FHIR CI-Build
WorkflowThis is the Continuous Integration Build of FHIR (will be incorrect/inconsistent at times).
See the Directory of published versions
| Clinical Decision Support Work Group | Maturity Level: N/A | Standards Status: Informative | Compartments: No defined compartments |
Raw XML (canonical form + also see XML Format Specification)
Opioid CDS Recommendation 10 ECA Rule (id = "opioidcds-10")
<?xml version="1.0" encoding="UTF-8"?> <PlanDefinition xmlns="http://hl7.org/fhir"> <id value="opioidcds-10"/> <text> <status value="extensions"/> <div xmlns="http://www.w3.org/1999/xhtml"><p> <b> Generated Narrative: PlanDefinition</b> <a name="opioidcds-10"> </a> <a name="hcopioidcds-10"> </a> </p> <div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource PlanDefinition "opioidcds-10" </p> </div> <p> <b> StructureDefinition Work Group</b> : cds</p> <p> <b> identifier</b> : <a href="http://terminology.hl7.org/5.5.0/NamingSystem-uri.html" title="As defined by RFC 3986 (http://www.ietf.org/rfc/rfc3986.txt)(with many schemes defined in many RFCs). For OIDs and UUIDs, use the URN form (urn:oid:(note: lowercase) and urn:uuid:). See http://www.ietf.org/rfc/rfc3001.txt and http://www.ietf.org/rfc/rfc4122.t xt This oid is used as an identifier II.root to indicate the the extension is an absolute URI (technically, an IRI). Typically, this is used for OIDs and GUIDs. Note that when this OID is used with OIDs and GUIDs, the II.extension should start with urn:oid or urn:uuid: Note that this OID is created to aid with interconversion between CDA and FHIR - FHIR uses urn:ietf:rfc:3986 as equivalent to this OID. URIs as identifiers appear more commonly in FHIR. This OID may also be used in CD.codeSystem.">URI</a> /urn:oid:2.16.840.1.113883.4.642.11.3, cdc-opioid-guidance (use: OFFICIAL)</p> <p> <b> version</b> : 0.1.0</p> <p> <b> name</b> : Cdcopioid10</p> <p> <b> title</b> : CDC Opioid Prescribing Guideline Recommendation #10</p> <p> <b> type</b> : ECA Rule <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-plan-definition-type.html">PlanDefinitionType</a> #eca-rule)</span> </p> <p> <b> status</b> : draft</p> <p> <b> date</b> : 2017-04-23</p> <p> <b> publisher</b> : HL7 International / Clinical Decision Support</p> <p> <b> contact</b> : </p> <p> <b> description</b> : When prescribing opioids for chronic pain, providers should use urine drug testing before starting opioid therapy and consider urine drug testing at least annually to assess for prescribed medications as well as other controlled prescription drugs and illicit drugs.</p> <h3> UseContexts</h3> <table class="grid"><tr> <td style="display: none">-</td> <td> <b> Code</b> </td> <td> <b> Value[x]</b> </td> </tr> <tr> <td style="display: none">*</td> <td> Clinical Focus (Details: http://terminology.hl7.org/CodeSystem/usage-context-type code focus = 'Clinical Focus', stated as 'Clinical Focus')</td> <td> Medication requested (situation) <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a> #182888003)</span> </td> </tr> <tr> <td style="display: none">*</td> <td> Clinical Focus (Details: http://terminology.hl7.org/CodeSystem/usage-context-type code focus = 'Clinical Focus', stated as 'Clinical Focus')</td> <td> Chronic pain (finding) <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a> #82423001)</span> </td> </tr> </table> <p> <b> jurisdiction</b> : United States of America <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-ISO3166Part1.html">ISO 3166-1 Codes for the representation of names of countries and their subdivisions — Part 1: Country code</a> #US)</span> </p> <p> <b> purpose</b> : CDC’s Guideline for Prescribing Opioids for Chronic Pain is intended to improve communication between providers and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder and overdose. The Guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care.</p> <p> <b> usage</b> : Providers should be aware if patients are taking other prescription drugs or illicit drugs that might increase their risk of an overdose.</p> <p> <b> copyright</b> : © CDC 2016+.