{
  "resourceType": "PlanDefinition",
  "id": "KDN5",
  "text": {
    "status": "additional",
    "div": "\u003cdiv xmlns\u003d\"http://www.w3.org/1999/xhtml\"\u003e\n      \u003ctable style\u003d\"width: 100%;\"\u003e\n           \u003ctr\u003e\n          \u003ctd\u003e\n            \u003cdiv style\u003d\"width: 200px; height: 100px; vertical-align: top;\"\u003eNational Comprehensive Cancer Network\u003c/div\u003e\n          \u003c/td\u003e\n          \u003ctd\u003e\n            \u003ch3\u003eChemotherapy Order Template\u003c/h3\u003e\n            \u003ch1\u003eKidney Cancer\u003c/h1\u003e\n            \u003ch2\u003eGemcitabine/CARBOplatin\u003c/h2\u003e\n          \u003c/td\u003e\n          \u003ctd style\u003d\"text-align: right; vertical-align: top;\"\u003eKDN5\u003c/td\u003e\n           \u003c/tr\u003e\n      \u003c/table\u003e\n      \u003ctable style\u003d\"width: 100%; border-top: 1px solid; border-bottom: 1px solid;\"\u003e\n           \u003ctr\u003e\n          \u003ctd style\u003d\"width: 33%; border-right: 1px solid; vertical-align: top\"\u003e\n            \u003ch4\u003eINDICATION:\u003c/h4\u003e\n            \u003cp\u003eMetastatic or Relapsed – Collecting Duct/Medullary Subtypes\u003c/p\u003e\n          \u003c/td\u003e\n          \u003ctd style\u003d\"width: 34%; border-right: 1px solid; vertical-align: top\"\u003e\n            \u003ch4\u003eREFERENCES:\u003c/h4\u003e\n            \u003col\u003e\n              \u003cli\u003e\n                \u003ca href\u003d\"http://www.example.org/professionals/physician_gls/PDF/kidney.pdf\"\u003eNCCN Guidelines® for Kidney Cancer. V.3.2015.\u003c/a\u003e\n              \u003c/li\u003e\n              \u003cli\u003e\n                \u003ca href\u003d\"http://www.ncbi.nlm.nih.gov/pubmed?term\u003d%22The+Journal+of+urology%22%5BJour%5D+AND+1698%5Bpage%5D+AND+2007%5Bpdat%5D+AND+Oudard+S%5Bauthor%5D\"\u003eOudard S, et al. \n                  \u003cem\u003eJ Urol\u003c/em\u003e. 2007;177(5):1698-702.\n                \u003c/a\u003e\n                \u003csup\u003e\n                  \u003ca href\u003d\"http://www.example.org/OrderTemplates/PDF/appendix_E.pdf\"\u003ea\u003c/a\u003e\n                \u003c/sup\u003e\n              \u003c/li\u003e\n            \u003c/ol\u003e\n          \u003c/td\u003e\n          \u003ctd style\u003d\"width: 33%; vertical-align: top\"\u003e\n            \u003ch4\u003eNCCN SUPPORTIVE CARE:\u003c/h4\u003e\n            \u003col\u003e\n              \u003cli\u003e\n                \u003ci\u003eEmetic Risk:\u003c/i\u003e\n                \u003ctable\u003e\n                  \u003ctr\u003e\n                    \u003ctd\u003eDay 1\u003c/td\u003e\n                    \u003ctd\u003eModerate\u003c/td\u003e\n                  \u003c/tr\u003e\n                  \u003ctr\u003e\n                    \u003ctd\u003eDay 8\u003c/td\u003e\n                    \u003ctd\u003eLow\u003c/td\u003e\n                  \u003c/tr\u003e\n                \u003c/table\u003e\n              \u003c/li\u003e\n              \u003cli\u003e\n                \u003ci\u003eFever Neutropenia Risk:\u003c/i\u003e\n                \u003cbr/\u003e\n                Refer to \n                \u003ca href\u003d\"http://www.example.org/professionals/physician_gls/PDF/myeloid_growth.pdf\"\u003eNCCN Guidelines for Myeloid Growth Factors. V.2.2014\u003c/a\u003e\n              \u003c/li\u003e\n            \u003c/ol\u003e\n          \u003c/td\u003e\n           \u003c/tr\u003e\n      \u003c/table\u003e\n      \u003ch4\u003eCHEMOTHERAPY REGIMEN\u003c/h4\u003e\n      \u003cp\u003e\n           \u003ci\u003e21-day cycle for 6 cycles\u003c/i\u003e\n      \u003c/p\u003e\n      \u003cul\u003e\n           \u003cli\u003eGemcitabine 1250 mg/m\n          \u003csup\u003e2\u003c/sup\u003e IV over 30 minutes on Days 1 and 8\n          \u003c/li\u003e\n           \u003cli\u003eCARBOplatin AUC 5 IV over 30 minutes on Day 1\u003c/li\u003e\n      \u003c/ul\u003e\n    \u003c/div\u003e"
