R6 Ballot (2nd Draft)

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Example ActivityDefinition/citalopramPrescription (JSON)

Clinical Decision Support Work GroupMaturity Level: N/AStandards Status: InformativeCompartments: No defined compartments

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

Activity definition to prescribe citalopram to a patient

{
  "resourceType" : "ActivityDefinition",
  "id" : "citalopramPrescription",
  "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 (basic 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"
      }
    }
  }],
  "extension" : [{
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
    "valueCode" : "cds"
  }],
  "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" : "HL7 International / Clinical Decision Support",
  "contact" : [{
    "telecom" : [{
      "system" : "url",
      "value" : "http://www.hl7.org/Special/committees/dss"
    }]
  }],
  "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" : "Mild recurrent major depression"
      }]
    }
  },
  {
    "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.