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Resource "low-suicide-risk-order-set" Version "1" (PlanDefinition)

Tags:

XML or JSON representation . provenance for this resource

Id:
PlanDefinition/low-suicide-risk-order-set

Identifier:
value: mmi:low-suicide-risk-order-set

Title:
Low Suicide Risk Order Set

Status:
draft

Description:
Orders to be applied to a patient characterized as low suicide risk.

Purpose:
This order set helps ensure consistent application of appropriate orders for the care of low suicide risk patients.

Usage:
This order set should be applied after assessing a patient for suicide risk, when the findings of that assessment indicate the patient has low suicide risk.

Context:

system: http://hl7.org/fhir/usage-context-type

code: age

value:
system: https://meshb.nlm.nih.gov
code: D000328
display: Adult

Context:

system: http://hl7.org/fhir/usage-context-type

code: focus

value:
system: http://snomed.info/sct
code: 87512008
display: Mild major depression

Context:

system: http://hl7.org/fhir/usage-context-type

code: focus

value:
system: http://snomed.info/sct
code: 40379007
display: Major depression, recurrent, mild

Context:

system: http://hl7.org/fhir/usage-context-type

code: focus

value:
system: http://snomed.info/sct
code: 394687007
display: Low suicide risk

Context:

system: http://hl7.org/fhir/usage-context-type

code: focus

value:
system: http://snomed.info/sct
code: 225337009
display: Suicide risk assessment

Context:

system: http://hl7.org/fhir/usage-context-type

code: user

value:
system: http://snomed.info/sct
code: 309343006
display: Physician

Context:

system: http://hl7.org/fhir/usage-context-type

code: venue

value:
system: http://snomed.info/sct
code: 440655000
display: Outpatient environment

Topic:
text: Suicide risk assessment

Contributor:
author:
Motive Medical Intelligence

Library:
reference: Library/suiciderisk-orderset-logic
display: SuicideRiskLogic

Actions

Step:
title: Suicide Risk Assessment and Outpatient Management
Step:
title: Consults and Referrals
Step:
text: Refer to outpatient mental health program for evaluation and treatment of mental health conditions now
condition:
reference:
#referralToMentalHealthCare
description: refer to primary care mental-health integrated care program for evaluation and treatment of mental health conditions now
category: referral
Step:
title: Medications
Step:
title: First-Line Antidepressants
Step:
title: Selective Serotonin Reuptake Inhibitors (Choose a mazimum of one or document reasons for exception)
Step:
text: citalopram 20 mg tablet 1 tablet oral 1 time daily now (30 table; 3 refills)
condition:
reference:
#citalopramPrescription
category: drug
Step:
text: escitalopram 10 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)
Step:
text: fluoxetine 20 mg capsule 1 capsule oral 1 time daily now (30 tablet; 3 refills)
Step:
text: paroxetine 20 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)
Step:
text: sertraline 50 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)
Step:
text: Dopamine Norepinephrine Reuptake Inhibitors (Choose a maximum of one or document reasons for exception)
Step:
text: Serotonin Norepinephrine Reuptake Inhibitors (Choose a maximum of one or doument reasons for exception)
Step:
text: Norepinephrine-Serotonin Modulators (Choose a maximum of one or document reasons for exception)


