"url": "http://motivemi.com/artifacts/PlanDefinition/low-suicide-risk-order-set"
"identifier": [
{
"use": "official",
"system": "http://motivemi.com/artifacts",
"value": "mmi:low-suicide-risk-order-set"
}
]
"version": "1.0.0"
"name": "LowSuicideRiskOrderSet"
"title": "Low Suicide Risk Order Set"
"subtitle":
"type":
"status": "active"
"experimental": true
"subject[x]":
"date": "2015-08-15"
"publisher": "Motive Medical Intelligence"
"contact": [
{
"telecom": [
{
"system": "phone",
"value": "415-362-4007",
"use": "work"
},
{
"system": "email",
"value": "info@motivemi.com",
"use": "work"
}
]
}
]
"description": "Orders to be applied to a patient characterized as low suicide risk."
"useContext": [
{
"code": {
"system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
"code": "age"
},
"valueCodeableConcept": {
"coding": [
{
"system": "https://meshb.nlm.nih.gov",
"code": "D000328",
"display": "Adult"
}
]
}
},
{
"code": {
"system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
"code": "focus"
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "87512008",
"display": "Mild major depression"
}
]
}
},
{
"code": {
"system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
"code": "focus"
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "40379007",
"display": "Major depression, recurrent, mild"
}
]
}
},
{
"code": {
"system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
"code": "focus"
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "394687007",
"display": "Low suicide risk"
}
]
}
},
{
"code": {
"system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
"code": "focus"
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "225337009",
"display": "Suicide risk assessment"
}
]
}
},
{
"code": {
"system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
"code": "user"
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "309343006",
"display": "Physician"
}
]
}
},
{
"code": {
"system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
"code": "venue"
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "440655000",
"display": "Outpatient environment"
}
]
}
}
]
"jurisdiction": [
{
"coding": [
{
"system": "urn:iso:std:iso:3166",
"code": "US"
}
]
}
]
"purpose": "This order set helps ensure consistent application of appropriate orders for the care of low suicide risk patients."
"usage": "This order set should be applied after assessing a patient for suicide risk, when the findings of that assessment indicate the patient has low suicide risk."
"copyright": "© Copyright 2016 Motive Medical Intelligence. All rights reserved."
"approvalDate": "2016-03-12"
"lastReviewDate": "2016-08-15"
"effectivePeriod": {
"start": "2016-01-01",
"end": "2017-12-31"
}
"topic": [
{
"text": "Suicide risk assessment"
}
]
"author": [
{
"name": "Motive Medical Intelligence",
"telecom": [
{
"system": "phone",
"value": "415-362-4007",
"use": "work"
},
{
"system": "email",
"value": "info@motivemi.com",
"use": "work"
}
]
}
]
"editor":
"reviewer":
"endorser":
"relatedArtifact": [
{
"type": "derived-from",
"display": "Practice Guideline for the Treatment of Patients with Major Depressive Disorder",
"url": "http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf"
},
{
"type": "composed-of",
"resource": "ActivityDefinition/referralPrimaryCareMentalHealth"
},
{
"type": "composed-of",
"resource": "ActivityDefinition/citalopramPrescription"
}
]
"library": [
"Library/suiciderisk-orderset-logic"
]
"goal":
"action": [
{
"title": "Suicide Risk Assessment and Outpatient Management",
"action": [
{
"title": "Consults and Referrals",
"groupingBehavior": "logical-group",
"selectionBehavior": "any",
"action": [
{
"textEquivalent": "Refer to outpatient mental health program for evaluation and treatment of mental health conditions now",
"definitionCanonical": "#referralToMentalHealthCare",
"dynamicValue": [
{
"path": "timing.event",
"expression": {
"language": "text/cql",
"expression": "Now()"
}
},
{
"path": "specialty",
"expression": {
"language": "text/cql",
"expression": "Code '261QM0850X' from SuicideRiskLogic.\"NUCC Provider Taxonomy\" display 'Adult Mental Health'"
}
},
{
"path": "occurrenceDateTime",
"expression": {
"language": "text/cql",
"expression": "SuicideRiskLogic.ServiceRequestFulfillmentTime"
}
},
{
"path": "subject",
"expression": {
"language": "text/cql",
"expression": "SuicideRiskLogic.Patient"
}
},
{
"path": "requester.agent",
"expression": {
"language": "text/cql",
"expression": "SuicideRiskLogic.Practitioner"
}
},
{
"path": "reasonCode",
"expression": {
