{
  "resourceType" : "Bundle",
  "id" : "PrimaryScreeningDecision_eve-acsgeneticrisk__act-acshighriskmammo__act-acshighriskmri",
  "type" : "collection",
  "entry" : [{
    "fullUrl" : "http://cancerscreeningcds.github.io/bcsm-cds/CarePlan/132",
    "resource" : {
      "resourceType" : "CarePlan",
      "id" : "132",
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"CarePlan_132\"> </a><p class=\"res-header-id\"><b>Generated Narrative: CarePlan 132</b></p><a name=\"132\"> </a><a name=\"hc132\"> </a><a name=\"132-en-US\"> </a><p><b>instantiatesCanonical</b>: <a href=\"PlanDefinition-PrimaryScreeningDecision.html\">Primary Screening Decision</a></p><p><b>status</b>: Draft</p><p><b>intent</b>: Proposal</p><p><b>subject</b>: <a href=\"Bundle-eve-Age45to54_act-acsavgrecs45_act-uspstfavgrecs.html#Patient_defaultPatient\">Jane Doe</a></p><p><b>created</b>: 2024-12-10 00:00:00+0000</p><h3>Activities</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Reference</b></td></tr><tr><td style=\"display: none\">*</td><td><a href=\"Bundle-PrimaryScreeningDecision_eve-acsgeneticrisk__act-acshighriskmammo__act-acshighriskmri.html#RequestGroup_133\">Bundle: type = collection</a></td></tr></table></div>"
      },
      "instantiatesCanonical" : ["http://cancerscreeningcds.github.io/bcsm-cds/PlanDefinition/PrimaryScreeningDecision"],
      "status" : "draft",
      "intent" : "proposal",
      "subject" : {
        "reference" : "Patient/defaultPatient",
        "display" : "Jane Doe"
      },
      "created" : "2024-12-10T00:00:00.0Z",
      "activity" : [{
        "reference" : {
          "reference" : "RequestGroup/133"
        }
      }]
    }
  },
  {
    "fullUrl" : "http://cancerscreeningcds.github.io/bcsm-cds/RequestGroup/133",
    "resource" : {
      "resourceType" : "RequestGroup",
      "id" : "133",
      "text" : {
        "status" : "extensions",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"RequestGroup_133\"> </a><p class=\"res-header-id\"><b>Generated Narrative: RequestGroup 133</b></p><a name=\"133\"> </a><a name=\"hc133\"> </a><a name=\"133-en-US\"> </a><p><b>instantiatesCanonical</b>: <a href=\"PlanDefinition-PrimaryScreeningDecision.html\">Primary Screening Decision</a></p><p><b>status</b>: Draft</p><p><b>intent</b>: Proposal</p><p><b>subject</b>: <a href=\"Bundle-eve-Age45to54_act-acsavgrecs45_act-uspstfavgrecs.html#Patient_defaultPatient\">Jane Doe</a></p><blockquote><p><b>action</b></p><blockquote><p><b>id</b></p>ACSGeneticRiskMammo</blockquote><p><b>Recommendation Flag Extension</b>: <span title=\"Codes:{http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/recommendation-flag-code-system overdue}\">Overdue</span></p><p><b>title</b>: Annual screening mammogram starting age 30</p><p><b>description</b>: An annual screening mammogram starting at age 30 is recommended.\n\nWomen who are at higher than average risk for breast cancer based on known genetic markers or syndromes should get a mammogram every year, typically starting at age 30.</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 24606-6}\">MG Breast Screening</span></p><h3>Documentations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Label</b></td><td><b>Display</b></td><td><b>Url</b></td></tr><tr><td style=\"display: none\">*</td><td>Citation</td><td>ACS</td><td>American Cancer Society Recommendations for the Early Detection of Breast Cancer</td><td><a href=\"https://www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html\">https://www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html</a></td></tr></table><p><b>timing</b>: Events: 2011-01-01 , Once per 1 year</p><p><b>resource</b>: <a href=\"Bundle-PrimaryScreeningDecision_eve-acsgeneticrisk__act-acshighriskmammo__act-acshighriskmri.html#ServiceRequest_134\">Bundle: type = collection</a></p></blockquote><blockquote><p><b>action</b></p><blockquote><p><b>id</b></p>ACSGeneticRiskMri</blockquote><p><b>Recommendation Flag Extension</b>: <span title=\"Codes:{http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/recommendation-flag-code-system overdue}\">Overdue</span></p><p><b>title</b>: Annual screening MRI starting age 30</p><p><b>description</b>: An annual screening MRI starting at age 30 is recommended.\n\nWomen who are at higher than average risk for breast cancer based on known genetic markers or syndromes should get a breast MRI every year, typically starting at age 30.