FHIR © HL7.org  |  Server Home  |  Health Intersections FHIR Server v1.0.262  |  FHIR Version 3.5.0  | User: ANONYMOUS (Unknown)  

History Record

XML or JSON representation

Links: First Previous Next Last  (18 found). Search: http://test.fhir.org/r4/PlanDefinition/_history?&_prior=2018-10-20T17:10:31.187Z&_format=text/xhtml&history-id=3463540f-062b-4190-845c-260364596c 

PlanDefinition "zika-virus-intervention" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Id:
PlanDefinition/zika-virus-intervention

Identifier:
value: zika-virus-intervention

Title:
Example Zika Virus Intervention

Status:
active

Description:
Zika Virus Management intervention describing the CDC Guidelines for Zika Virus Reporting and Management.

Topic:
text: Zika Virus Management

Library:
reference: Library/zika-virus-intervention-logic

Actions

Step:
title: Zika Virus Assessment
condition:
type: applicability
expression: Is Patient Pregnant
Step:
condition:
type: applicability
expression: Should Administer Zika Virus Exposure Assessment
condition:
reference:
#administer-zika-virus-exposure-assessment
description: Administer Zika Virus Exposure Assessment
category: procedure
Step:
condition:
type: applicability
expression: Should Order Serum + Urine rRT-PCR Test
condition:
reference:
ActivityDefinition/order-serum-urine-rrt-pcr-test
Step:
condition:
type: applicability
expression: Should Order Serum Zika Virus IgM + Dengue Virus IgM
condition:
reference:
#order-serum-zika-dengue-virus-igm
description: Order Serum Zika and Dengue Virus IgM
related:
type: documentation
display: Explanation of diagnostic tests for Zika virus and which to use based on the patients clinical and exposure history.
category: diagnostic
Step:
condition:
type: applicability
expression: Should Consider IgM Antibody Testing
condition:
reference:
ActivityDefinition/consider-igm-antibody-testing
Step:
condition:
type: applicability
expression: Should Provide Mosquito Prevention and Contraception Advice
Step:
condition:
reference:
#provide-mosquito-prevention-advice
description: Provide mosquito prevention advice
related:
type: documentation
display: Advice for patients about how to avoid Mosquito bites.
related:
type: documentation
display: Advice for patients about which mosquito repellents are effective and safe to use in pregnancy. [DEET, IF3535 and Picardin are safe during]
category: communication
Step:
condition:
reference:
ActivityDefinition/provide-contraception-advice


{
  "resourceType" : "PlanDefinition",
  "id" : "zika-virus-intervention",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2018-09-06T12:48:29.046Z"
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Id: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">PlanDefinition/zika-virus-intervention</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Identifier: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <b>value: </b>\n <span>zika-virus-intervention</span>\n </td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Title: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">Example Zika Virus Intervention</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Status: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">active</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Description: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">Zika Virus Management intervention describing the CDC Guidelines for Zika Virus Reporting and Management.</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Topic: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <span>\n <b>text: </b>\n <span>Zika Virus Management</span>\n </span>\n </td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Library: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <b>reference: </b>\n <span>Library/zika-virus-intervention-logic</span>\n </td>\n </tr>\n </table>\n <p/>\n <h2>Actions</h2>\n <p style=\"width: 100%;\" class=\"hierarchy\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 25px;\">\n <b>title: </b>\n <span>Zika Virus Assessment</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 50px;\">\n <b>type: </b>\n <span>applicability</span>\n <br/>\n </span>\n <span style=\"padding-left: 50px;\">\n <b>expression: </b>\n <span>Is Patient Pregnant</span>\n <br/>\n </span>\n </span>\n <span style=\"padding-left: 25px;\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 50px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 75px;\">\n <b>type: </b>\n <span>applicability</span>\n <br/>\n </span>\n <span style=\"padding-left: 75px;\">\n <b>expression: </b>\n <span>Should Administer Zika Virus Exposure Assessment</span>\n <br/>\n </span>\n </span>\n <span style=\"padding-left: 50px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 75px;\">\n <b>reference: </b>\n <br/>\n <span style=\"padding-left: 100px;\">#administer-zika-virus-exposure-assessment</span>\n <br/>\n <span>\n&#9;&#9;&#9;&#9;&#9;&#9;&#9; <span style=\"padding-left: 75px;\">\n&#9;&#9;&#9;&#9;&#9;&#9;&#9;&#9;<b>description: </b>\n&#9;&#9;&#9;&#9;&#9;&#9;&#9;&#9;<span>Administer Zika Virus Exposure Assessment</span>\n&#9;&#9;&#9;&#9;&#9;&#9;&#9;&#9;<br/>\n&#9;&#9;&#9;&#9;&#9;&#9;&#9; </span>\n&#9;&#9;&#9;&#9;&#9;&#9;&#9; <span style=\"padding-left: 75px;\">\n&#9;&#9;&#9;&#9;&#9;&#9;&#9;&#9;<b>category: </b>\n&#9;&#9;&#9;&#9;&#9;&#9;&#9;&#9;<span>procedure</span>\n&#9;&#9;&#9;&#9;&#9;&#9;&#9;&#9;<br/>\n&#9;&#9;&#9;&#9;&#9;&#9;&#9; </span>\n </span>\n </span>\n </span>\n <span style=\"padding-left: 50px;\"/>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 75px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>type: </b>\n <span>applicability</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\">\n <b>expression: </b>\n <span>Should Order Serum + Urine rRT-PCR Test</span>\n <br/>\n </span>\n </span>\n <span style=\"padding-left: 75px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>reference: </b>\n <br/>\n <span style=\"padding-left: 125px;\">ActivityDefinition/order-serum-urine-rrt-pcr-test</span>\n <br/>\n </span>\n </span>\n <span style=\"padding-left: 50px;\"/>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 75px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>type: </b>\n <span>applicability</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\">\n <b>expression: </b>\n <span>Should Order Serum Zika Virus IgM + Dengue Virus IgM</span>\n <br/>\n </span>\n </span>\n <span style=\"padding-left: 75px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>reference: </b>\n <br/>\n <span style=\"padding-left: 125px;\">#order-serum-zika-dengue-virus-igm</span>\n <br/>\n <span>\n <span style=\"padding-left: 50px;\">\n <span style=\"padding-left: 50px;\">\n <b>description: </b>\n <span>Order Serum Zika and Dengue Virus IgM</span>\n <br/>\n </span>\n <span style=\"padding-left: 75px;\">\n <b>related:</b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>type: </b>\n <span>documentation</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\">\n <b>display: </b>\n <span>Explanation of diagnostic tests for Zika virus and which to use based on the patients clinical and exposure history.</span>\n <br/>\n </span>\n </span>\n <span style=\"padding-left: 100px;\">\n <b>category: </b>\n <span>diagnostic</span>\n <br/>\n </span>\n </span>\n </span>\n <span/>\n </span>\n </span>\n <span style=\"padding-left: 50px;\"/>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 75px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>type: </b>\n <span>applicability</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\">\n <b>expression: </b>\n <span>Should Consider IgM Antibody Testing</span>\n <br/>\n </span>\n </span>\n <span style=\"padding-left: 75px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>reference: </b>\n <br/>\n <span style=\"padding-left: 125px;\">ActivityDefinition/consider-igm-antibody-testing</span>\n <br/>\n </span>\n </span>\n <span style=\"padding-left: 50px;\"/>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 75px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>type: </b>\n <span>applicability</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\">\n <b>expression: </b>\n <span>Should Provide Mosquito Prevention and Contraception Advice</span>\n <br/>\n </span>\n </span>\n <span style=\"padding-left: 50px;\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 75px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>reference: </b>\n <br/>\n <span style=\"padding-left: 125px;\">#provide-mosquito-prevention-advice</span>\n <span>\n <span style=\"padding-left: 75px;\">\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>description: </b>\n <span>Provide mosquito prevention advice</span>\n <br/>\n </span>\n <span style=\"padding-left: 75px;\">\n <b>related:</b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>type: </b>\n <span>documentation</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\">\n <b>display: </b>\n <span>Advice for patients about how to avoid Mosquito bites.</span>\n <br/>\n </span>\n </span>\n <span style=\"padding-left: 75px;\">\n <b>related:</b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>type: </b>\n <span>documentation</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\">\n <b>display: </b>\n <span>Advice for patients about which mosquito repellents are effective and safe to use in pregnancy. [DEET, IF3535 and Picardin are safe during]</span>\n <br/>\n </span>\n </span>\n <span style=\"padding-left: 100px;\">\n <b>category: </b>\n <span>communication</span>\n <br/>\n </span>\n </span>\n </span>\n </span>\n </span>\n <span style=\"padding-left: 75px;\"/>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 75px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>reference: </b>\n <br/>\n <span style=\"padding-left: 125px;\">ActivityDefinition/provide-contraception-advice</span>\n <br/>\n </span>\n </span>\n </span>\n </span>\n </span>\n </span>\n </span>\n </p>\n </div>"
  },
  "url" : "http://example.org/PlanDefinition/zika-virus-intervention",
  "identifier" : [
    {
      "use" : "official",
      "value" : "zika-virus-intervention"
    }
  ],
  "version" : "2.0.0",
  "title" : "Example Zika Virus Intervention",
  "status" : "active",
  "date" : "2017-01-12",
  "description" : "Zika Virus Management intervention describing the CDC Guidelines for Zika Virus Reporting and Management.",
  "topic" : [
    {
      "text" : "Zika Virus Management"
    }
  ],
  "relatedArtifact" : [
    {
      "type" : "derived-from",
      "url" : "https://www.cdc.gov/mmwr/volumes/65/wr/mm6539e1.htm?s_cid=mm6539e1_w"
    },
    {
      "type" : "predecessor",
      "resource" : "PlanDefinition/zika-virus-intervention-initial"
    }
  ],
  "library" : [
    "Library/zika-virus-intervention-logic"
  ],
  "action" : [
    {
      "title" : "Zika Virus Assessment",
      "trigger" : [
        {
          "type" : "named-event",
          "name" : "patient-view"
        }
      ],
      "condition" : [
        {
          "kind" : "applicability",
          "expression" : {
            "language" : "text/cql",
            "expression" : "Is Patient Pregnant"
          }
        }
      ],
      "action" : [
        {
          "condition" : [
            {
              "kind" : "applicability",
              "expression" : {
                "language" : "text/cql",
                "expression" : "Should Administer Zika Virus Exposure Assessment"
              }
            }
          ],
          "definition" : "ActivityDefinition/administer-zika-virus-exposure-assessment"
        },
        {
          "condition" : [
            {
              "kind" : "applicability",
              "expression" : {
                "language" : "text/cql",
                "expression" : "Should Order Serum + Urine rRT-PCR Test"
              }
            }
          ],
          "definition" : "ActivityDefinition/order-serum-urine-rrt-pcr-test"
        },
        {
          "condition" : [
            {
              "kind" : "applicability",
              "expression" : {
                "language" : "text/cql",
                "expression" : "Should Order Serum Zika Virus IgM + Dengue Virus IgM"
              }
            }
          ],
          "definition" : "ActivityDefinition/order-serum-zika-dengue-virus-igm"
        },
        {
          "condition" : [
            {
              "kind" : "applicability",
              "expression" : {
                "language" : "text/cql",
                "expression" : "Should Consider IgM Antibody Testing"
              }
            }
          ],
          "definition" : "ActivityDefinition/consider-igm-antibody-testing"
        },
        {
          "condition" : [
            {
              "kind" : "applicability",
              "expression" : {
                "language" : "text/cql",
                "expression" : "Should Provide Mosquito Prevention and Contraception Advice"
              }
            }
          ],
          "action" : [
            {
              "definition" : "ActivityDefinition/provide-mosquito-prevention-advice"
            },
            {
              "definition" : "ActivityDefinition/provide-contraception-advice"
            }
          ]
        }
      ]
    }
  ]
}

PlanDefinition "zika-virus-intervention-initial" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Id:
PlanDefinition/zika-virus-intervention-initial

Identifier:
value: zika-virus-intervention

Title:
Example Zika Virus Intervention

Status:
active

Description:
Zika Virus Management intervention describing the CDC Guidelines for Zika Virus Reporting and Management.

Topic:
text: Zika Virus Management

Library:
reference: Library/zika-virus-intervention-logic

Actions

Step:
title: Zika Virus Assessment
condition:
type: applicability
expression: Is Patient Pregnant
Step:
condition:
type: applicability
expression: Should Administer Zika Virus Exposure Assessment
condition:
reference:
#administer-zika-virus-exposure-assessment
description: Administer Zika Virus Exposure Assessment
category: procedure
Step:
condition:
type: applicability
expression: Should Order Serum + Urine rRT-PCR Test
condition:
reference:
ActivityDefinition/order-serum-urine-rrt-pcr-test
Step:
condition:
type: applicability
expression: Should Order Serum Zika Virus IgM + Dengue Virus IgM
condition:
reference:
#order-serum-zika-dengue-virus-igm
description: Order Serum Zika and Dengue Virus IgM
related:
type: documentation
display: Explanation of diagnostic tests for Zika virus and which to use based on the patients clinical and exposure history.
category: diagnostic
Step:
condition:
type: applicability
expression: Should Consider IgM Antibody Testing
condition:
reference:
ActivityDefinition/consider-igm-antibody-testing
Step:
condition:
type: applicability
expression: Should Provide Mosquito Prevention and Contraception Advice
Step:
condition:
reference:
#provide-mosquito-prevention-advice
description: Provide mosquito prevention advice
related:
type: documentation
display: Advice for patients about how to avoid Mosquito bites.
related:
type: documentation
display: Advice for patients about which mosquito repellents are effective and safe to use in pregnancy. [DEET, IF3535 and Picardin are safe during]
category: communication
Step:
condition:
reference:
ActivityDefinition/provide-contraception-advice


{
  "resourceType" : "PlanDefinition",
  "id" : "zika-virus-intervention-initial",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2018-09-06T12:48:28.968Z"
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Id: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">PlanDefinition/zika-virus-intervention-initial</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Identifier: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <b>value: </b>\n <span>zika-virus-intervention</span>\n </td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Title: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">Example Zika Virus Intervention</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Status: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">active</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Description: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">Zika Virus Management intervention describing the CDC Guidelines for Zika Virus Reporting and Management.</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Topic: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <span>\n <b>text: </b>\n <span>Zika Virus Management</span>\n </span>\n </td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Library: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <b>reference: </b>\n <span>Library/zika-virus-intervention-logic</span>\n </td>\n </tr>\n </table>\n <p/>\n <h2>Actions</h2>\n <p style=\"width: 100%;\" class=\"hierarchy\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 25px;\">\n <b>title: </b>\n <span>Zika Virus Assessment</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 50px;\">\n <b>type: </b>\n <span>applicability</span>\n <br/>\n </span>\n <span style=\"padding-left: 50px;\">\n <b>expression: </b>\n <span>Is Patient Pregnant</span>\n <br/>\n </span>\n </span>\n <span style=\"padding-left: 25px;\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 50px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 75px;\">\n <b>type: </b>\n <span>applicability</span>\n <br/>\n </span>\n <span style=\"padding-left: 75px;\">\n <b>expression: </b>\n <span>Should Administer Zika Virus Exposure Assessment</span>\n <br/>\n </span>\n </span>\n <span style=\"padding-left: 50px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 75px;\">\n <b>reference: </b>\n <br/>\n <span style=\"padding-left: 100px;\">#administer-zika-virus-exposure-assessment</span>\n <br/>\n <span>\n&#9;&#9;&#9;&#9;&#9;&#9;&#9; <span style=\"padding-left: 75px;\">\n&#9;&#9;&#9;&#9;&#9;&#9;&#9;&#9;<b>description: </b>\n&#9;&#9;&#9;&#9;&#9;&#9;&#9;&#9;<span>Administer Zika Virus Exposure Assessment</span>\n&#9;&#9;&#9;&#9;&#9;&#9;&#9;&#9;<br/>\n&#9;&#9;&#9;&#9;&#9;&#9;&#9; </span>\n&#9;&#9;&#9;&#9;&#9;&#9;&#9; <span style=\"padding-left: 75px;\">\n&#9;&#9;&#9;&#9;&#9;&#9;&#9;&#9;<b>category: </b>\n&#9;&#9;&#9;&#9;&#9;&#9;&#9;&#9;<span>procedure</span>\n&#9;&#9;&#9;&#9;&#9;&#9;&#9;&#9;<br/>\n&#9;&#9;&#9;&#9;&#9;&#9;&#9; </span>\n </span>\n </span>\n </span>\n <span style=\"padding-left: 50px;\"/>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 75px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>type: </b>\n <span>applicability</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\">\n <b>expression: </b>\n <span>Should Order Serum + Urine rRT-PCR Test</span>\n <br/>\n </span>\n </span>\n <span style=\"padding-left: 75px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>reference: </b>\n <br/>\n <span style=\"padding-left: 125px;\">ActivityDefinition/order-serum-urine-rrt-pcr-test</span>\n <br/>\n </span>\n </span>\n <span style=\"padding-left: 50px;\"/>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 75px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>type: </b>\n <span>applicability</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\">\n <b>expression: </b>\n <span>Should Order Serum Zika Virus IgM + Dengue Virus IgM</span>\n <br/>\n </span>\n </span>\n <span style=\"padding-left: 75px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>reference: </b>\n <br/>\n <span style=\"padding-left: 125px;\">#order-serum-zika-dengue-virus-igm</span>\n <br/>\n <span>\n <span style=\"padding-left: 50px;\">\n <span style=\"padding-left: 50px;\">\n <b>description: </b>\n <span>Order Serum Zika and Dengue Virus IgM</span>\n <br/>\n </span>\n <span style=\"padding-left: 75px;\">\n <b>related:</b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>type: </b>\n <span>documentation</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\">\n <b>display: </b>\n <span>Explanation of diagnostic tests for Zika virus and which to use based on the patients clinical and exposure history.</span>\n <br/>\n </span>\n </span>\n <span style=\"padding-left: 100px;\">\n <b>category: </b>\n <span>diagnostic</span>\n <br/>\n </span>\n </span>\n </span>\n <span/>\n </span>\n </span>\n <span style=\"padding-left: 50px;\"/>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 75px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>type: </b>\n <span>applicability</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\">\n <b>expression: </b>\n <span>Should Consider IgM Antibody Testing</span>\n <br/>\n </span>\n </span>\n <span style=\"padding-left: 75px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>reference: </b>\n <br/>\n <span style=\"padding-left: 125px;\">ActivityDefinition/consider-igm-antibody-testing</span>\n <br/>\n </span>\n </span>\n <span style=\"padding-left: 50px;\"/>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 75px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>type: </b>\n <span>applicability</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\">\n <b>expression: </b>\n <span>Should Provide Mosquito Prevention and Contraception Advice</span>\n <br/>\n </span>\n </span>\n <span style=\"padding-left: 50px;\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 75px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>reference: </b>\n <br/>\n <span style=\"padding-left: 125px;\">#provide-mosquito-prevention-advice</span>\n <span>\n <span style=\"padding-left: 75px;\">\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>description: </b>\n <span>Provide mosquito prevention advice</span>\n <br/>\n </span>\n <span style=\"padding-left: 75px;\">\n <b>related:</b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>type: </b>\n <span>documentation</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\">\n <b>display: </b>\n <span>Advice for patients about how to avoid Mosquito bites.</span>\n <br/>\n </span>\n </span>\n <span style=\"padding-left: 75px;\">\n <b>related:</b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>type: </b>\n <span>documentation</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\">\n <b>display: </b>\n <span>Advice for patients about which mosquito repellents are effective and safe to use in pregnancy. [DEET, IF3535 and Picardin are safe during]</span>\n <br/>\n </span>\n </span>\n <span style=\"padding-left: 100px;\">\n <b>category: </b>\n <span>communication</span>\n <br/>\n </span>\n </span>\n </span>\n </span>\n </span>\n <span style=\"padding-left: 75px;\"/>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 75px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>reference: </b>\n <br/>\n <span style=\"padding-left: 125px;\">ActivityDefinition/provide-contraception-advice</span>\n <br/>\n </span>\n </span>\n </span>\n </span>\n </span>\n </span>\n </span>\n </p>\n </div>"
  },
  "url" : "http://example.org/PlanDefinition/zika-virus-intervention",
  "identifier" : [
    {
      "use" : "official",
      "value" : "zika-virus-intervention"
    }
  ],
  "version" : "1.0.0",
  "title" : "Example Zika Virus Intervention",
  "status" : "active",
  "date" : "2016-11-14",
  "description" : "Zika Virus Management intervention describing the CDC Guidelines for Zika Virus Reporting and Management.",
  "topic" : [
    {
      "text" : "Zika Virus Management"
    }
  ],
  "relatedArtifact" : [
    {
      "type" : "derived-from",
      "url" : "https://www.cdc.gov/mmwr/volumes/65/wr/mm6539e1.htm?s_cid=mm6539e1_w"
    },
    {
      "type" : "successor",
      "resource" : "PlanDefinition/zika-virus-intervention"
    }
  ],
  "library" : [
    "Library/zika-virus-intervention-logic"
  ],
  "action" : [
    {
      "title" : "Zika Virus Assessment",
      "trigger" : [
        {
          "type" : "named-event",
          "name" : "patient-view"
        }
      ],
      "condition" : [
        {
          "kind" : "applicability",
          "expression" : {
            "language" : "text/cql",
            "expression" : "Is Patient Pregnant"
          }
        }
      ],
      "action" : [
        {
          "condition" : [
            {
              "kind" : "applicability",
              "expression" : {
                "language" : "text/cql",
                "expression" : "Should Administer Zika Virus Exposure Assessment"
              }
            }
          ],
          "definition" : "ActivityDefinition/administer-zika-virus-exposure-assessment"
        },
        {
          "condition" : [
            {
              "kind" : "applicability",
              "expression" : {
                "language" : "text/cql",
                "expression" : "Should Order Serum + Urine rRT-PCR Test"
              }
            }
          ],
          "definition" : "ActivityDefinition/order-serum-urine-rrt-pcr-test"
        },
        {
          "condition" : [
            {
              "kind" : "applicability",
              "expression" : {
                "language" : "text/cql",
                "expression" : "Should Order Serum Zika Virus IgM + Dengue Virus IgM"
              }
            }
          ],
          "definition" : "ActivityDefinition/order-serum-zika-dengue-virus-igm"
        },
        {
          "condition" : [
            {
              "kind" : "applicability",
              "expression" : {
                "language" : "text/cql",
                "expression" : "Should Consider IgM Antibody Testing"
              }
            }
          ],
          "definition" : "ActivityDefinition/consider-igm-antibody-testing"
        },
        {
          "condition" : [
            {
              "kind" : "applicability",
              "expression" : {
                "language" : "text/cql",
                "expression" : "Should Provide Mosquito Prevention and Contraception Advice"
              }
            }
          ],
          "action" : [
            {
              "definition" : "ActivityDefinition/provide-mosquito-prevention-advice"
            },
            {
              "definition" : "ActivityDefinition/provide-contraception-advice"
            }
          ]
        }
      ]
    }
  ]
}

