opioidcds-03
type: PlanDefinition
node role: treeRoot
id:
  v: opioidcds-03
meta:
  profile:
    v: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-recommendationdefinition
    l: cpg-recommendationdefinition
  profile:
    v: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-publishableplandefinition
    l: cpg-publishableplandefinition
text:
  status:
    v: extensions
  div:
    v: Id: opioidcds-03 Url: Recommendation #3 - Opioid Immediate Release Form When Starting Opioid Therapy Version: 2022.1.0 Identifier: value: cdc-opioid-guidance Name: PlanDefinition_Recommendation_03_Order_Sign Title: Recommendation #3 - Opioid Immediate Release Form When Starting Opioid Therapy Status: draft Experimental: true Type: system: http://terminology.hl7.org/CodeSystem/plan-definition-type code: eca-rule display: ECA Rule Date: 2025-08-06 Publisher: Centers for Disease Control and Prevention (CDC) Description: When starting opioid therapy for acute, subacute, or chronic pain, clinicians should prescribe immediate-release opioids instead of extended-release and long-acting (ER/LA) opioids. Logic Definitions: Library Name Name sequence OpioidCDSREC03 Chronic Pain Extended Release Opioid Analgesic with Ambulatory Misuse Potential Prescriptions 0 define "Chronic Pain Extended Release Opioid Analgesic with Ambulatory Misuse Potential Prescriptions": ( Common."Is Opioid Analgesic with Ambulatory Misuse Potential?"( ContextPrescriptions ) ) AmbulatoryOpioidPrescription where Routines."Is Subacute or Chronic Pain Prescription?"( AmbulatoryOpioidPrescription ) and AmbulatoryOpioidPrescription.medication in Common."Extended release opioid with ambulatory misuse potential" Library Name Name sequence OpioidCDSREC03 Patient Is Being Prescribed Extended Release Opioid Analgesic with Ambulatory Misuse Potential 1 define "Patient Is Being Prescribed Extended Release Opioid Analgesic with Ambulatory Misuse Potential": exists( "Chronic Pain Extended Release Opioid Analgesic with Ambulatory Misuse Potential Prescriptions" ) Library Name Name sequence OpioidCDSCommonConfig Age Less than 18 Years Is Enabled 2 // CDC 2022 General Inclusion Criteria define "Age Less than 18 Years Is Enabled": true Library Name Name sequence OpioidCDSRoutines Patient Age Less Than 18 3 define "Patient Age Less Than 18": if (Config."Age Less than 18 Years Is Enabled") then AgeInYearsAt(Today()) < 18 …
contained: Library
  id:
    v: effective-data-requirements
  extension:
    extension:
      url:
        v: libraryName
        l: libraryName
      value: String
        v: OpioidCDSREC03
    extension:
      url:
        v: name
        l: name
      value: String
        v: Chronic Pain Extended Release Opioid Analgesic with Ambulatory Misuse Potential Prescriptions
    extension:
      url:
        v: statement
        l: statement
      value: String
        v: define "Chronic Pain Extended Release Opioid Analgesic with Ambulatory Misuse Potential Prescriptions": ( Common."Is Opioid Analgesic with Ambulatory Misuse Potential?"( ContextPrescriptions ) ) AmbulatoryOpioidPrescription where Routines."Is Subacute or Chronic Pain Prescription?"( AmbulatoryOpioidPrescription ) and AmbulatoryOpioidPrescription.medication in Common."Extended release opioid with ambulatory misuse potential"
    extension:
      url:
        v: displaySequence
        l: displaySequence
      value: Integer
        v: 0
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
      l: cqf-logicDefinition
  extension:
    extension:
      url:
        v: libraryName
        l: libraryName
      value: String
        v: OpioidCDSREC03
    extension:
      url:
        v: name
        l: name
      value: String
        v: Patient Is Being Prescribed Extended Release Opioid Analgesic with Ambulatory Misuse Potential
    extension:
      url:
        v: statement
        l: statement
      value: String
        v: define "Patient Is Being Prescribed Extended Release Opioid Analgesic with Ambulatory Misuse Potential": exists( "Chronic Pain Extended Release Opioid Analgesic with Ambulatory Misuse Potential Prescriptions" )
    extension:
      url:
        v: displaySequence
        l: displaySequence
      value: Integer
        v: 1
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
      l: cqf-logicDefinition
  extension:
    extension:
      url:
        v: libraryName
        l: libraryName
      value: String
        v: OpioidCDSCommonConfig
    extension:
      url:
        v: name
        l: name
      value: String
        v: Age Less than 18 Years Is Enabled
    extension:
      url:
        v: statement
        l: statement
      value: String
        v: // CDC 2022 General Inclusion Criteria define "Age Less than 18 Years Is Enabled": true
    extension:
      url:
        v: displaySequence
        l: displaySequence
      value: Integer
        v: 2
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
      l: cqf-logicDefinition
  extension:
    extension:
      url:
        v: libraryName
        l: libraryName
      value: String
        v: OpioidCDSRoutines
    extension:
      url:
        v: name
        l: name
      value: String
        v: Patient Age Less Than 18
    extension:
      url:
        v: statement
        l: statement
      value: String
        v: define "Patient Age Less Than 18": if (Config."Age Less than 18 Years Is Enabled") then AgeInYearsAt(Today()) < 18 else false
    extension:
      url:
        v: displaySequence
        l: displaySequence
      value: Integer
        v: 3
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
      l: cqf-logicDefinition
  extension:
    extension:
      url:
        v: libraryName
        l: libraryName
      value: String
        v: OpioidCDSCommonConfig
    extension:
      url:
        v: name
        l: name
      value: String
        v: Sickle Cell Check Enabled
    extension:
      url:
        v: statement
        l: statement
      value: String
        v: // Sickle Cell define "Sickle Cell Check Enabled": true
    extension:
      url:
        v: displaySequence
        l: displaySequence
      value: Integer
        v: 4
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
      l: cqf-logicDefinition
  extension:
    extension:
      url:
        v: libraryName
        l: libraryName
      value: String
        v: OpioidCDSCommonConfig
    extension:
      url:
        v: name
        l: name
      value: String
        v: Sickle Cell Assumed Active
    extension:
      url:
        v: statement
        l: statement
      value: String
        v: define "Sickle Cell Assumed Active": true
    extension:
      url:
        v: displaySequence
        l: displaySequence
      value: Integer
        v: 5
    url:
      v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
      l: cqf-logicDefinition
  extension:
    extension:
      url:
        v: libraryName
        l: libraryName
      value: String
        v: OpioidCDSCommon
    extension:
      url:
        v: name
        l: name
      value: String
        v: US Core-Categorized Conditions
    extension:
      url:
        v: statement
        l: statement
      value: String