</p> <p> <b> topic</b> : Opioid Prescribing <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span> </p> <p> <b> author</b> : Kensaku Kawamoto, MD, PhD, MHS: , Bryn Rhodes: , Floyd Eisenberg, MD, MPH: , Robert McClure, MD, MPH: </p> <blockquote> <p> <b> relatedArtifact</b> </p> <p> <b> type</b> : documentation</p> <p> <b> display</b> : CDC guideline for prescribing opioids for chronic pain</p> <blockquote> <p> <b> document</b> </p> </blockquote> </blockquote> <p> <b> library</b> : <a href="http://example.org/fhir/Library/opioidcds-recommendation-10">http://example.org/fhir/Library/opioidcds-recommendation-10</a> </p> <blockquote> <p> <b> action</b> </p> <p> <b> Strength of recommendation</b> : Strong <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-recommendation-strength.html">StrengthOfRecommendationRating</a> #strong)</span> </p> <p> <b> Quality of evidence</b> : Low quality <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-evidence-quality.html">QualityOfEvidenceRating</a> #low)</span> </p> <p> <b> title</b> : Annual Urine Screening Check</p> <p> <b> description</b> : Patient has not had a urine screening in the past 12 months</p> <h3> Documentations</h3> <table class="grid"><tr> <td style="display: none">-</td> <td> <b> Type</b> </td> </tr> <tr> <td style="display: none">*</td> <td> documentation</td> </tr> </table> <h3> Triggers</h3> <table class="grid"><tr> <td style="display: none">-</td> <td> <b> Type</b> </td> <td> <b> Name</b> </td> </tr> <tr> <td style="display: none">*</td> <td> named-event</td> <td> medication-prescribe</td> </tr> </table> <blockquote> <p> <b> condition</b> </p> <p> <b> kind</b> : applicability</p> <h3> Expressions</h3> <table class="grid"><tr> <td style="display: none">-</td> <td> <b> Description</b> </td> <td> <b> Language</b> </td> <td> <b> Expression</b> </td> </tr> <tr> <td style="display: none">*</td> <td> Patient has not had a urine screening in the past 12 months</td> <td> text/cql</td> <td> No Screenings in Past Year</td> </tr> </table> </blockquote> <blockquote> <p> <b> dynamicValue</b> </p> <p> <b> path</b> : activity.extension</p> <h3> Expressions</h3> <table class="grid"><tr> <td style="display: none">-</td> <td> <b> Language</b> </td> <td> <b> Expression</b> </td> </tr> <tr> <td style="display: none">*</td> <td> text/cql</td> <td> Get Indicator</td> </tr> </table> </blockquote> <h3> Actions</h3> <table class="grid"><tr> <td style="display: none">-</td> <td> <b> Description</b> </td> </tr> <tr> <td style="display: none">*</td> <td> Will perform urine screening</td> </tr> <tr> <td style="display: none">*</td> <td> Not for chronic pain management. Snooze 3 months</td> </tr> </table> </blockquote> <blockquote> <p> <b> action</b> </p> <p> <b> Strength of recommendation</b> : Strong <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-recommendation-strength.html">StrengthOfRecommendationRating</a> #strong)</span> </p> <p> <b> Quality of evidence</b> : Low quality <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-evidence-quality.html">QualityOfEvidenceRating</a> #low)</span> </p> <p> <b> title</b> : Positive Urine Screening Check</p> <p> <b> description</b> : Patient has a urine screening testing positive for either unprescribed opioids or illicit drugs in the past 12 months</p> <h3> Documentations</h3> <table class="grid"><tr> <td style="display: none">-</td> <td> <b> Type</b> </td> </tr> <tr> <td style="display: none">*</td> <td> documentation</td> </tr> </table> <blockquote> <p> <b> condition</b> </p> <p> <b> kind</b> : applicability</p> <h3> Expressions</h3> <table class="grid"><tr> <td style="display: none">-</td> <td> <b> Description</b> </td> <td> <b> Language</b> </td> <td> <b> Expression</b> </td> </tr> <tr> <td style="display: none">*</td> <td> Patient has a positive urine screening in the past 12 months</td> <td> text/cql</td> <td> Has Positive Screening?