Release 5 Ballot

This page is part of the FHIR Specification (v5.0.0-ballot: R5 Ballot - see ballot notes). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4

Example Library/opioidcds-recommendation-08 (XML)

Clinical Decision Support Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: Not linked to any defined compartments

Raw XML (canonical form + also see XML Format Specification)

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Opioid CDS Recommendation 8 Logic (id = "opioidcds-recommendation-08")

<?xml version="1.0" encoding="UTF-8"?>

<Library xmlns="http://hl7.org/fhir">
  <id value="opioidcds-recommendation-08"/> 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">
      <h2> Participants</h2> 
      <table class="grid">
        <tr> 
          <td> Author</td> 
          <td> Kensaku Kawamoto, MD, PhD, MHS</td> 
        </tr> 
        <tr> 
          <td> Author</td> 
          <td> Bryn Rhodes</td> 
        </tr> 
        <tr> 
          <td> Author</td> 
          <td> Floyd Eisenberg, MD, MPH</td> 
        </tr> 
        <tr> 
          <td> Author</td> 
          <td> Robert McClure, MD, MPH</td> 
        </tr> 
      </table> 
      <h2> Related Artifacts</h2> 
      <table class="grid">
        <tr> 
          <td> Documentation</td> 
          <td> CDC guideline for prescribing opioids for chronic pain</td> 
          <td> 
            <p> 
              <code> 
                <a href="https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chro
                nic-pain---united-states-2016#420">https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chro
                  nic-pain---united-states-2016#420</a> 
              </code>  (
              <code/>  )
            </p> 
          </td> 
        </tr> 
        <tr> 
          <td> Depends On</td> 
          <td/>  
          <td> 
            <code> http://example.org/fhir/Library/opioidcds-common</code> 
          </td> 
        </tr> 
        <tr> 
          <td> Documentation</td> 
          <td> MME Conversion Tables</td> 
          <td> 
            <p> 
              <code> 
                <a href="https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf">https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf</a> 
              </code>  (
              <code/>  )
            </p> 
          </td> 
        </tr> 
      </table> 
      <h2> Data Requirements</h2> 
      <table class="grid">
        <tr> 
          <td colspan="2">
            <b> Type</b> : 
            <a href="medicationrequest.html">MedicationRequest</a> 
          </td> 
        </tr> 
        <tr style="background-color: #efefef">
          <td> Filter</td> 
          <td> Value</td> 
        </tr> 
        <tr> 
          <td> medicationCodeableConcept</td> 
          <td> In ValueSet 
            <a href="http://example.org/fhir/ValueSet/naloxone">http://example.org/fhir/ValueSet/naloxone</a> 
          </td> 
        </tr> 
      </table> 
      <table class="grid">
        <tr> 
          <td colspan="2">
            <b> Type</b> : 
            <a href="medicationrequest.html">MedicationRequest</a> 
          </td> 
        </tr> 
        <tr style="background-color: #efefef">
          <td> Filter</td> 
          <td> Value</td> 
        </tr> 
        <tr> 
          <td> medicationCodeableConcept</td> 
          <td> In ValueSet 
            <a href="http://example.org/fhir/ValueSet/opioids-abused-in-ambulatory-care">http://example.org/fhir/ValueSet/opioids-abused-in-ambulatory-care</a> 
          </td> 
        </tr> 
      </table> 
      <table class="grid">
        <tr> 
          <td colspan="2">
            <b> Type</b> : 
            <a href="medicationrequest.html">MedicationRequest</a> 
          </td> 
        </tr> 
        <tr style="background-color: #efefef">
          <td> Filter</td> 
          <td> Value</td> 
        </tr> 
        <tr> 
          <td> medicationCodeableConcept</td> 
          <td> In ValueSet 
