Clinical Practice Guidelines
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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

: VA CKD Protocol - XML Representation

Draft as of 2019-07-28

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<PlanDefinition xmlns="http://hl7.org/fhir">
  <id value="va-ckd-protocol"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-pathwaydefinition"/>
  </meta>
  <text>
    <status value="extensions"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: PlanDefinition</b><a name="va-ckd-protocol"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource PlanDefinition &quot;va-ckd-protocol&quot; </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-cpg-pathwaydefinition.html">CPG Pathway Definition</a></p></div><p><b>CPG Knowledge Capability Extension</b>: shareable</p><p><b>CPG Knowledge Capability Extension</b>: computable</p><p><b>CPG Knowledge Capability Extension</b>: publishable</p><p><b>CPG Knowledge Representation Level Extension</b>: structured</p><p><b>url</b>: <code>http://hl7.org/fhir/uv/cpg/PlanDefinition/va-ckd-protocol</code></p><p><b>identifier</b>: id: VA_CKD_Protocol (use: OFFICIAL)</p><p><b>version</b>: 1.0.0</p><p><b>name</b>: VA_CKD_Protocol</p><p><b>title</b>: VA CKD Protocol</p><p><b>type</b>: Clinical Protocol <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-plan-definition-type.html">PlanDefinitionType</a>#clinical-protocol)</span></p><p><b>status</b>: draft</p><p><b>experimental</b>: true</p><p><b>date</b>: 2019-07-28 00:00:00+0000</p><p><b>publisher</b>: HL7 International - Clinical Decision Support WG</p><p><b>contact</b>: HL7 International - Clinical Decision Support WG: <a href="http://www.hl7.org/Special/committees/dss/index.cfm">http://www.hl7.org/Special/committees/dss/index.cfm</a></p><p><b>description</b>: VA CKD Protocol</p><h3>UseContexts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Code</b></td><td><b>Value[x]</b></td></tr><tr><td style="display: none">*</td><td>Clinical Focus (Details: http://terminology.hl7.org/CodeSystem/usage-context-type code focus = 'Clinical Focus', stated as 'Clinical Focus')</td><td>Chronic kidney disease (disorder) <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a>#709044004)</span></td></tr></table><p><b>jurisdiction</b>: World <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (m49.htm#001)</span></p><p><b>copyright</b>: Copyright © Example.org 2019.</p><p><b>approvalDate</b>: 2019-07-28</p><p><b>lastReviewDate</b>: 2019-07-28</p><p><b>effectivePeriod</b>: 2019-07-28 --&gt; (ongoing)</p><p><b>topic</b>: Treatment <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-definition-topic.html">DefinitionTopic</a>#treatment)</span></p><p><b>author</b>: Dave Carlson: </p><blockquote><p><b>action</b></p><blockquote><p><b>id</b></p>001</blockquote><p><b>title</b>: History and Phyiscal</p><p><b>description</b>: Obtain initial clinical information: medical history (including risk factors for kidney disease), physical examination and review existing laboratory results.</p><p><b>code</b>: History and Physical <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-cpg-common-process-cs.html">CPG Common Process Code System</a>#history-and-physical)</span></p></blockquote><blockquote><p><b>action</b></p><blockquote><p><b>id</b></p>002</blockquote><p><b>title</b>: At-Risk Population</p><p><b>description</b>: Evaluate at-risk patients for CKD: obtain SCr, eGFR, urinalysis, &amp; spot urine UAER.</p><p><b>code</b>: History and Physical <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-cpg-common-process-cs.html">CPG Common Process Code System</a>#history-and-physical)</span></p></blockquote><blockquote><p><b>action</b></p><blockquote><p><b>id</b></p>003</blockquote><p><b>title</b>: Urgent/Emergent Conditions</p><p><b>description</b>: Does patient have an urgent or emergent condition?</p><p><b>code</b>: Triage <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-cpg-common-process-cs.html">CPG Common Process Code System</a>#triage)</span></p><blockquote><p><b>action</b></p><blockquote><p><b>id</b></p>003.1</blockquote><p><b>title</b>: Refer to emergency department.</p><p><b>description</b>: Refer to emergency department to manage or stabilize.</p><p><b>code</b>: Triage <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-cpg-common-process-cs.html">CPG Common Process Code System</a>#triage)</span></p></blockquote></blockquote><blockquote><p><b>action</b></p><blockquote><p><b>id</b></p>004</blockquote><p><b>title</b>: Criteria for Confirmed CKD</p><p><b>description</b>: Does patient have evidence of CKD?</p><p><b>code</b>: Determine Diagnosis <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-cpg-common-process-cs.html">CPG Common Process Code System</a>#determine-diagnosis)</span></p><blockquote><p><b>condition</b></p><p><b>kind</b>: applicability</p><h3>Expressions</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Language</b></td><td><b>Expression</b></td></tr><tr><td style="display: none">*</td><td>text/cql</td><td>Has evidence of CKD?</td></tr></table></blockquote><blockquote><p><b>action</b></p><blockquote><p><b>id</b></p>004.1</blockquote><p><b>title</b>: Stages of CKD.</p><p><b>description</b>: Complete clinical assessment. Determine stage of CKD.</p><p><b>code</b>: Determine Diagnosis <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-cpg-common-process-cs.html">CPG Common Process Code System</a>#determine-diagnosis)</span></p></blockquote><blockquote><p><b>action</b></p><blockquote><p><b>id</b></p>004.2</blockquote><p><b>title</b>: Strategies to Slow Progression.</p><p><b>description</b>: Establish primary etiology of CKD and treatment plan to slow progression.</p><p><b>code</b>: Guideline-based Care <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="CodeSystem-cpg-common-process-cs.html">CPG Common Process Code System</a>#guideline-based-care)</span></p></blockquote></blockquote></div>
