Low Suicide Risk Order Set (id = "low-suicide-risk-order-set")

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          This order set helps ensure consistent application of appropriate orders for the care
             of low suicide risk patients.
            
        
         
      
         
      
         
      
            
        
               
          
                  
            
               
          
            
        
            
        
               
          This order set should be applied after assessing a patient for suicide risk, when the
             findings of that assessment indicate the patient has low suicide risk.
            
        
         
      
         
      
         
      
            
        
               
          
                  
            
               
          
            
        
            
        
               
          
                  
            
                     
              
                     
              
                  
            
                  
            
                     
              
                     
              
                  
            
                  
            
                     
              
                     
              
                     
              
                        
                
                           
                  
                              
                    
                                 
                      
                                 
              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                    Refer to outpatient mental health program for evaluation and treatment of mental health
                       conditions now
                              
                    
                           
                  
                           
                  
                              
                    
                              
                    
                              
                    
                                 
                      
                                 
                      
                                 
                      
                                 
                      
                                    
                        
                                       
                          
                                       
                          
                                          
                            
                                          
                            refer to primary care mental-health integrated care program for evaluation and treatment
                               of mental health conditions now
                                          
                            
                                       
                          
                                       
                          
                                          
                            
                                          
                            
                                          
                            
                                       
                          
                                    
                        
                                 
                      
                              
                    
                           
                  
                           
                  
                        
                
                     
              
                  
            
                  
            
                     
              
                     
              
                     
              
                        
                
                        
                
                        
                
                     
              
                     
              
                        
                
                           
                  
                           
                  
                           
                  
                              
                    
                              
                    
                              
                    
                           
                  
                           
                  
                              
                    
                                 
                      
                                 
                      
                                 
                      
                                    
                        
                                    
                        Selective Serotonin Reuptake Inhibitors (Choose a mazimum of one or document reasons for
                           exception)
                                    
                        
                                 
                      
                                 
                      
                                    
                        
                                       
                          
                                       
                          
                                       
                          
                                          
                            
                                          
                            
                                          
                            
                                       
                          
                                       
                          
                                          
                            
                                          
                            
                                          
                            
                                             
                              
                                             
                              
                                             
                              
                                             
                              
                                             
                              
                                                
                                
                                                   
                                  
                                                   
                                  
                                                      
                                    
                                                      
                                    
                                                      
                                    
                                                   
                                  
                                                
                                
                                             
                              
                                             
                              
                                             
                              
                                          
                            
                                       
                          
                                       
                          
                                    
                        
                                    
                        
                                       
                          
                                       
                          
                                       
                          
                                          
                            
                                          
                            
                                          
                            
                                       
                          
                                       
                          
                                    
                        
                                    
                        
                                       
                          
                                       
                          
                                       
                          
                                          
                            
                                          
                            
                                          
                            
                                       
                          
                                       
                          
                                    
                        
                                    
                        
                                       
                          
                                       
                          
                                       
                          
                                          
                            
                                          
                            
                                          
                            
                                       
                          
                                       
                          
                                    
                        
                                    
                        
                                       
                          
                                       
                          
                                       
                          
                                          
                            
                                          
                            
                                          
                            
                                       
                          
                                       
                          
                                    
                        
                                 
                      
                              
                    
                              
                    
                                 
                      
                                 
                      
                                 
                      
                                    
                        
                                    
                        Dopamine Norepinephrine Reuptake Inhibitors (Choose a maximum of one or document reasons
                           for exception)
                                    
                        
                                 
                      
                                 
                      
                              
                    
                              
                    
                                 
                      
                                 
                      
                                 
                      
                                    
                        
                                    
                        Serotonin Norepinephrine Reuptake Inhibitors (Choose a maximum of one or doument reasons
                           for exception)
                                    
                        
                                 
                      
                                 
                      
                              
                    
                              
                    
                                 
                      
                                 
                      
                                 
                      
                                    
                        
                                    
                        
                                    
                        
                                 
                      
                                 
                      
                              
                    
                           
                  
                        
                
                     
              
                  
            
               
          
            
        
         
      
      
    
  
  
    
      
      
      refer to primary care mental-health integrated care program for evaluation and treatment
       of mental health conditions now
      
      
        
          
          
        
        
      
      
        
          
            
              
              
            
          
        
      
      
        
      
    
  
  
    
      
      
      
      
        
      
      
        
        
          
            
            
