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 (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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Activity definition to prescribe citalopram to a patient (id = "citalopramPrescription")

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

<ActivityDefinition xmlns="http://hl7.org/fhir">
  <id value="citalopramPrescription"/> 
  <text> <status value="generated"/> <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> </text> <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> 
        <doseForm> 
          <coding> 
            <system value="http://snomed.info/sct"/> 
            <code value="385055001"/> 
            <display value="Tablet dose form"/> 
          </coding> 
          <text value="Tablet dose form"/> 
        </doseForm> 
        <ingredient> 
          <item> 
            <reference> 
            <reference value="#citalopramSubstance"/> 
            </reference> 
          </item> 
          <strengthRatio> 
            <numerator> 
              <value value="20"/> 
              <unit value="mg"/> 
            </numerator> 
            <denominator> 
              <value value="1"/> 
              <unit value="{tbl}"/> 
            </denominator> 
          </strengthRatio> 
        </ingredient> 
    </Medication> 
  </contained> 
  <contained> 
    <Substance> 
      <id value="citalopramSubstance"/> 
      <instance value="false"/> 
      <code> 
        <concept> 
          <coding> 
            <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/> 
            <code value="2556"/> 
          </coding> 
          <text value="citalopram"/> 
        </concept> 
      </code> 
    </Substance> 
  </contained> 
  <url value="http://motivemi.com/artifacts/ActivityDefinition/citalopramPrescription"/> 
  <identifier> 
    <system value="urn:ietf:rfc:3986"/> 
    <value value="urn:oid:2.16.840.1.113883.4.642.19.6"/> 
  </identifier> 
  <identifier> 
    <use value="official"/> 
    <system value="http://motivemi.com"/> 
    <value value="citalopramPrescription"/> 
  </identifier> 
  <version value="1.0.0"/> 
  <name value="CitalopramPrescription"/> 
  <title value="Citalopram Prescription"/> 
  <status value="active"/> 
  <experimental value="true"/> 
  <date value="2015-08-15"/> 
  <publisher value="Motive Medical Intelligence"/> 
  <contact> 
    <telecom> 
      <system value="phone"/> 
      <value value="415-362-4007"/> 
      <use value="work"/> 
    </telecom> 
    <telecom> 
      <system value="email"/> 
      <value value="info@motivemi.com"/> 
      <use value="work"/> 
    </telecom> 
  </contact> 
  <description value="Citalopram 20 mg tablet 1 tablet oral 1 time daily now (30 table; 3 refills"/> 
  <useContext> 
    <code> 
      <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/> 
      <code value="age"/> 
    </code> 
    <valueCodeableConcept> 
      <coding> 
        <system value="https://meshb.nlm.nih.gov"/> 
        <code value="D000328"/> 
        <display value="Adult"/> 
      </coding> 
    </valueCodeableConcept> 
  </useContext> 
  <useContext> 
    <code> 
      <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/> 
      <code value="focus"/> 
    </code> 
    <valueCodeableConcept> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="87512008"/> 
        <display value="Mild major depression"/> 
      </coding> 
    </valueCodeableConcept> 
  </useContext> 
  <useContext> 
    <code> 
      <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/> 
      <code value="focus"/> 
    </code> 
    <valueCodeableConcept> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="40379007"/> 
        <display value="Major depression, recurrent, mild"/> 
      </coding> 
    </valueCodeableConcept> 
  </useContext> 
  <useContext> 
    <code> 
      <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/> 
      <code value="focus"/> 
    </code> 
    <valueCodeableConcept> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="225444004"/> 
        <display value="At risk for suicide (finding)"/> 
      </coding> 
    </valueCodeableConcept> 
  </useContext> 
  <useContext> 
    <code> 
      <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/> 
      <code value="focus"/> 
    </code> 
    <valueCodeableConcept> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="306206005"/> 
        <display value="Referral to service (procedure)"/> 
      </coding> 
    </valueCodeableConcept> 
  </useContext> 
  <useContext> 
    <code> 
      <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/> 
      <code value="user"/> 
    </code> 
    <valueCodeableConcept> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="309343006"/> 
        <display value="Physician"/> 
      </coding> 
    </valueCodeableConcept> 
  </useContext> 
  <useContext> 
    <code> 
      <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/> 
      <code value="venue"/> 
    </code> 
    <valueCodeableConcept> 
      <coding> 
        <system value="http://snomed.info/sct"/> 
        <code value="440655000"/> 
        <display value="Outpatient environment"/> 
      </coding> 
    </valueCodeableConcept> 
  </useContext> 
  <jurisdiction> 
    <coding> 
      <system value="urn:iso:std:iso:3166"/> 
      <code value="US"/> 
    </coding> 
  </jurisdiction> 
  <purpose value="Defines a guideline supported prescription for the treatment of depressive disorders"/> 
  <usage value="This activity definition is used as part of various suicide risk order sets"/> 
  <copyright value="© Copyright 2016 Motive Medical Intelligence. All rights reserved."/> 
  <approvalDate value="2016-03-12"/> 
  <lastReviewDate value="2016-08-15"/> 
  <effectivePeriod> 
    <start value="2016-01-01"/> 
    <end value="2017-12-31"/> 
  </effectivePeriod> 
  <topic> 
    <text value="Mental Health Treatment"/> 
  </topic> 
  <author> 
    <name value="Motive Medical Intelligence"/> 
    <telecom> 
    <system value="phone"/> 
    <value value="415-362-4007"/> 
    <use value="work"/> 
    </telecom> 
    <telecom> 
      <system value="email"/> 
    <value value="info@motivemi.com"/> 
    <use value="work"/> 
    </telecom> 
  </author> 
    <relatedArtifact> 
      <type value="citation"/> 
      <display value="Practice Guideline for the Treatment of Patients with Major Depressive Disorder"/> 
      <document> 
        <url value="http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf"/> 
      </document> 
  </relatedArtifact> 
  <relatedArtifact> 
      <type value="composed-of"/> 
      <resource value="#citalopramMedication"/> 
  </relatedArtifact> 
  <kind value="MedicationRequest"/> 
  <productReference> 
    <reference value="#citalopramMedication"/> 
  </productReference> 
  <dosage> 
    <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> 
        <coding> 
          <system value="http://terminology.hl7.org/CodeSystem/dose-rate-type"/> 
          <code value="ordered"/> 
          <display value="Ordered"/> 
        </coding> 
      </type> 
      <doseQuantity> 
        <value value="1"/> 
        <unit value="{tbl}"/> 
      </doseQuantity> 
    </doseAndRate> 
  </dosage> 
  <dynamicValue> 
    <path value="dispenseRequest.numberOfRepeatsAllowed"/> 
    <expression> 
      <description value="dispenseRequest.numberOfRepeatsAllowed is three (3)"/> 
      <language value="text/cql"/> 
      <expression value="3"/> 
    </expression> 
  </dynamicValue> 
  <dynamicValue> 
    <path value="dispenseRequest.quantity"/> 
    <expression> 
      <description value="dispenseRequest.quantity is thirty (30) tablets"/> 
      <language value="text/cql"/> 
      <expression value="30 '{tbl}'"/> 
    </expression> 
  </dynamicValue> 
</ActivityDefinition>

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.