2022 CDC Clinical Practice Guideline for Prescribing Opioids Implementation Guide
2022.1.0 - CI Build
2022 CDC Clinical Practice Guideline for Prescribing Opioids Implementation Guide
2022.1.0 - CI Build
2022 CDC Clinical Practice Guideline for Prescribing Opioids Implementation Guide, published by Centers for Disease Control and Prevention (CDC). This guide is not an authorized publication; it is the continuous build for version 2022.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/opioid-cds-r4/ and changes regularly. See the Directory of published versions
| Draft as of 2023-05-01 |
<PlanDefinition xmlns="http://hl7.org/fhir">
<id value="opioidcds-12-patient-view"/>
<meta>
<profile
value="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-recommendationdefinition"/>
<profile
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<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<table class="grid dict">
<tr>
<th scope="row"><b>Id: </b></th>
<td style="padding-left: 4px;">opioidcds-12-patient-view</td>
</tr>
<tr>
<th scope="row"><b>Url: </b></th>
<td style="padding-left: 4px;"><a href="PlanDefinition-opioidcds-12-patient-view.html">PlanDefinition - 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain: Recommendation #12 (patient-view)</a></td>
</tr>
<tr>
<th scope="row"><b>Version: </b></th>
<td style="padding-left: 4px;">2022.1.0</td>
</tr>
<tr>
<th scope="row"><b>Identifier: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<b>value: </b> <span>cdc-opioid-guidance</span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Name: </b></th>
<td style="padding-left: 4px;">PlanDefinition_Recommendation_12_Patient_View</td>
</tr>
<tr>
<th scope="row"><b>Title: </b></th>
<td style="padding-left: 4px;">PlanDefinition - 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain: Recommendation #12 (patient-view)</td>
</tr>
<tr>
<th scope="row"><b>Status: </b></th>
<td style="padding-left: 4px;">draft</td>
</tr>
<tr>
<th scope="row"><b>Experimental: </b></th>
<td style="padding-left: 4px;">true</td>
</tr>
<tr>
<th scope="row"><b>Type: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<b>system: </b> <span><a href="http://terminology.hl7.org/5.3.0/CodeSystem-plan-definition-type.html">PlanDefinitionType</a></span>
</p>
<p style="margin-bottom: 5px;">
<b>code: </b> <span>eca-rule</span>
</p>
<p style="margin-bottom: 5px;">
<b>display: </b> <span>ECA Rule</span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Date: </b></th>
<td style="padding-left: 4px;">2023-05-01</td>
</tr>
<tr>
<th scope="row"><b>Publisher: </b></th>
<td style="padding-left: 4px;">Centers for Disease Control and Prevention (CDC)</td>
</tr>
<tr>
<th scope="row"><b>Description: </b></th>
<td style="padding-left: 4px;">Arrange evidence-based treatment (usually medication-assisted treatment with buprenorphine or methadone in combination with behavioral therapies) for patients with opioid use disorder.</td>
</tr>
<tr>
<th scope="row"><a name="effective-data-requirements"> </a><b>Logic Definitions: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>
<tr>
<td>OpioidCDSREC12PatientView</td>
<td>Get Summary</td>
<td>0</td>
</tr>
</table>
<pre><code class="language-cql">define &quot;Get Summary&quot;:
if &quot;Is Recommendation Applicable?&quot;
then 'Recommend opioid agonist or partial agonist treatment with methadone maintenance therapy or buprenorphine'/* and/or behavioral therapy' */
else null</code></pre>
<br/><br/>
<table class="grid-dict">
<tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>
<tr>
<td>OpioidCDSCommonConfig</td>
<td>Age Less than 18 Years Is Enabled</td>
<td>1</td>
</tr>
</table>
<pre><code class="language-cql">// Opioid Review Useful
define &quot;Age Less than 18 Years Is Enabled&quot;:
true</code></pre>
<br/><br/>
<table class="grid-dict">
<tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>
<tr>
<td>OpioidCDSCommon</td>
<td>Patient 18 or Older?</td>
<td>2</td>
</tr>
</table>
<pre><code class="language-cql">define &quot;Patient 18 or Older?&quot;:
Config.&quot;Age Less than 18 Years Is Enabled&quot;
and AgeInYears() &gt;= 18</code></pre>
<br/><br/>
<table class="grid-dict">
<tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>
<tr>
<td>OpioidCDSCommonConfig</td>
<td>Evidence Based Treatment Criteria For Opioid Use Disorder</td>
