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Example Library/opioidcds-recommendation-05 (Narrative)

Clinical Decision Support Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: No defined compartments

This is the narrative for the resource. See also the XML, JSON or Turtle format. This example conforms to the profile Library.

Generated Narrative: Library opioidcds-recommendation-05

Participants

AuthorKensaku Kawamoto, MD, PhD, MHS
Author Bryn Rhodes
Author Floyd Eisenberg, MD, MPH
Author Robert McClure, MD, MPH

Related Artifacts

documentationCDC guideline for prescribing opioids for chronic pain
depends-on http://example.org/fhir/Library/opioidcds-common
documentation MME Conversion Tables

Data Requirements

Type: MedicationRequest
Filter Value
status One of these codes: [not stated] active: active
category One of these codes: MedicationRequest Category Codes outpatient: Outpatient

Contents

application/elm+xml

<?xml version="1.0" encoding="UTF-8"?>
<library xmlns="urn:hl7-org:elm:r1" xmlns:t="urn:hl7-org:elm-types:r1" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:xsd="http://www.w3.org/2001/XMLSchema" xmlns:fhir="http://hl7.org/fhir" xmlns:qdm43="urn:healthit-gov:qdm:v4_3" xmlns:qdm53="urn:healthit-gov:qdm:v5_3" xmlns:a="urn:hl7-org:cql-annotations:r1">
   <identifier id="OpioidCDS_STU4" version="0.1.0"/>
   <schemaIdentifier id="urn:hl7-org:elm" version="r1"/>
   <usings>
      <def localIdentifier="System" uri="urn:hl7-org:elm-types:r1"/>
      <def localIdentifier="FHIR" uri="http://hl7.org/fhir" version="3.2.0"/>
   </usings>
   <includes>
      <def localIdentifier="MMECommon" path="OpioidCDS_STU4_Common" version="0.1.0"/>
   </includes>
   <parameters>
      <def name="UserID" accessLevel="Public">
         <parameterTypeSpecifier name="t:String" xsi:type="NamedTypeSpecifier"/>
      </def>
      <def name="ContextPrescriptions" accessLevel="Public">
         <parameterTypeSpecifier xsi:type="ListTypeSpecifier">
            <elementType name="fhir:MedicationRequest" xsi:type="NamedTypeSpecifier"/>
         </parameterTypeSpecifier>
      </def>
   </parameters>
   <statements>
      <def name="Patient" context="Patient">
         <expression xsi:type="SingletonFrom">
            <operand dataType="fhir:Patient" xsi:type="Retrieve"/>
         </expression>
      </def>
      <def name="Get Active Prescriptions" context="Patient" accessLevel="Public">
         <expression xsi:type="Query">
            <source alias="activeRx">
               <expression dataType="fhir:MedicationRequest" xsi:type="Retrieve"/>
            </source>
            <where xsi:type="And">
               <operand xsi:type="Equal">
                  <operand path="value" xsi:type="Property">
                     <source path="status" scope="activeRx" xsi:type="Property"/>
                  </operand>
                  <operand valueType="t:String" value="active" xsi:type="Literal"/>
               </operand>
               <operand xsi:type="Equal">
                  <operand path="value" xsi:type="Property">
                     <source path="code" xsi:type="Property">
                        <source xsi:type="Indexer">
                           <operand xsi:type="Flatten">
                              <operand xsi:type="Query">
                                 <source alias="$this">
                                    <expression path="category" scope="activeRx" xsi:type="Property"/>
                                 </source>
                                 <where xsi:type="Not">
                                    <operand xsi:type="IsNull">
                                       <operand path="coding" xsi:type="Property">
                                          <source name="$this" xsi:type="AliasRef"/>
                                       </operand>
                                    </operand>
                                 </where>
                                 <return>
                                    <expression path="coding" xsi:type="Property">
                                       <source name="$this" xsi:type="AliasRef"/>
                                    </expression>
                                 </return>
                              </operand>
                           </operand>
                           <operand valueType="t:Integer" value="0" xsi:type="Literal"/>
                        </source>
                     </source>
                  </operand>
                  <operand valueType="t:String" value="outpatient" xsi:type="Literal"/>
               </operand>
            </where>
         </expression>
      </def>
      <def name="Total MME" context="Patient" accessLevel="Public">
         <expression name="TotalMME" libraryName="MMECommon" xsi:type="FunctionRef">
            <operand xsi:type="Union">
               <operand name="ContextPrescriptions" xsi:type="ParameterRef"/>
               <operand name="Get Active Prescriptions" xsi:type="ExpressionRef"/>
            </operand>
         </expression>
      </def>
      <def name="Is MME 50 Or More?" context="Patient" accessLevel="Public">
         <expression xsi:type="GreaterOrEqual">
            <operand name="Total MME" xsi:type="ExpressionRef"/>
            <operand value="50" unit="mg/d" xsi:type="Quantity"/>
         </expression>
      </def>
      <def name="Get Indicator" context="Patient" accessLevel="Public">
         <expression valueType="t:String" value="warning" xsi:type="Literal"/>
      </def>
      <def name="Get Summary" context="Patient" accessLevel="Public">
         <expression xsi:type="Concatenate">
            <operand valueType="t:String" value="High risk for opioid overdose - " xsi:type="Literal"/>
            <operand xsi:type="Case">
               <caseItem>
                  <when xsi:type="GreaterOrEqual">
                     <operand path="value" xsi:type="Property">
                        <source name="Total MME" xsi:type="ExpressionRef"/>
                     </operand>
                     <operand xsi:type="ToDecimal">
                        <operand valueType="t:Integer" value="90" xsi:type="Literal"/>
                     </operand>
                  </when>
                  <then valueType="t:String" value="taper now" xsi:type="Literal"/>
               </caseItem>
               <else valueType="t:String" value="consider tapering" xsi:type="Literal"/>
            </operand>
         </expression>
      </def>
      <def name="Get Detail" context="Patient" accessLevel="Public">
         <expression xsi:type="Concatenate">
            <operand xsi:type="Concatenate">
               <operand valueType="t:String" value="Total morphine milligram equivalent (MME) is " xsi:type="Literal"/>
               <operand xsi:type="ToString">
                  <operand name="Total MME" xsi:type="ExpressionRef"/>
               </operand>
            </operand>
            <operand valueType="t:String" value=". Taper to less than 50." xsi:type="Literal"/>
         </expression>
      </def>
   </statements>
</library>

 

 

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.