R5 Final QA

This page is part of the FHIR Specification (v5.0.0-draft-final: Final QA Preview for R5 - 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 R3

Example ActivityDefinition/citalopramPrescription (JSON)

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

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

Activity definition to prescribe citalopram to a patient

{
  "resourceType" : "ActivityDefinition",
  "id" : "citalopramPrescription",
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative: ActivityDefinition</b><a name=\"citalopramPrescription\"> </a></p><div style=\"display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%\"><p style=\"margin-bottom: 0px\">Resource ActivityDefinition &quot;citalopramPrescription&quot; </p></div><p><b>url</b>: <code>http://motivemi.com/artifacts/ActivityDefinition/citalopramPrescription</code></p><p><b>identifier</b>: id: urn:oid:2.16.840.1.113883.4.642.19.6, id: citalopramPrescription (use: OFFICIAL)</p><p><b>version</b>: 1.0.0</p><p><b>name</b>: CitalopramPrescription</p><p><b>title</b>: Citalopram Prescription</p><p><b>status</b>: active</p><p><b>experimental</b>: true</p><p><b>date</b>: 2015-08-15</p><p><b>publisher</b>: Motive Medical Intelligence</p><p><b>contact</b>: ph: 415-362-4007(WORK),<a href=\"mailto:info@motivemi.com\">info@motivemi.com</a></p><p><b>description</b>: Citalopram 20 mg tablet 1 tablet oral 1 time daily now (30 table; 3 refills</p><h3>UseContexts</h3><table class=\"grid\"><tr><td>-</td><td><b>Code</b></td><td><b>Value[x]</b></td></tr><tr><td>*</td><td>Age Range (Details: http://terminology.hl7.org/CodeSystem/usage-context-type code age = 'Age Range', stated as 'null')</td><td>Adult <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (meshb.nlm.nih.gov#D000328)</span></td></tr><tr><td>*</td><td>Clinical Focus (Details: http://terminology.hl7.org/CodeSystem/usage-context-type code focus = 'Clinical Focus', stated as 'null')</td><td>Mild major depression <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#87512008)</span></td></tr><tr><td>*</td><td>Clinical Focus (Details: http://terminology.hl7.org/CodeSystem/usage-context-type code focus = 'Clinical Focus', stated as 'null')</td><td>Major depression, recurrent, mild <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#40379007)</span></td></tr><tr><td>*</td><td>Clinical Focus (Details: http://terminology.hl7.org/CodeSystem/usage-context-type code focus = 'Clinical Focus', stated as 'null')</td><td>At risk for suicide (finding) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#225444004)</span></td></tr><tr><td>*</td><td>Clinical Focus (Details: http://terminology.hl7.org/CodeSystem/usage-context-type code focus = 'Clinical Focus', stated as 'null')</td><td>Referral to service (procedure) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#306206005)</span></td></tr><tr><td>*</td><td>User Type (Details: http://terminology.hl7.org/CodeSystem/usage-context-type code user = 'User Type', stated as 'null')</td><td>Physician <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#309343006)</span></td></tr><tr><td>*</td><td>Clinical Venue (Details: http://terminology.hl7.org/CodeSystem/usage-context-type code venue = 'Clinical Venue', stated as 'null')</td><td>Outpatient environment <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#440655000)</span></td></tr></table><p><b>jurisdiction</b>: United States of America <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-ISO3166Part1.html\">ISO 3166-1 Codes for the representation of names of countries and their subdivisions — Part 1: Country code</a>#US)</span></p><p><b>purpose</b>: Defines a guideline supported prescription for the treatment of depressive disorders</p><p><b>usage</b>: This activity definition is used as part of various suicide risk order sets</p><p><b>copyright</b>: © Copyright 2016 Motive Medical Intelligence. All rights reserved.