</td> </tr> </table> </blockquote> <blockquote> <p> <b> action</b> </p> <p> <b> Strength of recommendation</b> : Strong <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-recommendation-strength.html">StrengthOfRecommendationRating</a> #strong)</span> </p> <p> <b> Quality of evidence</b> : Low quality <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-evidence-quality.html">QualityOfEvidenceRating</a> #low)</span> </p> <p> <b> title</b> : Unprescribed Opioids Found In Urine Screening</p> <p> <b> description</b> : Patient has a positive urine screening in the past 12 months for opioid(s), which is not prescribed</p> <blockquote> <p> <b> documentation</b> </p> </blockquote> <blockquote> <p> <b> condition</b> </p> </blockquote> <blockquote> <p> <b> dynamicValue</b> </p> </blockquote> <blockquote> <p> <b> dynamicValue</b> </p> </blockquote> <blockquote> <p> <b> action</b> </p> </blockquote> </blockquote> <blockquote> <p> <b> action</b> </p> <p> <b> Strength of recommendation</b> : Strong <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-recommendation-strength.html">StrengthOfRecommendationRating</a> #strong)</span> </p> <p> <b> Quality of evidence</b> : Low quality <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-evidence-quality.html">QualityOfEvidenceRating</a> #low)</span> </p> <p> <b> title</b> : Prescribed Opioids Not Found In Urine Screening</p> <p> <b> description</b> : Patient has a positive urine screening in the past 12 months, which does not include prescribed opioids</p> <blockquote> <p> <b> documentation</b> </p> </blockquote> <blockquote> <p> <b> condition</b> </p> </blockquote> <blockquote> <p> <b> dynamicValue</b> </p> </blockquote> <blockquote> <p> <b> dynamicValue</b> </p> </blockquote> </blockquote> <blockquote> <p> <b> action</b> </p> <p> <b> Strength of recommendation</b> : Strong <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-recommendation-strength.html">StrengthOfRecommendationRating</a> #strong)</span> </p> <p> <b> Quality of evidence</b> : Low quality <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-evidence-quality.html">QualityOfEvidenceRating</a> #low)</span> </p> <p> <b> title</b> : Illicit Drugs Found In Urine Screening</p> <p> <b> description</b> : Patient has a positive urine screening in the past 12 months for illicit drugs</p> <blockquote> <p> <b> documentation</b> </p> </blockquote> <blockquote> <p> <b> condition</b> </p> </blockquote> <blockquote> <p> <b> dynamicValue</b> </p> </blockquote> <blockquote> <p> <b> dynamicValue</b> </p> </blockquote> <blockquote> <p> <b> action</b> </p> </blockquote> </blockquote> </blockquote> </div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"><valueCode value="cds"/> </extension> <identifier> <system value="urn:ietf:rfc:3986"/> <value value="urn:oid:2.16.840.1.113883.4.642.11.3"/> </identifier> <identifier> <use value="official"/> <value value="cdc-opioid-guidance"/> </identifier> <version value="0.1.0"/> <name value="Cdcopioid10"/> <title value="CDC Opioid Prescribing Guideline Recommendation #10"/> <type> <coding> <system value="http://terminology.hl7.org/CodeSystem/plan-definition-type"/> <code value="eca-rule"/> <display value="ECA Rule"/> </coding> </type> <status value="draft"/> <date value="2017-04-23"/> <publisher value="HL7 International / Clinical Decision Support"/> <contact> <telecom> <system value="url"/> </telecom> </contact> <description value="When prescribing opioids for chronic pain, providers should use urine drug testing before starting opioid therapy and consider urine drug testing at least annually to assess for prescribed medications as well as other controlled prescription drugs and illicit drugs."/> <useContext> <code> <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/> <code value="focus"/> <display value="Clinical Focus"/> </code> <valueCodeableConcept> <coding> <system value="http://snomed.info/sct"/> <code value="182888003"/> <display value="Medication requested (situation)"/> </coding> </valueCodeableConcept> </useContext> <useContext> <code> <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/> <code value="focus"/> <display value="Clinical Focus"/> </code> <valueCodeableConcept> <coding> <system value="http://snomed.info/sct"/> <code value="82423001"/> <display value="Chronic pain (finding)"/> </coding> </valueCodeableConcept> </useContext> <jurisdiction> <coding> <system value="urn:iso:std:iso:3166"/> <code value="US"/> <display value="United States of America"/> </coding> </jurisdiction> <purpose value="CDC’s Guideline for Prescribing Opioids for Chronic Pain is intended to improve communication between providers and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder and overdose. The Guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care."