"language": "text/cql",
"expression": "SuicideRiskLogic.RiskAssessmentScore"
}
},
{
"path": "reasonReference",
"expression": {
"language": "text/cql",
"expression": "SuicideRiskLogic.RiskAssessment"
}
}
]
}
]
},
{
"title": "Medications",
"groupingBehavior": "logical-group",
"selectionBehavior": "at-most-one",
"action": [
{
"title": "First-Line Antidepressants",
"documentation": [
{
"type": "citation",
"document": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence",
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/evidence-quality",
"code": "high"
}
],
"text": "High Quality"
}
}
],
"contentType": "text/html",
"url": "http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf",
"title": "Practice Guideline for the Treatment of Patients with Major Depressive Disorder"
}
}
],
"groupingBehavior": "logical-group",
"selectionBehavior": "at-most-one",
"action": [
{
"title": "Selective Serotonin Reuptake Inhibitors (Choose a mazimum of one or document reasons for exception)",
"documentation": [
{
"type": "citation",
"document": {
"contentType": "text/html",
"url": "http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6daeb45c-451d-b135-bf8f-2d6dff4b6b01",
"title": "National Library of Medicine. DailyMed website. CITALOPRAM- citalopram hydrobromide tablet, film coated."
}
}
],
"groupingBehavior": "logical-group",
"selectionBehavior": "at-most-one",
"action": [
{
"textEquivalent": "citalopram 20 mg tablet 1 tablet oral 1 time daily now (30 table; 3 refills)",
"definitionCanonical": "#citalopramPrescription",
"dynamicValue": [
{
"path": "status",
"expression": {
"language": "text/cql",
"expression": "'draft'"
}
},
{
"path": "patient",
"expression": {
"language": "text/cql",
"expression": "SuicideRiskLogic.Patient"
}
},
{
"path": "prescriber",
"expression": {
"language": "text/cql",
"expression": "SuicideRiskLogic.Practitioner"
}
},
{
"path": "reasonCode",
"expression": {
"language": "text/cql",
"expression": "SuicideRiskLogic.RiskAssessmentScore"
}
},
{
"path": "reasonReference",
"expression": {
"language": "text/cql",
"expression": "SuicideRiskLogic.RiskAssessment"
}
}
]
},
{
"textEquivalent": "escitalopram 10 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)"
},
{
"textEquivalent": "fluoxetine 20 mg capsule 1 capsule oral 1 time daily now (30 tablet; 3 refills)"
},
{
"textEquivalent": "paroxetine 20 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)"
},
{
"textEquivalent": "sertraline 50 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)"
}
]
},
{
"textEquivalent": "Dopamine Norepinephrine Reuptake Inhibitors (Choose a maximum of one or document reasons for exception)"
},
{
"textEquivalent": "Serotonin Norepinephrine Reuptake Inhibitors (Choose a maximum of one or doument reasons for exception)"
},
{
"textEquivalent": "Norepinephrine-Serotonin Modulators (Choose a maximum of one or document reasons for exception)"
}
]
}
]
}
]
}
]
{
"resourceType": "PlanDefinition",
"id": "low-suicide-risk-order-set",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Id: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">PlanDefinition/low-suicide-risk-order-set</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Identifier: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <b>value: </b>\n <span>mmi:low-suicide-risk-order-set</span>\n </td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Title: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">Low Suicide Risk Order Set</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Status: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">draft</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Description: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">Orders to be applied to a patient characterized as low suicide risk.</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Purpose: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">This order set helps ensure consistent application of appropriate orders for the care of low suicide risk patients.</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Usage: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">This order set should be applied after assessing a patient for suicide risk, when the findings of that assessment indicate the patient has low suicide risk.