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Plandefinition-example.xml

Clinical Decision Support Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Not linked to any defined compartments

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Low Suicide Risk Order Set (id = "low-suicide-risk-order-set")

<?xml version="1.0" encoding="UTF-8"?>

<PlanDefinition xmlns="http://hl7.org/fhir">
  <id value="low-suicide-risk-order-set"/> 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">
         <table class="grid dict">
            <tr> 
               <td> 
                  <b> Id: </b> 
               </td> 
            </tr> 
            <tr> 
               <td style="padding-left: 25px; padding-right: 25px;">PlanDefinition/low-suicide-risk-order-set</td> 
            </tr> 
         </table> 
         <p/>  
         <table class="grid dict">
            <tr> 
               <td> 
                  <b> Identifier: </b> 
               </td> 
            </tr> 
            <tr> 
               <td style="padding-left: 25px; padding-right: 25px;">
                  <b> value: </b> 
                  <span> mmi:low-suicide-risk-order-set</span> 
               </td> 
            </tr> 
         </table> 
         <p/>  
         <table class="grid dict">
            <tr> 
               <td> 
                  <b> Title: </b> 
               </td> 
            </tr> 
            <tr> 
               <td style="padding-left: 25px; padding-right: 25px;">Low Suicide Risk Order Set</td> 
            </tr> 
         </table> 
         <p/>  
         <table class="grid dict">
            <tr> 
               <td> 
                  <b> Status: </b> 
               </td> 
            </tr> 
            <tr> 
               <td style="padding-left: 25px; padding-right: 25px;">draft</td> 
            </tr> 
         </table> 
         <p/>  
         <table class="grid dict">
            <tr> 
               <td> 
                  <b> Description: </b> 
               </td> 
            </tr> 
            <tr> 
               <td style="padding-left: 25px; padding-right: 25px;">Orders to be applied to a patient characterized as low suicide risk.</td> 
            </tr> 
         </table> 
         <p/>  
         <table class="grid dict">
            <tr> 
               <td> 
                  <b> Purpose: </b> 
               </td> 
            </tr> 
            <tr> 
               <td style="padding-left: 25px; padding-right: 25px;">This order set helps ensure consistent application of appropriate orders for the care
             of low suicide risk patients.</td> 
            </tr> 
         </table> 
         <p/>  
         <table class="grid dict">
            <tr> 
               <td> 
                  <b> Usage: </b> 
               </td> 
            </tr> 
            <tr> 
               <td style="padding-left: 25px; padding-right: 25px;">This order set should be applied after assessing a patient for suicide risk, when the
             findings of that assessment indicate the patient has low suicide risk.</td> 
            </tr> 
         </table> 
         <p/>  
         <table class="grid dict">
            <tr> 
               <td> 
                  <b> Context: </b> 
               </td> 
            </tr> 
            <tr style="vertical-align: top;">
               <td style="padding-right: 25px;">
                  <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
                     <b> system: </b> 
                     <span> http://terminology.hl7.org/CodeSystem/usage-context-type</span> 
                  </p> 
                  <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
                     <b> code: </b> 
                     <span> age</span> 
                  </p> 
                  <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
                     <b> value: </b> 
                     <br/>  
                     <span> 
                        <span> 
                           <span> 
                              <span style="padding-left: 25px;">
                                 <b> system: </b> 
                                 <span> https://meshb.nlm.nih.gov</span> 
                                 <br/>  
                              </span> 
                              <span style="padding-left: 25px;">
                                 <b> code: </b> 
                                 <span> D000328</span> 
                                 <br/>  
                              </span> 
                              <span style="padding-left: 25px;">
                                 <b> display: </b> 
                                 <span> Adult</span> 
                              </span> 
                           </span> 
                        </span> 
                     </span> 
                  </p> 
               </td> 
            </tr> 
         </table> 
         <table class="grid dict">
            <tr> 
               <td> 
                  <b> Context: </b> 
               </td> 
            </tr> 
            <tr style="vertical-align: top;">
               <td style="padding-right: 25px;">
                  <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
                     <b> system: </b> 
                     <span> http://terminology.hl7.org/CodeSystem/usage-context-type</span> 
                  </p> 
                  <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
                     <b> code: </b> 
                     <span> focus</span> 
                  </p> 
                  <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
                     <b> value: </b> 
                     <br/>  