PlanDefinition "protocol-example" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

id: example,

identifier: , system: http://acme.org, value: example-1,

title: Obesity Assessment Protocol,

status: draft,

type: condition,

purpose: Example of A medical algorithm for assessment and treatment of overweight and obesity,

author: , display: National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov/health-pro/guidelines/current/obesity-guidelines/e_textbook/txgd/algorthm/algorthm.htm,

step: , name: Measure BMI, description: Measure, Weight, Height, Waist, Circumference; Calculate BMI Weight must be measured so that the BMI can be calculated. Most charts are based on weights obtained with the patient wearing undergarments and no shoes. BMI can be manually calculated (kg/[height in meters]2), but is more easily obtained from a nomogram. Waist circumference is important because evidence suggests that abdominal fat is a particularly strong determinant of cardiovascular risk in those with a BMI of 25 to 34.9 kg/m2. Increased waist circumference can also be a marker of increased risk even in persons of normal weight. The technique for measuring waist circumference is described in the text. A nutrition assessment will also help to assess the diet and physical activity habits of overweight patients, precondition: , union: , description: The practitioner must seek to determine whether the patient has ever been overweight. While a technical definition is provided, a simple question such as 'Have you ever been overweight?' will accomplish the same goal. Questions directed towards weight history, dietary habits, physical activities, and medications may provide useful information about the origins of obesity in particular patients., condition: , type: , coding: , system: http://acme.org, code: 1234, display: Obesity, valueBoolean: true, union: , description: BMI Measured in Past 2 Years For those who have not been overweight, a 2 year interval is appropriate for the reassessment of BMI. While this time span is not evidence-based, it is believed to be a reasonable compromise between the need to identify weight gain at an early stage and the need to limit the time, effort, and cost of repeated measurements., condition: , type: , text: BMI in last 2 years, valueBoolean: false, activity: , detail: , category: procedure, code: , coding: , system: http://loinc.org, code: 39156-5, display: Body mass index (BMI) [Ratio], performer: , display: Nurse Ratched, description: Extra information on activity ,


{
  "resourceType" : "PlanDefinition",
  "id" : "protocol-example",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2018-09-06T12:48:28.906Z"
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n<p>\n <b>id: </b>example, </p>\n\n <p>\n <b>identifier: </b>, <b>system: </b>http://acme.org, <b>value: </b>example-1, </p>\n <p>\n <b>title: </b>Obesity Assessment Protocol, </p>\n <p>\n <b>status: </b>draft, </p>\n <p>\n <b>type: </b>condition, </p>\n <p>\n <b>purpose: </b>Example of A medical algorithm for assessment and treatment of overweight and obesity, </p>\n <p>\n <b>author: </b>, <b>display: </b>National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov/health-pro/guidelines/current/obesity-guidelines/e_textbook/txgd/algorthm/algorthm.htm, </p>\n <p>\n <b>step: </b>, <b>name: </b>Measure BMI, <b>description: </b>Measure, Weight, Height, Waist, Circumference; Calculate BMI Weight must be measured so that the BMI can be calculated. Most charts are based on weights obtained with the patient wearing undergarments and no shoes. BMI can be manually calculated (kg/[height in meters]2), but is more easily obtained from a nomogram. Waist circumference is important because evidence suggests that abdominal fat is a particularly strong determinant of cardiovascular risk in those with a BMI of 25 to 34.9 kg/m2. Increased waist circumference can also be a marker of increased risk even in persons of normal weight. The technique for measuring waist circumference is described in the text. A nutrition assessment will also help to assess the diet and physical activity habits of overweight patients, <b>precondition: </b>, <b>union: </b>, <b>description: </b>The practitioner must seek to determine whether the patient has ever been overweight. While a technical definition is provided, a simple question such as 'Have you ever been overweight?' will accomplish the same goal. Questions directed towards weight history, dietary habits, physical activities, and medications may provide useful information about the origins of obesity in particular patients., <b>condition: </b>, <b>type: </b>, <b>coding: </b>, <b>system: </b>http://acme.org, <b>code: </b>1234, <b>display: </b>Obesity, <b>valueBoolean: </b>true, <b>union: </b>, <b>description: </b>BMI Measured in Past 2 Years For those who have not been overweight, a 2 year interval is appropriate for the reassessment of BMI. While this time span is not evidence-based, it is believed to be a reasonable compromise between the need to identify weight gain at an early stage and the need to limit the time, effort, and cost of repeated measurements., <b>condition: </b>, <b>type: </b>, <b>text: </b>BMI in last 2 years, <b>valueBoolean: </b>false, <b>activity: </b>, <b>detail: </b>, <b>category: </b>procedure, <b>code: </b>, <b>coding: </b>, <b>system: </b>http://loinc.org, <b>code: </b>39156-5, <b>display: </b>Body mass index (BMI) [Ratio], <b>performer: </b>, <b>display: </b>Nurse Ratched, <b>description: </b>Extra information on activity , </p>\n </div>"
  },
  "contained" : [
    {
      "resourceType" : "ActivityDefinition",
      "id" : "procedure",
      "status" : "draft",
      "description" : "Extra information on activity ",
      "kind" : "ServiceRequest",
      "code" : {
        "coding" : [
          {
            "system" : "http://loinc.org",
            "code" : "39156-5",
            "display" : "Body mass index (BMI) [Ratio]"
          }
        ]
      },
      "participant" : [
        {
          "type" : "practitioner",
          "role" : {
            "coding" : [
              {
                "system" : "http://terminology.hl7.org/CodeSystem/practitioner-role",
                "code" : "doctor",
                "display" : "Doctor"
              }
            ]
          }
        }
      ]
    }
  ],
  "identifier" : [
    {
      "system" : "http://acme.org",
      "value" : "example-1"
    }
  ],
  "title" : "Obesity Assessment Protocol",
  "type" : {
    "coding" : [
      {
        "code" : "clinical-protocol"
      }
    ]
  },
  "status" : "draft",
  "useContext" : [
    {
      "code" : {
        "code" : "focus"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "414916001",
            "display" : "Obesity (disorder)"
          }
        ]
      }
    }
  ],
  "purpose" : "Example of A medical algorithm for assessment and treatment of overweight and obesity",
  "author" : [
    {
      "name" : "National Heart, Lung, and Blood Institute",
      "telecom" : [
        {
          "system" : "url",
          "value" : "https://www.nhlbi.nih.gov/health-pro/guidelines"
        }
      ]
    }
  ],
  "relatedArtifact" : [
    {
      "type" : "derived-from",
      "display" : "Overweight and Obesity Treatment Guidelines",
      "url" : "http://www.nhlbi.nih.gov/health-pro/guidelines/current/obesity-guidelines/e_textbook/txgd/algorthm/algorthm.htm"
    }
  ],
  "goal" : [
    {
      "id" : "reduce-bmi-ratio",
      "category" : {
        "text" : "Treatment"
      },
      "description" : {
        "text" : "Reduce BMI to below 25"
      },
      "priority" : {
        "text" : "medium-priority"
      },
      "start" : {
        "text" : "When the patient's BMI Ratio is at or above 25"
      },
      "addresses" : [
        {
          "coding" : [
            {
              "system" : "http://snomed.info/sct",
              "code" : "414916001",
              "display" : "Obesity (disorder)"
            }
          ]
        }
      ],
      "documentation" : [
        {
          "type" : "justification",
          "display" : "Evaluation and Treatment Strategy",
          "url" : "https://www.nhlbi.nih.gov/health-pro/guidelines/current/obesity-guidelines/e_textbook/txgd/42.htm"
        }
      ],
      "target" : [
        {
          "measure" : {
            "coding" : [
              {
                "system" : "http://loinc.org",
                "code" : "39156-5",
                "display" : "Body mass index (BMI) [Ratio]"
              }
            ]
          },
          "detailRange" : {
            "high" : {
              "value" : 24.9,
              "unit" : "kg/m2"
            }
          },
          "due" : {
            "value" : 1,
            "unit" : "a"
          }
        }
      ]
    }
  ],
  "action" : [
    {
      "title" : "Measure BMI",
      "description" : "Measure, Weight, Height, Waist, Circumference; Calculate BMI",
      "textEquivalent" : "Weight must be measured so that the BMI can be calculated. Most charts are based on weights obtained with the patient wearing undergarments and no shoes. BMI can be manually calculated (kg/[height in meters]2), but is more easily obtained from a nomogram. Waist circumference is important because evidence suggests that abdominal fat is a particularly strong determinant of cardiovascular risk in those with a BMI of 25 to 34.9 kg/m2. Increased waist circumference can also be a marker of increased risk even in persons of normal weight. The technique for measuring waist circumference is described in the text. A nutrition assessment will also help to assess the diet and physical activity habits of overweight patients",
      "goalId" : [
        "reduce-bmi-ratio"
      ],
      "condition" : [
        {
          "kind" : "applicability",
          "expression" : {
            "description" : "The practitioner must seek to determine whether the patient has ever been overweight. While a technical definition is provided, a simple question such as 'Have you ever been overweight?' will accomplish the same goal. Questions directed towards weight history, dietary habits, physical activities, and medications may provide useful information about the origins of obesity in particular patients. For those who have not been overweight, a 2 year interval is appropriate for the reassessment of BMI. While this time span is not evidence-based, it is believed to be a reasonable compromise between the need to identify weight gain at an early stage and the need to limit the time, effort, and cost of repeated measurements.",
            "language" : "text/cql",
            "expression" : "exists ([Condition: Obesity]) or not exists ([Observation: BMI] O where O.effectiveDateTime 2 years or less before Today())"
          }
        }
      ],
      "requiredBehavior" : "must-unless-documented",
      "cardinalityBehavior" : "single",
      "definition" : "#procedure"
    }
  ]
}

PlanDefinition "options-example" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

[Put rendering here]

{
  "resourceType" : "PlanDefinition",
  "id" : "options-example",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2018-09-06T12:48:28.859Z"
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">[Put rendering here]</div>"
  },
  "contained" : [
    {
      "resourceType" : "ActivityDefinition",
      "id" : "activitydefinition-medicationrequest-1",
      "status" : "draft",
      "kind" : "MedicationRequest",
      "productCodeableConcept" : {
        "text" : "Medication 1"
      }
    },
    {
      "resourceType" : "ActivityDefinition",
      "id" : "activitydefinition-medicationrequest-2",
      "status" : "draft",
      "kind" : "MedicationRequest",
      "productCodeableConcept" : {
        "text" : "Medication 2"
      }
    }
  ],
  "title" : "This example illustrates relationships between actions.",
  "status" : "draft",
  "action" : [
    {
      "groupingBehavior" : "logical-group",
      "selectionBehavior" : "all",
      "action" : [
        {
          "id" : "medication-action-1",
          "title" : "Administer Medication 1",
          "definition" : "#activitydefinition-medicationrequest-1"
        },
        {
          "id" : "medication-action-2",
          "title" : "Administer Medication 2",
          "relatedAction" : [
            {
              "actionId" : "medication-action-1",
              "relationship" : "after-end",
              "offsetDuration" : {
                "value" : 1,
                "unit" : "h"
              }
            }
          ],
          "definition" : "#activitydefinition-medicationrequest-2"
        }
      ]
    }
  ]
}

PlanDefinition "opioidcds-11" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: opioidcds-11

url: http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-11

identifier: cdc-opioid-guidance (OFFICIAL)

version: 0.1.0

name: cdc-opioid-11

title: CDC Opioid Prescribing Guideline Recommendation #11

type: ECA Rule (Details : {http://terminology.hl7.org/CodeSystem/plan-definition-type code 'eca-rule' = 'ECA Rule', given as 'ECA Rule'})

status: draft

date: 19/03/2018

publisher: Centers for Disease Control and Prevention (CDC)

description: Concurrently prescribing opioid medications with benzodiazepines increases the risk of harm for the patient.

useContext: ,

jurisdiction: United States of America (Details : {urn:iso:std:iso:3166 code 'US' = 'United States of America', given as 'United States of America'})

purpose: CDC’s Guideline for Prescribing Opioids for Chronic Pain is intended to improve communication between providers and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder and overdose. The Guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care.

usage: Clinicians should avoid prescribing opioid pain medication and benzodiazepines concurrently whenever possible.

copyright: © CDC 2016+.

topic: Opioid Prescribing (Details )

author: , , ,

relatedArtifact: ,

library: Library/opioidcds-recommendation-11

action

title: Existing patient has concurrent opioid and benzodiazepine prescriptions.

description: Checking if the trigger prescription meets the inclusion criteria for recommendation #11 workflow.

documentation:

trigger:

Conditions

-KindExpression
*applicability

groupingBehavior: visual-group

selectionBehavior: exactly-one

dynamicValue

path: action.description

expression:

dynamicValue

path: action.title

expression:

dynamicValue

path: action.extension

expression:

Actions

-
*
*
*

{
  "resourceType" : "PlanDefinition",
  "id" : "opioidcds-11",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2018-09-06T12:48:28.796Z"
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: opioidcds-11</p><p><b>url</b>: <b>http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-11</b></p><p><b>identifier</b>: cdc-opioid-guidance (OFFICIAL)</p><p><b>version</b>: 0.1.0</p><p><b>name</b>: cdc-opioid-11</p><p><b>title</b>: CDC Opioid Prescribing Guideline Recommendation #11</p><p><b>type</b>: ECA Rule <span>(Details : {http://terminology.hl7.org/CodeSystem/plan-definition-type code 'eca-rule' = 'ECA Rule', given as 'ECA Rule'})</span></p><p><b>status</b>: draft</p><p><b>date</b>: 19/03/2018</p><p><b>publisher</b>: Centers for Disease Control and Prevention (CDC)</p><p><b>description</b>: Concurrently prescribing opioid medications with benzodiazepines increases the risk of harm for the patient.</p><p><b>useContext</b>: , </p><p><b>jurisdiction</b>: United States of America <span>(Details : {urn:iso:std:iso:3166 code 'US' = 'United States of America', given as 'United States of America'})</span></p><p><b>purpose</b>: CDC&#8217;s Guideline for Prescribing Opioids for Chronic Pain is intended to improve communication between providers and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder and overdose. The Guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care.</p><p><b>usage</b>: Clinicians should avoid prescribing opioid pain medication and benzodiazepines concurrently whenever possible.</p><p><b>copyright</b>: &#169; CDC 2016+.</p><p><b>topic</b>: Opioid Prescribing <span>(Details )</span></p><p><b>author</b>: , , , </p><p><b>relatedArtifact</b>: , </p><p><b>library</b>: <a>Library/opioidcds-recommendation-11</a></p><blockquote><p><b>action</b></p><p><b>title</b>: Existing patient has concurrent opioid and benzodiazepine prescriptions.</p><p><b>description</b>: Checking if the trigger prescription meets the inclusion criteria for recommendation #11 workflow.</p><p><b>documentation</b>: </p><p><b>trigger</b>: </p><h3>Conditions</h3><table><tr><td>-</td><td><b>Kind</b></td><td><b>Expression</b></td></tr><tr><td>*</td><td>applicability</td><td/></tr></table><p><b>groupingBehavior</b>: visual-group</p><p><b>selectionBehavior</b>: exactly-one</p><blockquote><p><b>dynamicValue</b></p><p><b>path</b>: action.description</p><p><b>expression</b>: </p></blockquote><blockquote><p><b>dynamicValue</b></p><p><b>path</b>: action.title</p><p><b>expression</b>: </p></blockquote><blockquote><p><b>dynamicValue</b></p><p><b>path</b>: action.extension</p><p><b>expression</b>: </p></blockquote><h3>Actions</h3><table><tr><td>-</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr></table></blockquote></div>"
  },
  "url" : "http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-11",
  "identifier" : [
    {
      "use" : "official",
      "value" : "cdc-opioid-guidance"
    }
  ],
  "version" : "0.1.0",
  "name" : "cdc-opioid-11",
  "title" : "CDC Opioid Prescribing Guideline Recommendation #11",
  "type" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/plan-definition-type",
        "code" : "eca-rule",
        "display" : "ECA Rule"
      }
    ]
  },
  "status" : "draft",
  "date" : "2018-03-19",
  "publisher" : "Centers for Disease Control and Prevention (CDC)",
  "description" : "Concurrently prescribing opioid medications with benzodiazepines increases the risk of harm for the patient.",
  "useContext" : [
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "focus",
        "display" : "Clinical Focus"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "182888003",
            "display" : "Medication requested (situation)"
          }
        ]
      }
    },
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "focus",
        "display" : "Clinical Focus"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "82423001",
            "display" : "Chronic pain (finding)"
          }
        ]
      }
    }
  ],
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US",
          "display" : "United States of America"
        }
      ]
    }
  ],
  "purpose" : "CDC’s Guideline for Prescribing Opioids for Chronic Pain is intended to improve communication between providers and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder and overdose. The Guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care.",
  "usage" : "Clinicians should avoid prescribing opioid pain medication and benzodiazepines concurrently whenever possible.",
  "copyright" : "© CDC 2016+.",
  "topic" : [
    {
      "text" : "Opioid Prescribing"
    }
  ],
  "author" : [
    {
      "name" : "Kensaku Kawamoto, MD, PhD, MHS"
    },
    {
      "name" : "Bryn Rhodes"
    },
    {
      "name" : "Floyd Eisenberg, MD, MPH"
    },
    {
      "name" : "Robert McClure, MD, MPH"
    }
  ],
  "relatedArtifact" : [
    {
      "type" : "documentation",
      "display" : "CDC guideline for prescribing opioids for chronic pain",
      "url" : "https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chronic-pain---united-states-2016#420"
    },
    {
      "type" : "documentation",
      "display" : "MME Conversion Tables",
      "url" : "https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf"
    }
  ],
  "library" : [
    "Library/opioidcds-recommendation-11"
  ],
  "action" : [
    {
      "title" : "Existing patient has concurrent opioid and benzodiazepine prescriptions.",
      "description" : "Checking if the trigger prescription meets the inclusion criteria for recommendation #11 workflow.",
      "documentation" : [
        {
          "type" : "documentation",
          "document" : {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation",
                "valueCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/recommendation-strength",
                      "code" : "strong",
                      "display" : "Strong"
                    }
                  ]
                }
              },
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence",
                "valueCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/evidence-quality",
                      "code" : "low",
                      "display" : "Low quality"
                    }
                  ]
                }
              }
            ]
          }
        }
      ],
      "trigger" : [
        {
          "type" : "named-event",
          "name" : "medication-prescribe"
        }
      ],
      "condition" : [
        {
          "kind" : "applicability",
          "expression" : {
            "description" : "Check whether the existing patient is using opioids concurrently with benzodiazepines.",
            "language" : "text/cql",
            "expression" : "Inclusion Criteria"
          }
        }
      ],
      "groupingBehavior" : "visual-group",
      "selectionBehavior" : "exactly-one",
      "dynamicValue" : [
        {
          "path" : "action.description",
          "expression" : {
            "language" : "text/cql",
            "expression" : "Get Detail"
          }
        },
        {
          "path" : "action.title",
          "expression" : {
            "language" : "text/cql",
            "expression" : "Get Summary"
          }
        },
        {
          "path" : "action.extension",
          "expression" : {
            "language" : "text/cql",
            "expression" : "Get Indicator"
          }
        }
      ],
      "action" : [
        {
          "description" : "Will revise"
        },
        {
          "description" : "Risk of overdose carefully considered and outweighed by benefit; snooze 3 mo"
        },
        {
          "description" : "N/A - see comment; snooze 3 mo"
        }
      ]
    }
  ]
}

PlanDefinition "opioidcds-10" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: opioidcds-10

url: http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-10

identifier: cdc-opioid-guidance (OFFICIAL)

version: 0.1.0

name: cdc-opioid-10

title: CDC Opioid Prescribing Guideline Recommendation #10

type: ECA Rule (Details : {http://terminology.hl7.org/CodeSystem/plan-definition-type code 'eca-rule' = 'ECA Rule', given as 'ECA Rule'})

status: draft

date: 23/04/2017

publisher: Centers for Disease Control and Prevention (CDC)

description: When prescribing opioids for chronic pain, providers should use urine drug testing before starting opioid therapy and consider urine drug testing at least annually to assess for prescribed medications as well as other controlled prescription drugs and illicit drugs.