<td>3</td>
</tr>
</table>
<pre><code class="language-cql">// Recommendation 12
define &quot;Evidence Based Treatment Criteria For Opioid Use Disorder&quot;:
true</code></pre>
<br/><br/>
<table class="grid-dict">
<tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>
<tr>
<td>OpioidCDSREC12PatientView</td>
<td>Not Receiving Evidence-Based Treatment for Opioid Use Disorder</td>
<td>4</td>
</tr>
</table>
<pre><code class="language-cql">define &quot;Not Receiving Evidence-Based Treatment for Opioid Use Disorder&quot;:
Config.&quot;Evidence Based Treatment Criteria For Opioid Use Disorder&quot;
and not (
if Config.&quot;Can the implementing EHR support queries for past medications by date range?&quot; then
exists (
[MedicationRequest: Common.&quot;Buprenorphine and methadone medications&quot;] MR
where MR.status in { 'active', 'completed' }
and date from MR.authoredOn during day of &quot;Opioid Use Disorder Lookback Period&quot;
)
else
true
/* update 2022 removes &quot;behavioral therapy condition&quot;
or exists (
[Procedure: Common.&quot;Substance misuse behavioral counseling&quot;] 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&lt;DateTime&gt;
end
) during day of &quot;Opioid Use Disorder Lookback Period&quot;
)*/
)</code></pre>
<br/><br/>
<table class="grid-dict">
<tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>
<tr>
<td>OpioidCDSCommon</td>
<td>US Core-Categorized Conditions</td>
<td>5</td>
</tr>
</table>
<pre><code class="language-cql">// 3. Medications indicating end of life
/* or exists (
&quot;Medications Indicating End of Life&quot;
) */
define &quot;US Core-Categorized Conditions&quot;:
[Condition: category in &quot;Encounter Diagnosis Condition Category&quot;]
union [Condition: category in &quot;Problem List Condition Category&quot;]
union [Condition: category in &quot;US Core Health Concern Condition Category&quot;]</code></pre>
<br/><br/>
<table class="grid-dict">
<tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>
<tr>
<td>OpioidCDSREC12PatientView</td>
<td>Opioid Use Disorder Lookback Period</td>
<td>6</td>
</tr>
</table>
<pre><code class="language-cql">define &quot;Opioid Use Disorder Lookback Period&quot;:
Interval[Today() - 90 days, Today()]</code></pre>
<br/><br/>
<table class="grid-dict">
<tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>
<tr>
<td>OpioidCDSREC12PatientView</td>
<td>Presence of Diagnosis of Opioid Use Disorder</td>
<td>7</td>
</tr>
</table>
<pre><code class="language-cql">define &quot;Presence of Diagnosis of Opioid Use Disorder&quot;:
exists (
Common.&quot;US Core-Categorized Conditions&quot; C
where C.code in Common.&quot;Opioid misuse disorders&quot;
and C.clinicalStatus in Common.&quot;Active Condition&quot;
and date from C.recordedDate during day of &quot;Opioid Use Disorder Lookback Period&quot;
)</code></pre>
<br/><br/>
<table class="grid-dict">
<tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>
<tr>
<td>OpioidCDSREC12PatientView</td>
<td>Positive Result from Opioid Use Disorder Evaluation Tool</td>
<td>8</td>
</tr>
</table>
<pre><code class="language-cql">define &quot;Positive Result from Opioid Use Disorder Evaluation Tool&quot;:
true</code></pre>
<br/><br/>
<table class="grid-dict">
<tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>
<tr>
<td>OpioidCDSREC12PatientView</td>
<td>Inclusion Criteria</td>
<td>9</td>
</tr>
</table>
<pre><code class="language-cql">define &quot;Inclusion Criteria&quot;:
Common.&quot;Patient 18 or Older?&quot;
and &quot;Not Receiving Evidence-Based Treatment for Opioid Use Disorder&quot;
and &quot;Presence of Diagnosis of Opioid Use Disorder&quot;
and &quot;Positive Result from Opioid Use Disorder Evaluation Tool&quot;</code></pre>
<br/><br/>
<table class="grid-dict">
<tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>
<tr>
<td>OpioidCDSREC12PatientView</td>
<td>Exclusion Criteria</td>
<td>10</td>
</tr>
</table>
<pre><code class="language-cql">define &quot;Exclusion Criteria&quot;:
false</code></pre>
<br/><br/>
<table class="grid-dict">
<tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>
<tr>
<td>OpioidCDSREC12PatientView</td>
<td>Is Recommendation Applicable?</td>
<td>11</td>
</tr>
</table>
<pre><code class="language-cql">define &quot;Is Recommendation Applicable?&quot;:
&quot;Inclusion Criteria&quot;