            <a href="http://example.org/fhir/ValueSet/benzodiazepines">http://example.org/fhir/ValueSet/benzodiazepines</a> 
          </td> 
        </tr> 
      </table> 
      <table class="grid">
        <tr> 
          <td colspan="2">
            <b> Type</b> : 
            <a href="condition.html">Condition</a> 
          </td> 
        </tr> 
        <tr style="background-color: #efefef">
          <td> Filter</td> 
          <td> Value</td> 
        </tr> 
        <tr> 
          <td> code</td> 
          <td> In ValueSet 
            <a href="http://example.org/fhir/ValueSet/substance-abuse">http://example.org/fhir/ValueSet/substance-abuse</a> 
          </td> 
        </tr> 
      </table> 
      <h2> Contents</h2> 
      <p> 
        <code> application/elm+xml</code> 
      </p> 
      <pre> 
        <code class="language-xml">&lt;?xml version=&quot;1.0&quot; encoding=&quot;UTF-8&quot;?&gt;
&lt;library xmlns=&quot;urn:hl7-org:elm:r1&quot; xmlns:t=&quot;urn:hl7-org:elm-types:r1&quot;
           xmlns:xsi=&quot;http://www.w3.org/2001/XMLSchema-instance&quot; xmlns:xsd=&quot;http://www.w3
          .org/2001/XMLSchema&quot; xmlns:fhir=&quot;http://hl7.org/fhir&quot; xmlns:qdm43=&quot;urn:hea
          lthit-gov:qdm:v4_3&quot; xmlns:qdm53=&quot;urn:healthit-gov:qdm:v5_3&quot; xmlns:a=&quot;urn:h
          l7-org:cql-annotations:r1&quot;&gt;
   &lt;annotation startLine=&quot;63&quot; startChar=&quot;11&quot; endLine=&quot;63&quot;
           endChar=&quot;48&quot; message=&quot;Could not resolve code path medicationCodeableConcept
           for the type of the retrieve FHIR.MedicationRequest.&quot; errorType=&quot;semantic&quot;
           errorSeverity=&quot;warning&quot; xsi:type=&quot;a:CqlToElmError&quot;/&gt;
   &lt;annotation startLine=&quot;63&quot; startChar=&quot;11&quot; endLine=&quot;63&quot;
           endChar=&quot;48&quot; message=&quot;Could not resolve membership operator for
           terminology target of the retrieve.&quot; errorType=&quot;semantic&quot; errorSeverity=&quot;
          warning&quot; xsi:type=&quot;a:CqlToElmError&quot;/&gt;
   &lt;annotation startLine=&quot;81&quot; startChar=&quot;5&quot; endLine=&quot;81&quot;
           endChar=&quot;68&quot; message=&quot;Could not resolve code path medicationCodeableConcept
           for the type of the retrieve FHIR.MedicationRequest.&quot; errorType=&quot;semantic&quot;
           errorSeverity=&quot;warning&quot; xsi:type=&quot;a:CqlToElmError&quot;/&gt;
   &lt;annotation startLine=&quot;81&quot; startChar=&quot;5&quot; endLine=&quot;81&quot;
           endChar=&quot;68&quot; message=&quot;Could not resolve membership operator for
           terminology target of the retrieve.&quot; errorType=&quot;semantic&quot; errorSeverity=&quot;
          warning&quot; xsi:type=&quot;a:CqlToElmError&quot;/&gt;
   &lt;annotation startLine=&quot;74&quot; startChar=&quot;11&quot; endLine=&quot;74&quot;
           endChar=&quot;55&quot; message=&quot;Could not resolve code path medicationCodeableConcept
           for the type of the retrieve FHIR.MedicationRequest.&quot; errorType=&quot;semantic&quot;
           errorSeverity=&quot;warning&quot; xsi:type=&quot;a:CqlToElmError&quot;/&gt;
   &lt;annotation startLine=&quot;74&quot; startChar=&quot;11&quot; endLine=&quot;74&quot;
           endChar=&quot;55&quot; message=&quot;Could not resolve membership operator for
           terminology target of the retrieve.&quot; errorType=&quot;semantic&quot; errorSeverity=&quot;
          warning&quot; xsi:type=&quot;a:CqlToElmError&quot;/&gt;
   &lt;annotation startLine=&quot;77&quot; startChar=&quot;12&quot; endLine=&quot;77&quot;
           endChar=&quot;41&quot; message=&quot;Could not resolve membership operator for
           terminology target of the retrieve.&quot; errorType=&quot;semantic&quot; errorSeverity=&quot;
          warning&quot; xsi:type=&quot;a:CqlToElmError&quot;/&gt;
   &lt;identifier id=&quot;OpioidCDS_STU4_REC_08&quot; version=&quot;0.1.0&quot;/&gt;
