Clinical Practice Guidelines
2.0.0 - STU2 International flag

Clinical Practice Guidelines, published by HL7 International / Clinical Decision Support. This guide is not an authorized publication; it is the continuous build for version 2.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/cqf-recommendations/ and changes regularly. See the Directory of published versions

Example Bundle: activity-example-administermedication-bundle

Generated Narrative: Bundle activity-example-administermedication-bundle

Bundle activity-example-administermedication-bundle of type collection


Entry 1 - fullUrl = http://hl7.org/fhir/uv/cpg/Library/administermedication-asset-collection

Resource Library:

Generated Narrative: Library administermedication-asset-collection

Related Artifacts

Depends Onhttp://fhir.org/guides/cqf/common/Library/FHIR-ModelInfo|4.0.1
Depends Onhttp://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1
Depends OnCPG Activity Type Code System
Composed OfActivity Example Administer Medication AD
Composed OfAdminister Medication Library
Composed OfActivity Example Administer Medication PD

Entry 2 - fullUrl = http://hl7.org/fhir/uv/cpg/Library/administermedication-library

Resource Library:

Generated Narrative: Library administermedication-library

Related Artifacts

Depends Onhttp://fhir.org/guides/cqf/common/Library/FHIR-ModelInfo|4.0.1
Depends Onhttp://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1
Depends OnCPG Activity Type Code System

Parameters

Patientout01Patient
Medication Proposalout0*MedicationRequest
Medication Not Proposedout0*MedicationRequest
Inclusion Criteriaout01boolean
Active or Completed Medication Administrationout0*MedicationAdministration
Medication Administration Not Doneout0*MedicationAdministration
Administer Proposalout0*Task
Administer Proposal Rejectedout0*Task
Is Recommendation Applicableout01boolean

Data Requirements

Type: MedicationRequest (MedicationRequest)
Type: MedicationRequest (MedicationRequest)
Type: MedicationAdministration (MedicationAdministration)
Type: MedicationAdministration (MedicationAdministration)
Type: Task (Task)
Type: Task (Task)

Contents

text/cql

library AdministerMedication

using FHIR version '4.0.1'

include FHIRHelpers version '4.0.1'

codesystem "Activity Type": 'http://hl7.org/fhir/uv/cpg/CodeSystem/cpg-activity-type-cs'

code "Administer medication": 'administer-medication' from "Activity Type"

context Patient

/* Recommendation to administer an existing order for a medication */

/*
Positive recommendation:

If the medication has been ordered but has not been administered
  Propose administering the medication

Given a proposal, the user can:
  Accept the proposal
  Ignore the proposal
  Reject the proposal without reason
  Reject the proposal with reason

Scenario 1: No event, no request, decision support should propose
Scenario 2: No event, active proposal, decision support should not propose
Scenario 3: No event, rejected proposal, decision support should not propose
Scenario 4: Event, no request, decision support should not propose
Scenario 5: Event, active proposal, decision support should not propose
Scenario 6: Event not done, no request, decision support should not propose
Scenario 7: Event not done, active proposal, decision support should not propose

*/

define "Inclusion Criteria":
  Patient.active
    and exists ("Medication Order")

define "Active or Completed Medication Administration":
  [MedicationAdministration] M
    where M.status in { 'in-progress', 'on-hold', 'completed' }

define "Medication Administration Not Done":
  [MedicationAdministration] M
    where M.status in { 'not-done', 'stopped' } // TODO: Is 'stopped' appropriate here?

define "Medication Order":
  [MedicationRequest] M
    where M.status in { 'active' }
      and M.intent = 'order'
      and M.doNotPerform is not true

define "Administer Proposal":
  [Task] R
    where R.code ~ "Administer medication"
      and R.status in { 'draft', 'requested', 'received', 'accepted', 'ready' }
      and doNotPerform(R) is not true

define "Administer Proposal Rejected":
  [Task] R
    where R.code ~ "Administer medication"
      and R.status in { 'rejected' }
      and doNotPerform(R) is not true

define "Is Recommendation Applicable":
  "Inclusion Criteria"
    and not exists (
      "Active or Completed Medication Administration"
        union "Medication Administration Not Done"
    )
    and not exists (
      "Administer Proposal"
        union "Administer Proposal Rejected"
    )

define function doNotPerform(task Task):
  singleton from (
    task.modifierExtension E
      where E.url = 'http://hl7.org/fhir/StructureDefinition/request-doNotPerform'
  ).value as boolean

