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Resource "example-cardiology-os" Version "1" (PlanDefinition)

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XML or JSON representation . provenance for this resource

Generated Narrative with Details

id: example-cardiology-os

contained: , , , , , , , , , , , ,

url: http://va.gov/kas/orderset/B5-Cardiology-ChestPainCAD-OS

identifier: bb7ccea6-9744-4743-854a-bcffd87191f6 (OFFICIAL), CLIN0004AG, KP-914

version: 0.1

name: ChestPainCoronaryArteryDiseaseOrderSetKNART

title: Chest Pain (CP) - Coronary Artery Disease (CAD) Order Set KNART

type: Order Set (Details : {http://terminology.hl7.org/CodeSystem/plan-definition-type code 'order-set' = 'Order Set', given as 'Order Set'})

status: active

date: Aug 29, 2017

publisher: Department of Veterans Affairs

description: The Cardiology chest pain (CP) and coronary artery disease (CAD) group of KNARTs are intended to assist primary care providers in the management of adult patients with stable chest pain (with or without known CAD); aid in determining when a cardiology consultation is appropriate; provide guidance for initial noninvasive diagnostic orders (stress testing) and provide a structured documentation template for the process. Stable patients with cardiac chest pain require risk stratification, office-based workup, initiation of disease-specific medications, and subspecialty referral to a cardiologist.

useContext:

usage: The Cardiology chest pain (CP) and coronary artery disease (CAD) group of KNARTs are intended to assist primary care providers in the management of adult patients with stable chest pain (with or without known CAD); aid in determining when a cardiology consultation is appropriate; provide guidance for initial noninvasive diagnostic orders (stress testing) and provide a structured documentation template for the process. Stable patients with cardiac chest pain require risk stratification, office-based workup, initiation of disease-specific medications, and subspecialty referral to a cardiologist. This context excludes emergent patients (new/ongoing/unstable pattern CP). Included are those patients with stable CP with or without known CAD, to be considered for evaluation by cardiology.

copyright: © Copyright Cognitive Medical Systems, Inc. 9444 Waples Street Suite 300 San Diego, CA 92121