            
          
        
        
          
            
            
          
          
        
        
          
            
              
              
              
            
          
          
            
            
          
        
      
      
        
        
          
          
        
      
      
        
        
          
          
        
      
    
  
  
    
      
      
        
          
          
        
        
      
      
        
          
          
          
        
        
      
      
        
          
        
        
          
            
            
          
          
            
            
          
        
      
    
  
  
    
      
      
        
          
          
        
        
      
    
  
  
  
    
    
    
  
  
  
  
  
  
  
  
  
    
      
      
      
    
    
      
      
      
    
  
  
  
    
      
      
    
    
      
        
        
        
      
    
  
  
    
      
      
    
    
      
        
        
        
      
    
  
  
    
      
      
    
    
      
        
        
        
      
    
  
  
    
      
      
    
    
      
        
        
        
      
    
  
  
    
      
      
    
    
      
        
        
        
      
    
  
  
    
      
      
    
    
      
        
        
        
      
    
  
  
    
      
      
    
    
      
        
        
        
      
    
  
  
    
      
      
    
  
  This order set helps ensure consistent application of appropriate orders for the care
   of low suicide risk patients.
  This order set should be applied after assessing a patient for suicide risk, when the
   findings of that assessment indicate the patient has low suicide risk.
  
  
  
  
    
    
  
  
    
  
  
    
    
      
      
      
    
    
      
      
      
    
  
  
    
    
    
    
      
    
  
  
    
    
  
  
    
    
  
  
  
    
    
      
      
      
      
        Refer to outpatient mental health program for evaluation and treatment of mental health
         conditions now
        
        
          
          
            
            
          
        
        
          
          
            
            Code '261QM0850X' from SuicideRiskLogic.&quot;NUCC Provider Taxonomy&quot; display 'Adult
             Mental Health'
          
        
        
          
          
            
            
          
        
        
          
          
            
            
          
        
        
          
          
            
            
          
        
        
          
          
            
            
          
        
        
          
          
            
            
          
        
      
    
    
      
      
      
      
        
        
          
          
          
            
              
                
                  
                  
                
                
              
            
            
            
            
          
        
        
        
        
          Selective Serotonin Reuptake Inhibitors (Choose a mazimum of one or document reasons for
           exception)
          
            
            
            
              
              
              National Library of Medicine. DailyMed website. CITALOPRAM- citalopram hydrobromide tablet,
               film coated.
            
          
          
          
          
            
            
            
              
              
                
                
              
            
            
              
              
                
                
              
            
            
              
              
                
                
              
            
            
              
              
                
                
              
            
            
              
              
                
                
              
            
          
          
            
          
          
            
          
          
            
          
          
            
          
        
        
          Dopamine Norepinephrine Reuptake Inhibitors (Choose a maximum of one or document reasons
           for exception)
        
        
          Serotonin Norepinephrine Reuptake Inhibitors (Choose a maximum of one or doument reasons
           for exception)
        
        
          
        
      
    
  

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                  <b> Id: </b> 
               </td> 
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            <tr> 
               <td style="padding-left: 25px; padding-right: 25px;">PlanDefinition/low-suicide-risk-order-set</td> 
            </tr> 
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         <p/>  
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            <tr> 
               <td> 
                  <b> Identifier: </b> 
               </td> 
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            <tr> 
               <td style="padding-left: 25px; padding-right: 25px;">
                  <b> value: </b> 
                  <span> mmi:low-suicide-risk-order-set</span> 
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               <td> 
                  <b> Title: </b> 
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               <td style="padding-left: 25px; padding-right: 25px;">Low Suicide Risk Order Set</td> 
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                  <b> Status: </b> 
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                  <b> Description: </b> 
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               <td style="padding-left: 25px; padding-right: 25px;">Orders to be applied to a patient characterized as low suicide risk.</td> 
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                  <b> Purpose: </b> 
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               <td style="padding-left: 25px; padding-right: 25px;">This order set helps ensure consistent application of appropriate orders for the
             care of low suicide risk patients.</td> 
            </tr>          </table>          <p/>           <table class="grid dict">            <tr>                <td>                   <b> Usage: </b>                </td>             </tr>             <tr>                <td style="padding-left: 25px; padding-right: 25px;">This order set should be applied after assessing a patient for suicide risk, when