</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Context: </b>\n </td>\n </tr>\n <tr style=\"vertical-align: top;\">\n <td style=\"padding-right: 25px;\">\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>system: </b>\n <span>http://terminology.hl7.org/CodeSystem/usage-context-type</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>code: </b>\n <span>age</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>value: </b>\n <br/>\n <span>\n <span>\n <span>\n <span style=\"padding-left: 25px;\">\n <b>system: </b>\n <span>https://meshb.nlm.nih.gov</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>code: </b>\n <span>D000328</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>display: </b>\n <span>Adult</span>\n </span>\n </span>\n </span>\n </span>\n </p>\n </td>\n </tr>\n </table>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Context: </b>\n </td>\n </tr>\n <tr style=\"vertical-align: top;\">\n <td style=\"padding-right: 25px;\">\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>system: </b>\n <span>http://terminology.hl7.org/CodeSystem/usage-context-type</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>code: </b>\n <span>focus</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>value: </b>\n <br/>\n <span>\n <span>\n <span>\n <span style=\"padding-left: 25px;\">\n <b>system: </b>\n <span>http://snomed.info/sct</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>code: </b>\n <span>87512008</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>display: </b>\n <span>Mild major depression</span>\n </span>\n </span>\n </span>\n </span>\n </p>\n </td>\n </tr>\n </table>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Context: </b>\n </td>\n </tr>\n <tr style=\"vertical-align: top;\">\n <td style=\"padding-right: 25px;\">\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>system: </b>\n <span>http://terminology.hl7.org/CodeSystem/usage-context-type</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>code: </b>\n <span>focus</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>value: </b>\n <br/>\n <span>\n <span>\n <span>\n <span style=\"padding-left: 25px;\">\n <b>system: </b>\n <span>http://snomed.info/sct</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>code: </b>\n <span>40379007</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>display: </b>\n <span>Major depression, recurrent, mild</span>\n </span>\n </span>\n </span>\n </span>\n </p>\n </td>\n </tr>\n </table>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Context: </b>\n </td>\n </tr>\n <tr style=\"vertical-align: top;\">\n <td style=\"padding-right: 25px;\">\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>system: </b>\n <span>http://terminology.hl7.org/CodeSystem/usage-context-type</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>code: </b>\n <span>focus</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>value: </b>\n <br/>\n <span>\n <span>\n <span>\n <span style=\"padding-left: 25px;\">\n <b>system: </b>\n <span>http://snomed.info/sct</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>code: </b>\n <span>394687007</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>display: </b>\n <span>Low suicide risk</span>\n </span>\n </span>\n </span>\n </span>\n </p>\n </td>\n </tr>\n </table>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Context: </b>\n </td>\n </tr>\n <tr style=\"vertical-align: top;\">\n <td style=\"padding-right: 25px;\">\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>system: </b>\n <span>http://terminology.hl7.org/CodeSystem/usage-context-type</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>code: </b>\n <span>focus</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>value: </b>\n <br/>\n <span>\n <span>\n <span>\n <span style=\"padding-left: 25px;\">\n <b>system: </b>\n <span>http://snomed.info/sct</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>code: </b>\n <span>225337009</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>display: </b>\n <span>Suicide risk assessment</span>\n </span>\n </span>\n </span>\n </span>\n </p>\n </td>\n </tr>\n </table>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Context: </b>\n </td>\n </tr>\n <tr style=\"vertical-align: top;\">\n <td style=\"padding-right: 25px;\">\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>system: </b>\n <span>http://terminology.hl7.org/CodeSystem/usage-context-type</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>code: </b>\n <span>user</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>value: </b>\n <br/>\n <span>\n <span>\n <span>\n <span style=\"padding-left: 25px;\">\n <b>system: </b>\n <span>http://snomed.info/sct</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>code: </b>\n <span>309343006</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>display: </b>\n <span>Physician</span>\n </span>\n </span>\n </span>\n </span>\n </p>\n </td>\n </tr>\n </table>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Context: </b>\n </td>\n </tr>\n <tr style=\"vertical-align: top;\">\n <td style=\"padding-right: 25px;\">\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>system: </b>\n <span>http://terminology.hl7.org/CodeSystem/usage-context-type</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>code: </b>\n <span>venue</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>value: </b>\n <br/>\n <span>\n <span>\n <span>\n <span style=\"padding-left: 25px;\">\n <b>system: </b>\n <span>http://snomed.info/sct</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>code: </b>\n <span>440655000</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>display: </b>\n <span>Outpatient environment</span>\n </span>\n </span>\n </span>\n </span>\n </p>\n </td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Topic: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <span>\n <b>text: </b>\n <span>Suicide risk assessment</span>\n </span>\n </td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Contributor: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <b>\n <span>author</span>:\n </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 50px; padding-right: 25px;\">Motive Medical Intelligence</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Library: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <b>reference: </b>\n <span>Library/suiciderisk-orderset-logic</span>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <b>display: </b>\n <span>SuicideRiskLogic</span>\n </td>\n </tr>\n </table>\n <p/>\n <h2>Actions</h2>\n <p style=\"width: 100%;\" class=\"hierarchy\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 25px;\">\n <b>title: </b>\n <span>Suicide Risk Assessment and Outpatient Management</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 50px;\">\n <b>title: </b>\n <span>Consults and Referrals</span>\n <br/>\n </span>\n <span style=\"padding-left: 50px;\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 75px;\">\n <b>text: </b>\n <span>Refer to outpatient mental health program for evaluation and treatment of mental health conditions now</span>\n <br/>\n </span>\n <span style=\"padding-left: 75px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>reference: </b>\n <br/>\n <span style=\"padding-left: 125px;\">#referralToMentalHealthCare</span>\n <span>\n <span style=\"padding-left: 75px;\">\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>description: </b>\n <span>refer to primary care mental-health integrated care program for evaluation and treatment of mental health conditions now</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\">\n <b>category: </b>\n <span>referral</span>\n <br/>\n </span>\n </span>\n </span>\n </span>\n </span>\n <span style=\"padding-left: 50px;\"/>\n </span>\n </span>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 50px;\">\n <b>title: </b>\n <span>Medications</span>\n <br/>\n </span>\n <span style=\"padding-left: 50px;\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 75px;\">\n <b>title: </b>\n <span>First-Line Antidepressants</span>\n <br/>\n </span>\n <span style=\"padding-left: 75px;\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>title: </b>\n <span>Selective Serotonin Reuptake Inhibitors (Choose a mazimum of one or document reasons for exception)</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 125px;\">\n <b>text: </b>\n <span>citalopram 20 mg tablet 1 tablet oral 1 time daily now (30 table; 3 refills)</span>\n <br/>\n </span>\n <span style=\"padding-left: 125px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 150px;\">\n <b>reference: </b>\n <br/>\n <span style=\"padding-left: 175px;\">#citalopramPrescription</span>\n <span/>\n <span>\n <span style=\"padding-left: 125px;\">\n <br/>\n <span style=\"padding-left: 150px;\">\n <b>category: </b>\n <span>drug</span>\n <br/>\n </span>\n </span>\n </span>\n <span/>\n <span/>\n </span>\n </span>\n <span style=\"padding-left: 100px;\"/>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 125px;\">\n <b>text: </b>\n <span>escitalopram 10 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\"/>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 125px;\">\n <b>text: </b>\n <span>fluoxetine 20 mg capsule 1 capsule oral 1 time daily now (30 tablet; 3 refills)</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\"/>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 