</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 30794-2}\">MR Breast</span></p><h3>Documentations</h3><table class=\"grid\"><tr><td style=\"display: none\">-</td><td><b>Type</b></td><td><b>Label</b></td><td><b>Display</b></td><td><b>Citation</b></td><td><b>Url</b></td></tr><tr><td style=\"display: none\">*</td><td>Citation</td><td>ACS</td><td>American Cancer Society Guidelines for Breast Screening with MRI as an Adjunct to Mammography</td><td><div><p>Oeffinger KC, Fontham ETH, Etzioni R, et al. Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update From the American Cancer Society. JAMA. 2015;314(15):1599–1614.</p>\n</div></td><td><a href=\"https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/canjclin.57.2.75\">https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/canjclin.57.2.75</a></td></tr></table><p><b>timing</b>: Events: 2011-01-01 , Once per 1 year</p><p><b>resource</b>: <a href=\"Bundle-PrimaryScreeningDecision_eve-acsgeneticrisk__act-acshighriskmammo__act-acshighriskmri.html#ServiceRequest_135\">Bundle: type = collection</a></p></blockquote></div>"
      },
      "instantiatesCanonical" : ["http://cancerscreeningcds.github.io/bcsm-cds/PlanDefinition/PrimaryScreeningDecision"],
      "status" : "draft",
      "intent" : "proposal",
      "subject" : {
        "reference" : "Patient/defaultPatient",
        "display" : "Jane Doe"
      },
      "action" : [{
        "id" : "ACSGeneticRiskMammo",
        "extension" : [{
          "url" : "http://cancerscreeningcds.github.io/bcsm-cds/StructureDefinition/csm-recommendation-flag",
          "valueCodeableConcept" : {
            "coding" : [{
              "system" : "http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/recommendation-flag-code-system",
              "code" : "overdue",
              "display" : "Overdue"
            }]
          }
        }],
        "title" : "Annual screening mammogram starting age 30",
        "description" : "An annual screening mammogram starting at age 30 is recommended.\n\nWomen who are at higher than average risk for breast cancer based on known genetic markers or syndromes should get a mammogram every year, typically starting at age 30.",
        "code" : [{
          "coding" : [{
            "system" : "http://loinc.org",
            "code" : "24606-6",
            "display" : "MG Breast Screening"
          }]
        }],
        "documentation" : [{
          "type" : "citation",
          "label" : "ACS",
          "display" : "American Cancer Society Recommendations for the Early Detection of Breast Cancer",
          "url" : "https://www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html"
        }],
        "timingTiming" : {
          "event" : ["2011-01-01"],
          "repeat" : {
            "boundsPeriod" : {
              "start" : "2011-01-01"
            },
            "frequency" : 1,
            "period" : 1,
            "periodUnit" : "a"
          }
        },
        "resource" : {
          "reference" : "ServiceRequest/134"
        }
      },
      {
        "id" : "ACSGeneticRiskMri",
        "extension" : [{
          "url" : "http://cancerscreeningcds.github.io/bcsm-cds/StructureDefinition/csm-recommendation-flag",
          "valueCodeableConcept" : {
            "coding" : [{
              "system" : "http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/recommendation-flag-code-system",
              "code" : "overdue",
              "display" : "Overdue"
            }]
          }
        }],
        "title" : "Annual screening MRI starting age 30",
        "description" : "An annual screening MRI starting at age 30 is recommended.\n\nWomen who are at higher than average risk for breast cancer based on known genetic markers or syndromes should get a breast MRI every year, typically starting at age 30.",
        "code" : [{
          "coding" : [{
            "system" : "http://loinc.org",
            "code" : "30794-2",
            "display" : "MR Breast"
          }]
        }],
        "documentation" : [{
          "type" : "citation",
          "label" : "ACS",
          "display" : "American Cancer Society Guidelines for Breast Screening with MRI as an Adjunct to Mammography",
