2022 CDC Clinical Practice Guideline for Prescribing Opioids Implementation Guide
2022.1.0 - CI Build

2022 CDC Clinical Practice Guideline for Prescribing Opioids Implementation Guide, published by Centers for Disease Control and Prevention (CDC). This guide is not an authorized publication; it is the continuous build for version 2022.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/cqframework/opioid-cds-r4/ and changes regularly. See the Directory of published versions

2022 CDC Clinical Practice Guideline - Documentation

This section contains documentation for implementers from both the clinical and technical perspectives. The process documentation describes the assumptions and decisions made, as well as a functional description of the recommendations. The integration documentation describes the overall approach and documents the artifacts contained in the IG, while the implementation documentation provides developer-level documentation on how to use the artifacts.

Pilot Testing Reports

Recommendation Pilot Site Test Period Version Tested Functionality Validated Functionality Not Validated Comments
4 Yale 2020 patient-view Alert when there is extended release prescribed instead of immediate release
10 Yale 2020 patient-view Alert when there has been no UDS for patient in past year
11 Yale 2020 patient-view Alert when co-prescribing with benzos
12 Yale 2020 patient-view Alert is triggered when patient has been diagnosis for OUD
10 Duke 2020 patient-view Alert when there has been no UDS for patient in past year
11 Duke 2020 patient-view Alert when co-prescribing with benzos
10 Yale 2021 order-sign Will alert when there has been no UDS for patient in past year
10 Yale 2021 order-sign with suggestion card Creates an order for a UDS when a patient has not had a UDS in the past year
10 Duke 2021 order-sign If a patient has not had a UDS, then the alert recommends a UDS. If the patient did have a UDS in the past year and tested positive for cocaine or PCP an alert was issued. When Duke configured the BPA to create a UDS order (as opposed to using a suggestion card), it resulted in a loop when the user accepted the alert. Accepting the alert resulted in an order-sign event that triggered the CDS service. The only way to break the alert was to decline the recommendation. This was not an issue at Yale.
8 Colorado 2022 order-sign The MME calculation was disabled in the version of Rec 8 that was integration tested. The test case that was validated was co-prescribing with a benzo. This produce an alert recommending naloxone. Integration testing was conducted for one use case - co-prescribing with a benzo. Other recommendation conditions such as history of SUD and daily MME >=50 we not validated. An MME calculation was not conducted as part of this testing.
10 Colorado 2022 order-sign Validated base use case of a patient who has not had a UDS in the past year. Focus was on documenting performance with response times of under a second. Enhanced functionality around unexpected test results was not tested.
10 MUSC 2022 order-sign Validated base use case of a patient who has not had a UDS in the past year. Also validated alerts for positive results for cocaine, PCP, and opiates.
11 MUSC 2022 order-select Validate co-prescribing alert both for patients with pending benzo order and an existing opioid order and for patients with a pending opioid order and existing benzo order.