125px;\">\n <b>text: </b>\n <span>paroxetine 20 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\"/>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 125px;\">\n <b>text: </b>\n <span>sertraline 50 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\"/>\n </span>\n </span>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 125px;\">\n <b>text: </b>\n <span>Dopamine Norepinephrine Reuptake Inhibitors (Choose a maximum of one or document reasons for exception)</span>\n <br/>\n </span>\n <span style=\"padding-left: 75px;\"/>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>text: </b>\n <span>Serotonin Norepinephrine Reuptake Inhibitors (Choose a maximum of one or doument reasons for exception)</span>\n <br/>\n </span>\n <span style=\"padding-left: 75px;\"/>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>text: </b>\n <span>Norepinephrine-Serotonin Modulators (Choose a maximum of one or document reasons for exception)</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\"/>\n </span>\n </span>\n </span>\n </span>\n </span>\n </span>\n </span>\n </p>\n </div>"
},
"contained": [
{
"resourceType": "ActivityDefinition",
"id": "referralToMentalHealthCare",
"status": "draft",
"description": "refer to primary care mental-health integrated care program for evaluation and treatment of mental health conditions now",
"kind": "ServiceRequest",
"code": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "306206005"
}
],
"text": "Referral to service (procedure)"
},
"timingTiming": {
"_event": [
{
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/cqf-expression",
"valueExpression": {
"language": "text/cql",
"expression": "Now()"
}
}
]
}
]
},
"participant": [
{
"type": "practitioner"
}
]
},
{
"resourceType": "ActivityDefinition",
"id": "citalopramPrescription",
"status": "draft",
"kind": "MedicationRequest",
"productReference": {
"reference": "#citalopramMedication"
},
"dosage": [
{
"text": "1 tablet oral 1 time daily",
"timing": {
"repeat": {
"frequency": 1,
"period": 1,
"periodUnit": "d"
}
},
"route": {
"coding": [
{
"code": "26643006",
"display": "Oral route (qualifier value)"
}
],
"text": "Oral route (qualifier value)"
},
"doseAndRate": [
{
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
"code": "ordered",
"display": "Ordered"
}
]
},
"doseQuantity": {
"value": 1,
"unit": "{tbl}"
}
}
]
}
],
"dynamicValue": [
{
"path": "dispenseRequest.numberOfRepeatsAllowed",
"expression": {
"language": "text/cql",
"expression": "3"
}
},
{
"path": "dispenseRequest.quantity",
"expression": {
"language": "text/cql",
"expression": "30 '{tbl}'"
}
}
]
},
{
"resourceType": "Medication",
"id": "citalopramMedication",
"code": {
"coding": [
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "200371"
}
],
"text": "citalopram"
},
"form": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "385055001",
"display": "Tablet dose form"
}
],
"text": "Tablet dose form"
},
"ingredient": [
{
"itemReference": {
"reference": "#citalopramSubstance"
},
"strength": {
"numerator": {
"value": 20,
"unit": "mg"
},
"denominator": {
"value": 1,
"unit": "{tbl}"
}
}
}
]
},
{
"resourceType": "Substance",
"id": "citalopramSubstance",
"code": {
"coding": [
{
"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
"code": "2556"
}
],
"text": "citalopram"
}
}
],
"url": "http://motivemi.com/artifacts/PlanDefinition/low-suicide-risk-order-set",
"identifier": [
{
"use": "official",
"system": "http://motivemi.com/artifacts",
"value": "mmi:low-suicide-risk-order-set"
}
],
"version": "1.0.0",
"name": "LowSuicideRiskOrderSet",
"title": "Low Suicide Risk Order Set",
"status": "active",
"experimental": true,
"date": "2015-08-15",
"publisher": "Motive Medical Intelligence",
"contact": [
{
"telecom": [
{
"system": "phone",
"value": "415-362-4007",
"use": "work"
},
{
"system": "email",
"value": "info@motivemi.com",
"use": "work"
}
]
}
],
"description": "Orders to be applied to a patient characterized as low suicide risk.",
"useContext": [
{
"code": {
"system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
"code": "age"
},
"valueCodeableConcept": {
"coding": [
{
"system": "https://meshb.nlm.nih.gov",
"code": "D000328",
"display": "Adult"
}
]
}
},
{
"code": {
"system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
"code": "focus"
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "87512008",
"display": "Mild major depression"
}
]
}
},
{
"code": {
"system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
"code": "focus"
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "40379007",