Entry 3 - fullUrl = http://hl7.org/fhir/uv/cpg/PlanDefinition/activity-example-administermedication-pd

Resource PlanDefinition:

Generated Narrative: PlanDefinition activity-example-administermedication-pd

CQF Knowledge capability: shareable

CQF Knowledge capability: computable

CQF Knowledge capability: publishable

url: PlanDefinition Activity Example Administer Medication PD

name: ActivityExampleAdministerMedicationPD

title: Activity Example Administer Medication PD

type: ECA Rule

status: Active

experimental: true

description:

Example Plan Definition for a recommendation to administer a medication

library: Administer Medication Library

action

title: Collect date of patient last visit

condition

kind: Applicability

Expressions

-LanguageExpression
*text/cqlIs Recommendation Applicable

type: Create

definition: Activity Example Administer Medication AD


Entry 4 - fullUrl = http://hl7.org/fhir/uv/cpg/Bundle/am-scenario7-bundle

Resource Bundle:

Generated Narrative: Bundle am-scenario7-bundle

Bundle am-scenario7-bundle of type collection


Entry 1 - fullUrl = http://hl7.org/fhir/uv/cpg/GuidanceResponse/am-scenario7-gr

Resource GuidanceResponse:

Generated Narrative: GuidanceResponse am-scenario7-gr

module: Administer Medication Library

status: Success

subject: Example Patient Female, DoB: 1990-10-01

outputParameters: Parameters: Inclusion Criteria, Is Recommendation Applicable


Generated Narrative: Parameters #output

Parameters

Inclusion Criteriatrue
Is Recommendation Applicablefalse

Entry 2 - fullUrl = http://hl7.org/fhir/uv/cpg/MedicationAdministration/am-scenario7

Resource MedicationAdministration:

Generated Narrative: MedicationAdministration am-scenario7

status: not-done

subject: Example Patient Female, DoB: 1990-10-01

request: MedicationRequest: status = active; intent = order; priority = routine; medication[x] = Product containing precisely fentanyl 25 microgram/1 hour prolonged-release transdermal patch (clinical drug)

Dosages

-TextDose
*apply one patch three times per week1 patch (Details: Orderable Drug Form codePATCH = 'Patch')

Entry 3 - fullUrl = http://hl7.org/fhir/uv/cpg/MedicationRequest/am-scenario7-mr

Resource MedicationRequest:

Generated Narrative: MedicationRequest am-scenario7-mr

status: Active

intent: Order

priority: Routine

subject: Example Patient Female, DoB: 1990-10-01

dosageInstruction

sequence: 1

text: apply one patch three times per week

timing: 3 per 1 weeks

DoseAndRates

-TypeDose[x]
*Ordered1 patch (Details: Orderable Drug Form codePATCH = 'Patch')

dispenseRequest

validityPeriod: 2015-01-15 --> 2016-01-15

quantity: 6 patch (Details: Orderable Drug Form codePATCH = 'Patch')

ExpectedSupplyDurations

-ValueUnitSystemCode
*14dayshttp://unitsofmeasure.orgd

Entry 4 - fullUrl = http://hl7.org/fhir/uv/cpg/Patient/am-scenario7-patient

Resource Patient:

Generated Narrative: Patient am-scenario7-patient

Example Patient Female, DoB: 1990-10-01


Active:trueDeceased:false

Entry 5 - fullUrl = http://hl7.org/fhir/uv/cpg/Task/request-am-scenario7

Resource Task:

Generated Narrative: Task request-am-scenario7

instantiatesCanonical: Activity Example Administer Medication AD

status: In Progress

intent: Order

code: Administer a medication

for: Example Patient Female, DoB: 1990-10-01

Inputs

-TypeValue[x]
*Administer a medicationMedicationRequest: status = active; intent = order; priority = routine; medication[x] = Product containing precisely fentanyl 25 microgram/1 hour prolonged-release transdermal patch (clinical drug)