</p><p><b>approvalDate</b>: 2016-03-12</p><p><b>lastReviewDate</b>: 2016-08-15</p><p><b>effectivePeriod</b>: 2016-01-01 --&gt; 2017-12-31</p><p><b>topic</b>: Mental Health Treatment <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ()</span></p><p><b>author</b>: Motive Medical Intelligence: ph: 415-362-4007(WORK),<a href=\"mailto:info@motivemi.com\">info@motivemi.com</a></p><blockquote><p><b>relatedArtifact</b></p><p><b>type</b>: citation</p><p><b>display</b>: Practice Guideline for the Treatment of Patients with Major Depressive Disorder</p><blockquote><p><b>document</b></p></blockquote></blockquote><blockquote><p><b>relatedArtifact</b></p><p><b>type</b>: composed-of</p><p><b>resource</b>: <code>#citalopramMedication</code></p></blockquote><p><b>kind</b>: MedicationRequest</p><p><b>product</b>: <a name=\"citalopramMedication\"> </a></p><blockquote><p/><p><a name=\"citalopramMedication\"> </a></p><p><b>code</b>: citalopram <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"http://terminology.hl7.org/4.0.0/CodeSystem-v3-rxNorm.html\">RxNorm</a>#200371)</span></p><p><b>doseForm</b>: Tablet dose form <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> (<a href=\"https://browser.ihtsdotools.org/\">SNOMED CT</a>#385055001)</span></p><blockquote><p><b>ingredient</b></p><h3>Items</h3><table class=\"grid\"><tr><td>-</td><td><b>Reference</b></td></tr><tr><td>*</td><td><a href=\"#citalopramSubstance\">#citalopramSubstance</a></td></tr></table><p><b>strength</b>: 20 mg/1 {tbl}</p></blockquote></blockquote><blockquote><p><b>dosage</b></p><p><b>text</b>: 1 tablet oral 1 time daily</p><p><b>timing</b>: Once per 1 days</p><p><b>route</b>: Oral route (qualifier value) <span style=\"background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki\"> ([not stated]#26643006)</span></p><blockquote><p><b>doseAndRate</b></p></blockquote></blockquote><blockquote><p><b>dynamicValue</b></p><p><b>path</b>: dispenseRequest.numberOfRepeatsAllowed</p><h3>Expressions</h3><table class=\"grid\"><tr><td>-</td><td><b>Description</b></td><td><b>Language</b></td><td><b>Expression</b></td></tr><tr><td>*</td><td>dispenseRequest.numberOfRepeatsAllowed is three (3)</td><td>text/cql</td><td>3</td></tr></table></blockquote><blockquote><p><b>dynamicValue</b></p><p><b>path</b>: dispenseRequest.quantity</p><h3>Expressions</h3><table class=\"grid\"><tr><td>-</td><td><b>Description</b></td><td><b>Language</b></td><td><b>Expression</b></td></tr><tr><td>*</td><td>dispenseRequest.quantity is thirty (30) tablets</td><td>text/cql</td><td>30 '{tbl}'</td></tr></table></blockquote></div>"
  },
  "contained" : [{
    "resourceType" : "Medication",
    "id" : "citalopramMedication",
    "code" : {
      "coding" : [{
        "system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
        "code" : "200371"
      }],
      "text" : "citalopram"
    },
    "doseForm" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "385055001",
        "display" : "Tablet dose form"
      }],
      "text" : "Tablet dose form"
    },
    "ingredient" : [{
      "item" : {
        "reference" : {
          "reference" : "#citalopramSubstance"
        }
      },
      "strengthRatio" : {
        "numerator" : {
          "value" : 20,
          "unit" : "mg"
        },
        "denominator" : {
          "value" : 1,
          "unit" : "{tbl}"
        }
      }
    }]
  },
  {
    "resourceType" : "Substance",
    "id" : "citalopramSubstance",
    "instance" : false,
    "code" : {
      "concept" : {
        "coding" : [{
          "system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
          "code" : "2556"
        }],
        "text" : "citalopram"
      }
    }
  }],
  "url" : "http://motivemi.com/artifacts/ActivityDefinition/citalopramPrescription",
  "identifier" : [{
    "system" : "urn:ietf:rfc:3986",
    "value" : "urn:oid:2.16.840.1.113883.4.642.19.6"
  },
  {
    "use" : "official",
    "system" : "http://motivemi.com",
    "value" : "citalopramPrescription"
  }],
  "version" : "1.0.0",
  "name" : "CitalopramPrescription",
  "title" : "Citalopram Prescription",
  "status" : "active",
  "experimental" : true,
  "date" : "2015-08-15",
  "publisher" : "Motive Medical Intelligence",
  "contact" : [{
    "telecom" : [{
      "system" : "phone",
      "value" : "415-362-4007",
      "use" : "work"
    },
    {
      "system" : "email",
      "value" : "info@motivemi.com",
      "use" : "work"
    }]
  }],
  "description" : "Citalopram 20 mg tablet 1 tablet oral 1 time daily now (30 table; 3 refills",
  "useContext" : [{
    "code" : {
      "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
      "code" : "age"
    },
    "valueCodeableConcept" : {
