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12.18.1.1 Operation $apply on PlanDefinition

Clinical Decision Support Work Group

Maturity Level: 2

Trial Use

Compartments: N/A

The apply operation applies a PlanDefinition to a given context

The official URL for this operation definition is

 http://hl7.org/fhir/OperationDefinition/PlanDefinition-apply

Formal Definition (as a OperationDefinition).

URL: [base]/PlanDefinition/[id]/$apply

This is not an idempotent operation

The result of this operation is a CarePlan resource with a single activity represented by a RequestGroup. The RequestGroup will have actions for each of the applicable actions in the plan based on evaluating the applicability condition in context. For each applicable action, the definition is applied as described in the $apply operation of the ActivityDefinition resource, and the resulting resource is added as an activity to the CarePlan. If the ActivityDefinition includes library references, those libraries will be available to the evaluated expressions. If those libraries have parameters, those parameters will be bound by name to the parameters given to the operation. For a more detailed description, refer to the PlanDefinition and ActivityDefinition resource documentation

12.18.1.1.1 Examples

Apply the low suicide risk order set to patient 124 (Request):

GET [base]/PlanDefinition/example/$apply?patient=124

Returned on successful application of the order set (Response):

HTTP/1.1 200 OK

<?xml version="1.0" encoding="UTF-8"?>
<CarePlan xmlns="http://hl7.org/fhir">
  <!-- This example demonstrates the result of an $apply operation for the citalopramPrescription activity definition. -->
  <id value="apply-operation-response"/>
  <text>
	<status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml">
    Generated...
    </div>
  </text>
  <contained>
	<ServiceRequest>
	  <id value="referralrequest"/>
	  <status value="draft"/>
      <intent value="proposal"/>
      <code>
		<coding>
		  <system value="http://snomed.info/sct"/>
		  <code value="306206005"/>
		</coding>
		<text value="Referral to service (procedure)"/>
      </code>
      <subject>
        <reference value="Patient/124"/>
      </subject>
      <occurrenceDateTime value="2017-02-26T11:47:00.000Z"/>
      <requester>
		<reference value="Practitioner/123"/>
	  </requester>
      <performerType>
		  <coding>
			  <system value="http://nucc.org/provider-taxonomy"/>
			  <code value="261QM0850X"/>
			  <display value="Adult Mental Health"/>
		  </coding>
      </performerType>
	  <reasonCode>
		  <coding>
			  <system value="http://example.org/CodeSystem/suicide-risk-assessment-score"/>
			  <code value="Low"/>
			  <display value="Low Suicide Risk"/>
		  </coding>
		  <text value="Low Suicide Risk"/>
	  </reasonCode>
	  <reasonReference>
		  <reference value="RiskAssessment/suicide-risk-assessment"/>
	  </reasonReference>
	</ServiceRequest>
  </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>
        <form>
          <coding>
            <system value="http://snomed.info/sct"/>
            <code value="385055001"/>
            <display value="Tablet dose form"/>
          </coding>
          <text value="Tablet dose form"/>
        </form>
        <ingredient>
          <itemReference>
            <reference value="#citalopramSubstance"/>
          </itemReference>
          <amount>
            <numerator>
              <value value="20"/>
              <unit value="mg"/>
            </numerator>
            <denominator>
              <value value="1"/>
              <unit value="{tbl}"/>
            </denominator>
          </amount>
        </ingredient>
    </Medication>
  </contained>
  <contained>
    <Substance>
      <id value="citalopramSubstance"/>
      <code>
        <coding>
          <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
          <code value="2556"/>
        </coding>
        <text value="citalopram"/>
      </code>
    </Substance>
  </contained>
  <contained>
	<MedicationRequest>
	  <id value="citalopramPrescription"/>
	  <status value="draft"/>
	  <intent value="proposal"/>
	  <medicationReference>
		  <reference value="#citalopramMedication"/>
	  </medicationReference>
	  <subject>
		  <reference value="Patient/124"/>
	  </subject>
	  <requester>
		<reference value="Practitioner/123"/>
	  </requester>
	  <reasonCode>
		  <coding>
			  <system value="http://example.org/CodeSystem/suicide-risk-assessment-score"/>
			  <code value="Low"/>
			  <display value="Low Suicide Risk"/>
		  </coding>
		  <text value="Low Suicide Risk"/>
	  </reasonCode>
	  <reasonReference>
		  <reference value="RiskAssessment/suicide-risk-assessment"/>
	  </reasonReference>
	  <!--definition>
		<reference value="ActivityDefinition/citalopramPrescription"/>
	  </definition-->
	  <instantiates value="ActivityDefinition/citalopramPrescription"/>
	  <dosageInstruction>
		<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><text value="ordered"/></type>
			<doseQuantity>
				<value value="1"/>
				<unit value="{tbl}"/>
			</doseQuantity>
		</doseAndRate>
	  </dosageInstruction>
	  <dispenseRequest>
		  <numberOfRepeatsAllowed value="3"/>
		  <quantity>
			  <value value="30"/>
			  <unit value="{tbl}"/>
		  </quantity>
	  </dispenseRequest>
	</MedicationRequest>
  </contained>
  <!--definition>
    <reference value="PlanDefinition/example"/>
  </definition-->
  <instantiates value="PlanDefinition/example"/>
  <status value="draft"/>
  <intent value="proposal"/>
  <subject>
	  <reference value="Patient/124"/>
  </subject>
  <activity>
	<reference>
		<reference value="#referralrequest"/>
	</reference>
  </activity>
  <activity>
    <reference>
      <reference value="#citalopramPrescription"/>
    </reference>
  </activity>
</CarePlan>

For more information about operations, including how they are invoked, see Operations.