String
v: // 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"]

url:
  v: displaySequence
  l: displaySequence
value: Integer
  v: 6

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: Positive Sickle Cell Condition
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Positive Sickle Cell Condition": if Config."Sickle Cell Check Enabled" and not Config."Sickle Cell Assumed Active" then ( "US Core-Categorized Conditions" C where C.code in "Sickle Cell Diseases" and C.clinicalStatus in "Active Condition" ) else if Config."Sickle Cell Check Enabled" and Config."Sickle Cell Assumed Active" then ( "US Core-Categorized Conditions" C where C.code in "Sickle Cell Diseases" ) else null
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 7
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Condition Positive for Sickle Cell
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Condition Positive for Sickle Cell": if (Config."Sickle Cell Check Enabled") then exists( Common."Positive Sickle Cell Condition" ) else false
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 8
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommonConfig
extension:
  url:
    v: name
    l: name
  value: String
    v: Active Cancer Treatment Encounters Condition Is Enabled
extension:
  url:
    v: statement
    l: statement
  value: String
    v: // Active Cancer Treatment define "Active Cancer Treatment Encounters Condition Is Enabled": true
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 9
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Encounter Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: // End of Opioid Naive Routine /* ** Routine #3 ** Active Cancer Treatment Routine ** ** Definition | Answer to Proceed | Details | Data (Terminology) Requirement ** --------------------------------------------------------------------------------------------------------------------------------- ** Two office visits within the | No | Look for a minimum of two distinct | Office Visit ** past 12 months | | encounters within 12 months of the date | ** | | of the current visit for which each of the | ** | | following is true: | ** | | - the encounter diagnosis (primary or | ** | | secondary or co-morbidity diagnosis) | ** | | is listed in the CDC Malignant Cancer | ** | | Conditions value set | ** --------------------------------------------------------------------------------------------------------------------------------- ** Office visits with an | No | The encounter is performed by an | Oncology specialty ** oncology specialist | | oncologist as defined in the oncology | designations (NUCC) ** present | | specialty designations using the | ** | | National Uniform Claim Committee | ** | | (NUCC) classifications | ** --------------------------------------------------------------------------------------------------------------------------------- ** Office visits including CDC | No | The encounter diagnosis (primary or | CDC malignant cancer ** malignant cancer | | secondary or co-morbidity diagnosis) | conditions ** condition | | is listed in the CDC Malignant Cancer | ** | | Conditions value set | ** ---------------------------------------------------------------------------------------------------------------------------------- ** */ define "Encounter Period": Interval[Today() - 12 months, Today())
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 10
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: USCore Encounter Cancer Diagnoses
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "USCore Encounter Cancer Diagnoses": [Condition: category in "Encounter Diagnosis Condition Category"] CancerDiagnoses where CancerDiagnoses.code in "CDC malignant cancer conditions"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 11
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Encounters with Cancer Diagnosis During Encounter Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: // encounter-diagnosis, problem-list and health-concern Conditions // define "US Core-Categorized Cancer Diagnoses": // Common."US Core-Categorized Conditions" C // where C.code in Common."CDC malignant cancer conditions" // define "Encounters with Cancer Diagnosis During Encounter Period": // [Encounter] Encounter // with "US Core-Categorized Cancer Diagnoses" CancerDiagnosis // such that date from Encounter.period."start".value in day of "Encounter Period" // and EndsWith(CancerDiagnosis.encounter.reference, Encounter.id) define "Encounters with Cancer Diagnosis During Encounter Period": [Encounter] Encounters where date from Encounters.period."start" in day of "Encounter Period" and exists ( Common."USCore Encounter Cancer Diagnoses" CancerDiagnoses where EndsWith(CancerDiagnoses.encounter.reference, Encounters.id) )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 12
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Number of Encounters with Cancer Diagnosis During Encounter Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Number of Encounters with Cancer Diagnosis During Encounter Period": Count ("Encounters with Cancer Diagnosis During Encounter Period")
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 13
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Two or More Encounters with Cancer Diagnosis During Encounter Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Two or More Encounters with Cancer Diagnosis During Encounter Period": "Number of Encounters with Cancer Diagnosis During Encounter Period" >= 2
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 14
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: USCore Problem List Cancer Diagnoses
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "USCore Problem List Cancer Diagnoses": [Condition: category in "Problem List Condition Category"] CancerDiagnoses where CancerDiagnoses.code in "CDC malignant cancer conditions"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 15
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Active Cancer Diagnosis on Problem List
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Active Cancer Diagnosis on Problem List": exists ( Common."USCore Problem List Cancer Diagnoses" CancerDiagnoses where CancerDiagnoses.category in Common."Problem List Condition Category" and exists( CancerDiagnoses.clinicalStatus.coding ClinicalStatus where ClinicalStatus.code ~ 'active' ) )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 16
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Is Active Cancer Treatment?
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Is Active Cancer Treatment?": if (Config."Active Cancer Treatment Encounters Condition Is Enabled") then "Has Two or More Encounters with Cancer Diagnosis During Encounter Period" or "Has Active Cancer Diagnosis on Problem List" else false
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 17
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommonConfig
extension:
  url:
    v: name
    l: name
  value: String
    v: End-Stage Disease Criteria Enabled
extension:
  url:
    v: statement
    l: statement
  value: String
    v: // CDC 2022 General Inclusion Criteria define "End-Stage Disease Criteria Enabled": true
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 18
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Conditions Likely Terminal for Opioid Prescribing
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Conditions Likely Terminal for Opioid Prescribing": if (Config."End-Stage Disease Criteria Enabled") then exists ( Common."US Core-Categorized Conditions" EOLC where EOLC.code in Common."Conditions likely terminal for opioid prescribing" // and EOLC.clinicalStatus in Common."Active Condition" ) else false
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 19
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: CDC 2022 Guideline General Inclusion Criteria
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "CDC 2022 Guideline General Inclusion Criteria": not "Patient Age Less Than 18" and not "Condition Positive for Sickle Cell" and not "Is Active Cancer Treatment?" and not "Conditions Likely Terminal for Opioid Prescribing"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 20
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommonConfig
extension:
  url:
    v: name
    l: name
  value: String
    v: Opioid Naive Prescription Condition Is Enabled
extension:
  url:
    v: statement
    l: statement
  value: String
    v: // Opioid Naive define "Opioid Naive Prescription Condition Is Enabled": true
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 21
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommonConfig
extension:
  url:
    v: name
    l: name
  value: String
    v: Can the implementing EHR support queries for past medications by date range?
extension:
  url:
    v: statement
    l: statement
  value: String
    v: // Subroutine 2 - Past Medications define "Can the implementing EHR support queries for past medications by date range?": true
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 22
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: Active Ambulatory Opioid Rx
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Active Ambulatory Opioid Rx": if Config."Can the implementing EHR support queries for past medications by date range?" then ( "Get MedicationRequest Medication as Code"("Get Active Ambulatory Medication Requests"([MedicationRequest])) ) Rx where date from Rx.authoredOn 2 years or less on or before Today() and Rx.medication in "Opioid analgesics with ambulatory misuse potential" else List<FHIR.MedicationRequest>{}
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 23
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Prescription/Dispense Inclusion Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: // End of CDC 2022 General Inclusion Criteria Routine /* ** Routine #2 ** Opioid Naive Routine ** ** Definition | Answer to Proceed | Details | Data (Terminology) Requirement ** ---------------------------------------------------------------------------------------------------------------------------------------- ** Opioid analgesics with | No | Look for an existing prescription (order) for | Opioid analgesics with ** ambulatory misuse potential | | opioid that is in the value set for opioid with | ambulatory misuse potential ** prescription in past 90 days | | ambulatory abuse potential authored | ** excluding the previous 24 | | within the past 90 days (excluding previous 24 | ** hours | | hours) | ** ---------------------------------------------------------------------------------------------------------------------------------------- ** Opioid analgesics with | No | Look for evidence of active medication on | Opioid analgesics with ** ambulatory misuse potential | | the medication list that is in the value set | ambulatory misuse potential ** reported in past 90 days | | for opioid with ambulatory care abuse | ** excluding previous 24 hours* | | potential | ** ---------------------------------------------------------------------------------------------------------------------------------------- ** Opioid analgesics with | No | Look for evidence of a dispensing event for | Opioid analgesics with ** ambulatory misuse potential | | medication that is in the value set for opioid | ambulatory misuse potential ** dispensing event in past 90 | | with ambulatory use potential occurring | ** days excluding previous 24 | | within the past 90 days (excluding previous 24 | ** hours | | hours) | ** ---------------------------------------------------------------------------------------------------------------------------------------- ** *Future consideration: Current algorithm addresses only orders (prescriptions). ** ** Note – orders use RxNorm, but medication lists and disp…
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 24
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Opioid RX with Ambulatory Abuse Potential In Past 90 Days
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Opioid RX with Ambulatory Abuse Potential In Past 90 Days": Common."Active Ambulatory Opioid Rx" Rx where Rx.authoredOn during day of "Prescription/Dispense Inclusion Period"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 25
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Opioid RX with Ambulatory Abuse Potential In Past 90 Days
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Opioid RX with Ambulatory Abuse Potential In Past 90 Days": if (Config."Opioid Naive Prescription Condition Is Enabled") then exists ("Opioid RX with Ambulatory Abuse Potential In Past 90 Days") else false
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 26
