2nd DSTU Draft For Comment

This page is part of the FHIR Specification (v0.4.0: DSTU 2 Draft). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions

4.11.9 Resource Contraindication - Examples

Example Index:

Drug-drug interaction between prescription and medication statementXMLJSON
Diagnostic order is placed when a recent image of the same body site already existsXMLJSON
Patient is allergic to an inactive ingredient in an ordered medicationXMLJSON
Lab order is contraindicated based on a patient's existing medicationXMLJSON

4.11.9.1 Drug-drug

XML

Drug-drug interaction between prescription and medication statement (id = "ddi")

Raw XML

<Contraindication xmlns="http://hl7.org/fhir">
  <id value="ddi"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><!-- Snipped for brevity --></div>
  </text>
  <category>
    <coding>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="DRG"/>
      <display value="Drug Interaction Alert"/>
    </coding>
  </category>
  <severity value="H"/>
  <implicated>
    <reference value="MedicationStatement/tylenol"/>
    <display value="500 mg Acetaminophen tablet 1/day, PRN since 2010"/>
  </implicated>
  <implicated>
    <reference value="MedicationPrescription/warfarin"/>
    <display value="Warfarin 1 MG TAB prescribed Jan. 5, 2014"/>
  </implicated>
  <detail value="Risk of internal bleeding.  Those who take acetaminophen along with the widely used blood-thinning
   drug warfarin may face the risk of serious internal bleeding. People on warfarin who take
   acetaminophen for at least seven days in a row should be closely watched for bleeding."/>
  <date value="2014-01-05"/>
  <author>
    <reference value="Device/dsp"/>
  </author>
  <mitigation>
    <action>
      <coding>
        <system value="http://hl7.org/fhir/v3/ActCode"/>
        <code value="30"/>
        <display value="Stopped Concurrent Therapy"/>
      </coding>
      <text value="Asked patient to discontinue regular use of Tylenol and to consult with clinician if they
       need to resume to allow appropriate INR monitoring"/>
    </action>
    <date value="2014-01-05"/>
    <author>
      <reference value="Practitioner/example"/>
      <display value="Dr. Adam Careful"/>
    </author>
  </mitigation>
</Contraindication>

JSON

Drug-drug interaction between prescription and medication statement

Raw JSON (Canonical)

{
  "resourceType": "Contraindication",
  "id": "ddi",
  "text": {
    "status": "generated",
    "div": "<div>!-- Snipped for Brevity --></div>"
  },
  "category": {
    "coding": [
      {
        "system": "http://hl7.org/fhir/v3/ActCode",
        "code": "DRG",
        "display": "Drug Interaction Alert"
      }
    ]
  },
  "severity": "H",
  "implicated": [
    {
      "reference": "MedicationStatement/tylenol",
      "display": "500 mg Acetaminophen tablet 1/day, PRN since 2010"
    },
    {
      "reference": "MedicationPrescription/warfarin",
      "display": "Warfarin 1 MG TAB prescribed Jan. 5, 2014"
    }
  ],
  "detail": "Risk of internal bleeding.  Those who take acetaminophen along with the widely used blood-thinning drug warfarin may face the risk of serious internal bleeding. People on warfarin who take acetaminophen for at least seven days in a row should be closely watched for bleeding.",
  "date": "2014-01-05",
  "author": {
    "reference": "Device/dsp"
  },
  "mitigation": [
    {
      "action": {
        "coding": [
          {
            "system": "http://hl7.org/fhir/v3/ActCode",
            "code": "30",
            "display": "Stopped Concurrent Therapy"
          }
        ],
        "text": "Asked patient to discontinue regular use of Tylenol and to consult with clinician if they need to resume to allow appropriate INR monitoring"
      },
      "date": "2014-01-05",
      "author": {
        "reference": "Practitioner/example",
        "display": "Dr. Adam Careful"
      }
    }
  ]
}

4.11.9.2 Duplicate Therapy

XML

Diagnostic order is placed when a recent image of the same body site already exists (id = "duplicate")

Raw XML

<Contraindication xmlns="http://hl7.org/fhir">
  <id value="duplicate"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><!-- Snipped for brevity --></div>
  </text><!--    test 1    -->
  <category>
    <coding>
      <system value="http://hl7.org/fhir/v3/ActCode"/>
      <code value="DUPTHPY"/>
      <display value="Duplicate Therapy Alert"/>
    </coding>
  </category>
  <implicated>
    <reference value="DiagnosticOrder/di"/>
    <display value="Chest CT - ordered May 8, 2013 by Dr. Adam Careful"/>
  </implicated><!--    test 2    -->
  <implicated>
    <reference value="ImagingStudy/example"/>
    <display value="Image 1 from Series 3: CT Images on Patient MINT (MINT1234) taken at 1-Jan 2011 01:20
     AM"/>
  </implicated>
  <detail value="Similar test was performed within the past 14 days"/>
  <date value="2013-05-08"/>
  <author>
    <reference value="Device/dsp"/>
  </author>
</Contraindication>

JSON

Diagnostic order is placed when a recent image of the same body site already exists

Raw JSON (Canonical)

{
  "resourceType": "Contraindication",
  "id": "duplicate",
  "text": {
    "status": "generated",
    "div": "<div>!-- Snipped for Brevity --></div>"
  },
  "category": {
    "coding": [
      {
        "system": "http://hl7.org/fhir/v3/ActCode",
        "code": "DUPTHPY",
        "display": "Duplicate Therapy Alert"
      }
    ]
  },
  "implicated": [
    {
      "reference": "DiagnosticOrder/di",
      "display": "Chest CT - ordered May 8, 2013 by Dr. Adam Careful"
    },
    {
      "reference": "ImagingStudy/example",
      "display": "Image 1 from Series 3: CT Images on Patient MINT (MINT1234) taken at 1-Jan 2011 01:20 AM"
    }
  ],
  "detail": "Similar test was performed within the past 14 days",
  "date": "2013-05-08",
  "author": {
    "reference": "Device/dsp"
  }
}

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.