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Clinical Decision Support Work Group Maturity Level: 2Trial Use Compartments: N/A

The apply operation applies a PlanDefinition to a given context.

The official URL for this operation definition is

 http://hl7.org/fhir/OperationDefinition/PlanDefinition-apply

Formal Definition (as a OperationDefinition).

URL: [base]/PlanDefinition/$apply

URL: [base]/PlanDefinition/[id]/$apply

This is not an idempotent operation

In Parameters:
NameCardinalityTypeBindingProfileDocumentation
planDefinition0..1PlanDefinition

The plan definition to be applied. If the operation is invoked at the instance level, this parameter is not allowed; if the operation is invoked at the type level, this parameter is required

patient1..1string
(reference)

The patient that is the target of the plan to be applied

encounter0..1string
(reference)

The encounter in context, if any

practitioner0..1string
(reference)

The practitioner applying the plan definition

organization0..1string
(reference)

The organization applying the plan definition

userType0..1CodeableConcept

The type of user initiating the request, e.g. patient, healthcare provider, or specific type of healthcare provider (physician, nurse, etc.)

userLanguage0..1CodeableConcept

Preferred language of the person using the system

userTaskContext0..1CodeableConcept

The task the system user is performing, e.g. laboratory results review, medication list review, etc. This information can be used to tailor decision support outputs, such as recommended information resources

setting0..1CodeableConcept

The current setting of the request (inpatient, outpatient, etc.)

settingContext0..1CodeableConcept

Additional detail about the setting of the request, if any

Out Parameters:
NameCardinalityTypeBindingProfileDocumentation
return1..1CarePlan

The CarePlan that is the result of applying the plan definition

Note: as this is the only out parameter, it is a resource, and it has the name 'return', the result of this operation is returned directly as a resource

The result of this operation is a CarePlan resource with a single activity represented by a RequestGroup. The RequestGroup will have actions for each of the applicable actions in the plan based on evaluating the applicability condition in context. For each applicable action, the definition is applied as described in the $apply operation of the ActivityDefinition resource, and the resulting resource is added as an activity to the CarePlan. If the ActivityDefinition includes library references, those libraries will be available to the evaluated expressions. If those libraries have parameters, those parameters will be bound by name to the parameters given to the operation. For a more detailed description, refer to the PlanDefinition and ActivityDefinition resource documentation

Request: Apply the low suicide risk order set to patient 124

GET [base]/PlanDefinition/example/$apply?patient=124

Response: Returned on successful application of the order set

HTTP/1.1 200 OK

<?xml version="1.0" encoding="UTF-8"?>
<CarePlan xmlns="http://hl7.org/fhir">
  <!-- This example demonstrates the result of an $apply operation for the citalopramPrescription activity definition. -->
  <id value="apply-operation-response"/>
  <text>
	<status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
    Generated...
    </div>
  </text>
  <contained>
	<ServiceRequest>
	  <id value="referralrequest"/>
	  <status value="draft"/>
      <intent value="proposal"/>
      <code>
		<coding>
		  <system value="http://snomed.info/sct"/>
		  <code value="306206005"/>
		</coding>
		<text value="Referral to service (procedure)"/>
      </code>
      <subject>
        <reference value="Patient/124"/>
      </subject>
      <occurrenceDateTime value="2017-02-26T11:47:00.000Z"/>
      <requester>
		<reference value="Practitioner/123"/>
	  </requester>
      <performerType>
		  <coding>
			  <system value="http://nucc.org/provider-taxonomy"/>
			  <code value="261QM0850X"/>
			  <display value="Adult Mental Health"/>
		  </coding>
      </performerType>
	  <reasonCode>
		  <coding>
			  <system value="http://example.org/CodeSystem/suicide-risk-assessment-score"/>
			  <code value="Low"/>
			  <display value="Low Suicide Risk"/>
		  </coding>
		  <text value="Low Suicide Risk"/>
	  </reasonCode>
	  <reasonReference>
		  <reference value="RiskAssessment/suicide-risk-assessment"/>
	  </reasonReference>
	</ServiceRequest>
  </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>
        <form>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="385055001"/>
            <display value="Tablet dose form"/>
          </coding>
          <text value="Tablet dose form"/>
        </form>
        <ingredient>
          <itemReference>
            <reference value="#citalopramSubstance"/>
          </itemReference>
          <amount>
            <numerator>
              <value value="20"/>
              <unit value="mg"/>
            </numerator>
            <denominator>
              <value value="1"/>
              <unit value="{tbl}"/>
            </denominator>
          </amount>
        </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>
  <contained>
	<MedicationRequest>
	  <id value="citalopramPrescription"/>
	  <status value="draft"/>
	  <intent value="proposal"/>
	  <medicationReference>
		  <reference value="#citalopramMedication"/>
	  </medicationReference>
	  <subject>
		  <reference value="Patient/124"/>
	  </subject>
	  <requester>
		<reference value="Practitioner/123"/>
	  </requester>
	  <reasonCode>
		  <coding>
			  <system value="http://example.org/CodeSystem/suicide-risk-assessment-score"/>
			  <code value="Low"/>
			  <display value="Low Suicide Risk"/>
		  </coding>
		  <text value="Low Suicide Risk"/>
	  </reasonCode>
	  <reasonReference>
		  <reference value="RiskAssessment/suicide-risk-assessment"/>
	  </reasonReference>
	  <!--definition>
		<reference value="ActivityDefinition/citalopramPrescription"/>
	  </definition-->
	  <instantiates value="ActivityDefinition/citalopramPrescription"/>
	  <dosageInstruction>
		<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><text value="ordered"/></type>
			<doseQuantity>
				<value value="1"/>
				<unit value="{tbl}"/>
			</doseQuantity>
		</doseAndRate>
	  </dosageInstruction>
	  <dispenseRequest>
		  <numberOfRepeatsAllowed value="3"/>
		  <quantity>
			  <value value="30"/>
			  <unit value="{tbl}"/>
		  </quantity>
	  </dispenseRequest>
	</MedicationRequest>
  </contained>
  <instantiatesCanonical value="PlanDefinition/example"/>
  <status value="draft"/>
  <intent value="proposal"/>
  <subject>
	  <reference value="Patient/124"/>
  </subject>
  <activity>
	<reference>
		<reference value="#referralrequest"/>
	</reference>
  </activity>
  <activity>
    <reference>
      <reference value="#citalopramPrescription"/>
    </reference>
  </activity>
</CarePlan>

 

For more information about operations, including how they are invoked, see Operations.