and not &quot;Exclusion Criteria&quot;</code></pre>
<br/><br/>
<table class="grid-dict">
<tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>
<tr>
<td>OpioidCDSREC12PatientView</td>
<td>Get Detail</td>
<td>12</td>
</tr>
</table>
<pre><code class="language-cql">define &quot;Get Detail&quot;:
if &quot;Is Recommendation Applicable?&quot;
then null
else null</code></pre>
<br/><br/>
<table class="grid-dict">
<tr><th><b>Library Name</b></th><th><b>Name</b></th><th><b>sequence</b></th></tr>
<tr>
<td>OpioidCDSREC12PatientView</td>
<td>Get Indicator</td>
<td>13</td>
</tr>
</table>
<pre><code class="language-cql">define &quot;Get Indicator&quot;:
if &quot;Is Recommendation Applicable?&quot;
then 'warning'
else null</code></pre>
<br/><br/>
</td>
</tr>
<tr>
<th scope="row"><b>Knowledge Capability: </b></th>
<td style="padding-left: 4px;">
shareable computable executable publishable
</td>
</tr>
<tr>
<th scope="row"><b>Use Context: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr><th><b>code</b></th><th><b>value</b></th><th><b>display</b></th></tr>
<tr>
<td>focus</td>
<td>182888003</td>
<td>Medication requested (situation)</td>
</tr>
<tr>
<td>focus</td>
<td>82423001</td>
<td>Chronic pain (finding)</td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Jurisdiction: </b></th>
<td style="padding-left: 4px;">US</td>
</tr>
<tr>
<th scope="row"><b>Purpose: </b></th>
<td style="padding-left: 4px;"><div><p>The 2022 CDC Clinical Practice Guideline for Prescribing Opioids for 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.</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Usage: </b></th>
<td style="padding-left: 4px;">Clinicians should offer or arrange evidence-based treatment (usually medication-assisted treatment with buprenorphine or methadone) for patients with opioid use disorder.</td>
</tr>
<tr>
<th scope="row"><b>Copyright: </b></th>
<td style="padding-left: 4px;"><div><p>© CDC 2016+.</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Related Artifacts: </b></th>
<td style="padding-left: 4px;">
<p><b>Documentation</b></p>
<ul>
<li>
<a href="https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm"> 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain</a>
</li>
</ul>
</td>
</tr>
<tr>
<th scope="row"><b>Libraries: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr><td><a href="Library-OpioidCDSREC12PatientView.html">Library - Recommendation #12 (patient-view) - Evidence-based Treatment for Patients with Opioid Use Disorder</a></td></tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Actions: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<td>
<b> Current patient is 18 or older and recieving evidence-based treatment for Opioid Misuse Disorders.:</b> Checking if the trigger prescription meets the inclusion criteria for recommendation #12 workflow.<br/>
<b>When:</b> <i>named-event:</i> patient-view<br/>
<b>If:</b> <i>applicability:</i> Check whether the current patient is 18 or older and recieving evidence-based treatment for Opioid Misuse Disorders. <i>(Is Recommendation Applicable?)</i><br/>
<b>Then:</b>
<table class="grid-dict">
<tr>
<td>
<b> :</b> Will order methadone or buprenorphine<br/>
<b>Then:</b>
</td>
</tr>
<tr>
<td>
<b> :</b> N/A - see comment, snooze 3 months<br/>
<b>Then:</b>
</td>
</tr>
</table>
</td>
</tr>
</table>
</td>
</tr>
</table>
</div>
</text>
<contained>
<Library>
<id value="effective-data-requirements"/>
<status value="active"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/library-type"/>
<code value="module-definition"/>
</coding>
</type>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library Common"/>
<resource
value="http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSCommon|2022.1.0"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library Config"/>
<resource
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<relatedArtifact>
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<resource
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<relatedArtifact>
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<resource
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<relatedArtifact>
<type value="depends-on"/>
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<resource
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<relatedArtifact>
<type value="depends-on"/>