useContext: ,

jurisdiction: United States of America (Details : {urn:iso:std:iso:3166 code 'US' = 'United States of America', given as 'United States of America'})

purpose: CDC’s Guideline for Prescribing Opioids for Chronic Pain is intended to improve communication between providers and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder and overdose. The Guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care.

usage: Providers should be aware if patients are taking other prescription drugs or illicit drugs that might increase their risk of an overdose.

copyright: © CDC 2016+.

topic: Opioid Prescribing (Details )

author: , , ,

relatedArtifact:

library: Library/opioidcds-recommendation-10

action

title: Annual Urine Screening Check

description: Patient has not had a urine screening in the past 12 months

documentation:

trigger:

Conditions

-KindExpression
*applicability

DynamicValues

-PathExpression
*activity.extension

Actions

-
*
*

action

title: Positive Urine Screening Check

description: Patient has a urine screening testing positive for either unprescribed opioids or illicit drugs in the past 12 months

documentation:

Conditions

-KindExpression
*applicability

Actions

-
*
*
*

{
  "resourceType" : "PlanDefinition",
  "id" : "opioidcds-10",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2018-09-06T12:48:28.734Z"
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: opioidcds-10</p><p><b>url</b>: <b>http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-10</b></p><p><b>identifier</b>: cdc-opioid-guidance (OFFICIAL)</p><p><b>version</b>: 0.1.0</p><p><b>name</b>: cdc-opioid-10</p><p><b>title</b>: CDC Opioid Prescribing Guideline Recommendation #10</p><p><b>type</b>: ECA Rule <span>(Details : {http://terminology.hl7.org/CodeSystem/plan-definition-type code 'eca-rule' = 'ECA Rule', given as 'ECA Rule'})</span></p><p><b>status</b>: draft</p><p><b>date</b>: 23/04/2017</p><p><b>publisher</b>: Centers for Disease Control and Prevention (CDC)</p><p><b>description</b>: When prescribing opioids for chronic pain, providers should use urine drug testing before starting opioid therapy and consider urine drug testing at least annually to assess for prescribed medications as well as other controlled prescription drugs and illicit drugs.</p><p><b>useContext</b>: , </p><p><b>jurisdiction</b>: United States of America <span>(Details : {urn:iso:std:iso:3166 code 'US' = 'United States of America', given as 'United States of America'})</span></p><p><b>purpose</b>: CDC&#8217;s Guideline for Prescribing Opioids for Chronic Pain is intended to improve communication between providers and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder and overdose. The Guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care.</p><p><b>usage</b>: Providers should be aware if patients are taking other prescription drugs or illicit drugs that might increase their risk of an overdose.</p><p><b>copyright</b>: &#169; CDC 2016+.</p><p><b>topic</b>: Opioid Prescribing <span>(Details )</span></p><p><b>author</b>: , , , </p><p><b>relatedArtifact</b>: </p><p><b>library</b>: <a>Library/opioidcds-recommendation-10</a></p><blockquote><p><b>action</b></p><p><b>title</b>: Annual Urine Screening Check</p><p><b>description</b>: Patient has not had a urine screening in the past 12 months</p><p><b>documentation</b>: </p><p><b>trigger</b>: </p><h3>Conditions</h3><table><tr><td>-</td><td><b>Kind</b></td><td><b>Expression</b></td></tr><tr><td>*</td><td>applicability</td><td/></tr></table><h3>DynamicValues</h3><table><tr><td>-</td><td><b>Path</b></td><td><b>Expression</b></td></tr><tr><td>*</td><td>activity.extension</td><td/></tr></table><h3>Actions</h3><table><tr><td>-</td></tr><tr><td>*</td></tr><tr><td>*</td></tr></table></blockquote><blockquote><p><b>action</b></p><p><b>title</b>: Positive Urine Screening Check</p><p><b>description</b>: Patient has a urine screening testing positive for either unprescribed opioids or illicit drugs in the past 12 months</p><p><b>documentation</b>: </p><h3>Conditions</h3><table><tr><td>-</td><td><b>Kind</b></td><td><b>Expression</b></td></tr><tr><td>*</td><td>applicability</td><td/></tr></table><h3>Actions</h3><table><tr><td>-</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr></table></blockquote></div>"
  },
  "url" : "http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-10",
  "identifier" : [
    {
      "use" : "official",
      "value" : "cdc-opioid-guidance"
    }
  ],
  "version" : "0.1.0",
  "name" : "cdc-opioid-10",
  "title" : "CDC Opioid Prescribing Guideline Recommendation #10",
  "type" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/plan-definition-type",
        "code" : "eca-rule",
        "display" : "ECA Rule"
      }
    ]
  },
  "status" : "draft",
  "date" : "2017-04-23",
  "publisher" : "Centers for Disease Control and Prevention (CDC)",
  "description" : "When prescribing opioids for chronic pain, providers should use urine drug testing before starting opioid therapy and consider urine drug testing at least annually to assess for prescribed medications as well as other controlled prescription drugs and illicit drugs.",
  "useContext" : [
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "focus",
        "display" : "Clinical Focus"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "182888003",
            "display" : "Medication requested (situation)"
          }
        ]
      }
    },
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "focus",
        "display" : "Clinical Focus"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "82423001",
            "display" : "Chronic pain (finding)"
          }
        ]
      }
    }
  ],
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US",
          "display" : "United States of America"
        }
      ]
    }
  ],
  "purpose" : "CDC’s Guideline for Prescribing Opioids for Chronic Pain is intended to improve communication between providers and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder and overdose. The Guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care.",
  "usage" : "Providers should be aware if patients are taking other prescription drugs or illicit drugs that might increase their risk of an overdose.",
  "copyright" : "© CDC 2016+.",
  "topic" : [
    {
      "text" : "Opioid Prescribing"
    }
  ],
  "author" : [
    {
      "name" : "Kensaku Kawamoto, MD, PhD, MHS"
    },
    {
      "name" : "Bryn Rhodes"
    },
    {
      "name" : "Floyd Eisenberg, MD, MPH"
    },
    {
      "name" : "Robert McClure, MD, MPH"
    }
  ],
  "relatedArtifact" : [
    {
      "type" : "documentation",
      "display" : "CDC guideline for prescribing opioids for chronic pain",
      "url" : "https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chronic-pain---united-states-2016#420"
    }
  ],
  "library" : [
    "Library/opioidcds-recommendation-10"
  ],
  "action" : [
    {
      "title" : "Annual Urine Screening Check",
      "description" : "Patient has not had a urine screening in the past 12 months",
      "documentation" : [
        {
          "type" : "documentation",
          "document" : {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation",
                "valueCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/recommendation-strength",
                      "code" : "strong",
                      "display" : "Strong"
                    }
                  ]
                }
              },
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence",
                "valueCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/evidence-quality",
                      "code" : "low",
                      "display" : "Low quality"
                    }
                  ]
                }
              }
            ]
          }
        }
      ],
      "trigger" : [
        {
          "type" : "named-event",
          "name" : "medication-prescribe"
        }
      ],
      "condition" : [
        {
          "kind" : "applicability",
          "expression" : {
            "description" : "Patient has not had a urine screening in the past 12 months",
            "language" : "text/cql",
            "expression" : "No Screenings in Past Year"
          }
        }
      ],
      "dynamicValue" : [
        {
          "path" : "activity.extension",
          "expression" : {
            "language" : "text/cql",
            "expression" : "Get Indicator"
          }
        }
      ],
      "action" : [
        {
          "description" : "Will perform urine screening"
        },
        {
          "description" : "Not for chronic pain management. Snooze 3 months"
        }
      ]
    },
    {
      "title" : "Positive Urine Screening Check",
      "description" : "Patient has a urine screening testing positive for either unprescribed opioids or illicit drugs in the past 12 months",
      "documentation" : [
        {
          "type" : "documentation",
          "document" : {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation",
                "valueCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/recommendation-strength",
                      "code" : "strong",
                      "display" : "Strong"
                    }
                  ]
                }
              },
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence",
                "valueCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/evidence-quality",
                      "code" : "low",
                      "display" : "Low quality"
                    }
                  ]
                }
              }
            ]
          }
        }
      ],
      "condition" : [
        {
          "kind" : "applicability",
          "expression" : {
            "description" : "Patient has a positive urine screening in the past 12 months",
            "language" : "text/cql",
            "expression" : "Has Positive Screening?"
          }
        }
      ],
      "action" : [
        {
          "title" : "Unprescribed Opioids Found In Urine Screening",
          "description" : "Patient has a positive urine screening in the past 12 months for opioid(s), which is not prescribed",
          "documentation" : [
            {
              "type" : "documentation",
              "document" : {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation",
                    "valueCodeableConcept" : {
                      "coding" : [
                        {
                          "system" : "http://terminology.hl7.org/CodeSystem/recommendation-strength",
                          "code" : "strong",
                          "display" : "Strong"
                        }
                      ]
                    }
                  },
                  {
                    "url" : "http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence",
                    "valueCodeableConcept" : {
                      "coding" : [
                        {
                          "system" : "http://terminology.hl7.org/CodeSystem/evidence-quality",
                          "code" : "low",
                          "display" : "Low quality"
                        }
                      ]
                    }
                  }
                ]
              }
            }
          ],
          "condition" : [
            {
              "kind" : "applicability",
              "expression" : {
                "description" : "Patient has a positive urine screening in the past 12 months for opioid(s), which is not prescribed",
                "language" : "text/cql",
                "expression" : "Has Unprescribed Opioids?"
              }
            }
          ],
          "dynamicValue" : [
            {
              "path" : "activity.extension",
              "expression" : {
                "language" : "text/cql",
                "expression" : "Get Indicator"
              }
            },
            {
              "path" : "action.description",
              "expression" : {
                "language" : "text/cql",
                "expression" : "Inconsistent Unprescribed Opioids"
              }
            }
          ],
          "action" : [
            {
              "description" : "Not for chronic pain management. Snooze 3 months"
            }
          ]
        },
        {
          "title" : "Prescribed Opioids Not Found In Urine Screening",
          "description" : "Patient has a positive urine screening in the past 12 months, which does not include prescribed opioids",
          "documentation" : [
            {
              "type" : "documentation",
              "document" : {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation",
                    "valueCodeableConcept" : {
                      "coding" : [
                        {
                          "system" : "http://terminology.hl7.org/CodeSystem/recommendation-strength",
                          "code" : "strong",
                          "display" : "Strong"
                        }
                      ]
                    }
                  },
                  {
                    "url" : "http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence",
                    "valueCodeableConcept" : {
                      "coding" : [
                        {
                          "system" : "http://terminology.hl7.org/CodeSystem/evidence-quality",
                          "code" : "low",
                          "display" : "Low quality"
                        }
                      ]
                    }
                  }
                ]
              }
            }
          ],
          "condition" : [
            {
              "kind" : "applicability",
              "expression" : {
                "description" : "Patient has a positive urine screening in the past 12 months, which does not include prescribed opioids",
                "language" : "text/cql",
                "expression" : "Has Missing Opioids?"
              }
            }
          ],
          "dynamicValue" : [
            {
              "path" : "activity.extension",
              "expression" : {
                "language" : "text/cql",
                "expression" : "Get Indicator"
              }
            },
            {
              "path" : "action.description",
              "expression" : {
                "language" : "text/cql",
                "expression" : "Inconsistent Missing Opioids"
              }
            }
          ]
        },
        {
          "title" : "Illicit Drugs Found In Urine Screening",
          "description" : "Patient has a positive urine screening in the past 12 months for illicit drugs",
          "documentation" : [
            {
              "type" : "documentation",
              "document" : {
                "extension" : [
                  {
                    "url" : "http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation",
                    "valueCodeableConcept" : {
                      "coding" : [
                        {
                          "system" : "http://terminology.hl7.org/CodeSystem/recommendation-strength",
                          "code" : "strong",
                          "display" : "Strong"
                        }
                      ]
                    }
                  },
                  {
                    "url" : "http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence",
                    "valueCodeableConcept" : {
                      "coding" : [
                        {
                          "system" : "http://terminology.hl7.org/CodeSystem/evidence-quality",
                          "code" : "low",
                          "display" : "Low quality"
                        }
                      ]
                    }
                  }
                ]
              }
            }
          ],
          "condition" : [
            {
              "kind" : "applicability",
              "expression" : {
                "description" : "Patient has a positive urine screening in the past 12 months for illicit drugs",
                "language" : "text/cql",
                "expression" : "Has Illicit Drugs in Screening?"
              }
            }
          ],
          "dynamicValue" : [
            {
              "path" : "activity.extension",
              "expression" : {
                "language" : "text/cql",
                "expression" : "Get Indicator"
              }
            },
            {
              "path" : "action.description",
              "expression" : {
                "language" : "text/cql",
                "expression" : "Inconsistent Illicit Drugs"
              }
            }
          ],
          "action" : [
            {
              "description" : "Not for chronic pain management. Snooze 3 months"
            }
          ]
        }
      ]
    }
  ]
}

PlanDefinition "opioidcds-08" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: opioidcds-08

url: http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-08

identifier: cdc-opioid-guidance (OFFICIAL)

version: 0.1.0

name: cdc-opioid-08

title: CDC Opioid Prescribing Guideline Recommendation #8

type: ECA Rule (Details : {http://terminology.hl7.org/CodeSystem/plan-definition-type code 'eca-rule' = 'ECA Rule', given as 'ECA Rule'})

status: draft

date: 19/03/2018

publisher: Centers for Disease Control and Prevention (CDC)

description: Clinicians should incorporate into the management plan strategies to mitigate risk, including considering offering naloxone when factors that increase risk for opioid overdose, such as history of overdose, history of substance use disorder, higher opioid dosages (≥50 MME/day), or concurrent benzodiazepine use, are present.

useContext: ,

jurisdiction: United States of America (Details : {urn:iso:std:iso:3166 code 'US' = 'United States of America', given as 'United States of America'})

purpose: CDC’s Guideline for Prescribing Opioids for Chronic Pain is intended to improve communication between providers and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder and overdose. The Guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care.

usage: Before starting and periodically during continuation of opioid therapy, clinicians should evaluate risk factors for opioid-related harms.

copyright: © CDC 2016+.

topic: Opioid Prescribing (Details )

author: , , ,

relatedArtifact: ,

library: Library/opioidcds-recommendation-08

action

title: Existing patient exhibits risk factors for opioid-related harms.

description: Checking if the trigger prescription meets the inclusion criteria for recommendation #8 workflow.

documentation:

trigger:

Conditions

-KindExpression
*applicability

groupingBehavior: visual-group

selectionBehavior: exactly-one

dynamicValue

path: action.description

expression:

dynamicValue

path: action.title

expression:

dynamicValue

path: action.extension

expression:

Actions

-
*
*
*

{
  "resourceType" : "PlanDefinition",
  "id" : "opioidcds-08",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2018-09-06T12:48:28.671Z"
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: opioidcds-08</p><p><b>url</b>: <b>http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-08</b></p><p><b>identifier</b>: cdc-opioid-guidance (OFFICIAL)</p><p><b>version</b>: 0.1.0</p><p><b>name</b>: cdc-opioid-08</p><p><b>title</b>: CDC Opioid Prescribing Guideline Recommendation #8</p><p><b>type</b>: ECA Rule <span>(Details : {http://terminology.hl7.org/CodeSystem/plan-definition-type code 'eca-rule' = 'ECA Rule', given as 'ECA Rule'})</span></p><p><b>status</b>: draft</p><p><b>date</b>: 19/03/2018</p><p><b>publisher</b>: Centers for Disease Control and Prevention (CDC)</p><p><b>description</b>: Clinicians should incorporate into the management plan strategies to mitigate risk, including considering offering naloxone when factors that increase risk for opioid overdose, such as history of overdose, history of substance use disorder, higher opioid dosages (&#8805;50 MME/day), or concurrent benzodiazepine use, are present.</p><p><b>useContext</b>: , </p><p><b>jurisdiction</b>: United States of America <span>(Details : {urn:iso:std:iso:3166 code 'US' = 'United States of America', given as 'United States of America'})</span></p><p><b>purpose</b>: CDC&#8217;s Guideline for Prescribing Opioids for Chronic Pain is intended to improve communication between providers and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder and overdose. The Guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care.</p><p><b>usage</b>: Before starting and periodically during continuation of opioid therapy, clinicians should evaluate risk factors for opioid-related harms.</p><p><b>copyright</b>: &#169; CDC 2016+.</p><p><b>topic</b>: Opioid Prescribing <span>(Details )</span></p><p><b>author</b>: , , , </p><p><b>relatedArtifact</b>: , </p><p><b>library</b>: <a>Library/opioidcds-recommendation-08</a></p><blockquote><p><b>action</b></p><p><b>title</b>: Existing patient exhibits risk factors for opioid-related harms.</p><p><b>description</b>: Checking if the trigger prescription meets the inclusion criteria for recommendation #8 workflow.</p><p><b>documentation</b>: </p><p><b>trigger</b>: </p><h3>Conditions</h3><table><tr><td>-</td><td><b>Kind</b></td><td><b>Expression</b></td></tr><tr><td>*</td><td>applicability</td><td/></tr></table><p><b>groupingBehavior</b>: visual-group</p><p><b>selectionBehavior</b>: exactly-one</p><blockquote><p><b>dynamicValue</b></p><p><b>path</b>: action.description</p><p><b>expression</b>: </p></blockquote><blockquote><p><b>dynamicValue</b></p><p><b>path</b>: action.title</p><p><b>expression</b>: </p></blockquote><blockquote><p><b>dynamicValue</b></p><p><b>path</b>: action.extension</p><p><b>expression</b>: </p></blockquote><h3>Actions</h3><table><tr><td>-</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr></table></blockquote></div>"
  },
  "url" : "http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-08",
  "identifier" : [
    {
      "use" : "official",
      "value" : "cdc-opioid-guidance"
    }
  ],
  "version" : "0.1.0",
  "name" : "cdc-opioid-08",
  "title" : "CDC Opioid Prescribing Guideline Recommendation #8",
  "type" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/plan-definition-type",
        "code" : "eca-rule",
        "display" : "ECA Rule"
      }
    ]
  },
  "status" : "draft",
  "date" : "2018-03-19",
  "publisher" : "Centers for Disease Control and Prevention (CDC)",
  "description" : "Clinicians should incorporate into the management plan strategies to mitigate risk, including considering offering naloxone when factors that increase risk for opioid overdose, such as history of overdose, history of substance use disorder, higher opioid dosages (≥50 MME/day), or concurrent benzodiazepine use, are present.",
  "useContext" : [
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "focus",
        "display" : "Clinical Focus"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "182888003",
            "display" : "Medication requested (situation)"
          }
        ]
      }
    },
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "focus",
        "display" : "Clinical Focus"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "82423001",
            "display" : "Chronic pain (finding)"
          }
        ]
      }
    }
  ],
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US",
          "display" : "United States of America"
        }
      ]
    }
  ],
  "purpose" : "CDC’s Guideline for Prescribing Opioids for Chronic Pain is intended to improve communication between providers and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder and overdose. The Guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care.",
  "usage" : "Before starting and periodically during continuation of opioid therapy, clinicians should evaluate risk factors for opioid-related harms.",
  "copyright" : "© CDC 2016+.",
  "topic" : [
    {
      "text" : "Opioid Prescribing"
    }
  ],
  "author" : [
    {
      "name" : "Kensaku Kawamoto, MD, PhD, MHS"
    },
    {
      "name" : "Bryn Rhodes"
    },
    {
      "name" : "Floyd Eisenberg, MD, MPH"
    },
    {
      "name" : "Robert McClure, MD, MPH"
    }
  ],
  "relatedArtifact" : [
    {
      "type" : "documentation",
      "display" : "CDC guideline for prescribing opioids for chronic pain",
      "url" : "https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chronic-pain---united-states-2016#420"
    },
    {
      "type" : "documentation",
      "display" : "MME Conversion Tables",
      "url" : "https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf"
    }
  ],
  "library" : [
    "Library/opioidcds-recommendation-08"
  ],
  "action" : [
    {
      "title" : "Existing patient exhibits risk factors for opioid-related harms.",
      "description" : "Checking if the trigger prescription meets the inclusion criteria for recommendation #8 workflow.",
      "documentation" : [
        {
          "type" : "documentation",
          "document" : {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation",
                "valueCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/recommendation-strength",
                      "code" : "strong",
                      "display" : "Strong"
                    }
                  ]
                }
              },
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence",
                "valueCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/evidence-quality",
                      "code" : "low",
                      "display" : "Low quality"
                    }
                  ]
                }
              }
            ]
          }
        }
      ],
      "trigger" : [
        {
          "type" : "named-event",
          "name" : "medication-prescribe"
        }
      ],
      "condition" : [
        {
          "kind" : "applicability",
          "expression" : {
            "description" : "Check whether the existing patient exhibits risk factors for opioid-related harms, such as concurrent use with benzodiazepine, a history of substance abuse, and/or a average MME greater than 50 mg/day.",
            "language" : "text/cql",
            "expression" : "Inclusion Criteria"
          }
        }
      ],
      "groupingBehavior" : "visual-group",
      "selectionBehavior" : "exactly-one",
      "dynamicValue" : [
        {
          "path" : "action.description",
          "expression" : {
            "language" : "text/cql",
            "expression" : "Get Detail"
          }
        },
        {
          "path" : "action.title",
          "expression" : {
            "language" : "text/cql",
            "expression" : "Get Summary"
          }
        },
        {
          "path" : "action.extension",
          "expression" : {
            "language" : "text/cql",
            "expression" : "Get Indicator"
          }
        }
      ],
      "action" : [
        {
          "description" : "Will offer Naloxone instead"
        },
        {
          "description" : "Risk of overdose carefully considered and outweighed by benefit; snooze 3 mo"
        },
        {
          "description" : "N/A - see comment; snooze 3 mo"
        }
      ]
    }
  ]
}

