Release 4 FHIR CI-Build

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

Plandefinition-opioidcds-10.ttl

Example PlanDefinition/opioidcds-10 (Turtle)

Maturity Level : N/A
Responsible Owner: Clinical Decision Support Work Group Standards Status : Informative Compartments : Not linked to any No defined compartments

Raw Turtle (+ also see Turtle/RDF Format Specification )

Opioid CDS Recommendation 10 ECA Rule 

@prefix fhir: <http://hl7.org/fhir/> .
@prefix owl: <http://www.w3.org/2002/07/owl#> .
@prefix rdf: <http://www.w3.org/1999/02/22-rdf-syntax-ns#> .

@prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> .
@prefix sct: <http://snomed.info/id/> .
@prefix xsd: <http://www.w3.org/2001/XMLSchema#> .

# - resource -------------------------------------------------------------------

<http://hl7.org/fhir/PlanDefinition/opioidcds-10> a fhir:PlanDefinition;
  fhir:nodeRole fhir:treeRoot;
  fhir:Resource.id [ fhir:value "opioidcds-10"];
  fhir:DomainResource.text [
     fhir:Narrative.status [ fhir:value "generated" ];
     fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative with Details</b></p><p><b>id</b>: opioidcds-10</p><p><b>url</b>: <b>http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-10</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-10</p><p><b>title</b>: CDC Opioid Prescribing Guideline Recommendation #10</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>: 23/04/2017</p><p><b>publisher</b>: Centers for Disease Control and Prevention (CDC)</p><p><b>description</b>: When prescribing opioids for chronic pain, providers should use urine drug testing before starting opioid therapy and consider urine drug testing at least annually to assess for prescribed medications as well as other controlled prescription drugs and illicit drugs.</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 be aware if patients are taking other prescription drugs or illicit drugs that might increase their risk of an overdose.</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-10</a></p><blockquote><p><b>action</b></p><p><b>title</b>: Annual Urine Screening Check</p><p><b>description</b>: Patient has not had a urine screening in the past 12 months</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><h3>DynamicValues</h3><table><tr><td>-</td><td><b>Path</b></td><td><b>Expression</b></td></tr><tr><td>*</td><td>activity.extension</td><td/></tr></table><h3>Actions</h3><table><tr><td>-</td></tr><tr><td>*</td></tr><tr><td>*</td></tr></table></blockquote><blockquote><p><b>action</b></p><p><b>title</b>: Positive Urine Screening Check</p><p><b>description</b>: Patient has a urine screening testing positive for either unprescribed opioids or illicit drugs in the past 12 months</p><p><b>documentation</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><h3>Actions</h3><table><tr><td>-</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr></table></blockquote></div>"
  ];
  fhir:PlanDefinition.url [ fhir:value "http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-10"];
  fhir:PlanDefinition.identifier [
     fhir:index 0;
     fhir:Identifier.use [ fhir:value "official" ];
     fhir:Identifier.value [ fhir:value "cdc-opioid-guidance" ]
  ];
  fhir:PlanDefinition.version [ fhir:value "0.1.0"];
  fhir:PlanDefinition.name [ fhir:value "cdc-opioid-10"];
  fhir:PlanDefinition.title [ fhir:value "CDC Opioid Prescribing Guideline Recommendation #10"];
  fhir:PlanDefinition.type [
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/plan-definition-type" ];
       fhir:Coding.code [ fhir:value "eca-rule" ];
       fhir:Coding.display [ fhir:value "ECA Rule" ]

<http://hl7.org/fhir/PlanDefinition/opioidcds-10> a fhir:PlanDefinition ;
  fhir:nodeRole fhir:treeRoot ;
  fhir:id [ fhir:v "opioidcds-10"] ; # 
  fhir:extension ( [
     fhir:url [
       fhir:v "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"^^xsd:anyURI ;
       fhir:l <http://hl7.org/fhir/StructureDefinition/structuredefinition-wg>
     ] ;
     fhir:value [
       a fhir:Code ;
       fhir:v "cds"

     ]
  ];
  fhir:PlanDefinition.status [ fhir:value "draft"];
  fhir:PlanDefinition.date [ fhir:value "2017-04-23"^^xsd:date];
  fhir:PlanDefinition.publisher [ fhir:value "Centers for Disease Control and Prevention (CDC)"];
  fhir:PlanDefinition.description [ fhir:value "When prescribing opioids for chronic pain, providers should use urine drug testing before starting opioid therapy and consider urine drug testing at least annually to assess for prescribed medications as well as other controlled prescription drugs and illicit drugs."];
  fhir:PlanDefinition.useContext [
     fhir:index 0;
     fhir:UsageContext.code [
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/usage-context-type" ];
       fhir:Coding.code [ fhir:value "focus" ];
       fhir:Coding.display [ fhir:value "Clinical Focus" ]
     ];
     fhir:UsageContext.valueCodeableConcept [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         a sct:182888003;
         fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
         fhir:Coding.code [ fhir:value "182888003" ];
         fhir:Coding.display [ fhir:value "Medication requested (situation)" ]
       ]

