Clinical Practice Guidelines
2.0.0-ballot - ballot International flag

This page is part of the Clinical Guidelines (v2.0.0-ballot: STU2 Ballot 1) based on FHIR (HL7® FHIR® Standard) R4. The current version which supersedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions

Example Bundle: activity-example-administermedication-bundle

Bundle activity-example-administermedication-bundle of type collection


Entry 1 - fullUrl = http://example.org/Library/activity-example-administermedication-1

Resource Library:

Related Artifacts

Depends Onhttp://fhir.org/guides/cqf/common/Library/FHIR-ModelInfo|4.0.1
Depends Onhttp://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1
Depends OnCPG Activity Type Code System
Composed OfActivity Example Administer Medication AD
Composed OfAdminister Medication Library
Composed OfActivity Example Administer Medication PD


Entry 2 - fullUrl = http://example.org/Library/AdministerMedication

Resource Library:

Related Artifacts

Depends Onhttp://fhir.org/guides/cqf/common/Library/FHIR-ModelInfo|4.0.1
Depends Onhttp://fhir.org/guides/cqf/common/Library/FHIRHelpers|4.0.1
Depends OnCPG Activity Type Code System

Parameters

PatientOut01Patient
Medication ProposalOut0*MedicationRequest
Medication Not ProposedOut0*MedicationRequest
Inclusion CriteriaOut01boolean
Active or Completed Medication AdministrationOut0*MedicationAdministration
Medication Administration Not DoneOut0*MedicationAdministration
Administer ProposalOut0*Task
Administer Proposal RejectedOut0*Task
Is Recommendation ApplicableOut01boolean

Data Requirements

Type: MedicationRequest (MedicationRequest)
Type: MedicationRequest (MedicationRequest)
Type: MedicationAdministration (MedicationAdministration)
Type: MedicationAdministration (MedicationAdministration)
Type: Task (Task)
Type: Task (Task)

Contents

text/cql

library AdministerMedication

using FHIR version '4.0.1'

include FHIRHelpers version '4.0.1'

codesystem "Activity Type": 'http://hl7.org/fhir/uv/cpg/CodeSystem/cpg-activity-type-cs'

code "Administer medication": 'administer-medication' from "Activity Type"

context Patient

/* Recommendation to administer an existing order for a medication */

/*
Positive recommendation:

If the medication has been ordered but has not been administered
  Propose administering the medication

Given a proposal, the user can:
  Accept the proposal
  Ignore the proposal
  Reject the proposal without reason
  Reject the proposal with reason

Scenario 1: No event, no plan or proposal, decision support should propose
Scenario 2: No event, incomplete proposal, decision support should not propose
Scenario 3: No event, rejected proposal, decision support should not propose
Scenario 4: Event, no proposal, decision support should not propose
Scenario 5: Event, proposal, decision support should not propose
Scenario 6: Event not done, no proposal, decision support should not propose
Scenario 7: Event not done, proposal, decision support should not propose

*/

define "Inclusion Criteria":
  Patient.active
    and exists ("Medication Proposal")
    and not exists ("Medication Not Proposed")

define "Active or Completed Medication Administration":
  [MedicationAdministration] M
    where M.status in { 'in-progress', 'on-hold', 'completed' }

define "Medication Administration Not Done":
  [MedicationAdministration] M
    where M.status in { 'not-done', 'stopped' } // TODO: Is 'stopped' appropriate here?

define "Medication Proposal":
  [MedicationRequest] M
    where M.status in { 'draft', 'active', 'on-hold', 'completed' }

define "Medication Not Proposed":
  [MedicationRequest] M
    where M.status in { 'cancelled', 'stopped' }

define "Administer Proposal":
  [Task] R
    where R.code ~ "Administer medication"
      and R.status in { 'draft', 'requested', 'received', 'accepted', 'ready' }
      and not Coalesce(doNotPerform(R), false)

define "Administer Proposal Rejected":
  [Task] R
    where R.code ~ "Administer medication"
      and R.status in { 'rejected' }
      and not Coalesce(doNotPerform(R), false)

define "Is Recommendation Applicable":
  "Inclusion Criteria"
    and not exists (
      "Active or Completed Medication Administration"
        union "Medication Administration Not Done"
    )
    and not exists (
      "Administer Proposal"
        union "Administer Proposal Rejected"
    )

define function doNotPerform(task Task):
  singleton from (
    task.modifierExtension E
      where E.url = 'http://hl7.org/fhir/StructureDefinition/request-doNotPerform'
  ).value as boolean