"display": "Major depression, recurrent, mild"
}
]
}
},
{
"code": {
"system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
"code": "focus"
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "394687007",
"display": "Low suicide risk"
}
]
}
},
{
"code": {
"system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
"code": "focus"
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "225337009",
"display": "Suicide risk assessment"
}
]
}
},
{
"code": {
"system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
"code": "user"
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "309343006",
"display": "Physician"
}
]
}
},
{
"code": {
"system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
"code": "venue"
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "440655000",
"display": "Outpatient environment"
}
]
}
}
],
"jurisdiction": [
{
"coding": [
{
"system": "urn:iso:std:iso:3166",
"code": "US"
}
]
}
],
"purpose": "This order set helps ensure consistent application of appropriate orders for the care of low suicide risk patients.",
"usage": "This order set should be applied after assessing a patient for suicide risk, when the findings of that assessment indicate the patient has low suicide risk.",
"copyright": "© Copyright 2016 Motive Medical Intelligence. All rights reserved.",
"approvalDate": "2016-03-12",
"lastReviewDate": "2016-08-15",
"effectivePeriod": {
"start": "2016-01-01",
"end": "2017-12-31"
},
"topic": [
{
"text": "Suicide risk assessment"
}
],
"author": [
{
"name": "Motive Medical Intelligence",
"telecom": [
{
"system": "phone",
"value": "415-362-4007",
"use": "work"
},
{
"system": "email",
"value": "info@motivemi.com",
"use": "work"
}
]
}
],
"relatedArtifact": [
{
"type": "derived-from",
"display": "Practice Guideline for the Treatment of Patients with Major Depressive Disorder",
"url": "http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf"
},
{
"type": "composed-of",
"resource": "ActivityDefinition/referralPrimaryCareMentalHealth"
},
{
"type": "composed-of",
"resource": "ActivityDefinition/citalopramPrescription"
}
],
"library": [
"Library/suiciderisk-orderset-logic"
],
"action": [
{
"title": "Suicide Risk Assessment and Outpatient Management",
"action": [
{
"title": "Consults and Referrals",
"groupingBehavior": "logical-group",
"selectionBehavior": "any",
"action": [
{
"textEquivalent": "Refer to outpatient mental health program for evaluation and treatment of mental health conditions now",
"definitionCanonical": "#referralToMentalHealthCare",
"dynamicValue": [
{
"path": "timing.event",
"expression": {
"language": "text/cql",
"expression": "Now()"
}
},
{
"path": "specialty",
"expression": {
"language": "text/cql",
"expression": "Code '261QM0850X' from SuicideRiskLogic.\"NUCC Provider Taxonomy\" display 'Adult Mental Health'"
}
},
{
"path": "occurrenceDateTime",
"expression": {
"language": "text/cql",
"expression": "SuicideRiskLogic.ServiceRequestFulfillmentTime"
}
},
{
"path": "subject",
"expression": {
"language": "text/cql",
"expression": "SuicideRiskLogic.Patient"
}
},
{
"path": "requester.agent",
"expression": {
"language": "text/cql",
"expression": "SuicideRiskLogic.Practitioner"
}
},
{
"path": "reasonCode",
"expression": {
"language": "text/cql",
"expression": "SuicideRiskLogic.RiskAssessmentScore"
}
},
{
"path": "reasonReference",
"expression": {
"language": "text/cql",
"expression": "SuicideRiskLogic.RiskAssessment"
}
}
]
}
]
},
{
"title": "Medications",
"groupingBehavior": "logical-group",
"selectionBehavior": "at-most-one",
"action": [
{
"title": "First-Line Antidepressants",
"documentation": [
{
"type": "citation",
"document": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence",
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/evidence-quality",
"code": "high"
}
],
"text": "High Quality"
}
}
],
"contentType": "text/html",
"url": "http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf",
"title": "Practice Guideline for the Treatment of Patients with Major Depressive Disorder"
}
}
],
"groupingBehavior": "logical-group",
"selectionBehavior": "at-most-one",
"action": [
{
"title": "Selective Serotonin Reuptake Inhibitors (Choose a mazimum of one or document reasons for exception)",
"documentation": [
{
"type": "citation",
"document": {
"contentType": "text/html",
"url": "http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6daeb45c-451d-b135-bf8f-2d6dff4b6b01",
"title": "National Library of Medicine. DailyMed website. CITALOPRAM- citalopram hydrobromide tablet, film coated."