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<resource
value="http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-us-core-health-concern-category"/>
</relatedArtifact>
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<type value="depends-on"/>
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<resource
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<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Active Condition"/>
<resource
value="http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-clinical-status-active"/>
</relatedArtifact>
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<name value="Get Summary"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="string"/>
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<parameter>
<name value="Is Recommendation Applicable?"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name value="Get Detail"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
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<parameter>
<name value="Get Indicator"/>
<use value="out"/>
<min value="0"/>
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<type value="Patient"/>
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<profile value="http://hl7.org/fhir/StructureDefinition/Condition"/>
<mustSupport value="category"/>
<codeFilter>
<path value="category"/>
<valueSet
value="http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-encounter-diagnosis-category"/>
</codeFilter>
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<dataRequirement>
<type value="Condition"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Condition"/>
<mustSupport value="category"/>
<codeFilter>
<path value="category"/>
<valueSet
value="http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-problem-list-category"/>
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<profile value="http://hl7.org/fhir/StructureDefinition/Condition"/>
<mustSupport value="category"/>
<codeFilter>
<path value="category"/>
<valueSet
value="http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-us-core-health-concern-category"/>
</codeFilter>
</dataRequirement>
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url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability">
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<valueCode value="publishable"/>
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<valueReference>🔗
<reference value="Device/cqf-tooling"/>
</valueReference>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="OpioidCDSREC12PatientView"/>
</extension>
<extension url="name">
<valueString value="Get Summary"/>
</extension>
<extension url="statement">
<valueString
value="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"/>
</extension>
<extension url="displaySequence">
<valueInteger value="0"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="OpioidCDSCommonConfig"/>
</extension>
<extension url="name">
<valueString value="Age Less than 18 Years Is Enabled"/>
</extension>
<extension url="statement">
<valueString
value="// Opioid Review Useful
define "Age Less than 18 Years Is Enabled":
true"/>
</extension>
<extension url="displaySequence">
<valueInteger value="1"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="OpioidCDSCommon"/>
</extension>
<extension url="name">
<valueString value="Patient 18 or Older?"/>
</extension>
<extension url="statement">
<valueString
value="define "Patient 18 or Older?":
Config."Age Less than 18 Years Is Enabled"
and AgeInYears() >= 18"/>
</extension>
<extension url="displaySequence">
<valueInteger value="2"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="OpioidCDSCommonConfig"/>
</extension>
<extension url="name">
<valueString
value="Evidence Based Treatment Criteria For Opioid Use Disorder"/>
</extension>
<extension url="statement">
<valueString
value="// Recommendation 12
define "Evidence Based Treatment Criteria For Opioid Use Disorder":
true"/>
</extension>
<extension url="displaySequence">
<valueInteger value="3"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="OpioidCDSREC12PatientView"/>
</extension>
<extension url="name">
<valueString
value="Not Receiving Evidence-Based Treatment for Opioid Use Disorder"/>
</extension>
<extension url="statement">
<valueString
value="define "Not Receiving Evidence-Based Treatment for Opioid Use Disorder":
