This page is part of the FHIR Specification (v5.0.0-ballot: FHIR R5 Ballot Preview). 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
Clinical Decision Support Work Group | Maturity Level: N/A | Standards Status: Informative | Compartments: Not linked to any defined compartments |
Raw XML (canonical form + also see XML Format Specification)
Opioid CDS Common Library (id = "opioidcds-common")
<?xml version="1.0" encoding="UTF-8"?> <Library xmlns="http://hl7.org/fhir"> <id value="opioidcds-common"/> <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-chronic-pai n---united-states-2016#420">https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chronic-pai n---united-states-2016#420</a> </code> ( <code/> ) </p> </td> </tr> <tr> <td> Depends On</td> <td/> <td> <code> http://example.org/fhir/Library/omtk-logic</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> Contents</h2> <p> <code> application/elm+xml</code> </p> <pre> <code> <?xml version="1.0" encoding="UTF-8"?> <library xmlns="urn:hl7-org:elm:r1" xmlns:t="urn:hl7-org:elm-types:r1" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:xsd="http://www.w3.org/20 01/XMLSchema" xmlns:fhir="http://hl7.org/fhir" xmlns:qdm43="urn:healthit-gov:qdm: v4_3" xmlns:qdm53="urn:healthit-gov:qdm:v5_3" xmlns:a="urn:hl7-org:cql-annotation s:r1"> <identifier id="OpioidCDS_STU4_Common" version="0.1.0"/> <schemaIdentifier id="urn:hl7-org:elm" version="r1"/> <usings> <def localIdentifier="System" uri="urn:hl7-org:elm-types:r1"/> <def localIdentifier="FHIR" uri="http://hl7.org/fhir" version="3.2 .0"/> </usings> <includes> <def localIdentifier="OMTKLogic" path="OMTKLogic" version="0.1.0&q uot;/> </includes> <valueSets> <def name="Benzodiazepines" id="benzodiazepines" accessLevel="Publ ic"/> <def name="Naloxone" id="naloxone" accessLevel="Public"/> <def name="Ambulatory Abuse Potential Opioids" id="opioids-abused-in-ambulat ory-care" accessLevel="Public"/> <def name="End Of Life Opioids" id="opioids-indicating-end-of-life" accessLevel="Public"/> <def name="Long Acting Opioids" id="long-acting-opioids" accessLevel="Public"/> <def name="Illicit Drug Screening" id="illicit-drug-urine-screening" accessLevel="Public"/> <def name="Opioid Drug Screening" id="opioid-urine-screening" accessLevel="Public"/> <def name="Opioids" id="opioids" accessLevel="Public"/> <def name="Codeine Cough Meds" id="opioids-codeine-cough-meds" accessLevel="Public"/> <def name="Short Acting Opioids" id="short-acting-opioids" accessLevel="Public"/> </valueSets> <statements> <def name="IsForChronicPain" context="Patient" accessLevel="Public "> <expression valueType="t:Boolean" value="true" xsi:type="Litera l"/> </def> <def name="HasMetastaticCancer" context="Patient" accessLevel="Pub lic"> <expression valueType="t:Boolean" value="false" xsi:type="Liter al"/> </def> <def name="ToCode" context="Patient" accessLevel="Public" xsi:type="FunctionDef"> <expression classType="t:Code" xsi:type="Instance"> <element name="code"> <value path="value" xsi:type="Property"> <source path="code" xsi:type="Property"> <source name="coding" xsi:type="OperandRef"/> </source> </value> </element> <element name="system"> <value path="value" xsi:type="Property"> <source path="system" xsi:type="Property"> <source name="coding" xsi:type="OperandRef"/> </source> </value> </element> <element name="version"> <value path="value" xsi:type="Property"> <source path="version" xsi:type="Property"> <source name="coding" xsi:type="OperandRef"/> </source> </value> </element> <element