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| Clinical Decision Support Work Group | Maturity Level : N/A | Standards Status : Informative | Compartments : Not linked to any defined 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",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource "opioidcds-04" </p></div><p><b>url</b>: <code>http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-04</code></p><p><b>identifier</b>: id: 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 style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"codesystem-plan-definition-type.html\">PlanDefinitionType</a>#eca-rule)</span></p><p><b>status</b>: draft</p><p><b>date</b>: 2018-03-19</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>jurisdiction</b>: United States of America <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (unknown#US)</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 style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p><p><b>author</b>: Kensaku Kawamoto, MD, PhD, MHS: , Bryn Rhodes: , Floyd Eisenberg, MD, MPH: , Robert McClure, MD, MPH: </p><p><b>library</b>: <a href=\"http://example.org/fhir/Library/opioidcds-recommendation-04\">http://example.org/fhir/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><blockquote><p><b>condition</b></p><p><b>kind</b>: applicability</p></blockquote><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></blockquote><blockquote><p><b>dynamicValue</b></p><p><b>path</b>: action.description</p></blockquote><blockquote><p><b>dynamicValue</b></p><p><b>path</b>: activity.extension</p></blockquote><h3>Actions</h3><table class=\"grid\"><tr><td>-</td><td><b>Description</b></td></tr><tr><td>*</td><td>Will precribe immediate release</td></tr><tr><td>*</td><td>Risk of overdose carefully considered and outweighed by benefit; snooze 3 mo</td></tr><tr><td>*</td><td>N/A - see comment; snooze 3 mo</td></tr></table></blockquote></div>"
},
"url": "http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-04",
"identifier": [
{
"use": "official",
"value": "cdc-opioid-guidance"
"url" : "http://hl7.org/fhir/ig/opioid-cds/PlanDefinition/opioidcds-04",
"identifier" : [{
"use" : "official",
"value" : "cdc-opioid-guidance"
}],
"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",
"experimental" : true,
"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)"
}]
}
],
"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",
"url" : "https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chronic-pain---united-states-2016#420",
"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",
"url" : "https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf",
"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" : [{
"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"
}
},
{
"name": "Bryn Rhodes"
"path" : "action.description",
"expression" : {
"language" : "text/cql",
"expression" : "Get Detail"
}
},
{
"name": "Floyd Eisenberg, MD, MPH"
"path" : "activity.extension",
"expression" : {
"language" : "text/cql",
"expression" : "Get Indicator"
}
}],
"action" : [{
"description" : "Will precribe immediate release"
},
{
"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"
"description" : "Risk of overdose carefully considered and outweighed by benefit; snooze 3 mo"
},
{
"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": [
{
"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
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FHIR
Release
4
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Correction
#1)
(v4.0.1)
4B
(v4.3.0)
hl7.fhir.r4b.core#4.3.0
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