Generated Narrative: PlanDefinition

CPG Knowledge Capability Extension : shareable

CPG Knowledge Capability Extension : computable

CPG Knowledge Capability Extension : executable

CPG Knowledge Capability Extension : publishable

CQFM Software System : Device/cqf-tooling

CQFM Logic Definition

url

libraryName

value : OpioidCDSREC12PatientView

url

name

value : Get Summary

url

statement

value : define "Get Summary": if "Is Recommendation Applicable?" then 'Recommend opioid agonist or partial agonist treatment with methadone maintenance therapy or buprenorphine'/* and/or behavioral therapy' */ else null

url

displaySequence

value : 0

CQFM Logic Definition

url

libraryName

value : OpioidCDSCommonConfig

url

name

value : Age Less than 18 Years Is Enabled

url

statement

value : // Opioid Review Useful define "Age Less than 18 Years Is Enabled": true

url

displaySequence

value : 1

CQFM Logic Definition

url

libraryName

value : OpioidCDSCommon

url

name

value : Patient 18 or Older?

url

statement

value : define "Patient 18 or Older?": Config."Age Less than 18 Years Is Enabled" and AgeInYears() >= 18

url

displaySequence

value : 2

CQFM Logic Definition

url

libraryName

value : OpioidCDSCommonConfig

url

name

value : Evidence Based Treatment Criteria For Opioid Use Disorder

url

statement

value : // Recommendation 12 define "Evidence Based Treatment Criteria For Opioid Use Disorder": true

url

displaySequence

value : 3

CQFM Logic Definition

url

libraryName

value : OpioidCDSREC12PatientView

url

name

value : Not Receiving Evidence-Based Treatment for Opioid Use Disorder

url

statement

value : define "Not Receiving Evidence-Based Treatment for Opioid Use Disorder": Config."Evidence Based Treatment Criteria For Opioid Use Disorder" and not ( if Config."Can the implementing EHR support queries for past medications by date range?" then exists ( [MedicationRequest: Common."Buprenorphine and methadone medications"] MR where MR.status in { 'active', 'completed' } and date from MR.authoredOn during day of "Opioid Use Disorder Lookback Period" ) else true /* update 2022 removes "behavioral therapy condition" or exists ( [Procedure: Common."Substance misuse behavioral counseling"] P where P.status ~ 'completed' and ( case when P.performed is FHIR.dateTime then Interval[FHIRHelpers.ToDateTime(P.performed as FHIR.dateTime), FHIRHelpers.ToDateTime(P.performed as FHIR.dateTime)] when P.performed is FHIR.Period then FHIRHelpers.ToInterval(P.performed as FHIR.Period) else null as Interval<DateTime> end ) during day of "Opioid Use Disorder Lookback Period" )*/ )

url

displaySequence

value : 4

CQFM Logic Definition

url

libraryName

value : OpioidCDSCommon

url

name

value : US Core-Categorized Conditions

url

statement

value : // 3. Medications indicating end of life /* or exists ( "Medications Indicating End of Life" ) */ define "US Core-Categorized Conditions": [Condition: category in "Encounter Diagnosis Condition Category"] union [Condition: category in "Problem List Condition Category"] union [Condition: category in "US Core Health Concern Condition Category"]

url

displaySequence

value : 5

CQFM Logic Definition

url

libraryName

value : OpioidCDSREC12PatientView

url

name

value : Opioid Use Disorder Lookback Period

url

statement

value : define "Opioid Use Disorder Lookback Period": Interval[Today() - 90 days, Today()]

url

displaySequence

value : 6

CQFM Logic Definition

url

libraryName

value : OpioidCDSREC12PatientView

url

name

value : Presence of Diagnosis of Opioid Use Disorder

url

statement

value : define "Presence of Diagnosis of Opioid Use Disorder": exists ( Common."US Core-Categorized Conditions" C where C.code in Common."Opioid misuse disorders" and C.clinicalStatus in Common."Active Condition" and date from C.recordedDate during day of "Opioid Use Disorder Lookback Period" )

url

displaySequence

value : 7

CQFM Logic Definition

url

libraryName

value : OpioidCDSREC12PatientView

url

name

value : Positive Result from Opioid Use Disorder Evaluation Tool

url

statement

value : define "Positive Result from Opioid Use Disorder Evaluation Tool": true

url

displaySequence

value : 8

CQFM Logic Definition

url

libraryName

value : OpioidCDSREC12PatientView

url

name

value : Inclusion Criteria

url

statement

value : define "Inclusion Criteria": Common."Patient 18 or Older?" and "Not Receiving Evidence-Based Treatment for Opioid Use Disorder" and "Presence of Diagnosis of Opioid Use Disorder" and "Positive Result from Opioid Use Disorder Evaluation Tool"

url

displaySequence

value : 9

CQFM Logic Definition

url

libraryName

value : OpioidCDSREC12PatientView

url

name

value : Exclusion Criteria

url

statement

value : define "Exclusion Criteria": false

url

displaySequence

value : 10

CQFM Logic Definition

url

libraryName

value : OpioidCDSREC12PatientView

url

name

value : Is Recommendation Applicable?