PlanDefinition "opioidcds-07" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: opioidcds-07

url: http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-07

identifier: cdc-opioid-guidance (OFFICIAL)

version: 0.1.0

name: cdc-opioid-07

title: CDC Opioid Prescribing Guideline Recommendation #7

type: ECA Rule (Details : {http://terminology.hl7.org/CodeSystem/plan-definition-type code 'eca-rule' = 'ECA Rule', given as 'ECA Rule'})

status: draft

date: 19/03/2018

publisher: Centers for Disease Control and Prevention (CDC)

description: Clinicians should evaluate benefits and harms with patients within 1 to 4 weeks of starting opioid therapy for chronic pain or of dose escalation. Clinicians should evaluate benefits and harms of continued therapy with patients every 3 months or more frequently.

useContext: ,

jurisdiction: United States of America (Details : {urn:iso:std:iso:3166 code 'US' = 'United States of America', given as 'United States of America'})

purpose: CDC’s Guideline for Prescribing Opioids for Chronic Pain is intended to improve communication between providers and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder and overdose. The Guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care.

usage: If benefits do not outweigh harms of continued opioid therapy, clinicians should optimize other therapies and work with patients to taper opioids to lower dosages or to taper and discontinue opioids.

copyright: © CDC 2016+.

topic: Opioid Prescribing (Details )

author: , , ,

relatedArtifact: ,

library: Library/opioidcds-recommendation-07

action

title: Existing patient should be evaluated for risk of continued opioid therapy.

description: Checking if the trigger prescription meets the inclusion criteria for recommendation #7 workflow.

documentation:

trigger:

Conditions

-KindExpression
*applicability

groupingBehavior: visual-group

selectionBehavior: exactly-one

dynamicValue

path: action.title

expression:

dynamicValue

path: action.description

expression:

dynamicValue

path: action.extension

expression:

Actions

-
*
*
*

{
  "resourceType" : "PlanDefinition",
  "id" : "opioidcds-07",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2018-09-06T12:48:28.609Z"
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: opioidcds-07</p><p><b>url</b>: <b>http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-07</b></p><p><b>identifier</b>: cdc-opioid-guidance (OFFICIAL)</p><p><b>version</b>: 0.1.0</p><p><b>name</b>: cdc-opioid-07</p><p><b>title</b>: CDC Opioid Prescribing Guideline Recommendation #7</p><p><b>type</b>: ECA Rule <span>(Details : {http://terminology.hl7.org/CodeSystem/plan-definition-type code 'eca-rule' = 'ECA Rule', given as 'ECA Rule'})</span></p><p><b>status</b>: draft</p><p><b>date</b>: 19/03/2018</p><p><b>publisher</b>: Centers for Disease Control and Prevention (CDC)</p><p><b>description</b>: Clinicians should evaluate benefits and harms with patients within 1 to 4 weeks of starting opioid therapy for chronic pain or of dose escalation. Clinicians should evaluate benefits and harms of continued therapy with patients every 3 months or more frequently.</p><p><b>useContext</b>: , </p><p><b>jurisdiction</b>: United States of America <span>(Details : {urn:iso:std:iso:3166 code 'US' = 'United States of America', given as 'United States of America'})</span></p><p><b>purpose</b>: CDC&#8217;s Guideline for Prescribing Opioids for Chronic Pain is intended to improve communication between providers and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder and overdose. The Guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care.</p><p><b>usage</b>: If benefits do not outweigh harms of continued opioid therapy, clinicians should optimize other therapies and work with patients to taper opioids to lower dosages or to taper and discontinue opioids.</p><p><b>copyright</b>: &#169; CDC 2016+.</p><p><b>topic</b>: Opioid Prescribing <span>(Details )</span></p><p><b>author</b>: , , , </p><p><b>relatedArtifact</b>: , </p><p><b>library</b>: <a>Library/opioidcds-recommendation-07</a></p><blockquote><p><b>action</b></p><p><b>title</b>: Existing patient should be evaluated for risk of continued opioid therapy.</p><p><b>description</b>: Checking if the trigger prescription meets the inclusion criteria for recommendation #7 workflow.</p><p><b>documentation</b>: </p><p><b>trigger</b>: </p><h3>Conditions</h3><table><tr><td>-</td><td><b>Kind</b></td><td><b>Expression</b></td></tr><tr><td>*</td><td>applicability</td><td/></tr></table><p><b>groupingBehavior</b>: visual-group</p><p><b>selectionBehavior</b>: exactly-one</p><blockquote><p><b>dynamicValue</b></p><p><b>path</b>: action.title</p><p><b>expression</b>: </p></blockquote><blockquote><p><b>dynamicValue</b></p><p><b>path</b>: action.description</p><p><b>expression</b>: </p></blockquote><blockquote><p><b>dynamicValue</b></p><p><b>path</b>: action.extension</p><p><b>expression</b>: </p></blockquote><h3>Actions</h3><table><tr><td>-</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr></table></blockquote></div>"
  },
  "url" : "http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-07",
  "identifier" : [
    {
      "use" : "official",
      "value" : "cdc-opioid-guidance"
    }
  ],
  "version" : "0.1.0",
  "name" : "cdc-opioid-07",
  "title" : "CDC Opioid Prescribing Guideline Recommendation #7",
  "type" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/plan-definition-type",
        "code" : "eca-rule",
        "display" : "ECA Rule"
      }
    ]
  },
  "status" : "draft",
  "date" : "2018-03-19",
  "publisher" : "Centers for Disease Control and Prevention (CDC)",
  "description" : "Clinicians should evaluate benefits and harms with patients within 1 to 4 weeks of starting opioid therapy for chronic pain or of dose escalation. Clinicians should evaluate benefits and harms of continued therapy with patients every 3 months or more frequently.",
  "useContext" : [
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "focus",
        "display" : "Clinical Focus"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "182888003",
            "display" : "Medication requested (situation)"
          }
        ]
      }
    },
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "focus",
        "display" : "Clinical Focus"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "82423001",
            "display" : "Chronic pain (finding)"
          }
        ]
      }
    }
  ],
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US",
          "display" : "United States of America"
        }
      ]
    }
  ],
  "purpose" : "CDC’s Guideline for Prescribing Opioids for Chronic Pain is intended to improve communication between providers and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder and overdose. The Guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care.",
  "usage" : "If benefits do not outweigh harms of continued opioid therapy, clinicians should optimize other therapies and work with patients to taper opioids to lower dosages or to taper and discontinue opioids.",
  "copyright" : "© CDC 2016+.",
  "topic" : [
    {
      "text" : "Opioid Prescribing"
    }
  ],
  "author" : [
    {
      "name" : "Kensaku Kawamoto, MD, PhD, MHS"
    },
    {
      "name" : "Bryn Rhodes"
    },
    {
      "name" : "Floyd Eisenberg, MD, MPH"
    },
    {
      "name" : "Robert McClure, MD, MPH"
    }
  ],
  "relatedArtifact" : [
    {
      "type" : "documentation",
      "display" : "CDC guideline for prescribing opioids for chronic pain",
      "url" : "https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chronic-pain---united-states-2016#420"
    },
    {
      "type" : "documentation",
      "display" : "MME Conversion Tables",
      "url" : "https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf"
    }
  ],
  "library" : [
    "Library/opioidcds-recommendation-07"
  ],
  "action" : [
    {
      "title" : "Existing patient should be evaluated for risk of continued opioid therapy.",
      "description" : "Checking if the trigger prescription meets the inclusion criteria for recommendation #7 workflow.",
      "documentation" : [
        {
          "type" : "documentation",
          "document" : {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation",
                "valueCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/recommendation-strength",
                      "code" : "strong",
                      "display" : "Strong"
                    }
                  ]
                }
              },
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence",
                "valueCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/evidence-quality",
                      "code" : "low",
                      "display" : "Low quality"
                    }
                  ]
                }
              }
            ]
          }
        }
      ],
      "trigger" : [
        {
          "type" : "named-event",
          "name" : "medication-prescribe"
        }
      ],
      "condition" : [
        {
          "kind" : "applicability",
          "expression" : {
            "description" : "Check whether the existing patient, without an end of life condition or risk assessment in the past 90 days, has taken an opioid-with-abuse-potential for 7 of the past 10 days or 63 of the past 90 days.",
            "language" : "text/cql",
            "expression" : "Inclusion Criteria"
          }
        }
      ],
      "groupingBehavior" : "visual-group",
      "selectionBehavior" : "exactly-one",
      "dynamicValue" : [
        {
          "path" : "action.title",
          "expression" : {
            "language" : "text/cql",
            "expression" : "Get Summary"
          }
        },
        {
          "path" : "action.description",
          "expression" : {
            "language" : "text/cql",
            "expression" : "Get Detail"
          }
        },
        {
          "path" : "action.extension",
          "expression" : {
            "language" : "text/cql",
            "expression" : "Get Indicator"
          }
        }
      ],
      "action" : [
        {
          "description" : "Will schedule assessment of risk for opioid use for the patient"
        },
        {
          "description" : "Risk of overdose carefully considered and outweighed by benefit; snooze 3 mo"
        },
        {
          "description" : "N/A - see comment; snooze 3 mo"
        }
      ]
    }
  ]
}

PlanDefinition "opioidcds-05" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: opioidcds-05

url: http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-05

identifier: cdc-opioid-guidance (OFFICIAL)

version: 0.1.0

name: cdc-opioid-05

title: CDC Opioid Prescribing Guideline Recommendation #5

type: ECA Rule (Details : {http://terminology.hl7.org/CodeSystem/plan-definition-type code 'eca-rule' = 'ECA Rule', given as 'ECA Rule'})

status: draft

date: 23/04/2017

publisher: Centers for Disease Control and Prevention (CDC)

description: When opioids are started, providers should prescribe the lowest effective dosage.

useContext: ,

jurisdiction: United States of America (Details : {urn:iso:std:iso:3166 code 'US' = 'United States of America', given as 'United States of America'})

purpose: CDC’s Guideline for Prescribing Opioids for Chronic Pain is intended to improve communication between providers and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder and overdose. The Guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care.

usage: Providers should use caution when prescribing opioids at any dosage, should carefully reassess evidence of individual benefits and risks when considering increasing dosage to ≥50 morphine milligram equivalents (MME)/day, and should avoid increasing dosage to ≥90 MME/day or carefully justify a decision to titrate dosage to >90 MME/day

copyright: © CDC 2016+.

topic: Opioid Prescribing (Details )

author: , , ,

relatedArtifact: ,

library: Library/opioidcds-recommendation-05

action

title: High risk for opioid overdose.

description: Total morphine milligram equivalent (MME) exceeds recommended amount. Taper to less than 50.

documentation:

trigger:

Conditions

-KindExpression
*applicability

groupingBehavior: visual-group

selectionBehavior: exactly-one

dynamicValue

path: action.title

expression:

dynamicValue

path: action.description

expression:

dynamicValue

path: activity.extension

expression:

Actions

-
*
*
*
*

{
  "resourceType" : "PlanDefinition",
  "id" : "opioidcds-05",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2018-09-06T12:48:28.531Z"
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: opioidcds-05</p><p><b>url</b>: <b>http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-05</b></p><p><b>identifier</b>: cdc-opioid-guidance (OFFICIAL)</p><p><b>version</b>: 0.1.0</p><p><b>name</b>: cdc-opioid-05</p><p><b>title</b>: CDC Opioid Prescribing Guideline Recommendation #5</p><p><b>type</b>: ECA Rule <span>(Details : {http://terminology.hl7.org/CodeSystem/plan-definition-type code 'eca-rule' = 'ECA Rule', given as 'ECA Rule'})</span></p><p><b>status</b>: draft</p><p><b>date</b>: 23/04/2017</p><p><b>publisher</b>: Centers for Disease Control and Prevention (CDC)</p><p><b>description</b>: When opioids are started, providers should prescribe the lowest effective dosage.</p><p><b>useContext</b>: , </p><p><b>jurisdiction</b>: United States of America <span>(Details : {urn:iso:std:iso:3166 code 'US' = 'United States of America', given as 'United States of America'})</span></p><p><b>purpose</b>: CDC&#8217;s Guideline for Prescribing Opioids for Chronic Pain is intended to improve communication between providers and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder and overdose. The Guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care.</p><p><b>usage</b>: Providers should use caution when prescribing opioids at any dosage, should carefully reassess evidence of individual benefits and risks when considering increasing dosage to &#8805;50 morphine milligram equivalents (MME)/day, and should avoid increasing dosage to &#8805;90 MME/day or carefully justify a decision to titrate dosage to &gt;90 MME/day</p><p><b>copyright</b>: &#169; CDC 2016+.</p><p><b>topic</b>: Opioid Prescribing <span>(Details )</span></p><p><b>author</b>: , , , </p><p><b>relatedArtifact</b>: , </p><p><b>library</b>: <a>Library/opioidcds-recommendation-05</a></p><blockquote><p><b>action</b></p><p><b>title</b>: High risk for opioid overdose.</p><p><b>description</b>: Total morphine milligram equivalent (MME) exceeds recommended amount. Taper to less than 50.</p><p><b>documentation</b>: </p><p><b>trigger</b>: </p><h3>Conditions</h3><table><tr><td>-</td><td><b>Kind</b></td><td><b>Expression</b></td></tr><tr><td>*</td><td>applicability</td><td/></tr></table><p><b>groupingBehavior</b>: visual-group</p><p><b>selectionBehavior</b>: exactly-one</p><blockquote><p><b>dynamicValue</b></p><p><b>path</b>: action.title</p><p><b>expression</b>: </p></blockquote><blockquote><p><b>dynamicValue</b></p><p><b>path</b>: action.description</p><p><b>expression</b>: </p></blockquote><blockquote><p><b>dynamicValue</b></p><p><b>path</b>: activity.extension</p><p><b>expression</b>: </p></blockquote><h3>Actions</h3><table><tr><td>-</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr></table></blockquote></div>"
  },
  "url" : "http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-05",
  "identifier" : [
    {
      "use" : "official",
      "value" : "cdc-opioid-guidance"
    }
  ],
  "version" : "0.1.0",
  "name" : "cdc-opioid-05",
  "title" : "CDC Opioid Prescribing Guideline Recommendation #5",
  "type" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/plan-definition-type",
        "code" : "eca-rule",
        "display" : "ECA Rule"
      }
    ]
  },
  "status" : "draft",
  "date" : "2017-04-23",
  "publisher" : "Centers for Disease Control and Prevention (CDC)",
  "description" : "When opioids are started, providers should prescribe the lowest effective dosage.",
  "useContext" : [
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "focus",
        "display" : "Clinical Focus"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "182888003",
            "display" : "Medication requested (situation)"
          }
        ]
      }
    },
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "focus",
        "display" : "Clinical Focus"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "82423001",
            "display" : "Chronic pain (finding)"
          }
        ]
      }
    }
  ],
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US",
          "display" : "United States of America"
        }
      ]
    }
  ],
  "purpose" : "CDC’s Guideline for Prescribing Opioids for Chronic Pain is intended to improve communication between providers and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder and overdose. The Guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care.",
  "usage" : "Providers should use caution when prescribing opioids at any dosage, should carefully reassess evidence of individual benefits and risks when considering increasing dosage to ≥50 morphine milligram equivalents (MME)/day, and should avoid increasing dosage to ≥90 MME/day or carefully justify a decision to titrate dosage to >90 MME/day",
  "copyright" : "© CDC 2016+.",
  "topic" : [
    {
      "text" : "Opioid Prescribing"
    }
  ],
  "author" : [
    {
      "name" : "Kensaku Kawamoto, MD, PhD, MHS"
    },
    {
      "name" : "Bryn Rhodes"
    },
    {
      "name" : "Floyd Eisenberg, MD, MPH"
    },
    {
      "name" : "Robert McClure, MD, MPH"
    }
  ],
  "relatedArtifact" : [
    {
      "type" : "documentation",
      "display" : "CDC guideline for prescribing opioids for chronic pain",
      "url" : "https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chronic-pain---united-states-2016#420"
    },
    {
      "type" : "documentation",
      "display" : "MME Conversion Tables",
      "url" : "https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf"
    }
  ],
  "library" : [
    "Library/opioidcds-recommendation-05"
  ],
  "action" : [
    {
      "title" : "High risk for opioid overdose.",
      "description" : "Total morphine milligram equivalent (MME) exceeds recommended amount. Taper to less than 50.",
      "documentation" : [
        {
          "type" : "documentation",
          "document" : {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation",
                "valueCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/recommendation-strength",
                      "code" : "strong",
                      "display" : "Strong"
                    }
                  ]
                }
              },
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence",
                "valueCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/evidence-quality",
                      "code" : "low",
                      "display" : "Low quality"
                    }
                  ]
                }
              }
            ]
          }
        }
      ],
      "trigger" : [
        {
          "type" : "named-event",
          "name" : "medication-prescribe"
        }
      ],
      "condition" : [
        {
          "kind" : "applicability",
          "expression" : {
            "description" : "Is total MME >= 50?",
            "language" : "text/cql",
            "expression" : "Is MME 50 Or More?"
          }
        }
      ],
      "groupingBehavior" : "visual-group",
      "selectionBehavior" : "exactly-one",
      "dynamicValue" : [
        {
          "path" : "action.title",
          "expression" : {
            "language" : "text/cql",
            "expression" : "getSummary"
          }
        },
        {
          "path" : "action.description",
          "expression" : {
            "language" : "text/cql",
            "expression" : "getDetail"
          }
        },
        {
          "path" : "activity.extension",
          "expression" : {
            "language" : "text/cql",
            "expression" : "getIndicator"
          }
        }
      ],
      "action" : [
        {
          "description" : "Will reduce dosage"
        },
        {
          "description" : "Risk of overdose carefully considered and outweighed by benefit; snooze 3 mo"
        },
        {
          "description" : "Acute pain; snooze 1 mo"
        },
        {
          "description" : "N/A - see comment (will be reviewed by medical director); snooze 3 mo"
        }
      ]
    }
  ]
}

PlanDefinition "opioidcds-04" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: opioidcds-04

url: http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-04

identifier: cdc-opioid-guidance (OFFICIAL)

version: 0.1.0

name: cdc-opioid-04

title: CDC Opioid Prescribing Guideline Recommendation #4

type: ECA Rule (Details : {http://terminology.hl7.org/CodeSystem/plan-definition-type code 'eca-rule' = 'ECA Rule', given as 'ECA Rule'})

status: draft

date: 19/03/2018

publisher: Centers for Disease Control and Prevention (CDC)

description: When starting opioid therapy for chronic pain, clinicians should prescribe immediate-release opioids instead of extended-release/long-acting (ER/LA) opioids.

useContext: ,

jurisdiction: United States of America (Details : {urn:iso:std:iso:3166 code 'US' = 'United States of America', given as 'United States of America'})

purpose: CDC’s Guideline for Prescribing Opioids for Chronic Pain is intended to improve communication between providers and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder and overdose. The Guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care.

usage: Providers should use caution when prescribing extended-release/long-acting (ER/LA) opioids as they carry a higher risk and negligible benefit compared to immediate-release opioids.

copyright: © CDC 2016+.

topic: Opioid Prescribing (Details )

author: , , ,

relatedArtifact: ,

library: Library/opioidcds-recommendation-04

action

title: Extended-release opioid prescription triggered.

description: Checking if the trigger prescription meets the inclusion criteria for recommendation #4 workflow.

documentation:

trigger:

Conditions

-KindExpression
*applicability

groupingBehavior: visual-group

selectionBehavior: exactly-one

dynamicValue

path: action.title

expression:

dynamicValue

path: action.description

expression:

dynamicValue

path: activity.extension

expression:

Actions

-
*
*
*

{
  "resourceType" : "PlanDefinition",
  "id" : "opioidcds-04",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2018-09-06T12:48:28.468Z"
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: opioidcds-04</p><p><b>url</b>: <b>http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-04</b></p><p><b>identifier</b>: cdc-opioid-guidance (OFFICIAL)</p><p><b>version</b>: 0.1.0</p><p><b>name</b>: cdc-opioid-04</p><p><b>title</b>: CDC Opioid Prescribing Guideline Recommendation #4</p><p><b>type</b>: ECA Rule <span>(Details : {http://terminology.hl7.org/CodeSystem/plan-definition-type code 'eca-rule' = 'ECA Rule', given as 'ECA Rule'})</span></p><p><b>status</b>: draft</p><p><b>date</b>: 19/03/2018</p><p><b>publisher</b>: Centers for Disease Control and Prevention (CDC)</p><p><b>description</b>: When starting opioid therapy for chronic pain, clinicians should prescribe immediate-release opioids instead of extended-release/long-acting (ER/LA) opioids.</p><p><b>useContext</b>: , </p><p><b>jurisdiction</b>: United States of America <span>(Details : {urn:iso:std:iso:3166 code 'US' = 'United States of America', given as 'United States of America'})</span></p><p><b>purpose</b>: CDC&#8217;s Guideline for Prescribing Opioids for Chronic Pain is intended to improve communication between providers and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder and overdose. The Guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care.</p><p><b>usage</b>: Providers should use caution when prescribing extended-release/long-acting (ER/LA) opioids as they carry a higher risk and negligible benefit compared to immediate-release opioids.</p><p><b>copyright</b>: &#169; CDC 2016+.</p><p><b>topic</b>: Opioid Prescribing <span>(Details )</span></p><p><b>author</b>: , , , </p><p><b>relatedArtifact</b>: , </p><p><b>library</b>: <a>Library/opioidcds-recommendation-04</a></p><blockquote><p><b>action</b></p><p><b>title</b>: Extended-release opioid prescription triggered.</p><p><b>description</b>: Checking if the trigger prescription meets the inclusion criteria for recommendation #4 workflow.</p><p><b>documentation</b>: </p><p><b>trigger</b>: </p><h3>Conditions</h3><table><tr><td>-</td><td><b>Kind</b></td><td><b>Expression</b></td></tr><tr><td>*</td><td>applicability</td><td/></tr></table><p><b>groupingBehavior</b>: visual-group</p><p><b>selectionBehavior</b>: exactly-one</p><blockquote><p><b>dynamicValue</b></p><p><b>path</b>: action.title</p><p><b>expression</b>: </p></blockquote><blockquote><p><b>dynamicValue</b></p><p><b>path</b>: action.description</p><p><b>expression</b>: </p></blockquote><blockquote><p><b>dynamicValue</b></p><p><b>path</b>: activity.extension</p><p><b>expression</b>: </p></blockquote><h3>Actions</h3><table><tr><td>-</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr></table></blockquote></div>"
  },
  "url" : "http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-04",
  "identifier" : [
    {
      "use" : "official",
      "value" : "cdc-opioid-guidance"
    }
  ],
  "version" : "0.1.0",
  "name" : "cdc-opioid-04",
  "title" : "CDC Opioid Prescribing Guideline Recommendation #4",
  "type" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/plan-definition-type",
        "code" : "eca-rule",
        "display" : "ECA Rule"
      }
    ]
  },
  "status" : "draft",
  "date" : "2018-03-19",
  "publisher" : "Centers for Disease Control and Prevention (CDC)",
  "description" : "When starting opioid therapy for chronic pain, clinicians should prescribe immediate-release opioids instead of extended-release/long-acting (ER/LA) opioids.",
  "useContext" : [
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "focus",
        "display" : "Clinical Focus"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "182888003",
            "display" : "Medication requested (situation)"
          }
        ]
      }
    },
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "focus",
        "display" : "Clinical Focus"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "82423001",
            "display" : "Chronic pain (finding)"
          }
        ]
      }
    }
  ],
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US",
          "display" : "United States of America"
        }
      ]
    }
  ],
  "purpose" : "CDC’s Guideline for Prescribing Opioids for Chronic Pain is intended to improve communication between providers and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder and overdose. The Guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care.",
  "usage" : "Providers should use caution when prescribing extended-release/long-acting (ER/LA) opioids as they carry a higher risk and negligible benefit compared to immediate-release opioids.",
  "copyright" : "© CDC 2016+.",
  "topic" : [
    {
      "text" : "Opioid Prescribing"
    }
  ],
  "author" : [
    {
      "name" : "Kensaku Kawamoto, MD, PhD, MHS"
    },
    {
      "name" : "Bryn Rhodes"
    },
    {
      "name" : "Floyd Eisenberg, MD, MPH"
    },
    {
      "name" : "Robert McClure, MD, MPH"
    }
  ],
  "relatedArtifact" : [
    {
      "type" : "documentation",
      "display" : "CDC guideline for prescribing opioids for chronic pain",
      "url" : "https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chronic-pain---united-states-2016#420"
    },
    {
      "type" : "documentation",
      "display" : "MME Conversion Tables",
      "url" : "https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf"
    }
  ],
  "library" : [
    "Library/opioidcds-recommendation-04"
  ],
  "action" : [
    {
      "title" : "Extended-release opioid prescription triggered.",
      "description" : "Checking if the trigger prescription meets the inclusion criteria for recommendation #4 workflow.",
      "documentation" : [
        {
          "type" : "documentation",
          "document" : {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation",
                "valueCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/recommendation-strength",
                      "code" : "strong",
                      "display" : "Strong"
                    }
                  ]
                }
              },
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence",
                "valueCodeableConcept" : {
                  "coding" : [
                    {
                      "system" : "http://terminology.hl7.org/CodeSystem/evidence-quality",
                      "code" : "low",
                      "display" : "Low quality"
                    }
                  ]
                }
              }
            ]
          }
        }
      ],
      "trigger" : [
        {
          "type" : "named-event",
          "name" : "medication-prescribe"
        }
      ],
      "condition" : [
        {
          "kind" : "applicability",
          "expression" : {
            "description" : "Check whether the opioid prescription for the existing patient is extended-release without any opioids-with-abuse-potential prescribed in the past 90 days.",
            "language" : "text/cql",
            "expression" : "Inclusion Criteria"
          }
        }
      ],
      "groupingBehavior" : "visual-group",
      "selectionBehavior" : "exactly-one",
      "dynamicValue" : [
        {
          "path" : "action.title",
          "expression" : {
            "language" : "text/cql",
            "expression" : "Get Summary"
          }
        },
        {
          "path" : "action.description",
          "expression" : {
            "language" : "text/cql",
            "expression" : "Get Detail"
          }
        },
        {
          "path" : "activity.extension",
          "expression" : {
            "language" : "text/cql",
            "expression" : "Get Indicator"
          }
        }
      ],
      "action" : [
        {
          "description" : "Will precribe immediate release"
        },
        {
          "description" : "Risk of overdose carefully considered and outweighed by benefit; snooze 3 mo"
        },
        {
          "description" : "N/A - see comment; snooze 3 mo"
        }
      ]
    }
  ]
}

PlanDefinition "low-suicide-risk-order-set" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

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://terminology.hl7.org/CodeSystem/usage-context-type

code: age

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

Context:

system: http://terminology.hl7.org/CodeSystem/usage-context-type

code: focus

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

Context:

system: http://terminology.hl7.org/CodeSystem/usage-context-type

code: focus

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

Context:

system: http://terminology.hl7.org/CodeSystem/usage-context-type

code: focus

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

Context:

system: http://terminology.hl7.org/CodeSystem/usage-context-type

code: focus

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

Context:

system: http://terminology.hl7.org/CodeSystem/usage-context-type

code: user

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

Context:

system: http://terminology.hl7.org/CodeSystem/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)


{
  "resourceType" : "PlanDefinition",
  "id" : "low-suicide-risk-order-set",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2018-09-06T12:48:28.375Z"
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Id: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">PlanDefinition/low-suicide-risk-order-set</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Identifier: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <b>value: </b>\n <span>mmi:low-suicide-risk-order-set</span>\n </td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Title: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">Low Suicide Risk Order Set</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Status: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">draft</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Description: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">Orders to be applied to a patient characterized as low suicide risk.</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Purpose: </b>\n </td>\n </tr>\n <tr>\n <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>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Usage: </b>\n </td>\n </tr>\n <tr>\n <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>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Context: </b>\n </td>\n </tr>\n <tr style=\"vertical-align: top;\">\n <td style=\"padding-right: 25px;\">\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>system: </b>\n <span>http://terminology.hl7.org/CodeSystem/usage-context-type</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>code: </b>\n <span>age</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>value: </b>\n <br/>\n <span>\n <span>\n <span>\n <span style=\"padding-left: 25px;\">\n <b>system: </b>\n <span>https://meshb.nlm.nih.gov</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>code: </b>\n <span>D000328</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>display: </b>\n <span>Adult</span>\n </span>\n </span>\n </span>\n </span>\n </p>\n </td>\n </tr>\n </table>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Context: </b>\n </td>\n </tr>\n <tr style=\"vertical-align: top;\">\n <td style=\"padding-right: 25px;\">\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>system: </b>\n <span>http://terminology.hl7.org/CodeSystem/usage-context-type</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>code: </b>\n <span>focus</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>value: </b>\n <br/>\n <span>\n <span>\n <span>\n <span style=\"padding-left: 25px;\">\n <b>system: </b>\n <span>http://snomed.info/sct</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>code: </b>\n <span>87512008</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>display: </b>\n <span>Mild major depression</span>\n </span>\n </span>\n </span>\n </span>\n </p>\n </td>\n </tr>\n </table>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Context: </b>\n </td>\n </tr>\n <tr style=\"vertical-align: top;\">\n <td style=\"padding-right: 25px;\">\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>system: </b>\n <span>http://terminology.hl7.org/CodeSystem/usage-context-type</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>code: </b>\n <span>focus</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>value: </b>\n <br/>\n <span>\n <span>\n <span>\n <span style=\"padding-left: 25px;\">\n <b>system: </b>\n <span>http://snomed.info/sct</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>code: </b>\n <span>40379007</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>display: </b>\n <span>Major depression, recurrent, mild</span>\n </span>\n </span>\n </span>\n </span>\n </p>\n </td>\n </tr>\n </table>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Context: </b>\n </td>\n </tr>\n <tr style=\"vertical-align: top;\">\n <td style=\"padding-right: 25px;\">\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>system: </b>\n <span>http://terminology.hl7.org/CodeSystem/usage-context-type</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>code: </b>\n <span>focus</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>value: </b>\n <br/>\n <span>\n <span>\n <span>\n <span style=\"padding-left: 25px;\">\n <b>system: </b>\n <span>http://snomed.info/sct</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>code: </b>\n <span>394687007</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>display: </b>\n <span>Low suicide risk</span>\n </span>\n </span>\n </span>\n </span>\n </p>\n </td>\n </tr>\n </table>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Context: </b>\n </td>\n </tr>\n <tr style=\"vertical-align: top;\">\n <td style=\"padding-right: 25px;\">\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>system: </b>\n <span>http://terminology.hl7.org/CodeSystem/usage-context-type</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>code: </b>\n <span>focus</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>value: </b>\n <br/>\n <span>\n <span>\n <span>\n <span style=\"padding-left: 25px;\">\n <b>system: </b>\n <span>http://snomed.info/sct</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>code: </b>\n <span>225337009</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>display: </b>\n <span>Suicide risk assessment</span>\n </span>\n </span>\n </span>\n </span>\n </p>\n </td>\n </tr>\n </table>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Context: </b>\n </td>\n </tr>\n <tr style=\"vertical-align: top;\">\n <td style=\"padding-right: 25px;\">\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>system: </b>\n <span>http://terminology.hl7.org/CodeSystem/usage-context-type</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>code: </b>\n <span>user</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>value: </b>\n <br/>\n <span>\n <span>\n <span>\n <span style=\"padding-left: 25px;\">\n <b>system: </b>\n <span>http://snomed.info/sct</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>code: </b>\n <span>309343006</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>display: </b>\n <span>Physician</span>\n </span>\n </span>\n </span>\n </span>\n </p>\n </td>\n </tr>\n </table>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Context: </b>\n </td>\n </tr>\n <tr style=\"vertical-align: top;\">\n <td style=\"padding-right: 25px;\">\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>system: </b>\n <span>http://terminology.hl7.org/CodeSystem/usage-context-type</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>code: </b>\n <span>venue</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>value: </b>\n <br/>\n <span>\n <span>\n <span>\n <span style=\"padding-left: 25px;\">\n <b>system: </b>\n <span>http://snomed.info/sct</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>code: </b>\n <span>440655000</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>display: </b>\n <span>Outpatient environment</span>\n </span>\n </span>\n </span>\n </span>\n </p>\n </td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Topic: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <span>\n <b>text: </b>\n <span>Suicide risk assessment</span>\n </span>\n </td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Contributor: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <b>\n <span>author</span>:\n </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 50px; padding-right: 25px;\">Motive Medical Intelligence</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Library: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <b>reference: </b>\n <span>Library/suiciderisk-orderset-logic</span>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <b>display: </b>\n <span>SuicideRiskLogic</span>\n </td>\n </tr>\n </table>\n <p/>\n <h2>Actions</h2>\n <p style=\"width: 100%;\" class=\"hierarchy\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 25px;\">\n <b>title: </b>\n <span>Suicide Risk Assessment and Outpatient Management</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 50px;\">\n <b>title: </b>\n <span>Consults and Referrals</span>\n <br/>\n </span>\n <span style=\"padding-left: 50px;\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 75px;\">\n <b>text: </b>\n <span>Refer to outpatient mental health program for evaluation and treatment of mental health conditions now</span>\n <br/>\n </span>\n <span style=\"padding-left: 75px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>reference: </b>\n <br/>\n <span style=\"padding-left: 125px;\">#referralToMentalHealthCare</span>\n <span>\n <span style=\"padding-left: 75px;\">\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>description: </b>\n <span>refer to primary care mental-health integrated care program for evaluation and treatment of mental health conditions now</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\">\n <b>category: </b>\n <span>referral</span>\n <br/>\n </span>\n </span>\n </span>\n </span>\n </span>\n <span style=\"padding-left: 50px;\"/>\n </span>\n </span>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 50px;\">\n <b>title: </b>\n <span>Medications</span>\n <br/>\n </span>\n <span style=\"padding-left: 50px;\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 75px;\">\n <b>title: </b>\n <span>First-Line Antidepressants</span>\n <br/>\n </span>\n <span style=\"padding-left: 75px;\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>title: </b>\n <span>Selective Serotonin Reuptake Inhibitors (Choose a mazimum of one or document reasons for exception)</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 125px;\">\n <b>text: </b>\n <span>citalopram 20 mg tablet 1 tablet oral 1 time daily now (30 table; 3 refills)</span>\n <br/>\n </span>\n <span style=\"padding-left: 125px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 150px;\">\n <b>reference: </b>\n <br/>\n <span style=\"padding-left: 175px;\">#citalopramPrescription</span>\n <span/>\n <span>\n <span style=\"padding-left: 125px;\">\n <br/>\n <span style=\"padding-left: 150px;\">\n <b>category: </b>\n <span>drug</span>\n <br/>\n </span>\n </span>\n </span>\n <span/>\n <span/>\n </span>\n </span>\n <span style=\"padding-left: 100px;\"/>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 125px;\">\n <b>text: </b>\n <span>escitalopram 10 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\"/>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 125px;\">\n <b>text: </b>\n <span>fluoxetine 20 mg capsule 1 capsule oral 1 time daily now (30 tablet; 3 refills)</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\"/>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 125px;\">\n <b>text: </b>\n <span>paroxetine 20 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\"/>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 125px;\">\n <b>text: </b>\n <span>sertraline 50 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\"/>\n </span>\n </span>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 125px;\">\n <b>text: </b>\n <span>Dopamine Norepinephrine Reuptake Inhibitors (Choose a maximum of one or document reasons for exception)</span>\n <br/>\n </span>\n <span style=\"padding-left: 75px;\"/>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>text: </b>\n <span>Serotonin Norepinephrine Reuptake Inhibitors (Choose a maximum of one or doument reasons for exception)</span>\n <br/>\n </span>\n <span style=\"padding-left: 75px;\"/>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>text: </b>\n <span>Norepinephrine-Serotonin Modulators (Choose a maximum of one or document reasons for exception)</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\"/>\n </span>\n </span>\n </span>\n </span>\n </span>\n </span>\n </span>\n </p>\n </div>"
  },
  "contained" : [
    {
      "resourceType" : "ActivityDefinition",
      "id" : "referralToMentalHealthCare",
      "status" : "draft",
      "description" : "refer to primary care mental-health integrated care program for evaluation and treatment of mental health conditions now",
      "kind" : "ServiceRequest",
      "code" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "306206005"
          }
        ],
        "text" : "Referral to service (procedure)"
      },
      "timingTiming" : {
        "_event" : [
          {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/cqf-expression",
                "valueExpression" : {
                  "language" : "text/cql",
                  "expression" : "Now()"
                }
              }
            ]
          }
        ]
      },
      "participant" : [
        {
          "type" : "practitioner"
        }
      ]
    },
    {
      "resourceType" : "ActivityDefinition",
      "id" : "citalopramPrescription",
      "status" : "draft",
      "kind" : "MedicationRequest",
      "productReference" : {
        "reference" : "#citalopramMedication"
      },
      "dosage" : [
        {
          "text" : "1 tablet oral 1 time daily",
          "timing" : {
            "repeat" : {
              "frequency" : 1,
              "period" : 1,
              "periodUnit" : "d"
            }
          },
          "route" : {
            "coding" : [
              {
                "code" : "26643006",
                "display" : "Oral route (qualifier value)"
              }
            ],
            "text" : "Oral route (qualifier value)"
          },
          "doseAndRate" : [
            {
              "type" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/dose-rate-type",
                    "code" : "ordered",
                    "display" : "Ordered"
                  }
                ]
              },
              "doseQuantity" : {
                "value" : 1,
                "unit" : "{tbl}
"
              }
            }
          ]
        }
      ],
      "dynamicValue" : [
        {
          "path" : "dispenseRequest.numberOfRepeatsAllowed",
          "expression" : {
            "language" : "text/cql",
            "expression" : "3"
          }
        },
        {
          "path" : "dispenseRequest.quantity",
          "expression" : {
            "language" : "text/cql",
            "expression" : "30 '{tbl}'"
          }
        }
      ]
    },
    {
      "resourceType" : "Medication",
      "id" : "citalopramMedication",
      "code" : {
        "coding" : [
          {
            "system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
            "code" : "200371"
          }
        ],
        "text" : "citalopram"
      },
      "form" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "385055001",
            "display" : "Tablet dose form"
          }
        ],
        "text" : "Tablet dose form"
      },
      "ingredient" : [
        {
          "itemReference" : {
            "reference" : "#citalopramSubstance"
          },
          "amount" : {
            "numerator" : {
              "value" : 20,
              "unit" : "mg"
            },
            "denominator" : {
              "value" : 1,
              "unit" : "{tbl}"
            }
          }
        }
      ]
    },
    {
      "resourceType" : "Substance",
      "id" : "citalopramSubstance",
      "code" : {
        "coding" : [
          {
            "system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
            "code" : "2556"
          }
        ],
        "text" : "citalopram"
      }
    }
  ],
  "url" : "http://motivemi.com/artifacts/PlanDefinition/low-suicide-risk-order-set",
  "identifier" : [
    {
      "use" : "official",
      "system" : "http://motivemi.com/artifacts",
      "value" : "mmi:low-suicide-risk-order-set"
    }
  ],
  "version" : "1.0.0",
  "name" : "LowSuicideRiskOrderSet",
  "title" : "Low Suicide Risk Order Set",
  "status" : "active",
  "experimental" : true,
  "date" : "2015-08-15",
  "publisher" : "Motive Medical Intelligence",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "phone",
          "value" : "415-362-4007",
          "use" : "work"
        },
        {
          "system" : "email",
          "value" : "info@motivemi.com",
          "use" : "work"
        }
      ]
    }
  ],
  "description" : "Orders to be applied to a patient characterized as low suicide risk.",
  "useContext" : [
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "age"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "https://meshb.nlm.nih.gov",
            "code" : "D000328",
            "display" : "Adult"
          }
        ]
      }
    },
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "focus"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "87512008",
            "display" : "Mild major depression"
          }
        ]
      }
    },
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "focus"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "40379007",
            "display" : "Major depression, recurrent, mild"
          }
        ]
      }
    },
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "focus"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "394687007",
            "display" : "Low suicide risk"
          }
        ]
      }
    },
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "focus"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "225337009",
            "display" : "Suicide risk assessment"
          }
        ]
      }
    },
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "user"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "309343006",
            "display" : "Physician"
          }
        ]
      }
    },
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "venue"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "440655000",
            "display" : "Outpatient environment"
          }
        ]
      }
    }
  ],
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US"
        }
      ]
    }
  ],
  "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.",
  "copyright" : "© Copyright 2016 Motive Medical Intelligence. All rights reserved.",
  "approvalDate" : "2016-03-12",
  "lastReviewDate" : "2016-08-15",
  "effectivePeriod" : {
    "start" : "2016-01-01",
    "end" : "2017-12-31"
  },
  "topic" : [
    {
      "text" : "Suicide risk assessment"
    }
  ],
  "author" : [
    {
      "name" : "Motive Medical Intelligence",
      "telecom" : [
        {
          "system" : "phone",
          "value" : "415-362-4007",
          "use" : "work"
        },
        {
          "system" : "email",
          "value" : "info@motivemi.com",
          "use" : "work"
        }
      ]
    }
  ],
  "relatedArtifact" : [
    {
      "type" : "derived-from",
      "display" : "Practice Guideline for the Treatment of Patients with Major Depressive Disorder",
      "url" : "http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf"
    },
    {
      "type" : "composed-of",
      "resource" : "ActivityDefinition/referralPrimaryCareMentalHealth"
    },
    {
      "type" : "composed-of",
      "resource" : "ActivityDefinition/citalopramPrescription"
    }
  ],
  "library" : [
    "Library/suiciderisk-orderset-logic"
  ],
  "action" : [
    {
      "title" : "Suicide Risk Assessment and Outpatient Management",
      "action" : [
        {
          "title" : "Consults and Referrals",
          "groupingBehavior" : "logical-group",
          "selectionBehavior" : "any",
          "action" : [
            {
              "textEquivalent" : "Refer to outpatient mental health program for evaluation and treatment of mental health conditions now",
              "definition" : "#referralToMentalHealthCare",
              "dynamicValue" : [
                {
                  "path" : "timing.event",
                  "expression" : {
                    "language" : "text/cql",
                    "expression" : "Now()"
                  }
                },
                {
                  "path" : "specialty",
                  "expression" : {
                    "language" : "text/cql",
                    "expression" : "Code '261QM0850X' from SuicideRiskLogic.\"NUCC Provider Taxonomy\" display 'Adult Mental Health'"
                  }
                },
                {
                  "path" : "occurrenceDateTime",
                  "expression" : {
                    "language" : "text/cql",
                    "expression" : "SuicideRiskLogic.ServiceRequestFulfillmentTime"
                  }
                },
                {
                  "path" : "subject",
                  "expression" : {
                    "language" : "text/cql",
                    "expression" : "SuicideRiskLogic.Patient"
                  }
                },
                {
                  "path" : "requester.agent",
                  "expression" : {
                    "language" : "text/cql",
                    "expression" : "SuicideRiskLogic.Practitioner"
                  }
                },
                {
                  "path" : "reasonCode",
                  "expression" : {
                    "language" : "text/cql",
                    "expression" : "SuicideRiskLogic.RiskAssessmentScore"
                  }
                },
                {
                  "path" : "reasonReference",
                  "expression" : {
                    "language" : "text/cql",
                    "expression" : "SuicideRiskLogic.RiskAssessment"
                  }
                }
              ]
            }
          ]
        },
        {
          "title" : "Medications",
          "groupingBehavior" : "logical-group",
          "selectionBehavior" : "at-most-one",
          "action" : [
            {
              "title" : "First-Line Antidepressants",
              "documentation" : [
                {
                  "type" : "citation",
                  "document" : {
                    "extension" : [
                      {
                        "url" : "http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence",
                        "valueCodeableConcept" : {
                          "coding" : [
                            {
                              "system" : "http://terminology.hl7.org/CodeSystem/evidence-quality",
                              "code" : "high"
                            }
                          ],
                          "text" : "High Quality"
                        }
                      }
                    ],
                    "contentType" : "text/html",
                    "url" : "http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf",
                    "title" : "Practice Guideline for the Treatment of Patients with Major Depressive Disorder"
                  }
                }
              ],
              "groupingBehavior" : "logical-group",
              "selectionBehavior" : "at-most-one",
              "action" : [
                {
                  "title" : "Selective Serotonin Reuptake Inhibitors (Choose a mazimum of one or document reasons for exception)",
                  "documentation" : [
                    {
                      "type" : "citation",
                      "document" : {
                        "contentType" : "text/html",
                        "url" : "http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6daeb45c-451d-b135-bf8f-2d6dff4b6b01",
                        "title" : "National Library of Medicine. DailyMed website. CITALOPRAM- citalopram hydrobromide tablet, film coated."
                      }
                    }
                  ],
                  "groupingBehavior" : "logical-group",
                  "selectionBehavior" : "at-most-one",
                  "action" : [
                    {
                      "textEquivalent" : "citalopram 20 mg tablet 1 tablet oral 1 time daily now (30 table; 3 refills)",
                      "definition" : "#citalopramPrescription",
                      "dynamicValue" : [
                        {
                          "path" : "status",
                          "expression" : {
                            "language" : "text/cql",
                            "expression" : "'draft'"
                          }
                        },
                        {
                          "path" : "patient",
                          "expression" : {
                            "language" : "text/cql",
                            "expression" : "SuicideRiskLogic.Patient"
                          }
                        },
                        {
                          "path" : "prescriber",
                          "expression" : {
                            "language" : "text/cql",
                            "expression" : "SuicideRiskLogic.Practitioner"
                          }
                        },
                        {
                          "path" : "reasonCode",
                          "expression" : {
                            "language" : "text/cql",
                            "expression" : "SuicideRiskLogic.RiskAssessmentScore"
                          }
                        },
                        {
                          "path" : "reasonReference",
                          "expression" : {
                            "language" : "text/cql",
                            "expression" : "SuicideRiskLogic.RiskAssessment"
                          }
                        }
                      ]
                    },
                    {
                      "textEquivalent" : "escitalopram 10 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)"
                    },
                    {
                      "textEquivalent" : "fluoxetine 20 mg capsule 1 capsule oral 1 time daily now (30 tablet; 3 refills)"
                    },
                    {
                      "textEquivalent" : "paroxetine 20 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)"
                    },
                    {
                      "textEquivalent" : "sertraline 50 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)"
                    }
                  ]
                },
                {
                  "textEquivalent" : "Dopamine Norepinephrine Reuptake Inhibitors (Choose a maximum of one or document reasons for exception)"
                },
                {
                  "textEquivalent" : "Serotonin Norepinephrine Reuptake Inhibitors (Choose a maximum of one or doument reasons for exception)"
                },
                {
                  "textEquivalent" : "Norepinephrine-Serotonin Modulators (Choose a maximum of one or document reasons for exception)"
                }
              ]
            }
          ]
        }
      ]
    }
  ]
}