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Opioid Dispense with Ambulatory Abuse Potential In Past 90 Days
extension:
  url:
    v: statement
    l: statement
  value: String
    v: // NOTE: 2020-02-05: Review direction of MedicationStatement resource (US-Core focusing on MedicationRequest i/o Statement) // NOTE: 2020-04-21: MedicationStatement a) Shouldn't be use since guidance/direction from USCore is targeting MedicationUse in R5, and b) Breaks in the publisher /* define "Reports of Opioid with Ambulatory Care Abuse Potential Reported in Past 90 Days": [MedicationStatement: Common."Opioid analgesics with ambulatory misuse potential"] Statement where Statement.status in {'active', 'completed'} and Statement.effective during day of "Report Inclusion Period" */ /* define "Has Report of Opioid with Ambulatory Care Abuse Potential Reported in Past 90 Days": Config."Opioid Naive Report Condition Is Enabled" and exists ("Reports of Opioid with Ambulatory Care Abuse Potential Reported in Past 90 Days") */ define "Opioid Dispense with Ambulatory Abuse Potential In Past 90 Days": [MedicationDispense: Common."Opioid analgesics with ambulatory misuse potential"] OpioidDispense where OpioidDispense.whenHandedOver during day of "Prescription/Dispense Inclusion Period" and OpioidDispense.status = 'completed'
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 27
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Opioid Dispense with Ambulatory Abuse Potential In Past 90 Days
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Opioid Dispense with Ambulatory Abuse Potential In Past 90 Days": if (Config."Opioid Naive Prescription Condition Is Enabled") then exists ("Opioid Dispense with Ambulatory Abuse Potential In Past 90 Days") else false
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 28
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Is Opioid Naive?
extension:
  url:
    v: statement
    l: statement
  value: String
    v: // NOTE: MedicationStatement-dependent logic comment out due to bug in Publisher not supporting MedicationStatement in AllTypes. define "Is Opioid Naive?": not ("Has Opioid RX with Ambulatory Abuse Potential In Past 90 Days") /* and not ("Has Report of Opioid with Ambulatory Care Abuse Potential Reported in Past 90 Days") */ and not ("Has Opioid Dispense with Ambulatory Abuse Potential In Past 90 Days")
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 29
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSREC03
extension:
  url:
    v: name
    l: name
  value: String
    v: Inclusion Criteria
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Inclusion Criteria": "Patient Is Being Prescribed Extended Release Opioid Analgesic with Ambulatory Misuse Potential" and Routines."CDC 2022 Guideline General Inclusion Criteria" and Routines."Is Opioid Naive?"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 30
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: Conditions Indicating End of Life or With Limited Life Expectancy
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Conditions Indicating End of Life or With Limited Life Expectancy": ( "US Core-Categorized Conditions" C where C.code in "Conditions likely terminal for opioid prescribing" and C.clinicalStatus in "Active Condition" ) union ( "US Core-Categorized Conditions" C where C.code in "Limited life expectancy conditions" and C.clinicalStatus in "Active Condition" )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 31
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommonConfig
extension:
  url:
    v: name
    l: name
  value: String
    v: Hospice Findings Exclusion Enabled
extension:
  url:
    v: statement
    l: statement
  value: String
    v: // OpioidCDSCommon define "Hospice Findings Exclusion Enabled": false
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 32
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: Admitted/Referred/Discharged to Hospice Care
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Admitted/Referred/Discharged to Hospice Care": ( if (Config."Hospice Findings Exclusion Enabled") then [Observation: code in "Hospice Finding Codes"] O where not (O.status.value in { 'unknown', 'entered-in-error', 'cancelled' }) else {} ) union ( [Encounter] E where date from E.period.start 1 year or less on or before Today() and ( if E.hospitalization.dischargeDisposition.coding is null or not exists (E.hospitalization.dischargeDisposition.coding) then false else E.hospitalization.dischargeDisposition in "Hospice Disposition" ) and E.status.value in { 'planned', 'arrived', 'in-progress', 'finished', 'onleave' } )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 33
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: End of Life Assessment
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "End of Life Assessment": // 1. Conditions indicating end of life or with limited life expectancy exists ( "Conditions Indicating End of Life or With Limited Life Expectancy" ) // 2. Admitted/referred/discharged to hospice care or exists ( "Admitted/Referred/Discharged to Hospice Care" )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 34
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSREC03
extension:
  url:
    v: name
    l: name
  value: String
    v: Exclusion Criteria
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Exclusion Criteria": Common."End of Life Assessment"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 35
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSREC03
extension:
  url:
    v: name
    l: name
  value: String
    v: Is Recommendation Applicable?
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Is Recommendation Applicable?": "Inclusion Criteria" and not "Exclusion Criteria"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 36
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: Is Opioid Analgesic with Ambulatory Misuse Potential?
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function "Is Opioid Analgesic with Ambulatory Misuse Potential?"(value List<MedicationRequest>): ("Get MedicationRequest Medication as Code"(value)) Rx where Rx.medication in "Opioid analgesics with ambulatory misuse potential" and Rx.category in "Community"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 37
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: Get MedicationRequest Medication as Code
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function "Get MedicationRequest Medication as Code"(value List<MedicationRequest>): value Rx let Med: if Rx.medication is Reference then singleton from ( [Medication] M where M.id = (Last(Split((Rx.medication as FHIR.Reference).reference, '/'))) ) else null return MedicationRequest { id: Rx.id, status: Rx.status, intent: Rx.intent, category: Rx.category, medication: if Rx.medication is Reference then Med.code else Rx.medication as CodeableConcept, subject: Rx.subject, authoredOn: Rx.authoredOn, recorder: Rx.recorder, dosageInstruction: Rx.dosageInstruction, dispenseRequest: Rx.dispenseRequest }
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 38
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToString
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToString(value string): value.value
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 39
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToConcept
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToConcept(concept FHIR.CodeableConcept): if concept is null then null else System.Concept { codes: concept.coding C return ToCode(C), display: concept.text.value }
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 40
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToCode
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToCode(coding FHIR.Coding): if coding is null then null else System.Code { code: coding.code.value, system: coding.system.value, version: coding.version.value, display: coding.display.value }
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 41
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Is Subacute or Chronic Pain Prescription?
extension:
  url:
    v: statement
    l: statement
  value: String
    v: // End of Active Cancer Treatment Routine /* ** Routine #4 ** For Subacute or Chronic Pain Routine ** ** Definition | Answer to Proceed | Details | Data (Terminology) Requirement ** ----------------------------------------------------------------------------------------------------------------------------------- ** Order for opioid analgesic | Yes | Order for opioid analgesics with ambulatory | Opioid analgesics with ** with expected supply | | misuse potential with a supply duration of >= | ambulatory misuse potential ** duration >= 28 days | | 28 days | ** | | | ** | | - Subacute definition = order for opioid | ** | | analgesics with ambulatory misuse | ** | | potential with a supply duration of one to | ** | | two months. | ** | | - Chronic pain definition = order for opioid | ** | | analgesics with ambulatory misuse | ** | | potential with a supply duration of >= two | ** | | months. | ** ----------------------------------------------------------------------------------------------------------------------------------- ** */ define function "Is Subacute or Chronic Pain Prescription?"(prescription FHIR.MedicationRequest): "Is Subacute or Chronic Pain Using Expected Supply Duration"(prescription) or "Is Subacute or Chronic Pain Using Validity Period"(prescription)
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 42
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Is Subacute or Chronic Pain Using Expected Supply Duration
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function "Is Subacute or Chronic Pain Using Expected Supply Duration"(prescription FHIR.MedicationRequest): ( prescription.dispenseRequest is not null and prescription.dispenseRequest.expectedSupplyDuration is not null and ( Common.GetDurationInDays(prescription.dispenseRequest.expectedSupplyDuration) >= 28 days ) )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 43
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: GetDurationInDays
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function GetDurationInDays(value FHIR.Duration): if value is null then null else case when value.code.value ~ 'a' then System.Quantity{ value: value.value.value * 365.0, unit: 'days' } when value.code.value ~ 'mo' then System.Quantity{ value: value.value.value * 30.0, unit: 'days' } when value.code.value ~ 'wk' then System.Quantity{ value: value.value.value * 7.0, unit: 'days' } when value.code.value ~ 'd' then System.Quantity{ value: value.value.value, unit: 'days' } when value.code.value ~ 'h' then System.Quantity{ value: value.value.value / 24.0, unit: 'days' } when value.code.value ~ 'min' then System.Quantity{ value: value.value.value / 60.0 / 24.0, unit: 'days' } when value.code.value ~ 's' then System.Quantity{ value: value.value.value / 60.0 / 60.0 / 24.0, unit: 'days' } when value.code.value ~ 'ms' then System.Quantity{ value: value.value.value / 60.0 / 60.0 / 24.0 / 1000.0, unit: 'days' } when value.code.value is null then Message(1000, true, 'Undefined', 'Error', 'Duration unit code is null') else Message(1000, true, 'Undefined', 'Error', 'Unsupported duration unit code: ' + value.code.value) end
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 44
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Is Subacute or Chronic Pain Using Validity Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function "Is Subacute or Chronic Pain Using Validity Period"(prescription FHIR.MedicationRequest): ( prescription.dispenseRequest is not null and prescription.dispenseRequest.validityPeriod is not null and ( days between prescription.dispenseRequest.validityPeriod.start and prescription.dispenseRequest.validityPeriod.end >= 28 ) )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 45
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToDateTime
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToDateTime(value dateTime): value.value
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 46
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: Get Active Ambulatory Medication Requests
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function "Get Active Ambulatory Medication Requests" (value List<MedicationRequest>) returns List<MedicationRequest>: value Rx where Rx.status.value = 'active' and Rx.category in "Community"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 47
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToString
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToString(value MedicationDispenseStatus): value.value
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 48
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

