MOPA — Medical Oncology Prior Authorization
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: Oncology CRD Service Capability Statement

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<CapabilityStatement xmlns="http://hl7.org/fhir">
  <id value="ocpa-crd-service"/>
  <language value="en"/>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: CapabilityStatement ocpa-crd-service</b></p><a name="ocpa-crd-service"> </a><a name="hcocpa-crd-service"> </a><h2 id="title">Oncology CRD Service Capability Statement</h2><ul><li>Implementation Guide Version: 0.1.1-snapshot-080926 </li><li>FHIR Version: 4.0.1 </li><li>Supported Formats: <code>json</code>, <code>xml</code></li><li>Published on: 2026-05-04 </li><li>Published by: HL7 International / Clinical Interoperability Council </li></ul><blockquote class="impl-note"><p><strong>Note to Implementers: FHIR Capabilities</strong></p><p>Any FHIR capability may be 'allowed' by the system unless explicitly marked as 'SHALL NOT'. A few items are marked as MAY in the Implementation Guide to highlight their potential relevance to the use case.</p></blockquote><h3 id="shallIGs">SHALL Support the Following Implementation Guides</h3><ul><li><a href="index.html">http://hl7.org/fhir/us/codex-mopa/ImplementationGuide/hl7.fhir.us.codex-mopa</a></li><li><a href="http://hl7.org/fhir/us/davinci-crd/2.2.1/index.html">http://hl7.org/fhir/us/davinci-crd/ImplementationGuide/hl7.fhir.us.davinci-crd</a></li></ul><h2 id="rest">FHIR RESTful Capabilities</h2><div class="panel panel-default"><div class="panel-heading"><h3 id="mode1" class="panel-title">Mode: <code>server</code></h3></div><div class="panel-body"><div><p>A conformant Oncology CRD Service SHALL:</p>
<ol>
<li>Be capable of evaluating the selected anti-cancer regimen <code>RequestGroup</code> and optionally
resolving its instantiated <code>PlanDefinition</code>.</li>
<li>Evaluate patient-specific treatment-intent and line-of-therapy slices carried with the
Da Vinci CRD <code>ext-request-category</code> URL on the RequestGroup. Use
<code>fhirAuthorization</code> — when provided in the CDS Hooks request — to query the EHR FHIR
server for additional required oncology patient context (cancer condition, staging,
biomarkers, performance status, and prior therapy).</li>
<li>Return informational cards at <code>order-select</code> indicating the approvability status of the
ordered regimen. These cards are advisory — the order has not been committed.</li>
<li>Return a final determination at <code>order-sign</code> with the appropriate indicator: <code>success</code>
for Authorization Satisfied, <code>warning</code> for PA-required or DTR-required.</li>
<li>Surface biosimilar substitution requirements at <code>order-select</code> so the provider is
informed of payer modifications before signing.</li>
<li>Return a DTR launch card when required context is not available from the EHR FHIR server.</li>
</ol>
</div></div></div><h3 id="resourcesCap1">Capabilities by Resource/Profile</h3><h4 id="resourcesSummary1">Summary</h4><p>The summary table lists the resources that are part of this configuration, and for each resource it lists:</p><ul><li>The relevant profiles (if any)</li><li>The interactions supported by each resource (<b><span class="bg-info">R</span></b>ead, <b><span class="bg-info">S</span></b>earch, <b><span class="bg-info">U</span></b>pdate, and <b><span class="bg-info">C</span></b>reate, are always shown, while <b><span class="bg-info">VR</span></b>ead, <b><span class="bg-info">P</span></b>atch, <b><span class="bg-info">D</span></b>elete, <b><span class="bg-info">H</span></b>istory on <b><span class="bg-info">I</span></b>nstance, or <b><span class="bg-info">H</span></b>istory on <b><span class="bg-info">T</span></b>ype are only present if at least one of the resources has support for them.