  ] ) ; # 
  fhir:identifier ( [
     fhir:system [
       fhir:v "urn:ietf:rfc:3986"^^xsd:anyURI ;
       fhir:l <urn:ietf:rfc:3986>
     ] ;
     fhir:value [ fhir:v "urn:oid:2.16.840.1.113883.4.642.11.3" ]
  ] [
     fhir:use [ fhir:v "official" ] ;
     fhir:value [ fhir:v "cdc-opioid-guidance" ]
  ] ) ; # 
  fhir:version [ fhir:v "0.1.0"] ; # 
  fhir:name [ fhir:v "Cdcopioid10"] ; # 
  fhir:title [ fhir:v "CDC Opioid Prescribing Guideline Recommendation #10"] ; # 
  fhir:type [
     fhir:coding ( [
       fhir:system [
         fhir:v "http://terminology.hl7.org/CodeSystem/plan-definition-type"^^xsd:anyURI ;
         fhir:l <http://terminology.hl7.org/CodeSystem/plan-definition-type>
       ] ;
       fhir:code [ fhir:v "eca-rule" ] ;
       fhir:display [ fhir:v "ECA Rule" ]
     ] )
  ] ; # 
  fhir:status [ fhir:v "draft"] ; # 
  fhir:date [ fhir:v "2017-04-23"^^xsd:date] ; # 
  fhir:publisher [ fhir:v "HL7 International / Clinical Decision Support"] ; # 
  fhir:contact ( [
     fhir:telecom ( [
       fhir:system [ fhir:v "url" ] ;
       fhir:value [ fhir:v "http://www.hl7.org/Special/committees/dss" ]
     ] )
  ] ) ; # 
  fhir:description [ fhir:v "When prescribing opioids for chronic pain, providers should use urine drug testing before starting opioid therapy and consider urine drug testing at least annually to assess for prescribed medications as well as other controlled prescription drugs and illicit drugs."] ; # 
  fhir:useContext ( [
     fhir:code [
       fhir:system [
         fhir:v "http://terminology.hl7.org/CodeSystem/usage-context-type"^^xsd:anyURI ;
         fhir:l <http://terminology.hl7.org/CodeSystem/usage-context-type>
       ] ;
       fhir:code [ fhir:v "focus" ] ;
       fhir:display [ fhir:v "Clinical Focus" ]
     ] ;
     fhir:value [
       a fhir:CodeableConcept ;
       fhir:coding ( [
         a sct:182888003 ;
         fhir:system [
           fhir:v "http://snomed.info/sct"^^xsd:anyURI ;
           fhir:l <http://snomed.info/sct>
         ] ;
         fhir:code [ fhir:v "182888003" ] ;
         fhir:display [ fhir:v "Medication requested (situation)" ]
       ] )

     ]
  ], [
     fhir:index 1;
     fhir:UsageContext.code [
       fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/usage-context-type" ];
       fhir:Coding.code [ fhir:value "focus" ];
       fhir:Coding.display [ fhir:value "Clinical Focus" ]
     ];
     fhir:UsageContext.valueCodeableConcept [
       fhir:CodeableConcept.coding [
         fhir:index 0;
         a sct:82423001;
         fhir:Coding.system [ fhir:value "http://snomed.info/sct" ];
         fhir:Coding.code [ fhir:value "82423001" ];
         fhir:Coding.display [ fhir:value "Chronic pain (finding)" ]
       ]

  ] [
     fhir:code [
       fhir:system [
         fhir:v "http://terminology.hl7.org/CodeSystem/usage-context-type"^^xsd:anyURI ;
         fhir:l <http://terminology.hl7.org/CodeSystem/usage-context-type>
       ] ;
       fhir:code [ fhir:v "focus" ] ;
       fhir:display [ fhir:v "Clinical Focus" ]
     ] ;
     fhir:value [
       a fhir:CodeableConcept ;
       fhir:coding ( [
         a sct:82423001 ;
         fhir:system [
           fhir:v "http://snomed.info/sct"^^xsd:anyURI ;
           fhir:l <http://snomed.info/sct>
         ] ;
         fhir:code [ fhir:v "82423001" ] ;
         fhir:display [ fhir:v "Chronic pain (finding)" ]
       ] )

     ]
  ];
  fhir:PlanDefinition.jurisdiction [
     fhir:index 0;
     fhir:CodeableConcept.coding [
       fhir:index 0;
       fhir:Coding.system [ fhir:value "urn:iso:std:iso:3166" ];
       fhir:Coding.code [ fhir:value "US" ];
       fhir:Coding.display [ fhir:value "United States of America" ]