/> <usage value="Providers should be aware if patients are taking other prescription drugs or illicit drugs that might increase their risk of an overdose."/> <copyright value="© CDC 2016+."/> <topic> <text value="Opioid Prescribing"/> </topic> <author> <name value="Kensaku Kawamoto, MD, PhD, MHS"/> </author> <author> <name value="Bryn Rhodes"/> </author> <author> <name value="Floyd Eisenberg, MD, MPH"/> </author> <author> <name value="Robert McClure, MD, MPH"/> </author> <relatedArtifact> <type value="documentation"/> <display value="CDC guideline for prescribing opioids for chronic pain"/> <document> <url value="https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chro nic-pain---united-states-2016#420"/> </document> </relatedArtifact> <library value="http://example.org/fhir/Library/opioidcds-recommendation-10"/> <action> <extension url="http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation"> <valueCodeableConcept> <coding> <system value="http://terminology.hl7.org/CodeSystem/recommendation-strength"/> <code value="strong"/> <display value="Strong"/> </coding> </valueCodeableConcept> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence"> <valueCodeableConcept> <coding> <system value="http://terminology.hl7.org/CodeSystem/evidence-quality"/> <code value="low"/> <display value="Low quality"/> </coding> </valueCodeableConcept> </extension> <title value="Annual Urine Screening Check"/> <description value="Patient has not had a urine screening in the past 12 months"/> <documentation> <type value="documentation"/> </documentation> <trigger> <type value="named-event"/> <name value="medication-prescribe"/> </trigger> <condition> <kind value="applicability"/> <expression> <description value="Patient has not had a urine screening in the past 12 months"/> <language value="text/cql"/> <expression value="No Screenings in Past Year"/> </expression> </condition> <dynamicValue> <path value="activity.extension"/> <expression> <language value="text/cql"/> <expression value="Get Indicator"/> </expression> </dynamicValue> <action> <description value="Will perform urine screening"/> </action> <action> <description value="Not for chronic pain management. Snooze 3 months"/> </action> </action> <action> <extension url="http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation"> <valueCodeableConcept> <coding> <system value="http://terminology.hl7.org/CodeSystem/recommendation-strength"/> <code value="strong"/> <display value="Strong"/> </coding> </valueCodeableConcept> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence"> <valueCodeableConcept> <coding> <system value="http://terminology.hl7.org/CodeSystem/evidence-quality"/> <code value="low"/> <display value="Low quality"/> </coding> </valueCodeableConcept> </extension> <title value="Positive Urine Screening Check"/> <description value="Patient has a urine screening testing positive for either unprescribed opioids or illicit drugs in the past 12 months"/> <documentation> <type value="documentation"/> </documentation> <condition> <kind value="applicability"/> <expression> <description value="Patient has a positive urine screening in the past 12 months"/> <language value="text/cql"/> <expression value="Has Positive Screening?"