             the findings of that assessment indicate the patient has low suicide risk.</td> 
            </tr>          </table>          <p/>           <table class="grid dict">            <tr>                <td>                   <b> Context: </b>                </td>             </tr>             <tr style="vertical-align: top;">               <td style="padding-right: 25px;">                  <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">                     <b> system: </b>                      <span> http://terminology.hl7.org/CodeSystem/usage-context-type</span>                   </p>                   <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">                     <b> code: </b>                      <span> age</span>                   </p>                   <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">                     <b> value: </b>                      <br/>                       <span>                         <span>                            <span>                               <span style="padding-left: 25px;">                                 <b> system: </b>                                  <span> https://meshb.nlm.nih.gov</span>                                  <br/>                                </span>                               <span style="padding-left: 25px;">                                 <b> code: </b>                                  <span> D000328</span>                                  <br/>                                </span>                               <span style="padding-left: 25px;">                                 <b> display: </b>                                  <span> Adult</span>                               </span>                            </span>                         </span>                      </span>                   </p>                </td>             </tr>          </table>          <table class="grid dict">            <tr>                <td>                   <b> Context: </b>                </td>             </tr>             <tr style="vertical-align: top;">               <td style="padding-right: 25px;">                  <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">                     <b> system: </b>                      <span> http://terminology.hl7.org/CodeSystem/usage-context-type</span>                   </p>                   <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">                     <b> code: </b>                      <span> focus</span>                   </p>                   <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">                     <b> value: </b>                      <br/>                       <span>                         <span>                            <span>                               <span style="padding-left: 25px;">                                 <b> system: </b>                                  <span> http://snomed.info/sct</span>                                  <br/>                                </span>                               <span style="padding-left: 25px;">                                 <b> code: </b>                                  <span> 87512008</span>                                  <br/>                                </span>                               <span style="padding-left: 25px;">                                 <b> display: </b>                                  <span> Mild major depression</span>                               </span>                            </span>                         </span>                      </span>                   </p>                </td>             </tr>          </table>          <table class="grid dict">            <tr>                <td>                   <b> Context: </b>                </td>             </tr>             <tr style="vertical-align: top;">               <td style="padding-right: 25px;">                  <p style="padding-left: 25px; 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margin-top: 5px; margin-bottom: 5px;">                     <b> system: </b>                      <span> http://terminology.hl7.org/CodeSystem/usage-context-type</span>                   </p>                   <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">                     <b> code: </b>                      <span> focus</span>                   </p>                   <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">                     <b> value: </b>                      <br/>                       <span>                         <span>                            <span>                               <span style="padding-left: 25px;">                                 <b> system: </b>                                  <span> http://snomed.info/sct</span>                                  <br/>                                </span>                               <span style="padding-left: 25px;">                                 <b> code: </b>                                  <span> 394687007</span>                                  <br/>                                </span>                               <span style="padding-left: 25px;">                                 <b> display: </b>                                  <span> Low suicide risk</span>                               </span>                            </span>                         </span>                      </span>                   </p>                </td>             </tr>          </table>          <table class="grid dict">            <tr>                <td>                   <b> Context: </b>                </td>             </tr>             <tr style="vertical-align: top;">               <td style="padding-right: 25px;">                  <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">                     <b> system: </b>                      <span> http://terminology.hl7.org/CodeSystem/usage-context-type</span>                   </p>                   <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">                     <b> code: </b>                      <span> focus</span>                   </p>                   <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">                     <b> value: </b>                      <br/>                       <span>                         <span>                            <span>                               <span style="padding-left: 25px;">                                 <b> system: </b>                                  <span> http://snomed.info/sct</span>                                  <br/>                                </span>                               <span style="padding-left: 25px;">                                 <b> code: </b>                                  <span> 225337009</span>                                  <br/>                                </span>                               <span style="padding-left: 25px;">                                 <b> display: </b>                                  <span> Suicide risk assessment</span>                               </span>                            </span>                         </span>                      </span>                   </p>                </td>             </tr>          </table>          <table class="grid dict">            <tr>                <td>                   <b> Context: </b>                </td>             </tr>             <tr style="vertical-align: top;">               <td style="padding-right: 25px;">                  <p style="padding-left: 25px; 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margin-top: 5px; margin-bottom: 5px;">                     <b> system: </b>                      <span> http://terminology.hl7.org/CodeSystem/usage-context-type</span>                   </p>                   <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">                     <b> code: </b>                      <span> venue</span>                   </p>                   <p style="padding-left: 25px; margin-top: 5px; margin-bottom: 5px;">                     <b> value: </b>                      <br/>                       <span>                         <span>                            <span>                               <span style="padding-left: 25px;">                                 <b> system: </b>                                  <span> http://snomed.info/sct</span>                                  <br/>                                </span>                               <span style="padding-left: 25px;">                                 <b> code: </b>                                  <span> 440655000</span>                                  <br/>                                </span>                               <span style="padding-left: 25px;">                                 <b> display: </b>                                  <span> Outpatient environment</span>                               </span>                            </span>                         </span>                      </span>                   </p>                </td>             </tr>          </table>          <p/>           <table class="grid dict">            <tr>                <td>                   <b> Topic: </b>                </td>             </tr>             <tr>                <td style="padding-left: 25px; padding-right: 25px;">                  <span>                      <b> text: </b>                      <span> Suicide risk assessment</span>                   </span>                </td>             </tr>          </table>          <p/>           <table class="grid dict">            <tr>                <td>                   <b> Contributor: </b>                </td>             </tr>             <tr>                <td style="padding-left: 25px; padding-right: 25px;">                  <b>                      <span> author</span> :                  </b>                </td>             </tr>             <tr>                <td style="padding-left: 50px; padding-right: 25px;">Motive Medical Intelligence</td>             </tr>          </table>          <p/>           <table class="grid dict">            <tr>                <td>                   <b> Library: </b>                </td>             </tr>             <tr>                <td style="padding-left: 25px; padding-right: 25px;">                  <b> reference: </b>                   <span> Library/suiciderisk-orderset-logic</span>                </td>             </tr>             <tr>                <td style="padding-left: 25px; padding-right: 25px;">                  <b> display: </b>                   <span> SuicideRiskLogic</span>                </td>             </tr>          </table>          <p/>           <h2> Actions</h2>          <p class="hierarchy" style="width: 100%;">            <span>                <b> Step: </b>                <br/>                 <span style="padding-left: 25px;">                  <b> title: </b>                   <span> Suicide Risk Assessment and Outpatient Management</span>                   <br/>                 </span>                <span style="padding-left: 25px;">                  <span>                      <b> Step: </b>                      <br/>                       <span style="padding-left: 50px;">                        <b> title: </b>                         <span> Consults and Referrals</span>                         <br/>                       </span>                      <span style="padding-left: 50px;">                        <span>                            <b> Step: </b>                            <br/>                             <span style="padding-left: 75px;">                              <b> text: </b>                               <span> Refer to outpatient mental health program for evaluation and treatment of mental