  </text>
  <extension
             url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability">
    <valueCode value="shareable"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability">
    <valueCode value="computable"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeCapability">
    <valueCode value="publishable"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/uv/cpg/StructureDefinition/cpg-knowledgeRepresentationLevel">
    <valueCode value="structured"/>
  </extension>
  <url value="http://hl7.org/fhir/uv/cpg/PlanDefinition/va-ckd-protocol"/>
  <identifier>
    <use value="official"/>
    <value value="VA_CKD_Protocol"/>
  </identifier>
  <version value="1.0.0"/>
  <name value="VA_CKD_Protocol"/>
  <title value="VA CKD Protocol"/>
  <type>
    <coding>
      <system
              value="http://terminology.hl7.org/CodeSystem/plan-definition-type"/>
      <code value="clinical-protocol"/>
      <display value="Clinical Protocol"/>
    </coding>
  </type>
  <status value="draft"/>
  <experimental value="true"/>
  <date value="2019-07-28T00:00:00+00:00"/>
  <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="VA CKD Protocol"/>
  <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="709044004"/>
        <display value="Chronic kidney disease (disorder)"/>
      </coding>
    </valueCodeableConcept>
  </useContext>
  <jurisdiction>
    <coding>
      <system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
      <code value="001"/>
      <display value="World"/>
    </coding>
  </jurisdiction>
  <copyright value="Copyright © Example.org 2019."/>
  <approvalDate value="2019-07-28"/>
  <lastReviewDate value="2019-07-28"/>
  <effectivePeriod>
    <start value="2019-07-28"/>
  </effectivePeriod>
  <topic>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/definition-topic"/>
      <code value="treatment"/>
      <display value="Treatment"/>
    </coding>
  </topic>
  <author>
    <name value="Dave Carlson"/>
  </author>
  <action id="001">
    <title value="History and Phyiscal"/>
    <description
                 value="Obtain initial clinical information: medical history (including risk factors for kidney disease), physical examination and review existing laboratory results."/>
    <code>
      <coding>
        <system
                value="http://hl7.org/fhir/uv/cpg/CodeSystem/cpg-common-process-cs"/>
        <code value="history-and-physical"/>
        <display value="History and Physical"/>
      </coding>
    </code>
  </action>
  <action id="002">
    <title value="At-Risk Population"/>
    <description
                 value="Evaluate at-risk patients for CKD: obtain SCr, eGFR, urinalysis, &amp; spot urine UAER."/>
    <code>
      <coding>
        <system
                value="http://hl7.org/fhir/uv/cpg/CodeSystem/cpg-common-process-cs"/>
        <code value="history-and-physical"/>
        <display value="History and Physical"/>
      </coding>
    </code>
  </action>
  <action id="003">
    <title value="Urgent/Emergent Conditions"/>
    <description value="Does patient have an urgent or emergent condition?"/>
    <code>
      <coding>
        <system
                value="http://hl7.org/fhir/uv/cpg/CodeSystem/cpg-common-process-cs"/>
        <code value="triage"/>
        <display value="Triage"/>
      </coding>
    </code>
    <action id="003.1">
      <title value="Refer to emergency department."/>
      <description
                   value="Refer to emergency department to manage or stabilize."/>
      <code>
        <coding>
          <system
                  value="http://hl7.org/fhir/uv/cpg/CodeSystem/cpg-common-process-cs"/>
          <code value="triage"/>
          <display value="Triage"/>
        </coding>
      </code>
    </action>
  </action>
  <action id="004">
    <title value="Criteria for Confirmed CKD"/>
    <description value="Does patient have evidence of CKD?"/>
    <code>
      <coding>
        <system
                value="http://hl7.org/fhir/uv/cpg/CodeSystem/cpg-common-process-cs"/>
        <code value="determine-diagnosis"/>
        <display value="Determine Diagnosis"/>
      </coding>
    </code>
    <condition>
      <kind value="applicability"/>
      <expression>
        <language value="text/cql"/>
        <expression value="Has evidence of CKD?"/>
      </expression>
    </condition>
    <action id="004.1">
      <title value="Stages of CKD."/>
      <description
                   value="Complete clinical assessment. Determine stage of CKD."/>
      <code>
        <coding>
          <system
                  value="http://hl7.org/fhir/uv/cpg/CodeSystem/cpg-common-process-cs"/>
          <code value="determine-diagnosis"/>
          <display value="Determine Diagnosis"/>
        </coding>
      </code>
    </action>
    <action id="004.2">
      <title value="Strategies to Slow Progression."/>
      <description
                   value="Establish primary etiology of CKD and treatment plan to slow progression."/>
      <code>
        <coding>
          <system
                  value="http://hl7.org/fhir/uv/cpg/CodeSystem/cpg-common-process-cs"/>
          <code value="guideline-based-care"/>
          <display value="Guideline-based Care"/>
        </coding>
      </code>
    </action>
  </action>
</PlanDefinition>