  ] ) ; # 
  fhir:jurisdiction ( [
     fhir:coding ( [
       fhir:system [
         fhir:v "urn:iso:std:iso:3166"^^xsd:anyURI ;
         fhir:l <urn:iso:std:iso:3166>
       ] ;
       fhir:code [ fhir:v "US" ] ;
       fhir:display [ fhir:v "United States of America" ]
     ] )
  ] ) ; # 
  fhir:purpose [ fhir:v "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."] ; # 
  fhir:usage [ fhir:v "Providers should be aware if patients are taking other prescription drugs or illicit drugs that might increase their risk of an overdose."] ; # 
  fhir:copyright [ fhir:v "© CDC 2016+."] ; # 
  fhir:topic ( [
     fhir:text [ fhir:v "Opioid Prescribing" ]
  ] ) ; # 
  fhir:author ( [
     fhir:name [ fhir:v "Kensaku Kawamoto, MD, PhD, MHS" ]
  ] [
     fhir:name [ fhir:v "Bryn Rhodes" ]
  ] [
     fhir:name [ fhir:v "Floyd Eisenberg, MD, MPH" ]
  ] [
     fhir:name [ fhir:v "Robert McClure, MD, MPH" ]
  ] ) ; # 
  fhir:relatedArtifact ( [
     fhir:type [ fhir:v "documentation" ] ;
     fhir:display [ fhir:v "CDC guideline for prescribing opioids for chronic pain" ] ;
     fhir:document [
       fhir:url [
         fhir:v "https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chronic-pain---united-states-2016#420"^^xsd:anyURI ;
         fhir:l <https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chronic-pain---united-states-2016#420>
       ]

     ]
  ];
  fhir:PlanDefinition.purpose [ fhir:value "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."];
  fhir:PlanDefinition.usage [ fhir:value "Providers should be aware if patients are taking other prescription drugs or illicit drugs that might increase their risk of an overdose."];
  fhir:PlanDefinition.copyright [ fhir:value "© CDC 2016+."];
  fhir:PlanDefinition.topic [
     fhir:index 0;
     fhir:CodeableConcept.text [ fhir:value "Opioid Prescribing" ]
  ];
  fhir:PlanDefinition.author [
     fhir:index 0;
     fhir:ContactDetail.name [ fhir:value "Kensaku Kawamoto, MD, PhD, MHS" ]
  ], [
     fhir:index 1;
     fhir:ContactDetail.name [ fhir:value "Bryn Rhodes" ]
  ], [
     fhir:index 2;
     fhir:ContactDetail.name [ fhir:value "Floyd Eisenberg, MD, MPH" ]
  ], [
     fhir:index 3;
     fhir:ContactDetail.name [ fhir:value "Robert McClure, MD, MPH" ]
  ];
  fhir:PlanDefinition.relatedArtifact [
     fhir:index 0;
     fhir:RelatedArtifact.type [ fhir:value "documentation" ];
     fhir:RelatedArtifact.display [ fhir:value "CDC guideline for prescribing opioids for chronic pain" ];
     fhir:RelatedArtifact.url [ fhir:value "https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chronic-pain---united-states-2016#420" ]
  ];
  fhir:PlanDefinition.library [
     fhir:value "Library/opioidcds-recommendation-10";
     fhir:index 0;
     fhir:link <http://hl7.org/fhir/Library/opioidcds-recommendation-10>
  ];
  fhir:PlanDefinition.action [
     fhir:index 0;
     fhir:PlanDefinition.action.title [ fhir:value "Annual Urine Screening Check" ];
     fhir:PlanDefinition.action.description [ fhir:value "Patient has not had a urine screening in the past 12 months" ];
     fhir:PlanDefinition.action.documentation [
       fhir:index 0;
       fhir:RelatedArtifact.type [ fhir:value "documentation" ];
       fhir:RelatedArtifact.document [
         fhir:Element.extension [
           fhir:index 0;
           fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation" ];
           fhir:Extension.valueCodeableConcept [
             fhir:CodeableConcept.coding [
               fhir:index 0;
               fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/recommendation-strength" ];
               fhir:Coding.code [ fhir:value "strong" ];
               fhir:Coding.display [ fhir:value "Strong" ]
             ]
           ]
         ], [
           fhir:index 1;
           fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence" ];
           fhir:Extension.valueCodeableConcept [
             fhir:CodeableConcept.coding [
               fhir:index 0;
               fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/evidence-quality" ];
               fhir:Coding.code [ fhir:value "low" ];
               fhir:Coding.display [ fhir:value "Low quality" ]
             ]
           ]
         ]

