Clinical Practice Guidelines Example Implementation Guide - Chronic Kidney Disease
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Clinical Practice Guidelines Example Implementation Guide - Chronic Kidney Disease, published by HL7 International - Clinical Decision Support WG. This guide is not an authorized publication; it is the continuous build for version 1.0.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/cpg-example-ckd/ and changes regularly. See the Directory of published versions

: VA CKD Protocol Pathway - XML Representation

Active as of 2024-11-18

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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 class="res-header-id"><b>Generated Narrative: PlanDefinition va-ckd-protocol</b></p><a name="va-ckd-protocol"> </a><a name="hcva-ckd-protocol"> </a><a name="va-ckd-protocol-en-US"> </a><p><b>CQF Knowledge capability</b>: shareable</p><p><b>CQF Knowledge capability</b>: computable</p><p><b>CQF Knowledge capability</b>: publishable</p><p><b>CQF knowledge representation level</b>: structured</p><p><b>url</b>: <a href="PlanDefinition-va-ckd-protocol.html">PlanDefinition VA CKD Protocol Pathway</a></p><p><b>identifier</b>: VA_CKD_Protocol (use: official, )</p><p><b>version</b>: 1.0.0</p><p><b>name</b>: VACKDProtocol</p><p><b>title</b>: VA CKD Protocol Pathway</p><p><b>type</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/plan-definition-type clinical-protocol}">Clinical Protocol</span></p><p><b>status</b>: Active</p><p><b>experimental</b>: true</p><p><b>date</b>: 2024-11-18 18:20:09+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>: </p><div><p>VA CKD Protocol</p>
</div><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><a href="http://terminology.hl7.org/6.0.2/CodeSystem-usage-context-type.html#usage-context-type-focus">UsageContextType focus</a>: Clinical Focus</td><td><span title="Codes:{http://snomed.info/sct 709044004}">Chronic kidney disease (disorder)</span></td></tr></table><p><b>jurisdiction</b>: <span title="Codes:{http://unstats.un.org/unsd/methods/m49/m49.htm 001}">World</span></p><p><b>topic</b>: <span title="Codes:{http://terminology.hl7.org/CodeSystem/definition-topic treatment}">Treatment</span></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>: <span title="Codes:{http://hl7.org/fhir/uv/cpg/CodeSystem/cpg-common-process-cs history-and-physical}">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>: <span title="Codes:{http://hl7.org/fhir/uv/cpg/CodeSystem/cpg-common-process-cs history-and-physical}">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>: <span title="Codes:{http://hl7.org/fhir/uv/cpg/CodeSystem/cpg-common-process-cs triage}">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>: <span title="Codes:{http://hl7.org/fhir/uv/cpg/CodeSystem/cpg-common-process-cs triage}">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>: <span title="Codes:{http://hl7.org/fhir/uv/cpg/CodeSystem/cpg-common-process-cs determine-diagnosis}">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>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>: <span title="Codes:{http://hl7.org/fhir/uv/cpg/CodeSystem/cpg-common-process-cs determine-diagnosis}">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>: <span title="Codes:{http://hl7.org/fhir/uv/cpg/CodeSystem/cpg-common-process-cs guideline-based-care}">Guideline-based Care</span></p></blockquote></blockquote></div>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/cqf-knowledgeCapability">
    <valueCode value="shareable"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/cqf-knowledgeCapability">
    <valueCode value="computable"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/cqf-knowledgeCapability">
    <valueCode value="publishable"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/cqf-knowledgeRepresentationLevel">
    <valueCode value="structured"/>
  </extension>
  <url
       value="http://cqframework.org/cpg-example-ckd/PlanDefinition/va-ckd-protocol"/>
  <identifier>
    <use value="official"/>
    <value value="VA_CKD_Protocol"/>
  </identifier>
  <version value="1.0.0"/>
  <name value="VACKDProtocol"/>
  <title value="VA CKD Protocol Pathway"/>
  <type>
    <coding>
      <system
              value="http://terminology.hl7.org/CodeSystem/plan-definition-type"/>
      <code value="clinical-protocol"/>
      <display value="Clinical Protocol"/>
    </coding>
  </type>
  <status value="active"/>
  <experimental value="true"/>
  <date value="2024-11-18T18:20:09+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>
  <topic>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/definition-topic"/>
      <code value="treatment"/>
      <display value="Treatment"/>
    </coding>
  </topic>
  <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>