                       health conditions now</span> 
                              <br/>                             </span>                            <span style="padding-left: 75px;">                              <b> condition: </b>                               <br/>                                <span style="padding-left: 100px;">                                 <b> reference: </b>                                  <br/>                                   <span style="padding-left: 125px;">#referralToMentalHealthCare</span>                                  <span>                                     <span style="padding-left: 75px;">                                       <br/>                                         <span style="padding-left: 100px;">                                          <b> description: </b>                                           <span> refer to primary care mental-health integrated care program for evaluation and

                               treatment of mental health conditions now</span> 
                                          <br/>                                         </span>                                        <span style="padding-left: 100px;">                                          <b> category: </b>                                           <span> referral</span>                                           <br/>                                         </span>                                     </span>                                  </span>                               </span>                            </span>                            <span style="padding-left: 50px;"/>                         </span>                      </span>                   </span>                   <span>                      <b> Step: </b>                      <br/>                       <span style="padding-left: 50px;">                        <b> title: </b>                         <span> Medications</span>                         <br/>                       </span>                      <span style="padding-left: 50px;">                        <span>                            <b> Step: </b>                            <br/>                             <span style="padding-left: 75px;">                              <b> title: </b>                               <span> First-Line Antidepressants</span>                               <br/>                             </span>                            <span style="padding-left: 75px;">                              <span>                                  <b> Step: </b>                                  <br/>                                   <span style="padding-left: 100px;">                                    <b> title: </b>                                     <span> Selective Serotonin Reuptake Inhibitors (Choose a mazimum of one or document reasons