                     <span> 
                        <span> 
                           <span> 
                              <span style="padding-left: 25px;">
                                 <b> system: </b> 
                                 <span> http://snomed.info/sct</span> 
                                 <br/>  
                              </span> 
                              <span style="padding-left: 25px;">
                                 <b> code: </b> 
                                 <span> 87512008</span> 
                                 <br/>  
                              </span> 
                              <span style="padding-left: 25px;">
                                 <b> display: </b> 
                                 <span> Mild major depression</span> 
                              </span> 
                           </span> 
                        </span> 
                     </span> 
                  </p> 
               </td> 
            </tr> 
         </table> 
         <table class="grid dict">
            <tr> 
               <td> 
                  <b> Context: </b> 
               </td> 
            </tr> 
            <tr style="vertical-align: top;">
               <td style="padding-right: 25px;">
                  <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
                     <b> system: </b> 
                     <span> http://terminology.hl7.org/CodeSystem/usage-context-type</span> 
                  </p> 
                  <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
                     <b> code: </b> 
                     <span> focus</span> 
                  </p> 
                  <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
                     <b> value: </b> 
                     <br/>  
                     <span> 
                        <span> 
                           <span> 
                              <span style="padding-left: 25px;">
                                 <b> system: </b> 
                                 <span> http://snomed.info/sct</span> 
                                 <br/>  
                              </span> 
                              <span style="padding-left: 25px;">
                                 <b> code: </b> 
                                 <span> 40379007</span> 
                                 <br/>  
                              </span> 
                              <span style="padding-left: 25px;">
                                 <b> display: </b> 
                                 <span> Major depression, recurrent, mild</span> 
                              </span> 
                           </span> 
                        </span> 
                     </span> 
                  </p> 
               </td> 
            </tr> 
         </table> 
         <table class="grid dict">
            <tr> 
               <td> 
                  <b> Context: </b> 
               </td> 
            </tr> 
            <tr style="vertical-align: top;">
               <td style="padding-right: 25px;">
                  <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
                     <b> system: </b> 
                     <span> http://terminology.hl7.org/CodeSystem/usage-context-type</span> 
                  </p> 
                  <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
                     <b> code: </b> 
                     <span> focus</span> 
                  </p> 
                  <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
                     <b> value: </b> 
                     <br/>  
                     <span> 
                        <span> 
                           <span> 
                              <span style="padding-left: 25px;">
                                 <b> system: </b> 
                                 <span> http://snomed.info/sct</span> 
                                 <br/>  
                              </span> 
                              <span style="padding-left: 25px;">
                                 <b> code: </b> 
                                 <span> 394687007</span> 
                                 <br/>  
                              </span> 
                              <span style="padding-left: 25px;">
                                 <b> display: </b> 
                                 <span> Low suicide risk</span> 
                              </span> 
                           </span> 
                        </span> 
                     </span> 
                  </p> 
               </td> 
            </tr> 
         </table> 
         <table class="grid dict">
            <tr> 
               <td> 
                  <b> Context: </b> 
               </td> 
            </tr> 
            <tr style="vertical-align: top;">
               <td style="padding-right: 25px;">
                  <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
                     <b> system: </b> 
                     <span> http://terminology.hl7.org/CodeSystem/usage-context-type</span> 
                  </p> 
                  <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
                     <b> code: </b> 
                     <span> focus</span> 
                  </p> 
                  <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
                     <b> value: </b> 
                     <br/>  
                     <span> 
                        <span> 
                           <span> 
                              <span style="padding-left: 25px;">
                                 <b> system: </b> 
                                 <span> http://snomed.info/sct</span> 
