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narratives.r4.examples.plandefinition.low-suicide-risk.json Maven / Gradle / Ivy

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{
  "resourceType": "PlanDefinition",
  "id": "example",
  "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",
      "category": "referral",
      "code": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "306206005"
          }
        ],
        "text": "Referral to service (procedure)"
      },
      "timingTiming": {
        "event": [
          {
            "extension": [
              {
                "url": "http://hl7.org/fhir/StructureDefinition/cqif-cqlExpression",
                "valueString": "Now()"
              }
            ]
          }
        ]
      },
      "participantType": [
        "practitioner"
      ]
    },
    {
      "resourceType": "ActivityDefinition",
      "id": "citalopramPrescription",
      "status": "draft",
      "category": "drug",
      "productReference": {
        "reference": "#citalopramMedication"
      },
      "dosageInstruction": [
        {
          "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)"
          },
          "doseQuantity": {
            "value": 1,
            "unit": "{tbl}"
          }
        }
      ],
      "dynamicValue": [
        {
          "path": "dispenseRequest.numberOfRepeatsAllowed",
          "expression": "3"
        },
        {
          "path": "dispenseRequest.quantity",
          "expression": "30 '{tbl}'"
        }
      ]
    },
    {
      "resourceType": "Medication",
      "id": "citalopramMedication",
      "code": {
        "coding": [
          {
            "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
            "code": "200371"
          }
        ],
        "text": "citalopram"
      },
      "product": {
        "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"
      }
    }
  ],
  "identifier": [
    {
      "use": "official",
      "value": "mmi:low-suicide-risk-order-set"
    }
  ],
  "version": "1.0.0",
  "title": "Low Suicide Risk Order Set",
  "status": "draft",
  "date": "2015-08-15",
  "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.",
  "approvalDate": "2016-03-12",
  "lastReviewDate": "2016-08-15",
  "effectivePeriod": {
    "start": "2016-01-01",
    "end": "2017-12-31"
  },
  "useContext": [
    {
      "code": {
        "system": "http://hl7.org/fhir/usage-context-type",
        "code": "age"
      },
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "https://meshb.nlm.nih.gov",
            "code": "D000328",
            "display": "Adult"
          }
        ]
      }
    },
    {
      "code": {
        "system": "http://hl7.org/fhir/usage-context-type",
        "code": "focus"
      },
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "87512008",
            "display": "Mild major depression"
          }
        ]
      }
    },
    {
      "code": {
        "system": "http://hl7.org/fhir/usage-context-type",
        "code": "focus"
      },
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "40379007",
            "display": "Major depression, recurrent, mild"
          }
        ]
      }
    },
    {
      "code": {
        "system": "http://hl7.org/fhir/usage-context-type",
        "code": "focus"
      },
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "394687007",
            "display": "Low suicide risk"
          }
        ]
      }
    },
    {
      "code": {
        "system": "http://hl7.org/fhir/usage-context-type",
        "code": "focus"
      },
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "225337009",
            "display": "Suicide risk assessment"
          }
        ]
      }
    },
    {
      "code": {
        "system": "http://hl7.org/fhir/usage-context-type",
        "code": "user"
      },
      "valueCodeableConcept": {
        "coding": [
          {
            "system": "http://snomed.info/sct",
            "code": "309343006",
            "display": "Physician"
          }
        ]
      }
    },
    {
      "code": {
        "system": "http://hl7.org/fhir/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"
        }
      ]
    }
  ],
  "topic": [
    {
      "text": "Suicide risk assessment"
    }
  ],
  "contributor": [
    {
      "type": "author",
      "name": "Motive Medical Intelligence",
      "contact": [
        {
          "telecom": [
            {
              "system": "phone",
              "value": "415-362-4007",
              "use": "work"
            },
            {
              "system": "email",
              "value": "[email protected]",
              "use": "work"
            }
          ]
        }
      ]
    }
  ],
  "publisher": "Motive Medical Intelligence",
  "contact": [
    {
      "telecom": [
        {
          "system": "phone",
          "value": "415-362-4007",
          "use": "work"
        },
        {
          "system": "email",
          "value": "[email protected]",
          "use": "work"
        }
      ]
    }
  ],
  "library": [
    {
      "reference": "Library/mmi-suiciderisk-orderset-logic",
      "display": "SuicideRiskLogic"
    }
  ],
  "actionDefinition": [
    {
      "title": "Suicide Risk Assessment and Outpatient Management",
      "actionDefinition": [
        {
          "title": "Consults and Referrals",
          "groupingBehavior": "logical-group",
          "selectionBehavior": "any",
          "actionDefinition": [
            {
              "textEquivalent": "Refer to outpatient mental health program for evaluation and treatment of mental health conditions now",
              "activityDefinition": {
                "reference": "#referralToMentalHealthCare"
              },
              "dynamicValue": [
                {
                  "path": "timing.event",
                  "expression": "Now()"
                },
                {
                  "path": "specialty",
                  "expression": "Code '261QM0850X' from SuicideRiskLogic.\"NPI Taxonomy\""
                },
                {
                  "path": "fulfillmentTime",
                  "expression": "SuicideRiskLogic.ReferralRequestFulfillmentTime"
                },
                {
                  "path": "patient",
                  "expression": "SuicideRiskLogic.Patient"
                },
                {
                  "path": "requester",
                  "expression": "SuicideRiskLogic.Practitioner"
                },
                {
                  "path": "reason",
                  "expression": "SuicideRiskLogic.RiskAssessmentScore"
                },
                {
                  "path": "supportingInformation",
                  "expression": "SuicideRiskLogic.RiskAssessment"
                }
              ]
            }
          ]
        },
        {
          "title": "Medications",
          "groupingBehavior": "logical-group",
          "selectionBehavior": "at-most-one",
          "actionDefinition": [
            {
              "title": "First-Line Antidepressants",
              "documentation": [
                {
                  "type": "justification",
                  "document": {
                    "extension": [
                      {
                        "url": "http://hl7.org/fhir/StructureDefinition/cqif-qualityOfEvidence",
                        "valueCodeableConcept": {
                          "coding": [
                            {
                              "system": "http://hl7.org/fhir/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",
              "actionDefinition": [
                {
                  "title": "Selective Serotonin Reuptake Inhibitors (Choose a mazimum of one or document reasons for exception)",
                  "documentation": [
                    {
                      "type": "justification",
                      "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",
                  "actionDefinition": [
                    {
                      "textEquivalent": "citalopram 20 mg tablet 1 tablet oral 1 time daily now (30 table; 3 refills)",
                      "activityDefinition": {
                        "reference": "#citalopramPrescription"
                      },
                      "dynamicValue": [
                        {
                          "path": "status",
                          "expression": "'draft'"
                        },
                        {
                          "path": "patient",
                          "expression": "SuicideRiskLogic.Patient"
                        },
                        {
                          "path": "prescriber",
                          "expression": "SuicideRiskLogic.Practitioner"
                        },
                        {
                          "path": "reasonCode",
                          "expression": "SuicideRiskLogic.RiskAssessmentScore"
                        },
                        {
                          "path": "reasonReference",
                          "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)"
                }
              ]
            }
          ]
        }
      ]
    }
  ]
}




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