   &lt;schemaIdentifier id=&quot;urn:hl7-org:elm&quot; version=&quot;r1&quot;/&gt;
   &lt;usings&gt;
      &lt;def localIdentifier=&quot;System&quot; uri=&quot;urn:hl7-org:elm-types:r1&quot;/&gt
          ;
      &lt;def localIdentifier=&quot;FHIR&quot; uri=&quot;http://hl7.org/fhir&quot;
           version=&quot;3.2.0&quot;/&gt;
   &lt;/usings&gt;
   &lt;includes&gt;
      &lt;def localIdentifier=&quot;Common&quot; path=&quot;OpioidCDS_STU4_Common&quot;
           version=&quot;0.1.0&quot;/&gt;
   &lt;/includes&gt;
   &lt;parameters&gt;
      &lt;def name=&quot;ContextPrescriptions&quot; accessLevel=&quot;Public&quot;&gt;
         &lt;parameterTypeSpecifier xsi:type=&quot;ListTypeSpecifier&quot;&gt;
            &lt;elementType name=&quot;fhir:MedicationRequest&quot; xsi:type=&quot;NamedTypeS
          pecifier&quot;/&gt;
         &lt;/parameterTypeSpecifier&gt;
      &lt;/def&gt;
   &lt;/parameters&gt;
   &lt;valueSets&gt;
      &lt;def name=&quot;Substance Abuse&quot; id=&quot;TODO&quot; accessLevel=&quot;Public&q
          uot;/&gt;
   &lt;/valueSets&gt;
   &lt;statements&gt;
      &lt;def name=&quot;Patient&quot; context=&quot;Patient&quot;&gt;
         &lt;expression xsi:type=&quot;SingletonFrom&quot;&gt;
            &lt;operand dataType=&quot;fhir:Patient&quot; xsi:type=&quot;Retrieve&quot;/&gt;
         &lt;/expression&gt;
      &lt;/def&gt;
      &lt;def name=&quot;Validate Trigger Event&quot; context=&quot;Patient&quot;
           accessLevel=&quot;Public&quot;&gt;
         &lt;expression xsi:type=&quot;Exists&quot;&gt;
            &lt;operand xsi:type=&quot;Query&quot;&gt;
               &lt;source alias=&quot;triggerScript&quot;&gt;
                  &lt;expression name=&quot;ContextPrescriptions&quot; xsi:type=&quot;Paramet
          erRef&quot;/&gt;
               &lt;/source&gt;
               &lt;where name=&quot;IsOpioidWithAmbulatoryAbusePotential&quot;
           libraryName=&quot;Common&quot; xsi:type=&quot;FunctionRef&quot;&gt;
                  &lt;operand name=&quot;ToCode&quot; libraryName=&quot;Common&quot;
           xsi:type=&quot;FunctionRef&quot;&gt;
                     &lt;operand xsi:type=&quot;Indexer&quot;&gt;
                        &lt;operand path=&quot;coding&quot; xsi:type=&quot;Property&quot;&gt;
                           &lt;source path=&quot;medication&quot; scope=&quot;triggerScript&q
          uot; xsi:type=&quot;Property&quot;/&gt;
                        &lt;/operand&gt;
                        &lt;operand valueType=&quot;t:Integer&quot; value=&quot;0&quot;
           xsi:type=&quot;Literal&quot;/&gt;
                     &lt;/operand&gt;
                  &lt;/operand&gt;
               &lt;/where&gt;
            &lt;/operand&gt;
         &lt;/expression&gt;
      &lt;/def&gt;
      &lt;def name=&quot;Exclusion Criteria&quot; context=&quot;Patient&quot; accessLevel=&qu
          ot;Public&quot;&gt;
         &lt;expression xsi:type=&quot;Exists&quot;&gt;
            &lt;operand dataType=&quot;fhir:MedicationRequest&quot; codeProperty=&quot;medica
          tionCodeableConcept&quot; xsi:type=&quot;Retrieve&quot;&gt;
               &lt;codes name=&quot;Naloxone&quot; libraryName=&quot;Common&quot;
           xsi:type=&quot;ValueSetRef&quot;/&gt;
            &lt;/operand&gt;
         &lt;/expression&gt;
      &lt;/def&gt;
      &lt;def name=&quot;Get Active Ambulatory Opioid Rx&quot; context=&quot;Patient&quot;
           accessLevel=&quot;Public&quot;&gt;
         &lt;expression xsi:type=&quot;Union&quot;&gt;
            &lt;operand xsi:type=&quot;Query&quot;&gt;
               &lt;source alias=&quot;Rx&quot;&gt;
                  &lt;expression dataType=&quot;fhir:MedicationRequest&quot; codeProperty=&qu
          ot;medicationCodeableConcept&quot; xsi:type=&quot;Retrieve&quot;&gt;
                     &lt;codes name=&quot;Ambulatory Abuse Potential Opioids&quot;
           libraryName=&quot;Common&quot; xsi:type=&quot;ValueSetRef&quot;/&gt;
                  &lt;/expression&gt;