                                 <br/>  
                              </span> 
                              <span style="padding-left: 25px;">
                                 <b> code: </b> 
                                 <span> 225337009</span> 
                                 <br/>  
                              </span> 
                              <span style="padding-left: 25px;">
                                 <b> display: </b> 
                                 <span> Suicide risk assessment</span> 
                              </span> 
                           </span> 
                        </span> 
                     </span> 
                  </p> 
               </td> 
            </tr> 
         </table> 
         <table class="grid dict">
            <tr> 
               <td> 
                  <b> Context: </b> 
               </td> 
            </tr> 
            <tr style="vertical-align: top;">
               <td style="padding-right: 25px;">
                  <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
                     <b> system: </b> 
                     <span> http://terminology.hl7.org/CodeSystem/usage-context-type</span> 
                  </p> 
                  <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
                     <b> code: </b> 
                     <span> user</span> 
                  </p> 
                  <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
                     <b> value: </b> 
                     <br/>  
                     <span> 
                        <span> 
                           <span> 
                              <span style="padding-left: 25px;">
                                 <b> system: </b> 
                                 <span> http://snomed.info/sct</span> 
                                 <br/>  
                              </span> 
                              <span style="padding-left: 25px;">
                                 <b> code: </b> 
                                 <span> 309343006</span> 
                                 <br/>  
                              </span> 
                              <span style="padding-left: 25px;">
                                 <b> display: </b> 
                                 <span> Physician</span> 
                              </span> 
                           </span> 
                        </span> 
                     </span> 
                  </p> 
               </td> 
            </tr> 
         </table> 
         <table class="grid dict">
            <tr> 
               <td> 
                  <b> Context: </b> 
               </td> 
            </tr> 
            <tr style="vertical-align: top;">
               <td style="padding-right: 25px;">
                  <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
                     <b> system: </b> 
                     <span> http://terminology.hl7.org/CodeSystem/usage-context-type</span> 
                  </p> 
                  <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
                     <b> code: </b> 
                     <span> venue</span> 
                  </p> 
                  <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">
                     <b> value: </b> 
                     <br/>  
                     <span> 
                        <span> 
                           <span> 
                              <span style="padding-left: 25px;">
                                 <b> system: </b> 
                                 <span> http://snomed.info/sct</span> 
                                 <br/>  
                              </span> 
                              <span style="padding-left: 25px;">
                                 <b> code: </b> 
                                 <span> 440655000</span> 
                                 <br/>  
                              </span> 
                              <span style="padding-left: 25px;">
                                 <b> display: </b> 
                                 <span> Outpatient environment</span> 
                              </span> 
                           </span> 
                        </span> 
                     </span> 
                  </p> 
               </td> 
            </tr> 
         </table> 
         <p/>  
         <table class="grid dict">
            <tr> 
               <td> 
                  <b> Topic: </b> 
               </td> 
            </tr> 
            <tr> 
               <td style="padding-left: 25px; padding-right: 25px;">
                  <span> 
                     <b> text: </b> 
                     <span> Suicide risk assessment</span> 
                  </span> 
               </td> 
            </tr> 
         </table> 
         <p/>  
         <table class="grid dict">
            <tr> 
               <td> 
                  <b> Contributor: </b> 
               </td> 
            </tr> 
            <tr> 
               <td style="padding-left: 25px; padding-right: 25px;">
                  <b> 
                     <span> author</span> :
                  </b> 
               </td> 
            </tr> 
            <tr> 
               <td style="padding-left: 50px; padding-right: 25px;">Motive Medical Intelligence</td> 
            </tr> 
         </table> 
         <p/>  
         <table class="grid dict">
            <tr> 
               <td> 
                  <b> Library: </b> 
               </td> 
            </tr> 
            <tr> 
               <td style="padding-left: 25px; padding-right: 25px;">
                  <b> reference: </b> 
                  <span> Library/suiciderisk-orderset-logic</span> 
