Clinical Practice Guidelines
1.0.0 - ci-build
Clinical Practice Guidelines
1.0.0 - ci-build
Clinical Practice Guidelines, published by HL7 International - Clinical Decision Support WG. This is not an authorized publication; it is the continuous build for version 1.0.0). This version is based on the current content of https://github.com/HL7/cqf-recommendations/ and changes regularly. See the Directory of published versions
| Active as of 2018-03-25 |
<Library xmlns="http://hl7.org/fhir">
<id value="OpioidCDSR4Common"/>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><h2>Participants</h2><table class="grid"><tr><td>Author</td><td>Kensaku Kawamoto, MD, PhD, MHS</td></tr><tr><td>Author</td><td>Bryn Rhodes</td></tr><tr><td>Author</td><td>Floyd Eisenberg, MD, MPH</td></tr><tr><td>Author</td><td>Robert McClure, MD, MPH</td></tr></table><h2>Related Artifacts</h2><table class="grid"><tr><td>documentation</td><td>CDC guideline for prescribing opioids for chronic pain</td><td>https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fmmwr%2Fvolumes%2F65%2Frr%2Frr6501e1er.htm</td></tr></table><h2>Contents</h2><p><code>text/cql</code></p><pre><code class="language-sql">library OpioidCDSR4Common version '0.1.0'
using FHIR version '4.0.0'
include FHIRHelpers version '4.0.0' called FHIRHelpers
include OMTKLogic version '0.0.0' called OMTKLogic
codesystem "SNOMED": 'http://snomed.info/sct'
codesystem "Medication Request Category Codes": 'http://terminology.hl7.org/CodeSystem/medicationrequest-category'
valueset "Active Condition": 'http://hl7.org/fhir/uv/cpg/ValueSet/cpg-active-condition'
valueset "Benzodiazepines": 'http://fhir.org/guides/cdc/opioid-cds/ValueSet/benzodiazepines'
// TODO: Fix this name
valueset "End of Life Conditions": 'http://fhir.org/guides/cdc/opioid-cds/ValueSet/end-of-life-conditions'
// Harvested from VSAC - OID: 2.16.840.1.113762.1.4.1108.15
// NOTE: This harvest note is incorrect, none of the following 3 value sets contain any of the codes in the above referenced valueset
// Rob will construct an appropriate hospice value set aligned with current eCQM program usage and we will use that when available
valueset "Hospice Disposition": 'http://fhir.org/guides/cdc/opioid-cds/ValueSet/hospice-disposition'
valueset "Hospice Finding Codes": 'http://fhir.org/guides/cdc/opioid-cds/ValueSet/hospice-finding'
valueset "Hospice Procedure Codes": 'http://fhir.org/guides/cdc/opioid-cds/ValueSet/hospice-procedure'
valueset "Illicit Drug Screening": 'http://fhir.org/guides/cdc/opioid-cds/ValueSet/illicit-drug-urine-screening'
// Harvested from VSAC - OID: 2.16.840.1.113883.3.526.3.1259
valueset "Limited Life Expectancy Conditions": 'http://fhir.org/guides/cdc/opioid-cds/ValueSet/limited-life-expectancy-conditions'
valueset "Long Acting Opioids": 'http://fhir.org/guides/cdc/opioid-cds/ValueSet/long-acting-opioids'
valueset "Naloxone": 'http://fhir.org/guides/cdc/opioid-cds/ValueSet/naloxone'
valueset "Risk Assessment": 'http://fhir.org/guides/cdc/opioid-cds/ValueSet/opioid-abuse-assessment'
valueset "Opioid Drug Screening": 'http://fhir.org/guides/cdc/opioid-cds/ValueSet/opioid-urine-screening'
valueset "Ambulatory Abuse Potential Opioids": 'http://fhir.org/guides/cdc/opioid-cds/ValueSet/opioids-abused-in-ambulatory-care'
valueset "Substance Abuse": 'http://fhir.org/guides/cdc/opioid-cds/ValueSet/substance-abuse'
// TODO: Turn this into a valueset
code "Referral to Hospice": '306205009' from "SNOMED"
