Clinical Practice Guidelines
3.0.0-ballot - STU 3 Ballot International flag

Clinical Practice Guidelines, published by HL7 International / Clinical Decision Support. This guide is not an authorized publication; it is the continuous build for version 3.0.0-ballot built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/cqf-recommendations/ and changes regularly. See the Directory of published versions

Library: Stop Medication Library (Experimental)

Official URL: http://hl7.org/fhir/uv/cpg/Library/stopmedication-library Version: 3.0.0-ballot
Active as of 2026-11-10 Computable Name: StopMedicationLibrary
Other Identifiers: OID:2.16.840.1.113883.4.642.40.48.28.21

Logic for an example recommendation to stop a medication

Metadata
Title Stop Medication Library
Version 3.0.0-ballot
Identifier urn:oid:2.16.840.1.113883.4.642.40.48.28.21
Experimental true
Jurisdiction World
Steward (Publisher) HL7 International / Clinical Decision Support
Steward Contact HL7 International / Clinical Decision Support
Description

Logic for an example recommendation to stop a medication
Type http://terminology.hl7.org/CodeSystem/library-type#logic-library
Data Requirement Type: Patient
Profile(s): Patient
Data Requirement Type: MedicationRequest
Profile(s): MedicationRequest
Must Support Elements: intent, status, doNotPerform
Data Requirement Type: Task
Profile(s): Task
Must Support Elements: code, url, value
Parameters
Name Use Card. Type Documentation
Patient Out 0..1 Patient
Medication Order Out 0..* MedicationRequest
Inclusion Criteria Out 0..1 boolean
Stop Medication Proposal Out 0..* Task
Is Recommendation Applicable Out 0..1 boolean
Library Content
CQL Content 
library StopMedication

using FHIR version '4.0.1'

include FHIRHelpers version '4.0.1'

codesystem "Activity Type": 'http://hl7.org/fhir/uv/cpg/CodeSystem/cpg-activity-type-cs'

code "Stop Activity": 'stop-activity' from "Activity Type"

context Patient

/* Recommendation to stop an existing order for a medication */

/*
Positive recommendation:

If an active order for the medication exists
  Propose stopping the medication

Given a proposal, the user can:
  Accept the proposal
  Ignore the proposal
  Reject the proposal without reason
  Reject the proposal with reason

Scenario 1: Active medication order, no plan or proposal, decision support should propose
Scenario 2: Active medication order, incomplete proposal, decision support should not propose
Scenario 3: Active medication order, rejected proposal, decision support should not propose
Scenario 4: No active medication order, decision support should not propose

*/

define "Medication Order":
  [MedicationRequest] M
    where M.intent = 'order'
      and M.status = 'active'
      and M.doNotPerform is not true

define "Inclusion Criteria":
  Patient.active
    and exists "Medication Order"

define "Stop Medication Proposal":
  [Task] T
    where T.code ~ "Stop Activity"
      and doNotPerform(T) is not true

define "Is Recommendation Applicable":
  "Inclusion Criteria"
    and not exists "Stop Medication Proposal"

define function doNotPerform(task Task):
  singleton from (
    task.extension E
      where E.url = 'http://hl7.org/fhir/StructureDefinition/request-doNotPerform'
  ).value as boolean
ELM XML Content 
Encoded data
ELM JSON Content 
Encoded data
Citations and References
Dependency Description: Code System Activity Type
Resource: CPG Activity Type Code System
Canonical URL: http://hl7.org/fhir/uv/cpg/CodeSystem/cpg-activity-type-cs
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