               </td> 
            </tr> 
            <tr> 
               <td style="padding-left: 25px; padding-right: 25px;">
                  <b> display: </b> 
                  <span> SuicideRiskLogic</span> 
               </td> 
            </tr> 
         </table> 
         <p/>  
         <h2> Actions</h2> 
         <p class="hierarchy" style="width: 100%;">
            <span> 
               <b> Step: </b> 
               <br/>  
               <span style="padding-left: 25px;">
                  <b> title: </b> 
                  <span> Suicide Risk Assessment and Outpatient Management</span> 
                  <br/>  
               </span> 
               <span style="padding-left: 25px;">
                  <span> 
                     <b> Step: </b> 
                     <br/>  
                     <span style="padding-left: 50px;">
                        <b> title: </b> 
                        <span> Consults and Referrals</span> 
                        <br/>  
                     </span> 
                     <span style="padding-left: 50px;">
                        <span> 
                           <b> Step: </b> 
                           <br/>  
                           <span style="padding-left: 75px;">
                              <b> text: </b> 
                              <span> Refer to outpatient mental health program for evaluation and treatment of mental health
                       conditions now</span> 
                              <br/>  
                           </span> 
                           <span style="padding-left: 75px;">
                              <b> condition: </b> 
                              <br/>  
                              <span style="padding-left: 100px;">
                                 <b> reference: </b> 
                                 <br/>  
                                 <span style="padding-left: 125px;">#referralToMentalHealthCare</span> 
                                 <span> 
                                    <span style="padding-left: 75px;">
                                       <br/>  
                                       <span style="padding-left: 100px;">
                                          <b> description: </b> 
                                          <span> refer to primary care mental-health integrated care program for evaluation and treatment
                               of mental health conditions now</span> 
                                          <br/>  
                                       </span> 
                                       <span style="padding-left: 100px;">
                                          <b> category: </b> 
                                          <span> referral</span> 
                                          <br/>  
                                       </span> 
                                    </span> 
                                 </span> 
                              </span> 
                           </span> 
                           <span style="padding-left: 50px;"/> 
                        </span> 
                     </span> 
                  </span> 
                  <span> 
                     <b> Step: </b> 
                     <br/>  
                     <span style="padding-left: 50px;">
                        <b> title: </b> 
                        <span> Medications</span> 
                        <br/>  
                     </span> 
                     <span style="padding-left: 50px;">
                        <span> 
                           <b> Step: </b> 
                           <br/>  
                           <span style="padding-left: 75px;">
                              <b> title: </b> 
                              <span> First-Line Antidepressants</span> 
                              <br/>  
                           </span> 
                           <span style="padding-left: 75px;">
                              <span> 
                                 <b> Step: </b> 
                                 <br/>  
                                 <span style="padding-left: 100px;">
                                    <b> title: </b> 
                                    <span> Selective Serotonin Reuptake Inhibitors (Choose a mazimum of one or document reasons for
                           exception)</span> 
                                    <br/>  
                                 </span> 
                                 <span style="padding-left: 100px;">
                                    <span> 
                                       <b> Step: </b> 
                                       <br/>  
                                       <span style="padding-left: 125px;">
                                          <b> text: </b> 
                                          <span> citalopram 20 mg tablet 1 tablet oral 1 time daily now (30 table; 3 refills)</span> 
                                          <br/>  
                                       </span> 
                                       <span style="padding-left: 125px;">
                                          <b> condition: </b> 
                                          <br/>  
                                          <span style="padding-left: 150px;">
                                             <b> reference: </b> 
                                             <br/>  
                                             <span style="padding-left: 175px;">#citalopramPrescription</span> 
                                             <span/>  
                                             <span> 
                                                <span style="padding-left: 125px;">
