hl7/fhir-qi-core

Quality Improvement Core FHIR Profiles

Quality Improvement Core Profiles (QI-Core)

This repository contains the source for the QI-Core implementation guide, which defines a set of FHIR profiles and extensions for use in clinical quality measurement and decision support. The implementation guide is the result of a harmonization of data requirements between the Quality Data Model (QDM) and the virtual Medical Record (vMR).

The implementation guide is based on FHIR version 4.0.1 (R4 release) and depends on the US Core implementation guide (STU 6).

Commits to this repository will automatically trigger a new build of the IG, which will then be published to the following location:

http://build.fhir.org/ig/HL7/fhir-qi-core

Build log is available here:

http://ig-build.fhir.org.s3-website-us-east-1.amazonaws.com/logs/HL7/fhir-qi-core/

Full debugging information is available here:

http://build.fhir.org/ig/HL7/fhir-qi-core/debug.tgz

Local Build

To initially build locally, clone the repository and run the following commands in order below in the root command:

1. _updatePublisher[.bat | .sh] - Process retrieves the current version of the IG publisher and stores it within the input-cache folder. The IG publisher is updated on a regular basis but this process does not have to be executed for every instance of the publication process.

2. _genonce[.bat | .sh] - This initiates the publication process. Launching the .bat file (Windows) or .sh file (Unix/Mac) will launch HL7's IGPublisher program and build/publish the IG one time.

Dependencies

Before the instructions in the above "Local Build" section will work, you need to install several primary dependencies.

Java

Go to http://www.oracle.com/technetwork/java/javase/downloads/ and download the latest (version 8 or higher) JDK for your platform, and install it.

Ruby

Jekyll requires Ruby version 2.1 or greater. Depending on your operating system, you may already have Ruby bundled with it. Otherwise, or if you need a newer version, go to https://www.ruby-lang.org/en/downloads/ for directions.

Jekyll

Go to https://jekyllrb.com and follow the instructions there, for example gem install jekyll bundler. The end result of this should be that the binary "jekyll" is now in your path.

The latest version of the IG publisher is available here:

https://github.com/FHIR/latest-ig-publisher/raw/master/org.hl7.fhir.publisher.jar

fhir-qi-core's Issues

Auto-generated list templates unsuitable for use

The FHIR IG is equipped to autogenerate the following lists from templates:

{% include list-extensions.xhtml %}
{% include list-codesystems.xhtml %}
{% include list-valuesets.xhtml %}

Unfortunately, the result is not very useful, as the the lists are unordered, have bad title/explanations, and fail to include the weirdly named exceptions (such as Encounter Class).

To fix these three issues and employ the templates (improving ease of future edits), we'd need the following:

1. List sorting (would have to raise this with the IG dev team)
2. Improve naming and descriptions of each item (e.g., QICoreCodesystemName -> Codesystem Name)
3. Modify weird names so they get picked up by list template

Need release or tag for 5.0.0-ballot

Please create a tag or release of this github repo for the Sept 2022 ballot version (5.0.0-ballot) (STU 5 Ballot - 2022SEP) before we change master in preparation for 5.0.0 publication.

US Core official urls aren't valid

Causing resolution errors like the following:
Unable to resolve resource 'http://hl7.org/fhir/us/core/ValueSet/us-core-procedure-code'

These errors should be resolved once the official urls are open. This issue is for tracking purposes and doesn't require action.

Need release or tag for 6.0.0-ballot

Please create a tag or release of this github repo for the STU6 Ballot (September 2023) (6.0.0-ballot)

Need release or tag for 5.0.0 Publication

Please create a tag or release of this github repo for the STU5 Publication (v5.0.0)

Missing clinicalTrial and validityPeriod extensions

FHIR STU3 had extensions for Patient.clinicalTrial and MedicationDispense.validityPeriod, but it appears as though they were removed in FHIR R4.

Need to include these extensions in the IG as the QDM to QiCore mappings expect and reference them.

Class names in QUICK should be user-friendly

The Class names as displayed in QUICK appear to be the profile names (e.g. qicore-adverseevent), rather than the user-friendly AdverseEvent. The intent of the QUICK documentation is to provide the author's logical view of the content, so the user-friendly name should be used.

Generated StructureDefinitions aren't referencing the derived profile

When building a derived profile, the baseDefinition element of the generated StructureDefinition reference doesn't reference the derived profile.

This is causing the following line from the template to return the endpoint http://hl7.org/fhir/StructureDefinition/... instead of http://hl7.org/fhir/us/core/StructureDefinition/...

This is likely an issue with the publisher....

Created a workaround here

Remove workaround once fixed in publisher or guidance for other solutions is provided.

system code and display not needed with negation example

[1] https://github.com/HL7/fhir-qi-core/blob/master/resources/procedure-negation-example.xml#L23

Should the following be removed from [1] since the valueset-reference extension was added?

<system value="http://snomed.info/sct"/>
<code value="80146002"/>
<display value="Excision of appendix (procedure)"/>

Probably applicable to other negation examples as well.

Missing links to negation examples FHIR-24045

The following pages are listed in ig.json but are not linked from https://github.com/HL7/fhir-qi-core/blob/master/pages/examples.md

• "Communication-negation-example.html"
• "Immunization-negation-example.html"
• "MedicationAdministration-negation-example.html"
• "MedicationDispense-negation-example.html"
• "MedicationRequest-negation-example.html"
• "Observation-negation-example.html"
• "Procedure-negation-example.html"
• "ServiceRequest-negation-example.html"

Also https://github.com/HL7/fhir-qi-core/blob/master/pages/_includes/qicore-medication-ex.html still has a description suggesting negation, but that example is not a negation example. This was the problem with FHIR-24045, along with the need for negation examples (provided in PR66).

https://jira.hl7.org/browse/FHIR-24045