  },
  "contained": [
    {
      "resourceType": "ActivityDefinition",
      "id": "1111",
      "status": "draft",
      "productCodeableConcept": {
        "coding": [
          {
            "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
            "code": "12574",
            "display": "gemcitabine"
          }
        ],
        "text": "gemcitabine"
      },
      "dosage": [
        {
          "text": "1250 mg/m² IV over 30 minutes",
          "timing": {
            "repeat": {
              "duration": 30,
              "durationUnit": "min"
            }
          },
          "route": {
            "text": "IV"
          },
          "doseAndRate": [
            {
              "type": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
                    "code": "ordered",
                    "display": "Ordered"
                  }
                ]
              },
              "doseQuantity": {
                "value": 1250,
                "unit": "mg/m²"
              }
            }
          ]
        }
      ]
    },
    {
      "resourceType": "ActivityDefinition",
      "id": "2222",
      "status": "draft",
      "productCodeableConcept": {
        "coding": [
          {
            "system": "http://www.nlm.nih.gov/research/umls/rxnorm",
            "code": "40048",
            "display": "Carboplatin"
          }
        ],
        "text": "CARBOplatin"
      },
      "dosage": [
        {
          "text": "AUC 5 IV over 30 minutes",
          "timing": {
            "repeat": {
              "duration": 30,
              "durationUnit": "min"
            }
          },
          "route": {
            "text": "IV"
          },
          "doseAndRate": [
            {
              "type": {
                "coding": [
                  {
                    "system": "http://terminology.hl7.org/CodeSystem/dose-rate-type",
                    "code": "ordered",
                    "display": "Ordered"
                  }
                ]
              },
              "doseQuantity": {
                "extension": [
                  {
                    "url": "http://example.org/fhir/AUC-dose",
                    "valueInteger": 5
                  }
                ]
              }
            }
          ]
        }
      ]
    }
  ],
  "extension": [
    {
      "url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode": "cds"
    }
  ],
  "identifier": [
    {
      "system": "http://example.org/ordertemplates",
      "value": "KDN5"
    },
    {
      "system": "urn:ietf:rfc:3986",
      "value": "urn:oid:2.16.840.1.113883.4.642.11.21"
    }
  ],
  "version": "1",
  "name": "GemcitabineCARBOplatin",
  "title": "Gemcitabine/CARBOplatin",
  "type": {
    "text": "Chemotherapy Order Template"
  },
  "status": "draft",
  "experimental": true,
  "publisher": "HL7 International / Clinical Decision Support",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "http://www.hl7.org/Special/committees/dss"
        }
      ]
    }
  ],
  "description": "Gemcitabine/CARBOplatin",
  "useContext": [
    {
      "code": {
        "system": "http://example.org/fhir/CodeSystem/indications",
        "code": "treamentSetting-or-diseaseStatus"
      },
      "valueCodeableConcept": {
        "text": "Metastatic"
      }
    },
    {
      "code": {
        "system": "http://example.org/fhir/CodeSystem/indications",
        "code": "disease-or-histology"
      },
      "valueCodeableConcept": {
        "text": "Collecting Duct/Medullary Subtypes"
      }
    },
    {
      "code": {
        "system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code": "focus"
      },
      "valueCodeableConcept": {
        "text": "Kidney Cancer"
      }
    },
    {
      "code": {
        "system": "http://example.org/fhir/CodeSystem/indications",
        "code": "treatmentSetting-or-diseaseStatus"
      },
