{ "resourceType" : "CarePlan", "id" : "care-plan-cvd-screening-example", "meta" : { "profile" : ["https://hl7.lt/fhir/cvd/StructureDefinition/care-plan-lt-cvd"] }, "language" : "en", "text" : { "status" : "extensions", "div" : "

English

Generated Narrative: CarePlan care-plan-cvd-screening-example

Language: en

Profile: Care Plan: CVD prevention measures (LT)

CVD Risk Group Extension: Very large

status: Active

intent: Plan

title: Plan for Heart and Blood Vessel Disease Screening Measures

description: Comprehensive plan detailing lifestyle modifications, pharmacological advice, and biometric targets for CVD risk reduction.

subject: Jonas Petrauskas(official) Male, DoB: 1985-01-01 ( http://hospital-lt.lt/patient-id#HOSPLT-10005\u00a0(use:\u00a0usual,\u00a0))

created: 2025-10-31 10:00:00+0200

supportingInfo:

goal:

activity

PerformedActivities

-Concept
*Tobacco use cessation education (procedure)

progress:

Quitting smoking intervention selected: Pharmacological and Behavior change tools.

\n

activity

PerformedActivities

-Concept
*Diet education (procedure)

progress: ,

Healthy Nutrition Plan: Diet should include consumption of fruits and vegetables > 200 g/day, 35–45 g of fiber (recommended from grains), moderate consumption of nuts (30 g/day, unsalted), 1–2 servings of fish per week (one fatty fish), limited amounts of lean meat, low-fat dairy products, and liquid vegetable oils.\nSaturated fats <10% of total fat intake, replacing them with polyunsaturated fats, reducing trans fats, preferably not from processed foods and making up <1% of total energy intake.\nSalt ˂ 5–6 g per day.\nAvoid alcohol if consumed, limit intake to ˂100 g per week or <15 g per day. Avoid high-energy foods, such as sugar-sweetened soft drinks.

\n

Focus on reducing processed sugar intake dramatically by eliminating soft drinks.

\n

activity

PerformedActivities

-Concept
*Physical activity consultation (procedure)

progress: ,

30-60 minutes of moderate physical activity daily, beneficial and irregular physical activity.

\n

Focus on 3 sessions of swimming per week in addition to daily walks.

\n

activity

PerformedActivities

-Concept
*Antilipid treatment prescribed by the doctor.

progress:

Atorvastatin 20mg daily.

\n

note:

Recommend follow-up appointment with a cardiologist in three months to review treatment efficacy and progress toward goals.

\n

Generated Narrative: Goal #goal-ldl

lifecycleStatus: Active

description: Target LDL Cholesterol, considering the cardiovascular disease risk group

subject: Jonas Petrauskas(official) Male, DoB: 1985-01-01 ( http://hospital-lt.lt/patient-id#HOSPLT-10005\u00a0(use:\u00a0usual,\u00a0))

Targets

-MeasureDetail[x]Due[x]
*Cholesterol in LDL [Mass/volume] in Serum or Plasma by calculation1.4 mmol/L (Details: UCUM codemmol/L = 'mmol/L')2026-10-31

Generated Narrative: Goal #goal-bmi

lifecycleStatus: Active

description: Target Body Mass Index (BMI) of 22.5 kg/m2

subject: Jonas Petrauskas(official) Male, DoB: 1985-01-01 ( http://hospital-lt.lt/patient-id#HOSPLT-10005\u00a0(use:\u00a0usual,\u00a0))

Targets

-MeasureDetail[x]
*Body mass index (BMI) [Ratio]22.5 kg/m2 (Details: UCUM codekg/m2 = 'kg/m2')

Generated Narrative: Goal #goal-bp

lifecycleStatus: Planned

description: Target BP 120-129/<80 mmHg

subject: Jonas Petrauskas(official) Male, DoB: 1985-01-01 ( http://hospital-lt.lt/patient-id#HOSPLT-10005\u00a0(use:\u00a0usual,\u00a0))