<?xml version="1.0" encoding="UTF-8"?>
<PlanDefinition xmlns="http://hl7.org/fhir">
  <id value="low-suicide-risk-order-set"/>
  <meta>
    <versionId value="1"/>
    <lastUpdated value="2018-09-06T12:38:08.453Z"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <table class="grid dict">
        <tr>
          <td>
            <b>Id: </b> </td> </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">PlanDefinition/low-suicide-risk-order-set</td> </tr> </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Identifier: </b> </td> </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>value: </b>
            <span>mmi:low-suicide-risk-order-set</span> </td> </tr> </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Title: </b> </td> </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">Low Suicide Risk Order Set</td> </tr> </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Status: </b> </td> </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">draft</td> </tr> </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Description: </b> </td> </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">Orders to be applied to a patient characterized as low suicide risk.</td> </tr> </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Purpose: </b> </td> </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">This order set helps ensure consistent application of appropriate orders for the care of low suicide risk patients.</td> </tr> </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Usage: </b> </td> </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">This order set should be applied after assessing a patient for suicide risk, when the findings of that assessment indicate the patient has low suicide risk.</td> </tr> </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Context: </b> </td> </tr>
        <tr style="vertical-align: top">
          <td style="padding-right: 25px">
            <p style="padding-left: 25px margin-top: 5px margin-bottom: 5px">
              <b>system: </b>
              <span>http://hl7.org/fhir/usage-context-type</span> </p>
            <p style="padding-left: 25px margin-top: 5px margin-bottom: 5px">
              <b>code: </b>
              <span>age</span> </p>
            <p style="padding-left: 25px margin-top: 5px margin-bottom: 5px">
              <b>value: </b>
              <br/>
              <span>
                <span>
                  <span>
                    <span style="padding-left: 25px">
                      <b>system: </b>
                      <span>https://meshb.nlm.nih.gov</span>
                      <br/> </span>
                    <span style="padding-left: 25px">
                      <b>code: </b>
                      <span>D000328</span>
                      <br/> </span>
                    <span style="padding-left: 25px">
                      <b>display: </b>
                      <span>Adult</span> </span> </span> </span> </span> </p> </td> </tr> </table>
      <table class="grid dict">
        <tr>
          <td>
            <b>Context: </b> </td> </tr>
        <tr style="vertical-align: top">
          <td style="padding-right: 25px">
            <p style="padding-left: 25px margin-top: 5px margin-bottom: 5px">
              <b>system: </b>
              <span>http://hl7.org/fhir/usage-context-type</span> </p>
            <p style="padding-left: 25px margin-top: 5px margin-bottom: 5px">
              <b>code: </b>
              <span>focus</span> </p>
            <p style="padding-left: 25px margin-top: 5px margin-bottom: 5px">
              <b>value: </b>
              <br/>
              <span>
                <span>
                  <span>
                    <span style="padding-left: 25px">
                      <b>system: </b>
                      <span>http://snomed.info/sct</span>
                      <br/> </span>
                    <span style="padding-left: 25px">
                      <b>code: </b>
                      <span>87512008</span>
                      <br/> </span>
                    <span style="padding-left: 25px">
                      <b>display: </b>
                      <span>Mild major depression</span> </span> </span> </span> </span> </p> </td> </tr> </table>
      <table class="grid dict">
        <tr>
          <td>
            <b>Context: </b> </td> </tr>
        <tr style="vertical-align: top">
          <td style="padding-right: 25px">
            <p style="padding-left: 25px margin-top: 5px margin-bottom: 5px">
              <b>system: </b>
              <span>http://hl7.org/fhir/usage-context-type</span> </p>
            <p style="padding-left: 25px margin-top: 5px margin-bottom: 5px">
