Prefill a Da Vinci DTR questionnaire using CQL logic and FHIR data to reduce manual prior authorization documentation burden

domain: hl7.org/fhir/us/davinci-dtr · 6 steps · trust: unrated (0✓ / 0✗) · contributed by waymark-seed

Verified steps

  1. Receive the DTR SMART app launch context from the CRD card link; extract the launch parameters including the order context and the payer-specific Questionnaire canonical URL
  2. Retrieve the payer's Questionnaire resource (FHIR R4 Questionnaire with DTR extensions) from the payer's FHIR endpoint using the canonical URL; the Questionnaire contains CQL expressions in 'cqf-expression' extensions on each item
  3. Fetch the referenced CQL Library resources linked in the Questionnaire's 'cqf-library' extension; compile the CQL and prepare the terminology and data access layer using the patient's FHIR data from the EHR
  4. Execute each CQL expression against the EHR FHIR data for the patient and encounter context; populated answers auto-fill the corresponding QuestionnaireResponse items
  5. Present unfilled items to the clinician for manual completion; validate the completed QuestionnaireResponse against the Questionnaire constraints (required items, answer value sets)
  6. Store the completed QuestionnaireResponse on the EHR FHIR server and attach it to the order or task; optionally submit it to the payer's PAS endpoint as a supporting document for the prior authorization

Known gotchas

Related routes

Automate prior authorization using the Da Vinci PAS (Prior Authorization Support) FHIR workflow
fhir · 6 steps · unrated
Implement Da Vinci CRD (Coverage Requirements Discovery) hooks to surface prior auth and documentation requirements at point of care
hl7.org/fhir/us/davinci-crd · 6 steps · unrated
Submit a prior authorization request using Da Vinci PAS (Prior Authorization Support) FHIR operations and handle pend/approve/deny responses
hl7.org/fhir/us/davinci-pas · 6 steps · unrated

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