      "valueCodeableConcept": {
        "text": "Relapsed"
      }
    },
    {
      "code": {
        "system": "http://example.org/fhir/CodeSystem/indications",
        "code": "disease-or-histology"
      },
      "valueCodeableConcept": {
        "text": "Collecting Duct/Medullary Subtypes"
      }
    },
    {
      "code": {
        "system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
        "code": "focus"
      },
      "valueCodeableConcept": {
        "text": "Kidney Cancer – Collecting Duct/Medullary Subtypes - Metastatic"
      }
    }
  ],
  "copyright": "All rights reserved.",
  "approvalDate": "2016-07-27",
  "lastReviewDate": "2016-07-27",
  "author": [
    {
      "name": "Lee Surprenant"
    }
  ],
  "relatedArtifact": [
    {
      "type": "derived-from",
      "display": "NCCN Guidelines for Kidney Cancer. V.2.2016",
      "document": {
        "url": "http://www.example.org/professionals/physician_gls/PDF/kidney.pdf"
      }
    },
    {
      "type": "citation",
      "_type": {
        "extension": [
          {
            "url": "http://example.org/fhir/regimenReferenceType",
            "valueCode": "a"
          }
        ]
      },
      "citation": "Oudard S, et al. J Urol. 2007;177(5):1698-702",
      "document": {
        "url": "http://www.ncbi.nlm.nih.gov/pubmed/17437788"
      }
    }
  ],
  "action": [
    {
      "selectionBehavior": "exactly-one",
      "action": [
        {
          "selectionBehavior": "all",
          "action": [
            {
              "groupingBehavior": "sentence-group",
              "selectionBehavior": "exactly-one",
              "action": [
                {
                  "id": "cycle-definition-1",
                  "textEquivalent": "21-day cycle for 6 cycles",
                  "timingTiming": {
                    "repeat": {
                      "count": 6,
                      "duration": 21,
                      "durationUnit": "d"
                    }
                  },
                  "action": [
                    {
                      "id": "action-1",
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/timing-daysOfCycle",
                          "extension": [
                            {
                              "url": "day",
                              "valueInteger": 1
                            },
                            {
                              "url": "day",
                              "valueInteger": 8
                            }
                          ]
                        }
                      ],
                      "textEquivalent": "Gemcitabine 1250 mg/m² IV over 30 minutes on days 1 and 8",
                      "definitionCanonical": "#1111"
                    },
                    {
                      "id": "action-2",
                      "extension": [
                        {
                          "url": "http://hl7.org/fhir/StructureDefinition/timing-daysOfCycle",
                          "extension": [
                            {
                              "url": "day",
                              "valueInteger": 1
                            }
                          ]
                        }
                      ],
                      "textEquivalent": "CARBOplatin AUC 5 IV over 30 minutes on Day 1",
                      "relatedAction": [
                        {
                          "targetId": "action-1",
                          "relationship": "concurrent-with-start"
                        }
                      ],
                      "definitionCanonical": "#2222"
                    }
                  ]
                }
              ]
            }
          ]
        }
      ]
    }
  ],
  "meta": {
    "tag": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
        "code": "HTEST",
        "display": "test health data"
      }
    ]
  }
}