              <b>code: </b>
              <span>focus</span> </p>
            <p style="padding-left: 25px margin-top: 5px margin-bottom: 5px">
              <b>value: </b>
              <br/>
              <span>
                <span>
                  <span>
                    <span style="padding-left: 25px">
                      <b>system: </b>
                      <span>http://snomed.info/sct</span>
                      <br/> </span>
                    <span style="padding-left: 25px">
                      <b>code: </b>
                      <span>40379007</span>
                      <br/> </span>
                    <span style="padding-left: 25px">
                      <b>display: </b>
                      <span>Major depression, recurrent, mild</span> </span> </span> </span> </span> </p> </td> </tr> </table>
      <table class="grid dict">
        <tr>
          <td>
            <b>Context: </b> </td> </tr>
        <tr style="vertical-align: top">
          <td style="padding-right: 25px">
            <p style="padding-left: 25px margin-top: 5px margin-bottom: 5px">
              <b>system: </b>
              <span>http://hl7.org/fhir/usage-context-type</span> </p>
            <p style="padding-left: 25px margin-top: 5px margin-bottom: 5px">
              <b>code: </b>
              <span>focus</span> </p>
            <p style="padding-left: 25px margin-top: 5px margin-bottom: 5px">
              <b>value: </b>
              <br/>
              <span>
                <span>
                  <span>
                    <span style="padding-left: 25px">
                      <b>system: </b>
                      <span>http://snomed.info/sct</span>
                      <br/> </span>
                    <span style="padding-left: 25px">
                      <b>code: </b>
                      <span>394687007</span>
                      <br/> </span>
                    <span style="padding-left: 25px">
                      <b>display: </b>
                      <span>Low suicide risk</span> </span> </span> </span> </span> </p> </td> </tr> </table>
      <table class="grid dict">
        <tr>
          <td>
            <b>Context: </b> </td> </tr>
        <tr style="vertical-align: top">
          <td style="padding-right: 25px">
            <p style="padding-left: 25px margin-top: 5px margin-bottom: 5px">
              <b>system: </b>
              <span>http://hl7.org/fhir/usage-context-type</span> </p>
            <p style="padding-left: 25px margin-top: 5px margin-bottom: 5px">
              <b>code: </b>
              <span>focus</span> </p>
            <p style="padding-left: 25px margin-top: 5px margin-bottom: 5px">
              <b>value: </b>
              <br/>
              <span>
                <span>
                  <span>
                    <span style="padding-left: 25px">
                      <b>system: </b>
                      <span>http://snomed.info/sct</span>
                      <br/> </span>
                    <span style="padding-left: 25px">
                      <b>code: </b>
                      <span>225337009</span>
                      <br/> </span>
                    <span style="padding-left: 25px">
                      <b>display: </b>
                      <span>Suicide risk assessment</span> </span> </span> </span> </span> </p> </td> </tr> </table>
      <table class="grid dict">
        <tr>
          <td>
            <b>Context: </b> </td> </tr>
        <tr style="vertical-align: top">
          <td style="padding-right: 25px">
            <p style="padding-left: 25px margin-top: 5px margin-bottom: 5px">
              <b>system: </b>
              <span>http://hl7.org/fhir/usage-context-type</span> </p>
            <p style="padding-left: 25px margin-top: 5px margin-bottom: 5px">
              <b>code: </b>
              <span>user</span> </p>
            <p style="padding-left: 25px margin-top: 5px margin-bottom: 5px">
              <b>value: </b>
              <br/>
              <span>
                <span>
                  <span>
                    <span style="padding-left: 25px">
                      <b>system: </b>
                      <span>http://snomed.info/sct</span>
                      <br/> </span>
                    <span style="padding-left: 25px">
                      <b>code: </b>
                      <span>309343006</span>
                      <br/> </span>
                    <span style="padding-left: 25px">
                      <b>display: </b>
                      <span>Physician</span> </span> </span> </span> </span> </p> </td> </tr> </table>
      <table class="grid dict">
        <tr>
          <td>
            <b>Context: </b> </td> </tr>
