R4 Draft for Comment
WorkflowThis page is part of the FHIR Specification (v3.2.0: R4 Ballot 1). 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 R3
| Clinical Decision Support Work Group | Maturity Level: N/A | Ballot Status: Informative | Compartments: Not linked to any defined compartments |
Low Suicide Risk Order Set
{
"resourceType": "PlanDefinition",
"id": "low-suicide-risk-order-set",
"text": {
"status": "generated",
"div": "<div xmlns=\"http://www.w3.org/1999/xhtml\">\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Id: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">PlanDefinition/low-suicide-risk-order-set</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Identifier: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <b>value: </b>\n <span>mmi:low-suicide-risk-order-set</span>\n </td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Title: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">Low Suicide Risk Order Set</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Status: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">draft</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Description: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">Orders to be applied to a patient characterized as low suicide risk.</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Purpose: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">This order set helps ensure consistent application of appropriate orders for the care of low suicide risk patients.</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Usage: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">This order set should be applied after assessing a patient for suicide risk, when the findings of that assessment indicate the patient has low suicide risk.</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Context: </b>\n </td>\n </tr>\n <tr style=\"vertical-align: top;\">\n <td style=\"padding-right: 25px;\">\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>system: </b>\n <span>http://hl7.org/fhir/usage-context-type</span>\n </p>\n <p style=\"padding-left: 25px; 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margin-top: 5px; margin-bottom: 5px;\">\n <b>system: </b>\n <span>http://hl7.org/fhir/usage-context-type</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>code: </b>\n <span>focus</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>value: </b>\n <br/>\n <span>\n <span>\n <span>\n <span style=\"padding-left: 25px;\">\n <b>system: </b>\n <span>http://snomed.info/sct</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>code: </b>\n <span>394687007</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>display: </b>\n <span>Low suicide risk</span>\n </span>\n </span>\n </span>\n </span>\n </p>\n </td>\n </tr>\n </table>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Context: </b>\n </td>\n </tr>\n <tr style=\"vertical-align: top;\">\n <td style=\"padding-right: 25px;\">\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>system: </b>\n <span>http://hl7.org/fhir/usage-context-type</span>\n </p>\n <p style=\"padding-left: 25px; 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margin-top: 5px; margin-bottom: 5px;\">\n <b>value: </b>\n <br/>\n <span>\n <span>\n <span>\n <span style=\"padding-left: 25px;\">\n <b>system: </b>\n <span>http://snomed.info/sct</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>code: </b>\n <span>309343006</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>display: </b>\n <span>Physician</span>\n </span>\n </span>\n </span>\n </span>\n </p>\n </td>\n </tr>\n </table>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Context: </b>\n </td>\n </tr>\n <tr style=\"vertical-align: top;\">\n <td style=\"padding-right: 25px;\">\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>system: </b>\n <span>http://hl7.org/fhir/usage-context-type</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>code: </b>\n <span>venue</span>\n </p>\n <p style=\"padding-left: 25px; margin-top: 5px; margin-bottom: 5px;\">\n <b>value: </b>\n <br/>\n <span>\n <span>\n <span>\n <span style=\"padding-left: 25px;\">\n <b>system: </b>\n <span>http://snomed.info/sct</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>code: </b>\n <span>440655000</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <b>display: </b>\n <span>Outpatient environment</span>\n </span>\n </span>\n </span>\n </span>\n </p>\n </td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Topic: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <span>\n <b>text: </b>\n <span>Suicide risk assessment</span>\n </span>\n </td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Contributor: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <b>\n <span>author</span>:\n </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 50px; padding-right: 25px;\">Motive Medical Intelligence</td>\n </tr>\n </table>\n <p/>\n <table class=\"grid dict\">\n <tr>\n <td>\n <b>Library: </b>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <b>reference: </b>\n <span>Library/suiciderisk-orderset-logic</span>\n </td>\n </tr>\n <tr>\n <td style=\"padding-left: 25px; padding-right: 25px;\">\n <b>display: </b>\n <span>SuicideRiskLogic</span>\n </td>\n </tr>\n </table>\n <p/>\n <h2>Actions</h2>\n <p style=\"width: 100%;\" class=\"hierarchy\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 25px;\">\n <b>title: </b>\n <span>Suicide Risk Assessment and Outpatient Management</span>\n <br/>\n </span>\n <span style=\"padding-left: 25px;\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 50px;\">\n <b>title: </b>\n <span>Consults and Referrals</span>\n <br/>\n </span>\n <span style=\"padding-left: 50px;\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 75px;\">\n <b>text: </b>\n <span>Refer to outpatient mental health program for evaluation and treatment of mental health conditions now</span>\n <br/>\n </span>\n <span style=\"padding-left: 75px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>reference: </b>\n <br/>\n <span style=\"padding-left: 125px;\">#referralToMentalHealthCare</span>\n <span>\n <span style=\"padding-left: 75px;\">\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>description: </b>\n <span>refer to primary care mental-health integrated care program for evaluation and treatment of mental health conditions now</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\">\n <b>category: </b>\n <span>referral</span>\n <br/>\n </span>\n </span>\n </span>\n </span>\n </span>\n <span style=\"padding-left: 50px;\"/>\n </span>\n </span>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 50px;\">\n <b>title: </b>\n <span>Medications</span>\n <br/>\n </span>\n <span style=\"padding-left: 50px;\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 75px;\">\n <b>title: </b>\n <span>First-Line Antidepressants</span>\n <br/>\n </span>\n <span style=\"padding-left: 75px;\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>title: </b>\n <span>Selective Serotonin Reuptake Inhibitors (Choose a mazimum of one or document reasons for exception)</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\">\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 125px;\">\n <b>text: </b>\n <span>citalopram 20 mg tablet 1 tablet oral 1 time daily now (30 table; 3 refills)</span>\n <br/>\n </span>\n <span style=\"padding-left: 125px;\">\n <b>condition: </b>\n <br/>\n <span style=\"padding-left: 150px;\">\n <b>reference: </b>\n <br/>\n <span style=\"padding-left: 175px;\">#citalopramPrescription</span>\n <span/>\n <span>\n <span style=\"padding-left: 125px;\">\n <br/>\n <span style=\"padding-left: 150px;\">\n <b>category: </b>\n <span>drug</span>\n <br/>\n </span>\n </span>\n </span>\n <span/>\n <span/>\n </span>\n </span>\n <span style=\"padding-left: 100px;\"/>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 125px;\">\n <b>text: </b>\n <span>escitalopram 10 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\"/>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 125px;\">\n <b>text: </b>\n <span>fluoxetine 20 mg capsule 1 capsule oral 1 time daily now (30 tablet; 3 refills)</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\"/>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 125px;\">\n <b>text: </b>\n <span>paroxetine 20 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\"/>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 125px;\">\n <b>text: </b>\n <span>sertraline 50 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\"/>\n </span>\n </span>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 125px;\">\n <b>text: </b>\n <span>Dopamine Norepinephrine Reuptake Inhibitors (Choose a maximum of one or document reasons for exception)</span>\n <br/>\n </span>\n <span style=\"padding-left: 75px;\"/>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>text: </b>\n <span>Serotonin Norepinephrine Reuptake Inhibitors (Choose a maximum of one or doument reasons for exception)</span>\n <br/>\n </span>\n <span style=\"padding-left: 75px;\"/>\n </span>\n <span>\n <b>Step: </b>\n <br/>\n <span style=\"padding-left: 100px;\">\n <b>text: </b>\n <span>Norepinephrine-Serotonin Modulators (Choose a maximum of one or document reasons for exception)</span>\n <br/>\n </span>\n <span style=\"padding-left: 100px;\"/>\n </span>\n </span>\n </span>\n </span>\n </span>\n </span>\n </span>\n </p>\n </div>"
},
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"doseQuantity": {
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"ingredient": [
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"unit": "mg"
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"url": "http://motivemi.com/artifacts/PlanDefinition/low-suicide-risk-order-set",
"identifier": [
{
"use": "official",
"system": "http://motivemi.com/artifacts",
"value": "mmi:low-suicide-risk-order-set"
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],
"version": "1.0.0",
"name": "LowSuicideRiskOrderSet",
"title": "Low Suicide Risk Order Set",
"status": "active",
"experimental": true,
"date": "2015-08-15",
"publisher": "Motive Medical Intelligence",
"description": "Orders to be applied to a patient characterized as low suicide risk.",
"purpose": "This order set helps ensure consistent application of appropriate orders for the care of low suicide risk patients.",
"usage": "This order set should be applied after assessing a patient for suicide risk, when the findings of that assessment indicate the patient has low suicide risk.",
"approvalDate": "2016-03-12",