// TODO: Turn this into a valueset
code "Outpatient": 'outpatient' from "Medication Request Category Codes"
// TODO: Capture process decisions for long-term opioid use
define IsForChronicPain: true
define "Active Ambulatory Opioid Rx":
[MedicationRequest: "Ambulatory Abuse Potential Opioids"] Rx
where Rx.status = 'active'
and ToCodes(Rx.category.coding) contains "Outpatient"
define "Active Ambulatory Benzodiazepine Rx":
[MedicationRequest: "Benzodiazepines"] Rx
where Rx.status = 'active'
and ToCodes(Rx.category.coding) contains "Outpatient"
define "Active Ambulatory Naloxone Rx":
[MedicationRequest: "Naloxone"] Rx
where Rx.status = 'active'
and ToCodes(Rx.category.coding) contains "Outpatient"
define "Ambulatory Opioid Rx":
[MedicationRequest: "Ambulatory Abuse Potential Opioids"] Rx
where ToCodes(Rx.category.coding) contains "Outpatient"
define "End of Life Assessment":
// 1. Conditions indicating end of life or with limited life expectancy
exists (
(
[Condition: "End of Life Conditions"] C
where C.clinicalStatus in "Active Condition"
)
union
(
[Condition: code in "Limited Life Expectancy Conditions"] C
where C.clinicalStatus in "Active Condition"
)
)
// 2. Admitted/referred/discharged to hospice care
or exists (
(
[ServiceRequest: code in "Referral to Hospice"] RR
where RR.status in { 'active', 'completed' }
)
union
(
[ServiceRequest: code in "Hospice Procedure Codes"] P
where P.status in { 'in-progress', 'completed' }
)
union
(
[ServiceRequest: code in "Hospice Procedure Codes"] E
where E.status in { 'planned', 'arrived', 'in-progress', 'finished', 'onleave' }
)
union
(
[Observation: code in "Hospice Finding Codes"] O
where not (O.status in { 'unknown', 'entered-in-error', 'cancelled' })
)
union
(
[Encounter] E
where
(
if E.hospitalization.dischargeDisposition.coding is null
or not exists (E.hospitalization.dischargeDisposition.coding)
then false
else E.hospitalization.dischargeDisposition in "Hospice Disposition"
)
and E.status in { 'planned', 'arrived', 'in-progress', 'finished', 'onleave' }
)
)
define function Prescriptions(Orders List<MedicationRequest>):
Orders O
let
// NOTE: Assuming medication is specified as a CodeableConcept with a single RxNorm code
rxNormCode: ToCode(O.medication.coding[0]),
medicationName: OMTKLogic.GetMedicationName(rxNormCode),
// NOTE: Assuming a single dosage instruction element
dosageInstruction: O.dosageInstruction[0],
repeat: dosageInstruction.timing.repeat,
frequency: Coalesce(repeat.frequencyMax.value, repeat.frequency.value),
period: System.Quantity { value: repeat.period.value, unit: repeat.periodUnit.value },
doseDescription:
Coalesce(
// There should be a conversion from FHIR.SimpleQuantity to System.Quantity
if dosageInstruction.doseAndRate[0].dose is FHIR.Range
then ToString(ToQuantity(dosageInstruction.doseAndRate[0].dose.low))
+ '-' + ToString(ToQuantity(dosageInstruction.doseAndRate[0].dose.high))
+ dosageInstruction.doseAndRate[0].dose.high.unit.value
else ToString(ToQuantity(dosageInstruction.doseAndRate[0].dose)),
''
),
frequencyDescription:
ToString(dosageInstruction.timing.repeat.frequency.value) +
Coalesce(
'-' + ToString(dosageInstruction.timing.repeat.frequencyMax.value),
''
)
return {
rxNormCode: rxNormCode,
isDraft: O.status.value = 'draft',
// NOTE: Assuming asNeeded is expressed as a boolean
isPRN: dosageInstruction.asNeeded.value,
prescription:
if dosageInstruction.text is not null then
