-
Notifications
You must be signed in to change notification settings - Fork 3
Pathway Data Model
(For the most up-to-date definitions of the data model, see /src/types/pathways-model.d.ts)
A Pathway is represented as a directed acyclic graph (DAG) comprised of nodes and transitions between those nodes.
-
name: string - the simple name of the pathway; should be unique and meaningful -
description: string - human readable description of the pathway -
library: string - the name of a CQL library that this pathway references. In most cases this will likely be themCODE_Libray.cql -
precondition: list<Precondition> - list of required preconditions that a patient should have, in terms of mCODE data, in order for the current pathway to be applicable -
nodes: object - named key/value pairs ofPathwayNodeobjects -
elm: object - wrapper for preconverted ELM based on the CQL in the pathway-
preconditions: object - preconverted ELM for the CQL from the required preconditions for the patient -
navigational: object - preconverted ELM for the CQL from the nodes in the pathway
-
-
elementName: string - friendly name of the mCODE element in question -
expected: string - friendly name of the expected value for the patient to have -
cql: string - CQL string to fetch data from the patient, must return a tuple with 2 fields:-
value- the actual value from the patient -
match- boolean flag indicating whethervalueis a match forexpected. (i.e, there will be many instances where equivalence is more broad than equality. The CQL should check for code matching within hierarchies, among other things)
-
PathwayNode is abstract - all instances must either be Action nodes or Branch nodes.
-
label: string - the title of the PathwayNode, a short description of what this node represents. This should always be visible in the UI, even if the node is collapsed. -
transitions: list<Transition> - list of transitions out from this node. Branch nodes will always have multiple options, Action nodes may have a single option, or multiple options representing a "choice" - i.e., the pathway action allows for either option but the final decision is left to the clinician
An action node represents actions within the pathway which the oncologist may accept or decline, such as procedures, prescriptions, etc.
An action node will transition out to one or more nodes, where during execution only one path will be chosen. If multiple transitions are provided, these represent "treatment options" within the pathway where the choice is left up to the user.
-
action: list<Action> : list of all actions involved with this action node. For example a drug regimen may contain multiple MedicationRequests, etc. The intent of these is that there is no inherent sequence necessary and all may be initiated in parallel. All of these actions must be represented in thecqlsuch that the node is identified as complete if and only if all the actions within the node have been completed. -
cql: string - a CQL snippet which will produce a Documentation Resource pointing to the relevant FHIR resource(s) that this action creates. For instance if the node represents a procedure to be performed, this CQL will fetch and return the corresponding Procedure FHIR resource.
(inspired by CDS Hooks -- see https://cds-hooks.org/specification/1.0/#action)
-
type: string - "create" or "update" -
description: string - human readable description of what the action represents -
resource: object - template FHIR resource(s) to be added to or updated on the patient record
A Branch node represents a "fork in the road" where the flow of the module is directed by some logical condition. A branch node will transition out to two or more nodes, where during execution only one path will be chosen.
-
transition: string - the key of the node to transition to -
condition: object? - (optional: only transitions from branch nodes will have conditions)-
description: string - human readable description of the condition that would lead to this transition being taken -
cql: string - CQL snippet that returns a Documentation Resource pointing to documentation of the given query, if this transition should be taken. (for example, if the transition should be taken for patients with tumor marker of HER2+, the CQL should return the TumorMarkerTest Observation for documentation)
-
-
elementName: string - friendly name of the mCODE element -
expected: string - friendly human readable description of the expected value -
actual: string - result from the patient's record indicating the actual value of the selected mCODE element -
match: boolean - whether or notexpectedmatchesactual. Note that in most cases strict string/number equality checking is insufficient
-
patientId: string - identifier for the patient (ie, theidfield from the Patient FHIR resource) -
currentNodes: string[] - all possible nodes which are marked as current. This could be one node with a documentation resource which is incomplete or a list of the next nodes to move to -
documentation: list<(Documentation)> - the documentation for each node with a resource associated to it -
path: list<string> - the sequence of node names indicating the path the patient has taken so far through the pathway. This is all nodes who have an associated documentation
The impetus for the documentation is that the CQL execution engine does not work with raw FHIR but with FHIR-like models, and as such does not return raw FHIR from queries. The idea here is that instead of trying to rebuild the FHIR using a complex CQL query, we will instead just query enough information to re-fetch the relevant FHIR if necessary. (ex, the resourceType and ID)
-
node: string - Name of the node for which this resource was fetched
Extends Documentation with the resource properties of the associated node.
-
resourceType: string - The resourceType of the FHIR resource that was returned (ex, Procedure, MedicationRequest, etc) -
id: string - The id field from the FHIR resource that was returned, to allow for a query to fetch the full resource. -
status: string - Status code from the FHIR resource. (TODO: there may need to be some processing on this)