Config."Evidence Based Treatment Criteria For Opioid Use Disorder"
and not (
if Config."Can the implementing EHR support queries for past medications by date range?" then
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"
)
else
true
/* update 2022 removes "behavioral therapy condition"
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"
)*/
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="4"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="OpioidCDSCommon"/>
</extension>
<extension url="name">
<valueString value="US Core-Categorized Conditions"/>
</extension>
<extension url="statement">
<valueString
value="// 3. Medications indicating end of life
/* or exists (
"Medications Indicating End of Life"
) */
define "US Core-Categorized Conditions":
[Condition: category in "Encounter Diagnosis Condition Category"]
union [Condition: category in "Problem List Condition Category"]
union [Condition: category in "US Core Health Concern Condition Category"]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="5"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="OpioidCDSREC12PatientView"/>
</extension>
<extension url="name">
<valueString value="Opioid Use Disorder Lookback Period"/>
</extension>
<extension url="statement">
<valueString
value="define "Opioid Use Disorder Lookback Period":
Interval[Today() - 90 days, Today()]"/>
</extension>
<extension url="displaySequence">
<valueInteger value="6"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="OpioidCDSREC12PatientView"/>
</extension>
<extension url="name">
<valueString value="Presence of Diagnosis of Opioid Use Disorder"/>
</extension>
<extension url="statement">
<valueString
value="define "Presence of Diagnosis of Opioid Use Disorder":
exists (
Common."US Core-Categorized Conditions" C
where C.code in Common."Opioid misuse disorders"
and C.clinicalStatus in Common."Active Condition"
and date from C.recordedDate during day of "Opioid Use Disorder Lookback Period"
)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="7"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="OpioidCDSREC12PatientView"/>
</extension>
<extension url="name">
<valueString
value="Positive Result from Opioid Use Disorder Evaluation Tool"/>
</extension>
<extension url="statement">
<valueString
value="define "Positive Result from Opioid Use Disorder Evaluation Tool":
true"/>
</extension>
<extension url="displaySequence">
<valueInteger value="8"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="OpioidCDSREC12PatientView"/>
</extension>
<extension url="name">
<valueString value="Inclusion Criteria"/>
</extension>
<extension url="statement">
<valueString
value="define "Inclusion Criteria":
Common."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""/>
</extension>
<extension url="displaySequence">
<valueInteger value="9"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="OpioidCDSREC12PatientView"/>
</extension>
<extension url="name">
<valueString value="Exclusion Criteria"/>
</extension>
<extension url="statement">
<valueString value="define "Exclusion Criteria":
false"/>
</extension>
<extension url="displaySequence">
<valueInteger value="10"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="OpioidCDSREC12PatientView"/>
</extension>
<extension url="name">
<valueString value="Is Recommendation Applicable?"/>
</extension>
<extension url="statement">
<valueString
value="define "Is Recommendation Applicable?":
"Inclusion Criteria"
and not "Exclusion Criteria""/>
</extension>
<extension url="displaySequence">
<valueInteger value="11"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="OpioidCDSREC12PatientView"/>
</extension>
<extension url="name">
<valueString value="Get Detail"/>
</extension>
<extension url="statement">
<valueString
value="define "Get Detail":
if "Is Recommendation Applicable?"
then null
else null"/>
</extension>
<extension url="displaySequence">
<valueInteger value="12"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/us/cqfmeasures/StructureDefinition/cqfm-logicDefinition">
<extension url="libraryName">
<valueString value="OpioidCDSREC12PatientView"/>
</extension>
<extension url="name">
<valueString value="Get Indicator"/>
</extension>
<extension url="statement">
<valueString
value="define "Get Indicator":
if "Is Recommendation Applicable?"