}
}
],
"groupingBehavior": "logical-group",
"selectionBehavior": "at-most-one",
"action": [
{
"textEquivalent": "citalopram 20 mg tablet 1 tablet oral 1 time daily now (30 table; 3 refills)",
"definitionCanonical": "#citalopramPrescription",
"dynamicValue": [
{
"path": "status",
"expression": {
"language": "text/cql",
"expression": "'draft'"
}
},
{
"path": "patient",
"expression": {
"language": "text/cql",
"expression": "SuicideRiskLogic.Patient"
}
},
{
"path": "prescriber",
"expression": {
"language": "text/cql",
"expression": "SuicideRiskLogic.Practitioner"
}
},
{
"path": "reasonCode",
"expression": {
"language": "text/cql",
"expression": "SuicideRiskLogic.RiskAssessmentScore"
}
},
{
"path": "reasonReference",
"expression": {
"language": "text/cql",
"expression": "SuicideRiskLogic.RiskAssessment"
}
}
]
},
{
"textEquivalent": "escitalopram 10 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)"
},
{
"textEquivalent": "fluoxetine 20 mg capsule 1 capsule oral 1 time daily now (30 tablet; 3 refills)"
},
{
"textEquivalent": "paroxetine 20 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)"
},
{
"textEquivalent": "sertraline 50 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)"
}
]
},
{
"textEquivalent": "Dopamine Norepinephrine Reuptake Inhibitors (Choose a maximum of one or document reasons for exception)"
},
{
"textEquivalent": "Serotonin Norepinephrine Reuptake Inhibitors (Choose a maximum of one or doument reasons for exception)"
},
{
"textEquivalent": "Norepinephrine-Serotonin Modulators (Choose a maximum of one or document reasons for exception)"
}
]
}
]
}
]
}
]
}
{
"resourceType" : "PlanDefinition",
// from Resource: id, meta, implicitRules, and language
// from DomainResource: text, contained, extension, and modifierExtension
"url" : "<uri>", // Canonical identifier for this plan definition, represented as a URI (globally unique)
"identifier" : [{ Identifier }], // Additional identifier for the plan definition
"version" : "<string>", // Business version of the plan definition
"name" : "<string>", // C? Name for this plan definition (computer friendly)
"title" : "<string>", // Name for this plan definition (human friendly)
"subtitle" : "<string>", // Subordinate title of the plan definition
"type" : { CodeableConcept }, // order-set | clinical-protocol | eca-rule | workflow-definition
"status" : "<code>", // R! draft | active | retired | unknown
"experimental" : <boolean>, // For testing purposes, not real usage
// subject[x]: Type of individual the plan definition is focused on. One of these 2:
"subjectCodeableConcept" : { CodeableConcept },
"subjectReference" : { Reference(Group) },
"date" : "<dateTime>", // Date last changed
"publisher" : "<string>", // Name of the publisher (organization or individual)
"contact" : [{ ContactDetail }], // Contact details for the publisher
"description" : "<markdown>", // Natural language description of the plan definition
"useContext" : [{ UsageContext }], // The context that the content is intended to support
"jurisdiction" : [{ CodeableConcept }], // Intended jurisdiction for plan definition (if applicable)
"purpose" : "<markdown>", // Why this plan definition is defined
"usage" : "<string>", // Describes the clinical usage of the plan
"copyright" : "<markdown>", // Use and/or publishing restrictions
"approvalDate" : "<date>", // When the plan definition was approved by publisher
"lastReviewDate" : "<date>", // When the plan definition was last reviewed
"effectivePeriod" : { Period }, // When the plan definition is expected to be used
"topic" : [{ CodeableConcept }], // E.g. Education, Treatment, Assessment
"author" : [{ ContactDetail }], // Who authored the content
"editor" : [{ ContactDetail }], // Who edited the content
"reviewer" : [{ ContactDetail }], // Who reviewed the content
"endorser" : [{ ContactDetail }], // Who endorsed the content
"relatedArtifact" : [{ RelatedArtifact }], // Additional documentation, citations
"library" : [{ canonical(Library) }], // Logic used by the plan definition
"goal" : [{ // What the plan is trying to accomplish
"category" : { CodeableConcept }, // E.g. Treatment, dietary, behavioral
"description" : { CodeableConcept }, // R! Code or text describing the goal
"priority" : { CodeableConcept }, // high-priority | medium-priority | low-priority
"start" : { CodeableConcept }, // When goal pursuit begins
"addresses" : [{ CodeableConcept }], // What does the goal address
"documentation" : [{ RelatedArtifact }], // Supporting documentation for the goal
"target" : [{ // Target outcome for the goal
"measure" : { CodeableConcept }, // The parameter whose value is to be tracked
// detail[x]: The target value to be achieved. One of these 3:
"detailQuantity" : { Quantity },
"detailRange" : { Range },
"detailCodeableConcept" : { CodeableConcept },
"due" : { Duration } // Reach goal within
}]
}],
"action" : [{ // Action defined by the plan
"prefix" : "<string>", // User-visible prefix for the action (e.g. 1. or A.)