        <tr style="vertical-align: top">
          <td style="padding-right: 25px">
            <p style="padding-left: 25px margin-top: 5px margin-bottom: 5px">
              <b>system: </b>
              <span>http://hl7.org/fhir/usage-context-type</span> </p>
            <p style="padding-left: 25px margin-top: 5px margin-bottom: 5px">
              <b>code: </b>
              <span>venue</span> </p>
            <p style="padding-left: 25px margin-top: 5px margin-bottom: 5px">
              <b>value: </b>
              <br/>
              <span>
                <span>
                  <span>
                    <span style="padding-left: 25px">
                      <b>system: </b>
                      <span>http://snomed.info/sct</span>
                      <br/> </span>
                    <span style="padding-left: 25px">
                      <b>code: </b>
                      <span>440655000</span>
                      <br/> </span>
                    <span style="padding-left: 25px">
                      <b>display: </b>
                      <span>Outpatient environment</span> </span> </span> </span> </span> </p> </td> </tr> </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Topic: </b> </td> </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <span>
              <b>text: </b>
              <span>Suicide risk assessment</span> </span> </td> </tr> </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Contributor: </b> </td> </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>
              <span>author</span>: </b> </td> </tr>
        <tr>
          <td style="padding-left: 50px padding-right: 25px">Motive Medical Intelligence</td> </tr> </table>
      <p/>
      <table class="grid dict">
        <tr>
          <td>
            <b>Library: </b> </td> </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>reference: </b>
            <span>Library/suiciderisk-orderset-logic</span> </td> </tr>
        <tr>
          <td style="padding-left: 25px padding-right: 25px">
            <b>display: </b>
            <span>SuicideRiskLogic</span> </td> </tr> </table>
      <p/>
      <h2>Actions</h2>
      <p style="width: 100%" class="hierarchy">
        <span>
          <b>Step: </b>
          <br/>
          <span style="padding-left: 25px">
            <b>title: </b>
            <span>Suicide Risk Assessment and Outpatient Management</span>
            <br/> </span>
          <span style="padding-left: 25px">
            <span>
              <b>Step: </b>
              <br/>
              <span style="padding-left: 50px">
                <b>title: </b>
                <span>Consults and Referrals</span>
                <br/> </span>
              <span style="padding-left: 50px">
                <span>
                  <b>Step: </b>
                  <br/>
                  <span style="padding-left: 75px">
                    <b>text: </b>
                    <span>Refer to outpatient mental health program for evaluation and treatment of mental health conditions now</span>
                    <br/> </span>
                  <span style="padding-left: 75px">
                    <b>condition: </b>
                    <br/>
                    <span style="padding-left: 100px">
                      <b>reference: </b>
                      <br/>
                      <span style="padding-left: 125px">#referralToMentalHealthCare</span>
                      <span>
                        <span style="padding-left: 75px">
                          <br/>
                          <span style="padding-left: 100px">
                            <b>description: </b>
                            <span>refer to primary care mental-health integrated care program for evaluation and treatment of mental health conditions now</span>
                            <br/> </span>
                          <span style="padding-left: 100px">
                            <b>category: </b>
                            <span>referral</span>
                            <br/> </span> </span> </span> </span> </span>
                  <span style="padding-left: 50px"/> </span> </span> </span>
            <span>
              <b>Step: </b>
              <br/>
              <span style="padding-left: 50px">
                <b>title: </b>
                <span>Medications</span>
                <br/> </span>
              <span style="padding-left: 50px">
                <span>
                  <b>Step: </b>
                  <br/>
                  <span style="padding-left: 75px">
                    <b>title: </b>
                    <span>First-Line Antidepressants</span>
                    <br/> </span>
                  <span style="padding-left: 75px">