then 'warning'
else null"/>
</extension>
<extension url="displaySequence">
<valueInteger value="13"/>
</extension>
</extension>
<extension
url="http://fhir.org/guides/cdc/opioid-cds/StructureDefinition/effectiveDataRequirements" id="effective-data-requirements">
<valueReference>
<reference value="#effective-data-requirements"/>
</valueReference>
</extension>
<url
value="http://fhir.org/guides/cdc/opioid-cds/PlanDefinition/opioidcds-12-patient-view"/>
<identifier>
<use value="official"/>
<value value="cdc-opioid-guidance"/>
</identifier>
<version value="2022.1.0"/>
<name value="PlanDefinition_Recommendation_12_Patient_View"/>
<title
value="PlanDefinition - 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain: Recommendation #12 (patient-view)"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/plan-definition-type"/>
<code value="eca-rule"/>
<display value="ECA Rule"/>
</coding>
</type>
<status value="draft"/>
<experimental value="true"/>
<date value="2023-05-01"/>
<publisher value="Centers for Disease Control and Prevention (CDC)"/>
<contact>
<telecom>
<system value="url"/>
<value value="https://www.cdc.gov"/>
</telecom>
</contact>
<description
value="Arrange evidence-based treatment (usually medication-assisted treatment with buprenorphine or methadone in combination with behavioral therapies) for patients with opioid use disorder."/>
<useContext>
<code>
<system
value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
<code value="focus"/>
<display value="Clinical Focus"/>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="182888003"/>
<display value="Medication requested (situation)"/>
</coding>
</valueCodeableConcept>
</useContext>
<useContext>
<code>
<system
value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
<code value="focus"/>
<display value="Clinical Focus"/>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="82423001"/>
<display value="Chronic pain (finding)"/>
</coding>
</valueCodeableConcept>
</useContext>
<jurisdiction>
<coding>
<system value="urn:iso:std:iso:3166"/>
<code value="US"/>
<display value="United States of America"/>
</coding>
</jurisdiction>
<purpose
value="The 2022 CDC Clinical Practice Guideline for Prescribing Opioids for 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
value="Clinicians should offer or arrange evidence-based treatment (usually medication-assisted treatment with buprenorphine or methadone) for patients with opioid use disorder."/>
<copyright value="© CDC 2016+."/>
<topic>
<text value="Opioid Prescribing"/>
</topic>
<author>
<name value="Kensaku Kawamoto, MD, PhD, MHS"/>
</author>
<author>
<name value="Bryn Rhodes"/>
</author>
<author>
<name value="Floyd Eisenberg, MD, MPH"/>
</author>
<author>
<name value="Robert McClure, MD, MPH"/>
</author>
<relatedArtifact>
<type value="documentation"/>
<display
value="2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain"/>
<url value="https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm"/>
<document>
<url value="https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm"/>
</document>
</relatedArtifact>
<library
value="http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSREC12PatientView"/>
<action>
<title
value="Current patient is 18 or older and recieving evidence-based treatment for Opioid Misuse Disorders."/>
<description
value="Checking if the trigger prescription meets the inclusion criteria for recommendation #12 workflow."/>
<documentation>
<type value="documentation"/>
<url
value="https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm#Recommendation12:~:text=and%20overdose%20death-,(recommendation%20category%3A%20A%3B%20evidence%20type%3A%201).,-Implementation%20Considerations"/>
<document>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/recommendation-strength"/>
<code value="strong"/>
<display value="Strong"/>
</coding>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/evidence-quality"/>
<code value="high"/>
<display value="High quality"/>
</coding>
</valueCodeableConcept>
</extension>
<url
value="https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm#Recommendation12:~:text=and%20overdose%20death-,(recommendation%20category%3A%20A%3B%20evidence%20type%3A%201).,-Implementation%20Considerations"/>
</document>
</documentation>
<trigger>
<type value="named-event"/>
<name value="patient-view"/>
</trigger>
<condition>
<kind value="applicability"/>
<expression>
<description
value="Check whether the current patient is 18 or older and recieving evidence-based treatment for Opioid Misuse Disorders."/>
<language value="text/cql.identifier"/>
<expression value="Is Recommendation Applicable?"/>
</expression>
</condition>
<groupingBehavior value="visual-group"/>
<selectionBehavior value="any"/>
<dynamicValue>
<path value="action.title"/>
<expression>
<language value="text/cql.identifier"/>
<expression value="Get Summary"/>
</expression>
</dynamicValue>
<dynamicValue>
<path value="action.description"/>
<expression>
<language value="text/cql.identifier"/>
<expression value="Get Detail"/>
</expression>
</dynamicValue>
<dynamicValue>
<path value="activity.extension"/>
<expression>
<language value="text/cql.identifier"/>
<expression value="Get Indicator"/>
</expression>
</dynamicValue>
<action>
<description value="Will order methadone or buprenorphine"/>
</action>
<action>
<description value="N/A - see comment, snooze 3 months"/>
</action>
</action>
</PlanDefinition>