  ] ) ; # 
  fhir:library ( [
     fhir:v "http://example.org/fhir/Library/opioidcds-recommendation-10"^^xsd:anyURI ;
     fhir:l <http://example.org/fhir/Library/opioidcds-recommendation-10>
  ] ) ; # 
  fhir:action ( [
     fhir:extension ( [
       fhir:url [
         fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation"^^xsd:anyURI ;
         fhir:l <http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation>
       ] ;
       fhir:value [
         a fhir:CodeableConcept ;
         fhir:coding ( [
           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/recommendation-strength"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/recommendation-strength>
           ] ;
           fhir:code [ fhir:v "strong" ] ;
           fhir:display [ fhir:v "Strong" ]
         ] )

       ]
     ];
     fhir:PlanDefinition.action.trigger [
       fhir:index 0;
       fhir:TriggerDefinition.type [ fhir:value "named-event" ];
       fhir:TriggerDefinition.name [ fhir:value "medication-prescribe" ]
     ];
     fhir:PlanDefinition.action.condition [
       fhir:index 0;
       fhir:PlanDefinition.action.condition.kind [ fhir:value "applicability" ];
       fhir:PlanDefinition.action.condition.expression [
         fhir:Expression.description [ fhir:value "Patient has not had a urine screening in the past 12 months" ];
         fhir:Expression.language [ fhir:value "text/cql" ];
         fhir:Expression.expression [ fhir:value "No Screenings in Past Year" ]

     ] [
       fhir:url [
         fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence"^^xsd:anyURI ;
         fhir:l <http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence>
       ] ;
       fhir:value [
         a fhir:CodeableConcept ;
         fhir:coding ( [
           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/evidence-quality"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/evidence-quality>
           ] ;
           fhir:code [ fhir:v "low" ] ;
           fhir:display [ fhir:v "Low quality" ]
         ] )

       ]
     ];
     fhir:PlanDefinition.action.dynamicValue [
       fhir:index 0;
       fhir:PlanDefinition.action.dynamicValue.path [ fhir:value "activity.extension" ];
       fhir:PlanDefinition.action.dynamicValue.expression [
         fhir:Expression.language [ fhir:value "text/cql" ];
         fhir:Expression.expression [ fhir:value "Get Indicator" ]

     ] ) ;
     fhir:title [ fhir:v "Annual Urine Screening Check" ] ;
     fhir:description [ fhir:v "Patient has not had a urine screening in the past 12 months" ] ;
     fhir:documentation ( [
       fhir:type [ fhir:v "documentation" ]
     ] ) ;
     fhir:trigger ( [
       fhir:type [ fhir:v "named-event" ] ;
       fhir:name [ fhir:v "medication-prescribe" ]
     ] ) ;
     fhir:condition ( [
       fhir:kind [ fhir:v "applicability" ] ;
       fhir:expression [
         fhir:description [ fhir:v "Patient has not had a urine screening in the past 12 months" ] ;
         fhir:language [ fhir:v "text/cql-identifier" ] ;
         fhir:expression [ fhir:v "No Screenings in Past Year" ]

       ]
     ];
     fhir:PlanDefinition.action.action [
       fhir:index 0;
       fhir:PlanDefinition.action.description [ fhir:value "Will perform urine screening" ]
     ], [
       fhir:index 1;
       fhir:PlanDefinition.action.description [ fhir:value "Not for chronic pain management. Snooze 3 months" ]
     ]
  ], [
     fhir:index 1;
     fhir:PlanDefinition.action.title [ fhir:value "Positive Urine Screening Check" ];
     fhir:PlanDefinition.action.description [ fhir:value "Patient has a urine screening testing positive for either unprescribed opioids or illicit drugs in the past 12 months" ];
     fhir:PlanDefinition.action.documentation [
       fhir:index 0;
       fhir:RelatedArtifact.type [ fhir:value "documentation" ];
       fhir:RelatedArtifact.document [
         fhir:Element.extension [
           fhir:index 0;
           fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation" ];
           fhir:Extension.valueCodeableConcept [
             fhir:CodeableConcept.coding [
               fhir:index 0;
               fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/recommendation-strength" ];
               fhir:Coding.code [ fhir:value "strong" ];
               fhir:Coding.display [ fhir:value "Strong" ]
             ]
           ]
         ], [
           fhir:index 1;
           fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence" ];
           fhir:Extension.valueCodeableConcept [
             fhir:CodeableConcept.coding [
               fhir:index 0;
               fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/evidence-quality" ];
               fhir:Coding.code [ fhir:value "low" ];
               fhir:Coding.display [ fhir:value "Low quality" ]
             ]
           ]
         ]

