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We use DSLs to enable writing rules for all of the following reasons:

  • to create pre-validated constructions of re-usable logic
  • to use logical language more familiar to medical informaticists
  • to reference clinical data constructed as a virtual medical record (vMR)
  • to hide some of the syntactic complexity of Drools

Theere are 39 DSLs used in this URI example, and they fall into several groups, as follows:

DSLs that create and reference intermediate results

We call these intermediate results "Assertions" and they exist in two forms:

  • Internal Data Model as a class named "Assertion" defined as a String, which can be added to a fact list and used for logical inferencing within Drools.  Note that the same Assertion may exist in working memory multiple times

  • Drools Global named "assertions", which is a java HashSet<String> that can be have values added or referenced within Drools, but changes to it will not trigger rules to fire.  However, it can be referenced outside of Drools, both in the jBPM processes, and by OpenCDS at the end of a stateless Drools session.  We use "assertions" both to create intermediate results that we can pass to subsequent steps in a process, and for debugging, since globals continue to exist once control is passed from Drools back to OpenCDS.  Note that there will be no duplicates among the members of the assertions global.

All of our DSLs that create "Assertions" on the RHS of a rule always create both forms of "Assertions", so that it can both trigger logical inferencing, and be seen outside of Drools.  On the other hand, DSLs that reference "Assertions" in the LHS of a rule always reference the class "Assertion", because that is the form that triggers inferencing in Drools. 

DSLs for the LHS include:

  • Assertion.Exists - references that an Assertion containing an enumerated concept code exists in Drools working memory

  • Assertion.Not.Exists - references that a particular Assertion containing an enumerated concept code does not exist in Drools working memory

  • Assertion.String.Exists - references that an Assertion containing a simple string exists in Drools working memory

DSLs for the RHS include:

  • Assert - creates a string using an enumerated concept code, for standardized assertions, e.g., "C3390" which is enumerated in the OpenCDS Apelon instance as "QM HEDIS-FPC 81-100 Percent"
  • Assert.NamedDate - creates a string of a name value pair, separated by an equal-sign, e.g., "importantDate=20140704", which might be useful for debugging
  • Assert.String - allows you to specify a simple string, e.g."ruleABCfired", or "patientNeedsHbA1cTest"

 

DSLs that control the Concept Determination Methods that you want to use in this Knowledge Module

These DSLs are always used in pairs, and serve to constrain the valuesets (aka mapping files) used to map actual data to the concepts used to write the rules.

  • Concept.Det.Clin.Stmt.Identify - LHS, e.g., "Concept for ClinicalStatement is not determined according to [HEDIS 2014]"
  • Concept.Det.Clin.Stmt.Remove - RHS, e.g., ""
  • Concept.Det.Entity.Identify - LHS
  • Concept.Det.Entity.Remove - RHS
  • Concept.Det.Rship.Identify - LHS
  • Concept.Det.Rship.Remove - RHS

 

DSLs that select patient demographics of interest to this Knowledge Module

 

  • Dem.Age.Time
  • Missing.DOB

 

DSLs that select encounters of interest to this Knowledge Module

 

  • Enc.From.NamedList.After.Med.SubDispense.Count.Id
  • Enc.From.NamedList.After.Med.SubDispense.DaysSupply.Active.Count.Id
  • Enc.From.NamedList.Before.After.Enc.Rship.EncDx.Count.Id
  • Enc.From.NamedList.Rship.EncDx.Not.Multiple.Count.Id
  • Enc.Rship.EncDx.Between.Times.Count.Id
  • Enc.Rship.EncDx.Between.Times.Count.Id
  • Enc.Between.Times.Count.Id
  • Set.EncListId.Add.EncListRefs
  • Set.EncListId.EncListRefs.No.Time.Overlap

 

DSLs that initialize variables useful in individual rules

 

  • Init.EvalTime.FpId.EvalpId

 

DSLs that create and inference on new generic facts in working memory

 

  • Insert.EncListRef.As.NamedList
  • Insert.EncListRef.As.NamedList
  • Insert.NamedDate.After.NamedDate
  • Insert.NamedDate.From.Earliest.Enc.In.NamedList
  • NamedDate.Exists.Not.Null
  • NamedEnc.Exists.Not.Null
  • NamedList.Exists.EncListId
  • NamedList.Exists.Not.Empty

 

DSLs that create output structures for this Knowledge Module as ObservationResults in working memory

 

  • Out.Nested.Obs.Num.Denom
  • Out.Assertions
  • Out.Concepts.All.Read
  • Out.Concepts.All.Write
  • Out.Nested.Obs.Num.Denom
  • Out.Root.Obs.Focus.EvalpId

 

DSLs that select Medications of interest to this Knowledge Module

 

  • SubDispense.Med.Between.NamedDates.NoTimes
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