HL7 FHIR Clinical Guidelines for Hypertension Treatment

Owned by Dave Carlson
Last updated: Sept 29, 2020
2 min read

This page presents a complete executable example using the HL7 FHIR Clinical Guidelines IG. The scope of this example is described on the Hypertension Use Case page, and is aligned with the same example scope implemented using the BPM+ Hypertension Example Models .

Patient Persona

VA Human Factors Engineering (HFE) is developing a collection of Veteran Personas that represent fictional, yet realistic representations of a type of user likely to interact with a product or service in the VA healthcare delivery system. They are data-driven, with each persona representing a unique set of characteristics related to how users interact with a product or service. Patient personas enable the project team to establish an โ€˜empathetic bridgeโ€™ to their users. They can provide a quick, preliminary understanding of the intended users of new teams โ€“ particularly prior to investigating user needs. User personas are particularly helpful in providing an immediate perspective of various user types when considering potential capabilities or design alternatives.

The VA HFE persona for โ€œDanโ€ is well-suited for our Hypertension use case developing/evaluating applications and decision support for Patient-Centered Care Management. We also leverage Danโ€™s persona to illustrate and test the COVID-19 Severity Classification use case because Danโ€™s conditions (age over 65, with hypertension and diabetes) present a patient with higher risk for COVID-19 complications.

Sample Patient Data

As a part of this project, we are creating a set of validated FHIR resources that represent Danโ€™s clinical records, currently using FHIR R4. These resources are continually evolving and are available in a GitHub repository:

CPG-on-FHIR Artifacts

We are implementing support for the Hypertension guidelines by following the HL7 FHIR Clinical Guidelines IG (aka, CPG-on-FHIR), which includes use of:

  • Clinical Quality Language (CQL) to represent guideline recommendations and evaluation strategies.

  • FHIR Library resources that contain the CQL logic files within a FHIR server and enable them to be loaded by the CQL evaluation engine.

  • FHIR PlanDefinition and ActivityDefinition resources that define trigger conditions (via CQL expressions) for evaluation strategies, and ECA rules for guideline recommendations.

  • FHIR ValueSets used by CQL logic.

  • All of these definitions are available on GitHub:

Logica FHIR Sandbox

The FHIR resources for patient and practitioner personas and CPG-on-FHIR artifacts are loaded into a Logica FHIR sandbox for testing and demonstration. See the page, Testing with Logica FHIR Sandbox, for a detailed description on how we are leveraging the Logica sandbox.