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Added examples for Opioid guidelines and radiology assessment.
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‎source/includes/_examples.md‎

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# Examples
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## CDC Guideline for Prescribing Opioids for Chronic Pain
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This example illustrates the use of the CDS Hooks `medication-prescribe` hook to implement Recommendation #5 from the [CDC guideline for prescribing opioids for chronic pain](https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chronic-pain---united-states-2016#420).
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This example is taken from the [Opioid Prescribing Support Implementation Guide](http://build.fhir.org/ig/cqframework/opioid-cds/), developed in partnership with the Centers for Disease Control and Prevention [(CDC)](https://www.cdc.gov/).
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The example illustrates a prescription for Acetaminophen/Hydrocodone Bitartrate for a patient that already has a prescription for Oxycodone Hydrochloride:
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```json
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{
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"hookInstance": "d1577c69-dfbe-44ad-ba6d-3e05e953b2ea",
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"fhirServer": "http://fhirtest.uhn.ca/baseDstu2",
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"hook": "medication-prescribe",
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"user": "Practitioner/example",
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"context": [
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{
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"resourceType": "MedicationOrder",
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"id": "medrx001",
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"dateWritten": "2017-05-05",
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"status": "draft",
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"patient": {
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"reference": "Patient/example"
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},
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"medicationCodeableConcept": {
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"coding": [
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{
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"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
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"code": "857001",
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"display": "Acetaminophen 325 MG / Hydrocodone Bitartrate 10 MG Oral Tablet"
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}
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]
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},
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"dosageInstruction": [
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{
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"text": "Take 1 tablet Oral every 4 hours as needed",
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"timing": {
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"repeat": {
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"frequency": 6,
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"frequencyMax": 6,
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"period": 1,
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"unit": "d"
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}
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},
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"asNeededBoolean": true,
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"doseQuantity": {
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"value": 10,
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"unit": "mg",
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"system": "http://unitsofmeasure.org",
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"code": "mg"
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}
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}
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]
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}
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],
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"patient": "Patient/Patient-12214",
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"prefetch": {
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"medication": {
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"response": {
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"status": "200 OK"
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},
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"resource": {
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"resourceType": "MedicationOrder",
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"id": "medrx002",
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"dateWritten": "2017-04-25",
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"status": "active",
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"patient": {
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"reference": "Patient/Patient-12214"
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},
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"medicationCodeableConcept": {
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"coding": [
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{
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"system": "http://www.nlm.nih.gov/research/umls/rxnorm",
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"code": "1049621",
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"display": "Oxycodone Hydrochloride 5 MG Oral Tablet"
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}
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]
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},
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"dosageInstruction": [
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{
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"text": "Take 1 tablet by mouth every 4 hours as needed for pain.",
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"timing": {
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"repeat": {
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"frequency": 6,
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"period": 1,
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"periodUnits": "d"
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}
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},
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"asNeededBoolean": true,
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"doseQuantity": {
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"value": 5,
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"unit": "mg",
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"system": "http://unitsofmeasure.org",
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"code": "mg"
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}
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}
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]
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}
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}
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}
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}
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```
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This request results in the following response:
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```json
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{
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"summary": "High risk for opioid overdose - taper now",
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"indicator": "warning",
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"links": [
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{
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"label": "CDC guideline for prescribing opioids for chronic pain",
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"type": "absolute",
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"url": "https://guidelines.gov/summaries/summary/50153/cdc-guideline-for-prescribing-opioids-for-chronic-pain---united-states-2016#420"
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},
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{
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"label": "MME Conversion Tables",
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"type": "absolute",
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"url": "https://www.cdc.gov/drugoverdose/pdf/calculating_total_daily_dose-a.pdf"
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}
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],
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"detail": "Total morphine milligram equivalent (MME) is 125mg. Taper to less than 50."
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}```
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## Radiology Appropriateness
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This example illustrates the use of the CDS Hooks `order-review` hook to implement Radiology Appropriateness scoring.
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```json
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{
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"hookInstance": "d1577c69-dfbe-44ad-ba6d-3e05e953b2ea",
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"fhirServer": "http://fhirtest.uhn.ca/baseDstu2",
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"hook": "medication-prescribe",
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"user": "Practitioner/example",
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"context": [
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{
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"resourceType": "ProcedureRequest",
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"id": "procedure-request-1",
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"status": "draft",
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"intent": "proposal",
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"priority": "routine",
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"code":
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"coding": [{
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"system": "http://www.ama-assn.org/go/cpt",
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"code": "70450",
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"display": "CT, head, wo iv contrast"
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}],
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"subject": {
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"reference": "Patient/example"
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},
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"requester": {
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"agent": {
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"reference": "Practitioner/exampmle"
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}
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}
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}
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],
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"patient": "Patient/example"
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}
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```
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The appropriateness score is communicated via an update of the procedure request:
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```json
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{
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"cards": [
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{
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"summary": "Usually appropriate",
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"indicator": "info",
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"detail": "The requested procedure is usually appropriate for the given indications.",
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"suggestions": [
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{
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"label": "The appropriateness score for this procedure given these indications is 9, usually appropriate.",
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"actions": [
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"type": "update",
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"description": "Update the order to record the appropriateness score.",
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"resource": {
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"resourceType": "ProcedureRequest",
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"id": "procedure-request-1",
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"extension": [
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{
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"url": "http://hl7.org/fhir/us/qicore/StructureDefinition/procedurerequest-appropriatenessScore",
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"valueDecimal": "9"
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}
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],
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"status": "draft",
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"intent": "proposal",
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"priority": "routine",
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"code":
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"coding": [{
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"system": "http://www.ama-assn.org/go/cpt",
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"code": "70450",
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"display": "CT, head, wo iv contrast"
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}],
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"subject": {
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"reference": "Patient/example"
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},
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"requester": {
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"agent": {
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"reference": "Practitioner/exampmle"
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}
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}
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}
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]
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}
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]
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}
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]
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}
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```

‎source/index.html.md‎

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- prefetch
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- hook_catalog
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- community
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- examples
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search: true
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---

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