<status value="active"/> <experimental value="true"/> <date value="2015-08-15"/> <publisher value="Motive Medical Intelligence"/> <contact> <telecom> <system value="phone"/> <value value="415-362-4007"/> <use value="work"/> </telecom> <telecom> <system value="email"/> <value value="info@motivemi.com"/> <use value="work"/> </telecom> </contact> <description value="Orders to be applied to a patient characterized as low suicide risk."/> <useContext> <code> <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/> <code value="age"/> </code> <valueCodeableConcept> <coding> <system value="https://meshb.nlm.nih.gov"/> <code value="D000328"/> <display value="Adult"/> </coding> </valueCodeableConcept> </useContext> <useContext> <code> <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/> <code value="focus"/> </code> <valueCodeableConcept> <coding> <system value="http://snomed.info/sct"/> <code value="87512008"/> <display value="Mild major depression"/> </coding> </valueCodeableConcept> </useContext> <useContext> <code> <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/> <code value="focus"/> </code> <valueCodeableConcept> <coding> <system value="http://snomed.info/sct"/> <code value="40379007"/> <display value="Major depression, recurrent, mild"/> </coding> </valueCodeableConcept> </useContext> <useContext> <code> <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/> <code value="focus"/> </code> <valueCodeableConcept> <coding> <system value="http://snomed.info/sct"/> <code value="394687007"/> <display value="Low suicide risk"/> </coding> </valueCodeableConcept> </useContext> <useContext> <code> <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/> <code value="focus"/> </code> <valueCodeableConcept> <coding> <system value="http://snomed.info/sct"/> <code value="225337009"/> <display value="Suicide risk assessment"/> </coding> </valueCodeableConcept> </useContext> <useContext> <code> <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/> <code value="user"/> </code> <valueCodeableConcept> <coding> <system value="http://snomed.info/sct"/> <code value="309343006"/> <display value="Physician"/> </coding> </valueCodeableConcept> </useContext> <useContext> <code> <system value="http://terminology.hl7.org/CodeSystem/usage-context-type"/> <code value="venue"/> </code> <valueCodeableConcept> <coding> <system value="http://snomed.info/sct"/> <code value="440655000"/> <display value="Outpatient environment"/> </coding> </valueCodeableConcept> </useContext> <jurisdiction> <coding> <system value="urn:iso:std:iso:3166"/> <code value="US"/> </coding> </jurisdiction> <purpose value="This order set helps ensure consistent application of appropriate orders for the care of low suicide risk patients."/> <usage value="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."/> <copyright value="© Copyright 2016 Motive Medical Intelligence. All rights reserved."/> <approvalDate value="2016-03-12"/> <lastReviewDate value="2016-08-15"/> <effectivePeriod> <start value="2016-01-01"/> <end value="2017-12-31"/> </effectivePeriod> <topic> <text value="Suicide risk assessment"/> </topic> <author> <name value="Motive Medical Intelligence"/> <telecom> <system value="phone"/> <value value="415-362-4007"/> <use value="work"/> </telecom> <telecom> <system value="email"/> <value value="info@motivemi.com"/> <use value="work"/> </telecom> </author> <relatedArtifact> <type value="derived-from"/> <display value="Practice Guideline for the Treatment of Patients with Major Depressive Disorder"/> <url value="http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf"/> <document> <url value="http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf"/> </document> </relatedArtifact> <relatedArtifact> <type value="composed-of"/> <resource value="http://example.org/fhir/ActivityDefinition/referralPrimaryCareMentalHealth"/> </relatedArtifact> <relatedArtifact> <type value="composed-of"/> <resource value="http://example.org/fhir/ActivityDefinition/citalopramPrescription"/> </relatedArtifact> <library value="http://example.org/fhir/Library/suiciderisk-orderset-logic"/> <action> <title value="Suicide Risk Assessment and Outpatient Management"/> <action> <title value="Consults and Referrals"/> <groupingBehavior value="logical-group"/> <selectionBehavior value="any"/> <action> <textEquivalent value="Refer to outpatient mental health program for evaluation and treatment of mental health conditions now"/> <definitionCanonical value="#referralToMentalHealthCare"/> <dynamicValue> <path value="timing.event"/> <expression> <language value="text/cql"/> <expression value="Now()"/> </expression> </dynamicValue> <dynamicValue> <path