Library-opioidcds-common - FHIR v5.0.0-draft-final

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
Example Library/opioidcds-common (Narrative)

Clinical Decision Support Work Group
Maturity Level: N/A
Standards Status: Informative
Compartments: Not linked to any defined compartments
This is the narrative for the resource. See also the XML, JSON or Turtle format. This example conforms to the profile Library.
Participants

Author
Kensaku Kawamoto, MD, PhD, MHS
Author
Bryn Rhodes
Author
Floyd Eisenberg, MD, MPH
Author
Robert McClure, MD, MPH
Related Artifacts

Documentation
CDC guideline for prescribing opioids for chronic pain
https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chronic-pain---united-states-2016#420 ()
Depends On http://example.org/fhir/Library/omtk-logic
Documentation
MME Conversion Tables
https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf ()
application/elm+xml
<?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/2001/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-annotations: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"/>
   </includes>
   <valueSets>
      <def name="Benzodiazepines" id="benzodiazepines" accessLevel="Public"/>
      <def name="Naloxone" id="naloxone" accessLevel="Public"/>
      <def name="Ambulatory Abuse Potential Opioids" id="opioids-abused-in-ambulatory-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="Literal"/>
      </def>
      <def name="HasMetastaticCancer" context="Patient" accessLevel="Public">
         <expression valueType="t:Boolean" value="false" xsi:type="Literal"/>
      </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"/>
         </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="NamedTypeSpecifier"/>
         </operand>
      </def>
      <def name="Prescriptions" context="Patient" accessLevel="Public" 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="Property"/>
                     </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="Literal"/>
               </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="QueryLetRef"/>
                              </operand>
                              <isTypeSpecifier name="fhir:Range" xsi:type="NamedTypeSpecifier"/>
                           </operand>
                        </condition>
                        <then xsi:type="Concatenate">
                           <operand xsi:type="Concatenate">
                              <operand xsi:type="Concatenate">
                                 <operand xsi:type="ToString">
                                    <operand name="ToQuantity" xsi:type="FunctionRef">
                                       <operand path="low" xsi:type="Property">
                                          <source path="dose" xsi:type="Property">
                                             <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">
                                    <operand path="high" xsi:type="Property">
                                       <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">
                                       <source name="dosageInstruction" xsi:type="QueryLetRef"/>
                                    </source>
                                 </source>
                              </source>
                           </operand>
                        </then>
                        <else xsi:type="ToString">
                           <operand name="ToQuantity" xsi:type="FunctionRef">
                              <operand asType="fhir:Quantity" xsi:type="As">
                                 <operand path="dose" xsi:type="Property">
                                    <source name="dosageInstruction" xsi:type="QueryLetRef"/>
                                 </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="QueryLetRef"/>
                              </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="Literal"/>
                  </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="Property"/>
                        </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"/>
                        </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="QueryLetRef"/>
                                 </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="QueryLetRef"/>
                              </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="QueryLetRef"/>
                                       <operand valueType="t:String" value=" " xsi:type="Literal"/>
                                    </operand>
                                    <operand name="doseDescription" xsi:type="QueryLetRef"/>
                                 </operand>
                                 <operand valueType="t:String" value=" q" xsi:type="Literal"/>
                              </operand>
                              <operand name="frequencyDescription" xsi:type="QueryLetRef"/>
                           </operand>
                           <operand xsi:type="If">
                              <condition asType="t:Boolean" xsi:type="As">
                                 <operand path="value" xsi:type="Property">
                                    <source path="asNeeded" xsi:type="Property">
                                       <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="QueryLetRef"/>
                              </operand>
                              <isTypeSpecifier name="fhir:Range" xsi:type="NamedTypeSpecifier"/>
                           </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="QueryLetRef"/>
                              </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="QueryLetRef"/>
                              </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"/>
                           <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="NamedTypeSpecifier"/>
            </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="Property"/>
                           </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="Property"/>
                  </element>
                  <element name="isDraft">
                     <value path="isDraft" scope="P" xsi:type="Property"/>
                  </element>
                  <element name="isPRN">
                     <value path="isPRN" scope="P" xsi:type="Property"/>
                  </element>
                  <element name="prescription">
                     <value path="prescription" scope="P" xsi:type="Property"/>
                  </element>
                  <element name="dailyDose">
                     <value path="dailyDoseDescription" xsi:type="Property">
                        <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="NamedTypeSpecifier"/>
            </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="Property"/>
                        </expression>
                     </return>
                  </source>
               </value>
            </element>
            <element name="unit">
               <value valueType="t:String" value="mg/d" xsi:type="Literal"/>
            </element>
         </expression>
         <operand name="prescriptions">
            <operandTypeSpecifier xsi:type="ListTypeSpecifier">
               <elementType name="fhir:MedicationRequest" xsi:type="NamedTypeSpecifier"/>
            </operandTypeSpecifier>
         </operand>
      </def>
      <def name="GetPeriodDays" context="Patient" accessLevel="Public" 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="Literal"/>
               </when>
               <then valueType="t:Decimal" value="365.0" xsi:type="Literal"/>
            </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="Literal"/>
            </caseItem>
            <caseItem>
               <when xsi:type="StartsWith">
                  <operand name="value" xsi:type="OperandRef"/>
                  <operand valueType="t:String" value="hour" xsi:type="Literal"/>
               </when>
               <then xsi:type="Divide">
                  <operand valueType="t:Decimal" value="1.0" xsi:type="Literal"/>
                  <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"/>
         </expression>
         <operand name="value">
            <operandTypeSpecifier name="t:String" xsi:type="NamedTypeSpecifier"/>
         </operand>
      </def>
      <def name="GetDurationInDays" context="Patient" accessLevel="Public" 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="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="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="NamedTypeSpecifier"/>
         </operand>
      </def>
      <def name="ProbableDaysInRange" context="Patient" accessLevel="Public" 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" 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"/>
                              <operand name="periodDays" xsi:type="QueryLetRef"/>
                           </operand>
                        </operand>
                        <operand valueType="t:Decimal" value="1.0" xsi:type="Literal"/>
                     </operand>
                  </condition>
                  <then valueType="t:Decimal" value="1.0" xsi:type="Literal"/>
                  <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">
                     <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">
                     <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">
                                 <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">
                              <source path="dispenseRequest" scope="orders" xsi:type="Property"/>
                           </source>
                        </source>
                     </operand>
                     <operand xsi:type="Today"/>
                  </then>
                  <else valueType="t:Integer" value="0" xsi:type="Literal"/>
               </expression>
            </let>
            <return>
               <expression xsi:type="GreaterOrEqual">
                  <operand xsi:type="Multiply">
                     <operand xsi:type="Multiply">
                        <operand name="dosesPerDay" xsi:type="QueryLetRef"/>
                        <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"/>
                        </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="NamedTypeSpecifier"/>
            </operandTypeSpecifier>
         </operand>
         <operand name="daysPast">
            <operandTypeSpecifier name="t:Integer" xsi:type="NamedTypeSpecifier"/>
         </operand>
         <operand name="numDaysInDaysPast">
            <operandTypeSpecifier name="t:Integer" xsi:type="NamedTypeSpecifier"/>
         </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="Public" 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="Public" 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="Public" 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="Public" 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" 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>
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.
Example Library/opioidcds-common (Narrative)

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