               &lt;/source&gt;
               &lt;where xsi:type=&quot;And&quot;&gt;
                  &lt;operand xsi:type=&quot;Equal&quot;&gt;
                     &lt;operand path=&quot;value&quot; xsi:type=&quot;Property&quot;&gt;
                        &lt;source path=&quot;status&quot; scope=&quot;Rx&quot;
           xsi:type=&quot;Property&quot;/&gt;
                     &lt;/operand&gt;
                     &lt;operand valueType=&quot;t:String&quot; value=&quot;active&quot;
           xsi:type=&quot;Literal&quot;/&gt;
                  &lt;/operand&gt;
                  &lt;operand xsi:type=&quot;Equal&quot;&gt;
                     &lt;operand path=&quot;value&quot; xsi:type=&quot;Property&quot;&gt;
                        &lt;source path=&quot;code&quot; xsi:type=&quot;Property&quot;&gt;
                           &lt;source xsi:type=&quot;Indexer&quot;&gt;
                              &lt;operand xsi:type=&quot;Flatten&quot;&gt;
                                 &lt;operand xsi:type=&quot;Query&quot;&gt;
                                    &lt;source alias=&quot;$this&quot;&gt;
                                       &lt;expression path=&quot;category&quot;
           scope=&quot;Rx&quot; xsi:type=&quot;Property&quot;/&gt;
                                    &lt;/source&gt;
                                    &lt;where xsi:type=&quot;Not&quot;&gt;
                                       &lt;operand xsi:type=&quot;IsNull&quot;&gt;
                                          &lt;operand path=&quot;coding&quot; xsi:type=&quot;
          Property&quot;&gt;
                                             &lt;source name=&quot;$this&quot;
           xsi:type=&quot;AliasRef&quot;/&gt;
                                          &lt;/operand&gt;
                                       &lt;/operand&gt;
                                    &lt;/where&gt;
                                    &lt;return&gt;
                                       &lt;expression path=&quot;coding&quot; xsi:type=&quot;
          Property&quot;&gt;
                                          &lt;source name=&quot;$this&quot; xsi:type=&quot;Al
          iasRef&quot;/&gt;
                                       &lt;/expression&gt;
                                    &lt;/return&gt;
                                 &lt;/operand&gt;
                              &lt;/operand&gt;
                              &lt;operand valueType=&quot;t:Integer&quot; value=&quot;0&quot;
           xsi:type=&quot;Literal&quot;/&gt;
                           &lt;/source&gt;
                        &lt;/source&gt;
                     &lt;/operand&gt;
                     &lt;operand valueType=&quot;t:String&quot; value=&quot;outpatient&quot;
           xsi:type=&quot;Literal&quot;/&gt;
                  &lt;/operand&gt;
               &lt;/where&gt;
            &lt;/operand&gt;
            &lt;operand name=&quot;ContextPrescriptions&quot; xsi:type=&quot;ParameterRef&quo
          t;/&gt;
         &lt;/expression&gt;
      &lt;/def&gt;
      &lt;def name=&quot;Average MME&quot; context=&quot;Patient&quot; accessLevel=&quot;Publ
          ic&quot;&gt;
         &lt;expression name=&quot;TotalMME&quot; libraryName=&quot;Common&quot;
           xsi:type=&quot;FunctionRef&quot;&gt;
            &lt;operand name=&quot;Get Active Ambulatory Opioid Rx&quot; xsi:type=&quot;Expre
          ssionRef&quot;/&gt;
         &lt;/expression&gt;
      &lt;/def&gt;
      &lt;def name=&quot;MME &gt;= 50 mg/d?&quot; context=&quot;Patient&quot; accessLevel=&qu
          ot;Public&quot;&gt;
         &lt;expression xsi:type=&quot;If&quot;&gt;
            &lt;condition asType=&quot;t:Boolean&quot; xsi:type=&quot;As&quot;&gt;
               &lt;operand xsi:type=&quot;IsNull&quot;&gt;
                  &lt;operand name=&quot;Average MME&quot; xsi:type=&quot;ExpressionRef&quot;
          /&gt;
               &lt;/operand&gt;
            &lt;/condition&gt;