                    <span>
                      <b>Step: </b>
                      <br/>
                      <span style="padding-left: 100px">
                        <b>title: </b>
                        <span>Selective Serotonin Reuptake Inhibitors (Choose a mazimum of one or document reasons for exception)</span>
                        <br/> </span>
                      <span style="padding-left: 100px">
                        <span>
                          <b>Step: </b>
                          <br/>
                          <span style="padding-left: 125px">
                            <b>text: </b>
                            <span>citalopram 20 mg tablet 1 tablet oral 1 time daily now (30 table 3 refills)</span>
                            <br/> </span>
                          <span style="padding-left: 125px">
                            <b>condition: </b>
                            <br/>
                            <span style="padding-left: 150px">
                              <b>reference: </b>
                              <br/>
                              <span style="padding-left: 175px">#citalopramPrescription</span>
                              <span/>
                              <span>
                                <span style="padding-left: 125px">
                                  <br/>
                                  <span style="padding-left: 150px">
                                    <b>category: </b>
                                    <span>drug</span>
                                    <br/> </span> </span> </span>
                              <span/>
                              <span/> </span> </span>
                          <span style="padding-left: 100px"/> </span>
                        <span>
                          <b>Step: </b>
                          <br/>
                          <span style="padding-left: 125px">
                            <b>text: </b>
                            <span>escitalopram 10 mg tablet 1 tablet oral 1 time daily now (30 tablet 3 refills)</span>
                            <br/> </span>
                          <span style="padding-left: 100px"/> </span>
                        <span>
                          <b>Step: </b>
                          <br/>
                          <span style="padding-left: 125px">
                            <b>text: </b>
                            <span>fluoxetine 20 mg capsule 1 capsule oral 1 time daily now (30 tablet 3 refills)</span>
                            <br/> </span>
                          <span style="padding-left: 100px"/> </span>
                        <span>
                          <b>Step: </b>
                          <br/>
                          <span style="padding-left: 125px">
                            <b>text: </b>
                            <span>paroxetine 20 mg tablet 1 tablet oral 1 time daily now (30 tablet 3 refills)</span>
                            <br/> </span>
                          <span style="padding-left: 100px"/> </span>
                        <span>
                          <b>Step: </b>
                          <br/>
                          <span style="padding-left: 125px">
                            <b>text: </b>
                            <span>sertraline 50 mg tablet 1 tablet oral 1 time daily now (30 tablet 3 refills)</span>
                            <br/> </span>
                          <span style="padding-left: 100px"/> </span> </span> </span>
                    <span>
                      <b>Step: </b>
                      <br/>
                      <span style="padding-left: 125px">
                        <b>text: </b>
                        <span>Dopamine Norepinephrine Reuptake Inhibitors (Choose a maximum of one or document reasons for exception)</span>
                        <br/> </span>
                      <span style="padding-left: 75px"/> </span>
                    <span>
                      <b>Step: </b>
                      <br/>
                      <span style="padding-left: 100px">
                        <b>text: </b>
                        <span>Serotonin Norepinephrine Reuptake Inhibitors (Choose a maximum of one or doument reasons for exception)</span>
                        <br/> </span>
                      <span style="padding-left: 75px"/> </span>
                    <span>
                      <b>Step: </b>
                      <br/>
                      <span style="padding-left: 100px">
                        <b>text: </b>
                        <span>Norepinephrine-Serotonin Modulators (Choose a maximum of one or document reasons for exception)</span>
