Workflow
This
page
is
part
of
the
Continuous
Integration
Build
of
FHIR
Specification
(v4.0.1:
R4
-
Mixed
Normative
and
STU
)
in
it's
permanent
home
(it
will
always
(will
be
available
incorrect/inconsistent
at
this
URL).
The
current
version
which
supercedes
this
version
is
5.0.0
.
For
a
full
list
of
available
versions,
see
times).
See
the
Directory
of
published
versions
.
Page
versions:
R5
R4B
R4
| Responsible Owner: Clinical Decision Support Work Group | Standards Status : Informative |
Compartments
:
|
Raw JSON ( canonical form + also see JSON Format Specification )
Opioid CDS Recommendation 4 ECA Rule
{
"resourceType": "PlanDefinition",
"id": "opioidcds-04",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: opioidcds-04</p><p><b>url</b>: <b>http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-04</b></p><p><b>identifier</b>: cdc-opioid-guidance (OFFICIAL)</p><p><b>version</b>: 0.1.0</p><p><b>name</b>: cdc-opioid-04</p><p><b>title</b>: CDC Opioid Prescribing Guideline Recommendation #4</p><p><b>type</b>: ECA Rule <span>(Details : {http://terminology.hl7.org/CodeSystem/plan-definition-type code 'eca-rule' = 'ECA Rule', given as 'ECA Rule'})</span></p><p><b>status</b>: draft</p><p><b>date</b>: 19/03/2018</p><p><b>publisher</b>: Centers for Disease Control and Prevention (CDC)</p><p><b>description</b>: When starting opioid therapy for chronic pain, clinicians should prescribe immediate-release opioids instead of extended-release/long-acting (ER/LA) opioids.</p><p><b>useContext</b>: , </p><p><b>jurisdiction</b>: United States of America <span>(Details : {urn:iso:std:iso:3166 code 'US' = 'United States of America', given as 'United States of America'})</span></p><p><b>purpose</b>: CDC’s Guideline for Prescribing Opioids for Chronic Pain is intended to improve communication between providers and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder and overdose. The Guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care.</p><p><b>usage</b>: Providers should use caution when prescribing extended-release/long-acting (ER/LA) opioids as they carry a higher risk and negligible benefit compared to immediate-release opioids.</p><p><b>copyright</b>: © CDC 2016+.</p><p><b>topic</b>: Opioid Prescribing <span>(Details )</span></p><p><b>author</b>: , , , </p><p><b>relatedArtifact</b>: , </p><p><b>library</b>: <a>Library/opioidcds-recommendation-04</a></p><blockquote><p><b>action</b></p><p><b>title</b>: Extended-release opioid prescription triggered.</p><p><b>description</b>: Checking if the trigger prescription meets the inclusion criteria for recommendation #4 workflow.</p><p><b>documentation</b>: </p><p><b>trigger</b>: </p><h3>Conditions</h3><table><tr><td>-</td><td><b>Kind</b></td><td><b>Expression</b></td></tr><tr><td>*</td><td>applicability</td><td/></tr></table><p><b>groupingBehavior</b>: visual-group</p><p><b>selectionBehavior</b>: exactly-one</p><blockquote><p><b>dynamicValue</b></p><p><b>path</b>: action.title</p><p><b>expression</b>: </p></blockquote><blockquote><p><b>dynamicValue</b></p><p><b>path</b>: action.description</p><p><b>expression</b>: </p></blockquote><blockquote><p><b>dynamicValue</b></p><p><b>path</b>: activity.extension</p><p><b>expression</b>: </p></blockquote><h3>Actions</h3><table><tr><td>-</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr></table></blockquote></div>"
"resourceType" : "PlanDefinition",
"id" : "opioidcds-04",
"extension" : [{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode" : "cds"
}],
"identifier" : [{
"system" : "urn:ietf:rfc:3986",
"value" : "urn:oid:2.16.840.1.113883.4.642.11.4"
},
"url": "http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-04",
"identifier": [
{
"use": "official",
"value": "cdc-opioid-guidance"
{
"use" : "official",
"value" : "cdc-opioid-guidance"
}],
"version" : "0.1.0",
"name" : "Cdcopioid04",
"title" : "CDC Opioid Prescribing Guideline Recommendation #4",
"type" : {
"coding" : [{
"system" : "http://terminology.hl7.org/CodeSystem/plan-definition-type",
"code" : "eca-rule",
"display" : "ECA Rule"
}]
},
"status" : "draft",
"date" : "2018-03-19",
"publisher" : "HL7 International / Clinical Decision Support",