            &lt;then valueType=&quot;t:Boolean&quot; value=&quot;false&quot; xsi:type=&quot;L
          iteral&quot;/&gt;
            &lt;else xsi:type=&quot;GreaterOrEqual&quot;&gt;
               &lt;operand name=&quot;Average MME&quot; xsi:type=&quot;ExpressionRef&quot;/&g
          t;
               &lt;operand value=&quot;50&quot; unit=&quot;mg/d&quot; xsi:type=&quot;Quantity
          &quot;/&gt;
            &lt;/else&gt;
         &lt;/expression&gt;
      &lt;/def&gt;
      &lt;def name=&quot;On Benzodiazepine&quot; context=&quot;Patient&quot; accessLevel=&quo
          t;Public&quot;&gt;
         &lt;expression xsi:type=&quot;Exists&quot;&gt;
            &lt;operand dataType=&quot;fhir:MedicationRequest&quot; codeProperty=&quot;medica
          tionCodeableConcept&quot; xsi:type=&quot;Retrieve&quot;&gt;
               &lt;codes name=&quot;Benzodiazepines&quot; libraryName=&quot;Common&quot;
           xsi:type=&quot;ValueSetRef&quot;/&gt;
            &lt;/operand&gt;
         &lt;/expression&gt;
      &lt;/def&gt;
      &lt;def name=&quot;Inclusion Criteria&quot; context=&quot;Patient&quot; accessLevel=&qu
          ot;Public&quot;&gt;
         &lt;expression xsi:type=&quot;And&quot;&gt;
            &lt;operand xsi:type=&quot;And&quot;&gt;
               &lt;operand name=&quot;Validate Trigger Event&quot; xsi:type=&quot;ExpressionR
          ef&quot;/&gt;
               &lt;operand xsi:type=&quot;Not&quot;&gt;
                  &lt;operand name=&quot;Exclusion Criteria&quot; xsi:type=&quot;ExpressionRe
          f&quot;/&gt;
               &lt;/operand&gt;
            &lt;/operand&gt;
            &lt;operand xsi:type=&quot;Or&quot;&gt;
               &lt;operand name=&quot;MME &gt;= 50 mg/d?&quot; xsi:type=&quot;ExpressionRef&q
          uot;/&gt;
               &lt;operand name=&quot;On Benzodiazepine&quot; xsi:type=&quot;ExpressionRef&qu
          ot;/&gt;
            &lt;/operand&gt;
         &lt;/expression&gt;
      &lt;/def&gt;
      &lt;def name=&quot;Has Substance Abuse History&quot; context=&quot;Patient&quot;
           accessLevel=&quot;Public&quot;&gt;
         &lt;expression xsi:type=&quot;Exists&quot;&gt;
            &lt;operand dataType=&quot;fhir:Condition&quot; codeProperty=&quot;code&quot;
           xsi:type=&quot;Retrieve&quot;&gt;
               &lt;codes name=&quot;Substance Abuse&quot; xsi:type=&quot;ValueSetRef&quot;/&g
          t;
            &lt;/operand&gt;
         &lt;/expression&gt;
      &lt;/def&gt;
      &lt;def name=&quot;Get Indicator&quot; context=&quot;Patient&quot; accessLevel=&quot;Pu
          blic&quot;&gt;
         &lt;expression valueType=&quot;t:String&quot; value=&quot;warning&quot;
           xsi:type=&quot;Literal&quot;/&gt;
      &lt;/def&gt;
      &lt;def name=&quot;Get Summary&quot; context=&quot;Patient&quot; accessLevel=&quot;Publ
          ic&quot;&gt;
         &lt;expression valueType=&quot;t:String&quot; value=&quot;Incorporate
           into the management plan strategies to mitigate risk; including considering offering
           naloxone when factors that increase risk for opioid overdose are present&quot;
           xsi:type=&quot;Literal&quot;/&gt;
      &lt;/def&gt;
      &lt;def name=&quot;Get Notification&quot; context=&quot;Patient&quot; accessLevel=&quot
          ;Public&quot;&gt;
         &lt;expression xsi:type=&quot;Concatenate&quot;&gt;
            &lt;operand valueType=&quot;t:String&quot; value=&quot;Consider offering
           naloxone given following risk factor(s) for opioid overdose: &quot; xsi:type=&quot;Literal&qu
          ot;/&gt;
            &lt;operand xsi:type=&quot;If&quot;&gt;
               &lt;condition asType=&quot;t:Boolean&quot; xsi:type=&quot;As&quot;&gt;
                  &lt;operand name=&quot;MME &gt;= 50 mg/d?&quot; xsi:type=&quot;ExpressionRe
          f&quot;/&gt;
               &lt;/condition&gt;
               &lt;then xsi:type=&quot;Concatenate&quot;&gt;
                  &lt;operand xsi:type=&quot;Concatenate&quot;&gt;