                        <br/> </span>
                      <span style="padding-left: 100px"/> </span> </span> </span> </span> </span> </span> </span> </p> </div>
  </text>
  <contained>
    <ActivityDefinition>
      <id value="referralToMentalHealthCare"/>
      <status value="draft"/>
      <description value="refer to primary care mental-health integrated care program for evaluation and treatment of mental health conditions now"/>
      <kind value="ReferralRequest"/>
      <code>
        <coding>
          <system value="http://snomed.info/sct"/>
          <code value="306206005"/>
        </coding>
        <text value="Referral to service (procedure)"/>
      </code>
      <timingTiming>
        <event>
          <extension url="http://hl7.org/fhir/StructureDefinition/cqif-cqlExpression">
            <valueString value="Now()"/>
          </extension>
        </event>
      </timingTiming>
      <participant>
        <type value="practitioner"/>
      </participant>
    </ActivityDefinition>
  </contained>
  <contained>
    <ActivityDefinition>
      <id value="citalopramPrescription"/>
      <status value="draft"/>
      <kind value="MedicationRequest"/>
      <productReference>
        <reference value="#citalopramMedication"/>
      </productReference>
      <dosage>
        <text value="1 tablet oral 1 time daily"/>
        <timing>
          <repeat>
            <frequency value="1"/>
            <period value="1"/>
            <periodUnit value="d"/>
          </repeat>
        </timing>
        <route>
          <coding>
            <code value="26643006"/>
            <display value="Oral route (qualifier value)"/>
          </coding>
          <text value="Oral route (qualifier value)"/>
        </route>
        <doseQuantity>
          <value value="1"/>
          <unit value="{tbl}"/>
        </doseQuantity>
      </dosage>
      <dynamicValue>
        <path value="dispenseRequest.numberOfRepeatsAllowed"/>
        <expression value="3"/>
      </dynamicValue>
      <dynamicValue>
        <path value="dispenseRequest.quantity"/>
        <expression value="30 &apos;{tbl}&apos;"/>
      </dynamicValue>
    </ActivityDefinition>
  </contained>
  <contained>
    <Medication>
      <id value="citalopramMedication"/>
      <code>
        <coding>
          <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
          <code value="200371"/>
        </coding>
        <text value="citalopram"/>
      </code>
      <form>
        <coding>
          <system value="http://snomed.info/sct"/>
          <code value="385055001"/>
          <display value="Tablet dose form"/>
        </coding>
        <text value="Tablet dose form"/>
      </form>
      <ingredient>
        <itemReference>
          <reference value="#citalopramSubstance"/>
        </itemReference>
        <amount>
          <numerator>
            <value value="20"/>
            <unit value="mg"/>
          </numerator>
          <denominator>
            <value value="1"/>
            <unit value="{tbl}"/>
          </denominator>
        </amount>
      </ingredient>
    </Medication>
  </contained>
  <contained>
    <Substance>
      <id value="citalopramSubstance"/>
      <code>
        <coding>
          <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
          <code value="2556"/>
        </coding>
        <text value="citalopram"/>
      </code>
    </Substance>
  </contained>
  <url value="http://motivemi.com/artifacts/PlanDefinition/low-suicide-risk-order-set"/>
  <identifier>
    <use value="official"/>
    <system value="http://motivemi.com/artifacts"/>
    <value value="mmi:low-suicide-risk-order-set"/>
  </identifier>
  <version value="1.0.0"/>
  <name value="LowSuicideRiskOrderSet"/>
  <title value="Low Suicide Risk Order Set"/>
  <status value="active"/>
  <experimental value="true"/>
  <date value="2015-08-15"/>
  <publisher value="Motive Medical Intelligence"/>
  <description value="Orders to be applied to a patient characterized as low suicide risk."/>
  <purpose value="This order set helps ensure consistent application of appropriate orders for the care of low suicide risk patients."/>
  <usage value="This order set should be applied after assessing a patient for suicide risk, when the findings of that assessment indicate the patient has low suicide risk."/>
  <approvalDate value="2016-03-12"/>
  <lastReviewDate value="2016-08-15"/>
  <effectivePeriod>
    <start value="2016-01-01"/>
    <end value="2017-12-31"/>
  </effectivePeriod>
  <useContext>
    <code>
      <system value="http://hl7.org/fhir/usage-context-type"/>
      <code value="age"/>
    </code>
    <valueCodeableConcept>
      <coding>
        <system value="https://meshb.nlm.nih.gov"/>
