Need a do not perform reason on QI-Core Device Request profile

XMLWordPrintableJSON

    • Type: Change Request
    • Resolution: Persuasive
    • Priority: Medium
    • US QI Core (FHIR)
    • STU3
    • Clinical Quality Information
    • STU
    • QI-Core Profiles
    • D.4.1
    • Hide

      Resolution - Persuasive :

      Due to the definition of DeviceRequest, it is intended for devices for use by a patient and it is not consistent with existing use cases for eCQMs.

      DeviceRequest is focused on orders/prescriptions for devices intended for use by patients. The QDM datatype Device, Order and Device, Recommended is focused on implantable devices. As such ServiceRequest is more appropriate for existing use cases. However, although not included in existing eCQMs, there is justification for using DeviceRequest especially for use cases such as appropriate orders for non-implantable devices such as Continuous Positive Airway Pressure (CPAP) machines for a diagnosis of obstructive sleep apnea. The use case is already addressed in existing DaVinci examples: Templates and Rules (which references a sleep study procedure and a CPAP DeviceRequest), LookupServiceInitiative _ _ (referencing documentation requirements for CPAP use), and PayerCoverageDecisionExchangeUseCases _ _ (referencing CPAP machines and face masks as devices). Therefore, QI-Core should retain Device _ _ and DeviceRequest _ _and QI-Core should develop a profile for DeviceNotRequested consistent with the other QDM negation rationale concepts.

      Retain DeviceRequest and add DeviceNotRequested.

      DeviceRequest (DeviceNotRequested)

      _Value set for negation:[ http://hl7.org/fhir/extension-valueset-reference.html|http://hl7.org/fhir/extension-valueset-reference.html] _

      status ="completed"

      _doNotPerform is true _

      DeviceRequest.reasonCode (new extension) = use a value set created from a combination of existing eCQM rationale value set (still extensible binding)

      timing = DeviceRequest.authoredOn

      Show
      Resolution - Persuasive : Due to the definition of DeviceRequest, it is intended for devices for use by a patient and it is not consistent with existing use cases for eCQMs. DeviceRequest is focused on orders/prescriptions for devices intended for use by patients. The QDM datatype Device, Order and Device, Recommended is focused on implantable devices. As such ServiceRequest is more appropriate for existing use cases. However, although not included in existing eCQMs, there is justification for using DeviceRequest especially for use cases such as appropriate orders for non-implantable devices such as Continuous Positive Airway Pressure (CPAP) machines for a diagnosis of obstructive sleep apnea. The use case is already addressed in existing DaVinci examples: Templates and Rules (which references a sleep study procedure and a CPAP DeviceRequest), LookupServiceInitiative _ _ (referencing documentation requirements for CPAP use), and PayerCoverageDecisionExchangeUseCases _ _ (referencing CPAP machines and face masks as devices). Therefore, QI-Core should retain Device _ _ and DeviceRequest _ _and QI-Core should develop a profile for DeviceNotRequested consistent with the other QDM negation rationale concepts. Retain DeviceRequest and add DeviceNotRequested. DeviceRequest (DeviceNotRequested) _Value set for negation:[ http://hl7.org/fhir/extension-valueset-reference.html |http://hl7.org/fhir/extension-valueset-reference.html] _ status ="completed" _doNotPerform is true _ DeviceRequest.reasonCode (new extension) = use a value set created from a combination of existing eCQM rationale value set (still extensible binding) timing = DeviceRequest.authoredOn
    • Linda Michaelsen/Peter Muir: 24-0-0
    • Enhancement
    • Compatible, substantive

      The QICoreDeviceRequest profile needs the ability to provide a reason for the doNotPerform. The profile has an extension for doNotPerform, but the reason element of the base resource is listed as only a reason for the request, not a reason why the request should not be performed.

      NOTE: This was submitted as a ballot comment referencing an existing tracker (#20601).

            Assignee:
            cschuler
            Reporter:
            Patricia Craig
            Patricia Craig
            Watchers:
            3 Start watching this issue

              Created:
              Updated:
              Resolved: