# entry[].resource.text.div
National Comprehensive Cancer Network

Chemotherapy Order Template

Kidney Cancer

Gemcitabine/CARBOplatin

KDN5

INDICATION:

Metastatic or Relapsed – Collecting Duct/Medullary Subtypes

REFERENCES:

NCCN Guidelines® for Kidney Cancer. V.3.2015.

Oudard S, et al. J Urol. 2007;177(5):1698-702. a

NCCN SUPPORTIVE CARE:

Emetic Risk:

Day 1 | Moderate
Day 8 | Low

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

# entry[].resource.publisher
National Comprehensive Cancer Network, Inc.

# entry[].resource.useContext[].valueCodeableConcept.text
Kidney Cancer – Collecting Duct/Medullary Subtypes - Metastatic

# entry[].resource.relatedArtifact[].display
NCCN Guidelines for Kidney Cancer. V.2.2016

# entry[].resource.action[].action[].action[].action[].action[].textEquivalent
Gemcitabine 1250 mg/m² IV over 30 minutes on days 1 and 8

# entry[].resource.action[].action[].action[].action[].action[].textEquivalent
CARBOplatin AUC 5 IV over 30 minutes on Day 1

# entry[].resource.text.div
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

# entry[].resource.title
Chalmydia Screening CDS Example Using Common

# entry[].resource.description
Chlamydia Screening CDS Example Using Common

# entry[].resource.action[].title
Patient has not had chlamydia screening within the recommended timeframe...

# entry[].resource.text.div
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

-
*
*

# entry[].resource.contained[].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.

# entry[].resource.contained[].dosage[].text
nitroglycerin 0.4 mg tablet sub-lingual every 5 minutes as needed for chest pain; maximum 3 tablets

# entry[].resource.title
Chest Pain (CP) - Coronary Artery Disease (CAD) Order Set KNART

# entry[].resource.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.

# entry[].resource.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.

# entry[].resource.copyright
© Copyright Cognitive Medical Systems, Inc. 9444 Waples Street Suite 300 San Diego, CA 92121

# entry[].resource.relatedArtifact[].display
Cardiology: Chest Pain (CP) / Coronary Artery Disease (CAD) Clinical Content White Paper

# entry[].resource.relatedArtifact[].display
Outcome CVD (coronary death, myocardial infarction, coronary insufficiency, angina, ischemic stroke, hemorrhagic stroke, transient ischemic attack, peripheral artery disease, heart failure)

# entry[].resource.relatedArtifact[].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.

# entry[].resource.relatedArtifact[].display
General cardiovascular risk profile for use in primary care: the Framingham Heart Study

# entry[].resource.relatedArtifact[].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.

# entry[].resource.relatedArtifact[].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

# entry[].resource.relatedArtifact[].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.

# entry[].resource.relatedArtifact[].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)

# entry[].resource.relatedArtifact[].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.

# entry[].resource.relatedArtifact[].display
LABEL: ASPIRIN 81 MG- aspirin tablet, coated

# entry[].resource.relatedArtifact[].display
LABEL: CLOPIDOGREL- clopidogrel bisulfate tablet, film coated

# entry[].resource.relatedArtifact[].display
LABEL: LIPITOR- atorvastatin calcium tablet, film coated

# entry[].resource.relatedArtifact[].display
LABEL: METOPROLOL SUCCINATE EXTENDED-RELEASE - metoprolol succinate tablet, film coated, extended release

# entry[].resource.relatedArtifact[].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.

# entry[].resource.relatedArtifact[].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.

# entry[].resource.action[].action[].action[].textEquivalent
Referral to cardiology to evaluate chest pain (routine)

# entry[].resource.action[].action[].action[].dynamicValue[].expression.expression
Code '261QM0850X' from CardiologyChestPainLogic."NUCC Provider Taxonomy" display 'Adult Mental Health'

# entry[].resource.action[].action[].description
Consider the following medications for stable patients to be initiated prior to the cardiology consultation.

# entry[].resource.action[].action[].action[].action[].textEquivalent
metoprolol tartrate 25 mg tablet 1 tablet oral 2 time daily

# entry[].resource.action[].action[].action[].action[].textEquivalent
metoprolol tartrate 50 mg tablet 1 tablet oral 2 time daily

# entry[].resource.action[].action[].action[].action[].textEquivalent
amlodipine 5  tablet 1 tablet oral  daily

# entry[].resource.action[].action[].action[].action[].textEquivalent
nitroglycerin 0.4 mg tablet sub-lingual every 5 minutes as needed for chest pain; maximum 3 tablets

# entry[].resource.text.div
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.

# entry[].resource.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.

# entry[].resource.action[].title
Mother should be administered a breastfeeding readiness assessment.

# entry[].resource.action[].action[].title
Create the breastfeeding readiness assessment order.

# entry[].resource.action[].action[].textEquivalent
Administer a breastfeeding readiness assessment.

# entry[].resource.action[].action[].textEquivalent
A Breastfeeding Readiness Assessment is recommended, please authorize or reject the order.

# entry[].resource.text.div
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.

# entry[].resource.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.

# entry[].resource.action[].title
Mother should be administered a breastfeeding readiness assessment.

# entry[].resource.action[].condition[].expression.expression
Should Notify Provider to Sign Assessment Order

# entry[].resource.action[].action[].textEquivalent
A Breastfeeding Readiness Assessment is recommended, please authorize or reject the order.

# entry[].resource.text.div
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.

# entry[].resource.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.

# entry[].resource.action[].title
Mother should be administered a breastfeeding readiness assessment.

# entry[].resource.action[].condition[].expression.expression
Should Notify Nurse to Perform Assessment

# entry[].resource.action[].action[].title
Notify the charge nurse to perform the assessment.

# entry[].resource.action[].action[].textEquivalent
A Breastfeeding Readiness Assessment is recommended, please administer the assessment.

# entry[].resource.action[].action[].title
Notify the bedside nurse to perform the assessment.

# entry[].resource.action[].action[].textEquivalent
A Breastfeeding Readiness Assessment is recommended, please administer the assessment.

# entry[].resource.text.div
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

# entry[].resource.description
Exclusive breastfeeding intervention intended to improve outcomes for exclusive breastmilk feeding of newborns by creating a lactation consult for the mother if appropriate.

# entry[].resource.action[].title
Mother should be referred to a lactation specialist for consultation.

# entry[].resource.text.div
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)

# entry[].resource.contained[].description
refer to primary care mental-health integrated care program for evaluation and treatment of mental health conditions now

# entry[].resource.description
Orders to be applied to a patient characterized as low suicide risk.

# entry[].resource.purpose
This order set helps ensure consistent application of appropriate orders for the care of low suicide risk patients.

# entry[].resource.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.

# entry[].resource.copyright
© Copyright 2016 Motive Medical Intelligence. All rights reserved.

# entry[].resource.relatedArtifact[].display
Practice Guideline for the Treatment of Patients with Major Depressive Disorder

# entry[].resource.action[].title
Suicide Risk Assessment and Outpatient Management

# entry[].resource.action[].action[].action[].textEquivalent
Refer to outpatient mental health program for evaluation and treatment of mental health conditions now

# entry[].resource.action[].action[].action[].dynamicValue[].expression.expression
Code '261QM0850X' from SuicideRiskLogic."NUCC Provider Taxonomy" display 'Adult Mental Health'

# entry[].resource.action[].action[].action[].documentation[].document.title
Practice Guideline for the Treatment of Patients with Major Depressive Disorder

# entry[].resource.action[].action[].action[].action[].title
Selective Serotonin Reuptake Inhibitors (Choose a mazimum of one or document reasons for exception)

# entry[].resource.action[].action[].action[].action[].documentation[].document.title
National Library of Medicine. DailyMed website. CITALOPRAM- citalopram hydrobromide tablet, film coated.

# entry[].resource.action[].action[].action[].action[].action[].textEquivalent
citalopram 20 mg tablet 1 tablet oral 1 time daily now (30 table; 3 refills)

# entry[].resource.action[].action[].action[].action[].action[].textEquivalent
escitalopram 10 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)

# entry[].resource.action[].action[].action[].action[].action[].textEquivalent
fluoxetine 20 mg capsule 1 capsule oral 1 time daily now (30 tablet; 3 refills)

# entry[].resource.action[].action[].action[].action[].action[].textEquivalent
paroxetine 20 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)

# entry[].resource.action[].action[].action[].action[].action[].textEquivalent
sertraline 50 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)

# entry[].resource.action[].action[].action[].action[].textEquivalent
Dopamine Norepinephrine Reuptake Inhibitors (Choose a maximum of one or document reasons for exception)

# entry[].resource.action[].action[].action[].action[].textEquivalent
Serotonin Norepinephrine Reuptake Inhibitors (Choose a maximum of one or doument reasons for exception)

# entry[].resource.action[].action[].action[].action[].textEquivalent
Norepinephrine-Serotonin Modulators (Choose a maximum of one or document reasons for exception)

# entry[].resource.text.div
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

- | Kind | Expression
* | applicability |

groupingBehavior: visual-group

selectionBehavior: exactly-one

dynamicValue

path: action.title

expression:

dynamicValue

path: action.description

expression:

dynamicValue

path: activity.extension

expression:

Actions

-
*
*
*

# entry[].resource.title
CDC Opioid Prescribing Guideline Recommendation #4

# entry[].resource.publisher
Centers for Disease Control and Prevention (CDC)

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

# entry[].resource.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.

# entry[].resource.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.

# entry[].resource.relatedArtifact[].display
CDC guideline for prescribing opioids for chronic pain

# entry[].resource.action[].description
Checking if the trigger prescription meets the inclusion criteria for recommendation #4 workflow.

# entry[].resource.action[].condition[].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.

# entry[].resource.action[].action[].description
Risk of overdose carefully considered and outweighed by benefit; snooze 3 mo

# entry[].resource.text.div
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

- | Kind | Expression
* | applicability |

groupingBehavior: visual-group

selectionBehavior: exactly-one

dynamicValue

path: action.title

expression:

dynamicValue

path: action.description

expression:

dynamicValue

path: activity.extension

expression:

Actions

-
*
*
*
*

# entry[].resource.title
CDC Opioid Prescribing Guideline Recommendation #5

# entry[].resource.publisher
Centers for Disease Control and Prevention (CDC)

# entry[].resource.description
When opioids are started, providers should prescribe the lowest effective dosage.

# entry[].resource.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.

# entry[].resource.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

# entry[].resource.relatedArtifact[].display
CDC guideline for prescribing opioids for chronic pain

# entry[].resource.action[].description
Total morphine milligram equivalent (MME) exceeds recommended amount. Taper to less than 50.

# entry[].resource.action[].action[].description
Risk of overdose carefully considered and outweighed by benefit; snooze 3 mo

# entry[].resource.action[].action[].description
N/A - see comment (will be reviewed by medical director); snooze 3 mo

# entry[].resource.text.div
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

- | Kind | Expression
* | applicability |

groupingBehavior: visual-group

selectionBehavior: exactly-one

dynamicValue

path: action.title

expression:

dynamicValue

path: action.description

expression:

dynamicValue

path: action.extension

expression:

Actions

-
*
*
*

# entry[].resource.title
CDC Opioid Prescribing Guideline Recommendation #7

# entry[].resource.publisher
Centers for Disease Control and Prevention (CDC)

# entry[].resource.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.

# entry[].resource.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.

# entry[].resource.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.

# entry[].resource.relatedArtifact[].display
CDC guideline for prescribing opioids for chronic pain

# entry[].resource.action[].title
Existing patient should be evaluated for risk of continued opioid therapy.

# entry[].resource.action[].description
Checking if the trigger prescription meets the inclusion criteria for recommendation #7 workflow.

# entry[].resource.action[].condition[].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.

# entry[].resource.action[].action[].description
Will schedule assessment of risk for opioid use for the patient

# entry[].resource.action[].action[].description
Risk of overdose carefully considered and outweighed by benefit; snooze 3 mo

# entry[].resource.text.div
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

- | Kind | Expression
* | applicability |

groupingBehavior: visual-group

selectionBehavior: exactly-one

dynamicValue

path: action.description

expression:

dynamicValue

path: action.title

expression:

dynamicValue

path: action.extension

expression:

Actions

-
*
*
*

# entry[].resource.title
CDC Opioid Prescribing Guideline Recommendation #8

# entry[].resource.publisher
Centers for Disease Control and Prevention (CDC)

# entry[].resource.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.

# entry[].resource.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.

# entry[].resource.usage
Before starting and periodically during continuation of opioid therapy, clinicians should evaluate risk factors for opioid-related harms.

# entry[].resource.relatedArtifact[].display
CDC guideline for prescribing opioids for chronic pain

# entry[].resource.action[].title
Existing patient exhibits risk factors for opioid-related harms.

# entry[].resource.action[].description
Checking if the trigger prescription meets the inclusion criteria for recommendation #8 workflow.

# entry[].resource.action[].condition[].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 an average MME greater than 50 mg/day.

# entry[].resource.action[].action[].description
Risk of overdose carefully considered and outweighed by benefit; snooze 3 mo

# entry[].resource.text.div
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

- | Kind | Expression
* | applicability |

DynamicValues

- | Path | Expression
* | 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

- | Kind | Expression
* | applicability |

Actions

-
*
*
*

# entry[].resource.title
CDC Opioid Prescribing Guideline Recommendation #10

# entry[].resource.publisher
Centers for Disease Control and Prevention (CDC)

# entry[].resource.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.

# entry[].resource.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.

# entry[].resource.usage
Providers should be aware if patients are taking other prescription drugs or illicit drugs that might increase their risk of an overdose.

# entry[].resource.relatedArtifact[].display
CDC guideline for prescribing opioids for chronic pain

# entry[].resource.action[].description
Patient has not had a urine screening in the past 12 months

# entry[].resource.action[].condition[].expression.description
Patient has not had a urine screening in the past 12 months

# entry[].resource.action[].action[].description
Not for chronic pain management. Snooze 3 months

# entry[].resource.action[].description
Patient has a urine screening testing positive for either unprescribed opioids or illicit drugs in the past 12 months

# entry[].resource.action[].condition[].expression.description
Patient has a positive urine screening in the past 12 months

# entry[].resource.action[].action[].title
Unprescribed Opioids Found In Urine Screening

# entry[].resource.action[].action[].description
Patient has a positive urine screening in the past 12 months for opioid(s), which is not prescribed

# entry[].resource.action[].action[].condition[].expression.description
Patient has a positive urine screening in the past 12 months for opioid(s), which is not prescribed

# entry[].resource.action[].action[].action[].description
Not for chronic pain management. Snooze 3 months

# entry[].resource.action[].action[].title
Prescribed Opioids Not Found In Urine Screening

# entry[].resource.action[].action[].description
Patient has a positive urine screening in the past 12 months, which does not include prescribed opioids

# entry[].resource.action[].action[].condition[].expression.description
Patient has a positive urine screening in the past 12 months, which does not include prescribed opioids

# entry[].resource.action[].action[].description
Patient has a positive urine screening in the past 12 months for illicit drugs

# entry[].resource.action[].action[].condition[].expression.description
Patient has a positive urine screening in the past 12 months for illicit drugs

# entry[].resource.action[].action[].action[].description
Not for chronic pain management. Snooze 3 months

# entry[].resource.text.div
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

- | Kind | Expression
* | applicability |

groupingBehavior: visual-group

selectionBehavior: exactly-one

dynamicValue

path: action.description

expression:

dynamicValue

path: action.title

expression:

dynamicValue

path: action.extension

expression:

Actions

-
*
*
*

# entry[].resource.title
CDC Opioid Prescribing Guideline Recommendation #11

# entry[].resource.publisher
Centers for Disease Control and Prevention (CDC)

# entry[].resource.description
Concurrently prescribing opioid medications with benzodiazepines increases the risk of harm for the patient.

# entry[].resource.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.

# entry[].resource.usage
Clinicians should avoid prescribing opioid pain medication and benzodiazepines concurrently whenever possible.

# entry[].resource.relatedArtifact[].display
CDC guideline for prescribing opioids for chronic pain

# entry[].resource.action[].title
Existing patient has concurrent opioid and benzodiazepine prescriptions.

# entry[].resource.action[].description
Checking if the trigger prescription meets the inclusion criteria for recommendation #11 workflow.

# entry[].resource.action[].condition[].expression.description
Check whether the existing patient is using opioids concurrently with benzodiazepines.

# entry[].resource.action[].action[].description
Risk of overdose carefully considered and outweighed by benefit; snooze 3 mo

# entry[].resource.text.div
[Put rendering here]

# entry[].resource.title
This example illustrates relationships between actions.

# entry[].resource.text.div
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 ,

# entry[].resource.purpose
Example of A medical algorithm for assessment and treatment of overweight and obesity

# entry[].resource.author[].name
National Heart, Lung, and Blood Institute

# entry[].resource.relatedArtifact[].display
Overweight and Obesity Treatment Guidelines

# entry[].resource.goal[].start.text
When the patient's BMI Ratio is at or above 25

# entry[].resource.action[].description
Measure, Weight, Height, Waist, Circumference; Calculate BMI

# entry[].resource.action[].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

# entry[].resource.action[].condition[].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.

# entry[].resource.action[].condition[].expression.expression
exists ([Condition: Obesity]) or not exists ([Observation: BMI] O where O.effectiveDateTime 2 years or less before Today())

# entry[].resource.text.div
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

# entry[].resource.description
Zika Virus Management intervention describing the CDC Guidelines for Zika Virus Reporting and Management.

# entry[].resource.action[].action[].condition[].expression.expression
Should Administer Zika Virus Exposure Assessment

# entry[].resource.action[].action[].condition[].expression.expression
Should Order Serum Zika Virus IgM + Dengue Virus IgM

# entry[].resource.action[].action[].condition[].expression.expression
Should Provide Mosquito Prevention and Contraception Advice

# entry[].resource.text.div
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

# entry[].resource.description
Zika Virus Management intervention describing the CDC Guidelines for Zika Virus Reporting and Management.

# entry[].resource.action[].action[].condition[].expression.expression
Should Administer Zika Virus Exposure Assessment

# entry[].resource.action[].action[].condition[].expression.expression
Should Order Serum Zika Virus IgM + Dengue Virus IgM

# entry[].resource.action[].action[].condition[].expression.expression
Should Provide Mosquito Prevention and Contraception Advice