                           for exception)</span> 
                                    <br/>                                   </span>                                  <span style="padding-left: 100px;">                                    <span>                                        <b> Step: </b>                                        <br/>                                         <span style="padding-left: 125px;">                                          <b> text: </b>                                           <span> citalopram 20 mg tablet 1 tablet oral 1 time daily now (30 table; 3 refills)</span>                                           <br/>                                         </span>                                        <span style="padding-left: 125px;">                                          <b> condition: </b>                                           <br/>                                            <span style="padding-left: 150px;">                                             <b> reference: </b>                                              <br/>                                               <span style="padding-left: 175px;">#citalopramPrescription</span>                                              <span/>                                               <span>                                                 <span style="padding-left: 125px;">                                                   <br/>                                                     <span style="padding-left: 150px;">                                                      <b> category: </b>                                                       <span> drug</span>                                                       <br/>                                                     </span>                                                 </span>                                              </span>                                              <span/>                                               <span/>                                            </span>                                        </span>                                        <span style="padding-left: 100px;"/>                                     </span>                                     <span>                                        <b> Step: </b>                                        <br/>                                         <span style="padding-left: 125px;">                                          <b> text: </b>                                           <span> escitalopram 10 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)</span>                                           <br/>                                         </span>                                        <span style="padding-left: 100px;"/>                                     </span>                                     <span>                                        <b> Step: </b>                                        <br/>                                         <span style="padding-left: 125px;">                                          <b> text: </b>                                           <span> fluoxetine 20 mg capsule 1 capsule oral 1 time daily now (30 tablet; 3 refills)</span>                                           <br/>                                         </span>                                        <span style="padding-left: 100px;"/>                                     </span>                                     <span>                                        <b> Step: </b>                                        <br/>                                         <span style="padding-left: 125px;">                                          <b> text: </b>                                           <span> paroxetine 20 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)</span>                                           <br/>                                         </span>                                        <span style="padding-left: 100px;"/>                                     </span>                                     <span>                                        <b> Step: </b>                                        <br/>                                         <span style="padding-left: 125px;">                                          <b> text: </b>                                           <span> sertraline 50 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)</span>                                           <br/>                                         </span>                                        <span style="padding-left: 100px;"/>                                     </span>                                  </span>                               </span>                               <span>                                  <b> Step: </b>                                  <br/>                                   <span style="padding-left: 125px;">                                    <b> text: </b>                                     <span> Dopamine Norepinephrine Reuptake Inhibitors (Choose a maximum of one or document

                           reasons for exception)</span> 
                                    <br/>                                   </span>                                  <span style="padding-left: 75px;"/>                               </span>                               <span>                                  <b> Step: </b>                                  <br/>                                   <span style="padding-left: 100px;">                                    <b> text: </b>                                     <span> Serotonin Norepinephrine Reuptake Inhibitors (Choose a maximum of one or doument

                           reasons for exception)</span> 
                                    <br/>                                   </span>                                  <span style="padding-left: 75px;"/>                               </span>                               <span>                                  <b> Step: </b>                                  <br/>                                   <span style="padding-left: 100px;">                                    <b> text: </b>                                     <span> Norepinephrine-Serotonin Modulators (Choose a maximum of one or document reasons

                           for exception)</span> 
                                    <br/>                                   </span>                                  <span style="padding-left: 100px;"/>                               </span>                            </span>                         </span>                      </span>                   </span>                </span>             </span>          </p>       </div>   </text>     <!--   The referral and medication requests here are only partially specified, additional

   information will be provided from context, see the action definitions in the body
   of the plan definition below   -->
  <contained>     <ActivityDefinition>       <id value="referralToMentalHealthCare"/>       <status value="draft"/>       <description value="refer to primary care mental-health integrated care program for evaluation and

       treatment of mental health conditions now"/> 
        <!--   Kind indicates the type of resource that is defined by this activity, a ServiceRequest

       in this case   -->
      <kind value="ServiceRequest"/>       <code>         <coding>           <system value="http://snomed.info/sct"/>           <code value="306206005"/>         </coding>         <text value="Referral to service (procedure)"/>       </code>       <timingTiming>         <event>             <!--   The expression here specifies the value for the timing of the resulting resource.

