<?xml version="1.0" encoding="UTF-8"?><ActivityDefinition xmlns="http://hl7.org/fhir">
  <id value="citalopramPrescription"/>
  <meta>
    <security>
      <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
      <code value="HTEST"/>
      <display value="test health data"/>
    </security>
  </meta>
  <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 (basic dose form)"/>
        </coding>
        <text value="Tablet dose form"/>
      </doseForm>
      <ingredient>
        <item>
          <reference>
            <reference value="#citalopramSubstance"/>
          </reference>
        </item>
        <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>
        <concept>
          <coding>
            <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
            <code value="2556"/>
          </coding>
          <text value="citalopram"/>
        </concept>
      </code>
    </Substance>
  </contained>
  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="cds"/>
  </extension>
  <url value="http://motivemi.com/artifacts/ActivityDefinition/citalopramPrescription"/>
  <identifier>
    <system value="urn:ietf:rfc:3986"/>
    <value value="urn:oid:2.16.840.1.113883.4.642.19.6"/>
  </identifier>
  <identifier>
    <use value="official"/>
    <system value="http://motivemi.com"/>
    <value value="citalopramPrescription"/>
  </identifier>
  <version value="1.0.0"/>
  <name value="CitalopramPrescription"/>
  <title value="Citalopram Prescription"/>
  <status value="active"/>
  <experimental value="true"/>
  <date value="2015-08-15"/>
  <publisher value="HL7 International / Clinical Decision Support"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/dss"/>
    </telecom>
  </contact>
  <description value="Citalopram 20 mg tablet 1 tablet oral 1 time daily now (30 table; 3 refills"/>
  <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="Mild recurrent 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="225444004"/>
        <display value="At increased risk for suicide (finding)"/>
      </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="306206005"/>
        <display value="Referral to service (procedure)"/>
      </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="Defines a guideline supported prescription for the treatment of depressive disorders"/>
  <usage value="This activity definition is used as part of various suicide risk order sets"/>
  <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="Mental Health Treatment"/>
  </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="citation"/>
    <display value="Practice Guideline for the Treatment of Patients with Major Depressive Disorder"/>
    <document>
      <url value="http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf"/>
    </document>
  </relatedArtifact>
  <relatedArtifact>
    <type value="composed-of"/>
    <resource value="#citalopramMedication"/>
  </relatedArtifact>
  <kind value="MedicationRequest"/>
  <productReference>
    <reference value="#citalopramMedication"/>
  </productReference>
  <dosageInstruction>
    <renderedInstruction value="1 tablet oral 1 time daily"/>
    <step>
      <component>
        <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>
      </component>
    </step>
  </dosageInstruction>
  <dynamicValue>
    <path value="dispenseRequest.numberOfRepeatsAllowed"/>
    <expression>
      <description value="dispenseRequest.numberOfRepeatsAllowed is three (3)"/>
      <language value="text/cql-expression"/>
      <expression value="3"/>
    </expression>
  </dynamicValue>
  <dynamicValue>
    <path value="dispenseRequest.quantity"/>
    <expression>
      <description value="dispenseRequest.quantity is thirty (30) tablets"/>
      <language value="text/cql-expression"/>
      <expression value="30 '{tbl}'"/>
    </expression>
  </dynamicValue>
</ActivityDefinition>