PlanDefinition "KDN5" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

National Comprehensive Cancer Network

Chemotherapy Order Template

Kidney Cancer

Gemcitabine/CARBOplatin

KDN5

INDICATION:

Metastatic or Relapsed – Collecting Duct/Medullary Subtypes

REFERENCES:

  1. NCCN Guidelines® for Kidney Cancer. V.3.2015.
  2. Oudard S, et al. J Urol. 2007;177(5):1698-702. a

NCCN SUPPORTIVE CARE:

  1. Emetic Risk:
    Day 1 Moderate
    Day 8 Low
  2. Fever Neutropenia Risk:
    Refer to NCCN Guidelines for Myeloid Growth Factors. V.2.2014

CHEMOTHERAPY REGIMEN

21-day cycle for 6 cycles

  • Gemcitabine 1250 mg/m2 IV over 30 minutes on Days 1 and 8
  • CARBOplatin AUC 5 IV over 30 minutes on Day 1

{
  "resourceType" : "PlanDefinition",
  "id" : "KDN5",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2018-09-06T12:48:28.296Z"
  },
  "text" : {
    "status" : "additional",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <table style=\"width: 100%;\">\n <tr>\n <td>\n <!-- link to NCCN image -->\n <div style=\"width: 200px; height: 100px; vertical-align: top;\">National Comprehensive Cancer Network</div>\n </td>\n <td>\n <h3>Chemotherapy Order Template</h3>\n <h1>Kidney Cancer</h1>\n <h2>Gemcitabine/CARBOplatin</h2>\n </td>\n <td style=\"text-align: right; vertical-align: top;\">KDN5</td>\n </tr>\n </table>\n <table style=\"width: 100%; border-top: 1px solid; border-bottom: 1px solid;\">\n <tr>\n <td style=\"width: 33%; border-right: 1px solid; vertical-align: top\">\n <h4>INDICATION:</h4>\n <p>Metastatic or Relapsed &#8211; Collecting Duct/Medullary Subtypes</p>\n </td>\n <td style=\"width: 34%; border-right: 1px solid; vertical-align: top\">\n <h4>REFERENCES:</h4>\n <ol>\n <li><a href=\"http://www.example.org/professionals/physician_gls/PDF/kidney.pdf\">NCCN Guidelines&#174; for Kidney Cancer. V.3.2015.</a></li>\n <li><a href=\"http://www.ncbi.nlm.nih.gov/pubmed?term=%22The+Journal+of+urology%22%5BJour%5D+AND+1698%5Bpage%5D+AND+2007%5Bpdat%5D+AND+Oudard+S%5Bauthor%5D\">Oudard S, et al. <em>J Urol</em>. 2007;177(5):1698-702.</a><sup>\n <a href=\"http://www.example.org/OrderTemplates/PDF/appendix_E.pdf\">a</a></sup>\n </li>\n </ol>\n </td>\n <td style=\"width: 33%; vertical-align: top\">\n <h4>NCCN SUPPORTIVE CARE:</h4>\n <ol>\n <li>\n <i>Emetic Risk:</i>\n <table>\n <tr>\n <td>Day 1</td>\n <td>Moderate</td>\n </tr>\n <tr>\n <td>Day 8</td>\n <td>Low</td>\n </tr>\n </table>\n </li>\n <li>\n <i>Fever Neutropenia Risk:</i><br/>\n Refer to <a href=\"http://www.example.org/professionals/physician_gls/PDF/myeloid_growth.pdf\">NCCN Guidelines for Myeloid Growth Factors. V.2.2014</a>\n </li>\n </ol>\n </td>\n </tr>\n </table>\n <!-- same as the regimen section of the Composition resource only this version is without the style guide notes -->\n <h4>CHEMOTHERAPY REGIMEN</h4>\n <p>\n <i>21-day cycle for 6 cycles</i>\n </p>\n <ul>\n <li>Gemcitabine 1250 mg/m<sup>2</sup> IV over 30 minutes on Days 1 and 8</li>\n <li>CARBOplatin AUC 5 IV over 30 minutes on Day 1</li>\n </ul>\n </div>"
  },
  "contained" : [
    {
      "resourceType" : "ActivityDefinition",
      "id" : "1111",
      "status" : "draft",
      "productCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
            "code" : "12574",
            "display" : "gemcitabine"
          }
        ],
        "text" : "gemcitabine"
      },
      "dosage" : [
        {
          "text" : "1250 mg/m² IV over 30 minutes",
          "timing" : {
            "repeat" : {
              "duration" : 30,
              "durationUnit" : "min"
            }
          },
          "route" : {
            "text" : "IV"
          },
          "doseAndRate" : [
            {
              "type" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/dose-rate-type",
                    "code" : "ordered",
                    "display" : "Ordered"
                  }
                ]
              },
              "doseQuantity" : {
                "value" : 1250,
                "unit" : "mg/m²"
              }
            }
          ]
        }
      ]
    },
    {
      "resourceType" : "ActivityDefinition",
      "id" : "2222",
      "status" : "draft",
      "productCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
            "code" : "40048",
            "display" : "Carboplatin"
          }
        ],
        "text" : "CARBOplatin"
      },
      "dosage" : [
        {
          "text" : "AUC 5 IV over 30 minutes",
          "timing" : {
            "repeat" : {
              "duration" : 30,
              "durationUnit" : "min"
            }
          },
          "route" : {
            "text" : "IV"
          },
          "doseAndRate" : [
            {
              "type" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/dose-rate-type",
                    "code" : "ordered",
                    "display" : "Ordered"
                  }
                ]
              },
              "doseQuantity" : {
                "extension" : [
                  {
                    "url" : "http://example.org/fhir/AUC-dose",
                    "valueInteger" : 5
                  }
                ]
              }
            }
          ]
        }
      ]
    }
  ],
  "identifier" : [
    {
      "system" : "http://example.org/ordertemplates",
      "value" : "KDN5"
    }
  ],
  "version" : "1",
  "title" : "Gemcitabine/CARBOplatin",
  "type" : {
    "text" : "Chemotherapy Order Template"
  },
  "status" : "draft",
  "experimental" : true,
  "publisher" : "National Comprehensive Cancer Network, Inc.",
  "useContext" : [
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/usagecontext-group",
          "valueString" : "A"
        }
      ],
      "code" : {
        "system" : "http://example.org/fhir/CodeSystem/indications",
        "code" : "treamentSetting-or-diseaseStatus"
      },
      "valueCodeableConcept" : {
        "text" : "Metastatic"
      }
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/usagecontext-group",
          "valueString" : "A"
        }
      ],
      "code" : {
        "system" : "http://example.org/fhir/CodeSystem/indications",
        "code" : "disease-or-histology"
      },
      "valueCodeableConcept" : {
        "text" : "Collecting Duct/Medullary Subtypes"
      }
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/usagecontext-group",
          "valueString" : "A"
        }
      ],
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "focus"
      },
      "valueCodeableConcept" : {
        "text" : "Kidney Cancer"
      }
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/usagecontext-group",
          "valueString" : "B"
        }
      ],
      "code" : {
        "system" : "http://example.org/fhir/CodeSystem/indications",
        "code" : "treatmentSetting-or-diseaseStatus"
      },
      "valueCodeableConcept" : {
        "text" : "Relapsed"
      }
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/usagecontext-group",
          "valueString" : "B"
        }
      ],
      "code" : {
        "system" : "http://example.org/fhir/CodeSystem/indications",
        "code" : "disease-or-histology"
      },
      "valueCodeableConcept" : {
        "text" : "Collecting Duct/Medullary Subtypes"
      }
    },
    {
      "extension" : [
        {
          "url" : "http://hl7.org/fhir/StructureDefinition/usagecontext-group",
          "valueString" : "B"
        }
      ],
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "focus"
      },
      "valueCodeableConcept" : {
        "text" : "Kidney Cancer – Collecting Duct/Medullary Subtypes - Metastatic"
      }
    }
  ],
  "copyright" : "All rights reserved.",
  "approvalDate" : "2016-07-27",
  "lastReviewDate" : "2016-07-27",
  "author" : [
    {
      "name" : "Lee Surprenant"
    }
  ],
  "relatedArtifact" : [
    {
      "type" : "derived-from",
      "display" : "NCCN Guidelines for Kidney Cancer. V.2.2016",
      "url" : "http://www.example.org/professionals/physician_gls/PDF/kidney.pdf"
    },
    {
      "type" : "citation",
      "_type" : {
        "extension" : [
          {
            "url" : "http://example.org/fhir/regimenReferenceType",
            "valueCode" : "a"
          }
        ]
      },
      "citation" : "Oudard S, et al. J Urol. 2007;177(5):1698-702",
      "url" : "http://www.ncbi.nlm.nih.gov/pubmed/17437788"
    }
  ],
  "action" : [
    {
      "selectionBehavior" : "exactly-one",
      "action" : [
        {
          "selectionBehavior" : "all",
          "action" : [
            {
              "groupingBehavior" : "sentence-group",
              "selectionBehavior" : "exactly-one",
              "action" : [
                {
                  "id" : "cycle-definition-1",
                  "textEquivalent" : "21-day cycle for 6 cycles",
                  "timingTiming" : {
                    "repeat" : {
                      "count" : 6,
                      "duration" : 21,
                      "durationUnit" : "d"
                    }
                  },
                  "action" : [
                    {
                      "id" : "action-1",
                      "extension" : [
                        {
                          "extension" : [
                            {
                              "url" : "day",
                              "valueInteger" : 1
                            },
                            {
                              "url" : "day",
                              "valueInteger" : 8
                            }
                          ],
                          "url" : "http://hl7.org/fhir/StructureDefinition/timing-daysOfCycle"
                        }
                      ],
                      "textEquivalent" : "Gemcitabine 1250 mg/m² IV over 30 minutes on days 1 and 8",
                      "definition" : "#1111"
                    },
                    {
                      "id" : "action-2",
                      "extension" : [
                        {
                          "extension" : [
                            {
                              "url" : "day",
                              "valueInteger" : 1
                            }
                          ],
                          "url" : "http://hl7.org/fhir/StructureDefinition/timing-daysOfCycle"
                        }
                      ],
                      "textEquivalent" : "CARBOplatin AUC 5 IV over 30 minutes on Day 1",
                      "relatedAction" : [
                        {
                          "actionId" : "action-1",
                          "relationship" : "concurrent-with-start"
                        }
                      ],
                      "definition" : "#2222"
                    }
                  ]
                }
              ]
            }
          ]
        }
      ]
    }
  ]
}

PlanDefinition "exclusive-breastfeeding-intervention-04" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Id:
PlanDefinition/exclusive-breastfeeding-intervention-04

Identifier:
value: exclusive-breastfeeding-intervention-04

Title:
Exclusive Breastfeeding Intervention-04

Status:
active

Description:
Exclusive breastfeeding intervention intended to improve outcomes for exclusive breastmilk feeding of newborns by creating a lactation consult for the mother if appropriate.

Topic:
text: Exclusive Breastfeeding

Library:
reference: Library/library-exclusive-breastfeeding-cds-logic

Actions

Step:
title: Mother should be referred to a lactation specialist for consultation.
condition:
type: applicability
expression: Should Create Lactation Consult
Step:
title: Create a lactation consult request.
text: Create a lactation consult request


{
  "resourceType" : "PlanDefinition",
  "id" : "exclusive-breastfeeding-intervention-04",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2018-09-06T12:48:28.234Z"
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Id: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">PlanDefinition/exclusive-breastfeeding-intervention-04</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Identifier: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <b>value: </b>\n <span>exclusive-breastfeeding-intervention-04</span>\n </td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Title: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">Exclusive Breastfeeding Intervention-04</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Status: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">active</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Description: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">Exclusive breastfeeding intervention intended to improve outcomes for exclusive breastmilk feeding of newborns by creating a lactation consult for the mother if appropriate.</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Topic: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <span>\n <b>text: </b>\n <span>Exclusive Breastfeeding</span>\n </span>\n </td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Library: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <b>reference: </b>\n <span>Library/library-exclusive-breastfeeding-cds-logic</span>\n </td>\n </tr>\n </table>\n <p/>\n <h2>Actions</h2>\n <p style=\"width: 100%;\" class=\"hierarchy\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 25px;\">\n <b>title: </b>\n <span>Mother should be referred to a lactation specialist for consultation.</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 50px;\">\n <b>type: </b>\n <span>applicability</span>\n <br/>\n </span>\n <span style=\"padding-left: 50px;\">\n <b>expression: </b>\n <span>Should Create Lactation Consult</span>\n <br/>\n </span>\n </span>\n <span style=\"padding-left: 25px;\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 50px;\">\n <b>title: </b>\n <span>Create a lactation consult request.</span>\n <br/>\n </span>\n <span style=\"padding-left: 50px;\">\n <b>text: </b>\n <span>Create a lactation consult request</span>\n <br/>\n </span>\n <span style=\"padding-left: 50px;\"/>\n </span>\n </span>\n </span>\n </p>\n </div>"
  },
  "identifier" : [
    {
      "use" : "official",
      "value" : "exclusive-breastfeeding-intervention-04"
    }
  ],
  "version" : "1.0.0",
  "title" : "Exclusive Breastfeeding Intervention-04",
  "status" : "active",
  "date" : "2015-03-08",
  "description" : "Exclusive breastfeeding intervention intended to improve outcomes for exclusive breastmilk feeding of newborns by creating a lactation consult for the mother if appropriate.",
  "topic" : [
    {
      "text" : "Exclusive Breastfeeding"
    }
  ],
  "relatedArtifact" : [
    {
      "type" : "derived-from",
      "resource" : "Measure/measure-exclusive-breastfeeding"
    }
  ],
  "library" : [
    "Library/library-exclusive-breastfeeding-cds-logic"
  ],
  "action" : [
    {
      "title" : "Mother should be referred to a lactation specialist for consultation.",
      "trigger" : [
        {
          "type" : "named-event",
          "name" : "Admission"
        },
        {
          "type" : "named-event",
          "name" : "Birth"
        },
        {
          "type" : "named-event",
          "name" : "Infant Transfer to Recovery"
        },
        {
          "type" : "named-event",
          "name" : "Transfer to Post-Partum"
        }
      ],
      "condition" : [
        {
          "kind" : "applicability",
          "expression" : {
            "language" : "text/cql",
            "expression" : "Should Create Lactation Consult"
          }
        }
      ],
      "action" : [
        {
          "title" : "Create a lactation consult request.",
          "textEquivalent" : "Create a lactation consult request",
          "type" : {
            "coding" : [
              {
                "code" : "create"
              }
            ]
          },
          "dynamicValue" : [
            {
              "path" : "/",
              "expression" : {
                "language" : "text/cql",
                "expression" : "Create Lactation Consult Request"
              }
            }
          ]
        }
      ]
    }
  ]
}

PlanDefinition "exclusive-breastfeeding-intervention-03" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Id:
PlanDefinition/exclusive-breastfeeding-intervention-03

Identifier:
value: exclusive-breastfeeding-intervention-03

Title:
Exclusive Breastfeeding Intervention-03

Status:
active

Description:
Exclusive breastfeeding intervention intended to improve outcomes for exclusive breastmilk feeding of newborns by notifying the charge and/or bedside nurse to perform the breastfeeding readiness assessment.

Topic:
text: Exclusive Breastfeeding

Library:
reference: Library/library-exclusive-breastfeeding-cds-logic

Actions

Step:
title: Mother should be administered a breastfeeding readiness assessment.
condition:
type: applicability
expression: Should Notify Nurse to Perform Assessment
Step:
title: Notify the charge nurse to perform the assessment.
text: A Breastfeeding Readiness Assessment is recommended, please administer the assessment.
Step:
title: Notify the bedside nurse to perform the assessment.
text: A Breastfeeding Readiness Assessment is recommended, please administer the assessment.