name="display"> <value path="value" xsi:type="Property"> <source path="display" xsi:type="Property"> <source name="coding" xsi:type="OperandRef"/> </source> </value> </element> </expression> <operand name="coding"> <operandTypeSpecifier name="fhir:Coding" xsi:type="NamedTypeSpecifier& quot;/> </operand> </def> <def name="ToQuantity" context="Patient" accessLevel="Public" xsi:type="FunctionDef"> <expression classType="t:Quantity" xsi:type="Instance"> <element name="value"> <value path="value" xsi:type="Property"> <source path="value" xsi:type="Property"> <source name="quantity" xsi:type="OperandRef"/> </source> </value> </element> <element name="unit"> <value path="value" xsi:type="Property"> <source path="unit" xsi:type="Property"> <source name="quantity" xsi:type="OperandRef"/> </source> </value> </element> </expression> <operand name="quantity"> <operandTypeSpecifier name="fhir:Quantity" xsi:type="NamedTypeSpecifie r"/> </operand> </def> <def name="Prescriptions" context="Patient" accessLevel="Public&qu ot; xsi:type="FunctionDef"> <expression xsi:type="Query"> <source alias="O"> <expression name="Orders" xsi:type="OperandRef"/> </source> <let identifier="rxNormCode"> <expression name="ToCode" xsi:type="FunctionRef"> <operand xsi:type="Indexer"> <operand path="coding" xsi:type="Property"> <source path="medication" scope="O" xsi:type="Pr operty"/> </operand> <operand valueType="t:Integer" value="0" xsi:type=" Literal"/> </operand> </expression> </let> <let identifier="medicationName"> <expression name="GetMedicationName" libraryName="OMTKLogic" xsi:type="FunctionRef"> <operand name="rxNormCode" xsi:type="QueryLetRef"/> </expression> </let> <let identifier="dosageInstruction"> <expression xsi:type="Indexer"> <operand path="dosageInstruction" scope="O" xsi:type=" Property"/> <operand valueType="t:Integer" value="0" xsi:type="Lit eral"/> </expression> </let> <let identifier="repeat"> <expression path="repeat" xsi:type="Property"> <source path="timing" xsi:type="Property"> <source name="dosageInstruction" xsi:type="QueryLetRef"/ > </source> </expression> </let> <let identifier="frequency"> <expression xsi:type="Coalesce"> <operand path="value" xsi:type="Property"> <source path="frequencyMax" xsi:type="Property"> <source name="repeat" xsi:type="QueryLetRef"/> </source> </operand> <operand path="value" xsi:type="Property"> <source path="frequency" xsi:type="Property"> <source name="repeat" xsi:type="QueryLetRef"/> </source> </operand> </expression> </let> <let identifier="period"> <expression classType="t:Quantity" xsi:type="Instance"> <element name="value"> <value path="value" xsi:type="Property"> <source path="period" xsi:type="Property"> <source name="repeat" xsi:type="QueryLetRef"/> </source> </value> </element> <element name="unit"> <value path="value" xsi:type="Property"> <source path="periodUnit" xsi:type="Property"> <source name="repeat" xsi:type="QueryLetRef"/> </source> </value> </element> </expression> </let> <let identifier="doseDescription"> <expression xsi:type="Coalesce"> <operand xsi:type="ToList"> <operand xsi:type="If"> <condition asType="t:Boolean" xsi:type="As"> <operand xsi:type="Is"> <operand path="dose" xsi:type="Property"> <source name="dosageInstruction" xsi:type="QueryL etRef"/> </operand> <isTypeSpecifier name="fhir:Range" xsi:type="NamedTy peSpecifier"/> </operand> </condition> <then xsi:type="Concatenate"> <operand xsi:type="Concatenate"> <operand xsi:type="Concatenate"> <operand