medicationName + ' ' + dosageInstruction.text.value
else
// TODO: Shouldn't need the .value here on asNeededBoolean
medicationName + ' ' + doseDescription + ' q' + frequencyDescription + (if dosageInstruction.asNeeded.value then ' PRN' else ''),
// TODO: Shouldn't need the ToQuantity here...
dose: if dosageInstruction.doseAndRate[0].dose is FHIR.Range
then ToQuantity(dosageInstruction.doseAndRate[0].dose.high)
else ToQuantity(dosageInstruction.doseAndRate[0].dose),
dosesPerDay: Coalesce(OMTKLogic.ToDaily(frequency, period), 1.0)
}
define function MME(prescriptions List<MedicationRequest>):
(Prescriptions(prescriptions)) P
let mme: SingletonFrom(OMTKLogic.CalculateMMEs({ { rxNormCode: P.rxNormCode, doseQuantity: P.dose, dosesPerDay: P.dosesPerDay } }))
return {
rxNormCode: P.rxNormCode,
isDraft: P.isDraft,
isPRN: P.isPRN,
prescription: P.prescription,
dailyDose: mme.dailyDoseDescription,
conversionFactor: mme.conversionFactor,
mme: mme.mme
}
define function TotalMME(prescriptions List<MedicationRequest>):
System.Quantity {
value: Sum((MME(prescriptions)) M return M.mme.value),
unit: 'mg/d'
}
define function ProbableDaysInRange(Orders List<MedicationRequest>, daysPast Integer, numDaysInDaysPast Integer):
Orders orders
let
frequency: orders.dosageInstruction[0].timing.repeat.frequency.value,
period: orders.dosageInstruction[0].timing.repeat.period.value,
periodDays: GetPeriodDays(orders.dosageInstruction[0].timing.repeat.periodUnit.value),
dosesPerDay:
if (frequency / (period * periodDays)) >= 1.0
then 1.0
else frequency / (period * periodDays),
repeat: orders.dispenseRequest.numberOfRepeatsAllowed.value,
supplyDuration: GetDurationInDays(orders.dispenseRequest.expectedSupplyDuration),
validityPeriod: days between orders.dispenseRequest.validityPeriod."start".value and Today(),
endDifference:
if orders.dispenseRequest.validityPeriod."end".value < Today()
then days between orders.dispenseRequest.validityPeriod."end".value and Today()
else 0
return
if (repeat * supplyDuration) < numDaysInDaysPast then false
else
(dosesPerDay * ((repeat * supplyDuration) / validityPeriod) * (daysPast - endDifference)) >= numDaysInDaysPast
define function GetPeriodDays(value System.String):
case
when value = 'a' then 365.0
when value = 'mo' then 30.0
when value = 'h' then 1.0/24.0
when value = 'min' then 1.0/24.0*60.0
when value = 's' then 1.0/24.0*60.0*60.0
when value = 'ms' then 1.0/24.0*60.0*60.0*1000.0
else 1.0
end
define function GetDurationInDays(value FHIR.Duration):
case
when StartsWith(value.unit.value, 'a') then value.value.value * 365.0
when StartsWith(value.unit.value, 'mo') then value.value.value * 30.0
when StartsWith(value.unit.value, 'wk') then value.value.value * 7.0
when StartsWith(value.unit.value, 'd') then value.value.value
when StartsWith(value.unit.value, 'h') then value.value.value / 24.0
when StartsWith(value.unit.value, 'min') then value.value.value / 60.0 / 24.0
when StartsWith(value.unit.value, 's') then value.value.value / 60.0 / 60.0 / 24.0
when StartsWith(value.unit.value, 'ms') then value.value.value / 60.0 / 60.0 / 24.0 / 1000.0
else Message(1000, true, 'Undefined', 'Error', 'Unsupported duration unit')
end
define function GetIngredient(rxNormCode Code):
OMTKLogic.GetIngredients(rxNormCode).ingredientName
define function GetIngredients(rxNormCodes List<Code>):
rxNormCodes rnc return GetIngredient(rnc)
define function GetMedicationNames(medications List<MedicationRequest>):
medications M