        <code value="D000328"/>
        <display value="Adult"/>
      </coding>
    </valueCodeableConcept>
  </useContext>
  <useContext>
    <code>
      <system value="http://hl7.org/fhir/usage-context-type"/>
      <code value="focus"/>
    </code>
    <valueCodeableConcept>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="87512008"/>
        <display value="Mild major depression"/>
      </coding>
    </valueCodeableConcept>
  </useContext>
  <useContext>
    <code>
      <system value="http://hl7.org/fhir/usage-context-type"/>
      <code value="focus"/>
    </code>
    <valueCodeableConcept>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="40379007"/>
        <display value="Major depression, recurrent, mild"/>
      </coding>
    </valueCodeableConcept>
  </useContext>
  <useContext>
    <code>
      <system value="http://hl7.org/fhir/usage-context-type"/>
      <code value="focus"/>
    </code>
    <valueCodeableConcept>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="394687007"/>
        <display value="Low suicide risk"/>
      </coding>
    </valueCodeableConcept>
  </useContext>
  <useContext>
    <code>
      <system value="http://hl7.org/fhir/usage-context-type"/>
      <code value="focus"/>
    </code>
    <valueCodeableConcept>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="225337009"/>
        <display value="Suicide risk assessment"/>
      </coding>
    </valueCodeableConcept>
  </useContext>
  <useContext>
    <code>
      <system value="http://hl7.org/fhir/usage-context-type"/>
      <code value="user"/>
    </code>
    <valueCodeableConcept>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="309343006"/>
        <display value="Physician"/>
      </coding>
    </valueCodeableConcept>
  </useContext>
  <useContext>
    <code>
      <system value="http://hl7.org/fhir/usage-context-type"/>
      <code value="venue"/>
    </code>
    <valueCodeableConcept>
      <coding>
        <system value="http://snomed.info/sct"/>
        <code value="440655000"/>
        <display value="Outpatient environment"/>
      </coding>
    </valueCodeableConcept>
  </useContext>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="US"/>
    </coding>
  </jurisdiction>
  <topic>
    <text value="Suicide risk assessment"/>
  </topic>
  <contributor>
    <type value="author"/>
    <name value="Motive Medical Intelligence"/>
    <contact>
      <telecom>
        <system value="phone"/>
        <value value="415-362-4007"/>
        <use value="work"/>
      </telecom>
      <telecom>
        <system value="email"/>
        <value value="info@motivemi.com"/>
        <use value="work"/>
      </telecom>
    </contact>
  </contributor>
  <contact>
    <telecom>
      <system value="phone"/>
      <value value="415-362-4007"/>
      <use value="work"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="info@motivemi.com"/>
      <use value="work"/>
    </telecom>
  </contact>
  <copyright value="&#169; Copyright 2016 Motive Medical Intelligence. All rights reserved."/>
  <relatedArtifact>
    <type value="derived-from"/>
    <display value="Practice Guideline for the Treatment of Patients with Major Depressive Disorder"/>
    <url value="http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="composed-of"/>
    <resource>
      <reference value="ActivityDefinition/referralPrimaryCareMentalHealth"/>
    </resource>
  </relatedArtifact>
  <relatedArtifact>
    <type value="composed-of"/>
    <resource>
      <reference value="ActivityDefinition/citalopramPrescription"/>
    </resource>
  </relatedArtifact>
  <library>
    <reference value="Library/suiciderisk-orderset-logic"/>
    <display value="SuicideRiskLogic"/>
  </library>
  <action>
    <title value="Suicide Risk Assessment and Outpatient Management"/>
    <action>
      <title value="Consults and Referrals"/>
      <groupingBehavior value="logical-group"/>
      <selectionBehavior value="any"/>
      <action>
        <textEquivalent value="Refer to outpatient mental health program for evaluation and treatment of mental health conditions now"/>
        <definition>
          <reference value="#referralToMentalHealthCare"/>
        </definition>
        <dynamicValue>
          <path value="timing.event"/>
          <expression value="Now()"/>
        </dynamicValue>
        <dynamicValue>
          <path value="specialty"/>
          <expression value="Code &apos;261QM0850X&apos; from SuicideRiskLogic.&quot;NUCC Provider Taxonomy&quot; display &apos;Adult Mental Health&apos;"/>
        </dynamicValue>
        <dynamicValue>
          <path value="occurrenceDateTime"/>
          <expression value="SuicideRiskLogic.ReferralRequestFulfillmentTime"/>