           In this case, referralRequest.fulfillmentTime.start   -->
          <extension url="http://hl7.org/fhir/StructureDefinition/cqf-expression">            <valueExpression>               <language value="text/cql"/>           <expression value="Now()"/>             </valueExpression>           </extension>         </event>       </timingTiming>       <participant>         <type value="practitioner"/>       </participant>     </ActivityDefinition>   </contained>   <contained>     <ActivityDefinition>       <id value="citalopramPrescription"/>       <status value="draft"/>       <kind value="MedicationRequest"/>       <productReference>         <reference value="#citalopramMedication"/>       </productReference>       <dosage>         <text value="1 tablet oral 1 time daily"/>         <timing>           <repeat>             <frequency value="1"/>             <period value="1"/>             <periodUnit value="d"/>           </repeat>         </timing>         <route>           <coding>             <code value="26643006"/>             <display value="Oral route (qualifier value)"/>           </coding>           <text value="Oral route (qualifier value)"/>         </route>         <doseAndRate>           <type>             <coding>               <system value="http://terminology.hl7.org/CodeSystem/dose-rate-type"/>               <code value="ordered"/>               <display value="Ordered"/>             </coding>           </type>           <doseQuantity>             <value value="1"/>             <unit value="{tbl}"/>           </doseQuantity>         </doseAndRate>       </dosage>       <dynamicValue>         <path value="dispenseRequest.numberOfRepeatsAllowed"/>         <expression>           <language value="text/cql"/>           <expression value="3"/>       </expression>       </dynamicValue>       <dynamicValue>         <path value="dispenseRequest.quantity"/>         <expression>           <language value="text/cql"/>           <expression value="30 '{tbl}'"/>       </expression>       </dynamicValue>     </ActivityDefinition>   </contained>   <contained>     <Medication>       <id value="citalopramMedication"/>       <code>         <coding>           <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>           <code value="200371"/>         </coding>         <text value="citalopram"/>       </code>         <doseForm>           <coding>             <system value="http://snomed.info/sct"/>             <code value="385055001"/>             <display value="Tablet dose form"/>           </coding>           <text value="Tablet dose form"/>         </doseForm>         <ingredient>           <item>             <reference>             <reference value="#citalopramSubstance"/>             </reference>           </item>           <strengthRatio>             <numerator>               <value value="20"/>               <unit value="mg"/>             </numerator>             <denominator>               <value value="1"/>               <unit value="{tbl}"/>             </denominator>           </strengthRatio>         </ingredient>     </Medication>   </contained>   <contained>     <Substance>       <id value="citalopramSubstance"/>       <instance value="false"/>       <code>         <concept>           <coding>             <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>             <code value="2556"/>           </coding>           <text value="citalopram"/>         </concept>       </code>     </Substance>   </contained>   <url value="http://motivemi.com/artifacts/PlanDefinition/low-suicide-risk-order-set"/>   <identifier>     <system value="urn:ietf:rfc:3986"/>     <value value="urn:oid:2.16.840.1.113883.4.642.11.7"/>   </identifier>   <identifier>     <use value="official"/>     <system value="http://motivemi.com/artifacts"/>     <value value="mmi:low-suicide-risk-order-set"/>   </identifier>   <version value="1.0.0"/>   <name value="LowSuicideRiskOrderSet"/>   <title value="Low Suicide Risk Order Set"/>   <status value="active"/>   <experimental value="true"/>   <date value="2015-08-15"/>   <publisher value="Motive Medical Intelligence"/>   <contact>     <telecom>       <system value="phone"/>       <value value="415-362-4007"/>       <use value="work"/>     </telecom>     <telecom>       <system value="email"/>       <value value="info@motivemi.com"/>       <use value="work"/>     </telecom>   </contact>   <description value="Orders to be applied to a patient characterized as low suicide risk."/>   <useContext>     <code>       <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>       <code value="age"/>     </code>     <valueCodeableConcept>       <coding>         <system value="https://meshb.nlm.nih.gov"/>         <code value="D000328"/>         <display value="Adult"/>       </coding>     </valueCodeableConcept>   </useContext>   <useContext>     <code>       <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>       <code value="focus"/>     </code>     <valueCodeableConcept>       <coding>         <system value="http://snomed.info/sct"/>         <code value="87512008"/>         <display value="Mild major depression"/>       </coding>     </valueCodeableConcept>   </useContext>   <useContext>     <code>       <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>       <code value="focus"/>     </code>     <valueCodeableConcept>       <coding>         <system value="http://snomed.info/sct"/>         <code value="40379007"/>         <display value="Major depression, recurrent, mild"/>       </coding>     </valueCodeableConcept>   </useContext>   <useContext>     <code>       <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>       <code value="focus"/>     </code>     <valueCodeableConcept>       <coding>         <system value="http://snomed.info/sct"/>         <code value="394687007"/>         <display value="Low suicide risk"/>       </coding>     </valueCodeableConcept>   </useContext>   <useContext>     <code>       <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>       <code value="focus"/>     </code>     <valueCodeableConcept>       <coding>         <system value="http://snomed.info/sct"/>         <code value="225337009"/>         <display value="Suicide risk assessment"/>       </coding>     </valueCodeableConcept>   </useContext>   <useContext>     <code>       <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>       <code value="user"/>     </code>     <valueCodeableConcept>       <coding>         <system value="http://snomed.info/sct"/>         <code value="309343006"/>         <display value="Physician"/>       </coding>     </valueCodeableConcept>   </useContext>   <useContext>     <code>       <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>       <code value="venue"/>     </code>     <valueCodeableConcept>       <coding>         <system value="http://snomed.info/sct"/>         <code value="440655000"/>         <display value="Outpatient environment"/>       </coding>     </valueCodeableConcept>   </useContext>   <jurisdiction>     <coding>       <system value="urn:iso:std:iso:3166"/>       <code value="US"/>     </coding>   </jurisdiction>   <purpose value="This order set helps ensure consistent application of appropriate orders for the