/> </expression> </condition> <action> <extension url="http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation"> <valueCodeableConcept> <coding> <system value="http://terminology.hl7.org/CodeSystem/recommendation-strength"/> <code value="strong"/> <display value="Strong"/> </coding> </valueCodeableConcept> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence"> <valueCodeableConcept> <coding> <system value="http://terminology.hl7.org/CodeSystem/evidence-quality"/> <code value="low"/> <display value="Low quality"/> </coding> </valueCodeableConcept> </extension> <title value="Unprescribed Opioids Found In Urine Screening"/> <description value="Patient has a positive urine screening in the past 12 months for opioid(s), which is not prescribed"/> <documentation> <type value="documentation"/> </documentation> <condition> <kind value="applicability"/> <expression> <description value="Patient has a positive urine screening in the past 12 months for opioid(s), which is not prescribed"/> <language value="text/cql"/> <expression value="Has Unprescribed Opioids?"/> </expression> </condition> <dynamicValue> <path value="activity.extension"/> <expression> <language value="text/cql"/> <expression value="Get Indicator"/> </expression> </dynamicValue> <dynamicValue> <path value="action.description"/> <expression> <language value="text/cql"/> <expression value="Inconsistent Unprescribed Opioids"/> </expression> </dynamicValue> <action> <description value="Not for chronic pain management. Snooze 3 months"/> </action> </action> <action> <extension url="http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation"> <valueCodeableConcept> <coding> <system value="http://terminology.hl7.org/CodeSystem/recommendation-strength"/> <code value="strong"/> <display value="Strong"/> </coding> </valueCodeableConcept> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence"> <valueCodeableConcept> <coding> <system value="http://terminology.hl7.org/CodeSystem/evidence-quality"/> <code value="low"/> <display value="Low quality"/> </coding> </valueCodeableConcept> </extension> <title value="Prescribed Opioids Not Found In Urine Screening"/> <description value="Patient has a positive urine screening in the past 12 months, which does not include prescribed opioids"/> <documentation> <type value="documentation"/> </documentation> <condition> <kind value="applicability"/> <expression> <description value="Patient has a positive urine screening in the past 12 months, which does not include prescribed opioids"/> <language value="text/cql"/> <expression value="Has Missing Opioids?"/> </expression> </condition> <dynamicValue> <path value="activity.extension"/> <expression> <language value="text/cql"/> <expression value="Get Indicator"/> </expression> </dynamicValue> <dynamicValue> <path value="action.description"/> <expression> <language value="text/cql"/> <expression value="Inconsistent Missing Opioids"/> </expression> </dynamicValue> </action> <action> <extension url="http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation"> <valueCodeableConcept> <coding> <system value="http://terminology.hl7.org/CodeSystem/recommendation-strength"/> <code value="strong"/> <display value="Strong"/> </coding> </valueCodeableConcept> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence"> <valueCodeableConcept> <coding> <system value="http://terminology.hl7.org/CodeSystem/evidence-quality"/> <code value="low"/> <display value="Low quality"/> </coding> </valueCodeableConcept> </extension> <title value="Illicit Drugs Found In Urine Screening"/> <description value="Patient has a positive urine screening in the past 12 months for illicit drugs"/> <documentation> <type value="documentation"/> </documentation> <condition> <kind value="applicability"/> <expression> <description value="Patient has a positive urine screening in the past 12 months for illicit drugs"/> <language value="text/cql"/> <expression value="Has Illicit Drugs in Screening?"/> </expression> </condition> <dynamicValue> <path value="activity.extension"/> <expression> <language value="text/cql"/> <expression value="Get Indicator"/> </expression> </dynamicValue> <dynamicValue> <path value="action.description"/> <expression> <language value="text/cql"/> <expression value="Inconsistent Illicit Drugs"/> </expression> </dynamicValue> <action> <description value="Not for chronic pain management. Snooze 3 months"/> </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.
FHIR ®© HL7.org 2011+. FHIR R6 hl7.fhir.core#6.0.0-cibuild generated on Thu, Apr 25, 2024 12:46+0000.
Links: Search |
Version History |
Contents |
Glossary |
QA |
Compare to R5 |
|
Propose a change