     ] ) ;
     fhir:dynamicValue ( [
       fhir:path [ fhir:v "activity.extension" ] ;
       fhir:expression [
         fhir:language [ fhir:v "text/cql-identifier" ] ;
         fhir:expression [ fhir:v "Get Indicator" ]

       ]
     ];
     fhir:PlanDefinition.action.condition [
       fhir:index 0;
       fhir:PlanDefinition.action.condition.kind [ fhir:value "applicability" ];
       fhir:PlanDefinition.action.condition.expression [
         fhir:Expression.description [ fhir:value "Patient has a positive urine screening in the past 12 months" ];
         fhir:Expression.language [ fhir:value "text/cql" ];
         fhir:Expression.expression [ fhir:value "Has Positive Screening?" ]

     ] ) ;
     fhir:action ( [
       fhir:description [ fhir:v "Will perform urine screening" ]
     ] [
       fhir:description [ fhir:v "Not for chronic pain management. Snooze 3 months" ]
     ] )
  ] [
     fhir:extension ( [
       fhir:url [
         fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation"^^xsd:anyURI ;
         fhir:l <http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation>
       ] ;
       fhir:value [
         a fhir:CodeableConcept ;
         fhir:coding ( [
           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/recommendation-strength"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/recommendation-strength>
           ] ;
           fhir:code [ fhir:v "strong" ] ;
           fhir:display [ fhir:v "Strong" ]
         ] )

       ]
     ];
     fhir:PlanDefinition.action.action [
       fhir:index 0;
       fhir:PlanDefinition.action.title [ fhir:value "Unprescribed Opioids Found In Urine Screening" ];
       fhir:PlanDefinition.action.description [ fhir:value "Patient has a positive urine screening in the past 12 months for opioid(s), which is not prescribed" ];
       fhir:PlanDefinition.action.documentation [
         fhir:index 0;
         fhir:RelatedArtifact.type [ fhir:value "documentation" ];
         fhir:RelatedArtifact.document [
           fhir:Element.extension [
             fhir:index 0;
             fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation" ];
             fhir:Extension.valueCodeableConcept [
               fhir:CodeableConcept.coding [
                 fhir:index 0;
                 fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/recommendation-strength" ];
                 fhir:Coding.code [ fhir:value "strong" ];
                 fhir:Coding.display [ fhir:value "Strong" ]
               ]
             ]
           ], [
             fhir:index 1;
             fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence" ];
             fhir:Extension.valueCodeableConcept [
               fhir:CodeableConcept.coding [
                 fhir:index 0;
                 fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/evidence-quality" ];
                 fhir:Coding.code [ fhir:value "low" ];
                 fhir:Coding.display [ fhir:value "Low quality" ]
               ]
             ]
           ]

     ] [
       fhir:url [
         fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence"^^xsd:anyURI ;
         fhir:l <http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence>
       ] ;
       fhir:value [
         a fhir:CodeableConcept ;
         fhir:coding ( [
           fhir:system [
             fhir:v "http://terminology.hl7.org/CodeSystem/evidence-quality"^^xsd:anyURI ;
             fhir:l <http://terminology.hl7.org/CodeSystem/evidence-quality>
           ] ;
           fhir:code [ fhir:v "low" ] ;
           fhir:display [ fhir:v "Low quality" ]
         ] )
       ]
     ] ) ;
     fhir:title [ fhir:v "Positive Urine Screening Check" ] ;
     fhir:description [ fhir:v "Patient has a urine screening testing positive for either unprescribed opioids or illicit drugs in the past 12 months" ] ;
     fhir:documentation ( [
       fhir:type [ fhir:v "documentation" ]
     ] ) ;
     fhir:condition ( [
       fhir:kind [ fhir:v "applicability" ] ;
       fhir:expression [
         fhir:description [ fhir:v "Patient has a positive urine screening in the past 12 months" ] ;
         fhir:language [ fhir:v "text/cql-identifier" ] ;
         fhir:expression [ fhir:v "Has Positive Screening?" ]
       ]
     ] ) ;
     fhir:action ( [
       fhir:extension ( [
         fhir:url [
           fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation"^^xsd:anyURI ;
           fhir:l <http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation>
         ] ;
         fhir:value [
           a fhir:CodeableConcept ;
           fhir:coding ( [
             fhir:system [
               fhir:v "http://terminology.hl7.org/CodeSystem/recommendation-strength"^^xsd:anyURI ;
               fhir:l <http://terminology.hl7.org/CodeSystem/recommendation-strength>
             ] ;
             fhir:code [ fhir:v "strong" ] ;
             fhir:display [ fhir:v "Strong" ]
           ] )