v: EffectiveDataRequirements

v: active

coding:
  system:
    v: http://terminology.hl7.org/CodeSystem/library-type
    l: library-type
  code:
    v: module-definition

type:
  v: depends-on
display:
  v: FHIR model information
resource:
  v: http://fhir.org/guides/cqf/common/Library/FHIR-ModelInfo|4.0.1
  l: http://fhir.org/guides/cqf/common/Library/FHIR-ModelInfo

type:
  v: depends-on
display:
  v: Library Common
resource:
  v: http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSCommon|2022.1.0
  l: http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSCommon

type:
  v: depends-on
display:
  v: Library FHIRHelpers
resource:
  v: http://fhir.org/guides/cdc/opioid-cds/Library/FHIRHelpers|4.0.1
  l: http://fhir.org/guides/cdc/opioid-cds/Library/FHIRHelpers

type:
  v: depends-on
display:
  v: Library Routines
resource:
  v: http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSRoutines|2022.1.0
  l: http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSRoutines

type:
  v: depends-on
display:
  v: Library Config
resource:
  v: http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSCommonConfig|2022.1.0
  l: http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSCommonConfig

type:
  v: depends-on
display:
  v: Value set Opioid analgesics with ambulatory misuse potential
resource:
  v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/opioid-analgesics-with-ambulatory-misuse-potential
  l: opioid-analgesics-with-ambulatory-misuse-potential

type:
  v: depends-on
display:
  v: Value set Community
resource:
  v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/medicationrequest-category-community
  l: medicationrequest-category-community

type:
  v: depends-on
display:
  v: Value set Extended release opioid with ambulatory misuse potential
resource:
  v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/extended-release-opioid-with-ambulatory-misuse-potential
  l: extended-release-opioid-with-ambulatory-misuse-potential

type:
  v: depends-on
display:
  v: Value set Encounter Diagnosis Condition Category
resource:
  v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-encounter-diagnosis-category
  l: condition-encounter-diagnosis-category

type:
  v: depends-on
display:
  v: Value set Problem List Condition Category
resource:
  v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-problem-list-category
  l: condition-problem-list-category

type:
  v: depends-on
display:
  v: Value set US Core Health Concern Condition Category
resource:
  v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-us-core-health-concern-category
  l: condition-us-core-health-concern-category

type:
  v: depends-on
display:
  v: Value set Sickle Cell Diseases
resource:
  v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/sickle-cell-diseases
  l: sickle-cell-diseases

type:
  v: depends-on
display:
  v: Value set Active Condition
resource:
  v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-clinical-status-active
  l: condition-clinical-status-active

type:
  v: depends-on
display:
  v: Value set CDC malignant cancer conditions
resource:
  v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/cdc-malignant-cancer-conditions
  l: cdc-malignant-cancer-conditions

type:
  v: depends-on
display:
  v: Value set Conditions likely terminal for opioid prescribing
resource:
  v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/conditions-likely-terminal-for-opioid-prescribing
  l: conditions-likely-terminal-for-opioid-prescribing

type:
  v: depends-on
display:
  v: Value set Limited life expectancy conditions
resource:
  v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/limited-life-expectancy-conditions
  l: limited-life-expectancy-conditions

type:
  v: depends-on
display:
  v: Value set Hospice Finding Codes
resource:
  v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/hospice-finding
  l: hospice-finding

type:
  v: depends-on
display:
  v: Value set Hospice Disposition
resource:
  v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/hospice-disposition
  l: hospice-disposition

name:
  v: ContextPrescriptions
use:
  v: in
min:
  v: 0
max:
  v: *
type:
  v: MedicationRequest

name:
  v: Is Recommendation Applicable?
use:
  v: out
min:
  v: 0
max:
  v: 1
type:
  v: boolean

type:
  v: Medication
profile:
  v: http://hl7.org/fhir/StructureDefinition/Medication
  l: Medication
must support:
  v: id
must support:
  v: code

type:
  v: Patient
profile:
  v: http://hl7.org/fhir/StructureDefinition/Patient
  l: Patient

type:
  v: Condition
profile:
  v: http://hl7.org/fhir/StructureDefinition/Condition
  l: Condition
must support:
  v: category
must support:
  v: code
must support:
  v: clinicalStatus
code filter:
  path:
    v: category
  value set:
    v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-us-core-health-concern-category
    l: condition-us-core-health-concern-category

