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Except for the Fallback Library, evaluation of an automated processing type Library requires that a measurement has been submitted and that the ProcedureRequest ServiceRequest refers to an ActivityDefinition which refers to the Library, that is, the Library must be used in a CarePlan complex associated with the Patient for which a measurement is submitted.

The Fallback Library

The Fallback Library is a rule that ensures creation of a Task that draws attention to a measurement needing evaluation. It is intended for implicit use in case no other automated processing type library has been set up for a given ProcedureRequest through its ActivityDefinition.

The Library has:

• .type set to automated-processing

• .parameter

  • .use set to in for input

  • .type set to Observation

The Library rule sets up instructions that causes production of a:

a Task with:

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.category set to MeasurementForAssessment (a Coding signifying a measurement should be assessed/evaluated)

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.priority set to routine

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.description set to “Måling til vurdering” which is Danish for measurement to be assessed

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a measurement is submitted.

Library Triaging Against Reference Ranges

This Library is intended for use with an ActivityDefinition which specifies submitting of an Observation where the submitted Observation.value is to be compared against the reference range(s) defined in the ProcedureRequest ServiceRequest associated with the ActivityDefinition.

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Although the example here uses Questionnaire answers of integer type, the principle in the Library can easily be adjusted to processing of coded answers as long as they each have an integer value correspondence.

Library Activating a Self-Treatment

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ServiceRequest

An example use for this Library is to trigger activation of one or more ProcedureRequest ServiceRequest of self-treatment type based on answers (a QuestionnaireResponse) to a Questionnaire or, alternatively, computed from a submitted Observation. In the following, it is assumed that triggering is based on a QuestionnaireResponse.

In the initial state, the CarePlan would contain:

• a number of ProcedureRequestServiceRequest, say, specifying measuring and questionnaire answering activities (this is typical content but irrelevant for activation of the self-treatment activity).

• an active ProcedureRequestServiceRequest, here denoted the trigger ProcedureRequestServiceRequest, specifying answering of the Questionnaire that triggers the self-treatment activity

• an inactive (through a ProcedureRequestServiceRequest.status set to suspended) self-treatment type ProcedureRequestServiceRequest. This could specify an activity to perform a weight measurement or answering of a self-treatment related Questionnaire.

The trigger ProcedureRequest ServiceRequest references an ActivityDefinition which references the Library described below.

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package rules
import org.hl7.fhir.dstu3.model.QuestionnaireResponse
// Further imports omitted for brevity

global com.systematic.ehealth.automatedprocessing.AutomatedProcessingDTO ruleResult

rule "SelfTreatmentProcedureRequestActivationRuleSelfTreatmentServiceRequestActivationRule"

dialect "java"

when
   $questionnaireResponses : Collection()
   $listQrs : ArrayList() from collect (QuestionnaireResponse() from $questionnaireResponses)
then
   QuestionnaireResponse qr = (QuestionnaireResponse)$listQrs.get(0);
   boolean activate = false;
   
   // QuestionnaireResponse examined (omitted), activate set to true when needed
   
   ruleResult.setActivateSelfTreatment(activate);
end

The automated processing reaction to a true parameter passed to setActivateSelfTreatment is described in Activation of suspended Self-treatment type ProcedureRequestServiceRequest.

Calculation Type Library Resource Examples

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• .type set to logic-library

• .parameter[0]

  • .use set to in for input

  • .type set to QuestionnaireResponse

• .parameter[1]

  • .use set to out for output

  • .type set to CodeableConcept

The Library rule sets examines the answers of the QuestionnaireResponse and determines the corresponding SituationQuality Coding(s).

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Prerequisite to submitting the Observation, the QuestionnaireResponse for the said Questionnaire would be passed as parameter to the evaluate operation on the Library, returning one or more Coding for UsageQuality. The returned Coding(s) would then be carried to Observation.ehealth-quality.

The Library type, input and input output are identical to that of Library for Calculating Situation Quality, and the rule differs in that the resulting Coding specifies UsageQuality.

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