   care of low suicide risk patients."/> 
  <usage value="This order set should be applied after assessing a patient for suicide risk, when

   the findings of that assessment indicate the patient has low suicide risk."/> 
  <copyright value="© Copyright 2016 Motive Medical Intelligence. All rights reserved."/>   <approvalDate value="2016-03-12"/>   <lastReviewDate value="2016-08-15"/>   <effectivePeriod>     <start value="2016-01-01"/>     <end value="2017-12-31"/>   </effectivePeriod>   <topic>     <text value="Suicide risk assessment"/>   </topic>   <author>     <name value="Motive Medical Intelligence"/>     <telecom>       <system value="phone"/>       <value value="415-362-4007"/>     <use value="work"/>     </telecom>     <telecom>     <system value="email"/>     <value value="info@motivemi.com"/>     <use value="work"/>     </telecom>   </author>   <relatedArtifact>     <type value="derived-from"/>     <display value="Practice Guideline for the Treatment of Patients with Major Depressive Disorder"/>     <document>       <url value="http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf"/>     </document>   </relatedArtifact>   <relatedArtifact>     <type value="composed-of"/>     <resource value="http://example.org/fhir/ActivityDefinition/referralPrimaryCareMentalHealth"/>   </relatedArtifact>   <relatedArtifact>     <type value="composed-of"/>     <resource value="http://example.org/fhir/ActivityDefinition/citalopramPrescription"/>   </relatedArtifact>   <library value="http://example.org/fhir/Library/suiciderisk-orderset-logic"/>     <!--   Actions   -->  <action>     <title value="Suicide Risk Assessment and Outpatient Management"/>     <action>       <title value="Consults and Referrals"/>       <groupingBehavior value="logical-group"/>       <selectionBehavior value="any"/>       <action>         <textEquivalent value="Refer to outpatient mental health program for evaluation and treatment of mental

         health conditions now"/> 
        <definitionCanonical value="#referralToMentalHealthCare"/>           <!--   These expressions will be evaluated with the library referenced above as an include

           -->
        <dynamicValue>           <path value="timing.event"/>           <expression>             <language value="text/cql"/>             <expression value="Now()"/>       </expression>         </dynamicValue>         <dynamicValue>           <path value="specialty"/>             <!--   This expression is code selector syntax in CQL, returning the code from the NPI

           provider taxonomy   -->
          <expression>             <language value="text/cql"/>             <expression value="Code '261QM0850X' from SuicideRiskLogic.&quot;NUCC Provider Taxonomy&quot; display

             'Adult Mental Health'"/> 
      </expression>         </dynamicValue>         <dynamicValue>         <!--   The fulfillmentTime element of the resulting ServiceRequest will be set to the