type:
  v: Condition
profile:
  v: http://hl7.org/fhir/StructureDefinition/Condition
  l: Condition
must support:
  v: category
must support:
  v: code
must support:
  v: clinicalStatus
must support:
  v: encounter
must support:
  v: encounter.reference
code filter:
  path:
    v: category
  value set:
    v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-encounter-diagnosis-category
    l: condition-encounter-diagnosis-category

type:
  v: Condition
profile:
  v: http://hl7.org/fhir/StructureDefinition/Condition
  l: Condition
must support:
  v: category
must support:
  v: code
must support:
  v: clinicalStatus
must support:
  v: clinicalStatus.coding
code filter:
  path:
    v: category
  value set:
    v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/condition-problem-list-category
    l: condition-problem-list-category

type:
  v: Encounter
profile:
  v: http://hl7.org/fhir/StructureDefinition/Encounter
  l: Encounter
must support:
  v: period
must support:
  v: period.start
must support:
  v: id
must support:
  v: hospitalization
must support:
  v: hospitalization.dischargeDisposition
must support:
  v: hospitalization.dischargeDisposition.coding
must support:
  v: status
must support:
  v: status.value

type:
  v: MedicationRequest
profile:
  v: http://hl7.org/fhir/StructureDefinition/MedicationRequest
  l: MedicationRequest
must support:
  v: authoredOn
must support:
  v: medication
must support:
  v: medication.reference
must support:
  v: id
must support:
  v: status
must support:
  v: intent
must support:
  v: category
must support:
  v: subject
must support:
  v: recorder
must support:
  v: dosageInstruction
must support:
  v: dispenseRequest
must support:
  v: status.value

type:
  v: MedicationDispense
profile:
  v: http://hl7.org/fhir/StructureDefinition/MedicationDispense
  l: MedicationDispense
must support:
  v: medication
must support:
  v: whenHandedOver
must support:
  v: status
code filter:
  path:
    v: medication
  value set:
    v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/opioid-analgesics-with-ambulatory-misuse-potential
    l: opioid-analgesics-with-ambulatory-misuse-potential

type:
  v: MedicationDispense
profile:
  v: http://hl7.org/fhir/StructureDefinition/MedicationDispense
  l: MedicationDispense
must support:
  v: medication.reference
must support:
  v: whenHandedOver
must support:
  v: status

type:
  v: Observation
profile:
  v: http://hl7.org/fhir/StructureDefinition/Observation
  l: Observation
must support:
  v: code
must support:
  v: status
must support:
  v: status.value
code filter:
  path:
    v: code
  value set:
    v: http://fhir.org/guides/cdc/opioid-cds/ValueSet/hospice-finding
    l: hospice-finding

url:
  v: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability
  l: cpg-knowledgeCapability
value: Code
  v: shareable

url:
  v: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability
  l: cpg-knowledgeCapability
value: Code
  v: computable

url:
  v: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability
  l: cpg-knowledgeCapability
value: Code
  v: executable

url:
  v: http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability
  l: cpg-knowledgeCapability
value: Code
  v: publishable