value="specialty"/> <expression> <language value="text/cql"/> <expression value="Code '261QM0850X' from SuicideRiskLogic."NUCC Provider Taxonomy" display 'Adult Mental Health'"/> </expression> </dynamicValue> <dynamicValue> <path value="occurrenceDateTime"/> <expression> <language value="text/cql"/> <expression value="SuicideRiskLogic.ServiceRequestFulfillmentTime"/> </expression> </dynamicValue> <dynamicValue> <path value="subject"/> <expression> <language value="text/cql"/> <expression value="SuicideRiskLogic.Patient"/> </expression> </dynamicValue> <dynamicValue> <path value="requester.agent"/> <expression> <language value="text/cql"/> <expression value="SuicideRiskLogic.Practitioner"/> </expression> </dynamicValue> <dynamicValue> <path value="reasonCode"/> <expression> <language value="text/cql"/> <expression value="SuicideRiskLogic.RiskAssessmentScore"/> </expression> </dynamicValue> <dynamicValue> <path value="reasonReference"/> <expression> <language value="text/cql"/> <expression value="SuicideRiskLogic.RiskAssessment"/> </expression> </dynamicValue> </action> </action> <action> <title value="Medications"/> <groupingBehavior value="logical-group"/> <selectionBehavior value="at-most-one"/> <action> <title value="First-Line Antidepressants"/> <documentation> <type value="citation"/> <url value="http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf"/> <document> <extension url="http://hl7.org/fhir/StructureDefinition/cqf-qualityOfEvidence"> <valueCodeableConcept> <coding> <system value="http://terminology.hl7.org/CodeSystem/evidence-quality"/> <code value="high"/> </coding> <text value="High Quality"/> </valueCodeableConcept> </extension> <contentType value="text/html"/> <url value="http://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/mdd.pdf"/> <title value="Practice Guideline for the Treatment of Patients with Major Depressive Disorder"/> </document> </documentation> <groupingBehavior value="logical-group"/> <selectionBehavior value="at-most-one"/> <action> <title value="Selective Serotonin Reuptake Inhibitors (Choose a mazimum of one or document reasons for exception)"/> <documentation> <type value="citation"/> <url value="http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6daeb45c-451d-b135-bf8f-2d6dff4b6b01"/> <document> <contentType value="text/html"/> <url value="http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6daeb45c-451d-b135-bf8f-2d6dff4b6b01"/> <title value="National Library of Medicine. DailyMed website. CITALOPRAM- citalopram hydrobromide tablet, film coated."/> </document> </documentation> <groupingBehavior value="logical-group"/> <selectionBehavior value="at-most-one"/> <action> <textEquivalent value="citalopram 20 mg tablet 1 tablet oral 1 time daily now (30 table; 3 refills)"/> <definitionCanonical value="#citalopramPrescription"/> <dynamicValue> <path value="status"/> <expression> <language value="text/cql"/> <expression value="'draft'"/> </expression> </dynamicValue> <dynamicValue> <path value="patient"/> <expression> <language value="text/cql"/> <expression value="SuicideRiskLogic.Patient"/> </expression> </dynamicValue> <dynamicValue> <path value="prescriber"/> <expression> <language value="text/cql"/> <expression value="SuicideRiskLogic.Practitioner"/> </expression> </dynamicValue> <dynamicValue> <path value="reasonCode"/> <expression> <language value="text/cql"/> <expression value="SuicideRiskLogic.RiskAssessmentScore"/> </expression> </dynamicValue> <dynamicValue> <path value="reasonReference"/> <expression> <language value="text/cql"/> <expression value="SuicideRiskLogic.RiskAssessment"/> </expression> </dynamicValue> </action> <action> <textEquivalent value="escitalopram 10 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)"/> </action> <action> <textEquivalent value="fluoxetine 20 mg capsule 1 capsule oral 1 time daily now (30 tablet; 3 refills)"/> </action> <action> <textEquivalent value="paroxetine 20 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)"/> </action> <action> <textEquivalent value="sertraline 50 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)"/> </action> </action> <action> <textEquivalent value="Dopamine Norepinephrine Reuptake Inhibitors (Choose a maximum of one or document reasons for exception)"/> </action> <action> <textEquivalent value="Serotonin Norepinephrine Reuptake Inhibitors (Choose a maximum of one or doument reasons for exception)"/> </action> <action> <textEquivalent value="Norepinephrine-Serotonin Modulators (Choose a maximum of one or document reasons for exception)"/> </action> </action> </action> </action> </PlanDefinition>