         ]
       ];
       fhir:PlanDefinition.action.condition [
         fhir:index 0;
         fhir:PlanDefinition.action.condition.kind [ fhir:value "applicability" ];
         fhir:PlanDefinition.action.condition.expression [
           fhir:Expression.description [ fhir:value "Patient has a positive urine screening in the past 12 months for opioid(s), which is not prescribed" ];
           fhir:Expression.language [ fhir:value "text/cql" ];
           fhir:Expression.expression [ fhir:value "Has Unprescribed Opioids?" ]

       ] [
         fhir:url [
           fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence"^^xsd:anyURI ;
           fhir:l <http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence>
         ] ;
         fhir:value [
           a fhir:CodeableConcept ;
           fhir:coding ( [
             fhir:system [
               fhir:v "http://terminology.hl7.org/CodeSystem/evidence-quality"^^xsd:anyURI ;
               fhir:l <http://terminology.hl7.org/CodeSystem/evidence-quality>
             ] ;
             fhir:code [ fhir:v "low" ] ;
             fhir:display [ fhir:v "Low quality" ]
           ] )

         ]
       ];
       fhir:PlanDefinition.action.dynamicValue [
         fhir:index 0;
         fhir:PlanDefinition.action.dynamicValue.path [ fhir:value "activity.extension" ];
         fhir:PlanDefinition.action.dynamicValue.expression [
           fhir:Expression.language [ fhir:value "text/cql" ];
           fhir:Expression.expression [ fhir:value "Get Indicator" ]

       ] ) ;
       fhir:title [ fhir:v "Unprescribed Opioids Found In Urine Screening" ] ;
       fhir:description [ fhir:v "Patient has a positive urine screening in the past 12 months for opioid(s), which is not prescribed" ] ;
       fhir:documentation ( [
         fhir:type [ fhir:v "documentation" ]
       ] ) ;
       fhir:condition ( [
         fhir:kind [ fhir:v "applicability" ] ;
         fhir:expression [
           fhir:description [ fhir:v "Patient has a positive urine screening in the past 12 months for opioid(s), which is not prescribed" ] ;
           fhir:language [ fhir:v "text/cql-identifier" ] ;
           fhir:expression [ fhir:v "Has Unprescribed Opioids?" ]

         ]
       ], [
         fhir:index 1;
         fhir:PlanDefinition.action.dynamicValue.path [ fhir:value "action.description" ];
         fhir:PlanDefinition.action.dynamicValue.expression [
           fhir:Expression.language [ fhir:value "text/cql" ];
           fhir:Expression.expression [ fhir:value "Inconsistent Unprescribed Opioids" ]

       ] ) ;
       fhir:dynamicValue ( [
         fhir:path [ fhir:v "activity.extension" ] ;
         fhir:expression [
           fhir:language [ fhir:v "text/cql-identifier" ] ;
           fhir:expression [ fhir:v "Get Indicator" ]

         ]
       ];
       fhir:PlanDefinition.action.action [
         fhir:index 0;
         fhir:PlanDefinition.action.description [ fhir:value "Not for chronic pain management. Snooze 3 months" ]
       ]
     ], [
       fhir:index 1;
       fhir:PlanDefinition.action.title [ fhir:value "Prescribed Opioids Not Found In Urine Screening" ];
       fhir:PlanDefinition.action.description [ fhir:value "Patient has a positive urine screening in the past 12 months, which does not include prescribed opioids" ];
       fhir:PlanDefinition.action.documentation [
         fhir:index 0;
         fhir:RelatedArtifact.type [ fhir:value "documentation" ];
         fhir:RelatedArtifact.document [
           fhir:Element.extension [
             fhir:index 0;
             fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation" ];
             fhir:Extension.valueCodeableConcept [
               fhir:CodeableConcept.coding [
                 fhir:index 0;
                 fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/recommendation-strength" ];
                 fhir:Coding.code [ fhir:value "strong" ];
                 fhir:Coding.display [ fhir:value "Strong" ]
               ]
             ]
           ], [
             fhir:index 1;
             fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence" ];
             fhir:Extension.valueCodeableConcept [
               fhir:CodeableConcept.coding [
                 fhir:index 0;
                 fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/evidence-quality" ];
                 fhir:Coding.code [ fhir:value "low" ];
                 fhir:Coding.display [ fhir:value "Low quality" ]
               ]
             ]
           ]

       ] [
         fhir:path [ fhir:v "action.description" ] ;
         fhir:expression [
           fhir:language [ fhir:v "text/cql-identifier" ] ;
           fhir:expression [ fhir:v "Inconsistent Unprescribed Opioids" ]

         ]
       ];
       fhir:PlanDefinition.action.condition [
         fhir:index 0;
         fhir:PlanDefinition.action.condition.kind [ fhir:value "applicability" ];
         fhir:PlanDefinition.action.condition.expression [
           fhir:Expression.description [ fhir:value "Patient has a positive urine screening in the past 12 months, which does not include prescribed opioids" ];
           fhir:Expression.language [ fhir:value "text/cql" ];
           fhir:Expression.expression [ fhir:value "Has Missing Opioids?" ]