author: , ,

relatedArtifact: , , , , , , , , , , ,

library: #cardiology-chestPain-logic

action

Actions

-
*
*

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      "type" : "justification",
      "display" : "LABEL: LIPITOR- atorvastatin calcium tablet, film coated",
      "citation" : "LABEL: LIPITOR- atorvastatin calcium tablet, film coated [Internet].: National Library of Medicine; 2017. Available from: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7fe85155-bc00-406b-b097-e8aece187a8a.",
      "url" : "https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7fe85155-bc00-406b-b097-e8aece187a8a"
    },
    {
      "type" : "justification",
      "display" : "LABEL: METOPROLOL SUCCINATE EXTENDED-RELEASE - metoprolol succinate tablet, film coated, extended release",
      "citation" : "LABEL: LIPITOR- atorvastatin calcium tablet, film coated [Internet].: National Library of Medicine; 2017. Available from: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=7fe85155-bc00-406b-b097-e8aece187a8a.",
      "url" : "https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=2d948600-35d8-4490-983b-918bdce488c8"
    },
    {
      "type" : "justification",
      "display" : "LABEL: NITROGLYCERIN- nitroglycerin tablet",
      "citation" : "LABEL: NITROGLYCERIN- nitroglycerin tablet [Internet].: National Library of Medicine; 2017. Available from: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=67bf2a15-b115-47ac-ae28-ce2dafd6b5c9.",
      "url" : "https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=67bf2a15-b115-47ac-ae28-ce2dafd6b5c9"
    },
    {
      "type" : "justification",
      "display" : "LABEL: SIMVASTATIN - simvastatin tablet",
      "citation" : "LABEL: SIMVASTATIN - simvastatin tablet [Internet].: National Library of Medicine; 2017. Available from: https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5c1c694c-4b08-469e-b538-08e69df06146.",
      "url" : "https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=5c1c694c-4b08-469e-b538-08e69df06146"
    },
    {
      "type" : "justification",
      "display" : "Chest Pain Guideline Development Group. NICE guidance. Chest pain of recent onset: assessment and diagnosis of recent onset chest pain or discomfort of suspected cardiac origin.",
      "citation" : "Skinner JS, Smeeth L, Kendall JM, Adams PC, Timmis A, Chest Pain Guideline Development Group. NICE guidance. chest pain of recent onset: Assessment and diagnosis of recent onset chest pain or discomfort of suspected cardiac origin. Heart. 2010 June 01;96(12):974-8.",
      "url" : "http://heart.bmj.com/content/96/12/974.long"
    }
  ],
  "library" : [
    "#cardiology-chestPain-logic"
  ],
  "action" : [
    {
      "action" : [
        {
          "title" : "Consults and Referrals",
          "groupingBehavior" : "logical-group",
          "selectionBehavior" : "any",
          "action" : [
            {
              "textEquivalent" : "Referral to cardiology to evaluate chest pain (routine)",
              "definitionCanonical" : "#referralToCardiologyConsult",
              "dynamicValue" : [
                {
                  "path" : "timing.event",
                  "expression" : {
                    "language" : "text/cql",
                    "expression" : "Now()"
                  }
                },
                {
                  "path" : "specialty",
                  "expression" : {
                    "language" : "text/cql",
                    "expression" : "Code '261QM0850X' from CardiologyChestPainLogic.\"NUCC Provider Taxonomy\" display 'Adult Mental Health'"
                  }
                },
                {
                  "path" : "occurrenceDateTime",
                  "expression" : {
                    "language" : "text/cql",
                    "expression" : "CardiologyChestPainLogic.ServiceRequestFulfillmentTime"
                  }
                },
                {
                  "path" : "subject",
                  "expression" : {
                    "language" : "text/cql",
                    "expression" : "CardiologyChestPainLogic.Patient"
                  }
                },
                {
                  "path" : "requester.agent",
                  "expression" : {
                    "language" : "text/cql",
                    "expression" : "CardiologyChestPainLogic.Practitioner"
                  }
                },
                {
                  "path" : "reasonCode",
                  "expression" : {
                    "language" : "text/cql",
                    "expression" : "CardiologyChestPainLogic.CardiologyReferralReason"
                  }
                },
                {
                  "path" : "reasonReference",
                  "expression" : {
                    "language" : "text/cql",
                    "expression" : "CardiologyChestPainLogic.RiskAssessment"
                  }
                }
              ]
            },
            {
              "title" : "Reason for cardiology consultation",
              "definitionCanonical" : "#CollectReferralReason"
            },
            {
              "title" : "Goal of cardiology consultation",
              "definitionCanonical" : "#CardiologyConsultationGoal"
            }
          ]
        },
        {
          "title" : "Medications",
          "description" : "Consider the following medications for stable patients to be initiated prior to the cardiology consultation.",
          "action" : [
            {
              "groupingBehavior" : "logical-group",
              "selectionBehavior" : "at-most-one"
            },
            {
              "title" : "Antianginal Therapy",
              "groupingBehavior" : "logical-group",
              "selectionBehavior" : "at-most-one",
              "action" : [
                {
                  "textEquivalent" : "metoprolol tartrate 25 mg tablet 1 tablet oral 2 time daily",
                  "definitionCanonical" : "#metoprololTartrate25Prescription",
                  "dynamicValue" : [
                    {
                      "path" : "status",
                      "expression" : {
                        "language" : "text/cql",
                        "expression" : "'draft'"
                      }
                    },
                    {
                      "path" : "patient",
                      "expression" : {
                        "language" : "text/cql",
                        "expression" : "CardiologyChestPainLogic.Patient"
                      }
                    },
                    {
                      "path" : "prescriber",
                      "expression" : {
                        "language" : "text/cql",
                        "expression" : "CardiologyChestPainLogic.Practitioner"
                      }
                    }
                  ]
                },
                {
                  "textEquivalent" : "metoprolol tartrate 50 mg tablet 1 tablet oral 2 time daily",
                  "definitionCanonical" : "#metoprololTartrate50Prescription",
                  "dynamicValue" : [
                    {
                      "path" : "status",
                      "expression" : {
                        "language" : "text/cql",
                        "expression" : "'draft'"
                      }
                    },
                    {
                      "path" : "patient",
                      "expression" : {
                        "language" : "text/cql",
                        "expression" : "CardiologyChestPainLogic.Patient"
                      }
                    },
                    {
                      "path" : "prescriber",
                      "expression" : {
                        "language" : "text/cql",
                        "expression" : "CardiologyChestPainLogic.Practitioner"
                      }
                    }
                  ]
                },
                {
                  "textEquivalent" : "amlodipine 5 tablet 1 tablet oral daily",
                  "definitionCanonical" : "#amlodipinePrescription",
                  "dynamicValue" : [
                    {
                      "path" : "status",
                      "expression" : {
                        "language" : "text/cql",
                        "expression" : "'draft'"
                      }
                    },
                    {
                      "path" : "patient",
                      "expression" : {
                        "language" : "text/cql",
                        "expression" : "CardiologyChestPainLogic.Patient"
                      }
                    },
                    {
                      "path" : "prescriber",
                      "expression" : {
                        "language" : "text/cql",
                        "expression" : "CardiologyChestPainLogic.Practitioner"
                      }
                    }
                  ]
                }
              ]
            },
            {
              "title" : "Nitroglycerin",
              "groupingBehavior" : "logical-group",
              "selectionBehavior" : "at-most-one",
              "action" : [
                {
                  "textEquivalent" : "nitroglycerin 0.4 mg tablet sub-lingual every 5 minutes as needed for chest pain; maximum 3 tablets",
                  "definitionCanonical" : "#nitroglycerinPrescription",
                  "dynamicValue" : [
                    {
                      "path" : "status",
                      "expression" : {
                        "language" : "text/cql",
                        "expression" : "'draft'"
                      }
                    },
                    {
                      "path" : "patient",
                      "expression" : {
                        "language" : "text/cql",
                        "expression" : "CardiologyChestPainLogic.Patient"
                      }
                    },
                    {
                      "path" : "prescriber",
                      "expression" : {
                        "language" : "text/cql",
                        "expression" : "CardiologyChestPainLogic.Practitioner"
                      }
                    }
                  ]
                }
              ]
            }
          ]
        }
      ]
    }
  ]
}