return OMTKLogic.GetIngredients(ToRxNormCode(M.medication.coding)).rxNormCode.display
/*
* Conversion Functions
*/
define function ToCode(coding FHIR.Coding):
System.Code {
code: coding.code.value,
system: coding.system.value,
version: coding.version.value,
display: coding.display.value
}
define function ToCodes(coding List<FHIR.Coding>):
coding c return ToCode(c)
define function ToRxNormCode(coding List<FHIR.Coding>):
singleton from (
coding C where C.system = 'http://www.nlm.nih.gov/research/umls/rxnorm'
)
define function ToQuantity(quantity FHIR.Quantity):
System.Quantity { value: quantity.value.value, unit: quantity.unit.value }
</code></pre><p><code>No Content</code> (<code>application/elm+xml</code>)</p></div>
</text>
<url
value="http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSR4Common"/>
<version value="1.0.0"/>
<name value="OpioidCDSR4Common"/>
<title value="Opioid CDS R4 Common Logic"/>
<status value="active"/>
<experimental value="true"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/library-type"/>
<code value="logic-library"/>
<display value="Logic Library"/>
</coding>
</type>
<date value="2018-03-25T13:49:09-06:00"/>
<publisher value="HL7 International - Clinical Decision Support WG"/>
<contact>
<name value="HL7 International - Clinical Decision Support WG"/>
<telecom>
<system value="url"/>
<value value="http://www.hl7.org/Special/committees/dss/index.cfm"/>
</telecom>
</contact>
<description
value="Common Opioid Decision Support Logic for use in implementing CDC Opioid Prescribing Guidelines."/>
<useContext>
<code>
<system
value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
<code value="focus"/>
<display value="Clinical Focus"/>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="182888003"/>
<display value="Medication requested (situation)"/>
</coding>
</valueCodeableConcept>
</useContext>
<useContext>
<code>
<system
value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
<code value="focus"/>
<display value="Clinical Focus"/>
</code>
<valueCodeableConcept>
<coding>
<system value="http://snomed.info/sct"/>
<code value="82423001"/>
<display value="Chronic pain (finding)"/>
</coding>
</valueCodeableConcept>
</useContext>
<jurisdiction>
<coding>
<system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
<code value="001"/>
<display value="World"/>
</coding>
</jurisdiction>
<purpose
value="This library contains common logic across recommendations including MME calculations, conversions, and looking up codes in valuesets."/>
<usage
value="This library is used for decision support for opioid guideline recommendations when applying PlanDefinitions."/>
<copyright value="© CDC 2016+."/>
<topic>
<text value="Opioid Prescribing"/>
</topic>
<author>
<name value="Kensaku Kawamoto, MD, PhD, MHS"/>
</author>
<author>
<name value="Bryn Rhodes"/>
</author>
<author>
<name value="Floyd Eisenberg, MD, MPH"/>
</author>
<author>
<name value="Robert McClure, MD, MPH"/>
</author>
<relatedArtifact>
<type value="documentation"/>
<display value="CDC guideline for prescribing opioids for chronic pain"/>
<url
value="https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fmmwr%2Fvolumes%2F65%2Frr%2Frr6501e1er.htm"/>
<document>
<url
value="https://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fmmwr%2Fvolumes%2F65%2Frr%2Frr6501e1er.htm"/>
</document>
</relatedArtifact>
<content>
<contentType value="text/cql"/>
<data
value="library OpioidCDSR4Common version '0.1.0'