</li><li><span>The required, recommended, and some optional search parameters (if any). </span></li><li>The linked resources enabled for <code>_include</code></li><li>The other resources enabled for <code>_revinclude</code></li><li>The operations on the resource (if any)</li></ul><div class="table-responsive"><table class="table table-condensed table-hover"><thead><tr><th><b>Resource Type</b></th><th><b>Profile</b></th><th class="text-center"><b title="GET a resource (read interaction)">R</b></th><th class="text-center"><b title="GET all set of resources of the type (search interaction)">S</b></th><th class="text-center"><b title="PUT a new resource version (update interaction)">U</b></th><th class="text-center"><b title="POST a new resource (create interaction)">C</b></th><th><b title="Required and recommended search parameters">Searches</b></th><th><code><b>_include</b></code></th><th><code><b>_revinclude</b></code></th><th><b>Operations</b></th></tr></thead><tbody><tr><td><a href="#RequestGroup1-1">RequestGroup</a></td><td>Supported Profiles<br/>  <a href="StructureDefinition-anticancer-regimen-requestgroup.html">Anti-Cancer Regimen RequestGroup</a></td><td class="text-center">y</td><td class="text-center"/><td class="text-center"/><td class="text-center"/><td/><td/><td/><td/></tr><tr><td><a href="#PlanDefinition1-2">PlanDefinition</a></td><td>Supported Profiles<br/>  <a href="StructureDefinition-anticancer-regimen-plandefinition.html">Anti-Cancer Regimen PlanDefinition</a></td><td class="text-center">y</td><td class="text-center"/><td class="text-center"/><td class="text-center"/><td/><td/><td/><td/></tr><tr><td><a href="#Condition1-3">Condition</a></td><td> </td><td class="text-center"/><td class="text-center">y</td><td class="text-center"/><td class="text-center"/><td/><td/><td/><td/></tr><tr><td><a href="#Observation1-4">Observation</a></td><td> </td><td class="text-center"/><td class="text-center">y</td><td class="text-center"/><td class="text-center"/><td/><td/><td/><td/></tr><tr><td><a href="#MedicationRequest1-5">MedicationRequest</a></td><td> </td><td class="text-center"/><td class="text-center">y</td><td class="text-center"/><td class="text-center"/><td/><td/><td/><td/></tr></tbody></table></div><hr/><div class="panel panel-default"><div class="panel-heading"><h4 id="RequestGroup1-1" class="panel-title"><span style="float: right;">Resource Conformance: unspecified </span>RequestGroup</h4></div><div class="panel-body"><div class="container"><div class="row"><div class="col-lg-4"><span class="lead">Core FHIR Resource</span><br/><a href="http://hl7.org/fhir/R4/requestgroup.html">RequestGroup</a></div><div class="col-lg-4"><span class="lead">Reference Policy</span><br/></div><div class="col-lg-4"><span class="lead">Interaction summary</span><br/><ul><li>Supports <code>read</code>.</li></ul></div></div><p/><div class="row"><div class="col-6"><span class="lead">Supported Profiles</span><p><a href="StructureDefinition-anticancer-regimen-requestgroup.html">Anti-Cancer Regimen RequestGroup</a></p></div></div><p/><div class="row"><div class="col-12"><span class="lead">Documentation</span><blockquote><div><p>SHALL resolve and evaluate RequestGroup resources received in CDS Hooks context.draftOrders, including the profile-sliced Da Vinci CRD ext-request-category values for treatment intent and line of therapy.</p>
</div></blockquote></div></div></div></div></div><div class="panel panel-default"><div class="panel-heading"><h4 id="PlanDefinition1-2" class="panel-title"><span style="float: right;">Resource Conformance: unspecified </span>PlanDefinition</h4></div><div class="panel-body"><div class="container"><div class="row"><div class="col-lg-4"><span class="lead">Core FHIR Resource</span><br/><a href="http://hl7.org/fhir/R4/plandefinition.html">PlanDefinition</a></div><div class="col-lg-4"><span class="lead">Reference Policy</span><br/></div><div class="col-lg-4"><span class="lead">Interaction summary</span><br/><ul><li>Supports <code>read</code>.</li></ul></div></div><p/><div class="row"><div class="col-6"><span class="lead">Supported Profiles</span><p><a href="StructureDefinition-anticancer-regimen-plandefinition.html">Anti-Cancer Regimen PlanDefinition</a></p></div></div><p/><div class="row"><div class="col-12"><span class="lead">Documentation</span><blockquote><div><p>SHOULD resolve PlanDefinition referenced by RequestGroup.instantiatesCanonical.</p>
