R6 Ballot (2nd Draft)

Publish-box (todo)

Example PlanDefinition/KDN5 (JSON)

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

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

Chemotherapy Regimen

{
  "resourceType" : "PlanDefinition",
  "id" : "KDN5",
  "text" : {
    "status" : "additional",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n      \n      <table style=\"width: 100%;\">\n        \n        <tr>\n          \n          <td>\n            \n            \n            <div style=\"width: 200px; height: 100px; vertical-align: top;\">National Comprehensive Cancer Network</div>\n          \n          </td>\n          \n          <td>\n            \n            <h3>Chemotherapy Order Template</h3>\n            \n            <h1>Kidney Cancer</h1>\n            \n            <h2>Gemcitabine/CARBOplatin</h2>\n          \n          </td>\n          \n          <td style=\"text-align: right; vertical-align: top;\">KDN5</td>\n        \n        </tr>\n      \n      </table>\n      \n      <table style=\"width: 100%; border-top: 1px solid; border-bottom: 1px solid;\">\n        \n        <tr>\n          \n          <td style=\"width: 33%; border-right: 1px solid; vertical-align: top\">\n            \n            <h4>INDICATION:</h4>\n            \n            <p>Metastatic or Relapsed – Collecting Duct/Medullary Subtypes</p>\n          \n          </td>\n          \n          <td style=\"width: 34%; border-right: 1px solid; vertical-align: top\">\n            \n            <h4>REFERENCES:</h4>\n            \n            <ol>\n              \n              <li>\n                <a href=\"http://www.example.org/professionals/physician_gls/PDF/kidney.pdf\">NCCN Guidelines® for Kidney Cancer. V.3.2015.</a>\n              </li>\n              \n              <li>\n                <a href=\"http://www.ncbi.nlm.nih.gov/pubmed?term=%22The+Journal+of+urology%22%5BJour%5D+AND+1698%5Bpage%5D+AND+2007%5Bpdat%5D+AND+Oudard+S%5Bauthor%5D\">Oudard S, et al. \n                  <em>J Urol</em>. 2007;177(5):1698-702.\n                </a>\n                <sup>\n                  \n                  <a href=\"http://www.example.org/OrderTemplates/PDF/appendix_E.pdf\">a</a>\n                </sup>\n              \n              </li>\n            \n            </ol>\n          \n          </td>\n          \n          <td style=\"width: 33%; vertical-align: top\">\n            \n            <h4>NCCN SUPPORTIVE CARE:</h4>\n            \n            <ol>\n              \n              <li>\n                \n                <i>Emetic Risk:</i>\n                \n                <table>\n                  \n                  <tr>\n                    \n                    <td>Day 1</td>\n                    \n                    <td>Moderate</td>\n                  \n                  </tr>\n                  \n                  <tr>\n                    \n                    <td>Day 8</td>\n                    \n                    <td>Low</td>\n                  \n                  </tr>\n                \n                </table>\n              \n              </li>\n              \n              <li>\n                \n                <i>Fever Neutropenia Risk:</i>\n                <br/>\n                Refer to \n                <a href=\"http://www.example.org/professionals/physician_gls/PDF/myeloid_growth.pdf\">NCCN Guidelines for Myeloid Growth Factors. V.2.2014</a>\n              \n              </li>\n            \n            </ol>\n          \n          </td>\n        \n        </tr>\n      \n      </table>\n      \n      \n      <h4>CHEMOTHERAPY REGIMEN</h4>\n      \n      <p>\n        \n        <i>21-day cycle for 6 cycles</i>\n      \n      </p>\n      \n      <ul>\n        \n        <li>Gemcitabine 1250 mg/m\n          <sup>2</sup> IV over 30 minutes on Days 1 and 8\n        </li>\n        \n        <li>CARBOplatin AUC 5 IV over 30 minutes on Day 1</li>\n      \n      </ul>\n    \n    </div>"
  },
  "contained" : [{
    "resourceType" : "ActivityDefinition",
    "id" : "1111",
    "status" : "draft",
    "productCodeableConcept" : {
      "coding" : [{
        "system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
        "code" : "12574",
        "display" : "gemcitabine"
      }],
      "text" : "gemcitabine"
    },
    "dosage" : [{
      "text" : "1250 mg/m² IV over 30 minutes",
      "timing" : {
        "repeat" : {
          "duration" : 30,
          "durationUnit" : "min"
        }
      },
      "route" : {
        "text" : "IV"
      },
      "doseAndRate" : [{
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/dose-rate-type",
            "code" : "ordered",
            "display" : "Ordered"
          }]
        },
        "doseQuantity" : {
          "value" : 1250,
          "unit" : "mg/m²"
        }
      }]
    }]
  },
  {
    "resourceType" : "ActivityDefinition",
    "id" : "2222",
    "status" : "draft",
    "productCodeableConcept" : {
      "coding" : [{
        "system" : "http://www.nlm.nih.gov/research/umls/rxnorm",
        "code" : "40048",
        "display" : "Carboplatin"
      }],
      "text" : "CARBOplatin"
    },
    "dosage" : [{
      "text" : "AUC 5 IV over 30 minutes",
      "timing" : {
        "repeat" : {
          "duration" : 30,
          "durationUnit" : "min"
        }
      },
      "route" : {
        "text" : "IV"
      },
      "doseAndRate" : [{