using FHIR version '4.0.0'

include FHIRHelpers version '4.0.0' called FHIRHelpers
include OMTKLogic version '0.0.0' called OMTKLogic

codesystem "SNOMED": 'http://snomed.info/sct'
codesystem "Medication Request Category Codes": 'http://terminology.hl7.org/CodeSystem/medicationrequest-category'

valueset "Active Condition": 'http://hl7.org/fhir/uv/cpg/ValueSet/cpg-active-condition'
valueset "Benzodiazepines": 'http://fhir.org/guides/cdc/opioid-cds/ValueSet/benzodiazepines'
// TODO: Fix this name
valueset "End of Life Conditions": 'http://fhir.org/guides/cdc/opioid-cds/ValueSet/end-of-life-conditions'
// Harvested from VSAC - OID: 2.16.840.1.113762.1.4.1108.15
// NOTE: This harvest note is incorrect, none of the following 3 value sets contain any of the codes in the above referenced valueset
// Rob will construct an appropriate hospice value set aligned with current eCQM program usage and we will use that when available
valueset "Hospice Disposition": 'http://fhir.org/guides/cdc/opioid-cds/ValueSet/hospice-disposition'
valueset "Hospice Finding Codes": 'http://fhir.org/guides/cdc/opioid-cds/ValueSet/hospice-finding'
valueset "Hospice Procedure Codes": 'http://fhir.org/guides/cdc/opioid-cds/ValueSet/hospice-procedure'
valueset "Illicit Drug Screening": 'http://fhir.org/guides/cdc/opioid-cds/ValueSet/illicit-drug-urine-screening'
// Harvested from VSAC - OID: 2.16.840.1.113883.3.526.3.1259
valueset "Limited Life Expectancy Conditions": 'http://fhir.org/guides/cdc/opioid-cds/ValueSet/limited-life-expectancy-conditions'
valueset "Long Acting Opioids": 'http://fhir.org/guides/cdc/opioid-cds/ValueSet/long-acting-opioids'
valueset "Naloxone": 'http://fhir.org/guides/cdc/opioid-cds/ValueSet/naloxone'
valueset "Risk Assessment": 'http://fhir.org/guides/cdc/opioid-cds/ValueSet/opioid-abuse-assessment'
valueset "Opioid Drug Screening": 'http://fhir.org/guides/cdc/opioid-cds/ValueSet/opioid-urine-screening'
valueset "Ambulatory Abuse Potential Opioids": 'http://fhir.org/guides/cdc/opioid-cds/ValueSet/opioids-abused-in-ambulatory-care'
valueset "Substance Abuse": 'http://fhir.org/guides/cdc/opioid-cds/ValueSet/substance-abuse'

// TODO: Turn this into a valueset
code "Referral to Hospice": '306205009' from "SNOMED"
// TODO: Turn this into a valueset
code "Outpatient": 'outpatient' from "Medication Request Category Codes"

// TODO: Capture process decisions for long-term opioid use
define IsForChronicPain: true

define "Active Ambulatory Opioid Rx":
  [MedicationRequest: "Ambulatory Abuse Potential Opioids"] Rx
    where Rx.status = 'active'
      and ToCodes(Rx.category.coding) contains "Outpatient"

define "Active Ambulatory Benzodiazepine Rx":
  [MedicationRequest: "Benzodiazepines"] Rx
    where Rx.status = 'active'
      and ToCodes(Rx.category.coding) contains "Outpatient"

define "Active Ambulatory Naloxone Rx":
  [MedicationRequest: "Naloxone"] Rx
    where Rx.status = 'active'
      and ToCodes(Rx.category.coding) contains "Outpatient"

define "Ambulatory Opioid Rx":
  [MedicationRequest: "Ambulatory Abuse Potential Opioids"] Rx
      where ToCodes(Rx.category.coding) contains "Outpatient"

