{"action":[{"action":[{"description":"Will perform urine screening"},{"description":"Not for chronic pain management. 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Snooze 3 months"}],"condition":[{"expression":{"description":"Patient has a positive urine screening in the past 12 months for opioid(s), which is not prescribed","expression":"Has Unprescribed Opioids?","language":"text/cql-identifier"},"kind":"applicability"}],"description":"Patient has a positive urine screening in the past 12 months for opioid(s), which is not prescribed","documentation":[{"type":"documentation"}],"dynamicValue":[{"expression":{"expression":"Get Indicator","language":"text/cql-identifier"},"path":"activity.extension"},{"expression":{"expression":"Inconsistent Unprescribed Opioids","language":"text/cql-identifier"},"path":"action.description"}],"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation","valueCodeableConcept":{"coding":[{"code":"strong","display":"Strong","system":"http://terminology.hl7.org/CodeSystem/recommendation-strength"}]}},{"url":"http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence","valueCodeableConcept":{"coding":[{"code":"low","display":"Low quality","system":"http://terminology.hl7.org/CodeSystem/evidence-quality"}]}}],"title":"Unprescribed Opioids Found In Urine Screening"},{"condition":[{"expression":{"description":"Patient has a positive urine screening in the past 12 months, which does not include prescribed opioids","expression":"Has Missing Opioids?","language":"text/cql-identifier"},"kind":"applicability"}],"description":"Patient has a positive urine screening in the past 12 months, which does not include prescribed opioids","documentation":[{"type":"documentation"}],"dynamicValue":[{"expression":{"expression":"Get Indicator","language":"text/cql-identifier"},"path":"activity.extension"},{"expression":{"expression":"Inconsistent Missing Opioids","language":"text/cql-identifier"},"path":"action.description"}],"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation","valueCodeableConcept":{"coding":[{"code":"strong","display":"Strong","system":"http://terminology.hl7.org/CodeSystem/recommendation-strength"}]}},{"url":"http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence","valueCodeableConcept":{"coding":[{"code":"low","display":"Low quality","system":"http://terminology.hl7.org/CodeSystem/evidence-quality"}]}}],"title":"Prescribed Opioids Not Found In Urine Screening"},{"action":[{"description":"Not for chronic pain management. Snooze 3 months"}],"condition":[{"expression":{"description":"Patient has a positive urine screening in the past 12 months for illicit drugs","expression":"Has Illicit Drugs in Screening?","language":"text/cql-identifier"},"kind":"applicability"}],"description":"Patient has a positive urine screening in the past 12 months for illicit drugs","documentation":[{"type":"documentation"}],"dynamicValue":[{"expression":{"expression":"Get Indicator","language":"text/cql-identifier"},"path":"activity.extension"},{"expression":{"expression":"Inconsistent Illicit Drugs","language":"text/cql-identifier"},"path":"action.description"}],"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation","valueCodeableConcept":{"coding":[{"code":"strong","display":"Strong","system":"http://terminology.hl7.org/CodeSystem/recommendation-strength"}]}},{"url":"http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence","valueCodeableConcept":{"coding":[{"code":"low","display":"Low quality","system":"http://terminology.hl7.org/CodeSystem/evidence-quality"}]}}],"title":"Illicit Drugs Found In Urine Screening"}],"condition":[{"expression":{"description":"Patient has a positive urine screening in the past 12 months","expression":"Has Positive Screening?","language":"text/cql-identifier"},"kind":"applicability"}],"description":"Patient has a urine screening testing positive for either unprescribed opioids or illicit drugs in the past 12 months","documentation":[{"type":"documentation"}],"extension":[{"url":"http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation","valueCodeableConcept":{"coding":[{"code":"strong","display":"Strong","system":"http://terminology.hl7.org/CodeSystem/recommendation-strength"}]}},{"url":"http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence","valueCodeableConcept":{"coding":[{"code":"low","display":"Low quality","system":"http://terminology.hl7.org/CodeSystem/evidence-quality"}]}}],"title":"Positive Urine Screening Check"}],"author":[{"name":"Kensaku Kawamoto, MD, PhD, MHS"},{"name":"Bryn Rhodes"},{"name":"Floyd Eisenberg, MD, MPH"},{"name":"Robert McClure, MD, MPH"}],"contact":[{"telecom":[{"system":"url","value":"http://www.hl7.org/Special/committees/dss"}]}],"copyright":"© CDC 2016+.","date":"2017-04-23","description":"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.","extension":[{"url":"http://hl7.org/fhir/StructureDefinition/structuredefinition-wg","valueCode":"cds"}],"id":"opioidcds-10","identifier":[{"system":"urn:ietf:rfc:3986","value":"urn:oid:2.16.840.1.113883.4.642.11.3"},{"use":"official","value":"cdc-opioid-guidance"}],"jurisdiction":[{"coding":[{"code":"US","display":"United States of America","system":"urn:iso:std:iso:3166"}]}],"library":["http://example.org/fhir/Library/opioidcds-recommendation-10"],"name":"Cdcopioid10","publisher":"HL7 International / Clinical Decision Support","purpose":"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.","relatedArtifact":[{"display":"CDC guideline for prescribing opioids for chronic pain","document":{"url":"https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chronic-pain---united-states-2016#420"},"type":"documentation"}],"resourceType":"PlanDefinition","status":"draft","title":"CDC Opioid Prescribing Guideline Recommendation #10","topic":[{"text":"Opioid Prescribing"}],"type":{"coding":[{"code":"eca-rule","display":"ECA Rule","system":"http://terminology.hl7.org/CodeSystem/plan-definition-type"}]},"usage":"Providers should be aware if patients are taking other prescription drugs or illicit drugs that might increase their risk of an overdose.","useContext":[{"code":{"code":"focus","display":"Clinical Focus","system":"http://terminology.hl7.org/CodeSystem/usage-context-type"},"valueCodeableConcept":{"coding":[{"code":"182888003","display":"Medication requested (situation)","system":"http://snomed.info/sct"}]}},{"code":{"code":"focus","display":"Clinical Focus","system":"http://terminology.hl7.org/CodeSystem/usage-context-type"},"valueCodeableConcept":{"coding":[{"code":"82423001","display":"Chronic pain (finding)","system":"http://snomed.info/sct"}]}}],"version":"0.1.0"}