                                                   <br/>  
                                                   <span style="padding-left: 150px;">
                                                      <b> category: </b> 
                                                      <span> drug</span> 
                                                      <br/>  
                                                   </span> 
                                                </span> 
                                             </span> 
                                             <span/>  
                                             <span/>  
                                          </span> 
                                       </span> 
                                       <span style="padding-left: 100px;"/> 
                                    </span> 
                                    <span> 
                                       <b> Step: </b> 
                                       <br/>  
                                       <span style="padding-left: 125px;">
                                          <b> text: </b> 
                                          <span> escitalopram 10 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)</span> 
                                          <br/>  
                                       </span> 
                                       <span style="padding-left: 100px;"/> 
                                    </span> 
                                    <span> 
                                       <b> Step: </b> 
                                       <br/>  
                                       <span style="padding-left: 125px;">
                                          <b> text: </b> 
                                          <span> fluoxetine 20 mg capsule 1 capsule oral 1 time daily now (30 tablet; 3 refills)</span> 
                                          <br/>  
                                       </span> 
                                       <span style="padding-left: 100px;"/> 
                                    </span> 
                                    <span> 
                                       <b> Step: </b> 
                                       <br/>  
                                       <span style="padding-left: 125px;">
                                          <b> text: </b> 
                                          <span> paroxetine 20 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)</span> 
                                          <br/>  
                                       </span> 
                                       <span style="padding-left: 100px;"/> 
                                    </span> 
                                    <span> 
                                       <b> Step: </b> 
                                       <br/>  
                                       <span style="padding-left: 125px;">
                                          <b> text: </b> 
                                          <span> sertraline 50 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)</span> 
                                          <br/>  
                                       </span> 
                                       <span style="padding-left: 100px;"/> 
                                    </span> 
                                 </span> 
                              </span> 
                              <span> 
                                 <b> Step: </b> 
                                 <br/>  
                                 <span style="padding-left: 125px;">
                                    <b> text: </b> 
                                    <span> Dopamine Norepinephrine Reuptake Inhibitors (Choose a maximum of one or document reasons
                           for exception)</span> 
                                    <br/>  
                                 </span> 
                                 <span style="padding-left: 75px;"/> 
                              </span> 
                              <span> 
                                 <b> Step: </b> 
                                 <br/>  
                                 <span style="padding-left: 100px;">
                                    <b> text: </b> 
                                    <span> Serotonin Norepinephrine Reuptake Inhibitors (Choose a maximum of one or doument reasons
                           for exception)</span> 
                                    <br/>  
                                 </span> 
                                 <span style="padding-left: 75px;"/> 
                              </span> 
                              <span> 
                                 <b> Step: </b> 
                                 <br/>  
                                 <span style="padding-left: 100px;">
                                    <b> text: </b> 
                                    <span> Norepinephrine-Serotonin Modulators (Choose a maximum of one or document reasons for exception)</span> 
                                    <br/>  
                                 </span> 
                                 <span style="padding-left: 100px;"/> 
                              </span> 
                           </span> 
                        </span> 
                     </span> 
                  </span> 
               </span> 
            </span> 
         </p> 
      </div> 
  </text> 
  <!--   The referral and medication requests here are only partially specified, additional information
   will be provided from context, see the action definitions in the body of the plan definition