       ] ) ;
       fhir:action ( [
         fhir:description [ fhir:v "Not for chronic pain management. Snooze 3 months" ]
       ] )
     ] [
       fhir:extension ( [
         fhir:url [
           fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation"^^xsd:anyURI ;
           fhir:l <http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation>
         ] ;
         fhir:value [
           a fhir:CodeableConcept ;
           fhir:coding ( [
             fhir:system [
               fhir:v "http://terminology.hl7.org/CodeSystem/recommendation-strength"^^xsd:anyURI ;
               fhir:l <http://terminology.hl7.org/CodeSystem/recommendation-strength>
             ] ;
             fhir:code [ fhir:v "strong" ] ;
             fhir:display [ fhir:v "Strong" ]
           ] )

         ]
       ];
       fhir:PlanDefinition.action.dynamicValue [
         fhir:index 0;
         fhir:PlanDefinition.action.dynamicValue.path [ fhir:value "activity.extension" ];
         fhir:PlanDefinition.action.dynamicValue.expression [
           fhir:Expression.language [ fhir:value "text/cql" ];
           fhir:Expression.expression [ fhir:value "Get Indicator" ]

       ] [
         fhir:url [
           fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence"^^xsd:anyURI ;
           fhir:l <http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence>
         ] ;
         fhir:value [
           a fhir:CodeableConcept ;
           fhir:coding ( [
             fhir:system [
               fhir:v "http://terminology.hl7.org/CodeSystem/evidence-quality"^^xsd:anyURI ;
               fhir:l <http://terminology.hl7.org/CodeSystem/evidence-quality>
             ] ;
             fhir:code [ fhir:v "low" ] ;
             fhir:display [ fhir:v "Low quality" ]
           ] )

         ]
       ], [
         fhir:index 1;
         fhir:PlanDefinition.action.dynamicValue.path [ fhir:value "action.description" ];
         fhir:PlanDefinition.action.dynamicValue.expression [
           fhir:Expression.language [ fhir:value "text/cql" ];
           fhir:Expression.expression [ fhir:value "Inconsistent Missing Opioids" ]

       ] ) ;
       fhir:title [ fhir:v "Prescribed Opioids Not Found In Urine Screening" ] ;
       fhir:description [ fhir:v "Patient has a positive urine screening in the past 12 months, which does not include prescribed opioids" ] ;
       fhir:documentation ( [
         fhir:type [ fhir:v "documentation" ]
       ] ) ;
       fhir:condition ( [
         fhir:kind [ fhir:v "applicability" ] ;
         fhir:expression [
           fhir:description [ fhir:v "Patient has a positive urine screening in the past 12 months, which does not include prescribed opioids" ] ;
           fhir:language [ fhir:v "text/cql-identifier" ] ;
           fhir:expression [ fhir:v "Has Missing Opioids?" ]

         ]
       ]
     ], [
       fhir:index 2;
       fhir:PlanDefinition.action.title [ fhir:value "Illicit Drugs Found In Urine Screening" ];
       fhir:PlanDefinition.action.description [ fhir:value "Patient has a positive urine screening in the past 12 months for illicit drugs" ];
       fhir:PlanDefinition.action.documentation [
         fhir:index 0;
         fhir:RelatedArtifact.type [ fhir:value "documentation" ];
         fhir:RelatedArtifact.document [
           fhir:Element.extension [
             fhir:index 0;
             fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation" ];
             fhir:Extension.valueCodeableConcept [
               fhir:CodeableConcept.coding [
                 fhir:index 0;
                 fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/recommendation-strength" ];
                 fhir:Coding.code [ fhir:value "strong" ];
                 fhir:Coding.display [ fhir:value "Strong" ]
               ]
             ]
           ], [
             fhir:index 1;
             fhir:Extension.url [ fhir:value "http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence" ];
             fhir:Extension.valueCodeableConcept [
               fhir:CodeableConcept.coding [
                 fhir:index 0;
                 fhir:Coding.system [ fhir:value "http://terminology.hl7.org/CodeSystem/evidence-quality" ];
                 fhir:Coding.code [ fhir:value "low" ];
                 fhir:Coding.display [ fhir:value "Low quality" ]
               ]
             ]
           ]

       ] ) ;
       fhir:dynamicValue ( [
         fhir:path [ fhir:v "activity.extension" ] ;
         fhir:expression [
           fhir:language [ fhir:v "text/cql-identifier" ] ;
           fhir:expression [ fhir:v "Get Indicator" ]

