FHIR Clinical Guidelines Implementation Guide

This implementation guide is a multi-stakeholder effort to use FHIR resources to build shareable and computable representations of the content of clinical care guidelines. The guide focuses on the recommendations of a clinical guideline, establishing patterns, profiles, conformance requirements, and guidance for the patient-independent, as well as analogous patterns for the patient-specific representation of guideline recommendations.

The goals of the implementation guide are:

1. To reduce duplicate development effort involved in the implementation of clinical practice guideline recommendations in clinical systems.
2. To reduce unnecessary and/or unintentional variability in clinical practice guideline implementation.
3. Improve efficiency and effectiveness of guideline dissemination and implementation processes (e.g. decrease time to uptake of clinical best practices)
4. Measure compliance with clinical practice guideline recommendations
5. Improve appropriate compliance with clinical practice guideline recommendations
6. Afford means for full lifecycle feedback loop in best practice development process (e.g. Professional Guideline Development, Learning Health System, Clinical Translational and Implementation Sciences) including basic considerations for discovery to delivery.

Github Repository and Implementation Guide

Repository: https://github.com/HL7/cqf-recommendations

Continuous Integration Build: http://build.fhir.org/ig/HL7/cqf-recommendations/

Latest Publication (STU1 v1.0.0): http://hl7.org/fhir/uv/cpg/

Implementation Guide Proposal

http://wiki.hl7.org/index.php?title=Clinical_Guidelines_FHIR_IG_Proposal

Working Call: On the HL7 Conference Calling Center:

https://www.hl7.org/concalls/CallDetails.cfm?concall=61840

Wednesday 4:00PM ET, 1st and 3rd Wednesdays of each month, next call 2022-06-01

Join Zoom Meeting

https://zoom.us/j/2097018272?pwd=WC9tVWY2NnRTSmVHN21ja3gxeERqZz09

Meeting ID: 209 701 8272
Password: 343027
One tap mobile
+16465588656,,2097018272# US (New York)
+16699009128,,2097018272# US (San Jose)

Will use the conferencing audio, not the HL7 dial-in

Current Status:

FHIR Clinical Guidelines has been published STU 1.0.0: http://hl7.org/fhir/uv/cpg/

Discussion happens on the #cql stream in Zulip: https://chat.fhir.org/#narrow/stream/179220-cql

Some broad next steps are:

• Support publication of content IGs, including:
  • Opioid MME: http://build.fhir.org/ig/cqframework/opioid-mme-r4/
  • Opioid R4: http://build.fhir.org/ig/cqframework/opioid-cds-r4/
  • WHO Core: http://build.fhir.org/ig/who-int/core/
  • WHO Family Planning: http://build.fhir.org/ig/who-int/fp-cds/index.html
  • WHO Sexually Transmitted Infection: http://build.fhir.org/ig/who-int/sti-cds/index.html
  • WHO Antenatal Care: http://build.fhir.org/ig/who-int/anc-cds/
  • USPTF Lung Cancer Screening: http://build.fhir.org/ig/cqframework/lcs-cds/
  • Chronic Pain Management
  • Hypertension
  • COVID-19 Severity Score
• Support testing and implementation of CPG-conforming content
• Support CPG ecosystem capabilities
  • Terminology Service
  • Repository Service
  • Version Manifest
  • ModelInfo Libraries

Informational Resources:

Introductory Slides: CQF-Recommendations.pptx

CQL4CDS Seminar: https://alphora.atlassian.net/wiki/spaces/PUB/blog/2021/03/03/1367605264/CQL+for+CDS+Seminar+-+2+24+2021

Content IG Development:

• Content IG Walkthrough: An introductory tutorial that walks through creating, testing, publishing, and integrating a CQF Recommendation:
  • cqframework/content-ig-walkthrough: A walkthrough of building a FHIR content implementation guide (github.com)
• Atom Plug-in: A plug-in for the Atom editor that supports content authoring use cases
  • cqframework/atom_cql_support (github.com)