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12.23.10.1 Operation $apply on PlanDefinition

Clinical Decision Support Work Group

Maturity Level: 3

Trial Use

Compartments: N/A

The apply operation applies a PlanDefinition to a given subject.

The canonical URL for this operation definition is

 http://hl7.org/fhir/OperationDefinition/PlanDefinition-apply

Formal Definition (as a OperationDefinition).

URL: [base]/PlanDefinition/$apply

URL: [base]/PlanDefinition/[id]/$apply

This is an idempotent operation

The result of this operation is a Bundle for each subject, where the Bundle contains as its first entry a RequestOrchestration that is the direct result of applying the PlanDefinition to that subject, and any subsequent entries in the Bundle are resources that were created or updated as part of that process. The RequestOrchestration will have actions for each of the applicable actions in the plan based on evaluating the applicability condition in context. For each applicable action, the definition is applied as described in the $apply operation of the ActivityDefinition resource, and the resulting resource is added as an entry to the Bundle. If the ActivityDefinition includes library references, those libraries will be available to the evaluated expressions. If those libraries have parameters, those parameters will be bound by name to the parameters given to the operation. In addition, parameters to the $apply operation are available within dynamicValue expressions as context variables, accessible by the name of the parameter, prefixed with a percent (%) symbol. For a more detailed description, refer to the PlanDefinition and ActivityDefinition resource documentation. Note that result of this operation is transient (i.e. none of the resources created by the operation are persisted in the server, they are all returned as entries in the result Bundle(s)). The result effectively represents a proposed set of activities, and it is up to the caller to determine whether and how those activities are actually carried out and/or persisted.

12.23.10.1.1 Examples

Request: Apply the low suicide risk order set to patient 124

GET [base]/PlanDefinition/example/$apply?subject=Patient/124

Response: Returned on successful application of the order set

HTTP/1.1 200 OK

<?xml version="1.0" encoding="UTF-8"?>
<Parameters xmlns="http://hl7.org/fhir">
<Bundle>
  <type value="collection"/>
  <entry>
    <fullUrl value="http://example.org/fhir/RequestOrchestration/apply-operation-response"/>
    <resource>
      <RequestOrchestration>
        <!-- This example demonstrates the result of an $apply operation for the citalopramPrescription activity definition. -->
        <id value="apply-operation-response"/>
        <instantiatesCanonical value="http://example.org/fhir/PlanDefinition/example"/>
        <status value="draft"/>
        <intent value="proposal"/>
        <subject>
      	  <reference value="Patient/124"/>
        </subject>
        <activity>
      	<reference>
      		<reference value="ServiceRequest/referralrequest"/>
      	</reference>
        </activity>
        <activity>
          <reference>
            <reference value="MedicationRequest/citalopramPrescription"/>
          </reference>
        </activity>
      </RequestOrchestration>
    </resource>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/ServiceRequest/referralrequest"/>
    <resource>
      <ServiceRequest>
    	  <id value="referralrequest"/>
    	  <status value="draft"/>
          <intent value="proposal"/>
          <code>
    		<coding>
    		  <system value="http://snomed.info/sct"/>
    		  <code value="306206005"/>
    		</coding>
    		<text value="Referral to service (procedure)"/>
          </code>
          <subject>
            <reference value="Patient/124"/>
          </subject>
          <occurrenceDateTime value="2017-02-26T11:47:00.000Z"/>
          <requester>
    		<reference value="Practitioner/123"/>
    	  </requester>
          <performerType>
    		  <coding>
    			  <system value="http://nucc.org/provider-taxonomy"/>
    			  <code value="261QM0850X"/>
    			  <display value="Adult Mental Health"/>
    		  </coding>
          </performerType>
    	  <reasonCode>
    		  <coding>
    			  <system value="http://example.org/CodeSystem/suicide-risk-assessment-score"/>
    			  <code value="Low"/>
    			  <display value="Low Suicide Risk"/>
    		  </coding>
    		  <text value="Low Suicide Risk"/>
    	  </reasonCode>
    	  <reasonReference>
    		  <reference value="RiskAssessment/suicide-risk-assessment"/>
    	  </reasonReference>
    	</ServiceRequest>
    </resource>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/Medication/citalopramMedication"/>
    <resource>
      <Medication>
        <id value="citalopramMedication"/>
        <code>
          <coding>
            <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
            <code value="200371"/>
          </coding>
          <text value="citalopram"/>
        </code>
          <form>
            <coding>
              <system value="http://snomed.info/sct"/>
              <code value="385055001"/>
              <display value="Tablet dose form"/>
            </coding>
            <text value="Tablet dose form"/>
          </form>
          <ingredient>
            <itemReference>
              <reference value="Substance/citalopramSubstance"/>
            </itemReference>
            <amount>
              <numerator>
                <value value="20"/>
                <unit value="mg"/>
              </numerator>
              <denominator>
                <value value="1"/>
                <unit value="{tbl}"/>
              </denominator>
            </amount>
          </ingredient>
      </Medication>
    </resource>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/Substance/citalopramSubstance"/>
    <resource>
      <Substance>
        <id value="citalopramSubstance"/>
        <code>
            <coding>
              <system value="http://www.nlm.nih.gov/research/umls/rxnorm"/>
              <code value="2556"/>
            </coding>
            <text value="citalopram"/>
        </code>
      </Substance>
    </resource>
  </entry>
  <entry>
    <fullUrl value="http://example.org/fhir/MedicationRequest/citalopramPrescription"/>
    <resource>
      <MedicationRequest>
    	  <id value="citalopramPrescription"/>
    	  <status value="draft"/>
    	  <intent value="proposal"/>
    	  <medicationReference>
    		  <reference value="Medication/citalopramMedication"/>
    	  </medicationReference>
    	  <subject>
    		  <reference value="Patient/124"/>
    	  </subject>
    	  <requester>
    		<reference value="Practitioner/123"/>
    	  </requester>
    	  <reasonCode>
    		  <coding>
    			  <system value="http://example.org/CodeSystem/suicide-risk-assessment-score"/>
    			  <code value="Low"/>
    			  <display value="Low Suicide Risk"/>
    		  </coding>
    		  <text value="Low Suicide Risk"/>
    	  </reasonCode>
    	  <reasonReference>
    		  <reference value="RiskAssessment/suicide-risk-assessment"/>
    	  </reasonReference>
    	  <!--definition>
    		<reference value="http://example.org/fhir/ActivityDefinition/citalopramPrescription"/>
    	  </definition-->
    	  <instantiates value="http://example.org/fhir/ActivityDefinition/citalopramPrescription"/>
    	  <dosageInstruction>
    		<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><text value="ordered"/></type>
    			<doseQuantity>
    				<value value="1"/>
    				<unit value="{tbl}"/>
    			</doseQuantity>
    		</doseAndRate>
    	  </dosageInstruction>
    	  <dispenseRequest>
    		  <numberOfRepeatsAllowed value="3"/>
    		  <quantity>
    			  <value value="30"/>
    			  <unit value="{tbl}"/>
    		  </quantity>
    	  </dispenseRequest>
    	</MedicationRequest>
    </resource>
  </entry>
</Bundle>
</Parameters>

For more information about operations, including how they are invoked, see Operations.