define "End of Life Assessment":
  // 1. Conditions indicating end of life or with limited life expectancy
  exists (
    (
      [Condition: "End of Life Conditions"] C
        where C.clinicalStatus in "Active Condition"
    )
    union
    (
      [Condition: code in "Limited Life Expectancy Conditions"] C
        where C.clinicalStatus in "Active Condition"
    )
  )
  // 2. Admitted/referred/discharged to hospice care
  or exists (
    (
      [ServiceRequest: code in "Referral to Hospice"] RR
        where RR.status in { 'active', 'completed' }
    )
    union
    (
      [ServiceRequest: code in "Hospice Procedure Codes"] P
        where P.status in { 'in-progress', 'completed' }
    )
    union
    (
      [ServiceRequest: code in "Hospice Procedure Codes"] E
        where E.status in { 'planned', 'arrived', 'in-progress', 'finished', 'onleave' }
    )
    union
    (
      [Observation: code in "Hospice Finding Codes"] O
        where not (O.status in { 'unknown', 'entered-in-error', 'cancelled' })
    )
    union
    (
      [Encounter] E
        where
          (
            if E.hospitalization.dischargeDisposition.coding is null
                or not exists (E.hospitalization.dischargeDisposition.coding)
              then false
            else E.hospitalization.dischargeDisposition in "Hospice Disposition"
          )
          and E.status in { 'planned', 'arrived', 'in-progress', 'finished', 'onleave' }
    )
  )

define function Prescriptions(Orders List<MedicationRequest>):
  Orders O
    let
      // NOTE: Assuming medication is specified as a CodeableConcept with a single RxNorm code
      rxNormCode: ToCode(O.medication.coding[0]),
      medicationName: OMTKLogic.GetMedicationName(rxNormCode),
      // NOTE: Assuming a single dosage instruction element
      dosageInstruction: O.dosageInstruction[0],
      repeat: dosageInstruction.timing.repeat,
      frequency: Coalesce(repeat.frequencyMax.value, repeat.frequency.value),
      period: System.Quantity { value: repeat.period.value, unit: repeat.periodUnit.value },
      doseDescription:
        Coalesce(
          // There should be a conversion from FHIR.SimpleQuantity to System.Quantity
          if dosageInstruction.doseAndRate[0].dose is FHIR.Range
            then ToString(ToQuantity(dosageInstruction.doseAndRate[0].dose.low))
                          + '-' + ToString(ToQuantity(dosageInstruction.doseAndRate[0].dose.high))
                          + dosageInstruction.doseAndRate[0].dose.high.unit.value
            else ToString(ToQuantity(dosageInstruction.doseAndRate[0].dose)),
            ''
        ),
      frequencyDescription:
        ToString(dosageInstruction.timing.repeat.frequency.value) +
          Coalesce(
            '-' + ToString(dosageInstruction.timing.repeat.frequencyMax.value),
            ''
          )
    return {
      rxNormCode: rxNormCode,
      isDraft: O.status.value = 'draft',
      // NOTE: Assuming asNeeded is expressed as a boolean
      isPRN: dosageInstruction.asNeeded.value,
      prescription:
        if dosageInstruction.text is not null then
          medicationName + ' ' + dosageInstruction.text.value
        else
          // TODO: Shouldn't need the .value here on asNeededBoolean
          medicationName + ' ' + doseDescription + ' q' + frequencyDescription + (if dosageInstruction.asNeeded.value then ' PRN' else ''),
      // TODO: Shouldn't need the ToQuantity here...
      dose: if dosageInstruction.doseAndRate[0].dose is FHIR.Range
            then ToQuantity(dosageInstruction.doseAndRate[0].dose.high)
            else ToQuantity(dosageInstruction.doseAndRate[0].dose),
      dosesPerDay: Coalesce(OMTKLogic.ToDaily(frequency, period), 1.0)
    }

define function MME(prescriptions List<MedicationRequest>):
  (Prescriptions(prescriptions)) P
    let mme: SingletonFrom(OMTKLogic.CalculateMMEs({ { rxNormCode: P.rxNormCode, doseQuantity: P.dose, dosesPerDay: P.dosesPerDay } }))
    return {
      rxNormCode: P.rxNormCode,
      isDraft: P.isDraft,
      isPRN: P.isPRN,
      prescription: P.prescription,
      dailyDose: mme.dailyDoseDescription,
      conversionFactor: mme.conversionFactor,
      mme: mme.mme
    }