xsi:type="ToString"> <operand name="ToQuantity" xsi:type="FunctionR ef"> <operand path="low" xsi:type="Property" ;> <source path="dose" xsi:type="Property&q uot;> <source name="dosageInstruction" xsi:type="QueryLetRef"/> </source> </operand> </operand> </operand> <operand valueType="t:String" value="-" xsi:type="Literal"/> </operand> <operand xsi:type="ToString"> <operand name="ToQuantity" xsi:type="FunctionRef& quot;> <operand path="high" xsi:type="Property"& gt; <source path="dose" xsi:type="Property" ;> <source name="dosageInstruction" xsi:type="QueryLetRef"/> </source> </operand> </operand> </operand> </operand> <operand path="value" xsi:type="Property"> <source path="unit" xsi:type="Property"> <source path="high" xsi:type="Property"> <source path="dose" xsi:type="Property"&g t; <source name="dosageInstruction" xsi:type=" QueryLetRef"/> </source> </source> </source> </operand> </then> <else xsi:type="ToString"> <operand name="ToQuantity" xsi:type="FunctionRef"& gt; <operand asType="fhir:Quantity" xsi:type="As"&g t; <operand path="dose" xsi:type="Property"> <source name="dosageInstruction" xsi:type="Que ryLetRef"/> </operand> </operand> </operand> </else> </operand> </operand> </expression> </let> <let identifier="frequencyDescription"> <expression xsi:type="Concatenate"> <operand xsi:type="ToString"> <operand path="value" xsi:type="Property"> <source path="frequency" xsi:type="Property"> <source path="repeat" xsi:type="Property"> <source path="timing" xsi:type="Property"> <source name="dosageInstruction" xsi:type="QueryL etRef"/> </source> </source> </source> </operand> </operand> <operand xsi:type="Coalesce"> <operand xsi:type="Concatenate"> <operand valueType="t:String" value="-" xsi:type="Literal"/> <operand xsi:type="ToString"> <operand path="value" xsi:type="Property"> <source path="frequencyMax" xsi:type="Property" > <source path="repeat" xsi:type="Property"> ; <source path="timing" xsi:type="Property" > <source name="dosageInstruction" xsi:type=" QueryLetRef"/> </source> </source> </source> </operand> </operand> </operand> <operand valueType="t:String" value="" xsi:type="Li teral"/> </operand> </expression> </let> <return> <expression xsi:type="Tuple"> <element name="rxNormCode"> <value name="rxNormCode" xsi:type="QueryLetRef"/> </element> <element name="isDraft"> <value xsi:type="Equal"> <operand path="value" xsi:type="Property"> <source path="status" scope="O" xsi:type="Pro perty"/> </operand> <operand valueType="t:String" value="draft" xsi:type="Literal"/> </value> </element> <element name="isPRN"> <value path="value" xsi:type="Property"> <source path="asNeeded" xsi:type="Property"> <source name="dosageInstruction" xsi:type="QueryLetRef& quot;/> </source> </value> </element> <element name="prescription"> <value xsi:type="If"> <condition asType="t:Boolean" xsi:type="As"> <operand xsi:type="Not"> <operand xsi:type="IsNull"> <operand path="text" xsi:type="Property"> <source name="dosageInstruction" xsi:type="Que ryLetRef"/> </operand> </operand> </operand> </condition> <then xsi:type="Concatenate"> <operand xsi:type="Concatenate"> <operand name="medicationName" xsi:type="QueryLetRef "/> <operand valueType="t:String" value=" " xsi:type="Literal"/> </operand> <operand path="value" xsi:type="Property"> <source path="text" xsi:type="Property"> <source name="dosageInstruction" xsi:type="QueryL etRef"/> </source> </operand> </then> <else xsi:type="Concatenate"> <operand xsi:type="Concatenate"> <operand xsi:type="Concatenate"> <operand