This page is part of the Clinical Guidelines (v1.0.0: STU 1) based on FHIR R4. This is the current published version in it's permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions
This example defines computable content for two recommendations in the WHO Antenatal Care Guildines (ANC):
Overall, the guideline recommends a contact schedule consisting of 8 contacts at specific points in the pregnancy. This is represented with the ANC Contact Schedule (a pathway) describing the expected schedule:
ANC Contact 1: up to 12 weeks
ANC Contact 2: 20 weeks
ANC Contact 3: 26 weeks
ANC Contact 4: 30 weeks
ANC Contact 5: 34 weeks
ANC Contact 6: 36 weeks
ANC Contact 7: 38 weeks
ANC Contact 8: 40 weeks
ANC Delivery: 41+ weeks
The protocol contains actions for each expected contact with an applicability condition to specify the timing, and pointing to the ANC Contact (a strategy) describing each contact:
Registration: PlanDefinition/cpg-common-registration
Record health history:
if "Is First Contact"
New profile: Questionnaire/anc-first-contact
Questionnaire/anc-every-contact
Assess danger signs:
Questionnaire/anc-quick-check
Assess current pregnancy:
Case management or referral:
Schedule followup visit
(Note that the above content is an example and is not necessarily fit for immediate use).
These definitions reference the ANC Common Library to provide the logic for the applicability conditions.
Within the context of this overall schedule, the guideline contains specific recommendations related to various aspects of the health of the mother. One of these is recommendation A2, for Iron and Folic Acid Supplementation, detailed in the following sections as part of this example.
Daily oral iron and folic acid supplementation with 30 mg to 60 mg of elemental iron2 and 400 μg (0.4 mg) of folic acid3 is recommended for pregnant women to prevent maternal anaemia, puerperal sepsis, low birth weight, and preterm birth.
Intermittent oral iron and folic acid supplementation with 120 mg of elemental iron5 and 2800 μg (2.8 mg) of folic acid once weekly is recommended for pregnant women to improve maternal and neonatal outcomes if daily iron is not acceptable due to side-effects, and in populations with an anaemia prevalence among pregnant women of less than 20%.
These recommendations use the ANCRecommendationA2 library to define the logic involved, and the ANCRecommendationA2 recommendation definition to establish the event-condition-action rule for when they should be used.