          "citation" : "Oeffinger KC, Fontham ETH, Etzioni R, et al. Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update From the American Cancer Society. JAMA. 2015;314(15):1599–1614.",
          "url" : "https://acsjournals.onlinelibrary.wiley.com/doi/full/10.3322/canjclin.57.2.75"
        }],
        "timingTiming" : {
          "event" : ["2011-01-01"],
          "repeat" : {
            "boundsPeriod" : {
              "start" : "2011-01-01"
            },
            "frequency" : 1,
            "period" : 1,
            "periodUnit" : "a"
          }
        },
        "resource" : {
          "reference" : "ServiceRequest/135"
        }
      }]
    }
  },
  {
    "fullUrl" : "http://cancerscreeningcds.github.io/bcsm-cds/ServiceRequest/134",
    "resource" : {
      "resourceType" : "ServiceRequest",
      "id" : "134",
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ServiceRequest_134\"> </a><p class=\"res-header-id\"><b>Generated Narrative: ServiceRequest 134</b></p><a name=\"134\"> </a><a name=\"hc134\"> </a><a name=\"134-en-US\"> </a><p><b>basedOn</b>: <a href=\"ActivityDefinition-BreastCancerScreeningServiceRequest.html\">Breast Cancer Screening Service Request</a></p><p><b>status</b>: option</p><p><b>intent</b>: Proposal</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 24606-6}\">MG Breast Screening</span></p><p><b>subject</b>: <a href=\"Bundle-eve-Age45to54_act-acsavgrecs45_act-uspstfavgrecs.html#Patient_defaultPatient\">Jane Doe</a></p><p><b>occurrence</b>: 2011-01-01</p><p><b>reasonCode</b>: <span title=\"Codes:{http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/screening-observation-code-system geneticriskexclusion}\">Genetic risk exclusion</span></p></div>"
      },
      "basedOn" : [{
        "reference" : "http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/BreastCancerScreeningServiceRequest"
      }],
      "status" : "option",
      "intent" : "proposal",
      "code" : {
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "24606-6",
          "display" : "MG Breast Screening"
        }]
      },
      "subject" : {
        "reference" : "Patient/defaultPatient",
        "display" : "Jane Doe"
      },
      "occurrenceDateTime" : "2011-01-01",
      "reasonCode" : [{
        "coding" : [{
          "system" : "http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/screening-observation-code-system",
          "code" : "geneticriskexclusion",
          "display" : "Genetic risk exclusion"
        }]
      }]
    }
  },
  {
    "fullUrl" : "http://cancerscreeningcds.github.io/bcsm-cds/ServiceRequest/135",
    "resource" : {
      "resourceType" : "ServiceRequest",
      "id" : "135",
      "text" : {
        "status" : "generated",
        "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><a name=\"ServiceRequest_135\"> </a><p class=\"res-header-id\"><b>Generated Narrative: ServiceRequest 135</b></p><a name=\"135\"> </a><a name=\"hc135\"> </a><a name=\"135-en-US\"> </a><p><b>basedOn</b>: <a href=\"ActivityDefinition-BreastCancerScreeningServiceRequest.html\">Breast Cancer Screening Service Request</a></p><p><b>status</b>: option</p><p><b>intent</b>: Proposal</p><p><b>code</b>: <span title=\"Codes:{http://loinc.org 30794-2}\">MR Breast</span></p><p><b>subject</b>: <a href=\"Bundle-eve-Age45to54_act-acsavgrecs45_act-uspstfavgrecs.html#Patient_defaultPatient\">Jane Doe</a></p><p><b>occurrence</b>: 2011-01-01</p><p><b>reasonCode</b>: <span title=\"Codes:{http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/screening-observation-code-system geneticriskexclusion}\">Genetic risk exclusion</span></p></div>"
      },
      "basedOn" : [{
        "reference" : "http://cancerscreeningcds.github.io/bcsm-cds/ActivityDefinition/BreastCancerScreeningServiceRequest"
      }],
      "status" : "option",
      "intent" : "proposal",
      "code" : {
        "coding" : [{
          "system" : "http://loinc.org",
          "code" : "30794-2",
          "display" : "MR Breast"
        }]
      },
      "subject" : {
        "reference" : "Patient/defaultPatient",
        "display" : "Jane Doe"
      },
      "occurrenceDateTime" : "2011-01-01",
      "reasonCode" : [{
        "coding" : [{
          "system" : "http://cancerscreeningcds.github.io/bcsm-cds/CodeSystem/screening-observation-code-system",
          "code" : "geneticriskexclusion",
          "display" : "Genetic risk exclusion"
        }]
      }]
    }
  }]
}