           result of the ServiceRequestFulfillmentTime expression defined in the SuicideRiskLogic
           library   -->
          <path value="occurrenceDateTime"/>           <expression>             <language value="text/cql"/>             <expression value="SuicideRiskLogic.ServiceRequestFulfillmentTime"/>       </expression>         </dynamicValue>         <dynamicValue>           <path value="subject"/>           <expression>             <language value="text/cql"/>             <expression value="SuicideRiskLogic.Patient"/>       </expression>         </dynamicValue>         <dynamicValue>           <path value="requester.agent"/>           <expression>             <language value="text/cql"/>             <expression value="SuicideRiskLogic.Practitioner"/>       </expression>         </dynamicValue>         <dynamicValue>           <path value="reasonCode"/>           <expression>             <language value="text/cql"/>             <expression value="SuicideRiskLogic.RiskAssessmentScore"/>       </expression>         </dynamicValue>         <dynamicValue>           <path value="reasonReference"/>           <expression>             <language value="text/cql"/>             <expression value="SuicideRiskLogic.RiskAssessment"/>         </expression>         </dynamicValue>       </action>     </action>     <action>       <title value="Medications"/>       <groupingBehavior value="logical-group"/>       <selectionBehavior value="at-most-one"/>       <action>         <title value="First-Line Antidepressants"/>           <documentation>             <type value="citation"/>             <document>             <extension url="http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence">        <valueCodeableConcept>           <coding>             <system value="http://terminology.hl7.org/CodeSystem/evidence-quality"/>             <code value="high"/>           </coding>           <text value="High Quality"/>         </valueCodeableConcept>             </extension>             <contentType value="text/html"/>             <url value="http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf"/>             <title value="Practice Guideline for the Treatment of Patients with Major Depressive Disorder"/>           </document>         </documentation>         <groupingBehavior value="logical-group"/>         <selectionBehavior value="at-most-one"/>         <action>           <title value="Selective Serotonin Reuptake Inhibitors (Choose a mazimum of one or document reasons

           for exception)"/> 
          <documentation>             <type value="citation"/>             <document>               <contentType value="text/html"/>               <url value="http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6daeb45c-451d-b135-bf8f-2d6dff4b6b01"/>               <title value="National Library of Medicine. DailyMed website. CITALOPRAM- citalopram hydrobromide

               tablet, film coated."/> 
            </document>           </documentation>           <groupingBehavior value="logical-group"/>           <selectionBehavior value="at-most-one"/>           <action>             <textEquivalent value="citalopram 20 mg tablet 1 tablet oral 1 time daily now (30 table; 3 refills)"/>             <definitionCanonical value="#citalopramPrescription"/>             <dynamicValue>               <path value="status"/>               <expression>                 <language value="text/cql"/>                 <expression value="'draft'"/>         </expression>             </dynamicValue>             <dynamicValue>               <path value="patient"/>               <expression>                 <language value="text/cql"/>                 <expression value="SuicideRiskLogic.Patient"/>               </expression>             </dynamicValue>             <dynamicValue>               <path value="prescriber"/>               <expression>                 <language value="text/cql"/>                 <expression value="SuicideRiskLogic.Practitioner"/>         </expression>             </dynamicValue>             <dynamicValue>               <path value="reasonCode"/>               <expression>                 <language value="text/cql"/>                 <expression value="SuicideRiskLogic.RiskAssessmentScore"/>         </expression>             </dynamicValue>             <dynamicValue>               <path value="reasonReference"/>               <expression>                 <language value="text/cql"/>                 <expression value="SuicideRiskLogic.RiskAssessment"/>               </expression>             </dynamicValue>           </action>           <action>             <textEquivalent value="escitalopram 10 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)"/>               <!--   Follows pattern established above   -->          </action>           <action>             <textEquivalent value="fluoxetine 20 mg capsule 1 capsule oral 1 time daily now (30 tablet; 3 refills)"/>               <!--   Follows pattern established above   -->          </action>           <action>             <textEquivalent value="paroxetine 20 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)"/>               <!--   Follows pattern established above   -->          </action>           <action>             <textEquivalent value="sertraline 50 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)"/>               <!--   Follows pattern established above   -->          </action>         </action>         <action>           <textEquivalent value="Dopamine Norepinephrine Reuptake Inhibitors (Choose a maximum of one or document

           reasons for exception)"/> 
            <!--   Follows pattern established above   -->        </action>         <action>           <textEquivalent value="Serotonin Norepinephrine Reuptake Inhibitors (Choose a maximum of one or doument

           reasons for exception)"/> 
            <!--   Follows pattern established above   -->        </action>         <action>           <textEquivalent value="Norepinephrine-Serotonin Modulators (Choose a maximum of one or document reasons

           for exception)"/> 
            <!--   Follows pattern established above   -->        </action>       </action>     </action>   </action> 


</

PlanDefinition

>