Cervical Cancer Screening CDS for OpenMRS
0.1.0 - ci-build International flag

Cervical Cancer Screening CDS for OpenMRS, published by Hopena Health. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/dhes/cervical-cancer-cds/tree/main and changes regularly. See the Directory of published versions

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Official URL: https://hopenahealth.com/fhir/cervical-cancer-cds/ImplementationGuide/hopena.cervical-cancer-cds Version: 0.1.0
Draft as of 2026-04-21 Computable Name: CervicalCancerCDS

This implementation guide provides computable clinical decision support (CDS) for cervical cancer screening and treatment, implementing the WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention, 2nd edition (2021).

Scope

This IG implements Algorithm 5: HPV DNA primary screening with VIA triage for both the general population of women and women living with HIV (WLHIV). It covers the full screening cascade:

  • Screening eligibility and scheduling – age, sex, HIV status, screening interval
  • Triage – VIA assessment of HPV-positive women
  • Treatment – ablation eligibility checklist, modality selection
  • Follow-up – post-treatment and post-triage-negative retesting, WLHIV double follow-up

Target Platform

OpenMRS O3 Reference Application with the FHIR2 module, deployed in low- and middle-income countries (LMICs). The CDS artifacts are platform-agnostic FHIR R4 and CQL, usable with any FHIR-enabled system.

Artifacts

This IG contains:

  • 5 CQL libraries implementing the clinical logic
  • 4 PlanDefinition resources defining ECA (Event-Condition-Action) rules
  • 5 FHIR Library resources wrapping the CQL for FHIR-based evaluation

See the Artifacts page for the complete list.

Technical Approach

Clinical logic is authored in CQL (Clinical Quality Language) and compiled to ELM for runtime evaluation. The CQL uses CIEL terminology codes mapped to SNOMED CT, LOINC, and ICD-10, matching the OpenMRS concept dictionary.

The CDS follows WHO SMART Guidelines L3 conventions: one CQL library per decision table, shared definitions in a common library, PlanDefinition resources for each decision rule.

Decision Modeling and Traceability

This IG includes formal OMG DMN decision model artifacts that document the relationship between the WHO guideline text and the CQL implementation. Two L2 decision models are provided:

  • A textualist model that mirrors the WHO guideline language without interpretation
  • A purposive model that reflects the CQL's concrete, operationalized choices

An Interpretation Register documents every divergence between the two, categorized as Specification, Disambiguation, Inference, or Correction. See the Decision Modeling page for the full methodology.

Dependencies

IGPackageFHIRComment
.. Cervical Cancer Screening CDS for OpenMRShopena.cervical-cancer-cds#0.1.0R4
... HL7 Terminology (THO)hl7.terminology.r4#7.1.0R4Automatically added as a dependency - all IGs depend on HL7 Terminology
... FHIR Extensions Packhl7.fhir.uv.extensions.r4#5.2.0R4Automatically added as a dependency - all IGs depend on the HL7 Extension Pack
... Using CQL with FHIRhl7.fhir.uv.cql#1.0.0R4This IG uses CQL profiles and capabilities provided by the Using CQL With FHIR IG
... FHIR Tooling Extensions IGhl7.fhir.uv.tools.r4#1.1.2R4for example references

IP Statements

This publication includes IP covered under the following statements.