   below   -->
  <contained> 
    <ActivityDefinition> 
      <id value="referralToMentalHealthCare"/> 
      <status value="draft"/> 
      <description value="refer to primary care mental-health integrated care program for evaluation and treatment
       of mental health conditions now"/> 
      <!--   Kind indicates the type of resource that is defined by this activity, a ServiceRequest
       in this case   -->
      <kind value="ServiceRequest"/> 
      <code> 
        <coding> 
          <system value="http://snomed.info/sct"/> 
          <code value="306206005"/> 
        </coding> 
        <text value="Referral to service (procedure)"/> 
      </code> 
      <timingTiming> 
        <event> 
          <!--   The expression here specifies the value for the timing of the resulting resource. In
           this case, referralRequest.fulfillmentTime.start   -->
          <extension url="http://hl7.org/fhir/StructureDefinition/cqf-expression">
            <valueExpression> 
              <language value="text/cql"/> 
          <expression value="Now()"/> 
            </valueExpression> 
          </extension> 
        </event> 
      </timingTiming> 
      <participant> 
        <type value="practitioner"/> 
      </participant> 
    </ActivityDefinition> 
  </contained> 
  <contained> 
    <ActivityDefinition> 
      <id value="citalopramPrescription"/> 
      <status value="draft"/> 
      <kind value="MedicationRequest"/> 
      <productReference> 
        <reference value="#citalopramMedication"/> 
      </productReference> 
      <dosage> 
        <text value="1 tablet oral 1 time daily"/> 
        <timing> 
          <repeat> 
            <frequency value="1"/> 
            <period value="1"/> 
            <periodUnit value="d"/> 
          </repeat> 
        </timing> 
        <route> 
          <coding> 
            <code value="26643006"/> 
            <display value="Oral route (qualifier value)"/> 
          </coding> 
          <text value="Oral route (qualifier value)"/> 
        </route> 
        <doseAndRate> 
          <type> 
            <coding> 
              <system value="http://terminology.hl7.org/CodeSystem/dose-rate-type"/> 
              <code value="ordered"/> 
              <display value="Ordered"/> 
            </coding> 
          </type> 
          <doseQuantity> 
            <value value="1"/> 
            <unit value="{tbl}"/> 
          </doseQuantity> 
        </doseAndRate> 
        
      </dosage> 
      <dynamicValue> 
        <path value="dispenseRequest.numberOfRepeatsAllowed"/> 
        <expression> 
          <language value="text/cql"/> 
          <expression value="3"/> 
      </expression> 
      </dynamicValue> 
      <dynamicValue> 
        <path value="dispenseRequest.quantity"/> 
        <expression> 
          <language value="text/cql"/> 
          <expression value="30 '{tbl}'"/> 
      </expression> 
      </dynamicValue> 
    </ActivityDefinition> 
  </contained> 
  <contained> 
    <Medication> 
      <id value="citalopramMedication"/> 
      <code> 
        <coding> 
          <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/> 
          <code value="200371"/> 
        </coding> 
        <text value="citalopram"/> 
      </code> 
        <doseForm> 
          <coding> 
            <system value="http://snomed.info/sct"/> 
            <code value="385055001"/> 
            <display value="Tablet dose form"/> 
          </coding> 
          <text value="Tablet dose form"/> 
        </doseForm> 
        <ingredient> 
          <itemReference> 
            <reference value="#citalopramSubstance"/> 
          </itemReference> 
          <strengthRatio> 
            <numerator> 
              <value value="20"/> 
              <unit value="mg"/> 
            </numerator> 
            <denominator> 
              <value value="1"/> 
              <unit value="{tbl}"/> 
            </denominator> 
          </strengthRatio> 
        </ingredient> 
    </Medication> 
  </contained> 
  <contained> 
    <Substance> 
      <id value="citalopramSubstance"/> 
      <code> 
        <coding> 
          <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/> 
          <code value="2556"/> 
        </coding> 
        <text value="citalopram"/> 
      </code> 
    </Substance> 
  </contained> 
  <url value="http://motivemi.com/artifacts/PlanDefinition/low-suicide-risk-order-set"/> 
  <identifier> 
    <use value="official"/> 
    <system value="http://motivemi.com/artifacts"/> 
    <value value="mmi:low-suicide-risk-order-set"/> 
  </identifier> 
  <version value="1.0.0"/> 
  <name value="LowSuicideRiskOrderSet"/> 
  <title value="Low Suicide Risk Order Set"/> 
  <status value="active"/> 
  <experimental value="true"/> 
  <date value="2015-08-15"/> 
  <publisher value="Motive Medical Intelligence"/> 
  <contact> 
    <telecom> 
      <system value="phone"/> 
      <value value="415-362-4007"/> 
      <use value="work"/> 
    </telecom> 
    <telecom> 
      <system value="email"/> 
      <value value="info@motivemi.com"/> 
      <use value="work"/> 
    </telecom> 
  </contact> 
  <description value="Orders to be applied to a patient characterized as low suicide risk."/> 
  <useContext> 
    <code> 
      <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/> 
      <code value="age"/> 
    </code> 
    <valueCodeableConcept> 
      <coding> 
        <system value="https://meshb.nlm.nih.gov"/> 
        <code value="D000328"/> 
        <display value="Adult"/> 
      </coding> 
    </valueCodeableConcept> 
  </useContext> 
  <useContext> 
    <code> 
      <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/> 
      <code value="focus"/> 
    </code> 