url

statement

value : define "Is Recommendation Applicable?": "Inclusion Criteria" and not "Exclusion Criteria"

url

displaySequence

value : 11

CQFM Logic Definition

url

libraryName

value : OpioidCDSREC12PatientView

url

name

value : Get Detail

url

statement

value : define "Get Detail": if "Is Recommendation Applicable?" then null else null

url

displaySequence

value : 12

CQFM Logic Definition

url

libraryName

value : OpioidCDSREC12PatientView

url

name

value : Get Indicator

url

statement

value : define "Get Indicator": if "Is Recommendation Applicable?" then 'warning' else null

url

displaySequence

value : 13

CQFM Effective Data Requirements :

Related Artifacts

depends-on	Library Common	http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSCommon|2022.1.0
depends-on	Library Config	http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSCommonConfig|2022.1.0
depends-on	Library FHIRHelpers	http://fhir.org/guides/cdc/opioid-cds/Library/FHIRHelpers|4.0.1
depends-on	Value set Encounter Diagnosis Condition Category	ValueSet - Encounter Diagnosis Condition Categories
depends-on	Value set Problem List Condition Category	ValueSet - Problem List Condition Category
depends-on	Value set US Core Health Concern Condition Category	ValueSet - US Core Health Concern Condition Category
depends-on	Value set Opioid misuse disorders	Opioid misuse disorders
depends-on	Value set Active Condition	ValueSet - Condition Clinical Status Active

Parameters

Get Summary	out	0	1	string
Is Recommendation Applicable?	out	0	1	boolean
Get Detail	out	0	1	Resource
Get Indicator	out	0	1	string

Data Requirements

Type : Patient ( Patient )

Type : Condition ( Condition )
Filter	Value
category	In ValueSet ValueSet - Encounter Diagnosis Condition Categories

Type : Condition ( Condition )
Filter	Value
category	In ValueSet ValueSet - Problem List Condition Category

Type : Condition ( Condition )
Filter	Value
category	In ValueSet ValueSet - US Core Health Concern Condition Category

Contents

url : http://fhir.org/guides/cdc/opioid-cds/PlanDefinition/opioidcds-12-patient-view

identifier : id: cdc-opioid-guidance (use: OFFICIAL)

version : 2022.1.0

name : PlanDefinition_Recommendation_12_Patient_View

title : PlanDefinition - 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain: Recommendation #12 (patient-view)

type : ECA Rule (plan-definition-type#eca-rule)

status : DRAFT

experimental : true

date : 2023-05-01

publisher : Centers for Disease Control and Prevention (CDC)

contact : https://www.cdc.gov

description : Arrange evidence-based treatment (usually medication-assisted treatment with buprenorphine or methadone in combination with behavioral therapies) for patients with opioid use disorder.

UseContexts

-	Code	Value[x]
*	Clinical Focus (Details: http://terminology.hl7.org/CodeSystem/usage-context-type code focus = 'focus', stated as 'Clinical Focus')	Medication requested (situation) (SNOMED CT#182888003)
*	Clinical Focus (Details: http://terminology.hl7.org/CodeSystem/usage-context-type code focus = 'focus', stated as 'Clinical Focus')	Chronic pain (finding) (SNOMED CT#82423001)

jurisdiction : United States of America (ISO Country Codes (ISO-3166)#US)

purpose : The 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain is intended to improve communication between providers and patients about the risks and benefits of opioid therapy for chronic pain, improve the safety and effectiveness of pain treatment, and reduce the risks associated with long-term opioid therapy, including opioid use disorder and overdose. The Guideline is not intended for patients who are in active cancer treatment, palliative care, or end-of-life care.

usage : Clinicians should offer or arrange evidence-based treatment (usually medication-assisted treatment with buprenorphine or methadone) for patients with opioid use disorder.

copyright : © CDC 2016+.

topic : Opioid Prescribing ()

author : Kensaku Kawamoto, MD, PhD, MHS: , Bryn Rhodes: , Floyd Eisenberg, MD, MPH: , Robert McClure, MD, MPH:

relatedArtifact

library : http://fhir.org/guides/cdc/opioid-cds/Library/OpioidCDSREC12PatientView

action

title : Current patient is 18 or older and recieving evidence-based treatment for Opioid Misuse Disorders.

description : Checking if the trigger prescription meets the inclusion criteria for recommendation #12 workflow.

documentation

Triggers

-	Type	Name
*	NAMEDEVENT	patient-view

condition

kind : APPLICABILITY

Expressions

-	Description	Language	Expression
*	Check whether the current patient is 18 or older and recieving evidence-based treatment for Opioid Misuse Disorders.	text/cql.identifier	Is Recommendation Applicable?

groupingBehavior : VISUALGROUP

selectionBehavior : ANY

dynamicValue

path : action.title

Expressions

-	Language	Expression
*	text/cql.identifier	Get Summary

dynamicValue

path : action.description

Expressions

-	Language	Expression
*	text/cql.identifier	Get Detail

dynamicValue

path : activity.extension

Expressions

-	Language	Expression
*	text/cql.identifier	Get Indicator

Actions

-	Description
*	Will order methadone or buprenorphine
*	N/A - see comment, snooze 3 months