        "type" : {
          "coding" : [{
            "system" : "http://terminology.hl7.org/CodeSystem/dose-rate-type",
            "code" : "ordered",
            "display" : "Ordered"
          }]
        },
        "doseQuantity" : {
          "extension" : [{
            "url" : "http://example.org/fhir/AUC-dose",
            "valueInteger" : 5
          }]
        }
      }]
    }]
  }],
  "extension" : [{
    "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
    "valueCode" : "cds"
  }],
  "identifier" : [{
    "system" : "http://example.org/ordertemplates",
    "value" : "KDN5"
  }],
  "version" : "1",
  "name" : "GemcitabineCARBOplatin",
  "title" : "Gemcitabine/CARBOplatin",
  "type" : {
    "text" : "Chemotherapy Order Template"
  },
  "status" : "draft",
  "experimental" : true,
  "publisher" : "HL7 International / Clinical Decision Support",
  "contact" : [{
    "telecom" : [{
      "system" : "url",
      "value" : "http://www.hl7.org/Special/committees/dss"
    }]
  }],
  "description" : "Gemcitabine/CARBOplatin",
  "useContext" : [{
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/usagecontext-group",
      "valueString" : "A"
    }],
    "code" : {
      "system" : "http://example.org/fhir/CodeSystem/indications",
      "code" : "treamentSetting-or-diseaseStatus"
    },
    "valueCodeableConcept" : {
      "text" : "Metastatic"
    }
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/usagecontext-group",
      "valueString" : "A"
    }],
    "code" : {
      "system" : "http://example.org/fhir/CodeSystem/indications",
      "code" : "disease-or-histology"
    },
    "valueCodeableConcept" : {
      "text" : "Collecting Duct/Medullary Subtypes"
    }
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/usagecontext-group",
      "valueString" : "A"
    }],
    "code" : {
      "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
      "code" : "focus"
    },
    "valueCodeableConcept" : {
      "text" : "Kidney Cancer"
    }
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/usagecontext-group",
      "valueString" : "B"
    }],
    "code" : {
      "system" : "http://example.org/fhir/CodeSystem/indications",
      "code" : "treatmentSetting-or-diseaseStatus"
    },
    "valueCodeableConcept" : {
      "text" : "Relapsed"
    }
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/usagecontext-group",
      "valueString" : "B"
    }],
    "code" : {
      "system" : "http://example.org/fhir/CodeSystem/indications",
      "code" : "disease-or-histology"
    },
    "valueCodeableConcept" : {
      "text" : "Collecting Duct/Medullary Subtypes"
    }
  },
  {
    "extension" : [{
      "url" : "http://hl7.org/fhir/StructureDefinition/usagecontext-group",
      "valueString" : "B"
    }],
    "code" : {
      "system" : "http://terminology.hl7.org/CodeSystem/usage-context-type",
      "code" : "focus"
    },
    "valueCodeableConcept" : {
      "text" : "Kidney Cancer – Collecting Duct/Medullary Subtypes - Metastatic"
    }
  }],
  "copyright" : "All rights reserved.",
  "approvalDate" : "2016-07-27",
  "lastReviewDate" : "2016-07-27",
  "author" : [{
    "name" : "Lee Surprenant"
  }],
  "relatedArtifact" : [{
    "type" : "derived-from",
    "display" : "NCCN Guidelines for Kidney Cancer. V.2.2016",
    "document" : {
      "url" : "http://www.example.org/professionals/physician_gls/PDF/kidney.pdf"
    }
  },
  {
    "type" : "citation",
    "_type" : {
      "extension" : [{
        "url" : "http://example.org/fhir/regimenReferenceType",
        "valueCode" : "a"
      }]
    },
    "citation" : "Oudard S, et al. J Urol. 2007;177(5):1698-702",
    "document" : {
      "url" : "http://www.ncbi.nlm.nih.gov/pubmed/17437788"
    }
  }],
  "action" : [{
    "selectionBehavior" : "exactly-one",
    "action" : [{
      "selectionBehavior" : "all",
      "action" : [{
        "groupingBehavior" : "sentence-group",
        "selectionBehavior" : "exactly-one",
        "action" : [{
          "id" : "cycle-definition-1",
          "textEquivalent" : "21-day cycle for 6 cycles",
          "timingTiming" : {
            "repeat" : {
              "count" : 6,
              "duration" : 21,
              "durationUnit" : "d"
            }
          },
          "action" : [{
            "id" : "action-1",
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/timing-daysOfCycle",
              "extension" : [{
                "url" : "day",
                "valueInteger" : 1
              },
              {
                "url" : "day",
                "valueInteger" : 8
              }]
            }],
            "textEquivalent" : "Gemcitabine 1250 mg/m² IV over 30 minutes on days 1 and 8",
            "definitionCanonical" : "#1111"
          },
          {
            "id" : "action-2",
            "extension" : [{
              "url" : "http://hl7.org/fhir/StructureDefinition/timing-daysOfCycle",
              "extension" : [{
                "url" : "day",
                "valueInteger" : 1
              }]
            }],
            "textEquivalent" : "CARBOplatin AUC 5 IV over 30 minutes on Day 1",
            "relatedAction" : [{
              "targetId" : "action-1",
              "relationship" : "concurrent-with-start"
            }],
            "definitionCanonical" : "#2222"
          }]
        }]
      }]
    }]
  }]
}

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.