FHIR Clinical Guidelines (v1.0.0) (STU1)

Clinical Practice Guidelines, published by 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


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AuthorKensaku Kawamoto, MD, PhD, MHS
AuthorBryn Rhodes
AuthorFloyd Eisenberg, MD, MPH
AuthorRobert McClure, MD, MPH

Related Artifacts

documentationCDC guideline for prescribing opioids for chronic painhttps://www.cdc.gov/mmwr/volumes/65/rr/rr6501e1.htm?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fmmwr%2Fvolumes%2F65%2Frr%2Frr6501e1er.htm
depends-onOpioid CDS R4 Common Logic
documentationMME Conversion Tableshttps://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf

Data Requirements

Type: MedicationRequest
statusOne of these codes: http://hl7.org/fhir/CodeSystem/medicationrequest-status active: Active
categoryOne of these codes: http://terminology.hl7.org/CodeSystem/medicationrequest-category outpatient: Outpatient



library OpioidCDSR4Recommendation05 version '0.1.0'

using FHIR version '4.0.0'

include OpioidCDSR4Common version '0.1.0' called Common

** Recommendation #5

  Plan Definition:

parameter ContextPrescriptions List<MedicationRequest>

context Patient

define "Inclusion Criteria":
  AgeInYears() >= 18
    and not "Exclusion Criteria"
    and "Total MME" >= 50 'mg/d'

define "Exclusion Criteria":
  Common."End of Life Assessment"

define "Total MME":
  Common.TotalMME(ContextPrescriptions union Common."Active Ambulatory Opioid Rx")

define "Taper Now": "Total MME".value >= 90

define "Consider Tapering": "Total MME".value < 90

define "Get Indicator":
  if "Inclusion Criteria"
    then 'warning'
  else null

define "Get Summary":
  if "Inclusion Criteria"
      'High risk for opioid overdose - '
        + case when "Taper Now"
           then 'taper now'
           else 'consider tapering'
  else null

define "Get Detail":
  if "Inclusion Criteria"
    then'Total morphine milligram equivalent (MME) is ' + ToString("Total MME") + '. Taper to less than 50.'
  else null