      "coding" : [{
        "system" : "https://meshb.nlm.nih.gov",
        "code" : "D000328",
        "display" : "Adult"
      }]
    }
  },
  {
    "code" : {
      "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
      "code" : "focus"
    },
    "valueCodeableConcept" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "87512008",
        "display" : "Mild major depression"
      }]
    }
  },
  {
    "code" : {
      "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
      "code" : "focus"
    },
    "valueCodeableConcept" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "40379007",
        "display" : "Major depression, recurrent, mild"
      }]
    }
  },
  {
    "code" : {
      "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
      "code" : "focus"
    },
    "valueCodeableConcept" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "225444004",
        "display" : "At risk for suicide (finding)"
      }]
    }
  },
  {
    "code" : {
      "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
      "code" : "focus"
    },
    "valueCodeableConcept" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "306206005",
        "display" : "Referral to service (procedure)"
      }]
    }
  },
  {
    "code" : {
      "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
      "code" : "user"
    },
    "valueCodeableConcept" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "309343006",
        "display" : "Physician"
      }]
    }
  },
  {
    "code" : {
      "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
      "code" : "venue"
    },
    "valueCodeableConcept" : {
      "coding" : [{
        "system" : "http://snomed.info/sct",
        "code" : "440655000",
        "display" : "Outpatient environment"
      }]
    }
  }],
  "jurisdiction" : [{
    "coding" : [{
      "system" : "urn:iso:std:iso:3166",
      "code" : "US"
    }]
  }],
  "purpose" : "Defines a guideline supported prescription for the treatment of depressive disorders",
  "usage" : "This activity definition is used as part of various suicide risk order sets",
  "copyright" : "© Copyright 2016 Motive Medical Intelligence. All rights reserved.",
  "approvalDate" : "2016-03-12",
  "lastReviewDate" : "2016-08-15",
  "effectivePeriod" : {
    "start" : "2016-01-01",
    "end" : "2017-12-31"
  },
  "topic" : [{
    "text" : "Mental Health Treatment"
  }],
  "author" : [{
    "name" : "Motive Medical Intelligence",
    "telecom" : [{
      "system" : "phone",
      "value" : "415-362-4007",
      "use" : "work"
    },
    {
      "system" : "email",
      "value" : "info@motivemi.com",
      "use" : "work"
    }]
  }],
  "relatedArtifact" : [{
    "type" : "citation",
    "display" : "Practice Guideline for the Treatment of Patients with Major Depressive Disorder",
    "document" : {
      "url" : "http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf"
    }
  },
  {
    "type" : "composed-of",
    "resource" : "#citalopramMedication"
  }],
  "kind" : "MedicationRequest",
  "productReference" : {
    "reference" : "#citalopramMedication"
  },
  "dosage" : [{
    "text" : "1 tablet oral 1 time daily",
    "timing" : {
      "repeat" : {
        "frequency" : 1,
        "period" : 1,
        "periodUnit" : "d"
      }
    },
    "route" : {
      "coding" : [{
        "code" : "26643006",
        "display" : "Oral route (qualifier value)"
      }],
      "text" : "Oral route (qualifier value)"
    },
    "doseAndRate" : [{
      "type" : {
        "coding" : [{
          "system" : "http://terminology.hl7.org/CodeSystem/dose-rate-type",
          "code" : "ordered",
          "display" : "Ordered"
        }]
      },
      "doseQuantity" : {
        "value" : 1,
        "unit" : "{tbl}"
      }
    }]
  }],
  "dynamicValue" : [{
    "path" : "dispenseRequest.numberOfRepeatsAllowed",
    "expression" : {
      "description" : "dispenseRequest.numberOfRepeatsAllowed is three (3)",
      "language" : "text/cql",
      "expression" : "3"
    }
  },
  {
    "path" : "dispenseRequest.quantity",
    "expression" : {
      "description" : "dispenseRequest.quantity is thirty (30) tablets",
      "language" : "text/cql",
      "expression" : "30 '{tbl}'"
    }
  }]
}

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.