xsi:type="Concatenate"> <operand xsi:type="Concatenate"> <operand name="medicationName" xsi:type="Qu eryLetRef"/> <operand valueType="t:String" value=" " xsi:type="Literal"/> </operand> <operand name="doseDescription" xsi:type="Quer yLetRef"/> </operand> <operand valueType="t:String" value=" q" xsi:type="Literal"/> </operand> <operand name="frequencyDescription" xsi:type="Query LetRef"/> </operand> <operand xsi:type="If"> <condition asType="t:Boolean" xsi:type="As"> <operand path="value" xsi:type="Property"> ; <source path="asNeeded" xsi:type="Property&quo t;> <source name="dosageInstruction" xsi:type=" QueryLetRef"/> </source> </operand> </condition> <then valueType="t:String" value=" PRN" xsi:type="Literal"/> <else valueType="t:String" value="" xsi:type="Literal"/> </operand> </else> </value> </element> <element name="dose"> <value xsi:type="If"> <condition asType="t:Boolean" xsi:type="As"> <operand xsi:type="Is"> <operand path="dose" xsi:type="Property"> <source name="dosageInstruction" xsi:type="QueryL etRef"/> </operand> <isTypeSpecifier name="fhir:Range" xsi:type="NamedTy peSpecifier"/> </operand> </condition> <then name="ToQuantity" xsi:type="FunctionRef"> <operand path="high" xsi:type="Property"> <source path="dose" xsi:type="Property"> <source name="dosageInstruction" xsi:type="QueryL etRef"/> </source> </operand> </then> <else name="ToQuantity" xsi:type="FunctionRef"> <operand asType="fhir:Quantity" xsi:type="As"> <operand path="dose" xsi:type="Property"> <source name="dosageInstruction" xsi:type="QueryL etRef"/> </operand> </operand> </else> </value> </element> <element name="dosesPerDay"> <value xsi:type="Coalesce"> <operand name="ToDaily" libraryName="OMTKLogic" xsi:type="FunctionRef"> <operand name="frequency" xsi:type="QueryLetRef"/& gt; <operand name="period" xsi:type="QueryLetRef"/> </operand> <operand valueType="t:Decimal" value="1.0" xsi:type="Literal"/> </value> </element> </expression> </return> </expression> <operand name="Orders"> <operandTypeSpecifier xsi:type="ListTypeSpecifier"> <elementType name="fhir:MedicationRequest" xsi:type="NamedTypeSpeci fier"/> </operandTypeSpecifier> </operand> </def> <def name="MME" context="Patient" accessLevel="Public" xsi:type="FunctionDef"> <expression xsi:type="Query"> <source alias="P"> <expression name="Prescriptions" xsi:type="FunctionRef"> <operand name="prescriptions" xsi:type="OperandRef"/> </expression> </source> <let identifier="mme"> <expression xsi:type="SingletonFrom"> <operand name="CalculateMMEs" libraryName="OMTKLogic" xsi:type="FunctionRef"> <operand xsi:type="List"> <element xsi:type="Tuple"> <element name="rxNormCode"> <value path="rxNormCode" scope="P" xsi:type="Property"/> </element> <element name="doseQuantity"> <value path="dose" scope="P" xsi:type="Pro perty"/> </element> <element name="dosesPerDay"> <value path="dosesPerDay" scope="P" xsi:type="Property"/> </element> </element> </operand> </operand> </expression> </let> <return> <expression xsi:type="Tuple"> <element name="rxNormCode"> <value path="rxNormCode" scope="P" xsi:type="Proper ty"/> </element> <element name="isDraft"> <value path="isDraft" scope="P" xsi:type="Property& quot;/> </element> <element name="isPRN"> <value path="isPRN" scope="P" xsi:type="Property&qu ot;/> </element> <element name="prescription"> <value path="prescription" scope="P" xsi:type="Prop erty"/> </element> <element name="dailyDose"> <value path="dailyDoseDescription" xsi:type="Property"&g t; <source