=============================================================================== Factors_to_Consider_in_Managing_Chronic_Pain CQL Change Log ------------------------------------------------------------------------------- The following CQL downloads are available on CDS Connect: - Factors_to_Consider_in_Managing_Chronic_Pain_v1.0.0_Pilot_CQL.zip - Factors_to_Consider_in_Managing_Chronic_Pain_v1.1.0_Feb2020_Updates_CQL.zip - Factors_to_Consider_in_Managing_Chronic_Pain_FHIRv400_v1.0.0_CQL.zip =============================================================================== Factors_to_Consider_in_Managing_Chronic_Pain_v1.0.0_Pilot_CQL.zip ------------------------------------------------------------------------------- The Factors_to_Consider_in_Managing_Chronic_Pain_v1.0.0_Pilot_CQL.zip file contains the FHIR DSTU2-based CQL logic files exactly as they were piloted in Summer 2018. Implementors will likely want to use more recent versions, but this version is provided for historical purposes and reference. =============================================================================== Factors_to_Consider_in_Managing_Chronic_Pain_v1.1.0_Feb2020_Updates_CQL.zip ------------------------------------------------------------------------------- The Factors_to_Consider_in_Managing_Chronic_Pain_v1.1.0_Feb2020_Updates_CQL.zip file contains the most recently updated FHIR DSTU2-based CQL logic files. This version has not been piloted in a clinical setting, but is largely based on the initial piloted version. The February 2020 updates introduce the following changes from the initially piloted version of the artifact: - Added the following value sets for identifying Risk Factors for Opiod-Related Harms (in addition to existing ones): - Depression Diagnosis ICD9 (2.16.840.1.113883.3.600.143) - Anxiety Disorders ICD9 (2.16.840.1.113883.3.1240.2017.3.2.1015) - Substance Abuse (2.16.840.1.113883.3.464.1003.106.11.1010) - Pregnancy (New ICD10 codes published in 2018 and 2019) (2.16.840.1.113762.1.4.1032.80) - Changed the Suicide Attempt value set to 2.16.840.1.113762.1.4.1032.102 - Removed specific inclusion of SNOMED-CT 86849004 since it is now in the Suicide Attempt value set - Added LOINC codes for the Pain intensity, Enjoyment of life, General activity scale [PEG] - Previous local codes are still supported (but discouraged) - Added logic to normalize long LOINC display text for PEG codes to shorter names - Added LOINC code for the STarT Back Screening Tool - Previous local code is still supported (but discouraged) - Added logic to display the range for Opioid Risk Tool (ORT) - Updated QuantityText logic to not include '{score}' units (since the scalar number is enough in those cases) - Updated the CDS Connect Commons library to 1.3.1 in order to resolve an implicit conversion from FHIR.Date to System.DateTime that is no longer allowed by the CQL-to-ELM translator. =============================================================================== Factors_to_Consider_in_Managing_Chronic_Pain_FHIRv400_v1.0.0_CQL.zip ------------------------------------------------------------------------------- The Factors_to_Consider_in_Managing_Chronic_Pain_FHIRv400_v1.0.0_CQL.zip file contains FHIR R4-based CQL logic files corresponding to the most recently updated FHIR DSTU2-based CQL logic files. This version has not been piloted in a clinical setting. While the intent of the logic remains the same as the FHIR DSTU2-based version, changes in the FHIR specification (from DSTU2 to R4) require more significant changes to the logic than the February 2020 update to the FHIR DSTU2-based version required. In addition to the changes outline for the February 2020 update to the FHIR DSTU2-based logic, the R4 representation contains the following changes related to the movement from FHIR DSTU2 to FHIR R4: - MedicationOrder is replaced by MedicationRequest, and as a result, the reported type has changed from "Order" to "Request" - MedicationOrder dateWritten is replaced by MedicationRequest authoredOn - MedicationRequest no longer supports the dateEnded property, so end dates will always be blank for MedicationRequests - MedicationStatement no longer supports the wasNotTaken property - Observation adds an "instant" variant of the effective time - Observation's interpretation changed from single-value to multi-value, so the FHIR R4-based CQL only looks at the first interpretation value - Observations now check for verificationStatus "corrected", in addition to "final" and "amended" - Condition no longer supports the abatementBoolean property - Condition's clinicalStatus was changed from a code to a CodeableConcept - Condition's dateRecorded (Date) is replaced by recordedDate (DateTime) - ActiveOrRecurring Conditions now check for clinicalStatus "recurrence" in addition to "active" and "relapse" - ProcedureRequest is replaced by ServiceRequest - ProcedureRequest's orderedOn is replaced by ServiceRequest's authoredOn - ReferralRequest is replaced by ServiceRequest - ProcedureRequest's dateSent is replaced by ServiceRequest's authoredOn - NonPharmacologicTreatmentServiceRequests now queries for active or completed ServiceRequests rather than accepted, in-progress, or completed ProcedureRequests and accepted, active, or completed ReferralRequests - Procedure no longer supports the notDone property - ProcedurePerformance now excludes statuses: preparation, not-done, entered-in-error, and unknown - Due to changes in the CQL model representation of FHIR, choices are now accessed via CQL casts rather than explicit properties