</div></blockquote></div></div></div></div></div><div class="panel panel-default"><div class="panel-heading"><h4 id="Condition1-3" class="panel-title"><span style="float: right;">Resource Conformance: unspecified </span>Condition</h4></div><div class="panel-body"><div class="container"><div class="row"><div class="col-lg-4"><span class="lead">Core FHIR Resource</span><br/><a href="http://hl7.org/fhir/R4/condition.html">Condition</a></div><div class="col-lg-4"><span class="lead">Reference Policy</span><br/></div><div class="col-lg-4"><span class="lead">Interaction summary</span><br/><ul><li>Supports <code>search-type</code>.</li></ul></div></div><p/><p/><div class="row"><div class="col-12"><span class="lead">Documentation</span><blockquote><div><p>SHALL query Condition (primary cancer condition) from EHR FHIR server when fhirAuthorization is provided.</p>
</div></blockquote></div></div></div></div></div><div class="panel panel-default"><div class="panel-heading"><h4 id="Observation1-4" class="panel-title"><span style="float: right;">Resource Conformance: unspecified </span>Observation</h4></div><div class="panel-body"><div class="container"><div class="row"><div class="col-lg-4"><span class="lead">Core FHIR Resource</span><br/><a href="http://hl7.org/fhir/R4/observation.html">Observation</a></div><div class="col-lg-4"><span class="lead">Reference Policy</span><br/></div><div class="col-lg-4"><span class="lead">Interaction summary</span><br/><ul><li>Supports <code>search-type</code>.</li></ul></div></div><p/><p/><div class="row"><div class="col-12"><span class="lead">Documentation</span><blockquote><div><p>MAY query Observation for staging, biomarkers, and performance status when required by policy; treatment intent and line of therapy are carried only in RequestGroup ext-request-category values.</p>
</div></blockquote></div></div></div></div></div><div class="panel panel-default"><div class="panel-heading"><h4 id="MedicationRequest1-5" class="panel-title"><span style="float: right;">Resource Conformance: unspecified </span>MedicationRequest</h4></div><div class="panel-body"><div class="container"><div class="row"><div class="col-lg-4"><span class="lead">Core FHIR Resource</span><br/><a href="http://hl7.org/fhir/R4/medicationrequest.html">MedicationRequest</a></div><div class="col-lg-4"><span class="lead">Reference Policy</span><br/></div><div class="col-lg-4"><span class="lead">Interaction summary</span><br/><ul><li>Supports <code>search-type</code>.</li></ul></div></div><p/><p/><div class="row"><div class="col-12"><span class="lead">Documentation</span><blockquote><div><p>SHOULD query MedicationRequest (prior therapy) from EHR FHIR server when relevant.</p>
</div></blockquote></div></div></div></div></div></div>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="cic"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status">
    <valueCode value="informative">
      <extension
                 url="http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom">
        <valueCanonical
                        value="http://hl7.org/fhir/us/codex-mopa/ImplementationGuide/hl7.fhir.us.codex-mopa"/>
      </extension>
    </valueCode>
  </extension>
  <url
       value="http://hl7.org/fhir/us/codex-mopa/CapabilityStatement/ocpa-crd-service"/>
  <version value="0.1.1-snapshot-080926"/>
  <name value="OcpaCrdServiceCapabilityStatement"/>
  <title value="Oncology CRD Service Capability Statement"/>
  <status value="draft"/>
  <experimental value="true"/>
  <date value="2026-05-04"/>
  <publisher value="HL7 International / Clinical Interoperability Council"/>
  <contact>
    <name value="HL7 International / Clinical Interoperability Council"/>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/cic"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="ciclist@lists.HL7.org"/>