name="mme" xsi:type="QueryLetRef"/> </value> </element> <element name="conversionFactor"> <value path="conversionFactor" xsi:type="Property"> <source name="mme" xsi:type="QueryLetRef"/> </value> </element> <element name="mme"> <value path="mme" xsi:type="Property"> <source name="mme" xsi:type="QueryLetRef"/> </value> </element> </expression> </return> </expression> <operand name="prescriptions"> <operandTypeSpecifier xsi:type="ListTypeSpecifier"> <elementType name="fhir:MedicationRequest" xsi:type="NamedTypeSpeci fier"/> </operandTypeSpecifier> </operand> </def> <def name="TotalMME" context="Patient" accessLevel="Public" xsi:type="FunctionDef"> <expression classType="t:Quantity" xsi:type="Instance"> <element name="value"> <value xsi:type="Sum"> <source xsi:type="Query"> <source alias="M"> <expression name="MME" xsi:type="FunctionRef"> <operand name="prescriptions" xsi:type="OperandRef" ;/> </expression> </source> <return> <expression path="value" xsi:type="Property"> <source path="mme" scope="M" xsi:type="Proper ty"/> </expression> </return> </source> </value> </element> <element name="unit"> <value valueType="t:String" value="mg/d" xsi:type="Litera l"/> </element> </expression> <operand name="prescriptions"> <operandTypeSpecifier xsi:type="ListTypeSpecifier"> <elementType name="fhir:MedicationRequest" xsi:type="NamedTypeSpeci fier"/> </operandTypeSpecifier> </operand> </def> <def name="GetPeriodDays" context="Patient" accessLevel="Public&qu ot; xsi:type="FunctionDef"> <expression xsi:type="Case"> <caseItem> <when xsi:type="StartsWith"> <operand name="value" xsi:type="OperandRef"/> <operand valueType="t:String" value="year" xsi:type="L iteral"/> </when> <then valueType="t:Decimal" value="365.0" xsi:type="Liter al"/> </caseItem> <caseItem> <when xsi:type="StartsWith"> <operand name="value" xsi:type="OperandRef"/> <operand valueType="t:String" value="month" xsi:type=" Literal"/> </when> <then valueType="t:Decimal" value="30.0" xsi:type="Litera l"/> </caseItem> <caseItem> <when xsi:type="StartsWith"> <operand name="value" xsi:type="OperandRef"/> <operand valueType="t:String" value="hour" xsi:type="L iteral"/> </when> <then xsi:type="Divide"> <operand valueType="t:Decimal" value="1.0" xsi:type="L iteral"/> <operand valueType="t:Decimal" value="24.0" xsi:type=" Literal"/> </then> </caseItem> <caseItem> <when xsi:type="StartsWith"> <operand name="value" xsi:type="OperandRef"/> <operand valueType="t:String" value="minute" xsi:type="Literal"/> </when> <then xsi:type="Multiply"> <operand xsi:type="Divide"> <operand valueType="t:Decimal" value="1.0" xsi:type="Literal"/> <operand valueType="t:Decimal" value="24.0" xsi:type="Literal"/> </operand> <operand valueType="t:Decimal" value="60.0" xsi:type=" Literal"/> </then> </caseItem> <else valueType="t:Decimal" value="1.0" xsi:type="Literal&qu ot;/> </expression> <operand name="value"> <operandTypeSpecifier name="t:String" xsi:type="NamedTypeSpecifier&quo t;/> </operand> </def> <def name="GetDurationInDays" context="Patient" accessLevel="Publi c" xsi:type="FunctionDef"> <expression xsi:type="Case"> <caseItem> <when xsi:type="StartsWith"> <operand path="value" xsi:type="Property"> <source path="unit" xsi:type="Property"> <source name="value" xsi:type="OperandRef"/> </source> </operand> <operand valueType="t:String" value="year" xsi:type="L iteral"/> </when> <then xsi:type="Multiply"> <operand path="value" xsi:type="Property"> <source path="value" xsi:type="Property"> <source name="value" xsi:type="OperandRef"/> </source> </operand> <operand