" }, "contained" : [{ "resourceType" : "Goal", "id" : "goal-ldl", "lifecycleStatus" : "active", "description" : { "text" : "Target LDL Cholesterol, considering the cardiovascular disease risk group" }, "subject" : { "reference" : "Patient/patient-male-example" }, "target" : [{ "measure" : { "coding" : [{ "system" : "http://loinc.org", "code" : "13457-7", "display" : "Cholesterol in LDL [Mass/volume] in Serum or Plasma by calculation" }] }, "detailQuantity" : { "value" : 1.4, "unit" : "mmol/L", "system" : "http://unitsofmeasure.org", "code" : "mmol/L" }, "dueDate" : "2026-10-31" }] }, { "resourceType" : "Goal", "id" : "goal-bmi", "lifecycleStatus" : "active", "description" : { "text" : "Target Body Mass Index (BMI) of 22.5 kg/m2" }, "subject" : { "reference" : "Patient/patient-male-example" }, "target" : [{ "measure" : { "coding" : [{ "system" : "http://loinc.org", "code" : "39156-5", "display" : "Body mass index (BMI) [Ratio]" }] }, "detailQuantity" : { "value" : 22.5, "unit" : "kg/m2", "system" : "http://unitsofmeasure.org", "code" : "kg/m2" } }] }, { "resourceType" : "Goal", "id" : "goal-bp", "lifecycleStatus" : "planned", "description" : { "text" : "Target BP 120-129/<80 mmHg" }, "subject" : { "reference" : "Patient/patient-male-example" } }], "extension" : [{ "url" : "https://hl7.lt/fhir/cvd/StructureDefinition/risk-group-ext-lt-cvd", "valueCodeableConcept" : { "coding" : [{ "system" : "https://tx.hl7.lt/fhir/CodeSystem/risk-group", "code" : "very-large", "display" : "Very large" }] } }], "status" : "active", "intent" : "plan", "title" : "Plan for Heart and Blood Vessel Disease Screening Measures", "description" : "Comprehensive plan detailing lifestyle modifications, pharmacological advice, and biometric targets for CVD risk reduction.", "subject" : { "reference" : "Patient/patient-male-example" }, "created" : "2025-10-31T10:00:00+02:00", "supportingInfo" : [{ "display" : "A healthy weight is when Body Mass Index (BMI) is 18.5-24.9 kg/m2." }, { "display" : "Regular use of prescribed medication: Antilipid treatment, Antihypertensive and heart rate regulating (cardioprotective) treatment, Currently used medications." }], "goal" : [{ "reference" : "#goal-ldl" }, { "reference" : "#goal-bmi" }, { "reference" : "#goal-bp" }], "activity" : [{ "performedActivity" : [{ "concept" : { "coding" : [{ "system" : "http://snomed.info/sct", "code" : "702388001", "display" : "Tobacco use cessation education (procedure)" }] } }], "progress" : [{ "text" : "Quitting smoking intervention selected: Pharmacological and Behavior change tools." }] }, { "performedActivity" : [{ "concept" : { "coding" : [{ "system" : "http://snomed.info/sct", "code" : "11816003", "display" : "Diet education (procedure)" }] } }], "progress" : [{ "text" : "Healthy Nutrition Plan: Diet should include consumption of fruits and vegetables > 200 g/day, 35–45 g of fiber (recommended from grains), moderate consumption of nuts (30 g/day, unsalted), 1–2 servings of fish per week (one fatty fish), limited amounts of lean meat, low-fat dairy products, and liquid vegetable oils.\nSaturated fats <10% of total fat intake, replacing them with polyunsaturated fats, reducing trans fats, preferably not from processed foods and making up <1% of total energy intake.\nSalt ˂ 5–6 g per day.\nAvoid alcohol if consumed, limit intake to ˂100 g per week or <15 g per day. Avoid high-energy foods, such as sugar-sweetened soft drinks." }, { "text" : "Focus on reducing processed sugar intake dramatically by eliminating soft drinks." }] }, { "performedActivity" : [{ "concept" : { "coding" : [{ "system" : "http://snomed.info/sct", "code" : "1287704009", "display" : "Physical activity consultation (procedure)" }] } }], "progress" : [{ "text" : "30-60 minutes of moderate physical activity daily, beneficial and irregular physical activity." }, { "text" : "Focus on 3 sessions of swimming per week in addition to daily walks." }] }, { "performedActivity" : [{ "concept" : { "text" : "Antilipid treatment prescribed by the doctor." } }], "progress" : [{ "text" : "Atorvastatin 20mg daily." }] }], "note" : [{ "text" : "Recommend follow-up appointment with a cardiologist in three months to review treatment efficacy and progress toward goals." }] }