"contact" : [{
"telecom" : [{
"system" : "url",
"value" : "http://www.hl7.org/Special/committees/dss"
}]
}],
"description" : "When starting opioid therapy for chronic pain, clinicians should prescribe immediate-release opioids instead of extended-release/long-acting (ER/LA) opioids.",
"useContext" : [{
"code" : {
"system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
"code" : "focus",
"display" : "Clinical Focus"
},
"valueCodeableConcept" : {
"coding" : [{
"system" : "http://snomed.info/sct",
"code" : "182888003",
"display" : "Medication requested (situation)"
}]
}
],
"version": "0.1.0",
"name": "cdc-opioid-04",
"title": "CDC Opioid Prescribing Guideline Recommendation #4",
"type": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/plan-definition-type",
"code": "eca-rule",
"display": "ECA Rule"
}
]
},
"status": "draft",
"date": "2018-03-19",
"publisher": "Centers for Disease Control and Prevention (CDC)",
"description": "When starting opioid therapy for chronic pain, clinicians should prescribe immediate-release opioids instead of extended-release/long-acting (ER/LA) opioids.",
"useContext": [
{
"code": {
"system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
"code": "focus",
"display": "Clinical Focus"
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "182888003",
"display": "Medication requested (situation)"
}
]
}
{
"code" : {
"system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
"code" : "focus",
"display" : "Clinical Focus"
},
{
"code": {
"system": "http://terminology.hl7.org/CodeSystem/usage-context-type",
"code": "focus",
"display": "Clinical Focus"
},
"valueCodeableConcept": {
"coding": [
{
"system": "http://snomed.info/sct",
"code": "82423001",
"display": "Chronic pain (finding)"
}
]
}
"valueCodeableConcept" : {
"coding" : [{
"system" : "http://snomed.info/sct",
"code" : "82423001",
"display" : "Chronic pain (finding)"
}]
}
],
"jurisdiction": [
{
"coding": [
{
"system": "urn:iso:std:iso:3166",
"code": "US",
"display": "United States of America"
}
]
}],
"jurisdiction" : [{
"coding" : [{
"system" : "urn:iso:std:iso:3166",
"code" : "US",
"display" : "United States of America"
}]
}],
"purpose" : "CDC’s Guideline for Prescribing Opioids for Chronic Pain is intended to improve communication between providers and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder and overdose. The Guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care.",
"usage" : "Providers should use caution when prescribing extended-release/long-acting (ER/LA) opioids as they carry a higher risk and negligible benefit compared to immediate-release opioids.",
"copyright" : "© CDC 2016+.",
"topic" : [{
"text" : "Opioid Prescribing"
}],
"author" : [{
"name" : "Kensaku Kawamoto, MD, PhD, MHS"
},
{
"name" : "Bryn Rhodes"
},
{
"name" : "Floyd Eisenberg, MD, MPH"
},
{
"name" : "Robert McClure, MD, MPH"
}],
"relatedArtifact" : [{
"type" : "documentation",
"display" : "CDC guideline for prescribing opioids for chronic pain",
"document" : {
"url" : "https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chronic-pain---united-states-2016#420"
}
],
"purpose": "CDC’s Guideline for Prescribing Opioids for Chronic Pain is intended to improve communication between providers and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder and overdose. The Guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care.",
"usage": "Providers should use caution when prescribing extended-release/long-acting (ER/LA) opioids as they carry a higher risk and negligible benefit compared to immediate-release opioids.",
"copyright": "© CDC 2016+.",
"topic": [
{
"text": "Opioid Prescribing"
},
{
"type" : "documentation",
"display" : "MME Conversion Tables",
"document" : {
"url" : "https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf"
}
],
"author": [
{
"name": "Kensaku Kawamoto, MD, PhD, MHS"
}],
"library" : ["http://example.org/fhir/Library/opioidcds-recommendation-04"],
"action" : [{
"extension" : [{
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation",
"valueCodeableConcept" : {
"coding" : [{
"system" : "http://terminology.hl7.org/CodeSystem/recommendation-strength",