valueType="t:Decimal" value="365.0" xsi:type="Literal"/> </then> </caseItem> <caseItem> <when xsi:type="StartsWith"> <operand path="value" xsi:type="Property"> <source path="unit" xsi:type="Property"> <source name="value" xsi:type="OperandRef"/> </source> </operand> <operand valueType="t:String" value="month" xsi:type=" Literal"/> </when> <then xsi:type="Multiply"> <operand path="value" xsi:type="Property"> <source path="value" xsi:type="Property"> <source name="value" xsi:type="OperandRef"/> </source> </operand> <operand valueType="t:Decimal" value="30.0" xsi:type=" Literal"/> </then> </caseItem> <else path="value" xsi:type="Property"> <source path="value" xsi:type="Property"> <source name="value" xsi:type="OperandRef"/> </source> </else> </expression> <operand name="value"> <operandTypeSpecifier name="fhir:Duration" xsi:type="NamedTypeSpecifie r"/> </operand> </def> <def name="ProbableDaysInRange" context="Patient" accessLevel="Pub lic" xsi:type="FunctionDef"> <expression xsi:type="Query"> <source alias="orders"> <expression name="Orders" xsi:type="OperandRef"/> </source> <let identifier="frequency"> <expression path="value" xsi:type="Property"> <source path="frequency" xsi:type="Property"> <source path="repeat" xsi:type="Property"> <source path="timing" xsi:type="Property"> <source xsi:type="Indexer"> <operand path="dosageInstruction" scope="orders" ; xsi:type="Property"/> <operand valueType="t:Integer" value="0" xsi:type="Literal"/> </source> </source> </source> </source> </expression> </let> <let identifier="period"> <expression path="value" xsi:type="Property"> <source path="period" xsi:type="Property"> <source path="repeat" xsi:type="Property"> <source path="timing" xsi:type="Property"> <source xsi:type="Indexer"> <operand path="dosageInstruction" scope="orders" ; xsi:type="Property"/> <operand valueType="t:Integer" value="0" xsi:type="Literal"/> </source> </source> </source> </source> </expression> </let> <let identifier="periodDays"> <expression name="GetPeriodDays" xsi:type="FunctionRef"> <operand path="value" xsi:type="Property"> <source path="periodUnit" xsi:type="Property"> <source path="repeat" xsi:type="Property"> <source path="timing" xsi:type="Property"> <source xsi:type="Indexer"> <operand path="dosageInstruction" scope="orders&q uot; xsi:type="Property"/> <operand valueType="t:Integer" value="0" xsi:type="Literal"/> </source> </source> </source> </source> </operand> </expression> </let> <let identifier="dosesPerDay"> <expression xsi:type="If"> <condition asType="t:Boolean" xsi:type="As"> <operand xsi:type="GreaterOrEqual"> <operand xsi:type="Divide"> <operand xsi:type="ToDecimal"> <operand name="frequency" xsi:type="QueryLetRef" ;/> </operand> <operand xsi:type="Multiply"> <operand name="period" xsi:type="QueryLetRef"/& gt; <operand name="periodDays" xsi:type="QueryLetRef&quo t;/> </operand> </operand> <operand valueType="t:Decimal" value="1.0" xsi:type="Literal"/> </operand> </condition> <then valueType="t:Decimal" value="1.0" xsi:type="Lite ral"/> <else xsi:type="Divide"> <operand xsi:type="ToDecimal"> <operand name="frequency" xsi:type="QueryLetRef"/> </operand> <operand xsi:type="Multiply"> <operand name="period" xsi:type="QueryLetRef"/> <operand name="periodDays" xsi:type="QueryLetRef"/> ; </operand> </else> </expression> </let> <let identifier="repeat"> <expression path="value" xsi:type="Property"> <source path="numberOfRepeatsAllowed" xsi:type="Property"&g t; <source