define function TotalMME(prescriptions List<MedicationRequest>):
  System.Quantity {
    value: Sum((MME(prescriptions)) M return M.mme.value),
    unit: 'mg/d'
  }

define function ProbableDaysInRange(Orders List<MedicationRequest>, daysPast Integer, numDaysInDaysPast Integer):
  Orders orders
    let
      frequency: orders.dosageInstruction[0].timing.repeat.frequency.value,
      period: orders.dosageInstruction[0].timing.repeat.period.value,
      periodDays: GetPeriodDays(orders.dosageInstruction[0].timing.repeat.periodUnit.value),
      dosesPerDay:
        if (frequency / (period * periodDays)) >= 1.0
        then 1.0
        else frequency / (period * periodDays),
      repeat: orders.dispenseRequest.numberOfRepeatsAllowed.value,
      supplyDuration: GetDurationInDays(orders.dispenseRequest.expectedSupplyDuration),
      validityPeriod: days between orders.dispenseRequest.validityPeriod."start".value and Today(),
      endDifference:
        if orders.dispenseRequest.validityPeriod."end".value < Today()
        then days between orders.dispenseRequest.validityPeriod."end".value and Today()
        else 0
    return
      if (repeat * supplyDuration) < numDaysInDaysPast then false
      else
        (dosesPerDay * ((repeat * supplyDuration) / validityPeriod) * (daysPast - endDifference)) >= numDaysInDaysPast

define function GetPeriodDays(value System.String):
  case
    when value = 'a' then 365.0
    when value = 'mo' then 30.0
    when value = 'h' then 1.0/24.0
    when value = 'min' then 1.0/24.0*60.0
    when value = 's' then 1.0/24.0*60.0*60.0
    when value = 'ms' then 1.0/24.0*60.0*60.0*1000.0
    else 1.0
  end

  define function GetDurationInDays(value FHIR.Duration):
    case
      when StartsWith(value.unit.value, 'a') then value.value.value * 365.0
      when StartsWith(value.unit.value, 'mo') then value.value.value * 30.0
      when StartsWith(value.unit.value, 'wk') then value.value.value * 7.0
      when StartsWith(value.unit.value, 'd') then value.value.value
      when StartsWith(value.unit.value, 'h') then value.value.value / 24.0
      when StartsWith(value.unit.value, 'min') then value.value.value / 60.0 / 24.0
      when StartsWith(value.unit.value, 's') then value.value.value / 60.0 / 60.0 / 24.0
      when StartsWith(value.unit.value, 'ms') then value.value.value / 60.0 / 60.0 / 24.0 / 1000.0
      else Message(1000, true, 'Undefined', 'Error', 'Unsupported duration unit')
    end

define function GetIngredient(rxNormCode Code):
  OMTKLogic.GetIngredients(rxNormCode).ingredientName

define function GetIngredients(rxNormCodes List<Code>):
  rxNormCodes rnc return GetIngredient(rnc)

define function GetMedicationNames(medications List<MedicationRequest>):
  medications M
    return OMTKLogic.GetIngredients(ToRxNormCode(M.medication.coding)).rxNormCode.display

/*
*  Conversion Functions
*/

define function ToCode(coding FHIR.Coding):
  System.Code {
    code: coding.code.value,
    system: coding.system.value,
    version: coding.version.value,
    display: coding.display.value
  }

define function ToCodes(coding List<FHIR.Coding>):
  coding c return ToCode(c)

define function ToRxNormCode(coding List<FHIR.Coding>):
  singleton from (
    coding C where C.system = 'http://www.nlm.nih.gov/research/umls/rxnorm'
  )

define function ToQuantity(quantity FHIR.Quantity):
  System.Quantity { value: quantity.value.value, unit: quantity.unit.value }
"/>
</content>
<content>
<contentType value="application/elm+xml"/>
</content>
</Library>
IG © 2022+ HL7 International - Clinical Decision Support WG. Package hl7.fhir.uv.cpg#1.0.0 based on FHIR 4.0.1. Generated 2023-09-21
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