    <valueCodeableConcept> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="87512008"/> 
        <display value="Mild major depression"/> 
      </coding> 
    </valueCodeableConcept> 
  </useContext> 
  <useContext> 
    <code> 
      <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/> 
      <code value="focus"/> 
    </code> 
    <valueCodeableConcept> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="40379007"/> 
        <display value="Major depression, recurrent, mild"/> 
      </coding> 
    </valueCodeableConcept> 
  </useContext> 
  <useContext> 
    <code> 
      <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/> 
      <code value="focus"/> 
    </code> 
    <valueCodeableConcept> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="394687007"/> 
        <display value="Low suicide risk"/> 
      </coding> 
    </valueCodeableConcept> 
  </useContext> 
  <useContext> 
    <code> 
      <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/> 
      <code value="focus"/> 
    </code> 
    <valueCodeableConcept> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="225337009"/> 
        <display value="Suicide risk assessment"/> 
      </coding> 
    </valueCodeableConcept> 
  </useContext> 
  <useContext> 
    <code> 
      <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/> 
      <code value="user"/> 
    </code> 
    <valueCodeableConcept> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="309343006"/> 
        <display value="Physician"/> 
      </coding> 
    </valueCodeableConcept> 
  </useContext> 
  <useContext> 
    <code> 
      <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/> 
      <code value="venue"/> 
    </code> 
    <valueCodeableConcept> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="440655000"/> 
        <display value="Outpatient environment"/> 
      </coding> 
    </valueCodeableConcept> 
  </useContext> 
  <jurisdiction> 
    <coding> 
      <system value="urn:iso:std:iso:3166"/> 
      <code value="US"/> 
    </coding> 
  </jurisdiction> 
  <purpose value="This order set helps ensure consistent application of appropriate orders for the care
   of low suicide risk patients."/> 
  <usage value="This order set should be applied after assessing a patient for suicide risk, when the
   findings of that assessment indicate the patient has low suicide risk."/> 
  <copyright value="© Copyright 2016 Motive Medical Intelligence. All rights reserved."/> 
  <approvalDate value="2016-03-12"/> 
  <lastReviewDate value="2016-08-15"/> 
  <effectivePeriod> 
    <start value="2016-01-01"/> 
    <end value="2017-12-31"/> 
  </effectivePeriod> 
  <topic> 
    <text value="Suicide risk assessment"/> 
  </topic> 
  <author> 
    <name value="Motive Medical Intelligence"/> 
    <telecom> 
      <system value="phone"/> 
      <value value="415-362-4007"/> 
    <use value="work"/> 
    </telecom> 
    <telecom> 
    <system value="email"/> 
    <value value="info@motivemi.com"/> 
    <use value="work"/> 
    </telecom> 
  </author> 
  <relatedArtifact> 
    <type value="derived-from"/> 
    <display value="Practice Guideline for the Treatment of Patients with Major Depressive Disorder"/> 
    <url value="http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf"/> 
  </relatedArtifact> 
  <relatedArtifact> 
    <type value="composed-of"/> 
    <resource value="ActivityDefinition/referralPrimaryCareMentalHealth"/> 
  </relatedArtifact> 
  <relatedArtifact> 
    <type value="composed-of"/> 
    <resource value="ActivityDefinition/citalopramPrescription"/> 
  </relatedArtifact> 
  <library value="Library/suiciderisk-orderset-logic"/> 
  <!--   Actions   -->
  <action> 
    <title value="Suicide Risk Assessment and Outpatient Management"/> 
    <action> 
      <title value="Consults and Referrals"/> 
      <groupingBehavior value="logical-group"/> 
      <selectionBehavior value="any"/> 
      <action> 
        <textEquivalent value="Refer to outpatient mental health program for evaluation and treatment of mental health
         conditions now"/> 
        <definitionCanonical value="#referralToMentalHealthCare"/> 
        <!--   These expressions will be evaluated with the library referenced above as an include
           -->
        <dynamicValue> 
          <path value="timing.event"/> 
          <expression> 
            <language value="text/cql"/> 
            <expression value="Now()"/> 
      </expression> 
        </dynamicValue> 
        <dynamicValue> 
          <path value="specialty"/> 
          <!--   This expression is code selector syntax in CQL, returning the code from the NPI provider
           taxonomy   -->
          <expression> 
            <language value="text/cql"/> 
            <expression value="Code '261QM0850X' from SuicideRiskLogic.&quot;NUCC Provider Taxonomy&quot; display 'Adult
             Mental Health'"/> 
      </expression> 
        </dynamicValue> 
        <dynamicValue> 
      <!--   The fulfillmentTime element of the resulting ServiceRequest will be set to the result
           of the ServiceRequestFulfillmentTime expression defined in the SuicideRiskLogic library
             -->
          <path value="occurrenceDateTime"/> 
          <expression> 
            <language value="text/cql"/> 
            <expression value="SuicideRiskLogic.ServiceRequestFulfillmentTime"/> 
      </expression> 
        </dynamicValue> 
        <dynamicValue> 
          <path value="subject"/> 
          <expression> 
            <language value="text/cql"/> 
            <expression value="SuicideRiskLogic.Patient"/> 
      </expression> 
        </dynamicValue> 
        <dynamicValue> 
          <path value="requester.agent"/> 
          <expression> 
