library OpioidCDSREC12PatientView version '2022.1.0'
using FHIR version '4.0.1'
include FHIRHelpers version '4.0.1' called FHIRHelpers
include OpioidCDSCommon version '2022.1.0' called Common
include OpioidCDSCommonConfig version '2022.1.0' called Config
/*
**
** Recommendation #12
** Clinicians should offer or arrange evidence-based treatment (usually
** medication-assisted treatment with buprenorphine or methadone in combination
** with behavioral therapies) for patients with opioid use disorder
** (recommendation category: A, evidence type: 2)
**
** When
** Patient is 18 years and older and not receiving evidence-based treatment for
** opioid use disorder, which may include medication treatment with buprenorphine
** or methadone, or opioid-specific behavioral counseling
** Patient has a diagnosis of opioid use disorder in the past 90 days
** Then
** Recommend opioid agonist or partial agonist treatment with methadone maintenance
** therapy, buprenorphine therapy, and/or behavioral therapy. Potential actions include:
** Order methadone or buprenorphine
** Refer to qualified treatment provider (i.e. substance disorder specialist)
** N/A - see comment; snooze 3 months
**
*/
// META: PlanDefinition: http://fhir.org/guides/cdc/opioid-cds-r4/PlanDefinition/plandefinition-OpioidCDSREC12PatientView
context Patient
define "Opioid Use Disorder Lookback Period":
Interval[Today() - 90 days, Today()]
define "Is Recommendation Applicable?":
"Inclusion Criteria"
and not "Exclusion Criteria"
define "Inclusion Criteria":
"Patient 18 or Older?"
and "Not Receiving Evidence-Based Treatment for Opioid Use Disorder"
and "Presence of Diagnosis of Opioid Use Disorder"
and "Positive Result from Opioid Use Disorder Evaluation Tool"
define "Exclusion Criteria":
false
define "Patient 18 or Older?":
Config."Age Less than 18 Years Is Enabled"
and AgeInYears() >= 18
define "Not Receiving Evidence-Based Treatment for Opioid Use Disorder":
Config."Evidence Based Treatment Criteria For Opioid Use Disorder"
and not (
exists (
[MedicationRequest: Common."Buprenorphine and methadone medications"] MR
where MR.status in { 'active', 'completed' }
and date from MR.authoredOn during day of "Opioid Use Disorder Lookback Period"
)
or exists (
[Procedure: Common."Substance misuse behavioral counseling"] P
where P.status ~ 'completed'
and (
case
when P.performed is FHIR.dateTime then
Interval[FHIRHelpers.ToDateTime(P.performed as FHIR.dateTime), FHIRHelpers.ToDateTime(P.performed as FHIR.dateTime)]
when P.performed is FHIR.Period then
FHIRHelpers.ToInterval(P.performed as FHIR.Period)
else
null as Interval<DateTime>
end
) during day of "Opioid Use Disorder Lookback Period"
)
)
define "Presence of Diagnosis of Opioid Use Disorder":
exists (
[Condition: category in Common."US Core Condition Category Codes"] C
where C.code in Common."Opioid misuse disorders"
and exists (
C.clinicalStatus.coding Coding
where FHIRHelpers.ToCode(Coding) ~ Common."Active Condition"
)
and date from C.recordedDate during day of "Opioid Use Disorder Lookback Period"
)
define "Positive Result from Opioid Use Disorder Evaluation Tool":
true
define "Get Indicator":
if "Is Recommendation Applicable?"
then 'warning'
else null
define "Get Summary":
if "Is Recommendation Applicable?"
then 'Recommend opioid agonist or partial agonist treatment with methadone maintenance therapy or buprenorphine and/or behavioral therapy'
else null
define "Get Detail":
if "Is Recommendation Applicable?"
then null
else null
|