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSREC03
extension:
  url:
    v: name
    l: name
  value: String
    v: Chronic Pain Extended Release Opioid Analgesic with Ambulatory Misuse Potential Prescriptions
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Chronic Pain Extended Release Opioid Analgesic with Ambulatory Misuse Potential Prescriptions": ( Common."Is Opioid Analgesic with Ambulatory Misuse Potential?"( ContextPrescriptions ) ) AmbulatoryOpioidPrescription where Routines."Is Subacute or Chronic Pain Prescription?"( AmbulatoryOpioidPrescription ) and AmbulatoryOpioidPrescription.medication in Common."Extended release opioid with ambulatory misuse potential"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 0
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSREC03
extension:
  url:
    v: name
    l: name
  value: String
    v: Patient Is Being Prescribed Extended Release Opioid Analgesic with Ambulatory Misuse Potential
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Patient Is Being Prescribed Extended Release Opioid Analgesic with Ambulatory Misuse Potential": exists( "Chronic Pain Extended Release Opioid Analgesic with Ambulatory Misuse Potential Prescriptions" )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 1
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommonConfig
extension:
  url:
    v: name
    l: name
  value: String
    v: Age Less than 18 Years Is Enabled
extension:
  url:
    v: statement
    l: statement
  value: String
    v: // CDC 2022 General Inclusion Criteria define "Age Less than 18 Years Is Enabled": true
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 2
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Patient Age Less Than 18
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Patient Age Less Than 18": if (Config."Age Less than 18 Years Is Enabled") then AgeInYearsAt(Today()) < 18 else false
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 3
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommonConfig
extension:
  url:
    v: name
    l: name
  value: String
    v: Sickle Cell Check Enabled
extension:
  url:
    v: statement
    l: statement
  value: String
    v: // Sickle Cell define "Sickle Cell Check Enabled": true
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 4
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommonConfig
extension:
  url:
    v: name
    l: name
  value: String
    v: Sickle Cell Assumed Active
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Sickle Cell Assumed Active": true
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 5
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: US Core-Categorized Conditions
extension:
  url:
    v: statement
    l: statement
  value: String
    v: // 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:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 6
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: Positive Sickle Cell Condition
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Positive Sickle Cell Condition": if Config."Sickle Cell Check Enabled" and not Config."Sickle Cell Assumed Active" then ( "US Core-Categorized Conditions" C where C.code in "Sickle Cell Diseases" and C.clinicalStatus in "Active Condition" ) else if Config."Sickle Cell Check Enabled" and Config."Sickle Cell Assumed Active" then ( "US Core-Categorized Conditions" C where C.code in "Sickle Cell Diseases" ) else null
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 7
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Condition Positive for Sickle Cell
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Condition Positive for Sickle Cell": if (Config."Sickle Cell Check Enabled") then exists( Common."Positive Sickle Cell Condition" ) else false
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 8
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommonConfig
extension:
  url:
    v: name
    l: name
  value: String
    v: Active Cancer Treatment Encounters Condition Is Enabled
extension:
  url:
    v: statement
    l: statement
  value: String
    v: // Active Cancer Treatment define "Active Cancer Treatment Encounters Condition Is Enabled": true
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 9
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Encounter Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: // End of Opioid Naive Routine /* ** Routine #3 ** Active Cancer Treatment Routine ** ** Definition | Answer to Proceed | Details | Data (Terminology) Requirement ** --------------------------------------------------------------------------------------------------------------------------------- ** Two office visits within the | No | Look for a minimum of two distinct | Office Visit ** past 12 months | | encounters within 12 months of the date | ** | | of the current visit for which each of the | ** | | following is true: | ** | | - the encounter diagnosis (primary or | ** | | secondary or co-morbidity diagnosis) | ** | | is listed in the CDC Malignant Cancer | ** | | Conditions value set | ** --------------------------------------------------------------------------------------------------------------------------------- ** Office visits with an | No | The encounter is performed by an | Oncology specialty ** oncology specialist | | oncologist as defined in the oncology | designations (NUCC) ** present | | specialty designations using the | ** | | National Uniform Claim Committee | ** | | (NUCC) classifications | ** --------------------------------------------------------------------------------------------------------------------------------- ** Office visits including CDC | No | The encounter diagnosis (primary or | CDC malignant cancer ** malignant cancer | | secondary or co-morbidity diagnosis) | conditions ** condition | | is listed in the CDC Malignant Cancer | ** | | Conditions value set | ** ---------------------------------------------------------------------------------------------------------------------------------- ** */ define "Encounter Period": Interval[Today() - 12 months, Today())
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 10
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: USCore Encounter Cancer Diagnoses
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "USCore Encounter Cancer Diagnoses": [Condition: category in "Encounter Diagnosis Condition Category"] CancerDiagnoses where CancerDiagnoses.code in "CDC malignant cancer conditions"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 11
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Encounters with Cancer Diagnosis During Encounter Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: // encounter-diagnosis, problem-list and health-concern Conditions // define "US Core-Categorized Cancer Diagnoses": // Common."US Core-Categorized Conditions" C // where C.code in Common."CDC malignant cancer conditions" // define "Encounters with Cancer Diagnosis During Encounter Period": // [Encounter] Encounter // with "US Core-Categorized Cancer Diagnoses" CancerDiagnosis // such that date from Encounter.period."start".value in day of "Encounter Period" // and EndsWith(CancerDiagnosis.encounter.reference, Encounter.id) define "Encounters with Cancer Diagnosis During Encounter Period": [Encounter] Encounters where date from Encounters.period."start" in day of "Encounter Period" and exists ( Common."USCore Encounter Cancer Diagnoses" CancerDiagnoses where EndsWith(CancerDiagnoses.encounter.reference, Encounters.id) )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 12
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Number of Encounters with Cancer Diagnosis During Encounter Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Number of Encounters with Cancer Diagnosis During Encounter Period": Count ("Encounters with Cancer Diagnosis During Encounter Period")
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 13
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Two or More Encounters with Cancer Diagnosis During Encounter Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Two or More Encounters with Cancer Diagnosis During Encounter Period": "Number of Encounters with Cancer Diagnosis During Encounter Period" >= 2
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 14
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: USCore Problem List Cancer Diagnoses
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "USCore Problem List Cancer Diagnoses": [Condition: category in "Problem List Condition Category"] CancerDiagnoses where CancerDiagnoses.code in "CDC malignant cancer conditions"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 15
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Active Cancer Diagnosis on Problem List
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Active Cancer Diagnosis on Problem List": exists ( Common."USCore Problem List Cancer Diagnoses" CancerDiagnoses where CancerDiagnoses.category in Common."Problem List Condition Category" and exists( CancerDiagnoses.clinicalStatus.coding ClinicalStatus where ClinicalStatus.code ~ 'active' ) )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 16
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Is Active Cancer Treatment?
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Is Active Cancer Treatment?": if (Config."Active Cancer Treatment Encounters Condition Is Enabled") then "Has Two or More Encounters with Cancer Diagnosis During Encounter Period" or "Has Active Cancer Diagnosis on Problem List" else false
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 17
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommonConfig
extension:
  url:
    v: name
    l: name
  value: String
    v: End-Stage Disease Criteria Enabled
extension:
  url:
    v: statement
    l: statement
  value: String
    v: // CDC 2022 General Inclusion Criteria define "End-Stage Disease Criteria Enabled": true
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 18
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Conditions Likely Terminal for Opioid Prescribing
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Conditions Likely Terminal for Opioid Prescribing": if (Config."End-Stage Disease Criteria Enabled") then exists ( Common."US Core-Categorized Conditions" EOLC where EOLC.code in Common."Conditions likely terminal for opioid prescribing" // and EOLC.clinicalStatus in Common."Active Condition" ) else false
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 19
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: CDC 2022 Guideline General Inclusion Criteria
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "CDC 2022 Guideline General Inclusion Criteria": not "Patient Age Less Than 18" and not "Condition Positive for Sickle Cell" and not "Is Active Cancer Treatment?" and not "Conditions Likely Terminal for Opioid Prescribing"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 20
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommonConfig
extension:
  url:
    v: name
    l: name
  value: String
    v: Opioid Naive Prescription Condition Is Enabled
extension:
  url:
    v: statement
    l: statement
  value: String
    v: // Opioid Naive define "Opioid Naive Prescription Condition Is Enabled": true
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 21
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommonConfig
extension:
  url:
    v: name
    l: name
  value: String
    v: Can the implementing EHR support queries for past medications by date range?
extension:
  url:
    v: statement
    l: statement
  value: String
    v: // Subroutine 2 - Past Medications define "Can the implementing EHR support queries for past medications by date range?": true
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 22
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: Active Ambulatory Opioid Rx
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Active Ambulatory Opioid Rx": if Config."Can the implementing EHR support queries for past medications by date range?" then ( "Get MedicationRequest Medication as Code"("Get Active Ambulatory Medication Requests"([MedicationRequest])) ) Rx where date from Rx.authoredOn 2 years or less on or before Today() and Rx.medication in "Opioid analgesics with ambulatory misuse potential" else List<FHIR.MedicationRequest>{}
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 23
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Prescription/Dispense Inclusion Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: // End of CDC 2022 General Inclusion Criteria Routine /* ** Routine #2 ** Opioid Naive Routine ** ** Definition | Answer to Proceed | Details | Data (Terminology) Requirement ** ---------------------------------------------------------------------------------------------------------------------------------------- ** Opioid analgesics with | No | Look for an existing prescription (order) for | Opioid analgesics with ** ambulatory misuse potential | | opioid that is in the value set for opioid with | ambulatory misuse potential ** prescription in past 90 days | | ambulatory abuse potential authored | ** excluding the previous 24 | | within the past 90 days (excluding previous 24 | ** hours | | hours) | ** ---------------------------------------------------------------------------------------------------------------------------------------- ** Opioid analgesics with | No | Look for evidence of active medication on | Opioid analgesics with ** ambulatory misuse potential | | the medication list that is in the value set | ambulatory misuse potential ** reported in past 90 days | | for opioid with ambulatory care abuse | ** excluding previous 24 hours* | | potential | ** ---------------------------------------------------------------------------------------------------------------------------------------- ** Opioid analgesics with | No | Look for evidence of a dispensing event for | Opioid analgesics with ** ambulatory misuse potential | | medication that is in the value set for opioid | ambulatory misuse potential ** dispensing event in past 90 | | with ambulatory use potential occurring | ** days excluding previous 24 | | within the past 90 days (excluding previous 24 | ** hours | | hours) | ** ---------------------------------------------------------------------------------------------------------------------------------------- ** *Future consideration: Current algorithm addresses only orders (prescriptions). ** ** Note – orders use RxNorm, but medication lists and disp…