            <language value="text/cql"/> 
            <expression value="SuicideRiskLogic.Practitioner"/> 
      </expression> 
        </dynamicValue> 
        <dynamicValue> 
          <path value="reasonCode"/> 
          <expression> 
            <language value="text/cql"/> 
            <expression value="SuicideRiskLogic.RiskAssessmentScore"/> 
      </expression> 
        </dynamicValue> 
        <dynamicValue> 
          <path value="reasonReference"/> 
          <expression> 
            <language value="text/cql"/> 
            <expression value="SuicideRiskLogic.RiskAssessment"/> 
        </expression> 
        </dynamicValue> 
      </action> 
    </action> 
    <action> 
      <title value="Medications"/> 
      <groupingBehavior value="logical-group"/> 
      <selectionBehavior value="at-most-one"/> 
      <action> 
        <title value="First-Line Antidepressants"/> 
          <documentation> 
            <type value="citation"/> 
            <document> 
            <extension url="http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence">
        <valueCodeableConcept> 
          <coding> 
            <system value="http://terminology.hl7.org/CodeSystem/evidence-quality"/> 
            <code value="high"/> 
          </coding> 
          <text value="High Quality"/> 
        </valueCodeableConcept> 
            </extension> 
            <contentType value="text/html"/> 
            <url value="http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf"/> 
            <title value="Practice Guideline for the Treatment of Patients with Major Depressive Disorder"/> 
          </document> 
        </documentation> 
        <groupingBehavior value="logical-group"/> 
        <selectionBehavior value="at-most-one"/> 
        <action> 
          <title value="Selective Serotonin Reuptake Inhibitors (Choose a mazimum of one or document reasons for
           exception)"/> 
          <documentation> 
            <type value="citation"/> 
            <document> 
              <contentType value="text/html"/> 
              <url value="http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6daeb45c-451d-b135-bf8f-2d6dff4b6b01"/> 
              <title value="National Library of Medicine. DailyMed website. CITALOPRAM- citalopram hydrobromide tablet,
               film coated."/> 
            </document> 
          </documentation> 
          <groupingBehavior value="logical-group"/> 
          <selectionBehavior value="at-most-one"/> 
          <action> 
            <textEquivalent value="citalopram 20 mg tablet 1 tablet oral 1 time daily now (30 table; 3 refills)"/> 
            <definitionCanonical value="#citalopramPrescription"/> 
            <dynamicValue> 
              <path value="status"/> 
              <expression> 
                <language value="text/cql"/> 
                <expression value="'draft'"/> 
        </expression> 
            </dynamicValue> 
            <dynamicValue> 
              <path value="patient"/> 
              <expression> 
                <language value="text/cql"/> 
                <expression value="SuicideRiskLogic.Patient"/> 
              </expression> 
            </dynamicValue> 
            <dynamicValue> 
              <path value="prescriber"/> 
              <expression> 
                <language value="text/cql"/> 
                <expression value="SuicideRiskLogic.Practitioner"/> 
        </expression> 
            </dynamicValue> 
            <dynamicValue> 
              <path value="reasonCode"/> 
              <expression> 
                <language value="text/cql"/> 
                <expression value="SuicideRiskLogic.RiskAssessmentScore"/> 
        </expression> 
            </dynamicValue> 
            <dynamicValue> 
              <path value="reasonReference"/> 
              <expression> 
                <language value="text/cql"/> 
                <expression value="SuicideRiskLogic.RiskAssessment"/> 
              </expression> 
            </dynamicValue> 
          </action> 
          <action> 
            <textEquivalent value="escitalopram 10 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)"/> 
            <!--   Follows pattern established above   -->
          </action> 
          <action> 
            <textEquivalent value="fluoxetine 20 mg capsule 1 capsule oral 1 time daily now (30 tablet; 3 refills)"/> 
            <!--   Follows pattern established above   -->
          </action> 
          <action> 
            <textEquivalent value="paroxetine 20 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)"/> 
            <!--   Follows pattern established above   -->
          </action> 
          <action> 
            <textEquivalent value="sertraline 50 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)"/> 
            <!--   Follows pattern established above   -->
          </action> 
        </action> 
        <action> 
          <textEquivalent value="Dopamine Norepinephrine Reuptake Inhibitors (Choose a maximum of one or document reasons
           for exception)"/> 
          <!--   Follows pattern established above   -->
        </action> 
        <action> 
          <textEquivalent value="Serotonin Norepinephrine Reuptake Inhibitors (Choose a maximum of one or doument reasons
           for exception)"/> 
          <!--   Follows pattern established above   -->
        </action> 
        <action> 
          <textEquivalent value="Norepinephrine-Serotonin Modulators (Choose a maximum of one or document reasons for exception)"/> 
          <!--   Follows pattern established above   -->
        </action> 
      </action> 
    </action> 
  </action> 
</PlanDefinition> 

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.