"title" : "<string>", // User-visible title
"description" : "<string>", // Brief description of the action
"textEquivalent" : "<string>", // Static text equivalent of the action, used if the dynamic aspects cannot be interpreted by the receiving system
"priority" : "<code>", // routine | urgent | asap | stat
"code" : [{ CodeableConcept }], // Code representing the meaning of the action or sub-actions
"reason" : [{ CodeableConcept }], // Why the action should be performed
"documentation" : [{ RelatedArtifact }], // Supporting documentation for the intended performer of the action
"goalId" : ["<id>"], // What goals this action supports
// subject[x]: Type of individual the action is focused on. One of these 2:
"subjectCodeableConcept" : { CodeableConcept },
"subjectReference" : { Reference(Group) },
"trigger" : [{ TriggerDefinition }], // When the action should be triggered
"condition" : [{ // Whether or not the action is applicable
"kind" : "<code>", // R! applicability | start | stop
"expression" : { Expression } // Boolean-valued expression
}],
"input" : [{ DataRequirement }], // Input data requirements
"output" : [{ DataRequirement }], // Output data definition
"relatedAction" : [{ // Relationship to another action
"actionId" : "<id>", // R! What action is this related to
"relationship" : "<code>", // R! before-start | before | before-end | concurrent-with-start | concurrent | concurrent-with-end | after-start | after | after-end
// offset[x]: Time offset for the relationship. One of these 2:
"offsetDuration" : { Duration }
"offsetRange" : { Range }
}],
// timing[x]: When the action should take place. One of these 6:
"timingDateTime" : "<dateTime>",
"timingAge" : { Age },
"timingPeriod" : { Period },
"timingDuration" : { Duration },
"timingRange" : { Range },
"timingTiming" : { Timing },
"participant" : [{ // Who should participate in the action
"type" : "<code>", // R! patient | practitioner | related-person | device
"role" : { CodeableConcept } // E.g. Nurse, Surgeon, Parent
}],
"type" : { CodeableConcept }, // create | update | remove | fire-event
"groupingBehavior" : "<code>", // visual-group | logical-group | sentence-group
"selectionBehavior" : "<code>", // any | all | all-or-none | exactly-one | at-most-one | one-or-more
"requiredBehavior" : "<code>", // must | could | must-unless-documented
"precheckBehavior" : "<code>", // yes | no
"cardinalityBehavior" : "<code>", // single | multiple
// definition[x]: Description of the activity to be performed. One of these 2:
"definitionCanonical" : { canonical(ActivityDefinition|PlanDefinition|
Questionnaire) },
"definitionUri" : "<uri>",
"transform" : { canonical(StructureMap) }, // Transform to apply the template
"dynamicValue" : [{ // Dynamic aspects of the definition
"path" : "<string>", // The path to the element to be set dynamically
"expression" : { Expression } // An expression that provides the dynamic value for the customization
}],
"action" : [{ Content as for PlanDefinition.action }] // A sub-action
}]
}
The following search parameters can be used to query PlanDefinition resources. Just submit them like so:
https://api.1up.health/fhir/r4/PlanDefinition?query-param=queryvalue
Search Parameter | Field Type | Resource Fields Searched |
---|---|---|
composed-of | reference | relatedArtifact.where |
context | text | useContext.value |
context-quantity | quantity | useContext.value |
context-type | text | useContext.code |
context-type-quantity | composite | useContext |
context-type-value | composite | useContext |
date | date | date |
definition | reference | action.definition |
depends-on | reference | relatedArtifact.where |
derived-from | reference | relatedArtifact.where |
description | text | description |
effective | date | effectivePeriod |
identifier | text | identifier |
jurisdiction | text | jurisdiction |
name | text | name |
predecessor | reference | relatedArtifact.where |
publisher | text | publisher |
status | text | status |
successor | reference | relatedArtifact.where |
title | text | title |
topic | text | topic |
type | text | type |
url | uri | url |
version | text | version |