FHIR R4 PlanDefinition Library

Overview

This asset is a component of MuleSoft Accelerator for Healthcare.

MuleSoft Accelerator for Healthcare enables healthcare providers to unlock critical patient data to build a patient 360 within Salesforce Health Cloud, faster and easier than ever before. The solution includes pre-built APIs, connectors, integration templates, and prescriptive end-to-end reference architecture to bring patient demographics information and COVID-19 test results from any EHR into Health Cloud using HL7 V2 or FHIR standards.

The solution also provides a library of United States Core Data for Interoperability (USCDI) and FHIR R4 resources to help healthcare developers adhere to interoperability needs and jumpstart the development of healthcare digital transformation initiatives.

Use case covered

This resource allows for the definition of various types of plans as a sharable, consumable, and executable artifact. The resource is general enough to support the description of a broad range of clinical artifacts such as clinical decision support rules, order sets and protocols.

This resource is a definition resource from a FHIR workflow perspective - see Workflow, specifically Definition.

A plan definition is a pre-defined group of actions to be taken in particular circumstances, often including conditional elements, options, and other decision points. The resource is flexible enough to be used to represent a variety of workflows, as well as clinical decision support and quality improvement assets, including order sets, protocols, and decision support rules.

PlanDefinitions can contain hierarchical groups of action definitions, where each action definition describes an activity to be performed (often in terms of an ActivityDefinition resource), and each group defines additional behavior, relationships, and applicable conditions between the actions in the overall definition.

In addition to describing what should take place, each action in a plan definition can specify when and whether the action should take place. For when the action should be taken, the trigger element specifies the action should be taken in response to some trigger occurring (such as a particular point in a workflow being reached, or as the result of a prescription being ordered). For whether the action should be taken, the condition element can be used to provide an expression that evaluates to true or false to indicate the applicability of the action to the specific context.

The process of applying a PlanDefinition to a particular context typically produces request resources representing the actions that should be performed, typically grouped within a CarePlan and/or RequestGroup to capture relationships between the resulting request resources.

Each ActivityDefinition is used to construct a specific resource, based on the definition of the activity and combined with contextual information for the particular patient that the plan definition is being applied to.

As with the ActivityDefinition, a PlanDefinition may provide information about how to transform the activity to a specific intent resource, either by specifying a StructureMap that can be used to perform the transformation completely, or by specifying values for specific elements of the resulting resource using dynamicValue elements in the action.

Note that these mechanisms are provided on both the ActivityDefinition and the PlanDefinition to allow both reusable transformation descriptions, as well as customization of those descriptions within specific contexts. As such, the transform descriptions specified on the PlanDefinition override transform descriptions defined on the ActivityDefinition.

Dynamic values within the definitions can be provided by specifying the expression directly, or by referencing an expression defined within a library. For more information on how to reference expressions within resources, refer to the Using Expressions topic.

As an example, the Low Suicide Risk example order set from the Clinical Decision Support Knowledge Artifact Specification can be represented using the PlanDefinition and ActivityDefinition structures: Low Suicide Risk Example Order Set.

In addition to the representation of PlanDefinitions, the $apply operation allows PlanDefinitions to be applied to a specific context such as a patient, practitioner, or institution. For Order Sets specifically, this operation is expected to place the orders defined by the order set, consistent with the service functional requirements defined by the Order Set specification.

This library is used by FHIR R4 PlanDefinition API.

More information about FHIR R4 PlanDefinition specification can be found here.