Entry 3 - fullUrl = http://example.org/PlanDefinition/activity-example-administermedication-2

Resource PlanDefinition:

Generated Narrative: PlanDefinition

Resource PlanDefinition "activity-example-administermedication-2"

Profile: CPG Computable Plan Definition

CQF Knowledge capability: shareable

CQF Knowledge capability: computable

CQF Knowledge capability: publishable

CQF knowledge representation level: structured

url: http://hl7.org/fhir/uv/cpg/PlanDefinition/activity-example-administermedication-2

version: 2.0.0

name: ActivityExampleAdministerMedication

title: Activity Example Administer Medication

type: ECA Rule (PlanDefinitionType#eca-rule)

status: DRAFT

experimental: true

date: 2023-11-02

publisher: HL7 International / Clinical Decision Support

description: Example Plan Definition for a recommendation to administer a medication

library: Administer Medication Library

action

title: Collect date of patient last visit

condition

kind: APPLICABILITY

Expressions

-LanguageExpression
*text/cqlIs Recommendation Applicable

type: Create (ActionType#create)

definition: Activity Example Administer Medication AD


Entry 4 - fullUrl = http://example.org/Bundle/am-scenario7-inline-bundle

Resource Bundle:

Bundle am-scenario7-inline-bundle of type collection


Entry 1 - fullUrl = http://example.org/GuidanceResponse/am-scenario7-1

Resource GuidanceResponse:

Generated Narrative: GuidanceResponse

Resource GuidanceResponse "am-scenario7-1"

module: Administer Medication Library

status: SUCCESS

subject: Patient/am-scenario7-patient " PATIENT"

outputParameters:

parameter

name: Inclusion Criteria

value: true

parameter

name: Is Recommendation Applicable

value: false


Parameters

Inclusion Criteriatrue
Is Recommendation Applicablefalse


Entry 2 - fullUrl = http://example.org/MedicationAdministration/am-scenario7-2

Resource MedicationAdministration:

Generated Narrative: MedicationAdministration

Resource MedicationAdministration "am-scenario7-2"

status: NOTDONE

subject: Patient/am-scenario7-patient " PATIENT"

request: MedicationRequest/am-scenario7-mr

Dosages

-TextDose
*apply one patch three times per week1 patch (Details: http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm code PATCH = 'Patch')


Entry 3 - fullUrl = http://example.org/MedicationRequest/am-scenario7-3

Resource MedicationRequest:

Generated Narrative: MedicationRequest

Resource MedicationRequest "am-scenario7-3"

status: ACTIVE

intent: ORDER

priority: ROUTINE

subject: Patient/am-scenario7-patient " PATIENT"

dosageInstruction

dispenseRequest

validityPeriod: 2015-01-15 --> 2016-01-15

quantity: 6 patch (Details: http://terminology.hl7.org/CodeSystem/v3-orderableDrugForm code PATCH = 'Patch')

ExpectedSupplyDurations

-ValueUnitSystemCode
*14daysUnified Code for Units of Measure (UCUM)d


Entry 4 - fullUrl = http://example.org/Patient/am-scenario7-4

Resource Patient:

Example Patient Female, DoB: 1990-10-01


Entry 5 - fullUrl = http://example.org/Task/request-am-scenario7-5

Resource Task:

Generated Narrative: Task

Resource Task "request-am-scenario7-5"

instantiatesCanonical: Activity Example Administer Medication AD

status: INPROGRESS

intent: ORDER

code: Administer a medication (CPG Activity Type Code System#administer-medication)

for: Patient/am-scenario7-patient " PATIENT"

Inputs

-TypeValue[x]
*Administer a medication (CPG Activity Type Code System#administer-medication)MedicationRequest/am-scenario7-mr