{
  "resourceType" : "PlanDefinition",
  "id" : "exclusive-breastfeeding-intervention-03",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2018-09-06T12:48:28.171Z"
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Id: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">PlanDefinition/exclusive-breastfeeding-intervention-03</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Identifier: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <b>value: </b>\n <span>exclusive-breastfeeding-intervention-03</span>\n </td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Title: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">Exclusive Breastfeeding Intervention-03</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Status: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">active</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Description: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">Exclusive breastfeeding intervention intended to improve outcomes for exclusive breastmilk feeding of newborns by notifying the charge and/or bedside nurse to perform the breastfeeding readiness assessment.</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Topic: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <span>\n <b>text: </b>\n <span>Exclusive Breastfeeding</span>\n </span>\n </td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Library: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <b>reference: </b>\n <span>Library/library-exclusive-breastfeeding-cds-logic</span>\n </td>\n </tr>\n </table>\n <p/>\n <h2>Actions</h2>\n <p style=\"width: 100%;\" class=\"hierarchy\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 25px;\">\n <b>title: </b>\n <span>Mother should be administered a breastfeeding readiness assessment.</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 50px;\">\n <b>type: </b>\n <span>applicability</span>\n <br/>\n </span>\n <span style=\"padding-left: 50px;\">\n <b>expression: </b>\n <span>Should Notify Nurse to Perform Assessment</span>\n <br/>\n </span>\n </span>\n <span style=\"padding-left: 25px;\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 50px;\">\n <b>title: </b>\n <span>Notify the charge nurse to perform the assessment.</span>\n <br/>\n </span>\n <span style=\"padding-left: 50px;\">\n <b>text: </b>\n <span>A Breastfeeding Readiness Assessment is recommended, please administer the assessment.</span>\n <br/>\n </span>\n <span style=\"padding-left: 50px;\"/>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 75px;\">\n <b>title: </b>\n <span>Notify the bedside nurse to perform the assessment.</span>\n <br/>\n </span>\n <span style=\"padding-left: 75px;\">\n <b>text: </b>\n <span>A Breastfeeding Readiness Assessment is recommended, please administer the assessment.</span>\n <br/>\n </span>\n </span>\n </span>\n </span>\n </p>\n </div>"
  },
  "identifier" : [
    {
      "use" : "official",
      "value" : "exclusive-breastfeeding-intervention-03"
    }
  ],
  "version" : "1.0.0",
  "title" : "Exclusive Breastfeeding Intervention-03",
  "status" : "active",
  "date" : "2015-03-08",
  "description" : "Exclusive breastfeeding intervention intended to improve outcomes for exclusive breastmilk feeding of newborns by notifying the charge and/or bedside nurse to perform the breastfeeding readiness assessment.",
  "topic" : [
    {
      "text" : "Exclusive Breastfeeding"
    }
  ],
  "relatedArtifact" : [
    {
      "type" : "derived-from",
      "resource" : "Measure/measure-exclusive-breastfeeding"
    }
  ],
  "library" : [
    "Library/library-exclusive-breastfeeding-cds-logic"
  ],
  "action" : [
    {
      "title" : "Mother should be administered a breastfeeding readiness assessment.",
      "trigger" : [
        {
          "type" : "named-event",
          "name" : "Admission"
        },
        {
          "type" : "named-event",
          "name" : "Birth"
        },
        {
          "type" : "named-event",
          "name" : "Infant Transfer to Recovery"
        },
        {
          "type" : "named-event",
          "name" : "Transfer to Post-Partum"
        }
      ],
      "condition" : [
        {
          "kind" : "applicability",
          "expression" : {
            "language" : "text/cql",
            "expression" : "Should Notify Nurse to Perform Assessment"
          }
        }
      ],
      "action" : [
        {
          "title" : "Notify the charge nurse to perform the assessment.",
          "textEquivalent" : "A Breastfeeding Readiness Assessment is recommended, please administer the assessment.",
          "type" : {
            "coding" : [
              {
                "code" : "create"
              }
            ]
          },
          "dynamicValue" : [
            {
              "path" : "/",
              "expression" : {
                "language" : "text/cql",
                "expression" : "Communication Request to Charge Nurse"
              }
            }
          ]
        },
        {
          "title" : "Notify the bedside nurse to perform the assessment.",
          "textEquivalent" : "A Breastfeeding Readiness Assessment is recommended, please administer the assessment.",
          "type" : {
            "coding" : [
              {
                "code" : "create"
              }
            ]
          },
          "dynamicValue" : [
            {
              "path" : "/",
              "expression" : {
                "language" : "text/cql",
                "expression" : "Communication Request to Bedside Nurse"
              }
            }
          ]
        }
      ]
    }
  ]
}

PlanDefinition "exclusive-breastfeeding-intervention-02" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Id:
PlanDefinition/exclusive-breastfeeding-intervention-02

Identifier:
value: exclusive-breastfeeding-intervention-02

Title:
Exclusive Breastfeeding Intervention-02

Status:
active

Description:
Exclusive breastfeeding intervention intended to improve outcomes for exclusive breastmilk feeding of newborns by notifying the provider to sign the breastmilk feeding readiness assessment order, if necessary.

Topic:
text: Exclusive Breastfeeding

Library:
reference: Library/library-exclusive-breastfeeding-cds-logic

Actions

Step:
title: Mother should be administered a breastfeeding readiness assessment.
condition:
type: applicability
expression: Should Notify Provider to Sign Assessment Order
Step:
title: Notify the provider to sign the order.
text: A Breastfeeding Readiness Assessment is recommended, please authorize or reject the order.


{
  "resourceType" : "PlanDefinition",
  "id" : "exclusive-breastfeeding-intervention-02",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2018-09-06T12:48:28.125Z"
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Id: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">PlanDefinition/exclusive-breastfeeding-intervention-02</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Identifier: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <b>value: </b>\n <span>exclusive-breastfeeding-intervention-02</span>\n </td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Title: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">Exclusive Breastfeeding Intervention-02</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Status: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">active</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Description: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">Exclusive breastfeeding intervention intended to improve outcomes for exclusive breastmilk feeding of newborns by notifying the provider to sign the breastmilk feeding readiness assessment order, if necessary.</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Topic: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <span>\n <b>text: </b>\n <span>Exclusive Breastfeeding</span>\n </span>\n </td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Library: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <b>reference: </b>\n <span>Library/library-exclusive-breastfeeding-cds-logic</span>\n </td>\n </tr>\n </table>\n <p/>\n <h2>Actions</h2>\n <p style=\"width: 100%;\" class=\"hierarchy\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 25px;\">\n <b>title: </b>\n <span>Mother should be administered a breastfeeding readiness assessment.</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 50px;\">\n <b>type: </b>\n <span>applicability</span>\n <br/>\n </span>\n <span style=\"padding-left: 50px;\">\n <b>expression: </b>\n <span>Should Notify Provider to Sign Assessment Order</span>\n <br/>\n </span>\n </span>\n <span style=\"padding-left: 25px;\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 50px;\">\n <b>title: </b>\n <span>Notify the provider to sign the order.</span>\n <br/>\n </span>\n <span style=\"padding-left: 50px;\">\n <b>text: </b>\n <span>A Breastfeeding Readiness Assessment is recommended, please authorize or reject the order.</span>\n <br/>\n </span>\n </span>\n </span>\n </span>\n </p>\n </div>"
  },
  "identifier" : [
    {
      "use" : "official",
      "value" : "exclusive-breastfeeding-intervention-02"
    }
  ],
  "version" : "1.0.0",
  "title" : "Exclusive Breastfeeding Intervention-02",
  "status" : "active",
  "date" : "2015-03-08",
  "description" : "Exclusive breastfeeding intervention intended to improve outcomes for exclusive breastmilk feeding of newborns by notifying the provider to sign the breastmilk feeding readiness assessment order, if necessary.",
  "topic" : [
    {
      "text" : "Exclusive Breastfeeding"
    }
  ],
  "relatedArtifact" : [
    {
      "type" : "derived-from",
      "resource" : "Measure/measure-exclusive-breastfeeding"
    }
  ],
  "library" : [
    "Library/library-exclusive-breastfeeding-cds-logic"
  ],
  "action" : [
    {
      "title" : "Mother should be administered a breastfeeding readiness assessment.",
      "trigger" : [
        {
          "type" : "named-event",
          "name" : "Admission"
        },
        {
          "type" : "named-event",
          "name" : "Birth"
        },
        {
          "type" : "named-event",
          "name" : "Infant Transfer to Recovery"
        },
        {
          "type" : "named-event",
          "name" : "Transfer to Post-Partum"
        }
      ],
      "condition" : [
        {
          "kind" : "applicability",
          "expression" : {
            "language" : "text/cql",
            "expression" : "Should Notify Provider to Sign Assessment Order"
          }
        }
      ],
      "action" : [
        {
          "title" : "Notify the provider to sign the order.",
          "textEquivalent" : "A Breastfeeding Readiness Assessment is recommended, please authorize or reject the order.",
          "type" : {
            "coding" : [
              {
                "code" : "create"
              }
            ]
          },
          "dynamicValue" : [
            {
              "path" : "/",
              "expression" : {
                "language" : "text/cql",
                "expression" : "Communication Request to Provider"
              }
            }
          ]
        }
      ]
    }
  ]
}

PlanDefinition "exclusive-breastfeeding-intervention-01" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Id:
PlanDefinition/exclusive-breastfeeding-intervention-01

Identifier:
value: exclusive-breastfeeding-intervention-01

Title:
Exclusive Breastfeeding Intervention-01

Status:
active

Description:
Exclusive breastfeeding intervention intended to improve outcomes for exclusive breastmilk feeding of newborns by ensuring that an appropriate breastfeeding readiness assessment order is created if necessary.

Topic:
text: Exclusive Breastfeeding

Library:
reference: Library/library-exclusive-breastfeeding-cds-logic

Actions

Step:
title: Mother should be administered a breastfeeding readiness assessment.
condition:
type: applicability
expression: Should Create Assessment Order
Step:
title: Create the breastfeeding readiness assessment order.
text: Administer a breastfeeding readiness assessment.
Step:
title: Notify the provider to sign the order.
text: A Breastfeeding Readiness Assessment is recommended, please authorize or reject the order.


{
  "resourceType" : "PlanDefinition",
  "id" : "exclusive-breastfeeding-intervention-01",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2018-09-06T12:48:28.062Z"
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Id: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">PlanDefinition/exclusive-breastfeeding-intervention-01</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Identifier: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <b>value: </b>\n <span>exclusive-breastfeeding-intervention-01</span>\n </td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Title: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">Exclusive Breastfeeding Intervention-01</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Status: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">active</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Description: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">Exclusive breastfeeding intervention intended to improve outcomes for exclusive breastmilk feeding of newborns by ensuring that an appropriate breastfeeding readiness assessment order is created if necessary.</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Topic: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <span>\n <b>text: </b>\n <span>Exclusive Breastfeeding</span>\n </span>\n </td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Library: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <b>reference: </b>\n <span>Library/library-exclusive-breastfeeding-cds-logic</span>\n </td>\n </tr>\n </table>\n <p/>\n <h2>Actions</h2>\n <p style=\"width: 100%;\" class=\"hierarchy\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 25px;\">\n <b>title: </b>\n <span>Mother should be administered a breastfeeding readiness assessment.</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 50px;\">\n <b>type: </b>\n <span>applicability</span>\n <br/>\n </span>\n <span style=\"padding-left: 50px;\">\n <b>expression: </b>\n <span>Should Create Assessment Order</span>\n <br/>\n </span>\n </span>\n <span style=\"padding-left: 25px;\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 50px;\">\n <b>title: </b>\n <span>Create the breastfeeding readiness assessment order.</span>\n <br/>\n </span>\n <span style=\"padding-left: 50px;\">\n <b>text: </b>\n <span>Administer a breastfeeding readiness assessment.</span>\n <br/>\n </span>\n <span style=\"padding-left: 50px;\"/>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 75px;\">\n <b>title: </b>\n <span>Notify the provider to sign the order.</span>\n <br/>\n </span>\n <span style=\"padding-left: 75px;\">\n <b>text: </b>\n <span>A Breastfeeding Readiness Assessment is recommended, please authorize or reject the order.</span>\n <br/>\n </span>\n </span>\n </span>\n </span>\n </p>\n </div>"
  },
  "identifier" : [
    {
      "use" : "official",
      "value" : "exclusive-breastfeeding-intervention-01"
    }
  ],
  "version" : "1.0.0",
  "title" : "Exclusive Breastfeeding Intervention-01",
  "status" : "active",
  "date" : "2015-03-08",
  "description" : "Exclusive breastfeeding intervention intended to improve outcomes for exclusive breastmilk feeding of newborns by ensuring that an appropriate breastfeeding readiness assessment order is created if necessary.",
  "topic" : [
    {
      "text" : "Exclusive Breastfeeding"
    }
  ],
  "relatedArtifact" : [
    {
      "type" : "derived-from",
      "resource" : "Measure/measure-exclusive-breastfeeding"
    }
  ],
  "library" : [
    "Library/library-exclusive-breastfeeding-cds-logic"
  ],
  "action" : [
    {
      "title" : "Mother should be administered a breastfeeding readiness assessment.",
      "trigger" : [
        {
          "type" : "named-event",
          "name" : "Admission"
        },
        {
          "type" : "named-event",
          "name" : "Birth"
        },
        {
          "type" : "named-event",
          "name" : "Infant Transfer to Recovery"
        },
        {
          "type" : "named-event",
          "name" : "Transfer to Post-Partum"
        }
      ],
      "condition" : [
        {
          "kind" : "applicability",
          "expression" : {
            "language" : "text/cql",
            "expression" : "Should Create Assessment Order"
          }
        }
      ],
      "action" : [
        {
          "title" : "Create the breastfeeding readiness assessment order.",
          "textEquivalent" : "Administer a breastfeeding readiness assessment.",
          "type" : {
            "coding" : [
              {
                "code" : "create"
              }
            ]
          },
          "dynamicValue" : [
            {
              "path" : "/",
              "expression" : {
                "language" : "text/cql",
                "expression" : "Create Breastfeeding Risk Assessment"
              }
            }
          ]
        },
        {
          "title" : "Notify the provider to sign the order.",
          "textEquivalent" : "A Breastfeeding Readiness Assessment is recommended, please authorize or reject the order.",
          "type" : {
            "coding" : [
              {
                "code" : "create"
              }
            ]
          },
          "dynamicValue" : [
            {
              "path" : "/",
              "expression" : {
                "language" : "text/cql",
                "expression" : "Communication Request to Provider"
              }
            }
          ]
        }
      ]
    }
  ]
}

PlanDefinition "example-cardiology-os" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Generated Narrative with Details

id: example-cardiology-os

contained: , , , , , , , , , , , ,

url: http://va.gov/kas/orderset/B5-Cardiology-ChestPainCAD-OS

identifier: bb7ccea6-9744-4743-854a-bcffd87191f6 (OFFICIAL), CLIN0004AG, KP-914

version: 0.1

name: ChestPainCoronaryArteryDiseaseOrderSetKNART

title: Chest Pain (CP) - Coronary Artery Disease (CAD) Order Set KNART

type: Order Set (Details : {http://terminology.hl7.org/CodeSystem/plan-definition-type code 'order-set' = 'Order Set', given as 'Order Set'})

status: active

date: 29/08/2017

publisher: Department of Veterans Affairs

description: The Cardiology chest pain (CP) and coronary artery disease (CAD) group of KNARTs are intended to assist primary care providers in the management of adult patients with stable chest pain (with or without known CAD); aid in determining when a cardiology consultation is appropriate; provide guidance for initial noninvasive diagnostic orders (stress testing) and provide a structured documentation template for the process. Stable patients with cardiac chest pain require risk stratification, office-based workup, initiation of disease-specific medications, and subspecialty referral to a cardiologist.

useContext:

usage: The Cardiology chest pain (CP) and coronary artery disease (CAD) group of KNARTs are intended to assist primary care providers in the management of adult patients with stable chest pain (with or without known CAD); aid in determining when a cardiology consultation is appropriate; provide guidance for initial noninvasive diagnostic orders (stress testing) and provide a structured documentation template for the process. Stable patients with cardiac chest pain require risk stratification, office-based workup, initiation of disease-specific medications, and subspecialty referral to a cardiologist. This context excludes emergent patients (new/ongoing/unstable pattern CP). Included are those patients with stable CP with or without known CAD, to be considered for evaluation by cardiology.

copyright: © Copyright Cognitive Medical Systems, Inc. 9444 Waples Street Suite 300 San Diego, CA 92121