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 24
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Opioid RX with Ambulatory Abuse Potential In Past 90 Days
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Opioid RX with Ambulatory Abuse Potential In Past 90 Days": Common."Active Ambulatory Opioid Rx" Rx where Rx.authoredOn during day of "Prescription/Dispense Inclusion Period"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 25
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Opioid RX with Ambulatory Abuse Potential In Past 90 Days
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Opioid RX with Ambulatory Abuse Potential In Past 90 Days": if (Config."Opioid Naive Prescription Condition Is Enabled") then exists ("Opioid RX with Ambulatory Abuse Potential In Past 90 Days") else false
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 26
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Opioid Dispense with Ambulatory Abuse Potential In Past 90 Days
extension:
  url:
    v: statement
    l: statement
  value: String
    v: // NOTE: 2020-02-05: Review direction of MedicationStatement resource (US-Core focusing on MedicationRequest i/o Statement) // NOTE: 2020-04-21: MedicationStatement a) Shouldn't be use since guidance/direction from USCore is targeting MedicationUse in R5, and b) Breaks in the publisher /* define "Reports of Opioid with Ambulatory Care Abuse Potential Reported in Past 90 Days": [MedicationStatement: Common."Opioid analgesics with ambulatory misuse potential"] Statement where Statement.status in {'active', 'completed'} and Statement.effective during day of "Report Inclusion Period" */ /* define "Has Report of Opioid with Ambulatory Care Abuse Potential Reported in Past 90 Days": Config."Opioid Naive Report Condition Is Enabled" and exists ("Reports of Opioid with Ambulatory Care Abuse Potential Reported in Past 90 Days") */ define "Opioid Dispense with Ambulatory Abuse Potential In Past 90 Days": [MedicationDispense: Common."Opioid analgesics with ambulatory misuse potential"] OpioidDispense where OpioidDispense.whenHandedOver during day of "Prescription/Dispense Inclusion Period" and OpioidDispense.status = 'completed'
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 27
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Has Opioid Dispense with Ambulatory Abuse Potential In Past 90 Days
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Has Opioid Dispense with Ambulatory Abuse Potential In Past 90 Days": if (Config."Opioid Naive Prescription Condition Is Enabled") then exists ("Opioid Dispense with Ambulatory Abuse Potential In Past 90 Days") else false
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 28
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Is Opioid Naive?
extension:
  url:
    v: statement
    l: statement
  value: String
    v: // NOTE: MedicationStatement-dependent logic comment out due to bug in Publisher not supporting MedicationStatement in AllTypes. define "Is Opioid Naive?": not ("Has Opioid RX with Ambulatory Abuse Potential In Past 90 Days") /* and not ("Has Report of Opioid with Ambulatory Care Abuse Potential Reported in Past 90 Days") */ and not ("Has Opioid Dispense with Ambulatory Abuse Potential In Past 90 Days")
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 29
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSREC03
extension:
  url:
    v: name
    l: name
  value: String
    v: Inclusion Criteria
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Inclusion Criteria": "Patient Is Being Prescribed Extended Release Opioid Analgesic with Ambulatory Misuse Potential" and Routines."CDC 2022 Guideline General Inclusion Criteria" and Routines."Is Opioid Naive?"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 30
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: Conditions Indicating End of Life or With Limited Life Expectancy
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Conditions Indicating End of Life or With Limited Life Expectancy": ( "US Core-Categorized Conditions" C where C.code in "Conditions likely terminal for opioid prescribing" and C.clinicalStatus in "Active Condition" ) union ( "US Core-Categorized Conditions" C where C.code in "Limited life expectancy conditions" and C.clinicalStatus in "Active Condition" )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 31
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommonConfig
extension:
  url:
    v: name
    l: name
  value: String
    v: Hospice Findings Exclusion Enabled
extension:
  url:
    v: statement
    l: statement
  value: String
    v: // OpioidCDSCommon define "Hospice Findings Exclusion Enabled": false
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 32
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: Admitted/Referred/Discharged to Hospice Care
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Admitted/Referred/Discharged to Hospice Care": ( if (Config."Hospice Findings Exclusion Enabled") then [Observation: code in "Hospice Finding Codes"] O where not (O.status.value in { 'unknown', 'entered-in-error', 'cancelled' }) else {} ) union ( [Encounter] E where date from E.period.start 1 year or less on or before Today() and ( if E.hospitalization.dischargeDisposition.coding is null or not exists (E.hospitalization.dischargeDisposition.coding) then false else E.hospitalization.dischargeDisposition in "Hospice Disposition" ) and E.status.value in { 'planned', 'arrived', 'in-progress', 'finished', 'onleave' } )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 33
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: End of Life Assessment
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "End of Life Assessment": // 1. Conditions indicating end of life or with limited life expectancy exists ( "Conditions Indicating End of Life or With Limited Life Expectancy" ) // 2. Admitted/referred/discharged to hospice care or exists ( "Admitted/Referred/Discharged to Hospice Care" )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 34
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSREC03
extension:
  url:
    v: name
    l: name
  value: String
    v: Exclusion Criteria
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Exclusion Criteria": Common."End of Life Assessment"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 35
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSREC03
extension:
  url:
    v: name
    l: name
  value: String
    v: Is Recommendation Applicable?
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define "Is Recommendation Applicable?": "Inclusion Criteria" and not "Exclusion Criteria"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 36
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: Is Opioid Analgesic with Ambulatory Misuse Potential?
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function "Is Opioid Analgesic with Ambulatory Misuse Potential?"(value List<MedicationRequest>): ("Get MedicationRequest Medication as Code"(value)) Rx where Rx.medication in "Opioid analgesics with ambulatory misuse potential" and Rx.category in "Community"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 37
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: Get MedicationRequest Medication as Code
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function "Get MedicationRequest Medication as Code"(value List<MedicationRequest>): value Rx let Med: if Rx.medication is Reference then singleton from ( [Medication] M where M.id = (Last(Split((Rx.medication as FHIR.Reference).reference, '/'))) ) else null return MedicationRequest { id: Rx.id, status: Rx.status, intent: Rx.intent, category: Rx.category, medication: if Rx.medication is Reference then Med.code else Rx.medication as CodeableConcept, subject: Rx.subject, authoredOn: Rx.authoredOn, recorder: Rx.recorder, dosageInstruction: Rx.dosageInstruction, dispenseRequest: Rx.dispenseRequest }
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 38
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToString
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToString(value string): value.value
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 39
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToConcept
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToConcept(concept FHIR.CodeableConcept): if concept is null then null else System.Concept { codes: concept.coding C return ToCode(C), display: concept.text.value }
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 40
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToCode
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToCode(coding FHIR.Coding): if coding is null then null else System.Code { code: coding.code.value, system: coding.system.value, version: coding.version.value, display: coding.display.value }
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 41
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Is Subacute or Chronic Pain Prescription?
extension:
  url:
    v: statement
    l: statement
  value: String
    v: // End of Active Cancer Treatment Routine /* ** Routine #4 ** For Subacute or Chronic Pain Routine ** ** Definition | Answer to Proceed | Details | Data (Terminology) Requirement ** ----------------------------------------------------------------------------------------------------------------------------------- ** Order for opioid analgesic | Yes | Order for opioid analgesics with ambulatory | Opioid analgesics with ** with expected supply | | misuse potential with a supply duration of >= | ambulatory misuse potential ** duration >= 28 days | | 28 days | ** | | | ** | | - Subacute definition = order for opioid | ** | | analgesics with ambulatory misuse | ** | | potential with a supply duration of one to | ** | | two months. | ** | | - Chronic pain definition = order for opioid | ** | | analgesics with ambulatory misuse | ** | | potential with a supply duration of >= two | ** | | months. | ** ----------------------------------------------------------------------------------------------------------------------------------- ** */ define function "Is Subacute or Chronic Pain Prescription?"(prescription FHIR.MedicationRequest): "Is Subacute or Chronic Pain Using Expected Supply Duration"(prescription) or "Is Subacute or Chronic Pain Using Validity Period"(prescription)
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 42
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Is Subacute or Chronic Pain Using Expected Supply Duration
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function "Is Subacute or Chronic Pain Using Expected Supply Duration"(prescription FHIR.MedicationRequest): ( prescription.dispenseRequest is not null and prescription.dispenseRequest.expectedSupplyDuration is not null and ( Common.GetDurationInDays(prescription.dispenseRequest.expectedSupplyDuration) >= 28 days ) )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 43
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: GetDurationInDays
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function GetDurationInDays(value FHIR.Duration): if value is null then null else case when value.code.value ~ 'a' then System.Quantity{ value: value.value.value * 365.0, unit: 'days' } when value.code.value ~ 'mo' then System.Quantity{ value: value.value.value * 30.0, unit: 'days' } when value.code.value ~ 'wk' then System.Quantity{ value: value.value.value * 7.0, unit: 'days' } when value.code.value ~ 'd' then System.Quantity{ value: value.value.value, unit: 'days' } when value.code.value ~ 'h' then System.Quantity{ value: value.value.value / 24.0, unit: 'days' } when value.code.value ~ 'min' then System.Quantity{ value: value.value.value / 60.0 / 24.0, unit: 'days' } when value.code.value ~ 's' then System.Quantity{ value: value.value.value / 60.0 / 60.0 / 24.0, unit: 'days' } when value.code.value ~ 'ms' then System.Quantity{ value: value.value.value / 60.0 / 60.0 / 24.0 / 1000.0, unit: 'days' } when value.code.value is null then Message(1000, true, 'Undefined', 'Error', 'Duration unit code is null') else Message(1000, true, 'Undefined', 'Error', 'Unsupported duration unit code: ' + value.code.value) end
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 44
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSRoutines
extension:
  url:
    v: name
    l: name
  value: String
    v: Is Subacute or Chronic Pain Using Validity Period
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function "Is Subacute or Chronic Pain Using Validity Period"(prescription FHIR.MedicationRequest): ( prescription.dispenseRequest is not null and prescription.dispenseRequest.validityPeriod is not null and ( days between prescription.dispenseRequest.validityPeriod.start and prescription.dispenseRequest.validityPeriod.end >= 28 ) )
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 45
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToDateTime
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToDateTime(value dateTime): value.value
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 46
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: OpioidCDSCommon
extension:
  url:
    v: name
    l: name
  value: String
    v: Get Active Ambulatory Medication Requests
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function "Get Active Ambulatory Medication Requests" (value List<MedicationRequest>) returns List<MedicationRequest>: value Rx where Rx.status.value = 'active' and Rx.category in "Community"
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 47
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