path="dispenseRequest" scope="orders" xsi:type="Property"/> </source> </expression> </let> <let identifier="supplyDuration"> <expression name="GetDurationInDays" xsi:type="FunctionRef"> ; <operand path="expectedSupplyDuration" xsi:type="Property"& gt; <source path="dispenseRequest" scope="orders" xsi:type="Property"/> </operand> </expression> </let> <let identifier="validityPeriod"> <expression precision="Day" xsi:type="DurationBetween"> <operand path="value" xsi:type="Property"> <source path="start" xsi:type="Property"> <source path="validityPeriod" xsi:type="Property"> <source path="dispenseRequest" scope="orders" xsi:type="Property"/> </source> </source> </operand> <operand xsi:type="Today"/> </expression> </let> <let identifier="endDifference"> <expression xsi:type="If"> <condition asType="t:Boolean" xsi:type="As"> <operand xsi:type="Less"> <operand path="value" xsi:type="Property"> <source path="end" xsi:type="Property"> <source path="validityPeriod" xsi:type="Property&quo t;> <source path="dispenseRequest" scope="orders" ; xsi:type="Property"/> </source> </source> </operand> <operand xsi:type="Today"/> </operand> </condition> <then precision="Day" xsi:type="DurationBetween"> <operand path="value" xsi:type="Property"> <source path="end" xsi:type="Property"> <source path="validityPeriod" xsi:type="Property"& gt; <source path="dispenseRequest" scope="orders" xsi:type="Property"/> </source> </source> </operand> <operand xsi:type="Today"/> </then> <else valueType="t:Integer" value="0" xsi:type="Litera l"/> </expression> </let> <return> <expression xsi:type="GreaterOrEqual"> <operand xsi:type="Multiply"> <operand xsi:type="Multiply"> <operand name="dosesPerDay" xsi:type="QueryLetRef"/&g t; <operand xsi:type="Divide"> <operand xsi:type="Multiply"> <operand xsi:type="ToDecimal"> <operand name="repeat" xsi:type="QueryLetRef" ;/> </operand> <operand name="supplyDuration" xsi:type="QueryLetRef "/> </operand> <operand xsi:type="ToDecimal"> <operand name="validityPeriod" xsi:type="QueryLetRef "/> </operand> </operand> </operand> <operand xsi:type="ToDecimal"> <operand xsi:type="Subtract"> <operand name="daysPast" xsi:type="OperandRef"/> ; <operand name="endDifference" xsi:type="QueryLetRef&quo t;/> </operand> </operand> </operand> <operand xsi:type="ToDecimal"> <operand name="numDaysInDaysPast" xsi:type="OperandRef"/ > </operand> </expression> </return> </expression> <operand name="Orders"> <operandTypeSpecifier xsi:type="ListTypeSpecifier"> <elementType name="fhir:MedicationRequest" xsi:type="NamedTypeSpeci fier"/> </operandTypeSpecifier> </operand> <operand name="daysPast"> <operandTypeSpecifier name="t:Integer" xsi:type="NamedTypeSpecifier&qu ot;/> </operand> <operand name="numDaysInDaysPast"> <operandTypeSpecifier name="t:Integer" xsi:type="NamedTypeSpecifier&qu ot;/> </operand> </def> <def name="IsNaloxone" context="Patient" accessLevel="Public" xsi:type="FunctionDef"> <expression xsi:type="InValueSet"> <code name="rxNormCode" xsi:type="OperandRef"/> <valueset name="Naloxone"/> </expression> <operand name="rxNormCode"> <operandTypeSpecifier name="t:Code" xsi:type="NamedTypeSpecifier" /> </operand> </def> <def name="IsBenzodiazepine" context="Patient" accessLevel="Public " xsi:type="FunctionDef"> <expression xsi:type="InValueSet"> <code name="rxNormCode" xsi:type="OperandRef"/> <valueset name="Benzodiazepines"/> </expression> <operand name="rxNormCode"> <operandTypeSpecifier name="t:Code" xsi:type="NamedTypeSpecifier" /> </operand> </def> <def