         ]
       ];
       fhir:PlanDefinition.action.condition [
         fhir:index 0;
         fhir:PlanDefinition.action.condition.kind [ fhir:value "applicability" ];
         fhir:PlanDefinition.action.condition.expression [
           fhir:Expression.description [ fhir:value "Patient has a positive urine screening in the past 12 months for illicit drugs" ];
           fhir:Expression.language [ fhir:value "text/cql" ];
           fhir:Expression.expression [ fhir:value "Has Illicit Drugs in Screening?" ]

       ] [
         fhir:path [ fhir:v "action.description" ] ;
         fhir:expression [
           fhir:language [ fhir:v "text/cql-identifier" ] ;
           fhir:expression [ fhir:v "Inconsistent Missing Opioids" ]

         ]
       ];
       fhir:PlanDefinition.action.dynamicValue [
         fhir:index 0;
         fhir:PlanDefinition.action.dynamicValue.path [ fhir:value "activity.extension" ];
         fhir:PlanDefinition.action.dynamicValue.expression [
           fhir:Expression.language [ fhir:value "text/cql" ];
           fhir:Expression.expression [ fhir:value "Get Indicator" ]

       ] )
     ] [
       fhir:extension ( [
         fhir:url [
           fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation"^^xsd:anyURI ;
           fhir:l <http://hl7.org/fhir/StructureDefinition/cqf-strengthOfRecommendation>
         ] ;
         fhir:value [
           a fhir:CodeableConcept ;
           fhir:coding ( [
             fhir:system [
               fhir:v "http://terminology.hl7.org/CodeSystem/recommendation-strength"^^xsd:anyURI ;
               fhir:l <http://terminology.hl7.org/CodeSystem/recommendation-strength>
             ] ;
             fhir:code [ fhir:v "strong" ] ;
             fhir:display [ fhir:v "Strong" ]
           ] )

         ]
       ], [
         fhir:index 1;
         fhir:PlanDefinition.action.dynamicValue.path [ fhir:value "action.description" ];
         fhir:PlanDefinition.action.dynamicValue.expression [
           fhir:Expression.language [ fhir:value "text/cql" ];
           fhir:Expression.expression [ fhir:value "Inconsistent Illicit Drugs" ]

       ] [
         fhir:url [
           fhir:v "http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence"^^xsd:anyURI ;
           fhir:l <http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence>
         ] ;
         fhir:value [
           a fhir:CodeableConcept ;
           fhir:coding ( [
             fhir:system [
               fhir:v "http://terminology.hl7.org/CodeSystem/evidence-quality"^^xsd:anyURI ;
               fhir:l <http://terminology.hl7.org/CodeSystem/evidence-quality>
             ] ;
             fhir:code [ fhir:v "low" ] ;
             fhir:display [ fhir:v "Low quality" ]
           ] )

         ]
       ];
       fhir:PlanDefinition.action.action [
         fhir:index 0;
         fhir:PlanDefinition.action.description [ fhir:value "Not for chronic pain management. Snooze 3 months" ]
       ]
     ]
  ] .

# - ontology header ------------------------------------------------------------

<http://hl7.org/fhir/PlanDefinition/opioidcds-10.ttl> a owl:Ontology;
  owl:imports fhir:fhir.ttl;
  owl:versionIRI <http://build.fhir.org/PlanDefinition/opioidcds-10.ttl> .

       ] ) ;
       fhir:title [ fhir:v "Illicit Drugs Found In Urine Screening" ] ;
       fhir:description [ fhir:v "Patient has a positive urine screening in the past 12 months for illicit drugs" ] ;
       fhir:documentation ( [
         fhir:type [ fhir:v "documentation" ]
       ] ) ;
       fhir:condition ( [
         fhir:kind [ fhir:v "applicability" ] ;
         fhir:expression [
           fhir:description [ fhir:v "Patient has a positive urine screening in the past 12 months for illicit drugs" ] ;
           fhir:language [ fhir:v "text/cql-identifier" ] ;
           fhir:expression [ fhir:v "Has Illicit Drugs in Screening?" ]
         ]
       ] ) ;
       fhir:dynamicValue ( [
         fhir:path [ fhir:v "activity.extension" ] ;
         fhir:expression [
           fhir:language [ fhir:v "text/cql-identifier" ] ;
           fhir:expression [ fhir:v "Get Indicator" ]
         ]
       ] [
         fhir:path [ fhir:v "action.description" ] ;
         fhir:expression [
           fhir:language [ fhir:v "text/cql-identifier" ] ;
           fhir:expression [ fhir:v "Inconsistent Illicit Drugs" ]
         ]
       ] ) ;
       fhir:action ( [
         fhir:description [ fhir:v "Not for chronic pain management. Snooze 3 months" ]
       ] )
     ] )
  ] ) . # 


# -------------------------------------------------------------------------------------

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.