extension:
  url:
    v: libraryName
    l: libraryName
  value: String
    v: FHIRHelpers
extension:
  url:
    v: name
    l: name
  value: String
    v: ToString
extension:
  url:
    v: statement
    l: statement
  value: String
    v: define function ToString(value MedicationDispenseStatus): value.value
extension:
  url:
    v: displaySequence
    l: displaySequence
  value: Integer
    v: 48
url:
  v: http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition
  l: cqf-logicDefinition

url:
  v: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem
  l: crmi-softwaresystem
value: Reference
  l: cqf-tooling
  reference:
    v: Device/cqf-tooling

url:
  v: http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements
  l: crmi-effectiveDataRequirements
value: Canonical
  v: #effective-data-requirements
  l: effective-data-requirements

use:
  v: official
value:
  v: cdc-opioid-guidance

v: 2022.1.0

v: PlanDefinition_Recommendation_03_Order_Sign

v: Recommendation #3 - Opioid Immediate Release Form When Starting Opioid Therapy

coding:
  system:
    v: http://terminology.hl7.org/CodeSystem/plan-definition-type
    l: plan-definition-type
  code:
    v: eca-rule
  display:
    v: ECA Rule

v: draft

v: true

v: 2025-08-06

v: Centers for Disease Control and Prevention (CDC)

telecom:
  system:
    v: url
  value:
    v: https://www.cdc.gov

v: When starting opioid therapy for acute, subacute, or chronic pain, clinicians should prescribe immediate-release opioids instead of extended-release and long-acting (ER/LA) opioids.

code:
  system:
    v: http://terminology.hl7.org/CodeSystem/usage-context-type
    l: usage-context-type
  code:
    v: focus
  display:
    v: Clinical Focus
value: CodeableConcept
  coding: http://snomed.info/id/182888003
    system:
      v: http://snomed.info/sct
      l: sct
    code:
      v: 182888003
    display:
      v: Medication requested (situation)

code:
  system:
    v: http://terminology.hl7.org/CodeSystem/usage-context-type
    l: usage-context-type
  code:
    v: focus
  display:
    v: Clinical Focus
value: CodeableConcept
  coding: http://snomed.info/id/82423001
    system:
      v: http://snomed.info/sct
      l: sct
    code:
      v: 82423001
    display:
      v: Chronic pain (finding)

code:
  system:
    v: http://terminology.hl7.org/CodeSystem/usage-context-type
    l: usage-context-type
  code:
    v: focus
  display:
    v: Clinical Focus
value: CodeableConcept
  coding: http://snomed.info/id/274663001
    system:
      v: http://snomed.info/sct
      l: sct
    code:
      v: 274663001
    display:
      v: Acute pain (finding)

code:
  system:
    v: http://terminology.hl7.org/CodeSystem/usage-context-type
    l: usage-context-type
  code:
    v: focus
  display:
    v: Clinical Focus
value: CodeableConcept
  text:
    v: Subacute pain

v: The 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain is intended to improve communication between clinicians and patients about the benefits and risks of pain treatments, including opioid therapy; improve the effectiveness and safety of pain treatment; mitigate pain; improve function and quality of life for patients with pain; and reduce risks associated with opioid pain therapy, including opioid use disorder, overdose, and death. The recommendations do not apply to pain related to sickle cell disease or cancer or to patients receiving palliative or end-of-life care.

v: Clinicians should not treat acute pain with ER/LA opioids or initiate opioid treatment for subacute or chronic pain with extended-release and long-acting (ER/LA) opioids, and clinicians should not prescribe ER/LA opioids for intermittent or as-needed use.

v: © CDC 2016+.

text:
  v: Opioid Prescribing

name:
  v: Kensaku Kawamoto, MD, PhD, MHS

name:
  v: Bryn Rhodes

name:
  v: Floyd Eisenberg, MD, MPH

name:
  v: Robert McClure, MD, MPH

type:
  v: documentation
display:
  v: 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain
url:
  v: https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm
  l: rr7103a1.htm
document:
  url:
    v: https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm
    l: rr7103a1.htm

extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation
    l: cqf-strengthOfRecommendation
  value: CodeableConcept
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/recommendation-strength
        l: recommendation-strength
      code:
        v: strong
      display:
        v: Strong
extension:
  url:
    v: http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence
    l: cqf-qualityOfEvidence
  value: CodeableConcept
    coding:
      system:
        v: http://terminology.hl7.org/CodeSystem/evidence-quality
        l: evidence-quality
      code:
        v: very-low
      display:
        v: Very Low quality
title:
  v: When Initiating Opioid Therapy, Utilize Immediate Release Opioids
description:
  v: Recommend prescribing immediate release opioids instead of extended-release or long-acting opioids [For guidance regarding prescribing extended release/ long-acting opioids, see Recommendation 3 of the 2022 CDC Clinical Practice Guideline](https://www.cdc.gov/mmwr/volumes/71/rr/rr7103a1.htm#Recommendation3).
priority:
  v: urgent
trigger:
  type:
    v: named-event
  name:
    v: order-sign
condition:
  kind:
    v: applicability
  expression:
    description:
      v: Check whether the current order is for an extended-release opioid with ambulatory misuse potential, the patient is opioid naive and if the 2022 CDC guideline general inclusion criteria is met
    language:
      v: text/cql.identifier
    expression:
      v: Is Recommendation Applicable?
grouping behavior:
  v: visual-group
selection behavior:
  v: any
action:
  description:
    v: Document - Will prescribe immediate release opioid
action:
  description:
    v: Snooze* - Benefits outweigh risks, snooze 3 months
action:
  description:
    v: Snooze* N/A see comment, snooze 3 months