FHIR CI-Build

This is the Continuous Integration Build of FHIR (will be incorrect/inconsistent at times).
See the Directory of published versions

Example PlanDefinition/example-cardiology-os (Narrative)

Clinical Decision Support Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: No defined compartments

This is the narrative for the resource. See also the XML, JSON or Turtle format. This example conforms to the profile PlanDefinition.


Generated Narrative: PlanDefinition

Resource PlanDefinition "example-cardiology-os"

StructureDefinition Work Group: cds

url: http://va.gov/kas/orderset/B5-Cardiology-ChestPainCAD-OS

identifier: URI/urn:oid:2.16.840.1.113883.4.642.11.8, urn:va.gov:kbs:knart:artifact:r1/bb7ccea6-9744-4743-854a-bcffd87191f6 (use: OFFICIAL), urn:va.gov:kbs:contract:VA118-16-D-1008:to:VA-118-16-F-1008-0007/CLIN0004AG, urn:cognitivemedicine.com:lab:jira/KP-914

version: 0.1

name: ChestPainCoronaryArteryDiseaseOrderSetKNART

title: Chest Pain (CP) - Coronary Artery Disease (CAD) Order Set KNART

type: Order Set (PlanDefinitionType#order-set)

status: active

date: 2017-08-29

publisher: HL7 International / Clinical Decision Support

contact:

description: The Cardiology chest pain (CP) and coronary artery disease (CAD) group of KNARTs are intended to assist primary care providers in the management of adult patients with stable chest pain (with or without known CAD); aid in determining when a cardiology consultation is appropriate; provide guidance for initial noninvasive diagnostic orders (stress testing) and provide a structured documentation template for the process. Stable patients with cardiac chest pain require risk stratification, office-based workup, initiation of disease-specific medications, and subspecialty referral to a cardiologist.

UseContexts

-CodeValue[x]
*Clinical Focus (Details: http://terminology.hl7.org/CodeSystem/usage-context-type code focus = 'Clinical Focus', stated as 'null')Heart disease (disorder) (SNOMED CT#56265001)

usage: The Cardiology chest pain (CP) and coronary artery disease (CAD) group of KNARTs are intended to assist primary care providers in the management of adult patients with stable chest pain (with or without known CAD); aid in determining when a cardiology consultation is appropriate; provide guidance for initial noninvasive diagnostic orders (stress testing) and provide a structured documentation template for the process. Stable patients with cardiac chest pain require risk stratification, office-based workup, initiation of disease-specific medications, and subspecialty referral to a cardiologist. This context excludes emergent patients (new/ongoing/unstable pattern CP). Included are those patients with stable CP with or without known CAD, to be considered for evaluation by cardiology.

copyright: © Copyright Cognitive Medical Systems, Inc. 9444 Waples Street Suite 300 San Diego, CA 92121

author: Bruce Bray MD: , Scott Wall MD: , Aiden Abidov MD, PhD:

relatedArtifact

type: derived-from

display: Cardiology: Chest Pain (CP) / Coronary Artery Disease (CAD) Clinical Content White Paper

document

relatedArtifact

type: justification

display: Outcome CVD (coronary death, myocardial infarction, coronary insufficiency, angina, ischemic stroke, hemorrhagic stroke, transient ischemic attack, peripheral artery disease, heart failure)

citation: Cardiovascular disease (10-year risk) [Internet].: Framingham Heart Study; cited 2017]. Available from: https://www.framinghamheartstudy.org/risk-functions/cardiovascular-disease/10-year-risk.php.

document

relatedArtifact

type: justification

display: General cardiovascular risk profile for use in primary care: the Framingham Heart Study

citation: Cardiovascular disease (10-year risk) [Internet].: Framingham Heart Study; cited 2017]. Available from: https://www.framinghamheartstudy.org/risk-functions/cardiovascular-disease/10-year-risk.php.

document

relatedArtifact

type: justification

display: 2014 ACC/AHA/AATS/PCNA/SCAI/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines, and the American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons

citation: Fihn SD, Blankenship JC, Alexander KP, Bittl JA, Byrne JG, Fletcher BJ, et al. 2014 ACC/AHA/AATS/PCNA/SCAI/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease: A report of the american college of cardiology/american heart association task force on practice guidelines, and the american association for thoracic surgery, preventive cardiovascular nurses association, society for cardiovascular angiography and interventions, and society of thoracic surgeons. J Thorac Cardiovasc Surg. 2015 March 01;149(3):5.

document

relatedArtifact

type: justification

display: ACC/AHA 2002 guideline update for exercise testing: summary article: A report of the American college of cardiology/American heart association task force on practice guidelines (committee to update the 1997 exercise testing guidelines)

citation: Gibbons RJ, Balady GJ, Bricker JT, Chaitman BR, Fletcher GF, Froelicher VF, et al. ACC/AHA 2002 guideline update for exercise testing: Summary article: A report of the american college of cardiology/american heart association task force on practice guidelines (committee to update the 1997 exercise testing guidelines). Circulation. 2002 October 01;106(14):1883-92.

document

relatedArtifact

type: justification

display: LABEL: ASPIRIN 81 MG- aspirin tablet, coated

citation: Label: ASPIRIN 81 MG- aspirin tablet, coated [Internet].: National Library of Medicine; 2017. Available from: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b4064039-2345-4227-b83d-54dc13a838d3.

document

relatedArtifact

type: justification

display: LABEL: CLOPIDOGREL- clopidogrel bisulfate tablet, film coated

citation: LABEL: CLOPIDOGREL- clopidogrel bisulfate tablet, film coated [Internet].: National Library of Medicine; 2017. Available from: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=edae8df1-caf9-ff72-1304-5ae8b355f8e7.