"code" : "strong",
"display" : "Strong"
}]
}
},
{
"name": "Bryn Rhodes"
"url" : "http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence",
"valueCodeableConcept" : {
"coding" : [{
"system" : "http://terminology.hl7.org/CodeSystem/evidence-quality",
"code" : "low",
"display" : "Low quality"
}]
}
}],
"title" : "Extended-release opioid prescription triggered.",
"description" : "Checking if the trigger prescription meets the inclusion criteria for recommendation #4 workflow.",
"documentation" : [{
"type" : "documentation"
}],
"trigger" : [{
"type" : "named-event",
"name" : "medication-prescribe"
}],
"condition" : [{
"kind" : "applicability",
"expression" : {
"description" : "Check whether the opioid prescription for the existing patient is extended-release without any opioids-with-abuse-potential prescribed in the past 90 days.",
"language" : "text/cql-identifier",
"expression" : "Inclusion Criteria"
}
}],
"groupingBehavior" : "visual-group",
"selectionBehavior" : "exactly-one",
"dynamicValue" : [{
"path" : "action.title",
"expression" : {
"language" : "text/cql-identifier",
"expression" : "Get Summary"
}
},
{
"name": "Floyd Eisenberg, MD, MPH"
"path" : "action.description",
"expression" : {
"language" : "text/cql-identifier",
"expression" : "Get Detail"
}
},
{
"name": "Robert McClure, MD, MPH"
}
],
"relatedArtifact": [
{
"type": "documentation",
"display": "CDC guideline for prescribing opioids for chronic pain",
"url": "https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chronic-pain---united-states-2016#420"
"path" : "activity.extension",
"expression" : {
"language" : "text/cql-identifier",
"expression" : "Get Indicator"
}
}],
"action" : [{
"description" : "Will precribe immediate release"
},
{
"type": "documentation",
"display": "MME Conversion Tables",
"url": "https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf"
}
],
"library": [
"Library/opioidcds-recommendation-04"
],
"action": [
"description" : "Risk of overdose carefully considered and outweighed by benefit; snooze 3 mo"
},
{
"title": "Extended-release opioid prescription triggered.",
"description": "Checking if the trigger prescription meets the inclusion criteria for recommendation #4 workflow.",
"documentation": [
{
"type": "documentation",
"document": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation",
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/recommendation-strength",
"code": "strong",
"display": "Strong"
}
]
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence",
"valueCodeableConcept": {
"coding": [
{
"system": "http://terminology.hl7.org/CodeSystem/evidence-quality",
"code": "low",
"display": "Low quality"
}
]
}
}
]
}
}
],
"trigger": [
{
"type": "named-event",
"name": "medication-prescribe"
}
],
"condition": [
{
"kind": "applicability",
"expression": {
"description": "Check whether the opioid prescription for the existing patient is extended-release without any opioids-with-abuse-potential prescribed in the past 90 days.",
"language": "text/cql",
"expression": "Inclusion Criteria"
}
}
],
"groupingBehavior": "visual-group",
"selectionBehavior": "exactly-one",
"dynamicValue": [
{
"path": "action.title",
"expression": {
"language": "text/cql",
"expression": "Get Summary"
}
},
{
"path": "action.description",
"expression": {
"language": "text/cql",
"expression": "Get Detail"
}
},
{
"path": "activity.extension",
"expression": {
"language": "text/cql",
"expression": "Get Indicator"
}
}
],
"action": [
{
"description": "Will precribe immediate release"
},
{
"description": "Risk of overdose carefully considered and outweighed by benefit; snooze 3 mo"
},
{
"description": "N/A - see comment; snooze 3 mo"
}
]
}
]
"description" : "N/A - see comment; snooze 3 mo"
}]
}]
}
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.
FHIR
®©
HL7.org
2011+.
FHIR
Release
4
(Technical
Correction
#1)
(v4.0.1)
R6
hl7.fhir.core#6.0.0-ballot3
generated
on
Fri,
Nov
1,
2019
09:36+1100.
QA
Page
7,
2025
18:59+0000.
Links:
Search
|
Version
History
|
Table
of
Contents
|
Credits
Glossary
|
QA
|
Compare
to
R3
R4
|
Compare
to
R5
|
Compare
to
Last
Ballot
|
|
Propose
a
change