name="IsOpioidWithAmbulatoryAbusePotential" context="Patient" accessLevel="Public" xsi:type="FunctionDef"> <expression xsi:type="InValueSet"> <code name="rxNormCode" xsi:type="OperandRef"/> <valueset name="Ambulatory Abuse Potential Opioids"/> </expression> <operand name="rxNormCode"> <operandTypeSpecifier name="t:Code" xsi:type="NamedTypeSpecifier" /> </operand> </def> <def name="IsLongActingOpioid" context="Patient" accessLevel="Publ ic" xsi:type="FunctionDef"> <expression xsi:type="InValueSet"> <code name="rxNormCode" xsi:type="OperandRef"/> <valueset name="Long Acting Opioids"/> </expression> <operand name="rxNormCode"> <operandTypeSpecifier name="t:Code" xsi:type="NamedTypeSpecifier" /> </operand> </def> <def name="IsEndOfLifeOpioid" context="Patient" accessLevel="Publi c" xsi:type="FunctionDef"> <expression xsi:type="InValueSet"> <code name="rxNormCode" xsi:type="OperandRef"/> <valueset name="End Of Life Opioids"/> </expression> <operand name="rxNormCode"> <operandTypeSpecifier name="t:Code" xsi:type="NamedTypeSpecifier" /> </operand> </def> <def name="IsOpioidDrugScreen" context="Patient" accessLevel="Publ ic" xsi:type="FunctionDef"> <expression xsi:type="InValueSet"> <code name="observationCode" xsi:type="OperandRef"/> <valueset name="Opioid Drug Screening"/> </expression> <operand name="observationCode"> <operandTypeSpecifier name="t:Code" xsi:type="NamedTypeSpecifier" /> </operand> </def> <def name="IsIllicitDrugScreen" context="Patient" accessLevel="Pub lic" xsi:type="FunctionDef"> <expression xsi:type="InValueSet"> <code name="observationCode" xsi:type="OperandRef"/> <valueset name="Illicit Drug Screening"/> </expression> <operand name="observationCode"> <operandTypeSpecifier name="t:Code" xsi:type="NamedTypeSpecifier" /> </operand> </def> <def name="GetIngredient" context="Patient" accessLevel="Public&qu ot; xsi:type="FunctionDef"> <expression xsi:type="Query"> <source alias="$this"> <expression name="GetIngredients" libraryName="OMTKLogic" xsi:type="FunctionRef"> <operand name="rxNormCode" xsi:type="OperandRef"/> </expression> </source> <where xsi:type="Not"> <operand xsi:type="IsNull"> <operand path="ingredientName" xsi:type="Property"> <source name="$this" xsi:type="AliasRef"/> </operand> </operand> </where> <return> <expression path="ingredientName" xsi:type="Property"> <source name="$this" xsi:type="AliasRef"/> </expression> </return> </expression> <operand name="rxNormCode"> <operandTypeSpecifier name="t:Code" xsi:type="NamedTypeSpecifier" /> </operand> </def> </statements> </library> </code> </pre> </div> </text> <identifier> <use value="official"/> <value value="OpioidCDS_Common"/> </identifier> <version value="0.1.0"/> <title value="Opioid CDS Common Logic"/> <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="Common Opioid Decision Support Logic for use in implementing CDC Opioid Prescribing Guidelines."/> <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="This library contains common logic across recommendations including MME calculations, conversions, and looking up codes in valuesets."/> <usage value="This library is used for decision support for opioid guideline recommendations when applying PlanDefinitions."/> <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"/> </author> <relatedArtifact> <type value="documentation"/> <display value="CDC guideline for prescribing opioids for chronic pain"/> <document> <url 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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.