    </telecom>
  </contact>
  <description
               value="Capability Statement for systems acting as an **Oncology CRD Service**
(e.g., a payer or prior-authorization platform).  A conformant service claims support for
the Da Vinci CRD oncology profile defined in this IG by meeting the requirements below."/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
      <display value="United States of America"/>
    </coding>
  </jurisdiction>
  <kind value="requirements"/>
  <fhirVersion value="4.0.1"/>
  <format value="json"/>
  <format value="xml"/>
  <implementationGuide
                       value="http://hl7.org/fhir/us/codex-mopa/ImplementationGuide/hl7.fhir.us.codex-mopa"/>
  <implementationGuide
                       value="http://hl7.org/fhir/us/davinci-crd/ImplementationGuide/hl7.fhir.us.davinci-crd"/>
  <rest>
    <mode value="server"/>
    <documentation
                   value="A conformant Oncology CRD Service SHALL:

1. Be capable of evaluating the selected anti-cancer regimen `RequestGroup` and optionally
   resolving its instantiated `PlanDefinition`.
2. Evaluate patient-specific treatment-intent and line-of-therapy slices carried with the
   Da Vinci CRD `ext-request-category` URL on the RequestGroup. Use
   `fhirAuthorization` — when provided in the CDS Hooks request — to query the EHR FHIR
   server for additional required oncology patient context (cancer condition, staging,
   biomarkers, performance status, and prior therapy).
3. Return informational cards at `order-select` indicating the approvability status of the
   ordered regimen. These cards are advisory — the order has not been committed.
4. Return a final determination at `order-sign` with the appropriate indicator: `success`
   for Authorization Satisfied, `warning` for PA-required or DTR-required.
5. Surface biosimilar substitution requirements at `order-select` so the provider is
   informed of payer modifications before signing.
6. Return a DTR launch card when required context is not available from the EHR FHIR server."/>
    <resource>
      <type value="RequestGroup"/>
      <supportedProfile
                        value="http://hl7.org/fhir/us/codex-mopa/StructureDefinition/anticancer-regimen-requestgroup"/>
      <documentation
                     value="SHALL resolve and evaluate RequestGroup resources received in CDS Hooks context.draftOrders, including the profile-sliced Da Vinci CRD ext-request-category values for treatment intent and line of therapy."/>
      <interaction>
        <code value="read"/>
      </interaction>
    </resource>
    <resource>
      <type value="PlanDefinition"/>
      <supportedProfile
                        value="http://hl7.org/fhir/us/codex-mopa/StructureDefinition/anticancer-regimen-plandefinition"/>
      <documentation
                     value="SHOULD resolve PlanDefinition referenced by RequestGroup.instantiatesCanonical."/>
      <interaction>
        <code value="read"/>
      </interaction>
    </resource>
    <resource>
      <type value="Condition"/>
      <documentation
                     value="SHALL query Condition (primary cancer condition) from EHR FHIR server when fhirAuthorization is provided."/>
      <interaction>
        <code value="search-type"/>
      </interaction>
    </resource>
    <resource>
      <type value="Observation"/>
      <documentation
                     value="MAY query Observation for staging, biomarkers, and performance status when required by policy; treatment intent and line of therapy are carried only in RequestGroup ext-request-category values."/>
      <interaction>
        <code value="search-type"/>
      </interaction>
    </resource>
    <resource>
      <type value="MedicationRequest"/>
      <documentation
                     value="SHOULD query MedicationRequest (prior therapy) from EHR FHIR server when relevant."/>
      <interaction>
        <code value="search-type"/>
      </interaction>
    </resource>
  </rest>
</CapabilityStatement>