Plandefinition-example-kdn5-simplified.xml

Chemotherapy Regimen (id = "KDN5")

<PlanDefinition xmlns="http://hl7.org/fhir">
  <id value="KDN5"/>
  <text>
    <status value="additional"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
      <table style="width: 100%;">
        <tr>
          <td>
            <!--  link to NCCN image  -->
            <div style="width: 200px; height: 100px; vertical-align: top;">National Comprehensive Cancer Network</div>
          </td>
          <td>
            <h3>Chemotherapy Order Template</h3>
            <h1>Kidney Cancer</h1>
            <h2>Gemcitabine/CARBOplatin</h2>
          </td>
          <td style="text-align: right; vertical-align: top;">KDN5</td>
        </tr>
      </table>
      <table style="width: 100%; border-top: 1px solid; border-bottom: 1px solid;">
        <tr>
          <td style="width: 33%; border-right: 1px solid; vertical-align: top">
            <h4>INDICATION:</h4>
            <p>Metastatic or Relapsed – Collecting Duct/Medullary Subtypes</p>
          </td>
          <td style="width: 34%; border-right: 1px solid; vertical-align: top">
            <h4>REFERENCES:</h4>
            <ol>
              <li><a href="http://www.example.org/professionals/physician_gls/PDF/kidney.pdf">NCCN Guidelines® for Kidney Cancer. V.3.2015.</a></li>
              <li><a href="http://www.ncbi.nlm.nih.gov/pubmed?term=%22The+Journal+of+urology%22%5BJour%5D+AND+1698%5Bpage%5D+AN
                D+2007%5Bpdat%5D+AND+Oudard+S%5Bauthor%5D">Oudard S, et al. <em>J Urol</em>. 2007;177(5):1698-702.</a><sup>
                  <a href="http://www.example.org/OrderTemplates/PDF/appendix_E.pdf">a</a></sup>
              </li>
            </ol>
          </td>
          <td style="width: 33%; vertical-align: top">
            <h4>NCCN SUPPORTIVE CARE:</h4>
            <ol>
              <li>
                <i>Emetic Risk:</i>
                <table>
                  <tr>
                    <td>Day 1</td>
                    <td>Moderate</td>
                  </tr>
                  <tr>
                    <td>Day 8</td>
                    <td>Low</td>
                  </tr>
                </table>
              </li>
              <li>
                <i>Fever Neutropenia Risk:</i><br/>
                Refer to <a href="http://www.example.org/professionals/physician_gls/PDF/myeloid_growth.pdf">NCCN Guidelines for Myeloid Growth Factors. V.2.2014</a>
              </li>
            </ol>
          </td>
        </tr>
      </table>
      <!--   same as the regimen section of the Composition resource only this version is without
       the style guide notes   -->
      <h4>CHEMOTHERAPY REGIMEN</h4>
      <p>
        <i>21-day cycle for 6 cycles</i>
      </p>
      <ul>
        <li>Gemcitabine 1250 mg/m<sup>2</sup> IV over 30 minutes on Days 1 and 8</li>
        <li>CARBOplatin AUC 5 IV over 30 minutes on Day 1</li>
      </ul>
    </div>
  </text>
  <!--   regimen entries represented using contained ActivityDefinition resources (with extensions)
     -->
  <contained>
    <ActivityDefinition>
      <id value="1111"/>
      <status value="draft"/>
      <productCodeableConcept>
        <coding>
          <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
          <code value="12574"/>
          <display value="gemcitabine"/>
        </coding>
        <text value="gemcitabine"/>
      </productCodeableConcept>
      <dosageInstruction>
        <text value="1250 mg/m² IV over 30 minutes on days 1 and 8"/>
        <timing>
          <extension url="http://example.org/fhir/daysOfCycle">
            <extension url="day">
              <valueInteger value="1"/>
            </extension>
            <extension url="day">
              <valueInteger value="8"/>
            </extension>
          </extension>
          <repeat>
            <duration value="30"/>
            <durationUnit value="min"/>
          </repeat>
        </timing>
        <route>
          <text value="IV"/>
        </route>
        <doseQuantity>
          <value value="1250"/>
          <unit value="mg/m²"/>
        </doseQuantity>
      </dosageInstruction>
    </ActivityDefinition>
  </contained>
  <contained>
    <ActivityDefinition>
      <id value="2222"/>
      <status value="draft"/>
      <productCodeableConcept>
        <coding>
          <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
          <code value="40048"/>
          <display value="Carboplatin"/>
        </coding>
        <text value="CARBOplatin"/>
      </productCodeableConcept>
      <dosageInstruction>
        <text value="AUC 5 IV over 30 minutes on Day 1"/>
        <timing>
          <extension url="http://example.org/fhir/daysOfCycle">
            <extension url="day">
              <valueInteger value="1"/>
            </extension>
          </extension>
          <repeat>
            <duration value="30"/>
            <durationUnit value="min"/>
          </repeat>
        </timing>
        <route>
          <text value="IV"/>
        </route>
        <doseQuantity>
          <!--   AUC as dose unit or as an extension?   -->
          <extension url="http://example.org/fhir/AUC-dose">
            <valueInteger value="5"/>
          </extension>
          <!--   <value value="5" />
          <unit value="AUC" />
          <system value="http://snomed.info/sct" />
          <code value="413573002" />   -->
        </doseQuantity>
      </dosageInstruction>
    </ActivityDefinition>
  </contained>

