type: exampleresource: PlanDefinitionexample: plandefinition-example
PlanDefinition Example: plandefinition-example
Narrative
| 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: Mild recurrent major depression
|
| 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)
Example XML
<?xml version="1.0" encoding="UTF-8"?>
<PlanDefinition xmlns="http://hl7.org/fhir" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<id value="low-suicide-risk-order-set"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<table class="grid dict">
<tr>
<td>
<b>Id: </b>
</td>
</tr>
<tr>
<td style="padding-left: 25px; padding-right: 25px;">PlanDefinition/low-suicide-risk-order-set</td>
</tr>
</table>
<p></p>
<table class="grid dict">
<tr>
<td>
<b>Identifier: </b>
</td>
</tr>
<tr>
<td style="padding-left: 25px; padding-right: 25px;">
<b>value: </b>
<span>mmi:low-suicide-risk-order-set</span>
</td>
</tr>
</table>
<p></p>
<table class="grid dict">
<tr>
<td>
<b>Title: </b>
</td>
</tr>
<tr>
<td style="padding-left: 25px; padding-right: 25px;">Low Suicide Risk Order Set</td>
</tr>
</table>
<p></p>
<table class="grid dict">
<tr>
<td>
<b>Status: </b>
</td>
</tr>
<tr>
<td style="padding-left: 25px; padding-right: 25px;">draft</td>
</tr>
</table>
<p></p>
<table class="grid dict">
<tr>
<td>
<b>Description: </b>
</td>
</tr>
<tr>
<td style="padding-left: 25px; padding-right: 25px;">Orders to be applied to a patient characterized as low suicide risk.</td>
</tr>
</table>
<p></p>
<table class="grid dict">
<tr>
<td>
<b>Purpose: </b>
</td>
</tr>
<tr>
<td style="padding-left: 25px; padding-right: 25px;">This order set helps ensure consistent application of appropriate orders for the care of low suicide risk patients.</td>
</tr>
</table>
<p></p>
<table class="grid dict">
<tr>
<td>
<b>Usage: </b>
</td>
</tr>
<tr>
<td style="padding-left: 25px; padding-right: 25px;">This order set should be applied after assessing a patient for suicide risk, when the findings of that assessment indicate the patient has low suicide risk.</td>
</tr>
</table>
<p></p>
<table class="grid dict">
<tr>
<td>
<b>Context: </b>
</td>
</tr>
<tr style="vertical-align: top;">
<td style="padding-right: 25px;">
<p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
<b>system: </b>
<span>http://terminology.hl7.org/CodeSystem/usage-context-type</span>
</p>
<p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
<b>code: </b>
<span>age</span>
</p>
<p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
<b>value: </b>
<br/>
<span>
<span>
<span>
<span style="padding-left: 25px;">
<b>system: </b>
<span>https://meshb.nlm.nih.gov</span>
<br/>
</span>
<span style="padding-left: 25px;">
<b>code: </b>
<span>D000328</span>
<br/>
</span>
<span style="padding-left: 25px;">
<b>display: </b>
<span>Adult</span>
</span>
</span>
</span>
</span>
</p>
</td>
</tr>
</table>
<table class="grid dict">
<tr>
<td>
<b>Context: </b>
</td>
</tr>
<tr style="vertical-align: top;">
<td style="padding-right: 25px;">
<p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
<b>system: </b>
<span>http://terminology.hl7.org/CodeSystem/usage-context-type</span>
</p>
<p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
<b>code: </b>
<span>focus</span>
</p>
<p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
<b>value: </b>
<br/>
<span>
<span>
<span>
<span style="padding-left: 25px;">
<b>system: </b>
<span>http://snomed.info/sct</span>
<br/>
</span>
<span style="padding-left: 25px;">
<b>code: </b>
<span>87512008</span>
<br/>
</span>
<span style="padding-left: 25px;">
<b>display: </b>
<span>Mild major depression</span>
</span>
</span>
</span>
</span>
</p>
</td>
</tr>
</table>
<table class="grid dict">
<tr>
<td>
<b>Context: </b>
</td>
</tr>
<tr style="vertical-align: top;">
<td style="padding-right: 25px;">
<p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
<b>system: </b>
<span>http://terminology.hl7.org/CodeSystem/usage-context-type</span>
</p>
<p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
<b>code: </b>
<span>focus</span>
</p>
<p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
<b>value: </b>
<br/>
<span>
<span>
<span>
<span style="padding-left: 25px;">
<b>system: </b>
<span>http://snomed.info/sct</span>
<br/>
</span>
<span style="padding-left: 25px;">
<b>code: </b>
<span>40379007</span>
<br/>
</span>
<span style="padding-left: 25px;">
<b>display: </b>
<span>Mild recurrent major depression</span>
</span>
</span>
</span>
</span>
</p>
</td>
</tr>
</table>
<table class="grid dict">
<tr>
<td>
<b>Context: </b>
</td>
</tr>
<tr style="vertical-align: top;">
<td style="padding-right: 25px;">
<p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
<b>system: </b>
<span>http://terminology.hl7.org/CodeSystem/usage-context-type</span>
</p>
<p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
<b>code: </b>
<span>focus</span>
</p>
<p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
<b>value: </b>
<br/>
<span>
<span>
<span>
<span style="padding-left: 25px;">
<b>system: </b>
<span>http://snomed.info/sct</span>
<br/>
</span>
<span style="padding-left: 25px;">
<b>code: </b>
<span>394687007</span>
<br/>
</span>
<span style="padding-left: 25px;">
<b>display: </b>
<span>Low suicide risk</span>
</span>
</span>
</span>
</span>
</p>
</td>
</tr>
</table>
<table class="grid dict">
<tr>
<td>
<b>Context: </b>
</td>
</tr>
<tr style="vertical-align: top;">
<td style="padding-right: 25px;">
<p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
<b>system: </b>
<span>http://terminology.hl7.org/CodeSystem/usage-context-type</span>
</p>
<p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
<b>code: </b>
<span>focus</span>
</p>
<p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
<b>value: </b>
<br/>
<span>
<span>
<span>
<span style="padding-left: 25px;">
<b>system: </b>
<span>http://snomed.info/sct</span>
<br/>
</span>
<span style="padding-left: 25px;">
<b>code: </b>
<span>225337009</span>
<br/>
</span>
<span style="padding-left: 25px;">
<b>display: </b>
<span>Suicide risk assessment</span>
</span>
</span>
</span>
</span>
</p>
</td>
</tr>
</table>
<table class="grid dict">
<tr>
<td>
<b>Context: </b>
</td>
</tr>
<tr style="vertical-align: top;">
<td style="padding-right: 25px;">
<p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
<b>system: </b>
<span>http://terminology.hl7.org/CodeSystem/usage-context-type</span>
</p>
<p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
<b>code: </b>
<span>user</span>
</p>
<p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
<b>value: </b>
<br/>
<span>
<span>
<span>
<span style="padding-left: 25px;">
<b>system: </b>
<span>http://snomed.info/sct</span>
<br/>
</span>
<span style="padding-left: 25px;">
<b>code: </b>
<span>309343006</span>
<br/>
</span>
<span style="padding-left: 25px;">
<b>display: </b>
<span>Physician</span>
</span>
</span>
</span>
</span>
</p>
</td>
</tr>
</table>
<table class="grid dict">
<tr>
<td>
<b>Context: </b>
</td>
</tr>
<tr style="vertical-align: top;">
<td style="padding-right: 25px;">
<p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
<b>system: </b>
<span>http://terminology.hl7.org/CodeSystem/usage-context-type</span>
</p>
<p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
<b>code: </b>
<span>venue</span>
</p>
<p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
<b>value: </b>
<br/>
<span>
<span>
<span>
<span style="padding-left: 25px;">
<b>system: </b>
<span>http://snomed.info/sct</span>
<br/>
</span>
<span style="padding-left: 25px;">
<b>code: </b>
<span>440655000</span>
<br/>
</span>
<span style="padding-left: 25px;">
<b>display: </b>
<span>Outpatient environment</span>
</span>
</span>
</span>
</span>
</p>
</td>
</tr>
</table>
<p></p>
<table class="grid dict">
<tr>
<td>
<b>Topic: </b>
</td>
</tr>
<tr>
<td style="padding-left: 25px; padding-right: 25px;">
<span>
<b>text: </b>
<span>Suicide risk assessment</span>
</span>
</td>
</tr>
</table>
<p></p>
<table class="grid dict">
<tr>
<td>
<b>Contributor: </b>
</td>
</tr>
<tr>
<td style="padding-left: 25px; padding-right: 25px;">
<b>
<span>author</span>:
</b>
</td>
</tr>
<tr>
<td style="padding-left: 50px; padding-right: 25px;">Motive Medical Intelligence</td>
</tr>
</table>
<p></p>
<table class="grid dict">
<tr>
<td>
<b>Library: </b>
</td>
</tr>
<tr>
<td style="padding-left: 25px; padding-right: 25px;">
<b>reference: </b>
<span>Library/suiciderisk-orderset-logic</span>
</td>
</tr>
<tr>
<td style="padding-left: 25px; padding-right: 25px;">
<b>display: </b>
<span>SuicideRiskLogic</span>
</td>
</tr>
</table>
<p></p>
<h2>Actions</h2>
<p class="hierarchy" style="width: 100%;">
<span>
<b>Step: </b>
<br/>
<span style="padding-left: 25px;">
<b>title: </b>
<span>Suicide Risk Assessment and Outpatient Management</span>
<br/>
</span>
<span style="padding-left: 25px;">
<span>
<b>Step: </b>
<br/>
<span style="padding-left: 50px;">
<b>title: </b>
<span>Consults and Referrals</span>
<br/>
</span>
<span style="padding-left: 50px;">
<span>
<b>Step: </b>
<br/>
<span style="padding-left: 75px;">
<b>text: </b>
<span>Refer to outpatient mental health program for evaluation and treatment of mental health conditions now</span>
<br/>
</span>
<span style="padding-left: 75px;">
<b>condition: </b>
<br/>
<span style="padding-left: 100px;">
<b>reference: </b>
<br/>
<span style="padding-left: 125px;">#referralToMentalHealthCare</span>
<span>
<span style="padding-left: 75px;">
<br/>
<span style="padding-left: 100px;">
<b>description: </b>
<span>refer to primary care mental-health integrated care program for evaluation and treatment of mental health conditions now</span>
<br/>
</span>
<span style="padding-left: 100px;">
<b>category: </b>
<span>referral</span>
<br/>
</span>
</span>
</span>
</span>
</span>
<span style="padding-left: 50px;"/>
</span>
</span>
</span>
<span>
<b>Step: </b>
<br/>
<span style="padding-left: 50px;">
<b>title: </b>
<span>Medications</span>
<br/>
</span>
<span style="padding-left: 50px;">
<span>
<b>Step: </b>
<br/>
<span style="padding-left: 75px;">
<b>title: </b>
<span>First-Line Antidepressants</span>
<br/>
</span>
<span style="padding-left: 75px;">
<span>
<b>Step: </b>
<br/>
<span style="padding-left: 100px;">
<b>title: </b>
<span>Selective Serotonin Reuptake Inhibitors (Choose a mazimum of one or document reasons for exception)</span>
<br/>
</span>
<span style="padding-left: 100px;">
<span>
<b>Step: </b>
<br/>
<span style="padding-left: 125px;">
<b>text: </b>
<span>citalopram 20 mg tablet 1 tablet oral 1 time daily now (30 table; 3 refills)</span>
<br/>
</span>
<span style="padding-left: 125px;">
<b>condition: </b>
<br/>
<span style="padding-left: 150px;">
<b>reference: </b>
<br/>
<span style="padding-left: 175px;">#citalopramPrescription</span>
<span/>
<span>
<span style="padding-left: 125px;">
<br/>
<span style="padding-left: 150px;">
<b>category: </b>
<span>drug</span>
<br/>
</span>
</span>
</span>
<span/>
<span/>
</span>
</span>
<span style="padding-left: 100px;"/>
</span>
<span>
<b>Step: </b>
<br/>
<span style="padding-left: 125px;">
<b>text: </b>
<span>escitalopram 10 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)</span>
<br/>
</span>
<span style="padding-left: 100px;"/>
</span>
<span>
<b>Step: </b>
<br/>
<span style="padding-left: 125px;">
<b>text: </b>
<span>fluoxetine 20 mg capsule 1 capsule oral 1 time daily now (30 tablet; 3 refills)</span>
<br/>
</span>
<span style="padding-left: 100px;"/>
</span>
<span>
<b>Step: </b>
<br/>
<span style="padding-left: 125px;">
<b>text: </b>
<span>paroxetine 20 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)</span>
<br/>
</span>
<span style="padding-left: 100px;"/>
</span>
<span>
<b>Step: </b>
<br/>
<span style="padding-left: 125px;">
<b>text: </b>
<span>sertraline 50 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)</span>
<br/>
</span>
<span style="padding-left: 100px;"/>
</span>
</span>
</span>
<span>
<b>Step: </b>
<br/>
<span style="padding-left: 125px;">
<b>text: </b>
<span>Dopamine Norepinephrine Reuptake Inhibitors (Choose a maximum of one or document reasons for exception)</span>
<br/>
</span>
<span style="padding-left: 75px;"/>
</span>
<span>
<b>Step: </b>
<br/>
<span style="padding-left: 100px;">
<b>text: </b>
<span>Serotonin Norepinephrine Reuptake Inhibitors (Choose a maximum of one or doument reasons for exception)</span>
<br/>
</span>
<span style="padding-left: 75px;"/>
</span>
<span>
<b>Step: </b>
<br/>
<span style="padding-left: 100px;">
<b>text: </b>
<span>Norepinephrine-Serotonin Modulators (Choose a maximum of one or document reasons for exception)</span>
<br/>
</span>
<span style="padding-left: 100px;"/>
</span>
</span>
</span>
</span>
</span>
</span>
</span>
</p>
</div>
</text>
<!-- The referral and medication requests here are only partially specified, additional information will be provided from context, see the action definitions in the body of the plan definition below -->
<contained>
<ActivityDefinition>
<id value="referralToMentalHealthCare"/>
<status value="draft"/>
<description value="refer to primary care mental-health integrated care program for evaluation and treatment of mental health conditions now"/>
<!-- Kind indicates the type of resource that is defined by this activity, a ServiceRequest in this case -->
<kind value="ServiceRequest"/>
<code>
<coding>
<system value="http://snomed.info/sct"/>
<code value="306206005"/>
</coding>
<text value="Referral to service (procedure)"/>
</code>
<timingTiming>
<event>
<!-- The expression here specifies the value for the timing of the resulting resource. In this case, referralRequest.fulfillmentTime.start -->
<extension url="http://hl7.org/fhir/StructureDefinition/cqf-expression">
<valueExpression>
<language value="text/cql-expression"/>
<expression value="Now()"/>
</valueExpression>
</extension>
</event>
</timingTiming>
<participant>
<type value="practitioner"/>
</participant>
</ActivityDefinition>
</contained>
<contained>
<ActivityDefinition>
<id value="citalopramPrescription"/>
<status value="draft"/>
<kind value="MedicationRequest"/>
<productReference>
<reference value="#citalopramMedication"/>
</productReference>
<dosage>
<text value="1 tablet oral 1 time daily"/>
<timing>
<repeat>
<frequency value="1"/>
<period value="1"/>
<periodUnit value="d"/>
</repeat>
</timing>
<route>
<coding>
<code value="26643006"/>
<display value="Oral route (qualifier value)"/>
</coding>
<text value="Oral route (qualifier value)"/>
</route>
<doseAndRate>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/dose-rate-type"/>
<code value="ordered"/>
<display value="Ordered"/>
</coding>
</type>
<doseQuantity>
<value value="1"/>
<unit value="{tbl}"/>
</doseQuantity>
</doseAndRate>
</dosage>
<dynamicValue>
<path value="dispenseRequest.numberOfRepeatsAllowed"/>
<expression>
<language value="text/cql-expression"/>
<expression value="3"/>
</expression>
</dynamicValue>
<dynamicValue>
<path value="dispenseRequest.quantity"/>
<expression>
<language value="text/cql-expression"/>
<expression value="30 '{tbl}'"/>
</expression>
</dynamicValue>
</ActivityDefinition>
</contained>
<contained>
<Medication>
<id value="citalopramMedication"/>
<code>
<coding>
<system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
<code value="200371"/>
</coding>
<text value="citalopram"/>
</code>
<doseForm>
<coding>
<system value="http://snomed.info/sct"/>
<code value="385055001"/>
<display value="Tablet (basic dose form)"/>
</coding>
<text value="Tablet dose form"/>
</doseForm>
<ingredient>
<item>
<reference>
<reference value="#citalopramSubstance"/>
</reference>
</item>
<strengthRatio>
<numerator>
<value value="20"/>
<unit value="mg"/>
</numerator>
<denominator>
<value value="1"/>
<unit value="{tbl}"/>
</denominator>
</strengthRatio>
</ingredient>
</Medication>
</contained>
<contained>
<Substance>
<id value="citalopramSubstance"/>
<instance value="false"/>
<code>
<concept>
<coding>
<system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
<code value="2556"/>
</coding>
<text value="citalopram"/>
</concept>
</code>
</Substance>
</contained>
<url value="http://motivemi.com/artifacts/PlanDefinition/low-suicide-risk-order-set"/>
<identifier>
<system value="urn:ietf:rfc:3986"/>
<value value="urn:oid:2.16.840.1.113883.4.642.11.7"/>
</identifier>
<identifier>
<use value="official"/>
<system value="http://motivemi.com/artifacts"/>
<value value="mmi:low-suicide-risk-order-set"/>
</identifier>
<version value="1.0.0"/>
<name value="LowSuicideRiskOrderSet"/>
<title value="Low Suicide Risk Order Set"/>
<status value="active"/>
<experimental value="true"/>
<date value="2015-08-15"/>
<publisher value="Motive Medical Intelligence"/>
<contact>
<telecom>
<system value="phone"/>
<value value="415-362-4007"/>
<use value="work"/>
</telecom>
<telecom>
<system value="email"/>
<value value="info@motivemi.com"/>
<use value="work"/>
</telecom>
</contact>
<description value="Orders to be applied to a patient characterized as low suicide risk."/>
<useContext>
<code>
<system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
<code value="age"/>
</code>
<valueCodeableConcept>
<coding>
<system value="https://meshb.nlm.nih.gov"/>
<code value="D000328"/>
<display value="Adult"/>
</coding>
</valueCodeableConcept>
</useContext>
<useContext>
<code>
<system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
<code value="focus"/>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="87512008"/>
<display value="Mild major depression"/>
</coding>
</valueCodeableConcept>
</useContext>
<useContext>
<code>
<system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
<code value="focus"/>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="40379007"/>
<display value="Mild recurrent major depression"/>
</coding>
</valueCodeableConcept>
</useContext>
<useContext>
<code>
<system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
<code value="focus"/>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="394687007"/>
<display value="Low suicide risk"/>
</coding>
</valueCodeableConcept>
</useContext>
<useContext>
<code>
<system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
<code value="focus"/>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="225337009"/>
<display value="Suicide risk assessment"/>
</coding>
</valueCodeableConcept>
</useContext>
<useContext>
<code>
<system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
<code value="user"/>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="309343006"/>
<display value="Physician"/>
</coding>
</valueCodeableConcept>
</useContext>
<useContext>
<code>
<system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
<code value="venue"/>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="440655000"/>
<display value="Outpatient environment"/>
</coding>
</valueCodeableConcept>
</useContext>
<jurisdiction>
<coding>
<system value="urn:iso:std:iso:3166"/>
<code value="US"/>
</coding>
</jurisdiction>
<purpose value="This order set helps ensure consistent application of appropriate orders for the care of low suicide risk patients."/>
<usage value="This order set should be applied after assessing a patient for suicide risk, when the findings of that assessment indicate the patient has low suicide risk."/>
<copyright value="© Copyright 2016 Motive Medical Intelligence. All rights reserved."/>
<approvalDate value="2016-03-12"/>
<lastReviewDate value="2016-08-15"/>
<effectivePeriod>
<start value="2016-01-01"/>
<end value="2017-12-31"/>
</effectivePeriod>
<topic>
<text value="Suicide risk assessment"/>
</topic>
<author>
<name value="Motive Medical Intelligence"/>
<telecom>
<system value="phone"/>
<value value="415-362-4007"/>
<use value="work"/>
</telecom>
<telecom>
<system value="email"/>
<value value="info@motivemi.com"/>
<use value="work"/>
</telecom>
</author>
<relatedArtifact>
<type value="derived-from"/>
<display value="Practice Guideline for the Treatment of Patients with Major Depressive Disorder"/>
<document>
<url value="http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf"/>
</document>
</relatedArtifact>
<relatedArtifact>
<type value="composed-of"/>
<resource value="http://example.org/fhir/ActivityDefinition/referralPrimaryCareMentalHealth"/>
</relatedArtifact>
<relatedArtifact>
<type value="composed-of"/>
<resource value="http://example.org/fhir/ActivityDefinition/citalopramPrescription"/>
</relatedArtifact>
<library value="http://example.org/fhir/Library/suiciderisk-orderset-logic"/>
<!-- Actions -->
<action>
<title value="Suicide Risk Assessment and Outpatient Management"/>
<action>
<title value="Consults and Referrals"/>
<groupingBehavior value="logical-group"/>
<selectionBehavior value="any"/>
<action>
<textEquivalent value="Refer to outpatient mental health program for evaluation and treatment of mental health conditions now"/>
<definitionCanonical value="#referralToMentalHealthCare"/>
<!-- These expressions will be evaluated with the library referenced above as an include -->
<dynamicValue>
<path value="timing.event"/>
<expression>
<language value="text/cql-expression"/>
<expression value="Now()"/>
</expression>
</dynamicValue>
<dynamicValue>
<path value="specialty"/>
<!-- This expression is code selector syntax in CQL, returning the code from the NPI provider taxonomy -->
<expression>
<language value="text/cql-expression"/>
<expression value="Code '261QM0850X' from SuicideRiskLogic."NUCC Provider Taxonomy" display 'Adult Mental Health'"/>
</expression>
</dynamicValue>
<dynamicValue>
<!-- The fulfillmentTime element of the resulting ServiceRequest will be set to the result of the ServiceRequestFulfillmentTime expression defined in the SuicideRiskLogic library -->
<path value="occurrenceDateTime"/>
<expression>
<language value="text/cql-expression"/>
<expression value="SuicideRiskLogic.ServiceRequestFulfillmentTime"/>
</expression>
</dynamicValue>
<dynamicValue>
<path value="subject"/>
<expression>
<language value="text/cql-expression"/>
<expression value="SuicideRiskLogic.Patient"/>
</expression>
</dynamicValue>
<dynamicValue>
<path value="requester.agent"/>
<expression>
<language value="text/cql-expression"/>
<expression value="SuicideRiskLogic.Practitioner"/>
</expression>
</dynamicValue>
<dynamicValue>
<path value="reasonCode"/>
<expression>
<language value="text/cql-expression"/>
<expression value="SuicideRiskLogic.RiskAssessmentScore"/>
</expression>
</dynamicValue>
<dynamicValue>
<path value="reasonReference"/>
<expression>
<language value="text/cql-expression"/>
<expression value="SuicideRiskLogic.RiskAssessment"/>
</expression>
</dynamicValue>
</action>
</action>
<action>
<title value="Medications"/>
<groupingBehavior value="logical-group"/>
<selectionBehavior value="at-most-one"/>
<action>
<extension url="http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence">
<valueCodeableConcept>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/evidence-quality"/>
<code value="high"/>
</coding>
<text value="High Quality"/>
</valueCodeableConcept>
</extension>
<title value="First-Line Antidepressants"/>
<documentation>
<type value="citation"/>
<document>
<contentType value="text/html"/>
<url value="http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf"/>
<title value="Practice Guideline for the Treatment of Patients with Major Depressive Disorder"/>
</document>
</documentation>
<groupingBehavior value="logical-group"/>
<selectionBehavior value="at-most-one"/>
<action>
<title value="Selective Serotonin Reuptake Inhibitors (Choose a mazimum of one or document reasons for exception)"/>
<documentation>
<type value="citation"/>
<document>
<contentType value="text/html"/>
<url value="http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6daeb45c-451d-b135-bf8f-2d6dff4b6b01"/>
<title value="National Library of Medicine. DailyMed website. CITALOPRAM- citalopram hydrobromide tablet, film coated."/>
</document>
</documentation>
<groupingBehavior value="logical-group"/>
<selectionBehavior value="at-most-one"/>
<action>
<textEquivalent value="citalopram 20 mg tablet 1 tablet oral 1 time daily now (30 table; 3 refills)"/>
<definitionCanonical value="#citalopramPrescription"/>
<dynamicValue>
<path value="status"/>
<expression>
<language value="text/cql-expression"/>
<expression value="'draft'"/>
</expression>
</dynamicValue>
<dynamicValue>
<path value="patient"/>
<expression>
<language value="text/cql-expression"/>
<expression value="SuicideRiskLogic.Patient"/>
</expression>
</dynamicValue>
<dynamicValue>
<path value="prescriber"/>
<expression>
<language value="text/cql-expression"/>
<expression value="SuicideRiskLogic.Practitioner"/>
</expression>
</dynamicValue>
<dynamicValue>
<path value="reasonCode"/>
<expression>
<language value="text/cql-expression"/>
<expression value="SuicideRiskLogic.RiskAssessmentScore"/>
</expression>
</dynamicValue>
<dynamicValue>
<path value="reasonReference"/>
<expression>
<language value="text/cql-expression"/>
<expression value="SuicideRiskLogic.RiskAssessment"/>
</expression>
</dynamicValue>
</action>
<action>
<textEquivalent value="escitalopram 10 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)"/>
<!-- Follows pattern established above -->
</action>
<action>
<textEquivalent value="fluoxetine 20 mg capsule 1 capsule oral 1 time daily now (30 tablet; 3 refills)"/>
<!-- Follows pattern established above -->
</action>
<action>
<textEquivalent value="paroxetine 20 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)"/>
<!-- Follows pattern established above -->
</action>
<action>
<textEquivalent value="sertraline 50 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)"/>
<!-- Follows pattern established above -->
</action>
</action>
<action>
<textEquivalent value="Dopamine Norepinephrine Reuptake Inhibitors (Choose a maximum of one or document reasons for exception)"/>
<!-- Follows pattern established above -->
</action>
<action>
<textEquivalent value="Serotonin Norepinephrine Reuptake Inhibitors (Choose a maximum of one or doument reasons for exception)"/>
<!-- Follows pattern established above -->
</action>
<action>
<textEquivalent value="Norepinephrine-Serotonin Modulators (Choose a maximum of one or document reasons for exception)"/>
<!-- Follows pattern established above -->
</action>
</action>
</action>
</action>
</PlanDefinition>