<?xml version="1.0" encoding="UTF-8"?><PlanDefinition xmlns="http://hl7.org/fhir">
  <id value="low-suicide-risk-order-set"/>
  <meta>
    <security>
      <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
      <code value="HTEST"/>
      <display value="test health data"/>
    </security>
  </meta>
  <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>Mild recurrent 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>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>
  <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"/>
              <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"/>
          <expression value="3"/>
        </expression>
      </dynamicValue>
      <dynamicValue>
        <path value="dispenseRequest.quantity"/>
        <expression>
          <language value="text/cql-expression"/>
          <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 (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/PlanDefinition/low-suicide-risk-order-set"/>
  <identifier>
    <system value="urn:ietf:rfc:3986"/>
    <value value="urn:oid:2.16.840.1.113883.4.642.11.7"/>
  </identifier>
  <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="HL7 International / Clinical Decision Support"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://www.hl7.org/Special/committees/dss"/>
    </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="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="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"/>
    <document>
      <url value="http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf"/>
    </document>
  </relatedArtifact>
  <relatedArtifact>
    <type value="composed-of"/>
    <resource value="http://example.org/fhir/ActivityDefinition/referralPrimaryCareMentalHealth"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="composed-of"/>
    <resource value="http://example.org/fhir/ActivityDefinition/citalopramPrescription"/>
  </relatedArtifact>
  <library value="http://example.org/fhir/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"/>
            <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"/>
            <expression value="Code '261QM0850X' from SuicideRiskLogic.&#34;NUCC Provider Taxonomy&#34; 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"/>
            <expression value="SuicideRiskLogic.ServiceRequestFulfillmentTime"/>
          </expression>
        </dynamicValue>
        <dynamicValue>
          <path value="subject"/>
          <expression>
            <language value="text/cql-expression"/>
            <expression value="SuicideRiskLogic.Patient"/>
          </expression>
        </dynamicValue>
        <dynamicValue>
          <path value="requester.agent"/>
          <expression>
            <language value="text/cql-expression"/>
            <expression value="SuicideRiskLogic.Practitioner"/>
          </expression>
        </dynamicValue>
        <dynamicValue>
          <path value="reasonCode"/>
          <expression>
            <language value="text/cql-expression"/>
            <expression value="SuicideRiskLogic.RiskAssessmentScore"/>
          </expression>
        </dynamicValue>
        <dynamicValue>
          <path value="reasonReference"/>
          <expression>
            <language value="text/cql-expression"/>
            <expression value="SuicideRiskLogic.RiskAssessment"/>
          </expression>
        </dynamicValue>
      </action>
    </action>
    <action>
      <title value="Medications"/>
      <groupingBehavior value="logical-group"/>
      <selectionBehavior value="at-most-one"/>
      <action>
        <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>
        <title value="First-Line Antidepressants"/>
        <documentation>
          <type value="citation"/>
          <document>
            <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"/>
                <expression value="'draft'"/>
              </expression>
            </dynamicValue>
            <dynamicValue>
              <path value="patient"/>
              <expression>
                <language value="text/cql-expression"/>
                <expression value="SuicideRiskLogic.Patient"/>
              </expression>
            </dynamicValue>
            <dynamicValue>
              <path value="prescriber"/>
              <expression>
                <language value="text/cql-expression"/>
                <expression value="SuicideRiskLogic.Practitioner"/>
              </expression>
            </dynamicValue>
            <dynamicValue>
              <path value="reasonCode"/>
              <expression>
                <language value="text/cql-expression"/>
                <expression value="SuicideRiskLogic.RiskAssessmentScore"/>
              </expression>
            </dynamicValue>
            <dynamicValue>
              <path value="reasonReference"/>
              <expression>
                <language value="text/cql-expression"/>
                <expression value="SuicideRiskLogic.RiskAssessment"/>
              </expression>
            </dynamicValue>
          </action>
          <!--  Follows pattern established above  -->
          <action>
            <textEquivalent value="escitalopram 10 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)"/>
          </action>
          <!--  Follows pattern established above  -->
          <action>
            <textEquivalent value="fluoxetine 20 mg capsule 1 capsule oral 1 time daily now (30 tablet; 3 refills)"/>
          </action>
          <!--  Follows pattern established above  -->
          <action>
            <textEquivalent value="paroxetine 20 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)"/>
          </action>
          <!--  Follows pattern established above  -->
          <action>
            <textEquivalent value="sertraline 50 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)"/>
          </action>
        </action>
        <!--  Follows pattern established above  -->
        <action>
          <textEquivalent value="Dopamine Norepinephrine Reuptake Inhibitors (Choose a maximum of one or document reasons for exception)"/>
        </action>
        <!--  Follows pattern established above  -->
        <action>
          <textEquivalent value="Serotonin Norepinephrine Reuptake Inhibitors (Choose a maximum of one or doument reasons for exception)"/>
        </action>
        <!--  Follows pattern established above  -->
        <action>
          <textEquivalent value="Norepinephrine-Serotonin Modulators (Choose a maximum of one or document reasons for exception)"/>
        </action>
      </action>
    </action>
  </action>
</PlanDefinition>