author: , ,

relatedArtifact: , , , , , , , , , , ,

library: #cardiology-chestPain-logic

action

Actions

-
*
*

{
  "resourceType" : "PlanDefinition",
  "id" : "example-cardiology-os",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2018-09-06T12:48:28.000Z"
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: example-cardiology-os</p><p><b>contained</b>: , , , , , , , , , , , , </p><p><b>url</b>: <b>http://va.gov/kas/orderset/B5-Cardiology-ChestPainCAD-OS</b></p><p><b>identifier</b>: bb7ccea6-9744-4743-854a-bcffd87191f6 (OFFICIAL), CLIN0004AG, KP-914</p><p><b>version</b>: 0.1</p><p><b>name</b>: ChestPainCoronaryArteryDiseaseOrderSetKNART</p><p><b>title</b>: Chest Pain (CP) - Coronary Artery Disease (CAD) Order Set KNART</p><p><b>type</b>: Order Set <span>(Details : {http://terminology.hl7.org/CodeSystem/plan-definition-type code 'order-set' = 'Order Set', given as 'Order Set'})</span></p><p><b>status</b>: active</p><p><b>date</b>: 29/08/2017</p><p><b>publisher</b>: Department of Veterans Affairs</p><p><b>description</b>: The Cardiology chest pain (CP) and coronary artery disease (CAD) group of KNARTs are intended to assist primary care providers in the management of adult patients with stable chest pain (with or without known CAD); aid in determining when a cardiology consultation is appropriate; provide guidance for initial noninvasive diagnostic orders (stress testing) and provide a structured documentation template for the process. Stable patients with cardiac chest pain require risk stratification, office-based workup, initiation of disease-specific medications, and subspecialty referral to a cardiologist.</p><p><b>useContext</b>: </p><p><b>usage</b>: The Cardiology chest pain (CP) and coronary artery disease (CAD) group of KNARTs are intended to assist primary care providers in the management of adult patients with stable chest pain (with or without known CAD); aid in determining when a cardiology consultation is appropriate; provide guidance for initial noninvasive diagnostic orders (stress testing) and provide a structured documentation template for the process. Stable patients with cardiac chest pain require risk stratification, office-based workup, initiation of disease-specific medications, and subspecialty referral to a cardiologist. This context excludes emergent patients (new/ongoing/unstable pattern CP). Included are those patients with stable CP with or without known CAD, to be considered for evaluation by cardiology.</p><p><b>copyright</b>: &#169; Copyright Cognitive Medical Systems, Inc. 9444 Waples Street Suite 300 San Diego, CA 92121</p><p><b>author</b>: , , </p><p><b>relatedArtifact</b>: , , , , , , , , , , , </p><p><b>library</b>: <a>#cardiology-chestPain-logic</a></p><blockquote><p><b>action</b></p><h3>Actions</h3><table><tr><td>-</td></tr><tr><td>*</td></tr><tr><td>*</td></tr></table></blockquote></div>"
  },
  "contained" : [
    {
      "resourceType" : "Library",
      "id" : "cardiology-chestPain-logic",
      "status" : "active",
      "type" : {
        "coding" : [
          {
            "system" : "http://terminology.hl7.org/CodeSystem/library-type",
            "code" : "logic-library",
            "display" : "Logic Library"
          }
        ]
      },
      "description" : "Placeholder library"
    },
    {
      "resourceType" : "ActivityDefinition",
      "id" : "referralToCardiologyConsult",
      "status" : "draft",
      "description" : "Consider other consult modalities which might be available (e.g., e-consult or other rapidly iterative consult method. A simple consult is included here as the overarching clinical intent.",
      "kind" : "ServiceRequest",
      "timingTiming" : {
        "_event" : [
          {
            "extension" : [
              {
                "url" : "http://hl7.org/fhir/StructureDefinition/cqf-expression",
                "valueExpression" : {
                  "language" : "text/cql",
                  "expression" : "Now()"
                }
              }
            ]
          }
        ]
      },
      "participant" : [
        {
          "type" : "practitioner"
        }
      ]
    },
    {
      "resourceType" : "ActivityDefinition",
      "id" : "metoprololTartrate25Prescription",
      "status" : "draft",
      "kind" : "MedicationRequest",
      "productReference" : {
        "reference" : "#metoprololTartrate25Medication"
      },
      "dosage" : [
        {
          "text" : "1 tablet oral 2 time daily",
          "timing" : {
            "repeat" : {
              "frequency" : 2,
              "period" : 1,
              "periodUnit" : "d"
            }
          },
          "route" : {
            "coding" : [
              {
                "code" : "26643006",
                "display" : "Oral route (qualifier value)"
              }
            ],
            "text" : "Oral route (qualifier value)"
          },
          "doseAndRate" : [
            {
              "type" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/dose-rate-type",
                    "code" : "ordered",
                    "display" : "Ordered"
                  }
                ]
              },
              "doseQuantity" : {
                "value" : 1,
                "unit" : "{tbl}"
              }
            }
          ]
        }
      ],
      "dynamicValue" : [
        {
          "path" : "medicationRequest.priority",
          "expression" : {
            "language" : "text/cql",
            "expression" : "routine"
          }
        }
      ]
    },
    {
      "resourceType" : "Medication",
      "id" : "metoprololTartrate25Medication",
      "code" : {
        "coding" : [
          {
            "system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
            "code" : "866426"
          }
        ],
        "text" : "Metoprolol Tartrate 25 MG"
      },
      "form" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "385055001",
            "display" : "Tablet dose form"
          }
        ],
        "text" : "Tablet dose form"
      },
      "ingredient" : [
        {
          "itemReference" : {
            "reference" : "#metoprololTartrate25Substance"
          },
          "amount" : {
            "numerator" : {
              "value" : 25,
              "unit" : "mg"
            },
            "denominator" : {
              "value" : 1,
              "unit" : "{tbl}"
            }
          }
        }
      ]
    },
    {
      "resourceType" : "Substance",
      "id" : "metoprololTartrate25Substance",
      "code" : {
        "coding" : [
          {
            "system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
            "code" : "6918"
          }
        ],
        "text" : "Metoprolol"
      }
    },
    {
      "resourceType" : "ActivityDefinition",
      "id" : "metoprololTartrate50Prescription",
      "status" : "draft",
      "kind" : "MedicationRequest",
      "productReference" : {
        "reference" : "#metoprololTartrate50Medication"
      },
      "dosage" : [
        {
          "text" : "1 tablet oral 2 time daily",
          "timing" : {
            "repeat" : {
              "frequency" : 2,
              "period" : 1,
              "periodUnit" : "d"
            }
          },
          "route" : {
            "coding" : [
              {
                "code" : "26643006",
                "display" : "Oral route (qualifier value)"
              }
            ],
            "text" : "Oral route (qualifier value)"
          },
          "doseAndRate" : [
            {
              "type" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/dose-rate-type",
                    "code" : "ordered",
                    "display" : "Ordered"
                  }
                ]
              },
              "doseQuantity" : {
                "value" : 1,
                "unit" : "{tbl}"
              }
            }
          ]
        }
      ],
      "dynamicValue" : [
        {
          "path" : "medicationRequest.priority",
          "expression" : {
            "language" : "text/cql",
            "expression" : "routine"
          }
        }
      ]
    },
    {
      "resourceType" : "Medication",
      "id" : "metoprololTartrate50Medication",
      "code" : {
        "coding" : [
          {
            "system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
            "code" : "866435"
          }
        ],
        "text" : "Metoprolol Tartrate 50 MG"
      },
      "form" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "385055001",
            "display" : "Tablet dose form"
          }
        ],
        "text" : "Tablet dose form"
      },
      "ingredient" : [
        {
          "itemReference" : {
            "reference" : "#metoprololTartrate50Substance"
          },
          "amount" : {
            "numerator" : {
              "value" : 50,
              "unit" : "mg"
            },
            "denominator" : {
              "value" : 1,
              "unit" : "{tbl}"
            }
          }
        }
      ]
    },
    {
      "resourceType" : "Substance",
      "id" : "metoprololTartrate50Substance",
      "code" : {
        "coding" : [
          {
            "system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
            "code" : "6918"
          }
        ],
        "text" : "Metoprolol"
      }
    },
    {
      "resourceType" : "ActivityDefinition",
      "id" : "nitroglycerinPrescription",
      "status" : "draft",
      "kind" : "MedicationRequest",
      "productReference" : {
        "reference" : "#nitroglycerinMedication"
      },
      "dosage" : [
        {
          "text" : "nitroglycerin 0.4 mg tablet sub-lingual every 5 minutes as needed for chest pain; maximum 3 tablets",
          "timing" : {
            "repeat" : {
              "frequency" : 1,
              "period" : 5,
              "periodUnit" : "min"
            }
          },
          "doseAndRate" : [
            {
              "type" : {
                "coding" : [
                  {
                    "system" : "http://terminology.hl7.org/CodeSystem/dose-rate-type",
                    "code" : "ordered",
                    "display" : "Ordered"
                  }
                ]
              },
              "doseQuantity" : {
                "value" : 1,
                "unit" : "{tbl}"
              }
            }
          ],
          "maxDosePerAdministration" : {
            "value" : 3,
            "unit" : "{tbl}"
          }
        }
      ],
      "dynamicValue" : [
        {
          "path" : "medicationRequest.priority",
          "expression" : {
            "language" : "text/cql",
            "expression" : "routine"
          }
        }
      ]
    },
    {
      "resourceType" : "Medication",
      "id" : "nitroglycerinMedication",
      "code" : {
        "coding" : [
          {
            "system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
            "code" : "316365"
          }
        ],
        "text" : "Nitroglycerin 0.4 MG"
      },
      "form" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "385055001",
            "display" : "Tablet dose form"
          }
        ],
        "text" : "Tablet dose form"
      },
      "ingredient" : [
        {
          "itemReference" : {
            "reference" : "#nitroglycerinSubstance"
          },
          "amount" : {
            "numerator" : {
              "value" : 0.4,
              "unit" : "mg"
            },
            "denominator" : {
              "value" : 1,
              "unit" : "{tbl}"
            }
          }
        }
      ]
    },
    {
      "resourceType" : "Substance",
      "id" : "nitroglycerinSubstance",
      "code" : {
        "coding" : [
          {
            "system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
            "code" : "4917"
          }
        ],
        "text" : "Nitroglycerin"
      }
    },
    {
      "resourceType" : "Questionnaire",
      "id" : "CollectReferralReason",
      "status" : "draft",
      "item" : [
        {
          "linkId" : "1",
          "text" : "Reason for Cardiology Consult",
          "type" : "choice",
          "required" : true,
          "repeats" : true,
          "answerValueSet" : "#CardiologyReferralReasonValues"
        }
      ]
    },
    {
      "resourceType" : "Questionnaire",
      "id" : "CardiologyConsultationGoal",
      "status" : "draft",
      "item" : [
        {
          "linkId" : "2",
          "text" : "Goal of cardiology consultation",
          "type" : "string"
        }
      ]
    }
  ],
  "url" : "http://va.gov/kas/orderset/B5-Cardiology-ChestPainCAD-OS",
  "identifier" : [
    {
      "use" : "official",
      "system" : "urn:va.gov:kbs:knart:artifact:r1",
      "value" : "bb7ccea6-9744-4743-854a-bcffd87191f6"
    },
    {
      "system" : "urn:va.gov:kbs:contract:VA118-16-D-1008:to:VA-118-16-F-1008-0007",
      "value" : "CLIN0004AG"
    },
    {
      "system" : "urn:cognitivemedicine.com:lab:jira",
      "value" : "KP-914"
    }
  ],
  "version" : "0.1",
  "name" : "ChestPainCoronaryArteryDiseaseOrderSetKNART",
  "title" : "Chest Pain (CP) - Coronary Artery Disease (CAD) Order Set KNART",
  "type" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/plan-definition-type",
        "code" : "order-set",
        "display" : "Order Set"
      }
    ]
  },
  "status" : "active",
  "date" : "2017-08-29",
  "publisher" : "Department of Veterans Affairs",
  "description" : "The Cardiology chest pain (CP) and coronary artery disease (CAD) group of KNARTs are intended to assist primary care providers in the management of adult patients with stable chest pain (with or without known CAD); aid in determining when a cardiology consultation is appropriate; provide guidance for initial noninvasive diagnostic orders (stress testing) and provide a structured documentation template for the process. Stable patients with cardiac chest pain require risk stratification, office-based workup, initiation of disease-specific medications, and subspecialty referral to a cardiologist.",
  "useContext" : [
    {
      "code" : {
        "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code" : "focus"
      },
      "valueCodeableConcept" : {
        "coding" : [
          {
            "system" : "http://snomed.info/sct",
            "code" : "look up value",
            "display" : "appropriate snomed condition"
          }
        ]
      }
    }
  ],
  "usage" : "The Cardiology chest pain (CP) and coronary artery disease (CAD) group of KNARTs are intended to assist primary care providers in the management of adult patients with stable chest pain (with or without known CAD); aid in determining when a cardiology consultation is appropriate; provide guidance for initial noninvasive diagnostic orders (stress testing) and provide a structured documentation template for the process. Stable patients with cardiac chest pain require risk stratification, office-based workup, initiation of disease-specific medications, and subspecialty referral to a cardiologist. This context excludes emergent patients (new/ongoing/unstable pattern CP). Included are those patients with stable CP with or without known CAD, to be considered for evaluation by cardiology.",
  "copyright" : "© Copyright Cognitive Medical Systems, Inc. 9444 Waples Street Suite 300 San Diego, CA 92121",
  "author" : [
    {
      "name" : "Bruce Bray MD"
    },
    {
      "name" : "Scott Wall MD"
    },
    {
      "name" : "Aiden Abidov MD, PhD"
    }
  ],
  "relatedArtifact" : [
    {
      "type" : "derived-from",
      "display" : "Cardiology: Chest Pain (CP) / Coronary Artery Disease (CAD) Clinical Content White Paper",
      "url" : "NEED-A-URL-HERE"
    },
    {
      "type" : "justification",
      "display" : "Outcome CVD (coronary death, myocardial infarction, coronary insufficiency, angina, ischemic stroke, hemorrhagic stroke, transient ischemic attack, peripheral artery disease, heart failure)",
      "citation" : "Cardiovascular disease (10-year risk) [Internet].: Framingham Heart Study; cited 2017]. Available from: https://www.framinghamheartstudy.org/risk-functions/cardiovascular-disease/10-year-risk.php.",
      "url" : "https://www.framinghamheartstudy.org/risk-functions/cardiovascular-disease/10-year-risk.php"
    },
    {
      "type" : "justification",
      "display" : "General cardiovascular risk profile for use in primary care: the Framingham Heart Study",
      "citation" : "Cardiovascular disease (10-year risk) [Internet].: Framingham Heart Study; cited 2017]. Available from: https://www.framinghamheartstudy.org/risk-functions/cardiovascular-disease/10-year-risk.php.",
      "url" : "https://www.framinghamheartstudy.org/risk-functions/cardiovascular-disease/10-year-risk.php"
    },
    {
      "type" : "justification",
      "display" : "2014 ACC/AHA/AATS/PCNA/SCAI/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, and the American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons",
      "citation" : "Fihn SD, Blankenship JC, Alexander KP, Bittl JA, Byrne JG, Fletcher BJ, et al. 2014 ACC/AHA/AATS/PCNA/SCAI/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease: A report of the american college of cardiology/american heart association task force on practice guidelines, and the american association for thoracic surgery, preventive cardiovascular nurses association, society for cardiovascular angiography and interventions, and society of thoracic surgeons. J Thorac Cardiovasc Surg. 2015 March 01;149(3):5.",
      "url" : "NEED-A-URL-HERE"
    },
    {
      "type" : "justification",
      "display" : "ACC/AHA 2002 guideline update for exercise testing: summary article: A report of the American college of cardiology/American heart association task force on practice guidelines (committee to update the 1997 exercise testing guidelines)",
      "citation" : "Gibbons RJ, Balady GJ, Bricker JT, Chaitman BR, Fletcher GF, Froelicher VF, et al. ACC/AHA 2002 guideline update for exercise testing: Summary article: A report of the american college of cardiology/american heart association task force on practice guidelines (committee to update the 1997 exercise testing guidelines). Circulation. 2002 October 01;106(14):1883-92.",
      "url" : "NEED-A-URL-HERE"
    },
    {
      "type" : "justification",
      "display" : "LABEL: ASPIRIN 81 MG- aspirin tablet, coated",
      "citation" : "Label: ASPIRIN 81 MG- aspirin tablet, coated [Internet].: National Library of Medicine; 2017. Available from: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b4064039-2345-4227-b83d-54dc13a838d3.",
      "url" : "https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b4064039-2345-4227-b83d-54dc13a838d3"
    },
    {
      "type" : "justification",
      "display" : "LABEL: CLOPIDOGREL- clopidogrel bisulfate tablet, film coated",
      "citation" : "LABEL: CLOPIDOGREL- clopidogrel bisulfate tablet, film coated [Internet].: National Library of Medicine; 2017. Available from: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=edae8df1-caf9-ff72-1304-5ae8b355f8e7.",
      "url" : "https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7fe85155-bc00-406b-b097-e8aece187a8a"
    },
    {
      "type" : "justification",
      "display" : "LABEL: LIPITOR- atorvastatin calcium tablet, film coated",
      "citation" : "LABEL: LIPITOR- atorvastatin calcium tablet, film coated [Internet].: National Library of Medicine; 2017. Available from: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7fe85155-bc00-406b-b097-e8aece187a8a.",
      "url" : "https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7fe85155-bc00-406b-b097-e8aece187a8a"
    },
    {
      "type" : "justification",
      "display" : "LABEL: METOPROLOL SUCCINATE EXTENDED-RELEASE - metoprolol succinate tablet, film coated, extended release",
      "citation" : "LABEL: LIPITOR- atorvastatin calcium tablet, film coated [Internet].: National Library of Medicine; 2017. Available from: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7fe85155-bc00-406b-b097-e8aece187a8a.",
      "url" : "https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=2d948600-35d8-4490-983b-918bdce488c8"
    },
    {
      "type" : "justification",
      "display" : "LABEL: NITROGLYCERIN- nitroglycerin tablet",
      "citation" : "LABEL: NITROGLYCERIN- nitroglycerin tablet [Internet].: National Library of Medicine; 2017. Available from: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=67bf2a15-b115-47ac-ae28-ce2dafd6b5c9.",
      "url" : "https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=67bf2a15-b115-47ac-ae28-ce2dafd6b5c9"
    },
    {
      "type" : "justification",
      "display" : "LABEL: SIMVASTATIN - simvastatin tablet",
      "citation" : "LABEL: SIMVASTATIN - simvastatin tablet [Internet].: National Library of Medicine; 2017. Available from: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5c1c694c-4b08-469e-b538-08e69df06146.",
      "url" : "https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5c1c694c-4b08-469e-b538-08e69df06146"
    },
    {
      "type" : "justification",
      "display" : "Chest Pain Guideline Development Group. NICE guidance. Chest pain of recent onset: assessment and diagnosis of recent onset chest pain or discomfort of suspected cardiac origin.",
      "citation" : "Skinner JS, Smeeth L, Kendall JM, Adams PC, Timmis A, Chest Pain Guideline Development Group. NICE guidance. chest pain of recent onset: Assessment and diagnosis of recent onset chest pain or discomfort of suspected cardiac origin. Heart. 2010 June 01;96(12):974-8.",
      "url" : "http://heart.bmj.com/content/96/12/974.long"
    }
  ],
  "library" : [
    "#cardiology-chestPain-logic"
  ],
  "action" : [
    {
      "action" : [
        {
          "title" : "Consults and Referrals",
          "groupingBehavior" : "logical-group",
          "selectionBehavior" : "any",
          "action" : [
            {
              "textEquivalent" : "Referral to cardiology to evaluate chest pain (routine)",
              "definition" : "#referralToCardiologyConsult",
              "dynamicValue" : [
                {
                  "path" : "timing.event",
                  "expression" : {
                    "language" : "text/cql",
                    "expression" : "Now()"
                  }
                },
                {
                  "path" : "specialty",
                  "expression" : {
                    "language" : "text/cql",
                    "expression" : "Code '261QM0850X' from CardiologyChestPainLogic.\"NUCC Provider Taxonomy\" display 'Adult Mental Health'"
                  }
                },
                {
                  "path" : "occurrenceDateTime",
                  "expression" : {
                    "language" : "text/cql",
                    "expression" : "CardiologyChestPainLogic.ServiceRequestFulfillmentTime"
                  }
                },
                {
                  "path" : "subject",
                  "expression" : {
                    "language" : "text/cql",
                    "expression" : "CardiologyChestPainLogic.Patient"
                  }
                },
                {
                  "path" : "requester.agent",
                  "expression" : {
                    "language" : "text/cql",
                    "expression" : "CardiologyChestPainLogic.Practitioner"
                  }
                },
                {
                  "path" : "reasonCode",
                  "expression" : {
                    "language" : "text/cql",
                    "expression" : "CardiologyChestPainLogic.CardiologyReferralReason"
                  }
                },
                {
                  "path" : "reasonReference",
                  "expression" : {
                    "language" : "text/cql",
                    "expression" : "CardiologyChestPainLogic.RiskAssessment"
                  }
                }
              ]
            },
            {
              "title" : "Reason for cardiology consultation",
              "definition" : "#CollectReferralReason"
            },
            {
              "title" : "Goal of cardiology consultation",
              "definition" : "#CardiologyConsultationGoal"
            }
          ]
        },
        {
          "title" : "Medications",
          "description" : "Consider the following medications for stable patients to be initiated prior to the cardiology consultation.",
          "action" : [
            {
              "groupingBehavior" : "logical-group",
              "selectionBehavior" : "at-most-one"
            },
            {
              "title" : "Antianginal Therapy",
              "groupingBehavior" : "logical-group",
              "selectionBehavior" : "at-most-one",
              "action" : [
                {
                  "textEquivalent" : "metoprolol tartrate 25 mg tablet 1 tablet oral 2 time daily",
                  "definition" : "#metoprololTartrate25Prescription",
                  "dynamicValue" : [
                    {
                      "path" : "status",
                      "expression" : {
                        "language" : "text/cql",
                        "expression" : "'draft'"
                      }
                    },
                    {
                      "path" : "patient",
                      "expression" : {
                        "language" : "text/cql",
                        "expression" : "CardiologyChestPainLogic.Patient"
                      }
                    },
                    {
                      "path" : "prescriber",
                      "expression" : {
                        "language" : "text/cql",
                        "expression" : "CardiologyChestPainLogic.Practitioner"
                      }
                    }
                  ]
                },
                {
                  "textEquivalent" : "metoprolol tartrate 50 mg tablet 1 tablet oral 2 time daily",
                  "definition" : "#metoprololTartrate50Prescription",
                  "dynamicValue" : [
                    {
                      "path" : "status",
                      "expression" : {
                        "language" : "text/cql",
                        "expression" : "'draft'"
                      }
                    },
                    {
                      "path" : "patient",
                      "expression" : {
                        "language" : "text/cql",
                        "expression" : "CardiologyChestPainLogic.Patient"
                      }
                    },
                    {
                      "path" : "prescriber",
                      "expression" : {
                        "language" : "text/cql",
                        "expression" : "CardiologyChestPainLogic.Practitioner"
                      }
                    }
                  ]
                },
                {
                  "textEquivalent" : "amlodipine 5 tablet 1 tablet oral daily",
                  "definition" : "#amlodipinePrescription",
                  "dynamicValue" : [
                    {
                      "path" : "status",
                      "expression" : {
                        "language" : "text/cql",
                        "expression" : "'draft'"
                      }
                    },
                    {
                      "path" : "patient",
                      "expression" : {
                        "language" : "text/cql",
                        "expression" : "CardiologyChestPainLogic.Patient"
                      }
                    },
                    {
                      "path" : "prescriber",
                      "expression" : {
                        "language" : "text/cql",
                        "expression" : "CardiologyChestPainLogic.Practitioner"
                      }
                    }
                  ]
                }
              ]
            },
            {
              "title" : "Nitroglycerin",
              "groupingBehavior" : "logical-group",
              "selectionBehavior" : "at-most-one",
              "action" : [
                {
                  "textEquivalent" : "nitroglycerin 0.4 mg tablet sub-lingual every 5 minutes as needed for chest pain; maximum 3 tablets",
                  "definition" : "#nitroglycerinPrescription",
                  "dynamicValue" : [
                    {
                      "path" : "status",
                      "expression" : {
                        "language" : "text/cql",
                        "expression" : "'draft'"
                      }
                    },
                    {
                      "path" : "patient",
                      "expression" : {
                        "language" : "text/cql",
                        "expression" : "CardiologyChestPainLogic.Patient"
                      }
                    },
                    {
                      "path" : "prescriber",
                      "expression" : {
                        "language" : "text/cql",
                        "expression" : "CardiologyChestPainLogic.Practitioner"
                      }
                    }
                  ]
                }
              ]
            }
          ]
        }
      ]
    }
  ]
}

PlanDefinition "chlamydia-screening-intervention" Version "1"

Tags: (no tags)  +

This Resource , XML or JSON representation, or the full version history.. provenance for this resource
Updated: by

Id:
PlanDefinition/chlamydia-screening-intervention

Identifier:
value: ChlamydiaScreening_CDS_UsingCommon

Title:
Chalmydia Screening CDS Example Using Common

Status:
draft

Description:
Chlamydia Screening CDS Example Using Common

Topic:
text: Chlamydia Screening

Library:
reference: Library/example

Actions

Step:
title: Patient has not had chlamydia screening within the recommended timeframe...
condition:
type: applicability
expression: NoScreening


{
  "resourceType" : "PlanDefinition",
  "id" : "chlamydia-screening-intervention",
  "meta" : {
    "versionId" : "1",
    "lastUpdated" : "2018-09-06T12:48:27.953Z"
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Id: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">PlanDefinition/chlamydia-screening-intervention</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Identifier: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <b>value: </b>\n <span>ChlamydiaScreening_CDS_UsingCommon</span>\n </td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Title: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">Chalmydia Screening CDS Example Using Common</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Status: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">draft</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Description: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">Chlamydia Screening CDS Example Using Common</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Topic: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <span>\n <b>text: </b>\n <span>Chlamydia Screening</span>\n </span>\n </td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Library: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <b>reference: </b>\n <span>Library/example</span>\n </td>\n </tr>\n </table>\n <p/>\n <h2>Actions</h2>\n <p style=\"width: 100%;\" class=\"hierarchy\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 25px;\">\n <b>title: </b>\n <span>Patient has not had chlamydia screening within the recommended timeframe...</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 50px;\">\n <b>type: </b>\n <span>applicability</span>\n </span>\n <br/>\n <span style=\"padding-left: 50px;\">\n <b>expression: </b>\n <span>NoScreening</span>\n </span>\n </span>\n </span>\n </p>\n </div>"
  },
  "identifier" : [
    {
      "use" : "official",
      "value" : "ChlamydiaScreening_CDS_UsingCommon"
    }
  ],
  "version" : "2.0.0",
  "title" : "Chalmydia Screening CDS Example Using Common",
  "status" : "draft",
  "date" : "2015-07-22",
  "description" : "Chlamydia Screening CDS Example Using Common",
  "topic" : [
    {
      "text" : "Chlamydia Screening"
    }
  ],
  "library" : [
    "Library/example"
  ],
  "action" : [
    {
      "title" : "Patient has not had chlamydia screening within the recommended timeframe...",
      "condition" : [
        {
          "kind" : "applicability",
          "expression" : {
            "language" : "text/cql",
            "expression" : "NoScreening"
          }
        }
      ],
      "dynamicValue" : [
        {
          "path" : "$this",
          "expression" : {
            "language" : "text/cql",
            "expression" : "ChlamydiaScreeningRequest"
          }
        }
      ]
    }
  ]
}