"lastReviewDate": "2016-08-15",
"effectivePeriod": {
"start": "2016-01-01",
"end": "2017-12-31"
},
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"jurisdiction": [
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"coding": [
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"system": "urn:iso:std:iso:3166",
"code": "US"
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],
"topic": [
{
"text": "Suicide risk assessment"
}
],
"contributor": [
{
"type": "author",
"name": "Motive Medical Intelligence",
"contact": [
{
"telecom": [
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"use": "work"
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"system": "email",
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"use": "work"
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]
}
],
"copyright": "© Copyright 2016 Motive Medical Intelligence. All rights reserved.",
"relatedArtifact": [
{
"type": "derived-from",
"display": "Practice Guideline for the Treatment of Patients with Major Depressive Disorder",
"url": "http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf"
},
{
"type": "composed-of",
"resource": {
"reference": "ActivityDefinition/referralPrimaryCareMentalHealth"
}
},
{
"type": "composed-of",
"resource": {
"reference": "ActivityDefinition/citalopramPrescription"
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}
],
"library": [
{
"reference": "Library/suiciderisk-orderset-logic",
"display": "SuicideRiskLogic"
}
],
"action": [
{
"title": "Suicide Risk Assessment and Outpatient Management",
"action": [
{
"title": "Consults and Referrals",
"groupingBehavior": "logical-group",
"selectionBehavior": "any",
"action": [
{
"textEquivalent": "Refer to outpatient mental health program for evaluation and treatment of mental health conditions now",
"definition": {
"reference": "#referralToMentalHealthCare"
},
"dynamicValue": [
{
"path": "timing.event",
"expression": "Now()"
},
{
"path": "specialty",
"expression": "Code '261QM0850X' from SuicideRiskLogic.\"NUCC Provider Taxonomy\" display 'Adult Mental Health'"
},
{
"path": "occurrenceDateTime",
"expression": "SuicideRiskLogic.ServiceRequestFulfillmentTime"
},
{
"path": "subject",
"expression": "SuicideRiskLogic.Patient"
},
{
"path": "requester.agent",
"expression": "SuicideRiskLogic.Practitioner"
},
{
"path": "reasonCode",
"expression": "SuicideRiskLogic.RiskAssessmentScore"
},
{
"path": "reasonReference",
"expression": "SuicideRiskLogic.RiskAssessment"
}
]
}
]
},
{
"title": "Medications",
"groupingBehavior": "logical-group",
"selectionBehavior": "at-most-one",
"action": [
{
"title": "First-Line Antidepressants",
"documentation": [
{
"type": "citation",
"document": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/cqif-qualityOfEvidence",
"valueCodeableConcept": {
"coding": [
{
"system": "http://hl7.org/fhir/evidence-quality",
"code": "high"
}
],
"text": "High Quality"
}
}
],
"contentType": "text/html",
"url": "http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf",
"title": "Practice Guideline for the Treatment of Patients with Major Depressive Disorder"
}
}
],
"groupingBehavior": "logical-group",
"selectionBehavior": "at-most-one",
"action": [
{
"title": "Selective Serotonin Reuptake Inhibitors (Choose a mazimum of one or document reasons for exception)",
"documentation": [
{
"type": "citation",
"document": {
"contentType": "text/html",
"url": "http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6daeb45c-451d-b135-bf8f-2d6dff4b6b01",
"title": "National Library of Medicine. DailyMed website. CITALOPRAM- citalopram hydrobromide tablet, film coated."
}
}
],
"groupingBehavior": "logical-group",
"selectionBehavior": "at-most-one",
"action": [
{
"textEquivalent": "citalopram 20 mg tablet 1 tablet oral 1 time daily now (30 table; 3 refills)",
"definition": {
"reference": "#citalopramPrescription"
},
"dynamicValue": [
{
"path": "status",
"expression": "'draft'"
},
{
"path": "patient",
"expression": "SuicideRiskLogic.Patient"
},
{
"path": "prescriber",
"expression": "SuicideRiskLogic.Practitioner"
},
{
"path": "reasonCode",
"expression": "SuicideRiskLogic.RiskAssessmentScore"
},
{
"path": "reasonReference",
"expression": "SuicideRiskLogic.RiskAssessment"
}
]
},
{
"textEquivalent": "escitalopram 10 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)"
},
{
"textEquivalent": "fluoxetine 20 mg capsule 1 capsule oral 1 time daily now (30 tablet; 3 refills)"
},
{
"textEquivalent": "paroxetine 20 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)"
},
{
"textEquivalent": "sertraline 50 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)"
}
]
},
{
"textEquivalent": "Dopamine Norepinephrine Reuptake Inhibitors (Choose a maximum of one or document reasons for exception)"
},
{
"textEquivalent": "Serotonin Norepinephrine Reuptake Inhibitors (Choose a maximum of one or doument reasons for exception)"
},
{
"textEquivalent": "Norepinephrine-Serotonin Modulators (Choose a maximum of one or document reasons for exception)"
}
]
}
]
}
]
}
]
}
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.
®© HL7.org 2011+. FHIR Release 4 Draft for Comment (Jan-2018 v3.2.0-12885) generated on Wed, Dec 20, 2017 15:58+1100. QA Page
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