Id:

PlanDefinition/low-suicide-risk-order-set

Identifier:

value: mmi:low-suicide-risk-order-set

Title:

Low Suicide Risk Order Set

Status:

draft

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.

Context:

system: http://terminology.hl7.org/CodeSystem/usage-context-type

code: age

value:
system: https://meshb.nlm.nih.gov
code: D000328
display: Adult

Context:

system: http://terminology.hl7.org/CodeSystem/usage-context-type

code: focus

value:
system: http://snomed.info/sct
code: 87512008
display: Mild major depression

Context:

system: http://terminology.hl7.org/CodeSystem/usage-context-type

code: focus

value:
system: http://snomed.info/sct
code: 40379007
display: Major depression, recurrent, mild

Context:

system: http://terminology.hl7.org/CodeSystem/usage-context-type

code: focus

value:
system: http://snomed.info/sct
code: 394687007
display: Low suicide risk

Context:

system: http://terminology.hl7.org/CodeSystem/usage-context-type

code: focus

value:
system: http://snomed.info/sct
code: 225337009
display: Suicide risk assessment

Context:

system: http://terminology.hl7.org/CodeSystem/usage-context-type

code: user

value:
system: http://snomed.info/sct
code: 309343006
display: Physician

Context:

system: http://terminology.hl7.org/CodeSystem/usage-context-type

code: venue

value:
system: http://snomed.info/sct
code: 440655000
display: Outpatient environment

Topic:

text: Suicide risk assessment

Contributor:

author:

Motive Medical Intelligence

Library:

reference: Library/suiciderisk-orderset-logic

display: SuicideRiskLogic

Actions

Step:
title: Suicide Risk Assessment and Outpatient Management
Step:
title: Consults and Referrals
Step:
text: Refer to outpatient mental health program for evaluation and treatment of mental health conditions now
condition:
reference:
#referralToMentalHealthCare
description: refer to primary care mental-health integrated care program for evaluation and treatment of mental health conditions now
category: referral
Step:
title: Medications
Step:
title: First-Line Antidepressants
Step:
title: Selective Serotonin Reuptake Inhibitors (Choose a mazimum of one or document reasons for exception)
Step:
text: citalopram 20 mg tablet 1 tablet oral 1 time daily now (30 table; 3 refills)
condition:
reference:
#citalopramPrescription
category: drug
Step:
text: escitalopram 10 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)
Step:
text: fluoxetine 20 mg capsule 1 capsule oral 1 time daily now (30 tablet; 3 refills)
Step:
text: paroxetine 20 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)
Step:
text: sertraline 50 mg tablet 1 tablet oral 1 time daily now (30 tablet; 3 refills)
Step:
text: Dopamine Norepinephrine Reuptake Inhibitors (Choose a maximum of one or document reasons for exception)
Step:
text: Serotonin Norepinephrine Reuptake Inhibitors (Choose a maximum of one or doument reasons for exception)
Step:
text: Norepinephrine-Serotonin Modulators (Choose a maximum of one or document reasons for exception)