } } ] diff --git a/src/utils/updateValueSetDB.js b/src/utils/updateValueSetDB.js index fbe3d7503..c29d69fcb 100644 --- a/src/utils/updateValueSetDB.js +++ b/src/utils/updateValueSetDB.js @@ -6,11 +6,11 @@ const path = require('path'); const temp = require('temp'); const { Library, Repository } = require('cql-execution'); const { CodeService } = require('cql-exec-vsac'); -const dstu2FactorsELM = require('../cql/dstu2/Factors_to_Consider_in_Managing_Chronic_Pain.json'); -const dstu2CommonsELM = require('../cql/dstu2/CDS_Connect_Commons_for_FHIRv102.json'); +const dstu2FactorsELM = require('../cql/dstu2/FactorsToConsiderInManagingChronicPainFHIRv102.json'); +const dstu2CommonsELM = require('../cql/dstu2/CDSConnectCommonsForFHIRv102.json'); const dstu2HelpersELM = require('../cql/dstu2/FHIRHelpers.json'); -const r4FactorsELM = require('../cql/r4/Factors_to_Consider_in_Managing_Chronic_Pain_FHIRv401.json'); -const r4CommonsELM = require('../cql/r4/CDS_Connect_Commons_for_FHIRv401.json'); +const r4FactorsELM = require('../cql/r4/FactorsToConsiderInManagingChronicPainFHIRv401.json'); +const r4CommonsELM = require('../cql/r4/CDSConnectCommonsForFHIRv401.json'); const r4HelpersELM = require('../cql/r4/FHIRHelpers.json'); // First ensure an API key is provided @@ -38,11 +38,11 @@ console.log(`Using temp folder: ${tempFolder}`); // same valuesets, but in case they don't we go ahead and load both of // them. const dstu2Lib = new Library(dstu2FactorsELM, new Repository({ - CDS_Connect_Commons_for_FHIRv102: dstu2CommonsELM, + CDSConnectCommonsForFHIRv102: dstu2CommonsELM, FHIRHelpers: dstu2HelpersELM })); const r4Lib = new Library(r4FactorsELM, new Repository({ - CDS_Connect_Commons_for_FHIRv401: r4CommonsELM, + CDSConnectCommonsForFHIRv401: r4CommonsELM, FHIRHelpers: r4HelpersELM }));