        </dynamicValue>
        <dynamicValue>
          <path value="subject"/>
          <expression value="SuicideRiskLogic.Patient"/>
        </dynamicValue>
        <dynamicValue>
          <path value="requester.agent"/>
          <expression value="SuicideRiskLogic.Practitioner"/>
        </dynamicValue>
        <dynamicValue>
          <path value="reasonCode"/>
          <expression value="SuicideRiskLogic.RiskAssessmentScore"/>
        </dynamicValue>
        <dynamicValue>
          <path value="reasonReference"/>
          <expression value="SuicideRiskLogic.RiskAssessment"/>
        </dynamicValue>
      </action>
    </action>
    <action>
      <title value="Medications"/>
      <groupingBehavior value="logical-group"/>
      <selectionBehavior value="at-most-one"/>
      <action>
        <title value="First-Line Antidepressants"/>
        <documentation>
          <type value="citation"/>
          <document>
            <extension url="http://hl7.org/fhir/StructureDefinition/cqif-qualityOfEvidence">
              <valueCodeableConcept>
                <coding>
                  <system value="http://hl7.org/fhir/evidence-quality"/>
                  <code value="high"/>
                </coding>
                <text value="High Quality"/>
              </valueCodeableConcept>
            </extension>
            <contentType value="text/html"/>
            <url value="http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf"/>
            <title value="Practice Guideline for the Treatment of Patients with Major Depressive Disorder"/>
          </document>
        </documentation>
        <groupingBehavior value="logical-group"/>
        <selectionBehavior value="at-most-one"/>
        <action>
          <title value="Selective Serotonin Reuptake Inhibitors (Choose a mazimum of one or document reasons for exception)"/>
          <documentation>
            <type value="citation"/>
            <document>
              <contentType value="text/html"/>
              <url value="http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6daeb45c-451d-b135-bf8f-2d6dff4b6b01"/>
              <title value="National Library of Medicine. DailyMed website. CITALOPRAM- citalopram hydrobromide tablet, film coated."/>
            </document>
          </documentation>
          <groupingBehavior value="logical-group"/>
          <selectionBehavior value="at-most-one"/>
          <action>
            <textEquivalent value="citalopram 20 mg tablet 1 tablet oral 1 time daily now (30 table 3 refills)"/>
            <definition>
              <reference value="#citalopramPrescription"/>
            </definition>
            <dynamicValue>
              <path value="status"/>
              <expression value="&apos;draft&apos;"/>
            </dynamicValue>
            <dynamicValue>
              <path value="patient"/>
              <expression value="SuicideRiskLogic.Patient"/>
            </dynamicValue>
            <dynamicValue>
              <path value="prescriber"/>
              <expression value="SuicideRiskLogic.Practitioner"/>
            </dynamicValue>
            <dynamicValue>
              <path value="reasonCode"/>
              <expression value="SuicideRiskLogic.RiskAssessmentScore"/>
            </dynamicValue>
            <dynamicValue>
              <path value="reasonReference"/>
              <expression value="SuicideRiskLogic.RiskAssessment"/>
            </dynamicValue>
          </action>
          <action>
            <textEquivalent value="escitalopram 10 mg tablet 1 tablet oral 1 time daily now (30 tablet 3 refills)"/>
          </action>
          <action>
            <textEquivalent value="fluoxetine 20 mg capsule 1 capsule oral 1 time daily now (30 tablet 3 refills)"/>
          </action>
          <action>
            <textEquivalent value="paroxetine 20 mg tablet 1 tablet oral 1 time daily now (30 tablet 3 refills)"/>
          </action>
          <action>
            <textEquivalent value="sertraline 50 mg tablet 1 tablet oral 1 time daily now (30 tablet 3 refills)"/>
          </action>
        </action>
        <action>
          <textEquivalent value="Dopamine Norepinephrine Reuptake Inhibitors (Choose a maximum of one or document reasons for exception)"/>
        </action>
        <action>
          <textEquivalent value="Serotonin Norepinephrine Reuptake Inhibitors (Choose a maximum of one or doument reasons for exception)"/>
        </action>
        <action>
          <textEquivalent value="Norepinephrine-Serotonin Modulators (Choose a maximum of one or document reasons for exception)"/>
        </action>
      </action>
    </action>
  </action>
</PlanDefinition>