                     &lt;operand valueType=&quot;t:String&quot; value=&quot;Average
           MME (&quot; xsi:type=&quot;Literal&quot;/&gt;
                     &lt;operand xsi:type=&quot;ToString&quot;&gt;
                        &lt;operand name=&quot;Average MME&quot; xsi:type=&quot;ExpressionRef
          &quot;/&gt;
                     &lt;/operand&gt;
                  &lt;/operand&gt;
                  &lt;operand valueType=&quot;t:String&quot; value=&quot;) &gt;=
           50 mg/day, &quot; xsi:type=&quot;Literal&quot;/&gt;
               &lt;/then&gt;
               &lt;else xsi:type=&quot;Concatenate&quot;&gt;
                  &lt;operand valueType=&quot;t:String&quot; value=&quot;&quot;
           xsi:type=&quot;Literal&quot;/&gt;
                  &lt;operand xsi:type=&quot;If&quot;&gt;
                     &lt;condition asType=&quot;t:Boolean&quot; xsi:type=&quot;As&quot;&gt;
                        &lt;operand name=&quot;On Benzodiazepine&quot; xsi:type=&quot;Express
          ionRef&quot;/&gt;
                     &lt;/condition&gt;
                     &lt;then valueType=&quot;t:String&quot; value=&quot;concurrent
           use of benzodiazepine, &quot; xsi:type=&quot;Literal&quot;/&gt;
                     &lt;else valueType=&quot;t:String&quot; value=&quot;&quot;
           xsi:type=&quot;Literal&quot;/&gt;
                  &lt;/operand&gt;
               &lt;/else&gt;
            &lt;/operand&gt;
         &lt;/expression&gt;
      &lt;/def&gt;
   &lt;/statements&gt;
&lt;/library&gt;
</code> 
      </pre> 
    </div> 
  </text> 
  <identifier> 
    <use value="official"/> 
    <value value="OpioidCDS_REC_04"/> 
  </identifier> 
  <version value="0.1.0"/> 
  <title value="Opioid CDS Logic for recommendation #4"/> 
  <status value="active"/> 
  <experimental value="false"/> 
  <type> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/library-type"/> 
      <code value="logic-library"/> 
      <display value="Logic Library"/> 
    </coding> 
  </type> 
  <date value="2018-03-25T13:49:09-06:00"/> 
  <publisher value="Centers for Disease Control and Prevention (CDC)"/> 
  <description value="Opioid decision support logic to consider offering Naloxone when factors that increase
   risk for opioid overdose are present."/> 
  <useContext> 
    <code> 
      <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/> 
      <code value="focus"/> 
      <display value="Clinical Focus"/> 
    </code> 
    <valueCodeableConcept> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="182888003"/> 
        <display value="Medication requested (situation)"/> 
      </coding> 
    </valueCodeableConcept> 
  </useContext> 
  <useContext> 
    <code> 
      <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/> 
      <code value="focus"/> 
      <display value="Clinical Focus"/> 
    </code> 
    <valueCodeableConcept> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="82423001"/> 
        <display value="Chronic pain (finding)"/> 
      </coding> 
    </valueCodeableConcept> 
  </useContext> 
  <jurisdiction> 
    <coding> 
      <system value="urn:iso:std:iso:3166"/> 
      <code value="US"/> 
      <display value="United States of America"/> 
    </coding> 
  </jurisdiction> 
  <purpose value="The purpose of this library is to determine whether increased risks for opioid
   overdose are present."/> 
  <usage value="This library is used to recommend the prescriber/user to consider offering Naloxone
   when increased risks for opioid overdose are present."/> 
  <copyright value="© CDC 2016+."/> 
  <topic> 
    <text value="Opioid Prescribing"/> 
  </topic> 
  <author> 
    <name value="Kensaku Kawamoto, MD, PhD, MHS"/> 
  </author> 
  <author> 
    <name value="Bryn Rhodes"/> 
  </author> 
  <author> 
    <name value="Floyd Eisenberg, MD, MPH"/> 
  </author> 
  <author> 
    <name value="Robert McClure, MD, MPH"/> 
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  </content> 
</Library>

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.