  <identifier>
    <system value="http://example.org/ordertemplates"/>
    <value value="KDN5"/>
  </identifier>
  <version value="1"/>
  <title value="Gemcitabine/CARBOplatin"/>
  <type>
    <text value="Chemotherapy Order Template"/>
  </type>
  <status value="draft"/>
  <experimental value="true"/>
  <approvalDate value="2016-07-27"/>
  <lastReviewDate value="2016-07-27"/>
  <!--   Indications   -->
  <useContext>
    <extension url="http://hl7.org/fhir/StructureDefinition/usagecontext-group">
      <valueString value="A"/>
    </extension>
    <code>
      <system value="http://example.org/fhir/CodeSystem/indications"/>
      <code value="treamentSetting-or-diseaseStatus"/>
    </code>
    <valueCodeableConcept>
      <text value="Metastatic"/>
    </valueCodeableConcept>
  </useContext>
  <useContext>
    <extension url="http://hl7.org/fhir/StructureDefinition/usagecontext-group">
      <valueString value="A"/>
    </extension>
    <code>
      <system value="http://example.org/fhir/CodeSystem/indications"/>
      <code value="disease-or-histology"/>
    </code>
    <valueCodeableConcept>
      <text value="Collecting Duct/Medullary Subtypes"/>
    </valueCodeableConcept>
  </useContext>
  <useContext>
    <extension url="http://hl7.org/fhir/StructureDefinition/usagecontext-group">
      <valueString value="A"/>
    </extension>
    <code>
      <system value="http://hl7.org/fhir/usage-context-type"/>
      <code value="focus"/>
    </code>
    <valueCodeableConcept>
      <text value="Kidney Cancer"/>
    </valueCodeableConcept>
  </useContext>
  <useContext>
    <extension url="http://hl7.org/fhir/StructureDefinition/usagecontext-group">
      <valueString value="B"/>
    </extension>
    <code>
      <system value="http://example.org/fhir/CodeSystem/indications"/>
      <code value="treatmentSetting-or-diseaseStatus"/>
    </code>
    <valueCodeableConcept>
      <text value="Relapsed"/>
    </valueCodeableConcept>
  </useContext>
  <useContext>
    <extension url="http://hl7.org/fhir/StructureDefinition/usagecontext-group">
      <valueString value="B"/>
    </extension>
    <code>
      <system value="http://example.org/fhir/CodeSystem/indications"/>
      <code value="disease-or-histology"/>
    </code>
    <valueCodeableConcept>
      <text value="Collecting Duct/Medullary Subtypes"/>
    </valueCodeableConcept>
  </useContext>
  <useContext>
    <extension url="http://hl7.org/fhir/StructureDefinition/usagecontext-group">
      <valueString value="B"/>
    </extension>
    <code>
      <system value="http://hl7.org/fhir/usage-context-type"/>
      <code value="focus"/>
    </code>
    <valueCodeableConcept>
      <text value="Kidney Cancer – Collecting Duct/Medullary Subtypes - Metastatic"/>
    </valueCodeableConcept>
  </useContext>
  <contributor>
    <type value="author"/>
    <name value="Lee Surprenant"/>
  </contributor>
  <publisher value="National Comprehensive Cancer Network, Inc."/>
  <copyright value="All rights reserved."/>
  <!--   list of references for the order template   -->
  <relatedArtifact>
    <type value="derived-from"/>
    <display value="NCCN Guidelines for Kidney Cancer. V.2.2016"/>
    <url value="http://www.example.org/professionals/physician_gls/PDF/kidney.pdf"/>
  </relatedArtifact>
  <relatedArtifact>
    <type value="citation">
      <extension url="http://example.org/fhir/regimenReferenceType">
        <valueCode value="a"/>
      </extension>
    </type>
    <citation value="Oudard S, et al. J Urol. 2007;177(5):1698-702"/>
    <url value="http://www.ncbi.nlm.nih.gov/pubmed/17437788"/>
  </relatedArtifact>

  <actionDefinition>
    <!--   list of regimen options. in this case only one   -->
    <selectionBehavior value="exactly-one"/>
    <actionDefinition>
      <!--   list of regimen parts. in this case only one   -->
      <selectionBehavior value="all"/>
      <actionDefinition>
        <!--   list of cycle definitions. in this case only one   -->
        <groupingBehavior value="sentence-group"/>
        <selectionBehavior value="exactly-one"/>
        <actionDefinition>
          <actionIdentifier>
            <system value="http://example.org/ordertemplates/KDN5"/>
            <value value="cycle-definition-1"/>
          </actionIdentifier>
          <textEquivalent value="21-day cycle for 6 cycles"/>

          <timingTiming>
            <repeat>
              <count value="6"/>
              <duration value="21"/>
              <durationUnit value="d"/>
            </repeat>
          </timingTiming>

          <!--   list of regimen entry references for this regimen part   -->
          <!--   references would duplicated in each cycle definition option
          (see http://build.fhir.org/codesystem-action-grouping-behavior.html#sentence-group)
            -->
          <actionDefinition>
            <textEquivalent value="Gemcitabine 1250 mg/m² IV over 30 minutes on days 1 and 8"/>
            <activityDefinition>
              <reference value="#1111"/>
            </activityDefinition>
          </actionDefinition>
          <actionDefinition>
            <textEquivalent value="CARBOplatin AUC 5 IV over 30 minutes on Day 1"/>
            <activityDefinition>
              <reference value="#2222"/>
            </activityDefinition>
          </actionDefinition> <!--   end of regimen entries   -->
        </actionDefinition> <!--   end of cycle definitions   -->
      </actionDefinition> <!--   end of regimen parts   -->
    </actionDefinition> <!--   end of regimen options   -->
  </actionDefinition>
</PlanDefinition>