document

relatedArtifact

type: justification

display: LABEL: LIPITOR- atorvastatin calcium tablet, film coated

citation: LABEL: LIPITOR- atorvastatin calcium tablet, film coated [Internet].: National Library of Medicine; 2017. Available from: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7fe85155-bc00-406b-b097-e8aece187a8a.

document

relatedArtifact

type: justification

display: LABEL: METOPROLOL SUCCINATE EXTENDED-RELEASE - metoprolol succinate tablet, film coated, extended release

citation: LABEL: LIPITOR- atorvastatin calcium tablet, film coated [Internet].: National Library of Medicine; 2017. Available from: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7fe85155-bc00-406b-b097-e8aece187a8a.

document

relatedArtifact

type: justification

display: LABEL: NITROGLYCERIN- nitroglycerin tablet

citation: LABEL: NITROGLYCERIN- nitroglycerin tablet [Internet].: National Library of Medicine; 2017. Available from: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=67bf2a15-b115-47ac-ae28-ce2dafd6b5c9.

document

relatedArtifact

type: justification

display: LABEL: SIMVASTATIN - simvastatin tablet

citation: LABEL: SIMVASTATIN - simvastatin tablet [Internet].: National Library of Medicine; 2017. Available from: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5c1c694c-4b08-469e-b538-08e69df06146.

document

relatedArtifact

type: justification

display: Chest Pain Guideline Development Group. NICE guidance. Chest pain of recent onset: assessment and diagnosis of recent onset chest pain or discomfort of suspected cardiac origin.

citation: Skinner JS, Smeeth L, Kendall JM, Adams PC, Timmis A, Chest Pain Guideline Development Group. NICE guidance. chest pain of recent onset: Assessment and diagnosis of recent onset chest pain or discomfort of suspected cardiac origin. Heart. 2010 June 01;96(12):974-8.

document

library: #cardiology-chestPain-logic

action

action

title: Consults and Referrals

groupingBehavior: logical-group

selectionBehavior: any

action

action

action

action

title: Medications

description: Consider the following medications for stable patients to be initiated prior to the cardiology consultation.

action

action

action


Generated Narrative: Library #cardiology-chestPain-logic

status: active

type: Logic Library (LibraryType#logic-library)

description: Placeholder library


Generated Narrative: ActivityDefinition #referralToCardiologyConsult

status: draft

description: Consider other consult modalities which might be available (e.g., e-consult or other rapidly iterative consult method. A simple consult is included here as the overarching clinical intent.

kind: ServiceRequest

timing: Events: Now()

Participants

-Type
*practitioner

Generated Narrative: ActivityDefinition #metoprololTartrate25Prescription

status: draft

kind: MedicationRequest

product: #metoprololTartrate25Medication

dosage

text: 1 tablet oral 2 time daily

timing: 2 per 1 days

route: Oral route (qualifier value) ([not stated]#26643006)

doseAndRate

dynamicValue

path: medicationRequest.priority

Expressions

-LanguageExpression
*text/cqlroutine

Generated Narrative: Medication #metoprololTartrate25Medication

code: Metoprolol Tartrate 25 MG (RxNorm#866426)

doseForm: Tablet dose form (SNOMED CT#385055001 "Tablet (basic dose form)")

ingredient

Items

-Reference
*#metoprololTartrate25Substance

strength: 25 mg/1 {tbl}


Generated Narrative: Substance #metoprololTartrate25Substance

instance: false

Codes

-Concept
*Metoprolol (RxNorm#6918)

Generated Narrative: ActivityDefinition #metoprololTartrate50Prescription

status: draft

kind: MedicationRequest

product: #metoprololTartrate50Medication

dosage

text: 1 tablet oral 2 time daily

timing: 2 per 1 days

route: Oral route (qualifier value) ([not stated]#26643006)

doseAndRate

dynamicValue

path: medicationRequest.priority

Expressions

-LanguageExpression
*text/cqlroutine

Generated Narrative: Medication #metoprololTartrate50Medication

code: Metoprolol Tartrate 50 MG (RxNorm#866435)

doseForm: Tablet dose form (SNOMED CT#385055001 "Tablet (basic dose form)")

ingredient

Items

-Reference
*#metoprololTartrate50Substance

strength: 50 mg/1 {tbl}


Generated Narrative: Substance #metoprololTartrate50Substance

instance: false

Codes

-Concept
*Metoprolol (RxNorm#6918)

Generated Narrative: ActivityDefinition #nitroglycerinPrescription

status: draft

kind: MedicationRequest

product: #nitroglycerinMedication

dosage

text: nitroglycerin 0.4 mg tablet sub-lingual every 5 minutes as needed for chest pain; maximum 3 tablets

timing: Once per 5 minutes

doseAndRate

maxDosePerAdministration: 3 {tbl}

dynamicValue

path: medicationRequest.priority

Expressions

-LanguageExpression
*text/cqlroutine

Generated Narrative: Medication #nitroglycerinMedication

code: Nitroglycerin 0.4 MG (RxNorm#316365)

doseForm: Tablet dose form (SNOMED CT#385055001 "Tablet (basic dose form)")

ingredient

Items

-Reference
*#nitroglycerinSubstance

strength: 0.4 mg/1 {tbl}


Generated Narrative: Substance #nitroglycerinSubstance

instance: false

Codes

-Concept
*Nitroglycerin (RxNorm#4917)

Generated Narrative: Questionnaire #CollectReferralReason

status: draft

Items

-LinkIdTextTypeRequiredRepeatsAnswerValueSet
*1Reason for Cardiology Consultcodingtruetrue#CardiologyReferralReasonValues

Generated Narrative: Questionnaire #CardiologyConsultationGoal

status: draft

Items

-LinkIdTextType
*2Goal of cardiology consultationstring

 

 

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.